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Applied Microbiology and Biotechnology Aug 2020Mannitol is a naturally occurring six-carbon sugar alcohol that has wide applications in the food and pharmaceutical industry because of its many properties, namely... (Review)
Review
Mannitol is a naturally occurring six-carbon sugar alcohol that has wide applications in the food and pharmaceutical industry because of its many properties, namely being a natural sweetener with a low metabolism and no glycemic index. The increasing demand for mannitol has spurred many studies of its production. Compared with its chemical synthesis and extraction from plants, both of which are difficult to satisfy for industrial requirements, biotechnological production of mannitol has received considerably more attention and interest from scientists because of its known advantages over those two methods. Accordingly, in this review, we summarize recent advances made in the production of mannitol through various biotechnological methods. The physicochemical properties, sources, and physiological functionalities and applications of mannitol are systematically covered and presented. Then, different determination methods for mannitol are also described and compared. Furthermore, different biotechnological strategies for the production of mannitol via fermentation engineering, protein engineering, and metabolic engineering receive a detailed overview in terms of mannitol-producing strains, enzymes, and their key reaction parameters and conditions. KEY POINTS: • Physiological functionalities and applications of mannitol are presented in detail. • Different determination methods for mannitol are also described and compared. • Various biotechnological strategies for the production of mannitol are reviewed.
Topics: Biotechnology; Fermentation; Mannitol; Metabolic Engineering; Protein Engineering; Sweetening Agents
PubMed: 32601737
DOI: 10.1007/s00253-020-10757-y -
The Nursing Clinics of North America Jun 2017Patients with increased intracranial pressure generally require pharmacologic therapies and often more definitive treatments, such as surgical intervention. The overall... (Review)
Review
Patients with increased intracranial pressure generally require pharmacologic therapies and often more definitive treatments, such as surgical intervention. The overall goal of these interventions is to maintain or re-establish adequate cerebral blood flow and prevent herniation. Regardless of the cause of increased intracranial pressure, osmotherapy is considered the mainstay of medical therapy, and should be administered as soon as possible. This article reviews the history of hyperosmolar and hypertonic therapies, the Monro-Kellie hypothesis, and types of cerebral edema. Pharmacologic properties, clinical applications, complications, recommended monitoring during therapy, and risks versus benefits are also discussed.
Topics: Adult; Aged; Aged, 80 and over; Female; Fluid Therapy; History, 20th Century; History, 21st Century; Humans; Intracranial Hypertension; Male; Mannitol; Middle Aged; Saline Solution, Hypertonic
PubMed: 28478873
DOI: 10.1016/j.cnur.2017.01.002 -
The Journal of Neuroscience Nursing :... Jun 1994Investigation into the use of osmotic therapy for ICP reduction began in 1919. Mannitol is the osmotic agent currently in use. Mannitol's effectiveness in reducing ICP... (Review)
Review
Investigation into the use of osmotic therapy for ICP reduction began in 1919. Mannitol is the osmotic agent currently in use. Mannitol's effectiveness in reducing ICP has been shown. Osmotic therapy using mannitol reduces ICP by mechanisms that remain unclear. Mannitol is thought to decrease brain volume by decreasing overall water content, to reduce blood volume by vasoconstriction and to reduce CSF volume by decreasing water content. Mannitol may also improve cerebral perfusion by decreasing viscosity or altering red blood cell rheology. Lastly, mannitol may exert a protective effect against biochemical injury. The most common complications of therapy are fluid and electrolyte imbalances, cardiopulmonary edema and rebound cerebral edema. Nursing care of the patient receiving mannitol requires vigilant monitoring of electrolytes and overall fluid balance, and observation for the development of cardiopulmonary complications in addition to neurologic assessment.
Topics: Brain Injuries; Drug Interactions; Humans; Mannitol; Monitoring, Physiologic; Nursing Assessment; Osmotic Pressure; Patient Care Planning; Pseudotumor Cerebri
PubMed: 7963823
DOI: 10.1097/01376517-199406000-00012 -
The Thoracic and Cardiovascular Surgeon Feb 1999Mannitol is widely used in all fields of medicine, due to its beneficial actions on the kidney and brain. Mannitol has been extensively used in cardiac surgery since its... (Review)
Review
Mannitol is widely used in all fields of medicine, due to its beneficial actions on the kidney and brain. Mannitol has been extensively used in cardiac surgery since its infancy, and remains in common usage to day. Mannitol is mainly used for its effects on the kidneys, but it has actions on the brain, lungs, heart, gastrointestinal tract and the red cell. Mannitol also has effects on free radicals and nitric oxide. As with virtually all treatments in medicine and surgery its use is not immune from side effects. The medical literature on mannitol over the past 30 years is considered.
Topics: Adult; Cardiac Surgical Procedures; Child; Diuretics, Osmotic; Heart Diseases; Humans; Infant; Infusions, Intravenous; Intraoperative Complications; Mannitol; Postoperative Complications
PubMed: 10218625
DOI: 10.1055/s-2007-1013112 -
Annals of Allergy, Asthma & Immunology... Feb 2011To review mannitol challenge data and advocate the approval of this testing modality in the United States. (Review)
Review
OBJECTIVES
To review mannitol challenge data and advocate the approval of this testing modality in the United States.
DATA SOURCES
A literature review was performed using the MEDLINE database for English-language articles published between January 1, 1993, and July 31, 2009, using the following keywords: mannitol bronchoprovocation test, inhaled mannitol, inhaled mannitol and asthma, and inhaled mannitol and exercise-induced asthma.
STUDY SELECTION
Trials were selected that established the effect of mannitol as a bronchoprovocation challenge, explored mannitol's mechanism of action, and compared mannitol to other accepted bronchoprovocation challenges.
RESULTS
Mannitol has demonstrated the ability to detect airway hyperreactivity in individuals. The mechanism of action is through the release of mast cell mediators. The sensitivity and specificity compare well with other indirect challenge testing methods.
CONCLUSION
Mannitol is a polyol sugar that can be converted to a powdered form and encapsulated. Once encapsulated it can be inhaled and causes narrowing of the airways in susceptible individuals. Mannitol likely triggers the release of inflammatory and/or bronchospasm mediators, causing the smooth muscle of the airway to contract and resulting in airway narrowing. The magnitude of decrease in forced expiratory volume in 1 second and the dose of mannitol needed to provoke the airway response provide a readily measurable and clinically useful assessment of airway hyperreactivity. Mannitol challenge is an accepted testing method in Australia, Europe, and Korea. Acceptance of the mannitol challenge in the United States would complement existing methods for assessing bronchial hyperreactivity and likely improve patient care.
Topics: Bronchial Provocation Tests; Forced Expiratory Volume; Humans; Leukotriene E4; Mannitol
PubMed: 21277509
DOI: 10.1016/j.anai.2010.11.010 -
Kidney International Oct 1997
Review
Topics: Acute Kidney Injury; Humans; Kidney; Mannitol; Nephrology
PubMed: 9328926
DOI: 10.1038/ki.1997.409 -
Drugs Jul 2012Mannitol dry powder for inhalation has been developed for the treatment of patients with cystic fibrosis. Two randomized, double-blind, multinational, 26-week, phase III... (Review)
Review
Mannitol dry powder for inhalation has been developed for the treatment of patients with cystic fibrosis. Two randomized, double-blind, multinational, 26-week, phase III trials (CF-301 and CF-302) examined the efficacy of inhaled dry powder mannitol in patients aged ≥ 6 years with cystic fibrosis who were receiving standard care (with a substantial proportion of patients receiving dornase alfa and antibacterials at baseline). Good compliance was seen in both studies. A sustained, significant (p<0.001) improvement in forced expiratory volume in 1 second (FEV(1)) [mean absolute change from baseline over 26 weeks; primary endpoint] was seen in patients with cystic fibrosis who received inhaled mannitol, compared with the control group, in the CF-301 trial, but not in the CF-302 trial (p=0.059). In both CF-301 and CF-302, the relative increase from baseline in percent predicted FEV(1) and the improvement from baseline in forced vital capacity were significantly greater in patients receiving inhaled mannitol than in the control group. In a pooled analysis of the CF-301 and CF-302 trials, the relative risk of a pulmonary exacerbation requiring intravenous antibacterials was significantly reduced by 29% for inhaled mannitol recipients versus the control group (relative risk 0.71; 95% CI 0.51, 0.98) [p=0.039]. Inhaled dry powder mannitol was generally well tolerated in adults with cystic fibrosis in the CF-301 and CF-302 studies, with most treatment-emergent adverse events being of mild to moderate severity.
Topics: Administration, Inhalation; Cystic Fibrosis; Dry Powder Inhalers; Forced Expiratory Volume; Humans; Mannitol; Molecular Structure; Mucociliary Clearance; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 22755516
DOI: 10.2165/11208950-000000000-00000 -
The Medical Letter on Drugs and... May 2021
Randomized Controlled Trial
Topics: Administration, Inhalation; Adolescent; Child; Cystic Fibrosis; Double-Blind Method; Female; Forced Expiratory Volume; Humans; Male; Mannitol
PubMed: 34101719
DOI: No ID Found -
Trends in Microbiology Jun 2007Mannitol is a 6-carbon polyol that is among the most abundant biochemical compounds in the biosphere. Mannitol has been ascribed a multitude of roles in filamentous... (Review)
Review
Mannitol is a 6-carbon polyol that is among the most abundant biochemical compounds in the biosphere. Mannitol has been ascribed a multitude of roles in filamentous fungi including carbohydrate storage, reservoir of reducing power, stress tolerance and spore dislodgement and/or dispersal. The advancement of genetic manipulation techniques in filamentous fungi has rapidly accelerated our understanding of the roles and metabolism of mannitol. The targeted deletion of genes encoding proteins of mannitol metabolism in several fungi, including phytopathogens, has proven that the metabolism of mannitol does not exist as a cycle and that many of the postulated roles are unsupported. These recent studies have provided a much needed focus on this mysterious metabolite and make this a fitting time to review the roles and metabolism of mannitol in filamentous fungi.
Topics: Fungi; Mannitol; Mitosporic Fungi; NADP; Spores, Fungal
PubMed: 17442575
DOI: 10.1016/j.tim.2007.04.002 -
Critical Reviews in Biotechnology Aug 2020Dietary habits that include an excess of added sugars have been strongly associated with an increased risk of obesity, heart disease, diabetes, and tooth decay. With... (Review)
Review
Dietary habits that include an excess of added sugars have been strongly associated with an increased risk of obesity, heart disease, diabetes, and tooth decay. With this association in view, modern food systems aim to replace added sugars with low calorie sweeteners, such as polyols. Polyols are generally not carcinogenic and do not trigger a glycemic response. Furthermore, owing to the absence of the carbonyl group, they are more stable compared to monosaccharides and do not participate in Maillard reactions. As such, since polyols are stable at high temperatures, and they do not brown or caramelize when heated. Therefore, polyols are widely used in the diets of hypocaloric and diabetic patients, as well as other specific cases where controlled caloric intake is required. In recent years, erythritol and mannitol have gained increased importance, especially in the food and pharmaceutical industries. In these areas, research efforts have been made to improve the productivity and yield of the two polyols, relying on biotechnological manufacturing methods. The present review highlights the recent advances in the biotechnological production of erythritol and mannitol and summarizes the benefits of using the two polyols in the food and pharmaceutical industries.
Topics: Bacteria; Biotechnology; Drug Industry; Erythritol; Fermentation; Food Industry; Humans; Mannitol; Metabolic Networks and Pathways; Polymers; Sweetening Agents; Yeasts
PubMed: 32299245
DOI: 10.1080/07388551.2020.1751057