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Exploring the medical and scientific background of blood drinking
Investigation and Research Into Sanguinarians
Investigation and Research Into Sanguinarians
Copyright 2005
by Sarah Mediv 
  All Rights reserved 
  E-Mail: s_faolchu@yahoo.com
Cytology and Gastroenterology
When we discuss cytology, we are looking at the basic function of the cell. How it moves nutrition in and out, what it does, and what can go wrong with the process. Each cell in the body can generally be classed into the organ it functions in, though there are many types of cells that make up one organ. For example, neurons in the brain can be divided into those on the cortex and those in the medullary area certain specific brain cells will clump in certain areas such as the optic nerves toward the front going to the eyes which are themselves composed of several types of cells doing various functions. because of this, it becomes more difficult to narrow down the most likely areas to look at for the sanguinarian. However, here I will focus on the cytology of gastrointestinal function since blood has to be absorbed somehow. Not to mention we can touch on defects of the cytological path in the gut and malabsorption or non-absorption of nutrients as well. Hence why gastrology and cytology are tied together here.

HOW DIGESTION WORKS

We can break digestion into two main parts: breakdown and absorption. Each portion of the gastrointestinal (GI) tract contributes a little to both of these events starting as early as the mouth, where some enzymes are released and some particals absorbed through the lining, all the way to the colon, where predominantly water but some other nutrients are also absorbed. Vital to both digestion and absorption are the proper functioning of the digestive enzymes and the proper functioning of the intestinal lining. Lack of an enzyme can result in maldigestion and malabsorption, same if the intestinal lining is compromised by failure of the nutrient "pumps" or inflammation of the intestinal tract.

The body carefully regulates what it does and does not need from the food we eat, turning on/off or up or down regulating certain pathways to allow more or less of that nutrient to pass. Each body system feedsback through neurons and hormones to tell the intestines what it needs. Dehydration means more water absorption, low iron increases iron absorption etc. However, the body is also picky about what type of nutrition it can and cannot use. Proteins over 2-3 peptides in size
cannot be absorbed without further break down. Heme iron is absorbed easier than non-heme iron, as another example. In some cases the body can convert a less absorbable form (like Fe3+) to a more absorbable form (Fe2+) by use of enzymes (ferric reductase, in this example). Sticking with the iron example, the body can then change either how much ferric reductase is produced, how much is transported into the cell (by divalent metal transporter 1) or even how much is taken out of the cell for use by the body (ferroportin). A system of many checks, but still capable of error. Hemochromatosis, a disease in which the body absorbes and stores too much iron, has many causes, but one example would be a mutation of the ferroportin gene resulting in it "ignoring" downregulation commands and allowing iron to freely enter the body.

For protein breakdown and absorption a multitude of enzymes are needed to work in coordination, each one breaking a different portion of the protien between specific amino acids.  As a whole, these protein enzymes are called proteases. Six main groups of proteases are currently known, and they vary depending on the pH they work best in. Hence some work best in an acidic pH (stomach digestion) some in more neutral pH (calpains) and some in basic pH (alkaline proteases). Failure of the protease either by incorrect formation or lack of proper amounts of the enzyme result in larger protein pieces that cannot be absorbed. An examples of a enzymatic failure disease would be exocrine pancreatic insufficiency (failure of production of trypsin, which also regulate fat breakdown and absorption). Most of the protein absorption occurs in the small intestine.

Fats and fatty acids are also primarly absorbed in the small intestine. They are first broken down into monoglycerides and free fatty acids which are then transported via chyle into the cells via diffusion. Chyle helps facilitate absorption as a "ferry" of sort aiding toallow about 97% of fat absorption when abundant, whereas lack of chyle reduces that absorption to 40-50%. Short chain fatty acids are more likely to move through via direct diffusion into hte bloodstream and by-pass the cellular conversion the longer chain fatty acids go through.

Carbohydrate absorption begins after starches are broken down into monosacchrides and a few disacchrides. Longer chain carbohydrates are almost never absorbed until broken down further. Of the absorbed carbohydrates, glucose is the most abundant. Absorption of glucose is tied to sodium absorption as well, if the sodium channels of the cell ar not working, then glucose cannot be absorbed.

MOVEMENT OF DIGESTED MATERIAL ACROSS THE INTESTINAL WALL

Here we get to the nitty-gritty detail of exactly how compounds move from the "tube" of the intestines, through the intestinal lining, and into the blood. Each nutrient type requires a different type of transport system which if not working properly, results in abarations to absorption and malnutrition through malabsorption.

Basic biology teaches us the lining of the small intestine is made of "fingers" called villi. each of these villi in turn have other villi on them (microvilli) allowing for the biggest surface area in the smallest space, increasing absorption. The connections between the cells that make the microvilli are too tight to allow most molecules to just flow between them, so most nutrients must pass through the call itself, like a gatekeeper.

In general, there are three types of nutrient transport: active transport, diffusion, and solvent drag. Active transport uses energy to open/close or rotate "doors" that allow certain nutrients to enter. Diffusion is the movements of nutrients by random motion, no energy is expended by the body. Solvent drag occurs when a solvent (such as water) is pulled across the membrane and and dissolved nutrients are pulled with it. Sodium is the most well-studied example of active transport with the body needing to absorb 25-35 grams of sodium a day in order to replace depletions by sweat and use. Active transport of sodium is also required to transport sugars and amino acids as sodium can "pull" these nutrients through during active transport. Sodium initially enters the intestinal cell via facilitated diffusion (use of a transport protein that binds more than one lement, such as sodium and glucose), but uses active transport to be pumped out of the cell into the blood and lymphatics. This sodium co-transport mechanism of facilitated diffusion is also important for absorption of amino acids. Water is an example of movement by diffusion, but is aided by the active transport of sodium. Generally, the inside of the cell is is hypertonic (caused by the sodium), causing water to move into it. However, if something more hypertonic is the intestines, water will move out instead. Fats, as mentioned, are primarly absorbed via diffusion from chyle. Once in the cell, the mono and di-saccharides are converted to triglycerides and moved into the lymphatics in chylomicrons. Short-chain fatty acids are not converted to triglycerides, however, and are absorbed directly via diffusion.

DIGESTION, CELL TRANSPORT, AND THE SANGUINARIAN

So what does this mean for the research into the sanguinarian? It poses two questions: 1) Why do sanguins seem to be able to tolerate the higher iron levels in blood? and 2) Why do sanguins that have not been able to get blood have (anectdotally) other digestive problems? We drink in blood and health results, which is not the norm for the general population. What is special or defective about our digestion that relies on blood and its pre-digested nutrients for health? Does sodium have anything to do with it?

We can look at bloodpanels and amino aicds and vitamins as mentioned in Biochemistry, but a number does not explain a reason. Biochemistry would be a point to look into the specific absoprtion and metabolic pathways of that particular protein, amino acid or micronutrient. Specialized enzymatic tests or even intestinal biopsies may be required to delve into the base of this issue.
References:

Murray, Robert K. et. el Harper's Illustrated Biochemistry. 28th Edition China: McGraw-Hill Company Inc. 2009.

Guyton, Arthur C and John E. Hall. Textbook of Medical Physiology. Tenth Edition. W.B. Saunders Company. Philidephia, PA. 2000.

Weinberg, E.D. Exposing the Hidden Dangers of Iron Cumberland House Publishing. Nashville, TN. 2004

National Digestive Diseases Information Clearinghouse. Web. <http://digestive.niddk.nih.gov/ddiseases/pubs/yrdd/>

Heuman, Douglas M. et. al. Gastroenterology W.B. Saunders Company. Philidelphia, PA. 1997.