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Fazelian S, Moradi F, Agah S, Hoseini A, Heydari H, Morvaridzadeh M, Omidi A, Pizarro AB, Ghafouri A, Heshmati J. Effect of omega-3 fatty acids supplementation on cardio-metabolic and oxidative stress parameters in patients with chronic kidney disease: a systematic review and meta-analysis. BMC Nephrol 2021; 22:160. [PMID: 33933009 PMCID: PMC8088683 DOI: 10.1186/s12882-021-02351-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background Omega-3 fatty acids (FAs) have been suggested as a beneficial supplement in chronic kidney disease (CKD) patients, but the results of randomized clinical trials (RCTs) are controversial. We conducted a systematic review and meta-analysis to evaluate all the RCTs about the impact of omega-3 FAs supplementation on cardiometabolic outcomes and oxidative stress parameters in patients with CKD. Methods We performed a systematic database search in PubMed/MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Central, up to May 2020. We included all placebo-controlled randomized trials that assessed the effect of omega-3 FAs supplementation on any cardiometabolic outcomes: blood pressure, total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) or triglycerides (TG) and oxidative stress parameters. Data were pooled using DerSimonian–Laird’s random-effects model. Results Finally, thirteen articles met the inclusion criteria for this review omega-3 FAs supplementation significantly decrease TC (SMD: -0.26; 95% CI: − 0.51, − 0.02; I2 = 52.7%), TG (SMD: -0.22; 95% CI: − 0.43, − 0.02; I2 = 36.0%) and Malondialdehyde (MDA) levels (SMD: -0.91; 95% CI: − 1.29, − 0.54; I2 = 00.0%) and also significantly increase superoxide dismutase (SOD) (SMD: 0.58; 95% CI: 0.27, 0.90; I2 = 00.0%) and Glutathione peroxidase (GPx) (SMD: 0.50; 95% CI: 0.14, 0.86; I2 = 00.0%) activities. However our results show that omega-3 FAs supplementation have no significant effects on HDL, LDL and blood pressure. Conclusion This systematic review and meta-analysis supports current evidence for the clinical benefit of omega-3 FAs intake to improve cardiometabolic parameters in CKD patients. However, well-designed RCTs still needed to provide a conclusive picture in this field. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-021-02351-9.
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Affiliation(s)
- Siavash Fazelian
- Clinical Research Development Unit, Ayatollah Kashani Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fatemeh Moradi
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Agah
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Akramsadat Hoseini
- Department of Education and Health Promotion,School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hafez Heydari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mojgan Morvaridzadeh
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Farabi Hospital, Faculty of Nutrition Sciences and Food Technology, Postal Code: 6715847141, Isar Square, Kermanshah, Iran
| | - Amirhosein Omidi
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Farabi Hospital, Faculty of Nutrition Sciences and Food Technology, Postal Code: 6715847141, Isar Square, Kermanshah, Iran
| | | | - Atie Ghafouri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Javad Heshmati
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Farabi Hospital, Faculty of Nutrition Sciences and Food Technology, Postal Code: 6715847141, Isar Square, Kermanshah, Iran.
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Miura K, Vail A, Chambers D, Hopkins PM, Ferguson L, Grant M, Rhodes LE, Green AC. Omega-3 fatty acid supplement skin cancer prophylaxis in lung transplant recipients: A randomized, controlled pilot trial. J Heart Lung Transplant 2018; 38:59-65. [PMID: 30352778 DOI: 10.1016/j.healun.2018.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Lung transplant recipients (LTRs) are at very high risk of skin cancer. Omega-3 fatty acids (FAs) are anti-inflammatory and immune-modulating and could potentially reduce this risk. We assessed the feasibility of omega-3 FA supplementation to reduce skin cancer among these patients. METHODS LTRs aged 18+ years, at least 1 year post-transplant, were recruited from the outpatient clinic of The Prince Charles Hospital, Brisbane. Participants were randomly allocated to 4-times-daily supplements containing either omega-3 FA (3.36 eicosapentaenoic acid [EPA] + docosahexaenoic acid) or placebo (4 g olive oil) for 12 months. Primary outcomes were rates of recruitment, retention, adherence (assessed by plasma omega-3 FA), and safety. Secondary outcomes were incident skin cancers. RESULTS Among 106 eligible lung transplant recipients, 49 consented to take part (46%) with 25 allocated to omega-3 FA and 24 to placebo supplements. Of these, 22 (88%) and 20 (83%), respectively, completed the trial. After 12 months, median plasma EPA increased substantially in the intervention group (125.0 to 340.0 µmol/L), but not the placebo group (98.0 to 134.5 µmol/L). In the intervention group, 6 patients developed skin cancers compared with 11 in the placebo group, giving an odds ratio (95% confidence interval) of 0.34 (0.09 to 1.32). There were no serious, active intervention-related adverse events. CONCLUSIONS This pilot trial among LTRs showed acceptable recruitment and high retention and adherence. We demonstrated a signal for reduction of new skin cancer cases in those taking omega-3 FA supplements, which supports the notion that a larger, more definitive trial is warranted.
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Affiliation(s)
- Kyoko Miura
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
| | - Andy Vail
- Centre for Biostatistics, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - Daniel Chambers
- Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, Queensland, Australia; School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter M Hopkins
- Queensland Lung Transplant Service, The Prince Charles Hospital Campus and School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Ferguson
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Michelle Grant
- Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Lesley E Rhodes
- Dermatology Research Centre, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - Adèle C Green
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia; CRUK Manchester Institute, University of Manchester, Manchester, UK
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Rateb SA. Influence of omega-3 incorporation in sperm preservation medium on physical and kinematic properties of chilled and cryopreserved ram spermatozoa. Reprod Domest Anim 2018; 53:1506-1516. [PMID: 30054952 DOI: 10.1111/rda.13289] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
Abstract
Two experiments were carried out to investigate the efficiency of supplementing sperm preservation medium with omega-3 polyunsaturated fatty acids on improving liquid-chilled storage and cryopreservation capacity of ram spermatozoa. Ejaculates (n = 100) were collected from five adult rams, Ovis aries, by an artificial vagina twice weekly throughout the period February-April, 2017. After initial evaluation, ejaculates of each collection session from the same males were pooled, diluted (1:10) with Tris-citric acid egg yolk extender, and were further split into five aliquots using a split-sample technique. The first aliquot served as control (omega-free), whereas the other four portions were supplemented with 0.1, 0.2, 0.3 or 0.4 mM omega-3, respectively (T0 ). Thereafter, the diluted specimens were stored at 4°C for 48 hr, during which sperm physical and morphometric properties were evaluated along with oxidative stress indices (T24 , T48 ). Omega-3 levels that efficiently mitigated the detrimental effects of chilled preservation, and maintained preservation aptitude of spermatozoa were further investigated for sperm cryosurvival against control (untreated). Post-thaw physical and kinematic properties of spermatozoa, in all groups, were objectively evaluated by a computer-assisted sperm analysis (CASA) system. The results showed that, at 48 hr of chilled storage, supplementing preservation medium with 0.4 mM omega-3 was positively correlated (p < 0.01) with each of progressive motility, live sperm, intact acrosome and intact cell membrane (r = 0.83, 0.85, 0.85, 0.89, respectively). Furthermore, a positive correlation (p < 0.01) was observed between inclusion of omega-3 in cryopreservation medium and each of post-thaw total sperm motility, progressive motility, live sperm, normal sperm, intact acrosome, intact cell membrane, VCL, VSL, VAP, ALH and STR (r = 0.76, 0.84, 0.79, 0.90, 0.89, 0.91, 0.61, 0.73, 0.65, 0.78 and 0.60, respectively). These results accentuate efficiency of supplementing the diluent with omega-3 fatty acids on improving chilled and cryopreservation aptitude of ram spermatozoa.
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Affiliation(s)
- Sherif A Rateb
- Animal and Poultry Production Division, Desert Research Center, Ministry of Agriculture and Land Reclamation, Cairo, Egypt
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Mildenberger J, Johansson I, Sergin I, Kjøbli E, Damås JK, Razani B, Flo TH, Bjørkøy G. N-3 PUFAs induce inflammatory tolerance by formation of KEAP1-containing SQSTM1/p62-bodies and activation of NFE2L2. Autophagy 2017; 13:1664-1678. [PMID: 28820283 PMCID: PMC5640206 DOI: 10.1080/15548627.2017.1345411] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Inflammation is crucial in the defense against infections but must be tightly controlled to limit detrimental hyperactivation. Our diet influences inflammatory processes and omega-3 polyunsaturated fatty acids (n-3 PUFAs) have known anti-inflammatory effects. The balance of pro- and anti-inflammatory processes is coordinated by macrophages and macroautophagy/autophagy has recently emerged as a cellular process that dampens inflammation. Here we report that the n-3 PUFA docosahexaenoic acid (DHA) transiently induces cytosolic speckles of the autophagic receptor SQSTM1/p62 (sequestosome 1) (described as SQSTM1/p62-bodies) in macrophages. We suggest that the formation of SQSTM1/p62-bodies represents a fast mechanism of NFE2L2/Nrf2 (nuclear factor, erythroid 2 like 2) activation by recruitment of KEAP1 (kelch like ECH associated protein 1). Further, the autophagy receptor TAX1BP1 (Tax1 binding protein 1) and ubiquitin-editing enzyme TNFAIP3/A20 (TNF α induced protein 3) could be identified in DHA-induced SQSTM1/p62-bodies. Simultaneously, DHA strongly dampened the induction of pro-inflammatory genes including CXCL10 (C-X-C motif chemokine ligand 10) and we suggest that formation of SQSTM1/p62-bodies and activation of NFE2L2 leads to tolerance towards selective inflammatory stimuli. Finally, reduced CXCL10 levels were related to the improved clinical outcome in n-3 PUFA-supplemented heart-transplant patients and we propose CXCL10 as a robust marker for the clinical benefits mobilized by n-3 PUFA supplementation.
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Affiliation(s)
- Jennifer Mildenberger
- a Centre of Molecular Inflammation Research and Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway.,b Department of Biomedical Laboratory Science, Faculty of Natural Sciences , Norwegian University of Science and Technology , Trondheim , Norway
| | - Ida Johansson
- a Centre of Molecular Inflammation Research and Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway
| | - Ismail Sergin
- d Department of Medicine, Cardiovascular Division , Washington University School of Medicine , St. Louis , MO , USA
| | - Eli Kjøbli
- b Department of Biomedical Laboratory Science, Faculty of Natural Sciences , Norwegian University of Science and Technology , Trondheim , Norway
| | - Jan Kristian Damås
- a Centre of Molecular Inflammation Research and Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway.,c Department of Infectious Diseases , St Olav University Hospital , Trondheim , Norway
| | - Babak Razani
- d Department of Medicine, Cardiovascular Division , Washington University School of Medicine , St. Louis , MO , USA.,e Department of Pathology & Immunology , Washington University School of Medicine , St. Louis , MO , USA
| | - Trude Helen Flo
- a Centre of Molecular Inflammation Research and Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway
| | - Geir Bjørkøy
- a Centre of Molecular Inflammation Research and Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway.,b Department of Biomedical Laboratory Science, Faculty of Natural Sciences , Norwegian University of Science and Technology , Trondheim , Norway
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Jabbari M, Khoshnevis T, Jenabi A, Yousefi F. The Effect of Omega-3 Supplement on Serum Lipid Profile in Patients Undergoing Hemodialysis: A Randomized Clinical Trial. ROMANIAN JOURNAL OF INTERNAL MEDICINE = REVUE ROUMAINE DE MÉDECINE INTERNE 2016; 54:222-227. [PMID: 28002035 DOI: 10.1515/rjim-2016-0031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Some recent suggestions could show omega-3 condition deficiency following prolonged hemodialysis; however, these claims and speculations have not been well demonstrated with sufficient evidences. Hence, we attempted to assess the beneficial effects of omega-3 on lipid profile in patients with end-stage renal disease (ESRD) undergoing hemodialysis. METHODS One hundred and seventeen ESRD patients who were on maintenance dialysis in Rasoul-e-Akram and Madaen Hospitals were enrolled in this randomized clinical trial. These patients were divided into two groups randomly using block randomization method (57 patients as the case group receiving omega-3 for 12 weeks and 60 as the control group). Blood sample was taken from all patients for measurement of lipid profile, serum hemoglobin, and C-reactive protein at baseline as well as after the completion of interventions (after 12 weeks). RESULTS The average change in the value of HDL-C was significantly more in the patients who received omega-3 than in the control group (MD, -7 mg/dL; 95% CI, -11 to 0 p = 0.000). Also, the reduction in serum creatinine level was more in the omega-3 group than in the control group (MD, 0.7 mg/dL; 95% CI, -0.4 to 2.1 p = 0.023). The change in other indices including serum triglyceride, total cholesterol, and serum hemoglobin levels was not different between the two groups. The multivariable linear regression analysis showed no difference in serum HDL level between the two groups adjusted for sex, age, and time of dialysis, while the level of serum HDL-C could be adversely predicted by duration time. Similar regression model showed a between-group difference in serum creatinine in the presence of potential confounders. CONCLUSION The change in serum HDL level following use of omega-3 supplement is influenced by time of dialysis, not by drug effect. However, consumption of omega-3 can significantly reduce serum creatinine.
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Roche J, Mouloungui Z, Cerny M, Merah O. Fatty acid and phytosterol accumulation during seed development in three oilseed species. Int J Food Sci Technol 2016. [DOI: 10.1111/ijfs.13153] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jane Roche
- INP-ENSIACET; LCA-Laboratory of Agro-industrial Chemistry; University of Toulouse; F-31030 Toulouse France
- INRA; UMR 1010 CAI F-31030 Toulouse France
| | - Zephirin Mouloungui
- INP-ENSIACET; LCA-Laboratory of Agro-industrial Chemistry; University of Toulouse; F-31030 Toulouse France
- INRA; UMR 1010 CAI F-31030 Toulouse France
| | - Muriel Cerny
- INP-ENSIACET; LCA-Laboratory of Agro-industrial Chemistry; University of Toulouse; F-31030 Toulouse France
- INRA; UMR 1010 CAI F-31030 Toulouse France
| | - Othmane Merah
- INP-ENSIACET; LCA-Laboratory of Agro-industrial Chemistry; University of Toulouse; F-31030 Toulouse France
- INRA; UMR 1010 CAI F-31030 Toulouse France
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Eide IA, Jenssen T, Hartmann A, Diep LM, Dahle DO, Reisæter AV, Bjerve KS, Christensen JH, Schmidt EB, Svensson M. Plasma levels of marine n-3 polyunsaturated fatty acids and renal allograft survival. Nephrol Dial Transplant 2015; 31:160-7. [PMID: 26410884 DOI: 10.1093/ndt/gfv339] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 08/12/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Marine n-3 polyunsaturated fatty acids (PUFAs) may exert beneficial effects on inflammation, fibrosis, endothelial function, lipid profile and blood pressure that may prevent graft loss. METHODS In this observational cohort study in Norwegian renal transplant recipients (n = 1990), transplanted between 1999 and 2011, associations between plasma marine n-3 PUFA levels and graft loss were assessed by multivariable Cox proportional hazard regression analysis. Plasma phospholipid fatty acid composition was determined by gas chromatography and individual fatty acids recorded as weight percentage (wt%) of total fatty acids in a stable phase 10 weeks after transplantation. RESULTS During a median follow-up time of 6.8 years, 569 (28.6%) renal allografts were lost, either due to patient death (n = 340, 59.8% of graft loss) or graft loss in surviving patients (n = 229, 40.2%). Plasma marine n-3 PUFA levels ranged from 1.35 to 23.87 wt%, with a median level of 7.95 wt% (interquartile range 6.20-10.03 wt%). When adjusting for established graft loss risk factors, there was a 11% reduced risk of graft loss for every 1.0 wt% increase in marine n-3 PUFA level [adjusted hazard ratio (HR) 0.89; 95% confidence interval (CI) 0.84-0.93], and a 10% reduced risk of graft loss in surviving patients (adjusted HR 0.90; 95% CI 0.84-0.97). CONCLUSION High levels of plasma marine n-3 PUFAs were associated with better renal allograft survival.
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Affiliation(s)
- Ivar A Eide
- Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Trond Jenssen
- Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anders Hartmann
- Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway Institute of Clinical Medicine, The University of Oslo, Oslo, Norway
| | - Lien M Diep
- Department of Biostatistics, Epidemiology and Health Care Economics, Oslo University Hospital, Oslo, Norway
| | - Dag O Dahle
- Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Anna V Reisæter
- Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway The Norwegian Renal Registry, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Kristian S Bjerve
- Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Erik B Schmidt
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - My Svensson
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
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Effect of immunosuppressive therapy on the serum fatty acids of phospholipids fraction in patients after heart transplantation. Transplant Proc 2014; 46:2825-9. [PMID: 25380928 DOI: 10.1016/j.transproceed.2014.09.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The effects of tacrolimus (Tac) and cyclosporine (CsA) on lipid profile is well known; however, little is known about the changes in fatty acids (FA) of phosholipids fraction (PL) in heart transplant patients after treatment with these immunosuppressants. This study aimed to investigate the effect of Tac and CsA on serum FA of PL in heart transplant patients. METHODS The study included 23 patients after heart transplantation on Tac (n = 14; group II) or CsA (n = 9; group I). Eleven healthy persons served as a control group. Serum FA of PL were extracted, separated on Sep-Pak NH2, methylated, and measured with the use of gas chromatography. Chemstation software was used to analyze the data. RESULTS No differences between the studied groups and control were noted for saturated FA, monounsaturated FA, polyunsaturated FA (PUFA), total FA, and PUFA n-6. The mean value of PUFA n-3 was significantly higher in the CsA group compared with the Tac group (P < .015) and control (P < .002) as well as in the Tac group compared with control (P < .001). For individual FA, higher mean concentration, compared with control, was found for C24, C20:2, C20:4, and C22:6 (P < .001 in all cases) and lower for C18:2cis (P < .001 in both groups) and for C18:3 in the Tac group. The mean values of PUFA n-6 to PUFA n-3 ratios were lower than in control (both P < .001). CONCLUSIONS Different pattern of FA of PL may indicate the different FA metabolism in heart transplant patients treated by different immunosuppressants. This should be taken into account when FA supplementation in these patients is considered.
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Effect of shortening replacement with flaxseed oil on physical, sensory, fatty acid and storage characteristics of cookies. Journal of Food Science and Technology 2014; 52:3694-700. [PMID: 26028753 DOI: 10.1007/s13197-014-1430-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 03/10/2014] [Accepted: 05/28/2014] [Indexed: 10/25/2022]
Abstract
Omega-3 fatty acid imparted good evidence of health benefits. Flaxseed oil, being the richest vegetarian source of alpha linolenic acid (omega-3 fatty acid), was incorporated in cookies by replacing shortening at level of 5 %, 10 %, 20 %, 30 %, 40 % and 50 %. Effect of shortening replacement with flaxseed oil on physical, textural and sensory attributes were investigated. Spread ratio and breaking strength of cookies increased as flaxseed oil level increased. Sensory score was not significantly affected up to 30 % shortening replacement with flaxseed oil as compared with the control cookies. Above 30 % flaxseed oil, sensory score was adversely affected. Fatty acid profile confirmed the enhancement of omega-3 fatty acid from 0 (control) to 14.14 % (30 % flaxseed oil cookies). The poly-unsaturated to saturated fatty acid ratio (P/S) increased from 0.088 (control) to 0.57 while ω - 6 to ω -3 fatty acid ratio of flaxseed oil cookies decreased from 4.51 (control) to 0.65 in the optimized cookies. The data on storage characteristics of the control and 30 % flaxseed oil cookies showed that there was significant change in the moisture content, Peroxide value (PV) and overall acceptability (OAA) up to 28 days of storage at 45 °C packed in polyethylene bags. Flaxseed oil cookies were acceptable up to 21 days of storage and afterwards noticeable off flavour was perceived.
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Cleverley K, Du X, Premecz S, Le K, Zeglinski M, Nicholson T, Goh CY, Lu Y, Anderson HD, Moghadasian MH, Jassal DS. The effects of fish oil consumption on cardiovascular remodeling in ApoE deficient mice. Can J Physiol Pharmacol 2013; 91:960-5. [PMID: 24117264 DOI: 10.1139/cjpp-2013-0077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Owing to their spontaneous development of atherosclerosis, apolipoprotein E knockout mice (ApoE(KO)) are one of the best studied animal models for this disease. Little is known about the utility of various omega-3 fatty acid regimens, in particular fish oils, in preventing cardiac disease in ApoE(KO) mice. The purpose of this study was to determine the cardiovascular effects of omega-3 fatty acid supplementation with either safflower oil (control), fish oil, flaxseed oil, or designed oil in ApoE(KO) mice fed a high-fat diet for a total of 16 weeks. In-vivo cardiac function was assessed weekly using murine echocardiography. Blood pressure, plasma lipid levels, and brain natriuretic peptide (BNP) were serially measured. The results show that ApoE(KO) mice fed fish oil demonstrated an increase in left ventricular wall thickness as a result of increased afterload. Despite chronic treatment with fish oil over 16 weeks, blood pressure increased in ApoE(KO) mice by 20% compared with the baseline. Both echocardiographic evidence of left ventricular hypertrophy and biochemical increase in BNP levels confirmed diastolic dysfunction in ApoE(KO) mice fed fish oil. This suggests that high-fat diet supplemented with fish oil may lead to adverse cardiovascular effects in ApoE deficient mice.
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Affiliation(s)
- Kelby Cleverley
- a Institute of Cardiovascular Sciences, St. Boniface Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada
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Liu M, Chen P, Véricel E, Lelli M, Béguin L, Lagarde M, Guichardant M. Characterization and biological effects of di-hydroxylated compounds deriving from the lipoxygenation of ALA. J Lipid Res 2013; 54:2083-2094. [PMID: 23740966 DOI: 10.1194/jlr.m035139] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
We have recently described a di-hydroxylated compound called protectin DX (PDX) which derives from docosahexaenoic acid (DHA) by double lipoxygenation. PDX exhibits anti-aggregatory and anti-inflammatory properties, that are also exhibited by similar molecules, called poxytrins, which possess the same E,Z,E conjugated triene geometry, and are synthesized from other polyunsaturated fatty acids with 22 or 20 carbons. Here we present new biological activities of di-hydroxylated metabolites deriving from α-linolenic acid (18:3n-3) treated by soybean 15-lipoxygenase (sLOX). We show that 18:3n-3 is converted by sLOX into mainly 13(S)-OH-18:3 after reduction of the hydroperoxide product. But surprisingly, and in contrast to DHA which is metabolized into only one di-hydroxylated compound, 18:3n-3 leads to four di-hydroxylated fatty acid isomers. We report here the complete characterization of these compounds using high field NMR and GC-MS techniques, and some of their biological activities. These compounds are: 9(R),16(S)-dihydroxy-10E,12E,14E-octadecatrienoic acid, 9(S),16(S)-dihydroxy-10E,12E,14E-octadecatrienoic acid, 9(S),16(S)-dihydroxy-10E,12Z,14E-octadecatrienoic acid, and 9(R),16(S)-dihydroxy-10E,12Z,14E-octadecatrienoic acid. They can also be synthesized by the human recombinant 15-lipoxygenase (type 2). Their inhibitory effect on blood platelet and anti-inflammatory properties were compared with those already reported for PDX.
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Affiliation(s)
- Miao Liu
- Université de Lyon, UMR 1060 Inserm (CarMeN), IMBL/INSA-Lyon, 69621 Villeurbanne, France
| | - Ping Chen
- Tea Science Department, College of Agriculture and Biotechnology, Zhejiang University, 310029 Hangzhou, China; and
| | - Evelyne Véricel
- Université de Lyon, UMR 1060 Inserm (CarMeN), IMBL/INSA-Lyon, 69621 Villeurbanne, France
| | - Moreno Lelli
- Centre de RMN à Très Hauts Champs, Université de Lyon (CNRS/ENS Lyon/UCB Lyon 1), 69100 Villeurbanne, France
| | - Laetitia Béguin
- Centre de RMN à Très Hauts Champs, Université de Lyon (CNRS/ENS Lyon/UCB Lyon 1), 69100 Villeurbanne, France
| | - Michel Lagarde
- Université de Lyon, UMR 1060 Inserm (CarMeN), IMBL/INSA-Lyon, 69621 Villeurbanne, France
| | - Michel Guichardant
- Université de Lyon, UMR 1060 Inserm (CarMeN), IMBL/INSA-Lyon, 69621 Villeurbanne, France.
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Shah M, Critchley W, Yonan N, Williams S, Shaw S. Second Line Options for Hyperlipidemia Management after Cardiac Transplantation. Cardiovasc Ther 2013; 31:138-46. [DOI: 10.1111/j.1755-5922.2012.00315.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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Mottram AR, Valdivia CR, Makielski JC. Fatty acids antagonize bupivacaine-induced I(Na) blockade. Clin Toxicol (Phila) 2011; 49:729-33. [PMID: 21970771 DOI: 10.3109/15563650.2011.613399] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Theories regarding the mechanism of intravenous fat emulsion for bupivacaine cardiotoxicity include creation of an intravascular lipid sink into which the cardiotoxic drug is sequestered, an improvement of impaired cardiac metabolism, and restoration of cardiomyocyte function by increasing intracellular calcium. However, work in this area is inconclusive and a more mechanistic explanation is desirable. We used a heterologous expression system (HEK-293 cells) and voltage clamp techniques to study the electrophysiologic effects of bupivacaine, polyunsaturated, and saturated fatty acids on sodium current (I(Na)) in stable cell lines expressing human cardiac sodium channels. Linolenic (polyunsaturated) and stearic (saturated) fatty acids were selected for study as they are components of commonly used lipid infusions. Bupivacaine-induced significant tonic and use dependent I(Na) block, as expected. Linolenic and stearic fatty acids directly modulated I(Na), inducing primarily tonic block. Greater block was seen with linolenic acid as compared with stearic acid. Simultaneous exposure to bupivacaine and fatty acids reduced both the tonic and use dependent block compared with bupivacaine alone. Reduction of bupivacaine-induced I(Na) block was greatest in cells treated with linolenic acid. These results suggest that the salutary effects of intravenous fat emulsion may be, in part, due to a direct modulatory effect of fatty acids on cardiac sodium channels.
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Affiliation(s)
- Allan R Mottram
- University of Wisconsin, Division of Emergency Medicine, 600 Highland Ave, F2/204 CSC, MC 3280, Madison, 53792, United States.
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Guler G, Aktumsek A, Cakmak Y, Zengin G, Citil O. Effect of Season on Fatty Acid Composition and n-3/n-6 Ratios of Zander and Carp Muscle Lipids in Altinapa Dam Lake. J Food Sci 2011; 76:C594-7. [DOI: 10.1111/j.1750-3841.2011.02136.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Papel de los ácidos grasos omega 3 en la prevención del cáncer de colon. REVISTA ESPAÑOLA DE NUTRICIÓN HUMANA Y DIETÉTICA 2011. [DOI: 10.1016/s2173-1292(11)70010-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Ramezani M, Nazemian F, Shamsara J, Koohrokhi R, Mohammadpour AH. Effect of omega-3 fatty acids on plasma level of 8-isoprostane in kidney transplant patients. J Ren Nutr 2010; 21:196-9. [PMID: 21093286 DOI: 10.1053/j.jrn.2010.06.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 05/23/2010] [Accepted: 06/13/2010] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE It has been shown previously that the serum level of F2-isoprostanes acts as an indicator of oxidative stress, which is a risk factor for vascular disease especially in end-stage renal disease. It is not known whether n-3 polyunsaturated fatty acids can decrease oxidative stress in renal recipient patients. DESIGN, SETTING, AND SUBJECTS In this single blind, randomized, placebo-controlled study, the effect of 3 and 6 months of fish oil administration on 8-isoprostane levels in renal transplant recipients was evaluated. INTERVENTION Twenty-two renal transplant patients who fulfilled inclusion and exclusion criteria randomly received either fish oil dietary supplementation, 6 g/day (720 mg of DHA and 1,080 mg of EPA) or placebo for 6 months. MAIN OUTCOME MEASURE Serum 8-isoprostane concentration was measured as markers of oxidative stress. RESULTS A significant decrease in 8-isoprostane levels was observed only in the placebo group after transplantation compared to baseline (P < 0.05). However, the group receiving fish oil had a significantly lower cholesterol level than that of the placebo group (P < 0.05). CONCLUSION On the basis of our results, omega-3 fatty acids supplementation decreased the beneficial effects of kidney transplantation on oxidative stress.
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Affiliation(s)
- Mohammad Ramezani
- Nanotechnology Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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Bouzidi N, Mekki K, Boukaddoum A, Dida N, Kaddous A, Bouchenak M. Effects of Omega-3 Polyunsaturated Fatty-Acid Supplementation on Redox Status in Chronic Renal Failure Patients With Dyslipidemia. J Ren Nutr 2010; 20:321-8. [DOI: 10.1053/j.jrn.2010.01.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Indexed: 11/11/2022] Open
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Levantesi G, Silletta MG, Marchioli R. Uses and benefits of omega-3 ethyl esters in patients with cardiovascular disease. J Multidiscip Healthc 2010; 3:79-96. [PMID: 21197357 PMCID: PMC3004594 DOI: 10.2147/jmdh.s4743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Indexed: 01/29/2023] Open
Abstract
Much evidence on the favorable effects of omega-3 ethyl esters on cardiovascular morbidity and mortality has been obtained in studies performed in healthy subjects and in different clinical settings. Here the clinical effects of omega-3 ethyl ester administration in patients with previous myocardial infarction or heart failure are reviewed, together with a discussion of underlying mechanisms of action. The pharmacokinetic and pharmacodynamic properties of omega-3 ethyl esters, as well as evidence concerning their safety and tolerability, are also reported.
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Affiliation(s)
- Giacomo Levantesi
- Laboratory of Clinical Epidemiology of Cardiovascular Disease, Consorzio Mario Negri Sud, Chieti, Italy
| | - Maria Giuseppina Silletta
- Laboratory of Clinical Epidemiology of Cardiovascular Disease, Consorzio Mario Negri Sud, Chieti, Italy
| | - Roberto Marchioli
- Laboratory of Clinical Epidemiology of Cardiovascular Disease, Consorzio Mario Negri Sud, Chieti, Italy
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Othman RA, Suh M, Fischer G, Azordegan N, Riediger N, Le K, Jassal DS, Moghadasian MH. A comparison of the effects of fish oil and flaxseed oil on cardiac allograft chronic rejection in rats. Am J Physiol Heart Circ Physiol 2008; 294:H1452-8. [DOI: 10.1152/ajpheart.01280.2007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Both fish and flaxseed oils are major sources of different n-3 fatty acids. Beneficial effects of fish oil on posttransplantation complications have been reported. The current study aimed to compare the effects of flaxseed and fish oils in a rat cardiac allograft model. Male Fischer and Lewis rats were used as donors and recipients, respectively, to generate a heterotopic cardiac allograft model. Animals were randomly assigned into three groups and fed a diet supplemented with 1) 5% (wt/wt) safflower oil (control, n = 7), 2) 5% (wt/wt) flaxseed oil ( n = 8), or 3) 2% (wt/wt) fish oil ( n = 7), and an intraperitoneal injection of cyclosporine A (CsA; 1.5 mg·kg−1·day−1) over 12 wk. Body weight, blood pressure, plasma levels of lipids, CsA, select cytokines, as well as graft function and chronic rejection features were assessed. Body weight and blood CsA levels were similar among the groups. Relative to controls, both treated groups had lower systolic and diastolic blood pressure and plasma levels of macrophage chemotactic protein-1. Treatment with fish oil significantly ( P < 0.05) lowered plasma levels of triglycerides, total cholesterol, and LDL-cholesterol. HDL-cholesterol concentrations were significantly higher ( P < 0.05) in the flaxseed oil-treated group compared with the other two groups. Both flaxseed oil and fish oil may provide similar biochemical, hemodynamic, and inflammatory benefits after heart transplantation; however, neither of the oils was able to statistically significantly impact chronic rejection or histological evidence of apparent cyclosporine-induced nephrotoxicity in this model.
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Dandona P, Chaudhuri A, Mohanty P. Macronutrients, advanced glycation end products, and vascular reactivity. Diabetes Care 2007; 30:2750-1. [PMID: 17901533 DOI: 10.2337/dc07-1323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Kavey REW, Allada V, Daniels SR, Hayman LL, McCrindle BW, Newburger JW, Parekh RS, Steinberger J. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research. J Cardiovasc Nurs 2007; 22:218-53. [PMID: 17545824 DOI: 10.1097/01.jcn.0000267827.50320.85] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Although for most children the process of atherosclerosis is subclinical, dramatically accelerated atherosclerosis occurs in some pediatric disease states, with clinical coronary events occurring in childhood and very early adult life. As with most scientific statements about children and the future risk for cardiovascular disease, there are no randomized trials documenting the effects of risk reduction on hard clinical outcomes. A growing body of literature, however, identifies the importance of premature cardiovascular disease in the course of certain pediatric diagnoses and addresses the response to risk factor reduction. For this scientific statement, a panel of experts reviewed what is known about very premature cardiovascular disease in 8 high-risk pediatric diagnoses and, from the science base, developed practical recommendations for management of cardiovascular risk.
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von Schacky C. A review of omega-3 ethyl esters for cardiovascular prevention and treatment of increased blood triglyceride levels. Vasc Health Risk Manag 2007; 2:251-62. [PMID: 17326331 PMCID: PMC1993981 DOI: 10.2147/vhrm.2006.2.3.251] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The two marine omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), prevalent in fish and fish oils, have been investigated as a strategy towards prophylaxis of atherosclerosis. While the results with fish and fish oils have been not as clear cut, the data generated with the purified ethyl ester forms of these two fatty acids are consistent. Although slight differences in biological activity exist between EPA and DHA, both exert a number of positive actions against atherosclerosis and its complications. EPA and DHA as ethyl esters inhibit platelet aggregability, and reduce serum triglycerides, while leaving other serum lipids essentially unaltered. Glucose metabolism has been studied extensively, and no adverse effects were seen. Pro-atherogenic cytokines are reduced, as are markers of endothelial activation. Endothelial function is improved, vascular occlusion is reduced, and the course of coronary atherosclerosis is mitigated. Heart rate is reduced, and heart rate variability is increased by EPA and DHA. An antiarrhythmic effect can be demonstrated on the supraventricular and the ventricular level. More importantly, two large studies showed reductions in clinical endpoints like sudden cardiac death or major adverse cardiac events. As a consequence, relevant cardiac societies recommend using 1 g/day of EPA and DHA for cardiovascular prevention, after a myocardial infarction and for prevention of sudden cardiac death.
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Affiliation(s)
- Clemens von Schacky
- Medizinische Klinik and Poliklinik Innenstadt, University of Munich, Munich, Germany.
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Cleemput I, Dobbels F. Measuring patient-reported outcomes in solid organ transplant recipients: an overview of instruments developed to date. PHARMACOECONOMICS 2007; 25:269-86. [PMID: 17402802 DOI: 10.2165/00019053-200725040-00002] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Improvements in organ preservation methods, immunosuppressive regimens and general post-transplant care have resulted in an increased life expectancy and a continually decreasing morbidity after solid organ transplantation. As attention gradually moves towards improving subjective patient outcomes, the use of patient-reported outcome measures (PROs) thus becomes increasingly important in post-transplant patient management. This paper provides a brief systematic overview of the transplant-specific PRO measures, and their psychometric properties, developed and used in solid organ transplant recipients to date. PRO measures may focus on or encompass different aspects of life relevant to organ transplant patients: overall quality of life (QOL), physical, psychological and social functioning, and adherence. Overall QOL can be measured using transplant-specific or generic QOL instruments, or a combination of both. In general, very little information is available on the psychometric properties of PRO measures, and there is no gold standard for PRO measurement. Transplant-specific and generic PRO instruments are complementary. Generic instruments will continue to be important for economic evaluations, but transplant-specific instruments may be more useful for patient management purposes, as they are generally more sensitive to small but clinically relevant changes in outcomes in transplant populations.
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Affiliation(s)
- Irina Cleemput
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium.
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Sekine S, Sasanuki S, Aoyama T, Takeuchi H. Lowering Systolic Blood Pressure and Increases in Vasodilator Levels in SHR with Oral .ALPHA.-Linolenic Acid Administration. J Oleo Sci 2007; 56:341-5. [PMID: 17898500 DOI: 10.5650/jos.56.341] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The present study attempted to clarify the antihypertensive effect and its mechanism when alpha-linolenic acid (ALA) is administered orally. For this purpose, 1 mL of flaxseed oil, which is rich in ALA, and high oleic safflower oil was administered orally to spontaneously hypertensive rats (SHR) of a control and an ALA group on days 1 and 5. Systolic blood pressure was measured on day 1, and blood and liver were collected on day 5. Four hours after the oral administration on day 1, systolic blood pressure of the ALA group was lower than that of the control group. Levels of plasma vasodilators, such as prostaglandin I(2) metabolite, nitric oxide metabolites, and bradykinin, in the ALA group were significantly higher than those in the control group, but levels of vasoconstrictors, such as angiotensin II and thromboxane A(2) metabolite, did not differ significantly. It is known that bradykinin induces prostaglandin I(2) and nitric oxide. The present study shows that ALA reduced the systolic blood pressure of SHR, and its mechanism may be related to increases of prostaglandin I(2) and nitric oxide through bradykinin stimulation.
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Affiliation(s)
- Seiji Sekine
- Central Research Laboratory, The Nisshin Oillio Group, Ltd., Yokosuka-shi, Kanagawa, Japan.
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Abstract
Despite advances in medical management and device therapy, chronic heart failure (CHF) remains a condition of high mortality and poor quality of life. Patients with CHF endure frequent admissions to hospital, with exacerbations of breathlessness or recurrent acute myocardial infarction and have a high incidence of sudden death. A high intake of marine polyunsaturated fatty acids (PUFAs) is associated with lower cardiovascular mortality in the general population, and diabetics, and can reduce cardiovascular deaths post-infarction. Many of the effects of PUFAs could be of benefit in CHF patients. They can improve endothelial function, reduce vascular tone, reduce platelet aggregability, improve myocardial relaxation, stabilize myocardial cells by prolonging the refractory period, and lead to increased appetite and weight gain. They also have potentially important immune-modulating effects, reducing cytokine production and release and altering prostaglandin metabolism. In this review article we discuss the potential benefits of PUFA supplementation in CHF patients using data from clinical trials and in vitro experiments.
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Bilchick KC, Henrikson CA, Skojec D, Kasper EK, Blumenthal RS. Treatment of hyperlipidemia in cardiac transplant recipients. Am Heart J 2004; 148:200-10. [PMID: 15308989 DOI: 10.1016/j.ahj.2004.03.050] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Of the 60,000 patients receiving heart transplants between 1982 and 2001, approximately 12,000 are currently alive. The high incidence of hyperlipidemia and coronary disease (also known as accelerated graft atherosclerosis, or AGA) in these patients warrants early prophylaxis soon after transplantation with 3-hydroxy-3-methylglutaryl (HMG) Co-A reductase inhibitors (statins). Immunosuppressive agents such as prednisone, cyclosporine, mycophenylate mofetil, and sirolimus are associated with hyperlipidemia. Statins, in addition to lowering cholesterol levels, also benefit cardiac transplant recipients via effects on the immune system and endothelial function. Recent data have demonstrated that statins decrease AGA and mortality rates. Furthermore, greater benefits are seen when statins are started early. The 2 statins shown to decrease mortality in patients after cardiac transplantation are pravastatin and simvastatin, which differ in their metabolism (pravastatin is the only statin with non-cytochrome metabolism) and lipophilicity (pravastatin is less lipophilic). Although the benefit of simvastatin has been shown to extend to 8 years after transplantation, increased adverse effects in other studies with higher doses of simvastatin have resulted in new prescribing recommendations, which state that the dose of simvastatin should probably not exceed 10 mg with cyclosporine or gemfibrozil and 20 mg with amiodarone or verapamil. The evidence for potential benefits, interactions, and adverse effects of other potential lipid-lowering drugs for this patient population, such as fibrates, niacin, fish oil, cholestyramine, and ezetimibe, are also discussed. A summary algorithm is proposed, including approaches to patients with statin-associated musculoskeletal symptoms and patients with inadequate results after initial statin therapy.
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Affiliation(s)
- Kenneth C Bilchick
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Butani L, Afshinnik A, Johnson J, Javaheri D, Peck S, German JB, Perez RV. Amelioration of tacrolimus-induced nephrotoxicity in rats using juniper oil. Transplantation 2003; 76:306-11. [PMID: 12883183 DOI: 10.1097/01.tp.0000072337.37671.39] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Calcineurin-inhibitor nephrotoxicity plays a role in the pathogenesis of chronic allograft nephropathy by causing renal ischemia mediated by vasoconstrictive metabolites of the prostanoid pathway. The purpose of our study was to evaluate whether altering the prostanoid profile using juniper oil (JO) would afford renoprotection in rats treated with tacrolimus. METHODS Diets supplemented with biologic oils (no supplementation, JO, fish oil [FO], safflower oil [SO], and arachidonic acid [AA]) were fed to five groups of rats for 5 weeks; during the last 2 weeks, tacrolimus was administered to all groups except for a control group of animals. At week 5, urinary prostaglandin (PG)F(2-alpha) and inulin clearances were measured. The rat kidneys were harvested to determine the renal cell membrane composition for arachidonic, eicosatrienoic, and eicosapentaenoic acids. RESULTS Both JO and FO completely reversed the decrease in inulin clearance seen with tacrolimus, the greatest effect being with JO (inulin clearance 15.1+/-3 vs. 6.0+/-1.1 ml/min in the nonsupplemented group; P<0.001); urinary PGF(2-alpha) excretion was also highest in the JO group (328+/-23 pg/mL, P<0.001 vs. the nonsupplemented group). Fatty acid membrane analysis showed greatest incorporation of eicosapentaenoic and eicosatrienoic acids in the JO- (5.7+/-0.6% and 3.1+/-0.4%, respectively) and FO- (8.1+/-0.7% and 2.8+/-0.6%, respectively) treated animals. CONCLUSIONS JO supplementation in tacrolimus-treated rats was associated with incorporation of vasodilatory prostanoids in the renal-cell membrane and elevated urinary PGF(2-alpha) excretion, and the precipitous fall in inulin clearance induced by tacrolimus was completely prevented. Whether this benefit will translate into a reduction in chronic allograft nephropathy remains to be determined. However, our preliminary data point towards the need for human trials.
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Affiliation(s)
- Lavjay Butani
- Section of Pediatric Nephrology, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
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Holm T, Aukrust P, Aagaard E, Ueland T, Haugstad TS, Kjekshus J, Simonsen S, Frøland SS, Gullestad L, Andreassen AK. Hypertension in relation to nitric oxide, asymmetric dimethylarginine, and inflammation: different patterns in heart transplant recipients and individuals with essential hypertension. Transplantation 2002; 74:1395-400. [PMID: 12451238 DOI: 10.1097/00007890-200211270-00009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Most heart transplant (HTx) recipients develop hypertension, characterized by increased peripheral vascular tone and endothelial dysfunction. Reduced levels of nitric oxide (NO) have been found in essential hypertension, and herein we investigated the possible role of altered concentrations of NO in posttransplant hypertension. METHODS Plasma levels of the NO-derived end products NO2(-) + NO3(-), the endogenous inhibitor of NO synthase asymmetric dimethylarginine (ADMA), and the inflammatory cytokine tumor necrosis factor (TNF)-alpha were examined in 65 stable hypertensive long-term (6 years [range 1-13]) survivors of HTx. HTx recipients were compared with 39 individuals with essential hypertension and 25 normotensive controls. RESULTS Hypertensive HTx recipients had raised NO2(-) + NO3(-) levels in plasma, positively correlated with 24-hour mean blood pressure (BP). In contrast, individuals with essential hypertension had decreased NO2(-) + NO3(-) concentration comparing controls, inversely correlated with 24-hour mean BP. Moreover, although TNF-alpha levels were significantly raised in HTx recipients compared with both healthy controls and individuals with essential hypertension, it was positively correlated to 24-hour BP and NO2(-) + NO3(-). Although only a slight increase was found in essential hypertension, no correlations were found in these nontransplant individuals. Finally, although asymmetric dimethylarginine (ADMA) tended to be raised in essential hypertension, this endogenous nitric oxide synthase (NOS) inhibitor was significantly decreased in HTx recipients compared with normotensive controls. CONCLUSION Our findings suggest that different mechanisms may be operating in the pathogenesis of posttransplant compared with essential hypertension, with persistent inflammation, raised NO2(-) + NO3(-), and decreased ADMA levels characterizing the former group.
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Affiliation(s)
- Torbjørn Holm
- Department of Cardiology, University of Oslo, Oslo, Norway
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Abstract
Hypertension is a major risk factor for many cardiovascular diseases including stroke, coronary heart disease, cardiac failure, and endstage renal disease. Therefore, prevention of hypertension becomes an important goal in overall efforts to control blood pressure and reduce the incidence of hypertension-related cardiovascular and renal complications and outcomes. Many risk factors underlying hypertension have been identified including nonmodifiable factors such as age, gender, genetic factors, and race, as well as modifiable factors including overweight, high sodium intake, low potassium intake, alcohol consumption, and reduced physical activity. A number of studies have demonstrated that interventions aimed at changing these modifiable factors might decrease blood pressure and even prevent the development of hypertension. Thus, present national recommendations and guidelines include lifestyle modifications ranging from weight loss in case of obesity, engagement in regular isotonic physical activity, reduced sodium diet (<100 mmol/d), supplementation of potassium, and alcohol moderation (<1 ounce of ethanol or its equivalent per day).
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Affiliation(s)
- Michel Slama
- Hypertension Research Laboratories, Division of Research, Oschner Clinic Foundation, New Orleans, LA 70121, USA.
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Hankins S, Mancini D. Drug treatment of clinical problems related to cardiac transplantation. HEART DISEASE (HAGERSTOWN, MD.) 2002; 4:242-51. [PMID: 12147184 DOI: 10.1097/00132580-200207000-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In recent years, several new immunosuppressive agents have become available for the treatment of cardiac transplant recipients. Use of these agents and their potential side effects are reviewed.
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Affiliation(s)
- Shelley Hankins
- Department of Medicine, Division of Circulatory Physiology, Columbia Presbyterian Hospital Center, New York, New York, USA
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Suzuki A, Kagawa D, Fujii A, Ochiai R, Tokimitsu I, Saito I. Short- and long-term effects of ferulic acid on blood pressure in spontaneously hypertensive rats. Am J Hypertens 2002; 15:351-7. [PMID: 11991222 DOI: 10.1016/s0895-7061(01)02337-8] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Ferulic acid (4-hydroxy-3-methoxycinnamic acid) is a phenolic compound contained in rice bran and other plants. The effect of ferulic acid on blood pressure (BP) was investigated in spontaneously hypertensive rats (SHR). After oral administration of ferulic acid (1 to 100 mg/kg) to SHR, systolic blood pressure (SBP) significantly decreased in a dose-dependent manner. When oral ferulic acid (50 mg/kg) was administered to SHR, BP was lowest at 1 h and returned to basal levels at 6 h. There was a significant correlation between SHR plasma ferulic acid and changes in the SBP of the tail artery, suggesting that absorbed ferulic acid reduces BP. When 7-week-old SHR were given 10 and 50 mg/kg/d of ferulic acid for 6 weeks, increases in BP were significantly attenuated compared to SHR on the control diet. Intravenous injection of ferulic acid dose dependently reduced carotid arterial pressure in anesthetized SHR. Furthermore, the depressor effect of intravenous ferulic acid (1 mg/kg) was significantly attenuated by pretreatment of SHR with the nitric oxide (NO) synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME; 3 mg/kg, administered intravenously). These data suggest that the hypotensive effect of ferulic acid in SHR is associated with NO-mediated vasodilation.
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Affiliation(s)
- Atsushi Suzuki
- Biological Science Laboratories, Kao Corporation, Tochigi, Japan
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Suzuki A, Kagawa D, Ochiai R, Tokimitsu I, Saito I. Green coffee bean extract and its metabolites have a hypotensive effect in spontaneously hypertensive rats. Hypertens Res 2002; 25:99-107. [PMID: 11924733 DOI: 10.1291/hypres.25.99] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The effects of a water-soluble green coffee bean extract (GCE) on blood pressure were investigated using spontaneously hypertensive rats (SHR). There was a dose-dependent reduction in blood pressure after a single ingestion (180 to 720 mg/kg, p.o.) or long-term ingestion (0.25 to 1% diet for 6 weeks) of GCE. A single oral ingestion (50 to 200 mg/kg) of 5-caffeoylquinic acid (5-CQA), the major component of GCE, dose-dependently decreased blood pressure, suggesting that 5-CQA is involved in the hypotensive effect of GCE in SHR. Because significant increases in caffeic acid (CA) or ferulic acid (FA) were detected in plasma after oral ingestion of 5-CQA in SHR, these acids (2.5, 5,10 micromol/kg) were intravenously injected into SHR under anesthesia and the carotid arterial pressure was measured. Of the two components, FA had a stronger depressor effect than CA. The depressor effect of FA (50 mg/kg, p.o.) was attenuated by the concurrent injection of atropine sulfate (5 mg/kg, s.c.), suggesting that the hypotensive effect of FA in SHR might be mediated via the muscarinic acetylcholine receptors. These findings indicate that oral ingestion of GCE or 5-CQA decreases blood pressure in SHR, and that FA, which is a metabolite of 5-CQA, is a candidate hypotensive component.
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Affiliation(s)
- Atsushi Suzuki
- Biological Science Laboratories, Kao Corp., Tochigi, Japan
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Holm T, Berge RK, Andreassen AK, Ueland T, Kjekshus J, Simonsen S, Frøland S, Gullestad L, Aukrust P. Omega-3 fatty acids enhance tumor necrosis factor-alpha levels in heart transplant recipients. Transplantation 2001; 72:706-11. [PMID: 11544435 DOI: 10.1097/00007890-200108270-00025] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Proinflammatory cytokines may contribute to clinical complications in heart transplant (HTx) recipients. Previous studies have shown immunomodulating effects of omega-3 fatty acids, but the results are somewhat conflicting. In this study, we examined plasma levels of tumor necrosis factor alpha (TNF-alpha), interleukin (IL) 10, and their relations to antioxidant vitamins in 45 HTx recipients before and after treatment with omega-3 fatty acids or placebo. METHODS The patients were long-time survivors of heart transplantation, randomized in a double-blind fashion to receive omega-3 fatty acids (3.4 g/day) or placebo for 1 year. Plasma levels of cytokines were measured by enzyme immunoassays and vitamin A, vitamin E, and beta-carotene by high-performance liquid chromatography. RESULTS In the omega-3, but not in the placebo group, there was a rise in the proinflammatory cytokine TNF-alpha (P<0.05), a decrease in the anti-inflammatory cytokine IL-10 (P=0.07), and a rise in TNF/IL-10 ratio (P<0.05) after 12 months, suggesting a proinflammatory net effect. In the omega-3 group, the increase in TNF-alpha was associated with an increase in eicosapentaenoic acid in plasma (r=0.58, P<0.02). During omega-3 fatty-acid treatment, but not during placebo, there was a decrease in vitamin E (P<0.05) and beta-carotene (P<0.05) levels, and the decrease in vitamin E was inversely correlated with the increase in TNF-alpha (r= -0.56, P<0.01). The rise in TNF-alpha levels during omega-3 fatty acids treatment was most pronounced in those patients with transplant coronary artery disease (P<0.04). CONCLUSION Our data suggest that omega-3 fatty acids in HTx recipients may change the balance between proinflammatory and anti-inflammatory cytokines in an inflammatory direction, possibly related to prooxidative effects of these fatty acids.
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Affiliation(s)
- T Holm
- Department of Cardiology, Research Institute for Internal Medicine, University of Oslo, Rikshospitalet, Norway.
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