Functional genomics identifies novel and diverse molecular targets of nutrients in vivo

Statins and Neuropathic Pain: A Narrative Review

The frequently prescribed drug class of statins have pleiotropic effects and have been implicated in neuropathic pain syndromes. This narrative review examines studies of statin-induced neuropathic pain which to date have been conducted only in animal models. However, the pathophysiology of diabetic neuropathy in humans may shed some light on the etiology of neuropathic pain. Statins have exhibited a paradoxical effect in that statins appear to reduce neuropathic pain in animals but have been associated with neuropathic pain in humans. While there are certain postulated mechanisms offering elucidation as to how statins might be associated with neuropathic pain, there is, as the American Heart Association stated, to date no definitive association between statins and neuropathic pain. Statins are important drugs that reduce cardiovascular risk factors and should be prescribed to appropriate patients with these risk factors but some of this population is also at elevated risk for neuropathic pain from other causes.

Vitamin E and neurological function

The clinical, neuropathological and electrophysiological evidence that vitamin E (alpha-tocopherol) is essential for normal neurological function will be reviewed. The possible reasons why neural tissues should be particularly affected by a deficiency of this fat-soluble vitamin and the mechanism(s) involved will be considered.

PCR-verified microarray analysis and functionalin vitrostudies indicate a role of α-tocopherol in vesicular transport

Global gene expression profiles of livers from mice, fed diets differing in alpha-tocopherol content, were compared using DNA microarray technology. Three hundred and eighty nine genes were found to significantly differ in their expression level by a factor of 2 or higher between the high and the low alpha-tocopherol group. Functional clustering using the EASE software identified 121 genes involved in transport processes. Twenty-one thereof were involved in (synaptic) vesicular trafficking. Up-regulation of syntaxin 1C (Stx1c), vesicle-associated membrane protein 1 (Vamp1), N-ethylmaleimide-sensitive factor (Nsf) and syntaxin binding protein 1 (Stxbp1, Munc18-1) was verified by real time PCR. At a functional level, alpha-tocopherol increased the secretory response in RBL and PC12 cells. Although here detected in liver, the alpha-tocopherol-responsive pathways are also relevant to neurotransmission. A role of alpha-tocopherol in the vesicular transport might not only affect its own absorption and transport but also explain the neural dysfunctions observed in severe alpha-tocopherol deficiency.

Vitamin E: the shrew waiting to be tamed

Vitamin E is the last of all vitamins whose essentiality is not yet understood. Its widely accepted role as a lipophilic antioxidant has been questioned, since proof of its in vivo relevance remained scarce. The influence of vitamin E on biomarkers of oxidative stress in vivo is inconsistent and metabolites of vitamin E having reacted as an antioxidant are hardly detectable. Novel functions of vitamin E include the regulation of enzymes, most of which are membrane bound or activated by membrane recruitment. Also, expression of genes responds to vitamin E. The search for a transcription factor common to all regulated genes failed so far and a receptor that specifically binds vitamin E has not yet been identified. According to microarray data, pathways preferentially affected by the vitamin E status are the inflammatory response and cellular traffic. A role of vitamin E in cellular trafficking could best explain the neurological symptoms seen in vitamin E deficiency. Emerging knowledge on vitamin E is compiled here with the perspective to unravel the molecular mechanisms that could more likely explain the essentiality of the vitamin than its ability to scavenge free radicals.

Induction of drug metabolizing enzymes by vitamin E

Vitamin E is an essential micronutrient involved in various processes relevant to human health and disease. Although it has long been considered just as an antioxidant, it has now become clear that vitamin E has functions far exceeding that as an antioxidant. These include regulation of cellular signaling processes and gene expression. Expression control of enzymes involved in drug metabolism was recognized during the investigation of vitamin E degradation. Vitamin E is metabolized by side chain degradation initiated by an omega-hydroxylation, catalyzed by a cytochrome P450 enzyme (CYP). This mechanism is identical for all forms of vitamin E. The degree to which they are degraded, however, varies dramatically, and may, in part, explain their different biological activities. CYPs degrade various endogenous and exogenous compounds and many of them are induced by their substrates. Also, gamma-tocotrienol, identified as substrate of CYPs, increased endogenous CYP3A4 in human HepG2 cells. In two studies with mice undertaken independently, alpha-tocopherol induced Cyp3a11, the murine homolog to human CYP3A4, whereas neither gamma-tocopherol nor gamma-tocotrienol, due to rapid degradation, showed any effect. CYPs are induced via the activation of the pregnane-X-receptor (PXR), a member of the family of nuclear receptors. They are activated by a large number of lipophilic xenobiotics. Also, vitamin E induced a reporter gene driven by PXR. The induction was highest with alpha- and gamma-tocotrienol and low but significant with alpha-tocopherol. This roughly correlates with the in vitro binding of vitamin E to PXR. These findings reveal that, in principle, vitamin E is able to directly influence gene activity. They also raise the question of whether vitamin E may interfere with drug metabolism in humans. Related research is urgently deeded.

Nutritional, Dietary and Postprandial Oxidative Stress

Nutritional, or dietary oxidative stress denotes a disturbance of the redox state resulting from excess oxidative load or from inadequate nutrient supply favoring prooxidant reactions. Low intake or impaired availability of dietary antioxidants including vitamins E and C, carotenoids, polyphenols, and other micronutrients (e.g., selenium) weakens the antioxidant network. Postprandial oxidative stress, as a subform of nutritional oxidative stress, ensues from sustained postprandial hyperlipidemia and/or hyperglycemia and is associated with a higher risk for atherosclerosis, diabetes, and obesity. In Western societies, a significant part of the day is spent in the postprandial state. Unsaturated fatty acids incorporated into LDL and oxidized LDL are an atherogenic factor. Lipid hydroperoxides present in the diet are absorbed, contributing to the prooxidant load. In hyperlipidemic and hyperglycemic subjects, endothelium-dependent vasodilation is impaired in the postprandial state, making postprandial oxidative stress an important factor modulating cardiovascular risk. Postprandial oxidative stress is attenuated when dietary antioxidants are supplied together with a meal rich in oxidized or oxidizable lipids. Ingestion of dietary polyphenols, e.g., from wine, cocoa, or tea, improves endothelial dysfunction and lowers the susceptibility of LDL lipids to oxidation. Polyphenols affect endothelial function not solely as antioxidants but also as modulatory signaling molecules.