Effect of cytidine diphosphate (CDP)-choline on growth hormone secretions in patients with brain or pituitary lesions

Endocrinol Jpn (1980) 27(3):265-271 1980

Plasma growth hormone (GH) was measured by radioimmuno assay before and after cytidine diphosphate choline (CDC: 300 mg, iv) administration in 42 patients (aged 6-80 years, average age 41 years) with brain or pituitary lesions. In patients with anterior-middle hypothalamic lesions or pinealoma, basal GH was within normal limits, and, in most cases, there was no change in GH level after CDC. In one patient with a meningioma compressing the anterior hypothalamic structures, GH was increased up to 90 minute after CDC. In patients with temporal lobe lesions, basal GH was similar to normal limits, and the level increased similarly to that seen in normal subjects after CDC. Similar results were observed in patients with frontal lobe lesions. The GH response to CDC was abolished in hypophysectomized patients and in one patient with a chromophobe adenoma, and it was partially abolished in three patients with acromegaly. It was concluded that the activation of the GH-secreting system by CDC is useful for evaluating hypothalamic involvement in intracranial lesions.

Dietary precursors and brain neurotransmitter formation.

Annu Rev Med (UNITED STATES) 1981, 32 p413-25

The rates of synthesis of serotonin, acetylcholine, and, under certain circumstances, dopamine and norepinephrine by brain neurons depend considerably on the availability to brain of the respective dietary precursors. This precursor dependence seems to be related to the fact that the enzyme catalyzing the rate-limiting step in the synthetic pathway for each transmitter is unsaturated with substrate at normal brain concentrations. Moreover, brain levels of the individual precursors rise following oral or parenteral administration of the pure compound or the ingestion of certain foods. Precursor-induced increases in brain transmitter formation seem to influence a variety of brain functions and behaviors, which suggests that transmitter release has been enhanced. It now appears that these precursors may become useful as therapeutic agents for the treatment of selected disease states, wherein the disease is related to reduced release of transmitter. Examples of Parkinson's disease (tyrosine), myasthenia gravis (choline or phosphatidylcholine), depression (tyrosine), and possibly abnormal appetite (tryptophan). Perhaps the future will bring the identification of still other neurotransmitters, whose rates of synthesis depend on precursor availability. Two potential candidates for which some information is already available are glycine (a spinal cord transmitter) and the prostaglandins (some of which may function as neuromodulators or transmitters) (48, 49). Each time a new precursor- product relationship is described, an opportunity becomes available for determining whether the precursor might be useful in treating disease states related to reduced transmitter release by neurons. The opportunities are worth exploring, since the use of a natural dietary constituent, even in purified form, is likely to produce fewer unwanted side-effects than are seen following administration of synthetic drugs.

Choline and human nutrition

ANNU. REV. NUTR. (USA), 1994, 14/- (269-296)

Choline is crucial for sustaining life. It modulates the basic signaling processes within cells, is a structural element in membranes, and is vital during critical periods in brain development. Choline metabolism is closely interrelated with the metabolism of methionine and folate. We believe that the normal human diet provides sufficient choline to sustain healthy organ function. However, vulnerable populations may become choline deficient, including the growing infant, the pregnant or lactating woman, the cirrhotic, and the patient fed intravenously. Further studies of choline requirements in these groups are required.

Choline may be an essential nutrient in malnourished patients with cirrhosis

GASTROENTEROLOGY (USA), 1989, 97/6 (1514-1520)

Elemental diets designed for nutritional support in protein-calorie malnutrition are often deficient in choline, a nonessential nutrient. Previously, malnourished patients on these diets were found to be at risk of developing plasma choline deficiency. We have now estimated the prevalence of this deficiency by determining fasting plasma levels of choline among cirrhotic and noncirrhotic malnourished male subjects maintained on regular hospital mixed food or elemental parenteral and enteral formulas. Plasma choline concentrations (microM, average plus or minus SD) were as follows: (i) mixed foods, 11.3 plus or minus 4.3 for cirrhotic (n = 22) and 9.3 plus or minus 2.4 for noncirrhotic (n = 12) patients; (ii) parenteral formula, 5.3 plus or minus 1.6 for cirrhotic (n = 5) and 8.6 plus or minus 5.2 for noncirrhotic (n = 16) subjects; and (iii) enteral formula, 6.1 plus or minus 1.2 for cirrhotic (n = 5) and 11.7 plus or minus 1.9 for noncirrhotic (n = 4) subjects. The level for healthy normal subjects eating mixed foods was 12.0 plus or minus 2.2. The prevalence of plasma choline deficiency, i.e. plasma levels greater than or equal to2 SD below the normal average, was as follows: parenteral formula, all cirrhotic and 10 of 16 noncirrhotic subjects; enteral formula, all cirrhotic and none of the noncirrhotic subjects. The reversibility of choline deficiency was examined in a longitudinal study of three phases involving 10 patients - 5 with alcoholic cirrhosis (all on enteral formula); 5 noncirrhotic (1 on enteral and 4 on parenteral formula). During phase 1 (3-day equilibration period; ad libitum regular hospital diet), plasma choline levels were within the normal range for all subjects. During phase 2 (2 wk, choline depletion phase, elemental formulas), choline levels were subnormal in all cirrhotic subjects (5.1 2+ 2.0 microM) on enteral formula and all noncirrhotic patients on parenteral formula (5.9 plus or minus 1.3 microM). During phase 3 (2 wk, choline repletion phase, elemental formula + 6 g choline/day), the levels normalized in all patients (cirrhotic 11.4 plus or minus 3.1 microM and noncirrhotic 11.9 plus or minus 3.2 microM). Analyses of abdominal computed tomographic scans and plasma liver chemistries in the cirrhotic subjects during the three phases suggested a correlation between plasma choline deficiency and hepatic steatosis and abnormal liver enzyme levels in some patients. Therefore, choline may be an essential nutrient in malnourished cirrhotic patients and its deficiency may be associated with adverse hepatic effects.

Behavioral effects of dietary neurotransmitter precursors: Basic and clinical aspects

Neuroscience and Biobehavioral Reviews (USA), 1996, 20/2 (313-323)

The levels and possibly function of several neurotransmitters can be influenced by the supply of their dietary precursors. The neurotransmitters include serotonin, dopamine, noradrenaline, histamine, acetylcholine and glycine, which are formed from tryptophan, tyrosine, histidine, choline and threonine. Tryptophan has been tested more than the other precursors in clinical trials and is currently available in some countries for the treatment of depression. Other uses for tryptophan and the therapeutic potential of other neurotransmitter precursors have not been tested adequately. Given the relative lack of toxicity of dietary components, further clinical trials with neurotransmitter precursors should be carried out.

Habituation of exploratory activity in mice: effects of combinations of piracetam and choline on memory processes.

Pharmacol Biochem Behav (UNITED STATES) Aug 1984, 21 (2) p209-12

The effects of various piracetam + choline combinations on an experimental model of memory were investigated. Mice were given two sessions in a simple photo-cell activity cage and the decrease in activity at the second session (habituation) served as an index of retention. Retention was facilitated by post-session administration of 2000 mg/kg piracetam IP and 50 mg/kg piracetam + 50 mg/kg choline IP. Similar injections of choline alone (10 to 200 mg/kg IP), piracetam alone (10 to 1000 mg/kg IP) or other combinations of piracetam and choline were without ffect. These results, consistent with those reported elsewhere, suggest that piracetam can interact with choline to facilitate memory processes.

Profound effects of combining choline and piracetam on memory enhancement and cholinergic function in aged rats.

Neurobiol Aging (UNITED STATES) Summer 1981, 2 (2) p105-11

In an attempt to gain some insight into possible approaches to reducing age-related memory disturbances, aged Fischer 344 rats were administered either vehicle, choline, piracetam or a combination of choline or piracetam. Animals in each group were tested behaviorally for retention of a one trial passive avoidance task, and biochemically to determine changes in choline and acetylcholine levels in hippocampus, cortex and striatum. Previous research has shown that rats of this strain suffer severe age-related deficits on this passive avoidance task and that memory disturbances are at least partially responsible. Those subjects given only choline (100 mg/kg) did not differ on the behavioral task from control animals administered vehicle. Rats given piracetam (100 mg/kg) performed slightly better than control rats (p less than 0.05), but rats given the piracetam/choline combination (100 mg/kg of each) exhibited retention scores several times better than those given piracetam alone. In a second study, it was show

Male rats fed methyl- and folate-deficient diets with or without niacin develop hepatic carcinomas associated with decreased tissue NAD concentrations and altered poly(ADP-ribose) polymerase activity

Journal of Nutrition (USA), 1997, 127/1 (30-36)

Folate is an essential cofactor in the generation of endogenous methionine, and there is evidence that folate deficiency exacerbates the effects of a diet low in choline and methionine, including alterations in poly(ADP-ribose) polymerase (PARP) activity, an enzyme associated with DNA replication and repair. Because PARP requires NAD as its substrate, we postulated that a deficiency of both folate and niacin would enhance the development of liver cancer in rats fed a diet deficient in methionine and choline. In two experiments, rats were fed choline- and folate-deficient, low methionine diets containing either 12 or 8% casein (12% MCFD, 8% MCFD) or 6% casein and 6% gelatin with niacin (MCFD) or without niacin (MCFND) and were compared with folate-supplemented controls. Liver NAD concentrations were lower in all methyl-deficient rats after 2-17 mo. At 17 mo, NAD concentrations in other tissues of rats fed these diets were also lower than in controls. Compared with control values, liver PARP activity was enhanced in rats fed the 12% MCFD diet but was lower in MCFND-fed rats following a further reduction in liver NAD concentration. These changes in PARP activity associated with lower NAD concentrations may slow DNA repair and enhance DNA damage. Only rats fed the MCFD and MCFND diets developed hepatocarcinomas after 12-17 mo. In Experiment 2, hepatocarcinomas were found in 100% of rats fed the MCFD and MCFND diets. These preliminary results indicate that folic acid deficiency enhances tumor development. Becausetions of NAD in these animals were also low, further studies are needed to clearly define the role of niacin in methyldeficient rats.