Application of nutrigenomics in skin health: nutraceutical or cosmeceutical?

Nutrigenomics is a growing field related to genetic testing based on the documentation of genetic mutations in an individual, giving us the ability to correct metabolic imbalances (personalized medicine) through specific dietary supplements or nutraceuticals. An off-shoot of nutrigenomics called dermagenetics (testing for selected genetic mutations related to skin health followed by advocating the use of either nutraceuticals or skin creams enriched by cosmeceuticals) is heading toward commercialization at a rapid rate by directly targeting the public. Although this growth represents an opportunity to explore the benefits of genetic advances in skin health, it is essential that the science, product claims, and ethical standards be critically evaluated and clear national guidelines be set in order to protect the consumer.

Studies on the nature of anti-platelet aggregatory factors in the seeds of the Amazonian Herb Guarana (Paullinia cupana).

Guarana (Paullinia cupana) is a popular herb native to the Amazon Basin and used extensively in soft drinks in Brazil, other Latin American countries, and more recently in the United States. Extracts derived from the dried seeds of guarana possess strong anti-platelet aggregatory properties. In this study, an active fraction containing this activity was purified and analyzed by high-performance liquid chromatography/mass spectrometry (HPLC/MS) techniques. It was noted that this fraction contains catechins, epicatechins, and their dimers, with a small amount of caffeine. It is suggested that complexes containing caffeine and catechins (and their dimers) might be responsible for anti-platelet aggregatory activity in guarana seeds and might offer health benefits towards decreasing risk of thrombosis and cardiovascular disease.

Understanding the nutrigenomic definitions and concepts at the food-genome junction.

The marked differences in individual response to dietary factors have led to major controversies in nutrition and puzzled nutrition scientists over the last century. The emerging field of nutrigenomics helps us to understand the basis for some of these differences and also promises us the ability to tailor diet based on individual genetic makeup. Great advances in Human Genome Project, documentation of single nucleotide polymorphisms (SNPs) in candidate genes and their association with metabolic imbalances have gradually added new tests to the nutrigenomic panel. Studies based on ethnopharmacology and phytotherapy concepts showed that nutrients and botanicals can interact with the genome causing marked changes in gene expression. This has led to the commercial development of nutraceuticals and functional foods that can modify negative health effects of individual genetic profile bringing the field to the "food/genome" junction. Despite the promise of nutrigenomics to personalize diet, there is skepticism whether it can truly bring about meaningful modification of the risk factors connected to chronic diseases, due to the lack of large scale nutrition intervention studies. Several intervention studies currently underway in the United States and abroad (Israel, Spain, and France) will further help validate nutrigenomic concepts. France has already introduced a National Nutrition and Health Program to assess nutritional status and risk of major metabolic diseases. As the field(s) related to nutritional genomics advance in their scope, it is essential that: (a) strict guidelines be followed in the nomenclature and definition of the subdisciplines; and (b) the state/federal regulatory guidelines be updated for diagnostic laboratories, especially for those offering tests directly to the public (without a physician's request) to help protect the consumer.

Nutrigenetics and nutraceuticals: the next wave riding on personalized medicine.

The Human Genome Project and subsequent identification of single nucleotide polymorphisms (SNPs) within populations has played a major role in predicting individual response to drugs (pharmacogenetics) leading to the concept of "personalized medicine." Nutritional genomics is a recent off-shoot of this genetic revolution that includes (1) nutrigenomics: the study of interaction of dietary components with the genome and the resulting proteonomic and metabolomic changes; and (2) nutrigenetics: understanding the gene-based differences in response to dietary components and developing nutraceuticals that are most compatible with health based on individual genetic makeup. Despite the extensive data on genetic polymorphisms in humans, its translation into medical practice has been slow because of the time required to accumulate population data on SNP incidence, understand the significance of a given SNP in disease, and develop suitable diagnostic tests. Nutrigenomics revitalized the field by showing that nutrients and botanicals can interact with the genome and modify subsequent gene expression, which has provided a great impetus for nutrigenetic research and nutraceutical development based on nutrigenetics. Polymorphisms in methlyene tetrahydrofolate reductase (MTHFR) (involved in folate metabolism), apolipoprotein E (Apo E) and ApoA1 (in cardiovascular disease), and leptin/leptin receptor (obesity) genes are some good examples for understanding basic nutrigenetics. Developing nutraceuticals to prevent and manage thrombosis risk in women with thrombophilic gene mutations are discussed in the context of the opportunities that exist at the nutrigenetic/pharmacogenetic interphase leading to "personalized nutrition." Further research on individual differences in genetic profiles and nutrient requirements will help establish nutrigenetics as an essential discipline for nutrition and dietetics practice.

Lipid peroxidation in the peritoneal fluid of infertile women with peritoneal endometriosis.

OBJECTIVE: To assess the level of lipid peroxidation in the peritoneal fluid of infertile women with peritoneal endometriosis and of fertile disease-free controls. STUDY DESIGN: Level of lipid peroxidation (malondialdeyde, malondialdeyde with copper addition, and cholest-3,5-dien-7-one) was measured in the peritoneal fluid obtained from 21 women with endometriosis-related infertility and from 21 fertile women having tubal ligation. RESULTS: : The level of lipid peroxidation did not differ significantly (P > 0.05) according to the stage of endometriosis. The level of lipid peroxidation (malondialdeyde, malondialdeyde with the addition of copper, and cholest-3,5-dien-7-one) did not differ significantly (P > 0.05) between patients with endometriosis-related infertility (0.07 nmol/ml, 0.34 nmol/ml, 0.24 microg/ml, respectively) and disease-free controls (0.04 nmol/ml, 0.21 nmol/ml, 0.25 microg/ml, respectively). CONCLUSION: The level of lipid peroxidation did not differ between women with endometriosis-related infertility and fertile disease-free controls, suggesting that increased reactive oxygen species may not be one of the factors responsible for compromised fertility in patients with endometriosis.

Detection of genomic polymorphisms associated with venous thrombosis using the invader biplex assay.

A multi-site study to assess the accuracy and performance of the biplex Invader assay for genotyping five polymorphisms implicated in venous thrombosis was carried out in seven laboratories. Genotyping results obtained using the Invader biplex assay were compared to those obtained from a reference method, either allele-specific polymerase chain reaction (AS-PCR), restriction fragment length polymorphism (PCR-RFLP) or PCR-mass spectrometry. Results were compared for five loci associated with venous thrombosis: Factor V Leiden, Factor II (prothrombin) G20210A, methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, and plasminogen activator inhibitor (PAI-1) 4G/5G. Of a total of 1448 genotypes tested in this study, there were 22 samples that gave different results between the Invader biplex assay and the PCR-based methods. On further testing, 21 were determined to be correctly genotyped by the Invader Assay and only a single discrepancy was resolved in favor of the PCR-based assays. The compiled results demonstrate that the Invader biplex assay provides results more than 99.9% concordant with standard PCR-based techniques and is a rapid and highly accurate alternative to target amplification-based methods.

Ergosterol (major sterol of baker's and brewer's yeast extracts) inhibits the growth of human breast cancer cells in vitro and the potential role of its oxidation products.

The derivation of chemopreventive agents from dietary sources has been the subject of considerable attention in recent years. Yeast extracts have been used as nutritional supplements for a number of years. In this communication we show that ergosterol (a 28-carbon sterol found in baker's and brewer's yeast) can prevent growth of breast cancer cells in vitro in the presence of estradiol-17 beta. Estrogen receptor (+) MCF-7 cells appear to be more sensitive to ergosterol than estrogen receptor (-) MDA-231 cells. However, MDA-231 cells were more sensitive to ergosterol in terms of apoptotic effects than MCF-7 cells, indicating that other mechanisms (antiestrogenic activity) may also be operative in estrogen receptor (+) cells. Compared to freshly prepared ergosterol, stored preparations were more potent in inhibiting growth of cancer cells, indicating that oxidation product(s) of ergosterol may be responsible for the noted effects. Further studies on in vivo effects of ergosterol and lipid extracts of yeast in animal models are warranted to determine their potential for use as supplements in humans.

Evidence of increased formation of products retaining strong antioxidant activity from estradiol-17beta oxidation in the presence of human plasma lipoproteins.

Estradiol-17beta (E2) exhibits potent antioxidant effects that cause continuous suppression of metal-catalyzed oxidation of low-density-lipoprotein in vitro. We sought to learn whether unidentified oxidation products retaining strong antioxidant property may be generated from E2 incubated with lipoproteins and subjected to oxidation by reactive oxygen species generators. E2 oxidation was markedly stimulated in the presence of both LDL and high-density lipoprotein. We have isolated two novel products (less polar than E2), formed when E2 was oxidized with copper sulfate and hydrogen peroxide in the presence of lipoproteins). Both compounds had molecular weights of 306 on gas chromatography/mass spectrometry. They appear to be as strong as E2 in inhibiting LDL oxidation in vitro. Because of their increased hydrophobicity, they have the potential of being associated with LDL and offer promise as agents that can limit LDL oxidation, thereby contributing to cardioprotection.

Estrogen replacement therapy and cardioprotection: mechanisms and controversies.

Epidemiological and case-controlled studies suggest that estrogen replacement therapy might be beneficial in terms of primary prevention of coronary heart disease (CHD). This beneficial effect of estrogens was initially considered to be due to the reduction of low density lipoproteins (LDL) and to increases in high density lipoproteins (HDL). Recent studies have shown that estrogens protect against oxidative stress and decrease LDL oxidation. Estrogens have direct effects on the arterial tissue and modulate vascular reactivity through nitric oxide and prostaglandin synthesis. While many of the effects of estrogen on vascular tissue are believed to be mediated by estrogen receptors alpha and beta, there is evidence for 'immediate non-genomic' effects. The role of HDL in interacting with 17beta-estradiol including its esterification and transfer of esterified estrogens to LDL is beginning to be elucidated. Despite the suggested positive effects of estrogens, two recent placebo-controlled clinical trials in women with CHD did not detect any beneficial effects on overall coronary events with estrogen therapy. In fact, there was an increase in CHD events in some women. Mutations in thrombogenic genes (factor V Leiden, prothrombin mutation, etc.) in a subset of women may play a role in this unexpected finding. Thus, the cardioprotective effect of estrogens appears to be more complicated than originally thought and requires more research.

Estrogen replacement therapy and cardioprotection: mechanisms and controversies

Epidemiological and case-controlled studies suggest that estrogen replacement therapy might be beneficial in terms of primary prevention of coronary heart disease (CHD). This beneficial effect of estrogens was initially considered to be due to the reduction of low density lipoproteins (LDL) and to increases in high density lipoproteins (HDL). Recent studies have shown that estrogens protect against oxidative stress and decrease LDL oxidation. Estrogens have direct effects on the arterial tissue and modulate vascular reactivity through nitric oxide and prostaglandin synthesis. While many of the effects of estrogen on vascular tissue are believed to be mediated by estrogen receptors alpha and ß, there is evidence for `immediate non-genomic' effects. The role of HDL in interacting with 17ß-estradiol including its esterification and transfer of esterified estrogens to LDL is beginning to be elucidated. Despite the suggested positive effects of estrogens, two recent placebo-controlled clinical trials in women with CHD did not detect any beneficial effects on overall coronary events with estrogen therapy. In fact, there was an increase in CHD events in some women. Mutations in thrombogenic genes (factor V Leiden, prothrombin mutation, etc.) in a subset of women may play a role in this unexpected finding. Thus, the cardioprotective effect of estrogens appears to be more complicated than originally thought and requires more research

Dietary inclusion of whole soy foods results in significant reductions in clinical risk factors for osteoporosis and cardiovascular disease in normal postmenopausal women.

OBJECTIVE: To determine the effects of dietary inclusion of soy foods on clinical markers for cardiovascular disease (CVD) and osteoporosis in normal postmenopausal women. DESIGN: This was a single open-group prospective clinical intervention. Forty-two normal postmenopausal women consumed three daily servings for 12 consecutive weeks of whole soy foods containing approximately 60 mg/d of isoflavones. Blood and urine specimens were obtained at baseline and after 12 weeks of dietary intervention. RESULTS: Serum and urine levels of individual and total isoflavones increased significantly (7-19 fold, p < 0.001) from baseline. A significant increase (9.3%, p < 0.05) in the mean lag-time of low-density lipoprotein cholesterol oxidation was seen and was positively correlated with serum phytoestrogens (p < 0.05). Significant increases were found in mean levels of high-density lipoprotein cholesterol (HDLc) (3.7%, p < 0.05) and serum osteocalcin (10.2%, p < 0.025). Significant decreases were observed in total cholesterol:HDLc ratios (5.5%, p < 0.006) and mean urinary N-telopeptide excretion (13.9%, p < 0.02). Urinary excretion of total isoflavones was negatively correlated with very-low-density lipoprotein cholesterol, triglycerides, and total cholesterol:HDLc ratios (p < 0.04). No significant changes from baseline in HDLc peroxidation, total cholesterol, triglycerides, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, bone-specific alkaline phosphatase, follicle-stimulating hormone, or estradiol levels were observed. CONCLUSIONS: Dietary inclusion of whole soy foods containing 60 mg/d of isoflavones results in significant serum levels of phytoestrogens and reductions in several key clinical risk factors for CVD and osteoporosis in normal postmenopausal women. Long-term, placebo-controlled clinical trials are needed to evaluate the effect of phytoestrogens on the clinical endpoints of CVD and osteoporosis in this population.

Metformin reduces weight, centripetal obesity, insulin, leptin, and low-density lipoprotein cholesterol in nondiabetic, morbidly obese subjects with body mass index greater than 30.

We studied 31 nondiabetic, habitually (> or =5 years) morbidly obese subjects (mean +/- SD body mass index [BMI] 43 +/- 8.7, median 43). Our specific aim was to determine whether metformin (2.55 g/d for 28 weeks) would ameliorate morbid obesity and reduce centripetal obesity; lipid and lipoprotein cholesterol, insulin, and leptin levels; and plasminogen activator inhibitor activity (PAI-Fx), risk factors for coronary heart disease (CHD). The patients were instructed to continue their prestudy dietary and exercise regimens without change. After 2 baseline visits 1 week apart, the 27 women and 4 men began receiving metformin, 2.55 g/d, which was continued for 28 weeks with follow-up visits at study weeks 5, 13, 21, and 29. Daily food intake was recorded by patients for 7 days before visits then reviewed with a dietitian. Kilocalories per day and per week were calculated. At each visit, fasting blood was obtained for measurement of lipid profile, insulin, leptin, and PAI-Fx. The mean +/- SD kilocalories consumed per day, 1,951 +/- 661 at entry, fell by week 29 to 1,719 +/- 493 (P =.014) but did not differ at weeks 5, 13, and 21 from that at week 29 (P >.2). Weight fell from 258 +/- 62 pounds at entry to 245 +/- 54 pounds at week 29 (P =.0001). Girth was reduced from 51.8 +/- 6.2 to 49.2 +/- 4.5 inches (P =.0001). Waist circumference fell from 44.0 +/- 6.4 inches to 41.3 +/- 5.9 (P =.0001). The waist/hip ratio fell from 0.85 +/- 0.09 to 0.84 +/- 0.09 (P =.04). Fasting serum insulin, 28 +/- 15 microU/mL at entry, fell to 21 +/- 11 microU/mL at week 29 (P =.0001), and leptin fell from 79 +/- 33 ng/mL to 55 +/- 27 ng/mL (P =.0001). On metformin, there were linear trends in decrements in weight, girth, waist circumference, waist/hip ratio, insulin, and leptin throughout the study period (P <.007). Low-density lipoprotein (LDL) cholesterol, 126 +/- 34 mg/dL at study entry, fell to 112 +/- 43 mg/dL at week 29 (P =.001), with a linear trend toward decreasing levels throughout (P =.036). By stepwise linear regression, the higher the entry weight, the larger the reduction in weight on metformin therapy (partial R(2) = 31%, P =.001). The greater the reduction in kilocalories consumed per day, the greater the decrease in weight on metformin therapy (partial R(2) = 15%, P =.011). The higher the waist/hip ratio at entry, the greater its reduction on metformin therapy (partial R(2) = 11%, P =.004). The higher the entry serum leptin, the greater its reduction on metformin therapy (partial R(2) = 29%, P =.002). The greater the reduction in insulin on metformin, the greater the reduction in leptin (partial R(2) = 8%, P =.03). The higher the entry PAI-Fx, the greater the reduction in PAI-Fx on metformin (partial R(2) = 43%, P =.0001). Metformin safely and effectively reduces CHD risk factors (weight, fasting insulin, leptin, LDL cholesterol, centripetal obesity) in morbidly obese, nondiabetic subjects with BMI > 30, probably by virtue of its insulin-sensitizing action.

Uptake and protection against oxidative stress by estrogen esters in THP-1 human macrophage cell lines.

Estrogen replacement therapy offers protection from coronary artery disease in postmenopausal women. However, there is serious concern that long-term unopposed estrogen use increases the risk of breast and endometrial cancer through estrogen-receptor-driven mechanisms. In this communication, we have explored an alternate route of estrogen delivery to macrophages using hydrophobic derivatives that associate with lipoproteins. Unlike free estradiol (E(2)), long-chain fatty acid esters of E(2) associate extensively with low-density lipoprotein (LDL). In THP-1 cells, E(2) esters accumulated to a significantly higher level when compared to E(2) in the presence of LDL. In the presence of oxidized LDL even greater amounts of E(2) esters accumulated in cells. In THP-1 cells, E(2) esters were capable of preventing the azo-bis-induced increase in oxidative stress (hydrogen peroxide formation). These studies suggest that (a) hydrophobic esters of estrogens that associate with LDL can be delivered to macrophages and (b) these esters can effectively function as antioxidants protecting against oxidative stress.

Evidence for the role of high density lipoproteins in mediating the antioxidant effect of estrogens.

Estrogens possess strong antioxidant effects in vitro, but in vivo studies in humans have yielded conflicting results. Little is known regarding factors that mediate the antioxidant effect of estrogens in vivo. In this study the potential role of high density lipoprotein (HDL) was examined. The antioxidant effect of estradiol-17beta (E2) added to low density lipoprotein (LDL) was lost after dialysis. In contrast, the antioxidant effect of E2 added to HDL was conserved after dialysis, suggesting that E2 was bound to HDL. Binding of E2 to LDL increased after esterification (especially to long chain fatty acids). In the presence of HDL, an increased amount of E2 was transferred to LDL. E2-17 ester was as potent as E2 in preventing LDL oxidation in vitro, but 3,17-diesters were not as effective (E2=E2-17 ester>E2-3 ester>E2-3,17 diester). This was also supported by experiments which showed that estrogens with masked 3-OH groups were not effective as antioxidants. These studies provide evidence that HDL could facilitate the antioxidant effect of E2 through initial association, esterification and eventual transfer of E2 esters to LDL. Therefore it is critical that HDL peroxidation parameters be evaluated in subjects receiving estrogen replacement therapy.

The effect of prolonged exercise on lipid peroxidation in eumenorrheic female runners.

PURPOSE: Recently a protective role has been demonstrated for estrogens as free radical scavengers. In this study, lipid peroxidation was evaluated in eumenorrheic runners before and after participation in a half-marathon. METHODS: Seven female runners who participated in regular training (average 25 miles x wk(-1) and reported regular menses (12/yr) served as subjects. Subjects were all in a low estrogen phase of their menstrual cycle as confirmed by menstrual record and plasma estradiol level (42.71 +/- 21.65 pg x mL(-1). Low density lipoprotein oxidation (formation of conjugated dienes) was determined 2 h prerace and 5 min after subject's completion of the race. RESULTS: Results showed a significant increase in lag phase time of conjugated dienes after prolonged exercise (28.43 +/- 4.89 min vs postrace 35.21 +/- 4.32 min, P < 0.05). No correlation between mean levels of estradiol and mean lipid peroxidation levels at rest, 5 min after exercise, or difference (prepost) was observed. CONCLUSION: Prolonged endurance exercise does not appear to increase potential for lipid peroxidation in trained eumenorrheic runners during a low estrogen phase of the menstrual cycle.

Evidence for interference in estradiol-17beta inactivation to estrone by oxidized low-density lipoprotein and selected lipid peroxidation products.

An elevation in plasma estrogen levels is believed to play a key role in the pathogenesis of breast cancer. The conversion of estradiol-17beta (E2) to estrone (E1) by 17beta-hydroxy steroid dehydrogenase type 4 (17-HSD4) represents a major pathway of its inactivation in cells. In this study the potential relationship between lipoprotein peroxidation products and E2 metabolism was examined. It was noted that oxidized low-density lipoprotein (OX-LDL), not native LDL, caused a time- and concentration-dependent inhibition of the conversion of labeled E2 to E1 in THP-1 macrophage cells. Further studies noted that among the lipoprotein peroxidation products examined, malondialdehyde (MDA) caused a marked decrease in this reaction, whereas hexanal and a variety of oxysterols had no effect. This inhibition of E1 formation from E2 in THP-1 cells was confirmed by the quantitation of estrone formed with high-pressure liquid chromatography and by the expression of 17-HSD4 by reverse transcriptase-polymerase chain reaction. MDA added to Hep G2 cells showed a similar trend in E1 formation. These results suggest that increased oxidative stress and lipid peroxidation might result in decreased inactivation of biologically active estrogen. This might be important in postmenopausal women undergoing estrogen replacement therapy.

Mechanisms involved in the protective effect of estradiol-17beta on lipid peroxidation and DNA damage.

Previous studies from our laboratory have shown that estrogens can protect against lipoprotein peroxidation and DNA damage. In this study, the mechanism of estradiol-17beta (E2) action was investigated by comparing E2 with selective scavengers of reactive oxygen species (ROS) in terms of inhibition of 1) human low-density lipoprotein (LDL) peroxidation (measured by the diene conjugation method) and 2) DNA damage (measured by the formation of strand breaks in supercoiled OX-174 RFI DNA). In addition, the direct effect of E2 on the generation of individual ROS was also measured. By use of ROS scavengers, it was determined that lipoprotein peroxidation was predominantly due to superoxide (39%), with some contributions from hydrogen peroxide (23%) and peroxy (38%) radicals. E2 was a more effective inhibitor of peroxidation than all the ROS scavengers combined. In DNA damage, scavengers of hydrogen peroxide, hydroxyl, and superoxide radical offered significant protection (49-65%). E2 alone offered a similar degree of protection, and no additional effect was evident when it was combined with ROS scavengers. E2 caused a significant reduction (37%) in the production of superoxide radical by bovine heart endothelial cells in culture but had no effect on the formation of either hydrogen peroxide or hydroxyl radicals. These studies show that 1) the protection offered by E2 in terms of lipid peroxidation could be due to its ability to inhibit generation of superoxide radical and prevent further chain propagation, and 2) in DNA damage protection, E2 mainly appears to inhibit chain propagation.

Exercised-induced increase in lipid peroxidation parameters in amenorrheic female athletes.

OBJECTIVE: To determine plasma lipid peroxidation parameters in eumenorrheic and amenorrheic athletes and to evaluate differences in their response to exercise-induced oxidative stress. In female athletes, intense physical exercise has been shown to be associated with an increased occurrence of menstrual dysfunction with lower levels of E2. Recently, a protective role has been demonstrated for estrogens as free radical scavengers. DESIGN: Comparison of eumenorrheic and amenorrheic athletes before and after an acute bout of exercise. SETTING: Academic Research Environment. PATIENT(S): Seven eumenorrheic (normally menstruating) and seven amenorrheic (<3 menses/year) female athletes aged 18 to 35 years participating in regular training. MAIN OUTCOME MEASURE(S): Plasma and low-density lipoprotein oxidation parameters, plasma E2 and vitamin E levels, and creatine kinase activity. RESULT(S): Both the amenorrheic and eumenorrheic athletes demonstrated a significant decrease in the lag time of conjugated diene formation after exercise (P < 0.01), with greater magnitude of change occurring in the amenorrheic athletes (P < 0.05). In addition, postexercise samples from amenorrheic (but not eumenorrhic) athletes showed a significant (P < 0.01) increase in oxysterol formation as compared to baseline values. Amenorrheic athletes also demonstrated a significantly higher baseline creatine kinase activity and a nonsignificant (P = 0.04) trend of an increase in creatine kinase activity after exercise. CONCLUSION(S): The results of this study shows that amenorrheic female athletes demonstrate an increased potential for lipid peroxidation after exercise. This could be related to lower plasma E2 levels in this group, considering the strong free radical scavenging ability of estrogens identified recently.