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Omega-3 supplementation associated with fewer and shorter seizures in epileptics
January 21 2019. A triple-blind trial reported in Clinical and Translational Medicine on January 16, 2019 found a benefit for supplementation with the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) among men and women with intractable seizures.
The trial included 50 patients with treatment-resistant epilepsy who received a placebo or 180 milligrams (mg) EPA plus 120 mg DHA twice daily for 16 weeks. Seizure frequency and duration, and blood levels of the inflammatory factors tumor necrosis factor-alpha (TNF-a) and interleukin-6 (IL-6) were assessed at the beginning and end of the trial.
Nine of the 25 participants who received omega-3 had no seizures during the study compared to five of the those who received a placebo. Length of seizures (in minutes) among those who received omega-3 averaged less than half that of the placebo group.
Median TNF-a levels declined by 38% in the supplemented subjects while increasing by 77% in the placebo group. Interleukin-6 levels were also significantly lower at the end of the trial among those who received omega-3 compared to the placebo, indicating a reduction in inflammation.
“The epileptogenesis process has been linked with the overproduction of pro-inflammatory cytokines such as tumor necrosis factor (TNF)-α and interleukin (IL)-6 as demonstrated by increased susceptibility to seizures in inflammatory disorders such as colitis, pneumonia and rheumatoid arthritis,” the authors write. “In addition, several studies have demonstrated the malfunction of the blood–brain barrier following the administration of pro-inflammatory cytokines IL-6 and TNF-α which might be associated with predisposition to seizure.”
“Supplementation resulted in a significant decrease in TNF-α and IL-6 concentrations,” they conclude. “Further studies are needed to compare different omega-3 fatty acid compositions and determine the most effective dose and treatment duration as well as the long-term benefits of this supplementation.”
Vitamin C shows promise as brain aging treatment
January 18 2019. A study reported on January 9, 2019 in the journal Nutrients revealed a protective role for supplementation with vitamin C, a well known antioxidant, in mice exposed to D-galactose, a sugar that occurs in some foods which has been shown to induce brain aging via the accumulation of oxidative stress.
One hundred-eight mice were divided to receive subcutaneous D-galactose or no D-galactose for 10 weeks. Beginning in the seventh week, half of the animals in each group were given a high oral dose of vitamin C for four weeks.
While mice that received D-galactose experienced a reduction in cognitive function and decreased neurogenesis in the brain’s hippocampus (an area associated with memory), animals that received vitamin C showed no reduction in hippocampal neurogenesis, which was attributed to improvements in cellular proliferation, neuronal differentiation and neuronal maturation. Furthermore, vitamin C was associated with protection against the upregulation of inflammatory factors and downregulation of the antioxidants superoxide dismutase (SOD) 1 and 2, sirtuin 1 and other factors in the hippocampus. Animals that received vitamin C additionally showed enhanced hippocampus-dependent memory function.
According to authors Sung Min Nam of Korea’s Konkuk University and colleagues, the decline in the production of the antioxidant enzymes SOD1 and SOD2 could be responsible for the increase in oxidative stress associated with D-galactose.
“Ascorbic acid-mediated beneficial effects on brain aging may be achieved by several mechanisms, including the promotion of neurogenesis and synaptic plasticity; increase in endogenous antioxidants; attenuation of neuroinflammation; and enhanced expression of Sirt1, caveolin-1, and brain-derived neurotrophic factor, in the hippocampus impaired by D-galactose,” they write. “These mechanisms might account for the subsequent functional improvement in hippocampus-dependent memory. Therefore, our findings suggest that ascorbic acid is a useful anti-brain aging agent.”
B vitamins could help individuals experiencing initial psychosis episode
January 16 2019. The outcome of trial reported on January 9, 2019 in Biological Psychiatry suggests a benefit for supplementation with B vitamins among individuals experiencing a first episode of psychosis, which can be a precursor to the development of schizophrenia or bipolar disorder.
Acting on previous research that revealed improvement in symptoms and lower levels of homocysteine in schizophrenics who supplemented with B vitamins, researchers led by Colin O’Donnell, MD, and Kelly Allott, DPsych, investigated the vitamins’ effect in 120 young men and women with first-episode psychosis who attended Orygen Youth Health's Early Psychosis Prevention and Intervention Centre. Participants received a placebo or a supplement containing 5 milligrams folic acid, 50 milligrams vitamin B6 and 0.4 milligrams vitamin B12 once daily for 12 weeks.
Symptom and cognitive function assessment conducted before and after the treatment period found that attention/vigilance remained stable among those who received B complex while deteriorating in the placebo group. One measure of attention/vigilance was found to more improved after B vitamin therapy among those who had high homocysteine levels at the beginning of the trial. Aspects of neurocognition improved among females and participants with affective psychosis who received B vitamins.
"This indicates the B vitamins could have a neuroprotective effect; although they are not improving a patient's concentration skills, they may be protecting these skills from declining," Dr Allott commented. "Psychosis is a diverse condition where everybody presents with different symptoms and a different biological profile. What was particularly interesting was that the participants who had abnormally high homocysteine levels at baseline were most responsive to the B vitamin supplements, in terms of improvement in attention. The results of this study support a more personalized approach to vitamin supplementation in first episode psychosis, suggesting those with elevated homocysteine are likely to benefit most."
Vitamin D supplementation could help reduce COPD exacerbations
January 14 2019. A study reported in Thorax on January 10, 2019 suggests a benefit for vitamin D supplementation among chronic obstructive pulmonary disease (COPD) patients who are deficient in the vitamin. Nearly all deaths from COPD (which includes emphysema and chronic bronchitis) are caused by disease exacerbations, which frequently occur in association with upper respiratory infections.
David A. Joliffe of Queen Mary University of London and colleagues analyzed data from 469 COPD patients who were participants in one of four clinical trials that evaluated the effects of vitamin D supplementation. Doses administered in the trials ranged from 1,200 IU per day to 100,000 IU per month.
Among subjects whose serum 25-hydroxyvitamin D levels were deficient at less than 10 nanograms per milliliter, the adjusted incidence rate of moderate to severe COPD exacerbations was reduced by 45% in association with vitamin D supplementation in comparison with the rate determined prior to supplementation. No significant adverse events were observed in association with vitamin D.
"New treatments are urgently needed to prevent COPD attacks,” noted lead researcher Adrian Martineau of Queen Mary University of London. “Our study shows that giving supplements to vitamin D-deficient COPD patients nearly halves their rate of potentially fatal attacks.”
"Vitamin D supplementation is safe, and it costs just a few pence to supplement a person for a year - so this is a potentially highly cost-effective treatment that could be targeted at those who have low vitamin D levels following routine testing” he remarked.
"Around a fifth of COPD patients in the UK - about 240,000 people - have low levels of vitamin D,” he added. “Reducing risk of attacks in such a large group would have major benefits for patients and for the National Health Service, since many attacks require costly hospital admission."
Pomegranate metabolite shows promise for IBD
January 11 2019. A report published on January 9, 2019 in Nature Communications suggests a benefit for urolithin A, a metabolite derived from pomegranate and berries, in the prevention and treatment of inflammatory bowel diseases (IBD), which include Crohn’s disease and ulcerative colitis and are characterized by inflammation due to gut leakage of toxins. “Urolithin A (UroA), a major microbial metabolite derived from polyphenolics of berries and pomegranate fruits displays anti-inflammatory, antioxidative, and anti-aging activities,” write Rabir Singh of the University of Louisville and colleagues. “Here, we show that urolithin A and its potent synthetic analogue (UAS03) significantly enhance gut barrier function and inhibit unwarranted inflammation.”
"Microbiota in our gut has evolved to generate beneficial microbial metabolites in the proximity of the gut barrier," noted co-senior author Venkatakrishna Jala, “however, the exact role of these metabolites has not been identified and the mechanism in which they exert their function is elusive.”
In rodent studies, the researchers found that administration of urolithin A or its synthetic analog protected against and reduced colonic inflammation in acute and chronic colitis. A series of experiments demonstrated that the molecules decreased gut permeability by increasing the expression of tight junction proteins that are lost in IBDs. "Restoring the gut barrier and reducing the inflammation using a small-molecule will provide a better therapeutic output in the treatment of IBDs," commented co-senior author Praveen Vemula of the Institute for Stem Cell Biology and Regenerative Medicine in Bangalore, India. "A synthetic analog overcomes the stability limitation that a microbial metabolite poses, thus enhancing the efficacy."
"The general belief thus far in the field is that urolithins have a beneficial effect only through their anti-inflammatory property,” Dr. Singh remarked. “We have for the first time discovered that their major mode of function is repairing the gut barrier dysfunction."
Trial reveals benefit for quercetin, dasatinib in pulmonary fibrosis
January 09 2019. Results of a pilot study reported on January 4, 2019 in the journal EBioMedicine indicate benefits for the senolytic compounds quercetin and dasatinib in patients with idiopathic pulmonary fibrosis (IPF), a progressive disease that causes scarring of the lungs. Senolytics are compounds that target senescent, damaged cells, which resist destruction and damage the cells that surround them.
Acting on positive results for treatment with the quercetin/dasatinib combination in a mouse model of IPF, researchers at the University of Texas Health San Antonio, in collaboration with Wake Forest School of Medicine and the Mayo Clinic evaluated the effects of the compounds in 14 older men and women diagnosed with mild to moderate disease. Participants received the senolytics for three consecutive days weekly for three weeks. Blood chemistry, assays of senescence-associated proteins secreted by senescent cells, symptoms, and markers of physical function were assessed before and after treatment.
At the end of the trial, the majority of participants showed mild improvement in physical function. "No drug therapies, including the available antifibrotic drugs, have ever shown to stabilize, let alone improve, an IPF patient's six-minute walk distance," commented coauthor Anoop M. Nambiar, MD. "But in this pilot study of dasatinib/quercetin, participants' six-minute walk distance improved an average of 21.5 meters.”
"Though small, this pilot study marks a major breakthrough in how we treat age-related diseases such as IPF," noted co-lead investigator Jamie Justice, PhD. "Here, we've therapeutically targeted a fundamental biological hallmark of aging that is implicated in IPF, and we show early but promising results for the first time in human patients."
"Our first-in-humans open-label pilot supports study feasibility and provides initial evidence that senolytics may alleviate physical dysfunction in IPF, warranting evaluation of dasatinib/quercetin in larger randomized controlled trials for senescence-related diseases,” the authors conclude.
Higher beta-carotene levels linked to lower mortality risk during three decades of follow-up
January 07 2019. The December 7, 2018 issue of Circulation Research published the finding of the National Cancer Institute of an association between higher serum levels of beta-carotene (a precursor of vitamin A) and a lower risk of dying during 31 years of follow-up.
The analysis included 29,103 men who participated in the Alpha-Tocopherol, Beta-Carotene Prevention Trial, which examined the association between vitamin E and beta-carotene supplementation and cancer risk. Serum beta-carotene, alpha-tocopherol and vitamin A levels were measured in stored blood samples collected before the trial’s commencement, which occurred during 1985 to 1988. Participants were followed until the end of 2015, during which 23,796 deaths occurred due to cardiovascular disease, cancer, respiratory disease, diabetes, injuries, accidents and other causes.
A declining risk of death from any cause during follow-up was associated with rising serum beta-carotene levels. Men whose beta-carotene levels were among the highest 20% of subjects had a 36% reduction in the risk of dying from any cause compared to those whose levels placed them among the lowest 20%. The strongest protective association was observed for diabetes mortality. Men whose beta-carotene levels were among the highest had a 79% lower risk of dying from diabetes compared to those whose levels were among the lowest.
“Despite substantial attention focused on the human health effects of beta-carotene, a systematic examination of the association between serum concentrations and long-term mortality has not been reported,” authors Jiaqi Huang and colleagues write. “To the best of our knowledge, this is the largest investigation of beta-carotene biochemical status and mortality.”
“We found significant inverse associations between serum beta carotene concentrations and all-cause and cause-specific mortality,” they conclude. “Whether low-dose beta carotene supplementation could be similarly associated with lower mortality would require evidence from controlled trials.
Probiotic supplementation associated with protection against surgery-related complications
January 04 2019. Results of a review and meta-analysis published on December 16, 2018 in the Journal of Clinical Medicine add evidence to a protective effect for probiotic and synbiotic (probiotic plus fiber prebiotic) supplementation against surgical site infections and other surgery-related complications. According to authors Karolina Skonieczna-Zydecka and colleagues, surgical site infections result in prolonged hospitalizations, unscheduled readmissions, extended antibiotic treatment, increased mortality risk, and high cost to healthcare systems.
“There is increasing evidence that human intestinal microbiota play an important role in the pathogenesis of surgical site infections,” the authors write. “Although historically, gut flora has been considered as a pathogen in human infections, recent studies show that alteration of the human microbiome (dysbiosis) may play a role in the pathogenesis of surgical site infections and other surgery-related complications.”
Dr. Skonieczna-Zydecka and her associates selected 35 trials for their analysis. They found that supplementation with probiotics was associated with significant reductions in C-reactive protein (CRP) and interleukin-6 (IL-6), which are markers of inflammation, compared to levels measured in unsupplemented patients. Supplemented patients also had higher levels of the short chain fatty acids acetic, butyric, and propionic acids. Probiotic and synbiotic supplementation were associated with a significant reduction in surgery-related complications, including abdominal distention, diarrhea, pneumonia, sepsis, surgery site infection, and urinary tract infection, as well as duration of antibiotic therapy, postoperative fever, and hospital stay.
“To the best of our knowledge this meta-analysis of 35 trials and 3028 patients is the first one to exclusively investigate the effect and possible mechanism of action of pro-/synbiotics to lower the risk of surgical site infections and surgery-related complications,” the authors announce. “The evidence presented in this systematic review strongly supports that dietary supplementation with probiotics in patients undergoing major abdominal surgeries has a beneficial effect.”
Magnesium supplementation improves glycemic response in diabetics
January 02 2019. The outcome of a trial reported on December 26, 2018 in Nutrients revealed improvements in glycemic response in association with supplementation with magnesium among patients with diabetes.
The trial included 42 type 2 diabetics between the ages of 35 to 60 years of age who received 250 milligrams per day elemental magnesium or no supplementation for three months. The composition of the two groups did not significantly differ in regard to age, gender, fasting blood glucose and magnesium levels. Blood samples collected before and after the treatment period were analyzed for fasting blood glucose, fasting insulin, fasting C-peptide (which evaluates insulin made by the body), hemoglobin A1c, and serum calcium and magnesium levels. Participants were instructed to consume a healthy diet that was high in fruit, vegetables, legumes, nuts and whole grains throughout the course of the study.
At the end of the trial, serum calcium levels were lower and magnesium levels were higher among participants who were given magnesium compared to the untreated control group, which resulted in a reduction of the calcium to magnesium ratio. Insulin, hemoglobin A1c, C-peptide and insulin resistance decreased significantly in the group that supplemented with magnesium in comparison with the controls. While fasting blood glucose increased by an average of 10.1 milligrams per deciliter (mg/dL) in the control group, it declined by an average of 10.55 mg/dL in magnesium-supplemented subjects.
“The results of this study revealed that oral magnesium supplementation reduces insulin resistance and improves the glycemic control indicators among type 2 diabetic patients,” authors Wafaa A. ELDerawi and colleagues conclude.
They note that “The differences in the results of the previous clinical trials, which investigated the effectiveness of magnesium supplements on glycemic control indicators, could be explained by the differences in the magnesium dosages and the duration of supplementation.”