Medknow Publications on behalf of Association of Surgeons of India
Abstract
The isoprenoid pathway produces three key metabolites _ endogenous
digoxin, dolichol and ubiquinone. It was considered pertinent to assess
the pathway in inflammatory bowel disease (ulcerative colitis and
regional ileitis). Since endogenous digoxin can regulate
neurotransmitter transport, the pathway and the related cascade was
also assessed in individuals with differing hemispheric dominance to
find out the role of hemispheric dominance in its pathogenesis. The
following parameters were measured in patients with inflammatory bowel
disease and in individuals with differing hemispheric dominance - 1.
plasma HMG CoA reductase, digoxin, dolichol, ubiquinone and magnesium
levels, 2. tryptophan/tyrosine catabolic patterns, 3. free radical
metabolism, 4. glycoconjugate metabolism, and 5. membrane composition
and RBC membrane Na+-K+ ATPase activity. Statistical analysis was done
by 'ANOVA'. In patients with inflammatory bowel disease there was
elevated digoxin synthesis, increased dolichol and glycoconjugate
levels, and low ubiquinone and elevated free radical levels. There was
also an increase in tryptophan catabolites and a reduction in tyrosine
catabolites. There was an increase in the cholesterol: phospholipid
ratio and a reduction in the glycoconjugate level of RBC membrane in
this group of patients. The same biochemical patterns were obtained in
those with right hemispheric dominance. Inflammatory bowel disease is
associated with an unregulated isoprenoid pathway and elevated digoxin
secretion from the hypothalamus. This can contribute to immune
activation, defective glycoprotein bowel antigen presentation and
autoimmunity, and a schizophreniform psychosis, important in its
pathogenesis. Inflammatory bowel disease occurs in right hemispheric
dominant individuals