Verbal and visual memory improve after choline supplementation in long-term total parenteral nutrition: a pilot study.
Buchman AL, Sohel M, Brown M, Jenden DJ, Ahn C, Roch M, Brawley TL
JPEN J Parenter Enteral Nutr 2001 Jan-Feb;25(1):30-5 Division of Gastroenterology and Hepatology, Northwestern University, Chicago, Illinois 60611, USA. email@example.com
BACKGROUND: Previous investigations have demonstrated that choline deficiency, manifested in low plasma-free choline concentration and hepatic injury, may develop in patients who require long-term total parenteral nutrition (TPN). Preliminary studies have suggested lecithin or choline supplementation might lead to improved visual memory in the elderly and reverse abnormal neuropsychological development in children. We sought to determine if choline-supplemented TPN would lead to improvement in neuropsychological test scores in a group of adult, choline-deficient outpatients receiving TPN. METHODS: Eleven subjects (8 males, 3 females) who received nightly TPN for more than 80% of their nutritional needs for at least 12 weeks before entry in the study were enrolled. Exclusion criteria included active drug abuse, mental retardation, cerebral vascular accident, head trauma, hemodialysis or peritoneal dialysis, (prothrombin time [PT] >2x control), or acquired immune deficiency syndrome (AIDS). Patients were randomly assigned to receive their usual TPN regimen (n = 6, aged 34.0 12.6 years) over a 12-hour nightly infusion or their usual TPN regimen plus choline chloride (2 g) (n = 5, aged 37.3 7.3 years). The following neuropsychological tests were administered at baseline and after 24 weeks of choline supplementation (or placebo): Weschler Adult Intelligence Scale-Revised (WAIS-R, intellectual functioning), Weschler Memory Scale-Revised (WMS-R, two subtests, verbal and visual memory), Rey-Osterrieth Complex Figure Test (visuospatial functioning and perceptual organization), Controlled Oral Word Association Test (verbal fluency), Grooved Pegboard (manual dexterity and motor speed), California Verbal Learning Test (CVLT, rote verbal learning ability), and Trail Making Parts A & B (visual scanning, psychomotor speed and set shifting). Scores were reported in terms of standard scores including z scores and percentile ranks. Mean absolute changes in raw scores were compared between groups using the Wilcoxon rank sum test, where p values < .05 constituted statistical significance. RESULTS: Significant improvements were found in the delayed visual recall of the WMS-R (7.0 2.7 vs -.33 5.7, p = .028), and borderline improvements in the List B subset of the CVLT (1.0 0.8 vs -2.0 2.4, p = .06) and the Trails A test (-3.8 8.1 vs 3.7 4.5 seconds, p = .067). No other statistically significant changes were seen. CONCLUSIONS: This pilot study indicates both verbal and visual memory may be impaired in patients who require long-term TPN and both may be improved with choline supplementation.
Effects of oral administration of soybean lecithin transphosphatidylated phosphatidylserine on impaired learning of passive avoidance in mice.
Furushiro M, Suzuki S, Shishido Y, Sakai M, Yamatoya H, Kudo S, Hashimoto S, Yokokura T Yakult Central Institute for Microbiological Research, Kunitachi, Tokyo, Japan. Jpn J Pharmacol 1997 Dec;75(4):447-50
Soybean lecithin transphosphatidylated phosphatidylserine (SB-tPS) was investigated for its effect on the impaired learning of a passive avoidance task by mice induced by scopolamine or cycloheximide. SB-tPS (240, 360, 480 mg/kg) administered orally significantly prolonged the step-through latency shortened by scopolamine. SB-tPS (240 mg/kg) administered orally also prolonged the step-through latency shortened by cycloheximide. These results suggest that the effect of SB-tPS on the impaired learning behavior may be related not only to the cholinergic system but also the serotonergic system.
Effects of chronic choline and lecithin on mouse hippocampal dendritic spine density.
Muma NA, Rowell PP Department of Pharmacology and Toxicology, University of Louisville School of Medicine, KY 40292. Exp Aging Res 1988 Summer-Autumn;14(2-3):137-41
Dendritic spines, which project from the dendrites of central neurons, are thought to contribute to the amount of contact area available for synaptic connections. The density of these spines has been found to correlate with learning and memory function, and there is a progressive decrease in dendritic spine density with aging. In addition, experimental animals given a choline-enriched diet have an increase in neocortical spine density compared to controls. In this study, the dendritic spine density of hippocampal pyramidal cells was examined in aged mice which had received life-long choline enriched, choline deficient or lecithin enriched diets. These treatments had no effect on hippocampal dendritic spine density compared to control. The results indicate that dietary supplementation may have different effects in different brain areas and that the relative increase in learning and memory function in aged animals given a choline or lecithin enriched diet is not due to an increase in hippocampal dendritic spine density.
Effects of oral physostigmine and lecithin on memory and attention in closed head-injured patients.
Levin HS, Peters BH, Kalisky Z, High WM, von Laufen A, Eisenberg HM, Morrison DP, Gary HE Cent Nerv Syst Trauma 1986 Fall;3(4):333-42
In view of the evidence for the role of the central cholinergic pathways in memory and preliminary studies suggesting alteration of neurotransmitters after severe head injury, we completed a double-blind, placebo-controlled study of combined oral physostigmine and lecithin. Sixteen survivors of moderate to severe closed head injury who had unequivocal memory deficit were studied during the course of inpatient rehabilitation. Although the results generally indicated no difference in the effects of the physostigmine-lecithin combination as compared to lecithin alone, sustained attention on the continuous performance test was more efficient under physostigmine than placebo when the drug condition occurred first in the crossover design. Further investigation of neurotransmitter manipulation is warranted in patients with traumatic brain injury.
Dietary polyenylphosphatidylcholine decreases cholesterolemia in hypercholesterolemic rabbits: role of the hepato-biliary axis.
Polichetti E, Janisson A, de la Porte PL, Portugal H, Leonardi J, Luna A, La Droitte P, Chanussot F INSERM U. 476, Marseille, France. Life Sci 2000 Oct 13;67(21):2563-76
The aim of this work was to study the cholesterol-lowering mechanisms induced by dietary soybean lecithin in hypercholesterolemic rabbits. Male New Zealand white rabbits (n = 6 in each group) were fed for 10 weeks either a low-fat control C diet, containing 27 g fat/kg, or high-fat diets enriched with 2 g cholesterol/kg and 77 g fat/kg. The high-fat diets contained 50 g lard (L), 50 g soybean triacylglycerol (SO), or 50 g pure soybean phosphatidylcholine (PLE). PLE diet decreased by 30% beta-VLDL-cholesterol, compared with SO diet. HDL2-, HDL3- and LDL-lipid contents were unchanged in the L, SO and PLE groups. In gallbladder bile, amounts of phospholipids, bile salts and cholesterol were significantly increased in PLE group by respectively 45%, 11% and 44%, in comparison with SO group. Intestinal and hepatic Hydroxy Methyl Glutaryl Coenzyme A reductase activities were not increased by PLE diet. Triacylglycerol hepatic content was lower in PLE group than in L or SO groups. Compared with triacylglycerol enriched diet, phosphatidylcholine enriched diet developed significant higher cholesterol- and triacylglycerol-lowering effects by a two-step mechanism: i) by reducing the beta-VLDLs, ii) by enhancing the secretion of bile cholesterol. Such results constitute promising effects of soybean phosphatidylcholine at the hepato-biliary level, in the treatment or prevention of hyperlipidemia and related atherosclerosis.
Soy lecithin reduces plasma lipoprotein cholesterol and early atherogenesis in hypercholesterolemic monkeys and hamsters: beyond linoleate.
Wilson TA, Meservey CM, Nicolosi RJ Center for Chronic Disease Control, Department of Health and Clinical Science, University of Massachusetts Lowell, 01854, USA. Atherosclerosis 1998 Sep;140(1):147-53
The current study was designed to investigate the hypocholesterolemic and anti-atherogenic properties of soy lecithin beyond its fatty acid content. In experiment 1, 18 cynomolgus monkeys were divided into three groups of six and fed diets which approximated either the average American diet (AAD), the American Heart Association (AHA) Step I diet, or a modified AHA (mAHA) Step I diet containing 3.4% soy lecithin for 8 weeks. Plasma samples were collected from food-deprived monkeys and analyzed for total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), very low- and low-density lipoprotein cholesterol (non-HDL-C), and triglyceride (TG) concentrations. Group comparisons revealed that monkeys fed the mAHA Step 1 diet had significantly lower plasma TC (-46%) and non-HDL-C (-55%) levels compared to the AAD diet, whereas monkeys fed the AHA Step 1 diet had lesser reductions in plasma TC (-21%) and non-HDL-C (-18%) levels. The monkeys fed the mAHA Step I diet had significantly lower plasma TC (-32%) and non-HDL-C (-45%) compared to the monkeys fed the AHA step diet. Also, only the mAHA Step I diet significantly reduced pre-treatment plasma TC and non-HDL-C levels by - 39 and -51% respectively with no significant effect on plasma HDL-C or TG levels. In experiment 2, 45 hamsters were divided into three groups of 15 and fed the following three modified non-purified diets for 8 weeks: a hypercholesterolemic diet (HCD) containing 10%, coconut oil and 0.05%, cholesterol, HCD plus 3.4%, soy lecithin (+SL), or the HCD with added levels of linoleate and choline equivalent to the +SL diet but no lecithin (-SL). Plasma lipids were determined as in experiment 1 and aortas were perfusion-fixed and Oil Red O stained for morphometric analyses of fatty streak area. Relative to the HCD group, the +SL-treated hamsters had significantly lower plasma TC (-58%), non-HDL-C (-73%) and aortic fatty streak area (-90%). Relative to the -SL group, hamsters fed the +SL diet had significantly lower plasma TC (-33%), non-HDL-C (-50%) and significantly reduced aortic fatty streak area (-79%). In conclusion, the first experiment suggests that the cholesterol-lowering efficacy of the AHA Step I diet can be enhanced with the addition of soy lecithin without reducing plasma HDL-C levels. whereas the second experiment suggest that the hypocholesterolemic, and in particular, the anti-atherogenic properties of soy lecithin cannot be attributed solely to its linoleate content.
Treatment of hypercholesterolaemia with oral lecithin.
Simons LA, Hickie JB, Ruys J Aust N Z J Med 1977 Jun;7(3):262-6
An open clinical trial was performed to evaluate the plasma cholesterol-lowering potential of oral lecithin in large doses (20--30 g/day), with or without supplementary clofibrate. Three healthy subjects and seven patients with hypercholesterolaemia were studied over periods ranging from eight weeks to 11 months. In one-third of healthy subjects and in 3/7 patients, lecithin therapy led to a significant fall in plasma cholesterol concentration (10--18% fall). Combination of lecithin and clofibrate in two of the patients led to still lower plasma cholesterol levels (21 and 22% fall). Most of the change in plasma cholesterol concentration, when it occurred, was due to a reduction in beta lipoproteins. Evidence is presented that oral lecithin may reduce plasma cholesterol levels by acting as a source of linoleic acid.
Polyunsaturated lecithin prevents acetaldehyde-mediated hepatic collagen accumulation by stimulating collagenase activity in cultured lipocytes.
Li J, Kim CI, Leo MA, Mak KM, Rojkind M, Lieber CS Alcohol Research and Treatment Center, Bronx Veterans Affairs Medical Center, New York. Hepatology 1992 Mar;15(3):373-81 Published erratum appears in Hepatology 1993 Jan;17(1):174
We recently found that polyunsaturated lecithin prevents ethanol from causing cirrhosis in the baboon. Because transformation of lipocytes to transitional cells plays a key role in hepatic fibrogenesis in vivo, and because this process in alcohol-fed baboons was found to be attenuated by polyunsaturated lecithin, we focused on lipocytes to study the mechanism of the protective effect. Rat lipocytes cultured on plastic undergo spontaneous activation, accompanied by expression of alpha-smooth muscle actin isoform and production of substantial amounts of type I collagen. The latter was further increased on incubation with acetaldehyde. This in vitro model was used here to study how acetaldehyde-mediated collagen production and accumulation can be turned off. Addition of polyunsaturated lecithin (10 mumols/L) was found to prevent the acetaldehyde-induced increase in collagen accumulation by 83% (p less than 0.001). By contrast, a saturated phospholipid (10 mumols/L dilauroyl phosphatidylcholine), a monounsaturated one (10 mumols/L linoleoyl-palmitoyl phosphatidylcholine) or linoleic acid (20 mumols/L bound to albumin) had no such effect. Incorporation of [3H]proline into collagen and the expression of alpha-1 (I) procollagen mRNA were increased by acetaldehyde; the latter was not significantly affected by polyunsaturated lecithin. Polyunsaturated lecithin increased lipocyte collagenase activity by 100% (p less than 0.001), whereas dilauroyl phosphatidylcholine, linoleoyl-palmitoyl phosphatidylcholine and linoleic acid had no such action. We concluded that (a) polyunsaturated lecithin selectively prevents the acetaldehyde-induced increase in collagen accumulation in lipocyte cultures, whereas other phospholipids or linoleate have no such effect; and (b) polyunsaturated lecithin does not modify the acetaldehyde-mediated increase in alpha-1 (I) procollagen mRNA, but it increases collagenase activity, suggesting that the protective effect exerted by polyunsaturated lecithin against alcohol induced fibrosis in vivo is due at least in part to stimulation of collagenase activity, which may prevent excess collagen accumulation by offsetting increased collagen production.