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Ann Surg 1998;228:518-527. II Gene Expression and Nutrition Carolyn D. Berdanier, PhD CHAPTER OUTLINE Introduction Protein Synthesis and Gene Expression Mutation versus Polymorphisms DNA Characteristics Transcription Translation Nutrient-Gene Interactions in Health and Disease INTRODUCTION The characteristics of every living creature are as much a result of the environment as they are a result of that creature's genetic material, deoxyribonucleic acid (DNA). DNA is a double-stranded helix composed of four bases: two pyrimidines (cytosine and thymine) and two purines (adenine and guanine) that are joined together by ribose and phosphate groups (Fig.
Ligands for these transcription factors include retinoic acid (vitamin A), fatty acids, vitamin D, thyroid hormone, and steroid hormones. " Zinc is bound to histidine- and cysteine-rich regions of the protein that envelops the DNA in a shape that looks like a finger. The zinc finger is shown in Figure 4-4. The zinc ion plays an enormous role in gene expression because of its central use in the zinc finger. There are numerous proteins aside from those of the steroid receptor superfamily that bind to specific base sequences in the promoter region.
A second clinical approach to assessing gut barrier failure and its relationship to sepsis and multiple organ dysfunction syndrome (MODS) has been by measuring intestinal permeability. " A prospective study by Doig and associates" found that increased intestinal permeability predicted the development of MODS and that ICU patients who developed MODS had persistently abnormal levels of intestinal permeability compared with patients who did not develop MODS. When endotoxemia was examined as a marker of loss of gut barrier function or 29 bacterial translocation, the results are similar to those observed in the gut permeability studies.