Linda M. Shecterle

The Role of Ribose on Oxidative Stress During Hypoxic Exercise: A Pilot Study

Oxygen free radicals are produced during stress, are unstable, and potentially interact with other cellular components or molecules. This reactivity can influence cellular function, including a prolongation in tissue recovery following exercise. We tested the effect of ribose (d-ribose), a pentose carbohydrate, in a double-blinded, crossover study on markers of free radical production during hypoxic exercise. Seven healthy volunteers cycled at their lactate threshold for 25 minutes while inhaling 16% O(2) with a subsequent 60-minute resting period at room air. Subjects ingested either placebo or 7 g of ribose in 250 mL of water before and after the exercise session. Urinary malondialdehyde (MDA) and plasma reduced glutathione levels increased significantly during placebo ingestion (0.2 +/- 0.03 nM/mg and 0.26 +/- 0.29 microM, respectively) but were lower with ribose supplementation (0.04 +/- 0.03 nM/mg and 0.38 +/- 0.29 microM, respectively; P < .05). Uric acid levels were similar between groups (ribose vs. placebo, 4.55 +/- 0.06 mg/dL vs. 4.67 +/- 0.06 mg/dL). Ribose demonstrated a beneficial trend in lower MDA and reduced glutathione levels during hypoxic stress.

D-ribose aids advanced ischemic heart failure patients

Patients with advanced heart failure are exercise intolerant. Low cellular energy levels in the failing heart have been proposed. Energy enhancing substrates have revealed mixed results. Ribose, a pentose monosaccharide, has shown to replenish low myocardial energy levels, improving cardiac dysfunction following ischemia, and improving ventilation efficiency in patients with heart failure. As current pharmaceuticals do not address cellular energy levels, this study was designed to investigate the role of ribose on ventilation at anaerobic threshold in congestive heart failure patients. d-ribose (5 gms/dose, tid) was assessed in 16 NYHA class III-IV, heart failure patients with VO(2), tidal volume/VCO(2), heart rate/tidal volume evaluated at 8 weeks. All patients had a significant improvement in ventilatory parameters at anaerobic threshold, along with a 44% Weber class improvement. Ribose improved the ventilatory exercise status in advanced heart failure patients.

Assessment of Hematological and Biochemical parameters with extended D-Ribose ingestion

D-ribose, a naturally occurring pentose carbohydrate, has been shown to replenish high- energy phosphates following myocardial ischemia and high intensity, repetitive exercise. Human studies have mainly involved short-term assessment, including potential toxicity. Reports describing adverse effects of D-ribose with prolonged ingestion have been lacking. Therefore, this study assessed the toxicity of extended consumption of D-ribose in healthy adults. Nineteen subjects ingested 20 grams/Day (10 grams, twice a Day) of ribose with serial measurements of biochemical and hematological parameters at Days 0, 7, and 14. No significant toxic changes over the 14-day assessment period occurred in complete blood count, albumin, alkaline phosphatase, gamma glutamyltransferase, alanine amiotransferase, and aspartate aminotransferase. However, D-ribose did produce an asymptomatic, mild hypoglycemia of short duration. Uric acid levels increased at Day 7, but decreased to baseline values by Day 14. D-ribose consumption for 14 days appears not to produce significant toxic changes in both hematological and biochemical parameters in healthy human volunteers.

The Patented Uses of D-Ribose in Cardiovascular Diseases

Cardiovascular diseases account for more deaths worldwide than any other illness. Myocardial ischemia, a common finding in cardiovascular diseases, lowers cellular energy levels, which affects a cells integrity and function. Pre-clinical animal studies have reported lower cellular energy levels with an associated decreased function following myocardial ischemia. Recently, scientists have reported that the failing heart is energy starved and yet no pharmaceuticals have been able to address this issue with satisfactory results. Over decades, researchers have explored the use of various metabolites to replenish deficient cellular energy levels following induced ischemia with mixed results. However, D-ribose, a natural occurring carbohydrate, has demonstrated significant enhancing abilities in replenishing deficient cellular energy levels following myocardial ischemia, as well as improving depressed function in numerous animal investigations. Subsequent clinical trials have further substantiated these benefits of D-ribose in patients afflicted with ischemic cardiovascular disease and those carrying the diagnosis of congestive heart failure. The future of effective therapies for ischemic heart disease and congestive heart failure must strongly consider novel pharmaceuticals directed at replenishing cellular energy levels. Intellectual property and the represented patents in this paper emphasize the use of D-ribose for its cellular energy enhancing potential, reflected in both objective and subjective clinical improvements; therefore, substantiating its value in patients with ischemic cardiovascular diseases.

Extracorporeal whole body hyperthermia treatment of HIV patients, a feasibility study

The literature supports that the retrovirus, Human Immunodeficiency Virus (HIV), which is thought to cause Acquired Immunodeficiency Syndrome (AIDS), is heat sensitive at temperatures which can be achieved in man. Invasive or non-invasive induction of whole body hyperthermia (WBH) has been used to treat an array of illnesses, primarily in the field of oncology, until recently. Non-invasive methods have proven to be less toxic than invasive means. However, new technology and refined patient management have shown a dramatic decrease in the side effects with extracorporeal whole body hyperthermia (EWBH). The Food and Drug Administration granted a prospective trial for six HIV positive/AIDS patients to undergo a single treatment of EWBH, with patients randomized to a core temperature of either 41 or 42 degrees C. All patients had failed antiretrovirals and experienced at least one episode of an opportunistic infection. Organetics, Ltd., PS-1 extracorporeal, centrifugal pump device was used to induce EWBH. Results of this feasibility study demonstrated the ability of this equipment and technique to induce EWBH with acceptable toxicity. It was not possible to assess efficacy in this small study.

Cellular Protection During Oxidative Stress: A Potential Role for D-ribose and Antioxidants

ABSTRACT A healthy cellular system involves the maintenance of an intracellular metabolic balance. Reactive oxygen species (ROS) are constantly produced as a normal product of cellular metabolism; however, during situations of cellular stress, these levels can increase dramatically with the potential to cause deleterious cellular structural and/or functional consequences. There is a significant elevation in these ROS following stressful situations, such as ischemia, hypoxia, high-intensity exercise, and in many diseases. To combat these ROS, neutralizing endogenous enzymes, as well as exogenous antioxidants, can aid in minimizing their potential untoward cellular effects. Exogenous reducing antioxidant agents, such as vitamin C and/or E, play a role in addressing these formed species; however, recent research has suggested that fruit seed extracts may provide additional cellular benefits beyond their antioxidant features. Furthermore, supplemental D-ribose enhances the recovery of high-energy phosphates following stress and appears to potentially offer additional benefits by reducing radical formation. Specifically, during periods of hypoxia/ischemia, supplemental D-ribose may play an inhibitory role in the breakdown of adenine nucleotides, influencing the subsequent formation of xanthine and uric acid compounds; and thereby affecting the release of superoxide anion radicals. The combination of D-ribose with reducing antioxidants may provide a more optimal state of cellular protection during and following times of oxidative stress.

Importance of monitoring blood viscosity during cardiopulmonary bypass.

Sir,Approximately 500,000 cardiopulmonary bypass (CPB) procedures using extracorporeal circulation are per-formed annually in the United States of America.. For decades, attention has focused on cerebral complications as a source of morbidity and disability post procedures. These deficits include impaired consciousness, seizures, cognitive impairment (memory, attention deficits, lan-guage difficulty) and stroke, all potentially limiting the ability to function independently. The reported inci-dence of neurological complications varies widely from 7 to 61% for transient deficits and 1.6 to 23% for perma-nent deficits.

Myocardial Ischemia: Alterations in Myocardial Cellular Energy and Diastolic Function, a Potential Role for D-Ribose

Cardiovascular disease still remains the leading cause of deaths worldwide in both males and females. A variety of factors have been associated to play a role in the development of this disease, such as an individual’s genetic background and continual life style factors. Life style factors (including diet) have greatly influenced the occurrence and progression of this disease. The medical profession has made great efforts to adequately address and to continually stress to their patients an altered life style to confront the non-genetic factors, in order to potentially minimize their risk for cardiovascular disease. This campaign has centered on a continual direction for refinements in diet, regular exercise, smoking cessation, and to control blood pressure to lower their risk for cardiovascular disease.

Supplements for exercise.

Athletes, and to a lesser degree “weekend warriors,” are always looking for an edge to physically maintain or excel in their exercise performance, lessen muscular soreness, minimize fatigue, and speed recovery. To try to achieve this state, many have turned to nutritional supplements. However, in order to effectively promote and maintain acceptance by the public, well-structured studies with finite endpoints must be performed with high standards and accurately reported in reputable journals to satisfy interested parties. Researchers have addressed a more effective means in replenishing muscular energy levels postexercise, as well as reducing soreness and fatigue, resulting in a more rigorous training schedule. Furthermore, the production of oxygen-free radicals during and following exercise has attracted attention over the past decade. These free radical compounds have the potential to harm the cell’s wall and hinder intracellular processes. Therefore, today’s sports medicine market has entertained products that have the potential to lessen this cellular energy drain, minimize the damaging effects from formed oxygen-free radicals during and following exercise, and offer the means to maintain or potentially exceed performance goals. However, finding effective supplements in meeting these goals is often more difficult than not. Many individuals find that the advertised benefits of a supplement from information found in the media, including the Internet, do not always live up to their claims, which casts not only doubt about the product but also questions credibility in the nutraceutical industry. The goal of an energy supplement should center on replenishing energy most effectively and quickly following a workout session.

Dermal benefits of topical D-ribose

Our aging skin undergoes changes with reductions in collagenous and elastic fibers, fibroblasts, mast cells, and macrophages with free radical production, which can result in reduced skin tone and wrinkle formation. Fibroblasts are important for dermal integrity and function with a decrease in function producing less skin tone, thinning, and wrinkle formation. Dermal levels of adenosine triphosphate (ATP) decline with aging, potentially altering dermal function. Supplemental D-ribose, a natural occurring carbohydrate, enhances ATP regeneration. D-ribose-based studies demonstrated benefits in both cell culture fibroblastic activities and a subsequent clinical study in women with decreased skin tone with wrinkles. Supplemental D-ribose may offer this needed cellular benefit.