Dietary intakes of citrus fruit and risk of gastric cancer incidence: an adaptive meta-analysis of cohort studies

Chinchkar A, Singh A, Upadhyay A, Mehari B. Ultrasonic-assisted extraction and UHPLC determination of ascorbic acid, polyphenols, and half-maximum effective concentration in Citrus medica and Ziziphus spina-christi fruits using multivariate experimental design

This study aimed to determine the concentrations of ascorbic acid and polyphenols in fruits and peels of Citrus medica and Ziziphus spina-christi grown in Ethiopia. Conditions of ultrasound-assisted extraction (UAE) and ultra-high-performance liquid chromatography coupled with a diode array detector (HPLC-DAD) were optimized, using a multivariate experimental design. The optimum conditions of UAE were 15 min extraction time at 35 ℃, with 75 % aqueous methanol as solvent, and a fruit powder-to-solvent ratio (m/v) of 1:15. Among the different drying conditions investigated, freeze-drying was found to be appropriate for analyzing ascorbic acid, polyphenols, and antioxidant potential. The overall ranges, across the fruits and peels, of ascorbic acid, total polyphenols, and antioxidant potentials (EC50) obtained were 8.7 ± 1.4-91.2 ± 2.6 mg/100 g, 253.0 ± 6.3-764.1 ± 25.8 mg GAE/100 g and 2.4 ± 0.1-26.1 ± 2.9 mg/mL, respectively. This indicates that the fruits and peels of the studied plants are advantageous as sources of ascorbic acid and polyphenols.

Humanistic Health Management and Cancer: Associations of Psychology, Nutrition, and Exercise with Cancer Progression and Pathogenesis

The incidence rate of cancer is increasing year by year due to the aging of the population, unhealthy living, and eating habits. At present, surgery and medication are still the main treatments for cancer, without paying attention to the impact of individual differences in health management on cancer. However, increasing evidence suggests that individual psychological status, dietary habits, and exercise frequency are closely related to the risk and prognosis of cancer. The reminder to humanity is that the medical concept of the unified treatment plan is insufficient in cancer treatment, and a personalized treatment plan may become a breakthrough point. On this basis, the concept of "Humanistic Health Management" (HHM) is proposed. This concept is a healthcare plan that focuses on self-health management, providing an accurate and comprehensive evaluation of individual lifestyle habits, psychology, and health status, and developing personalized and targeted comprehensive cancer prevention and treatment plans. This review will provide a detailed explanation of the relationship between psychological status, dietary, and exercise habits, and the regulatory mechanisms of cancer. Intended to emphasize the importance of HHM concept in cancer prevention and better prognostic efficacy, providing new ideas for the new generation of cancer treatment.

Vitamin C variation in citrus in response to genotypes, storage temperatures, and storage times: A systematic review and meta-analysis

Numerous published studies have highlighted discrepancies in the duration and storage temperature used for preserving vitamin C content on various citrus genotypes worldwide. The present study aimed to analyze the variation in vitamin C content as influenced by citrus genotype, duration, and storage temperature using meta-analysis approaches. Data searching, selection, and tabulation resulted in a comprehensive database constructed from 1412 data points gathered from 54 individual studies, following PRISMA-P guidelines. The vitamin C content varied widely, ranging from 0 to 76.2 mg/100 mL in whole data of citrus fruit. Meta-analysis findings revealed that the duration of storage significantly impacted the vitamin C content in citrus fruits. Specifically, for grapefruit, mandarin, and orange, the length of storage significantly influenced their vitamin C levels (P < 0.01), with a consistent decrease observed over time. The correlation coefficients (R2) were 0.63 for grapefruit, 0.9 for mandarin, and 0.69 for orange. In contrast, no significant difference was found in terms of vitamin C levels between hybrid and lime citrus concerning the impact of storage time. However, other results indicated a significant influence of storage temperature on the variation in vitamin C levels for both citrus and hybrid varieties (P < 0.001). Depending on the genotype, tangerine had significantly lower vitamin C content compared to other varieties, at 16.9 mg/100 mL, with vitamin C ranging from 13.2 to 20.9 mg/100 mL (P < 0.001). The highest vitamin C content was found in lemon and hybrid varieties, around 65.5 (range 59.3-76.2) and 48.3 (range 29.6-75.5), respectively, all in mg/100 mL (P < 0.001). Furthermore, there was a tendency for decreasing vitamin C concentration due to temperature (P = 0.078), while citrus variety experienced a decrease, although not significant. The ideal temperature (15 °C) and duration of storage (56 days) to minimize vitamin C loss in citrus fruits are at their optimum point. In conclusion, the deterioration of vitamin C in citrus fruits is influenced by both temperature and storage duration, and its content is also impacted by the variety of citrus.

Citrus fruit intake and incidence of renal cell carcinoma: A meta-analysis of observational studies

Observational studies on the association between citrus fruit intake and risk of renal cell carcinoma (RCC) have reported inconsistent results. We quantitatively assessed this association by conducting a meta-analysis. PubMed and Embase databases search was conducted including relevant studies published up to January, 2020. We included epidemiological studies that reported relative risks (RRs) or odds ratios (ORs) with 95% confidence intervals (CIs) for the association between citrus fruit intake and RCC risk. A total of eight epidemiological studies consisting of five cohort and three case-control studies were included. The overall analysis showed a significantly reduced risk of RCC for high intake of citrus fruit (OR = 0.84, 95% CI 0.73-0.95). No heterogeneity was detected among the included studies (p = 0.497 for heterogeneity; I2 = 0). There was no significant publication bias by Begg's test (p = 0.266) or Egger's test (P = 0.578). A statistically significant association between citrus fruit intake and RCC was observed in case-control studies (OR = 0.84, 95% CI 0.71-0.98), while no association was observed in cohort studies (OR = 0.84, 95% CI 0.64-1.05). In addition, the dose-response analysis indicated that the RCC risk reduced by 13% (95%CI 1.0%-27%, p = 0.04 for heterogeneity) for each 100 grams per day increment of citrus fruit intake. In summary, our findings suggest an inverse association between citrus fruit intake and RCC incidence.

Gastric Mucosal Protective Effects of Cinnamomum cassia in a Rat Model of Ethanol-Induced Gastric Injury

Cinnamomum cassia (cassia) is a tropical aromatic evergreen tree of the Lauraceae family well known for its fragrance and spicy flavor and widely used in Asian traditional medicine. It has recently garnered attention for its diverse potential health benefits, including anti-inflammatory, anti-cancer, and anti-diabetic properties. However, the gastroprotective effect of C. cassia, particularly against ethanol-induced gastric damage, remains unclear. We investigated the potential gastroprotective property of C. cassia and the underlying mechanisms of action in a rat model of ethanol-induced gastric injury. To assess its effectiveness, rats were fed C. cassia for a 14-day period prior to inducing gastric damage by oral administration of ethanol. Our results indicated that pre-treatment with C. cassia mitigated ethanol-induced gastric mucosal lesions and bleeding. Reduced gastric acid secretion and expression of acid secretion-linked receptors were also observed. Additionally, pretreatment with C. cassia led to decreased levels of inflammatory factors, including TNF-α, p-p65, and IκBα. Notably, C. cassia upregulated the expressions of HO1 and HSP90, with particular emphasis on the enhanced expression of PAS and MUC, the crucial gastric mucosa defense molecules. These findings suggest that C. cassia has protective effects on the gastric mucosa and can effectively reduce oxidative stress and inflammation.

Updates on global epidemiology, risk and prognostic factors of gastric cancer

Gastric cancer (GC) is defined as the primary epithelial malignancy derived from the stomach, and it is a complicated and heterogeneous disease with multiple risk factors. Despite its overall declining trend of incidence and mortality in various countries over the past few decades, GC remains the fifth most common malignancy and the fourth leading cause of cancer-related death globally. Although the global burden of GC has shown a significant downward trend, it remains severe in certain areas, such as Asia. GC ranks third in incidence and mortality among all cancer types in China, and it accounts for nearly 44.0% and 48.6% of new GC cases and GC-related deaths in the world, respectively. The regional differences in GC incidence and mortality are obvious, and annual new cases and deaths are increasing rapidly in some developing regions. Therefore, early preventive and screening strategies for GC are urgently needed. The clinical efficacies of conventional treatments for GC are limited, and the developing understanding of GC pathogenesis has increased the demand for new therapeutic regimens, including immune checkpoint inhibitors, cell immunotherapy and cancer vaccines. The present review describes the epidemiology of GC worldwide, especially in China, summarizes its risk and prognostic factors, and focuses on novel immunotherapies to develop therapeutic strategies for the management of GC patients.

A review of citrus plants as functional foods and dietary supplements for human health, with an emphasis on meta-analyses, clinical trials, and their chemical composition

Fruits, flowers, leaves, essential oils, hydrosols, and juices of citrus spp. Are utilized to prepare various forms of food products. Along with their nutritional values, in the health industry, different parts of the plants of the citrus genus have been used as supplements or remedies to prevent or control diseases. This review focused on reported meta-analyses and clinical trials on the health benefits of citrus plants as functional foods. Also, chemical compounds of various citrus species were reviewed. The following information sources were used for data collection: Google Scholar, the Web of Science, Scopus, and PubMed. Various keywords, including "citrus AND chemical compounds," "citrus AND phytochemicals," "citrus species," "citrus AND meta-analysis," "nutritional and therapeutical values of citrus spp.," "clinical trials AND citrus," "clinical trials AND Rutaceae," "health benefits of citrus spp.," "citrus edible or non-edible applications," and scientific names of the citrus plants were utilized to collect data for the review. The scientific name and common name of all twenty-eight citrus species, along with any of the above keywords, were also searched in the mentioned databases. Scientific papers and data sources were sought to review and discuss the citrus plant's nutritional and therapeutic importance. Several meta-analyses and clinical trials have reported beneficial effects of citrus spices on a variety of cancer risks, cardiovascular risk factors, neurologic disorders, urinary tract conditions, and gastrointestinal tract conditions. They have shown anxiolytic, antimicrobial, and pain-alleviating effects. Some of them can be helpful in managing obesity and cardiovascular risk factors.

Distribution, Antioxidant Capacity, Bioavailability and Biological Properties of Anthocyanin Pigments in Blood Oranges and Other Citrus Species

Anthocyanins are natural pigments that give a red, purple, and blue color to many plant, flower, fruit, and vegetable species. Their presence within the genus Citrus was first reported in 1916, and it is well-known that the red color of the flesh and rind of blood (red or pigmented) oranges (Citrus sinensis L. Osbeck) is due to the presence of anthocyanins. They are also present in the young shoots, flowers, and peel of lemon (Citrus limon (L.) Burm. f.), citron (Citrus medica L.), and other citrus species. Since then, the scientific community has expressed increasing interest in studying their profile and distribution, with many published studies focused on the quali-quantitative pattern in the different vegetative tissues belonging to the genus Citrus. Moreover, with the discovery of their relevant antioxidant activity, owing to their ability to capture free radicals, much research has been performed in the last two decades on their radical scavenging power, in vitro and in vivo biological properties, and anticarcinogenic capacity, also focusing attention on their bioavailability for humans. The present work is intended as a comprehensive review of the advances in scientific research on anthocyanin pigments naturally occurring within the genus Citrus, including their natural distribution, antioxidant capacity, bioavailability, and biological value and properties. The scientific evidence herein reported can be used to further increase the knowledge of this class of compounds and represents a valuable and comprehensive contribution to promoting anthocyanin-rich citrus fruit consumption as a healthy dietary habit.

Diet and gastric cancer risk: an umbrella review of systematic reviews and meta-analyses of prospective cohort studies

BACKGROUND

Several systematic reviews and meta-analyses evaluated the associations between dietary factors and the incidence of gastric cancer (GC).

OBJECTIVES

To evaluate the strength and validity of existing evidence, we conducted an umbrella review of published systematic reviews and meta-analyses that investigated the association between diets and GC incidence.

METHODS

We searched the PubMed, Embase, and Cochrane databases for systematic reviews and meta-analyses of prospective cohort studies investigating the association between dietary factors and GC risk. For each association, we recalculated the adjusted summary estimates with their 95% confidence interval (CI) and 95% prediction interval (PI) using a random-effects model. We used the I² statistic and Egger's test to assess heterogeneity and small-study effects, respectively. We also assessed the methodological quality of each study and the quality of evidence.

RESULTS

Finally, we identified 16 meta-analyses that described 57 associations in this umbrella review. Of the 57 associations, eight were statistically significant using random-effects, thirteen demonstrated substantial heterogeneity between studies (I² > 50%), and three found small-study effects. The methodological quality of meta-analyses was classified as critically low for two (13%), low for thirteen (81%), and only one (6%) was rated as high confidence. Quality of evidence was rated high for a positive association for GC incidence with a higher intake of total alcohol (RR = 1.19, 95% CI 1.06-1.34) and moderate-quality evidence to support that increased processed meat consumption can increase GC incidence. Three associations (total fruit, vitamin E, and carotenoids) were determined to be supported by low-quality evidence, and two (pickled vegetables/foods and citrus fruit) were supported by very low-quality.

CONCLUSIONS

Our findings support the dietary recommendations for preventative GC, emphasizing lower intake of alcohol and foods preserved by salting. New evidence suggests a possible role for total fruit, citrus fruit, carotenoids, and vitamin E. More research is needed on diets with lower quality evidence.

REGISTRATION NUMBER

CRD42021255115.

Daily Consumption of Lemon and Ginger Herbal Infusion Caused Tumor Regression and Activation of the Immune System in a Mouse Model of Breast Cancer

The Mediterranean diet includes the consumption of various fruits and vegetables. Lemon and ginger are highly popular in Mediterranean cuisine. The current study aims to evaluate both anticancer and immunomodulatory activities of lemon and ginger combination. The antiproliferative activities of the combination were tested against different cancer cell lines using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay. The degree of apoptosis induction and vascular endothelial growth factor expression were detected using ELISA. Balb/C mice were inoculated with the EMT6/P breast cancer cells and received combination water extract orally for 14 days. The effect of the water extract on splenocytes proliferation was measured using the mitogen proliferation assay. Macrophage function was evaluated using the nitro blue tetrazolium assay and pinocytosis was assessed using the neutral red method. Gas chromatography coupled to the tandem mass spectrometry was used to determine the composition of the combination. The lemon and ginger combination showed significant apoptosis induction and angiogenesis suppression effects. Fifty percent of the mice taking this combination did not develop tumors with a percentage of tumor reduction of 32.8%. This combination showed a potent effect in stimulating pinocytosis. Alpha-pinene and α-terpineol were detected in high percentages in the combination water extract. The lemon and ginger combination represents promising options to develop anticancer infusions for augmenting conventional anticancer therapies. Further testing is required to understand the exact molecular mechanisms of this combination.

Epidemiology of stomach cancer

Despite a decline in incidence and mortality during the last decades, stomach cancer is one of the main health challenges worldwide. According to the GLOBOCAN 2020 estimates, stomach cancer caused approximately 800000 deaths (accounting for 7.7% of all cancer deaths), and ranks as the fourth leading cause of cancer deaths in both genders combined. About 1.1 million new cases of stomach cancer were diagnosed in 2020 (accounting for 5.6% of all cancer cases). About 75% of all new cases and all deaths from stomach cancer are reported in Asia. Stomach cancer is one of the most lethal malignant tumors, with a five-year survival rate of around 20%. There are some well-established risk factors for stomach cancer: Helicobacter pylori infection, dietary factors, tobacco, obesity, and radiation. To date, the most important way of preventing stomach cancer is reduced exposure to risk factors, as well as screening and early detection. Further research on risk factors can help identify various opportunities for more effective prevention. Screening programs for stomach cancer have been implemented in a few countries, either as a national or opportunistic screening of high-risk individuals only. Generally, due to its high aggressiveness and heterogeneity, stomach cancer still remains a severe global health problem.

Sex as an effect modifier in the association between alcohol intake and gastric cancer risk

BACKGROUND

The results of previous meta-analyses evaluating the association between the alcohol intake and gastric cancer risk have reported that a statistical significance only for men.

AIM

To investigate the different association between alcohol intake and gastric cancer risk between men and women.

METHODS

The selection criteria included a prospective cohort study for evaluating alcohol intake and gastric cancer risk, with relative risks adjusted for potential confounders. Adjusted relative risk (RR) for the potential confounders and its 95% confidence interval (CI) in the highest vs lowest level were extracted from each study and a random-effects meta-analysis was conducted. Subgroup analyses by region, level of adjustment for smoking status, adjusting for body mass index, and year of publication were conducted.

RESULTS

A meta-analysis of all 27 cohorts showed that alcohol intake increased the risk of gastric cancer (summary RR = 1.13, 95%CI: 1.04-1.23, I² = 58.2%). Further, 13 men’s cohorts had higher summary RR while maintaining statistical significance, and only seven women’s cohorts had no statistical significance.

CONCLUSION

The present review suggests that alcohol consumption increases the risk of gastric cancer in men. These findings showed that the sex variable in the association between alcohol intake and gastric cancer risk seemed to be an effect modifier with an interaction term. It is necessary to re-estimate follow-up outcomes after stratifying for sex.

Vegetable and Fruit Consumption and Prognosis Among Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies

The number of cancer survivors is growing rapidly worldwide, especially long-term survivors. Although a healthy diet with a high vegetable and fruit consumption is a key factor in primary cancer prevention, there is a lack of specific dietary recommendations for cancer survivors, except in the case of breast cancer [World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) report]. We have therefore carried out a systematic review and meta-analysis of cohort studies reporting on the associations between vegetable and fruit intake with cancer recurrence and mortality and all-cause mortality in cancer patients. After a comprehensive search of PubMed and Scopus databases, the results of 28 selected articles were analyzed. A high vegetable intake before diagnosis was inversely associated with overall mortality in survivors of head and neck (HR: 0.75; 95% CI: 0.65, 0.87) and ovarian cancer (HR: 0.78; 95% CI: 0.66, 0.91). In ovarian cancer patients, prediagnosis fruit intake was also inversely associated with all-cause mortality (HR: 0.82; 95% CI: 0.70, 0.96). The evidence was insufficient for survivors of other cancers, although these associations generally tended to be protective. Therefore, more studies are needed to clarify the association between vegetable and fruit consumption and the prognosis of these different types of cancer. To date, the general recommendation to consume ≥5 servings of vegetables and fruit per day (∼400 g/d) could underestimate the needs of cancer survivors, particularly those with ovarian tumors, in which the recommendation could increase to ∼600 g/d (i.e., 300 g/d of vegetables and 300 g/d of fruit).

The Mexican consensus on the detection and treatment of early gastric cancer

Gastric cancer is one of the most frequent neoplasias in the digestive tract and is the result of premalignant lesion progression in the majority of cases. Opportune detection of those lesions is relevant, given that timely treatment offers the possibility of cure. There is no consensus in Mexico on the early detection of gastric cancer, and therefore, the Asociación Mexicana de Gastroenterología brought together a group of experts and produced the "Mexican consensus on the detection and treatment of early gastric cancer" to establish useful recommendations for the medical community. The Delphi methodology was employed, and 38 recommendations related to early gastric cancer were formulated. The consensus defines early gastric cancer as that which at diagnosis is limited to the mucosa and submucosa, irrespective of lymph node metástasis. In Mexico, as in other parts of the world, factors associated with early gastric cancer include Helicobacter pylori infection, a family history of the disease, smoking, and diet. Chromoendoscopy, magnification endoscopy, and equipment-based image-enhanced endoscopy are recommended for making the diagnosis, and accurate histopathologic diagnosis is invaluable for making therapeutic decisions. The endoscopic treatment of early gastric cancer, whether dissection or resection of the mucosa, should be preferred to surgical management, when similar oncologic cure results can be obtained. Endoscopic surveillance should be individualized.

Protective and anticancer effects of orange peel extract and naringin in doxorubicin treated esophageal cancer stem cell xenograft tumor mouse model

BACKGROUND

chemotherapy drugs are the common therapy for cancer cells with side effects. Recent studies reported that natural products may contribute to decreasing the side effects of chemotherapy drugs. Here, we aimed to investigate the effects of orange peel extract (OPE) and its main compound; naringin (NR) to protect the side effects of doxorubicin (Dox) in esophageal cancer stem cells (CSCs) derived tumors in vivo.

METHODS

for this purpose, Esophageal cancer cell (YM1) derived spheres were treated in vitro with OPE, NR, Dox, Dox in combination with OPE or NR. The cell viability was assessed by XTT and the apoptosis was measured using Annexin/7-AAD and the cell cycle was also quantified by using PI staining method. The pluripotency related genes expression was carried out using qRT-PCR The protective effects of OPE and NR were evaluated by body weight evaluation and oxidative stress factors: malondialdehyde (MDA), total antioxidant capacity (TAC) and superoxide dismutase (SOD) measurement in xenograft mice tumor model injected with Dox.

RESULTS

ESCC CSCs overexpress SOX₂ and OCT4 pluripotency genes. OPE or NR can protect the cellular toxicity of Dox in vitro mainly by decreasing cellular apoptosis of ESCC CSCs however S-phase cell cycle arrest has not been affected significantly. In vivo experiments revealed that the use of Dox simultaneously with OPE or NR not only can reduce the tumor size but also the body weight of the treated nude mice were maintained in comparison to Dox alone. In contrast to Dox alone, Dox in combination with OPE or NR showed less systemic toxicity and decreased oxidative stress fraction circulation, however, OPE seemed as more protective.

CONCLUSION

The results suggest that these natural compounds can be used as adjuvant therapy to lower systemic toxicity of chemotherapeutic agents like DOX in ESCC cancer stem cells treatment.

A Review of the Science of Colorful, Plant-Based Food and Practical Strategies for "Eating the Rainbow"

Over the past decades, thousands of published studies have amassed supporting recommendations to consume fruits and vegetables for physiological and psychological health. Newer research has emerged to suggest that these plant-based foods contain a plethora of not only vitamins and minerals, but perhaps, most importantly, phytonutrients. These phytonutrients have known pleiotropic effects on cellular structure and function, ultimately resulting in the modulation of protein kinases and subsequent epigenetic modification in a manner that leads to improved outcomes. Even though eating fruits and vegetables is a well-known feature of a healthy dietary pattern, population intakes continue to be below federal recommendations. To encourage consumers to include fruits and vegetables into their diet, an “eat by color” approach is proposed in this review. Although each individual food may have numerous effects based on its constituents, the goal of this simplified approach was to identify general patterns of benefits based on the preponderance of scientific data and known mechanisms of food-based constituents. It is suggested that such a consumer-oriented categorization of these plant-based foods may lead to greater recognition of their importance in the daily diet throughout the lifespan. Other adjunctive strategies to heighten awareness of fruits and vegetables are discussed.

Citrus peels prevent cancer

BACKGROUND

Citrus comprises the largest fruit sector worldwide, and its fruit peels are the dominant 'residue' of the industry. Though not profitable, Citrus peels are industrially used for making some byproducts (cattle feed, molasses, ethanol, fiber) and for the extraction of bioactives (flavonoids, essential oils, d-limonene). Still huge amounts of peels are wasted by Citrus industries, juice and other vending sectors.

PURPOSE

The biological potentials of these unutilized or 'wasted' Citrus peels are least exploited. Here we tested the anticancer potentials of Citrus medica (2 morphotypes), C. sinensis, C. maxima, C. limon and C. reticulata peels by in vitro assays and in vivo cancer models.

METHODS

Chemical profiles of Citrus peel oils and peel extracts were analyzed by gas chromatographic techniques (GC-FID, GC-MS) and HPTLC-densitometry, respectively. Anticancer potentials of Citrus peels (Citrus medica 2 morphotypes, C. sinensis, C. maxima, C. limon and C. reticulata) were evaluated by various in vitro assays (MTT assay, morphological observations, fast halo assay, flow cytometric analysis) and in vivo cancer models.

RESULTS

C. reticulata peels (extracts, essential oils) showed significant activity against DLA cell line in MTT assay. We found C. reticulata peel water extract inducing cell cycle arrest of DLA in G0/G1 phase followed by nuclear condensation, membrane blebbing, formation of apoptotic bodies and DNA damage leading to apoptosis. In in vivo experiments, C. reticulata peel extract pre-treated mice were significantly (50%) protected from DLA compared to post-treated mice (33%), without any conspicuous toxic symptoms. Citrus peels have volatiles (essential oils, limonoids) and non-volatiles (mainly polymethoxy flavones) as their bioactive/anticancer constituents.

CONCLUSION

Our results encourage the use of Citrus peels, which is wasted in huge amounts, as cancer preventive food additives and as anticancer agents.

Key lime (Citrus aurantifolia) inhibits the growth of triple drug resistant Helicobacter pylori

Background

Eradication rate for Helicobacter pylori (H. pylori) has decreased due to antibiotic resistance. Therefore, new strategies are needed to enhance H. pylori eradication, especially for H. pylori with high antibiotic resistance. The objective of this study was to evaluate anti-H. pylori activities of constituents from key lime (Citrus aurantifolia) and their possible inhibitory effects on urease activity of H. pylori.

Methods

Helicobacter pylori strain ATCC 43526 and triple drug resistant (TDR) H. pylori strains were used in this study. Urease activities of H. pylori strains were measured by ammonia colorimetrical quantification using ELISA reader. Minimum inhibitory concentrations were determined by agar dilution method for antibiotics and by modified media dilution method for each constituent of Citrus aurantifolia (C. aurantifolia).

Results

Citrus aurantifolia extract decreased the number of colonies of H. pylori strain ATCC 43526 and TDR H. pylori stains. An increasing concentration of C. aurantifolia extract attenuated urease activities of H. pylori strain ATCC 43526 and TDR H. pylori strains. Among constituents of C. aurantifolia, citral and 4-hexen-3-one were found to be able to inhibit the growth of H. pylori strain ATCC 43526 and TDR H. pylori strains. Furthermore, citral and 4-hexen-3-one inhibited urease activities of H. pylori strain ATCC 43526 and TDR H. pylori strains in a dose-dependent manner.

Conclusion

Citrus aurantifolia has antimicrobial effect on TDR H. pylori strains, suggesting that C. aurantifolia might have therapeutic potential to control antibiotic-resistant H. pylori strains that cause eradication failure using other antibiotics.

Association between alcohol consumption and the risk of gastric cancer: a meta-analysis of prospective cohort studies

Alcohol consumption is inconsistently associated with the risk of gastric cancer morbidity and mortality. The aim of this study was to systematically evaluate the association between alcohol consumption on gastric cancer risk. The PubMed, Embase, and Cochrane Library databases were searched from inception through April 2017. Prospective cohort studies evaluating the association between alcohol consumption and risk of gastric cancer which report its effect estimates with 95% confidence intervals (CIs) were included. The results summary was performed using the random-effect model. Twenty-two cohort studies involving 22,545 cases of gastric cancer and 5,820,431 participants were identified and included in our data analysis. Overall, drinking had little or no effect on gastric cancer as compared with non-drinkers. Furthermore, light and moderate alcohol consumption had no significant effect on gastric cancer risk when compared with non-drinkers. However, heavy alcohol consumption was associated with a greater risk of gastric cancer when compared with non-drinkers. The findings of the subgroup analyses indicated that light alcohol consumption was associated with a lower risk of gastric cancer in women, while heavy alcohol consumption was associated with an increased risk of gastric cancer regardless of country, gender, whether the study reported gastric cancer incidence, or whether the study adjusted for body mass index, educational attainment, or physical activity. The findings of this study suggest that light alcohol consumption might play a protective effect on gastric cancer in women, while heavy alcohol consumption is associated with a significantly increased risk of gastric cancer in all subgroups.

Consumption of garlic and lemon aqueous extracts combination reduces tumor burden by angiogenesis inhibition, apoptosis induction, and immune system modulation

OBJECTIVES

Dietary agents play an important role in cancer prevention and therapy because of their low toxicity and the perception that they are not a medicine. The aim of the present study was to investigate the anticancer effect of the administration of garlic and lemon aqueous extracts against breast cancer implanted in mice.

METHODS

We used 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay to determine the antiproliferative effect of both extracts and their combinations. Isobolographic method was used to calculate the combination index. Balb/C mice were inoculated with EMT6/P breast cancer cells and received intragastric administration of one of three treatments (garlic alone, lemon alone, or a combination of both). Change in tumor size and survival rates were measured. TUNEL assay was used to measure apoptosis and enzyme-linked immunosorbent assay (ELISA) was used to measure vascular endothelial growth factor expression. Serum levels of interferon-γ, interleukin (IL)-2, IL-4, and IL-10 were measured using ELISA and levels of aspartate transaminase, alanine transaminase, and creatinine were determined.

RESULTS

The combination of both extracts acts synergistically against breast cancer in mice. Of the treated mice, 80% were cured using this combination. This combination inhibited angiogenesis, induced apoptosis, and caused systemic activation in the immune system.

CONCLUSIONS

The combination of garlic and lemon aqueous extracts represents a promising option to develop an anticancer food for augmenting conventional anticancer therapies. However, further testing is essential to understand the exact molecular mechanisms of this combination and to test its therapeutic effect against other cancer models.