Protein digestibility and ACE inhibitory activity of fermented flours in older adults and standard gastrointestinal simulation.

Consumption of essential amino acids responsible for muscle protein synthesis is important in preventing sarcopenia among older individuals. This population may experience gastrointestinal disorders that inhibit protein digestibility, making it crucial to address. Therefore, solid-state fermentation (SSF) using Pleurotus ostreatus and air drying has been suggested as a means of improving the protein digestibility of lentils and quinoa. SSF combined with air drying at 70 °C resulted in a slight increase in protein hydrolysis compared to unfermented samples. SSF was found to boost the proportion of small peptides to 35 %. Following digestion, SSF and drying yielded bioactive peptides of 1400 and 450 Da, with a range of 11 % to 28 %, respectively, and peptides < 190 Da making up 60 % of the total. SSF promoted valine, leucine, and isoleucine generation; however, hot air drying reduced free amino acids due to the amino acid-reducing sugar bonding but was never lower than the initial content of its unfermented counterpart. Furthermore, SSF and drying at 70 °C improved the release of hydrophobic amino acids (>70 mg/g dry basis) and negatively charged amino acids (>20 mg/g dry basis) in lentils during digestion. The SSF samples exhibited lower angiotensin converting enzyme (ACE) inhibitory activity, ≤35 %, compared to unfermented flours after digestion. However, the ACE inhibitory activity increased in SSF-dried samples, in part because of melanoidins generated during drying. Finally, lower values of protein digestibility and thus smaller peptides, amino acid profile, and ACE inhibitory activity of fermented flours were found in the older adult digestion model.

Suboptimal use of ovarian function suppression in very young women with early breast cancer: a real-world data study.

PURPOSE: The incidence of breast cancer in young women (BCYW) has increased in recent decades. Malignant disease in this subset is characterized by its aggressiveness and poor prognosis. Ovarian function suppression (OFS) in these patients improves survival especially in hormone receptor-positive (HR +) cases. The Regan Composite Risk (RCR) is a prognostic tool to identify high-risk HR + BC candidates for OFS. Our study sought to characterize a Chilean cohort of early HR + BCYW assessing the use of OFS and its related prognosis and the utility of RCR in our patients. METHODS: This was a retrospective population cohort study that included ≤ 35-year-old early HR + /human epidermal growth factor receptor 2 -negative (HER2-) BC patients treated between 2001 and 2021. Analysis included clinical-pathological characteristics, treatment strategies, and survival. Also, we evaluated the association between RCR and survival. RESULTS: A total of 143 patients were included into our study, representing 2.9% of all early BC cases in our registry. Median age was 31 years old (range: 19-35). Most patients (93%) received endocrine therapy (ET). Of these, 18% received OFS. No survival differences were observed among treatment strategies. Median RCR score for patients treated with CT plus ET was significantly higher vs. ET alone (2.95 vs. 1.91; p = 0.0001). Conversely, patients treated with tamoxifen alone had significantly lower RCR scores vs. OFS (2.72 vs. 3.14; p = 0.04). Higher RCR scores were associated with poorer overall survival. CONCLUSION: Less than 20% of very young women with early HR + /HER2-BC in our cohort received OFS, in most cases, this involved surgical oophorectomy. RCR score was higher in patients that underwent CT and OFS and was associated with survival, regardless of treatment. We confirm the RCR score as a valuable prognostic tool to identify high-risk BC patients who could benefit from OFS.

Effect of beta-glucan supplementation on cystic fibrosis colonic microbiota: an in vitro study.

BACKGROUND: Children with cystic fibrosis (CF) present with gut dysbiosis, and current evidence impedes robust recommendations on the use of prebiotics. This study aimed at establishing the prebiotic potential of a commercial beta-glucan on the in vitro colonic microbiota of a child with CF compared to a healthy counterpart (H). METHODS: A dynamic simulator of colonic fermentation (twin-SHIME® model) was set up including the simulation of the proximal (PC) and distal colon (DC) of the CF and the H subjects by colonizing the bioreactors with faecal microbiota. During two weeks the system was supplied with the beta-glucan. At baseline, during treatment and post-treatment, microbiota composition was profiled by 16 S rRNA and short-chain fatty acids (SCFA) production was determined by GS-MS. RESULTS: At baseline, Faecalibacterium, was higher in CF' DC than in the H, along higher Acidaminococcus and less Megasphaera and Sutterella. Beta-glucan supplementation induced increased microbiota richness and diversity in both subjects during the treatment. At genus level, Pseudomonas and Veillonella decreased, while Akkermansia and Faecalibacterium increased significantly in CF. CONCLUSION: The supplementation with beta-glucan suggests positive results on CF colonic microbiota in the in vitro context, encouraging further research in the in vivo setting. IMPACT: Current evidence supports assessing the effect of prebiotics on modifying cystic fibrosis microbiota. The effect of beta-glucan supplementation was evaluated in a controlled dynamic in vitro colonic ecosystem. Beta-glucan supplement improved diversity in cystic fibrosis colonic microbiota. The treatment showed increased abundance of Faecalibacterium and Akkermansia in cystic fibrosis. New evidence supports the use of prebiotics in future clinical studies.

Association between Dietary Intake and Faecal Microbiota in Children with Cystic Fibrosis.

A "high-fat, high-energy diet" is commonly recommended for children with cystic fibrosis (CF), leading to negative consequences on dietary patterns that could contribute to altered colonic microbiota. The aim of this study was to assess dietary intake and to identify possible associations with the composition of faecal microbiota in a cohort of children with CF. A cross-sectional observational study was conducted, including a 3-day food record simultaneously with the collection of faecal samples. The results showed a high fat intake (43.9% of total energy intake) and a mean dietary fibre intake of 10.6 g/day. The faecal microbiota was characterised at the phylum level as 54.5% Firmicutes and revealed an altered proportion between Proteobacteria (32%) and Bacteroidota (2.2%). Significant associations were found, including a negative association between protein, meat, and fish intake and Bifidobacterium, a positive association between lipids and Escherichia/Shigella and Streptococcus, a negative association between carbohydrates and Veillonella and Klebsiella, and a positive association between total dietary fibre and Bacteroides and Roseburia. The results reveal that a "high-fat, high-energy" diet does not satisfy dietary fibre intake from healthy food sources in children with CF. Further interventional studies are encouraged to explore the potential of shifting to a high-fibre or standard healthy diet to improve colonic microbiota.

In Vitro Digestion Assessment (Standard vs. Older Adult Model) on Antioxidant Properties and Mineral Bioaccessibility of Fermented Dried Lentils and Quinoa.

The growing number of older adults necessitates tailored food options that accommodate the specific diseases and nutritional deficiencies linked with ageing. This study aims to investigate the influence of age-related digestive conditions in vitro on the phenolic profile, antioxidant activity, and bioaccessibility of minerals (Ca, Fe, and Mg) in two types of unfermented, fermented, and fermented dried quinoa and lentils. Solid-state fermentation, combined with drying at 70 °C, significantly boosted the total phenolic content in Castellana and Pardina lentils from 5.05 and 6.6 to 10.5 and 7.5 mg gallic acid/g dry weight, respectively, in the bioaccessible fraction following the standard digestion model, compared to the unfermented samples. The phenolic profile post-digestion revealed elevated levels of vanillic and caffeic acids in Castellana lentils, and vanillic acid in Pardina lentils, while caffeic acids in Castellana lentils were not detected in the bioaccessible fraction. The highest antioxidant potency composite index was observed in digested fermented dried Castellana lentils, with white quinoa samples exhibiting potency above 80%. Mineral bioaccessibility was greater in fermented and fermented dried samples compared to unfermented ones. Finally, the digestive changes that occur with ageing did not significantly affect mineral bioaccessibility, but compromised the phenolic profile and antioxidant activity.

Effect of Lactobacillaceae Probiotics on Colonic Microbiota and Metabolite Production in Cystic Fibrosis: A Comparative In Vitro Study.

Cystic Fibrosis-related gut dysbiosis (CFRGD) has become a recognised complication in children with this condition, and current evidence remains insufficient to guide the selection of probiotic strains for supplementation treatments. The aim of this study was to characterise the effect of three probiotic strains on CFRGD by means of a dynamic in vitro simulation of the colonic fermentation (SHIME®). The configuration of the system included three bioreactors colonised with the faecal inoculum of a child with cystic fibrosis. For 20 days, each bioreactor was supplied daily with either Lacticaseibacillus rhamnosus GG (ATCC 53103 TM), Limosilactobacillus reuteri (DSM 17938) or Lactiplantibacillus plantarum (DSM 22266). The baseline microbiota was characterised by a high abundance of Prevotella, Faecalibacterium and Acidaminococcus genera. After 20 days of supplementation, L. rhamnosus and L. plantarum reduced Prevotella significantly, and the three strains led to increased Faecalibacterium and Bifidobacterium and decreased Acidaminococcus, with some of these changes being maintained 10 days after ceasing supplementation. The metabolic activity remained unaltered in terms of short-chain fatty acids, but branched-chain fatty acids showed a significant decrease, especially with L. plantarum. Additionally, ammonia decreased at 20 days of supplementation, and lactate continuously increased with the three strains. The effects on colonic microbiota of L. rhamnosus, L. reuteri or L. plantarum were established, including increased beneficial bacteria, such as Faecalibacterium, and beneficial metabolites such as lactate; and on the other hand, a reduction in pathogenic genera, including Prevotella or Acidaminococcus and branched-chain fatty acids, overall supported their use as probiotics in the context of CFRGD.

Evaluation of the In Vitro Antimicrobial Efficacy against Staphylococcus aureus and epidermidis of a Novel 3D-Printed Degradable Drug Delivery System Based on Polycaprolactone/Chitosan/Vancomycin-Preclinical Study.

Acute and chronic bone infections, especially those caused by methicillin-resistant Staphylococcus aureus (MRSA), remains a major complication and therapeutic challenge. It is documented that local administration of vancomycin offers better results than the usual routes of administration (e.g., intravenous) when ischemic areas are present. In this work, we evaluate the antimicrobial efficacy against S. aureus and S. epidermidis of a novel hybrid 3D-printed scaffold based on polycaprolactone (PCL) and a chitosan (CS) hydrogel loaded with different vancomycin (Van) concentrations (1, 5, 10, 20%). Two cold plasma treatments were used to improve the adhesion of CS hydrogels to the PCL scaffolds by decreasing PCL hydrophobicity. Vancomycin release was measured by means of HPLC, and the biological response of ah-BM-MSCs growing in the presence of the scaffolds was evaluated in terms of cytotoxicity, proliferation, and osteogenic differentiation. The PCL/CS/Van scaffolds tested were found to be biocompatible, bioactive, and bactericide, as demonstrated by no cytotoxicity (LDH activity) or functional alteration (ALP activity, alizarin red staining) of the cultured cells and by bacterial inhibition. Our results suggest that the scaffolds developed would be excellent candidates for use in a wide range of biomedical fields such as drug delivery systems or tissue engineering applications.

The impact of age-related digestive disorders on in vitro digestibility of macronutrients and bioaccessibility of minor components of chia seeds.

Gastrointestinal (GI) functions deteriorate with age, primarily affecting protein digestion. The consumption of chia seeds may be helpful for the elderly because they offer a vegetable-based source of proteins, healthy lipids, fibre and micronutrients. The impact of common age-related GI deterioration on chia seed digestibility was assessed using in vitro digestion models. The goal was to study the potential of chia seeds as part of the diet of seniors. Deterioration in the oral, gastric and intestinal stages of digestion was cumulatively assessed in three digestion models: E1 (deterioration in oral conditions), E2 (deterioration in oral and gastric conditions) and E3 (deterioration in oral, gastric and intestinal conditions). Less efficient chewing (E1) decreased proteolysis, lipolysis and antioxidant capacity (p < 0.05). In contrast, deterioration in gastric functions seemed to affect only total polyphenolic content. Finally, in the model simulating the greatest deterioration in digestive functions (E3), all measured variables were negatively affected (proteolysis, lipolysis, amino acid release, total phenolic content, antioxidant capacity and calcium). Calcium bioaccessibility fell by 24 % with a decrease in pancreatic enzymes and bile secretion (E3). Age-related reduced digestive function did not affect the ratio of essential to non-essential amino acids in the digested samples in any case. However, under suboptimal GI conditions (E3), amino acids such as valine, leucine and isoleucine, which are important for sarcopenia prevention in the elderly, fell by 39 %, 49 % and 44 %, respectively. These findings might be helpful for further in vitro studies of chia seeds as a possible food ingredient. They may also be useful for the development of more targeted nutrition strategies in the elderly.

Impact of Air-Drying Temperature on Antioxidant Properties and ACE-Inhibiting Activity of Fungal Fermented Lentil Flour.

Solid-state fermentation (SSF) with Pleurotus ostreatus enhances the nutritional value of legumes. However, drying can cause significant changes in physical and nutritional properties of the final products. Thus, this work studies the impact of air-drying temperature (50, 60, and 70 °C) on relevant properties (antioxidant properties, ACE-inhibitory capacity, phytic acid, colour, and particle size) of two fermented lentils flour (Pardina and Castellana) using freeze-drying as a reference method. Castellana variety is a better substrate for Pleurotus, generating four times more biomass. In addition, an almost total reduction of phytic acid from 7.3 to 0.9 mg/g db is achieved in this variety. Air-drying significantly decreased the particle size and the final colour with ΔE > 20; nonetheless, the temperature does not play a crucial role. SSF decreased the total phenolic content and the antioxidant capacity regardless of the variety, however, drying at 70 °C increased total phenolic content (186%) in fermented Castellana flour. Comparing drying methods, freeze-drying implied a higher decrease in those parameters, reducing the TPC from 2.4 to 1.6 and from 7.7 to 3.4 mg gallic acid/g db in Pardina and Castellana dried flours. Finally, the flours inhibit the angiotensin I-converting-enzyme, and fermentation and drying increased their potential cardiovascular benefits.

Opioid-Free Anaesthesia Improves Anaesthesia Recovery when Compared with that of Opioid-Based Anaesthesia. Systematic Review and Meta-Analysis of Clinical Trials.

INTRODUCTION: Opioid Free Anesthesia (OFA) is a relatively new technique that has been questioned due to the lack of evidence regarding its benefit-risk balance. METHODS: Four international databases were searched for clinical trials comparing OFA with opioid based anesthesia. The primary outcome was pain control and the secondary included postoperative nausea and vomiting (PONV), gastrointestinal recovery, respiratory depression, urinary retention, length of hospital stay, surgical complications, number of patients with cessation of the intervention and other side effects. RESULTS: Pain was better controlled in the OFA group in all the measurements made (VAS 1h: Md = -0.81, CI95% = -0.48- -1.14, VAS 24h: Md = -1.25, CI95% =-2.41- -0.1, VAS >24h: Md = -1.36, CI95% = -1.73- -1). In the opioid group there was an increase in the risk of nausea (RR=2.69, CI95% = 2-3.61) and vomiting (RR = 3.99, CI95% = 2.06-7.74), whilst in the OFA group, there was an increased risk of bradycardia (RR= 1.62, CI95% = 1.02-2.57). The rest of the variables showed no differences between groups or could not be analyzed. CONCLUSION: There is a clear benefit of OFA in pain control and PONV, but there is also a higher risk of bradycardia. This technique should be considered in patients with a special risk of difficult postoperative pain control or PONV. However, the best drug combination to perform OFA is still unknown, as well as the type of patient that benefits more with less risk.

Exploring the Impact of Solid-State Fermentation on Macronutrient Profile and Digestibility in Chia (Salvia hispanica) and Sesame (Sesamum Indicum) Seeds.

Fermentation of plant-based substrates with edible fungi enhances the nutrient profile and digestibility, but it has been scarcely applied to edible seeds, which are rich in healthy lipids. In this study, chia and sesame seeds were solid-state fermented with Pleurotus ostreatus, followed by drying and milling. Fermentation led to increased content of lipid and protein in both seeds' products, and a change in fatty acid profile in favor of increased polyunsaturated fatty acids. Then, the samples were subjected to in vitro digestion. Lipolysis, determined by nuclear magnetic resonance, was higher in sesame than in chia products, and the fermented counterparts had increased values compared to the controls. In terms of physical properties, fermentation showed reduced particle size and increased matrix degradation and decreased viscosity of the digestion medium, which were related to increased lipolysis. In conclusion, applying solid-state fermentation on chia and sesame seeds could be a recommendable approach.

Impact of Cooking Preparation on In Vitro Digestion of Eggs Simulating Some Gastrointestinal Alterations in Elders.

This study aimed to in vitro assess the impact of the cooking process of eggs (hard-boiled, poached, and omelet) on nutrients digestibility and vitamins A and D3 bioaccessibility under elderly gastrointestinal (GI) conditions. Three elderly digestion models were mimicked: oral (E1); oral and gastric (E2); and oral, gastric, and intestinal (E3), and a healthy adult model (C). Proteolysis extent reduced after digestion of omelet under the E3 model (p < 0.05) (up to 37% of reduction). Thus, hard-boiled and poached were more recommendable to enhance protein digestibility in elders. Altered GI conditions negatively influence neither the absorbable lipid fraction nor the cholesterol stability. Finally, vitamin A bioaccessibility was not affected but D3 slightly decreased with the elderly (E3). Hence, the digestion of nutrients was dependent on the resulting matrix, poached being the greater supplier of protein and lipid end-digestion products. Poached and omelet, however, offer a high net supply of bioaccessible vitamin D3 for elders.

Advanced Research in Food Digestion.

Food digestion is the key process for delivering nutrients and bioactive compounds to the body [...].

In vitro digestion of salmon: Influence of processing and intestinal conditions on macronutrients digestibility.

Salmon is the main dietary source of omega-3 lipids and contains high-biological value protein. However, processing techniques could affect macronutrient digestibility. Also, altered intestinal conditions, particularly given in pancreatic insufficiency, could threaten digestibility. This study tested both hypotheses by subjecting raw, marinated and microwave-cooked salmon to static in vitro digestion under healthy (pH 7, bile concentration 10 mM) and altered (pH 6, bile 1 or 10 mM) intestinal conditions with different pancreatin concentrations. In the standard conditions, proteolysis was not affected by processing, but lipolysis decreased in marinated (46%) and raw salmon (57%) compared to the cooked matrix (67%). In altered conditions, proteolysis and lipolysis decreased to different extents depending on the treatment. Overall, processing affected proteolysis the most (f-ratio = 5.86), while intestinal conditions were the major determinants of lipolysis (f-ratio = 58.01). This study could set the ground to establish dietary recommendations of salmon for specific population groups.

Clinical evaluation of an evidence-based method based on food characteristics to adjust pancreatic enzyme supplements dose in cystic fibrosis.

BACKGROUND: Patients with cystic fibrosis (CF) and pancreatic insufficiency need pancreatic enzyme replacement therapy (PERT) for dietary lipids digestion. There is limited evidence for recommending the adequate PERT dose for every meal, and controlling steatorrhea remains a challenge. This study aimed to evaluate a new PERT dosing method supported by a self-management mobile-app. METHODS: Children with CF recruited from 6 European centres were instructed to use the app, including an algorithm for optimal PERT dosing based on in vitro digestion studies for every type of food. At baseline, a 24h self-selected diet was registered in the app, and usual PERT doses were taken by the patient. After 1 month, the same diet was followed, but PERT doses were indicated by the app. Change in faecal fat and coefficient of fat absorption (CFA) were determined. RESULTS: 58 patients (median age 8.1 years) participated. Baseline fat absorption was high: median CFA 96.9%, median 2.4g faecal fat). After intervention CFA did not significantly change, but range of PERT doses was reduced: interquartile ranges narrowing from 1447-3070 at baseline to 1783-2495 LU/g fat when using the app. Patients with a low baseline fat absorption (CFA<90%, n=12) experienced significant improvement in CFA after adhering to the recommended PERT dose (from 86.3 to 94.0%, p=0.031). CONCLUSION: the use of a novel evidence-based PERT dosing method, based on in vitro fat digestion studies incorporating food characteristics, was effective in increasing CFA in patients with poor baseline fat absorption and could safely be implemented in clinical practice.

Understanding the role of food matrix on the digestibility of dairy products under elderly gastrointestinal conditions.

This study aimed to evaluate the effect of some elderly in vitro gastrointestinal (GI) conditions on proteolysis and lipolysis extent, calcium, vitamins A and D bioaccessibility and lactose release in milk, yogurt, fresh and aged cheeses. To evaluate the impact of the some oral, gastric and intestinal disorders appearing with ageing on dairy digestion, three in-vitro elderly models were applied (E1 (oral altered conditions), E2 (oral and gastric altered conditions) and E3 (oral, gastric and intestinal altered conditions)) plus a healthy adult one as control. Proteolysis extent was significantly affected by elderly GI alterations (p < 0.05) (around 40% of reduction compared to control), being fresh and aged cheese proteolysis the most affected with an important descrease in leucine release (18 and 25%, respectively). Calcium, vitamins A and D3 bioaccesibility and lactose release seemed not to be highly compromised in these models of elderly conditions; however, the micronutrients bioaccessibility was very dependent on dairy matrix's structure. Finally, the amount of the lipid hydrolyzed fraction of cheeses is not influenced in the investigated models.

Enhancing the nutritional profile and digestibility of lentil flour by solid state fermentation with Pleurotus ostreatus.

Lentils (Lens culinaris) present an excellent nutrient profile. However, the increasing displacement of legumes from the diet and the possible negative effects of the food matrix and antinutrient factors encourage the application of new strategies to improve nutrient digestibility and to produce food concepts that contribute to the increase of legume consumption. This study approached the solid-state fermentation of lentils with an edible fungus (Pleurotus ostreatus) in order to produce improved lentil flour. Fermentation contributed to the increase of protein (23%), resistant starch (9.8%), and polyphenols (from 2.1 to 3.2 mg gallic acid equivalent per g dry matter). After simulating in vitro digestion, fermented flours presented a higher fraction of digested protein (17%) along with lower starch hydrolysis (34 vs. 24%), while the polyphenol content increased from 3.1 to 7.73 mg gallic acid equivalent per g dry matter. Thus, this study supports the application of solid-state fermentation with this edible fungus to obtain lentil flours with an enhanced digestibility profile as compared to non-fermented counterparts. Lentil flours could be used as a novel raw material in the formulation of new food concepts with an enhanced nutritional profile.

Anaesthesia and cancer: can anaesthetic drugs modify gene expression?

Cancer remains a primary cause of morbidity and mortality worldwide, and its incidence continues to increase. The most common cause of death in cancer patients is tumour recurrence. Surgery is the gold standard in the treatment of most tumours. However, cancer surgery can lead to the release of tumour cells into the systemic circulation. Surgical stress and several perioperative factors have been suggested to boost tumour growth, thereby increasing the risk of metastatic recurrence. Preclinical and clinical studies suggest that anaesthetics and adjuvants administered during the perioperative period may impact cancer recurrence and survival. This document summarises the current evidence regarding the effects of anaesthetic drugs and analgesic techniques on the immune system, systemic inflammatory response and tumour cells, as well as their impact on cancer recurrence.

Magnetic Solid-Phase Extraction Based on Poly 4-Vinyl Pyridine for HPLC-FLD Analysis of Naproxen in Urine Samples.

A magnetic solid phase extraction technique followed by liquid chromatography with a fluorescence detector for naproxen analysis in human urine samples was developed. The method includes the extraction of naproxen with a magnetic solid synthetized with magnetite and poly 4-vinylpriridine, followed by the magnetic separation of the solid phase and desorption of the analyte with methanol. Under optimal conditions, the linear range of the calibration curve was 0.05-0.60 µg L-1, with a limit of detection of 0.02 µg L-1. In all cases values of repeatability were lower than 5.0% with recoveries of 99.4 ± 1.3%. Precision and accuracy values are adequate for naproxen (Npx) analysis in urine samples.