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monarch-initiative / MAxO

Medical action ontology
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NTR: metallothionein inducer therapy #272

Closed sabrinatoro closed 2 years ago

sabrinatoro commented 2 years ago

NTR: metallothionein inducer therapy Parent: pharmacotherapy (MAXO_0000058) Definition: Therapy using any agent that acts by inducing metallothionein.

For example: (from https://www.ncbi.nlm.nih.gov/books/NBK1512/): zinc (metallothionein inducer) interferes with absorption of copper from the gastrointestinal tract presumably by inducing enterocyte metallothionein, which preferentially binds copper from the intestinal contents

LCCarmody commented 2 years ago

@laurenechan Could you weigh in on this discussion? we are wondering if 'zinc therapy' is the same as 'zinc supplementation'? Wondering where the line is for 'supplementation' and 'therapy'? is there one?

Any input would be helpful. Currently, we are using NCIt's definition for nutritional supplementation "The addition of one or more elements and/or chemical compounds that are either absent or deficient in an individual's daily diet." Maybe the definition is not accurate or complete? or do we need another 'zinc therapy'/'metallothionein inducer therapy' term under pharmacotherapy?

laurenechan commented 2 years ago

Hi @LCCarmody , sorry this took me a minute to get around to. I interpret supplementation and therapeutics to be different. Supplementation: typically oral administration, often taken with a goal of increasing intake to meet "daily needs" (which can be defined in a variety of ways by the individual, may be to prevent or manage a deficiency), can be a self led endeavor or can be recommended by a health provider, does not require Rx (this does not mean people will not take the nutrient at therapeutic levels, just that you can purchase OTC)

Therapeutic: could be oral, IV, topical etc. , requires Rx and/or guidance from a professional (dietitian, MD, potentially a naturopath but that label is a whole can of worms in itself), used in instances in which the individual is presenting with negative ramifications from a nutrient deficiency or something like zinc usage to reduce copper uptake, there should be a specific therapeutic outcome expected to result from the intervention. This may also include usage at a "non-typical" level like mega-dosing vitamin D.

I would start to draw a line for supplementation at usage within a certain range of 'normal intake', which can be guided off DRIs or other set values for nutrient needs. Something within like 150%-200% of daily intake may be within a supplemental realm. Therapeutic things should have a few more requirements like the need of a health professional, likely much higher dosages, and expected outcomes.

Hope this helps!

LCCarmody commented 2 years ago

Added zinc therapy