Albert van de Wiel

The role of alcohol in the anti low density lipoprotein oxidation activity of red wine.

Oxidation of low density lipoprotein cholesterol (LDL-c) is supposed to play a role in the generation of atherosclerotic lesions. Grape derived beverages supply a large number of nutritional antioxidants because of their high content of polyphenols. This might be one of the mechanisms behind the supposed beneficial effect of red wine. Wine also contains alcohol and its role in oxidation processes especially in vivo is unclear. In this study the effect of daily red wine consumption for 2 weeks on oxidizability status of LDL was investigated. The role of alcohol in LDL oxidation was further explored in in vitro experiments. After abstinence from alcoholic beverages, grape juices and tea for a week, seven healthy male volunteers consumed 375 ml of red wine (30 g alcohol) per day during 2 weeks. At the start and end of the drinking period blood samples were taken and the susceptibility of LDL-c to copper-induced oxidation was analyzed with the addition of distilled water (control) and dilutions of a 12% alcohol solution, white wine and red wine. Although red wine at concentrations achievable in vivo caused a significant prolongation of the lag-time of metal ion dependent LDL oxidation in vitro (85.9+/-23.0-114.1+/-30.8 min, P<0. 001), a significant shortening of lag-time was found in vivo after the 2 weeks of wine consumption (56.3+/-13.0 min, P<0.001). A shorter lag-time compared to the control was found for both alcohol and white wine in vitro. The changed oxidizability status of LDL after 2 weeks of wine consumption made it more susceptible for the in vitro antioxidant effect of red wine. At low dilutions red grape juice extended lag-time as well, which was not influenced by the addition of alcohol. Red wine has a strong inhibitory effect on copper-induced oxidation of LDL in vitro, while red grape juice has a minor effect, an effect which should be attributed to the non alcohol components in the beverages. In vivo, however, this effect can be overshadowed by the prooxidant influence of alcohol. The balance between alcohol and polyphenols of a wine may be critical for its in vivo effect on LDL oxidation.

Severe Hypertriglyceridemia Influenced by Alcohol (SHIBA)

AIMS This study was conducted to examine the relationship between triglyceride (TG) levels and a history of excessive drinking in patients with severe hypertriglyceridemia (HT). METHODS Alcohol intake as well as other risk factors associated with HT were searched for in case records of 300 patients known to the laboratory to have had a TG level over 11.3 mmol/l. RESULTS The majority of severe HT could be attributed to obesity, diabetes mellitus, excessive alcohol consumption or combinations of these. Excessive alcohol intake (over 210 g/week for males; over 140 g/week for females) was recorded for 24% of the total, and for 43% in the highest TG quartile. TG levels were significantly higher in the excessive drinkers (P < 0.001) and in patients with acute pancreatitis (P = 0.001). The incidence of pancreatitis in this cohort was 4% and limited to very high TG levels. CONCLUSION Excessive alcohol consumption was recorded in a quarter of patients with severe HT. Patients with the combination of obesity, diabetes and alcohol excess are prone to develop extremely high TG values.

The effect of oral iron supplementation on erythropoiesis in autologous blood donors

The effect of oral iron supplementation on erythropoiesis was studied prospectively in 34 autologous blood donors. The subjects, all of whom were to undergo total hip surgery, had normal iron status at the start of the study. During the preoperative period, in which 4 units of blood were collected, 17 patients received oral iron supplementation with 287 mg of ferrous sulfate (105 mg of elemental iron/day), while 17 patients did not use any iron supplementation. Oral iron supplementation during the 4‐week preoperative period lessened the decrease in ferritin levels after two phlebotomies. Neither the decrease in hemoglobin nor the increase in erythropoietin levels was influenced by iron supplementation. In both iron‐supplemented and control patients, serum erythropoietin levels returned to initial values within a few days after surgery. In autologous blood donors with a normal iron status, the use of supplemental iron does not affect erythropoiesis and is insufficient to maintain iron stores.

The efficacy of subcutaneous recombinant human erythropoietin in the correction of phlebotomy-induced anemia in autologous blood donors

The efficacy of subcutaneous recombinant human erythropoietin (rhEPO) (500 U/kg; administered twice a week during the 3 weeks before surgery) in the recovery of preoperative hemoglobin concentrations within a 3‐ week period was studied in 40 patients, each of whom donated 2 units (900 mL) of blood for their own use before total hip replacement surgery. Twenty autologous blood donors received rhEPO (EPO group) and 20 were not treated (control group). The initial hemoglobin concentration (14.0 ± 1.0 g/dL [140 ± 10 g/L]) was completely recovered before surgery (14.0 ± 1.6 g/dL [140 ± 16 g/L]) in the EPO group, while a decrease from 13.8 ± 1.1 to 12.2 ± 1.3 g per dL (138 ± 11 to 122 ± 13 g/L) was observed in the control group. The preoperative reticulocyte count showed more than sixfold increase in the EPO group, whereas a twofold to threefold increase was found in the control group. Serum ferritin concentration fell to 42 ± 29 micrograms per L in the EPO group and to 54 ± 35 micrograms per L in the control group. The postoperative serum erythropoietin concentration in the EPO group was significantly lower than that in the control group, but it did not differ from the pretreatment value and was attended by a higher hemoglobin concentration after surgery. Only transient flu‐like symptoms were mentioned by patients who were treated with rhEPO. Changes in blood pressure or platelet count or other adverse events were not observed. This study demonstrates that subcutaneous rhEPO is safe and effective for the complete correction of the loss of 2 units of blood within a 3‐week period.

Rapid Intake of Alcohol (Binge Drinking) Inhibits Platelet Adhesion to Fibrinogen Under Flow

BACKGROUND Moderate alcohol consumption is associated with decreased mortality from cardiovascular disease. Drinking large amounts in a short period (binge drinking) is associated with increased cardiovascular morbidity. We tested whether rapid consumption of a large dose of alcohol affects platelet aggregation and adhesion. METHODS Healthy volunteers (n = 20) were asked to drink three glasses of alcohol or red wine in a 45-min period. Thereafter, another 45 min was allowed for absorption of alcohol. Ninety minutes after the start of the experiment, blood was collected. This entire cycle was repeated once, resulting in consumption of six alcohol-containing drinks in 3 hr. Adenosine-diphosphate (ADP)-induced aggregation was measured and platelet adhesion to fibrinogen and collagen was measured in a perfusion chamber at shear rates of 300/sec and 1600/sec. Platelet coverage and aggregate size were measured. RESULTS Acute alcohol intake significantly increased platelet aggregation in suspension when stimulated with low concentrations of ADP (0.1 and 0.5 microg/ml). This effect was not observed when consuming red wine. In contrast, adhesion to fibrinogen was significantly inhibited by alcohol but not red wine at high shear rate after six drinks (p = 0.025). The inhibition was accompanied by a reduction in aggregate size at 90 and 180 min after the start of the experiment. Adhesion to collagen was not altered by either alcohol or red wine. CONCLUSIONS Rapid intake of alcohol increases platelet aggregation, which might contribute to the increased mortality associated with binge drinking. Red wine does not show increased platelet aggregation, which might support the reduction of cardiovascular disease in red wine consumers. However, alcohol inhibits platelet adhesion to fibrinogen-coated surface under flow. The diminished adhesion might contribute to the cardioprotective effects of alcohol.

Viability of platelets collected by apheresis versus the platelet-rich plasma technique: A direct comparison

Different platelet preparation techniques have not previously been compared directly and simultaneously with respect to in vivo platelet viability. Using a dual-label technique with 111-In and 114m-In, platelet apheresis was compared with the platelet-rich plasma (PRP) procedure with respect to platelet recovery and survival (n=4). Furthermore, a continuous flow cell separator (Cobe 2997) and an intermittent apheresis system (Haemonetics V50) were compared with each other (n=4). No differences in platelet viability were found between the PRP-platelets and the apheresis-platelets. Also no differences were found between the two apheresis systems. Although different platelet preparation methods result in a varying degree of platelet activation, no difference in platelet viability has been observed.

No acute effect of red wine on the coagulation pathway in healthy men

Binge drinking is associated with an increased risk of cardiovascular events. Those events often happen within hours after alcohol is consumed. Apart from arrhythmias and changes in blood pressure, these events may be caused by an acute (i.e., occurring within a 24-h period) shift of the hemostatic balance in a thrombogenic direction. Alcohol can influence platelet aggregation and inhibit fibrinolysis, but little is known about its direct effect on coagulation. In the current study, parameters of coagulation, reflecting either stimulation or inhibition, were measured 5 and 15 h after the consumption of four (62.5 g of alcohol) and eight (125 g of alcohol) glasses of red wine. Both doses had no direct effect on activated cephalin time, thrombin-antithrombin complexes, factors VII and VIII, and von Willebrand factor. In contrast with the observed effects on thrombocytes and fibrinolysis, the consumption of large amounts of wine does not influence the coagulation pathway.

Total hip replacement surgery does not influence RBC survival

BACKGROUND: RBC survival may be affected by mechanical or oxidative stress as well as the inflammatory effect of surgery, and thus may contribute to postoperative anemia.