Application of Manuka honey in treatment patients with GERD

Gastro-esophageal reflux disease has systematically increase in Western countries over recent years. Health benefits of Manuka honey allows to use it for medical purposes, for example reduction of inflammation of gastrointestinal mucosa. Thus, the aim of research was the application of Manuka honey in treatment patients with Gastro-esophageal reflux disease (GERD). The study was conducted on a group of 30 patients, which consumed Manuka honey or placebo for a period of 4 weeks. The gastroscopy and histology has been made twice, that is before and after experiment. Furthermore, the symptoms reports and nutritional interviews have been collected. The endoscopical examination showed that in Manuka group the improvement was 73.3%. In the sub-groups of esophagitis-A and esophagitis-B the improvement rate was 81.8%, and 50%, respectively. However, in the placebo group, the general improvement rate was much lower. The results have been confirmed in the histopathological examination. Moreover, it is worth noticing, that in sub-group declaring non-medication, the improvement was only for patients consuming Manuka honey. Changes of symptoms in subjective assessment of patients were evaluated after 2 and 4 weeks. The improvement rate in Manuka group was 86.7% and 100%, while in Placebo group it was only 26.7% and 40%, respectively. Manuka honey seems to be effective in GERD, which have been confirmed by subjective feelings of patients and by endoscopic and histopathologic examination. Our research is a pilot study before administration of Manuka honey to larger population. The results are promising and may facilitate the quality of life of patients with GERD.

Interleukin-4 during post-exercise recovery negatively correlates with the production of phagocyte-generated oxidants

Exhaustive run induced a biphasic oxidative response of circulating phagocytes in 16 amateur sportsmen. The first phase involved an increment just after exercise of enhanced whole blood chemiluminescence normalized per phagocyte count, whereas in the second phase a decrement from 1 h post-exercise and ongoing till 24 h. We tested whether plasma Interleukin IL-4, IL-8, IL-10 and Tumor Necrosis Factor α concentrations change in response to exhaustive run and whether there are associations between their levels and delta resting. Moreover, IL-8 and IL-10 significantly increased immediately post-exercise and after 1 h, but later normalized. Tumor necrosis factor α rose by 1.1-times only just after exercise. However, none of these cytokines showed any correlation with the investigated chemiluminescence. Exercise did not alter plasma concentrations of IL-4. However, pre-exercise IL-4 negatively correlated with measured luminescence just after exercise (ρ = -0.54, p < 0.05), and also tended to be negatively associated with decrements of the second phase at 1 h post-exercise ρ = -0.45, p = 0.08. It is suggested that plasma IL-4, by a negative association with blood phagocytes oxidants production, could be involved in the maintenance of proper balance between oxidants and anti-oxidants during strenuous exercise and post-exercise recovery.

Conception and pilot testing of a self-management health application for patients with pollen-related allergic rhinitis and allergic asthma-the APOLLO app

It has been shown that pollen information services are an important self-management tool for patients with pollen-related allergic rhinitis (AR) and allergic asthma (AA). This study aimed to design an online application for patients with AR and AA, which supports patients to better manage their disease as well as to evaluate the app and present the first results of the pilot study. The pollen data were obtained from the electronic pollen information network of Bavaria, Germany. Participants were asked to fill in their allergy-related complaints in the app over a 60-day period. Subsequently, the app was evaluated. Indices and diagrams visualized the participants' individual complaints as well as the daily pollen concentration in the air. In order to motivate participants to complete the app on a daily basis, we used elements of gamification. Two thirds of the participants (N = 46) reported feeling better informed about pollen counts and their allergy when using the app. The app's simple and comprehensible design was rated positively. More than 80% of the participants would recommend the app to their family and friends. The app can be a tool for patients with AR and AA to better understand their disease.

Association of body mass index and long-term mortality in patients from nationwide LIPIDOGRAM 2004-2015 cohort studies: no obesity paradox?

BACKGROUND

An obesity paradox has been described in relation to adverse clinical outcomes (e.g., mortality) with lower body mass index (BMI).

AIMS

We sought to evaluate the association between BMI and weight loss with long-term all-cause mortality in adult populations under the care of family physicians.

METHODS

LIPIDOGRAM studies were conducted in primary care in Poland in 2004, 2006, and 2015 and enrolled a total of 45,615 patients. The LIPIDOGRAM Plus study included 1627 patients recruited in the LIPIDOGRAM 2004 and repeated measurements in 2006 edition. Patients were classified by BMI categories as underweight, normal weight, overweight and class I, II, or III (obesity). Follow-up data up to December 2021 were obtained from the Central Statistical Office. Differences in all-cause mortality were analyzed using Kaplan‒Meier and Cox regression analyses.

RESULTS

Of 45,615 patients, 10,987 (24.1%) were normal weight, 320 (0.7%) were underweight, 19,134 (41.9%) were overweight, and 15,174 (33.2%) lived with obesity. Follow-up was available for 44,620 patients (97.8%, median duration 15.3 years, 61.7% females). In the crude analysis, long-term all-cause mortality was lowest for the normal-weight group (14%) compared with other categories. After adjusting for comorbidities, the highest risk of death was observed for the class III obesity and underweight categories (hazard ratio, HR 1.79, 95% CI [1.55-2.05] and HR 1.57, 95% CI [1.22-2.04]), respectively. The LIPIDOGRAM Plus analysis revealed that a decrease in body weight (by 5 and 10%) over 2 years was associated with a significantly increased risk of death during long-term follow-up-HR 1.45 (95% CI 1.05-2.02, p = 0.03) and HR 1.67 (95% CI 1.02-2.74, p < 0.001). Patients who experienced weight loss were older and more burdened with comorbidities.

CONCLUSIONS

Being underweight, overweight or obese is associated with a higher mortality risk in a population of patients in primary care. Patients who lost weight were older and more burdened with cardiometabolic diseases, which may suggest unintentional weight loss, and were at higher risk of death in the long-term follow-up. In nonsmoking patients without comorbidities, the lowest mortality was observed in those with a BMI < 25 kg/m2, and no U-curve relationship was observed.

Kidney Transplant Recipients Show Limited Lung Diffusion Capacity but Similar Hydrogen Peroxide Exhalation as Healthy Matched Volunteers: A Pilot Study

Patients with end-stage chronic kidney disease show higher systemic oxidative stress and exhale more hydrogen peroxide (H2O2) than healthy controls. Kidney transplantation reduces oxidative stress and H2O2 production by blood polymorphonuclear leukocytes (PMNs). Kidney transplant recipients (KTRs) may be predisposed to an impairment of lung diffusing capacity due to chronic inflammation. Lung function and H2O2 concentration in the exhaled breath condensate (EBC) were compared in 20 KTRs with stable allograft function to 20 healthy matched controls. Serum interleukin eight (IL-8) and C-reactive protein (CRP), blood cell counts, and spirometry parameters did not differ between groups. However, KTRs showed lower total lung diffusing capacity for carbon monoxide, corrected for hemoglobin concentration (TLCOc), in comparison to healthy controls (92.1 ± 11.5% vs. 102.3 ± 11.9% of predicted, p = 0.009), but similar EBC H2O2 concentration (1.63 ± 0.52 vs. 1.77 ± 0.50 µmol/L, p = 0.30). The modality of pre-transplant renal replacement therapy had no effect on TLCOc and EBC H2O2. TLCOc did not correlate with time after transplantation. In this study, TLCOc was less reduced in KTRs in comparison to previous reports. We suggest this fact and the non-elevated H2O2 exhalation exhibited by KTRs, may result perhaps from the evolution of the immunosuppressive therapy.

Polyphenols and Their Impact on the Prevention of Neurodegenerative Diseases and Development

It is well known that neurodegenerative diseases' development and progression are accelerated due to oxidative stress and inflammation, which result in impairment of mitochondrial function, cellular damage, and dysfunction of DNA repair systems. The increased consumption of antioxidants can postpone the development of these disorders and improve the quality of patients' lives who have already been diagnosed with neurodegenerative diseases. Prolonging life span in developed countries contributes to an increase in the incidence ratio of chronic age-related neurodegenerative disorders, such as PD (Parkinson's disease), AD (Alzheimer's disease), or numerous forms of age-related dementias. Dietary supplementation with neuroprotective plant-derived polyphenols might be considered an important element of healthy aging. Some polyphenols improve cognition, mood, visual functions, language, and verbal memory functions. Polyphenols bioavailability differs greatly from one compound to another and is determined by solubility, degree of polymerization, conjugation, or glycosylation resulting from chemical structure. It is still unclear which polyphenols are beneficial because their potential depends on efficient transport across the BBB (blood-brain barrier), bioavailability, and stability in the CNS (central nervous system). Polyphenols improve brain functions by having a direct impact on cells and processes in the CNS. For a direct effect, polyphenolic compounds must be able to overcome the BBB and accumulate in brain tissue. In this review, the latest achievements in studies (animal models and clinical trials) on the effect of polyphenols on brain activity and function are described. The beneficial impact of plant polyphenols on the brain may be summarized by their role in increasing brain plasticity and related cognition improvement. As reversible MAO (monoamine oxidase) inhibitors, polyphenols are mood modulators and improve neuronal self-being through an increase in dopamine, serotonin, and noradrenaline amounts in the brain tissue. After analyzing the prohealth effects of various eating patterns, it was postulated that their beneficial effects result from synergistic interactions between individual dietary components. Polyphenols act on the brain endothelial cells and improve the BBB's integrity and reduce inflammation, thus protecting the brain from additional injury during stroke or autoimmune diseases. Polyphenolic compounds are capable of lowering blood pressure and improving cerebral blood flow. Many studies have revealed that a nutritional model based on increased consumption of antioxidants has the potential to ameliorate the cognitive impairment associated with neurodegenerative disorders. Randomized clinical trials have also shown that the improvement of cognitive functions resulting from the consumption of foods rich in flavonoids is independent of age and health conditions. For therapeutic use, sufficient quantities of polyphenols must cross the BBB and reach the brain tissue in active form. An important issue in the direct action of polyphenols on the CNS is not only their penetration through the BBB, but also their brain metabolism and localization. The bioavailability of polyphenols is low. The most usual oral administration also conflicts with bioavailability. The main factors that limit this process and have an effect on therapeutic efficacy are: selective permeability across BBB, gastrointestinal transformations, poor absorption, rapid hepatic and colonic metabolism, and systemic elimination. Thus, phenolic compounds have inadequate bioavailability for human applications to have any beneficial effects. In recent years, new strategies have been attempted in order to exert cognitive benefits and neuroprotective effects. Converting polyphenols into nanostructures is one of the theories proposed to enhance their bioavailability. The following nanoscale delivery systems can be used to encapsulate polyphenols: nanocapsules, nanospheres, micelles, cyclodextrins, solid lipid nanoparticles, and liposomes. It results in great expectations for the wide-scale and effective use of polyphenols in the prevention of neurodegenerative diseases. Thus far, only natural polyphenols have been studied as neuroprotectors. Perhaps some modification of the chemical structure of a given polyphenol may increase its neuroprotective activity and transportation through the BBB. However, numerous questions should be answered before developing neuroprotective medications based on plant polyphenols.

Effect of Exercise Repetitions on Arylesterase Activity of PON1 in Plasma of Average-Trained Men-The Dissociation between Activity and Concentration

Exercise may increase the antioxidant capacity of plasma by stimulating antioxidant enzymes. The study aimed to measure the effect of three repetitions of acute exercise on arylesterase (ARE) activity of the paraoxonase 1 (PON1) enzyme. Eleven average-trained men (age 34.0 ± 5.2 years) completed three treadmill runs. ARE activity in plasma was evaluated spectrophotometrically and compared with PON1 concentration (PON1c), paraoxonase (PON) activity, and high-density lipoprotein cholesterol (HDL-C) at rest and after exercise. In all repetitions of the exercise, ARE activity remained stable, and ARE activity standardized for PON1c (ARE/PON1c) was lower post- than pre-exercise. The ARE/PON1c ratio changes returned to baseline levels during rest after each exercise session. Pre-exercise ARE activity correlated negatively with post-exercise C-reactive protein (CRP) (ρ = -0.35, p = 0.049), white blood cell count (WBC) (ρ = -0.35, p = 0.048), polymorphonuclear leukocytes (PMN) (ρ = -0.37, p = 0.037), and creatine kinase (CK) (ρ = -0.37, p = 0.036). ARE activity may be depleted under conditions of oxidative stress, as increases in PON1c during acute exercise did not result in parallel increases in ARE activity. No adaptation of the response of ARE activity to exercise was detected in subsequent exercise sessions. Individuals with lower pre-exercise ARE activity may develop a higher inflammatory response to strenuous exercise.

Effect of various factors on energy drinks consumption, and their connection with alcohol consumption

Energy drinks (EDs) have become widely popular among adolescents and young adults. Excessive consumption of EDs can lead to ED abuse and alcohol abuse. Therefore, this study has aimed to analyse the consumption of EDs in a group of patients suffering from alcohol dependence and among young adults, considering such issues as the amounts consumed, underlying reasons and threats arising from excessive consumption of ED and their mixing with alcohol (AmED). The study included 201 men (101 patients treated due to alcohol dependence and 100 young adults/students). Each research participant responded to questions in a survey designed by the researchers (socio-demographic data, clinical data, including consumption of ED, AmED and alcohol), the MAST and SADD. The participants also had their arterial blood pressure measured. EDs were consumed by 92% of the patients and 52% of young adults. A statistically significant dependence was confirmed between consumption of ED and tobacco smoking (p < 0.001), as well as the place of residence (p = 0.044). For 22% of the patients, ED consumption had an effect on alcohol consumption, where 7% admitted to feeling an increased urge to drink alcohol, and 15% said ED consumption decreased it. A statistically significant relationship (p < 0.001) was also shown between ED consumption and the consumption of EDs mixed with alcohol (AmED). This study may implicate that widespread consumption of EDs predisposes to the consumption of alcohol mixed with ED or separate.

Averrhoa carambola L., Cyphomandra betacea, Myrciaria dubia as a Source of Bioactive Compounds of Antioxidant Properties

Natural bioactive compounds play an important role in the prevention of various diseases. The exotic fruits Averrhoa carambola L. (star fruit), Cyphomandra betacea (tamarillo) and Myrciaria dubia (camu-camu) can be valuable sources of phytochemicals with antioxidant properties. The aim of this study has been to compare the antioxidant properties of these exotic fruits, the structure of polyphenolic compounds and the content of vitamin C and β-carotene. All the juices were analyzed for their antioxidant capacity (DPPH and ABTS assays) and the composition of phenolic compounds (TP and FBBB assays, total flavonoid content, total anthocyanins). In addition, HPLC assays were performed to analyse the content of phenolic acids, flavonoids, vitamin C and β-carotene. The results demonstrated that juice from the Myrciaria dubia fruit had the highest antioxidant capacity, which was 4.5-fold higher than that of juice from Averrhola carambola L., and nearly 7-fold higher than the antioxidant capacity of Cyphomandra betacea fruit juice. Additionally, juice from the camu-camu fruit had a 3- to 4-fold higher total polyphenol content (8290 ± 254 mg GAE L^-1) and a high level of vitamin C (8410.8 ± 16.9 mg AA kg^-1). In turn, tamarillo juice had a high content of total anthocyanins (5796 mg CGE L^-1) and phenolic acids (mostly chlorogenic acid and caffeic acid). Juice produced from carambola had a high content of total flavonoids (1345 mg CAE L^-1), and the composition of these compounds was dominated by flavanols (epicatechin). The research results justify the conclusion that fruits of Myrciaria dubia, Averrhoa carambola L., Cyphomandra betacea are rich sources of bioactive compounds with antioxidant properties, and in the near future may serve as healthful food ingredients.

Relationship of obesity to mortality in 47,399 patients from nationwide LIPIDOGRAM 2004–2015 cohort studies

Background

Evidence suggests that obesity may be associated with lower mortality rates in various cohorts of patients (obesity paradox). One possible explanation is unmeasured confounding factors induced by selection bias (collider stratification bias). Therefore, data from large cohorts with few exclusion criteria are of value as they may minimize this effect.

Purpose

To assess the association between two obesity measures body mass index (BMI; kg/m2) and waist circumference (WC; cm) with mortality in nationwide cohort of 47,399 patients.

Methods

Lipidogram studies were carried out in Poland in 2004, 2006 and 2015 in the population representative for patients in primary care setting. The median follow up was 5570 days. Patients were recruited in all 16 administrative regions in Poland and physicians were proportionally to the number of inhabitants in a given administrative region. Each patient was given a questionnaire on chronic diseases, treatment and lifestyle. Questionnaire was administered by physician. Association between BMI, WC and mortality was assessed by multivariate Cox regression and spline regression models. Weight status was classified as underweight (BMI &lt;18.5), normal weight (BMI 18.5–24.9), overweight (BMI 25–29.9), class I obesity (BMI 30–34.9), class II obesity BMI (35–39.9), and class III obesity BMI (&gt;40).

Results

The prevalence of hypertension, dyslipidemia, diabetes and coronary artery disease, showed a graded association with BMI, whilst smoking was most frequent in underweight patients. Correlation between BMI and WC was 0.748. As compared to normal weight patients' class III obese patients had highest mortality (HR 1.91; 95% CI: 1.650–2.202), following by class II obesity (HR 1.47, 95% CI: 1.33–1.62) and underweight patients (HR 1.47; 95% CI 1.1–1.8). Overweight patients had also slightly increased risk of dying as compared to normal weight patients (HR 1.12; 95% CI: 1.05–1.19). Similar U-shaped curve was observed for waist circumference. After adjustment for age, sex, smoking, diabetes, hypertension and LDL cholesterol highest mortality was observed for underweight patients (HR 1.88; 95% CI: 1.44–2.45), following by class III obesity (HR–1.51; 95% CI 1.31–1.75). Class I obesity and being overweight was associated with lower risk (HR 0.88; 95% CI: 0.82–0.94 and HR 0.86; 95% CI: 0.81–0.92, respectively).

Conclusions

No evidence of obesity paradox was present in unadjusted analysis. Lower mortality was observed in overweight and class I obese patients only after adjustment for risk factors and diseases typically associated with obesity. Results of multivariate analysis indicate that diseases that develop in obese patients are significantly associated with mortality more than obesity itself. Confounding may be responsible for discussed obesity paradox in literature therefore preventive measures to maintain BMI within normal range and prevent development of its complications should not be abolished.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): The present study was funded by an unrestricted educational grant from Valeant. As a supporter of the study, Valeant played no role in the study design, data analysis, data interpretation, or writing of the report. The present study was also supported by Silesian Analytical Laboratories (SLA, Katowice, Poland).

LDL levels and long-term all-cause mortality in patients from nationwide LIPIDOGRAM 2004–2015 cohort studies

Background

Data from multiple randomized clinical trials show that lowering LDL cholesterol with statins is associated with significant reduction of outcomes both in primary and secondary prevention. Despite this some epidemiological studies reported increased risk with lowest LDL levels. The reason for this apparent discrepancy is probably due to unbalanced confounding in epidemiological studies.

Purpose

To assess long term survival in propensity matched cohort from the LIPIDOGRAM study in patients on statin therapy.

Methods

Lipidogram studies were carried out in Poland in 2004, 2006 and 2015 in the population representative for patients in primary care setting. The median follow up was 5570 days. Patients were recruited in all 16 administrative regions in Poland and physicians (n&gt;1100) were proportionally distributed to the number of inhabitants in a given administrative region. Each patient was asked to fill the questionnaire on chronic diseases, treatment and lifestyle. Questionnaire was supervised by physician. Patients who were taking statins at the time of enrollment were matched to patients who were not on statin therapy. Groups were matched with regard to age, sex, body mass index, LDL cholesterol, diabetes mellitus, hypertension, previous myocardial infarction, chronic kidney disease, previous ischemic stroke, and atrial fibrillation. Nearest neighbor matching method was employed.

Results

To 13676 patients (28.9% of the LIPIDOGRAM 2004–2015 cohort) that took statin at the time of enrollment and 13676 patients not on statin treatment were matched. There were no significant differences between two groups with regard to all variables used in matching procedure including LDL cholesterol level. After 15 years of follow up There were 2585 deaths (18.9%) in patients who were treated with statin at the time of enrollment as compared to 2824 (20.6%) in patients with no treatment for dyslipidemia (absolute risk reduction (ARR) of −1.7%, p=0.003) Hazard ratio for mortality in patients who were not treated with statin at the enrollment in this propensity matched cohort was 1.11 (95% CI; 1.05–1.17, p=0.0002).

Conclusions

Despite similar LDL levels patients treated with statin at the time of enrollment had lower mortality risk as compared to patients not taking statins in long-term follow-up. Lower LDL levels that are not due to statin therapy might imply other underlying conditions that influence prognosis. Therefore, data from epidemiological studies that contradict results of balanced randomized trials due to intrinsic limitations should be approached with skepticism.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): The present study was funded by an unrestricted educational grant from Valeant. As a supporter of the study, Valeant played no role in the study design, data analysis, data interpretation, or writing of the report. The present study was also supported by Silesian Analytical Laboratories (SLA, Katowice, Poland).

Lean metabolic syndrome is associated with similar long-term prognosis as metabolic syndrome in overweight/obese patients. Analysis 47,399 Patients from nationwide LIPIDOGRAM 2004–2015 cohort studies

Background

Obesity was once though as an indispensable component of metabolic syndrome. Therefore, there a lot of definitions of metabolic syndrome with only few not including obesity as a criterion. The necessity of the obesity criterion in the metabolic health assessment is being questioned, as similar metabolic disturbances can occur in normal weight individuals. This relatively new concept is often referred as lean metabolic syndrome. Data on long term prognosis is scarce.

Purpose

To evaluate association between metabolic health and long-term prognosis.

Methods

Lipidogram studies were carried out in Poland in 2004, 2006 and 2015 in the population representative for patients in primary care setting. Patients were recruited in all 16 administrative regions in Poland and physicians were proportionally to the number of inhabitants in a given administrative region. Each patient was given a questionnaire on chronic diseases, treatment and lifestyle. Questionnaire was administered by physician. The diagnosis of metabolic syndrome was based on the presence of at least two of the following: 1) systolic blood pressure (SBP) ≥130 mmHg or diastolic blood pressure (DBP) ≥85 mmHg, 2) triglycerides (TG) &gt;150 mg/dl, 3) high-density lipoprotein cholesterol (HDL-C) &lt;40 mg/dl men and &lt;50 mg/dl in women, 4) total cholesterol (TC) &gt;200 mg/dl, and 5) fasting glucose (FBG) &gt;100 mg/dl. Basing on those criteria and BMI with a cut off value of 25 kg/m2, patients were divided into four categories: healthy slim, metabolically healthy overweight/obese, lean metabolic syndrome and overweight/obese metabolic syndrome. The median follow up was 5570. this analysis data were censored at 3650 days.

Results

The median age of the study participants was 56.4 years. 7901 (16.7%) fell into category healthy slim, 14607 (30.8%) were classified as metabolically healthy overweight/obese, 3827 (8.1%) fulfilled criteria for lean metabolic syndrome whilst the remaining 21063 (44.4%) patients were diagnosed with overweight/obese metabolic syndrome. There were 4065 deaths during 10 years follow-up. Patients with lean metabolic syndrome had similar risk as patients with overweight/obese metabolic syndrome (HR=1.33, 95% CI: 1.17–1.52, p&lt;0.001 and HR=1.32, 95% CI: 1.20–1.45, p&lt;0.001). Metabolically heathy overweight/obese patients had only slightly higher risk of dying than healthy slim patients but this difference was less pronounced (HR=1.11, 95% CI: 1.08–1.23, p=0.03).

Conclusions

Lean metabolic syndrome confers similar risk as metabolic syndrome in overweigh/obese patients.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): The present study was funded by an unrestricted educational grant from Valeant. As a supporter of the study, Valeant played no role in the study design, data analysis, data interpretation, or writing of the report. The present study was also supported by Silesian Analytical Laboratories (SLA, Katowice, Poland).

Antioxidant and Antimicrobial Properties of Selected Fruit Juices

Fruit and fruit juices are a valuable source of bioactive compounds, which can protect our organisms from oxidative stress. The phenolic compounds and other phytochemicals may affect the antimicrobial properties of juices. The aim of this study has been to evaluate antioxidant and antimicrobial properties of selected berry juices and vitamin C-rich fruit juices. The research material was composed of seven juices, including three from berries (elderberry chokeberry, cranberry), three from vitamin C-rich fruit (sea buckthorn, wild rose, Japanese quince) and one exotic juice from noni fruit. Antioxidant capacity, total polyphenol, total flavonoid and total anthocyanin content were determined. Furthermore, the antimicrobial activity and the minimal inhibitory concentration (MIC) as well as the minimal bactericidal concentration (MBC) were evaluated. The research showed that fruit juices from wild rose, chokeberry and Japanese quince had the highest antioxidant capacity. These juices were characterised by the rich content of polyphenols. Elderberry and chokeberry juices had the highest total anthocyanins. The juices differed in the content of bioactive compounds and specific bactericidal properties against Gram-positive or Gram-negative bacteria. Fruit juices from cranberry, Japanese quince and sea buckthorn had the highest antimicrobial activity. Wild rose, chokeberry and elderberry juices, despite their high antioxidant properties, showed antimicrobial activity only against Gram-positive strains, except Enterococcus faecalis and Clostridium perfringens. Significant differences in the content of bioactive compounds in fruit juices affect the antimicrobial properties juices.

The oral bioavailability of di-2-ethylhexyl phthalate (DEHP), di-isononyl phthalate (DiNP) and di-(isononyl)-cyclohexane-1,2-dicarboxylate (DINCH®) in house dust

Phthalates and other plasticizers are detected in high amounts in the indoor environment and therefore house dust can be an exposure source. Especially children have a relatively high unintended uptake of house dust, thus a higher exposure to plasticizers compared to adults may be possible. As accurate as possible exposure assessment data of the oral bioavailability of these compounds are necessary, however only one in vivo study with piglets is available so far. The aim of this study was to examine the oral bioavailability of phthalates and DINCH® in humans, which occur in typical house dust samples. We focused on the high molecular weight phthalates DEHP and DINP and their substitute DINCH®. Eleven volunteers ingested 6 g of house dust sieved to 2 mm. The urine was collected over a period of 36 h. The excreted plasticizers metabolites were quantified by an LC-MS/MS method. The mean recovery of urine metabolites was 51 % ± 20 % for DEHP, 26 % ± 13 % for DINP and 19 % ± 6% for DINCH® based on the parent compounds administered as dust samples. The metabolites of DEHP, DINP and DINCH® reached their maximum concentration after 2-19 hours post dose in urine. The bioavailability of DEHP was in agreement among the different dust samples. For DEHP, we were able to confirm previous findings from the oral bioavailability study with piglets and we could not observe a significant difference between the dust particle size (65 μm vs 2 mm) and the bioavailability. Considering the observed bioavailability, an estimated dust intake of 50 mg/d for toddlers can substantially contribute to the total plasticizer exposure.

Exhaustive Exercise Increases Spontaneous but Not fMLP-Induced Production of Reactive Oxygen Species by Circulating Phagocytes in Amateur Sportsmen

Strenuous exercise alters the oxidative response of blood phagocytes to various agonists. However, little is known about spontaneous post exercise oxidant production by these cells. In this cross-over trial, we tested whether an exhaustive treadmill run at a speed corresponding to 70% of VO2max affects spontaneous and fMLP-provoked oxidant production by phagocytes in 18 amateur sportsmen. Blood was collected before, just after, and 1, 3, 5 and 24 h post exercise for determination of absolute and normalized per phagocyte count spontaneous (a-rLBCL, rLBCL) and fMLP-induced luminol-enhanced whole blood chemiluminescence (a-fMLP-LBCL, fMLP-LBCL). a-rLBCL and rLBCL increased by 2.5- and 1.5-times just after exercise (p < 0.05) and then returned to baseline or decreased by about 2-times at the remaining time-points, respectively. a-fMLP-LBCL increased 1.7- and 1.6-times just after and at 3 h post-exercise (p < 0.05), respectively, while fMLP-LBCL was suppressed by 1.5- to 2.3-times at 1, 3, 5 and 24 h post-exercise. No correlations were found between elevated post-exercise a-rLBCL, a-fMLP-LBCL and run distance to exhaustion. No changes of oxidants production were observed in the control arm (1 h resting instead of exercise). Exhaustive exercise decreased the blood phagocyte-specific oxidative response to fMLP while increasing transiently spontaneous oxidant generation, which could be a factor inducing secondary rise in antioxidant enzymes activity.

Design and rationale of a nationwide screening analysis from the LIPIDOGRAM2015 and LIPIDOGEN2015 studies

INTRODUCTION

Cardiovascular disease (CVD) is a major cause of morbidity and mortality throughout the world. The LIPIDOGRAM2015 study was performed to estimate the prevalence of risk factors for atherosclerotic diseases as well as cardiovascular and related disorders in the primary care setting in Poland. The LIPIDOGEN2015 sub-study was designed to include a random cohort of patients in order to analyse parameters related to lipid metabolism, oxidative stress, inflammatory responses, autoimmune disorders, and gene variants that confer susceptibility to cardiometabolic and atherosclerotic diseases.

MATERIAL AND METHODS

The recruitment was carried out by 438 primary care physicians in Poland. The expected number of patients recruited for the LIPIDOGRAM2015 study was 13,000-14,000 with 13-15% (1700-2000) also participating in the LIPIDOGEN2015 sub-study. Each patient had to complete a questionnaire concerning medical and family history, concomitant diseases, and pharmacotherapy. Anthropometric measurements were performed at the doctor's office. For the LIPIDOGEN2015 sub-study, saliva samples for DNA isolation and blood samples for measurement of glycated haemoglobin, oxidative stress parameters, autoantibody levels, and inflammatory cytokine profile and apolipoprotein profile were collected. Follow-up data will be obtained from the National Health Fund in Poland.

RESULTS

The LIPIDOGRAM2015 and LIPIDOGEN2015 study cohort reflects the prevalence of cardiovascular risk factors and concomitant diseases, markers of oxidative stress, the presence of autoantibodies, inflammatory cytokine profile, and apolipoprotein profile, as well as genetic variants potentially conferring susceptibility to cardiometabolic and atherosclerotic diseases.

CONCLUSIONS

This study presents the prevalence of different CV risk factors, with special emphasis on lipid disorders, and it assesses the relationship between inflammation, oxidative stress, and mutations in genes encoding proteins regulating lipid metabolism, as well as genes conferring susceptibility to cardiovascular, cardiometabolic, and related diseases.

Current Trends in Cell-Free DNA Applications. Scoping Review of Clinical Trials

We aimed to summarize the current knowledge about the trends in cfDNA application based on the analysis of clinical trials registered until April 2021. International Clinical Trials Registry Platform (ICTRP) and Clinicaltrials.gov were searched with the keywords: "cf-DNA"; "Circulating DNA"; "Deoxyribonucleic Acid"; and "Cell-Free Deoxyribonucleic Acid". Of 605 clinical trials, we excluded 237 trials, and 368 remaining ones were subject to further analysis. The subject, number of participants, and study design were analyzed. Our scoping review revealed three main trends: oncology (n = 255), non-invasive prenatal diagnostic (n = 48), and organ transplantation (n = 41), and many (n = 22) less common such as sepsis, sport, or autoimmune diseases in 368 clinical trials. Clinical trials are translating theory into clinical care. However, the diagnostic value of cfDNA remains controversial, and diagnostic accuracy still needs to be evaluated. Thus, further studies are necessary until cfDNA turns into a standard in clinical practice.

Effect of Physiological Concentrations of Vitamin C on the Inhibitation of Hydroxyl Radical Induced Light Emission from Fe2+-EGTA-H2O2 and Fe3+-EGTA-H2O2 Systems In Vitro

Ascorbic acid (AA) has antioxidant properties. However, in the presence of Fe²⁺/Fe³⁺ ions and H₂O₂, it may behave as a pro-oxidant by accelerating and enhancing the formation of hydroxyl radicals (^•OH). Therefore, in this study we evaluated the effect of AA at concentrations of 1 to 200 µmol/L on ^•OH-induced light emission (at a pH of 7.4 and temperature of 37 °C) from 92.6 µmol/L Fe²⁺—185.2 µmol/L EGTA (ethylene glycol-bis (β-aminoethyl ether)-N,N,N′,N′-tetraacetic acid)—2.6 mmol/L H₂O₂, and 92.6 µmol/L Fe³⁺—185.2 µmol/L EGTA—2.6 mmol/L H₂O₂ systems. Dehydroascorbic acid (DHAA) at the same range of concentrations served as the reference compound. Light emission was measured with multitube luminometer (AutoLumat Plus LB 953) for 120 s after automatic injection of H₂O₂. AA at concentrations of 1 to 50 µmol/L and of 1 to 75 µmol/L completely inhibited light emission from Fe²⁺-EGTA-H₂O₂ and Fe³⁺-EGTA-H₂O₂, respectively. Concentrations of 100 and 200 µmol/L did not affect chemiluminescence of Fe³⁺-EGTA-H₂O₂ but tended to increase light emission from Fe²⁺-EGTA-H₂O₂. DHAA at concentrations of 1 to 100 µmol/L had no effect on chemiluminescence of both systems. These results indicate that AA at physiological concentrations exhibits strong antioxidant activity in the presence of chelated iron and H₂O₂.

[Guideline for the Diagnosis and Treatment of Asthma - Addendum 2020 - Guideline of the German Respiratory Society and the German Atemwegsliga in Cooperation with the Paediatric Respiratory Society and the Austrian Society of Pneumology]

The present addendum of the guideline for the diagnosis and treatment of asthma (2017) complements new insights into the diagnosis and management of asthma as well as for the newly approved drugs for the treatment of asthma. Current, evidence-based recommendations on diagnostic and therapeutic approaches are presented for children and adolescents as well as for adults with asthma.

Increased Circulating H3 Histone in Response to Repeated Bouts of Exercise Does Not Associate with Parallel Alterations of Cell-Free DNA

Numerous studies have shown that cf nDNA significantly rises in stress caused by exercise. However, during nuclear decondensation, released DNA is followed by histones. Histones are also a common disease marker. After PAD4 mediated hypercitrullination extracellular H3Cit exhibits high toxicity contributing to tissue damage which, in cases of systemic inflammation, may lead to multiorgan failure and finally to death. We tested whether circulating histones rise in response to strenuous exercise. Eleven average-trained men performed three treadmill exercise tests to exhaustion at speed corresponding to 70% VO2max separated by 72 h of resting. Blood was collected before and just after each bout of exercise and plasma proteins were measured using enzyme-linked immunosorbent assay, whereas platelet activity was estimated with Light Transmission Aggregometry. Both, circulating histones and PAD4 raised in response to exercise. Plasma citrullinated histones increased from 3.1 ng/mL to 5.96 ng/mL (p = 0.0059), from 3.65 ng/mL to 6.37 ng/mL (p = 0.02), and from 3.86 ng/mL to 4.75 ng/mL (p = 0.033) after the first, second, and third treadmill run, respectively. However despite the parallel increase, no significant correlation between citrullinated histone and aggregation or cell-free nDNA was found. Furthermore, positive correlations of cf nDNA with aggregation and PAD4, lactate with aggregation, and lactate with citrullinated histone have been observed.

Circulating cell free DNA response to exhaustive exercise in average trained men with type I diabetes mellitus

It is believed that neutrophils extracellular traps (NETs) formation is responsible for the increase in cf DNA after exercise. Since T1DM is accompanied by enhanced NETs generation, we compared exercise-induced increase in cf DNA in 14 men with T1DM and 11 healthy controls and analyzed its association with exercise load. Subjects performed a treadmill run to exhaustion at speed corresponding to 70% of their personal VO2max. Blood was collected before and just after exercise for determination of plasma cf nuclear and mitochondrial DNA (cf n-DNA, cf mt-DNA) by real-time PCR, blood cell count and metabolic markers. Exercise resulted in the increase in median cf n-DNA from 3.9 ng/mL to 21.0 ng/mL in T1DM group and from 3.3 ng/mL to 28.9 ng/mL in controls. Median exercise-induced increment (∆) in cf n-DNA did not differ significantly in both groups (17.8 ng/mL vs. 22.1 ng/mL, p = 0.23), but this variable correlated with run distance (r = 0.66), Δ neutrophils (r = 0.86), Δ creatinine (r = 0.65) and Δ creatine kinase (r = 0.77) only in controls. Pre- and post-exercise cf mt-DNA were not significantly different within and between groups. These suggest low usefulness of Δ cf n-DNA as a marker of exercise intensity in T1DM men.

Effects of two different types of single exercise modes on salivary C-reactive protein concentration, oxidative stress and antioxidant capacity in post-myocardial infarction patients

Objectives

The aim of the study was to determine the effects of two different types of single cardiac rehabilitation (CR) exercise modes on the inflammation status, oxidative stress and total antioxidant capacity (TAC) of saliva.

Methods

The study involved two groups of CR patients: group A (n = 21) used a cycloergometer, and group B (n = 21) received breathing and balance exercises. C-reactive protein as an inflammatory biomarker, malondialdehyde (MDA) as a measure of the level of oxidative stress and salivary 2.2-diphenyl-1-picryl-hydrazyl (DPPH) as an index of TAC were performed twice: before the beginning of the CR exercise (pre-CR) and immediately after (post-CR).

Results

No significant changes were observed for the inflammatory response of saliva after CR exercise regardless of its type. MDA decreased (pre-CR: 39.7 ± 101.9 vs. post-CR: 16.8 ± 44.3 ng·mL⁻¹; p < 0.01) and DPPH increased (pre-CR: 25.9 ± 16.7 vs. post-CR: 32.6 ± 14.0% reduction; p < 0.05) after CR exercise in the group B, with similar but not statistically significant changes in the group A.

Discussion

Two popular exercise modes, especially breathing and balance exercises, reduce salivary oxidative stress and enhance the antioxidant potential of saliva in CR patients. The approval of saliva as a non-invasive source of information about inflammation status, oxidative stress and antioxidant capacity in cardiac patients requires further studies.

[Statement of the German Society for Pulmonology and Respiratory Medicine Regarding the Regulation to Use FFP and Surgical Masks in the General Population]

On January 19, 2021, a new regulation on the mask requirement was issued in an initiative by the federal and state governments. This regulation obliges citizens to wear medical masks on public transport and in shops. In its statement, the German Society for Pneumology and Respiratory Medicine (DGP) describes the technical background of the various medical masks and explains their functionality using the associated standards. The DGP comes to the conclusion that FFP masks of the EN 149 standard were designed for the self-protection of the wearer and ensure this if the mask is worn properly and closes tightly to the face. Incorrect use must be avoided at all costs. Surgical masks in accordance with the EN 14683 standard were designed to protect against bacteria-carrying aerosols and, due to their design, have a rather low self-protection component. Community masks are not yet subject to any official standard. Community masks with electrostatic properties and high filtration performance could represent a reusable alternative in the future. Depending on the severity of their illness, patients with heart and/or lung diseases require a stress test with a mask to minimize medical risks.

The pattern of overnight changes in novel markers of acute kidney injury in patients with obstructive sleep apnea

BACKGROUND

Obstructive sleep apnea (OSA) may predispose patients to acute kidney injury (AKI) and chronic kidney disease (CKD).

OBJECTIVES

We postulated that apneic episodes during sleep in patients with OSA may result in episodes of subclinical AKI that may be detected by the use of novel sensitive serum and urine markers. The treatment of OSA may protect against renal injury.

MATERIAL AND METHODS

The study involved 86 men who had positive screening test results for OSA and estimated glomerular filtration rates (eGFR) calculated with the Chronic Kidney Disease Epidemiology Collaboration (CDK-EPI) equation >60 mL/min/1.73 m². All the patients underwent overnight polysomnography (the diagnostic night). The patients were divided into 2 groups: 45 patients with mild OSA and 41 patients with moderate-to-severe OSA. Those in the latter group were qualified for 6-8 weeks of continuous positive airway pressure (CPAP) treatment. Blood pressure, serum creatinine, high sensitivity C-reactive protein (hsCRP), urine creatinine, AKI markers cystatin C and neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1), liver-type fatty acid-binding protein, and endothelium marker intercellular adhesion molecule-1 (ICAM-1) were assessed in both groups before and after polysomnography. The same parameters were also measured in the patients with moderate-to-severe OSA after CPAP therapy.

RESULTS

Kidney injury molecule 1 and urine NGAL significantly increased after the diagnostic night in the whole group and in mild OSA patients (p = 0.04 and p = 0.001, respectively). Serum ICAM-1 significantly decreased after the diagnostic night only in mild OSA patients (p = 0.03. Urine cystatin C increased after 6-8 weeks of CPAP treatment in the moderate-to-severe OSA group (0.003). Serum ICAM-1 decreased after the CPAP treatment (p = 0.02). The CPAP therapy led also to a decrease in mean and diastolic (p = 0.005) blood pressure.

CONCLUSIONS

The pattern of overnight changes in serum and urine AKI markers after apneic episodes during sleep may suggest an increased risk of subclinical AKI in patients with OSA. The CPAP therapy is not protective against AKI, but may reduce some of its risk factors, including high blood pressure and endothelial damage.

May Measurement Month 2018: an analysis of blood pressure screening campaign results from Poland

Hypertension remains the most important cardiovascular risk factor in Poland. May Measurement Month is a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for blood pressure (BP) screening and demonstrating the potential of the opportunistic BP measurements. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in 146 sites in May 2018. Blood pressure was measured in 6450 subjects (mean age: 41 ± 15 years; 59% females). After multiple imputation, the age and sex standardized systolic and diastolic BP was 126.7/78.4 mmHg in the whole analysed group, 132.8/81.3 mmHg in subjects taking antihypertensive drugs, and 125.7/78.0 mmHg in those not taking any antihypertensive drugs. After multiple imputation, the proportions of subjects with high BP (systolic ≥140 mmHg or diastolic ≥90 mmHg or on treatment for raised BP) were 22.2% in the whole analysed group, 39.2% in subjects taking antihypertensive drugs, and 18.6% those not taking any antihypertensive drugs. Overall, hypertension was present in 32.8% of participants, among them 38.7% were not aware of the disease, 53.1% were taking antihypertensive drugs, and 32.3% had BP controlled to target (<140/90 mmHg). Blood pressure was increasing with increasing body mass index and alcohol intake. Smokers and project participants with diabetes had increased average BP. In conclusion, this project provides additional evidence for a considerable potential for further reduction of cardiovascular risk through improvement in detection and treatment of hypertension in Poland.

Respiratory diseases and allergy in farmers working with livestock: a EAACI position paper

Farmers constitute a large professional group worldwide. In developed countries farms tend to become larger, with a concentration of farm operations. Animal farming has been associated with negative respiratory effects such as work-related asthma and rhinitis. However, being born and raised or working on a farm reduces the risk of atopic asthma and rhinitis later in life. A risk of chronic bronchitis and bronchial obstruction/COPD has been reported in confinement buildings and livestock farmers. This position paper reviews the literature linking exposure information to intensive animal farming and the risk of work-related respiratory diseases and focuses on prevention. Animal farming is associated with exposure to organic dust containing allergens and microbial matter including alive microorganisms and viruses, endotoxins and other factors like irritant gases such as ammonia and disinfectants. These exposures have been identified as specific agents/risk factors of asthma, rhinitis, chronic bronchitis, COPD and reduced FEV₁. Published studies on dust and endotoxin exposure in livestock farmers do not show a downward trend in exposure over the last 30 years, suggesting that the workforce in these industries is still overexposed and at risk of developing respiratory disease. In cases of occupational asthma and rhinitis, avoidance of further exposure to causal agents is recommended, but it may not be obtainable in agriculture, mainly due to socio-economic considerations. Hence, there is an urgent need for focus on farming exposure in order to protect farmers and others at work in these and related industries from developing respiratory diseases and allergy.

The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET

Background

Peripheral neuropathy is a common comorbidity in COPD. We aimed to investigate associations between alterations commonly found in COPD and peripheral neuropathy, with particular emphasize on the distinction between direct and indirect effects.

Methods

We used visit 4 data of the COPD cohort COSYCONET, which included indicators of polyneuropathy (repeated tuning fork and monofilament testing), excluding patients with diabetes a/o increased HbA1c. These indicators were analysed for the association with COPD characteristics, including lung function, blood gases, 6-min walk distance (6-MWD), timed-up-and-go-test (TUG), exacerbation risk according to GOLD, C-reactive protein (CRP), and ankle-brachial index (ABI). Based on the results of conventional regression analyses adjusted for age, BMI, packyears and gender, we utilized structural equation modelling (SEM) to quantify the network of direct and indirect relationships between parameters.

Results

606 patients were eligible for analysis. The indices of polyneuropathy were highly correlated with each other and related to base excess (BE), ABI and TUG. ABI was linked to neuropathy and 6-MWD, exacerbations depended on FEV₁, 6-MWD and CRP. The associations could be summarized into a SEM comprising polyneuropathy as a latent variable (PNP) with three measured indicator variables. Importantly, PNP was directly dependent on ABI and particularly on BE. When also including patients with diabetes and/or elevated values of HbA1c (n = 742) the SEM remained virtually the same.

Conclusion

We identified BE and ABI as major determinants of peripheral neuropathy in patients with COPD. All other associations, particularly those with lung function and physical capacity, were indirect. These findings underline the importance of alterations of the micromilieu in COPD, in particular the degree of metabolic compensation and vascular status.

Assessment of Antioxidant Properties of Classic Energy Drinks in Comparison with Fruit Energy Drinks

Energy drinks (EDs) contain sugar, caffeine, and other bioactive compounds. Recently, new types of EDs, enriched with fruit juices, natural pigments, and plant extracts, have been launched in the market. The objective of this study was to investigate the composition and antioxidant properties of the most popular classic and fruit EDs. The study was carried out including 24 of the most popular energy drinks (classic and fruit EDs). The composition of EDs, especially caffeine and sugar, and antioxidant properties (antioxidant capacity, total polyphenols, total anthocyanins, vitamin C) were analyzed. Energy drinks with added fruit juice or natural pigments had a significantly higher (p ≤ 0.05) antioxidant capacity compared to classic energy drinks. Fruit EDs had a higher concentration of polyphenols and vitamin C. In some fruit EDs, slight amounts of anthocyanins were found. Generally, EDs are not a rich source of polyphenols and are not distinguished by high antioxidant capacity. However, fruit energy drinks and/or ones with added natural pigments have much better antioxidant properties than classic EDs. Both classic and fruit EDs contain a large amount of caffeine and sugar, therefore, it would be advisable not to drink large amounts of EDs for possible related health issues.

The Impact of an Inert Gas Atmosphere on the Kinetics of Changes in the Physical and Chemical Properties of Carrot Lyophilisate

The purpose of this study was to analyse the impact of blanching, the atmosphere of nitrogen and storage time on carotenoids content, colour and sorption properties of freeze-dried carrot. The material was stored for up to 16 weeks, in the dark, at room temperature. The colour was measured on the surface and in cross sections. As the storage time increased, there was a continual decrease in the carotenoids content in the carrot packed in atmospheric air. In the carrots packed in the atmosphere of nitrogen, no changes in carotenoid content were observed. The colour parameters correlated with the changes in the carotenoids content. The colour parameters changed on the surface and in cross sections in the same manner. During storage, a significant decrease in sorption properties of freeze-dried carrots was noted after 2 weeks of storage.

Decreased integrity of exercise-induced plasma cell free nuclear DNA - negative association with the increased oxidants production by circulating phagocytes

Strenuous exercise increases circulating cell free DNA (cfDNA) and stimulates blood phagocytes to generate reactive oxygen species (ROS) which may induce DNA strand breaks. We tested whether: (A) elevated cfDNA in response to three repeated bouts of exhaustive exercise has decreased integrity; (B) each bout of exercise increases luminol enhanced whole blood chemiluminescence (LBCL) as a measure of ROS production by polymorphonuclear leukocytes. Eleven men performed three treadmill exercise tests to exhaustion separated by 72 hours of resting. Pre- and post-exercise concentrations and integrity of cf nuclear and mitochondrial DNA (cf n-DNA, cf mt-DNA) and resting (r) and fMLP (n-formyl-methionyl-leucyl-phenylalanine)-stimulated LBCL were determined. Each bout increased concentrations of cf n-DNA by more than 10-times which was accompanied by about 2-times elevated post-exercise rLBCL and fMLP-LBCL. Post-exercise cf n-DNA integrity (integrity index, I_229/97) decreased after the first (0.59 ± 0.19 vs. 0.48 ± 0.18) and second (0.53 ± 0.14 vs. 0.44 ± 0.17) bout of exercise. There were negative correlations between I_229/97 and rLBCL (ƍ = –0.37), and I_229/97 and fMLP-LBCL (ƍ = –0.40) – analysis of pooled pre- and post-exercise data (n = 66). cf mt- DNA integrity (I_218/78) did not alter in response to exercise. This suggests an involvement of phagocyte ROS in cf n-DNA strand breaks in response to exhaustive exercise.

Potential of Liquid Biopsy in Papillary Thyroid Carcinoma in Context of miRNA, BRAF and p53 Mutation

BACKGROUND

Liquid biopsy is a minimally invasive detection method for molecular biomarkers such as miRNA and cell free DNA in body fluids. Deregulations of miRNA are involved in papillary thyroid carcinoma (PTC), one the most common endocrine malignancy. The most widespread common mutations detected in papillary thyroid cancers are BRAF mutations. Many studies indicate that the BRAF mutation is related to deregulation of miRNA. p53 has an important role in cell cycle control, DNA repair and apoptosis. Moreover, the p53 can regulate the expression of miRNAs and thus participate in thyroid oncogenesis.

OBJECTIVE

In this review, we briefly summarize the present state of knowledge about miRNA, BRAF and p53 mutation in the development of PTC and the possibility of using detecting BRAF mutation and miRNA expression in liquid biopsy.

RESULTS

The use of the plasma miRNA expression profile in combination with the BRAF mutation analysis in cf-DNA may be a valuable tool in management of PTC.

CONCLUSION

Numerous molecular variation characterize recent diagnostic and prognostic markers and therapeutic targets for this type of cancer, which offer unique chances for further research and clinical development of innovative treatment strategies for thyroid cancer.

Altered levels of circulating nuclear and mitochondrial DNA in patients with Papillary Thyroid Cancer

Papillary thyroid cancer is the most common thyroid cancer type. However, diagnostics based on fine needle biopsy cannot make a definitive diagnosis in 25% of thyroid nodules. Additionally, approximately 70% to 80% of thyroid lobectomies performed just for diagnostic purposes are benign. Despite this, biopsy still remains the main method of evaluation of thyroid nodules. Cell-free DNA (cf-DNA) measurement could give a new diagnostic opportunities which may reduce the number of unnecessary thyroid procedures. In this study, using a qPCR, we have examined the nuclear cf-DNA and mitochondrial cf-DNA in the plasma of 32 patients. We have found that the level of nuclear cf-DNA is almost 2-fold increased (median 3 089 vs. 1 872, p = 0.022), whereas mitochondrial cf-DNA content was significantly decreased in respect to healthy controls (median 44 992 vs. 92 220, p = 0.010). The ROC curve analysis showed high specificity for nuclear cf-DNA and mitochondrial cf-DNA, which may serve as a useful tool to decrease the number of unneeded surgeries. Our study reports the first epidemiological evidence for lower mitochondrial cf-DNA content in the patient group, what suggests that apart from nuclear cf-DNA also mitochondrial cf-DNA is affected by disease development.

Salivary and plasma native and non-urate total antioxidant capacity versus oral health status in older non-smoking adults

OBJECTIVE

The aim of this study was to evaluate the salivary C-reactive protein and native and non-urate total antioxidant capacity (TAC) of saliva and plasma in relation to various oral health status indexes in older non-smoking adults.

DESIGN

Oral health status indices involved the Decayed, Missing, Filled Teeth index, the number of decayed teeth, Approximal Plaque Index, Plaque Index and Community Periodontal Index with Treatment Needs. Sixty older patients (67.0 ± 4.5 years) with different levels of oral health were examined. Salivary C-reactive protein was assessed. The Ferric Reducing Ability of Saliva/Plasma (FRAS/FRAP) and 2.2-diphenyl-1-picryl-hydrazyl test of saliva/plasma (DPPHS/DPPH) were used to assess the native and non-urate salivary (FRAS, non-urate FRAS, DPPHS, non-urate DPPHS, and plasma TAC (FRAP, non-urate FRAP, DPPH, non-urate DPPH).

RESULTS

Salivary C-reactive protein, native TAC and non-urate TAC did not correspond to any oral health status index. No relation was found for plasma native and non-urate TAC either. In multivariate analyses, age was the only independent predictor of DPPHS and salivary uric acid (p < 0.05) while non-urate DPPH was only negatively predicted by Body Mass Index (p < 0.001). None of oral health status indices was selected as an independent predictor of salivary and plasma TAC or C-reactive protein of saliva.

CONCLUSION

Oral health status indexes did not appear to influence the native or the non-urate local antioxidant status of saliva, or the systemic antioxidant status of plasma; they had no local effect related to salivary C-reactive protein. However, lower plasma non-urate antioxidant potential was related to overweight/obesity.

Cell-free tumour DNA as a diagnostic and prognostic biomarker in non-small cell lung carcinoma

More than 1 million people dies worldwide due to lung cancer which is the first most incident cancer in males and the third in females. Only early diagnosis makes possible to achieve long-lasting remission or even cure the disease. Unfortunately, no tumour marker to achieve this goal has been identified, yet. One of putative lung cancer markers is free circulating tumor DNA. Its concentration seems to be related to cancer burden. Moreover, it can be subjected to mutational status analysis allowing for introduction of targeted treatment. This led to the idea of liquid biopsy which can substitute for a standard biopsy not feasible in certain clinical circumstances. Assessment of cell free tumour DNA can also inform about progression/recurrence of cancer and may have a prognostic value. Therefore, the aim of this article is to review on free circulating DNA as a potential marker in lung cancer.

Do we know more about hypertension in Poland after the May Measurement Month 2017?-Europe

Elevated blood pressure (BP) is a worldwide burden, leading to over 10 million deaths yearly. May Measurement Month (MMM) is a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for BP screening. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017. BP measurement, the definition of hypertension and statistical analysis followed the globally approved MMM17 Study Protocol. In Poland 5834 (98.9%, Caucasian) individuals were screened. After multiple imputation, 2601 (35.3%) had hypertension. Of individuals not receiving anti-hypertensive medication, 976 (20.6%) were hypertensive. Of individuals receiving anti-hypertensive medication, 532 (49.1%) had uncontrolled BP. In the crude screened group, 81.4% declared to not receive any anti-hypertensive treatment, while the remaining 18.6% were on such medications. In overweight and obese patients both systolic and diastolic BP were significantly higher than in normal weight and underweight subjects. In addition, BP measured on Sundays was significantly lower than on Mondays. MMM17 was one of the largest recent BP screening campaigns in Poland. We found that over 1/3 of participants were hypertensive. Almost half of the treated subjects had uncontrolled BP. These results suggest that opportunistic screening can identify substantial numbers with raised BP.

The Influence of an Eight-Week Cycloergometer-Based Cardiac Rehabilitation on Serum Antioxidant Status in Men with Coronary Heart Disease: A Prospective Study

Background and objectives: A body of evidence confirms the benefits of cardiac rehabilitation (CR) in coronary heart disease (CHD) patients, but it remains unclear whether it enhances the antioxidant potential. The aim of the study was to assess the influence of an eight-week aerobic cycloergometer-based CR program on serum total antioxidant capacity (TAC) and other CHD risk factors. Materials and Methods: The study involved 36 men with CHD (55.2 ± 9.0 years). TAC was assessed with two methods: ferric reducing ability of serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH). Aerobic capacity was evaluated during a submaximal exercise test. TAC and other anthropometric, biochemical and physical activity/fitness measures were performed twice: before the beginning and after termination of CR. Results: Aerobic capacity was higher (7.0 ± 2.6 vs. 8.0 ± 2.5 MET—metabolic equivalents; p < 0.01), but values of resting diastolic blood pressure were lower (81.9 ± 7.6 vs. 77.4 ± 8.9 mmHg; p < 0.01) after termination of CR. Other classic cardiometabolic, anthropometric, and biochemical measures did not change with CR. No difference in TAC-FRAS was found after CR, whereas TAC-DPPH was significantly lower (16.4 ± 4.0 vs. 13.2 ± 3.7% reduction; p < 0.01). Conclusions: Antioxidant potential measured as TAC-DPPH, but not as TAC-FRAS, decreased with the CR program. The recognized health benefits of CR are not related to augmented serum antioxidant status.

Intratumor heterogeneity and tissue distribution of KRAS mutation in non-small cell lung cancer: implications for detection of mutated KRAS oncogene in exhaled breath condensate

Purpose

Mutated KRAS oncogene in exhaled breath condensate (EBC) can be a genetic marker of non-small cell lung cancer (NSCLC). However, a possibility of inhomogeneous distribution in cancer tissue and intratumor heterogeneity of KRAS mutation may decrease its significance. We investigated a status of KRAS point mutation and its sequence at codon 12 in 51 NSCLC patients after tumor resection. The comparison of KRAS mutation status between EBC–DNA and cancer tissue was performed in 19 cases.

Methods

Five cancer tissue samples from disparate tumor regions and one from normal lung were harvested at surgery. EBC was collected for DNA analysis the previous day. KRAS point mutations at codon 12 were detected using mutant-enriched PCR technique and pyrosequenced.

Results

Forty-six cancers revealed concordance of KRAS mutation status: 27 contained mutated KRAS and 19 had only wild KRAS. Five NSCLCs revealed inhomogeneous distribution of KRAS mutation. Two different mutations were found in 14 NSCLCs and the most frequent one was G12D and G12V (n = 8). No mutated KRAS was found in normal lung. The concordance ratios of KRAS sequence in codon 12 between EBC–DNA and cancer were 18/19 for NSCLC patients and 11/12 for KRAS mutation positive NSCLC.

Conclusions

Intratumor heterogeneity and inhomogeneous distribution of KRAS point mutation in codon 12 in cancer tissue can occur in NSCLCs. There was a high accordance between KRAS mutation status in EBC–DNA and cancer tissue in NSCLC patients what suggests usefulness of monitoring KRAS mutation in EBC–DNA as a biomarker of NSCLC.

Combination of Methotrexate and Prednizone Decreases Circulating Concentrations of Interleukin 1Beta and Interleukin 6 in Patients with Rheumatoid Arthritis. Poor Correlation of Cytokine Suppression with Clinical Improvement

Objective

To evaluate the effect of methotrexate (MTX) in combination with prednizone on cytokine levels, acute phase proteins and thiobarbituric acid reactive substances (TBAR - an indicator of peroxidative damage to tissue lipids) in the blood of rheumatoid arthritis (RA) patients and to investigate their assgciations with clinical disease activity.

Methods

We measured blood concentrations of interleukin-1 R (IL-1p), interleukin- 6 (IL-6), TBARs and classical clinical and laboratory indices of disease activity in 36 RA subjects before and after 3 and 6 month treatment with MTX and prednizone. Only RA subjects who stopped any disease-modifying anti rheumatic drugs treatment for last 3 months were included in the study. Baseline cytokine and TBARs levels were compared with those obtained with 20 healthy controls.

Results-

Compared to controls RA subjects had elevated levels of circulating IL-1beta (63.3 ±47.6 vs 13.7 ± 7.8 pg/ml, p< 0.01), IL-6 (147.2 ± 76.5 vs 15.9 ± 13.3 pg/ml, p< 0.001) and TBARs (3.11 ± 0.42 vs 1.34 ± 0.45 nmol/1, p< 0.001) concentrations. MTX in combination with prednizone improved patient clinical status that was accompanied by 1.96-, 1.25-, and 1.35-fold decrease in IL-1beta, IL-6 and TBARs after 6 month treatment (p<0.001), respectively. Although, IL-1 and IL-6 revealed a few correlations with classical indices of disease activity no association was found between patient clinical status improvement and cytokine changes over 6 month treatment. Conclusions: MTX in combination with prednizone decreases blood levels of IL-1beta and IL-6 and inhibits the intensity of free radical- mediated processes in RA subjects. Monitoring of plasma concentrations of these cytokines could not predict the treatment efficacy.

Antioxidant Properties and Phenolic Compounds of Vitamin C-Rich Juices

Many studies have shown that bioactive compounds, for example, polyphenols, and so on can play an important role in reducing oxidative stress and protect against various diseases. The sources of these compounds in the human diet include mainly fruit and good quality fruit juices, which may contain polyphenols but also other phytochemicals such as vitamin C. The purpose of the study was to analyze the antioxidant properties of vitamin C-rich juices, which underwent mild processing. The content of total polyphenols (TP, FBBB), total flavonoids (TF), total anthocyanins (TA), and vitamin C as well as the antioxidant capacity (DPPH, ABTS) were evaluated in commercial fruit juices rich in vitamin C (acerola, gojiberry, sea buckthorn, wild rose, cranberry, Japanese quince). Moreover, phenolic acids and selected flavonoids were determined by HPLC methods. Among the examined fruit juices, acerola and wild rose juices contained the highest amounts of vitamin C and total polyphenols, and had the highest antioxidant capacity. Acerola owes its high antioxidant properties mainly to vitamin C, whereas the antioxidant capacity of wild rose is also attributed to its rich content of flavonoids and phenolic acids. Sea buckthorn juice and Japanese quince juice had a lower antioxidant capacity, yet higher than determined for gojiberry and cranberry juices. Total anthocyanins were the highest in cranberry juice. The results showed that the analyzed juices were a valuable source of natural antioxidants. Generally, vitamin C-rich juices are also good source of polyphenols. Vitamin C and polyphenols act synergistically and define the antioxidant properties of juices.

PRACTICAL APPLICATION

Bioactive compounds, for example, polyphenols play an important role in reducing oxidative stress and protect against various diseases. Sources of natural antioxidants in human diet include mainly fruit and good quality fruit juices. The study showed that the juices from acerola, gojiberry, sea buckthorn, wild rose, cranberry, Japanese quince were a valuable source of natural polyphenols and vitamin C. These compounds act synergistically and define the antioxidant properties of juices. Among all examined samples, acerola and wild rose juices seem to be the most valuable. Moreover, it's worth noticing that juices underwent mild processing (cold pressed and low pasteurization) retained more bioactive compounds, which affected their higher quality.

Acute health effects of desktop 3D printing (fused deposition modeling) using acrylonitrile butadiene styrene and polylactic acid materials: An experimental exposure study in human volunteers

3D printers are increasingly run at home. Nanoparticle emissions from those printers have been reported, which raises the question whether adverse health effects from ultrafine particles (UFP) can be elicited by 3D printers. We exposed 26 healthy adults in a single-blinded, randomized, cross-over design to emissions of a desktop 3D printer using fused deposition modeling (FDM) for 1 hour (high UFP-emitting acrylonitrile butadiene styrene [ABS] vs low-emitting polylactic acid [PLA]). Before and after exposures, cytokines (IL-1β, IL-6, TNF-α, INF-γ) and ECP in nasal secretions, exhaled nitric oxide (FeNO), urinary 8-isoprostaglandin F_2α (8-iso PGF_2α ), and self-reported symptoms were assessed. The exposures had no significant differential effect on 8-iso PGF_2α and nasal biomarkers. However, there was a difference (P < .05) in the time course of FeNO, with higher levels after ABS exposure. Moreover, indisposition and odor nuisance were increased for ABS exposure. These data suggest that 1 hour of exposure to 3D printer emissions had no acute effect on inflammatory markers in nasal secretions and urine. The slight relative increase in FeNO after ABS printing compared to PLA might be due to eosinophilic inflammation from inhaled UFP particles. This possibility should be investigated in further studies using additional biomarkers and longer observation periods.

Pregnancy and perinatal conditions and atopic disease prevalence in childhood and adulthood

BACKGROUND

Previous studies showed controversial results for the influence of pregnancy-related and perinatal factors on subsequent respiratory and atopic diseases in children. The aim of this study was to assess the association between perinatal variables and the prevalence of asthma, bronchial hyperreactivity (BHR), flexural eczema (FE), allergic rhinitis, and sensitization in childhood and early adulthood.

METHODS

The studied population was first examined in Munich and Dresden in 1995/1996 at age 9-11 years. Participants were followed until age 19-24 years using questionnaires and clinical examinations. Associations between perinatal data and subsequent atopic diseases were examined using logistic regression analyses adjusting for potential confounders.

RESULTS

Cesarean section was statistically significantly associated with BHR in early adulthood (odds ratio 4.8 [95% confidence interval 1.5-15.2]), while assisted birth was associated with presence of asthma symptoms in childhood (2.2 [1.2-3.9]), FE symptoms (2.2 [1.2-4.3]) and doctor's diagnosis of atopic dermatitis (1.9 [1.0-3.4]) in childhood, and sensitization in early adulthood (2.2 [1.1-4.3]). Lower birth length (1.9 [1.1-3.2]), lower birthweight (0.5 [0.3-0.9]), and higher birthweight (0.6 [0.4-1.0]) were predictive of sensitization in early adulthood compared to average birth length and birthweight, respectively. None of the other perinatal factors showed statistically significant associations with the outcomes.

CONCLUSIONS

Our results indicate that children who are born by cesarean section and especially by assisted birth, might be at greater risk for developing asthma, FE, and sensitization and should hence be monitored. Prenatal maternal stress might partly explain these associations, which should be further investigated.