Fabiana Andréa Moura

Antioxidant therapy for treatment of inflammatory bowel disease: Does it work?

Oxidative stress (OS) is considered as one of the etiologic factors involved in several signals and symptoms of inflammatory bowel diseases (IBD) that include diarrhea, toxic megacolon and abdominal pain. This systematic review discusses approaches, challenges and perspectives into the use of nontraditional antioxidant therapy on IBD, including natural and synthetic compounds in both human and animal models. One hundred and thirty four papers were identified, of which only four were evaluated in humans. Some of the challenges identified in this review can shed light on this fact: lack of standardization of OS biomarkers, absence of safety data and clinical trials for the chemicals and biological molecules, as well as the fact that most of the compounds were not repeatedly tested in several situations, including acute and chronic colitis. This review hopes to stimulate researchers to become more involved in this fruitful area, to warrant investigation of novel, alternative and efficacious antioxidant-based therapies.

Short stature of mothers from an area endemic for undernutrition is associated with obesity, hypertension and stunted children: a population-based study in the semi-arid region of Alagoas, Northeast Brazil

The objectives of the study were to investigate whether the health conditions of mothers with short stature differed from those with normal stature, and to establish if these aspects were associated with the health of the offspring. Data relating to health and socio-economic, demographic and anthropometric conditions were collected from a probabilistic sample population consisting of 1180 mothers and 1511 children ( < 10 years) living in the semi-arid region of the State of Alagoas, Brazil. Mothers were categorised according to stature, with those in the 1st quartile being defined as of short stature and those in the 4th quartile being defined as of normal stature and serving as a reference for the comparison of variables of interest. Following verification that maternal stature fulfilled parametric assumptions, its associations with the other variables were determined by calculating Pearson correlation coefficients. After excluding strongly self-correlated variables (r >or= 0.70), the remaining variables were analysed by multiple linear regression. The results showed that low maternal stature was independently associated with obesity (percentage body fat >or= 30; P = 0.045), abdominal adiposity (waist:hip ratio >or= 0.85; P = 0.007) and high systolic blood pressure ( >or= 140 mmHg; P = 0.006). Short maternal stature was associated with low birth weight ( < 3000 g; P = 0.01) and stunting (height-for-age Z score < - 2; P = 0.019) in the offspring. Thus, in the semi-arid region of Alagoas, women of short stature presented a higher prevalence of chronic degenerative diseases and produced less healthy children than women of normal stature.

Oxidative Stress and Inflammation in Hepatic Diseases: Therapeutic Possibilities of N-Acetylcysteine

Liver disease is highly prevalent in the world. Oxidative stress (OS) and inflammation are the most important pathogenetic events in liver diseases, regardless the different etiology and natural course. N-acetyl-l-cysteine (the active form) (NAC) is being studied in diseases characterized by increased OS or decreased glutathione (GSH) level. NAC acts mainly on the supply of cysteine for GSH synthesis. The objective of this review is to examine experimental and clinical studies that evaluate the antioxidant and anti-inflammatory roles of NAC in attenuating markers of inflammation and OS in hepatic damage. The results related to the supplementation of NAC in any form of administration and type of study are satisfactory in 85.5% (n = 59) of the cases evaluated (n = 69, 100%). Within this percentage, the dosage of NAC utilized in studies in vivo varied from 0.204 up to 2 g/kg/day. A standard experimental design of protection and treatment as well as the choice of the route of administration, with a broader evaluation of OS and inflammation markers in the serum or other biological matrixes, in animal models, are necessary. Clinical studies are urgently required, to have a clear view, so that, the professionals can be sure about the effectiveness and safety of NAC prescription.

Prevalência e fatores associados à anemia em gestantes da região semi-árida do Estado de Alagoas

PURPOSE to determine the prevalence and risk factors associated to anemia in pregnant women from the semiarid region of Alagoas, Brazil. METHODS transversal study comprising a sample (n=150) obtained taking into consideration the prevalence estimated by World Health Organization of 52%, an error of 8% and a confidence interval of 95%. Sampling has been done in three stages: 15 towns among the 38 in the region, four census sectors by town and 24 residences by sector. All the resident pregnant women were eligible, and their socio-economic, demographic, anthropometric and health data have been collected. Anemia was identified at the <11 g/dL hemoglobin level (Hemocue), and its association with risk factors, tested by multiple linear regression analysis. RESULTS anemia prevalence was 50%. Seventy eight per cent of the pregnant women were under pre-natal care. From those, 79.3% were in the second or third trimester of gestation. Nevertheless, only 21.2% of them were taking iron supplementation. Variables (p<0.05) independently associated with anemia (anemic versus not-anemic pregnant women) were: larger number of family members (4.5+/-2.3 versus 4,3+/-2.3; p=0.02), lower age group of the pregnant woman (23.9+/-6.3 versus 24.7+/-6.7; p=0.04), or of her partner (34.5+/-15.8 versus 36+/-17.5; p=0.03), no toilet in the house (30.7 versus 24%; p<0.001), history of child abortion and/or death (32.4 versus 16.4%; p<0.001), living in the country (60 versus 46.7%; p=0.03), average per capita income <US

Prevalência e fatores de risco para anemia em crianças pré-escolares do Estado de Alagoas, Brasil

1.00/day (60.3 versus 52.1%; p=0.02), pre-gestational weight <50 kg (33.3 versus 24.6%; p=0.03), pre-natal care onset after the first trimester of gestation (45.3 versus 18%; p=0.002). CONCLUSIONS anemia prevalence in pregnant women from the semiarid region of Alagoas constitutes a major health problem, deserving special attention by the people in charge of public policy.

Prevalência e fatores associados à Insegurança Alimentar e Nutricional em famílias dos municípios do norte de Alagoas, Brasil, 2010

OBJECTIVE: to estimate the prevalence and establish risk factors associated with anemia in children in the Brazilian State of Alagoas. METHODS: a cross-sectional study with a probabilistic sample of 666 children aged between 6 and 60 months. Anthropometric, environmental, demographic, socio-economic data were collected during home visits, along with information on health, the use of public services and the existence of diseases. The concentration of hemoglobin (Hb) was measured using a HemoCue® photometer, and a level of <11 g/dL was taken to indicate anemia. Pearsons test was used identify correlations and the X2 test to analyze associations between the category variables. The association of anemia with the predictor variables was confirmed by multiple logistic regression, with statistical significance set at p<0.05. RESULTS: the prevalence of anemia was 45.0%. Hb levels were positively and significantly associated with age (r=0.44; p<0.01). The highest prevalence was found in the 6-12 month age-group (75.2%). Multivariate analysis identified the following variables associated with anemia: age <36 months (p<0.001) and a household with five or more occupants (p=0.031). CONCLUSIONS: the degree of prevalence of anemia found indicates that this is a serious public health problem in the State of Alagoas. Larger families and those with children aged under three years should receive greater attention.

Colonic and Hepatic Modulation by Lipoic Acid and/or N-Acetylcysteine Supplementation in Mild Ulcerative Colitis Induced by Dextran Sodium Sulfate in Rats

Objetivou-se identificar a prevalencia e os fatores associados a inseguranca alimentar (INSAN) em familias do norte de Alagoas. Para isso, realizou-se estudo transversal com amostra probabilistica de 1.444 familias. A INSAN (leve, moderada ou grave) foi definida segundo a Escala Brasileira de Inseguranca Alimentar. Utilizou-se a razao de prevalencia (RP), calculada por regressao de Poisson, para avaliar a associacao da INSAN moderada + grave com as variaveis independentes, tanto na analise bruta como na ajustada. Nesta, foram incluidas as variaveis que na analise bruta atingiram p 4, chefe da familia ser do sexo feminino e escolaridade materna < 4 anos. Conclui-se que as familias estudadas apresentam alta prevalencia de INSAN, sobretudo aquelas com individuos < 18 anos.

Choline and Cystine Deficient Diets in Animal Models with Hepatocellular Injury: Evaluation of Oxidative Stress and Expression of RAGE, TNF-α, and IL-1β

Lipoic acid (LA) and N-acetylcysteine (NAC) are antioxidant and anti-inflammatory agents that have not yet been tested on mild ulcerative colitis (UC). This study aims to evaluate the action of LA and/or NAC, on oxidative stress and inflammation markers in colonic and hepatic rat tissues with mild UC, induced by dextran sodium sulfate (DSS) (2% w/v). LA and/or NAC (100 mg·kg·day−1, each) were given, once a day, in the diet, in a pretreatment phase (7 days) and during UC induction (5 days). Colitis induction was confirmed by histological and biochemical analyses (high performance liquid chromatography, spectrophotometry, and Multiplex®). A redox imbalance occurred before an immunological disruption in the colon. NAC led to a decrease in hydrogen peroxide (H2O2), malondialdehyde (MDA) levels, and myeloperoxidase activity. In the liver, DSS did not cause damage but treatments with both antioxidants were potentially harmful, with LA increasing MDA and LA + NAC increasing H2O2, tumor necrosis factor alpha, interferon gamma, and transaminases. In summary, NAC exhibited the highest colonic antioxidant and anti-inflammatory activity, while LA + NAC caused hepatic damage.

Close interplay of nitro-oxidative stress, advanced glycation end products and inflammation in inflammatory bowel diseases

This study aims to evaluate the effects of diets deficient in choline and/or cystine on hepatocellular injury in animal models (young male Wistar rats, aged 21 days), by monitoring some of the oxidative stress biomarkers and the expression of RAGE, TNF-α, and IL-1β. The animals were divided into 6 groups (n = 10) and submitted to different diets over 30 days: AIN-93 diet (standard, St), AIN-93 choline deficient (CD) diet and AIN-93 choline and cystine deficient (CCD) diet, in the pellet (pl) and powder (pw) diet forms. Independently of the diet form, AIN-93 diet already led to hepatic steatosis and CD/CCD diets provoked hepatic damage. The increase of lipid peroxidation, represented by the evaluation of thiobarbituric acid reactive species, associated with the decrease of levels of antioxidant enzymes, were the parameters with higher significance toward redox profile in this model of hepatic injury. Regarding inflammation, in relation to TNF-α, higher levels were evidenced in CD(pl), while, for IL-1β, no significant alteration was detected. RAGE expression was practically the same in all groups, with exception of CCD(pw) versus CCD(pl). These results together confirm that AIN-93 causes hepatic steatosis and choline and/or cysteine deficiencies produce important hepatic injury associated with oxidative stress and inflammatory profiles.

PRE-OPERATIVE FASTING: WHY ABBREVIATE?

BACKGROUND Inflammatory bowel disease (IBD) exhibits no defined aetiology. However, such factors as genetic and nitro-oxidative stress are associated with chronic inflammation and IBD progression to colorectal cancer (CRC). The present review discusses the association of nitro-oxidative stress, inflammation and advanced glycation end products (AGE) and its corresponding receptor (RAGE) in IBD and examines the connection between these factors and nuclear factors, such as nuclear factor kappa B (NF- κB), factor-erythroid 2-related factor-2 (Nrf2), and p53 mutant (p53M). METHODS We searched the PubMed, ScienceDirect and Web of Science databases using a combination of the following terms: IBD, CRC, oxidative stress, inflammation, NF-κB, Nrf2, p53M, AGE and RAGE. RESULTS Oxidative stress and inflammation activated two cellular pathways, the nuclear expression of pro-inflammatory, pro-oxidant and pro-oncogenic genes based on NF-κB and p53M, which is associated with NF-κB activation, deoxyribonucleic acid (DNA) damage and the expression of pro-oncogenic genes. Nrf2 stimulates the nuclear expression of enzymatic and non-enzymatic antioxidant systems and anti-inflammatory genes, and is inhibited by chronic oxidative stress, NF-κB and p53M. AGE/RAGE are involved in inflammation progression because RAGE polymorphisms and increased RAGE levels are found in IBD patients. Alterations of these pathways in combination with oxidative damage are responsible for IBD symptoms and the progression to CRC. CONCLUSIONS IBD is an inflammatory and nitro-oxidative stress-based bowel disease. Achieving a molecular understanding.