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El-Baz AM, El-Ganiny AM, Hellal D, Anwer HM, El-Aziz HAA, Tharwat IE, El-Adawy MA, Helal SEDM, Mohamed MTA, Azb TM, Elshafaey HM, Shalata AA, Elmeligi SM, Abdelbary NH, El-Kott AF, Al-Saeed FA, Salem ET, El-Sokkary MMA, Shata A, Shabaan AA. Valuable effects of lactobacillus and citicoline on steatohepatitis: role of Nrf2/HO-1 and gut microbiota. AMB Express 2023; 13:57. [PMID: 37291355 DOI: 10.1186/s13568-023-01561-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/16/2023] [Indexed: 06/10/2023] Open
Abstract
Non-alcoholic steatohepatitis (NASH) is a more dangerous form of chronic non-alcoholic fatty liver disease (NAFLD). In the current investigation, the influence of citicoline on high-fat diet (HFD)-induced NASH was examined, both alone and in combination with Lactobacillus (probiotic). NASH was induced by feeding HFD (10% sugar, 10% lard stearin, 2% cholesterol, and 0.5% cholic acid) to rats for 13 weeks and received single i.p. injection of streptozotocin (STZ, 30 mg/kg) after 4 weeks. Citicoline was given at two dose levels (250 mg and 500 mg, i.p.) at the beginning of the sixth week, and in combination with an oral suspension of Lactobacillus every day for eight weeks until the study's conclusion. HFD/STZ induced steatohepatitis as shown by histopathological changes, elevated serum liver enzymes, serum hyperlipidemia and hepatic fat accumulation. Moreover, HFD convinced oxidative stress by increased lipid peroxidation marker (MDA) and decreased antioxidant enzymes (GSH and TAC). Upregulation of TLR4/NF-kB and the downstream inflammatory cascade (TNF-α, and IL-6) as well as Pentaraxin, fetuin-B and apoptotic markers (caspase-3 and Bax) were observed. NASH rats also had massive increase in Bacteroides spp., Fusobacterium spp., E. coli, Clostridium spp., Providencia spp., Prevotella interrmedia, and P. gingivalis while remarkable drop in Bifidobacteria spp. and Lactobacillus spp. Co-treatment with citicoline alone and with Lactobacillus improve histopathological NASH outcomes and reversed all of these molecular pathological alterations linked to NASH via upregulating the expression of Nrf2/HO-1 and downregulating TLR4/NF-kB signaling pathways. These results suggest that citicoline and lactobacillus may represent new hepatoprotective strategies against NASH progression.
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Affiliation(s)
- Ahmed M El-Baz
- Department of Microbiology and Biotechnology, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt.
- Department of Microbiology and Biotechnology, Faculty of Pharmacy, Delta University for Science and Technology, International Coastal Road, Gamasa City, Mansoura, Dakahlia, P.O. Box +11152, Egypt.
| | - Amira M El-Ganiny
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, 44519, Zagazig, Egypt
| | - Doaa Hellal
- Department of Clinical Pharmacology, Faculty of Medicine, Mansoura University, 35516, Mansoura, Egypt
| | - Hala M Anwer
- Department of Physiology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Hend A Abd El-Aziz
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Ibrahim E Tharwat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Mohamed A El-Adawy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Shehab El-Din M Helal
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Menna Tallah A Mohamed
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Tassnim M Azb
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Hanya M Elshafaey
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - AbdulRahman A Shalata
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Sahar M Elmeligi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Noran H Abdelbary
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Attalla F El-Kott
- Department of Biology, College of Science, King Khalid University, 61421, Abha, Saudi Arabia
- Department of Zoology, College of Science, Damanhour University, 22511, Damanhour, Egypt
| | - Fatimah A Al-Saeed
- Department of Biology, College of Science, King Khalid University, 61421, Abha, Saudi Arabia
| | - Eman T Salem
- Department of Basic Science, Faculty of Physical Therapy, Horus University-Egypt, 34518, Horus, New Damietta, Egypt
| | | | - Ahmed Shata
- Department of Clinical Pharmacology, Faculty of Medicine, Mansoura University, 35516, Mansoura, Egypt
- Department of Clinical Pharmacy, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
| | - Ahmed A Shabaan
- Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, 11152, Gamasa, Egypt
- Department of Pharmacology and Toxicology, Faculty of pharmacy, Mansoura University, 35516, Mansoura, Egypt
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Secades JJ, Gareri P. Citicoline: pharmacological and clinical review, 2022 update. Rev Neurol 2022; 75:S1-S89. [PMID: 36544369 PMCID: PMC10548481 DOI: 10.33588/rn.75s05.2022311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Indexed: 12/24/2022]
Abstract
This review is based on the previous one published in 2016 (Secades JJ. Citicoline: pharmacological and clinical review, 2016 update. Rev Neurol 2016; 63 (Supl 3): S1-S73), incorporating 176 new references, having all the information available in the same document to facilitate the access to the information in one document. This review is focused on the main indications of the drug, as acute stroke and its sequelae, including the cognitive impairment, and traumatic brain injury and its sequelae. There are retrieved the most important experimental and clinical data in both indications.
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Affiliation(s)
- Julio J. Secades
- Medical Department. Grupo Ferrer, S.A.
Barcelona, SpainMedical DepartmentGrupo Ferrer, S.A.BarcelonaSpain
| | - Pietro Gareri
- Center for Cognitive Disorders and Dementia -
Catanzaro Lido. ASP Catanzaro. Catanzaro, ItalyCenter for Cognitive Disorders and Dementia -
Catanzaro LidoCenter for Cognitive Disorders and Dementia -
Catanzaro LidoCatanzaroItaly
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Mah E, Chen O, Liska DJ, Blumberg JB. Dietary Supplements for Weight Management: A Narrative Review of Safety and Metabolic Health Benefits. Nutrients 2022; 14:nu14091787. [PMID: 35565754 PMCID: PMC9099655 DOI: 10.3390/nu14091787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 12/15/2022] Open
Abstract
Dietary supplements for weight management include myriad ingredients with thermogenic, lipotropic, satiety, and other metabolic effects. Recently, the safety of this product category has been questioned. In this review, we summarize the safety evidence as well as relevant clinical findings on weight management and metabolic effects of six representative dietary supplement ingredients: caffeine, green tea extract (GTE), green coffee bean extract (GCBE), choline, glucomannan, and capsaicinoids and capsinoids. Of these, caffeine, GTE (specifically epigallocatechin gallate [EGCG]), and choline have recommended intake limits, which appear not to be exceeded when used according to manufacturers’ instructions. Serious adverse events from supplements with these ingredients are rare and typically involve unusually high intakes. As with any dietary component, the potential for gastrointestinal intolerance, as well as possible interactions with concomitant medications/supplements exist, and the health status of the consumer should be considered when consuming these components. Most of the ingredients reviewed also improved markers of metabolic health, such as glucose, lipids, and blood pressure, although the data are limited for some. In summary, weight management supplements containing caffeine, GTE, GCBE, choline, glucomannan, and capsaicinoids and capsinoids are generally safe when taken as directed and demonstrate metabolic health benefits for overweight and obese people.
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Affiliation(s)
- Eunice Mah
- Biofortis Research, Addison, IL 60101, USA
- Correspondence:
| | - Oliver Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (O.C.); (J.B.B.)
| | | | - Jeffrey B. Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (O.C.); (J.B.B.)
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van Lee L, Crozier SR, Aris IM, Tint MT, Sadananthan SA, Michael N, Quah PL, Robinson SM, Inskip HM, Harvey NC, Barker M, Cooper C, Velan SS, Lee YS, Fortier MV, Yap F, Gluckman PD, Tan KH, Shek LP, Chong YS, Godfrey KM, Chong MFF. Prospective associations of maternal choline status with offspring body composition in the first 5 years of life in two large mother-offspring cohorts: the Southampton Women's Survey cohort and the Growing Up in Singapore Towards healthy Outcomes cohort. Int J Epidemiol 2019; 48:433-444. [PMID: 30649331 PMCID: PMC6751083 DOI: 10.1093/ije/dyy291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Choline status has been positively associated with weight and fat mass in animal and human studies. As evidence examining maternal circulating choline concentrations and offspring body composition in human infants/children is lacking, we investigated this in two cohorts. METHODS Maternal choline concentrations were measured in the UK Southampton Women's Survey (SWS; serum, n = 985, 11 weeks' gestation) and Singapore Growing Up Towards healthy Outcomes (GUSTO); n = 955, 26-28 weeks' gestation) mother-offspring cohorts. Offspring anthropometry was measured at birth and up to age 5 years. Body fat mass was determined using dual-energy x-ray absorptiometry at birth and age 4 years for SWS; and using air-displacement plethysmography at birth and age 5 years for GUSTO. Linear-regression analyses were performed, adjusting for confounders. RESULTS In SWS, higher maternal choline concentrations were associated with higher neonatal total body fat mass {β = 0.60 standard deviation [SD]/5 µmol/L maternal choline [95% confidence interval (CI) 0.04-1.16]} and higher subscapular skinfold thickness [β = 0.55 mm/5 µmol/L (95% CI, 0.12-1.00)] at birth. In GUSTO, higher maternal choline concentrations were associated with higher neonatal body mass index-for-age z-score [β = 0.31 SD/5 µmol/L (0.10-0.51)] and higher triceps [β = 0.38 mm/5 µmol/L (95% CI, 0.11-0.65)] and subscapular skinfold thicknesses [β = 0.26 mm/5 µmol/L (95% CI, 0.01-0.50)] at birth. No consistent trends were observed between maternal choline and offspring gain in body mass index, skinfold thicknesses, abdominal circumference, weight, length/height and adiposity measures in later infancy and early childhood. CONCLUSION Our study provides evidence that maternal circulating choline concentrations during pregnancy are positively associated with offspring BMI, skinfold thicknesses and adiposity at birth, but not with growth and adiposity through infancy and early childhood to the age of 5 years.
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Affiliation(s)
- Linde van Lee
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
| | - Izzuddin M Aris
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mya T Tint
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Phaik Ling Quah
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Sian M Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Mary Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Sendhil S Velan
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Laboratory of Molecular Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Marielle V Fortier
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore, Nanyang Technological University, Singapore, Singapore
- Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Liggings Institute, University of Auckland, New Zealand
| | - Kok Hian Tan
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Lynette P Shek
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Mary FF Chong
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Clinical Nutrition Research Centre, Agency for Science, Technology, and Research, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Wignall ND, Brown ES. Citicoline in addictive disorders: a review of the literature. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 40:262-8. [PMID: 24950234 PMCID: PMC4139283 DOI: 10.3109/00952990.2014.925467] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 05/07/2014] [Accepted: 05/12/2014] [Indexed: 11/13/2022]
Abstract
BACKGROUND Citicoline is a dietary supplement that has been used as a neuroprotective agent for neurological disorders such as stroke and dementia. Citicoline influences acetylcholine, dopamine, and glutamate neurotransmitter systems; serves as an intermediate in phospholipid metabolism; and enhances the integrity of neuronal membranes. Interest has grown in citicoline as a treatment for addiction since it may have beneficial effects on craving, withdrawal symptoms, and cognitive functioning, as well as the ability to attenuate the neurotoxic effects of drugs of abuse. OBJECTIVES To review the literature on citicoline's use in addictive disorders. METHODS Using PubMed we conducted a narrative review of the clinical literature on citicoline related to addictive disorders from the years 1900-2013 using the following keywords: citicoline, CDP-choline, addiction, cocaine, alcohol, substance abuse, and substance dependence. Out of approximately 900 first hits, nine clinical studies have been included in this review. RESULTS Most addiction research investigated citicoline for cocaine use. The findings suggest that it is safe and well tolerated. Furthermore, citicoline appears to decrease craving and is associated with a reduction in cocaine use, at least at high doses in patients with both bipolar disorder and cocaine dependence. Limited data suggest citicoline may also hold promise for alcohol and cannabis dependence and in reducing food consumption. CONCLUSIONS Currently, there is limited research on the efficacy of citicoline for addictive disorders, but the available literature suggests promising results. Future research should employ larger sample sizes, increased dosing, and more complex study designs.
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Affiliation(s)
- Nicholas D. Wignall
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX
| | - E. Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX
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