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Cheng XR, Zhao ZW, Chen YY, Song J, Ma JH, Zhang CX, Amadou I, Lu NY, Tang X, Guan B. Interventional Effect of Donkey Bone Collagen Peptide Iron Chelate on Cyclophosphamide Induced Immunosuppressive Mice. Nutrients 2024; 16:2413. [PMID: 39125294 PMCID: PMC11314553 DOI: 10.3390/nu16152413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/08/2024] [Accepted: 07/20/2024] [Indexed: 08/12/2024] Open
Abstract
Immunodeficiency can disrupt normal physiological activity and function. In this study, donkey bone collagen peptide (DP) and its iron chelate (DPI) were evaluated their potential as immunomodulators in cyclophosphamide (Cytoxan®, CTX)-induced Balb/c mice. The femoral tissue, lymphocytes, and serum from groups of mice were subjected to hematoxylin and eosin (H&E) staining, methylthiazolyldiphenyl-tetrazolium bromide (MTT) cell proliferation assays, and enzyme-linked immunosorbent assay (ELISA), respectively. Furthermore, a non-targeted metabolomics analysis based on UPLC-MS/MS and a reverse transcription polymerase chain reaction (RT-qPCR) technology were used to explore the specific metabolic pathways of DPI regulating immunocompromise. The results showed that CTX was able to significantly reduce the proliferative activity of mouse splenic lymphocytes and led to abnormal cytokine expression. After DP and DPI interventions, bone marrow tissue damage was significantly improved. In particular, DPI showed the ability to regulate the levels of immune factors more effectively than Fe2+ and DP. Furthermore, metabolomic analysis in both positive and negative ion modes showed that DPI and DP jointly regulated the levels of 20 plasma differential metabolites, while DPI and Fe2+ jointly regulated 14, and all 3 jointly regulated 10. Fe2+ and DP regulated energy metabolism and pyrimidine metabolism pathways, respectively. In contrast, DPI mainly modulated the purine salvage pathway and the JAK/STAT signaling pathway, which are the key to immune function. Therefore, DPI shows more effective immune regulation than Fe2+ and DP alone, and has good application potential in improving immunosuppression.
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Affiliation(s)
- Xiang-Rong Cheng
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
| | - Zi-Wei Zhao
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
| | - Yu-Yao Chen
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
| | - Jie Song
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
| | - Jia-Hui Ma
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
| | - Chen-Xi Zhang
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
| | - Issoufou Amadou
- Faculty of Agriculture and Environment Sciences, Dan Dicko Dankoulodo University of Maradi, Maradi BP 465, Niger
| | - Nai-Yan Lu
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
| | - Xue Tang
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
| | - Bin Guan
- Department of Pharmacy, Affiliated Wuxi Fifth Hospital of Jiangnan University, Wuxi 214011, China
- Department of Pharmacy, The Fifth People’s Hospital of Wuxi, Wuxi 214011, China
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Lešić S, Ivanišević Z, Špiljak B, Tomas M, Šoštarić M, Včev A. The Impact of Vitamin Deficiencies on Oral Manifestations in Children. Dent J (Basel) 2024; 12:109. [PMID: 38668021 PMCID: PMC11049216 DOI: 10.3390/dj12040109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/29/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Vitamins play a vital role in human health, particularly in the development and maintenance of oral health in children. These nutrients are broadly categorized into fat-soluble and water-soluble types, crucial for children's well-being. The objective of this study is to investigate the impact of vitamin deficiencies on the oral health of children, focusing on how these deficiencies contribute to various oral health issues and determining the relationship between specific vitamin shortages and oral diseases. Findings indicate that shortages in vitamins A and D lead to enamel issues and a higher susceptibility to dental diseases, vitamin E assists in treating oral mucositis, and vitamin K is essential for blood clotting in dental surgeries. Deficits in B-complex and vitamin C result in enamel hypomineralization and soft tissue ailments, including aphthous stomatitis and gingival petechiae. Additionally, a lack of vitamin B7 compromises the immune response, increasing oral candidiasis risk. Therefore, vitamin deficiencies markedly affect children's oral health, highlighting the need for joint efforts between dental professionals and caregivers for effective pediatric care. Addressing vitamin deficiencies through supplementation and tailored dental care emphasizes the significance of nutritional health in children's overall and dental well-being, advocating for a collaborative approach to achieve optimal health outcomes.
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Affiliation(s)
- Stjepanka Lešić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia; (S.L.); (Z.I.)
| | - Zrinka Ivanišević
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia; (S.L.); (Z.I.)
| | - Bruno Špiljak
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia; (S.L.); (Z.I.)
| | - Magdalena Šoštarić
- Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Aleksandar Včev
- Department of Pathophysiology, Physiology and Immunology, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia;
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Cozer AWD, Souza FCV, Santiago LD, Lima MR, Pimenta SJ, Fernandes BL, Enes BN, Gama RS, Gomides TAR. Effects of Iron-Fortified Foods on the Nutritional Status of Children Residing in Regions Vulnerable to Parasitic Diseases: A Systematic Review. Prev Nutr Food Sci 2024; 29:8-17. [PMID: 38576884 PMCID: PMC10987379 DOI: 10.3746/pnf.2024.29.1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/09/2024] [Accepted: 02/22/2024] [Indexed: 04/06/2024] Open
Abstract
Parasitic infections (PIs) remain a public health concern among school-age children living in areas of greater socioeconomic vulnerability, especially in Brazil, Russia, India, China, and South Africa. PIs can promote nutritional deficiencies, increasing the risk of anemia and impaired physical and cognitive development. Thus, fortified foods have been considered as a promising strategy for improving the nutritional status of children and preventing PI complications. This systematic review aimed to present the effects of iron-fortified foods for deworming and improving blood parameters in schoolchildren residing in areas that are vulnerable to PIs. This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of randomized clinical trials addressing the use of fortified foods and micronutrients in children living in areas endemic for PIs. The PubMed, LILACS, Scopus, and Cochrane databases were searched to identify articles published between 2000 and 2020. A total of 153 records were retrieved from the databases, 10 of which were considered eligible for this study. On the basis of our analysis, most of the selected studies showed that the inclusion of fortified foods in the diet improved blood and infectious parameters. Therefore, fortified foods can be used as an important tool for controlling the adverse outcomes of PIs among children living in areas of greater vulnerability. However, more studies on this topic are needed to provide more evidence and consolidate strategies using iron-fortified food.
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Affiliation(s)
| | | | | | - Marlucy Rodrigues Lima
- Department of Pharmacy, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
| | - Sabrina Julie Pimenta
- Department of Dentistry, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
| | - Bárbara Leles Fernandes
- Department of Pharmacy, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
| | - Barbara Nery Enes
- Department of Nutrition, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
| | - Rafael Silva Gama
- Department of Pharmacy, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
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Li Y, Li LX, Cui H, Xu WX, Fu HY, Li JZ, Fan RF. Dietary Iron Overload Triggers Hepatic Metabolic Disorders and Inflammation in Laying Hen. Biol Trace Elem Res 2024:10.1007/s12011-024-04149-w. [PMID: 38502261 DOI: 10.1007/s12011-024-04149-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024]
Abstract
Iron, an essential trace element, is involved in various physiological processes; however, consumption of excessive iron possesses detrimental effects. In practical feed production, the iron content added to feeds often far exceeds the actual demand, resulting in an excess of iron in the body. The liver as a central regulator of iron homeostasis is susceptible to damage caused by disorders in iron metabolism. A model of hepatic iron overload in laying hens was developed in this study by incorporating iron into their diet, and the specific mechanisms underlying iron overload-induced hepatic injury were investigated. Firstly, this study revealed that a high-iron diet resulted in hepatic iron overload, accompanied by impaired liver function. Next, assessment of oxidative stress markers indicated a decrease in activities of T-SOD and CAT, coupled with an increase in MDA content, pointing to the iron-overloaded liver oxidative stress. Thirdly, the impact of iron overload on hepatic glycolipid and bile acid metabolism-related gene expressions were explored, including PPAR-α, GLUT2, and CYP7A1, highlighting disruptions in hepatic metabolism. Subsequently, analyses of inflammation-related genes such as iNOS and IL-1β at both protein and mRNA levels demonstrated the presence of inflammation in the liver under conditions of dietary iron overload. Overall, this study provided comprehensive evidence that dietary iron overload contributed to disorders in glycolipid and bile acid metabolism, accompanied by inflammatory responses in laying hens. Further detailing the specific pathways involved and the implications of these findings could offer valuable insights for future research and practical applications in poultry nutrition.
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Affiliation(s)
- Yue Li
- College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Engineering Technology Research Center of Animal Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
| | - Lan-Xin Li
- College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Engineering Technology Research Center of Animal Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
| | - Han Cui
- College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Engineering Technology Research Center of Animal Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
| | - Wan-Xue Xu
- College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Engineering Technology Research Center of Animal Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
| | - Hong-Yu Fu
- College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Engineering Technology Research Center of Animal Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
| | - Jiu-Zhi Li
- College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
- Shandong Provincial Engineering Technology Research Center of Animal Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China
| | - Rui-Feng Fan
- College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China.
- Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China.
- Shandong Provincial Engineering Technology Research Center of Animal Disease Control and Prevention, Shandong Agricultural University, 61 Daizong StreetShandong Province, Tai'an City, 271018, China.
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Syarif AL, Ansariadi A, Wahiduddin W, Wijaya E, Amiruddin R, Citrakesumasari C, Ishak H. Awareness and practices in preventing maternal iron deficiency among pregnant women living in urban slum areas in Makassar City, Indonesia. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:452. [PMID: 38464632 PMCID: PMC10920762 DOI: 10.4103/jehp.jehp_551_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/07/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND During pregnancy, the body requires more complex nutritional intake. Therefore, problems with fulfilling nutrition during pregnancy occur often. One of the most common nutritional problems in pregnancy is iron deficiency anemia, the most widespread micronutrient problem and the most difficult to overcome worldwide. This study aimed to determine awareness and prevention behavior associated with the incidence of iron deficiency in pregnant women living in urban slum areas. MATERIALS AND METHODS This was a cross-sectional study. The data collection used KoboToolbox, an Android-based tool. Iron status was examined by serum ferritin level assay using ELISA at the Microbiology Laboratory Unit of Hasanuddin University Hospital. RESULTS The prevalence of pregnant women who experienced iron deficiency was 78%. The logistic regression analysis showed that poor awareness (AOR = 3.03, CI 95% 1.26-7.29, P = 0.013) and practices in taking iron enhancers (AOR = 2.85, CI 95% 1.18-6.92, P = 0.020) became the main factors associated with iron deficiency among pregnant women. CONCLUSIONS Poor awareness and practices regarding consuming iron enhancers increased the risk of iron deficiency among pregnant women living in urban slum areas. Iron deficiency is a major health concern for pregnant women, especially those living in slum settlements, which must be addressed. A more optimal healthcare system for pregnant women may reduce the incidence of iron anemia in pregnancy by improving health promotion and optimizing healthcare services.
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Affiliation(s)
- Aidah Luthfiah Syarif
- Master Program in Public Health, Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Indonesia
| | - Ansariadi Ansariadi
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Indonesia
| | - Wahiduddin Wahiduddin
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Indonesia
| | - Eri Wijaya
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Indonesia
| | - Ridwan Amiruddin
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Indonesia
| | | | - Hasanuddin Ishak
- Department of Environmental Health, Faculty of Public Health, Hasanuddin University, Indonesia
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Shi C, Cheng C, Lin X, Qian Y, Du Y, Chen G. Flammulina velutipes polysaccharide-iron(III) complex used to treat iron deficiency anemia after being absorbed via GLUT2 and SGLT1 transporters. FOOD SCIENCE AND HUMAN WELLNESS 2023. [DOI: 10.1016/j.fshw.2023.02.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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Naz N, Khan MR, Shabbir MA, Faisal MN. Effect of iron-fortified jamun leather on the Asunra-induced anemia in Sprague Dawley rats. Front Nutr 2023; 10:1195981. [PMID: 37384107 PMCID: PMC10293738 DOI: 10.3389/fnut.2023.1195981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/25/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction Micronutrients such as minerals and vitamins are required in a minute quantity but play a pivotal role in the functioning of the body. Therefore, deficiency in one of them can lead to lethal health conditions. Iron deficiency anaemia is one of the most common micronutrient deficiencies across the world and is affecting women and children. Methods The present study aimed to investigate the anti-anaemic effect of fortified jamun leather on anaemia biomarkers and haematology in anaemic female Sprague Dawley rats. A total of 40 Sprague Dawley rats were used in 4 groups. Iron deficiency anaemia was induced by oral administration of the Asunra drug. The treatments were fed at two dosage levels i.e., 40 and 60% iron-fortified leather. All animals were treated for 60 days and the parameters including biochemical, and histopathology of the kidney and liver were examined. Results The experiment's findings showed that the group fed with iron-fortified leather (G3) succeeded significantly (P < 0.05) in restoring the serum iron (98.68 ± 2.88 μg/dL), haemoglobin (12.41 ± 0.32 g/dL), ferritin (24.54 ± 1.98 ng/mL) and haematocrit levels (39.30 ± 1.66%) at the end of the 60 days period. Additionally, the treated group's mean values for transferrin and total iron binding capacity were lower than those of the anaemic rats, indicating an improvement in iron levels. The microscopic analysis revealed that treatments had no toxic effects on the kidney and liver tissues, except in the diseased group, which had necrosis and irregular cell structure. Conclusion Conclusively, iron-fortified jamun leather helped improve iron deficiency biomarkers and imparted a non-toxic effect on tissues in rats.
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Affiliation(s)
- Nosheen Naz
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Moazzam Rafiq Khan
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Muhammad Asim Shabbir
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Muhammad Naeem Faisal
- Institute of Pharmacy, Physiology, and Pharmacology, University of Agriculture, Faisalabad, Pakistan
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Hasan Khudhair D, Al-Gareeb AI, Al-kuraishy HM, El-Kadem AH, Elekhnawy E, Negm WA, Saber S, Cavalu S, Tirla A, Alotaibi SS, Batiha GES. Combination of Vitamin C and Curcumin Safeguards Against Methotrexate-Induced Acute Liver Injury in Mice by Synergistic Antioxidant Effects. Front Med (Lausanne) 2022; 9:866343. [PMID: 35492324 PMCID: PMC9047671 DOI: 10.3389/fmed.2022.866343] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/07/2022] [Indexed: 12/21/2022] Open
Abstract
Methotrexate (MTX), an antineoplastic and immunosuppressive drug, widely used in the treatment of different types of cancers and the management of chronic inflammatory diseases. However, its use is associated with hepatotoxicity. Vitamin C (VC) and curcumin (CUR) exhibit anti-inflammatory and antioxidant effects. Thus, we aimed to investigate the potential hepatoprotective effects of VC and CUR pretreatment alone and in combination against MTX-induced hepatotoxicity. Albino mice were randomly divided into 7 groups: the control group, which received only normal saline; MTX group; VC group, pretreated with VC (100 or 200 mg/kg/day orally) for 10 days; CUR group, pretreated with CUR (10 or 20 mg/kg/day orally); and combination group, which received VC (100 mg/kg) and CUR (10 mg/kg). MTX was administered (20 mg/kg, intraperitoneally) to all the groups on the tenth day to induce hepatotoxicity. Forty eight hours after MTX administration, the mice were anesthetized. Blood samples were collected, the liver was removed for biochemical analysis, and a part of the tissue was preserved in formalin for histopathological analysis. The results indicated that pretreatment with a combination of VC and CUR induced a more significant decrease in the serum levels of alanine transaminase, aspartate transaminase, alkaline phosphatase, and lactic dehydrogenase and a significant increase in the tissue level of superoxide dismutase and glutathione; furthermore, it induced a significant decrease in malondialdehyde levels and improvement in histopathological changes in the liver tissues, confirming the potential hepatoprotective effects of the combination therapy on MTX-induced liver injury. To conclude, MTX-induced hepatotoxicity is mediated by induction of oxidative stress as evident by increased lipid peroxidation and reduction of antioxidant enzyme activity. Pretreatment with VC, CUR or their combination reduces the MTX-induced hepatotoxicity by antioxidant and anti-inflammatory effects. However, the combined effect of VC and CUR provided a synergistic hepatoprotective effect that surpasses pretreatment with CUR alone but seems to be similar to that of VC 200 mg/kg/day. Therefore, VC and CUR combination or a large dose of VC could be effective against MTX-induced hepatotoxicity. In this regard, further studies are warranted to confirm the combined hepatoprotective effect of VC and CUR against MTX-induced hepatotoxicity.
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Affiliation(s)
- Dhekra Hasan Khudhair
- Department of Clinical Pharmacology and Medicine, College of Medicine, University of Al-Mustansiriyah, Baghdad, Iraq
| | - Ali I. Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, University of Al-Mustansiriyah, Baghdad, Iraq
| | - Hayder M. Al-kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, University of Al-Mustansiriyah, Baghdad, Iraq
| | - Aya H. El-Kadem
- Department of Pharmacology, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Engy Elekhnawy
- Pharmaceutical Microbiology Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Walaa A. Negm
- Department of Pharmacognosy, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Sameh Saber
- Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, Egypt
| | - Simona Cavalu
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Adrian Tirla
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Saqer S. Alotaibi
- Department of Biotechnology, College of Science, Taif University, Taif, Saudi Arabia
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
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Ghamdi FA, Naqvi S, Alabassi FA, Alhayyani S, Baig MR, Kumar V, Anwar F. Alterations in clinical characteristics of blood donors post COVID-19 recovery. Curr Pharm Des 2022; 28:981-992. [PMID: 35319357 DOI: 10.2174/1381612828666220322123225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/31/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Corona Virus Disease-19 (COVID-19), a current worldwide pandemic is a cuase of concern. Risk-adjusted differences in outcomes of the patients are not well characterized. Susceptibility to infection with respect to blood group, blood pressure, pulse rate, hemoglobin, age and BMI were analyzed. METHODS Blood donors, of all the ages and gender, who recovered from COVID-19 infection, were selected for the study Samples from Regional laboratory and the Central blood bank of Hafr al Batin, Saudi Arabia were collected. Out of 1508 healthy blood donor 134 had recovered from corona without any preexisting diseases. RESULTS Major donors were male (85.1%). 28% donors in age range of 26-35 years. O+(32.8%) were the highest donors. Systolic and diastolic blood pressure and pulse rate elevated significantly of age group 46-55 (p<0.05) and 56-65 (p<0.001). Systolic blood pressure in males (134.13 ± 9.57) was significantly higher (p<0.05) than those of females (129.35 ± 10.61). Donors with Rh+ significantly higher systolic (p<0.05) and pulse rate (p<0.05) as compared to Rh-. DISCUSSION O+ donors were highly susceptible. Blood pressure, pulse rate and Hb alter with age. Males exhibit higher variation in systolic blood pressure, with Rh+ factor playing a predominant role. Donors above 45-years of age and a high BMI have significantly elevated blood pressure and pulse. These results are challenging or contradictory from the results of Turkish and Chinese studies where blood group A+ was more predominantly affected by the SARS-CoV-2 with minimum infection rate on females and Rh- donors. CONCLUSION Factors like blood group V-2 treatment especially with the age group of 45 years and above.
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Affiliation(s)
- Fahad Al Ghamdi
- King Abdulaziz University, Department of Biochemistry, P.O. Box 80203 Jeddah 21589
| | - Salma Naqvi
- Gulf Medical University, Department of Biomedical Sciences, Ajman
| | - Fahad A Alabassi
- King Abdulaziz University, Department of Biochemistry, P.O. Box 80203 Jeddah 21589
| | - Sultan Alhayyani
- King Abdulaziz University, Department of Chemistry. College of Sciences & Arts, Rabigh
| | - Mirza Rafi Baig
- Dubai Pharmacy College, Department of Biochemistry; Sam Higginbottom Institute of Agriculture, Pharmaceutical sciences, Allahabad
| | - Vikas Kumar
- Dubai Pharmacy College, Department of Biochemistry; Sam Higginbottom Institute of Agriculture, Pharmaceutical sciences, Allahabad
| | - Firoz Anwar
- King Abdulaziz University, Department of Biochemistry, P.O. Box 80203 Jeddah 21589
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Sarlak S, Tabeidian SA, Toghyani M, Shahraki ADF, Goli M, Habibian M. Effects of Replacing Inorganic with Organic Iron on Performance, Egg Quality, Serum and Egg Yolk Lipids, Antioxidant Status, and Iron Accumulation in Eggs of Laying Hens. Biol Trace Elem Res 2021; 199:1986-1999. [PMID: 32666433 DOI: 10.1007/s12011-020-02284-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/10/2020] [Indexed: 01/06/2023]
Abstract
This study compared the effects dietary organic (ferrous glycine [FG]) versus inorganic (ferrous sulfate [FS]) iron in laying hens on performance, egg quality, serum and egg yolk lipids, antioxidant status, and iron enrichment of eggs. A total of 378 Shaver White layers were allotted to 7 treatments with 6 replicates (9 birds each) from 30 to 42 weeks of age. A basal diet (19 mg iron/kg) served as control, while the other six diets were supplemented with either FS or FG to provide 30, 60, and 120 mg/kg of added iron. Dietary FG and FS treatments improved (P < 0.05) laying rate, egg weight, and egg quality of layers, relative to the control, albeit eggshell strength and eggshell calcium also deteriorated with the highest level of FS (P < 0.05). The iron treatment groups exhibited a lower serum and egg yolk levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol that accompanied by higher levels of high-density lipoprotein cholesterol and greater activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx) as compared with the control (P < 0.05). The contents of malondialdehyde and protein carbonyl were conversely related to the activities SOD and GPx (P < 0.05). The serum and egg fractions (yolk, albumen, and shell) displayed gradually increases in iron contents as the level of iron increased in the diet (P < 0.05), while FG was superior to FS at all tested levels (P < 0.05). To summary, FS can be replaced by FG, with more favorable impacts on egg quality and iron enrichment.
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Affiliation(s)
- Sima Sarlak
- Department of Animal Science, Faculty of Agriculture, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Sayed Ali Tabeidian
- Department of Animal Science, Faculty of Agriculture, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
| | - Majid Toghyani
- Department of Animal Science, Faculty of Agriculture, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | | | - Mohammad Goli
- Department of Food Sciences and Technology, Faculty of Agriculture, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Mahmood Habibian
- Young Researchers and Elite Club, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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11
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Preparation and characterization of chemically modified high amylose maize starch-ascorbyl palmitate inclusion complexes in mild reaction condition. Lebensm Wiss Technol 2021. [DOI: 10.1016/j.lwt.2021.110983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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12
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Kressin C, Pandya K, Woodward BM, Donaldson C, Flannery AH. Ascorbic Acid in the Acute Care Setting. JPEN J Parenter Enteral Nutr 2021; 45:874-881. [PMID: 33675075 DOI: 10.1002/jpen.2102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Ascorbic acid (AA) is an essential nutrient with many physiologic roles not limited to the prevention of scurvy. Beyond its role as a supplement, it has gained popularity in the acute care setting as an inexpensive medication for a variety of conditions. Because of limitations with absorption of oral formulations and reduced serum concentrations observed in acute illness, intravenous (IV) administration, and higher doses, may be needed to produce the desired serum concentrations for a particular indication. Following a PubMed search, we reviewed published studies relevant to AA in the acute care setting and summarized the results in a narrative review. In the acute care setting, AA may be used for improved wound healing, improved organ function in sepsis and acute respiratory distress syndrome, faster resolution of vasoplegic shock after cardiac surgery, reduction of resuscitative fluids in severe burn injury, and as an adjunctive analgesic, among other uses. Each indication differs in its level of evidence supporting exogenous administration of AA, but overall, AA was not commonly associated with adverse effects in the identified studies. Use of AA remains an active area of clinical investigation for various indications in the acute care patient population.
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Affiliation(s)
- Christian Kressin
- Acute Care Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | - Komal Pandya
- Acute Care Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | | | - Chris Donaldson
- Acute Care Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | - Alexander H Flannery
- Acute Care Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA.,Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
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13
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Wang Z, Yang B, Chen X, Zhou Q, Li H, Chen S, Yin D, He H, He M. Nobiletin Regulates ROS/ADMA/DDAHII/eNOS/NO Pathway and Alleviates Vascular Endothelium Injury by Iron Overload. Biol Trace Elem Res 2020; 198:87-97. [PMID: 32002792 DOI: 10.1007/s12011-020-02038-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022]
Abstract
Iron overload is harmful to health and associates with intracellular excessive reactive oxygen species (ROS) generation. Nobiletin (Nob) is known to be antioxidant and anti-inflammatory. However, whether Nob can protect endothelial cells against iron overload has not been studied, and the specific mechanism has not yet been elucidated. In this study, we have identified the protective effects of Nob, and its underlying molecular mechanism in human umbilical vein endothelial cells (HUVECs) suffered from iron overload via ROS/ADMA/DDAHII/eNOS/NO pathway. We found that compared with 50 μM iron dextran treatment, co-treatment with 20 μM Nob increased cell viability and decreased lactate dehydrogenase activity. Besides, Nob could upregulate DDAHII expression and activity, promote eNOS phosphorylation to produce more NO, reduce ADMA content, and therefore increase superoxide dismutase, catalase, and glutathione peroxidase activities, and decrease malondialdehyde level and ROS generation. Nob also inhibited mitochondrial permeability transition pore (mPTP) openness and cleaved caspase-3 expression, and decreased apoptosis induced by iron overload. These results were consistent when Nob was replaced by the positive control reagents L-arginine (a competitive substrate of ADMA), cyclosporin A (an mPTP closing agent), or edaravone (a free radical scavenger). The addition of pAD/DDAHII-shRNA adenovirus reversed the above effects of Nob. These data suggested that the protective mechanism of Nob was to inhibit ROS burst, upregulate DDAHII expression and activity, promote eNOS phosphorylation, produce NO, reduce ADMA content, and ultimately alleviate iron overload damage in vascular endothelium.
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Affiliation(s)
- Zhiqing Wang
- Jiangxi Provincial Institute of Hypertension, the First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Bin Yang
- Jiangxi Provincial Key Laboratory of Basic Pharmacology, Nanchang University School of Pharmaceutical Science, Nanchang, 330006, China
| | - Xuepiao Chen
- Jiangxi Provincial Key Laboratory of Basic Pharmacology, Nanchang University School of Pharmaceutical Science, Nanchang, 330006, China
| | - Qing Zhou
- Jiangxi Provincial Key Laboratory of Basic Pharmacology, Nanchang University School of Pharmaceutical Science, Nanchang, 330006, China
| | - Hongwei Li
- Jiangxi Provincial Key Laboratory of Basic Pharmacology, Nanchang University School of Pharmaceutical Science, Nanchang, 330006, China
| | - Shuping Chen
- Jiangxi Provincial Key Laboratory of Basic Pharmacology, Nanchang University School of Pharmaceutical Science, Nanchang, 330006, China
| | - Dong Yin
- Jiangxi Provincial Key Laboratory of Molecular Medicine, the Second Affiliated Hospital, Nanchang University, Nanchang, 330006, China
| | - Huan He
- Jiangxi Provincial Key Laboratory of Basic Pharmacology, Nanchang University School of Pharmaceutical Science, Nanchang, 330006, China.
| | - Ming He
- Jiangxi Provincial Institute of Hypertension, the First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
- Jiangxi Provincial Key Laboratory of Basic Pharmacology, Nanchang University School of Pharmaceutical Science, Nanchang, 330006, China
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14
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Leukocyte telomere length is associated with iron overload in male adults with hereditary hemochromatosis. Biosci Rep 2020; 40:226596. [PMID: 33026063 PMCID: PMC7584811 DOI: 10.1042/bsr20201916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/12/2020] [Accepted: 09/11/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Hereditary hemochromatosis (HH) is a primary iron overload (IO) condition. Absolute telomere length (ATL) is a marker of cellular aging and DNA damage associated with chronic diseases and mortality. Aim: To evaluate the relationship between ATL and IO in patients with HH. Methods: Cross-sectional study including 25 patients with HH: 8 with IO and 17 without IO (ferritin < 300 ng/ml) and 25 healthy controls. Inclusion criteria were: age > 18 years, male sex and HH diagnosis. Patients with diabetes or other endocrine and autoimmune diseases were excluded. ATL was measured by real-time PCR. Results: HH patients with IO were older (P<0.001) and showed higher ferritin concentration (P<0.001). Patients with HH, disregarding the iron status, showed higher glucose and body mass index (BMI) than controls (both P<0.01). ATL was shorter in patients with IO than controls [with IO: 8 (6–14), without IO: 13 (9–20), and controls: 19 (15–25) kilobase pairs, P<0.01]; with a linear trend within groups (P for trend <0.01). Differences in ATL remained statistically significant after adjusting by age, BMI and glucose (P<0.05). Discussion: Patients with IO featured shorter ATL while patients without IO showed only mild alterations vs. controls. Screening for IO is encouraged to prevent iron-associated cellular damage and early telomere attrition.
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15
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Effects of Indigenous Diet Iron Content and Location on Hemoglobin Levels of Ghanaians. Nutrients 2020; 12:nu12092710. [PMID: 32899839 PMCID: PMC7551967 DOI: 10.3390/nu12092710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 11/17/2022] Open
Abstract
Multiple studies have demonstrated strong links between diet and anemia, but few have explored the impact of food groups on hemoglobin (Hb). We analyzed the correlation between Ghanaian diet and Hb levels to explore reduction of anemia prevalence through dietary interventions. Demographics, food frequency questionnaires (FFQ), and blood samples were obtained from 140 volunteers (ages 18–65) in five locations across Ghana. Hb was measured; estimated iron consumption was calculated. FFQ items were grouped by food type, and a regression analysis was performed to determine the most important dietary predictors of Hb. Moreover, 47% of total participants were anemic; 64% of females and 28% of males. Hb levels were highest in Mole (13.9 g/dL, SD = ±1.9), independent of sex distribution. The regression model revealed a 62.7% adjusted correlation between food groups and Hb levels. Animal foods (β = 0.016, t = 5.08, p < 0.01) and plant protein (β = 0.013, t = 2.86, p < 0.01) were the most influential groups to Hb levels. It is of vital importance to emphasize the benefits of consuming animal foods and plant proteins within the Ghanaian population. The ease of access to plant proteins makes it likely that this food group will be most influential and have the greatest impact in reduction of anemia in the Ghanaian population.
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16
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Choi YK, Kang JI, Han S, Kim YR, Jo J, Kang YW, Choo DR, Hyun JW, Koh YS, Yoo ES, Kang HK. L-Ascorbic Acid Inhibits Breast Cancer Growth by Inducing IRE/JNK/CHOP-Related Endoplasmic Reticulum Stress-Mediated p62/SQSTM1 Accumulation in the Nucleus. Nutrients 2020; 12:nu12051351. [PMID: 32397306 PMCID: PMC7284633 DOI: 10.3390/nu12051351] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/24/2020] [Accepted: 05/02/2020] [Indexed: 12/11/2022] Open
Abstract
Anticancer effects of L-ascorbic acid (Vitamin C, L-AA) have been reported in various types of cancers. L-AA intake reduces breast cancer recurrence and mortality; however, the role of L-AA in the treatment of breast cancer remains poorly understood. In this study, we investigated the effect and mechanism action of L-AA on breast cancer growth. L-AA inhibited the growth of breast cancer cells by inducing apoptotic cell death at the evaluated treatment concentrations without affecting normal cells. Moreover, L-AA induces autophagosome formation via regulation of mammalian target of rapamycin (mTOR), Beclin1, and autophagy-related genes (ATGs) and increased autophagic flux. Notably, we observed that L-AA increased p62/SQSTM1 (sequestosome 1) protein levels. Accumulation of p62 protein in cancer cells in response to stress has been reported, but its role in cancer regulation remains controversial. Here, we demonstrated that L-AA-induced p62 accumulation is related to L-AA-induced breast cancer growth inhibition. Furthermore, L-AA induced endoplasmic reticulum (ER) stress via the IRE–JNK–CHOP (inositol-requiring endonuclease–c-Jun N-terminal kinase–C/EBP homologous protein) signaling pathways, which increased the nuclear levels of p62/SQSTM1. These findings provide evidence that L-AA-induced ER stress could be crucial for p62 accumulation-dependent cell death, and L-AA can be useful in breast cancer treatment.
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Affiliation(s)
- Youn Kyung Choi
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
| | - Jung-Il Kang
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
| | - Sanghoon Han
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
| | - Young Ree Kim
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
| | - Jaemin Jo
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
| | - Yong Woo Kang
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
| | - Do Ryeon Choo
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
| | - Jin Won Hyun
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
- Jeju Research Center for Natural Medicine, Jeju National University; 102 Jejudaehakno, Jeju 63243, Korea
| | - Young Sang Koh
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
- Jeju Research Center for Natural Medicine, Jeju National University; 102 Jejudaehakno, Jeju 63243, Korea
| | - Eun-Sook Yoo
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
- Jeju Research Center for Natural Medicine, Jeju National University; 102 Jejudaehakno, Jeju 63243, Korea
| | - Hee-Kyoung Kang
- Department of Medicine, School of Medicine, Jeju National University 102 Jejudaehakno, Jeju 63243, Korea; (Y.K.C.); (J.-I.K.); (S.H.); (Y.R.K.); (J.J.); (Y.W.K.); (D.R.C.); (J.W.H.); (Y.S.K.); (E.-S.Y.)
- Jeju Research Center for Natural Medicine, Jeju National University; 102 Jejudaehakno, Jeju 63243, Korea
- Correspondence: ; Tel.:+82-10-6214-5464
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17
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Mechanick JI, Apovian C, Brethauer S, Timothy Garvey W, Joffe AM, Kim J, Kushner RF, Lindquist R, Pessah-Pollack R, Seger J, Urman RD, Adams S, Cleek JB, Correa R, Figaro MK, Flanders K, Grams J, Hurley DL, Kothari S, Seger MV, Still CD. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures - 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Obesity (Silver Spring) 2020; 28:O1-O58. [PMID: 32202076 DOI: 10.1002/oby.22719] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 10/09/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The development of these updated clinical practice guidelines (CPGs) was commissioned by the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), American Society for Metabolic and Bariatric Surgery (ASMBS), Obesity Medicine Association (OMA), and American Society of Anesthesiologists (ASA) Boards of Directors in adherence with the AACE 2017 protocol for standardized production of CPGs, algorithms, and checklists. METHODS Each recommendation was evaluated and updated based on new evidence from 2013 to the present and subjective factors provided by experts. RESULTS New or updated topics in this CPG include: contextualization in an adiposity-based chronic disease complications-centric model, nuance-based and algorithm/checklist-assisted clinical decision-making about procedure selection, novel bariatric procedures, enhanced recovery after bariatric surgery protocols, and logistical concerns (including cost factors) in the current health care arena. There are 85 numbered recommendations that have updated supporting evidence, of which 61 are revised and 12 are new. Noting that there can be multiple recommendation statements within a single numbered recommendation, there are 31 (13%) Grade A, 42 (17%) Grade B, 72 (29%) Grade C, and 101 (41%) Grade D recommendations. There are 858 citations, of which 81 (9.4%) are evidence level (EL) 1 (highest), 562 (65.5%) are EL 2, 72 (8.4%) are EL 3, and 143 (16.7%) are EL 4 (lowest). CONCLUSIONS Bariatric procedures remain a safe and effective intervention for higher-risk patients with obesity. Clinical decision-making should be evidence based within the context of a chronic disease. A team approach to perioperative care is mandatory, with special attention to nutritional and metabolic issues.
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Affiliation(s)
- Jeffrey I Mechanick
- Guideline Task Force Chair (AACE); Professor of Medicine, Medical Director, Marie-Josée and Henry R. Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart; Director, Metabolic Support Divisions of Cardiology and Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York; Past President, AACE and ACE
| | - Caroline Apovian
- Guideline Task Force Co-Chair (TOS); Professor of Medicine and Director, Nutrition and Weight Management, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Stacy Brethauer
- Guideline Task Force Co-Chair (ASMBS); Professor of Surgery, Vice Chair of Surgery, Quality and Patient Safety; Medical Director, Supply Chain Management, Ohio State University, Columbus, Ohio
| | - W Timothy Garvey
- Guideline Task Force Co-Chair (AACE); Butterworth Professor, Department of Nutrition Sciences, GRECC Investigator and Staff Physician, Birmingham VAMC; Director, UAB Diabetes Research Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Aaron M Joffe
- Guideline Task Force Co-Chair (ASA); Professor of Anesthesiology, Service Chief, Otolaryngology, Oral, Maxillofacial, and Urologic Surgeries, Associate Medical Director, Respiratory Care, University of Washington, Harborview Medical Center, Seattle, Washington
| | - Julie Kim
- Guideline Task Force Co-Chair (ASMBS); Harvard Medical School, Mount Auburn Hospital, Cambridge, Massachusetts
| | - Robert F Kushner
- Guideline Task Force Co-Chair (TOS); Professor of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Richard Lindquist
- Guideline Task Force Co-Chair (OMA); Director, Medical Weight Management, Swedish Medical Center; Director, Medical Weight Management, Providence Health Services; Obesity Medicine Consultant, Seattle, Washington
| | - Rachel Pessah-Pollack
- Guideline Task Force Co-Chair (AACE); Clinical Associate Professor of Medicine, Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, New York
| | - Jennifer Seger
- Guideline Task Force Co-Chair (OMA); Adjunct Assistant Professor, Department of Family and Community Medicine, Long School of Medicine, UT Health Science Center, San Antonio, Texas
| | - Richard D Urman
- Guideline Task Force Co-Chair (ASA); Associate Professor of Anesthesia, Brigham and Women's Hospital, Boston, Massachusetts
| | - Stephanie Adams
- Writer (AACE); AACE Director of Clinical Practice Guidelines Development, Jacksonville, Florida
| | - John B Cleek
- Writer (TOS); Associate Professor, Department of Nutrition Sciences, University of Alabama, Birmingham, Alabama
| | - Riccardo Correa
- Technical Analysis (AACE); Assistant Professor of Medicine and Endocrinology, Diabetes and Metabolism Fellowship Director, University of Arizona College of Medicine, Phoenix, Arizona
| | - M Kathleen Figaro
- Technical Analysis (AACE); Board-certified Endocrinologist, Heartland Endocrine Group, Davenport, Iowa
| | - Karen Flanders
- Writer (ASMBS); Massachusetts General Hospital Weight Center, Boston, Massachusetts
| | - Jayleen Grams
- Writer (AACE); Associate Professor, Department of Surgery, University of Alabama at Birmingham; Staff Surgeon, Birmingham VA Medical Center, Birmingham, Alabama
| | - Daniel L Hurley
- Writer (AACE); Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
| | - Shanu Kothari
- Writer (ASMBS); Fellowship Director of MIS/Bariatric Surgery, Gundersen Health System, La Crosse, Wisconsin
| | - Michael V Seger
- Writer (OMA); Bariatric Medical Institute of Texas, San Antonio, Texas, Clinical Assistant Professor, University of Texas Health Science Center, Houston, Texas
| | - Christopher D Still
- Writer (TOS); Medical Director, Center for Nutrition and Weight Management Director, Geisinger Obesity Institute; Medical Director, Employee Wellness, Geisinger Health System, Danville, Pennsylvania
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18
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Iron Overload Damages the Endothelial Mitochondria via the ROS/ADMA/DDAHII/eNOS/NO Pathway. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:2340392. [PMID: 31781327 PMCID: PMC6875360 DOI: 10.1155/2019/2340392] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/24/2019] [Accepted: 09/21/2019] [Indexed: 02/06/2023]
Abstract
It has been recognized that iron overload may harm the body's health. Vascular endothelial cells (VECs) are one of the main targets of iron overload injury, and the mechanism involved was thought to be related to the excessive generation of reactive oxygen species (ROS). However, the subcellular and temporal characteristics of ROS generation, potential downstream mechanisms, and target organelles in VECs injured by iron overload have not been expounded yet. In this study, we elucidated the abovementioned issues through both in vivo and in vitro experiments. Mice were fed pellet diets that were supplemented with iron for 4 consecutive months. Results showed that the thoracic aortic strips' endothelium-dependent dilation was significantly impaired and associated with inflammatory changes, noticeable under brown TUNEL-positive staining in microscopy analysis. In addition, the serum content of asymmetric dimethylarginine (ADMA) increased, whereas nitric oxide (NO) levels decreased. Furthermore, the dimethylarginine dimethylaminohydrolase II (DDAHII) expression and activity, as well as the phosphorylation of endothelial nitric oxide synthase (eNOS) in aortic tissue, were inhibited. Human umbilical vein endothelial cells were treated with 50 μM iron dextran for 48 hours, after which the cell viability, NO content, DDAHII expression and activity, and phosphorylation of eNOS decreased and lactate dehydrogenase and caspase-3 activity, ADMA content, and apoptotic cells significantly increased. After the addition of L-arginine (L-Arg) or pAD/DDAHII, the abovementioned changes were reversed. By dynamically detecting the changes of ROS generation in the cytoplasm and mitochondria and interfering with different aspects of signaling pathways, we have confirmed for the first time that excessive ROS originates from the cytoplasm and activates the ROS-induced ROS release (RIRR) mechanism, leading to mitochondrial dysfunction. Together, our data suggested that excessive free iron ions produced excess ROS in the cytoplasm. Thus, excess ROS create one vicious circle by activating the ADMA/eNOS/DDAHII/NO pathway and another vicious circle by activation of the RIRR mechanism, which, when combined, induce a ROS burst, resulting in mitochondrial dysfunction and damaged VECs.
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19
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Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, Kushner RF, Lindquist R, Pessah-Pollack R, Seger J, Urman RD, Adams S, Cleek JB, Correa R, Figaro MK, Flanders K, Grams J, Hurley DL, Kothari S, Seger MV, Still CD. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures - 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Surg Obes Relat Dis 2019; 16:175-247. [PMID: 31917200 DOI: 10.1016/j.soard.2019.10.025] [Citation(s) in RCA: 240] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The development of these updated clinical practice guidelines (CPG) was commissioned by the American Association of Clinical Endocrinologists, The Obesity Society, the American Society of Metabolic and Bariatric Surgery, the Obesity Medicine Association, and the American Society of Anesthesiologists boards of directors in adherence to the American Association of Clinical Endocrinologists 2017 protocol for standardized production of CPG, algorithms, and checklists. METHODS Each recommendation was evaluated and updated based on new evidence from 2013 to the present and subjective factors provided by experts. RESULTS New or updated topics in this CPG include contextualization in an adiposity-based, chronic disease complications-centric model, nuance-based, and algorithm/checklist-assisted clinical decision-making about procedure selection, novel bariatric procedures, enhanced recovery after bariatric surgery protocols, and logistical concerns (including cost factors) in the current healthcare arena. There are 85 numbered recommendations that have updated supporting evidence, of which 61 are revised and 12 are new. Noting that there can be multiple recommendation statements within a single numbered recommendation, there are 31 (13%) Grade A, 42 (17%) Grade B, 72 (29%) Grade C, and 101 (41%) Grade D recommendations. There are 858 citations, of which 81 (9.4%) are evidence level (EL) 1 (highest), 562 (65.5%) are EL 2, 72 (8.4%) are EL 3, and 143 (16.7%) are EL 4 (lowest). CONCLUSIONS Bariatric procedures remain a safe and effective intervention for higher-risk patients with obesity. Clinical decision-making should be evidence-based within the context of a chronic disease. A team approach to perioperative care is mandatory with special attention to nutritional and metabolic issues.
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Affiliation(s)
- Jeffrey I Mechanick
- Marie-Josée and Henry R. Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, New York, New York; Metabolic Support Divisions of Cardiology and Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Caroline Apovian
- Nutrition and Weight Management, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | | | - W Timothy Garvey
- Department of Nutrition Sciences, Birmingham VA Medical Center, Birmingham, Alabama; UAB Diabetes Research Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Aaron M Joffe
- University of Washington, Harborview Medical Center, Seattle, Washington
| | - Julie Kim
- Harvard Medical School, Mount Auburn Hospital, Cambridge, Massachusetts
| | - Robert F Kushner
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Rachel Pessah-Pollack
- Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, New York
| | - Jennifer Seger
- Department of Family and Community Medicine, Long School of Medicine, UT Health Science Center, San Antonio, Texas
| | | | - Stephanie Adams
- American Association of Clinical Endocrinologists, Jacksonville, Florida
| | - John B Cleek
- Department of Nutrition Sciences, Birmingham VA Medical Center, Birmingham, Alabama
| | | | | | - Karen Flanders
- Massachusetts General Hospital Weight Center, Boston, Massachusetts
| | - Jayleen Grams
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama; Birmingham VA Medical Center, Birmingham, Alabama
| | - Daniel L Hurley
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
| | | | - Michael V Seger
- Bariatric Medical Institute of Texas, San Antonio, Texas, University of Texas Health Science Center, Houston, Texas
| | - Christopher D Still
- Center for Nutrition and Weight Management Director, Geisinger Obesity Institute, Danville, Pennsylvania; Employee Wellness, Geisinger Health System, Danville, Pennsylvania
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