Case Report
The Sage of Tea and the Inherited Metabolic Diseases
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Lu Yu (733 -804 AD, Tang Dynasty), was an orphan brought up and educated in a monastery. Because of his deep knowledge of tea, he was also called "the Sage of Tea". From the historical records, we conclude that Lu Yu maybe a patient of IMDs.
Keywords: Lu Yu, The Sage of Tea, Inherited metabolic diseases (IMDs), Traditional Chinese Medicine
INTRODUCTION
Lu Yu (733 -804 AD, Tang Dynasty), was an orphan brought up and educated in a monastery. Because of his deep knowledge of tea, he was also called "the Sage of Tea" [1].
Inherited metabolic diseases (IMDs) are a heterogeneous group of rare diseases with a collective incidence of 1 in 500 to 4,000 live births, representing a substantial public health burden [2-4]. The clinical disorders that arise from a single gene defect and develop as a consequence of a blockage of the metabolic pathways are accepted as inherited metabolic diseases [5], such as phenylketonuria (PKU), maple syrup urine disease (MSUD) and diabetes. Diabetes is a kind of metabolic disease. The cases of diabetes were definitely documented in Traditional Chinese medicine, just as Sima Xiangru (Chinese: 司马相如), Du Fu (Chinese: 杜甫), Ouyang Xiu (Chinese: 欧阳修).
IMDs have recently become an important part of medicine [6]. They are usually classified into 3 main groups:
- Intoxication diseases (i.e., amino-acidopathies, organic aciduria, fructose intolerance and galactosaemia, iron and copper overload, porphyria) [7-9]
- Diseases linked to energy deficiency (i.e., glycogenolysis, mitochondrial diseases, disorders of fatty acid oxidation and ketogenesis, congenital lactic acidosis) [10,11]
- Diseases due to degradation or synthesis defect of complex molecules (i.e., lysosomal or peroxisomal diseases, and congenital disorders of glycosylation) [12]
Over the past decade, a newborn screening (NBS) program was introduced to detect presymptomatic newborns with IMDs, tandem mass spectrometry (MS/MS) has been a major technological breakthrough for the NBS program by providing a way to detect multiple metabolites simultaneously [3,13].
As physicians of maternal and child health hospital of Hubei province, from the historical records, we conclude that Lu Yu maybe a patient of IMDs.
The first, from his origins. Lu Yu was an orphan; he did not know who his parents were. Maybe he was a patient of IMDs, his parents abandoned him because of the specific smell produced by the patients of IMDs [7].
The second, from his autobiography [14]. The autobiography of Lu Yu recorded that Lu Yu was ugly in appearance and had a terrible stutter. He was famous for his bad temper and strange character. Ugliness, stuttering, bad temper and strange character are clinical manifestations of IMDs [15].
The third, from his life experience in monastery. In buddhist temple, Lu Yu didn't eat fish and meat, only eat vegetables and congee. Meat and fish contain a lot of protein, by contrast, vegetables and congee contain less protein. Low protein diet is one of the important methods to treat IMDs (just as PKU) [16].
The fourth, from his name. Lu Yu had the second name Ji (Chinese: 疾 and the third name Ji Ci (Chinese: 疵). 疾 means disease in Chinese, 疵 means disease related to eat some kinds of food in Chinese.
From these reasons, we can conclude that Lu Yu was a patient of IMDs, especially a patient of PKU. He also knew that low-protein diet was good for his disease and treated his disease in some way of traditional Chinese medicine.
FUNDING
This work was supported by Hubei Provincial Health and Family Planning Scientific Research Project [Grant # WJ2018H0137].
CONFLICT OF INTERESTS
The authors have no conflicts of interest relevant to this article.
- The Sage of Tea - Lu Yu, from Chinese Government Network. Available online at: http://en.hubei.gov.cn/photo_gallery/people/201511/t20151102_742334.shtml
- Feuchtbaum L, Carter J, Dowray S, Currier RJ, Lorey F (2012) Birth prevalence of disorders detectable through newborn screening by race/ethnicity. Genet Med 14: 937-945.
- Wilcken B, Wiley V, Hammond J, Carpenter K (2003) Screening newborns for inborn errors of metabolism by tandem mass spectrometry. N Engl J Med 348: 2304-2312.
- Kyoung JP, Seungman P, Eunhee L, Jong HP, June HP, et al. (2016) A Population-Based Genomic Study of Inherited Metabolic Diseases Detected Through Newborn Screening. Ann Lab Med 36: 561-572.
- Şahin E, Halil S (2016) Endocrine Dysfunctions in Patients with Inherited Metabolic Diseases. J Clin Res Pediatr Endocrinol 8: 330-333.
- Claire D, Karine M, Dries D, Jean-Louis W, Jean-Marie S, et al. (2012) Hypoglycemia related to inherited metabolic diseases in adults. Orphanet J Rare Dis 7: 26-36.
- Neto EV, Maia Filho HS, Monteiro CB, Carvalho LM, Tonon T, et al. (2017) Quality of life and adherence to treatment in early-treated Brazilian phenylketonuria pediatric patients. Braz J Med Biol Res 51(2): e6709.
- Packman W, Henderson SL, Mehta I, Ronen R, Danner D, et al. (2007) Psychosocial issues in families affected by maple syrup urine disease. J Genet Couns 16: 799-809.
- Splinter K, Niemi A-K, Cox R, Platt J, Shah M, et al. (2016) Impaired health-related quality of life in children and families affected by Methylmalonic Acidemia. J Genet Couns 25: 936-944.
- Vockley J, Burton B, Berry GT, Longo N, Phillips J, et al. (2017) UX007 for the treatment of long chain-fatty acid oxidation disorders: Safety and efficacy in children and adults following 24weeks of treatment. Mol Genet Metab. 120: 370-377.
- Bonnefont JP, Bastin J, Behin A, Djouadi F (2009) Bezafibrate for an inborn mitochondrial beta-oxidation defect. N Engl J Med 360: 838-340.
- Wyatt K, Henley W, Anderson L, Anderson R, Nikolaou V, et al. (2012) The effectiveness and cost-effectiveness of enzyme and substrate replacement therapies: A longitudinal cohort study of people with lysosomal storage disorders. Health Technol Assess. 16: 1-543.
- Mak CM, Lee HC, Chan AY, Lam CW (2013) Inborn errors of metabolism and expanded newborn screening: Review and update. Crit Rev Clin Lab Sci 50: 142-162.
- The autobiography of Lu Yu. Available online at: https://en.wikipedia.org/wiki/Lu_Yu
- Carlota P, Sandra B, Rita F, Dorinda MS, Agnes R, et al. (2018) Patient and observer reported outcome measures to evaluate health-related quality of life in inherited metabolic diseases: A scoping review. Orphanet J Rare Dis 13: 215-240.
- Willig LK, Petrikin JE, Smith LD, Saunders CJ, Thiffault I, et al. (2015) Whole-genome sequencing for identification of Mendelian disorders in critically ill infants: A retrospective analysis of diagnostic and clinical findings. Lancet Respir Med 3: 377-387.
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