Kathryn R. Napier

The sweet life: diet sugar concentration influences paracellular glucose absorption

Small birds and bats face strong selection pressure to digest food rapidly in order to reduce digesta mass carried during flight. One mechanism is rapid absorption of a high proportion of glucose via the paracellular pathway (transfer between epithelial cells, not mediated by transporter proteins). Intestinal paracellular permeability to glucose was assessed for two nectarivorous passerines, the Australian New Holland honeyeater (Phylidonyris novaehollandiae) and African white-bellied sunbird (Cinnyris talatala) by measuring the bioavailability of radiolabelled, passively absorbed l-glucose. Bioavailability was high in both species and increased with diet sugar concentration (honeyeaters, 37 and 81% and sunbirds, 53 and 71% for 250 and 1000 mmol l−1 sucrose diets, respectively). We conclude that the relative contribution of paracellular to total glucose absorption increases with greater digesta retention time in the intestine, and paracellular absorption may also be modulated by factors such as intestinal lumen osmolality and interaction with mediated glucose uptake. The dynamic state of paracellular absorption should be taken into account in future studies.

Sugar preferences of avian nectarivores are correlated with intestinal sucrase activity

Nectar-feeding birds generally demonstrate preference for hexose solutions at low sugar concentrations, switching to sucrose/no preference at higher concentrations. Species vary in the concentration at which the switch from hexose preference occurs; this could reflect physiological constraints that would also influence nectar selection when foraging. We recorded concentration-dependent sugar type preferences in three opportunistic/generalist Australian nectarivorous species: Dicaeum hirundinaceum, Zosterops lateralis, and Lichenostomus virescens. All three preferred hexoses up to sugar concentrations of 0.25 mol L−1 and switched to sucrose/no preference for higher concentrations. Using these and literature records, we investigated physiological mechanisms that may explain the concentration dependence of sugar type preferences and compared diet preference data with foraging records. We measured sucrase activity in Z. lateralis and L. virescens as well as three specialized nectarivorous species (Anthochaera carunculata, Phylidonyris novaehollandiae, and Trichoglossus haematodus) for comparison with published concentration-dependent sugar preference data. Sucrase activity varied between these species (). The minimum diet concentration at which birds show no sugar preference was significantly correlated with sucrase activity for the 11 species analyzed (). Birds with the lowest sucrase activity showed hexose preference at higher diet concentrations, and birds with the greatest sucrase activity showed either no hexose preference or hexose preference on only the most dilute diets. Foraging data compiled from the literature also support the laboratory analyses; for example, T. haematodus (preference for hexose over a wide range of diet concentrations, low sucrase activity) also feed primarily on hexose nectars in the wild. Intestinal sucrase activity is likely to contribute to diet selectivity in nectarivorous bird species.

Mechanism and rate of glucose absorption differ between an Australian honeyeater (Meliphagidae) and a lorikeet (Loriidae)

SUMMARY Efficient mechanisms of glucose absorption are necessary for volant animals as a means of reducing mass during flight: they speed up gut transit time and require smaller volume and mass of gut tissue. One mechanism that may be important is absorption via paracellular (non-mediated) pathways. This may be particularly true for nectarivorous species which encounter large quantities of sugar in their natural diet. We investigated the extent of mediated and non-mediated glucose absorption in red wattlebirds Anthochaera carunculata (Meliphagidae) and rainbow lorikeets Trichoglossus haematodus (Loriidae) to test the hypothesis that paracellular uptake accounts for a significant proportion of total glucose uptake in these species. We found that routes of glucose absorption are highly dynamic in both species. In lorikeets, absorption of l-glucose (non-mediated uptake) is slower than that of d-glucose (mediated and non-mediated uptake), with as little as 10% of total glucose absorbed by the paracellular pathway initially (contrasting previous indirect estimates of∼ 0%). Over time, however, more glucose may be absorbed via the paracellular route. Glucose absorption by both mediated and non-mediated mechanisms in wattlebirds occurred at a faster rate than in lorikeets, and wattlebirds also rely substantially on paracellular uptake. In wattlebirds, we recorded higher bioavailability of l-glucose (96±3%) compared with d-glucose (57±2%), suggesting problems with the in vivo use of radiolabeled d-glucose. Further trials with 3-O-methyl-d-glucose revealed high bioavailability in wattlebirds (90±5%). This non-metabolisable glucose analogue remains the probe of choice for measuring uptake rates in vivo, especially in birds in which absorption and metabolism occur extremely rapidly.

Design of the familial hypercholesterolaemia australasia network registry: Creating opportunities for greater international collaboration

Familial Hypercholesterolemia (FH) is the most common and serious monogenic disorder of lipoprotein metabolism that leads to premature coronary heart disease. There are over 65,000 people estimated to have FH in Australia, but many remain undiagnosed. Patients with FH are often undertreated, but with early detection, cascade family testing and adequate treatment, patient outcomes can improve. Patient registries are key tools for providing new information on FH and enhancing care worldwide. The development and design of the FH Australasia Network Registry is a crucial component in the comprehensive model of care for FH, which aims to provide a standardized, high-quality and cost-effective system of care that is likely to have the highest impact on patient outcomes. Informed by stakeholder engagement, the FH Australasia Network Registry was collaboratively developed by government, patient and clinical networks and research groups. The open-source, webbased Rare Disease Registry Framework was the architecture chosen for this registry owing to its open-source standards, modular design, interoperability, scalability and security features; all these are key components required to meet the ever changing clinical demands across regions. This paper provides a high level blueprint for other countries and jurisdictions to help inform and map out the critical features of an FH registry to meet their particular health system needs.

A Web-Based Registry for Familial Hypercholesterolaemia

Familial hypercholesterolaemia (FH) is the most common and serious monogenic disorder of lipoprotein metabolism that leads to premature coronary heart disease. Patients with FH are often under-treated, and many remain undiagnosed. The deployment of the FH Australasia Network Registry is a crucial component of the comprehensive model of care for FH, which aims to provide a standardised, high-quality and cost-effective system of care that is likely to have the highest impact on patient outcomes. The FH Australasia Network Registry was customised using a registry framework that is an open source, interoperable system that enables the efficient customisation and deployment of national and international web-based disease registries that can be modified dynamically as registry requirements evolve. The FH Australasia Network Registry can be employed to improve health services for FH patients across the Australasia-Pacific region, through the collation of data to facilitate clinical service planning, clinical trials, clinical audits, and to inform clinical best practice.

Design of a framework for the deployment of collaborative independent rare disease-centric registries: Gaucher disease registry model

Orphan drug clinical trials often are adversely affected by a lack of high quality treatment efficacy data that can be reliably compared across large patient cohorts derived from multiple governmental and country jurisdictions. It is critical that these patient data be captured with limited corporate involvement. For some time, there have been calls to develop collaborative, non-proprietary, patient-centric registries for post-market surveillance of aspects related to orphan drug efficacy. There is an urgent need for the development and sustainable deployment of these ‘independent’ registries that can capture comprehensive clinical, genetic and therapeutic information on patients with rare diseases. We therefore extended an open-source registry platform, the Rare Disease Registry Framework (RDRF) to establish an Independent Rare Disease Registry (IRDR). We engaged with an established rare disease community for Gaucher disease to determine system requirements, methods of data capture, consent, and reporting. A non-proprietary IRDR model is presented that can serve as autonomous data repository, but more importantly ensures that the relevant data can be made available to appropriate stakeholders in a secure, timely and efficient manner to improve clinical decision-making and the lives of those with a rare disease.

Identification of a novel vitivirus from grapevines in New Zealand

We report a sequence of a novel vitivirus from Vitis vinifera obtained using two high-throughput sequencing (HTS) strategies on RNA. The initial discovery from small-RNA sequencing was confirmed by HTS of the total RNA and Sanger sequencing. The new virus has a genome structure similar to the one reported for other vitiviruses, with five open reading frames (ORFs) coding for the conserved domains described for members of that genus. Phylogenetic analysis of the complete genome sequence confirmed its affiliation to the genus Vitivirus, with the closest described viruses being grapevine virus E (GVE) and Agave tequilana leaf virus (ATLV). However, the virus we report is distinct and shares only 51% amino acid sequence identity with GVE in the replicase polyprotein and 66.8% amino acid sequence identity with ATLV in the coat protein. This is well below the threshold determined by the ICTV for species demarcation, and we propose that this virus represents a new species. It is provisionally named “grapevine virus G”.

A Registry Framework Enabling Patient-Centred Care

Clinical decisions rely on expert knowledge that draws on quality patient phenotypic and physiological data. In this regard, systems that can support patient-centric care are essential. Patient registries are a key component of patient-centre care and can come in many forms such as disease-specific, recruitment, clinical, contact, post market and surveillance. There are, however, a number of significant challenges to overcome in order to maximise the utility of these information management systems to facilitate improved patient-centred care. Registries need to be harmonised regionally, nationally and internationally. However, the majority are implemented as standalone systems without consideration for data standards or system interoperability. Hence the task of harmonisation can become daunting. Fortunately, there are strategies to address this. In this paper, a disease registry framework is outlined that enables efficient deployment of national and international registries that can be modified dynamically as registry requirements evolve. This framework provides a basis for the development and implementation of data standards and enables patients to seamlessly belong to multiple registries. Other significant advances include the ability for registry curators to create and manage registries themselves without the need to contract software developers, and the concept of a registry description language for ease of registry template sharing.

Mistletoebirds and Xylose: Australian Frugivores Differ in Their Handling of Dietary Sugars

Carbohydrate-rich mistletoe fruits are consumed by a wide range of avian species. Small birds absorb a large portion of water-soluble nutrients, such as glucose, via the paracellular pathway. d-xylose, a pentose monosaccharide, is abundant in some nectars and mistletoe fruits consumed by birds, and it has been suggested that it is most likely absorbed via the paracellular pathway in birds. We measured apparent assimilation efficiency () and bioavailability (f) for d-xylose and d- and l-glucose in three frugivorous Australian bird species. Mistletoebirds, silvereyes, and singing honeyeaters showed significantly lower for d-xylose than for d-glucose. Across two diet sugar concentrations, silvereyes and singing honeyeaters significantly increased f of both l-glucose (a metabolically inert isomer of d-glucose commonly used to quantify paracellular uptake) and d-xylose on the more concentrated diet, probably because of increased gut processing time. By contrast, mistletoebirds (mistletoe fruit specialists) did not vary f of either sugar with diet concentration. Mistletoebirds also showed higher f for d-xylose than l-glucose and eliminated d-xylose more slowly than silvereyes and singing honeyeaters, demonstrating differences in the handling of dietary xylose between these species. Our results suggest that d-xylose may be absorbed by both mediated and nonmediated mechanisms in mistletoebirds.

Gastrointestinal and renal responses to variable water intake in whitebellied sunbirds and New Holland honeyeaters

SUMMARY Nectarivores face a constant challenge in terms of water balance, experiencing water loading or dehydration when switching between food plants or between feeding and fasting. To understand how whitebellied sunbirds and New Holland honeyeaters meet the challenges of varying preformed water load, we used the elimination of intramuscular-injected [14C]-l-glucose and 3H2O to quantify intestinal and renal water handling on diets varying in sugar concentration. Both sunbirds and honeyeaters showed significant modulation of intestinal water absorption, allowing excess water to be shunted through the intestine when on dilute diets. Despite reducing their fractional water absorption, both species showed linear increases in water flux and fractional body water turnover as water intake increased (both afternoon and morning), suggesting that the modulation of fractional water absorption was not sufficient to completely offset dietary water loads. In both species, glomerular filtration rate was independent of water gain (but was higher for the afternoon), as was renal fractional water reabsorption (measured in the afternoon). During the natural overnight fast, both sunbirds and honeyeaters arrested whole kidney function. Evaporative water loss in sunbirds was variable but correlated with water gain. Both sunbirds and honeyeaters appear to modulate intestinal water absorption as an important component of water regulation to help deal with massive preformed water loads. Shutting down glomerular filtration rate during the overnight fast is another way of saving energy for osmoregulatory function. Birds maintain osmotic balance on diets varying markedly in preformed water load by varying both intestinal water absorption and excretion through the intestine and kidneys.