Effects of low molecular weight organic acids on Cu accumulation by castor bean and soil enzyme activities

Chelating agents have been considered as an important phytoremediation strategy to enhance heavy metal extraction from contaminated soil. A pot experiment was conducted to explore the effects of low molecular weight organic acids (LMWOAs) on the phytoremediation efficiency of copper (Cu) by castor bean, and soil enzyme activities. Results indicated that the addition of all the three kinds of LMWOAs (citric, tartaric, oxalic acids) did not decrease the biomass of castor bean, despite the fact they reduced the concentration of chlorophyll-a in leaves compared to the control. The Cu concentrations in the roots and shoots significantly increased by 6-106% and 5-148%, respectively, in the LMWOAs treatments so that the total accumulation of Cu by whole plants in all the LMWOAs treatments increased by 21-189% in comparison with the control. The values of the translocation factor (TF) and bio-concentration factor (BCF) of Cu in castor bean also rose following the addition of LMWOAs, indicating that the LMWOAs enhanced the uptake and transportation of Cu. Moreover, the application of LMWOAs did not significantly change the soil pH but significantly increased the activity of soil enzymes (urease, catalase, and alkaline phosphatase). The addition of exogenous LMWOAs increased the available Cu significantly in the soil, thus promoted the phytoextraction efficiency of Cu by castor bean. These results will provide some new insights into the practical use of LMWOAs for the phytoremediation of heavy-metal-contaminated soil employing castor bean.

Association of Dietary Acid Load with the Prevalence of Metabolic Syndrome among Participants in Baseline Survey of the Japan Multi-Institutional Collaborative Cohort Study

The association between dietary acid load and metabolic syndrome (MetS) has not been fully investigated. A cross-sectional study was performed on 14,042 men and 14,105 women (aged 35-69 years) who participated in a baseline survey of the Japan Multi-Institutional Collaborative Cohort study. Dietary acid load was assessed using the net-endogenous-acid-production (NEAP) score that is closely correlated with the rate of renal net acid excretion. MetS was diagnosed according to the Joint Interim Statement Criteria of 2009 using body-mass index instead of waist circumference. After adjusting for potential confounders, higher NEAP scores were associated with a significantly increased odds ratio (OR) of MetS, obesity, high blood pressure, and high fasting blood glucose. These associations remained significant after further adjustment for carbohydrate intake or two nutrient-pattern scores significantly associated with MetS. After adjustment for fiber, iron, potassium, and vitamin pattern scores, the OR of MetS for the highest quartile of NEAP scores, relative to the lowest quartile, was 1.25 (95% confidence interval 1.12-1.39). There was no significant interaction between sex, age, or body-mass index and NEAP. Higher dietary acid load was associated with a higher prevalence of MetS and several of its components, independently of carbohydrate intake or nutrient patterns.

Dietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: Findings from an updated systematic review and meta-analysis

OBJECTIVES

There is no clear summarised report of the association between dietary acid load components including potential renal acid load (PRAL) and net-endogenous acid production (NEAP) with cardiometabolic risk factors. In the current meta-analysis, we aimed to systematically review and summarise the eligible observational studies evaluating the association between PRAL and NEAP with blood pressure and hypertension and markers of glucose haemostasis among adults.

DESIGN AND SETTING

In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases up to May 2019, relevant studies were included in the literature review. Observational studies evaluating the association between PRAL and NEAP with the systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), haemoglobin A₁ C (HbA₁ C), HOMA-β and quantitative insulin check index (QUICKI) and also prevalence or odds of hypertension, hyperglycaemia and diabetes were included.

RESULTS

Total number of studies included in the 14 separate meta-analyses were as follows: Mean (SD) of SBP (PRAL, n = 12; NEAP, n = 6), mean (SD) of DBP (PRAL, n = 8; NEAP, n = 3), mean (SD) of FBS (PRAL, n = 12; NEAP, n = 5), mean (SD) of HbA₁ C (PRAL, n = 6; NEAP, n = 4), mean (SD) of HOMA-IR (PRAL, n = 7), mean (SD) of insulin (PRAL, n = 7; NEAP, n = 2); OR of type 2 diabetes mellitus (T₂ DM) (PRAL, n = 8; NEAP; n = 6), HTN prevalence (PRAL, n = 9; NEAP, n = 9), T₂ DM prevalence (PRAL, n = 7; NEAP, n = 6). According to our results, being in the highest PRAL categories was associated with higher SBP (WMD = 0.98; CI: 0.51, 1.45; P < .001), DBP (WMD = 0.61; CI: 0.089, 1.135; P = .022), insulin (WMD = -0.235, CI: 0.070, 0.400; P = .005), higher odds of diabetes (OR = 1.19; CI: 1.092, 1.311; P < .001), higher prevalence of T₂ DM (13% and 11% in highest vs lowest category). While, being in the highest category of NEAP was only associated with higher odds of diabetes (OR = 1.22; CI: 1.14, 1.31, P < .001). In subgroup analysis for finding the possible source of heterogeneity, the continent, dietary assessment tool, sample size and gender were the potent sources of heterogeneity. No association between PRAL and NEAP with HbA₁ C, HOMA-IR was reported.

CONCLUSIONS

In the current meta-analysis, we found potent negative effects of high dietary acid load particularly higher PRAL scores cardiometabolic risk factors. Therefore, lower acidogenic food ingredients in the diets are suggested for the prevention of cardiovascular risk factors and diabetes.

Increased dietary calcium inclusion in fully acidified prepartum diets improved postpartum uterine health and fertility when fed to Holstein cows

The objective of this study was to determine the effects of prepartum negative dietary cation-anion difference diet (DCAD) fed at two dietary Ca inclusion rates on postpartum uterine health and ovulation dynamics of multiparous Holstein cows (n = 76). Treatments began at 28 days before expected calving until parturition and were: CON: DCAD = +6 mEq/100g of DM with low dietary Ca (46.2 ± 15.2 g Ca/d; 0.4% DM; n = 26); ND: DCAD = -24 mEq/100g of DM with low dietary Ca (44.1 ± 16.1 Ca/d; 0.4% DM; n = 24); NDCA: DCAD = -24 mEq/100g of DM with high dietary Ca (226.6 ± 96.0 g Ca/d; 2.0% DM; n = 26). Vaginal discharge was evaluated through the fresh period via Metricheck (MC) for presence of purulent material. Polymorphonuclear (PMN) cell concentration in the uterus was evaluated at 15 and 30 days relative to calving (DRC). Endometrial tissue was harvested at 30 DRC for glandular morphology, presence of tight-junctions and adheren-junctions proteins, as well as assessment of superoxide dismutase (SOD) and glutathione peroxidase (GPX) activity. Blood plasma and serum samples were harvested in the prepartum and postpartum phase and were assessed for concentrations of lipopolysaccharide binding protein (LBP), serum amyloid A (SAA), and haptoglobin (HP). Ovarian dynamics were assessed through the fresh period until first timed artificial insemination (TAI). Cows fed CON had a lower MC score (P = 0.06) than the average of cows fed ND and cows fed NDCA. Cows fed ND had a higher MC score than cows fed NDCA. Cows fed NDCA had greater uterine gland epithelial height (P = 0.02) than cows fed ND. Cows fed NDCA also had a greater number of epithelial cells per gland (P = 0.05) than cows fed ND. Cows fed NDCA had greater intensity of occludin expression (P = 0.15) than cows fed ND. Cows fed NDCA had increased activity of SOD (P = 0.05) and decreased activity of GPX (P < 0.001) than cows fed ND. Cows fed ND had higher plasma HP concentrations than cows fed NDCA in the prepartum (P = 0.01) and post-partum (P = 0.03) periods. Cows fed ND and NDCA had lower (P = 0.01) postpartum plasma HP concentration than cows fed CON. In conclusion, cows fed NDCA had an improved uterine environment most likely due to alleviation of oxidative stress, an enhanced immune response to parturition and uterine discharge comparable to cows fed CON.

Higher dietary acid load is associated with higher likelihood of peripheral arterial disease among American adults

OBJECTIVE

To explore the association between dietary acid load, potential renal acid load (PRAL) and net endogenous acid production (NEAP), and peripheral arterial disease (PAD) in a national representative sample of American adults.

METHODS

The National Health and Nutrition Examination Survey (NHANES) database (for 1999-2002) was used. PAD was diagnosed by ankle brachial index assessment. Analysis of covariance was used to examine adjusted mean of different dietary acid load by PAD status; multivariable logistic regression was used to relate dietary acid load with prevalent PAD. Sample weighting was accounted for in all analyses.

RESULTS

Of the 4864 eligible participants aged 40-85, 2482 (51.0%) were men, and 269 (5.5%) had PAD. After adjustment for age-, sex-, race-, estimated glomerular filtration rate (eGFR), smoking, dietary fat, carbohydrates, protein, saturated fat, and dietary fiber, and energy intake, body mass index, hypertension, cholesterol, triglyceride and diabetes, estimated glomerular filtration rate, participants with PAD had higher mean of (PRAL: 16.2 vs 9.1mEq/d, NEAP: 56.2 vs 50.1mEq/d, both p<0.001) than PAD-free participants. In logistic regression with same cofounders, the top quarter of PRAL (more acidic) was associated with 31% higher odds of the PAD compared with the bottom quarter (more alkaline) [odds ratio: 1.31, 95% confidence interval: 1.11-1.57].

CONCLUSION

Our findings, for the first time, suggest that dietary acids load, an index of acid-base balance, is associated with the likelihood of PAD after adjustment for main clinical and anthropometrical confounding factors. These results support the hypothesis that diet plays an important role in chronic disease occurrence.

Dietary Acid Load and Mental Health Outcomes in Children and Adolescents: Results from the GINIplus and LISA Birth Cohort Studies

High dietary acid load may have detrimental effects on mental health during childhood and adolescence. We examined cross-sectional and prospective associations of dietary acid load and mental health problems in a population-based sample, using data from the German birth cohort studies GINIplus (German Infant Nutritional Intervention plus environmental and genetic influences on allergy development) and LISA (Influences of lifestyle-related factors on the immune system and the development of allergies in childhood). These studies included detailed assessments of dietary intake through a food frequency questionnaire (FFQ), mental health outcomes measured through the Strengths and Difficulties Questionnaire (SDQ), and covariates. Using logistic regression, cross-sectional associations between dietary acid load measured as potential renal acid load (PRAL) and SDQ subscales were assessed at age 10 years (N = 2350) and 15 years (N = 2061). Prospective associations were assessed, considering PRAL at 10 years as exposure and SDQ subscales at 15 years as outcome (N = 1685). Results indicate that children with a diet higher in PRAL have more emotional problems (OR = 1.33 (95% CI = 1.15; 1.54); p < 0.001), and show hyperactivity more often (1.22 (1.04; 1.43); p = 0.014) at 10 years. No significant associations were present either cross-sectionally at age 15 years, nor prospectively. Results were confirmed in sensitivity analyses. These findings reveal first evidence for potential relationships between PRAL and mental health in childhood, although we cannot exclude reverse causality, i.e., that dietary behavior and PRAL are influenced by mental status. Future studies should address confirmation and identify biological mechanisms.

Dietary Acid Load and Potassium Intake Associate with Blood Pressure and Hypertension Prevalence in a Representative Sample of the German Adult Population

Diets rich in fruits and vegetables, like the Dietary Approaches to Stop Hypertension (DASH)-diet, are usually characterized by high potassium intake and reduced dietary acid load, and have been shown to reduce blood pressure (BP). However, the relevance of potential renal acid load (PRAL) for BP has not been compared with the relevance to BP of urinary biomarker (K-urine)- and dietary food frequency questionnaire (K-FFQ)-based estimates of potassium intake in a general adult population sample. For 6788 participants (aged 18–79 years) of the representative German Health-Interview and Examination Survey for Adults (DEGS1), associations of PRAL, K-urine, and K-FFQ with BP and hypertension prevalence were cross-sectionally examined in multivariable linear and logistic regression models. PRAL was significantly associated with higher systolic BP (p = 0.0002) and higher hypertension prevalence (Odds ratio [OR] high vs. low PRAL = 1.45, p = 0.0004) in models adjusted for age, sex, body mass index (BMI), estimated sodium intake, kidney function, relevant medication, and further important covariates. Higher estimates of K-FFQ and K-urine were related to lower systolic BP (p = 0.04 and p < 0.0001) and lower hypertension prevalence (OR = 0.82, p = 0.04 and OR = 0.77, p = 0.02) as well as a lower diastolic BP (p = 0.03 and p = 0.0003). Our results show, for the first time in a comparative analysis of a large representative population sample, significant relationships of BP and hypertension prevalence with questionnaire- and biomarker-based estimates of potassium intake and with an estimate of dietary acid load.

Diet-dependent acid load and type 2 diabetes: pooled results from three prospective cohort studies

AIMS/HYPOTHESIS

Studies suggest a potential link between low-grade metabolic acidosis and type 2 diabetes. A western dietary pattern increases daily acid load but the association between diet-dependent acid load and type 2 diabetes is still unclear. This study aimed to assess whether diet-dependent acid load is associated with the risk of type 2 diabetes.

METHODS

We examined the association between energy-adjusted net endogenous acid production (NEAP), potential renal acid load (PRAL) and animal protein-to-potassium ratio (A:P) on incident type 2 diabetes in 67,433 women from the Nurses' Health Study, 84,310 women from the Nurses' Health Study II and 35,743 men from the Health Professionals' Follow-up Study who were free from type 2 diabetes, cardiovascular disease and cancer at baseline. Study-specific HRs were estimated using Cox proportional hazards models with time-varying covariates and were pooled using a random effects meta-analysis.

RESULTS

We documented 15,305 cases of type 2 diabetes during 4,025,131 person-years of follow-up. After adjustment for diabetes risk factors, dietary NEAP, PRAL and A:P were positively associated with type 2 diabetes (pooled HR [95% CI] for highest (Q5) vs lowest quintile (Q1): 1.29 [1.22, 1.37], p _trend <0.0001; 1.29 [1.22, 1.36], p _trend <0.0001 and 1.32 [1.24, 1.40], p _trend <0.0001 for NEAP, PRAL and A:P, respectively). These results were not fully explained by other dietary factors including glycaemic load and dietary quality (HR [95% CI] for Q5 vs Q1: 1.21 [1.09, 1.33], p _trend <0.0001; 1.19 [1.08, 1.30] and 1.26 [1.17, 1.36], p _trend <0.0001 for NEAP, PRAL and A:P, respectively).

CONCLUSIONS/INTERPRETATION

This study suggests that higher diet-dependent acid load is associated with an increased risk of type 2 diabetes. This association is not fully explained by diabetes risk factors and overall diet quality.

The Association between Renal Hyperfiltration and the Sources of Habitual Protein Intake and Dietary Acid Load in a General Population with Preserved Renal Function: The KoGES Study

Although the differential response of the kidney to the acute load of various sources of dietary protein in subjects with normal renal function is well known, the influence of habitual dietary protein intake and dietary acid load on renal function has not been tested well. The association between renal hyperfiltration (RHF), the earlier and possibly reversible stage of chronic kidney disease, and the sources of habitual dietary protein and dietary acid load was analyzed with the baseline data of 123,169 middle-aged healthy Koreans of a large prospective cohort study, who had a baseline estimated glomerular filtration rate (eGFR) >60 mL/min/m2 and no known history of diabetes and/or hypertension. eGFR was calculated with the Chronic Kidney Disease Epidemiology Collaboration equation using serum creatinine and RHF was defined as eGFR >95th percentile after adjustment for age, sex, height, and body weight. Dietary acid load was calculated with estimated net endogenous acid production (eNEAP). Although the level of habitual intake of animal protein was positively and vegetable protein was negatively associated with RHF, this association was significant only in women and younger participants (younger than sex-specific median age). The odds for RHF increased as the percentile rank of eNEAP increased until about the 50th percentile and then leveled off. The positive association between eNEAP and RHF was significant in both sexes and age groups. Dietary acid load was associated with RHF regardless of sex and age and rather than the amount of the total or the individual sources of habitual dietary protein, may be a better target for the dietary intervention of chronic kidney disease.

Dietary Acid-Base Load and Risk of Chronic Kidney Disease in Adults: Tehran Lipid and Glucose Study

INTRODUCTION

The objective was to examine whether dietary acid load was associated with chronic kidney disease (CKD) in adults.

MATERIALS AND METHODS

The cross-sectional analyses included 4564 participants, aged 20 years and older, who participated in the 4th phase of the Tehran Lipid and Glucose Study and had complete dietary and serum creatinine data. Dietary data were obtained from using a 147-item food-frequency questionnaire. Dietary acid load was calculated as the potential renal acid load (PRAL). Anthropometrics, blood pressure, and fasting plasma glucose, and lipids were measured. Chronic kidney disease was defined as an estimated glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2 calculated using the Modification of Diet in Renal Disease equation. Risk of CKD was obtained in quartiles of PRAL with logistic recreation.

RESULTS

The mean dietary PRAL of the participants was -22.0 mEq/d. After adjustment for age, sex, and body mass index, the odds ratio for CKD in the highest compared to the lowest quartile of PRAL was 1.38 (95% confidence interval [CI], 1.02 to 1.83). After additional adjustment for energy intake and smoking, the odds ratio for CKD in the 4th quartile of PRAL compared to the 1st was 1.42 (95% CI, 1.06 to 1.91). In the final model, after additional adjustment for dietary intake of total fat, carbohydrate, dietary fiber, fructose, sodium, diabetes mellitus, and hypertension, the risk of CKD in the highest dietary PRAL category, compared to the lowest, increased by 42%.

CONCLUSIONS

After adjusting for possible confounding factors, we found that higher PRAL (more acidic diet) was associated with higher prevalent CKD in Iranian adults.

Combined effect of a mixture of tetracycline, acid, and detergent, and nisin against Enterococcus faecalis and Actinomyces viscosus biofilms

OBJECTIVES

To evaluate the combined effect of a mixture of tetracycline, acid, and detergent (MTAD) and Nisin against Enterococcus faecalis (E. faecalis) and Actinomyces viscosus (A. viscosus) biofilms.

METHODS

This study was conducted between June and December 2013 in collaboration with Dental Caries Research Chair, College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Single-species biofilms (n=9/species/observation period) were generated on membrane filter discs and subjected to 5, 10, or 15 minute incubation with MTADN (MTAD with 3% Nisin), 5.25% sodium hypochlorite (NaOCl), or normal saline. The colony forming units were counted using the Dark field colony counter.

RESULTS

A 100% bactericidal effect of 5.25% NaOCl was noted during the 3 observation periods; a significant reduction (p=0.000) in mean survival rates of E. faecalis (77.3+13.6) and A. viscosus (39.6+12.6) was noted after 5 minutes exposure to MTADN compared with normal saline (78000000+5291503) declining to almost no growth after 10 and 15 minutes. The survival rates of the E. faecalis and A. viscosus biofilm were no different after treatment with MTADN and 5.25% NaOCl at the 3 observation periods (p=1.000).

CONCLUSION

A combination of MTAD and Nisin was as effective as NaOCl against E. faecalis and A. viscosus biofilms.

Nutrient intake and dietary patterns of relevance to dental health of 12-year-old Libyan children

OBJECTIVE

There are few data on the dietary intake of children in Libya, and none on free sugars intake. The present study aimed to report the intake of macronutrients and eating habits of relevance to dental health in a group of Libyan schoolchildren and to investigate any gender differences for these variables.

DESIGN

Dietary information was obtained from a randomly selected sample using an estimated 3 d food diary. Dietary data were coded using food composition tables and entered into a Microsoft® Access database. Intakes of energy, macronutrients, sugars and the amount of acidic items consumed were determined using purpose-written programs.

SETTING

Benghazi, Libya.

SUBJECTS

Schoolchildren aged 12 years.

RESULTS

One hundred and eighty children (ninety-two boys and eighty-eight girls) completed the study. Their mean age was 12·3 (sd 0·29) years. The average daily energy intake was 7·01 (sd 1·54) MJ/d. The percentage contributions to energy intake from protein, fat and carbohydrate were 16 %, 30 % and 54 %, respectively. Total sugars contributed 20·4 % of the daily energy intake, and free sugars 12·6 %. The median daily intake of acidic items was 203 g/d, and of acidic drinks was 146 g/d. There were no statistically significant differences in nutrient intakes between genders. Intake of acidic items was higher in girls (P < 0·001).

CONCLUSIONS

The contribution to energy intake from macronutrients was in accordance with global nutrition guidelines. The acidic drinks intake was low compared with other populations, while free sugars intake was above the recommended threshold of 10 % of energy intake.

Dental erosion in a road-side battery technician: case report and a review of the literature

BACKGROUND

Tooth wear has been generally described as being caused by erosion, abrasion and attrition. Erosion is currently believed to be the major factor involved in tooth wear, and its contribution in the development of tooth wear may be increasing. Among the numerous causes of erosion, extrinsic factors are the most common. Damage of tooth tissue has been described in battery factory workers due to acidic aerosol, but this has not been reported among roadside 'battery technicians' who dispense acidic solutions with a pipette, and often taste it to determine its 'specific gravity'.

CASE DESCRIPTION

A 24-year-old man was referred to the authors' clinic for management of his grossly damaged teeth after presenting for oral diagnosis. History and investigation pointed to extensive erosive lesion as a result of abnormal and prolonged use of lead-acid rechargeable battery solution in his workplace.

CLINICAL IMPLICATIONS

These groups of workers are prone to severe dental erosion, thereby compromising their oral function and health. They are also prone to a range of illnesses, especially kidney disease, because the acid solution is significantly rich in dissolved lead. Therefore, medical referral for complete assessment is required when any of this group present with an unexplained associated illness.

Acute local tolerability of acidic aqueous vehicles delivered via Respimat Soft Mist Inhaler in hyperreactive asthma patients

BACKGROUND

Acidic inhalers can be associated with increased adverse reactions.

OBJECTIVES

This study aimed to determine the acute local tolerability of acidic aqueous placebo formulations delivered via Respimat Soft Mist Inhaler (SMI) and placebo chlorofluorocarbon metered dose inhaler (CFC-MDI).

METHODS

A single-dose (four inhalations), randomized, double-blind within Respimat SMI device, four-way crossover study in asthma patients with documented bronchial hyperresponsiveness was used. Patients received acidic placebo solutions [pH 2.7, 3.4 or 7.0 (neutral)], delivered via Respimat SMI or placebo CFC-MDI. The primary endpoint was the largest decrease in forced expiratory volume in 1 s (FEV(1)) from baseline to 0-30 min after dosing. Secondary endpoints included spirometry, paradoxical bronchoconstriction (defined as a fall in FEV(1) >or=15% below baseline within 30 min of dosing), cough episodes and adverse events.

RESULTS

Thirty-two patients were included in the per-protocol population (mean age 27 years, 62.5% males). The mean percentage decrease in FEV(1) was comparable between treatment groups: -1.6% (Respimat SMI pH 2.7), -1.8% (Respimat SMI pH 7.0), -1.9% (CFC-MDI), and -2.3% (Respimat SMI pH 3.4); no patient experienced paradoxical bronchoconstriction. The mean number of cough episodes was significantly lower in the Respimat SMI pH 2.7 group versus CFC-MDI (p = 0.0165). No patient used rescue medication. Only 3 patients experienced at least one adverse event.

CONCLUSIONS

The Respimat SMI pH 2.7 placebo solution does not induce adverse events in these patients. Compared with the CFC-MDI placebo suspension, Respimat SMI is a well-tolerated inhaled medication delivery system that can accommodate medication formulations with a wide range of pH solutions.

In vitro-reassembled plant virus-like particles for loading of polyacids

The coat protein (CP) of certain plant viruses may reassemble into empty virus-like particles (VLPs) and these protein cages may serve as potential drug delivery platforms. In this paper, the production of novel VLPs from the Hibiscus chlorotic ringspot virus (HCRSV) is reported and the capacity to load foreign materials was characterized. VLPs were readily produced by destabilizing the HCRSV in 8 M urea or Tris buffer pH 8, in the absence of calcium ions, followed by removal of viral RNA by ultrahigh-speed centrifugation and the reassembly of the CP in sodium acetate buffer pH 5. The loading of foreign materials into the VLPs was dependent on electrostatic interactions. Anionic polyacids, such as polystyrenesulfonic acid and polyacrylic acid, were successfully loaded but neutrally charged dextran molecules were not. The molecular-mass threshold for the polyacid cargo was about 13 kDa, due to the poor retention of smaller molecules, which readily diffused through the holes between the S domains present on the surface of the VLPs. These holes precluded the entry of large molecules, but allowed smaller molecules to enter or exit. The polyacid-loaded VLPs had comparable size, morphology and surface-charge density to the native HCRSV, and the amount of polyacids loaded was comparable to the weight of the native genomic materials. The conditions applied to disassembly-reassembly of the virions did not change the structural conformation of the CP. HCRSV-derived VLPs may provide a promising nano-sized protein cage for delivery of anionic drug molecules.

[Characterization of the biological properties of acid-treated chrysotile-asbestos fibers]

Boiling of chrysotile of the textile brand PRZh1-50 in concentrated hydrochloric acid for 10, 15, and 20 minutes gave rise to three chrysotile-asbestos samples. The content of MgO decreased from to 24, 19, and 9%, respectively. As compared with the baseline values, the number and force of positively charged electrical centers were less in the samples containing 24 and 19% MgO and more in the sample having 9% MgO; the negatively charged centers were present in the former two samples and absent in the third one. When the samples were intrapleurally administered to rats, their hemolytic activity, induction of active oxygen radicals, mutagenic activity (micronuclear test using murine bone marrow cells), and the frequency of mesotheliomas were less in the treated samples than in the baseline ones; but there were no differences between the treated samples. Thus, the altered physicochemical properties of the fibrillar surface of asbestos diminished its biological aggressiveness; however, increased treatment rates failed to lead to its further decrease. There was no relationship of the biological properties to the number and force of electric charges of the surface.

Bone Contact Around Osseointegrated Implants: A Histologic Study of Acid-Etched and Machined Surfaces

Current literature reports that surface acid etching can improve bone--implant contact (BIC). The aim of this study was to evaluate the differences of BIC between acid-etched (Osseotite) and machined surface implants. Six white New Zealand mature rabbits were used in the present investigation. Each rabbit received two implants, specially made with two surfaces on it (one acid-etched and one machined) into each tibia. A total of 24 implants were inserted. Two animals each were killed at 15, 30, and 60 days after implant placement. Histomorphometry of BIC was statistically evaluated. The acid-etched surfaces showed a greater bone contact percentage than the machined ones during the early phase of healing (15 days), which was not statistically significant. On the other hand, after 30 and 60 days, the differences of BIC between acid-etched and machined surfaces were statistically significant. The acid-etched surface appears to improve BIC at a later stage of healing.

Poly(amidoamine) (PAMAM) dendritic nanostructures for controlled site-specific delivery of acidic anti-inflammatory active ingredient

The purpose of the investigation was to evaluate the potential of polyamidoamine (PAMAM) dendrimer as nanoscale drug delivery units for controlled release of water insoluble and acidic anti-inflammatory drug. Flurbiprofen (FB) was selected as a model acidic anti-inflammatory drug. The aqueous solutions of 4.0 generation (G) PAMAM dendrimer in different concentrations were prepared and used further for solubilizing FB. Formation of dendrimer complex was characterized by Fourier transform infrared spectroscopy. The effect of pH on the solubility of FB in dendrimer was evaluated. Dendrimer formulations were further evaluated for in vitro release study and hemolytic toxicity. Pharmacokinetic and biodistribution were studied in male albino rats. Efficacy of dendrimer formulation was tested by carrageenan induced paw edema model. It was observed that the loaded drug displayed initial rapid release (more than 40% till 3rd hour) followed by rather slow release. Pharmacodynamic study revealed 75% inhibition at 4th hour that was maintained above 50% till 8th hour. The mean residence time (MRT) and terminal half-life (THF) of the dendritic formulation increased by 2-fold and 3-fold, respectively, compared with free drug. Hence, with dendritic system the drug is retained for longer duration in the biosystem with 5-fold greater distribution. It may be concluded that the drug-loaded dendrimers not only enhanced the solubility but also controlled the delivery of the bioactive with localized action at the site of inflammation.

The B1-subunit of the H(+) ATPase is required for maximal urinary acidification

The multisubunit vacuolar-type H(+)ATPases mediate acidification of various intracellular organelles and in some tissues mediate H(+) secretion across the plasma membrane. Mutations in the B1-subunit of the apical H(+)ATPase that secretes protons in the distal nephron cause distal renal tubular acidosis in humans, a condition characterized by metabolic acidosis with an inappropriately alkaline urine. To examine the detailed cellular and organismal physiology resulting from this mutation, we have generated mice deficient in the B1-subunit (Atp6v1b1(-/-) mice). Urine pH is more alkaline and metabolic acidosis is more severe in Atp6v1b1(-/-) mice after oral acid challenge, demonstrating a failure of normal urinary acidification. In Atp6v1b1(-/-) mice, the normal urinary acidification induced by a lumen-negative potential in response to furosemide infusion is abolished. After an acute intracellular acidification, Na(+)-independent pH recovery rates of individual Atp6v1b1(-/-) intercalated cells of the cortical collecting duct are markedly reduced and show no further decrease after treatment with the selective H(+)ATPase inhibitor concanamycin. Apical expression of the alternative B-subunit isoform, B2, is increased in Atp6v1b1(-/-) medulla and colocalizes with the H(+)ATPase E-subunit; however, the greater severity of metabolic acidosis in Atp6v1b1(-/-) mice after oral acid challenge indicates that the B2-subunit cannot fully functionally compensate for the loss of B1. Our results indicate that the B1 isoform is the major B-subunit isoform that incorporates into functional, plasma membrane H(+)ATPases in intercalated cells of the cortical collecting duct and is required for maximal urinary acidification.

Acute histologic effects of extraesophageal reflux on vocal fold healing

This study evaluates how extraesophageal reflux affects membranous vocal fold healing in a canine model. We created membranous vocal fold injuries in the animals and randomly assigned them to topical application of acid and pepsin at pH 2 or pH 6 or of normal saline solution every other day for 12 days. The experimental vocal folds were compared to uninjured, control vocal folds from animals painlessly sacrificed for other reasons. Hematoxylin and eosin, fibronectin, and procollagen I staining were performed for histologic analysis. The injured specimens had three times greater cellular infiltrate (p < or = .001, analysis of variance) and twice as much fibronectin and procollagen I (p < or = .001, analysis of variance) as did the specimens from the control animals. No significant differences or trends were identified for cellular infiltrate, fibronectin, or procollagen I within the injured groups (p > .05, Bonferroni t-test). Acute wound healing did not appear to be influenced by the presence of acid and pepsin at pH 2 or 6 as compared to saline solution.

Ammonium hexafluorosilicate increased acid resistance of bovine enamel and dentine

Although diamine silver fluoride (AgF: (NH3)2AgF) stains teeth black, it is known as a very effective agent to prevent the dental caries progress. In order to find another fluoride that has a similar anticariogenic effect without changing tooth color, we prepared ammonium hexafluorosilicate (SiF: (NH4)2SiF6), in which the silver of AgF is replaced with silicon. In this study, the anticariogenic effect of SiF was evaluated using bovine teeth. Fluoride solutions, SiF, AgF, acidulated phosphate fluoride (APF), and sodium fluoride (NaF), were applied to bovine enamel and dentine blocks, and the depth of demineralization was measured after exposure to a demineralizing solution for 24 h. Also, fluoride was applied to a simulated dentine caries specimen to evaluate the caries progress-preventing ability. For the dentine specimens, mineral loss (Delta Z) was also measured with microradiography. We found that SiF treated enamel showed better acid resistance than specimens treated with NaF or APF. AgF treated enamel also showed similar acid resistance, but was stained black. SiF and AgF treated caries-affected dentine showed reduced demineralization when exposed to a demineralization solution for 24 h. Mineral loss (Delta Z) was reduced to 85% and 75%, respectively. Although the acid resistance of the SiF treated teeth was inferior to that of the AgF treated teeth, we consider that SiF has good potential as anticariogenic agent, since it increased acid resistance without changing tooth color.

Synthesis and biologically relevant properties of polyphosphazene polyacids

Polyphosphazene polyacids show potential as immunostimulating compounds and materials for microencapsulation. Their synthesis requires multistep chemical transition from a hydrolytically unstable macromolecular precursor, poly(dichlorophosphazene), to a water-soluble polyelectrolyte. Insufficient synthetic control in these reactions can lead to molecular weight variations and formation of macromolecules with "structural defects" resulting in significant variations in polymer performance. Simple and reproducible "one pot-one solvent" method is reported for the preparation of polyphosphazene polyacids-poly[di(carboxylatophenoxy)phosphazene] and its copolymers. Molecular weight characteristics and polymer compositions were studied as a function of reaction parameters. Macromolecular byproducts, incompletely substituted polymers containing hydroxyl groups and partially deprotected polymers containing propyl ester functionalities, were synthesized and characterized. It was demonstrated, that the presence of such groups can affect polymer characteristics, such as hydrolytic degradation profiles, immunostimulating activity, and microsphere forming properties. In vivo studies showed that the immunostimulating activity of polyphosphazene polyacids correlates with the content of acid functionalities in the polymer.

Laryngeal chemoreflexes induced by acid, water, and saline in nonsedated newborn lambs during quiet sleep

Laryngeal chemoreflexes (LCR) are triggered by the contact of assorted liquids with the laryngeal mucosa. In the neonatal period, the immature LCR consist primarily of apnea and bradycardia, which at times can be life threatening. The aim of this study was to assess LCR induction in nonsedated, newborn full-term lambs by several acid solutions, compared with distilled water and saline. Twelve lambs were instrumented for recording of glottal adductor and diaphragm EMG, EEG, eye movements, heart rate, systemic arterial pressure, and respiratory movements. LCR were induced during quiet sleep by the injection (0.5 ml) of saline, distilled water or two acid solutions (HCl and citric acid, pH 2, diluted in either water or saline). A chronic supraglottal catheter was used to inject the solutions in a random order. Distilled water and acid solutions did not induce any significant decrease in heart rate or respiratory rate. However, significant lower airway protective responses (swallowing, cough, and arousal) were observed after distilled water and especially acid solution administration. In conclusion, LCR in full-term lambs, particularly with acid solutions, are merely characterized by lower airway protective responses resembling mature LCR reported in adult mammals.

Neurotrophin-3 reverses chronic mechanical hyperalgesia induced by intramuscular acid injection

Injection of acid into the gastrocnemius muscle results in a persistent, mechanical hyperalgesia of the hindpaw (Sluka et al., 2001). Here, the ability of neurotrophins to alter the development of this secondary hyperalgesia was assessed using transgenic mice and exogenous neurotrophin administration. Acid-induced hyperalgesia was measured in wild-type and transgenic mice that overexpress neurotrophin-3 (NT-3) in muscle (myo/NT-3 mice). Mechanical and thermal sensitivity of the hindpaws were assessed after injections of acidic saline, pH 4, into the right medial gastrocnemius. Wild-type mice exhibited mechanical but not thermal hyperalgesia in both paws 1 d after acid injection. In contrast, myo/NT-3 mice developed a transient mechanical hyperalgesia in both paws that disappeared by 2-3 d. The reversal of hyperalgesia in myo/NT-3 mice could be mimicked by intramuscular administration of exogenous NT-3 to acid-injected mice but not by other neurotrophins. The route of NT-3 administration appears critical, because intrathecal or intraperitoneal delivery were ineffective. The hyperalgesia could only be reversed by NT-3 treatment concurrent with acid injection and not after the emergence of hyperalgesia. The acid-induced hyperalgesia did not redevelop after the termination of NT-3 treatment, suggesting that NT-3 permanently reversed the hyperalgesia. Consistent with the behavioral data, paw palpation of acid-injected mice significantly increased Fos expression in the spinal cord of wild-type but not myo/NT-3 or NT-3-injected mice. The attenuation of hyperalgesia suggests that NT-3 may be a modulator of muscle-derived pain, and NT-3 may suppress events that lead to secondary hyperalgesia triggered by insult to muscle afferents.

Ingestion of acid and alkaline agents: outcome and prognostic value of early upper endoscopy

BACKGROUND

Ingestion of caustic substances often leads to severe morbidity and, frequently, death. This study compared complications and survival for patients who ingested an acidic substance, mainly glacial acetic acid, or an alkaline agent.

METHODS

Records for 179 patients hospitalized for ingestion of a caustic agent (85 acid [75 glacial acetic acid], 94 alkali) were reviewed. Mucosal injury, systemic and GI complications, and survival were scored.

RESULTS

Outcome was less favorable for patients who ingested acid compared with those who ingested alkali with respect to mucosal injury (median: grade 2 vs. grade 1; p=0.013), hospital stay (mean: 9.9 vs. 7.2 days; p=0.01), admittance to the intensive care unit (44% vs. 22%; p=0.002), systemic complications (24% vs. 3%; p < 0.001), perforation (6% vs. 0%; p=0.017), and mortality (14% vs. 2%; p=0.003). There was no difference in the development of strictures (acid, 15% vs. alkali, 17%). The grade of mucosal injury at endoscopy was the strongest predictive factor for the occurrence of systemic and GI complications and mortality (relative risk 9: 95% CI[3, 30]). Ten of 29 (34%) patients with strictures were treated by endoscopic dilation alone, whereas the others primarily (n=7) or secondarily (n=11) underwent surgery. One patient with an esophageal stricture died from systemic complications.

CONCLUSIONS

Acid ingestion, particularly glacial acetic acid, is associated with a higher frequency of complications and mortality rate than alkali ingestion. Early endoscopy probably is safe and provides important prognostic information. Endoscopic treatment of caustic-induced strictures is only moderately successful.

OKP cells express the Na-dicarboxylate cotransporter NaDC-1

Urinary citrate concentration, a major factor in the formation of kidney stones, is primarily determined by its rate of reabsorption in the proximal tubule. Citrate reabsorption is mediated by the Na-dicarboxylate cotransporter-1 (NaDC-1). The opossum kidney (OKP) cell line possesses many characteristics of the renal proximal tubule. The OKP NaDC-1 (oNaDC-1) cDNA was cloned and encodes a 2.4-kb mRNA. When injected into Xenopus oocytes, the cotransporter is expressed and demonstrates Na-coupled citrate transport with a stoichiometry of >or=3 Na:1 citrate, specificity for di- and tricarboxylates, pH-dependent citrate transport, and pH-independent succinate transport, all characteristics of the other NaDC-1 orthologs. Chronic metabolic acidosis increases proximal tubule citrate reabsorption, leading to profound hypocitraturia and an increased risk for stone formation. Under the conditions studied, endogenous OKP NaDC-1 mRNA abundance is not regulated by changes in media pH. In OKP cells transfected with a green fluorescent protein-oNaDC-1 construct, however, media acidification increases Na-dependent citrate uptake, demonstrating posttranscriptional acid regulation of NaDC-1 activity.

Dietary acid, endothelins, and sleep

Acid addition to the body activates a series of homeostatic responses, one example of which is activation of NHE3, the proximal tubule Na(+)/H(+) antiporter. Feeding acid to rats increases apical membrane NHE3 abundance. Similarly, addition of acid to the media of OKP cells, a proximal tubule cell line, leads to an increase in apical membrane NHE3 activity that is due to increased trafficking of NHE3 to the apical membrane, and increased NHE3 mRNA and protein expression. Endothelins also increase NHE3 activity by inducing trafficking of NHE3 to the apical membrane, an effect mediated by the ET(B), but not the ET(A) receptor. Receptor specificity resides in the C-terminal loop and the second intracellular loop of the ET(B) receptor. In addition, the ET(B) receptor is required for acid signaling. An acid-induced signaling cascade has been defined that includes Pyk2, c-Src, ERK, c-fos, c-jun, and endothelin expression.

Phosphorylation of CREB and mechanical hyperalgesia is reversed by blockade of the cAMP pathway in a time-dependent manner after repeated intramuscular acid injections

Spinal activation of the cAMP pathway produces mechanical hyperalgesia, sensitizes nociceptive spinal neurons, and phosphorylates the transcription factor cAMP-responsive element binding protein (CREB), which initiates gene transcription. This study examined the role of the cAMP pathway in a model of chronic muscle pain by assessing associated behavioral changes and phosphorylation of CREB. Bilateral mechanical hyperalgesia of the paw was induced by administering two injections of acidic saline, 5 d apart, into the gastrocnemius muscle of male Sprague Dawley rats. Interestingly, the increases in immunoreactivity for CREB and phosphorylated CREB (p-CREB) in the spinal dorsal horn occur 24 hr, but not 1 week, after the second injection of acidic saline compared with pH 7.2 intramuscular injections. Spinal blockade of adenylate cyclase prevents the expected increase in p-CREB that occurs after intramuscular acid injection. The reversal of mechanical hyperalgesia by adenylate cyclase or protein kinase A inhibitors spinally follows a similar pattern with reversal at 24 hr, but not 1 week, compared with the vehicle controls. The p-CREB immunoreactivity in the superficial dorsal horn correlates with the mechanical withdrawal threshold such that increases in p-CREB are associated with decreases in threshold. Therefore, activation of the cAMP pathway in the spinal cord phosphorylates CREB and produces mechanical hyperalgesia associated with intramuscular acid injections. The mechanical hyperalgesia and phosphorylation of CREB depend on early activation of the cAMP pathway during the first 24 hr but are independent of the cAMP pathway by 1 week after intramuscular injection of acid.

Selective COX-2 inhibition is associated with decreased mucosal damage induced by acid and pepsin in rabbit esophagitis

OBJECTIVE

To evaluate the effects of COX-1 and/or COX-2 inhibition in a model of chronic esophagitis in rabbits.

METHODS

Both high- and low-grade esophagitis were induced in rabbits by the perfusion of acidified pepsin. Rabbits were treated with either a selective COX-2 inhibitor (DFU[3-(3-Fluorophenyl)-4-(4-Methanesulfonyl)-5,5-Dimethyl-5H-Furan-2-One];30 mg/Kg/day), a nonspecific COX inhibitor (indomethacin; 2 mg/Kg/day), or a COX-1 preferential inhibitor (piroxicam; 2 mg/Kg/12 h).

RESULTS

Prostaglandins are derived from COX-1 activity in the normal esophagus. Both low- and high-grade esophagitis are associated with a progressive increase of COX activity, which is partially dependent on the COX-2 isoform. DFU reduced muscosal damage in both models of esophagitis. However, indomethacin did not affect significantly mucosal damage, and piroxicam increased damage in low-grade esophagitis.

CONCLUSIONS

COX-1 activity is constitutive in the rabbit esophageal mucosa, but both COX-2 and COX-1 activity are increased under the impact of acidified pepsin. Treatment with the COX-2 inhibitor DFU is associated with improvement of mucosal damage, which may have therapeutic implications.

Effects of NMDA and non-NMDA ionotropic glutamate receptor antagonists on the development and maintenance of hyperalgesia induced by repeated intramuscular injection of acidic saline

Two unilateral injections of pH 4.0 saline into the gastrocnemius muscle result in a bilateral decrease in mechanical withdrawal threshold after the second injection. This decrease is significant by 4h and lasts through 1 week. The purpose of this study was to characterize the involvement of both N-methyl-D-aspartate (NMDA) and non-NMDA glutamate receptors in the spinal cord dorsal horn in the development and maintenance of mechanical hyperalgesia from repeated intramuscular injections of acidic saline. 2-amino-5-phosphonovaleric acid (AP5) (2-20 nmol, 10 microl, pH 7) or 1,2,3,4-tetrahydro-6-nitro-2,3-dioxo[f]quinoxaline-7-sulfonamide (NBQX) (1-10 nmol, 10 microl, pH 8-9) was administered intrathecally to the lumbar spinal cord to block NMDA and non-NMDA ionotropic glutamate receptors in the dorsal horn, respectively. Drugs were administered at one of three different time points: (1) prior to the first intramuscular injection of pH 4.0 saline on Day 0, (2) prior to the second intramuscular injection of pH 4.0 saline on Day 5, and (3) 1 week after the second injection. Mechanical withdrawal thresholds were measured with von Frey filaments before, 4h, and 24h after injection 1 and before, 4h, 24h, and 1 week after injection 2. AP5 had no effect on mechanical withdrawal thresholds when administered prior to the first intramuscular injection of pH 4.0 saline. When AP5 was administered before the second intramuscular injection, the bilateral decrease in mechanical withdrawal thresholds was delayed for up to 24h. Intrathecal administration of AP5 1 week after the second intramuscular injection of pH 4.0 saline produced a bilateral increase in mechanical withdrawal thresholds. Blockade of non-NMDA glutamate receptors in the spinal cord dorsal horn prior to either the first or second intramuscular injection of pH 4.0 saline had no effect on the development of mechanical hyperalgesia. However, spinal injection of NBQX 1 week after the second intramuscular injection of pH 4.0 saline resulted in an increase in mechanical withdrawal thresholds when compared to vehicle controls. These data suggest that both NMDA and non-NMDA glutamate receptors are involved in the maintenance of chronic, muscle-induced hyperalgesia.

Acid washing and stabilization of an artificial arsenic-contaminated soil

An acid-washing process was studied on a laboratory scale to extract the bulk of arsenic(V) from a highly contaminated Kuroboku soil (Andosol) so as to minimize the risk of arsenic to human health and the environment. The sorption and desorption behavior of arsenic in the soil suggested the possibility of arsenic leaching under acidic conditions. Artificially contaminated Kuroboku soil (2830 mg As/kg soil) was washed with different concentrations of hydrogen fluoride, phosphoric acid, sulfuric acid, hydrogen chloride, nitric acid, perchloric acid, hydrogen bromide, acetic acid, hydrogen peroxide, 3:1 hydrogen chloride-nitric acid, or 2:1 nitric acid-perchloric acid. Phosphoric acid proved to be most promising as an extractant, attaining 99.9% arsenic extraction at 9.4% acid concentration in 6 h. Sulfuric acid also attained high percentage extraction. The arsenic extraction by these acids reached equilibrium within 2 h. Elovich-type equation best described most of the kinetic data for dissolution of soil components as well as for extraction of arsenic. Dissolution of the soil components could be minimized by ceasing acid washing in 2 h. The acid-washed soil was further stabilized by the addition of lanthanum, cerium, and iron(III) salts or their oxides or hydroxides which form insoluble complex with arsenic. Both salts and oxides of lanthanum and cerium were effective in immobilizing arsenic in the soil attaining less than 0.01 mg/l As in the leaching test.

The dental implications of chronic use of acidic medicines in medically compromised children

OBJECTIVE

Liquid oral medicines form a significant proportion (11%) of the medicines used by the population as a whole, either prescribed or over the counter. The active agent, as well as some of the other ingredients, can pose a threat to oral health.

METHOD

Eight liquid oral medicines and two effervescent preparations routinely prescribed for long-term use by paediatric renal patients were assessed for titratable acidity and pH values.

RESULTS

All of the medicines tested were acidic and the majority were well below the critical pH of 5.5 at which enamel demineralisation takes place. The titratable acidity values, at a pH of 6.7, ranged between 0.01 and 1.54 for the liquid preparations but were 8.4 and 10.6 for the two effervescent tablets tested.

CONCLUSION

Surplus acid in effervescent preparations while ensuring palatability of medicines and thus compliance, may produce unwanted dental side effects in children who are already medically compromised.

Dietary effects on dental diseases

Dental caries is a highly prevalent chronic disease and its consequences cause a lot of pain and suffering. Sugars, particularly sucrose, are the most important dietary aetiological cause of caries. Both the frequency of consumption and total amount of sugars is important in the aetiology of caries. The evidence establishing sugars as an aetiological factor in dental caries is overwhelming. The foundation of this lies in the multiplicity of studies rather than the power of any one. That statement by the British Nutrition Foundation's Task Force on Oral Health, Diet and Other Factors, sums up the relationship between sugars and caries in Europe. There is no evidence that sugars naturally incorporated in the cellular structure of foods (intrinsic sugars) or lactose in milk or milk products (milk sugars) have adverse effects on health. Foods rich in starch, without the addition of sugars, play a small role in coronal dental caries. The intake of extrinsic sugars beyond four times a day leads to an increase risk of dental caries. The current dose-response relationship between caries and extrinsic sugars suggests that the sugars levels above 60 g/person/day for teenagers and adults increases the rate of caries. For pre-school and young children the intakes should be proportional to those for teenagers; about 30 g/person/day for pre-school children. Fluoride, particularly in toothpastes, is a very important preventive agent against dental caries. Toothbrushing without fluorides has little effect on caries. As additional fluoride to that currently available in toothpaste does not appear to be benefiting the teeth of the majority of people, the main strategy to further reduce the levels of caries, is reducing the frequency of sugars intakes in the diet. Dental erosion rates are considered to be increasing. The aetiology is acids in foods and drinks and to a much lesser extent from regurgitation.

Diet acids and alkalis influence calcium retention in bone

The urine-acidifying properties of food constituents depend on their content of non-oxidizable acids or precursors. Acidifying constituents such as animal proteins may negatively affect calcium metabolism and accelerate bone resorption, thus representing an aggravating factor for osteoporosis. This four-period, double-crossover study investigated whether a diet intervention specifically focused on acid load could modify calcium metabolism in humans. Eight healthy volunteers underwent a four-day metabolic preparation with two types of diets, one rich in acid ash-forming nutrients, and one providing base-forming nutrients (including bicarbonate-rich mineral water), both having similar contents of calcium, phosphate, sodium, proteins and calories. On the fourth day, a single oral dose of 1 g calcium was given, either as carbonate or as gluconolactate. Serial blood and urine samples revealed that the diet affected blood pH (average difference 0.014, p=0.002) and urine pH (average difference 1.02, p<0.0001) in the expected direction, but had no influence on the absorption of the calcium supplement. The acid-forming diet increased urinary calcium excretion by 74% when compared with the base-forming diet (p<0.0001), both at baseline and after the oral calcium load, and C-telopeptide excretion by 19% (p=0.01), suggesting a skeletal origin for the excess calcium output. This observation confirms that renally excreted acids derived from food influence calcium metabolism, and that alkalizing nutrients inhibit bone resorption. Further studies are needed to determine the clinical impact of dietary counseling for avoiding diet acids as a preventive measure against osteoporosis.

Cranberry juice consumption may reduce biofilms on uroepithelial cells: pilot study in spinal cord injured patients

STUDY DESIGN

A pilot study of 15 spinal cord injured patients.

OBJECTIVE

To determine whether alteration of fluid intake and use of cranberry juice altered the bacterial biofilm load in the bladder.

SETTING

London, Ontario, Canada.

METHODS

Urine samples were collected on day 0 (start of study), on day 7 following each patient taking one glass of water three times daily in addition to normal diet, and on day 15 following each patient taking one glass of cranberry juice thrice daily. One urine sample was sent for culture and a second processed to harvest, examine by light microscopy and Gram stain non-squamous uroepithelial cells to generate bacterial adhesion per 50 cells data.

RESULTS

The results showed that cranberry juice intake significantly reduced the biofilm load compared to baseline (P=0.013). This was due to a reduction in adhesion of Gram negative (P=0.054) and Gram positive (P=0.022) bacteria to cells. Water intake did not significantly reduce the bacterial adhesion or biofilm presence.

CONCLUSION

The findings provide evidence in support of further, larger clinical trials into the use of functional foods, particularly cranberry juice, to reduce the risk of UTI in a patient population highly susceptible to morbidity and mortality associated with drug resistant uropathogens.

SPONSORSHIP

This study was funded by Ocean Spray Cranberries, Lakeville, MA, USA.

Plasma levels after peroral and topical ibuprofen and effects upon low pH-induced cutaneous and muscle pain

Cutaneous applications are gaining popularity in the treatment of cutaneous pain and of painful disorders in joints and muscle. The low pH-pain model in human skin has previously been able to demonstrate the effects of NSAIDs in dose-dependent manner and to establish time-effect relationships. We examined the analgesic action of ibuprofen after cutaneous application and compared the effects with oral administration. The two studies (with n = 12 subjects each) were performed in a double-blind, randomized fashion with a 1-week cross-over interval. In study 1 volunteers received intradermal infusions with phosphate buffered saline solution of pH 5.2 and received either 800 mg ibuprofen per os and topical placebo, or 4 g of a 5% commercial ibuprofen gel topically applied and oral placebo capsules, respectively. In study 2 the same protocol was applied with painful intramuscular infusion of stronger, isotonic phosphate buffer (pH 5.2). The flow rate of the pH-infusion was individually adjusted to induce pain with a magnitude of 20% on a visual analogue scale (ranging from 'no' (0%) to 'unbearable pain' (100%)). Ibuprofen (S-, R-) plasma levels after oral administrations were measured with HPLC, and after topical applications, by gas chromatography combined with mass spectroscopy to determine plasma levels in the range of ng/ml. In the cutaneous model pain ratings decreased to zero after topical verum gel within 45 min of the observation period of 55 min. Pain reduction after peroral ibuprofen was of the same magnitude, but was achieved within only 30 min. In the muscle model, the commercial ibuprofen gel did not reduce the pain in the acidic muscle. The peroral ibuprofen was less effective in the muscle compared to the skin pain model, although there was a significant progressive pain reduction within 55 min. Reasons for the differential susceptibility of cutaneous vs muscular acidosis pain to ibuprofen remain to be established.

Immunopathology of a two-hit murine model of acid aspiration lung injury

In a two-hit model of acid aspiration lung injury, mice were subjected to nonlethal cecal ligation and puncture (CLP). After 48 h, intratracheal (IT) acid was administered, and mice were killed at several time points. Recruitment of neutrophils in response to acid was documented by myeloperoxidase assay and neutrophil counts in bronchoalveolar lavage (BAL) fluid and peaked at 8 h post-IT injection. Albumin in BAL fluid, an indicator of lung injury, also peaked at 8 h. When the contributions of the two hits were compared, neutrophil recruitment and lung injury occurred in response to acid but were not greatly influenced by addition of another hit. Neutrophil sequestration was preceded by elevations in KC and macrophage inflammatory protein-2alpha in plasma and BAL fluid. KC levels in BAL fluid were higher and peaked earlier than macrophage inflammatory protein-2alpha levels. When KC was blocked with specific antiserum, neutrophil recruitment was significantly reduced, whereas albumin in BAL fluid was not affected. In conclusion, murine KC mediated neutrophil recruitment but not lung injury in a two-hit model of aspiration lung injury.

Neural coding of gustatory information

The nervous system encodes information relating chemical stimuli to taste perception, beginning with transduction mechanisms at the receptor and ending in the representation of stimulus attributes by the activity of neurons in the brain. Recent studies have rekindled the long-standing debate about whether taste information is coded by the pattern of activity across afferent neurons or by specifically tuned 'labeled lines'. Taste neurons are broadly tuned to stimuli representing different qualities and are also responsive to stimulus intensity and often to touch and temperature. Their responsiveness is also modulated by a number of physiological factors. In addition to representing stimulus quality and intensity, activity in taste neurons must code information about the hedonic value of gustatory stimuli. These considerations suggest that individual gustatory neurons contribute to the coding of more than one stimulus parameter, making the response of any one cell meaningful only in the context of the activity of its neighbors.

Aluminum and acid effects on calcium and phosphorus metabolism in young growing chickens (Gallus gallus domesticus) and mallard ducks (Anas platyrhynchos)

Acidification is associated with increased mortality, reduced growth, and bone abnormalities in birds. Associated with acid deposition is an increase in aluminum availability due to solubilization from soil and other sources. (Conversely, experimental diets containing aluminum sulfate have much reduced pHs.) The present studies compare the effects of two levels of dietary acid (sulfuric acid) (0.122 and 0.56 mol H+ per kg feed; 0.056 and 0.277 mol sulfate per kg feed) and dietary aluminum (aluminum sulfate at 0.1 and 0.5%; sulfate at 0. 056 and 0.277 mol sulfate per kg feed) on bone growth, mineralization, and phosphorous/calcium homeostasis in growing birds (chickens and mallard ducks). Growth was reduced by the high acid (chicken) and aluminum (ducks and chickens) diets. A reduction in bone mineralization was observed in birds receiving aluminum-containing diets [low aluminum diet: decreased tibia ash, calcium, and phosphorus (chickens); high aluminum diet: decreased tibia dry weight, % of ash and mg; ash, calcium (chickens, ducks as % of ash), and phosphorus (chickens mg/duck, % of ash)]. Moreover, plasma concentrations of inorganic phosphate were reduced in chicks on the high aluminum diet. There were also marked decreases in bone growth and mineralization [tibia weight, ash (mg), calcium (mg), phosphorus (mg)] and plasma concentrations of 1,25-dihydroxy vitamin D3 in chicks on the high acid diet compared to those on a control diet. These changes were probably due to reduced feed intake; changes in bone indices being of a greater or similar magnitude in pairfed control. There was little change in bone indices, growth rate or feed consumption in ducklings receiving either the low or high acid diets. It is concluded that aluminum directly adversely affected bone mineralization whereas acid effects are mediated in part by changes in feed consumption.

Lack of correlation between trehalose accumulation, cell viability and intracellular acidification as induced by various stresses in Saccharomyces cerevisiae

A pma1-1 mutant of Saccharomyces cerevisiae with reduced H(+)-ATPase activity and the isogenic wild-type strain accumulated high levels of trehalose in response to a temperature upshift to 40 degrees C and after addition of 10% ethanol, but only modest levels in response to a rapid drop in external pH and after addition of decanoic acid. There was, however, no correlation between the absolute levels of trehalose in the stressed cells and their viability. All these treatments induced a significant decrease in intracellular pH, and surprisingly, this decrease was very similar in both strains, indicating that intracellular acidification could not be the triggering mechanism for trehalose accumulation in response to stress. A careful investigation of metabolic parameters was carried out to explain how trehalose accumulated under the four different stress conditions tested. No single and common mechanism for trehalose accumulation could be put forward and the transcriptional activation of TPS1 was not unequivocally related to trehalose accumulation. Another finding was that a pma1-1 mutant exhibited a two- to threefold greater capacity to accumulate trehalose than the isogenic wild-type. This enhanced disaccharide synthesis could be attributed to a twofold higher trehalose-6-phosphate synthase activity, together with a fourfold higher content of intracellular UDP-Glc. In addition, this mutant showed 1.5-fold higher levels of ATP compared to the wild-type. The various stress treatments studied showed that a drop in intracellular pH does not correlate with trehalose accumulation. It is suggested that plasma membrane alteration could be the physiological trigger inducing trehalose accumulation in yeast.

Reduction of Staphylococcus aureus in atopic skin lesions with acid electrolytic water--a new therapeutic strategy for atopic dermatitis

The subjects studied were 22 pediatric patients newly diagnosed with atopic dermatitis (AD); 11 were treated with acid electrolytic water (AEW), which has a strong bactericidal activity (AEW group), and the other 11 with tap water (placebo group). AEW or tap water, 1 ml/cm2 (body surface area), was sprayed on their skin lesions with a spray gun each twice a day for a week. There were no significant differences between the two groups in regard to sex, age, serum IgE, peripheral eosinophil counts, grading scores of AD, and duration of AD. The study was designed as a randomized, placebo-controlled, double-blind clinical trial. Colony counts of Staphylococcus aureus on skin lesions in the AEW group, both 3 min after spraying (P < 0.05) and after 1 week of skin treatment (P < 0.01), were significantly decreased as compared with colony counts before treatment, while there was no significant difference in the placebo group before and after treatment. Grading scores of AD also decreased in the AEW group (P < 0.01), but not in the placebo group. Both the subjects' guardians' evaluation and a referee physician's evaluation of treatment effect were significantly higher in the AEW group than in the placebo group (P < 0.01). AEW may be potentially effective in preventing a staphylococcal chronic inflammation in AD because of its strong bactericidal activity.

Trial of electrolyzed strong acid aqueous solution lavage in the treatment of peritonitis and intraperitoneal abscess

Electrolyzed strong acid aqueous solution is acidic water that contains active oxygen and active chlorine and possesses a redox potential. We performed peritoneal and abscess lavages with an electrolyzed strong acid aqueous solution to treat 7 patients with peritonitis and intraperitoneal abscesses, who were seen in our department between December 1994 and April 1995. The underlying disease was duodenal ulcer perforation in 4 of these 7 patients and gastric ulcer perforation, acute enteritis, and intraperitoneal perforation of pyometrium in 1 patient each. Irrigation was performed twice a day. Microbiological studies of the paracentesis fluid were negative in 3 cases, and the irrigation period was 2-4 days. Anaerobic bacteria were isolated in 3 of the 4 positive cases (Bacteroides in 2, Prevotella in 1), and a fungus (Candida) was isolated in the remaining patient. The period of irrigation in these patients ranged from 9 to 12 days, but conversion to a microorganism negative state was observed in 3-7 days.

Successful treatment of mediastinitis after cardiovascular surgery using electrolyzed strong acid aqueous solution

Dilute povidone-iodine solution has been widely used as an irrigant for the treatment of mediastinitis. However, its use is not without adverse effects and often causes poor growth of granulation tissues. To avoid the problems seen with the use of povidone-iodine solution, we applied electrolyzed strong acid aqueous solution (ESAAS) to mediastinal irrigation in 4 patients (2 infants and 2 adults) who developed mediastinitis after cardiovascular surgery. According to the "open" method, the mediastinal wound was left open and irrigated with ESAAS 1 to 3 times a day until the infection was eradicated. Satisfactory growth of granulation tissues was observed in all patients treated with no evidence of adverse effects attributable to ESAAS. Delayed primary sternum closure was performed for 2 patients, and musculocutaneous transposition of rectus abdominis for 1. Our experience suggests that irrigation with ESAAS is a safe and effective method of therapy for mediastinitis.

Treatment of infectious skin defects or ulcers with electrolyzed strong acid aqueous solution

A chronic ulcer with an infection such as methicillin-resistant Staphylococcus aureus is hard to heal. Plastic and reconstructive surgeons often encounter such chronic ulcers that are resistant to surgical or various conservative treatments. We applied conservative treatment using an electrolyzed strong acid aqueous solution and obtained satisfactory results. The lesion was washed with the solution or soaked in a bowl of the solution for approximately 20 min twice a day. Fresh electrolyzed strong acid aqueous solution is unstable and should be stored in a cool, dark site in a sealed bottle. It should be used within a week after it has been produced. Here we report on 15 cases of infectious ulcers that were treated by electrolyzed strong acid aqueous solution. Of these cases, 7 patients were healed, 3 were granulated, and in 5, infection subsided. In most cases the lesion became less reddish and less edematous. Discharge or foul odor from the lesion was decreased. Electrolyzed strong acid aqueous solution was especially effective for treating a chronic refractory ulcer combined with diabetes melitus or peripheral circulatory insufficiency. This clinically applied therapy of electrolyzed strong acid aqueous solution was found to be effective so that this new therapeutic technique for ulcer treatment can now be conveniently utilized.

Reduced bicarbonate secretion mediates increased distal tubule acidification induced by dietary acid

We examined the components of net HCO3 reabsorption (H+/HCO3 secretion) in in vivo perfused distal tubules of anesthetized rats to determine the mechanisms by which dietary acid increases acidification in this nephron segment. Animals eating a minimum electrolyte diet drank either 80 mM NH4Cl or 40 mM (NH4)2SO4 for 7-10 days and were compared with controls drinking distilled H2O. Net HCO3 reabsorption in distal tubules perfused with HCO3 concentration ([HCO3]) similar to that in situ (5 mM) was higher in (NH4)2SO4 animals than in control (21.6 +/- 1.8 vs. 12.5 +/- 1.3 pmol.mm-1.min-1, respectively, P < 0.02), but that for NH4Cl (17.9 +/- 1.5 pmol.mm-1.min-1, P = 0.09 vs. control) animals was not. Calculated H+ secretion was not different among groups perfused with the 5 mM HCO3 solution, but calculated HCO3 secretion was lower in (NH4)2SO4 animals than control (-2.4 +/- 0.3 vs. -5.3 +/- 0.6 pmol.mm-1.min-1, respectively, P < 0.02), but that for NH4Cl (-7.2 +/- 0.7 pmol.mm-1.min-1, P = not significant vs. control) was not. When distal tubules were perfused with solutions containing higher [HCO3] (10 nM), both net HCO3 reabsorption and calculated H+ secretion were significantly higher than control in both acid-ingesting groups. The data show that reduced HCO3 secretion mediates the increased distal tubule acidification induced by dietary acid, particularly at the low tubule fluid [HCO3] in situ. The data also show that acid ingested as the Cl- compared with the SO4(-) salt does not reduce HCO3 secretion and less effectively increases acidification in this nephron segment.

Effects of acidic reperfusion on arrhythmias and Na(+)-K(+)-ATPase activity in regionally ischemic rat hearts

We studied the effects of acidic reperfusion on 1) the incidence of ventricular fibrillation (VF) and 2) sarcolemmal Na(+)-K(+)-adenosinetriphosphatase (ATPase) activity. Isolated rat hearts (n = 12/group) were subjected to independent perfusion (15 min) of left and right coronary beds with pH 7.4 buffer followed by zero-flow ischemia (10 min) of the former bed. This was then reperfused for 5 min, with acidic (pH 6.6) buffer for the first 0 (control), 0.5,1,2, or 4 min and with pH 7.4 buffer thereafter. In the control group, 92% of hearts developed VF within 20 s of reperfusion and remained in VF. In the 0.5-, 1-, 2-, and 4-min acidic reperfusion groups, only 17, 17, 42, and 25% of hearts (P < 0.05 vs. control for all groups), respectively, exhibited VF during acidic reperfusion. However, on switching to pH 7.4, VF occurred in a further 50, 58, 0, and 0% of hearts, respectively; thus the overall incidences of VF were 67, 75, 42 (P < 0.05 vs. control), and 25% (P < 0.05 vs. control), respectively. Additional hearts (n = 8/group) were used for cytochemical determination of sarcolemmal Na(+)-K(+)-ATPase activity in both the ischemic/reperfused left ventricular (LV) and the nonischemic right ventricular (RV) free walls. Ischemia (10 min) reduced LV Na2(+)-K(+)-ATPase activity from 110 +/- 8 to 25 +/- 3% of the RV value. After 0.5, 1, 2, 3, and 4 min of acidic reperfusion, LV Na(+)-K(+)-ATPase activity was 24 +/- 3, 29 +/- 3, 37 +/- 5, 55 +/- 6, and 70 +/- 4, respectively (P < 0.05 vs. 10-min ischemia). No significant recovery of LV Na(+)-K(+)-ATPase activity occurred following up to 4 min of pH 7.4 reperfusion. In conclusion, 1) at least 2 min of acidic reperfusion is required to achieve sustained protection against VF and 2) the protective mechanism may involve enhanced recovery of Na(+)-K(+)-ATPase activity as well as inhibition of Na+ influx.

Effective treatment for acute alkali injury to the esophagus using weak-acid neutralization therapy: an ex-vivo study

OBJECTIVE

1) To evaluate whether neutralization therapy with weak acid is effective in reducing observed histopathologic esophageal tissue injury secondary to liquid alkali, 2) to quantify the temperature change of the neutralizing agent, and 3) to determine the effect of interval to therapy on injury severity.

METHODS

Harvested Sprague-Dawley rat esophagi were catheterized and placed in an oxygenated saline bath (37 degrees C) for 60 minutes and then fixed in 10% formalin. Nine groups (n = 10) were perfused with 50% sodium hydroxide (NaOH). Six of the groups were treated by neutralization with cooled orange juice (OJ) or cola that was maintained between 2 degrees C and 4 degrees C. This was performed at 0, 5, or 30 minutes after injury. In addition, two positive control groups were exposed to OJ or cola at time 0 and were not exposed to strong alkali. A third control group was exposed to strong alkali but was not administered any subsequent treatment. The temperature of the neutralizing agent was recorded prior to instillation and after exiting the esophagus. Blinded pathologic scoring of 0 (no injury) to 3 (severe) was recorded performed for six histopathologic categories: epithelial cell viability, cornified epithelial cell differentiation, granular cell differentiation, epithelial cell nuclei, muscle cells, and muscle cell nuclei. Comparisons were made among treatment times using the Kruskal-Wallis test and linear trend analysis.

RESULTS

For each histopathologic category and each treatment mode, the Kruskal-Wallis test showed significant differences between the groups (p < 0.002) over time. Trend analyses showed more severe injury with delayed neutralization therapy (p < 0.05) for each treatment mode and histopathologic category.

CONCLUSION

Early neutralization therapy with OJ or cola reduces acute esophageal alkali injury. Additional in-vivo study is needed before neutralization therapy is adopted for clinical use.