A nutriepigenetic pathway links nutrient information to sensory plasticity

Diet composition has a profound influence on brain physiology and behavior, but the mechanisms through which nutrient information is transmuted into neural changes remain elusive. Here we uncover how the metabolic enzyme O-GlcNAc Transferase (OGT) transforms information about the dietary environment into taste adaptations. We show that in the fly D. melanogaster, OGT decorates the chromatin of the sweet taste neurons and provides the nutrient context to drive changes in chromatin accessibility in response to high dietary sugar. Specifically, we found that OGT cooperates with the epigenetic silencer Polycomb Repressive Complex 2.1 (PRC2.1) to promote nutrient-sensitive variations in chromatin openness; these chromatin dynamics result in changes in gene expression and taste plasticity that are dependent on the catalytic activity of OGT. Parallel nutrigenomic signatures were also observed in the lingual epithelium of rats exposed to high dietary sugar, suggesting that this conserved metabolic-epigenetic pathway may also underlie diet-dependent taste changes in mammals. Together our findings reveal a novel role for nutriepigenetic signaling in the brain: amplifying nutrient perturbations into robust changes in chromatin accessibility and transcriptional output that shape neural and behavioral plasticity.

How Can Providers Better Address Recovery Needs for Geriatric TBI Survivors?

Older adults are at increased risk for poorer recovery from traumatic brain injury (TBI), incidence of pre-injury frailty, and comorbidity compared to younger adults. In this study, a longitudinal multiple case study approach was taken to describe gaps in health service delivery identified by older adults following mild-moderate TBI. Participants were interviewed at 1 week, and 1, 3, 6, and 12 months post injury (5 times). In total, 57 interviews were conducted with 13 participants and transcribed verbatim. Codes were identified inductively to develop a codebook for guiding thematic analysis in NVIVO. Two independent investigators double coded 16 transcripts (28%) and reached consensus; remaining transcripts were allocated to the two investigators for independent coding and verified and reconciled with the other coder until consensus was reached. Many participants were happy with the care they received. However, ongoing health issues and TBI symptoms sometimes remained unaddressed. Follow-up and care planning would have been helpful for most patients as well as ways to address common balance and dizziness issues. Among some, the unwillingness to go to a provider for follow-up or adhere to medication and physical therapy exercises were issues. In some cases, providers were unable to help or understand the reason for patients’ symptoms (e.g., smell/taste changes, ear issues, etc.). Sometimes, providers did not address the issues that were of most concern to patients, or they would prescribe treatments that were not acceptable to patients. Empathetic, tailored, and patient-centered approaches are needed to improve care delivery and outcomes.

Oral manifestations detected in COVID-19 patients: an integrative review

The aim of this integrative review consisted of verifying whether the oral manifestations detected in patients diagnosed with COVID-19 are useful in diagnosing the disease, whether they are a manifestation resulting from the disease, or whether there is evidence that there is no correlation between the pathologies. Therefore, articles in the PubMed, Lilacs, Scopus, Science Direct, Web of Science and Embase databases were searched, in addition to the search in gray literature. The terms used in the search were: “COVID-19” or “Sars-Cov-2” or “coronavirus” and “oral conditions” or “oral health” or “oral manifestations” and “diagnosis/complications” or “symptoms”. Thus, 1.305 articles were selected, of which 61 were selected to compose this review. Most of the included studies considered oral symptoms as taste changes, xerostomia and ulcerative lesions in the oral and labial mucosa. All symptoms related to this pathology still need further studies and investigations so that all mechanisms and manifestations related to it are completely elucidated.

Dietary Habits and Choices of 4-to 6-Year-Olds: Do Children Have a Preference for Sweet Taste?

Children develop food preferences by coming into direct contact with various food products through the senses of taste, touch, sight and smell. The aim of this study was to analyze the food preferences of children aged 4 to 6 years and to determine whether age and gender influence children’s food preferences and whether the preference for sweet taste changes with age. The study involved a paper questionnaire containing images of 115 different food products and dishes. The respondents expressed their preferences by choosing the appropriate emoji (happy, sad or neutral face). The study was conducted between 2018 and 2020, and it involved 684 children from 10 kindergartens. Girls chose a significantly higher number of foods and dishes they liked than boys (p = 0.002), and 4-year-olds gave a higher number of “neutral” responses than 5- and 6-year-olds (p = 0.001). Dietary diversity increased with age, and younger children were familiar with fewer foods than 6-year-olds (p = 0.002). Children had a clear preference for sweet taste, regardless of age and gender. Young children (4-year-olds) were more likely to accept healthy foods despite the fact that they were familiar with fewer products and dishes.

Describing taste changes and their potential impacts on paediatric patients receiving cancer treatments

ObjectivesTaste changes are common among paediatric patients receiving cancer treatments although specific descriptions and associations are uncertain. Primary objective was to describe the number of paediatric patients receiving cancer therapies who experienced taste changes, its impact on food intake and enjoyment of eating, and coping strategies.MethodsThis was a cross-sectional study that included English-speaking paediatric patients aged 4–18 years with a diagnosis of cancer or haematopoietic stem cell transplantation recipients receiving active treatment. Using a structured interview, we asked participants about their experience with taste changes, impacts and coping strategies. The respondent was the paediatric patient.ResultsWe enrolled 108 patients; median age was 11 years (IQR 8–15). The taste changes reported yesterday or today were food tasting bland (34%), bad (31%), different (27%), bitter (25%), extreme (19%), metallic (15%) or sour (12%). Taste changes were associated with decreased food intake (31%) and decreased enjoyment in eating (25%) yesterday or today. The most common coping strategies were eating food they liked (42%), eating strong-tasting food (39%), drinking liquids (35%), brushing teeth (31%) and sucking on candy (25%). Factors significantly associated with food tasting bad were as follows: older age (p=0.003), shorter time since cancer diagnosis (p=0.027), nausea and vomiting (p=0.008) and mucositis (p=0.009).ConclusionsAmong paediatric patients receiving cancer treatments, taste changes were common and were associated with decreased food intake and enjoyment in eating. Common coping strategies were described. Reducing nausea, vomiting and mucositis may improve taste changes.

Postoperative Assessment of Gustatory Activity Following Surgical Removal of Mandibular Third Molars

BACKGROUND The study focused on prospectively determining the incidence and severity of taste changes after surgical removal of mandibular third molar and correlating difficulty index of impaction and incidence of gustatory changes. METHODS 96 patients who required lower third molar extraction were included in the study. Their difficulty of impaction was measured using Pell and Gregory Difficulty Index and their gustatory activity was measured using a spatial taste test and a whole mouth wash test. The tests were carried out using 5 different stimuli, i.e., sweet, salt, bitter, umami and sour, in different concentrations and the subjects were asked to identify the stimuli preoperatively, postoperatively on day 7 and after 1 month.Tastes were scored from 1 - 9 for decreasing and altered taste sensations. RESULTS The results of our study showed that with increased difficulty index, taste sensation was altered. While most patients belonged to the Class II and Class I group as well as position A and B, taste changes were still noted due to difficulty in impaction, especially in the patients belonging to Class III and position C groups. The taste changes felt at POD - 7 were similar and unresolved in the one month follow up. The scores had a statistically significant difference (P < 0.05). CONCLUSIONS With a higher difficulty score, gustatory changes are felt due to the increased surgical manipulation required to remove the tooth from its socket. This is indicative of nerve damage during surgical extraction. KEY WORDS Postoperative, Assessment, Gustatory, Mandibular, Third Molar

Human Taste Cells Express ACE2: a Portal for SARS-CoV-2 Infection

Loss and changes in taste and smell are well-reported symptoms of SARS-CoV-2 infection. The virus targets cells for entry by high affinity binding of its spike protein to cell-surface angiotensin-converting enzyme-2 (ACE2). It was not known whether ACE2 is expressed on taste receptor cells (TRCs) nor if TRCs are infected directly. Using an in-situ hybridization (ISH) probe and an antibody specific to ACE2, it seems evident that ACE2 is present on a subpopulation of specialized TRCs, namely, PLCβ2 positive, Type II cells in taste buds in taste papillae. Fungiform papillae (FP) of a SARS-CoV-2+ patient exhibiting symptoms of COVID-19, including taste changes, were biopsied. Based on ISH, replicating SARS-CoV-2 was present in Type II cells of this patient. Therefore, taste Type II cells provide a portal for viral entry that predicts vulnerabilities to SARS-CoV-2 in the oral cavity. The continuity and cell turnover of the FP taste stem cell layer of the patient were disrupted during infection and had not fully recovered 6 weeks post symptom onset. Another patient suffering post-COVID-19 taste disturbances also had disrupted stem cells. These results indicate that a COVID-19 patient who experienced taste changes had replicating virus in their taste buds and that SARS-CoV-2 infection results in deficient stem cell turnover needed for differentiation into TRCs.

Otitis Media and Obesity—An Unusual Relationship in Children

Otitis media (OM) represents a public health matter, being the main cause of preventable hearing loss in pediatric patients. Besides well-established risk factors for developing OM, such as craniofacial abnormalities, prematurity, low birth weight, or tobacco exposure, there is evidence that obesity could be associated with a high incidence of OM. Our aim is to perform a literature review on the state of current published research on the relationship between OM and obesity and to discuss the interconnectivity between these two entities. We conducted an electronic search in PubMed and EMBASE databases. Out of 176 references, 15 articles were included in our study. Our findings suggest that obesity and overweight might be risk factors for developing OM, and vice versa. The main mechanisms for developing OM in obese patients include alteration in cytokine profile, increased gastroesophageal reflux, and/or fat accumulation. Conversely, ear infections exposure might increase the risk of obesity, mostly by taste changes through middle ear cavity inflammation.