Breath pentane analysis as an index of lipid peroxidation: a functional test of vitamin E status

Realization of Microfluidic Preconcentrator for N-Pentane Traces Impurities from the Gaseous Media

In this paper, we present the work of designing and fabricating a new generation of microelectromechanical systems (MEMS) based microfluidic preconcentrators (MFP) for volatile organic compounds (VOCs) quantification. The main objective of this work is to quantify the n-pentane impurities using MFP for sample preparation. The MFP was analyzed using Hewlett-Packard 5890 gas chromatography, having a flame ionization detector under isothermal conditions. The proposed MFP system includes two-microfluidic preconcentrators for continuous action and a system of four 3/2 solenoid valves with a control unit. Microfluidic preconcentrators were placed on metal plates and have circular channels filled with Al2O3 (50 μm), n-octane ResSil-C (80/100 mesh) sorbents of one nature and are hyphenated with the Peltier elements to regulate the temperature of sorption and desorption. The n-pentane quantitative determination was carried out using a calibration plot of gas mixtures on a successive dilution with the nitrogen. This study shows that the microfluidic preconcentrator system with Al2O3 and n-Octane ResSil-C sorbent concentrates the n-pentane traces up to 41 to 47 times from the gas mixture with the standard deviation of ≤5%. It has been observed that the n-octane ResSil-C based MFC shows very fast response (<5 min) and stability up to 300 cycles.

Membrane inlet mass spectrometry method for food intake impact assessment on specific volatile organic compounds in exhaled breath

This research work describes the development of a novel bioanalytical method for the assessment of food impact on selected exhaled breath volatile organic compounds (VOCs) using a fast and portable screening VOC prototype sensor based on membrane inlet mass spectrometry (MIMS). Method and sensor prototype functionality was verified by obtaining good response times, linearity in the examined concentration ranges, and sensitivity and repeatability for several breath VOCs—acetone, ethanol, n-pentane, and isoprene. A new VOC sensor prototype was also proven to be sensitive enough for selected breath VOC quantification with limits of detection at low part per billion (ppb) levels—5 ppb for n-pentane, 10 ppb for acetone and ethanol, and 25 ppb for isoprene. Food impact assessment was accomplished by tracking the levels of acetone, ethanol, n-pentane, and isoprene in exhaled breath samples collected from 50 healthy participants before the meal and 60 min and 120 min after the meal. For acetone, isoprene, and n-pentane, a larger impact was noticed 120 min after the meal, while for ethanol, it was after 60 min. Obtained VOC levels were in the expected concentration ranges. Mean values at all time points were ~ 500–900 ppb for acetone and ~ 400–600 ppb for ethanol. Most of the results for n-pentane were below 5 ppb, but the mean value for those which were detected was ~ 30 ppb. Along with samples, data about participants’ lifestyle were collected via a short questionnaire, which were compared against obtained VOC levels in order to reveal some significant correlations between habits of participants and their breath VOC levels.

Evaluating the In Vitro Potential of Natural Extracts to Protect Lipids from Oxidative Damage

Lipid peroxidation is a chemical reaction known to have negative impacts on living organisms' health and on consumer products' quality and safety. Therefore, it has been the subject of extensive scientific research concerning the possibilities to reduce it, both in vivo and in nonliving organic matrices. It can be started by a variety of oxidants, by both ROS-dependent and -independent pathways, all of them reviewed in this document. Another feature of this reaction is the capacity of lipid peroxyl radicals to react with the non-oxidized lipids, propagating the reaction even in the absence of an external trigger. Due to these specificities of lipid peroxidation, regular antioxidant strategies-although being helpful in controlling oxidative triggers-are not tailored to tackle this challenge. Thus, more suited antioxidant compounds or technologies are required and sought after by researchers, either in the fields of medicine and physiology, or in product development and biotechnology. Despite the existence of several laboratory procedures associated with the study of lipid peroxidation, a methodology to perform bioprospecting of natural products to prevent lipid peroxidation (a Lipid Peroxidation Inhibitory Potential assay, LPIP) is not yet well established. In this review, a critical look into the possibility of testing the capacity of natural products to inhibit lipid peroxidation is presented. In vitro systems used to peroxidize a lipid sample are also reviewed on the basis of lipid substrate origin, and, for each of them, procedural insights, oxidation initiation strategies, and lipid peroxidation extent monitoring are discussed.

Whole-food phytochemicals antioxidative potential in alloxan-diabetic rats

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Soybean and whole-wheat have beneficial effects on the oxidative status of AD rats more than broadbean.

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Feeding dried wheat is effective in improving MDA, GSH and α-T levels.

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Germination is favorable than drying and moistened heat. Germination enhances the effect of soybeans on TAGs and in the case of soy and wheat enhanced the effect on total cholesterol.

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Diabetic patients, beside controlling their hyperglycaemia with medication, are recommended to include whole foods containing naturally occurring phytochemicals to ameliorate their oxidative status.

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Possible protective factors in the diet such as flavonoids, lutein, lycopene, lignans, and saponins, may provide new strategies to enhance diet and health of diabetic patients.

Background

The importance of whole-food antioxidants in terms of promoting antioxidant recycling in the body in complex human diseases is not fully understood. We aim to discuss the benefits of whole-food antioxidants in ameliorating the diabetic complications in vivo and to address the effect of germination versus heat processing or drying on the potential therapeutic effect of whole grains and legumes. We studied the antioxidant status of alloxan-diabetic (AD) male Spargue Dawley rats, injected intraperitoneally with alloxan dose of 150 mg/kg body weight, and fed on experimental diets based on the flour of soybean, broadbean and whole-wheat for five weeks.

Results

Diabetes-induced oxidative stress in liver was manifested by significant increase in hepatic malondialdehyde (MDA), erythrocytes superoxide dismutase (eSOD) and plasma alpha-tocopherol (α-T) levels, reduction in hepatic glutathione (GSH) levels and catalase (CAT) activity. Consumption of soybean and whole-wheat both had beneficial effects on the oxidative status of AD rats more than broadbean. Feeding dried wheat was effective in improving MDA, GSH and α-T levels. Soybeans and wheat lowered triacylglycerols (TAGs) and tended to lower total cholesterol. Germination enhanced the effect of soybeans on TAGs and in the case of soy and wheat enhanced the effect on total cholesterol.

Conclusion

Whole foods containing naturally occurring phytochemicals and antioxidant vitamins such as legumes and whole grains are recommended, alongside medication, for controlling hyperglycaemia, blood lipids and oxidative status in diabetes.

On the importance of accurate quantification of individual volatile metabolites in exhaled breath

It is argued that shortcomings of certain approaches to breath analysis research based on superficial interpretation of non-quantitative data are inadvertently inhibiting the progression of non-invasive breath analysis into clinical practice. The objective of this perspective is to suggest more clinically profitable approaches to breath research. Thus, following a discourse on the challenges and expectations in breath research, a brief indication is given of the analytical techniques currently used for the analysis of very humid exhaled breath. The seminal work that has been carried out using GC-MS revealed that exhaled breath comprises large numbers of trace volatile organic compounds, VOCs. Unfortunately, analysis of these valuable GC-MS data is mostly performed using chemometrics to distinguish the VOC content of breath samples collected from patients and healthy controls, and reliable quantification of the VOCs is rarely deemed necessary. This limited approach ignores the requirements of clinically acceptable biomarkers and misses the opportunity to identify relationships between the concentrations of individual VOCs and certain related physiological or metabolic parameters. Therefore, a plea is made for more effort to be directed towards the positive identification and accurate quantification of individual VOCs in exhaled breath, which are more physiologically meaningful as best exemplified by the quantification of breath nitric oxide, NO. Support for the value of individual VOC quantification is illustrated by the SIFT-MS studies of breath hydrogen cyanide, HCN, a biomarker of Pseudomonas aeruginosa infection, breath acetic acid as an indicator of airways acidification in cystic fibrosis patients, and n-pentane as a breath biomarker of inflammation in idiopathic bowel disease patients. These single VOCs could be used as non-invasive monitors of the efficacy of therapeutic intervention. The increase of breath methanol following the ingestion of a known amount of the sweetener aspartame impressively shows that accurate breath analysis is a reliable indicator of blood concentrations. However, using individual VOCs for specific disease diagnosis does have its problems and it is, perhaps, more appropriate to see their concentrations as proxy markers of general underlying physiological change. We dedicate this perspective to Lars Gustafsson for his seminal work on breath research and especially for his pioneering work on nitric oxide measurements in exhaled breath in asthma, which best shows the utility and value of the quantification of individual breath biomarkers on which this perspective focuses.

Many tocopherols, one vitamin E

Four tocopherols are available in nature and are absorbed with the diet, but only one RRR-α-tocopherol satisfies the criteria of being a vitamin. The biological activity of the different tocopherols studied in the rat by the resorption-gestation test has been inconsistently extrapolated to human beings where the tocopherols have no influence on a successful pregnancy. Diminution of RRR-α-tocopherol intake results in diseases characterized by ataxia, whose pathogenetic mechanism, despite vigorous claims, has not been clarified. The calculation of the Daily Reference Intake (DRI), necessary to prevent disease, is based on an obsolete test, the peroxide-induced erythrocyte hemolysis, called the gold standard, but of highly questioned validity. If many epidemiological studies have given positive results, showing prevention by high vitamin E containing diets of cardiovascular events, neurodegenerative disease, macular degeneration and cancer, the clinical confirmatory intervention studies were mostly negative. On the positive side, besides preventing vitamin E deficiency diseases, vitamin E has shown efficacy as anti-inflammatory and immune boosting compound. It has also shown some efficacy in protecting against nonalcoholic hepato-steatosis. At a molecular level, vitamin E and some of its metabolites have shown capacity of regulating cell signaling and modulating gene transcription.

Vitamin E: Emerging aspects and new directions

The discovery of vitamin E will have its 100th anniversary in 2022, but we still have more questions than answers regarding the biological functions and the essentiality of vitamin E for human health. Discovered as a factor essential for rat fertility and soon after characterized for its properties of fat-soluble antioxidant, vitamin E was identified to have signaling and gene regulation effects in the 1980s. In the same years the cytochrome P-450 dependent metabolism of vitamin E was characterized and a first series of studies on short-chain carboxyethyl metabolites in the 1990s paved the way to the hypothesis of a biological role for this metabolism alternative to vitamin E catabolism. In the last decade other physiological metabolites of vitamin E have been identified, such as α-tocopheryl phosphate and the long-chain metabolites formed by the ω-hydroxylase activity of cytochrome P-450. Recent findings are consistent with gene regulation and homeostatic roles of these metabolites in different experimental models, such as inflammatory, neuronal and hepatic cells, and in vivo in animal models of acute inflammation. Molecular mechanisms underlying these responses are under investigation in several laboratories and side-glances to research on other fat soluble vitamins may help to move faster in this direction. Other emerging aspects presented in this review paper include novel insights on the mechanisms of reduction of the cardiovascular risk, immunomodulation and antiallergic effects, neuroprotection properties in models of glutamate excitotoxicity and spino-cerebellar damage, hepatoprotection and prevention of liver toxicity by different causes and even therapeutic applications in non-alcoholic steatohepatitis. We here discuss these topics with the aim of stimulating the interest of the scientific community and further research activities that may help to celebrate this anniversary of vitamin E with an in-depth knowledge of its action as vitamin.

Response of blood cell antioxidant enzyme defences to antioxidant diet supplementation and to intense exercise

BACKGROUND

Exhaustive exercise induces oxidative stress. The cellular antioxidant defence systems have demonstrated great adaptation to chronic exercise.

AIM

To establish the influence of the antioxidant diet supplementation on the erythrocyte and lymphocyte antioxidant enzyme activities in athletes at basal and post-exercise levels.

METHODS

Fifteen amateur trained male athletes were randomly distributed in two groups: control and antioxidant supplemented (90 days' diet supplementation with 500 mg/day vitamin E and 30 mg/day beta-carotene, and the last 15 days also with 1 g/day vitamin C). The study was double blind. Maximal and submaximal exercise tests were performed after three months of diet supplementation. The study was developed during the training and competition season.

RESULTS

The sportsmen of the supplemented group presented significantly higher plasmatic final levels of vitamin C, vitamin E and beta-carotene. Erythrocyte glutathione reductase activity significantly decreased in the placebo group but was maintained in the supplemented group after the three months studied. The erythrocyte superoxide dismutase activity increased after the training/competition period in the placebo group. Lymphocyte catalase and glutathione peroxidase activities increased significantly in the supplemented group after the supplementation period but were maintained in the placebo group. No effects of the antioxidant supplementation were observed in the erythrocyte antioxidant enzyme response to the exercise tests. The antioxidant supplementation induced a better adaptation of lymphocyte catalase after submaximal test.

CONCLUSIONS

Lymphocytes showed higher sensibility to antioxidant supplementation, improving the response of antioxidant enzymes to training and to acute exercise. In erythrocytes the training adaptations were more important than the antioxidant supplementation effects.

Breath ethanol and acetone as indicators of serum glucose levels: an initial report

BACKGROUND

Many volatile organic compounds are present in exhaled breath and may represent by-products of endogenous biological processes. Ethanol is produced via alcoholic fermentation of glucose by gut bacteria and yeast, while acetone derives from oxidations of free fatty acids, influenced by glucose metabolism. We hypothesized that the integrated analysis of breath ethanol and acetone would provide a good approximation of the blood glucose profile during a glucose load.

METHODS

We collected simultaneous exhaled breath gas, ambient air, and serum glucose and insulin samples from 10 healthy volunteers at baseline and during an oral glucose tolerance test (OGTT) (ingestion of 75 g of glucose followed by 120 min of sampling). Gas samples were analyzed by gas chromatography/mass spectrometry.

RESULTS

Mean glucose values displayed a typical OGTT pattern (rapid increase, peak values at 30-60 min, and gradual return to near baseline by 120 min). Breath ethanol displayed a similar pattern early in the test, with peak values at 30 min; this was followed by a fast return to basal levels by 60 min. Breath acetone decreased progressively below basal levels, with lowest readings obtained at 120 min. A multiple regression analysis of glucose, ethanol, and acetone was used to estimate glucose profiles that correlated with measured glucose values with an average individual correlation coefficient of 0.70, and not lower than 0.41 in any subject.

CONCLUSION

The integrated analysis of multiple exhaled gases may serve as a marker of blood glucose levels. Further studies are needed to assess the usefulness of this method in different populations.

Antioxidant vitamin supplementation in Crohn's disease decreases oxidative stress. a randomized controlled trial

OBJECTIVE

We showed previously that patients with Crohn's disease (CD) had increased oxidative stress and lower antioxidant vitamins compared with healthy controls. This is despite inactive or mildly active disease and maintenance therapy. The aim of this study was to evaluate in these patients the effects of antioxidant vitamin supplementation on oxidative stress.

METHODS

This is a randomized controlled trial where stable but oxidatively stressed CD subjects (n = 57) were supplemented with vitamins E (800 IU) and C (1000 mg) or their placebo for 4 wk. Oxidative stress measured by breath pentane and ethane output, plasma lipid peroxides, and F2-isoprostane was assessed at baseline and at 4 wk. Disease activity was also monitored by measuring CD activity index and plasma orosomucoid.

RESULTS

During supplementation, plasma vitamin C and alpha-tocopherol increased and all indices of oxidative stress decreased significantly. Disease activity remained stable.

CONCLUSIONS

In this population, vitamin E and C supplementation resulted in a significant reduction in oxidative stress. This suggests that patients with inactive or mildly active CD can be oxidatively stressed and have increased requirement in antioxidant vitamins.

Effects of intravenous supplementation with alpha-tocopherol in patients receiving total parenteral nutrition containing medium- and long-chain triglycerides

OBJECTIVE

To compare the effects of a lipid emulsion containing medium-chain triglycerides (MCT) and supplemented with alpha-tocopherol to a conventional long-chain triglyceride (LCT) emulsion.

DESIGN

Randomised double blind study.

SETTING

Department of Internal Medicine, Antwerp University Hospital.

SUBJECTS AND INTERVENTIONS

Twenty-four patients with an indication for total parenteral nutrition for a minimum of 10 days were randomly assigned to two groups: group E received as lipid source MCT/LCT (50/50) suplemented with 100 mg DL-alpha-tocopherol/day and group C received LCT. Blood samples were analysed at inclusion, after 4-6 and after 9-11 days.

RESULTS

In group E, serum alpha-tocopherol doubled from 11.4+/-6.9 at inclusion to 20.9+/-7.9 and to 23.8+/-8.8 microg/ml after 4 and 9 days, respectively, but did not change in group C (P=0.008). Production of thiobarbituric acid-reacting substances (TBARS) after 120 min incubation with copper decreased from 66+/-34 at inclusion to 29+/-25 nmol MDA/mg LDL and VLDL-cholesterol after 4 and to 42+/-17 after 9 days (P=0.022 when compared to group C, which underwent no significant changes). Velocity of production of fluorescent products decreased in group E but not in group C (P=0.026).

CONCLUSIONS

Supplementation of TPN containing MCT/LCT with 100 mg DL-alpha-tocopherol/day leads to a doubling in serum alpha-tocopherol and to a decrease in the susceptibility of LDL and VLDL to peroxidation in vitro.

SPONSORSHIP

This study was partly financed by B Braun Medical NVSA, Diegem, Belgium.

Lipid peroxidation and plasma antioxidant micronutrients in Crohn disease

BACKGROUND

In Crohn disease (CD), the increased production of reactive oxygen species from activated neutrophils may reduce plasma concentrations of antioxidant vitamins and result in increased oxidative stress.

OBJECTIVE

We compared lipid peroxidation, a measure of reactive-oxygen-species production, and plasma antioxidant vitamin concentrations between CD patients and healthy control subjects.

DESIGN

Thirty-seven nonsmoking CD patients (22 women and 15 men) were compared with an equal number of healthy control subjects who were matched by age, sex, and body mass index. In patients the mean CD activity index (CDAI) was 141.2 +/- 18.7 (range: 9.0-514), and 11 of 37 patients (30%) had a CDAI > or =150. Seventy-eight percent of patients were taking > or = 1 medication. Medication use by subjects included the following: 5-aminosalicylic acid (40% of subjects), antibiotics (22%), oral corticosteroids (30%), and immunosuppressants (19%).

RESULTS

Lipid peroxidation as measured by breath pentane output (CD patients, 7.47 +/- 0.98 pmol x kg(-1) x min(-1); control subjects, 4.97 +/- 0.48 pmol x kg(-1) x min(-1); P < or = 0.025), breath ethane output (CD patients, 11.24 +/- 1.17 pmol x kg(-1) x min(-1); control subjects, 5.46 +/- 0.71 pmol x kg(-1) x min(-1); P < or = 0.0005) and F2-isoprostane (CD patients, 78.6 +/- 8.0 ng/L; control subjects, 60.6 +/- 3.7 ng/L; P < or = 0.047) were significantly higher in CD patients than in control subjects. Plasma antioxidant vitamins (ascorbic acid, alpha- and beta-carotene, lycopene, and beta-cryptoxanthin) were all significantly lower in CD patients than in control subjects. There were no significant differences in macro- and micronutrient intakes between groups.

CONCLUSION

Patients with CD are oxidatively stressed, which was observed even though 70% of patients had a CDAI < or =150 and 78% of them were taking medications to treat CD.

Breath isoprene in patients with heart failure

BACKGROUND

Chronic heart failure (CHF) is characterised by increased vascular resistance. This increased after load on the left ventricle contributes to the vicious cycle that leads to progression of myocardial failure, multiple organ failure and death. There is evidence for increased oxidative stress in heart failure, which will influence the myocardium but also peripheral vasculature endothelium.

AIMS

The aim of the present study was to examine the production of isoprene, reputed to reflect oxidative stress, in patients with CHF compared to control subjects.

METHODS

Twelve patients with CHF and thirty-one healthy control subjects free from heart disease were studied. Breath was collected via a two-way non-re-breathing valve into a 60-l gas collection bag. A sample of ambient air was collected at the same time. A measured aliquot of patient breath and ambient air (approx. 1.5 l) was adsorbed onto a gas adsorption tube packed with poropak-Q. Isoprene was measured using GC/MS and the production rate calculated. All samples of breath were collected at 10.00 h after subjects had been sitting at rest for 15 min.

RESULTS

Breath isoprene production in subjects with CHF was significantly reduced compared to controls 83(23) vs. 168(20) pmol min(-1) kg(-1).

CONCLUSION

Breath isoprene does not directly reflect oxidative stress in CHF.

A controlled clinical trial of vitamin E supplementation in patients with congestive heart failure

BACKGROUND

Oxidative stress is increased in patients with congestive heart failure and can contribute to the progressive deterioration observed in these patients. Increased oxidative stress is the result of either an increased production of free radicals or a depletion of endogenous antioxidants, such as vitamin E.

OBJECTIVE

We aimed to determine whether vitamin E supplementation of patients with advanced heart failure would modify levels of oxidative stress, thereby preventing or delaying the deterioration associated with free radical injury.

DESIGN

Fifty-six outpatients with advanced heart failure (New York Heart Association functional class III or IV) were enrolled in a double-blind randomized controlled trial for 12 wk. At a baseline visit and at 2 follow-up visits, blood and breath samples were collected for the measurement of indexes of heart function and disease state, including malondialdehyde, isoprostanes, and breath pentane and ethane. Quality of life was also assessed at baseline and after 12 wk of treatment.

RESULTS

Vitamin E treatment significantly increased plasma concentrations of alpha-tocopherol in the treatment group but failed to significantly affect any other marker of oxidative stress or quality of life. In addition, concentrations of atrial natriuretic peptide (a humoral marker of ventricular dysfunction), neurohormonal-cytokine markers of prognosis, tumor necrosis factor, epinephrine, and norepinephrine were unchanged with treatment and were not significantly different from those in the control group.

CONCLUSION

Supplementation with vitamin E did not result in any significant improvements in prognostic or functional indexes of heart failure or in the quality of life of patients with advanced heart failure.

Urinary aldehydes as indicators of lipid peroxidation in vivo

The excretion of malondialdehyde (MDA), lipophilic aldehydes and related carbonyl compounds in rat and human urine was investigated. MDA was found to be excreted mainly in the form of two adducts with lysine, indicating that its predominant reaction in vivo is with the lysine residues of proteins. Adducts with the phospholipid bases serine and ethanolamine and the nucleic acid bases guanine and deoxyguanosine also were found. Except for the adduct with deoxyguanosine (dG-MDA), the excretion of these compounds increased with peroxidative stress imposed in the form of vitamin E deficiency or the administration of iron or carbon tetrachloride. Marked differences in the concentration of dG-MDA in different tissues were correlated with their content of fatty acids having three or more double bonds, the putative source of MDA. Fourteen nonpolar and eleven polar lipophilic aldehydes and other carbonyl compounds were identified as their 2,4-diphenylhydrazine derivatives in rat urine. The excretion of five nonpolar and nine polar compounds was increased under conditions of peroxidative stress. The profile of lipophilic aldehydes obtained for human urine resembled that for rat urine. Except for a reported 4-hydroxynon-2-enal conjugate with mercapturic acid, the conjugated forms of the lipophilic aldehydes excreted in urine remain unidentified. Aldehyde excretion is influenced by numerous factors that affect the formation of lipid peroxides in vivo such as energy status, physical activity and environmental temperature, as well as by wide variations in the intake of peroxides in the diet. Consequently, urinalysis for aldehydic products of lipid peroxidation is an unreliable indicator of the general state of peroxidative stress in vivo.

Is endogenous isoprene the only coeluting compound in the measurement of breath pentane?

Pentane is a widely used index of lipid peroxidation. Although isopentane, an isomer of pentane, is a major component of ambient air in urban areas, many studies have disregarded the possibility that this compound is coeluted in the measurement of breath pentane. In the present study, a gas chromatograph equipped with a cold trap apparatus and a large-bore glass capillary column was used for determination of pentane, isopentane and isoprene in breath and ambient air. Isoprene was detected in all subjects at a concentration higher than that in the ambient air. However, the concentrations of breath pentane and isopentane were similar to, or less than, those of the ambient air. We suggest that great care is required in the measurement of breath pentane so that endogenous isoprene and ambient isopentane are not coeluted.

Vitamin E: non-antioxidant roles

Vitamin E was originally considered a dietary factor of animal nutrition especially important for normal reproduction. The significance of vitamin E has been subsequently proven as a radical chain breaking antioxidant that can protect the integrity of tissues and play an important role in life processes. More recently alpha-tocopherol has been found to possess functions that are independent of its antioxidant/radical scavenging ability. Absorption in the body is alpha-tocopherol selective and other tocopherols are not absorbed or are absorbed to a lesser extent. Furthermore, pro-oxidant effects have been attributed to tocopherols as well as an anti-nitrating action. Non-antioxidant and non-pro-oxidant molecular mechanisms of tocopherols have been also described that are produced by alpha-tocopherol and not by beta-tocopherol. alpha-Tocopherol specific inhibitory effects have been seen on protein kinase C, on the growth of certain cells and on the transcription of some genes (CD36, and collagenase). Activation events have been seen on the protein phosphatase PP2A and on the expression of other genes (alpha-tropomyosin and Connective Tissue Growth Factor). Non-antioxidant molecular mechanisms have been also described for gamma-tocopherol, delta-tocopherol and tocotrienols.

Breath alkanes as a marker of oxidative stress in different clinical conditions

We assessed oxidative stress in three different clinical conditions: smoking, human immunodeficiency virus (HIV) infection, and inflammatory bowel disease, using breath alkane output and other lipid peroxidation parameters such as plasma lipid peroxides (LPO) and malondialdehyde (MDA). Antioxidant micronutrients such as selenium, vitamin E, C, beta-carotene and carotenoids were also measured. Lipid peroxidation was significantly higher and antioxidant vitamins significantly lower in smokers compared to nonsmokers. Beta-carotene or vitamin E supplementation significantly reduced lipid peroxidation in that population. However, vitamin C supplementation had no effect. In HIV-infected subjects, lipid peroxidation parameters were also elevated and antioxidant vitamins reduced compared to seronegative controls. Vitamin E and C supplementation resulted in a significant decrease in lipid peroxidation with a trend toward a reduction in viral load. In patients with inflammatory bowel disease, breath alkane output was also significantly elevated when compared to healthy controls. A trial with vitamin E and C is underway. In conclusion, breath alkane output, plasma LPO and MDA are elevated in certain clinical conditions such as smoking, HIV infection, and inflammatory bowel disease. This is associated with lower levels of antioxidant micronutrients. Supplementation with antioxidant vitamins significantly reduced these lipid peroxidation parameters. The results suggest that these measures are good markers for lipid peroxidation.

Asthma, oxidant stress, and diet

It has been suggested that the increased prevalence of atopy and asthma observed in many developed countries over the past 30 y is in part the result of a decrease in the incidence and severity of early childhood infections. The immunologic consequence of this phenomenon has been the expansion of T-lymphocyte populations away from the T-helper 1 (Th1) subset and in the direction of the Th2 subset. This leads to the creation of a cytokine-mediated propensity for the development of an intense inflammatory response in the airways, resulting in oxidative stress, airway tissue injury, and the development of atopy and asthmatic symptomatology. Over this same period, there has been a decreased intake of dietary substances that contribute to antioxidant defense, and this appears to have contributed to the rise of atopy and asthma. Studies evaluating the efficacy of these antioxidant substances in the prevention of asthma and as adjuvants in the treatment of asthma are reviewed, and suggestions are made for the direction of future studies.

A practical and reliable method for measuring ethane and pentane in expired air from humans

We describe a method for the collection of expired air and further document the performance of our analytical technique that is used to measure ethane and pentane simultaneously. Four minutes of breathing hydrocarbon-free air before collection effectively removed high concentrations of residual ambient ethane and pentane from the lungs, with washout times up to 30 min resulting in no further reductions in breath hydrocarbons. Mean (+/-SE) exhalation rates (pmol/kg b.wt./min) in 11 subjects were 2.4 +/- 0.6 for ethane and 1.5 +/- 1.3 for pentane. Total intraindividual variability in exhalation rates (as percent coefficient of variation, %CV), measured from 4 subjects on at least 6 different days, was greater for pentane (44% CV) than for ethane (29% CV). Analytical variability contributed 6% to the total %CV. Advantages of the method are described, and reasons for the large variability in values reported in the literature are discussed.

Vitamins and arthritis. The roles of vitamins A, C, D, and E

There are at least four mechanisms whereby the nutrient vitamins A, C, D, and E may be related to the processes that impede or give rise to OA. These nutrient vitamins have major roles in modulating oxidative stress, participating in immune responses, and contributing to cell differentiation. There is a substantial need to understand the contribution of these nutrients to OA, because they may provide important insight into ameliorating the initiation and progression of the disease. Simultaneously, greater understanding will add rationality to an area of potential intervention that is often based on anecdote. Investigation will be complex; there is the need to select appropriate systems. Typical animal model systems used in the study of OA are inappropriate because most animals can synthesize ascorbic acid. There is the need to disaggregate, as much as possible, the numerous subsets of OA and the plethora of processes that contribute to that heterogeneity. Certainly, there is the need to recognize the interdependency of the actions of each of these nutrients at the cellular level. Furthermore, humans rarely consume these nutrients as independent products. For example, watermelon is a primary source of both ascorbic acid and beta-carotene. Failure to address these complexities denies the scientist the opportunity to advance our understanding of health and disease processes. More importantly, failure to address these complexities denies the person with OA the opportunity to address his or her own health.

Optimal nutrition: vitamin E

Interest in the role of vitamin E in disease prevention has encouraged the search for reliable indices of vitamin E status. Most studies in human subjects make use of static markers, usually alpha-tocopherol concentrations in plasma or serum. Plasma or serum alpha-tocopherol concentrations of < 11.6, 11.6-16.2, and > 16.2 mumol/l are normally regarded as indicating deficient, low and acceptable vitamin E status respectively, although more recently it has been suggested that the optimal plasma alpha-tocopherol concentration for protection against cardiovascular disease and cancer is > 30 mumol/l at common plasma lipid concentrations in combination with plasma vitamin C concentrations of > 50 mumol/l and > 0.4 mumol beta-carotene/l. Assessment of vitamin E status has also been based on alpha-tocopherol concentrations in erythrocytes, lymphocytes, platelets, lipoproteins, adipose tissue, buccal mucosal cells and LDL, and on alpha-tocopherol: gamma-tocopherol in serum or plasma. Erythrocyte susceptibility to haemolysis or lipid oxidation, breath hydrocarbon exhalation, oxidative resistance of LDL, and alpha-tocopheryl quinone concentrations in cerebrospinal fluid have been used as functional markers of vitamin E status. However, many of these tests tend to be non-specific and poorly standardized. The recognition that vitamin E has important roles in platelet, vascular and immune function in addition to its antioxidant properties may lead to the identification of more specific biomarkers of vitamin E status.

Effects of vitamin E and C supplementation on oxidative stress and viral load in HIV-infected subjects

OBJECTIVES

The HIV-infected population is known to be oxidatively stressed and deficient in antioxidant micronutrients. Since in vitro replication of HIV is increased with oxidative stress, this study assessed the effect of antioxidant vitamin supplementation on lipid peroxidation, a measure of oxidative stress, and viral load in humans.

DESIGN

A randomized placebo-controlled, double-blind study.

METHODS

Forty-nine HIV-positive patients were randomized to receive supplements of both DL-alpha-tocopherol acetate (800 IU daily) and vitamin C (1000 mg daily), or matched placebo, for 3 months. Plasma antioxidant micronutrient status, breath pentane output, plasma lipid peroxides, malondialdehyde and viral load were measured at baseline and at 3 months. New or recurrent infections for the 6-month period after study entry were also recorded.

RESULTS

The vitamin group (n = 26) had an increase in plasma concentrations of alpha-tocopherol (P < 0.0005) and vitamin C (P < 0.005) and a reduction in lipid peroxidation measured by breath pentane (P < 0.025), plasma lipid peroxides (P < 0.01) and malondialdehyde (P < 0.0005) when compared with controls (n = 23). There was also a trend towards a reduction in viral load (mean +/- SD changes over 3 months, -0.45 +/- 0.39 versus +0.50 +/- 0.40 log10 copies/ml; P = 0.1; 95% confidence interval, -0.21 to -2.14). The number of infections reported was nine in the vitamin group and seven in the placebo group.

CONCLUSION

Supplements of vitamin E and C reduce oxidative stress in HIV and produce a trend towards a reduction in viral load. This is worthy of larger clinical trials, especially in HIV-infected persons who cannot afford new combination therapies.

The effect of exercise intensity on lipid peroxidation

This study characterizes exercise-induced lipid peroxidation during graded aerobic exercise in seven healthy men and women (36.4 +/- 3 yr). Levels of ethane and pentane in expired breath during cardiopulmonary exercise stress testing were measured at rest, lactic acidosis threshold (LAT), maximal exercise (VO2max), and recovery. Serum malonaldehyde (MDA) levels were measured at rest before exercise and 5 min after maximal exercise. Expired ethane and pentane flux levels were increased above resting levels at LAT, continued to rise at VO2max, then declined during recovery. Serum MDA levels were not significantly different before and after maximal exercise. Substantial exercise-induced lipid peroxidation (by expired ethane and pentane) apparently occurred in healthy individuals at LAT and continued to increase at VO2max, yet rapidly attenuated during post-exercise recovery. These findings indicate that in healthy individuals physical exercise induced lipid peroxidation transiently and that there was a removal of lipid peroxidation byproducts during recovery.

Lipid peroxidation during n-3 fatty acid and vitamin E supplementation in humans

The purpose of this study was to investigate in healthy humans the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake, alone or in combination with dL-alpha-tocopherol acetate (vitamin E) supplements on lipid peroxidation. Eighty men were randomly assigned in a double-blind fashion to take daily for 6 wk either menhaden oil (6.26 g, n-3 fatty acids) or olive oil supplements with either vitamin E (900 IU) or its placebo. Antioxidant vitamins, phospholipid composition, malondialdehyde (MDA), and lipid peroxides were measured in the plasma at baseline and week 6. At the same time, breath alkane output was measured. Plasma alpha-tocopherol concentration increased in those receiving vitamin E (P < 0.0001). In those supplemented with n-3 fatty acids, EPA and DHA increased in plasma phospholipids (P < 0.0001) and plasma MDA and lipid peroxides increased (P < 0.001 and P < 0.05, respectively). Breath alkane output did not change significantly and vitamin E intake did not prevent the increase in lipid peroxidation during menhaden oil supplementation. The results demonstrate that supplementing the diet with n-3 fatty acids resulted in an increase in lipid peroxidation, as measured by plasma MDA release and lipid peroxide products, which was not suppressed by vitamin E supplementation.

Breath pentane concentrations during labor and the effect of epidural analgesia on the pentane concentration

Increased lipid peroxidation has been observed in pregnancy and particularly in preeclampsia. Pentane, a by-product of lipid peroxidation, can be measured in exhaled breath, and its measurement is considered a non-invasive method of assessing lipid peroxidation in vivo. We measured pentane levels in the breath of 36 healthy parturient women and examined the effect of epidural analgesia on the pentane level. Single-expiratory breath samples were analyzed by gas chromatography. The breath pentane level was higher during labor (4.88 parts per billion [p.p.b.], 95% confidence interval 3.25-6.51 p.p.b.) than before the induction of labor (3.10 p.p.b., 95% confidence interval 2.01-4.19 p.p.b.). There was a significant decrease in the pentane level after the institution of epidural analgesia (2.27 p.p.b., 95% confidence interval 1.43-3.11 p.p.b.). Our results suggest that labor may be accompanied by an increase in lipid peroxidation, and epidural analgesia reverses this increase.

Influence of vitamin E treatment on glutathione system after renal ischemia in immature and adult rats

Survival rates were not significantly different 5 days after 20-min unilateral ischemia followed by contralateral nephrectomy: 58% in 20-day-old vs. 77% in 55-day-old rats. This experimental approach was used to characterize age dependent differences in the susceptibility of the glutathione system to ischemia and protective effects of treatment with vitamin E (10 mg/100 g b.wt. once daily s.c.) on the outcome after renal ischemia. The degree of postischemic changes (GSH, gamma-GT, TBARS) was the highest on days 1 and 2 after ischemia; at this time, survival rates were similar in young and adult rats. In adult animals, both glutathione content and the activity of gamma-GT were significantly reduced after ischemia whereas in immature rats only the glutathione content was distinctly diminished. At the 5th day after ischemia the parameters were almost normalized in the two age groups. Repeated administration of vitamin E improved the survival rate in adult rats up to 100%; in young animals, lethality was not influenced by vitamin E treatment. This reflects the beneficial effects of vitamin E on the glutathione system in adults whereas the vitamin was without effect on the immature rats' glutathione system.

Prooxidant effects of maternal smoking and formula in newborn infants

BACKGROUND

The purpose of this study was to use the breath ethane test to determine if either maternal cigarette smoking, formula, and/or deficiency of the antioxidant nutrients vitamins A and E was associated with oxidant stress in newborn infants. The rationale for this study was: (1) our observation that cigarette smoking was a source of oxidant stress in pregnant women, suggesting that it could be a source of oxidant stress for infants exposed in utero; (2) formula was predicted to be prooxidant compared to colostrum, which contains several compounds with antioxidant activity in vitro; and (3) deficiencies of vitamins A and E have been shown to promote oxidant stress in experimental animals.

METHODS

Breath ethane, a volatile alkane produced by peroxide of n-3 fatty acids, was utilized as an index of oxidant stress status. Forty-five healthy full-term infants of the women mentioned above were studied at 18-24 h of age, after four to six feedings of breast milk (colostrum) or caseinbased infant formula. Relationships between infant breath ethane, maternal smoking, mode of infant nutrition, and serum concentrations of the antioxidant vitamins A and E of infants were examined.

RESULTS

The breath ethane of the entire group of infants whose mothers smoked (n = 19) was increased compared to values of infants whose mothers did not smoke (n = 26): 97 +/- 16 versus 43 +/- 9 pmol/kg/min, p < 0.03. When infants of mothers who smoked were eliminated from the analysis in order to study effects of nutrition alone, formula appeared to be prooxidant compared to breast milk. Breath ethane of formula-fed infants (n = 16) was 62 +/- 13 versus 13 +/- 4 pmol/kg/min for breast-fed infants (n = 10), p < 0.04. For the group as a whole, there was no correlation between infant breath ethane and serum concentrations of vitamins A and E.

CONCLUSIONS

Exposure to maternal smoking in utero is prooxidant in newborn infants. Formula also has a prooxidant effect compared to colostrum in newborn infants not exposed to maternal smoking in utero. Further investigations will be necessary to explore the clinical consequences of these observations.

Gas chromatographic method using photoionization detection for the determination of breath pentane

Lipid peroxidation is thought to be an important event in the pathogenesis of atherosclerosis. It has been suggested that pentane, which can be formed during the oxidation of omega-6 fatty acids, is a marker of lipid peroxidation. Previous studies have reported elevated breath pentane and serum markers of lipid peroxidation in smokers. However, chromatographic separation of pentane from isoprene in virtually all of these studies was incomplete and the methods used did not resolve pentane into its isomers, n-pentane and isopentane. Additionally, most current methods are complicated, requiring trapping and concentrating steps to obtain adequate sensitivity prior to hydrocarbon analysis. The purpose of the current study was to develop a gas chromatographic system to analyze breath pentane, that addresses the above technical problems and that would provide a simple in vivo method for measuring lipid. n-Pentane and isopentane standards were easily separated from isoprene with a Al2O3/KCI capillary column contained in a portable gas chromatograph equipped with a photoionization detector. The analysis of repeated measures showed a low coefficient of variation for measurements of n-pentane (10%) and isopentane (9%). We measured breath pentane in 27 subjects (15 smokers, 12 non-smokers). There were no significant difference between the baseline and 4 week interval measurements of n-pentane for smokers both before and after cigarette smoking. The within-subject variability data showed that the assay is highly reproducible for both low and high pentane levels in smokers. Smokers were found to have higher levels of both n-pentane and isopentane than non-smokers (P < 0.001). In addition, smokers had further significant elevation of pentane levels 10 min after smoking (P < 0.001), which returned to baseline by 1 h. These studies demonstrate that measurement of breath pentane, using a gas chromatograph with a photoionization detector, is simple and reproducible. Additionally, these results suggest that pentane elevation associated with smoking is secondary to the oxidant effects of cigarette smoke and an important temporal relationship exists between cigarette smoking and breath sample analysis.

Role of oxidative stress in transition of hypertrophy to heart failure

OBJECTIVES

In an attempt to define the role of increased oxidative stress in the transition from compensatory hypertrophy to heart failure, this study examined the effects of long-term vitamin E therapy on the occurrence of heart failure subsequent to chronic pressure overload in guinea pigs.

BACKGROUND

Hyperfunctional heart hypertrophy has been shown to be accompanied by an increase in the endogenous antioxidant reserve, whereas congestive heart failure is accompanied by a decrease in this reserve. The effects of vitamin E, a naturally occurring antioxidant, on the development of heart failure from a hypertrophic stage were examined.

METHODS

The ascending aorta in guinea pigs was coarcted. For vitamin treatment, slow-release pellets were implanted at the time of the operation. The animals were assessed at 10 and 20 weeks for hemodynamic function, myocardial structure, antioxidant agents and oxidative stress.

RESULTS

Banding of the ascending aorta in guinea pigs resulted in hyperfunctional hypertrophy at 10 weeks, which was followed by congestive heart failure at 20 weeks. Hypertrophied hearts showed decreased oxidative stress, as evidenced by a higher oxidation-reduction (redox) state and less lipid peroxidation, whereas the failure stage was characterized by increased oxidative stress. Supplementation of animals with timed-release vitamin E tablets resulted in an increased myocardial content of the vitamin, and the banded animals did not develop any signs of heart failure at 20 weeks. Hemodynamic function at 20 weeks in these vitamin E-treated animals was also better maintained. The myocardial reduced glutathione/oxidized glutathione ratio of vitamin E-treated animals at 20 weeks was higher and lipid peroxidation was less compared with the untreated animals. Ultrastructural abnormalities were significantly less in the vitamin E-treated hearts compared with the untreated failing hearts at 20 weeks.

CONCLUSIONS

An improved myocardial redox state with vitamin E therapy, coupled with the modulation of the development of heart failure, may indicate a pathophysiologic role for increased oxidative stress in the pathogenesis of heart failure. This study suggests the potential therapeutic value of long-term antioxidant treatment in modulating or preventing the pathogenesis of heart failure.

Lipid peroxidation status as an index to evaluate the influence of dietary fats on vitamin E requirements of young pigs

The aims of the present study were to establish a suitable criterion for estimating the vitamin E requirement for young pigs, and to investigate the influence of dietary fats on the requirement of this nutrient. In Expt 1 weaned pigs were given a semi-purified diet supplemented with 0, 20, or 100 mg DL-alpha-tocopheryl acetate/kg. Pigs in Expt 2 were fed on diets containing 10 g sunflower oil (SO) stripped of vitamin E/kg in diets 1 and 2, 100 g SO/kg in diets 3 and 4, and 100 g tallow/kg in diet 5. Diets 2, 4 and 5 were supplemented with DL-alpha-tocopheryl acetate at 20 mg/kg for 0-28 d and 50 mg/kg for 29-56 d of the experiment respectively. Results showed that vitamin E concentrations in plasma and tissues reflected dietary levels of vitamin E. No apparent clinical signs of vitamin E deficiency were observed, but pigs fed on diets without vitamin E supplementation showed a higher (P < 0.05) lipid peroxidation status as indicated by thiobarbituric acid-reactive substances in erythrocytes, and ethane and pentane levels in exhaled gases than those fed on supplemental diets. This indicated that the former was deficient in vitamin E. Data in Expt 1 suggested that supplementation with 20 mg DL-alpha-tocopheryl acetate/kg is adequate for young pigs when the diet contains 30 g lard/kg. However, results in Expt 2 showed that this level was inadequate when the diet contains 100 g SO/kg or its equivalent to 70 mg polyunsaturated fatty acids (PUFA)/g. Vitamin E and lipid peroxidation status of pigs were affected by both dietary vitamin E and dietary PUFA. This demonstrates that the requirement for vitamin E in young pigs increases as PUFA levels in the diet increase. The present study shows that lipid peroxidation response of pigs is a suitable index to evaluate vitamin E requirements.

Levels of lipid peroxidation and antioxidants in vegetarians

Age dependence of lipid peroxidation levels estimated as conjugated dienes (CD) of plasma fatty acids was investigated in vegetarian and non-vegetarian males and females aged 11-14, 15-18, 19-39 and 40-60 years. The increase of CD levels with age was found in probands on both types of nutrition up to the age of 40 years. In the first three age groups, lipid peroxidation was insignificantly lower in vegetarians when compared to nonvegetarians. The increase of conjugated dienes was on the level of significance (p < 0.05) in the oldest vegetarians vs nonvegetarians. Therefore, content of defense parameters--antioxidative vitamin and enzyme--was estimated in blood of vegetarians aged 40-60 years. Significantly higher levels of vitamin C and catalase activity were found in vegetarians (C-63.6 and 86.5 mumol/l; CAT-1497 and 1313 U/ml for males and females, respectively) when compared to nonvegetarians (C-41.3 and 54.4 mumol/l; CAT-1192 and 1086 U/ml). A significant negative linear correlation (p < 0.001) for CD-C and CD-CAT was found in both sexes of vegetarians and in nonvegetarian females (p < 0.05 for nonvegetarian males). Important finding is a more pronounced in vegetarians (2.5-3.4 times higher slope of regression lines) indicating positive effect of vegetarian nutrition on efficiency of protection system.

The potential of the hydrocarbon breath test as a measure of lipid peroxidation

The straight chain aliphatic hydrocarbons ethane and pentane have been advocated as noninvasive markers of free-radical induced lipid peroxidation in humans. In in vitro studies, the evolution of ethane and pentane as end products of n-3 and n-6 polyunsaturated fatty acids, respectively, correlates very well with other markers of lipid peroxidation and even seems to be the most sensitive test available. In laboratory animals the use of both hydrocarbons as in vivo markers of lipid peroxidation has been validated extensively. Although there are other possible sources of hydrocarbons in the body, such as protein oxidation and colonic bacterial metabolism, these apparently are of limited importance and do not interfere with the interpretation of the hydrocarbon breath test. The production of hydrocarbons relative to that of other end products of lipid peroxidation depends on variables that are difficult to control, such as the local availability of iron(II) ions and dioxygen. In addition, hydrocarbons are metabolized in the body, which especially influences the excretion of pentane. Because of the extremely low concentrations of ethane and pentane in human breath, which often are not significantly higher than those in ambient air, the hydrocarbon breath test requires a flawless technique regarding such factors as: (1) the preparation of the subject with hydrocarbon-free air to wash out ambient air hydrocarbons from the lungs, (2) the avoidance of ambient air contamination of the breath sample by using appropriate materials for sampling and storing, and (3) the procedures used to concentrate and filter the samples prior to gas chromatographic determination. For the gas chromatographic separation of hydrocarbons, open tubular capillary columns are preferred because of their high resolution capacity. Only in those settings where expired hydrocarbon levels are substantially higher than ambient air levels might washout prove to be unnecessary, at least in adults. Although many investigators have concentrated on one marker, it seems preferable to measure both ethane and pentane concurrently. The results of the hydrocarbon breath test are not influenced by prior food consumption, but both vitamin E and beta-carotene supplementation decrease hydrocarbon excretion. Nevertheless, the long-term use of a diet high in polyunsaturated fatty acids, such as in parenteral nutrition regimens, may result in increased hydrocarbon exhalation. Hydrocarbon excretion slightly increases with increasing age. Short-term increases follow physical and intellectual stress and exposure to hyperbaric dioxygen.(ABSTRACT TRUNCATED AT 400 WORDS)