Alceu Afonso Jordão Júnior

Marcadores séricos de estresse oxidativo em mulheres inférteis com endometriose

OBJETIVO: comparar marcadores sericos de estresse oxidativo entre pacientes inferteis com e sem endometriose e avaliar a associacao destes marcadores com o estadiamento da doenca. METODOS: estudo prospectivo envolvendo a inclusao consecutiva de 112 pacientes inferteis, nao-obesas, com idade inferior a 39 anos, divididas em dois grupos: Endometriose (n=48, sendo 26 com endometriose minima e leve - Estadio I/II e 22 com endometriose moderada e grave - Estadio III/IV) e Controle (n=64, com fator tubario e/ou masculino de infertilidade). Durante a fase folicular precoce do ciclo menstrual, foram coletadas amostras sanguineas para analise dos niveis sericos de malondialdeido, glutationa e niveis totais de hidroperoxidos, por espectrofotometria e vitamina E, por cromatografia liquida de alto desempenho. Os resultados obtidos foram comparados da seguinte forma: os grupos endometriose versus controle; endometriose estadio I/II e controle, endometriose estadio III/IV e controle e entre os dois subgrupos de endometriose. Em todas as analises, foi considerado o nivel de significância de 5% (p<0,05). RESULTADOS: os niveis de vitamina E e glutationa foram mais baixos no soro de mulheres inferteis com endometriose moderada/grave (21,7±6,0 µMol/L e 159,6±77,2 nMol/g proteina, respectivamente) quando comparadas a mulheres com endometriose minima e leve (28,3±14,4 µMol/L e 199,6±56,1 nMol/g proteina, respectivamente). Os niveis totais de hidroperoxidos foram significativamente mais elevados no grupo endometriose (8,9±1,8 µMol/g proteina) em relacao ao Grupo Controle (8,0±2 µMol/g proteina) e nas portadoras de doenca III/IV (9,7±2,3 µMol/g proteina) em relacao a I/II (8,2±1,0 µMol/g proteina). Nao se observou diferenca significativa nos niveis sericos de malondialdeido entre os diversos grupos. CONCLUSOES: foi evidenciada uma associacao positiva entre infertilidade relacionada a endometriose, avanco do estadiamento da doenca e aumento dos niveis sericos de hidroperoxidos, sugerindo aumento da producao de especies reativas em portadoras de endometriose. Esses dados, associados a reducao dos niveis sericos de vitamina E e glutationa, sugerem a ocorrencia de estresse oxidativo sistemico em portadoras de infertilidade associada a endometriose.

Serum Vitamins in Adult Patients With Short Bowel Syndrome Receiving Intermittent Parenteral Nutrition

BACKGROUND Short bowel syndrome (SBS) occurs after massive intestinal resection, and parenteral nutrition (PN) therapy may be necessary even after a period of adaptation. The purpose of this study was to determine the vitamin status in adults with SBS receiving intermittent PN. METHODS The study was conducted on hospitalized adults with SBS who were receiving intermittent PN therapy (n = 8). Nine healthy volunteers, paired by age and sex, served as controls. Food ingestion, anthropometry, plasma folic acid, and vitamins B(12), C, A, D, E, and K were evaluated. RESULTS The levels of vitamins A, D, and B(12) in both groups were similar. SBS patients presented higher values of folic acid (21.3 ± 4.4 vs 14.4 ± 5.2, P = .01) and lower values of vitamin C (0.9 ± 0.4 vs 1.2 ± 0.3 mg/dL, P = .03), α-tocopherol (16.3 ± 3.4 vs 24.1 ± 2.7 µmol/L, P < .001), and phylloquinone (0.6 ± 0.2 vs 1.0 ± 0.5 nmol/L, P < .03). Eight-seven percent of patients had vitamin D deficiency, and all patients presented with serum vitamin E levels below reference values. CONCLUSIONS Despite all efforts to offer all the nutrients mentioned above, SBS patients had lower serum levels of vitamins C, E, and K, similar to those observed in patients on home PN. These findings suggest that the administered vitamins were not sufficient for the intermittent PN scheme and that individual adjustments are needed depending on the patients vitamin status.

Subnutrição e hipovitaminose A em pacientes com AIDS

Anthropometric measurements and biochemical determinations were performed on HIV-infected individuals and on patients with AIDS from the Ribeirao Preto region, SP, Brazil, in order to evaluate their nutritional and vitamin A status. Plasma retinol was measured by HPLC, and hepatic vitamin A stores were evaluated by the Relative Dose Response (RDR) test. Patients with AIDS presented significant undernutrition, with more marked alterations in the body fat compartment and a relative preservation of the parameters related to muscle mass (pattern of malnutrition predominantly of the marasmus type). Plasma retinol values below 1.05µmol/L were observed in 25% of the patients with AIDS and in 17.3% of HIV-infected patients and RDR values indicating low body stores of vitamin A were detected in 28% of the subjects. There was no correlation between serum retinol levels and CD4 lymphocyte counts, clinical diagnosis of AIDS, low BMI or AFI. On the other hand, hypovitaminosis A status was associated with low BMI.

Metabolic parameters of postmenopausal women after quinoa or corn flakes intake - a prospective and double-blind study

Abstract A prospective and double-blind study was conducted on 35 women with weight excess who consumed 25 grams of quinoa flakes (QF) or corn flakes (CF) daily during a period of four consecutive weeks. At the beginning (T1) and at the end (T2) of the intervention, total calorie intake was evaluated, anthropometric assessment was performed, blood was collected for the determination of glucose, total cholesterol and fractions, oxidative stress markers, vitamin E and enterolignans. Significant reductions were detected in serum triglyceride (CF group = 133.9 ± 89.4 to 113.7 ± 57 mg/dl and QF group = 112.3 ± 35 to 107.9 ± 33.1 mg/dl), TBARS (CF group = 3.2 ± 0.8 to 2.9 ± 0.5 µmol/l and QF group = 3.06 ± 0.6 to 2.89 ± 0.5 µmol/l) and vitamin E concentrations (CF group = 19.5 ± 5 to 17.9 ± 4 µM and QF group = 17.9 ± 4 to 16.9 ± 3 µM) and an increase in urinary excretion of enterolignans (CF group = 2.05 ± 1.3 to 2.24 ± 1.4 nm/ml and QF group = 2.9 ± 1.6 to 3.2 ± 2.7 nm/l), in both study groups. The reduction of total cholesterol (191 ± 35 to 181 ± 28 mg/dl) and LDL-cholesterol (LDL-c) (129 ± 35 to 121 ± 26 mg/dl), and the increase in GSH (1.78 ± 0.4 to 1.91 ± 0.4 µmol/l) occurred only in the QF group, showing a possible beneficial effect of QF intake.

Oxidative stress markers in adults 2 years after Roux-en-Y gastric bypass.

Introduction Obesity is a chronic disease associated with oxidative stress. Bariatric surgery for the treatment of obesity may affect biomarkers of oxidative stress. Objectives The aim of the present study was to evaluate the effect of Roux-en-Y gastric bypass (RYGB) on blood markers of oxidative stress, such as vitamins C and E, &bgr;-carotene, reduced glutathione (GSH), catalase (CAT), ferric reducing antioxidant potential (FRAP), and thiobarbituric acid-reactive substances (TBARS). Methods A prospective controlled clinical trial was carried out. The participants were distributed into two groups: a control group (n=35), which was evaluated once, and a bariatric group (n=35), which was evaluated at baseline as well as 6, 12, and 24 months after surgery. Results After surgery, the BMI decreased from 47.05±1.46 to 30.53±1.14 kg/m2 (P<0.001), but 25.7% of the participants regained weight after 24 months. In relation to the baseline, postsurgery reductions were found in vitamin C (31.9±4.6%, P<0.001), &bgr;-carotene (360.7±368.3%, P<0.001), vitamin E (22.8±4.1%, P<0.001), GSH (6.6±5.2%, P=0.090), CAT (12.7±5.6%, P=0.029), and FRAP (1.2±3.8%, P=0.085) 2 years after RYGB. TBARS levels decreased after 12 months (71.6±2.9%, P<0.001) in relation to the baseline but increased by 195.0±28.2% between the 12th and the 24th month (P<0.001). Conclusion The present findings show that oxidative stress returned 2 years after RYGB. Concentrations of vitamin C, &bgr;-carotene, GSH, CAT, and FRAP were decreased, whereas the concentration of TBARS decreased in the first year but increased in the following year, which may be partly explained by the imbalance between antioxidants and pro-oxidants.

Breast milk fatty acid composition of women living far from the coastal area in Brazil

OBJECTIVES To evaluate the fatty acid composition of mature human milk of women living far from the coastal area of Brazil. METHODS Mature breast milk samples were obtained from 47 lactating women aged between 18 and 35 years, who delivered their babies at term and who exclusively or predominantly breastfed. Milk collection took place after the fifth week postpartum by hand expression. The fatty acid composition of the milk was determined by gas chromatography. RESULTS It was observed that the concentration of eicosapentaenoic acid (0.08%) was higher than that observed in previous studies in Brazil. However, the content of docosahexaenoic acid (0.09%) found in human milk was one of the lowest verified in the world. The content of trans fatty acids (2.05%) was similar to that reported in national studies previous to the mandatory declaration of this fatty acid content in food labels, suggesting that this measure had no effect on reducing the content of this fatty acid in the usual diet of women. CONCLUSIONS Low levels of docosahexaenoic acid and high concentrations of trans fatty acids were observed in mature breast milk of women living far from the coastal area in Brazil.

Folic acid supplementation during early hepatocarcinogenesis: Cellular and molecular effects

Folic acid (FA) supplementation during carcinogenesis is controversial. Considering the impact of liver cancer as a public health problem and mandatory FA fortification in several countries, the role of FA supplementation in hepatocarcinogenesis should be elucidated. We evaluated FA supplementation during early hepatocarcinogenesis. Rats received daily 0.08 mg (FA8 group) or 0.16 mg (FA16 group) of FA/100 g body weight or water (CO group, controls). After a 2‐week treatment, animals were subjected to the “resistant hepatocyte” model of hepatocarcinogenesis (initiation with diethylnitrosamine, selection/promotion with 2‐acetylaminofluorene and partial hepatectomy) and euthanized after 8 weeks of treatment. Compared to the CO group, the FA16 group presented: reduced (p < 0.05) number of persistent and increased (p < 0.05) number of remodeling glutathione S‐transferase (GST‐P) positive preneoplastic lesions (PNL); reduced (p < 0.05) cell proliferation in persistent GST‐P positive PNL; decreased (p < 0.05) hepatic DNA damage; and a tendency (p < 0.10) for decreased c‐myc expression in microdissected PNL. Regarding all these parameters, no differences (p > 0.05) were observed between CO and FA8 groups. FA‐treated groups presented increased hepatic levels of S‐adenosylmethionine but only FA16 group presented increased S‐adenosylmethionine/S‐adenosylhomocysteine ratio. No differences (p > 0.05) were observed between experimental groups regarding apoptosis in persistent and remodeling GST‐P positive PNL, and global DNA methylation pattern in microdissected PNL. Altogether, the FA16 group, but not the FA8 group, presented chemopreventive activity. Reversion of PNL phenotype and inhibition of DNA damage and of c‐myc expression represent relevant FA cellular and molecular effects.

Effect of Citric Pectin on beta-Carotene Bioavailability in Rats

The effect of citric pectin on the bioavailability of synthetic beta-carotene was studied. Thirty Wistar rats were used, ten animals were sacrificed at the beginning of the experiment and remaining animals were divided into two groups and received the following diets for 30 days: control group (CG)--24 micrograms beta-carotene/g diet + 0% citric pectin; experimental group (EG)--24 micrograms beta-carotene/g diet + 7% citric pectin. Plasma and liver beta-carotene, vitamin A, and retinyl palmitate concentrations were determined by high-performance liquid chromatography (HPLC). Plasma retinol concentration was 1.42 +/- 0.36 mumol/L for CG and 1.10 +/- 0.24 mumol/L for EG (p = 0.1), and plasma beta-carotene concentration was 0.20 +/- 2.51 mumol/L for CG and 0.07 +/- 0.04 mumol/L for EG (p = 0.01). Only traces of retinyl palmitate were detected in CG and none in EG. Retinol did not differ significantly between groups CG and EG, while a significantly higher beta-carotene concentration was observed for CG. Liver concentrations of retinol (CG: 4.90 +/- 2.51 micrograms/g; EG: 2.68 +/- 1.12 micrograms/g), beta-carotene (CG: 0.98 +/- 0.28 microgram/g; EG: 0.11 +/- 0.06 microgram/g), and retinyl palmitate (CG: 95.47 +/- 45.13 micrograms/g, EG: 37.01 +/- 17.20 micrograms/g) differed significantly between groups (p < 0.05), with a lower concentration being observed for EG. We conclude that 7% citric pectin in the rat diet decreases the bioavailability of synthetic beta-carotene, reducing the liver reserves of vitamin A and beta-carotene.

Increased concentration of 8-hydroxy-2′-deoxyguanosine in follicular fluid of infertile women with endometriosis

Impaired oocyte quality and oxidative stress might be involved in the pathogenesis of endometriosis-related infertility. To improve our understanding of the role of oxidative stress in this condition, we compare eight oxidative stress markers from each stage, including the simultaneous analysis of lipids, proteins and DNA damage, in the serum and follicular fluid of infertile women with endometriosis and infertile controls undergoing controlled ovarian stimulation for intracytoplasmic sperm injection. In total, 87 serum samples (43 with endometriosis, 44 controls) and 61 follicular fluid samples (29 with endometriosis, 32 controls) free of blood contamination upon visual inspection and presenting granulosa cells alone or granulosa cells plus a retrieved mature oocyte were collected on the day of oocyte retrieval. Total hydroperoxides, malondialdehyde, advanced oxidation protein products, glutathione, superoxide dismutase (SOD) and total antioxidant capacity (TAC) were determined by spectrophotometry, vitamin E by high-performance liquid chromatography and 8-hydroxy-2′–deoxyguanosine (8OHdG) by enzyme-linked immunosorbent assay. The endometriosis group showed higher serum concentrations of glutathione and SOD, lower serum concentrations of TAC and higher follicular concentrations of 8OHdG and vitamin E compared with infertile controls. These data indicate both systemic and follicular oxidative stress in infertile patients with endometriosis. For the first time, we demonstrate the presence of oxidative DNA damage, represented by higher 8OHdG concentrations in the follicular microenvironment of these patients, possibly related to compromised oocyte quality and associated with the pathogenesis of endometriosis-related infertility.

Colon preneoplasia after carcinogen exposure is enhanced and colonic serotonergic system is suppressed by food deprivation

Calorie restriction regimens usually promote health and extend life-span in mammals. This is partially related to their preventive effects against malignancies. However, certain types of nutritional restriction failed to induce beneficial effects. The American Institute of Nutrition defines calorie restriction as diets which have only 40% fewer calories, but provide normal amounts of necessary food components such as protein, vitamins and minerals; whereas, food restriction means 40% less of all dietary ingredients plus 40% less calories. Our study aimed to test the hypothesis that the latter type of food deprivation (40% less food than consumed by standard fed rats) might increase cancer risk instead of reducing it, as is generally assumed for all dietary restrictive regimens. Since the endogenous modulation of the colon serotonergic system has been observed to play a role during the early steps of carcinogenesis we also investigated whether the serotoninergic system could be involved in the food intake modulation of cancer risk. For this, rats were exposed to a carcinogen and subjected to food deprivation for 56 days. Triglyceride levels and visceral adipose tissue were reduced while hepatic and colonic lipid peroxidation was increased. This dietary restriction also decreased serotonin levels in colon, and gene expression of its intestinal transporter and receptors. Finally, the numbers of preneoplastic lesions in the colon tissue of carcinogen-exposed rats were increased. Our data suggest that food deprivation enhances formation of early tumorigenic lesions by suppressing serotonergic activity in colon tissue.