Beer affects oxidative stress due to ethanol in rats

The relationship between chronic moderate beer consumption and oxidative stress was studied in rats. Animals were fed three different isocaloric diets for six weeks: a beer-containing diet (30% w/w), an ethanol-supplemented diet (1.1 g/100 g, the same as in the beer diet) and an alcohol-free basal diet. At the end of the feeding period, rats were analyzed for plasma and liver oxidative status. Some livers were isolated and exposed to ischemia-reperfusion to assess the additional oxidative stress determined by reperfusion. No significant differences in plasma antioxidant status were found among the three dietary groups. Lipoproteins from the beer group, however, showed a greater propensity to resist lipid peroxidation. Ischemia caused a decrease in liver energy and antioxidant status in all groups. Nevertheless, ATP was lower in the livers of rats exposed to the ethanol diet. During reperfusion, lipoperoxidation increased significantly in all groups. However, livers obtained from ethanol-treated rats showed the higher formation of lipoperoxides. In conclusion, a moderate consumption of beer in a well-balanced diet did not appear to cause oxidative stress in rats; moreover, probably through its minor components, beer could attenuate the oxidative action of ethanol by itself.

Metabolic features of inflammatory bowel disease in a remission phase of the disease activity

OBJECTIVES

To evaluate the anthropometric and metabolic characteristics of patients with Crohn's disease (CD) and ulcerative colitis (UC), comparing both groups with healthy volunteers.

DESIGN

A cross-sectional study.

SETTING

The Department of Internal Medicine, Catholic University Hospital, Rome, Italy.

SUBJECTS

Thirty-four patients with biopsy-proven inflammatory bowel disease (18 CD; 16 UC) in clinical remission (SCDAI < 3 and Powell-Tuck index < 4) not receiving steroid therapy.

INTERVENTIONS

All patients had a clinical examination.

MAIN OUTCOME MEASURES

Blood indicators of inflammation and nutritional status. Body composition was assessed by both anthropometry and bioimpedance and metabolic variables were measured by indirect calorimetry over a 60-90 min period.

RESULTS

CD had a lower body weight than both controls (58.1 kg, range 41.5-71.0 vs. 66.4 kg, range 57.0-76.0; P < 0.001) and UC) 58.1 kg, range 41.5-71.0 vs. 69.6 kg, range 50.5-94.0; (P < 0.001). Fat-free mass (FFM) did not differ between the groups, whilst fat mass was significantly lower in CD than in UC (P < 0.05) and controls (P < 0.001). Normalizing the basal metabolic rate by FFM, a higher value was found in CD compared with UC (143 kJ kg-1) d-(-1), range 97.5-179 vs. 133 kJ kg-1 d-1, range 123-148; P < 0.05) and control subject 143 kj kg-1 d-1, range 97.5-179 vs. 134 kj kg-1 d-1, range 122-162; P < 0.05). The nonprotein respiratory quotient was significantly lower in CD compared to UC 0.80, range 0.73-0.84 vs. 0.84, range 0.79-0.91; P < 0.01) and controls (0.80, range 0.73-0.84 vs. 0.83, range 0.81-0.87; P < 0.001), with a consequently higher lipid oxidation rate in CD.

CONCLUSIONS

CD subjects showed a decreased fat mass and enhanced utilization of lipids compared with UC and controls. These data could be explained by the larger intestinal involvement and considered as a contribution to lipid tissue wasting in CD.

Differences in metabolic variables between adult coeliac patients at diagnosis and patients on a gluten-free diet

BACKGROUND

Coeliac patients often have nutrient malabsorption with nutritional status impairment, but no report on their energy requirements is available. In this study body composition, dietary habits, basal energy expenditure, and substrate oxidation were investigated in patients with the classic form of coeliac disease.

METHODS

Sixteen untreated and 18 adult coeliac patients on a gluten-free diet participated in the study. Body composition was assessed by anthropometry and bioimpedance. Energy expenditure was measured by indirect calorimetry. A food diary over 7 days was collected.

RESULTS

Coeliac patients showed reduced body weight components but not a different fat-free mass percentage compared with age- and sex-matched healthy volunteers. Basal metabolic rate normalized by fat-free mass (BMR/FFM) was higher in coeliac patients than in controls. Untreated patients showed a significantly higher non-protein respiratory quotient with regard to both treated patients (P < 0.01) and controls (P < 0.05), an increased percentage of carbohydrate intake, and a good correlation between lipid faecal loss and carbohydrate oxidation (Spearman R = 0.74; P < 0.01).

CONCLUSIONS

Both groups of patients had lower fat mass and FFM content than controls. The preferential carbohydrate oxidation in untreated patients might be a result of both lipid malabsorption and high carbohydrate intake.

Prenatal exposure to ethanol in rats: effects on liver energy level and antioxidant status in mothers, fetuses, and newborns

The fetal alcohol syndrome is a clinical condition that affects newborns from alcoholic mothers. It is not clear, however, whether ethanol consumption during gestation can affect liver functions of fetuses and newborns. In this study, we aimed to assess the effects of ethanol administration on body weight, liver energy level, and antioxidant status of mothers, fetuses, and newborns. Pregnant rats were exposed to ethanol during the third week of gestation. Body weight, survival, and liver concentration of gluthatione (GSH) and adenosintriphosphate (ATP) were measured. No differences were observed in body weight or in liver ATP and GSH between mothers exposed to ethanol and control animals. Conversely, fetuses from rats exposed to ethanol showed a marked decrease in GSH, ATP, and body weight when compared to those from control rats. Newborns exposed prenatally to ethanol were no different from those born to control mothers. This study suggests that an amount of ethanol that is not sufficient to determine a significant effect on mothers can, nevertheless, cause a marked decrease in growth and in liver antioxidant and energy status in fetuses. These parameters, however, return to control value one week after ethanol discontinuation.

Schizophrenic symptoms and SPECT abnormalities in a coeliac patient: regression after a gluten-free diet

A 33-year-old patient, with pre-existing diagnosis of 'schizophrenic' disorder, came to our observation for severe diarrhoea and weight loss. Use of single photon emission computed tomography, (99mTc)HMPAO SPECT, demonstrated hypoperfusion of the left frontal brain area, without evidence of structural cerebral abnormalities. Jejunal biopsy showed villous atrophy. Antiendomysial antibodies were present. A gluten-free diet was started, resulting in a disappearence of psychiatric symptoms, and normalization of histological duodenal findings and of (99mTc)HMPAO SPECT pattern. This is the first case in which, in an undiagnosed and untreated coeliac patient with psychiatric manifestations, the (99mTc)HMPAO SPECT demonstrated a dysfunction of frontal cortex disappearing after a gluten-free diet.

Inflammatory bowel disease: a study of the association between anxiety and depression, physical morbidity, and nutritional status

BACKGROUND

The etiology of inflammatory bowel disease is unclear, and the role played by anxiety and depression is highly controversial. Anxiety and depression in patients with inflammatory bowel disease could be secondary to disabling symptoms, but the interaction between physical morbidity and psychologic illness in these subjects has not been sufficiently investigated. Patients with inflammatory bowel disease are nevertheless frequently undernourished, but there are no studies on the association between anxiety and depression and malnutrition. This study was designed to characterize anxiety and depression in subjects affected by inflammatory bowel disease and to establish the influence of physical morbidity and/or nutritional status on psychologic disorders.

METHODS

Seventy-nine consecutive patients, 43 with Crohn's disease (CD) and 36 with ulcerative colitis (UC), were enrolled in the study. An index of the disease activity and physical morbidity was obtained by the simplified Crohn's Disease Activity Index and Truelove-Witts criteria and using the Clinical Rating Scale. Thirty-six healthy volunteers were studied as controls. All the subjects were given the State and Trait Anxiety Inventory (STAI) test and the Zung self-rating Depression Scale.

RESULTS

The percentage of subjects with state anxiety was significantly higher in the CD (P < 0.001) and UC (P < 0.001) groups than in control subjects. There was no significant difference in trait anxiety among groups. The percentage of subjects with depression was significantly higher in the CD (P < 0.05) and UC (P < 0.05) groups than in control subjects. State anxiety and depression were significantly associated with physical morbidity and correlated with malnutrition in CD and UC patients.

CONCLUSION

Anxiety and depression in patients with inflammatory bowel disease could be reactive to the disabling symptoms and to malnutrition. As measured with the STAI, personality trait of anxiety does not seem to play an important role in inflammatory bowel disease.

Energy expenditure, substrate oxidation, and body composition in subjects with chronic alcoholism: new findings from metabolic assessment

There is some controversy as to the effect of ethanol on body weight and alcohol energy contribution to body mass. The aim of this study was to evaluate the effect of alcohol addiction on resting energy expenditure (REE) and body composition. Twelve patients with current alcoholism (A) without severe liver disease or lipid and carbohydrate malabsorption were compared with a group of healthy social drinkers (B) matched for sex, age, and height. Their caloric intake was computed on the basis of a food diary. REE was measured with indirect calorimetry, and body composition was assessed by both anthropometry and bioimpedance. A significant decrease in fat mass in A compared with B was found (14.8 +/- 5.39 vs. 19.0 +/- 3.50 kg; p < 0.05). No significant differences were observed in fat-free mass (FFM) or in total body water between the two groups. A showed higher REE values normalized by FFM than B (35.5 +/- 2.97 vs. 33.0 +/- 2.95 kcal/kgFFM; p < 0.05). The nonprotein respiratory quotient was significantly lower in A than in B (0.76 +/- 0.03 vs. 0.86 +/- 0.03; p < 0.001), and A showed significantly higher lipid oxidation and lower carbohydrate oxidation than B (p < 0.05). The daily caloric intake provided only by food ingestion was found to be significantly higher in controls, but because the percentage of alcohol calories of total energy intake was 46.3 +/- 6.80 in alcoholics and 13.6 +/- 3.59 in controls (p < 0.0001), the total caloric intake, computed as food intake plus alcohol intake, was higher in alcoholics than in control subjects. No statistical differences were found in urinary nitrogen excretion and fecal loss between groups. Patients with alcoholism showed an increased REE over predicted values and a preferential lipid oxidation with respect to controls; these findings could be related to induction of microsomal ethanol oxidizing system and to mitochondrial function adaptation secondary to chronic alcohol abuse. In either case, the effects of such changes in energy metabolism may contribute to alcohol associated hepatic injury.

Influence of alcohol on gastrointestinal motility: lactulose breath hydrogen testing in orocecal transit time in chronic alcoholics, social drinkers and teetotaler subjects

BACKGROUND/AIMS

The gastrointestinal tract is directly affected by the ingestion of alcohol. While the effect of acute ingestion of alcohol on the motility of the small intestine is well known, the influence of chronic intake of moderate amounts of alcohol and chronic alcoholism on gastrointestinal motility remains poorly understood. The aim of this study was to examine the orocecal transit (OCt) times in patients with chronic alcoholism and in "social drinkers" and compare them with a group of healthy teetotaler subjects, to assess the effects of chronic aleohol consumption on gastrointestinal transit through the application of a non-invasive technique: the hydrogen breath test.

METHODOLOGY

Thirty-one alcoholics were enrolled in the study. The control groups consisted of 31 healthy social drinkers and 24 healthy teetotaler subjects. OCt time was assessed using the hydrogen breath test after the administration of 10 g of lactulose.

RESULTS

The OCt time in patients with alcoholism was significantly delayed as compared with the social drinkers (p < 0.001) and healthy teetotaler subjects (p < 0.001); the OCt time in social drinkers was significantly longer than in healthy teetotaler subjects (p < 0.05). In the alcoholic group, there was no significant correlation between the OCt time and daily alcohol intake or years of alcohol addiction.

CONCLUSION

Our results show a significant prolongation of the OCt time, both in patients with alcoholism and in social drinkers, as compared to teetotaler subjects. Our findings of an increased OCt time related to the consumption of alcohol could support the hypothesis of the toxic effect of ethanol on smooth muscle contractile proteins of the small intestine and on vagal function.

Splenic function and alcohol addiction

Severe hyposplenism has been recently documented in alcoholic liver disease, and it has been suggested that alcohol itself is important in the derangement of splenic function, despite a lack of evidence of a direct toxic effect of alcohol on the spleen. The aim of the present study was to assess splenic function in alcoholic patients without severe liver disease and to correlate these data with the degree and duration of alcohol intake. Fifty-two alcoholics, 31 subjects with current alcohol abuse (group A)-13 abstinent from alcohol for 1 to 6 months (group B) and B abstinent from alcohol for 6 months to several years (group C)- and 26 healthy social drinkers were studied. Splenic function was assessed by counting the percentage of pitted red cells. An in vitro experiment was performed to verify whether the presence of pitted red cells could be due to an effect of alcohol on red cell morphology. The percentage of pitted red cells in subjects from group A was significantly higher than in subjects from group B (p < 0.01), from group C (p < 0.005), and from controls (p < 0.001). There was no significant difference between group B, group C, and controls. Ten subjects from group A and 1 from group B and no subject from group C had evidence of splenic hypofunction. There was no significant correlation between the percentage of pitted red cells and daily alcohol intake or years of alcohol addiction. In conclusion, our study shows that, in patients with alcoholism but without any severe liver damage, a significant but slight increase in pitted red cells is present. Further studies are needed to clarify whether this is due to a mild form of splenic hypofunction or merely indicates erythrocyte membrane alterations.

Anxiety and depression in adult untreated celiac subjects and in patients affected by inflammatory bowel disease: a personality "trait" or a reactive illness?

BACKGROUND/AIMS

Psychiatric illness and psychological behavioral pathologies may be present in celiac disease and in IBD patients. In these subjects anxiety and depression could be a main cause in the reduction of the compliance to the treatment. Aim of our study was to carry out a psychometric evaluation using appropriate means to determine the level of anxiety and depression and to distinguish between "state" and "trait" forms. The correction of such disturbances would improve the quality of life and the patients' compliance to treatment.

MATERIAL AND METHODS

Sixteen adult celiac patients, 16 subjects affected by IBD and 16 healthy control subjects matched for sex, residence and marital status were studied by psychological assessment. All the subjects were given the State and Trait Anxiety Inventory and the Ipat Depression Scale Questionnaire.

RESULTS

State anxiety was present in a higher percentage of celiac subjects and in the patients affected by IBD with respect to the healthy controls. Anxiety as a trait was present in a similar percentage in all the subjects evaluated. Depressive syndrome was present in a percentage of celiac patients statistically superior versus the healthy control group (p < 0.01).

CONCLUSION

Our results shown that anxiety is present as a "reactive" form and personality trait anxiety has no effect in celiac and IBD patients. As regard depression, our data confirm a possible linkage between brain functions and malabsorption.

An open multicentric study evaluating 4-hydroxybutyric acid sodium salt in the medium-term treatment of 179 alcohol dependent subjects. GHB Study Group

We report the results of an "open' multicentre study evaluating the use, tolerability and therapeutic efficacy of the sodium salt of 4-hydroxybutyric acid (GHB) for the medium-term treatment of withdrawal symptoms in 179 patients with alcohol dependence followed up as outpatients. The follow-up of patients was 6 and 12 months after drug discontinuation. Following a daily oral administration of 50 mg/kg for approximately 6 months, no serious systemic or single-organ consequences leading to drug discontinuation were reported, and tolerability was fair in all patients. Eleven subjects (10.1%) showed craving for the drug and voluntarily increased their doses (6-7 times the recommended levels). GHB led to complete abstinence during drug administration in 78.0% of the patients. A significant reduction of compulsive desire ("craving') was observed in parallel, as deduced from evaluation of a specific questionnaire, the Alcohol Craving Scale. At follow-up examination, 43 of the treated subjects remained abstinent at 6 months, and 30 subjects were abstinent for 1 year after drug discontinuation.

Normalization of immune response and phosphoinositide fatty acid composition of peripheral blood lymphocytes in an alcoholic patient after alcohol abstinence

After 10 months of alcohol abstinence a malnourished alcoholic patient improved his nutritional status. The analysis of peripheral blood lymphocyte response to mitogenic stimulation with the antibody anti-CD3 and of the fatty acid composition of the (poly)-phosphoinositide fraction derived from lymphocytes revealed: 1) a similar [3H]-thymidine uptake as in control (non-drinker) subjects; 2) a similar relative molar content of the main fatty acids in the (poly)-phosphoinositides as in control subjects. Alcohol abstinence can normalize both the parameters, which are greatly altered during alcohol abuse. This suggests a link between nutritional status and lymphocyte responsiveness via phosphoinositide fatty acid composition.

Clinical assessment of the relationship of Helicobacter pylori to gastroduodenal pathologies. A prospective analysis of 253 consecutive patients

The aim of our study was to evaluate the relationship between Helicobacter pylori infection and various gastroduodenal diseases. We also took into consideration alcohol intake and smoking. Two-hundred and fifty-three consecutive patients with ulcer-like symptoms underwent gastroscopic and histological examinations. H. pylori status was evaluated by means of culture, Giemsa stain and CP-test, upon obtaining bioptic samples of gastric mucosa. Two hundred eighteen patients were affected by gastritis, 171 of which were H. pylori positive (78.4%); of 164 patients with active gastritis, 158 were H. pylori positive (96.3%). In 63 patients with duodenal ulcer, H. pylori was present in 58 cases (92.1%). Of 14 patients with gastric ulcer, 11 were H. pylori positive (78.6%). Out of 133 patients with duodenitis associated with active ulcer or a history of previous ulcer, H. pylori was found in 112 patients (84.2%). Among the 27 patients with "autonomous" duodenitis, 18 were H. pylori positive (66.6%); the comparison between the two groups of patients with duodenitis concerning H. pylori infection was statistically significant (p = 0.033). Of the 119 patients tested for acquired MALT, 39 were found positive (32.7%); among these 34 patients were H. pylori positive (87.1%) and only 5 patients were H. pylori negative (12.9%). Thus our study confirms the importance of H. pylori in gastroduodenal pathology underlining its role in the development of acquired MALT (mucosa associated lymphoid tissue) for its possible evolution in low grade B cell primary gastric lymphoma. Alcohol intake and smoking do not appear to play a role in H. pylori infection.

A rare case of peritoneal mesothelioma in a male with ascites

Mesothelial lesions can present significant diagnostic problems. An accurate identification of the lesion is important in deciding what course of action to follow, as well as what the required treatment will be. We report the case of a man with untreatable ascites. Four years after the first symptom appeared, the patient suddenly began to lose weight. The CT scan showed a thickening of the peritoneal profile; a diffuse lesion of the mesothelium was then observed at laparotomy. Histological examination led to a diagnosis of malignant mesothelioma in a well-differentiated mesothelial lesion with diffuse involvement of the serosa of the small intestine and the lesser omentum.

Eosinophilic gastroenteritis in a patient with large-cell anaplastic lung carcinoma: a paraneoplastic syndrome?

A 39-year-old man was hospitalized with abdominal pain and diarrhoea. The total eosinophil count was 11,800/dL; the jejunal biopsy showed diffuse and patchy eosinophils and plasma cell infiltration of the lamina propria; symptoms and hypereosinophilia disappeared after steroid therapy. Two months later the symptoms reappeared together with left supraclavicular lymphnode enlargement. The chest X-ray showed a mass within the left lung apex. Lymph node biopsy showed metastases from large-cell anaplastic carcinoma. The possibility of eosinophilic gastroenteritis as a paraneoplastic manifestation is discussed.