The neuroprotective effect of traditional Chinese medicinal plants-A critical review.

Neurodegenerative and neuropsychiatric diseases are increasingly affecting individuals' quality of life, thus increasing their cost to social and health systems. These diseases have overlapping mechanisms, such as oxidative stress, protein aggregation, neuroinflammation, neurotransmission impairment, mitochondrial dysfunction, and excitotoxicity. Currently, there is no cure for neurodegenerative diseases, and the available therapies have adverse effects and low efficacy. For neuropsychiatric disorders, such as depression, the current therapies are not adequate to one-third of the patients, the so-called treatment-resistant patients. So, searching for new treatments is fundamental. Medicinal plants appear as a strong alternative and complement towards new treatment protocols, as they have been used for health purposes for thousands of years. Thus, the main goal of this review is to revisit the neuroprotective potential of some of the most predominant medicinal plants (and one fungus) used in traditional Chinese medicine (TCM), focusing on their proven mechanisms of action and their chemical compositions, to give clues on how they can be useful against neurodegeneration progression.

Cuidadores Principais Ante a Experiência da Morte: Seus Sentidos e Significados / Main Caregivers Facing Death Experience and Its Meanings / Cuidadores principales frente a la experiencia de la muerte y sus sentidos

O presente trabalho teve como objetivo compreender os sentidos e significados atribuídos pelos cuidadores principais à experiência de acompanhamento de pacientes com câncer em Cuidados ao Fim de Vida. Com este intuito, foi realizada uma pesquisa qualitativa exploratória, utilizando a observação participante como recurso metodológico. A análise de conteúdo foi utilizada como método de avaliação dos resultados, no qual a Teoria Existencialista de Viktor Frankl e a literatura contemporânea sobre Cuidados Paliativos serviram de substrato teórico à compreensão da temática em questão. Após a análise do diário de campo, foram extraídas cinco categorias temáticas: A espiritualidade atribuindo sentido à experiência; O tempo de espera; Morte como alívio do sofrimento; Revisão da história de vida; Incerteza quanto ao futuro. Foi possível perceber reações e sentimentos expostos pelos cuidadores, que, apesar do esgotamento físico e emocional, desejavam permanecer ao lado de seu familiar até sua morte. Entendemos que a comunicação da equipe ao cuidador sobre a aproximação da morte pode contribuir para o processo de elaboração psíquica desta vivência. A compreensão da experiência subjetiva do cuidador viabiliza uma abordagem efetiva da equipe às reais necessidades de cuidado do familiar....(AU)

This study aimed to understand the meanings attributed by the main caregivers of cancer patients in the End of Life. For this purpose, an exploratory qualitative research was conducted, using Participant Observation as a methodological resource. The Content Analysis was used as a valuation method. The Existentialist Theory of Viktor Frankl and contemporary literature on Palliative Care were used as a theoretical basis for understanding the thematic field concerned. After analyzing the field diary, five thematic categories were extracted: spirituality attributing meaning to experience; waiting time; death as relief of suffering; reviewing the history of life; uncertainty about the future. It could be observed reactions and feelings exposed by caregivers, that despite all the physical and emotional exhaustion, wanted to be next to their relatives until their death. We understand that staff communication to the caregiver about the approach of death may contribute to the psychic elaboration process of this experience, allowing caregivers to express their feelings and reflect on the future after the patients' death. Understanding the subjective caregiver experience enables an effective staff approach to real family care needs....(AU)

Este estudio tuvo como objetivo comprender los significados atribuidos por los principales cuidadores la experiencia de acompañamiento a los pacientes con cáncer al final de la vida. Para este propósito, se llevó a cabo una investigación cualitativa exploratoria, utilizando la observación participante como recurso metodológico. El análisis de contenido fue utilizado como un método de evaluación de los resultados, donde la teoría existencialista de Viktor Frankl y la literatura contemporánea sobre Cuidados Paliativos proporcionaron la base teórica para la comprensión del tema en cuestión. Tras el análisis del diario de campo, se extrajeron cinco categorías temáticas: La espiritualidad atribuyendo significado a la experiencia; El tiempo de espera; La muerte como alivio del sufrimiento; Revisión de la historia de vida; La incertidumbre sobre el futuro. Se pudo observar reacciones y sentimientos expuestos por los cuidadores, que a pesar del agotamiento físico y emocional, quisieron permanecer junto a su familiar hasta su muerte. Entendemos que la comunicación del equipo acerca de la proximidad de la muerte puede contribuir al proceso de elaboración psíquica de esta vivencia. La comprensión de la experiencia subjetiva del cuidador permite un enfoque eficaz del equipo a las reales necesidades de atención a la familia....(AU)

Metabolic diversity in tuber tissues of native Chiloé potatoes and commercial cultivars of Solanum tuberosum ssp. tuberosum L.

INTRODUCTION: The native potatoes (Solanum tuberosum ssp. tuberosum L.) cultivated on Chiloé Island in southern Chile have great variability in terms of tuber shape, size, color and flavor. These traits have been preserved throughout generations due to the geographical position of Chiloé, as well as the different uses given by local farmers. OBJECTIVES: The present study aimed to investigate the diversity of metabolites in skin and pulp tissues of eleven native accessions of potatoes from Chile, and evaluate the metabolite associations between tuber tissues. METHODS: For a deeper characterization of these accessions, we performed a comprehensive metabolic study in skin and pulp tissues of tubers, 3 months after harvesting. Specific targeted quantification of metabolites using 96 well microplates, and high-performance liquid chromatography combined with non-targeted metabolite profiling by gas chromatography time-of-flight mass spectrometry were used in this study. RESULTS: We observed differential levels of antioxidant activity and phenolic compounds between skin and pulp compared to a common commercial cultivar (Desireé). In addition, we uncovered considerable metabolite variability between different tuber tissues and between native potatoes. Network correlation analysis revealed different metabolite associations among tuber tissues that indicate distinct associations between primary metabolite and anthocyanin levels, and antioxidant activity in skin and pulp tissues. Moreover, multivariate analysis lead to the grouping of native and commercial cultivars based on metabolites from both skin and pulp tissues. CONCLUSIONS: As well as providing important information to potato producers and breeding programs on the levels of health relevant phytochemicals and other abundant metabolites such as starch, proteins and amino acids, this study highlights the associations of different metabolites in tuber skins and pulp, indicating the need for distinct strategies for metabolic engineering in these tissues. Furthermore, this study shows that native Chilean potato accessions have great potential as a natural source of phytochemicals.

Autoimmune Syndrome Induced by Adjuvants (ASIA) after Silicone Breast Augmentation Surgery.

Generally, the main complications of silicone implantation are local symptoms. However, some patients develop late-onset systemic symptoms often associated with a rare form of hyperactive immune response, as part of a syndrome known as autoimmune syndrome induced by adjuvants (ASIA). Reported cases of ASIA have shown resolution with explantation, but not with immunomodulatory therapy. In this report, we described a case of a previously healthy 23-year-old woman, who has undergone silicone breast implant augmentation, for aesthetic reasons, and developed localized cutaneous impairment 3 years postsurgery. She received a diagnosis of ASIA with a new presentation: Lupus-like manifestation through localized cutaneous impairment. This patient's symptoms were managed without the need for surgical intervention, which has not been previously reported, because the patient did not want an explantation for aesthetic reasons. The patient was started on hydroxychloroquine, 400 mg per day, and remains asymptomatic after 2 years of treatment. The exact predisposition to ASIA is still unknown. Without implant explantation and with immunomodulatory treatment, this patient's condition substantially improved. Based on our current understanding of this disease, it might not be prudent to indicate breast augmentation with silicone implants in patients with documented autoimmune reaction to an adjuvant, an established autoimmune condition, or genetic predisposition. However, if a patient does develop silicone-induced ASIA, explantation is no longer the only successfully reported option, as these symptoms can be managed with immune suppression.

Vitamin B5 and N-Acetylcysteine in Nonalcoholic Steatohepatitis: A Preclinical Study in a Dietary Mouse Model.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is the number one cause of chronic liver disease and second indication for liver transplantation in the Western world. Effective therapy is still not available. Previously we showed a critical role for caspase-2 in the pathogenesis of nonalcoholic steatohepatitis (NASH), the potentially progressive form of NAFLD. An imbalance between free coenzyme A (CoA) and acyl-CoA ratio is known to induce caspase-2 activation. OBJECTIVES: We aimed to evaluate CoA metabolism and the effects of supplementation with CoA precursors, pantothenate and cysteine, in mouse models of NASH. METHODS: CoA metabolism was evaluated in methionine-choline deficient (MCD) and Western diet mouse models of NASH. MCD diet-fed mice were treated with pantothenate and N-acetylcysteine or placebo to determine effects on NASH. RESULTS: Liver free CoA content was reduced, pantothenate kinase (PANK), the rate-limiting enzyme in the CoA biosynthesis pathway, was down-regulated, and CoA degrading enzymes were increased in mice with NASH. Decreased hepatic free CoA content was associated with increased caspase-2 activity and correlated with worse liver cell apoptosis, inflammation, and fibrosis. Treatment with pantothenate and N-acetylcysteine did not inhibit caspase-2 activation, improve NASH, normalize PANK expression, or restore free CoA levels in MCD diet-fed mice. CONCLUSION: In mice with NASH, hepatic CoA metabolism is impaired, leading to decreased free CoA content, activation of caspase-2, and increased liver cell apoptosis. Dietary supplementation with CoA precursors did not restore CoA levels or improve NASH, suggesting that alternative approaches are necessary to normalize free CoA during NASH.

Development of Active Films From Pectin and Fruit Extracts: Light Protection, Antioxidant Capacity, and Compounds Stability.

UNLABELLED: Pectin films containing fruit extracts were developed and tested in relation to ultraviolet light transmission, phytochemical contents, and antioxidant capacity during 90 d shelf life storage. Aqueous and alcoholic extracts from 5 different fruits (acerola, cashew apple, papaya, pequi, and strawberry) were obtained. Because the alcoholic extracts from acerola, cashew apple, and strawberry presented the highest phytochemical content and antioxidant capacity, they were incorporated into pectin films individually or as a mixture. Incorporation of these extracts into pectin films provided antioxidant capacity while retaining the physical properties. The pectin films containing fruit extract acted as adequate light barrier and prevented photooxidation. Among the prepared films, the pectin film containing acerola extract afforded the highest antioxidant capacity, with a half-life of 99 d. Overall, the results revealed that incorporation of fruit extracts into pectin films potentially produces antioxidant films and coatings for different food applications. PRACTICAL APPLICATION: The production of pectin films incorporated with fruit extract is based on combination of the antioxidant activity, natural color, and optical barrier properties from fruit phytochemical components to the active film. This film could be potentially used as active packing on food products in order to protect their nutrients against free radicals action and photooxidation and, hence, preserve the quality, integrity, and safety of food during the storage period.

Mouse models of diet-induced nonalcoholic steatohepatitis reproduce the heterogeneity of the human disease.

BACKGROUND AND AIMS: Non-alcoholic steatohepatitis (NASH), the potentially progressive form of nonalcoholic fatty liver disease (NAFLD), is the pandemic liver disease of our time. Although there are several animal models of NASH, consensus regarding the optimal model is lacking. We aimed to compare features of NASH in the two most widely-used mouse models: methionine-choline deficient (MCD) diet and Western diet. METHODS: Mice were fed standard chow, MCD diet for 8 weeks, or Western diet (45% energy from fat, predominantly saturated fat, with 0.2% cholesterol, plus drinking water supplemented with fructose and glucose) for 16 weeks. Liver pathology and metabolic profile were compared. RESULTS: The metabolic profile associated with human NASH was better mimicked by Western diet. Although hepatic steatosis (i.e., triglyceride accumulation) was also more severe, liver non-esterified fatty acid content was lower than in the MCD diet group. NASH was also less severe and less reproducible in the Western diet model, as evidenced by less liver cell death/apoptosis, inflammation, ductular reaction, and fibrosis. Various mechanisms implicated in human NASH pathogenesis/progression were also less robust in the Western diet model, including oxidative stress, ER stress, autophagy deregulation, and hedgehog pathway activation. CONCLUSION: Feeding mice a Western diet models metabolic perturbations that are common in humans with mild NASH, whereas administration of a MCD diet better models the pathobiological mechanisms that cause human NAFLD to progress to advanced NASH.

Improving dietary patterns in patients with nonalcoholic fatty liver disease.

PURPOSE OF REVIEW: Nonalcoholic fatty liver disease (NAFLD) is the liver epidemic of our time. Diet strongly influences its development and should be a component of any treatment plan. It is crucial to standardize diet recommendations in an evidence-based manner. RECENT FINDINGS: Calorie restriction per se seems beneficial regardless of macronutrients composition. However, fat consumption, mainly cholesterol and saturated fatty acids are particularly steatogenic. There is increasing evidence that fructose, mainly consumed as soft drinks, is highly deleterious to the liver. Controversial results regarding modest alcohol consumption, suggest that although alcohol should not be advised, it should not be strictly forbidden. Recent studies suggest beneficial effects of coffee and tea in NAFLD. SUMMARY: Patients with NAFLD should have an individualized diet recommendation, in order to lose at least 7% of their weight if overweight, reducing caloric intake, mainly at cost of cholesterol and saturated fatty acids. Simple sugars should be avoided, and soft drinks discouraged.