Association Between Nitrite and Nitrate Intake and Risk of Gastric Cancer: A Systematic Review and Meta-Analysis

Dietary Nitrate from Plant Foods: A Conditionally Essential Nutrient for Cardiovascular Health

Under specific conditions, such as catabolic stress or systemic inflammation, endogenous nutrient production becomes insufficient and exogenous supplementation (for example, through dietary intake) is required. Herein, we propose consideration of a dietary nitrate from plant foods as a conditionally essential nutrient for cardiovascular health based on its role in nitric oxide homeostasis. Nitrate derived from plant foods may function as a conditionally essential nutrient, whereas nitrate obtained from other dietary sources, such as drinking water and cured/processed meats, warrants separate consideration because of the associated health risks. We have surveyed the literature and summarized epidemiological evidence regarding the effect of dietary nitrate on cardiovascular disease and risk factors. Meta-analyses and population-based observational studies have consistently demonstrated an inverse association of dietary nitrate with blood pressure and cardiovascular disease outcomes. Considering the available evidence, we suggest 2 different approaches to providing dietary guidance on nitrate from plant-based dietary sources as a nutrient: the Dietary Reference Intakes developed by the National Academies of Sciences, Engineering, and Medicine, and the dietary guidelines evaluated by the Academy of Nutrition and Dietetics. Ultimately, this proposal underscores the need for food-based dietary guidelines to capture the complex and context-dependent relationships between nutrients, particularly dietary nitrate, and health.

Ultrasonic and homogenization: An overview of the preparation of an edible protein-polysaccharide complex emulsion

Emulsion systems are extensively utilized in the food industry, including dairy products, such as ice cream and salad dressing, as well as meat products, beverages, sauces, and mayonnaise. Meanwhile, diverse advanced technologies have been developed for emulsion preparation. Compared with other techniques, high-intensity ultrasound (HIUS) and high-pressure homogenization (HPH) are two emerging emulsification methods that are cost-effective, green, and environmentally friendly and have gained significant attention. HIUS-induced acoustic cavitation helps in efficiently disrupting the oil droplets, which effectively produces a stable emulsion. HPH-induced shear stress, turbulence, and cavitation lead to droplet disruption, altering protein structure and functional aspects of food. The key distinctions among emulsification devices are covered in this review, as are the mechanisms of the HIUS and HPH emulsification processes. Furthermore, the preparation of emulsions including natural polymers (e.g., proteins-polysaccharides, and their complexes), has also been discussed in this review. Moreover, the review put forward to the future HIUS and HPH emulsification trends and challenges. HIUS and HPH can prepare much emulsifier-stable food emulsions, (e.g., proteins, polysaccharides, and protein-polysaccharide complexes). Appropriate HIUS and HPH treatment can improve emulsions' rheological and emulsifying properties and reduce the emulsions droplets' size. HIUS and HPH are suitable methods for developing protein-polysaccharide forming stable emulsions. Despite the numerous studies conducted on ultrasonic and homogenization-induced emulsifying properties available in recent literature, this review specifically focuses on summarizing the significant progress made in utilizing biopolymer-based protein-polysaccharide complex particles, which can provide valuable insights for designing new, sustainable, clean-label, and improved eco-friendly colloidal systems for food emulsion. PRACTICAL APPLICATION: Utilizing complex particle-stabilized emulsions is a promising approach towards developing safer, healthier, and more sustainable food products that meet legal requirements and industrial standards. Moreover, the is an increasing need of concentrated emulsions stabilized by biopolymer complex particles, which have been increasingly recognized for their potential health benefits in protecting against lifestyle-related diseases by the scientific community, industries, and consumers.

Content of nitrate and nitrite in commercial and self-made beetroot juices and the effect of storage temperature

Popularity of beetroot juice (BJ) is growing due to its high inorganic nitrate content NO 3 - and its potential physiological benefits. However, the content of NO 3 - is not indicated in most commercial BJs and it can be affected by seasonal changes and storage conditions. This study analyzed the content of NO 3 - and nitrite NO 2 - in five and two commercial and self-made BJs, respectively, that were purchased in the summer and winter periods. The effect of storage temperature (20°C, 4°C, and -20°C) and pH was also analyzed. In nonconcentrated BJs, the NO 3 - content was 34 ± 20% (p = .075) in the winter than in the summer. NO 3 - was fully degraded in self-made BJ after 3 days at 20°C. This effect was attenuated by 78% and 82% when it was kept at 4°C and -20°C, respectively. The addition of lemon juice (5%) to self-made BJ was another useful approach to avoid NO 3 - degradation for 3 days when it was kept at 20°C. Regarding NO 2 - , self-made BJ had higher concentration (0.097 ± 0.01 mg/mL) compared to commercial BJs (<0.1 mg/mL; p = .001). The pH of self-made BJ was higher (6.3 ± 0.1) compared to commercial BJs (4.5 ± 0.3; p = .001). These results suggest that the content of NO 3 - in nonconcentrated BJs can substantially differ across the year and this is an important factor to take into account when recommending BJs to promote some of its potential physiological benefits.

Novel strategies for controlling nitrite content in prepared dishes: Current status, potential benefits, limitations and future challenges

Sodium nitrite is commonly used as a multifunctional curing ingredient in the processing of prepared dishes, especially meat products, to impart unique color, flavor and to prolong the shelf life of such products. However, the use of sodium nitrite in the meat industry has been controversial due to potential health risks. Finding suitable substitutes for sodium nitrite and controlling nitrite residue have been a major challenge faced by the meat processing industry. This paper summarizes possible factors affecting the variation of nitrite content in the processing of prepared dishes. New strategies for controlling nitrite residues in meat dishes, including natural pre-converted nitrite, plant extracts, irradiation, non-thermal plasma and high hydrostatic pressure (HHP), are discussed in detail. The advantages and limitations of these strategies are also summarized. Raw materials, cooking techniques, packaging methods, and storage conditions all affect the content of nitrite in the prepared dishes. The use of vegetable pre-conversion nitrite and the addition of plant extracts can help reduce nitrite residues in meat products and meet the consumer demand for clean labeled meat products. Atmospheric pressure plasma, as a non-thermal pasteurization and curing process, is a promising meat processing technology. HHP has good bactericidal effect and is suitable for hurdle technology to limit the amount of sodium nitrite added. This review is intended to provide insights for the control of nitrite in the modern production of prepared dishes.

Association between type of drinking water and upper gastrointestinal cancer incidence in the Linxian General Population

BACKGROUND

This study aimed to explore the association between drinking water source and risk of upper gastrointestinal (UGI) cancer, including esophageal cancer (EC) and gastric cancer (GC), in the Linxian General Population Nutrition Intervention Trial (NIT) cohort.

METHODS

In this study, we used data from the Linxian NIT cohort, which included 29,584 healthy adults aged 40 to 69 years. Subjects were enrolled in April 1986 and followed up until March 2016. Tap water drinking status and demographic characteristics were collected at baseline. Subjects who drank tap water were treated as the exposed group. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using the Cox proportional hazard model.

RESULTS

A total of 5,463 cases of UGI cancer were identified during the 30-year follow-up period. After adjusting for multiple factors, the incidence rate of UGI cancer in participants who drank tap water was significantly lower compared with individuals in the control (HR = 0.91, 95% CI: 0.86-0.97). A similar association was observed between tap water drinking and EC incidence (HR = 0.89, 95% CI: 0.82-0.97). The association between drinking tap water and risk of UGI cancer and EC incidence did not vary across the subgroup by age and gender (All P_interaction > 0.05). For EC incidence, an interaction effect was observed for riboflavin/niacin supplements and drinking water source (P_interaction = 0.03). No association was observed between drinking water source and GC incidence.

CONCLUSIONS

In this prospective cohort study in Linxian, participants who drank tap water had a lower risk of EC incidence. As a source of drinking water, use of tap water may reduce the risk of EC by avoiding exposure to nitrate/nitrite. Measures should be taken to improve the quality of drinking water in high-incidence areas of EC.

TRIAL REGISTRATION

The trial is registered with ClinicalTrials.gov (NCT00342654, 21/06/2006), and the trial name is Nutrition Intervention Trials in Linxian Follow-up Study.

Effects of NaCl and CaCl2 as Eustress Factors on Growth, Yield, and Mineral Composition of Hydroponically Grown Valerianella locusta

Corn salad (Valerianella locusta) is a popular winter salad, cultivated as an ingredient for ready-to-eat salads. The application of mild salinity stress (eustress) can increase the flavor and reduce the nitrate content of certain crops but, at the same time, a wrong choice of the eustress type and dose can negatively affect the overall productivity. In this research, the effects of different isosmotic salt solutions, corresponding to two different electrical conductivity (EC) levels, were investigated on the yield and mineral composition of hydroponically grown Valerianella locusta "Elixir". Five nutrient solutions (NS) were compared, including a basic NS used as the control, and four saline NS were obtained by adding to the basic NS either NaCl or CaCl₂ at two rates each, corresponding to two isosmotic salt levels at a low and high EC level. Corn salad proved moderately susceptible to long-term salinity stress, suffering growth losses at both low and high EC levels of saline solution, except from the low NaCl treatment. Hence, it appears that mild salinity stress induced by NaCl could be employed as an eustress solution and corn salad could be cultivated with low-quality irrigation water (20 mM NaCl) in hydroponic systems.

Association of Dietary Nitrate, Nitrite, and N-Nitroso Compounds Intake and Gastrointestinal Cancers: A Systematic Review and Meta-Analysis

N-nitroso compounds (NOCs) are a class of chemical carcinogens found in various environmental sources such as food, drinking water, cigarette smoke, the work environment, and the indoor air population. We conducted a systematic review and meta-analysis to investigate the links between nitrate, nitrite, and NOCs in food and water and the risk of gastrointestinal (GI) cancers, including esophageal cancer (EC), gastric cancer (GC), colorectal cancer (CRC), and pancreatic cancer (PC). A systematic search of the literature in Scopus, PubMed, Google Scholar, Web of Science, ScienceDirect, and Embase was performed for studies on the association between NOCs in drinking water and food sources and GI cancers. Forest plots of relative risk (RR) were constructed for all the cancer sites and the intake sources. The random-effects model was used to assess the heterogeneity between studies. Forty articles were included after removing duplicate and irrelevant articles. The meta-analysis indicated that the intake of high dose vs. low dose of these compounds was significantly associated with the overall GI cancer risk and nitrite (RR = 1.18, 95% CI = 1.07-1.29), and N-nitrosodimethylamine (NDMA) (RR = 1.32, 95% CI = 1.06-1.65). We found that dietary nitrite intake increased GC (RR = 1.33, 95% CI = 1.02-1.73), and EC (RR = 1.38, 95% CI = 1.01-1.89). Additionally, dietary NDMA intake increased the risk of CRC (RR = 1.36, 95% CI = 1.18-1.58). This meta-analysis provides some evidence that the intake of dietary and water nitrate, nitrite, and NOCs may be associated with GI cancers. In particular, dietary nitrite is linked to GC and EC risks and dietary NDMA intake is associated with CRC.

The Eschenmoser's Salt as a Formylation Agent for the Synthesis of Indolizinecarbaldehydes and Their Use for Colorimetric Nitrite Detection

C-H bond formylation is the most immediate way to incorporate the versatile formyl group into (hetero)aromatics. However, the type of reagents and severe conditions involved in the classical formylation methods often curtail their application, especially in the presence of other functional groups. Herein, we present the Eschenmoser's salt, a commercially available (dimethylamino)methylating chemical, as a useful reagent for the C-H formylation of indolizines and other compounds. The method is straightforward and mild, furnishing indolizinecarbaldehydes in modest-to-good yields with exclusive and remote regioselectivity. Furthermore, these compounds can be easily transformed into push-pull dyes and are highly selective in the colorimetric detection of nitrite, a substance extensively employed as preservative in the food industry, the concentration of which is crucial to control to prevent harmful effects in living organisms. The assay is simple, allowing the naked-eye detection of nitrite in solution or on a cotton swab for a wide range of concentrations.

Risk factors for gastric cancer: A comprehensive analysis of observational studies

Background

Multifarious factors have a causal relationship with gastric cancer (GC) development. We conducted a comprehensive analysis to evaluate the strength of the evidence examining non-genetic risk factors for gastric cancer.

Methods

PubMed, Web of Science, and the Cochrane Library were searched from inception to November 10, 2021 to identify meta-analyses of observational studies examining the association between environmental factors and GC risk. For each meta-analysis, the random effect size, 95% confidence interval, heterogeneity among studies, and evidence of publication bias were assessed; moreover, the evidence was graded using predefined criteria, and the methodological quality was evaluated using AMSTAR 2.

Results

A total of 137 associations were examined in 76 articles. Among these meta-analyses, 93 associations yielded significant estimates (p < 0.05). Only 10 associations had strong epidemiologic evidence, including 2 risk factors (waist circumference and bacon), and 8 protective factors (dietary total antioxidant capacity, vegetable fat, cruciferous vegetable, cabbage, total vitamin, vitamin A, vitamin C, and years of fertility); 26 associations had moderate quality of evidence; and the remaining 57 associations were rated as weak. Ninety-four (68.61%) associations showed significant heterogeneity. Twenty-five (18.25%) associations demonstrated publication bias.

Conclusions

In this comprehensive analysis, multiple associations were found between environmental factors and GC with varying levels of evidence. Healthy dietary habits and lifestyle patterns could reduce the risk for GC. However, further high-quality prospective studies are still necessary to draw more definitive conclusions.

DNA Damage Repair and Current Therapeutic Approaches in Gastric Cancer: A Comprehensive Review

DNA in cells is frequently damaged by endogenous and exogenous agents. However, comprehensive mechanisms to combat and repair DNA damage have evolved to ensure genomic stability and integrity. Improper DNA damage repair may result in various diseases, including some types of tumors and autoimmune diseases. Therefore, DNA damage repair mechanisms have been proposed as novel antitumor drug targets. To date, numerous drugs targeting DNA damage mechanisms have been developed. For example, PARP inhibitors that elicit synthetic lethality are widely used in individualized cancer therapies. In this review, we describe the latent DNA damage repair mechanisms in gastric cancer, the types of DNA damage that can contribute to the development of gastric cancer, and new therapeutic approaches for gastric cancer that target DNA damage repair pathways.

Nitrites and nitrates from food additives and natural sources and cancer risk: results from the NutriNet-Santé cohort

BACKGROUND

Nitrates and nitrites occur naturally in water and soil. They are also used as food additives (preservatives) in processed meats. They could play a role in the carcinogenicity of processed meat. The objective was to investigate the relationship between nitrate and nitrite intakes (natural food, water and food additive sources) and cancer risk in a large prospective cohort with detailed dietary assessment.

METHODS

Overall, 101    056 adults from the French NutriNet-Santé cohort (2009-ongoing, median follow-up 6.7 years) were included. Nitrites/nitrates exposure was evaluated using repeated 24-h dietary records, linked to a comprehensive composition database and accounting for commercial names/brands of industrial products. Associations with cancer risk were assessed using multi-adjusted Cox hazard models.

RESULTS

In total, 3311 incident cancer cases were diagnosed. Compared with non-consumers, high consumers of food additive nitrates had higher breast cancer risk [hazard ratio (HR) = 1.24 (95% CI 1.03-1.48), P = 0.02], more specifically for potassium nitrate. High consumers of food additive nitrites had higher prostate cancer risk [HR = 1.58 (1.14-2.18), P = 0.008], specifically for sodium nitrite. Although similar HRs were observed for colorectal cancer for additive nitrites [HR = 1.22 (0.85-1.75)] and nitrates [HR = 1.26 (0.90-1.76)], no association was detected, maybe due to limited statistical power for this cancer location. No association was observed for natural sources.

CONCLUSION

Food additive nitrates and nitrites were positively associated with breast and prostate cancer risks, respectively. Although these results need confirmation in other large-scale prospective studies, they provide new insights in a context of lively debate around the ban of these additives from the food industry.

Evaluation of CSTB and DMBT1 expression in saliva of gastric cancer patients and controls

Background

Gastric cancer (GC) is the fifth most common cancer and the third cause of cancer deaths globally, with late diagnosis, low survival rate, and poor prognosis. This case-control study aimed to evaluate the expression of cystatin B (CSTB) and deleted in malignant brain tumor 1 (DMBT1) in the saliva of GC patients with healthy individuals to construct diagnostic algorithms using statistical analysis and machine learning methods.

Methods

Demographic data, clinical characteristics, and food intake habits of the case and control group were gathered through a standard checklist. Unstimulated whole saliva samples were taken from 31 healthy individuals and 31 GC patients. Through ELISA test and statistical analysis, the expression of salivary CSTB and DMBT1 proteins was evaluated. To construct diagnostic algorithms, we used the machine learning method.

Results

The mean salivary expression of CSTB in GC patients was significantly lower (115.55 ± 7.06, p = 0.001), and the mean salivary expression of DMBT1 in GC patients was significantly higher (171.88 ± 39.67, p = 0.002) than the control.

Multiple linear regression analysis demonstrated that GC was significantly correlated with high levels of DMBT1 after controlling the effects of age of participants (R² = 0.20, p < 0.001).

Considering salivary CSTB greater than 119.06 ng/mL as an optimal cut-off value, the sensitivity and specificity of CSTB in the diagnosis of GC were 83.87 and 70.97%, respectively. The area under the ROC curve was calculated as 0.728. The optimal cut-off value of DMBT1 for differentiating GC patients from controls was greater than 146.33 ng/mL (sensitivity = 80.65% and specificity = 64.52%). The area under the ROC curve was up to 0.741.

As a result of the machine learning method, the area under the receiver-operating characteristic curve for the diagnostic ability of CSTB, DMBT1, demographic data, clinical characteristics, and food intake habits was 0.95. The machine learning model’s sensitivity, specificity, and accuracy were 100, 70.8, and 80.5%, respectively.

Conclusion

Salivary levels of DMBT1 and CSTB may be accurate in diagnosing GCs. Machine learning analyses using salivary biomarkers, demographic, clinical, and nutrition habits data simultaneously could provide affordability models with acceptable accuracy for differentiation of GC by a cost-effective and non-invasive method.

Electrochemical Sensing of Nitrite Ions Using Modified Electrode by Poly 1,8-Diaminonaphthalene/Functionalized Multi-Walled Carbon Nanotubes

A novel electrochemical sensor based on conducting polymer and multi-walled carbon nanotubes was reported for the detection of nitrite ions (NO₂⁻). The hybrid material poly 1,8-Diaminonaphthalene (poly 1,8-DAN)/functionalized multi-walled carbon nanotubes (f-MWCNT) was prepared by using a simple electrochemical approach which is based on the deposition of functionalized multi-walled carbon nanotubes (f-MWCNT) on the surface of the electrode followed by the electropolymerization of 1,8-DAN using cyclic voltammetry. The morphology and the electro-catalytic properties of the obtained electrodes were investigated with Fourier Transform Infrared Spectroscopy (FTIR), Transmission Electron Microscopy (TEM), Cyclic Voltammetry (CV), and Electrochemical Impedance Spectroscopy (EIS) showing an improvement of the electronic transfer due to the synergic effect between the proprieties of poly 1,8-DAN and f-MWCNT. Under the optimum experimental conditions, the poly 1,8-DAN/f-MWCNT/CPE exhibited excellent electro-catalytic activity towards nitrite detection. The nitrite anodic peak potential decreased by 210 mV compared to the bare carbon paste electrode. The calibration plot of nitrite detection was linear in the range of concentration from 300 to 6500 nM with a low detection limit of 75 nM.

The association between environmental exposure to perchlorate, nitrate, and thiocyanate and all-cause and cause-specific mortality

The aim is to examine the environmental exposure to perchlorate, nitrate, and thiocyanate and their associations with all-cause and cause-specific mortality in a general population. A total of 17,982 participants were enrolled from the National Health and Nutrition Examination Survey and urinary perchlorate, nitrate, and thiocyanate are measured using ion chromatography coupled with electrospray tandem mass spectrometry. Multivariable linear and logistic regression models were performed to explore the associations between urinary perchlorate, nitrate, and thiocyanate with all-cause and cause-specific mortality. Restricted cubic spline models were used to explore the nonlinearity. During a 7.5-year of follow-up, 1730 deaths occurred. Kaplan-Meier analysis suggested that urinary perchlorate, thiocyanate, and nitrate were associated with all-cause mortality (all log-rank P<0.001). After adjusted for traditional risk factors, we found that urinary perchlorate was inversely associated with cancer mortality (hazard ratio [HR] 0.87; 95% confidence interval [0.76, 0.99]; P=0.038) while nitrate was positively related to cancer mortality (HR 1.19, [1.05, 1.34]; P=0.006). Besides, urinary thiocyanate exposure was U-shape associated with the risk of all-cause mortality (P for nonlinearity<0.001). Urinary perchlorate was inversely while nitrate was positively associated with the risk of cancer mortality. The thiocyanate exposure was U-shape associated with the risk of all-cause mortality.

Quantitative aspects of nitric oxide production from nitrate and nitrite

Nitric oxide (NO) is involved in many physiological and pathological processes in the human body. At least two major pathways produce NO: (1) the L-arginine-NO-oxidative pathway in which NO synthase (NOS) enzymes convert L-arginine to NO; (2) the nitrate-nitrite-NO reductive pathway in which NO is produced from the serial reduction of nitrate and nitrite. The deficiency of NO is involved in the pathophysiology of cardiometabolic disorders. Intervention with foods containing nitrate and nitrite can potentially prevent or treat some chronic diseases, including cardiovascular diseases and diabetes. A better understanding of the NO cycle would help develop effective strategies for preventing or treating the disorders in which NO homeostasis is disturbed. This review summarizes quantitative aspects of NO production, emphasizing the nitrate-nitrite-NO pathway. Available data indicates that total NO production by NOS-dependent L-arginine-NO pathway is about 1000 μmol.day^-1. Of about 1700 μmol.day^-1 ingested nitrate, ~25 % is extracted by the salivary glands and of which ~20 % is converted nitrite. It means that about 5 % of ingested nitrate is converted to nitrite in the oral cavity; assuming that all produced nitrite is reduced to NO in the stomach, it can be calculated that contribution of the nitrate-nitrite-NO pathway to the whole-body NO production is about 85 μmol.day^-1 (1700 ×0.05=85) or approximately 100 μmol.day^-1. The lower contribution of the nitrate-nitrite-NO pathway does not mean that this pathway has lower importance in the whole-body NO homeostasis. Even in the adequate L-arginine supply, NOS-dependent NO production is insufficient to meet all NO functions, and the nitrate-nitrite-NO pathway must provide the rest. In conclusion, the contribution of the nitrate-nitrite-NO pathway in the whole human body NO production is <10 %, and the nitrate-nitrite-NO pathway is complementary to the NOS-dependent NO production.

Mucosal microbial microenvironment in early gastric neoplasia and non-neoplastic gastric disease

BACKGROUND AND AIM

The biological characterization of microbial environment in early gastric cancer (EGC), other than Helicobacter pylori, is limited. This study aimed to explore the microbial microenvironment in chronic gastritis (CG), fundic gland polyps (FGPs), low-grade intraepithelial neoplasia (LGIN), and EGC.

METHODS

16S-rRNA gene sequencing and bioinformatic analysis were performed on 63 individuals with 252 mucosal biopsies or endoscopic submucosal dissection margin samples from endoscopy.

RESULTS

The microbiota in gastric LGIN functions analogously to EGC in terms of functional prediction. Neoplastic lesions showed a significant difference to CG or FGPs in beta diversity of the microbiota. Bacteria genera including Paracoccus, Blautia, Barnesiella, Lactobacillus, Thauera, Collinsella were significantly enriched in gastric neoplastic mucosa (LGIN and EGC) compared with non-neoplastic tissues (CG and FGPs). While Pseudomonas and Kingella were depleted in neoplastic tissues. FGPs showed a distinctive microbial network system that negatively interacted with Helicobacter.

CONCLUSIONS

In terms of the mucosal microbial microenvironment, gastric LGIN and EGC showed no significant difference as early neoplastic lesions. We observed a coordinated microbial microenvironment that correlated negatively with Helicobacter.

Nitric oxide for the prevention and treatment of viral, bacterial, protozoal and fungal infections

Although the antimicrobial potential of nitric oxide (NO) is widely published, it is little used clinically. NO is a key signalling molecule modulating vascular, neuronal, inflammatory and immune responses. Endogenous antimicrobial activity is largely mediated by high local NO concentrations produced by cellular inducible nitric oxide synthase, and by derivative reactive nitrogen oxide species including peroxynitrite and S-nitrosothiols. NO may be taken as dietary substrate (inorganic nitrate, L-arginine), and therapeutically as gaseous NO, and transdermal, sublingual, oral, intranasal and intravenous nitrite or nitrate. Numerous preclinical studies have demonstrated that NO has generic static and cidal activities against viruses (including β-coronaviruses such as SARS-CoV-2), bacteria, protozoa and fungi/yeasts  in vitro. Therapeutic effects have been seen in animal models  in vivo, and phase II trials have demonstrated that NO donors can reduce microbial infection. Nevertheless, excess NO, as occurs in septic shock, is associated with increased morbidity and mortality. In view of the dose-dependent positive and negative effects of NO, safety and efficacy trials of NO and its donors are needed for assessing their role in the prevention and treatment of infections. Trials should test dietary inorganic nitrate for pre- or post-exposure prophylaxis and gaseous NO or oral, topical or intravenous nitrite and nitrate for treatment of mild-to-severe infections, including due to SARS-CoV-2 (COVID-19). This review summarises the evidence base from  in vitro, in vivo and early phase clinical studies of NO activity in viral, bacterial, protozoal and fungal infections.

Nitric oxide for the prevention and treatment of viral, bacterial, protozoal and fungal infections

Although the antimicrobial potential of nitric oxide (NO) is widely published, it is little used clinically. NO is a key signalling molecule modulating vascular, neuronal, inflammatory and immune responses. Endogenous antimicrobial activity is largely mediated by high local NO concentrations produced by cellular inducible nitric oxide synthase, and by derivative reactive nitrogen oxide species including peroxynitrite and S-nitrosothiols. NO may be taken as dietary substrate (inorganic nitrate, L-arginine), and therapeutically as gaseous NO, and transdermal, sublingual, oral, intranasal and intravenous nitrite or nitrate. Numerous preclinical studies have demonstrated that NO has generic static and cidal activities against viruses (including β-coronaviruses such as SARS-CoV-2), bacteria, protozoa and fungi/yeasts  in vitro. Therapeutic effects have been seen in animal models  in vivo, and phase II trials have demonstrated that NO donors can reduce microbial infection. Nevertheless, excess NO, as occurs in septic shock, is associated with increased morbidity and mortality. In view of the dose-dependent positive and negative effects of NO, safety and efficacy trials of NO and its donors are needed for assessing their role in the prevention and treatment of infections. Trials should test dietary inorganic nitrate for pre- or post-exposure prophylaxis and gaseous NO or oral, topical or intravenous nitrite and nitrate for treatment of mild-to-severe infections, including due to SARS-CoV-2 (COVID-19). This review summarises the evidence base from  in vitro, in vivo and early phase clinical studies of NO activity in viral, bacterial, protozoal and fungal infections.

Recent innovations of ultrasound green technology in herbal phytochemistry: A review

Ultrasound (US) has become one of the most important techniques in green chemistry and emerging technologies. Many research investigations documented the usefulness of US in a wide range of applications in food science, nanotechnology, and complementary medicine, where effective extraction of natural products is important. However, as with all novel technologies, US has advantages and limitations that require clarification for full adaptation at an industrial scale. The present review discusses recent applications of US in herbal phytochemistry with the emphasis on US effects on chemical structures of bioactive compounds extracted from herbs and their bioactivities. The impact of different US processing conditions such as frequency, intensity, duration, temperature, and pressure on the effectiveness of the extraction process and the properties of the extracted materials are also discussed. Different frequencies and intensities of US have demonstrated its potential applications in modifying, determining, and predicting the physicochemical properties of herbs and their extracts. US has important applications in nanotechnology where it supports the fabrication of inexpensive and eco-friendly herbal nanostructures, as well as acoustic-based biosensors for chemical imaging of the herbal tissues. The application of US enhances the rates of chemical processes such as hydrolysis of herbal fibers, which reduces the time and energy consumed without affecting the quality of the final products. Overall, the use of US in herbal science has great potential to create novel chemical constructions and to be used as an innovative diagnostic system in various biomedical, food, and analytical applications.

Intestinal microbiota alterations by dietary exposure to chemicals from food cooking and processing. Application of data science for risk prediction

Diet is one of the main sources of exposure to toxic chemicals with carcinogenic potential, some of which are generated during food processing, depending on the type of food (primarily meat, fish, bread and potatoes), cooking methods and temperature. Although demonstrated in animal models at high doses, an unequivocal link between dietary exposure to these compounds with disease has not been proven in humans. A major difficulty in assessing the actual intake of these toxic compounds is the lack of standardised and harmonised protocols for collecting and analysing dietary information. The intestinal microbiota (IM) has a great influence on health and is altered in some diseases such as colorectal cancer (CRC). Diet influences the composition and activity of the IM, and the net exposure to genotoxicity of potential dietary carcinogens in the gut depends on the interaction among these compounds, IM and diet. This review analyses critically the difficulties and challenges in the study of interactions among these three actors on the onset of CRC. Machine Learning (ML) of data obtained in subclinical and precancerous stages would help to establish risk thresholds for the intake of toxic compounds generated during food processing as related to diet and IM profiles, whereas Semantic Web could improve data accessibility and usability from different studies, as well as helping to elucidate novel interactions among those chemicals, IM and diet.

Gastric Cancer Among American Indian and Alaska Native Populations in the United States, 2005-2016

INTRODUCTION

American Indian and Alaska Native (AI/AN) populations have higher gastric cancer rates than the general US population. This study provides a comprehensive overview of incidence rates among AI/AN persons during 2005-2016 compared with non-Hispanic whites (whites).

METHODS

Population-based cancer registry data for 2005-2016 were linked with the Indian Health Service patient registration databases to address racial misclassification. Age-adjusted gastric cancer incidence rates were expressed per 100,000 per year. Incidence and trend analyses were restricted to purchased/referred care delivery area counties in 6 geographic regions, comparing gastric cancer incidence rates for AI/AN vs white populations in the United States.

RESULTS

Gastric cancer rates were higher in the AI/AN compared with white populations in nearly every US region. Incidence rates for central/distal portions of the stomach were higher in AI/AN individuals compared with whites. Rates of later stage gastric cancer were higher in AI/AN populations overall and in every region except the Pacific Coast and East. Incidence rates decreased significantly over time in both populations. Declining rates in the AI/AN populations were driven by changes in the Pacific Coast and Northern Plains regions.

DISCUSSION

AI/AN populations have a disproportionately high incidence of gastric cancer, especially in Alaska. High incidence in the central/distal portions of the stomach among AI/AN populations likely reflects a high prevalence of Helicobacter pylori infection in these populations. These data can be used to develop interventions to reduce risk factors and improve access to health services among AI/AN people at high risk for gastric cancer.

Comparative assessment of Brassica pekinensis L. genotypes for phytoavoidation of nitrate, cadmium and lead in multi-pollutant field

Information is needed for comparative assessment and agronomic practices for phytoavoidation in multi-pollutant field. A field study was conducted to explore 97 Brassica pekinensis L. genotypes with permissible limit of contaminants growing in a severely Cd, moderately nitrate and slightly Pb multi-polluted field. Thirteen genotypes, i.e. KGZY, CXQW, CAIB, JINL, JQIN, JFEN, WMQF, XLSH, TAIK, BJXS, JUKA, XYJQ and GQBW, were identified with permissible limit for nitrate, Cd and Pb based on their resistance to heavy metal and nitrate accumulation in leaves when grown in co-contaminated soils. Furthermore, the correlation between essential and toxic elements concentrations in plant of B. pekinensis were inconsistent. Generally speaking, application of increasing Ca, K and S fertilizers in appropriate forms and dosages tended to increase the yield and quality of B. pekinensis cultivated in multi-pollutant field.

Risk of stomach cancer incidence in a cohort of Mayak PA workers occupationally exposed to ionizing radiation

Stomach cancer is a widespread health condition associated with environmental and genetic factors. Contribution of ionizing radiation to stomach cancer etiology is not sufficiently studied. This study was aimed to assess an association of the stomach cancer incidence risk with doses from occupational radiation exposure in a cohort of workers hired at main Mayak production association facilities in 1948–1982 taking into account non-radiation factors including digestive disorders. The study cohort comprised 22,377 individuals and by 31.12.2013 343 stomach cancer diagnoses had been reported among the cohort members. Occupational stomach absorbed doses were provided by the Mayak Worker Dosimetry System– 2008 (MWDS–2008) for external gamma ray exposure and by the Mayak Worker Dosimetry System– 2013 (MWDS–2013) for internal exposure to plutonium. Excess relative risks (ERR) per Gy for stomach cancer were estimated using the Poisson’s regression. Analyses were run using the AMFIT module of the EPICURE software. The stomach cancer incidence risk in the study cohort was found to be significantly associated with the stomach absorbed dose of gamma rays: ERR/Gy = 0.19 (95% CI: 0.01, 0.44) with a 0 year lag, and ERR/Gy = 0.20 (95% CI: 0.01, 0.45) with a 5 year lag. To estimate the baseline risk, sex, attained age, smoking status and alcohol consumption, chronic diseases (peptic ulcer, gastritis and duodenitis) were taken into account. No modifications of the radiogenic risk by non-radiation factors were found in the study worker cohort. No association of the stomach cancer incidence risk with internal exposure to incorporated plutonium was observed.

Dietary inorganic nitrate attenuates hyperoxia-induced oxidative stress in obese type 2 diabetic male rats

AIMS

Hyperoxia has beneficial metabolic effects in type 2 diabetes. However, hyperoxia exacerbates already existing oxidative stress in type 2 diabetes. Nitrate, a nitric oxide donor, is an effective new treatment in type 2 diabetes and also has antioxidant properties. The aim of this study was to determine whether nitrate administration can attenuate hyperoxia-induced oxidative stress in obese type 2 diabetic rats.

MAIN METHODS

Fifty-six male Wistar rats (190-210 g) were divided into 8 groups: Controls (non-treated, nitrate-treated, O₂-treated, and nitrate + O₂-treated) and diabetes (non-treated, nitrate-treated, O₂-treated, and nitrate + O₂-treated). Diabetes was induced using high-fat diet and low-dose of streptozotocin (30 mg/kg). Rats in intervention groups, were exposed to 95% oxygen and consumed sodium nitrate (100 mg/L) in drinking water. Serum fasting glucose, oxidized (GSSG) and reduced (GSH) glutathiones, total oxidant status (TOS), catalase and superoxide dismutase (SOD) activities, and total antioxidant capacity (TAC) were measured after intervention. Oxidative stress index (OSI) was calculated as TOS/TAC ratio.

KEY FINDINGS

Diabetic rats had increased oxidative stress and hyperoxia exacerbated it. In O₂-diabetic rats, nitrate decreased GSSG (102.7 ± 2.1 vs. 236.0 ± 20.1 μM, P < 0.001), TOS (67.7 ± 7.3 vs. 104 ± 3.8 μM, P < 0.001), and OSI (0.44 ± 0.04 vs. 0.91 ± 0.07, P < 0.001) and increased catalase (2.8 ± 0.13 vs. 1.8 ± 0.21 KU/L, P = 0.014), SOD (53.4 ± 1.5 vs. 38.4 ± 1.2 U/mL, P < 0.001), GSH (43.7 ± 1.4 vs. 17.8 ± 0.5 mM, P = 0.003), TAC (152.5 ± 1.9 vs. 116.7 ± 5.0 mM, P < 0.001), and GSH/GSSG ratio (0.43 ± 0.01 vs. 0.08 ± 0.01, P = 0.005). Nitrate also potentiated effects of hyperoxia on decreasing fasting glucose.

SIGNIFICANCE

Our results showed that dietary nitrate attenuates hyperoxia-induced oxidative stress in type 2 diabetic rats.