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N-acetylcysteine protects transplanted livers
February 27, 2013. The February, 2013 issue of the journal Liver Transplantation reports the finding of researchers in Padua, Italy of a benefit for the amino acid N-acetylcysteine (NAC) in transplanted livers. The organs undergo damage following restoration of blood flow after transplantation, which affects their viability in transplant recipients.
"Liver transplantation is the standard treatment for end-stage liver disease," lead author Francesco D'Amico of Padova University noted. "Antioxidants such as NAC could potentially reduce damage to deceased donor livers, improving graft function."
Acting on the results of studies of animal livers which determined a benefit for NAC in reducing injury following blood flow restoration, Dr D’Amico’s team tested the effect of NAC in human livers. Sixty-nine non-living donors were infused with a solution containing NAC one hour prior to liver removal and transplant. Seventy-one patients who received standard liver transplants served as controls.
At three months, participants who received NAC-infused livers had graft survival rates of 93 percent in comparison with 82 percent of the control group. The complication rate among those whose livers were treated with NAC was less than half that of the controls. At one year, organ failure had occurred in 10 percent of the treatment group and 30 percent of the control subjects. In a separate analysis of patients who received suboptimal liver tissue, liver dysfunction occurred in 15 percent of the NAC group in comparison with 32 percent of the controls.
"Our study was the first randomized trial to investigate the use of NAC antioxidant infusion during the liver procurement procedure,” Dr D’Amico announced. “We propose that NAC be used during organ harvesting to improve liver transplantation outcomes, particularly with the increased use of suboptimal organs. NAC has a good safety profile and the very low cost per patient, make this protocol highly cost-effective in consideration of grafts survival, length of hospital stays and post operative complications. Moreover we are performing further analyses to determine beneficial effects on the other organ procured with NAC protocol."
Researchers explore anti-inflammatory action of aspirin
February 25, 2013. The February 21, 2013 issue of the journal Chemistry & Biology reports the finding of Harvard and University of Southern California researchers of a mechanism for the omega-3 fatty acid docosahexaenoic acid (DHA) and aspirin in combating inflammation.
Dr Charles Serhan of Brigham and Women's Hospital and Harvard Medical School and his associates describe the action of resolvins, which are members of a family of omega-3 lipid mediators that are involved in the resolution of inflammation. Failure to return to homeostasis after the initiation of inflammation causes tissue damage that contributes to a number of conditions, including cardiovascular disease and arthritis.
"In this report, we found that one resolvin, termed resolvin D3 from the omega-3 fatty acid DHA, persists longer at sites of inflammation than either resolvin D1 or resolvin D2 in the natural resolution of inflammation in mice," Dr Serhan stated. "This finding suggests that this late resolution phase resolvin D3 might display unique properties in fighting uncontrolled inflammation."
"Aspirin is able to modify an inflammatory enzyme to stop forming molecules that propagate inflammation and instead produce molecules from omega-3 fatty acids, like resolvin D3, that help inflammation to end,” coauthor Nicos Petasis of the University of Southern California reported. "We were able to produce by chemical synthesis both resolvin D3 and aspirin-triggered resolvin D3 in pure form, which allowed us to establish their complete structures and biological activities.”
The current research revealed a strong anti-inflammatory reflect for these resolvins when administered to mice and human cells. "We also identified the human receptor that is activated by resolvin D3, which is critical in understanding how resolvin D3 works in the body to resolve inflammation," Dr Serhan added. "With this new information, investigators will now also be able to study the pro-resolving and anti-inflammatory actions of resolvin D3 in other systems."
Resveratrol may help protect against hearing loss
February 22, 2013. In an article published online on February 4, 2013 in Otolaryngology—Head and Neck Surgery, Michael D. Seidman of Henry Ford Hospital in Detroit and his associates report that resveratrol, a compound that occurs in grapes, could help protect against hearing loss. "Our latest study focuses on resveratrol and its effect on bioinflammation, the body's response to injury and something that is believed to be the cause of many health problems including Alzheimer's disease, cancer, aging and hearing loss," Dr Seidman stated.
In the current study, 10 rats were exposed to acoustic trauma and their cochleae (inner ear structures) were examined for the expression of cyclooxygenase-2 (COX-2, a protein involved in inflammation and reactive oxygen species formation) at several time points during a 24-hour period. The researchers observed a rise in COX-2 protein expression following noise exposure, which increased over 24 hours. In an additional experiment that examined the cochleae of 20 rats at time points of up to 48 hours after a 24-hour period of noise exposure, a similar increase in COX-2 expression was observed, which began to decline eight hours after exposure.
In another experiment, eight rats were exposed to 24 hours of noise after pretreatment with resveratrol or a saline solution. Four rats that received no noise exposure served as controls. Cochleae were examined after noise exposure and COX-2 levels measured. Animals treated with resveratrol had an increase in COX-2 that was 7.3 times higher than that of the control group, in comparison with those treated with saline whose levels were 13.6 times higher.
"Resveratrol is a very powerful chemical that seems to protect against the body's inflammatory process as it relates to aging, cognition and hearing loss," said Dr Seidman.
Omega-3 emulsion reduces stroke damage
February 20, 2013. On February 20, 2013 in the journal PLOS One, Columbia University researchers report a benefit for omega-3 fatty acid-rich triglyceride lipid emulsions in an experimental model of ischemic stroke.
Richard J. Deckelbaum and his associates induced stroke in ten-day old mice and exposed them to a low oxygen environment for 15 minutes. Groups of animals were intraperitoneally injected with triglyceride emulsions containing the omega-3 fatty acids EPA, DHA or both omega-3 acids; omega-6-rich triglyceride emulsions or saline before and/or after brain injury was induced. Twenty-four hours subsequent to blood flow restoration, the animals’ brains were examined for damage.
Treatment with EPA and DHA prior to brain injury reduced total infarct volume by an average of 43 percent, and by 47 percent when the fatty acids were given afterward. A triglyceride emulsion enriched with DHA alone was found to reduce infarct volume by 51 percent when administered immediately after injury as well as when given two hours later. Examination of brain tissue from mice that received DHA revealed that the benefit was maintained after eight weeks.
"Since mice have a much faster metabolism than humans, longer windows of time for therapeutic effect after stroke are likely in humans," Dr Deckelbaum commented.
“A number of pathways are likely involved in omega-3 triglyceride neuroprotection,” the authors write. “For example, chronic administration of DHA resulted in increases of DHA levels in brain mitochondria.”
They add that DHA could help inhibit programmed cell death and improve the mitochondria’s ability to handle excessive intracellular calcium resulting from ischemia. "In most clinical trials in the past, the compounds tested affected only one pathway,” Dr Deckelbaum noted. “Omega-3 fatty acids, in contrast, are very bioactive molecules that target multiple mechanisms involved in brain death after stroke."
Reduced vitamin D levels found in Parkinson’s and Alzheimer’s diseases
February 18, 2013. The journal Nutrition published the results of a meta-analysis on February 13, 2013 that confirmed an association between reduced serum vitamin D levels and an increased risk of Alzheimer’s and Parkinson’s disease. The two neurodegenerative diseases are common cause of disability among the elderly, and their prevalence is expected to increase with the greater proportion of aging individuals in western societies.
Researchers at Shandong University of Technology in China selected six studies that included a total of 892 men and women for their analysis of Alzheimer’s disease and five studies including 3,915 subjects for their Parkinson’s disease analysis. Among Alzheimer’s disease cases, 25-hydroxyvitamin D [25(OH)D] levels were lower than those of the control patients in all but one study, resulting in a significantly lower risk of the disease in the subjects included in the analysis. For Parkinson’s disease patients, vitamin D levels were lower in all studies in comparison with controls, leading to a similar risk reduction as that determined in the Alzheimer’s disease analysis.
Possible mechanisms suggested by the authors to account for the findings include reduced sunlight exposure among Alzheimer’s and Parkinson’s disease patients, a greater prevalence of diseases associated with insufficient vitamin D levels that are risk factors or precursors of dementia, a reduction in vitamin D-associated immune system function needed to clear amyloid-beta and lewy bodies that play a role in the diseases, and a decrease in brain development factors dependent upon vitamin D and its receptor.
“In summary, the results of our meta-analysis indicate lower levels of 25(OH)D in patients with Alzheimer’s disease and Parkinson’s disease than in healthy controls,” the authors write. “We encourage further studies to determine the mechanisms underlying this association. In view of the clinical profile of vitamin D, it might be interesting to examine whether vitamin D supplements can lower the risk for Alzheimer’s disease or Parkinson’s disease.”
Vitamin C may help reduce common cold severity and duration
February 15, 2013. The Cochrane Library published the results of a meta-analysis on January 31, 2013 that concludes a benefit for vitamin C in treating the common cold.
Dr Harri Hemilä and Elizabeth Chalker selected 29 placebo-controlled trials that examined the effect of vitamin C on cold incidence among a total of 11,306 participants and 31 trials that evaluated the effect of regular vitamin C intake on the duration of a total of 9,745 colds. Trials included in the meta-analysis were restricted to those that administered 200 milligrams vitamin C per day or more. Although the trials that tested the effect of vitamin C against the development of colds failed to find a significant protective effect for the vitamin, among participants in five trials that included a total of 598 skiers, runners and military personnel engaged in subarctic exercises, the risk of developing a cold among those who received the vitamin was less than half that of unsupplemented participants.
When the researchers evaluated cold duration, regular supplementation modestly shortened the length of time that sufferers experienced symptoms. For children, duration was reduced by an average of 14 percent, and for adults, by an average of 8 percent. Among trials that included severity criteria, a reduction in cold severity was observed in association with vitamin C in comparison with placebo.
Although the authors recommend caution concerning generalization of the need for vitamin C supplementation on the basis of the current findings, they write, "Nevertheless, given the consistent effect of vitamin C on common cold duration and severity in the regular supplementation studies, and the low cost and safety, it may be worthwhile for common cold patients to test on an individual basis whether therapeutic vitamin C is beneficial for them."
High omega-3 levels show protective effect against sudden cardiac death among dialysis patients
February 13, 2013. In an article that appeared online on February 6, 2013 in the journal Kidney International, researchers from Indiana University School of Medicine in collaboration with scientists from Massachusetts General Hospital report an association between higher levels of long-chain omega-3 fatty acids in early kidney dialysis patients and a reduced risk of sudden cardiac death, the leading cause of mortality in this group.
Allon N. Friedman, MD and his colleagues compared omega-3 blood levels of 100 patients who underwent sudden cardiac death within the first year of dialysis to levels measured among 300 survivors. A declining risk of death was observed in association with increasing levels of omega-3 fatty acids, with those whose levels were among the top 25 percent of subjects having an 80 percent lower risk than those whose levels were lowest.
"We found that higher levels of omega-3 fatty acids in the blood of patients who were just starting hemodialysis were very strongly associated with a lower risk of sudden cardiac death over the first year of their treatment," stated Dr Friedman, who is an associate professor of medicine at the Indiana University School of Medicine’s Division of Nephrology.
"The risk of sudden cardiac death in hemodialysis patients is highest during the first year of treatment,” he noted. “The annual rate of sudden cardiac death is about 6 to 7 percent, which may even exceed the rate in patients with heart failure. This study is a first step toward identifying a possible treatment for sudden cardiac death in dialysis patients.”
"Because omega-3 fatty acids can be obtained from certain foods, such as fish oil, our findings also have important implications for the type of diet we recommend to patients on dialysis," he added.
Fruit and vegetables suggested as alternative to medication to prevent metabolic acidosis
February 11, 2013. An article published online on February 7, 2013 in the Clinical Journal of the American Society of Nephrology reveals that increasing the intake of fruit and vegetables may be just as effective as an alkalinizing medication to prevent metabolic acidosis and kidney damage in those with late-stage chronic kidney disease. Metabolic acidosis is a common occurrence in kidney disease and is caused by a failure of under-functioning kidneys to excrete excess acid from the blood. The condition can result in a number of adverse effects and has been associated with premature mortality.
While high protein foods, including meat and grain products are acidic, fruit and vegetables tend to be alkalinizing. Metabolic acidosis is currently prevented in most kidney disease patients by oral alkali supplementation therapies such as bicarbonate.
For the current study, Donald E. Wesson MD of Texas A&M College of Medicine and his associates randomized 71 stage 4 kidney disease patients to daily sodium bicarbonate for one year or an amount of fruit and vegetables per day calculated to reduce dietary acid by 50 percent. Plasma total carbon dioxide levels increased in both groups after a year, indicating a reduction in metabolic acidosis. A greater increase occurred in the bicarbonate-treated group. Kidney injury indicators were lower, and kidney function was similar in both groups at the end of the treatment period.
"We showed that by addition of alkali such as bicarbonate or alkali-inducing fruits and vegetables, patients had a favorable response by reduction of urinary kidney injury markers," Dr Wesson commented.
"A small group of highly motivated patients wishing to reduce their pill burden through dietary modification may benefit from the results of this study,” noted Muhammad Yaqoob, MD in an accompanying editorial. “However, many patients find it difficult to follow a diet high in fruits and vegetables and might therefore be more adherent to a supplement."
Experiments show Alzheimer's plaques reduced by vitamin D and DHA
February 08, 2013. The February 5, 2013 issue of the Journal of Alzheimer's Disease published the finding of researchers at the University of California, Los Angeles that active forms of vitamin D3 and docosahexaenoic acid (DHA) improve the ability of immune cells known as macrophages to clear amyloid-beta, a toxic protein that occurs in elevated amounts in the brains of Alzheimer’s disease patients. Milan Fiala and his colleagues “suggest that low vitamin D3 and docosahexaenoic acid intake and/or poor anabolic production of 1,25D3/resolvin D1 in peripheral blood mononuclear cells could contribute to Alzheimer’s disease onset/pathology.”
The team isolated macrophages from the blood of individuals with Alzheimer’s disease and healthy control subjects and incubated them with amyloid-beta prior to administering 1alpha, 25-dihroxyvitamin D3 (1,25D3) or resolvin D1, an active form of DHA. While both nutrients increased the macrophages’ ability to remove amyloid-beta and decrease amyloid-beta-induced cell death, they did so by utilizing different receptors.
The authors observe that macrophages from Alzheimer’s disease patients express inflammatory genes in different ways than the controls and that transcription of specific inflammatory genes is increased or decreased in these patients. "Further study may help us identify if these two distinct transcription patterns of inflammatory genes could possibly distinguish either two stages or two types of Alzheimer's disease," remarked coauthor Mathew Mizwicki.
"Our new study sheds further light on a possible role for nutritional substances such as vitamin D3 and omega-3 in boosting immunity to help fight Alzheimer's," Dr Fiala stated. "We may find that we need to carefully balance the supplementation with vitamin D3 and omega-3 fatty acids, depending on each patient in order to help promote efficient clearing of amyloid-beta. This is a first step in understanding what form and in which patients these nutrition substances might work best."
High vitamin D levels protective against development of type 1 diabetes in adulthood
February 06, 2013. The American Journal of Epidemiology published an article online on February 3, 2013 that revealed a protective effect for higher levels of vitamin D against the risk of type 1 diabetes in young adults. Type 1 diabetes is an autoimmune disease that was formerly called juvenile onset diabetes; however, approximately 60 percent of diagnoses occur in men and women older than the age of 20 years.
Kassandra L. Munger of Harvard School of Public Health and her colleagues compared 310 U.S. active duty personnel diagnosed with type 1 diabetes between 1997 and 2009 to 613 control subjects matched for age, gender and other factors. Serum samples from the Department of Defense Serum Repository collected before diagnosis were analyzed for 25-hydroxyvitamin D concentrations.
Over an average follow-up period of 5.4 years, a 25-hydroxyvitamin D level of at least 100 nanomoles per liter (nmol/L) among non-Hispanic Caucasians was associated with a 44 percent lower risk of developing type 1 diabetes in comparison with the risk experienced by those whose levels were less than 75 nmol/L. The incidence of type 1 diabetes was greatest among those whose vitamin D levels were among the lowest one-fifth of participants. "The risk of type 1 diabetes appears to be increased even at vitamin D levels that are commonly regarded as normal, suggesting that a substantial proportion of the population could benefit from increased vitamin D intake," observed senior author Alberto Ascherio, who is a professor of epidemiology and nutrition at Harvard School of Public Health.
"It is surprising that a serious disease such as type 1 diabetes could perhaps be prevented by a simple and safe intervention," Dr Munger remarked.
The authors concluded that "Whereas it is premature to recommend universal use of vitamin D supplements for prevention of type 1 diabetes, the possibility that many cases could be prevented by supplementation with 1,000-4,000 IU/day, which is largely considered safe, is enticing."
Researchers suggest reduced vitamin D levels have a role in influenza outbreaks
February 04, 2013. The December, 2010 issue of the International Journal of Infectious Diseases published an article by Norwegian researchers which discusses the evidence in favor of a major role for diminished vitamin D levels in flu season.
Asta Juzeniene of Oslo University Hospital’s Institute for Cancer Research and colleagues examined weekly and monthly incidence and death rates for pandemic and nonpandemic influenza in Sweden, Norway, the United States, Japan and Singapore. They observed that nonpandemic influenzas occur primarily in temperate regions and in winter when the skin’s vitamin D formation due to sun exposure is low, and that influenza seasonality is seldom observed in tropical regions. Although an initial pandemic can start in any season, secondary waves often occur in autumn or winter, and can be more serious. The increased lethality of secondary winter waves can also be explained by decreased vitamin D levels.
The authors note vitamin D levels are at their highest approximately one month after the season during which the vitamin’s rate of synthesis is greatest, which is near midsummer. At latitudes above 37 degrees, UVB exposure is greatly reduced from November through February, meaning that vitamin D production in the skin is minimal. Because of the role vitamin D plays in the immune system, a reduction in this important compound is associated with a decline in immune function, leading to decreased resistance against influenza and other pathogens.
“Non-pandemic influenzas usually arrive in winter/early spring, while the initial wave of pandemic influenzas may occur in any season, but with secondary waves in midwinter,” the authors write. “Seasonal waves of all influenzas are small at low latitudes. It seems likely that seasonal variations in the incidence and death rates of both pandemic and non-pandemic influenza are related to seasonal variations in vitamin D status.”
Beta-glucan reduces the incidence of colds
February 01, 2013. The February, 2013 issue of the European Journal of Nutrition published the results of a clinical trial conducted in Germany which found a protective effect for beta-glucan derived from brewers' yeast against the risk of acquiring the common cold, as well as a reduction in cold severity.
One hundred sixty-two healthy men and women with recurring colds were randomized to receive 900 milligrams (1,3)-(1,6)-beta-glucan or a placebo daily for 16 weeks. Participants were instructed to document common cold episodes and rate their symptoms, which included headache, joint pain, sore throat, feeling of lump in the throat and/or difficulty swallowing, hoarseness, cough, runny nose, nasal congestion, cold-related sleeping difficulties and fever. The subjects underwent examinations by a study investigator on the fifth day of each illness.
At the end of the trial, those who received beta-glucan had 25 percent fewer colds than the placebo group. Cold symptom scores were 15 percent lower on average, and cold-related sleep difficulties were significantly reduced by beta-glucan.
“The present placebo-controlled, randomized, double-blind intervention study provides clinical evidence that supplementation with yeast (1,3)-(1,6)-beta-glucan helps to reduce the occurrence of symptomatic common cold infections by 25% as compared to placebo,” Annegret Auinger and colleagues write. “This is in line with a recently published trial demonstrating the prophylactic effect of the same yeast (1,3)-(1,6)-beta-glucan preparation on the incidence and severity of common cold infections. Thus, since the susceptibility to get a common cold is closely related to the body’s immune status, both studies independently suggest the potential of yeast (1,3)-(1,6)-beta-glucan to stimulate the host immune system in order to provide defense against common cold viral attacks.”
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