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Farid A, Ooda A, Nabil A, Nasser A, Ahmed E, Ali F, Mohamed F, Farid H, Badran M, Ahmed M, Ibrahim M, Rasmy M, Saleeb M, Riad V, Ibrahim Y, Madbouly N. Eobania vermiculata whole-body muscle extract-loaded chitosan nanoparticles enhanced skin regeneration and decreased pro-inflammatory cytokines in vivo. J Nanobiotechnology 2023; 21:373. [PMID: 37828599 PMCID: PMC10571447 DOI: 10.1186/s12951-023-02143-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Usually, wounds recover in four to six weeks. Wounds that take longer time than this to heal are referred to as chronic wounds. Impaired healing can be caused by several circumstances like hypoxia, microbial colonization, deficiency of blood flow, reperfusion damage, abnormal cellular reaction and deficiencies in collagen production. Treatment of wounds can be enhanced through systemic injection of the antibacterial drugs and/or other topical applications of medications. However, there are a number of disadvantages to these techniques, including the limited or insufficient medication penetration into the underlying skin tissue and the development of bacterial resistance with repeated antibiotic treatment. One of the more recent treatment options may involve using nanotherapeutics in combination with naturally occurring biological components, such as snail extracts (SE). In this investigation, chitosan nanoparticles (CS NPs) were loaded with an Eobania vermiculata whole-body muscle extract. The safety of the synthesized NPs was investigated in vitro to determine if these NPs might be utilized to treat full-skin induced wounds in vivo. RESULTS SEM and TEM images showed uniformly distributed, spherical, smooth prepared CS NPs and snail extract-loaded chitosan nanoparticles (SE-CS NPs) with size ranges of 76-81 and 91-95 nm, respectively. The zeta potential of the synthesized SE-CS NPs was - 24.5 mV, while that of the CS NPs was 25 mV. SE-CS NPs showed a remarkable, in vitro, antioxidant, anti-inflammatory and antimicrobial activities. Successfully, SE-CS NPs (50 mg/kg) reduced the oxidative stress marker (malondialdehyde), reduced inflammation, increased the levels of the antioxidant enzymes (superoxide dismutase and glutathione), and assisted the healing of induced wounds. SE-CS NPs (50 mg/kg) can be recommended to treat induced wounds safely. SE was composed of a collection of several wound healing bioactive components [fatty acids, amino acids, minerals and vitamins) that were loaded on CS NPs. CONCLUSIONS The nanostructure enabled bioactive SE components to pass through cell membranes and exhibit their antioxidant and anti-inflammatory actions, accelerating the healing process of wounds. Finally, it is advised to treat rats' wounds with SE-CS NPs.
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Affiliation(s)
- Alyaa Farid
- Biotechnology Department, Faculty of Science, Cairo University, Giza, Egypt.
| | - Adham Ooda
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Ahmed Nabil
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Areej Nasser
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Esraa Ahmed
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Fatma Ali
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Fatma Mohamed
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Habiba Farid
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Mai Badran
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Mariam Ahmed
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Mariam Ibrahim
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Mariam Rasmy
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Martina Saleeb
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Vereena Riad
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Yousr Ibrahim
- Biotechnology/Biomolecular Chemistry Program, Faculty of Science, Cairo University, Giza, Egypt
| | - Neveen Madbouly
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt
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Shahunja KM, Sévin DC, Kendall L, Ahmed T, Hossain MI, Mahfuz M, Zhu X, Singh K, Singh S, Crowther JM, Gibson RA, Darmstadt GL. Effect of topical applications of sunflower seed oil on systemic fatty acid levels in under-two children under rehabilitation for severe acute malnutrition in Bangladesh: a randomized controlled trial. Nutr J 2021; 20:51. [PMID: 34092255 PMCID: PMC8183055 DOI: 10.1186/s12937-021-00707-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 05/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background Children with severe acute malnutrition (SAM) have inadequate levels of fatty acids (FAs) and limited capacity for enteral nutritional rehabilitation. We hypothesized that topical high-linoleate sunflower seed oil (SSO) would be effective adjunctive treatment for children with SAM. Methods This study tested a prespecified secondary endpoint of a randomized, controlled, unblinded clinical trial with 212 children with SAM aged 2 to 24 months in two strata (2 to < 6 months, 6 to 24 months in a 1:2 ratio) at Dhaka Hospital of icddr,b, Bangladesh between January 2016 and December 2017. All children received standard-of-care management of SAM. Children randomized to the emollient group also received whole-body applications of 3 g/kg SSO three times daily for 10 days. We applied difference-in-difference analysis and unsupervised clustering analysis using t-distributed stochastic neighbor embedding (t-SNE) to visualize changes in FA levels in blood from day 0 to day 10 of children with SAM treated with emollient compared to no-emollient. Results Emollient therapy led to systematically higher increases in 26 of 29 FAs over time compared to the control. These effects were driven primarily by changes in younger subjects (27 of 29 FAs). Several FAs, especially those most abundant in SSO showed high-magnitude but non-significant incremental increases from day 0 to day 10 in the emollient group vs. the no-emollient group; for linoleic acid, a 237 μg/mL increase was attributable to enteral feeding and an incremental 98 μg/mL increase (41%) was due to emollient therapy. Behenic acid (22:0), gamma-linolenic acid (18:3n6), and eicosapentaenoic acid (20:5n3) were significantly increased in the younger age stratum; minimal changes were seen in the older children. Conclusions SSO therapy for SAM augmented the impact of enteral feeding in increasing levels of several FAs in young children. Further research is warranted into optimizing this novel approach for nutritional rehabilitation of children with SAM, especially those < 6 months. Trial registration ClinicalTrials.gov: NCT02616289. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00707-3.
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Affiliation(s)
- K M Shahunja
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Daniel C Sévin
- Cellzome GmbH, GlaxoSmithKline R&D, Meyerhofstrasse 1, 69117, Heidelberg, Germany
| | - Lindsay Kendall
- GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, Hertfordshire, UK
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Iqbal Hossain
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Xinyi Zhu
- GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, Hertfordshire, UK
| | - Krishan Singh
- GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, Hertfordshire, UK
| | - Sunita Singh
- GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, Hertfordshire, UK
| | | | - Rachel A Gibson
- GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, Hertfordshire, UK
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, 1701 Page Mill Road, Room 121, Palo Alto, Stanford, CA, 94304, USA.
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Diana Draelos Z, Gunt H, Levy SB. Nature-based botanical facial oil oxidative stress protection. J Cosmet Dermatol 2020; 20:522-525. [PMID: 33350043 PMCID: PMC7953896 DOI: 10.1111/jocd.13879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/17/2020] [Accepted: 11/30/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION UV-induced oxidative skin stress leads to cutaneous photoaging. The objective of these 2 studies was to evaluate a nature-based botanical facial oil for the ability to decrease UV-induced oxidative skin stress. METHODS 22 females were enrolled in the UVA study, and 10 females were enrolled in the UVB study. Skin chemiluminescence induced by UVA exposure was measured at baseline and after 2 weeks of daily topical application of the nature-based facial oil was evaluated in study 1. In study 2, UVB-induced erythema was measured after 8 weeks of twice-daily topical application of the nature-based facial oil to a photoprotected site followed by skin biopsy to evaluate sunburn cell formation. In both studies, the treatment response was compared to the response on untreated skin. RESULTS The nature-based facial oil significantly reduced skin chemiluminescence following UVA exposure, demonstrating antioxidant activity. The nature-based facial oil also significantly reduced erythema formation following UVB exposure and resulted in reduced sunburn cell formation in 66.67% of subjects. CONCLUSION Topical nature-based facial oil can reduce UV-induced oxidative cutaneous damage.
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Abstract
Marine resources represent an interesting source of active ingredients for the cosmetics industry. Algae (macro and micro) are rich in proteins, amino acids, carbohydrates, vitamins (A, B, and C) and oligo-elements such as copper, iron and zinc. All those active principles play roles in hydration, firming, slimming, shine and protection. Marine organisms inhabit a wide spectrum of habitats. Photo-protective compounds can be obtained from organisms subjected to strong light radiation, such as in tropical systems or in shallow water. In the same way, molecules with antioxidant potential can be obtained from microorganisms inhabiting extreme systems such as hydrothermal vents. For example, marine bacteria collected around deep-sea hydrothermal vents produce complex and innovative polysaccharides in the laboratory which are useful in cosmetics. There are many properties that will be put forward by the cosmetic industries.
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Limketkai BN, Choe M, Patel S, Shah ND, Medici V. Nutritional Risk Factors in the Pathogenesis of Parenteral Nutrition-Associated Liver Disease. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0217-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
Safflower Oil is a polyunsaturated edible seed oil consisting primarily of triglycerides of linoleic acid. The oil is used in cosmetics as an emollient in topical lotions and creams at concentrations normally between 0.1 and 5 percent. The pure oil produced slight to moderate comedogenicity. However, products containing up to 5 percent Safflower Oil were not comedogenic in rabbits. Results of animal tests indicated that Safflower Oil was not an eye or skin irritant or contact sensitizer. The oil increased the incidence of 12-dimethylbenz(a)anthracene in rats. Safflower Oil has been used to treat human essential fatty acid deficiencies via oral and topical administration and is often applied to irritated and abraded skin. Products containing up to 5 percent Safflower Oil were negative for human skin irritation, sensitization, or photosensitization. From the information presented in this report, it is concluded that Safflower Oil is safe as a cosmetic ingredient in the present practices of use.
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Affiliation(s)
- W P T James
- MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ
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Abstract
A number of complications associated with total parenteral nutrition (TPN) have been identified, and methods of prevention or treatment have been developed. However, abnormal liver function continues to occur with the use of TPN, and little is known about its incidence and etiology. Twenty-three patients, receiving TPN through the TPN program at Holy Cross Hospital from January, 1978 to May, 1978, were studied. All patients received a basic parenteral amino acid solution (Travasol®), with varying amounts of nitrogen per day, depending on nitrogen balance studies. Dextrose was supplied in quantities necessary to provide 120 percent or more of the patient's calculated basal energy expenditure (BEE). Of the 23 patients studied, elevated liver function test values were detected in two patients (8.6 percent). In both cases, the complication developed within six to eight days, and both had received calories in excess of 213 percent of their calculated BEE and had a calorie to nitrogen (kcal: N) ratio greater than 150: 1. Mean calories as a percent of calculated BEE and kcal: N ratio were significantly higher in the patients with elevated liver function test (LFT) values than in those with normal LFT values ( p < 0.05 and p < 0.005, respectively). Following identification of the elevated LFT values, both patients were immediately placed on cyclic TPN (CyTPN). In the one patient, liver enzymes reverted toward normal after seven days of CyTPN, while the second patient required only five days. Cyclic TPN was deemed effective in the reversal of abnormal liver function in these two patients. It is speculated that the abnormal liver function was a result of fatty liver infiltration. The mechanism by which this infiltration occurs and its treatment are discussed.
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Ferreira MJ, Fiadeiro T, Silva M, Soares AP. Electrical conductance: a controversial parameter in the evaluation of emollients in atopic dermatitis. Skin Res Technol 2016; 4:138-41. [PMID: 27328908 DOI: 10.1111/j.1600-0846.1998.tb00099.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS Essential fatty acids are important in maintaining skin function and their deficiency is associated with scali-ness and increased transepidermal water loss (TEWL). This can be one of the pathogenic processes implicated in atopic dermatitis (AD). Several studies have assessed the value of essential fatty acid-enriched diets in AD but the benefits of topical γ-lino-lenic acid (GLA) therapy have been less well evaluated. The aims of this study were: a) to compare the effects of GLA-con-taining emollients and classical emollients, regarding clinical benefits, cutaneous hydration (by a conductance method) and TEWL; b) to assess the clinical relevance of these two biomet-rical methods (conductance and TEWL). METHODS Twenty-three AD children were randomised into four groups, to compare three emollients containing GLA in different concentrations and one classical emollient. They were evaluated in eight visits for 12 weeks, using a clinical score and measurements of TEWL with the Tewameter™ and of cutaneous hydration with the Nova™. RESULTS Kruskal-Wallis statistical analysis showed significant differences in cutaneous hydration (P<0.05) between each of the three treatment groups and the control group. TEWL and clinical scores did not show statistically significant differences. During the study no children from the GLA groups developed eczematous lesions versus two children from the non-GLA group. CONCLUSIONS Discrepancies between conductance and TEWL measurements may represent false positive results of the former method due to electrical phenomena related to polarity of the GLA molecule or of other elements in the formulations. However, some differences in clinical evolution between the GLA and non-GLA groups require further studies to assess the possible additional benefits of topical emollients containing GLA.
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Affiliation(s)
- M J Ferreira
- Dermatology Department, Hospital do Desterro, Lisbon, Portugal
| | - T Fiadeiro
- Dermatology Department, Hospital do Desterro, Lisbon, Portugal
| | - M Silva
- Dermatology Department, Hospital do Desterro, Lisbon, Portugal
| | - A P Soares
- Dermatology Department, Hospital do Desterro, Lisbon, Portugal
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Kolářová H, Tesařová M, Švecová Š, Stránecký V, Přistoupilová A, Zima T, Uhrová J, Volgina SY, Zeman J, Honzík T. Lipoprotein lipase deficiency: clinical, biochemical and molecular characteristics in three patients with novel mutations in the LPL gene. Folia Biol (Praha) 2014; 60:235-43. [PMID: 25863041 DOI: 10.14712/fb2014060050235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2024]
Abstract
Lipoprotein lipase (LPL) deficiency, caused by mutations in the LPL gene, is a rare autosomal recessive disorder manifesting in early childhood with recurrent abdominal pain, hepatosplenomegaly, acute pancreatitis, lipaemia retinalis and eruptive xanthomas. Typical laboratory findings are lactescent serum, extreme hypertriglyceridaemia and hypercholesterolaemia. The diagnostics is based on postheparin serum LPL assay and DNA analyses of the LPL gene. We report clinical, biochemical and molecular data of three children with LPL deficiency. One child manifested since the first week of life with recurrent abdominal pain (Patient 1), the second with abdominal distension and hepatosplenomegaly since the second month of life (Patient 3) and patient 2, asymptomatic younger brother of patient 1, was diagnosed in the first week of life. Lipaemia retinalis and splenomegaly were present in two symptomatic children, hepatomegaly in patient 3 and acute pancreatitis in patient 1. All children had lactescent serum, profound hypertriglyceridaemia (124 ± 25 mmol/l; controls < 2.2), hypercholesterolaemia (22.8 ± 7.3 mmol/l, controls < 4.2) and their LPL immunoreactive mass in serum did not increase after heparin injection. Molecular analyses revealed that both siblings are homozygous for novel mutation c.476C > G in the LPL gene changing the conserved amino acid of the catalytic centre. The third patient is a compound heterozygote for mutations c.604G>A and c.698A>G in the LPL gene, both affecting highly conserved amino acids. We conclude that LPL deficiency must be considered in neonates and young infants with abdominal pain and hypertriglyceridaemia because early treatment might prevent development of life-threatening acute pancreatitis.
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Affiliation(s)
- H Kolářová
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - M Tesařová
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Š Švecová
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - V Stránecký
- Institute of Inherited Metabolic Disorders, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - A Přistoupilová
- Institute of Inherited Metabolic Disorders, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - T Zima
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - J Uhrová
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - S Y Volgina
- Kazan State Medical University, Kazan, Russia
| | - J Zeman
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - T Honzík
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
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Gabe S. Managing high-output stomas: module 2 of 3. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2013; 22:S18-20. [PMID: 24037330 DOI: 10.12968/bjon.2013.22.sup11.s18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Simon Gabe
- Consultant Gastroenterologist and Senior Lecturer, St Marks Hospital, London
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Brahm A, Hegele RA. Hypertriglyceridemia. Nutrients 2013; 5:981-1001. [PMID: 23525082 PMCID: PMC3705331 DOI: 10.3390/nu5030981] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/14/2013] [Accepted: 03/15/2013] [Indexed: 12/20/2022] Open
Abstract
Hypertriglyceridemia (HTG) is commonly encountered in lipid and cardiology clinics. Severe HTG warrants treatment because of the associated increased risk of acute pancreatitis. However, the need to treat, and the correct treatment approach for patients with mild to moderate HTG are issues for ongoing evaluation. In the past, it was felt that triglyceride does not directly contribute to development of atherosclerotic plaques. However, this view is evolving, especially for triglyceride-related fractions and variables measured in the non-fasting state. Our understanding of the etiology, genetics and classification of HTG states is also evolving. Previously, HTG was considered to be a dominant disorder associated with variation within a single gene. The old nomenclature includes the term "familial" in the names of several hyperlipoproteinemia (HLP) phenotypes that included HTG as part of their profile, including combined hyperlipidemia (HLP type 2B), dysbetalipoproteinemia (HLP type 3), simple HTG (HLP type 4) and mixed hyperlipidemia (HLP type 5). This old thinking has given way to the idea that genetic susceptibility to HTG results from cumulative effects of multiple genetic variants acting in concert. HTG most is often a "polygenic" or "multigenic" trait. However, a few rare autosomal recessive forms of severe HTG have been defined. Treatment depends on the overall clinical context, including severity of HTG, concomitant presence of other lipid disturbances, and the patient's global risk of cardiovascular disease. Therapeutic strategies include dietary counselling, lifestyle management, control of secondary factors, use of omega-3 preparations and selective use of pharmaceutical agents.
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Affiliation(s)
- Amanda Brahm
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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Eichenfield LF, McCollum A, Msika P. The benefits of sunflower oleodistillate (SOD) in pediatric dermatology. Pediatr Dermatol 2009; 26:669-75. [PMID: 20199440 DOI: 10.1111/j.1525-1470.2009.01042.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
For millennia, sunflower seed oil has been used in folk medicine for both skin care and the treatment of skin disorders. In its natural state, the oil contains high levels of essential fatty acids, particularly linoleic acid, which has skin barrier-enhancing properties. A sunflower oleodistillate (SOD), which is produced through a molecular distillation process without the use of solvents, has been shown to increase the epidermal key lipid synthesis and to reduce inflammation in vitro and in animal models. It has also been shown to activate peroxisome proliferative-activated receptor-alpha (PPAR-alpha) in vitro. As PPAR-alpha agonists have been shown to stimulate keratinocyte differentiation, improve barrier function, and enhance lipid metabolism in the skin, it has been suggested that SOD might also be efficacious in atopic dermatitis (AD). An initial clinical evaluation of the care effect of a 2% SOD emulsion in 20 adult volunteers with atopic skin revealed the moisturizing properties of SOD. Finally, a strong steroid-sparing effect and a positive effect on quality-of-life parameters were clearly demonstrated for the 2% SOD cream in studies in infants and babies with AD.
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Affiliation(s)
- Lawrence F Eichenfield
- Pediatrics and Medicine (Dermatology), Pediatric and Adolescent Dermatology, Rady Children's Hospital, University of California San Diego School of Medicine, San Diego, California 92130, USA.
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Rahalkar AR, Giffen F, Har B, Ho J, Morrison KM, Hill J, Wang J, Hegele RA, Joy T. Novel LPL mutations associated with lipoprotein lipase deficiency: two case reports and a literature review. Can J Physiol Pharmacol 2009; 87:151-60. [PMID: 19295657 DOI: 10.1139/y09-005] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Lipoprotein lipase (LPL) is a key enzyme involved with hydrolysis and removal of triglycerides from plasma. LPL deficiency is a rare condition with an estimated prevalence of 1 in 106. It is characterized biochemically by elevated triglycerides and lowered HDL in the plasma and clinically by a constellation of signs and symptoms during childhood including failure to thrive, lipemia retinalis, eruptive xanthomas, hepatosplenomegaly, and acute pancreatitis. Nearly 100 mutations in the LPL gene have been associated with LPL deficiency. Here we report 2 unrelated pedigrees with LPL deficiency from 2 novel disease-causing LPL mutations: a Gly159Glu missense mutation in exon 5 and a 4-bp ACGG deletion at the 3' boundary of exon 2. We present molecular findings of these 2 cases and review the biochemical, clinical, and genetic features of LPL deficiency.
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Affiliation(s)
- Amit R Rahalkar
- Department of Vascular Biology and Medicine, Robarts Research Institute and Schulich School of Medicine and Dentistry, University of Western Ontario, P.O. Box 5015, 100 Perth Drive, London, ON N6A5K8, Canada
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Hemalatha S, Raghunath M. Dietary sesame (Sesamum indicum cultivar Linn) oil inhibits iron-induced oxidative stress in rats. Br J Nutr 2007; 92:581-7. [PMID: 15526409 DOI: 10.1079/bjn20041239] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The high stability of sesame oil against oxidative deterioration is attributed to lignans in its non-glycerol fraction. The present study evaluates the effects of feeding sesame lignans (sesamin and sesamolin) on Fe2+-induced oxidative stress in rats. Three groups, each of sixteen male weanling WNIN rats, were fed diets containing 200 g casein/kg and 100 g oil/kg (group 1, groundnut oil; group 2, sesame oil; group 3, sesame oil+sesamin (0·4 g/kg). After 45 d of feeding, eight rats from each group were injected with saline (9 g Na Cl/l, controls) intraperitoneally while the remaining eight rats were injected with 30 mg Fe2+/kg body weight as ferrous sulfate in normal saline. The animals were killed after 90 min to evaluate hepatic function and antioxidant status. Compared with those fed groundnut oil (group 1), sesame oil-fed rats (groups 2 and 3) had lower levels of hepatic thiobarbituric acid-reactive substances, serum glutamate:oxaloacetate transaminase activities and serum glutamate pyruvate transaminase activities, indicating protection against Fe-induced oxidative stress. Despite similar tocopherol levels in the three diets, hepatic α-tocopherol levels were higher in rats fed the sesame-oil diets (groups 2 and 3) compared with controls (group 1). However, activities of hepatic antioxidant enzymes (superoxide dismutase and glutathione peroxidase) were significantly (P<0·05) increased only in rats fed higher levels of lignans (group 3). These observations suggest that sesame lignans may have sparing effects on tocopherols. The increased bioavailability of tocopherols in the presence of dietary lignans might be due to the regeneration of oxidized tocopherols. The synergistic effects of lignans with tocols has nutritional and therapeutic implications.
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Affiliation(s)
- S Hemalatha
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
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Gura KM, Parsons SK, Bechard LJ, Henderson T, Dorsey M, Phipatanakul W, Duggan C, Puder M, Lenders C. Use of a fish oil-based lipid emulsion to treat essential fatty acid deficiency in a soy allergic patient receiving parenteral nutrition. Clin Nutr 2005; 24:839-47. [PMID: 16029913 DOI: 10.1016/j.clnu.2005.05.020] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2004] [Accepted: 05/31/2005] [Indexed: 10/25/2022]
Abstract
The treatment of essential fatty acid deficiency (EFAD) in a 17-year-old male following allogeneic bone marrow transplantation is described. His transplant was complicated by gastrointestinal bleeding that precluded the use of enteral feedings. Due to a severe soy allergy, he could not tolerate any intravenous fat emulsions marketed in the US. After months of receiving fat-free parenteral nutrition and intermittent use of enteral feeds, he developed signs and symptoms consistent with EFAD, including a rash and an elevated plasma triene:tetraene ratio of 0.231 (0.013-0.05). After receiving FDA approval, a parenteral fish oil emulsion was administered to provide fat calories and sufficient alpha-linolenic and linoleic acid to correct his EFAD. Therapy was initiated at 0.2 g/kg/day and advanced to 0.67 g/kg/day, providing approximately 45 mg/kg/day of linoleic acid. After 10 days of therapy, his rash disappeared and his triene:tetraene ratio improved to 0.07. By day 17 the ratio normalized to 0.047. This suggests that using a fish oil emulsion with minimal linoleic acid may be safely used as the sole source of fat calories and may be an option to prevent or treat EFAD in subjects allergic to soy that require a parenteral source of fat.
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Affiliation(s)
- Kathleen M Gura
- Department of Pharmacy, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.
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Bhutta ZA, Darmstadt GL, Hasan BS, Haws RA. Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Pediatrics 2005; 115:519-617. [PMID: 15866863 DOI: 10.1542/peds.2004-1441] [Citation(s) in RCA: 417] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developing-country communities has not been reported. OBJECTIVE This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in community-based neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning. METHODS Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies. RESULTS A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care. CONCLUSIONS This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy makers about the importance of investing in neonatal health.
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Affiliation(s)
- Zulfiqar A Bhutta
- Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, Karachi 74800, Pakistan.
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Tsai EC, Brown JA, Veldee MY, Anderson GJ, Chait A, Brunzell JD. Potential of essential fatty acid deficiency with extremely low fat diet in lipoprotein lipase deficiency during pregnancy: A case report. BMC Pregnancy Childbirth 2004; 4:27. [PMID: 15610556 PMCID: PMC544881 DOI: 10.1186/1471-2393-4-27] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2004] [Accepted: 12/20/2004] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Pregnancy in patients with lipoprotein lipase deficiency is associated with high risk of maternal pancreatitis and fetal death. A very low fat diet (< 10% of calories) is the primary treatment modality for the prevention of acute pancreatitis, a rare but potentially serious complication of severe hypertriglyceridemia. Since pregnancy can exacerbate hypertriglyceridemia in the genetic absence of lipoprotein lipase, a further reduction of dietary fat intake to < 1-2% of total caloric intake may be required during the pregnancy, along with the administration of a fibrate. It is uncertain if essential fatty acid deficiency will develop in the mother and fetus with this extremely low fat diet, or whether fibrates will cross the placenta and concentrate in the fetus. CASE PRESENTATION: A 23 year-old gravida 1 woman with primary lipoprotein lipase deficiency was seen at 7 weeks of gestation in the Lipid Clinic for management of severe hypertriglyceridemia that had worsened with pregnancy. While on her habitual fat intake of 10% of total calories, her pregnancy resulted in an exacerbation of the hypertriglyceridemia, which prompted further restriction of fat intake to < 2% of total calories, as well as administration of gemfibrozil at a lower than average dose. The level of gemfibrozil, as the active metabolite, in the venous and arterial fetal cord blood was within the expected therapeutic range for adults. The clinical signs and a biomarker of essential fatty acid deficiency, namely the ratio of 20:3 [n-9] to 20:4 [n-6] fatty acids, were closely monitored throughout her pregnancy. Despite her extremely low fat diet, the levels of essential fatty acids measured in the mother and in the fetal blood immediately postpartum were normal. Normal essential fatty acid levels may have been achieved by the topical application of sunflower oil. CONCLUSIONS: An extremely low fat diet in combination with topical sunflower oil and gemfibrozil administration was safely implemented in pregnancy associated with the severe hypertriglyceridemia of lipoprotein lipase deficiency.
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Affiliation(s)
- Elaine C Tsai
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way (152E), Seattle, Washington, USA
| | - Judy A Brown
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Megan Y Veldee
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Alan Chait
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - John D Brunzell
- Department of Medicine, University of Washington, Seattle, Washington, USA
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Mirtallo J, Canada T, Johnson D, Kumpf V, Petersen C, Sacks G, Seres D, Guenter P. Safe Practices for Parenteral Nutrition. JPEN J Parenter Enteral Nutr 2004. [DOI: 10.1177/01486071040280s601] [Citation(s) in RCA: 170] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Darmstadt GL, Badrawi N, Law PA, Ahmed S, Bashir M, Iskander I, Al Said D, El Kholy A, Husein MH, Alam A, Winch PJ, Gipson R, Santosham M. Topically applied sunflower seed oil prevents invasive bacterial infections in preterm infants in Egypt: a randomized, controlled clinical trial. Pediatr Infect Dis J 2004; 23:719-25. [PMID: 15295221 DOI: 10.1097/01.inf.0000133047.50836.6f] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Because the therapeutic options for managing infections in neonates in developing countries are often limited, innovative approaches to preventing infections are needed. Topical therapy with skin barrier-enhancing products may be an effective strategy for improving neonatal outcomes, particularly among preterm, low birth weight infants whose skin barrier is temporarily but critically compromised as a result of immaturity. METHODS We tested the impact of topical application of sunflower seed oil 3 times daily to preterm infants <34 weeks gestational age at the Kasr El-Aini neonatal intensive care unit at Cairo University on skin condition, rates of nosocomial infections and mortality. RESULTS Treatment with sunflower seed oil (n = 51) resulted in a significant improvement in skin condition (P = 0.037) and a highly significant reduction in the incidence of nosocomial infections (adjusted incidence ratio, 0.46; 95% confidence interval, 0.26-0.81; P = 0.007) compared with infants not receiving topical prophylaxis (n = 52). There were no reported adverse events as a result of topical therapy. CONCLUSIONS Given the low cost (approximately .20 dollars for a course of therapy) and technologic simplicity of the intervention and the effect size observed in this study, a clinical trial with increased numbers of subjects is indicated to evaluate the potential of topical therapy to reduce infections and save newborn lives in developing countries.
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Affiliation(s)
- Gary L Darmstadt
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
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Kucharekova M, Van De Kerkhof PCM, Van Der Valk PGM. A randomized comparison of an emollient containing skin-related lipids with a petrolatum-based emollient as adjunct in the treatment of chronic hand dermatitis. Contact Dermatitis 2003; 48:293-9. [PMID: 14531866 DOI: 10.1034/j.1600-0536.2003.00119.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Hand dermatitis is a multifactorial skin disorder in which skin barrier impairment is involved in the pathogenesis. The development of topical agents that improve skin barrier function is therefore a promising approach for the management of hand dermatitis. Topically applied lipids may interfere with skin barrier function, and emollients containing skin-related lipids have been suggested to facilitate repair of the skin barrier. However, evidence for the superiority of emollients containing skin-related lipids over the more traditional emollients is still lacking. The aim of this study was to compare an emollient containing skin-related lipids (Locobase Repair) with a traditional petrolatum-based emollient for the management of hand dermatitis. Adult males and females (n = 30) with mild to moderate chronic hand dermatitis were treated twice daily for 2 months either with an emollient containing skin-related lipids or with a pet.-based emollient. In the case of exacerbation, the patients of both treatment groups were allowed to use a mild corticosteroid according to instructions. Both treatment regimes significantly improved clinical signs of hand dermatitis as assessed by the investigator global assessment, hand eczema area and severity score. We did not observe significant differences in the improvement of clinical signs, itching, patients' assessment of efficacy, cosmetic acceptability or usage of topical corticosteroids between both treatment groups. In conclusion, this study confirms that the frequent use of emollients may be useful in the therapy of hand dermatitis. However, we could not demonstrate the superiority of this particular emollient containing skin-related lipids in patients with chronic hand dermatitis.
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Affiliation(s)
- M Kucharekova
- Department of Dermatology, University Medical Centre Nijmegen, The Netherlands.
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Taylor LJ, Lee RS, Long M, Rawlings AV, Tubek J, Whitehead L, Moss GP. Effect of occlusion on the percutaneous penetration of linoleic acid and glycerol. Int J Pharm 2002; 249:157-64. [PMID: 12433444 DOI: 10.1016/s0378-5173(02)00489-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The effect of occlusion on the in vitro percutaneous absorption of linoleic acid was investigated. A greater skin concentration of linoleic acid from an ethanolic vehicle was observed in non-occluded experiments compared with occluded experiments (P<0.05). Such changes were not observed as consistently when ethanol was replaced with a less volatile organic solvent (cyclomethicone). These observations were attributed to the increase in the concentration gradient due to the unimpeded evaporation of volatile solvents, which provided a greater driving force and enhanced non-occluded delivery in these systems, compared with occluded systems. Conversely, the percutaneous absorption of a polar material (glycerol) from an aqueous solution did not yield any such differences. While more conclusive comparisons between volatile and non-volatile solvents and penetrants would be required to substantiate fully these comparisons, it is apparent that non-occlusion of volatile solvents may enhance percutaneous absorption. The physicochemical properties of the penetrant, for example its natural state at skin temperature (i.e. solid or liquid) may further determine the degree of enhanced percutaneous absorption compared with occluded environments.
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Affiliation(s)
- Louise J Taylor
- Unilever Research, Port Sunlight Laboratory, Quarry Road East, Bebington, Merseyside, CH63 3JW, Wirral, UK
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Abstract
There are two common types of adult patient with a short bowel, those with jejunum in continuity with a functioning colon and those with a jejunostomy. Both groups have potential problems of undernutrition, but this is a greater problem in those without a colon, as they do not derive energy from anaerobic bacterial fermentation of carbohydrate to short chain fatty acids in the colon. Patients with a jejunostomy have major problems of dehydration, sodium and magnesium depletion all due to a large volume of stomal output. Both types of patient have lost at least 60 cm of terminal ileum and so will become deficient of vitamin B12. Both groups have a high prevalence of gallstones (45%) resulting from periods of biliary stasis. Patients with a retained colon have a 25% chance of developing calcium oxalate renal stones and they may have problems with D (-) lactic acidosis. The survival of patients with a short bowel, even if they need long-term parenteral nutrition, is good.
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Affiliation(s)
- J M Nightingale
- Gastroenterology Centre, Leicester Royal Infirmary, United Kingdom.
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Soriano CR, Martinez FE, Jorge SM. Cutaneous application of vegetable oil as a coadjutant in the nutritional management of preterm infants. J Pediatr Gastroenterol Nutr 2000; 31:387-90. [PMID: 11045835 DOI: 10.1097/00005176-200010000-00011] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The cutaneous application of vegetable oil as a therapeutic practice and dietary coadjuvant has been described mainly in adult patients at risk for essential fatty acid deficiency. In the current study, the effects of cutaneous soybean oil application on somatic growth and plasma linoleic and arachidonic acid levels were examined in enterally fed preterm newborns. METHODS Sixty consecutive preterm infants were chosen from patients admitted to the nursery. Infants were randomly assigned to one of two groups: the oil group, which was treated cutaneously with soybean oil, or the control group, which received no cutaneous treatment. RESULTS After 30 days, a significant increase in anthropometric parameters was observed in infants who received cutaneous oil, mainly in infants small for gestational age. An increase in linoleic acid level and a decrease in arachidonic acid level were seen in both groups but do not justify the difference found in growth rates in the control and oil groups. CONCLUSIONS Preterm infants treated cutaneously with soy oil showed better somatic growth than the control group. The factors leading to the present results, especially the response of the infants who were small for gestational age merit further evaluation.
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Affiliation(s)
- C R Soriano
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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Abstract
The relative importance of neonatal health and neonatal skin care has been highlighted in recent years as infant mortality rates have decreased while death rates during the neonatal period remain unacceptably high in many areas of the world. During the neonatal period, many newborns develop preventable, clinically apparent skin problems, and many more, especially preterm neonates, experience morbidity caused by compromised skin barrier integrity. Several strategies are available for protecting the integrity and promoting the hygiene of the skin and augmenting its function as a barrier to TEWL and heat loss and the entrance of infectious or toxic agents. Research defining optimal applications of many of these strategies, however, and the development of new approaches in skin care is one of the greatest challenges in pediatric dermatology and holds promise for improving neonatal outcome in the future. The ability to modulate epidermal barrier function and integrity relies largely on the topical use of protective materials and substances and manipulation of the external environment. As understanding of epidermal barrier development advances, perhaps pharmacologic manipulation of barrier development, as now practiced for augmentation of neonatal lung maturity, will become a reality. In the meantime, greater awareness among neonatal health care practitioners of state-of-the-art strategies for optimizing skin integrity in neonates is an important step toward improving neonatal health.
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Affiliation(s)
- G L Darmstadt
- Department of Pediatrics and Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
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28
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Abstract
This article discusses the causes, prognosis, and management of short bowel syndrome. Attempts to enhance intestinal adaptation with trophic factors and surgical treatment options, including small bowel transplantation, are discussed.
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Affiliation(s)
- J S Scolapio
- Division of Gastroenterology, Mayo Clinic, Jacksonville, Florida, USA
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29
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ApoE enhances lipid uptake by macrophages in lipoprotein lipase deficiency during pregnancy. J Lipid Res 1996. [DOI: 10.1016/s0022-2275(20)42008-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Abushufa R, Reed P, Weinkove C, Wales S, Shaffer J. Essential fatty acid status in patients on long-term home parenteral nutrition. JPEN J Parenter Enteral Nutr 1995; 19:286-90. [PMID: 8523627 DOI: 10.1177/0148607195019004286] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patients on total parenteral nutrition are known to be at risk of the development of essential fatty acid deficiency, presenting as a syndrome with scaly skin lesions and characterized by low plasma and erythrocyte linoleic acid concentrations. The essential fatty acid status of patients on long-term home parenteral nutrition who do have access to oral feeds has not been studied. METHODS With the use of an isocratic high-performance liquid chromatography method, fatty acids were measured in the erythrocytes and plasma of 25 nonfasting patients on long-term home parenteral nutrition and the findings compared with those of 46 hospital outpatients not on nutrition support and five laboratory staff. RESULTS Statistically significant differences in the two groups were limited to the erythrocytes. Linoleic acid was significantly lower (25.2 vs 40.7 mumol/10(6) red blood cells, p < .0001) and showed a significant correlation with triceps skinfold thickness (r = .52, p = .013). Palmitoleic and oleic acids were higher in patients than controls (10.8 vs 8.4 mumol/10(6) red blood cells, p = .009; 61.2 vs 51.7 mumol/10(6) red blood cells, p = .003). CONCLUSIONS Despite IV linoleic acid administration, patients on long-term home parenteral nutrition have low erythrocyte stores of this essential fatty acid. This appears to be related to their low body fat stores. We suggest that they may be using much of the infused linoleic acid as an energy source and therefore are at risk of subclinical essential fatty acid deficiency.
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Affiliation(s)
- R Abushufa
- Department of Medicine, Hope Hospital, Salford, United Kingdom
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31
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Affiliation(s)
- M Wolman
- Department of Pathology, Tel Aviv University, Sackler Faculty of Medicine, Israel
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Affiliation(s)
- J Brod
- Department of Biology, L'Oreal Research Laboratories, Aulnay-sous-Bois, France
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Christophe A, Hill EG, Holman RT. Efficacy of linoleic acid administered rectally as monoglyceride. Lipids 1987; 22:328-32. [PMID: 3600208 DOI: 10.1007/bf02534001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The potential of the rectal route for administration of essential fatty acids (EFA) as monoglyceride (MG) was investigated. EFA-deficient rats were supplemented with 14 mg linoleic acid/day for 3 days. Supplementation was either by oral administration as corn oil, orally as corn oil-derived MG or rectally as MG. The patterns of polyunsaturated fatty acids (PUFA) in liver and serum lipids, characteristic of EFA deficiency, were altered in the direction of normalcy in similar magnitude by all modes of supplementation, indicating that the rectal route may be useful for administration of EFA. The amounts of phospholipids (PL) and free fatty acids (FFA) in liver changed by all modes of administration. The magnitude of change of total PL and of FFA in liver depended upon the chemical form in which linoleic acid was administered and the route of administration, indicating that these factors affect lipid metabolism.
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36
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Roguet R, Lotte C, Berrebi C, Rouers D, Dupuis D, Rougier A, Corroller M, Wepierre J. In vivo distribution of linoleic acid in hairless rat skin following topical administration. Arch Dermatol Res 1986; 278:503-6. [PMID: 3789807 DOI: 10.1007/bf00455174] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Bougle D, Pepin D, Delhaye M, Chambaz J, Ricour C. Plasma and erythrocyte essential fatty acids during total parenteral nutrition in infants: effects of a cutaneous supply. JPEN J Parenter Enteral Nutr 1986; 10:216-9. [PMID: 3083136 DOI: 10.1177/0148607186010002216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In order to prevent essential fatty acid (EFA) deficiency induced by fat-free total parenteral nutrition (TPN), 10 infants on TPN were rubbed three times daily for 20 days using oenethera oil (80% EFA). Total EFA amount provided cutaneously was 1900 mg/kg/d. Plasma and red blood cells phospholipids were determined on days 1 and 20 in these 10 treated and six untreated infants on TPN and compared with those of normal control infants. On day 1, plasma nonessential FA including 20:3 n-9(p less than 0.01) were increased in both TPN groups while 18:2 n-6 and 18:3 n-3 (p less than 0.001 and p less than 0.01) were decreased. On the 20th day, EFA deficiency had worsened with a decrease in plasma level of 20:4 n-6 (p less than 0.02) and a higher than normal triene/tetraene ratio : 3.4 +/- 1.1 and 2.3 +/- 0.6 vs 0.1 +/- 0.1 (p less than 0.02). As for red blood cells phospholipids, 16:0 was increased and 18:2 n-6 and 20:3 n-6 were decreased (p less than 0.05) on day 1. On day 20, these FA were more abnormal while 20:3 n-9 became significantly increased (p less than 0.05). No difference was observed between the TPN groups at any time. These results show that cutaneous application of large amounts of EFA-rich oil is unable to prevent or cure TPN induced EFA deficiency.
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Friedman Z. Essential fatty acid consideration at birth in the premature neonate and the specific requirement for preformed prostaglandin precursors in the infant. Prog Lipid Res 1986; 25:355-64. [PMID: 3321088 DOI: 10.1016/0163-7827(86)90073-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The essentiality of certain PUFA is probably related to their capability to be incorporated into lipids and to act as precursor in the formation of ecosanoids. Esterified to phospholipids, the EFA influence the physico-chemical characteristics of biomembranes. Normal growth of infants is dependent upon an adequate supply of EFA. The human fetus, like the adult, is unable to synthesize the EFA, which must therefore be derived from the maternal circulation and pass through the placenta. Increased concentration of the polyenoic fatty acids with advanced gestational age may result from increased synthetic activity of these fatty acids by the fetus or the placenta or by preferential transfer of these fatty acids across the placenta. Several clinical manifestations have been ascribed in the human infant to prolonged EFA deficiency; however, none of these findings were noted in a group of sick newborn infants with very rapid onset of deficiency. Platelet dysfunction, decreased prostaglandin biosynthesis and turnover and altered pulmonary surfactant are among the effects of EFA deficiency on infants. Supplementation of the diet with EFA, parenterally or by the inunction of oil rich in linoleic acid, were reported to alleviate the symptoms of EPA deficiency. The minimal estimated requirement of linoleic acid is 1% of calories and 4% is an optimal intake. Most diets, including human breast milk, infant formulas and parenteral fat emulsions, far exceed the optimal intake of linoleic acid. Relatively little is known about the possible effects of high levels of linoleate in the diet.
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Affiliation(s)
- Z Friedman
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030
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Handa N, Suita S, Ikeda K, Doki T, Naito K. Requirement of parenteral fat in infants with biliary atresia. JPEN J Parenter Enteral Nutr 1985; 9:685-90. [PMID: 4068193 DOI: 10.1177/0148607185009006685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In a prospective study on infants with biliary atresia (BA) we measured the composition of the plasma fatty acid to determine the requirement of fat emulsion. In 14 infants who underwent initial operation for treatment of BA, a trend toward essential fatty acid (EFA) deficiency was evident before the surgery. Fourteen infants given parenteral nutrition (PN) after surgery were grouped into three according to the dose of fat emulsion, fat free in 4, 10% of the total calories in 5 and 20% of the total calories in 5. After operation, EFA deficiency gradually progressed when on fat free PN. Improvement in EFA deficiency occurred with the administration of fat which corresponded to 20% of the total caloric intake. During PN including fat emulsion, abnormal changes in liver function tests and serum lipid values due to fat emulsion were nil. Infusion of fat which supplies 20% of the total calories is thus recommended for correction of EFA deficiency and is tolerable in infants with obstructive liver disease. However, clinical and biochemical monitoring should be carefully done.
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Chapkin RS, Ziboh VA. Inability of skin enzyme preparations to biosynthesize arachidonic acid from linoleic acid. Biochem Biophys Res Commun 1984; 124:784-92. [PMID: 6439197 DOI: 10.1016/0006-291x(84)91026-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The lack of any information as to the origin of epidermal arachidonic acid, an important precursor of eicosanoids in the epidermis, prompted us to determine in vitro whether or not microsomal preparations from rat and guinea pig epidermis possess the delta 6 and delta 5 desaturase activities. The incubations were performed in parallel with microsomal preparations from liver of these animals where activities for these enzymes have previously been reported. The conversions of radioactive fatty acids were determined after methylation and separation of the 14C-fatty acid methyl esters by argentation thin layer chromatography. Data from these studies demonstrated that delta 5 desaturase activity is markedly lower in guinea pig liver than in rat liver. Interestingly, preparations from rat and guinea pig epidermis at all concentrations tested lacked the capacity to transform either linoleic acid into gammalinolenic acid or dihomogammalinolenic acid into arachidonic acid. This observation implies that arachidonic acid that is present in the epidermal phospholipids is biosynthesized elsewhere endogenously and transported to the epidermis for esterification into the phospholipids. The site of this biosynthesis is presumably the liver and the mode of transport to the epidermis remains to be determined. These studies indicate arachidonic acid per se as an essential fatty acid for the epidermis.
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Elia M. The effects of nitrogen and energy intake on the metabolism of normal, depleted and injured man: Considerations for practical nutritional support. Clin Nutr 1982; 1:173-92. [PMID: 16829378 DOI: 10.1016/0261-5614(82)90011-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article illustrates how the nutritional and metabolic effects of a range of protein and energy intakes depend on the clinical state of the patient and how these considerations may be used to provide guidelines for nutritional support. First, it is necessary to define states and mechanisms of malnutrition and then discuss the biochemical processes which underlie nutritional rehabilitation.
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Affiliation(s)
- M Elia
- Dunn Clinical Nutrition Centre, Addenbrookes Hospital, Trumpinton Street, Cambridge, CB2 1QE UK
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Affiliation(s)
- J Faintuch
- Hospital das Clinicas, 2(a) C.C.R., Av. Eneias de Aguiar, 255, Sao Paulo, SP 05403, Brazil
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Heymans HS, van den Heuvel CG, Smit W, Steendijk R. Catch-up growth following long-term administration of essential fatty acids in a girl with growth failure and essential fatty acid deficiency. ACTA PAEDIATRICA SCANDINAVICA 1982; 71:1037-9. [PMID: 7158328 DOI: 10.1111/j.1651-2227.1982.tb09572.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A 10-year-old girl with benign recurrent intrahepatic cholestasis, malabsorption of fat, growth failure (growth rate 1.2 cm/year) and deficiency of essential fatty acids (EFA) is described. Long-term administration of EFA, mainly by cutaneous application of sunflower seed oil, was followed by a remarkable catch-up growth (23.8 cm in 3.5 years) while the serum values for EFA improved. Since no other changes in the therapeutic regimen occurred and other causes of growth failure and subsequent acceleration of growth could be ruled out, it is highly probable that the observed increase in growth rate was the result of the administration of EFA.
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Nguyen TT, Ziboh VA, Uematsu S, McCullough JL, Weinstein G. New model of a scaling dermatosis: induction of hyperproliferation in hairless mice with eicosa-5,8,11-trienoic acid. J Invest Dermatol 1981; 76:384-7. [PMID: 7229430 DOI: 10.1111/1523-1747.ep12520900] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The present studies have demonstrated that topical application of a low concentration of eicosa-5,8,11-trienoic acid (a 20:3,n9 fatty acid previously reported to inhibit competitively the activity of the sheep vesicular cyclooxygenase) to skin of normal fed hairless mice produced severe scaly dermatosis which is characterized by marked hyperplasia and acanthosis of the epidermal layer. The precise mechanism of this induction of scaly dermatosis is presently unclear. It is nonetheless interesting that the treatment of skin with similar concentrations of other unsaturated fatty acids produced no visible or histologic effects. Furthermore, endogenous levels of arachidonic acid in epidermal phospholipid and triglyceride fractions were shown to increase significantly (p < 0.01) in skin treated with the 20:3,n9 fatty acid while the endogenous level of PGE2 in the same tissue decreased markedly. This latter observation is consistent at least in part, with a previous report from this laboratory in which the 20:3,n9 fatty acid inhibited in vitro the activity of the sheep vesicular cyclooxygenase (the rate limiting enzyme in the transformation of arachidonic acid into the prostaglandin endoperoxides) although the increase in arachidonic acid may also reflect an increased incorporation of this fatty acid into the epidermal lipids by the hyperproliferative tissue. Evaluation of the proliferative status of 20:3,n9 fatty acid-treated skin showed a significant increase (p < 0.01) in labeling and mitotic indices. The use of this potentially endogenous fatty acid may be a useful tool for further investigations of hyperproliferative skin diseases where dietary deficiency of essential fatty acids does not exist.
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Jarnum S, Ladefoged K. Long-term parenteral nutrition. I. Clinical experience in 70 patients from 1967 to 1980. Scand J Gastroenterol 1981; 16:903-11. [PMID: 6798687 DOI: 10.3109/00365528109181821] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Seventy patients, 37 females and 33 males, median age 46 years, have been treated with long-term parenteral nutrition for 816 patient-months, or 68 patient-years. Short-bowel syndrome was the commonest indication for parenteral nutrition (582 patient-months). Twenty-four patients were receiving home parenteral nutrition. Most had severe short-bowel syndrome following intestinal resection for Crohn's disease or mesenteric infarction. Metabolic complications included zinc deficiency syndrome in four patients before routine zinc administration and progressive halisteresis in five patients. The mortality for 26 patients with short-bowel syndrome was 23%, for 15 patients with intestinocutaneous fistulas 40%, and for 15 patients with severe emaciation for various causes 27%. Parenteral nutrition was withdrawn in 6 (23%) of the 26 patients with short-bowel syndrome, who subsequently were able to maintain body weight with oral feeding. Fifteen patients are still (February 1980) receiving home parenteral nutrition.
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Carpentier YA, Askanazi J, Elwyn DH, Gump FE, Nordenström J, Kinney JM. The effect of carbohydrate intake on the lipolytic rate in depleted patients. Metabolism 1980; 29:974-9. [PMID: 6775173 DOI: 10.1016/0026-0495(80)90042-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The effect of intravenous carbohydrate intake on glycerol turnover and fat metabolism was estimated in six nutritionally depleted surgical patients requiring total parenteral nutrition. Two diets were given. Nitrogen intake was the same in both diets. The calorie intake, adjusted by varying glucose intake, provided either 72% or 128% of the measured resting energy expenditure. Glycerol turnover was measured during administration of 5% dextrose solutions before starting total parenteral nutrition, and again after 4 days on each diet. Turnover rates of glycerol were closely correlated with plasma concentrations. However, fractional turnover rates were only two-thirds of normal values, indicating decreased clearance possibly due to decreased hepatic blood flow. Glycerol turnover, plasma free fatty acid concentrations, and rate of fat oxidation declined progressively with increased glucose intake. When compared with these results, previous studies of injured and septic patients showed: higher values for glycerol turnover, FFA concentrations, and fat oxidation; poor corrlation between glycerol turnover and concentration; inhibition of lipogenesis at high glucose intake; and high rates of norepinephrine excretion. The data suggest that in severe injury, counter regulatory hormones may almost completely block the effects of insulin on hormone sensitive lipase but have less influence on insulin stimulation of FFA esterification and inhibition of ketone body synthesis.
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Elias PM, Brown BE, Ziboh VA. The permeability barrier in essential fatty acid deficiency: evidence for a direct role for linoleic acid in barrier function. J Invest Dermatol 1980; 74:230-3. [PMID: 7373078 DOI: 10.1111/1523-1747.ep12541775] [Citation(s) in RCA: 161] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Essential fatty acid (EFA) deficient rodents demonstrate abnormal epidermal permeability barrier function and differentiation, defects which can be corrected by either topical or systemic administration of linoleic acid. Since linoleic acid is a precursor of prostaglandins, correction of the defect in barrier function may either reflect a prostaglandin-mediated return toward normal epidermal differentiation, or, instead, a direct effect of linoleic acid. To test these possibilities severely EFA-deficient mice were pretreated daily with indomethacin and/or 5,8,11,14-eicosatetrayeonic acid, and then placed on normal (lineolic acid-supplemented) diets. Endogenous formation of prostaglandin E2 was determined by thin-layer chromatography after transformation into prostaglandin B2 with ethanolic-hydrochloric acid. Animals treated with both indomethacin and TYA DEMONSTRATED SUBSTANTIAL REDUCTIONS IN PROSTAGLANDIN E2 levels in liver and skin. Animals replenished with linoleic acid invariably demonstrated a rapid return of barrier function toward normal whether or not they were blockaded, while nonreplenished animals, with or without inhibition of prostaglandin biosynthesis, demonstrated continued deterioration in barrier function. In other experiments, topically applied linoleic acid rapidly reversed the defect in barrier function at the sites of application prior to systemic correction of the EFA deficient state. These results suggest that: (1) defective cutaneous barrier function in EFA deficiency can be corrected locally without prior systemic reversal of the deficiency state; and (2) that linoleic acid may play a direct role in the epidermal permeability barrier independent of its role in prostaglandin metabolism.
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