Urinary Markers of Intestinal Yeast

Summary

Letter to the editor of Towsend Letter for Doctors and Patients gives the argument against the use of urinary arabinose for detection of invasive candidiasis and for the use of urinary D-arabinitol instead. Richard S. Lord, PhD

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Lord RS, “Urinary Markers of Intestinal Yeast.” Townsend Letter for Doctors. 2003. December (245): p. 96-97.

Details

The detection of clinically significant intestinal yeast growth is challenging. Because of the serious life-threatening nature of invasive candidiasis for immunosuppressed individuals, there is strong interest in markers that reveal early stages of this condition. [1] Evidence from a series of recent studies has led to a recommendation that urinary levels of the sugar alcohol, D-arabinitol, be used as a reliable biomarker for invasive candidiasis. [2] The enantiomeric L-arabinitol is not associated with intestinal yeast, and some investigators report the D-/L-arabinitol ratio as a marker. Invasive candidiasis is detected, for example, by such measures of D-arabinitol in newborn infants, and it is reported to be more sensitive than fungal blood cultures. [3] D-arabinitol is a five-carbon sugar alcohol produced from dietary carbohydrates when yeasts are rapidly growing in the reducing environment of the small intestine. Claims have been made that urinary arabinose, an aldopentose with chiral centers similar to arabinitol, is a marker of intestinal yeast growth. Several lines of existing evidence contradict these claims.