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Gustafsson A, Johansson E, Henckel E, Olin A, Rodriguez L, Brodin P, Lange S, Bohlin K. Antisecretory factor in breastmilk is associated with reduced incidence of sepsis in preterm infants. Pediatr Res 2024; 95:762-769. [PMID: 38001236 PMCID: PMC10899102 DOI: 10.1038/s41390-023-02909-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/28/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Antisecretory Factor (AF) is a protein present in breastmilk that regulates inflammatory processes. We aimed to investigate the level of AF in mothers' own milk (MOM) in relation to sepsis and other neonatal morbidities in preterm infants. METHODS Samples of breastmilk and infant plasma were collected at 1, 4, and 12 weeks after birth from 38 mothers and their 49 infants born before 30 weeks gestation. AF-compleasome in MOM was determined by a sandwich enzyme-linked immunosorbent assay (ELISA) and inflammatory markers in infant plasma by a panel of 92 inflammatory proteins. Neonatal treatments and outcomes were recorded. RESULTS The level of AF in MOM week 1 was lower for infants with later sepsis compared to no sepsis (p = 0.005). Corrected for nutritional intake of MOM, higher levels of AF decreased the risk for sepsis, OR 0.24. AF in MOM week 1 was negatively correlated to inflammatory proteins in infant plasma week 4, markedly IL-8, which was also associated with infant sepsis. Overall, higher AF levels in MOM was associated with fewer major morbidities of prematurity. CONCLUSION Mother's milk containing high levels of antisecretory factor is associated with reduced risk for sepsis and inflammation in preterm infants. IMPACT High level of antisecretory factor (AF) in mothers' own milk is associated with less risk for later sepsis in preterm infants. Receiving mothers' milk with low AF levels during the first week after birth is correlated with more inflammatory proteins in infant's plasma 2-4 weeks later. Human breastmilk has anti-inflammatory properties, and antisecretory factor in mothers' own milk is a component of potential importance for infants born preterm. The findings suggest that food supplementation with AF to mothers of preterm infants to increase AF-levels in breastmilk may be a means to decrease the risk of inflammatory morbidities of prematurity.
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Affiliation(s)
- Anna Gustafsson
- Department of Neonatology, Karolinska University Hospital, SE-17176, Stockholm, Sweden.
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
| | - Ewa Johansson
- Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Department of Clinical Microbiology, Västra Götaland Region, Gothenburg, Sweden
| | - Ewa Henckel
- Department of Neonatology, Karolinska University Hospital, SE-17176, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Axel Olin
- Science for Life Laboratory, Department of Women's and Children's Health, Karolinska Institutet, and Unit of Infectious Diseases, Karolinska University Hospital, SE-17176, Stockholm, Sweden
| | - Lucie Rodriguez
- Science for Life Laboratory, Department of Women's and Children's Health, Karolinska Institutet, and Unit of Infectious Diseases, Karolinska University Hospital, SE-17176, Stockholm, Sweden
| | - Petter Brodin
- Science for Life Laboratory, Department of Women's and Children's Health, Karolinska Institutet, and Unit of Infectious Diseases, Karolinska University Hospital, SE-17176, Stockholm, Sweden
| | - Stefan Lange
- Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Department of Clinical Microbiology, Västra Götaland Region, Gothenburg, Sweden
| | - Kajsa Bohlin
- Department of Neonatology, Karolinska University Hospital, SE-17176, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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2
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Webster KE, George B, Lee A, Galbraith K, Harrington-Benton NA, Judd O, Kaski D, Maarsingh OR, MacKeith S, Murdin L, Ray J, Van Vugt VA, Burton MJ. Lifestyle and dietary interventions for Ménière's disease. Cochrane Database Syst Rev 2023; 2:CD015244. [PMID: 36848645 PMCID: PMC9969956 DOI: 10.1002/14651858.cd015244.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Ménière's disease is a condition that causes recurrent episodes of vertigo, associated with hearing loss and tinnitus. Lifestyle or dietary modifications (including reducing the amount of salt or caffeine in the diet) are sometimes suggested to be of benefit for this condition. The underlying cause of Ménière's disease is unknown, as is the way in which these interventions may work. The efficacy of these different interventions at preventing vertigo attacks, and their associated symptoms, is currently unclear. OBJECTIVES To evaluate the benefits and harms of lifestyle and dietary interventions versus placebo or no treatment in people with Ménière's disease. SEARCH METHODS The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 14 September 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs in adults with Ménière's disease comparing any lifestyle or dietary intervention with either placebo or no treatment. We excluded studies with follow-up of less than three months, or with a cross-over design (unless data from the first phase of the study could be identified). DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were: 1) improvement in vertigo (assessed as a dichotomous outcome - improved or not improved), 2) change in vertigo (assessed as a continuous outcome, with a score on a numerical scale) and 3) serious adverse events. Our secondary outcomes were: 4) disease-specific health-related quality of life, 5) change in hearing, 6) change in tinnitus and 7) other adverse effects. We considered outcomes reported at three time points: 3 to < 6 months, 6 to ≤ 12 months and > 12 months. We used GRADE to assess the certainty of evidence for each outcome. MAIN RESULTS: We included two RCTs, one related to diet, and the other related to fluid intake and sleep. In a Swedish study, 51 participants were randomised to receive 'specially processed cereals' or standard cereals. The specially processed cereals are thought to stimulate the production of anti-secretory factor - a protein that reduces inflammation and fluid secretion. Participants received the cereals for three months. The only outcome reported by this study was disease-specific health-related quality of life. The second study was conducted in Japan. The participants (223) were randomised to receive abundant water intake (35 mL/kg/day), or to sleep in darkness (in an unlit room for six to seven hours per night), or to receive no intervention. The duration of follow-up was two years. The outcomes assessed were 'improvement in vertigo' and hearing. As these studies considered different interventions we were unable to carry out any meta-analysis, and for almost all outcomes the certainty of the evidence was very low. We are unable to draw meaningful conclusions from the numerical results. AUTHORS' CONCLUSIONS The evidence for lifestyle or dietary interventions for Ménière's disease is very uncertain. We did not identify any placebo-controlled RCTs for interventions that are frequently recommended for those with Ménière's disease, such as salt restriction or caffeine restriction. We identified only two RCTs that compared a lifestyle or dietary intervention to placebo or no treatment, and the evidence that is currently available from these studies is of low or very low certainty. This means that we have very low confidence that the effects reported are accurate estimates of the true effect of these interventions. Consensus on the appropriate outcomes to measure in studies of Ménière's disease is needed (i.e. a core outcome set) in order to guide future studies in this area and enable meta-analyses of the results. This must include appropriate consideration of the potential harms of treatment, as well as the benefits.
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Affiliation(s)
- Katie E Webster
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Ben George
- Corpus Christi College, University of Oxford, Oxford, UK
| | - Ambrose Lee
- Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Kevin Galbraith
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | | | - Owen Judd
- ENT Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Diego Kaski
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Otto R Maarsingh
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Samuel MacKeith
- ENT Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Louisa Murdin
- ENT Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Vincent A Van Vugt
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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3
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Ehinger E, Kopecky J, Darabi A, Visse E, Edvardsson C, Tomasevic G, Cederberg D, Belting M, Bengzon J, Siesjö P. Antisecretory factor is safe to use as add-on treatment in newly diagnosed glioblastoma. BMC Neurol 2023; 23:76. [PMID: 36803465 PMCID: PMC9938624 DOI: 10.1186/s12883-023-03119-4] [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: 09/19/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
PURPOSE Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Despite the best available treatment, prognosis remains poor. Current standard therapy consists of surgical removal of the tumor followed by radiotherapy and chemotherapy with the alkylating agent temozolomide (TMZ). Experimental studies suggest that antisecretory factor (AF), an endogenous protein with proposed antisecretory and anti-inflammatory properties, may potentiate the effect of TMZ and alleviate cerebral edema. Salovum is an egg yolk powder enriched for AF and is classified as a medical food in the European Union. In this pilot study, we evaluate the safety and feasibility of add-on Salovum in GBM patients. METHODS Eight patients with newly diagnosed, histologically confirmed GBM were prescribed Salovum during concomitant radiochemotherapy. Safety was determined by the number of treatment-related adverse events. Feasibility was determined by the number of patients who completed the full prescribed Salovum treatment. RESULTS No serious treatment-related adverse events were observed. Out of 8 included patients, 2 did not complete the full treatment. Only one of the dropouts was due to issues directly related to Salovum, which were nausea and loss of appetite. Median survival was 23 months. CONCLUSIONS We conclude that Salovum is safe to use as an add-on treatment for GBM. In terms of feasibility, adherence to the treatment regimen requires a determined and independent patient as the large doses prescribed may cause nausea and loss of appetite. TRIAL REGISTRATION ClinicalTrials.gov NCT04116138. Registered on 04/10/2019.
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Affiliation(s)
- Erik Ehinger
- Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden. .,Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden.
| | - Jan Kopecky
- grid.4514.40000 0001 0930 2361Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Anna Darabi
- grid.4514.40000 0001 0930 2361Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Edward Visse
- grid.4514.40000 0001 0930 2361Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Charlotte Edvardsson
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Gregor Tomasevic
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - David Cederberg
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Mattias Belting
- grid.4514.40000 0001 0930 2361Oncology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden ,grid.8993.b0000 0004 1936 9457Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden ,grid.411843.b0000 0004 0623 9987Department of Hematology, Oncology and Radiophysics, Skåne University Hospital, Lund, Sweden
| | - Johan Bengzon
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden ,grid.4514.40000 0001 0930 2361Lund Stem Cell Center, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Peter Siesjö
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden ,grid.4514.40000 0001 0930 2361Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden
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Bazzurro V, Gatta E, Angeli E, Cupello A, Lange S, Jennische E, Robello M, Diaspro A. Involvement of GABA A receptors containing α 6 subtypes in antisecretory factor activity on rat cerebellar granule cells studied by two-photon uncaging. Eur J Neurosci 2022; 56:4505-4513. [PMID: 35848658 PMCID: PMC9541628 DOI: 10.1111/ejn.15775] [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: 01/05/2022] [Revised: 06/11/2022] [Accepted: 07/07/2022] [Indexed: 11/28/2022]
Abstract
The antisecretory factor (AF) is an endogenous protein that counteracts intestinal hypersecretion and various inflammation conditions in vivo. It has been detected in many mammalian tissues and plasma, but its mechanisms of action are largely unknown. To study the pharmacological action of the AF on different GABAA receptor populations in cerebellar granule cells, we took advantage of the two‐photon uncaging method as this technique allows to stimulate the cell locally in well‐identified plasma membrane parts. We compared the electrophysiological response evoked by releasing a caged GABA compound on the soma, the axon initial segment and neurites before and after administering AF‐16, a 16 amino acids long peptide obtained from the amino‐terminal end of the AF protein. After the treatment with AF‐16, we observed peak current increases of varying magnitude depending on the neuronal region. Thus, studying the effects of furosemide and AF‐16 on the electrophysiological behaviour of cerebellar granules, we suggest that GABAA receptors, containing the α6 subunit, may be specifically involved in the increase of the peak current by AF, and different receptor subtype distribution may be responsible for differences in this increase on the cell.
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Affiliation(s)
- Virginia Bazzurro
- DIFILAB, Department of Physics, University of Genoa, Genoa, Italy.,Nanoscopy, CHT Erzelli, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Elena Gatta
- DIFILAB, Department of Physics, University of Genoa, Genoa, Italy
| | - Elena Angeli
- DIFILAB, Department of Physics, University of Genoa, Genoa, Italy
| | - Aroldo Cupello
- DIFILAB, Department of Physics, University of Genoa, Genoa, Italy
| | - Stefan Lange
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva Jennische
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mauro Robello
- DIFILAB, Department of Physics, University of Genoa, Genoa, Italy
| | - Alberto Diaspro
- DIFILAB, Department of Physics, University of Genoa, Genoa, Italy.,Nanoscopy, CHT Erzelli, Istituto Italiano di Tecnologia, Genoa, Italy
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5
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Upregulation of the endogenous peptide antisecretory factor enhances hippocampal long-term potentiation and promotes learning in wistar rats. Neuroscience 2022; 490:120-130. [PMID: 35276306 DOI: 10.1016/j.neuroscience.2022.03.002] [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: 11/29/2021] [Revised: 02/01/2022] [Accepted: 03/03/2022] [Indexed: 01/18/2023]
Abstract
Antisecretory Factor (AF) is an endogenous peptide known for its powerful antisecretory and anti-inflammatory properties. We have previously shown that AF also acts as a neuromodulator of GABAergic synaptic transmission in rat hippocampus in a way that results in disinhibition of CA1 pyramidal neurons. Disinhibition is expected to facilitate the induction of long-term potentiation (LTP), and LTP is known to play a crucial role in learning and memory acquisition. In the present study we investigated the effect of AF on LTP in CA3-CA1 synapses in rat hippocampus. In addition, endogenous AF plasma activity was upregulated by feeding the rats with specially processed cereals (SPC) and spatial learning and memory was studied in the Morris Water Maze (MWM). We found that LTP was significantly enhanced in the presence of AF, both when added exogenously in vitro as well as when upregulated endogenously by SPC-feeding. In the presence of the GABAA-receptor antagonist picrotoxin (PTX) there was however no significant enhancement of LTP. Moreover, rats fed with SPC demonstrated enhanced spatial learning and short-term memory, compared with control animals. These results show that the disinhibition of GABAergic transmission in the hippocampus by the endogenous peptide AF enhances LTP as well as spatial learning and memory.
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6
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Webster KE, Harrington-Benton NA, Judd O, Kaski D, Maarsingh OR, MacKeith S, Murdin L, Ray J, Van Vugt VA, Burton MJ. Lifestyle and dietary interventions for Ménière’s disease. Hippokratia 2022. [DOI: 10.1002/14651858.cd015244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Katie E Webster
- Cochrane ENT, Nuffield Department of Surgical Sciences; University of Oxford; Oxford UK
| | | | - Owen Judd
- ENT Department; University Hospitals of Derby and Burton NHS Foundation Trust; Derby UK
| | - Diego Kaski
- National Hospital for Neurology and Neurosurgery; London UK
| | - Otto R Maarsingh
- Department of General Practice, Amsterdam UMC; Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute; Amsterdam Netherlands
| | - Samuel MacKeith
- ENT Department; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| | - Louisa Murdin
- Ear Institute; Faculty of Brain Sciences, University College London; London UK
| | | | - Vincent A Van Vugt
- Department of General Practice, Amsterdam UMC; Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute; Amsterdam Netherlands
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7
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Barros VJDS, Severo JS, Mendes PHM, da Silva ACA, de Oliveira KBV, Parente JML, Lima MM, Neto EMM, Aguiar Dos Santos A, Tolentino Bento da Silva M. Effect of dietary interventions on inflammatory biomarkers of inflammatory bowel diseases: A systematic review of clinical trials. Nutrition 2021; 91-92:111457. [PMID: 34583136 DOI: 10.1016/j.nut.2021.111457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES In this review, we systematically assess whether dietary interventions are effective in attenuating inflammatory biomarkers in IBDs based on clinical trials available in the literature. RESEARCH METHODS & PROCEDURES This review was conducted in accordance with the guidelines of the PRISMA. We used the PubMed and SciVerse Scopus databases and the Cochrane collaboration tool to assess the risk of bias in clinical trials. The PICO (patient, intervention, comparison, and outcomes) strategy was used, with the descriptors: "Inflammatory bowel disease", "Crohn's disease", "cd", "ibd", "ulcerative colitis", "uc", "Diet", "Diet Habits", "Feeding", "Nutrients", "Food Intake", "Dietary patterns", "Inflammations", "Inflammation", "acute-phase proteins", "C-reactive protein", "interleukins", "tumor necrosis factor-alpha" and "inflammatory response". There is no conflict of interest. DATA ANALYSIS Fifteen studies were included, with a total of 627 participants. Of the total studies included, seven showed a reduction in some inflammatory markers in response to dietary interventions. This review was registered with the PROSPERO platform under number: CRD42021235150. CONCLUSIONS The results presented in this review reveal that dietary intervention with specific characteristics may be important during the treatment of the inflammatory process in patients with IBDs.
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Affiliation(s)
| | - Juliana Soares Severo
- Graduate Program in Food and Nutrition, Federal University of Piauí, Teresina, PI, Brazil
| | | | | | | | | | - Murilo Moura Lima
- University Hospital, Federal University of Piauí, Teresina, PI, Brazil
| | | | - Armênio Aguiar Dos Santos
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Moisés Tolentino Bento da Silva
- Graduate Program in Food and Nutrition, Graduate Program in Pharmacology, Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piauí, Teresina, PI, Brazil.
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Oğuz E, Cebeci A, Geçici CR. The relationship between nutrition and Ménière's disease. Auris Nasus Larynx 2021; 48:803-808. [PMID: 33773852 DOI: 10.1016/j.anl.2021.03.006] [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] [Received: 01/09/2021] [Revised: 02/13/2021] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
Ménière's disease is an inner ear disease with attacks characterized by ear fullness, tinnitus, fluctuant sensorineural hearing loss and vertigo. Although pathophysiology of the disease is not fully known, endolymphatic hydrops are believed to play a role. Although there is no certain treatment procedure for Ménière's disease, some treatments are applied to prevent attacks, to treat the symptoms that occur during the attacks, and to prevent the permanent effects of the symptoms on the hearing and balance system. Lifestyle changes, dietary modifications, diuretics, vasodilator corticosteroids, intratympanic steroids, surgical methods are some of these treatment methods. Dietary modification includes a low sodium diet, a reduction in daily alcohol and caffeine intake, a gluten-free diet, and a new dietary approach to specially processed grains, all of which are first-line treatments. The goal of this review article is to examine the relationship between MD and dietary intervention, which is frequently used in the prevention and treatment of MD attacks.
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Affiliation(s)
- Esma Oğuz
- Department of Nutrition and Dietetics, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Aybike Cebeci
- Department of Nutrition and Dietetics, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Cennet Reyyan Geçici
- Department of Audiology, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
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Viola P, Pisani D, Scarpa A, Cassandro C, Laria C, Aragona T, Ciriolo M, Spadera L, Ralli M, Cavaliere M, Iengo M, Chiarella G. The role of endogenous Antisecretory Factor (AF) in the treatment of Ménière's Disease: A two-year follow-up study. Preliminary results. Am J Otolaryngol 2020; 41:102673. [PMID: 32829060 DOI: 10.1016/j.amjoto.2020.102673] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/15/2020] [Accepted: 08/09/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the effects of increased endogenous Antisecretory Factor (AF) synthesis using specially processed cereals (SPC) in a sample of patients with defined unilateral Meniere's disease (MD), compared to the results of a treatment protocol of intravenous glycerol and dexamethasone. MATERIALS AND METHODS Twenty-six patients with unilateral MD were divided in 2 groups and treated with SPC and with intravenous glycerol and dexamethasone for 24 months. Audio-vestibular evaluation was performed before (T0) and every six months. The number of vertigo spells were evaluated before and after therapy and the Efficacy Index (EI) was calculated. Questionnaires for hearing loss, tinnitus and quality of life were administered. RESULTS EI decreased in the SPC group after 18 (T18) (p = .0017) and 24 (T24) months of therapy (p = .0111). There was a significant reduction for tinnitus score in the SPC group at T24 (p = .0131). No significant differences were found between the two groups at T0 (p = .4723), while a significant difference was found at T24 (p = .0027). Quality of life showed a significant improvement in daily activities in the SPC group (p = .0033) compared to the infusion therapy group. No statistically significant changes in PTA thresholds were found in both groups between T0 and T24. CONCLUSION The preliminary results of our study show a significant reduction of vertigo spells and a positive effect on tinnitus severity and on quality of life in patients with unilateral MD treated with SPC and when compared to patients treated with intravenous glycerol and dexamethasone. No effects on hearing thresholds were noted in both groups.
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Affiliation(s)
- Pasquale Viola
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Davide Pisani
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Alfonso Scarpa
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
| | | | - Carla Laria
- Department of Neurosciences, Reproductives and Odontostomatologic Sciences, Unit of Audiology, University of Naples "Federico II", Naples, Italy
| | | | - Marco Ciriolo
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Lucrezia Spadera
- Otolaryngology, San Leonardo Hospital, Castellammare di Stabia, Napoli, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Michele Cavaliere
- Department of Neurosciences, Reproductives and Odontostomatologic Sciences, Unit Ear, Nose and Throat Section, University of Naples "Federico II", Naples, Italy
| | - Maurizio Iengo
- Department of Neurosciences, Reproductives and Odontostomatologic Sciences, Unit Ear, Nose and Throat Section, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Chiarella
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
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10
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Barrueta Tenhunen A, van der Heijden J, Blokhin I, Massaro F, Hansson HA, Feinstein R, Larsson A, Larsson A, Tenhunen J. The antisecretory peptide AF-16 may modulate tissue edema but not inflammation in experimental peritonitis induced sepsis. PLoS One 2020; 15:e0232302. [PMID: 32822373 PMCID: PMC7446908 DOI: 10.1371/journal.pone.0232302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/31/2020] [Indexed: 12/01/2022] Open
Abstract
Sepsis is a life-threatening condition due to a dysregulated immunological response to infection. Apart from source control and broad-spectrum antibiotics, management is based on fluid resuscitation and vasoactive drugs. Fluid resuscitation implicates the risk of volume overload, which in turn is associated with longer stay in intensive care, prolonged use of mechanical ventilation and increased mortality. Antisecretory factor (AF), an endogenous protein, is detectable in most tissues and in plasma. The biologically active site of the protein is located in an 8-peptide sequence, contained in a synthetic 16-peptide fragment, named AF-16. The protein as well as the peptide AF-16 has multiple modulatory effects on abnormal fluid transport and edema formation/resolution as well as in a variety of inflammatory conditions. Apart from its' anti-secretory and anti-inflammatory characteristics, AF is an inhibitor of capillary leakage in intestine. It is not known whether the protein AF or the peptide AF-16 can ameliorate symptoms in sepsis. We hypothesized that AF-16 decreases the degree of hemodynamic instability, the need of fluid resuscitation, vasopressor dose and tissue edema in fecal peritonitis. To test the hypothesis, we induced peritonitis and sepsis by injecting autologous fecal solution into abdominal cavity of anesthetized pigs, and randomized (in a blind manner) the animals to intervention (AF-16, n = 8) or control (saline, n = 8) group. After the onset of hemodynamic instability (defined as mean arterial pressure < 60 mmHg maintained for > 5 minutes), intervention with AF-16 (20 mg/kg (50 mg/ml) in 0.9% saline) intravenously (only the vehicle in the control group) and a protocolized resuscitation was started. We recorded respiratory and hemodynamic parameters hourly for twenty hours or until the animal died and collected post mortem tissue samples at the end of the experiment. No differences between the groups were observed regarding hemodynamics, overall fluid balance, lung mechanics, gas exchange or histology. However, liver wet-to-dry ratio remained lower in AF-16 treated animals as compared to controls, 3.1 ± 0.4, (2.7-3.5, 95% CI, n = 8) vs 4.0 ± 0.6 (3.4-4.5, 95% CI, n = 8), p = 0.006, respectively. Bearing in mind the limited sample size, this experimental pilot study suggests that AF-16 may inhibit sepsis induced liver edema in peritonitis-sepsis.
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Affiliation(s)
- Annelie Barrueta Tenhunen
- Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden
- Department of Surgical Sciences, Section of Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Jaap van der Heijden
- Department of Surgical Sciences, Section of Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Ivan Blokhin
- Department of Surgical Sciences, Section of Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Fabrizia Massaro
- Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden
- Cardiac Anesthesia and Intensive Care, Anthea Hospital, GVM Care & Research, Bari, Italy
| | - Hans Arne Hansson
- Institute of Biomedicine, University of Gothenburg, Göteborg, Sweden
| | - Ricardo Feinstein
- Department of Pathology and Wildlife Diseases, National Veterinary Institute, Uppsala, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Section of Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Anders Larsson
- Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden
| | - Jyrki Tenhunen
- Department of Surgical Sciences, Section of Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
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Johansson E, Lange S, Oshalim M, Lönnroth I. Anti-Inflammatory Substances in Wheat Malt Inducing Antisecretory Factor. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2019; 74:489-494. [PMID: 31435787 PMCID: PMC6900268 DOI: 10.1007/s11130-019-00767-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Extensively malted cereals counteract enterotoxic diarrhea and inflammatory bowel diseases. This effect depends on a protein called antisecretory factor (AF), which is secreted into the blood as a larger complex known as the compleasome. In this study, we identified anti-inflammatory substances in malt and assayed their capacity to induce AF. Guaiacol and quercetin inhibited inflammation in a mouse footpad model, while catechin, sinapic acid, ferulic acid, and quercetin inhibited nitric oxide formation in RAW 264.7 cells. The proteasome activity in these cells was inhibited by vanillic acid and quercetin but not by the other tested phenols. As the transient receptor potential vanilloid 1 (TRPV1) might be involved in AF induction, the TRPV1 antagonist capsazepine was tested and shown to inhibit inflammation in mouse paw and nitric oxide formation. Catechin, ferulic acid, and sinapic acid induced AF in rat blood, and these substances were all increased in malt compared to control wheat. These phenols might therefore be of particular importance for the beneficial effect of malted cereals on inflammatory diseases. Our results further suggest that TRPV1 might play a role in the anti-inflammatory activity of phenols via the induction of AF.
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Affiliation(s)
- E Johansson
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, P.O.B 420, S-40530, Gothenburg, Sweden
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Region Västra Götaland, P.O.B 7193, S-40234, Gothenburg, Sweden
| | - S Lange
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, P.O.B 420, S-40530, Gothenburg, Sweden
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Region Västra Götaland, P.O.B 7193, S-40234, Gothenburg, Sweden
| | - M Oshalim
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Region Västra Götaland, P.O.B 7193, S-40234, Gothenburg, Sweden
| | - I Lönnroth
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, P.O.B 420, S-40530, Gothenburg, Sweden.
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Barrueta Tenhunen A, Massaro F, Hansson HA, Feinstein R, Larsson A, Larsson A, Perchiazzi G. Does the antisecretory peptide AF-16 reduce lung oedema in experimental ARDS? Ups J Med Sci 2019; 124:246-253. [PMID: 31701794 PMCID: PMC6968528 DOI: 10.1080/03009734.2019.1685029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Acute respiratory distress syndrome (ARDS) is an acute inflammatory condition with pulmonary capillary leakage and lung oedema formation. There is currently no pharmacologic treatment for the condition. The antisecretory peptide AF-16 reduces oedema in experimental traumatic brain injury. In this study, we tested AF-16 in an experimental porcine model of ARDS.Methods: Under surgical anaesthesia 12 piglets were subjected to lung lavage followed by 2 hours of injurious ventilation. Every hour for 4 hours, measurements of extravascular lung water (EVLW), mechanics of the respiratory system, and hemodynamics were obtained.Results: There was a statistically significant (p = 0.006, two-way ANOVA) reduction of EVLW in the AF-16 group compared with controls. However, this was not mirrored in any improvement in the wet-to-dry ratio of lung tissue samples, histology, inflammatory markers, lung mechanics, or gas exchange.Conclusions: This pilot study suggests that AF-16 might improve oedema resolution as indicated by a reduction in EVLW in experimental ARDS.
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Affiliation(s)
- Annelie Barrueta Tenhunen
- Hedenstierna Laboratory, Department of
Surgical Sciences, Uppsala University, Uppsala, Sweden
- CONTACT Annelie Barrueta Tenhunen
Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala
University, 75185 Uppsala, Sweden
| | - Fabrizia Massaro
- Hedenstierna Laboratory, Department of
Surgical Sciences, Uppsala University, Uppsala, Sweden
- Cardiac Anesthesia and Intensive Care, Anthea
Hospital, GVM Care & Research, Bari, Italy
| | - Hans Arne Hansson
- Institute of Biomedicine, University of
Gothenburg, Göteborg, Sweden
| | - Ricardo Feinstein
- Department of Pathology and Wildlife Diseases,
National Veterinary Institute, Uppsala, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Uppsala
University, Uppsala, Sweden
| | - Anders Larsson
- Hedenstierna Laboratory, Department of
Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Gaetano Perchiazzi
- Hedenstierna Laboratory, Department of
Surgical Sciences, Uppsala University, Uppsala, Sweden
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Scarpa A, Ralli M, Viola P, Cassandro C, Alicandri-Ciufelli M, Iengo M, Chiarella G, de Vincentiis M, Cavaliere M, Cassandro E. Food-induced stimulation of the antisecretory factor to improve symptoms in Meniere's disease: our results. Eur Arch Otorhinolaryngol 2019; 277:77-83. [PMID: 31605188 DOI: 10.1007/s00405-019-05682-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/01/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE Specially processed cereals (SPC) that increase endogenous antisecretory factor (AF) synthesis have been proposed to improve symptoms of Meniere's disease (MD) with controversial results. The aim of this study was to evaluate the effects of SPC in patients with definite unilateral MD and compare the results to a treatment protocol with intravenous glycerol and dexamethasone. METHODS Thirteen patients with unilateral MD were treated with SPC and 13 patients were treated with intravenous glycerol and dexamethasone for 12 months. Audio-vestibular evaluation was performed before (T0) and at the end of the treatments (T12). The number of vertigo spells were evaluated before and after therapy and the Efficacy Index (EI) was calculated. Questionnaires for hearing loss (HHIA), tinnitus (THI) and quality of life (TFL) were administered. RESULTS EI decreased in the SPC group in the second semester compared to the first although not significantly (p = 0.6323). There was a significant reduction for THI score in the SPC group at T12 (p = 0.0325). No significant differences were found between the two groups at T0 (p = 0.4723), while a significant difference was found at T12 (p = 0.0041). Quality of life showed an improvement in daily activities in the SPC group compared to infusion therapy group. CONCLUSION Our study shows a reduced number of vertigo attacks and a positive effect on the discomfort generated by tinnitus and quality of life in patients with unilateral MD treated with SPC and when compared to patients treated with intravenous glycerol and dexamethasone. No effects on hearing thresholds were noted in both groups.
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Affiliation(s)
- Alfonso Scarpa
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy.
| | - Pasquale Viola
- Unit of Audiology, Department of Experimental and Clinical Medicine, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | | | | | - Maurizio Iengo
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Ear, Nose and Throat Section, University of Naples ''Federico II'', Napoli, Italy
| | - Giuseppe Chiarella
- Unit of Audiology, Department of Experimental and Clinical Medicine, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Marco de Vincentiis
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Michele Cavaliere
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Ear, Nose and Throat Section, University of Naples ''Federico II'', Napoli, Italy
| | - Ettore Cassandro
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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14
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Viggiani MT, Di Leo A, Barone M. Can the Antisecretory Factor Be Considered a New Therapy for the Short Bowel Syndrome? Nutr Metab Insights 2019; 12:1178638819852061. [PMID: 31205420 PMCID: PMC6537051 DOI: 10.1177/1178638819852061] [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: 03/13/2019] [Accepted: 03/18/2019] [Indexed: 11/24/2022] Open
Abstract
Background and objective: The antisecretory factor (AF) exerts antisecretory and anti-inflammatory
properties in the bowel. The aim of this study was to evaluate the effect of
exogenous AF (Salovum) or cereals stimulating the endogenous AF
(SPC-Flakes), given alone or in combination, in patients with short bowel
syndrome (SBS). Methods: Patients received Salovum alone at T0 -T1, Salovum plus
SPC-Flakes at T1 -T2, and SPC-Flakes alone at
T2 -T3. At T0 and T3, water
balance, weight, lean mass (FFM), total body water (TBW), extracellular
water (ECW), and nutritional and inflammatory biochemical parameters were
evaluated. The water balance was also measured at T1,
T2, and 30 days (TS) from the end of
treatment. Results: Among the 7 patients enrolled, 2 discontinued treatment due to side effects
and 1 was excluded after a cancer was diagnosed. Salovum alone or with
SPC-Flakes did not improve the intestinal absorption in patients with SBS,
while the administration of SPC-Flakes alone lead towards a trend of
increased faecal volume. Weight, FFM, TBW, and ECW, as well as nutritional
and inflammatory status, did not statistically change at the end of
treatment (T3) as compared with T0. At TS
water balance was restored. Conclusion: The administration of exogenous AF or the stimulation of endogenous AF seems
to be unable to offer an effective therapy in patients with SBS. On the
contrary, their administration appears to aggravate fluid loss and induce
side effects.
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Affiliation(s)
- Maria Teresa Viggiani
- Gastroenterology Unit, Department of Emergency and Organ Transplantation (D.E.T.O.), University of Bari, Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari, Bari, Italy
| | - Alfredo Di Leo
- Gastroenterology Unit, Department of Emergency and Organ Transplantation (D.E.T.O.), University of Bari, Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari, Bari, Italy
| | - Michele Barone
- Gastroenterology Unit, Department of Emergency and Organ Transplantation (D.E.T.O.), University of Bari, Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari, Bari, Italy
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15
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Leong SC, Narayan S, Lesser TH. Antisecretory Factor–Inducing Therapy Improves Patient-Reported Functional Levels in Meniere's Disease. Ann Otol Rhinol Laryngol 2019. [DOI: 10.1177/000348941312201004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Samuel C. Leong
- Skull Base Unit, Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital Aintree, Liverpool, England
| | - Surya Narayan
- Department of Otorhinolaryngology, Royal Blackburn Hospital, Blackburn, England
| | - Tristram H. Lesser
- Skull Base Unit, Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital Aintree, Liverpool, England
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16
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Johansson E, Lange S, Lönnroth I. Aromatic substances in wheat malt inducing antisecretory factor and resistance to diarrhoea. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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17
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The Antisecretory Factor in Plasma and Breast Milk in Breastfeeding Mothers-A Prospective Cohort Study in Sweden. Nutrients 2018; 10:nu10091227. [PMID: 30181494 PMCID: PMC6164404 DOI: 10.3390/nu10091227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/29/2018] [Accepted: 09/03/2018] [Indexed: 12/25/2022] Open
Abstract
Inflammation and infection postpartum threaten the mother and her infant. Human milk provides a defense for the infant, but inflammatory complications like mastitis may lead to the cessation of breastfeeding. Antisecretory factor (AF) has a role in the regulation of secretory processes and inflammation. The objective of the study was to describe AF-levels in plasma and breast milk, and in relation to breast complications. Breastfeeding mothers (n = 95) were consecutively recruited at a Well Baby Clinic in Umeå, Sweden. At inclusion four weeks postpartum, samples of venous blood (10 mL) and breast milk (10 mL) were collected. Active AF was analyzed with ELISA using a monoclonal antibody mAb43, and was detected in all samples of plasma and breast milk with a positive correlation (Spearman coefficient = 0.40, p < 0.001; Pearson correlation = 0.34, p < 0.01). High AF-levels in plasma correlated with high AF-levels in breast milk. The results suggest a co-regulation between active AF in plasma and breastmilk, and/or a local regulation of AF in the breast. Further studies are needed to determine the pathways for the activation of AF-levels in breast milk and plasma.
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18
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Zaman S, Aamir K, Hanson LÅ, Lange S. High doses of Antisecretory Factor stop diarrhea fast without recurrence for six weeks post treatment. Int J Infect Dis 2018; 71:48-52. [DOI: 10.1016/j.ijid.2018.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/18/2018] [Accepted: 03/25/2018] [Indexed: 11/30/2022] Open
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Antisecretory Factor Modulates GABA A Receptor Activity in Neurons. J Mol Neurosci 2018; 64:312-320. [PMID: 29308551 DOI: 10.1007/s12031-017-1024-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
The antisecretory factor is an endogenous protein found in all mammalian tissues investigated so far. It acts by counteracting intestinal hypersecretion and various forms of inflammation, but the detailed mechanism of antisecretory factor (AF) action is unknown. We tested neuronal GABAA receptors by means of AF-16, a potent AF peptide derived from amino acids 36-51 from the NH2 part of AF. Cultured rat cerebellar granule cells were used, and the effects on the GABA-mediated chloride currents were determined by whole-cell patch clamp. Both the neurotransmitter GABA and AF-16 were added by perfusion of the experimental system. A 3-min AF-16 preincubation was more efficacious than 30 s in significantly elevating the rapidly desensitizing GABA-activated chloride current. No effect was found on the tonic, slowly desensitizing current. The GABA-activated current increase by AF-16 demonstrated a low k of 41 pM with a maximal increase of 37% persisting for some minutes after AF washout, independent from GABA concentration. This indicates an effect on the maximal stimulation (E%Max) excluding an altered affinity between GABA and its receptor. An immunocytochemical fluorescence approach with anti γ2 subunit antibodies demonstrated an increased expression of GABAA receptors. Thus, both the electrophysiological and the immunofluorescence approach indicate an increased appearance of GABAA receptors on the neuronal membrane. The rationale of the experiments was to test the effect of AF on a defined neuronal population of GABAA receptors. The implications of the results on the impact of AF on the enteric nervous system or on brain function are discussed.
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20
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Antisecretory Factor (AF) egg-yolk peptides reflects the intake of AF-activating feed in hens. CLINICAL NUTRITION EXPERIMENTAL 2017. [DOI: 10.1016/j.yclnex.2017.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Charlebois A, Rosenfeld G, Bressler B. The Impact of Dietary Interventions on the Symptoms of Inflammatory Bowel Disease: A Systematic Review. Crit Rev Food Sci Nutr 2017; 56:1370-8. [PMID: 25569442 DOI: 10.1080/10408398.2012.760515] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Diet may be a successful part of the treatment plan for improving outcome in patients with inflammatory bowel disease (IBD). This study aimed to systematically review all published clinical trials evaluating the effects of a regular diet on symptoms of IBD. Three medical databases were searched for clinical trials evaluating an intervention that involved dietary manipulation using a regular diet on adults with IBD whose symptoms were objectively measured before and after the intervention. The most common types of regular diet interventions that we observed in the literature fell into the following three categories: low residue/low fiber diets, exclusion diets, or other specific diets. Of all included studies, the few that were of higher quality and that observed a statistically significant improvement in symptoms in the diet group compared to the control group fell under the exclusion diet group or the other specific diet group. We were able to identify several high quality clinical trials evaluating dietary manipulations on symptoms of IBD. Exclusion diets and the low FODMAP diet are two areas identified in this review that show promise for having therapeutic benefits for patients with IBD.
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Affiliation(s)
- Ashley Charlebois
- a Department of Medicine , Division of Gastroenterology, University of British Columbia , Vancouver , British Columbia , Canada
| | - Greg Rosenfeld
- b Division of Gastroenterology, Department of Medicine, St. Paul's Hospital , University of British Columbia , Vancouver , Canada
| | - Brian Bressler
- b Division of Gastroenterology, Department of Medicine, St. Paul's Hospital , University of British Columbia , Vancouver , Canada
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22
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Lönnroth I, Oshalim M, Lange S, Johansson E. Interaction of Proteasomes and Complement C3, Assay of Antisecretory Factor in Blood. J Immunoassay Immunochem 2016; 37:43-54. [PMID: 25897558 DOI: 10.1080/15321819.2015.1042544] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Antisecretory factor (AF) is a protein complex which inhibits inflammation and regulates fluid transport. In this article, two new immunoassays (ELISA) are developed. The first ELISA establishes a 26S proteasome concentration of 0.41±0.03 μg/mL in normal plasma; the second ELISA discloses the binding of proteasomes to complement factor C3. The latter test values increased about tenfold following intake of processed cereals, paralleling with the old AF ELISA. The proteasome/C3 complex is purified and shown to expose hidden antisecretory peptide sequence and contain the inactive C3c protein. These findings might explain the antisecretory and anti-inflammatory effect during AF complex formation.
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Affiliation(s)
- Ivar Lönnroth
- a Department of Infectious Diseases , Institute of Biomedicine, Gothenburg University , Gothenburg , Sweden
| | - Merna Oshalim
- a Department of Infectious Diseases , Institute of Biomedicine, Gothenburg University , Gothenburg , Sweden.,b Clinical Microbiology , Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Stefan Lange
- a Department of Infectious Diseases , Institute of Biomedicine, Gothenburg University , Gothenburg , Sweden.,b Clinical Microbiology , Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Ewa Johansson
- a Department of Infectious Diseases , Institute of Biomedicine, Gothenburg University , Gothenburg , Sweden.,b Clinical Microbiology , Sahlgrenska University Hospital , Gothenburg , Sweden
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Food-induced changes of lipids in rat neuronal tissue visualized by ToF-SIMS imaging. Sci Rep 2016; 6:32797. [PMID: 27596988 PMCID: PMC5011716 DOI: 10.1038/srep32797] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/15/2016] [Indexed: 12/30/2022] Open
Abstract
Time of flight secondary ion mass spectrometry (ToF-SIMS) was used to image the lipid localization in brain tissue sections from rats fed specially processed cereals (SPC). An IonTof 5 instrument equipped with a Bi cluster ion gun was used to analyze the tissue sections. Data from 15 brain samples from control and cereal-fed rats were recorded and exported to principal components analysis (PCA). The data clearly show changes of certain lipids in the brain following cereal feeding. PCA score plots show a good separation in lipid distribution between the control and the SPC-fed group. The loadings plot reveal that the groups separated mainly due to changes in cholesterol, vitamin E and c18:2, c16:0 fatty acid distribution as well as some short chain monocarboxylic fatty acid compositions. These insights relate to the working mechanism of SPC as a dietary supplement. SPC is thought to activate antisecretory factor (AF), an endogenous protein with regulatory function for inflammation and fluid secretion. These data provide insights into lipid content in brain following SPC feeding and suggest a relation to activating AF.
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Mass spectrometric profiling of lipids in intestinal tissue from rats fed cereals processed for medical conditions. Biointerphases 2016; 11:02A310. [PMID: 26753787 DOI: 10.1116/1.4939599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Time-of-flight secondary ion mass spectrometry (ToF-SIMS) was used for lipid profiling of intestine tissue sections from rats fed specially processed cereals and rats fed ordinary feed as a control. This cereal is known to increase the activity of antisecretory factor in plasma and the exact mechanism for the activation process at the cellular level is unclear. ToF-SIMS has been used to track food induced changes in lipid content in intestinal tissue sections to gain insight into the possible mechanisms involved. Data from 20 intestine sections belonging to four different rats from each group of control and specially processed cereals-fed rats were obtained using the stage scan macroraster with a lateral resolution of 5 μm. Data were subsequently subjected to orthogonal partial least squares discriminant analysis. The data clearly show that changes of certain lipids are induced by the specially processed cereal feed. Scores plots show a well-defined separation between the two groups. The corresponding loading plots reveal that the groups separate mainly due to changes of vitamin E, phosphocholine, and phosphosphingolipid fragments, and that for the c18:2 fatty acid. The observed changes in lipids might give insight into the working mechanisms of antisecretory factor in the body, and this has been successfully used to understand the working mechanism of specially processed cereal-induced antisecretory factor activation in intestine.
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Ingvardsen CJ, Klokker M. Antisecretory therapy with no improvement in functional level in Ménière's disease. Acta Otolaryngol 2015; 136:232-5. [PMID: 26635204 DOI: 10.3109/00016489.2015.1115551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Conclusion Antisecretory factor-inducing (AF) specially processed cereals (SPC) were not shown to significantly improve the functional level in patients with MD. Objectives The aim of this study was to evaluate the effect of AF-inducing SPC in patients suffering from Ménière's disease (MD). Methods A randomized double-blinded, placebo-controlled cross-over study was conducted. All patients had a 2 months intake of SPC and control cereal with a 2 months washout period in between. The severity of MD was classified according to the American Academy of Otolaryngology-Head and Neck Surgery (AOO-HNS) functional scale, and the frequency of attacks was registered. Results Thirty-two patients completed the study. No carryover effect was found. In both functional level and frequency of attacks no significant effect of SPC was found. Seventeen patients showed improvement in functional level when treated with SPC (mean improvement = 0.9 points) and 14 when treated with placebo (mean improvements = 0.7 points). No patients showed worsening in functional level during treatment with SPC, but three showed worsening when treated with placebo. Seventeen patients reported fewer attacks when treated with SPC, and 22 when treated with placebo. Three patients reported more frequent attacks when treated with SPC, and three when treated with placebo. A non-parametric comparison and a parametric analysis supported the findings.
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Affiliation(s)
- Charlotte J Ingvardsen
- a Department of Otorhinolaryngology, Head & Neck Surgery and Audiology , Rigshospitalet, University of Copenhagen , Denmark
| | - Mads Klokker
- a Department of Otorhinolaryngology, Head & Neck Surgery and Audiology , Rigshospitalet, University of Copenhagen , Denmark
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Nawrot-Porąbka K, Jaworek J, Leja-Szpak A, Kot M, Lange S. The role of antisecretory factor in pancreatic exocrine secretion: studies in vivo and in vitro. Exp Physiol 2015; 100:267-77. [PMID: 25641073 DOI: 10.1113/expphysiol.2014.083899] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/09/2015] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Antisecretory factor, an endogenous protein detected in many tissues of the body, is known as an inhibitor of intestinal secretion, but its role in pancreatic exocrine secretory function has not yet been investigated. What is the main finding and its importance? In a rodent model, we show that antisecretory factor reduces pancreatic exocrine secretion, probably via its direct action on the pancreatic acini and via modulation of the enteropancreatic reflexes involving cholecystokinin and sensory nerves. Antisecretory factor (AF) regulates ion and water transport through the intestinal cell membrane. Antisecretory factor inhibits intestinal secretion, but its effect on the exocrine pancreas has not yet been shown. We investigated the effect of AF on pancreatic amylase secretion in vivo and in vitro using pancreatic acini isolated by collagenase digestion. For the in vivo study, Wistar rats were surgically equipped with silicone catheters, inserted into the pancreaticobiliary duct and into the duodenum. Capsaicin was used to deactivate the sensory nerves in turn to assess their involvement in the effects of AF on the exocrine pancreas. Antisecretory factor (1, 3 or 10 μg kg(-1) i.p.) was given in basal conditions or following stimulation of pancreatic secretion with diversion of pancreaticobiliary juice. For the in vitro study, rat pancreatic acini were incubated in the presence of increasing doses of AF (from 10(-8) to 10(-5) m) alone or in combination with caerulein (10(-12) m). Cytoplasmic cholecystokinin 1 (CCK1 ) receptor protein was detected by Western blot and immunoprecipitation studies. Antisecretory factor markedly reduced the output of pancreatic amylase both in basal conditions and when stimulated by diversion of pancreaticobiliary juice. Deactivation of the sensory nerves with capsaicin completely reversed the inhibitory effects of AF on the exocrine pancreas. Caerulein-induced enzyme secretion from the pancreatic acini was inhibited by AF, whereas basal secretion was unaffected. Administration of AF to the rats significantly diminished the synthesis of CCK1 receptor protein. We conclude that AF inhibits pancreatic exocrine secretion indirectly via sensory nerves and directly decreases amylase release from isolated pancreatic acini. The direct inhibitory action of AF on the exocrine pancreas could be related, at least in part, to a reduction of CCK1 receptors on pancreatic acinar cells.
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Affiliation(s)
- Katarzyna Nawrot-Porąbka
- Department of Medical Physiology, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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Stecksén-Blicks C, Granström E, Silfverdal SA, West CE. Prevalence of oral Candida in the first year of life. Mycoses 2015. [PMID: 26214300 DOI: 10.1111/myc.12355] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Colonisation of the gastrointestinal tract is influenced by primary microbial exposure and bioactive factors in breastmilk. The aim was to explore the prevalence of oral Candida in the first year of life in relation to selected exposures. Oral Candida was studied in 100 healthy infants at 4 and 8 weeks, 3, 6 and 12 months of age and related to delivery mode, birth weight, infant health and feeding, antibiotics, antimycotics, steroids and probiotics in mother and infant, living conditions, maternal smoking and infections The association between lactoferrin and antisecretory factor in breastmilk and maternal serum haemoglobin, transferrin, and ferritin levels in relation to oral Candida was also explored. About 11% to 15% of the infants had oral Candida at the respective age. Colonisation was fairly stable until 6 months of age. There was no conclusive impact of the investigated exposures at entry. Infants with a furry pet at home had a lower frequency of Candida at 3 months, (P < 0.05) whereas all but one colonised infant had older siblings at 12 months (P < 0.01). Lactoferrin in breastmilk was negatively associated with colonisation at 6 months of age. It is concluded that 11 to 15% had oral Candida. Exposure to furry pets and siblings impacted oral Candida.
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Affiliation(s)
- C Stecksén-Blicks
- Pediatric Dentistry, Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - E Granström
- Pediatric Dentistry, Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - S A Silfverdal
- Pediatrics, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - C E West
- Pediatrics, Department of Clinical Sciences, Umeå University, Umeå, Sweden
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Antisecretory factor peptide AF-16 inhibits the secreted autotransporter toxin-stimulated transcellular and paracellular passages of fluid in cultured human enterocyte-like cells. Infect Immun 2014; 83:907-22. [PMID: 25534938 DOI: 10.1128/iai.02759-14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Both the endogenous antisecretory factor (AF) protein and peptide AF-16, which has a sequence that matches that of the active N-terminal region of AF, inhibit the increase in the epithelial transport of fluid and electrolytes induced by bacterial toxins in animal and ex vivo models. We conducted a study to investigate the inhibitory effect of peptide AF-16 against the increase of transcellular passage and paracellular permeability promoted by the secreted autotransporter toxin (Sat) in a cultured cellular model of the human intestinal epithelial barrier. Peptide AF-16 produced a concentration-dependent inhibition of the Sat-induced increase in the formation of fluid domes, in the mucosal-to-serosal passage of D-[1-(14)C]mannitol, and in the rearrangements in the distribution and protein expression of the tight junction (TJ)-associated proteins ZO-1 and occludin in cultured human enterocyte-like Caco-2/TC7 cell monolayers. In addition, we show that peptide AF-16 also inhibits the cholera toxin-induced increase of transcellular passage and the Clostridium difficile toxin-induced effects on paracellular permeability and TJ protein organization in Caco-2/TC7 cell monolayers. Treatment of cell monolayers by the lipid raft disorganizer methyl-β-cyclodextrin abolished the inhibitory activity of peptide AF-16 at the transcellular passage level and did not modify the effect of the peptide at the paracellular level.
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Matson Dzebo M, Reymer A, Fant K, Lincoln P, Nordén B, Rocha S. Enhanced cellular uptake of antisecretory peptide AF-16 through proteoglycan binding. Biochemistry 2014; 53:6566-73. [PMID: 25289567 DOI: 10.1021/bi5010377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Peptide AF-16, which includes the active site of Antisecretory Factor protein, has antisecretory and anti-inflammatory properties, making it a potent drug candidate for treatment of secretory and inflammatory diseases such as diarrhea, inflammatory bowel diseases, and intracranial hypertension. Despite remarkable physiological effects and great pharmaceutical need for drug discovery, very little is yet understood about AF-16 mechanism of action. In order to address interaction mechanisms, we investigated the binding of AF-16 to sulfated glycosaminoglycan, heparin, with focus on the effect of pH and ionic strength, and studied the influence of cell-surface proteoglycans on cellular uptake efficiency. Confocal laser scanning microscopy and flow cytometry experiments on wild type and proteoglycan-deficient Chinese hamster ovary cells reveal an endocytotic nature of AF-16 cellular uptake that is, however, less efficient for the cells lacking cell-surface proteoglycans. Isothermal titration calorimetry provides quantitative thermodynamic data and evidence for that the peptide affinity to heparin increases at lower pH and ionic strength. Experimental data, supported by theoretical modeling, of peptide-glycosaminoglycan interaction indicate that it has a large electrostatic contribution, which will be enhanced in diseases accompanied by decreased pH and ionic strength. These observations show that cell-surface proteoglycans are of general and crucial importance for the antisecretory and anti-inflammatory activities of AF-16.
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Affiliation(s)
- Maria Matson Dzebo
- Chemical and Biological Engineering, Physical Chemistry, Chalmers University of Technology , SE-412 96 Gothenburg, Sweden
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Zaman S, Aamir K, Lange S, Jennische E, Silfverdal S, Hanson LÅ. Antisecretory factor effectively and safely stops childhood diarrhoea: a placebo-controlled, randomised study. Acta Paediatr 2014; 103:659-64. [PMID: 24484450 DOI: 10.1111/apa.12581] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 12/09/2013] [Accepted: 01/27/2014] [Indexed: 11/30/2022]
Abstract
AIM We studied the response to high doses of egg yolk containing antisecretory factor (B221® , Salovum®) in young children with acute diarrhoea, presenting to the Children's Hospital, Lahore, Pakistan. METHODS In a randomised, placebo-controlled trial, 36 children aged 7 to 60 months with acute diarrhoea of unknown aetiology, with mild-to-moderate dehydration, were randomised to the Salovum® or placebo groups. Initially, 16 grams of Salovum® or ordinary egg yolk (placebo) mixed in oral rehydration salts was given, followed by 8 g every 5 h until recovery. The number and consistency of stools were recorded. RESULTS The two groups were comparable in age, gender, duration of diarrhoea, hydration and nutritional status, although the proportion with watery stools was higher in the Salovum® group (p = 0.04). Reduction in the frequency of stools was seen at 7 versus 18 h (p < 0.0001) and normalising of stool consistency was 10 versus 18 h, p < 0.03) in the Salovum® and placebo groups. The overall effect was 35 versus 70 h in the two groups (p = 0.001). No side effects were reported. CONCLUSION High doses of AF in the form of Salovum® effectively and safely reduce childhood diarrhoea of a likely broad aetiology.
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Affiliation(s)
- Shakila Zaman
- Children's Hospital and Institute of Child Health Lahore Pakistan
| | - Khalida Aamir
- Children's Hospital and Institute of Child Health Lahore Pakistan
| | - Stefan Lange
- Institute of Biomedicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Eva Jennische
- Institute of Biomedicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | | | - Lars Å Hanson
- Department of Clinical Immunology University of Gothenburg Gothenburg Sweden
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Diet-induced antisecretory factor prevents intracranial hypertension in a dosage-dependent manner. Br J Nutr 2012; 109:2247-52. [PMID: 23153478 DOI: 10.1017/s0007114512004552] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Intake of specially processed cereal (SPC) stimulates endogenous antisecretory factor (AF) activity, and SPC intake has proven to be beneficial for a number of clinical conditions. The aim of the present study was to investigate the dosage relationship between SPC intake and plasma AF activity and to further correlate achieved AF levels to a biological effect. SPC was fed to rats in concentrations of 5, 10 or 15% for 2 weeks. A further group was fed 5% SPC for 4 weeks. AF activity and the complement factors C3c and factor H were analysed in plasma after the feeding period. Groups of rats fed the various SPC concentrations were subjected to a standardised freezing brain injury, known to induce increases in intracranial pressure (ICP). The AF activity in plasma increased after intake of SPC, in a dosage- and time-dependent manner. The complement factors C3c and factor H increased in a time-dependent manner. Measurements of ICP in animals fed with SPC prior to the brain injury showed that the ICP was significantly lower, compared with that of injured rats fed with a standard feed, and that the change was dose and time dependent. AF activity increases, in a dosage- and time-dependent manner, after intake of SPC. The inverse relationship between ICP after a head injury and the percentage of SPC in the feed indicate that the protective effect is, to a large extent, due to AF.
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Clinical activity of patupilone in patients with pretreated advanced/metastatic colon cancer: results of a phase I dose escalation trial. Br J Cancer 2011; 105:1646-53. [PMID: 22027708 PMCID: PMC3242596 DOI: 10.1038/bjc.2011.438] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: New agents that are active in patients with metastatic colorectal cancer are needed. Patupilone (EPO906; epothilone B) is a novel microtubule-stabilising agent. Methods: Patients with advanced colon cancer who progressed after prior treatment regimens received intravenous patupilone (6.5–10.0 mg m–2) once every 3 weeks by a 20-min infusion (20MI), 24-h continuous infusion (CI-1D) or 5-day intermittent 16-h infusion (16HI-5D). Adverse events (AEs), dose-limiting toxicities (DLTs), pharmacokinetics and anti-tumour activity were assessed. Results: Sixty patients were enrolled. The maximum tolerated dose (MTD) was not reached in the 20MI arm (n=31), as no DLTs were observed. Three patients in the CI-1D arm (n=26) experienced 1 DLT each at 7.5, 8.0 and 9.0 mg m–2, but MTD was not reached. However, the prolonged 16HI-5D arm was terminated at 6.5 mg m–2 after two of the three patients developed a DLT. Diarrhoea was the most common AE and DLT, with increased severity at the higher doses (9.0 and 10.0 mg m–2). Grade 3 or 4 diarrhoea was observed in 11 (35%) of the patients in the 20MI arm, 4 (15%) of the patients in the CI-1D arm and 2 (67%) of the patients in the 16HI-5D arm. Patupilone activity was observed in the 20MI arm with a disease control rate of 58%, including four confirmed partial responses. The disease control rate in CI-1D arm was 39%. Conclusion: Patupilone given once every 3 weeks as a 20-min infusion had promising anti-tumour activity and manageable safety profile at doses that demonstrated therapeutic efficacy.
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Al-Olama M, Wallgren A, Andersson B, Gatzinsky K, Hultborn R, Karlsson-Parra A, Lange S, Hansson HA, Jennische E. The peptide AF-16 decreases high interstitial fluid pressure in solid tumors. Acta Oncol 2011; 50:1098-104. [PMID: 21375367 DOI: 10.3109/0284186x.2011.562240] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The high interstitial fluid pressure (IFP) in solid tumors restricts the access to nutrients, oxygen and drugs. MATERIAL AND METHODS We investigated the ability of the peptide AF-16, involved in water and ion transfer through cell membranes, to lower the IFP in two different solid rat mammary tumors, one chemically induced, slowly growing, and the other transplantable, and rapidly progressing having high cellularity. AF-16 was administered either in the tumor capsule, intranasally or intravenously. The IFP was measured by a miniature fiber optic device. RESULTS AF-16 significantly lowered the IFP in both the slowly and the rapidly progressing tumors, whether administrated locally or systemically. The AF-16 induced IFP reduction was maximal after 90 min, lasted at least 3 h, and returned to pretreatment levels in less than 24 h. Topical AF-16 transiently reduced the IFP in the DMBA tumors from 17.7 ± 4.2 mmHg to 8.6 ± 2.1 mmHg. CONCLUSION We conclude that AF-16 transiently and reversibly lowered the high IFP in solid tumors during a few hours, which might translate into improved therapeutic efficacy.
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Affiliation(s)
- Mohamed Al-Olama
- Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Specially processed cereals diet increases plasma levels of active antisecretory factor and up-regulates rat hepatic glutathione S-transferase mu. Nutrition 2011; 27:949-54. [DOI: 10.1016/j.nut.2010.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 08/19/2010] [Accepted: 09/03/2010] [Indexed: 11/19/2022]
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Alam NH, Ashraf H, Olesen M, Salam MA, Gyr N, Meier R. Salovum egg yolk containing antisecretory factor as an adjunct therapy in severe cholera in adult males: a pilot study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2011; 29:297-302. [PMID: 21957667 PMCID: PMC3190359 DOI: 10.3329/jhpn.v29i4.8443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Cholera involves stimulation of intestinal secretory process in response to cholera toxin leading to profuse watery diarrhoea that might cause death due to dehydration unless timely rehydration therapy is initiated. Efforts to identify and test potential antisecretory agents are ongoing. Antisecretory factor (AF) is a naturally-occurring protein produced in the human secretory organs, including the intestine, with antisectory properties demonstrated in animal and human models of secretory diarrhoea. Salovum egg yolk powder contains antisecretory proteins in a much higher (500 times) concentration than that of normal hen eggs. This is achieved by feeding hens with specially-processed cereals, capable of inducing antisecretory proteins in the yolk. The aim of the study was to examine the effect of Salovum egg yolk powder containing AF in the treatment of adult cholera patients. In an open, randomized controlled trial (pilot study), 40 adult male patients with severe cholera were studied: 20 received standard treatment (oral rehydration solution, antibiotic, and usual hospital diet) plus Salovum egg yolk powder (study group) and 20 received standard treatment alone (control group). All the patients received tablet doxycycline (300 mg) once immediately after randomization. Written informed consent was obtained from each subject before enrollment. The main outcome measures were stool weight and duration of diarrhoea. The demographic and baseline clinical characteristics of the study patients were comparable between the groups. No significant differences were found in the mean stool weight, g/kg of body-weight during the first 24 hours [study vs control group, mean +/- standard deviation (SD), 218 +/- 119 vs 195 +/- 136], second 24 hours (mean +/- SD, 23 +/- 39 vs 22 +/- 34), and cumulative up to 72 hours (mean +/- SD, 245 +/- 152 vs 218 +/- 169). The duration (hours) of diarrhoea after admission in the hospital was also similar in both the groups (mean +/- SD, 33 +/- 14 vs 32 +/- 10). No adverse effect was observed. Salovum egg powder containing AF as an adjunct therapy in the treatment of severe cholera could not demonstrate any beneficial effect. Further studies with higher doses of Salovum egg yolk powder might be considered in future to establish its antisecretory effect.
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Affiliation(s)
- Nur H Alam
- Dr. N.H. Alam Clinical Sciences Division, icddr,b, GPO Box 128, Dhaka 1000, Bangladesh.
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Therapeutic effect of antisecretory factor-rich egg yolk on the late phases of 2,4,6-trinitrobenzenesulphonic acid colitis in mice. Br J Nutr 2011; 106:1522-8. [PMID: 21733301 DOI: 10.1017/s0007114511002042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Antisecretory factor (AF) is expressed in all tissues of mammals, inhibits intestinal hypersecretion and has anti-inflammatory properties as well. Endogenous AF synthesis may be stimulated by feeding hydrothermally processed cereals. Alternatively, freeze-dried egg yolk can be used as a source of exogenous AF. Several reports have suggested that AF from freeze-dried egg yolk may be useful in inflammatory bowel disease. We assessed the effect of freeze-dried, AF-rich egg yolk intake on 2,4,6-trinitrobenzenesulphonic acid (TNBS) colitis. Balb/c mice were randomised to receive (1) AF in sterile drinking-water (4 g/l, n 38) and (2) sterile drinking-water alone (vehicle, n 38) from TNBS or saline administration onwards. Different subsets of mice were killed at weeks 1-3 after TNBS or saline administration. Macroscopic and microscopic damage was assessed in colonic specimens. Eicosanoid and cytokine production was evaluated in supernatants of 24 h-incubated colonic explants. Myeloperoxidase activity was measured in frozen colonic samples, while apoptosis was assessed in paraffined samples by the in situ oligoligation method. AF-treated mice showed a milder colonic damage compared with the vehicle group, which became statistically significant at week 3. This was accompanied by decreased IL-2, IL-1 and leukotriene B4 production at weeks 2 and 3, as well as increased interferon-γ at week 1, in AF-treated mice compared with vehicle-treated mice. AF-treated mice had significantly increased counts of apoptotic cells in the lamina propria at weeks 1 and 2 post-TNBS. In conclusion, the administration of AF-rich egg yolk has a therapeutic effect in the late phases of TNBS colitis in Balb/c mice.
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Agouridis AP, Elisaf M, Milionis HJ. An overview of lipid abnormalities in patients with inflammatory bowel disease. Ann Gastroenterol 2011; 24:181-187. [PMID: 24713706 PMCID: PMC3959314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Accepted: 06/02/2011] [Indexed: 11/03/2022] Open
Abstract
INFLAMMATORY BOWEL DISEASE (IBD) IS A CHRONIC INFLAMMATORY DISORDER WHICH ENCOMPASSES TWO FORMS OF INTESTINAL INFLAMMATION: ulcerative colitis and Crohn's disease. It is reported that inflammation, carotid intima media thickness, homocysteine and insulin resistance, parameters that are all associated with atherosclerosis, are increased in IBD. On the contrary, it seems that IBD patients exhibit low levels of low density lipoprotein cholesterol and total cholesterol. This review highlights the lipid profiles that occur in IBD patients and summarizes data of studies using regimens that may affect lipid metabolism in these patients.
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Affiliation(s)
- Aris P. Agouridis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Moses Elisaf
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Haralampos J. Milionis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
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Ulgheri C, Grilli E, Rossi F, Piva G. Effect of hydrothermally processed cereals on the performance of weaned piglets. Livest Sci 2010. [DOI: 10.1016/j.livsci.2010.06.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Antisecretory factor (AF) is a protein secreted in plasma and other tissue fluids in mammals with proven antisecretory and anti-inflammatory activity; its immunohistological distribution suggests a role in the immune system. The expression level and the distribution of AF protein are altered during an immunological response. Exposure to bacterial toxins induces secretion of AF in plasma, probably reflecting a natural defence mechanism to agents causing diarrhoea, thereby contributing to a favourable clinical outcome and disease termination. An increase of AF levels in plasma by dietary means, such as specially processed cereals (SPC), has been demonstrated in human subjects and animals. Administration of SPC to patients affected by inflammatory bowel disease, gastroenteritis and Ménière's disease relieved symptoms and improved quality of life. A recent study showed the positive effect of SPC diet supplementation on prevention of the effects of exposure to low levels of blast overpressure in rats, reducing the extent of intracranial pressure increase and cognitive function impairment. AF-rich egg yolk powder improved health status in children suffering acute and chronic diarrhoea, reducing the frequency and increasing the consistency of stools. This kind of functional food could be used for prophylaxis in populations exposed to a high risk of morbidity and mortality caused by diarrhoea and as a complementary therapy in patients affected by chronic intestinal inflammatory disease to improve well-being. In pig husbandry AF-inducing diets, owing to their antisecretory activity and anti-inflammatory action, are a suitable option as an alternative to antibiotic growth promoters to counteract post-weaning diarrhoea.
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Säljö A, Bolouri H, Mayorga M, Svensson B, Hamberger A. Low-level blast raises intracranial pressure and impairs cognitive function in rats: prophylaxis with processed cereal feed. J Neurotrauma 2010; 27:383-9. [PMID: 19852583 DOI: 10.1089/neu.2009.1053] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
There is increasing evidence that even low levels of blast cause brain injury, but little is known about their thresholds and mechanisms. Exposure of rats to 10-60 kPa blasts elevate intracranial pressure (ICP) in a dose-dependent manner and impair cognitive function. We have evaluated a prophylactic measure against these brain injuries in a rat animal model, consisting of feeding them processed cereal. This type of feed is known to ameliorate disturbances in secretion of body fluids and to have anti-inflammatory effects. In humans, intake of processed cereals is effective against intestinal diarrhea and also reduces the symptoms of Ménière's disease. Rats were given either standard laboratory feed or processed cereal feed for 2 weeks before exposure to blast in a shock tube. The ICP was monitored at different time points up to 1 week after exposure to a 60-kPa blast, and for up to 24 h after exposure to a 30-kPa blast. Maximal ICP elevation was reached at 10 h in both groups. In the group of rats on standard feed exposed to 60 kPa, an ICP increase of 145% was noted at 10 h, and the corresponding increase in the rats fed processed cereal feed was only 50%. In rats exposed to a 30-kPa blast, those fed standard feed and processed cereal feed demonstrated increases of ICP of 80% and 40%, respectively. Cognitive function as measured by the Morris water maze was assessed in other groups of rats at 2 days after exposure to 10- or 30-kPa blasts. Their performance was significantly impaired at both exposure levels in rats on standard feed, but no functional impairment was seen in rats fed processed cereal feed.
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Affiliation(s)
- Annette Säljö
- Institute of Biomedicine, Department of Medical Chemistry and Cell Biology, Sahlgren Academy, University of Gothenburg, Gothenburg, SE 405 30 Sweden.
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Hanner P, Rask-Andersen H, Lange S, Jennische E. Antisecretory factor-inducing therapy improves the clinical outcome in patients with Ménière's disease. Acta Otolaryngol 2010; 130:223-7. [PMID: 19479454 DOI: 10.3109/00016480903022842] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Intake of antisecretory factor (AF)-inducing SPC-flakes significantly reduced vertigo in patients suffering from Ménière's disease (MD). The positive effect may be due to a modulation of the transport of water and ions in the endolymphatic space. OBJECTIVE To evaluate the effects of a 3-month treatment period with SPC-flakes in patients suffering from MD. PATIENTS AND METHODS A prospective, double-blind, placebo-controlled study was performed. A total of 51 adult patients with MD were included in the study: 27 subjects treated with SPC-flakes and 24 subjects with control cereals. The patients received SPC-flakes or control cereals (1 g per kg body weight per 24 h in two servings) for 3 months. Otoneurological examinations were carried out before and after this period. RESULTS The severity of MD was classified according to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) grading system. Fourteen of the 27 patients randomized to intake of the AF-inducing SPC-flakes reported decreased vertigo, compared with 2 of 24 in the control group (p < 0.001). No consistent change in the otoneurological examinations could be demonstrated in any of the groups of patients.
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Affiliation(s)
- Per Hanner
- Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Johansson E, Lönnroth I, Jonson I, Lange S, Jennische E. Development of monoclonal antibodies for detection of Antisecretory Factor activity in human plasma. J Immunol Methods 2008; 342:64-70. [PMID: 19109966 DOI: 10.1016/j.jim.2008.11.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Accepted: 11/25/2008] [Indexed: 11/24/2022]
Abstract
Antisecretory Factor (AF) is expressed in most tissues and can be demonstrated in plasma and other body fluids. Most of the AF in plasma is in an inactive form and activation of AF occurs after exposure to bacterial toxins or after intake of various dietary components. Patients with chronic diseases involving disturbances in inflammatory and secretory processes may benefit from an AF-inducing diet. The aim of the present study was to develop an in vitro assay for the analysis of AF-activity in human plasma. Monoclonal antibodies were raised against a native form of AF prepared from human placenta. Nine clones of the monoclonal antibodies recognizing AF and AF peptides were identified. With the aid of these antibodies, we developed a sensitive ELISA method for direct detection of AF-activity in human plasma. The AF activity in plasma from five healthy volunteers was low, 0.112+/-0.022 (absorbance at 405 nm), before intake of the AF-inducing diet with the SPC-Flakes, and increased significantly (p<0.05) to 0.444+/-0.068 after >or=6 weeks on the diet. A comparison of the plasma-AF values, obtained by the bioassay and the immunogenic assay (indirect ELISA), shows that there is a significant correlation (r=0.85) between the values from the two methods. The results indicate that the ELISA measures AF-activity and has the potential to be an important tool for the analysis of AF-activity in further clinical studies on AF-therapy.
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Affiliation(s)
- Ewa Johansson
- Bacteriological Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Hanson LÅ, Silfverdal SA, Hahn-Zoric M, Håversen L, Baltzer IM, Moisei M, Motas C. Immune Function. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2008; 639:97-111. [DOI: 10.1007/978-1-4020-8749-3_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Effects of a supplementary diet with specially processed cereals in patients with short bowel syndrome. Eur J Gastroenterol Hepatol 2008; 20:1085-93. [PMID: 19047840 DOI: 10.1097/meg.0b013e328303c00a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE Short bowel syndrome patients frequently experience impaired health-related quality of life. This syndrome is also associated with increased costs for the individuals concerned and the community. Intake of specially processed cereals has been demonstrated to decrease intestinal secretion. This study evaluates the effect of a supplementary diet with specially processed cereals compared with nonprocessed cereals. METHODS This investigation is a randomized double-blind, cross-over multicentre prospective study of 26 intestinal resected out patients, considered as short bowel syndrome patients. The patients were divided into groups A or B, in accordance with the first allocated treatment. Subgroup analyses of the underlying diagnoses and type of surgical procedure were performed. The studied parameters were faecal volume, nocturnal stools, abdominal pain/discomfort, health-related quality of life, peripheral blood tests and anthropometric data. RESULTS In both groups, intake of nonprocessed cereals significantly decreased the faecal volume. The subgroup analyses of patients with a history of ulcerative colitis (compared with Crohn's disease) and nonileostomy-operated procedure (compared with ileostomi-operated procedure) showed significantly decreased faecal volume during nonprocessed cereals intake. Peripheral blood tests, quality of life and anthropometry were not affected. CONCLUSION In this study, nonprocessed cereals seemed to be as effective as specially processed cereals in decreasing faecal volume in general and especially in ulcerative colitis patients (mainly operated with nonileostomy techniques). Our results indicate that use of supplementary cereals is safe for this group of patients, but should optimally include evaluation of the underlying diagnosis and the surgical method used.
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The peptide AF-16 abolishes sickness and death at experimental encephalitis by reducing increase of intracranial pressure. Brain Res 2008; 1227:189-97. [PMID: 18586012 DOI: 10.1016/j.brainres.2008.05.083] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 05/29/2008] [Accepted: 05/29/2008] [Indexed: 01/02/2023]
Abstract
Elevated intracranial pressure (ICP) is strongly aggravating the injury at brain inflammation, resulting in persistent neurological and psychiatric malfunctions. There is no efficient pharmacological treatment to achieve beneficial ICP reduction. Here, the peptide AF-16, comprising the amino terminal part of the endogenous protein Antisecretory Factor (AF), was used to suppress the raised ICP in experimental herpes simplex encephalitis (HSE) in rats. Intranasal instillation of the peptide AF-16 counteracted the ICP elevation and the prevalence of ICP spikes, abrogated the neurological morbidity, and abolished the mortality in a dose-dependent manner. AF-16, 25 microg twice daily intranasally, rescued all animals with HSE and abrogated neurological malfunction. In contrast, only 10% of the rats survived if treated with the vehicle. A single intranasal dose of 25 microg AF-16 to a rat displaying overt HSE symptoms reduced the ICP to normal levels within an hour. No effects on viral replication or antigen distribution were demonstrable. Thus, AF-16 abolished the prevalence of sickness signs, ICP elevation, neurological malfunctions and completely prevented deaths. We advocate use of AF-16 for suppression of elevated ICP.
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Ekesbo R, Nilsson PM, Sjölund K. Effects of anti-secretory factor (ASF) on irritable bowel syndrome (IBS). A double-blind, randomized study. Scand J Prim Health Care 2008; 26:106-10. [PMID: 18570009 PMCID: PMC3406645 DOI: 10.1080/02813430802005894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2006] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To evaluate the role of the endogenous protein anti-secretory factor (ASF) on the symptoms, especially loose stools, in irritable bowel ayndrome (IBS). DESIGN A diet with specially processed cereals (SPC) known to induce ASF production was used in patients with IBS, in an eight-week randomized, placebo-controlled study. SUBJECTS Eighty-two patients with IBS were randomized to a diet with either SPC or placebo. MAIN OUTCOME MEASURES The overall clinical condition and the quality of life were measured by VAS and SF-36 questionnaire, respectively. The plasma levels of ASF were determined in 14 patients with dominating loose stools before and after diet. RESULTS All patients significantly (p<0.001) improved in IBS-related symptoms irrespective of active or placebo diet. In an active-diet sub-group with diarrhoea (n=11) there was a significant (p<0.05) correlation between the increase of plasma ASF level and the improvement on the VAS. CONCLUSION Both study groups improved significantly on the VAS but no additive effect was seen for the active treatment. In the sub-group with loose stools, the SPC diet induced ASF plasma levels in IBS patients and was correlated to significant symptom improvement in the individual patient.
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Abstract
Dietary factors have been considered as a possible risk factor for ulcerative colitis (UC). Red meat, high fat intake and high protein intake are associated with development and relapse in UC. On the other hand, probiotics, fish oil and dietary fiber have shown good efficacy in the treatment of UC. This paper reviews the updated data on the role of dietary factors in the pathogenesis and treatment of UC.
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Johansson E, Jonson I, Bosaeus M, Jennische E. Identification of flotillin-1 as an interacting protein for antisecretory factor. ACTA ACUST UNITED AC 2007; 146:303-9. [PMID: 18164080 DOI: 10.1016/j.regpep.2007.11.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Revised: 11/16/2007] [Accepted: 11/19/2007] [Indexed: 10/22/2022]
Abstract
Antisecretory factor (AF) also named S5a/Rpn10 was originally identified through its capacity to inhibit intestinal hypersecretion and was later shown to be a component in the proteasome complex. AF is also a potent anti-inflammatory agent and can act as a neuromodulator. In this study we used yeast two-hybrid screens, with yeast strain PJ692A transformed with the bait vector pGBKT7 (AF aa 1-105) against yeast strain Y187 pretransformed with human brain or placenta cDNA libraries, to identify AF-binding proteins. Flotillin-1 was identified as a specific interacting factor with AF. Immunohistochemistry showed co-localization of AF and flotillin-1 in nervous tissue. Flotillin-1 is an integral membrane protein and a component of lipid rafts, a membrane specialization involved in transport processes. Intracellular AF may affect secretory processes by regulating the localization of signal proteins to lipid rafts.
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Affiliation(s)
- Ewa Johansson
- Institute of Biomedicine, Department of Infectious Diseases, Section of Clinical Bacteriology, Göteborg University, Göteborg, Sweden
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Zaman S, Mannan J, Lange S, Lönnroth I, Hanson LA. B 221, a medical food containing antisecretory factor reduces child diarrhoea: a placebo controlled trial. Acta Paediatr 2007; 96:1655-9. [PMID: 17937690 DOI: 10.1111/j.1651-2227.2007.00488.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM We investigated whether egg yolk in the form of B221 (Salovum), a medical food containing antisecretory factor (AF) might be used for treatment of acute and prolonged diarrhoea. METHODS 240 children 6-24 months of age, half with acute diarrhoea (<7 days) and half with prolonged diarrhoea (> or = 7 days) were randomly given 2 g of B221 or placebo every 5 h for 3 days, added to an oral rehydration salt solution. RESULTS B221 reduced the number of stools in the acute diarrhoea group compared with placebo (day 3, p = 0.0054). Stools normalizing in consistency (day 3, p = 0.053) and recovery within 3 days was commoner in the B221 group (p < 0.001). A successful outcome was recorded in 82.8% in the B221 group, compared to 54.4% in the placebo group. In the group with prolonged diarrhoea the stool consistency normalized earlier in the patients receiving B221 than in the patients receiving placebo (p = 0.008). A successful outcome was obtained in 90.9% and 63.2%, (p = 0.0011) in the B221 and placebo-treated groups respectively. CONCLUSION B221, which is a medical food, can be used to significantly improve the condition of children with acute, as well as prolonged diarrhoea caused by a broad range of undefined pathogens.
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