Reader Response: Fish Intake and MRI Burden of Cerebrovascular Disease in Older Adults
StevenBrenner, Retired Neurologist, Saint Louis University Neurology Dept. (retired)
Submitted December 04, 2021
I read the article by Thomas et. al. about less MRI burden of cerebrovascular disease in relation to increased fish intake.1 These results may be due to increased fish intake leading to decreased dietary intake of other foods such as red meat and dairy products, which are sources for glycolylneuraminic acid (Neu5Gc). This sialic acid is incorporated from diet, as it is not produced naturally in humans due to genetic deactivation of the enzyme cytidine monophosphate-N-acetylneuraminic acid (Neu5Ac) hydroxylase (CMAH) during evolution. This mutation is practically unique to humans, occurring since the last common ancestor of great apes and humans.
Neu5Gc from red meat is incorporated into endogenous glycoconjugates, causing chronic inflammation (xenosialitis) that can lead to atherosclerosis.2 Neu5Gc is rare in poultry and fish, but it is common in milk products and enriched in red meats.3 Humans typically have IgA, IgM, and IgG antibodies against Neu5Gc.3
Increased fish consumption alongside decreased red meat and dairy product intake may lead to reduced risk of cerebrovascular disease due to less chronic inflammation from the antigenic anti-Neu5Gc “xeno-autoantibodies” or xenosialitis in blood vessels causing atherosclerosis.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Thomas A, Crivello F, Mazoyer B, Debette S, Tzourio C, Samieri C. Fish Intake and MRI Burden of Cerebrovascular Disease in Older Adults. Neurology. 2021;97(22):e2213-e2222. doi:10.1212/WNL.0000000000012916
Kawanishi K, Dhar C, Do R, Varki N, Gordts PLSM, Varki A. Human species-specific loss of CMP-N-acetylneuraminic acid hydroxylase enhances atherosclerosis via intrinsic and extrinsic mechanisms. Proc Natl Acad Sci U S A. 2019;116(32):16036-16045. doi:10.1073/pnas.1902902116
Tangvoranuntakul P, Gagneux P, Diaz S, et al. Human uptake and incorporation of an immunogenic nonhuman dietary sialic acid. Proc Natl Acad Sci U S A. 2003;100(21):12045-12050. doi:10.1073/pnas.2131556100
I read the article by Thomas et. al. about less MRI burden of cerebrovascular disease in relation to increased fish intake.1 These results may be due to increased fish intake leading to decreased dietary intake of other foods such as red meat and dairy products, which are sources for glycolylneuraminic acid (Neu5Gc). This sialic acid is incorporated from diet, as it is not produced naturally in humans due to genetic deactivation of the enzyme cytidine monophosphate-N-acetylneuraminic acid (Neu5Ac) hydroxylase (CMAH) during evolution. This mutation is practically unique to humans, occurring since the last common ancestor of great apes and humans.
Neu5Gc from red meat is incorporated into endogenous glycoconjugates, causing chronic inflammation (xenosialitis) that can lead to atherosclerosis.2 Neu5Gc is rare in poultry and fish, but it is common in milk products and enriched in red meats.3 Humans typically have IgA, IgM, and IgG antibodies against Neu5Gc.3
Increased fish consumption alongside decreased red meat and dairy product intake may lead to reduced risk of cerebrovascular disease due to less chronic inflammation from the antigenic anti-Neu5Gc “xeno-autoantibodies” or xenosialitis in blood vessels causing atherosclerosis.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References