P-hydroxyphenylacetát
Microbial overgrowth
- Can include
- benzoate,
- Hippurate,
- Phenylacetate,
- Phenylpropionate,
- cresol,
- Hydroxybenzoate,
- Hydroxyphenylacetate,
- Hydroxyphenylpropionate
- 3,4-dihydroxyphenylpropionate,
- Indican,
- Tricarballylate,
- D-lactate,
- D-arabinitol
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Clostridium difficile
- Newly weaned pigs have revealed specific microbes that carry out tyrosine degradation
- Transamination to form p-hydroxyphenylacetate (HPA)
- Decarboxylation to p-cresol
- Carried out by Clostridium difficile
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Proteus vulgaris
- Can do only the first of these steps
- HPA will increase in urine if P. vulgaris is the predominant organism
- When P. vulgaris is accompanied by overgrowth of a newly identified strain of Lactobacillus
- However, p-cresol will be the major product to accumulate
- Urine collections may need to be timed following intake of specific sources
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Bolus of black currant juice
- Can cause the appearance of different products
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Small bowel disease associated with Giardia lamblia infestation
- P-Hydroxyphenylacetic aciduria has been found useful in detecting
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Ileal resection with blind loop
- P-Hydroxyphenylacetic aciduria has been found useful in detecting
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Other diseases of the small intestine associated with anaerobic bacterial overgrowth
- P-Hydroxyphenylacetic aciduria has been found useful in detecting
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Use of antibiotics against aerobic bacteria
- Such as neomycin
- Can encourage the growth of protozoa and anaerobic bacteria that then produce greater amounts of these compounds
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
A clostridial species isolated from swine feces
- Carries out the further metabolism of p-hydroxyphenylacetate to p-cresol
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Patients with cystic fibrosis
Conditions that severely impair amino acid absorption
- Can demonstrate the potential for intestinal bacterial conversion of phenylalanine and tyrosine to phenyl compounds that appear in urine
- These patients tend to excrete very high levels of phenylacetate and HPA
- Tyrosine released from dietary protein is rapidly absorbed in most individuals
- Conversion of tyrosine to HPA may be a rarely observed sign of dysbiosis in humans
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Izomery o- and m-hydroxyphenylacetate
- May be derived from dietary polyphenols that are unaffected by digestive enzymes
- Normally abundant dietary components
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Bacterial dysbiosis marker is m-hydroxyphenylacetate
- Appears when bacteria are introduced to germ-free rats
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Catechin and proanthocyanidin-rich chocolate
- Increases markedly in humans
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Quercetin
- Experiments conducted with a human anaerobic fecal fermentation device
- Metabolized within two hours to 3,4-dihydroxyphenylacetate
- Over the next eight hours, was converted to m-hydroxyphenylacetate
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
HPA is elevated in a wide variety of conditions
- Direct intestinal pathology or digestive organ failure
- Treatments vary greatly depending on the nature of the disorder
