Carnitine and antioxidants levels in patients with rheumatoid arthritis

Gut Dysbiosis and Dietary Interventions in Rheumatoid Arthritis-A Narrative Review

Rheumatoid arthritis (RA) is a chronic and progressive autoimmune disease. The pathogenesis of RA is complex and involves interactions between articular cells, such as fibroblast-like synoviocytes, and immune cells. These cells secrete pro-inflammatory cytokines, chemokines, metalloproteinases and other molecules that together participate in joint degradation. The current evidence suggests the important immunoregulatory role of the gut microbiome, which can affect susceptibility to diseases and infections. An altered microbiome, a phenomenon known as gut dysbiosis, is associated with the development of inflammatory diseases. Importantly, the profile of the gut microbiome depends on dietary habits. Therefore, dietary elements and interventions can indirectly impact the progression of diseases. This review summarises the evidence on the involvement of gut dysbiosis and diet in the pathogenesis of RA.

Chemometric profiling and anti-arthritic activity of aerial parts of Glinus oppositifolius (L.) Aug. DC

ETHNOPHARMACOLOGICAL RELEVANCE

Glinus oppositifolius (L.) Aug. DC. belongs to the family Molluginaceae, an annual prostrate herb traditionally used to treat inflammations, arthritis, malarial, wounds, fevers, diarrhoea, cancer, stomach discomfort, jaundice, and intestinal parasites. However, the anti-arthritic activity of the aerial part has still not been reported.

AIM OF THE STUDY

To investigate the antioxidant and anti-arthritic activity of G. oppositifolius in Complete Freund's Adjuvant (CFA) induced rats.

MATERIALS AND METHODS

The dried aerial parts of this plant material were defatted with n-hexane and extracted by methanol using a soxhlet apparatus. The in vitro anti-arthritic activity of methanolic extract of G. oppositifolius (MEGO) was evaluated in protein denaturation, membrane stabilization, and inhibition of proteinase assay at 25, 50, 100, 200, and 400 μg/ml concentrations. Female Wistar rats were immunized sub-dermally into the right hind paw with 0.1 ml of CFA. Rats were administered with MEGO at doses of 200 and 400 mg/kg once daily for fourteen days after arthritis induction. Assessment of arthritis was performed by measuring paw diameter, arthritic index, arthritic score, body weight, organ weight, and hematological and biochemical parameters, followed by the analysis of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), interleukin-1-beta (IL-1β), cyclooxygenase-2 (COX-2), interleukin 13 (IL-13) and interleukin 10 (IL-10) and histopathological study. In vivo antioxidant effect was investigated in enzymatic assays. The presence of phytoconstituents was analyzed by Gas Chromatography-Mass Spectrometry (GC-MS) and Liquid Chromatography-Mass Spectrometry (LC-MS), respectively. In silico molecular docking study of the compounds was carried out against COX-2, IL-1β, IL-6, and TNF-α using AutoDock 4.2 and BIOVIA-Discovery Studio Visualizer software.

RESULTS

MEGO's in vitro anti-arthritic activity showed dose-dependent inhibition of protein denaturation, membrane stabilization, and proteinase inhibition, followed by significant in vivo anti-arthritic activity. The rats treated with MEGO showed tremendous potential in managing arthritis-like symptoms by restoring hematological, biochemical, and histological changes in CFA-induced rats. MEGO (200 and 400 mg/kg) showed a significant alleviation in the levels of hyper expressed inflammatory mediators (TNF-α, IL-1β, and IL-6) and oxidative stress (SOD, CAT, GSH, and LPO) in CFA-induced rats. Spergulagenin-A as identified by LC-MS analysis, exhibited the highest binding affinity against COX-2 (-8.6), IL-1β (7.2 kcal/mol), IL-6 (-7.4 kcal/mol), and TNF-α (-6.5 kcal/mol).

CONCLUSIONS

Provided with the comprehensive investigation, methanolic extract of G. oppositifolius against arthritic-like condition is a proof of concept that revalidates its ethnic claim. The presence of Spergulagenin-A might be responsible for the anti-arthritic activity.

Effects of Trigonella foenum graecum (fenugreek) on rheumatoid arthritis: a systematic review

BACKGROUND

Adjuvant therapies especially medicinal plants have gained lots of attention nowadays and have been consumed all over the world for treating different diseases particularly rheumatoid arthritis (RA). Recent animal studies have indicated the benefits of fenugreek in RA and indicate that it may be a therapeutic candidate in RA; nonetheless, no systematic review is available about fenugreek and RA. This paper systematically reviewed the existing studies about fenugreek and RA and plausible mechanisms.

METHODS

Databases including PubMed, Scopus, Web of Science, ProQuest, and the search engine Google Scholar were searched until May 2022 and search alerts were used to receive studies issued after the primary search. There was no restriction in time and/or language. No human and in vitro research was detected; thus, animal investigations were considered. Also, the citations or references of studies were searched for potential studies. Book chapters, review papers, and grey literature (e.g. conference abstracts, dissertations, and patents) were not included.

RESULTS

Finally, 11 studies were entered in this systematic review. Animal investigations showed that fenugreek had favorable effects in RA and could control this disease via attenuating inflammation, suppressing oxidative stress, and displaying anti-arthritic activity.

CONCLUSION

Current review provides potent evidences about the efficacy of fenugreek in RA and elucidates the significance of more clinical investigations. HighlightsFenugreek had favorable effects in rheumatoid arthritis and could control this disease via attenuating inflammation, suppressing oxidative stress, and displaying anti-arthritic activity.

Long Term Treatment of Corticostreroids May Cause Hepatotoxicity and Oxidative Damage: A Case Controlled Study

Arthritis is a clinical condition, which mainly affects the structure and function joints. During this condition the joints gets swelled and stiffed resulting into development of pain and morbidity. Corticosteroids are frequently prescribed to manage various clinical conditions including the chronic inflammatory diseases such as arthritis. The steroidal drug also causes certain adverse effects depending on the dose, the route of administration and duration of treatment. However, a systematic investigation on the biochemical consequences of steroids as a therapeutic has not been carried out. In the present study we analyzed certain parameters associated to oxidative stress, liver function and energy metabolism has been done in the blood plasma of the arthritis patients who were using steroidal drugs (methylprednisolone and deflazacort) up to 168 days for the treatment of the disease. The results indicated increase in level of MDA and decrease in the activities of SOD, CAT and LDH. The activities of AST and ALT were found to be significantly enhanced over the increase in the treatment period. These results suggested that corticosteroids may induce lipid peroxidation, oxidative stress and liver toxicity in the arthritis patients in the dose and duration dependent manner. The use of antioxidants as supplements to the anti-arthritis agents could play a role in suppressing the oxidative stress mediated adverse effects. However, extensive research is required to explore for safer medication devoid of steroids to cure arthritis.

Graphical Abstract

Does propolis have any effect on rheumatoid arthritis? A review study

Rheumatoid arthritis (RA) is a chronic autoimmune disease in which inflammation and oxidative stress play a key role in its pathophysiology. Complementary therapies along with medications may be effective in the control of RA. Propolis is a natural substance extracted from beehives, which have confirmed anti-inflammatory and antioxidant effects. The present study aimed to review the possible effects of propolis on inflammation, oxidative stress, and lipid profile in patients with RA. English articles in online databases such as PubMed‑Medline, AMED, Google Scholar, EMBASE, Scopus, and Web of Science databases were searched. Pieces of evidence show that supplementation with propolis may have therapeutic effects on RA patients. Due to increased inflammation and oxidative stress in the affected joints of RA patients, propolis could inhibit the inflammatory cascades by inhibiting the nuclear factor kappa B pathway and reducing reactive oxygen species, malondialdehyde, and interleukin-17 by increasing some antioxidants. Therefore, inflammation and pain reduce, helping improve and control RA in patients. Further investigations are required with larger sample sizes and different doses of propolis to demonstrate the definite effects of propolis on various aspects of RA.

The Expression Levels and Significance of GSH, MDA, SOD, and 8-OHdG in Osteochondral Defects of Rabbit Knee Joints

Objective

To observe the dynamic changes in oxidative stress and the expression levels of antioxidant and oxidative parameters in the blood and synovial fluid in the osteochondral defects of the rabbit knee joints and to explore the significance.

Methods

Thirty New Zealand white rabbits were randomly selected and divided into a blank control group (n = 10), a model control group (n = 10), and an osteochondral defect group (n = 10). The osteochondral defect model of rabbit knee joint was constructed by medial parapatellar arthrotomy. The expression levels of glutathione (GSH), malondialdehyde (MDA), superoxide dismutase (SOD), and 8-hydroxydeoxyguanosine (8-OHdG) in peripheral venous blood and knee synovial fluid of the three groups were measured at the end of the 4th, 8th, and 12th weeks after treatment.

Results

The expression levels of GSH and SOD in the blood and synovial fluid in the osteochondral defect group at the end of the 8th and 12th weeks were observably lower than those of the other two groups (P < 0.05); higher expression levels of MDA and 8-OHdG in the blood and synovial fluid of the osteochondral defect group compared with those of the other two groups were obtained (P < 0.05). At the end of the 4th, 8th, and 12th weeks, the expression levels of MDA and 8-OHdG in the blood and synovial fluid of the osteochondral defect group presented an upward trend (P < 0.05).

Conclusion

The osteochondral defects initiate the oxidative stress in the body, which is presented as the decrease of GSH and SOD expression, and the upregulation of MDA and 8-OHdG expression.

2-Deoxy-D-glucose Alleviates Collagen-Induced Arthritis of Rats and Is Accompanied by Metabolic Regulation of the Spleen and Liver

Rheumatoid arthritis (RA) is significantly associated with glycolysis. This study used 2-deoxy-D-glucose (2-DG), an inhibitor of glycolysis, to treat rats with collagen-induced arthritis (CIA) and investigate the metabolic regulatory mechanism of glycolysis in the disease. 2-DG significantly alleviated CIA. Metabolomics and transcriptomics, as well as their integrative analysis, detected significant changes in the pathways of bile secretion, cholesterol and linoleic acid metabolism in the plasma, liver and spleen during the CIA process and the opposite changes following 2-DG treatment, whereas the expression of the genes regulating these metabolic pathways were changed only in the spleen. In the rat liver, levels of (S)-5-diphosphomevalonic acid in the terpenoid backbone biosynthesis pathway were significantly decreased during CIA progression and increased following 2-DG treatment, and levels of taurochenodeoxycholic acid in the pentose and glucuronate interconversions pathway showed the opposite results. In the spleen, levels of 3-methoxy-4-hydroxyphenylglycol glucuronide in bile secretion and 12(S)-leukotriene B4 in arachidonic acid metabolism were significantly decreased during CIA progression and increased following 2-DG treatment. The changes in the gene-metabolite network of bile secretion in the spleen correlated with a decreased plasma L-acetylcarnitine level in CIA rats and an increase following 2-DG treatment. Our analysis suggests the involvement of spleen and liver metabolism in CIA under the control of glycolysis.

The effect of L-Carnitine supplementation on clinical symptoms, C-reactive protein and malondialdehyde in obese women with knee osteoarthritis: a double blind randomized controlled trial

BACKGROUNDS

L-carnitine decreases oxidation and inflammation by reducing the fatty acid in plasma and using oxygen in ATP synthesis. As such, knee osteoarthritis (KOA) can be improved by reducing apoptotic chondrocytes. This study was designed to compare the effect of L-carnitine supplementation and low-calorie diet on improving KOA among obese women. We further investigated the effect of L- carnitine on improvement of KOA in obese women on low calorie diet.

METHODS

To conduct the study, 76 obese women with KOA were randomly assigned into two low-calorie diet groups: the first received 1000 mg of LCG and the second took the placebo (PLG) (n = 38). Anthropometry indices, body composition, lipid profile, C-reactive Protein (CRP), Malondialdehyde (MDA), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were assessed at the baseline condition and after 12 weeks.

RESULTS

The mean change of body mass index (BMI) (- 1.21 ± 0.84 vs. -0.79 ± 0.70; P = 0.02) and weight (- 2.76 ± 1.69 vs. -1.95 ± 1.73; P = 0.05) were significant in the LCG compared with the PLG. Likewise, LCG compared to the PLG showed insignificant improvement in waist circumference (WC) (- 5.65 ± 5.85 vs. -3.64 ± 3.37; P = 0.08). Total cholesterol (P = 0.02), MDA (P = 0.03), fat mass (P = 0.03) and visceral fat (P = 0.001) only showed decreased levels in LCG in comparison to the baseline condition. There was no significant difference between LCG and PLG, in the mean changes of hip circumference, visceral fat, free fat mass, fat mass, lipid profiles, CRP, MDA as well as stiffness, physical function, decrease of pain and total scores (P > 0.05).

CONCLUSION

The 12-week L-carnitine supplementation could improve BMI, but had no significant effect on other anthropometric and body composition measures as well as clinical symptoms, CRP, MDA, and lipid profile in women with KOA. Further trials with higher doses and longer durations are required. IRCT registration number: IRCT2017011932026N2. Registration date: 2017-04-27.

Identification of a Shared Microbiomic and Metabolomic Profile in Systemic Autoimmune Diseases

Dysbiosis has been described in systemic autoimmune diseases (SADs), including systemic lupus erythematosus (SLE), Sjögren’s syndrome (SjS), and primary anti-phosholipid syndrome (PAPS), however the biological implications of these associations are often elusive. Stool and plasma samples from 114 subjects, including in SLE (n = 27), SjS (n = 23), PAPs (n = 11) and undifferentiated connective tissue (UCTD, n = 26) patients, and geographically-matched healthy controls (HCs, n = 27), were collected for microbiome (16s rRNA gene sequencing) and metabolome (high-performance liquid chromatography coupled to mass spectrometry) analysis to identify shared characteristics across diseases. Out of 130 identified microbial genera, a subset of 29 bacteria was able to differentiate study groups (area under receiver operating characteristics (AUROC) = 0.730 ± 0.025). A fair classification was obtained with a subset of 41 metabolic peaks out of 254 (AUROC = 0.748 ± 0.021). In both models, HCs were well separated from SADs, while UCTD largely overlapped with the other diseases. In all of the SADs pro-tolerogenic bacteria were reduced, while pathobiont genera were increased. Metabolic alterations included two clusters comprised of: (a) members of the acylcarnitine family, positively correlating with a Prevotella-enriched cluster and negatively correlating with a butyrate-producing bacteria-enriched cluster; and (b) phospholipids, negatively correlating with butyrate-producing bacteria. These findings demonstrate a strong interaction between intestinal microbiota and metabolic function in patients with SADs.

Effect of Boron on the Repair of Osteochondral Defect and Oxidative Stress in Rats: an Experimental Study

The aim of this study was to investigate the effect of boron on the repair of osteochondral defect and also on some antioxidant and oxidant parameters of both cartilage tissue and blood. A total of 24 adult male Wistar rats weighing between 350 and 400 g were used in the study. Animals were randomly divided into control (n = 8), boron (n = 8) and hyaluronic acid (HA) groups (n = 8). Under general anesthesia, a cylindrical full-thickness osteochondral defect 1.5 mm in diameter and 2 mm in depth was formed using a drill on the anterior side of the articular surface of the femur condyle. Boron group received 0.1 ml (10 mg/kg) of boron and HA group received 0.1 ml of HA, whereas control group received 0.1 ml of physiological saline solution. All agents administered intraarticular route and once a week for four times. At the end of the third month, the animals were euthanized and blood and joint tissue malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), and catalase levels were measured. Defected femoral condyles of the rats were removed for a histopathological examination. Histopathology revealed that the total cartilage repair score of the HA group was better than those detected in boron and control groups. Blood and articular cartilage GSH, SOD, and catalase levels were higher in the boron and HA groups as compared to the control group, while MDA level was lower compared to the control group. In conclusion, it was suggested that boron was not as effective as HA in the repair of osteochondral defect, but its antioxidant property was superior to HA.

Association of oxidative stress with clinical characteristics in patients with rheumatoid arthritis

BACKGROUND

Few studies examining the association between oxidative stress and clinical parameters or disease activity in patients with rheumatoid arthritis (RA) are available. Therefore, the objective of this study was to test whether oxidative stress has any association with clinical parameters and disease activity in patients with RA.

MATERIALS AND METHODS

In this post hoc cross-sectional study, 45 patients with RA treated with traditional disease-modifying antirheumatic drugs (DMARDs) ± low-dose glucocorticoids ± nonsteroidal analgesics for at least 3 months were analysed. Oxidative stress parameters were malondialdehyde (MDA), superoxide dismutase (SOD), antioxidant potential (AOP) and nonenzymatic superoxide radical scavenger activity (NSSA). Clinical parameters were pain, patient global assessment, physician global assessment, Health Assessment Questionnaire (HAQ), and disease activity score (DAS28).

RESULTS

Plasma NSSA levels were significantly inversely correlated with tender joints count (r = -.304; P = .042), swollen joints count (r = -.342; P = .021) and DAS28 (r = -.396; P = .009). There were no significant correlations between MDA/SOD/AOP and any of clinical parameters or DAS28 (P > .05 for all). Multiple regression analysis revealed that NSSA was an independent variable of DAS28 (β=-.243, P = .016).

CONCLUSION

The preliminary results demonstrate that plasma NSSA levels were inversely correlated with tender and swollen joints count and DAS28 and that NSSA was independently associated with DAS28, in patients with RA treated with traditional DMARDs; and provide initial support that NSSA may be used as a biomarker of disease activity in patients with RA.

Umbelliferone β-d-galactopyranoside exerts an anti-inflammatory effect by attenuating COX-1 and COX-2

Umbelliferone β-d-galactopyranoside (UFG) is a coumarin found in many plants. This study examines the anti-inflammatory potential of UFG on chronic inflammation induced by Complete Freund Adjuvant (CFA) in experimental rats.

Amelioration of oxidative stress in the joint tissue may be the basis for the antiarthritic activity of Terminalia arjuna bark extract

AIM

In this study we have evaluated the antioxidant and antiarthritic activity of Terminalia arjuna bark extract (TABE) in collagen-induced arthritis (CIA) in rats.

METHODS

Arthritis was induced in rats by intradermal injection of the collagen-complete Freund's adjuvant emulsion. Right hind paw thickness was measured as a primary marker for severity of arthritis. Biochemical parameters such as tissue levels of superoxide dismutase (SOD), catalase, reduced glutathione (GSH), nitrites and thiobarbituric acid reactive substances (TBARS) were measured to determine the effect of treatment on antioxidant defenses. Articular elastase (ELA) level in the arthritic tissue was measured as a marker for neutrophil infiltration.

RESULT

Terminalia arjuna bark extract administration significantly inhibited the increase in paw thickness induced by immunization with collagen as compared to CIA-control animals. Further, it attenuated the fall in tissue SOD and GSH levels and mitigated the increase in tissue nitrites and TBARS levels as compared to CIA-control animals. Tissue ELA levels, which were significantly increased in the CIA-control animals as compared to normal animals were also significantly reduced by TABE administration.

CONCLUSION

Results of our study demonstrate the antioxidant and antiarthritic activity of TABE in CIA in rats. We believe that TABE could find clinical application in the management of rheumatoid arthritis and associated disorders.

Metabolomic analysis of biochemical changes in the plasma and urine of collagen-induced arthritis in rats after treatment with Huang-Lian-Jie-Du-Tang

ETHNOPHARMACOLOGICAL RELEVANCE

Huang-Lian-Jie-Du-Tang (HLJDT oren-gedoku-to in Japanese), a classical traditional Chinese medicine (TCM) formula, is well known for the treatment of inflammatory-related diseases such as gastritis, dermatitis, and ulcerative colitis. Our previous studies have indicated that HLJDT has therapeutic potential in rheumatoid arthritis treatment. To investigate the therapeutic mechanism of a traditional Chinese medicine formula Huang-Lian-Jie-Du-Tang (HLJDT oren-gedoku-to in Japanese) and its constituents combination for collagen-induced arthritis in rats using a metabolomics approach.

MATERIALS AND METHODS

Rats were divided into 9 groups, and drugs were administered from on the day after the onset of arthritis (day 12) until day 31 of the experiment once daily continuously. Urine and plasma were analyzed by reversed-phase liquid chromatography/quadrupole time-of-flight mass spectrometry (LC-Q-TOF-MS). Partial least-squares discriminate analysis (PLS-DA) models were built to evaluate the therapeutic effects of HLJDT and its constituents combination. 15 identified CIA biomarkers were investigated to explain its therapeutic mechanism.

RESULTS

Administration of HLJDT and its constituents combination in CIA rats not only significantly reduced arthritic scores and serum levels of IL-1β but also improved histopathologic changes in joint architecture. Urinary and plasma metabolic profiling revealed that perturbation of energy metabolism, lipid metabolism, oxidative injury and some amino acids metabolism occurred in collagen-induced arthritis (CIA). Our results also indicated that the disturbed urinary levels of succinic acid, citric acid, creatine, uridine, pantothenic acid, carnitine, phenylacetylglycine, allantoin and plasma levels of phenylpyruvic acid in model rats were gradually restored to normal after administration of HLJDT. The treatment of constituents combination of HLJDT group was able to restore to normal the disturbed urinary levels of citric acid, creatine, pantothenic acid, carnitine, pantothenic acid, phenylacetylglycine and plasma levels of uric acid, L-histidine, and l-phenylalanine in model rats.

CONCLUSIONS

Our study indicates that HLJDT and its constituents combination treatment can ameliorate CIA through partially regulating the perturbed energy metabolism. Our work demonstrated that metabonomics-based approach is a promising new tool to evaluate the therapeutic effects and mechanism of complex TCM prescriptions.

Effect of ascophyllan from brown algae Padina tetrastromatica on inflammation and oxidative stress in carrageenan-induced rats

Sulfated polysaccharide ascophyllan was isolated from the brown algae Padina tetrastromatica and purified by ion-exchange chromatography. Anti-inflammatory effect of ascophyllan fraction against carrageenan-induced paw edema in rats was studied. Paw edema in rats was induced by injecting 0.1 ml, 1 % carrageenan suspension in 0.9 % NaCl solution into the sub-plantar tissue of the right hind paw. Carrageenan caused a significant increase in the activity of inflammatory marker enzymes like lipoxygenases and cyclooxygenase in peripheral blood mononuclear cells and paw tissue and also increased the concentration of prostaglandin E2 (PGE2) and myeloperoxidase (MPO) in paw tissue. When compared to the reference drug diclofenac, ascophyllan fraction-3 (AF3) treatment significantly reduced the activities of anti-inflammatory enzymes, concentration of PGE2 and MPO. AF3 treatment decreased the mRNA level expression of TNF-α and IL-6. Concentration of thiobarbituric acid reactive substances was decreased. Activities of antioxidant enzymes and reduced glutathione level were increased on treatment with AF3. Histopathology of paw tissue showed decreased edema formation and cellular infiltration on supplementation with AF3. Thus the results demonstrated the potential beneficiary effect of ascophyllan fraction on carrageenan-treated rats.

Metabolomic study of collagen-induced arthritis in rats and the interventional effects of huang-lian-jie-du-tang, a traditional chinese medicine

Huang-Lian-Jie-Du-Tang (HLJDT) is a traditional Chinese medicine (TCM) with anti-inflammatory activity. The present study used a metabolomic approach based on LC-Q-TOF-MS to profile rheumatoid-arthritis- (RA-) related metabolic changes and to investigate the interventional mechanisms of HLJDT in collagen-induced arthritis rats. Forty male Wistar rats were randomly divided into five groups: (1) a model group, (2) a normal control group, (3) a dexamethasone group, (4) a HLJDT group, and (5) a group that received 13 components of HLJDT. Plasma samples were collected 8, 15, and 22 days after the rats were injected with bovine type II collagen. By combining variable importance in the projection values with partial least squares discriminant analysis, 18 potential biomarkers were identified in the plasma samples. The biomarkers were primarily involved in glycerophospholipid metabolism, fatty acid metabolism, tryptophan metabolism, linoleic acid metabolism, phenylalanine metabolism, purine metabolism, arachidonic acid metabolism, and bile acid biosynthesis. Using the potential biomarkers as a screening index, the results suggest that HLJDT can potentially reverse the process of RA by partially regulating fatty acid oxidation and arachidonic acid metabolism. This study demonstrates that a metabolomic strategy is useful for identifying potential RA biomarkers and investigating the underlying mechanisms of a TCM in RA treatment.

Nutraceuticals of anti-inflammatory activity as complementary therapy for rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by elevated oxidative stress and inflammatory biomarkers. The severe side effects of drug used during such disease necessitate the search for new and safe approaches. Food is a rich source of antioxidants and anti-inflammatory bioactive constituents including phenolic compounds, polyunsaturated fatty acids, phytosterols, toccopherols, and carotenoids. We have a series of publications dealing with the anti-inflammatory activity of different food extracts (as nutraceuticals) in experimental animals (acute and chronic inflammation model) and in clinical study (RA patients). Fish oil, primrose oil, extracts of black cumin, fenugreek, liquorice, coriander, tomato, carrot, sweet potato, broccoli, green tea, rosemary, hazelnut, walnut, wheat germ, and date in addition to the probiotic Bifidobacterium bifidum were the nutraceuticals studied. During these studies, changes in inflammatory biomarkers (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), seromucoids, fibrinogen, tumor necrosis factor-α (TNF-α), prostaglandin E2), oxidative stress (malondialdehyde), antioxidant status (total antioxidant capacity, vitamin C, vitamin E, retinol, β-carotene), the level of copper (Cu) and zinc (Zn) and colonic microflora in response to the administration of nutraceuticals have been assessed. Results of these studies showed that the majority of nutraceuticals studied possess beneficial effect toward chronic inflammatory diseases, which might be due to the presence of one or more of the above-mentioned phytochemicals. Conclusion: Anti-inflammatory and antioxidant nutraceuticals may serve as complementary medicine for the management of RA.

The anti-arthritic and anti-oxidative effect of NBD (6-nitro-1,3-benzodioxane) in adjuvant-induced arthritis (AIA) in rats

OBJECTIVES

The present study evaluated the anti-arthritic and anti-oxidative effects of 6-nitro-1,3-benzodioxane in the adjuvant-induced arthritis model in rats.

METHODS

Arthritis was induced in female rats by intradermal injection of MT37Ra. Arthritis was evaluated by arthritic score, body weight loss, paw volume measurement, and histological changes. The plantar test was used to evaluate the effect of NBD on hyperalgesia.

RESULTS

The hyperalgesia (p < 0.0001) and hind paw inflammation (p < 0.034) was significantly decreased with parallel increase in the body weight of the NBD-treated (25 mg/kg) group compared to arthritic control rats. The antioxidant activity analysis demonstrated that the treatment of NBD significantly suppressed the levels of nitric oxide (p < 0.001) and peroxide (p < 0.002) with a significant increase in the glutathione (p < 0.021) compared to the arthritic control group. Since the IL-1β and TNF-α are key pro-inflammatory cytokines in arthritis, we therefore measured their levels in the serum samples. In comparison to the arthritic control group, the NBD treatment significantly reduced the levels of IL-1β (p < 0.003) and TNF-α (p < 0.026).

CONCLUSION

Our results suggests that NBD is an anti-arthritic agent that not only reduces the severity of the disease process but also affects contributing factors of arthritic inflammation including free radicals and inflammatory cytokines production.

Hydroxyl radical modification of collagen type II increases its arthritogenicity and immunogenicity

Background

The oxidation of proteins by endogenously generated free radicals causes structural modifications in the molecules that lead to generation of neo-antigenic epitopes that have implications in various autoimmune disorders, including rheumatoid arthritis (RA). Collagen induced arthritis (CIA) in rodents (rats and mice) is an accepted experimental model for RA.

Methodology/Principal Findings

Hydroxyl radicals were generated by the Fenton reaction. Collagen type II (CII) was modified by ^•OH radical (CII-OH) and analysed by ultraviolet-visible (UV-VIS), fluorescence and circular dichroism (CD) spectroscopy. The immunogenicity of native and modified CII was checked in female Lewis rats and specificity of the induced antibodies was ascertained by enzyme linked immunosorbent assay (ELISA). The extent of CIA was evaluated by visual inspection. We also estimated the oxidative and inflammatory markers in the sera of immunized rats. A slight change in the triple helical structure of CII as well as fragmentation was observed after hydroxyl radical modification. The modified CII was found to be highly arthritogenic and immunogenic as compared to the native form. The CII-OH immunized rats exhibited increased oxidative stress and inflammation as compared to the CII immunized rats in the control group.

Conclusions/Significance

Neo-antigenic epitopes were generated on ^•OH modified CII which rendered it highly immunogenic and arthritogenic as compared to the unmodified form. Since the rodent CIA model shares many features with human RA, these results illuminate the role of free radicals in human RA.

Carnitine: a therapeutic option for childhood psoriatic onycho-pachydermo-periostitis (POPP)

Psoriatic onycho-pachydermo-periostitis (POPP)is a rare subset of psoriatic arthritis, characterized by onychopathy, painful thickening of the periungual soft tissues, and radiological features consisting of an exuberant periosteal reaction of the terminal phalanx. The POPP treatment is debated, and side effect risk of therapies may not be offset by their benefits. We report on a successful treatment with carnitine in a 15-year old boy suffering from POPP.

Anti-inflammatory and antioxidative effects of mucilage of Trigonella foenum graecum (Fenugreek) on adjuvant induced arthritic rats

The aim of this study was to investigate anti-inflammatory and antioxidant effects of mucilage from fenugreek in adjuvant induced arthritis in rats. Arthritis was induced by intradermal injection of complete Freund's adjuvant into the right hind paw produce inflammation of the joint. The activities of inflammatory enzymes like cyclooxygenase, lipoxygenase and myeloperoxidase, and levels of nitrite and C-reactive protein were observed. Also oxidative stress was measured by analyzing the activity of catalase, superoxide dismutase, glutathione peroxidase and the levels of glutathione and vitamin C and lipid peroxidation. The blood parameters like ESR, total WBC, RBC and hemoglobin content was checked. Fenugreek mucilage exhibited maximum percentage of edema inhibition at a dose of 75 mg/kg on 21st day of adjuvant arthritis. The effect was higher than that of standard drug indomethacin. The activities of cyclooxygenase-2 and myeloperoxidase and concentration of thiobarbituric acid reactive substance (TBARS) were decreased and the activities of antioxidant enzymes, vitamins C and reduced glutathione level were increased on treatment with fenugreek mucilage. The increment in ESR and total WBC, reduction in RBC count and hemoglobin and aberrant changes to the C-reactive protein (CRP) levels observed in the arthritic animals were also found to be significantly restored in fenugreek mucilage treated rats. Histopathology of paw tissue showed decreased edema formation and cellular infiltration on supplementation with fenugreek mucilage. Thus the results demonstrated the potential beneficiary effect of fenugreek mucilage on adjuvant induced arthritis in rats.

The effects of rose hip (Rosa canina) on plasma antioxidative activity and C-reactive protein in patients with rheumatoid arthritis and normal controls: a prospective cohort study

OBJECTIVES

Rose hip (Rosa canina) has been used as an herbal remedy against a wide range of ailments including inflammatory disorders. The anti-inflammatory and antioxidant properties of rose hips have been evaluated in vitro and active constituents have been isolated. Rose hip contains antioxidant nutrients and an anti-inflammatory galactolipid. Rheumatoid arthritis (RA) is an inflammatory disease where activated cells release reactive oxygen substances. Thus it could be relevant to investigate if rose hip had an anti-inflammatory and/or antioxidant effect in this situation.

METHODS

In this open case-control study 20 female patients with RA and 10 female controls were given 10.5 g rose hip powder daily (Litozin®) for 28 days. Blood samples were analysed at baseline and follow-up for the capacity of the antioxidant enzymes superoxide dismutase, glutathione peroxidase, glutathione reductase and catalase and the inflammatory marker C-reactive protein (CRP). The participants kept a food diary for the first 3 days and the last 3 days of the intervention period. The RA-patients completed The Stanford Health Assessment Questionnaire at baseline and follow-up.

RESULTS

CRP-concentrations of both patients and healthy controls did not change. Nor was any effect found on the activity of antioxidant enzymes. There was no difference in food intake at baseline, but in the last week the RA-group reduced their energy intake.

CONCLUSIONS

10.5 g Litozin® in 28 days had neither effect on clinical symptoms or laboratory measurements in patients with RA or healthy controls. This is in contrast to previous intervention studies with rose hip powder that found a reduction in the concentration of CRP. The results of the present study indicate that a daily amount of approximately 10 g rose hip powder for one month has no anti-inflammatory and/or antioxidant effect.

Increased oxidative stress in patients with familial Mediterranean fever during attack period

OBJECTIVES

We aimed to investigate the status of oxidant and antioxidants during attack period (AP) and attack free periods (AFP) in Familial Mediterranean fever (FMF) patients.

METHODS

Measured the levels of malondialdehyde (MDA), protein carbonyl (PC), glutathione (GSH) and antioxidant vitamins (A,C and E) as well as the activities of catalase (CAT) and glutathione peroxidase (GSH-Px) in serum and whole blood of FMF patients in FMF-AP and FMF-AFP.

RESULTS

Levels of MDA and PC were found significantly higher (p <0.05) both in serum and whole blood of FMF-AP group compared with other groups. The CAT and GSH-Px activities in FMF-AP group were found markedly lower (p <0.05) comparing to HC group. However, there were no statistically significant differences between the groups in terms of antioxidant vitamin levels.

CONCLUSIONS

Our study demonstrated increased oxidative stress in patients with FMF during AP. Investigations are needed to establish the effect of antioxidant supplementation on FMF attack frequency and severity. We also suggest that these increased MDA and PC levels and decreased antioxidants may be used as supportive markers to differentiate AP from AFP. These conclusions need to be validated in further multicenter studies with high number of FMF patients.

Relationship between anti-CCP antibodies and oxidant and anti-oxidant activity in patients with rheumatoid arthritis

OBJECTIVE/AIM

A new group of autoantibodies in Rheumatoid Arthritis (RA), the anti-cyclic citrullinated peptide (anti-CCP) antibodies directed to citrulline-containing proteins, which are of value for the severity of RA. Up to date, the relationship between anti-CCP antibodies and oxidant, anti-oxidant activity in patients with RA has not been elucidated in the previous studies. In this study we aimed to investigate the effect of anti-CCP antibodies in the circulation on whole blood, serum and synovial fluid oxidant and anti-oxidant activity in patients with RA.

MATERIALS AND METHODS

RA patients with anti-CCP (+) (n=25) and anti-CCP (-) (n=24) were recruited into the study. All patients had a positive rheumatoid factor (RF). The patients who were under treatment with only non-steroidal antiinflammatory drugs (NSAID) at the study time included in the study. Catalase (CAT), Glutathione peroxidase (GSHPx), Myeloperoxidase (MPO) activities and the levels of Malondialdehyde (MDA) were measured in whole blood, serum and synovial fluid in both groups.

RESULTS

There were no significant differences in terms of the mean whole blood and serum antioxidative activity (CAT, GSHpx) and the mean blood and serum MDA and MPO values (oxidative activity), between the patients with anti-CCP(+) and those with anti-CCP(-). There was increased synovial oxidant activity (MDA and MPO levels) (p<0.05) in anti-CCP(+) RA patients with or without ESR negativity when compared with anti-CCP(-) RA patients. There was positive correlation between anti-CCP antibody levels and synovial MDA and MPO levels (r=0.435, p<0.05, r=0.563, p<0.05 respectively) in anti-CCP (+) group.

CONCLUSIONS

In conclusion, anti-CCP antibody positivity seems to be associated with increased synovial fluid oxidant activity (increased MDA and MPO levels) in patients with RA. These conclusions need to be validated in a larger controlled study population.

N-(2-hydroxy phenyl) acetamide inhibits inflammation-related cytokines and ROS in adjuvant-induced arthritic (AIA) rats

The present study was carried out to study the anti-arthritic and anti-inflammatory activity of N-(2-hydroxy phenyl) acetamide in adjuvant-induced arthritis in adult female Sprague Dawley rats. During experimental period, body weight and paw oedema volume were observed. At the end of each experiment, plasma and serum samples were collected and used for estimation of pro-inflammatory cytokines IL-1 beta and TNF-alpha and oxidative stress markers i.e., nitric oxide, peroxide and GSH. Our results suggested that, the reduction in body weight and increase in paw oedema volume were significantly retarded in the AIA rats receiving 5mg/kg and 10mg/kg doses of N-(2-hydroxy phenyl) acetamide as compared to diseased control animals. The serum levels of IL-1 beta and TNF-alpha were reduced as compared to those in the diseased control group. Treatment with N-(2-hydroxy phenyl) acetamide also altered oxidative stress markers in relation to its anti-inflammatory activity. Based on our results, it can be concluded that N-(2-hydroxy phenyl) acetamide possesses promising anti-arthritic property.

Effect of green tea extract and vitamin C on oxidant or antioxidant status of rheumatoid arthritis rat model

Elevated free radical generation in inflamed joints and impaired antioxidant system has been implicated in rheumatoid arthritis (RA). Green tea extracts (GTE) have been shown to reduce inflammation in inflammatory arthritis murine model. This study investigates possible mechanisms by which vitamin C and GTE protect joints in RA rat model. This study included forty adult male rats that were divided into four groups (10 rats each); control group, collagen II induced RA group (CII), CII treated with vitamin C (CII + Vit C) and CII treated with GTE (CII + GTE) in physiology laboratory, Assiut University, Egypt. After 45 days of treatment, plasma levels of lipid peroxides (LPO), nitric oxide (NO), ceruloplasmin (CP), superoxide dismutase (SOD), uric acid (UA) and glutathione (GSH) were detected using colorimetric methods, PGE(2) using ELISA and copper (Cu) and zinc (Zn) using spectrometer. In CII group, levels of LPO, NO, PGE(2), UA, CP, Cu were higher while SOD, GSH, Zn were lower than controls. In groups treated with vitamin C and GTE, levels of SOD, GSH were increased while levels of LPO, NO, PGE(2), Cu, CP were decreased compared with CII group. Levels of UA were decreased and Zn increased in GTE treated group compared with CII group. GTE treated group showed higher Zn and low Cu levels compared with vitamin C treated group. This study suggests proper GTE and vitamin C intake may effectively normalize the impaired oxidant/antioxidant system and delaying complication of RA.

Preferential immunoglobulin oxidation in children with juvenile idiopathic arthritis

OBJECTIVE

Juvenile idiopathic arthritis (JIA) is a rare chronic inflammatory disorder of the joints. There is strong evidence that oxidative damage occurs in rheumatoid diseases, including JIA. The increased level of protein oxidation products in total plasma proteins has recently been reported in children with diagnosed JIA. The objective of this study was to find out which fraction of plasma proteins is mostly damaged by oxidative stress and whether the damaging effect correlates with certain clinical or laboratory parameters.

METHODS

A new approach to estimate the carbonyl content of plasma protein fractions was developed, based on two-stage electrophoresis and immunochemical detection of the carbonyl derivatives of the proteins. This method allowed us to detect and quantitate carbonyl groups in the albumin, alpha-2, beta and gamma-globulin fractions. Sera of 25 children with JIA and 13 healthy controls were tested.

RESULTS

Albumin and gamma-globulins were found to be most modified by oxidation. In a group of children with systemic JIA, both albumin and gamma-globulins were oxidized while plasma gamma-globulin fraction damage was prevalent in pauciarticular JIA.

CONCLUSIONS

Among plasma proteins of children with JIA, gamma-globulins were preferentially oxidized, whereas most of the other proteins did not seem to be affected. Oxidative modification of plasma proteins was correlated with the type of JIA. These findings may allow the use of carbonyls as clinical markers of inflammatory process activity in patients with different types of JIA. It is also a potential tool for monitoring oxidative protein damage in other diseases and therapies.

L-Carnitine Protects Human Retinal Pigment Epithelial Cells from Oxidative Damage

PURPOSE

To determine the efficacy of L-carnitine (LC) against oxidative changes in human retinal pigment epithelium (RPE) cells.

METHODS

The RPE cells from human donor eyes were cultured in Hams F-10 medium. The effect of LC on H2O2-induced morphologic changes in the RPE cells was analyzed by light microscopy. Reduction in cell death after the impact of LC treatment on H2O2-treated cells was analyzed by MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assays. In addition, the effect of H2O2 on the activity of RPE-antioxidant enzymes, glutathione (GSH) and superoxide dismutase (SOD), and LC-induced protection was also determined.

RESULTS

LC protected the RPE cells by inhibiting the peroxide-induced cytopathic effect from 50% to 10%. Nuclear condensation observed in 40% of the H2O2-treated cells decreased to 20% after LC treatment. The MTT assays demonstrated that 100 microM oxidant caused appreciable cell death, which was reduced by LC treatment; however, 100% protection was not achieved. Significant peroxide-induced cell death was seen within 5 hr of H2O2 treatment, and a quantifiable reduction was observed after LC treatment for a similar time period. The change in the antioxidant potential of the RPE induced by oxidative stress was restored by LC treatment, as demonstrated by an increase in GSH and SOD activities.

CONCLUSIONS

LC is capable of protecting the RPE cells from H2O2-induced oxidative damage, implying that micronutrients can have a positive effect and can play an important role in the treatment of oxidation-induced ocular disorders. Further studies are needed to understand the mechanism of LC-induced protection to the RPE cells.

Vitamin E in the primary prevention of rheumatoid arthritis: the Women's Health Study

OBJECTIVE

Vitamin E supplements may reduce the risk of developing rheumatoid arthritis (RA) through antioxidant effects. Although previous observational studies have investigated this question, no randomized trial data are available.

METHODS

The Women's Health Study is a randomized, double-blind, placebo-controlled trial designed to evaluate the benefits and risks of low-dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer among 39,876 female health professionals age > or = 45 years throughout the US, conducted between 1992 and 2004. After excluding women with self-reported RA at baseline, 39,144 women were included in the present study. The primary end point, definite RA, was confirmed using a connective tissue disease screening questionnaire, followed by medical record review for American College of Rheumatology criteria.

RESULTS

During an average followup of 10 years, 106 cases of definite RA occurred, 50 in the vitamin E group and 56 in the placebo group. Sixty-four (60%) RA cases were rheumatoid factor positive and 42 (40%) were rheumatoid factor negative. There was no significant association between vitamin E and risk of definite RA (relative risk [RR] 0.89, 95% confidence interval [95% CI] 0.61-1.31). There were also no significant risk reductions for either seropositive RA (RR 0.64, 95% CI 0.39-1.06) or seronegative RA (RR 1.47, 95% CI 0.79-2.72).

CONCLUSION

Six hundred IU of vitamin E supplements taken every other day is not associated with a significant reduction in the risk of developing RA among women in a randomized, double-blind, placebo-controlled trial.

Does diet have a role in the aetiology of rheumatoid arthritis?

Although dietary factors have been extensively studied in many chronic diseases, the role of diet in the epidemiology of rheumatoid arthritis (RA) has received little attention. Fruit and vegetables and dietary antioxidants are thought to play a protective role in the pathogenesis of CVD and some cancers, but few studies have investigated these dietary components in the aetiology of RA. Fish oil supplementation has consistently been shown to have a beneficial effect on the symptoms of established RA, but it is not known whether the PUFA present in fish oils can reduce the risk of developing the disease. There is evidence that RA is less severe in the southern Mediterranean countries, such as Italy and Greece, where oil-rich fish, fruit, vegetables and olive oil are consumed in greater amounts than in many other countries. Overall, the evidence for a role of diet in the aetiology of RA is limited to a small number of observational studies of very different designs. Recently, it was demonstrated that lower intakes of fruit and vegetables and dietary vitamin C are associated with an increased risk of developing inflammatory polyarthritis in a free-living population in Norfolk, UK. These findings provide further evidence for a role of diet in the development of inflammatory arthritis, although the mechanisms involved are uncertain.

Oxidative status of DBA/1J mice with type II collagen-induced arthritis

The present study was undertaken to compare the oxidant statuses of mice with collagen-induced arthritis (CIA) and those of healthy mice. For this purpose, serum oxidant products and arthritic profiles were measured in DBA/1J mice with CIA. In addition, the levels of oxidation products and the activities of antioxidant enzymes were determined in liver, heart, spleen, kidney, lung and brain. The induction of arthritis significantly increased anti-collagen antibody, rheumatoid factor, interleukin (IL)-1beta, IL-6, protein carbonyl (PCO), advanced glycation end-products (AGE), malondialdehyde (MDA) and low density lipoprotein (LDL)-cholesterol levels in serum (P < 0.05). CIA in DBA/1J mice was associated with significantly lower activities of superoxide dismutase, glutathione peroxidase and glutathione reductase in spleen but higher levels of oxidation products in spleen, kidney and liver than healthy normal mice (P < 0.05). However, lower concentrations of oxidized protein and higher activities of antioxidant enzymes were observed in CIA mouse lung and brain than in healthy normal mice. Dexamethasone treated CIA mice had decreased arthritis-related indices and showed: reduced PCO and AGE in spleen and brain, and increased PCO and AGE in heart, kidney and lung; increased MDA in heart, spleen, lung and brain; reduced SOD and GR activities in lung and brain; increased GPx activity in spleen and brain; and increased GR activity heart and spleen. These data suggest that mice with CIA were more susceptible to oxidative damage in the spleen and liver under the chronic inflammatory conditions.

Investigation of protein oxidation and lipid peroxidation in patients with rheumatoid arthritis

We aimed to determine the importance of neutrophil activation and the source of oxidative stress in the pathogenesis of rheumatoid arthritis (RA) by quantification of advanced oxidation protein products (AOPP) and total thiol levels as markers of oxidative protein damage, malondialdehyde (MDA) levels as a marker of lipid peroxidation and myeloperoxidase (MPO) activity as a marker of neutrophil activation in patients with RA. Fifty-seven rheumatoid arthritis patients were included in the study and sub-grouped according to disease activity (active, n = 31; inactive, n = 26) and compared with healthy controls (n = 25). Serum MPO activity, AOPP, MDA, and thiol levels were measured by an enzymic spectrophotometric method. Serum MPO activity (p < 0.001), AOPP (p < 0.001), MDA (p < 0.001) and levels of thiol (p < 0.002), were higher in the patient group than the controls. Active and inactive RA groups were compared with the control group and there were significant differences between each parameter. MPO activity, AOPP, MDA and thiol levels were significantly higher in both active and inactive RA patients than the controls. On the other hand, when a comparison was made between active and the inactive stage, a statistically significant difference was present only in MDA (p < 0.05) and AOPP levels (p < 0.05). There was also a significant positive correlation between all parameters. These data strongly suggest that neutrophils, which constitute the most important source of chlorinated oxidants due to their high MPO content, may be involved in serum AOPP formation and therefore the production of a novel class of pro-inflammatory mediators of oxidative stress in RA patients and that protein oxidation could play an important role in the pathogenesis of RA as does lipid peroxidation.

Paraoxonase and arylesterase levels in rheumatoid arthritis

It was reported that lipid peroxidation (LPO) products increase in rheumatoid arthritis (RA) patients and increased LPO products reduce many antioxidants. Lipid hydroperoxides (LOOHs) are byproduct of LPO. Paraoxonase (PON), arylesterase (ARE), free sulfhydryl (SH) groups, and ceruloplasmin (CP) are enzymes or proteins with antioxidant characteristics. This study aims to determine the levels of LOOHs and SH, and the activities of PON1, ARE, and CP in RA patients. The study included 47 active RA cases and 23 healthy volunteers. The levels of LOOHs and SH, and the activities of PON1, ARE, and CP were determined using appropriate methods. Student's t test and Spearman's correlation analysis methods were employed in the statistical evaluation. The level of LOOHs was found to be higher (p<0.001), while the level of SH and the activities of PON1, ARE, and CP were found to be lower (p<0.001, <0.001, <0.01, and <0.01, respectively) in the RA patient group when compared with the control group. There was a negative correlation between the level of LOOHs and the activity of PON1 in the patient group (r= -0.420 and p<0.01). The results of our study indicate increased oxidant and decreased antioxidant presence in RA patients. PON1 and ARE are known to have antiatherosclerotic effects in addition to their antioxidant characteristics. As the decrease in these antioxidants, resulting from increased oxidative stress in RA patients, development of atherosclerosis besides tissue injury seems inevitable.

Carnitine and Lipoic Acid Alleviates Protein Oxidation in Heart Mitochondria During Aging Process

Oxidative modification alters the function of proteins and is thought to play an important role in the decline of cellular function during aging process. In the present study, we have evaluated the levels of oxidant production, protein oxidation, reduced and oxidized glutathione in young, middle aged and aged rats. The animals were divided into six groups, each group consisting of six animals each. Groups I and II were young rats, Groups III and IV were middle-aged rats and Groups V and VI were aged rats. Groups II, IV and VI were treated with carnitine (300 mg/kg bw) and Dl-alpha-Lipoic acid (100 mg/kg bw) for 28 days. Statistical significance was carried out using ANOVA. There was a significant reduction in the levels of reduced glutathione and Redox ratio (P<0.05) in aged rats whereas elevation in the levels of oxidant production, protein carbonyls, advanced oxidation protein products and oxidized glutathione were observed. Co-supplementation of carnitine and lipoic acid improved these levels to near normalcy. Thus we conclude that the utilization of carnitine and lipoic acid will lead to an improvement in the quality of living during the later stages of life by preventing free radical induced damage to the proteins.

Oxidative stress on mitochondrial antioxidant defense system in the aging process: Role of dl-α-lipoic acid and l-carnitine

BACKGROUND

Oxidative damage is hypothesized to accumulate throughout the lifetime of an organism, eventually giving rise to aging. The mitochondria may be the primary cellular source and target of endogenous ROS as they are produced as a normal byproduct of the electron transport system.

METHODS

Male albino Wistar rats were used in this study. The animals were divided into 6 groups, each group consisting of 6 animals. Groups I, III, and V were young, middle-aged and aged control rats and Groups II, IV, and VI were treated with carnitine (300 mg/kg bw) and dl-alpha-lipoic acid (150 mg/kg bw), respectively. After the treatment period, the animals were sacrificed and the heart and skeletal muscle were removed for analysis.

RESULT

There was a significant reduction in the levels of antioxidants in both middle-aged and aged rats whereas the thiobarbituric acid reactive substances were found to be increased. Co-supplementation of carnitine and lipoic acid improved the antioxidant status and brought down the levels of TBARS.

CONCLUSION

Co-supplementation of lipoic acid with carnitine has a beneficial effect in reversing the age-related abnormalities seen in aging. This effect was associated with the decrease in free radical production and rise in antioxidant levels by carnitine and lipoic acid, thereby lowering oxidative stress.