Elevated serum MDA and depleted non-enzymatic antioxidants, macro-minerals and trace elements are associated with bipolar disorder

Imbalance of Plasma Copper and Zinc Levels and the Association Between the Cu/Zn Ratio and Lipid Peroxidation in Algerian Bipolar Patients

Trace elements, through their interaction with biomolecules, can play an important role in the pathophysiology of bipolar disorder and protect against oxidative stress effects. The purpose of this study is to examine plasma concentration levels of zinc (Zn) and copper (Cu) of Algerian patients, diagnosed with bipolar disorder, and to compare these levels with those of healthy controls. The Cu/Zn ratio was calculated to explore a possible correlation between these elements and lipid peroxidation in the study groups. A total of 33 patients diagnosed with bipolar disorder and 38 healthy subjects participated in this study. Plasma copper and zinc concentrations were measured using a polarographic analyzer. The marker of plasma lipid peroxidation (Malondialdehyde: MDA) was determined by UV spectrophotometry. Plasma Cu concentrations were higher in patients compared to controls (p < 0.05), while the Zn level was significantly lower. Consequently, the Cu/Zn ratio was significantly different between patients and controls. Regarding MDA, no significant difference was noticed between the two study groups. However, in patients, a negative correlation was found between MDA and Cu/Zn ratio (r= -0.38, p= 0.027). These results suggested that an elevated Cu/Zn ratio is associated with attenuated lipid peroxidation in our bipolar patients.

Sex differences in serum trace elements and minerals levels in unmedicated patients with major depressive episode: The role of suicidal ideation

BACKGROUND

We aimed to examine the influence of gender on serum trace elements and minerals levels in depression, as well as the impact of suicidal ideation (SI) on these gender dimorphisms.

METHODS

A total of 260 unmedicated patients with a current major depressive episode were enrolled. The Beck Scale for Suicide Ideation was utilized to evaluate SI. The serum levels of copper, zinc, iron, calcium, phosphorus, and magnesium were quantified.

RESULTS

Within the non-SI (NSI) group, females exhibited higher levels of copper (p = 0.001) and phosphorus (p = 0.008), and lower levels of zinc (p = 0.022) and calcium (p = 0.008) compared to males. Conversely, no discernible gender disparities were observed in the SI group (all p > 0.05). Also, no group differences in these trace elements/minerals were observed between the SI and NSI groups (all p > 0.05). Notably, serum iron levels exhibited a significant group-by-sex interaction effect (p = 0.024). Further analysis revealed that iron levels were higher in the SI group than in the NSI group among females (p = 0.048), but lower in females than in males within the NSI group (p < 0.001). Moreover, a positive association between the fourth quantile of serum iron and SI was detected in females (odds ratio [OR] = 2.88, 95 % confidence interval [CI]: 1.08-8.11).

CONCLUSIONS

Gender effects on serum trace element/mineral levels were different in depressed patients with and without SI. Female patients were susceptible to SI when serum iron was at the upper end of normal.

Investigation of mechanisms of action involved in the antidepressant-like effect of Trans,trans-farnesol in mice

This study aimed to investigate, through in vivo and biochemical methodologies, the effect of trans,trans-farnesol (12.5, 25, 50 or 100 mg/kg, p.o.) acute administration, adopting different behavioral and neurochemical parameters associated with an acute induced-depression model in mice. The initial results showed that, the oral treatment with trans,trans-farnesol, at the dose of 100 mg/kg induced a possible antidepressant-like effect in animals subjected to forced swim test (FST) and reserpine-induced akinesia. In addition, it was observed that the compound in question has an effect size and properties similar to imipramine (prototype of tricyclic antidepressants), but devoid of proconvulsant adverse effect. In biochemical assays, the pretreatment with trans,trans-farnesol, at a dose of 100 mg/kg (p.o.), decreased the hippocampal concentration of thiobarbituric acid reactive substances (TBARS) and restored striatal levels of noradrenaline and serotonin in mice subjected to FST. Altogether, these results suggest that trans,trans-farnesol showed a significant antidepressant-like effect, which seems to be mediated by the antagonism of muscarinic cholinergic receptors, reduction of oxidative stress and the modulation of noradrenaline and serotonin content in the central nervous system.

Association between serum zinc levels and suicidal ideation in US adults: A population-based cross-sectional study

BACKGROUND

Evidence suggests that the homeostatic disruption of zinc, copper, and selenium might contribute to the pathophysiology of mental disorders. However, the specific relationship between the serum levels of these trace elements with suicidal ideation remains poorly understood. This study aimed to investigated the association among suicidal ideation on serum levels of zinc, copper, and selenium.

METHODS

The cross-sectional study was conducted using data from a nationally representative sample of the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Suicidal ideation was assessed using Item #9 of the Patient Health Questionnaire-9 Items. Multivariate regression models and restricted cubic splines were performed and E-value was calculated.

RESULTS

A total of 4561 participants aged 20 years and older were analyzed, of whom 4.08 % had suicidal ideation. The serum zinc levels were lower in the suicidal ideation group than in the non-suicidal ideation group (P = 0.021). In Crude Model, the serum zinc levels were associated with a higher suicidal ideation risk in the second quartile compared with the highest quartile [odds ratio (OR) = 2.63; 95 % confidence interval (CI): 1.53-4.53]. The association persisted (OR = 2.35; 95 % CI: 1.20-4.58) after full adjustment, with E-value 2.44. A nonlinear relationship was observed between serum zinc levels and suicidal ideation (P = 0.028). No relationship was observed between suicidal ideation and serum copper or selenium levels (all P > 0.05).

CONCLUSIONS

Decreased serum zinc levels may increase susceptibility to suicidal ideation. Future studies are needed to validate the findings of this study.

Mendelian randomization investigation highlights different roles of selenium status in mental disorders

Observational studies have suggested a relationship between selenium status and mental disorders (MDs). However, it remains unclear whether selenium status was causally associated with MDs. Thus, we performed a two-sample Mendelian randomization analysis using genome-wide association studies (GWAS) summary statistics to investigate the causal effects of selenium levels on seven MDs, including schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), bipolar disorder (BD), anorexia nervosa (AN), attention-deficit/hyperactivity disorder (ADHD), and panic disorder (PD). Strong genetic instruments of blood selenium (n = 9) and blood-toenail selenium (n = 12) were applied to the above seven MDs GWAS datasets from Psychiatric Genomics Consortium, which were further replicated in the FinnGen Biobank. The inverse-variance weighted method was employed to calculate the causal effects. The results showed that genetically predicted blood selenium levels were associated with a decreased risk of schizophrenia (odds ratio [OR] = 0.90, 95% CI: 0.87-0.95) and AN (OR = 0.87, 95% CI: 0.77-0.97). However, both blood and blood-toenail selenium levels were linked to an increased risk of MDD (blood: OR = 1.08, 95% CI: 1.05-1.12; blood-toenail: OR = 1.08, 95% CI: 1.04-1.13) and ASD (blood: OR = 1.11, 95% CI: 1.05-1.17; blood-toenail: OR = 1.13, 95% CI: 1.05-1.21), respectively. No obvious associations were found between selenium levels and BD as well as ADHD. Our findings highlighted a protective role of selenium in SZ and AN, while a risk effect in MDD and ASD. Further studies are required to verify the underlying mechanism mediating the unequal effects of Se on different MDs, which will pave a new path for the intervention of MDs.

Non-enzymatic antioxidants, macro-minerals and monocyte/high-density lipoprotein cholesterol ratio among patients with bipolar disorder

OBJECTIVE

Recent studies show that oxidative stress is related to the pathogenesis of BD. Non-enzymatic antioxidants, macro-minerals and MHR (monocyte divided by high-density lipoprotein cholesterol) participated oxidative stress and can be obtained quickly in hematological examination. This study used large-scale clinical data to investigate them between BD and healthy controls (HCs), as well as between psychotic and non-psychotic BD to explore their roles in disease progression.

METHODS

A total of 3442 BD-manic (BD-M) and 1405 BD-depression (BD-D) in acute stage and 5000 HCs were enrolled, including 1592 BD-M with psychotic symptoms (P-BD-M), 1850 BD-M without psychotic symptoms (NP-BD-M), 655 P-BD-D, 750 NP-BD-D. The differences in these biological parameter levels among different groups were compared, and the contributing factors for the occurrence of BD-M or BD-D and psychotic symptoms of BD were analyzed.

RESULTS

We found higher levels of Na and MHR, and lower levels of K, Ca and ALB in BD-M or BD-D compared with the HCs respectively; levels of K, Na, Ca, ALB and MHR have differences among P-BD-M, NP-BD-M and HC; levels of K, Na, Ca and ALB have differences among P-BD-D, NP-BD-D and HC. In multiple logistic regression, higher levels of MHR and Na were associated with BD-M; MHR was shown to be independently associated with P-BD-M; K, Na, ALB were shown to be independently associated with P-BD-D.

CONCLUSIONS

Our study highlights the role of oxidative stress in the pathophysiology of BD. There is heterogeneity between BD-M and BD-D, and different oxidative stress mechanisms of psychotic symptoms exist in BD-M and BD-D.

Dissecting Causal Associations of Diet-Derived Circulating Antioxidants with Six Major Mental Disorders: A Mendelian Randomization Study

Although observational studies have suggested associations between circulating antioxidants and many mental disorders, causal inferences have not been confirmed. Mendelian randomization (MR) analyses were conducted using summary-level statistics from genome-wide association studies (GWASs) to explore whether genetically determined absolute circulating antioxidants (i.e., ascorbate, retinol, β-carotene, and lycopene) and metabolites (i.e., α- and γ-tocopherol, ascorbate, and retinol) were causally associated with the risk of six major mental disorders, including anxiety disorders (AD), major depressive disorder (MDD), bipolar disorder (BIP), schizophrenia (SCZ), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). MR analyses were performed per specific-outcome databases, including the largest GWAS published to date (from 9725 for OCD to 413,466 for BIP participants), UK Biobank (over 370,000 participants), and FinnGen (over 270,000 participants), followed by meta-analyses. We found no significant evidence that genetically determined diet-derived circulating antioxidants were significantly causally associated with the risk of the six above-mentioned major mental disorders. For absolute antioxidant levels, the odds ratios (ORs) ranged from 0.91 (95% CI, 0.67-1.23) for the effect of β-carotene on OCD to 1.18 (95% CI, 0.90-1.54) for the effect of ascorbate on OCD. Similarly, for antioxidant metabolites, ORs ranged from 0.87 (95% CI, 0.55-1.38) for the effect of ascorbate on MDD to 1.08 (95% CI, 0.88-1.33) for the effect of ascorbate on OCD. Our study does not support significant causal associations of genetically determined diet-derived circulating antioxidants with the risk of major mental disorders.

Nutrition and bipolar disorder: a systematic review

INTRODUCTION

Individuals with bipolar disorder (BD) have higher rates of unhealthy lifestyles and risk for medical comorbidities Research currently suggests that dietary factors may play a role in the development of depression and anxiety. Therefore, nutritional approaches are potential strategies for the treatment of BD. The aim of this review is to summarize the available evidence on nutrition and BD.

MATERIALS AND METHODS

The paper was developed based on PRISMA 2020 guidelines. The search was conducted in Sep-2021 using PubMed and Cochrane Library, augmented by manually checked references lists. The search found 986 studies, of which 47 were included, combined with 13 from reference lists, totaling 60 studies.

RESULTS

There were 33 observational trials, of which 15 focused on fatty acids, 9 on micronutrients, 5 on specific foods, 4 on macro and micronutrients. The 27 interventional studies mainly focused on fatty acids, micronutrients and N-acetylcysteine (NAC).

DISCUSSION

Dietary intake or supplementation of unsaturated fatty acids, mainly Omega-3 seems to be associated with improved BD symptoms, along with seafood, folic acid and zinc. Studies found variable, mainly non-significant impacts of creatine, carnitine, vitamin D, inositol or NAC supplementation on BD. There are promising results associated with Coenzyme Q10 (Coq10) and probiotics. Taken together, these preliminary findings suggest that dietetic approaches might be included as part of BD treatment. Also considering the high risk of metabolic disorders in individuals with BD, they should be encouraged to choose healthy dietary lifestyles, including daily intake of fruits, vegetables, seafood and whole grains.

Shared postulations between bipolar disorder and polycystic ovary syndrome pathologies

INTRODUCTION

Women with bipolar disorder (BD) present a high prevalence of polycystic ovary syndrome (PCOS) and other reproductive disorders even before diagnosis or treatment of the disease. Postulations on the potential molecular mechanisms of comorbid PCOS in women with BD remain limited to influence of medications and need further extension.

OBJECTIVES

This review focuses on evidence suggesting that common metabolic and immune disorders may play an important role in the development of BD and PCOS.

RESULTS

The literature covered in this review suggests that metabolic and immune disorders, including the dysfunction of the hypothalamic-pituitary-adrenal axis, chronic inflammatory state, gut microbial alterations, adipokine alterations and circadian rhythm disturbance, are observed in patients with BD and PCOS. Such disorders may be responsible for the increased prevalence of PCOS in the BD population and indicate a susceptibility gene overlap between the two diseases. Current evidence supports postulations of common metabolic and immune disorders as endophenotype in BD as well as in PCOS.

CONCLUSIONS

Metabolic and immune disorders may be responsible for the comorbid PCOS in the BD population. The identification of hallmark metabolic and immune features common to these two diseases will contribute to the clarification of the effect of BD on the reproductive endocrine function and development of symptomatic treatments targeting the biomarkers of the two diseases.

Malondialdehyde as a candidate biomarker for bipolar disorder: A meta-analysis

Malondialdehyde (MDA) represents one of the final products of lipid peroxidation that is thought to be enhanced and accelerated in patients affected by bipolar disorder (BD). Purpose of the present article is to critically summarize the available data about MDA as a candidate biomarker for BD. First, we carried out a systematic review of the literature selecting those papers that evaluated MDA levels in BD. Then, we performed two separate meta-analyses: one of the studies that compared healthy controls (HC) with unmedicated BD and one with the studies that assessed MDA levels before and after treatment in BD, showing that bipolar patients experience more oxidative stress than healthy subjects and that treatment is effective in reducing MDA levels. In the first set of studies, we also explored through a meta-regression whether age, gender and experiencing an episode specifically influenced the difference between BD and HC in MDA levels. Bipolar patients compared to healthy subjects had higher MDA levels (SMD: 0.94, 95% CI: 0.23-1.64). Age (p < 0.01), gender (p < 0.01) and the presence of a current mood episode (p < 0.01) significantly influenced MDA plasma/serum levels. Specifically, studies that included more female, older subjects and more BD in euthymia were more likely to have higher MDA levels. Finally, patients after treatment had lower levels of MDA compared to baseline (SMD: -0.52, 95% CI: -0.85 -0.19). More studies are needed to draw definitive conclusions.

Alterations of serum trace elements and other biochemical parameters are correlated with the pathogenesis of systemic lupus erythematosus: A preliminary study on Bangladeshi population

BACKGROUND

Systemic lupus erythematosus (SLE) is an autoimmune disorder in which the body's defense system wrongly attacks healthy body tissues. The objective of this current setup was to quantify and compare the serum concentration of ascorbic acid (Vit-C), malondialdehyde (MDA), c-reactive protein (CRP) and trace elements (Cu, Fe, Mn and Zn) in SLE and normal subjects.

METHODS

The proposed case-control study was performed with 25 SLE patients and 25 healthy subjects as case and control, respectively. The serum level of malondialdehyde (MDA) and vitamin C was evaluated by UV spectrophotometric method. For the determination of CRP, the latex agglutination method was used, whereas serum trace elements were estimated by atomic absorption spectroscopy (AAS).

RESULTS

This analysis demonstrated that patients with SLE possessed a significant (p < 0.001) higher level of MDA and lower level of vitamin C compared to control subjects. Pearson's correlation analysis found negative correlation between the serum level of MDA and vitamin C (r= -0.023, p = 0.887) for patients while control group also possessed similar result (r= -0.157, p = 0.453). The current findings have also revealed that serum level of Zn and Cu in SLE patients was significantly (p < 0.05) lowered to that of the control group, while serum level of Mn also showed a similar scenario. During Pearson's correlation analysis a significantly (p < 0.05) negative correlation was found between Zn and Mn (r= -0.410, p = 0.042) in patients' group.

CONCLUSION

Although our study was limited to a small sample size and confined to a particular area of the country, the study results support a significant role of antioxidants, CRP, and trace elements in the generation of SLE and, therefore, recommends a large spectrum study of the associations between SLE and these biochemical parameters.

Therapeutic approaches employing natural compounds and derivatives for treating bipolar disorder: emphasis on experimental models of the manic phase

Bipolar disorder (BD) is a complex psychiatric disease characterized by mood swings that include episodes of mania and depression. Given its cyclical nature, BD is especially hard to model; however, the standard practice has been to mimic manic episodes in animal models. Despite scientific advances, the pathophysiology of BD is not fully understood, and treatment remains limited. In the last years, natural products have emerged as potential neuroprotective agents for the treatment of psychiatric diseases. Thus, the aim of this review was to explore the therapeutic potential of natural compounds and derivatives against BD, taking into account preclinical and clinical studies. Reliable articles indexed in databases such as PubMed, Web of Science and Science Direct were used. In clinical studies, treatment with herbal plants extracts, omega-3, inositol, n-acetylcysteine and vitamin D has been associated with a clinical improvement in symptoms of mania and depression in BD patients. In animal models, it has been shown that red fruits extracts, curcumin, quercetin, gallic acid, alpha-lipoic acid and carvone can modulate many neurochemical pathways involved in the pathophysiology of manic episodes. Thus, this review appointed the advances in the consumption of natural compounds and derivatives as an important therapeutic strategy to mitigate the symptoms of BD.

Effects of different types and doses of whey protein on the physiological and intestinal flora in D-galactose induced aging mice

The elderly usually suffer from many diseases. Improving the quality of life of the elderly is an urgent social issue. In this present study, D-galactose treated aging mice models were used to reveal the effects of different animal sources and different doses of whey protein (WP) on the immune indexes organs and intestinal flora. A total of 9 groups were set up, including normal control (NC), negative control (NS), positive control (Vc), low-, medium- and high-doses of cow WP intervention groups (CL, CM and CH for short, correspondingly) and low-, medium- and high-doses of goat WP intervention groups (GL, GM and GH for short, correspondingly). The body weight gain, thymus/body weight ratio, superoxide dismutase (SOD) activity, malondialdehyde (MDA) content, spleen immunoglobulins G (IgG), spleen interleukin-2 (IL-2) and spleen interleukin-2 (IL-6) were measured. Then, the intestinal contents were collected, and 16s genes of intestinal bacteria were sequenced to reveal the changes in bacterial flora structure. WP intervention significantly increased the weight gain, thymus/body ratio and SOD activity, but decrease the content of MDA. WP intervention increased some immune indicators. All the WP treated aging mice showed similar values of physiological indexes to that of the Vc group, even better. The relative abundance of Lactobacillus and Stenotrophomonas was increased and decreased, respectively, by both cow and goat WP. Lactobacillus may be involved in regulating the functional repair of organisms. In contrast, Stenotrophomonas might play a negative role in the immune and antioxidant capacity of the body. Combining physiological indicators and intestinal flora structure, low-concentration WP for cow and goat might be optimal for aging models.

The pleiotropic beneficial intervention of olive oil intake on the Alzheimer's disease onset via fibrinolytic system

The daily consumption of Extra Virgin Olive Oil (EVOO) in Mediterranean nutrition is tightly associated with lower frequency of many diseases' appearance, including Alzheimer's disease (AD). Fibrinolytic system is already assumed to be involved in AD pathophysiology through various factors, especially plasminogen activator inhibitor-1 (PAI-1), a2-antiplasmin (α2ΑP) and tissue plasminogen activator (tPA). We, here, present a biochemical study, as a continuation of a clinical trial of a cohort of 84 participants, focusing on the pleiotropic effect of the annual EVOO consumption on the fibrinolytic factors of Mild Cognitive Impairment (MCI) patients. The levels of all these fibrinolytic factors, measured by Enzyme-Linked Immunosorbent Assay (ELISA) method, were reduced in the serum of MCI patients annually administered with EVOO, versus not treated MCI patients, as well as AD patients. The well-established AD hallmarks (Aβ1-40 and Aβ1-42 species, tau, and p-tau) of MCI patients' group, annually administered with EVOO, were restored to levels equal to those of the cognitively-healthy group; in contrast to those patients not being administered, and their AD hallmarks levels increased at the end of the year. Moreover, one of the EVOO annual consumption multimodal effects on the MCI patients focused on the levels of an oxidative stress trademark, malondialdehyde (MDA), which displayed also a visible quenching; On the other hand, an increase exhibited in the MCI patients not consuming EVOO one year after, was attributed to the lack of the EVOO anti-oxidative properties. These outcomes are exploitable towards the establishment of natural products like EVOO, as a preventive remedy fighting this neurodegenerative disorder, AD. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT03362996 MICOIL gov Identifier: NCT03362996.

Increased oxidative stress and altered serum macro-minerals and trace elements levels are associated with coronary artery disease

BACKGROUND

This study was designed to evaluate the serum malondialdehyde (MDA), non-enzymatic antioxidants (vitamin A and C), macro-minerals (magnesium and calcium), and trace elements (zinc, copper, and iron) levels in patients with coronary artery disease (CAD) and to explore their role in disease progression.

METHODS

This prospective case-control study was comprised of 40 CAD patients and 40 healthy volunteers as cases and control subjects, respectively. The level of lipid peroxidation was assessed by measuring the serum MDA level using a UV spectrophotometer. The levels of vitamins A and C were determined by high-performance liquid chromatography (HPLC) and UV spectrophotometric method, respectively. Atomic absorption spectroscopy (AAS) was used to measure serum macro-minerals (Mg and Ca) and trace elements (Zn, Cu, and Fe) concentrations.

RESULTS

The mean age of CAD patients and control subjects was 53.90 ± 2.22 and 37.03 ± 1.50 years, respectively. This study revealed significantly higher concentrations of MDA (p < 0.01) and lower concentrations of vitamin A (p < 0.01), and vitamin C (p < 0.05) in the CAD patients than in control subjects. The mean values of Mg, Cu, Zn, Ca, and Fe were 11.67 ± 0.64, 1.17 ± 0.03, 0.43 ± 0.02, 107.38 ± 1.81, and 1.66 ± 0.04 μg/mL, respectively for the CAD patients and 19.38 ± 0.65, 1.07 ± 0.02, 0.87 ± 0.02, 94.29 ± 1.89, and 1.52 ± 0.05 μg/mL, respectively for the controls and the differences were significant (p < 0.05) between the patients and controls.

CONCLUSION

From these findings, we can suggest that there is a strong association of CAD with an elevated level of MDA, depleted levels of antioxidants, and altered macro-minerals and trace elements concentrations.

Gallic acid protects cerebral cortex, hippocampus, and striatum against oxidative damage and cholinergic dysfunction in an experimental model of manic-like behavior: Comparison with lithium effects

Bipolar disorder is characterized by episodes of depression and mania, and oxidative stress has been associated with the observed neurochemical changes in this disease. We evaluated the effects of gallic acid on hyperlocomotion, acetylcholinesterase activity, and oxidative stress in an animal model of ketamine-induced mania. Rats were pretreated orally with vehicle, gallic acid (50 or 100 mg/kg), or lithium (45 mg/kg twice a day) for 14 days. Between days 8 and 14, the animals also received ketamine (25 mg/kg) or saline daily. On the 15th day, hyperlocomotion was assessed, following which the animals were euthanized, and brains were collected. Results showed that ketamine-induced hyperlocomotion and caused oxidative damage by increasing reactive oxygen species levels, lipid peroxidation, and nitrite levels, and decreasing the total thiol content and the activities of catalase, superoxide dismutase, and glutathione peroxidase in the brain. Pretreatment with gallic acid and lithium prevented hyperlocomotion and brain oxidative damage. Further, ketamine increased the acetylcholinesterase activity in the hippocampus and striatum, whereas gallic acid and lithium ameliorated this alteration. Thus, gallic acid may provide effective protection against manic-like behavior by reducing oxidative stress and preventing cholinergic signaling dysfunction in the brain regions involved in emotion regulation.

Serum CRP, MDA, Vitamin C, and Trace Elements in Bangladeshi Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disorder that is a painful health crisis. This study aimed to assess the serum C-reactive protein (CRP), malondialdehyde (MDA), non-enzymatic antioxidant (vitamin C), and trace elements (Zn, Cu, Mn, and Fe) in RA patients, and thereby correlate these parameters with the association of RA. This study included 20 Bangladeshi RA patients and 20 normal healthy volunteers as control subjects. CRP level was determined using a laboratory-based latex agglutination-enhanced immunoassay. The lipid peroxidation level was determined by measurement of the serum level of MDA. Non-enzymatic antioxidant vitamin C was assessed by UV spectrophotometric method. Trace elements were determined by atomic absorption spectroscopy (AAS). Our study observed significantly higher concentrations of CRP (p < 0.001) and MDA (p < 0.001), and significantly lower concentrations of vitamin C (p < 0.001) in the RA patient. The mean values of Zn, Cu, Mn, and Fe were 6.62 ± 0.34, 1.42 ± 0.17, 7.51 ± 0.23, and 29.25 ± 0.41 ppm for the RA patients respectively and 13.57 ± 9.13, 1.15 ± 0.17, 1.59 ± 0.18, and 62.47 ± 5.25 ppm for the control subjects, consequently. There was a significant difference (p < 0.05) in the trace element levels between the RA patients and control subjects. Our study suggests that a higher concentration of CRP and MDA, lower levels of vitamin C, and altered trace elements may be linked to RA.

Restoration of BMI1 levels after the administration of early harvest extra virgin olive oil as a therapeutic strategy against Alzheimer's disease

Even though Alzheimer's disease (AD) is the most common cause of dementia, the mechanisms governing the establishment and progression of the disease remain largely unknown. Here, we investigated the implication of the neuroprotective protein BMI1 (B lymphoma Mo-MLV insertion region 1 homolog) in AD and the possibility to reverse the onset of the disease through the administration of extra virgin olive oil (EVOO) in Mild Cognitive Impairment (MCI) patients. For this purpose, we utilized a wide bank of MCI patient samples to examine the potential effects of EVOO. We found that while EVOO treatment increases BMI1 levels, p53 levels drop in MCI patient serum after EVOO treatment for 12 months. Additionally, AD-related biomarkers (p-tau, Aβ1-42 and Aβ1-42/Aβ-40 ratio) return to normal levels after administration of EVOO in MCI patients for 12 months. Moreover, we show that upon EVOO administration, BMI1-upregulation correlates with reduction of oxidative stress and inflammatory responses. In conclusion, we provide clinical trial evidence to confirm that restoration of BMI1 activity through EVOO administration in MCI patients constitutes a potential therapeutic approach against neurodegeneration leading to AD.

Construction of a nitro-oxidative stress-driven, mechanistic model of mood disorders: A nomothetic network approach

Major depression is accompanied by increased IgM-mediated autoimmune responses to oxidative specific epitopes (OSEs) and nitric oxide (NO)-adducts. These responses were not examined in bipolar disorder type 1 (BP1) and BP2. IgM responses to malondialdehyde (MDA), phosphatidinylinositol, oleic acid, azelaic acid, and NO-adducts were determined in 35 healthy controls, and 47 major depressed (MDD), 29 BP1, and 25 BP2 patients. We also measured serum peroxides, IgG to oxidized LDL (oxLDL), and IgM/IgA directed to lipopolysaccharides (LPS). IgM responses to OSEs and NO-adducts (OSENO) were significantly higher in MDD and BP1 as compared with controls, and IgM to OSEs higher in MDD than in BP2. Partial Least Squares (PLS) analysis showed that 57.7% of the variance in the clinical phenome of mood disorders was explained by number of episodes, a latent vector extracted from IgM to OSENO, IgG to oxLDL, and peroxides. There were significant specific indirect effects of IgA/IgM to LPS on the clinical phenome, which were mediated by peroxides, IgM OSENO, and IgG oxLDL. Using PLS we have constructed a data-driven nomothetic network which ensembled causome (increased plasma LPS load), adverse outcome pathways (namely neuro-affective toxicity), and clinical phenome features of mood disorders in a data-driven model. Based on those feature sets, cluster analysis discovered a new diagnostic class characterized by increased plasma LPS load, peroxides, autoimmune responses to OSENO, and increased phenome scores. Using the new nomothetic network approach, we constructed a mechanistically transdiagnostic diagnostic class indicating neuro-affective toxicity in 74.3% of the mood disorder patients.

Malondialdehyde and bipolar disorder: A short comprehensive review of available literature

BACKGROUND

The pathogenetic mechanisms of Bipolar Disorder (BD) have not been totally clarified. Oxidative stress seems to be involved in the etiology of BD, and malondialdehyde (MDA) represents a candidate biomarker for monitoring this aspect in different medical conditions including mood disorders. This article has the objective to critically summarize the available data about the association between MDA and BD.

METHODS

A research in Pubmed, PsycINFO and Isi Web of Knowledge was fulfilled to identify studies in which MDA levels were measured in BD patients for the purpose of securing a comprehensive review concerning the issue.

RESULTS

We detected 20 articles that satisfied the inclusion criteria: most of them observed higher MDA levels (or Thiobarbituric acid-reactive substances-TBARS) in BD patients compared to healthy controls (HC), although there are some contrasting results, depending in particular on the phase of illness or the inclusion criteria or the methodological differences.

LIMITATIONS

We included studies, exclusively in English, that used different laboratory methods to measure MDA.

CONCLUSIONS

The analysed articles suggest that MDA or TBARS are increased in BD patients with respect to HC, thus supporting the hypothesis that MDA may be a promising and potential biomarker to monitor the course of BD, although further studies are needed to confirm this hypothesis.

Metallomics-based platforms for comparing the human blood serum profiles between bipolar disorder and schizophrenia patients

RATIONALE

An evaluation of bipolar disorder (BD) and schizophrenia (SCZ) was carried out, from a metallomics point of view, using native conditions, attempting to preserve the interaction between metals and biomolecules.

METHOD

For this task, blood serum samples from healthy individuals and patients were compared. In addition, the profiles of metal ions and metalloids involved in the pathologies were quantified, and a comparison was carried out of the protein profile in serum samples of healthy individuals and diseased patients.

RESULTS

After optimization and accuracy evaluation of the method, different concentrations of Li, Mg, Mn and Zn were observed in the samples of BD patients and high levels of copper for SCZ patients, indicating an imbalance in the homeostasis of important micronutrients. The treatment, especially with lithium, may be related to competition between metallic ions. BD-related metallobiomolecules were detected, preserving the binding between metal ions and biomolecules, with four fractions detected in the ultraviolet range (280 nm). Four fractions were collected by high-performance liquid chromatography/inductively coupled plasma mass spectrometry (HPLC/ICP-MS) and the proteins were identified by liquid chromatography/tandem mass spectrometry (LC/MS/MS). The Ig lambda chain V-IV region Hil, immunoglobulin heavy constant gama 1 (IGHG1) and beta-2-glycoprotein 1 (or ApoH) was identified in SCZ samples, suggesting its relationship with mood disorders. Surprisingly, Protein IGKV2D-28 was identified only in BD samples, opening up new possibilities for studies regarding the role of this protein in BD.

CONCLUSIONS

This approach brings new perspectives to the comprehension of mood disorders, highlighting the importance of metallomics science in disease development. This strategy showed an innovative potential for evaluating mood disorders at the proteomic level, making it possible to identify proteins related to mood disorders and BD.

Water- and Fat-Soluble Antioxidants in Human Seminal Plasma and Serum of Fertile Males

Reactive oxygen species (ROS) are physiologically involved in functions like sperm maturation, capacitation and acrosome reaction, but their excess is involved in male infertility. Antioxidants in seminal plasma (SP) are an important factor balancing physiologic and harmful ROS activities. In this study, we determined and compared the full profiles of the water- and fat-soluble antioxidants in SP and serum of 15 healthy fertile subjects (ranging between the ages of 35 and 42 years). Ejaculates were obtained after 2⁻5 days of sexual abstinence. After liquefaction and withdrawal of an aliquot for the sperm count, samples were centrifuged to obtain SP. Thirty min after semen donation, a venous blood sample was collected from each subject. Donors with lower SP concentrations of ascorbic acid (n = 5) or α-tocopherol (n = 5) received a 4 week oral administration of either vitamin C (100 mg/day) or vitamin E (30 mg/day). They were then re-assayed to determine the SP and serum levels of ascorbic acid and α-tocopherol. SP and serum samples were properly processed and analyzed by HPLC methods suitable to determine water (ascorbic acid, glutathione (GSH) and uric acid) and fat-soluble (all-trans-retinoic acid, all-trans-retinol, α-tocopherol, carotenoids and coenzyme Q10) antioxidants. Data demonstrate that only ascorbic acid is higher in SP than in serum (SP/serum ratio = 4.97 ± 0.88). The other water-soluble antioxidants are equally distributed in the two fluids (GSH SP/serum ratio = 1.14 ± 0.34; uric acid SP/serum ratio = 0.82 ± 0.12). All fat-soluble antioxidants are about 10 times less concentrated in SP than in serum. In donors treated with vitamin C or vitamin E, ascorbic acid and α-tocopherol significantly increased in both fluids. However, the SP/serum ratio of ascorbic acid was 4.15 ± 0.45 before and 3.27 ± 0.39 after treatment, whilst those of α-tocopherol were 0.11 ± 0.03 before and 0.10 ± 0.02 after treatment. The results of this study, by showing the peculiar composition in water- and fat-soluble antioxidants SP, indicate that it is likely that still-unknown mechanisms allow ascorbic acid accumulation in SP against a concentration gradient. SP mainly relies its defenses on water- rather than fat-soluble antioxidants and on the mechanisms ensuring their transfer from serum.

Combined actions of blueberry extract and lithium on neurochemical changes observed in an experimental model of mania: exploiting possible synergistic effects

Bipolar disorder is a psychiatric disease characterized by recurrent episodes of mania and depression. Blueberries contain bioactive compounds with important pharmacological effects such as neuroprotective and antioxidant actions. The aim of this study was to investigate the effects of blueberry extract and/or lithium on oxidative stress, and acetylcholinesterase (AChE) and Na⁺, K⁺-ATPase activity in an experimental ketamine-induced model of mania. Male Wistar rats were pretreated with vehicle, blueberry extract (200 mg/kg), and/or lithium (45 mg/kg or 22.5 mg/kg twice daily) for 14 days. Between the 8th and 14th days, the animals also received an injection of ketamine (25 mg/kg) or vehicle. On the 15th day the animals received a single injection of ketamine; after 30 min, the locomotor activity was evaluated in an open field test. Ketamine administration induced an increase in locomotor activity. In the cerebral cortex, hippocampus and striatum, ketamine also induced an increase in reactive oxygen species, lipid peroxidation and nitrite levels, as well a decrease in antioxidant enzyme activity. Pretreatment with blueberry extract or lithium was able to prevent this change. Ketamine increased the AChE and Na⁺, K⁺-ATPase activity in brain structures, while the blueberry extract partially prevented these alterations. In addition, our results showed that the neuroprotective effect was not potentiated when lithium and blueberry extract treatment were given together. In conclusion, our findings suggest that blueberry extract has a neuroprotective effect against an experimental model of mania. However, more studies should be performed to evaluate its effects as an adjuvant therapy.

Peripheral Oxidative Stress Markers in Patients with Bipolar Disorder during Euthymia and in Siblings

AIMS

Oxidative stress is increased during the acute phases of bipolar disorder (BD). Our aim here was to analyze oxidative stress biomarkers in patients with BD during euthymia and their siblings.

METHOD

A cross-sectional study was performed in euthymic patients with BD-I (n=48), unaffected siblings (n=23) and genetically unrelated healthy controls (n=21). Protein carbonyl content (PCC), total antioxidant capacity (TRAP), lipid peroxidation (TBARS) and uric acid were measured as biomarkers of oxidative stress in blood.

RESULTS

The antioxidant capacity (TRAP) was lower (p<0.001) in patients with BD compared to their siblings and controls, whereas no differences were observed in PCC, TBARS or uric acid. In patients, the concentrations of TRAP and TBARS were positively associated with the dose of valproic acid (p<0.05 and p<0.001, respectively). The concentrations of these biomarkers were not significantly associated with any of socio-demographic and clinical variables.

CONCLUSION

A selective reduction in antioxidant capacity is present in BD during euthymia state, whereas other markers of oxidative stress are unaltered during euthymia. Siblings did not show any alterations in oxidative stress biomarkers. Oxidative stress might represent a state-dependent marker in BD. The association between treatment with valproic acid and oxidative stress markers in euthymia deserves further studies.

Increased concentration of serum MDA, decreased antioxidants and altered trace elements and macro-minerals are linked to obesity among Bangladeshi population

BACKGROUND AND OBJECTIVE

Obesity is an emerging public health concern in Bangladesh. This study aimed to find the levels of the serum malondialdehyde (MDA), non-enzymatic antioxidants (vitamin A, C and E), trace elements (zinc and iron) and macro-minerals (calcium, potassium and sodium) in obesity and its action in disease advancement.

METHODS

Level of lipid peroxidation was estimated by measurement of the serum concentrations of malondialdehyde (MDA). Vitamin A and E concentration was found by RP-HPLC method and vitamin C was assessed for serum ascorbic acid by UV spectrophotometric method. Serum trace elements (Zn and Fe) and macro-minerals (Na, K and Ca) were estimated by Atomic Absorption Spectroscopy (AAS).

RESULTS

Our study observed significantly elevated concentrations of MDA (p < 0.001) and depleted concentrations of antioxidants (vitamin A, E and C) (p < 0.05) in the patient than control group. Analysis of serum trace elements (Zn and Fe) and macro-minerals (Na, K and Ca) and found that the mean values of Zn, Fe, Na, K and Ca were 0.39 ± 0.02 and 0.43 ± 0.03, 3284.81 ± 34.51, 162.18 ± 3.72, 44.62 ± 2.13 mg/L for the patient and 0.91 ± 0.13, 0.88 ± 0.06, 2562.74 ± 95.92, 243.58 ± 8.97, 87.66 ± 2.10 mg/L for the controls, consequently. There was a substantial difference in trace elements and macro-minerals between the patients and controls (p < 0.001).

CONCLUSION

Our study proposes that increased serum concentrations of MDA and decreased non-enzymatic antioxidant and altered trace elements and macro-minerals are powerfully related with obesity.

Synthesis and Characterization of Two Chiral Pyrrolyl α-Nitronyl Nitroxide Radicals and Determination of their Cytotoxicity and Radioprotective Properties in C6 Cells and Mice under Ionizing Radiation

In this study, two chiral nitronyl nitroxyl radicals, L1 and D1, were synthesized and evaluated for their potential radioprotective properties invitro and invivo. We synthesized the new stable nitronyl nitroxide radicals, L1 and D1, according to Ullman’s method, and their chemical structures were characterized using UV-vis absorption, electron spin resonance (ESR), and circular dichroism (CD) spectra. The cytotoxicity of L1 and D1 on C6 glioma cells (C6 cells) was examined using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. To study the anti-radiation effects of L1 and D1 on C6 cells, we determined the optical density (OD) values of irradiated C6 cells using the MTT assay. The effects of L1 and D1 on the survival rate of mice after radiation exposure was evaluated. To demonstrate the influence of L1 and D1 pre-treatment on the antioxidant enzyme system, we studied the activities of superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), and glutathione peroxidase (GSH) in mouse plasma after exposure to 6.5 Gy gamma radiation. The results showed that L1 and D1 did not have any obvious cytotoxicity at concentrations below 125μgmL−1. Moreover, L1 and D1 had the same cytotoxic effects on C6 cells. L1 and D1 significantly enhanced C6 cell survival after 8, 10, and 12 Gy radiation exposure, and there was no significant difference in the OD values between L1 and D1. The effects of these drugs on mouse survival rates were dose-dependent. Pre-treatment with different concentrations of L1, D1, or WR2721 significantly increased the activity of SOD, CAT, and GSH and significantly decreased the activity of MDA compared with radiation exposure only. In addition, the activities of SOD, CAT, and GSH in the L1 group were higher than those in the D1 group, whereas the activity of MDA was lower. Therefore, L1 and D1 have potential as safe and efficient therapeutic drugs against radiation damage.

Protective role of hazelnut peptides on oxidative stress injury in human umbilical vein endothelial cells

The crude protein hydrolysates of wild hazel have good immunoregulation and antioxidation effects. However, the components responsible for their antioxidation effect remain unknown. In this study, six antioxidative peptides (EW, DWDPK, ADGF, SGAF, ETTL, and AGGF) were tested for their protective effects on oxidative stress injury in human umbilical vein endothelial cells (HUVECs). The results demonstrated that the six peptides are nontoxic and have a protective effect on oxidative stress injury induced by Ang II. Three peptides (EW, ADGF, and DWDPK) inhibited the morphological changes, downregulated the content of lactate dehydrogenase and malondialdehyde, upregulated the activity of antioxidant enzymes catalase, total superoxide dismutase and glutathione peroxidase, and scavenged reactive oxygen species (ROS) in HUVECs. Quantitative reverse transcriptive polymerase chain reaction and western blot assays indicated that these three peptides regulated NADPH oxidase activity and ROS production by reducing NOX4 and p22phox levels. Overall, they have a significant protective effect against oxidative stress injury and have potential application in developing new functional foods. PRACTICAL APPLICATIONS: Corylus heterophylla Fisch is a good quality wild hazel distributed in Northeast China. Wild hazelnut of the species C. heterophylla Fisch was selected as experimental object and has high nutritive values and have abundant proteins (20%-30%), fats (40%-50%), carbohydrates (13%-24%), dietary fibers (8.2%-9.6%), vitamins, and micronutrients. Our results indicate that hazelnut peptides (EW, ADGF, and DWDPK) can ensure normal growth of cells by protecting important antioxidant enzyme systems, by enhancing antioxidant defense, by directly affecting nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity, and by reducing intracellular reactive oxygen species (ROS) production in HUVECs, indicating that the three antioxidative peptides have a protective effect against Ang II-induced oxidative stress injury. Therefore, the antioxidative peptides from C. heterophylla Fisch may be a promising candidate for functional food ingredients and/or pharmaceuticals.

Attenuation of lipid peroxidation and atherogenic factors in diabetic patients treated with gliclazide and metformin

BACKGROUND

Diabetes is associated with oxidative stress and considered as a major risk factor for cardiac disease. We attempted to investigate the role of oral antidiabetic (OAD) agents gliclazide and metformin in lowering the lipid peroxidation and managing the risk for cardiovascular (CV) complications in diabetic patients in comparison with nondiabetic healthy individuals.

MATERIALS AND METHODS

This cross-sectional study was comprised of 150 individuals grouped in three, namely, Group A (n = 60) healthy volunteers, Group B (n = 30) newly diagnosed diabetes, and Group C (n = 60) diabetes treated with OAD. Serum malondialdehyde (MDA), nitric oxide (NO), and Vitamin C were assessed for studying lipid peroxidation status, whereas serum triglyceride (TG) and total cholesterol were monitored as predictors for CV risk.

RESULTS

We found significantly higher concentrations of MDA and NO levels (P < 0.001) in both groups of patients (Group B and C) in comparison to control group (Group A). Regarding antioxidants, significantly lower concentrations of Vitamin C (P = 0.046) were found in Group B and C compared to Group A. Moreover, there was significant difference exhibited in concentration level of MDA (P = 0.001) and NO (P = 0.015) between Group B and C, whereas difference of Vitamin C (P = 0.147) was not statistically significant.

CONCLUSION

Our data confirmed that treatment with gliclazide and metformin significantly reduced the lipid peroxidation accompanied with attenuated levels of serum TGs and cholesterol and suggested that oral hypoglycemic agents have great impact to reduce the oxidative stress and increase the antioxidant status in diabetes.

In major affective disorders, early life trauma predict increased nitro-oxidative stress, lipid peroxidation and protein oxidation and recurrence of major affective disorders, suicidal behaviors and a lowered quality of life

Early life trauma (ELT) may increase the risk towards bipolar disorder (BD) and major depression (MDD), disorders associated with activated neuro-oxidative and neuro-nitrosative stress (O&NS) pathways. It has remained elusive whether ELTs are associated with O&NS and which ELTs are associated with distinct affective disorder phenotypes. This case-control study examined patients with BD (n = 68) and MDD (n = 37) and healthy controls (n = 66). The Child Trauma Questionnaire (CTQ) was used to assess specific ELT. We measured malondialdehyde (MDA), lipid hydroperoxides (LOOH), superoxide dismutase (SOD), catalase, advanced oxidation protein products (AOPP); NO metabolites (NOx), paraoxonase 1 activity, zinc, albumin, high density lipoprotein cholesterol and -SH groups and computed z-unit weighted composite scores. Physical neglect significantly predicts higher z-unit weighted composite scores of LOOH+SOD, LOOH+SOD+NOx, LOOH+SOD+NOx + MDA and LOOH+SOD+NOx + AOPP. Sexual abuse was associated with a significantly lower composite score of zinc+albumin+SH. Emotional abuse was associated with severity of depression and anxiety, number of depressive and manic episodes, alcohol and hypnotics use, lifetime suicidal behavior and lowered quality of life. Sexual abuse was associated with an increased risk towards BD, but not MDD. ELT, especially physical neglect, may drive increased (nitro-)oxidative stress coupled with lipid and protein oxidation, which - together with emotional abuse - may play a role in severity of illness, lowered quality of life and MDD. ELTs are also associated with the onset of BD, but this link did not appear to be related to activated O&NS pathways. These novel findings deserve confirmation in prospective studies.

Are there differences in lipid peroxidation and immune biomarkers between major depression and bipolar disorder: Effects of melancholia, atypical depression, severity of illness, episode number, suicidal ideation and prior suicide attempts

BACKGROUND

There is evidence that major depression (MDD) and bipolar disorder (BD) are accompanied by activated immune & oxidative (I&O) pathways.

METHODS

To compare I&O biomarkers between MDD and BD we assessed serum levels of thiobarbituric acid reactive substances (TBARS; a lipid peroxidation marker), soluble interleukin-2 receptor (sIL-2R), sIL-6R, IL-α, sIL-1R antagonist (sIL-1RA), tumor necrosis factor receptor 60kDa/80kDa (sTNFR60/R80) in 114 MDD and 133 BD patients, and 50 healthy controls. We computed z-unit weighted indices reflecting the 5 cytokine receptor levels (zCytR), cell-mediated immunity (zCMI) and I&O pathways (zCMI+TBARS).

RESULTS

There are no significant differences in biomarkers between MDD and BD. BD/MDD with atypical features is characterized by increased sIL-6R and TBARS, whereas melancholia is associated with higher TBARS and lower sTNFR60 levels. Severity of illness, as measured with the Hamilton Depression Rating Scale, is correlated with increased sIL-6R, sTNFR80, TBARS, zCytR and zCMI+TBARS. The number of episodes the year prior to blood sampling is positively associated with sTNFR80, TBARS, zCMI, zCMI+TBARS, while number of hospitalizations is positively associated with sIL-1RA. Prior suicidal attempts are associated with increased sIL-1RA, IL-1α, zCMI, TBARS and zCMI+TBARS, while TBARS is associated with current suicidal ideation.

CONCLUSIONS

There are no I&O biomarker differences between MDD and BD. Atypical depression is associated with increased IL-6 trans-signaling and lipid peroxidation. Severity of depression, number of episodes and suicidal attempts are associated with activated I&O pathways. Increased TBARS is the single best predictor of BD/MDD, atypical depression, melancholia and current suicidal ideation.

Progress in bipolar disorder drug design toward the development of novel therapeutic targets: a clinician's perspective

INTRODUCTION

Bipolar disorder (BD) is a considerable burden to the affected individual. The need for novel drug targets and improved drug design (DD) in BD is therefore clear. Areas covered: The following article provides a brief, narrative, clinician-oriented overview of the most promising novel pharmacological targets for BD along with a concise overview regarding the general DD process and the unmet needs relevant to BD. Expert opinion: A number of novel potential drug targets have been investigated. With the notable exception of the kynurenine pathway, available evidence is too scarce to highlight a definitive roadmap for forthcoming DD in BD. BD itself may present with different facets, as it is a polymorphic clinical spectrum. Therefore, promoting clinical-case stratification should be based on precision medicine, rather than on novel biological targets. Furthermore, the full release of raw study data to the scientific community and the development of uniform clinical trial standards (including more realistic outcomes) should be promoted to facilitate the DD process in BD.