16.00 Innregistrering og servering

17.00 Innledning

17.10 Nytten av diettbehandling i klinisk praksis – kasuistikk. Geir Flatabø, lege, Medisinsk Helsesenter AS

17.30 Gluten sensitivitet fra et klinisk perspektiv. Knut Lundin, Overlege, dr. med., førsteamanuensis, Rikshospitalet

18.00 En pasient forteller om sin erfaring med diettbehandling

18.10 Utvikling av en ny metode for påvisning av gluteneksorfiner og casomorfiner i Urin. Dag Tveiten, laboratorieleder, Lab1/Adrian Finvold, kjemiingeniør Lab1/stud. NTNU

18.30 Kulturelt innslag og pause

19.00 Probiotika ved diettbehandling. Gunnar Brønstad, dr.med, Neurozym Biotech AS

19.25 Omega-3 fettsyrer (EPA) og/eller vitamin E+C mot schizofreni. Et randomisert forsøk. Håvard Bentsen, Overlege, dr.med. Senter for Psykofarmakologi, Diakonhjemmet Sykehus.

19.50 Pause

20.00 Food antigens, intestinal inflammation and complement dysregulation in psychiatric disorders. Emily G. Severance, Ph.D. Stanley Division of Developmental Neurology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA

20.40 “Kalles time”

Program

Genetics

Epigenetics

Environmental «triggers»

You

• Nutrition• Lifestyle• Stress• Infections • Microbiota• ++++

Interactions

S

Neuropeptides in urineLC- MS/MS

Dag TveitenAdrian Finvold

2013

Peptides to nervous system

Incomplete breakdown of gluten and casein

Permeability – “Leaky gut syndrome”

Pathway

Diet and effect

UV- spectrum of urine

UV-spectrum of urine with given wavelengths

Derek - 27

Difficult birth – normal weight

Reduced weight soon after birth

9,5 kg when 2,5 years old

Diagnosed with Infantile Autism - 4 years old

Often GI symptoms – pain, diarea

Angry often/aggressive behaviour

Derek

Derek 2005 – 50 kgDerek 2007 – 64 kg

?

With permission from parents

DerekBefore GFCF diet:

Rigid, stiffness, unrelaxed

Hardly no eye contact Aggressive Tramping with his feet Biting and kicking

After GFCF diet: More relaxed Smiling more often More happy Eyecontact More communicative

Parents say: One hour after ingestion of ”forbidden” food – marked increased aggressive behaviour

Gluten- and casein free diet

Publications

Project LC-MSMS

• Autumn 2011• Investment Ms• Cooperation with HIOA, RH

(Medinova)• 4 students Bachelor in Chemistry

Peptide structures

Casomorphine 1-4 Gluten exorphine C

- Mass: 522,2 g/mol - Mass: 591.3 g/mol

Enzymatic degrading effects

Calibration curveRelation between signal and concentration

C - 5 Levels, 5 Levels Used, 15 Points, 15 Points Used, 0 QCs

Relative Concentration0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.2

Rela

tive R

esp

onse

s 1x10

00.1

0.20.30.40.5

0.60.70.80.9

11.11.2

1.31.41.51.6

1.71.81.9

2

2.12.22.32.4

2.5y = 5.727725 * x + 0.581928R^2 = 0.99745320Type:Linear, Origin:Ignore, Weight:None

Mass spectrometry Conclusions

Fast

Selective

Sensitive

Reliable

Mass spectrometry Patient - LC-MsMs

ID/RID

Reel krea. Kons.

(mmol/L)Kasomorfi

n 1-3Kasomorfi

n 1-4Kasomorfi

n 1-4AKasomorfin

1-5Kasomorfi

n 1-5AKasomorfi

n 1-7Kasomorfin

1-8Gluteneksorfi

n A4Gluteneksorfi

n A5Gluteneksorfi

n B4Gluteneksorfi

n B5Gluteneksorf

in C26305 13,7 239,7 139,1 1269,7 307,5 4807,1 110,1 0 0 0 0 0 0

Mass spectrometry Patient

Patient example

Patient lab results – Antibodies/Peptides

IgG cowmilk 68 U/mL (<20)IgG casein 40 U/mL (<20)IgA casein 13 U/mL (<12)

Casomorphin 1-4 41,4 nmol/L/kreatininCasomorphin 1-5 45,2 nmol/L/kreatininCasomorphin 1-7 200,1 nmol/L/kreatininCasomorphin 1-8 145,2 nmol/L/kreatinin

Hurra.hurraDet er bra .bra .bra.Dette går veien Som tosken og skreien . VH  K

Vi får ta en tittPå det som er blittEt enigma i en gåte Som nålen i en såte.Hi ,hi Kalle

Hipp hurraDette var bra.Nå har vi seiret ,Og dette må feires VH  kalle den nå helgale

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