Nutritional profiles in a public health perspective: a critical review.

Nutritional profiling is defined as 'the science of categorizing foods according to their nutritional composition' and it is useful for food labelling and regulation of health claims. The evidence for the link between nutrients and health outcomes was reviewed. A reduced salt intake reduces blood pressure, but only a few randomized controlled trials have verified the effect of salt on overall and cardiovascular mortality. Evidence linking a reduced fat intake with cardiovascular mortality and obesity is generally non-significant. Studies that have examined the relationship between obesity and diet have produced contrasting results. A simulation exercise that demonstrated that the impact of a reduced salt and fat intake on overall mortality would be negligible in the European population was carried out. Consideration of the literature and the results of this simulation exercise suggest that the introduction of nutritional profiles in Europe would be expected to have a very limited impact on health outcomes.

Serum silicon levels are elevated in women with silicone gel implants.

The metabolic fate of silicone gel leaked into the body from an implant is unknown. In this study, serum from 72 women with silicone gel breast implants and 55 control women was blindly assayed by inductively coupled plasma atomic emission spectroscopy (ICP-AES) for elemental silicon. Samples were processed using materials free of silicon. The mean silicon level in controls was 0.13 +/- 0.07 mg/l (range 0.06-0.35 mg/l), while in implant patients, the mean was significantly higher at 0.28 +/- 0.22 mg/l (range 0.06-0.87 mg/l) (P < 0.01, Student's t-test with correction for unequal variances). Using the mean of the control group + 2 SD as a cutoff for normal range (0.27 mg/l), 25/72 (34.7%) implant patients exceeded this value, compared with 2/55 (3.6%) controls. There was no significant correlation between past rupture of one or both implants, current rupture at the time of the blood draw or the number of years with implants and silicon levels. The results suggest that elevations of serum silicon are seen in many women with silicone gel breast implants. The kinetics of this elevation and the actual chemical species of the measured silicon remain to be determined.

Comparative uptake of calcium from milk and a calcium-rich mineral water in lactose intolerant adults: implications for treatment of osteoporosis.

Despite the links between low calcium (Ca) intake and age-related bone loss, hypertension, and colon cancer, the majority of Western populations have average daily Ca intakes substantially below recommended daily allowances. Although dietary products are widely known as a rich and valuable source of Ca in the diet, consumption of diary products is low and has been decreasing because of perceptions of excess calories and fat in the diet, as well as taste aversions. During the last decade, a marked increase in the consumption of bottled waters has occurred. Since some of these waters are characterized by high concentrations of Ca, we have studied Ca bioavailability from a Ca-rich water, using 15 lactose intolerant male individuals as subjects, and compared such bioavailability to that from milk. We report herein that the bioavailability of Ca from the water was generally as good as or better than that from milk, a food product well known for its very high Ca bioavailability. Indeed, in eight of 15 subjects, there was a higher level of Ca absorption from mineral water than from milk; bioavailability was equal in five of 15 subjects; in contrast, in two of 15 subjects, the bioavailability of Ca absorption from milk was greater than that from the mineral water. The potential implications of this observation for the prevention and management of age-related bone loss are important for preventive medicine and indicate a new, important source of dietary Ca for lactose intolerant individuals.

Anti-neutrophil cytoplasmic antibodies in patients with chromomycosis.

OBJECTIVE: Antineutrophil cytoplasmic antibodies (ANCA) are a family of antibodies that react to proteins within neutrophil granules and monocyte lysosomes, and occur prominently in sera from patients with systemic necrotizing vasculitis. The cytoplasmic staining pattern (c-ANCA) is very sensitive and specific for Wegener's granulomatosis (WG), and most commonly results from reactivity with proteinase 3 (PR3). The features of tissue damage in the fungal infection chromomycosis, in particular polymorphonuclear neutrophil (PMN) infiltration and granuloma formation, bear a resemblance to that seen in WG. METHODS: We tested sera from 25 patients with clinical and histologic diagnosis of chromomycosis for the presence of ANCA by indirect immunofluorescence. These same sera were analyzed for reactivity to neutrophil primary granule extracts and PR3 by ELISA. RESULTS: Five of the 25 patients (20%) had detectable c-ANCA, without central accentuation, at serum dilutions of at least 1:40. Three of these 5 ANCA-positive patients reacted with neutrophil primary granule extracts by ELISA; however, none of them reacted with PR3. CONCLUSIONS: These results demonstrate that fungal infection should be included among the conditions, unrelated to necrotizing vasculitis, that can trigger autoreactivity against myeloid lysosomal antigens.

Effects of low concentrations of arachidonic acid derived mediators on the membrane potential and respiratory burst responses of human neutrophils as assessed by flow cytometry.

Hypaque-Ficoll purified (95%) neutrophils (PMN) from normal healthy subjects were assessed for FMLP-elicited membrane potential (delta psi) responses and dichlorofluorescein (DCF) fluorescence (a measure of intracellular hydrogen peroxide production) using flow cytometry and appropriate fluorescent probes. Superoxide (O2) production was measured spectrophotometrically as the superoxide dismutase-inhibitable reduction of cytochrome C. The modulatory effects of dilute solutions of the arachidonic acid-derived inflammatory mediators LTB4, LTC4, LTD4, PGE1, PGE2 and PGF2 alpha (10(-9)-10(-5) M) were assessed in these systems. While LTB4 enhanced the proportion of cells depolarizing to the chemoattractant N-formyl-methionyl-leucyl-phenylalanine (FMLP) 2-3x with a maximum effect in the 10(-9)-10(-8) M range, LTC4 and LTD4 showed no such enhancement except at high concentrations (10(-6) M). Unlike LTB4, LTC4 and LTD4 were unable to enhance FMLP mediated PMN O2 or DCF responses at any concentration tested, implying a divergence between the effects of the leukotrienes on membrane potential and oxidant responses. Pre-incubation of PMN with prostaglandins E1 or E2 led to a dose dependent inhibition of the proportion of depolarizing PMN in response to FMLP; PGF2 alpha did not show such an effect. The present data indicate that LTB4, in addition to being a powerful direct neutrophil activator, may act in a priming capacity by increasing the proportion of subsequently FMLP responsive cells, while PGE's inhibit. These modulatory effects appear relatively specific for LTB4 and the E-series prostaglandins.

Pharmacological regulation of the immune system.

Immunomodulators include any agent or substance that has an effect on the host immune system. These effects may be stimulatory, suppressive or regulatory. Many drugs, chemicals and microbial products have been identified as having specific as well as nonimmunostimulating properties. The first agent to be used clinically as an immunostimulating drug was Bacillus Calmette-Guerin (BCG). Subsequently, other bacterial derivatives, including Corynebacterium parvum and bacterial lipopolysaccharides, were found to have stimulatory effects. Most research in immunostimulating agents has been done in cancer chemotherapy, where such compounds or preparations have been employed to (hopefully) restore chemotherapeutic agent-induced immunosuppression, and thus prevent the development of community-acquired or nosocomial infections. In contrast to immunostimulants, immunoregulators are traditionally defined as being capable of decreasing an abnormally elevated immune response, and therefore restore defective immune function. However, the differentiation between immunoregulators and immunostimulants is not always clearly defined, as the regulatory effects on the immune system of any particular drug may be multifaceted. Clearly, future research must be directed at defining the specific mechanisms of action of potential therapeutic drugs, and in developing improved molecules to ensure safety and efficacy in the clinical setting.

Unique phospholipid metabolism in mouse heart in response to dietary docosahexaenoic or alpha-linolenic acids.

Diet and fatty acid metabolism interact in yet unknown ways to modulate membrane fatty acid composition and certain cellular functions. For example, dietary precursors or metabolic products of n-3 fatty acid metabolism differ in their ability to modify specific membrane components. In the present study, the effect of dietary 22:6n-3 or its metabolic precursor, 18:3n-3, on the selective accumulation of 22:6n-3 by heart was investigated. The mass and fatty acid compositions of individual phospholipids (PL) in heart and liver were quantified in mice fed either 22:6n-3 (from crocodile oil) or 18:3n-3 (from soybean oil) for 13 wk. This study was conducted to determine if the selective accumulation of 22:6n-3 in heart was due to the incorporation of 22:6n-3 into cardiolipin (CL), a PL most prevalent in heart and known to accumulate 22:6n-3. Although heart was significantly enriched with 22:6n-3 relative to liver, the accumulation of 22:6n-3 by CL in heart could not quantitatively account for this difference. CL from heart did accumulate 22:6n-3, but only in mice fed preformed 22:6n-3. Diets rich in non-22:6n-3 fatty acids result in a fatty acid composition of phosphatidylcholine (PC) in heart that is unusually enriched with 22:6n-3. In this study, the mass of PC in heart was positively correlated with the enrichment of 22:6n-3 into PC. The increased mass of PC was coincident with a decrease in the mass of phosphatidylethanolamine, suggesting that 22:6n-3 induced PC synthesis by increasing phosphatidylethanolamine-N-methyltransferase activity in the heart.

The scientific rediscovery of a precious ancient Chinese herbal regimen: Cordyceps sinensis: part II.

Cordyceps sinensis (Berk.) Sacc. is a time-honored tonic food and herbal medicine in China, where recent research has shown that many of its traditional uses may be viewed from the basis of pharmacological activities. The ongoing exploration of C. sinensis in its wild form and cultured, fermented mycelial products derived from it, are reviewed from English and Chinese literature. Part II concludes the series with a review of C. sinensis in preclinical in vitro and in vivo studies, and open-label and double-blinded clinical trials on the respiratory, renal, hepatic, cardiovascular, immunologic, and nervous systems, and its effects on cancer, glucose metabolism, inflammatory conditions, and toxicological studies. In Part I, which appeared in the Fall 1998 issue of this journal (4(3):289-303), we discussed the effects of C. sinensis on antisenescence, endocrine and sexual functions, atherosclerosis, hyperlipidemia, and free radicals.

The scientific rediscovery of an ancient Chinese herbal medicine: Cordyceps sinensis: part I.

This review presents Cordyceps sinensis (Berk.) Sacc., a fungus highly valued in China as a tonic food and herbal medicine. The extant records show the continued use of C. sinensis is now centuries old. The major chemical, pharmacological, and toxicological studies on C. sinensis and the various derived, cultured, fermented mycelial products currently in use are reviewed from the English and Chinese literature. Preclinical in vitro and in vivo studies and clinical blinded or open-label trials in to date over 2000 patients are reviewed. These studies show the main activities of the fungus in oxygen-free radical scavenging, antisenescence, endocrine, hypolipidemic, antiatherosclerotic, and sexual function-restorative activities. The safety of the fungus, its effects on the nervous system, glucose metabolism, the respiratory, hepatic, cardiovascular, and immune systems, immunologic disease, inflammatory conditions, cancer, and diseases of the kidney will be reviewed in the second part of this article to be published in the winter issue of this journal.

Elevated serum silicon levels in women with silicone gel breast implants.

The metabolic fate of silicone gel leaked from an intact or ruptured prosthesis is unknown. In this study, serum was blindly assayed by inductively coupled plasma atomic emission spectroscopy (ICP-AES) for elemental silicon in 72 women with silicone gel breast implants and 55 control women (mean age 48 yr, both groups). Blood was drawn and processed using silicon-free materials. The mean silicon level in controls was 0.13 +/- 0.07 mg/L (range 0.06-0.35 mg/L), whereas in implant patients, the mean was significantly higher at 0.28 +/- 0.22 mg/L (range 0.06-0.87 mg/L) (P < 0.01, Student's t-test with correction for unequal variances). Using the mean of the control group + 2 SD as a cutoff for normal range (0.27 mg/L), 25/72 (34.7%) implant patients exceeded this value, compared with 2/55 (3.6%) controls. There was no significant correlation between past rupture of one or both implants, current rupture at the time of the blood draw, or the number of years with implants and silicon levels. The results suggest that serum silicon levels are elevated in many women with silicone gel breast implants. The chemical species involved and kinetics of this elevation remain to be determined.

[Re-examination of the role of mast cells, mediators of inflammation and heparin]. / Réexamen du rôle des mastocytes, des médiateurs de l'inflammation et de l'héparine.

Mast cells contain proteoglycans, e.g. heparin, which manifest potent anti-inflammatory features. Mast cell degranulation could eventually result in self limiting inflammation with shortened course due to heparin release. The recent availability of low molecular weight heparins will allow for clinical studies in allergic/inflammatory syndromes, e.g. asthma.

In vitro diagnosis in asthma: the state-of-the-art.

"In vitro assays in asthmatic patients have been exploring the "allergic" component of asthma. Solid-phase IgE tests can supplement or replace skin tests. Histamine release and determination are performed with automated, or RIA/ELISA; however, these assays are still research oriented. More recently, tryptase has been investigated, and the serum levels of this enzyme correlate well with mast-cell activation. But asthma is a multifactorial/facetted syndrome, and these assays provide minimal and specific informations which may just focus on limited etiological aspects of an elusive malady".

Critical evaluation of the clinical relevance of the IgG subclasses assays.

Human IgG subclasses play a major role in the physiological regulation and functions of the immune system. There "personality" is obvious. However, the determination requires appropriate reagents and technology. For the IgG1, IgG2, IgG3 subclasses, the radial immunodiffusion technique may be sufficient. For the IgG4 subclass determination and measurement, more elaborate techniques are required. These measurements of existing proteins are of major interest in congenital as well as acquired immune deficiencies more often, besides the total subclass deficiency, these are of utmost interest to evaluate the specific response of a given subclass to a specific antigen. The IgG4 allergen specific subclass has been considered to be involved both in allergic reactions and associated with the appropriate response to allergen-specific immunotherapy. It is now accepted that IgG4 does not play an discernable role in the acute inflammatory response of type I hypersensitivity; it has also been demonstrated that a number of patients who demonstrate elevated levels of allergens specific IgG4 are not protected against allergenic exposure, and conversely, a number of patients who have been heated by immunotherapy without demonstrating any significant increase in their serum levels of allergen specific IgG4 are indeed very well protected. In the field of allergy, the IgG4 determinations remain a matter of controversy and research.

Anti-inflammatory effects of a stabilized lipid extract of Perna canaliculus (Lyprinol).

A lipid-rich extract, prepared by supercritical fluid (CO2) extraction of freeze-dried stabilized NZ green-lipped mussel powder (Lyprinol) has shown significant anti-inflammatory (AI) activity when given to animals and humans. When treated p.o. with Lyprinol, Wistar and Dark Agouti rats developed neither adjuvant-induced polyarthritis or collagen(II)-induced auto-allergic arthritis. This was achieved with doses < NSAIDs, and 200 times < of other seed or fish oils. Lyprinol subfractions inhibited LTB4 biosynthesis by PMN in vitro, and PGE2 production by activated macrophages. Much of this AI activity was associated with omega-3 PUFAs and natural antioxidants [e.g. carotenoids]. In contrast to NSAIDs, Lyprinol is non-gastro toxic in disease-stressed rats at 300 mg/kg p.o., and does not affect platelet aggregation [human, rat]. Clinical studies, either controlled or randomized, have demonstrated very significant AI activity in patients with osteoarthritis (OA), rheumatoid arthritis (RA), asthma, and other inflammatory conditions. Lyprinol is a reproducible, stable source of bioactive lipids with much greater potency than plant/marine oils currently used as nutritional supplements to ameliorate signs of inflammation.

[Current concepts in the treatment of asthma (in the United States)]. / Conceptions actuelles du traitement de l'asthme (aux Etats-Unis).

The practice of medicine, in the United States, is regulated by different concepts when compared to France. Anti-asthmatic medications are very similar to the ones available in Western Europe, except the combinations (e.g. Berodual/Duovent), and the 200 mcg Beclomethasone MDls. Environmental control is emphasized, as well as a smoke-free environment. Immunotherapy is not recommended, although actively prescribed for generating income. For the last few years, American and French concepts -and problems-regarding asthma are coming closer.

Evaluation of possible histamine release from human peripheral blood cells using an enzyme immunoassay (HRT) with components of intravenous catheters.

The HRT Assay was evaluated for its capacity to measure histamine release from blood basophils following the introduction of extracts from catheters made of Aquavene or silicone. Blood samples were collected from twenty-one volunteers of the University of California, Davis campus and from seven individual who had experienced a systemic event during the insertion of catheters made from Aquavene. None of the blood samples released histamine in quantities that would be anticipated in an anaphylactic or anaphylactoid reaction when challenged with the extracts; all released histamine when challenged with polymyxin B, used as a positive control. Based upon these results, none of the components of either the Aquavene-based or silicone-based catheters are thought to cause a histamine-associated reaction in subjects. This assay proved to be both expedient and reliable in its determination of the release of histamine from blood basophils.

A celebration of wine: wine IS medicine.

Wine describes a diverse commodity class composed of the yeast fermentation products of the must, or juice, pressed from grapes, the fruit of genus Vitis, but both in animal and human studies, wine demonstrates beneficial properties that are independent from the presence of alcohol. These benefits for health are mostly associated with polyphenols, and are absorbable from wine but poorly from unfermented grape juice. Dealcoholised wine is providing all the benefits without the toxicity, and is very affordable; improvements in the organoleptic quality of dealcoholised wine(s) as well as massive distribution are current challenges.

Pseudoasthma in a case of asthma.

The respiratory system, which is composed of the upper and lower airways performs varied and distinct functions. These can also be the sites of various pathological processes. Asthma is one of the major conditions involving the lower airways whereas laryngeal dysfunction due to various conditions has also been known to occur. Isolated laryngeal dysfunction with abnormal vocal cord movements has been shown to occur both in various organic and non-organic conditions. The non-organic laryngeal dysfunction with a functional component is being increasingly recognized, the symptoms of which can be easily confused with those of asthma. We describe a patient who is believed to have both asthma and functional laryngeal dysfunction with paradoxical motion of the vocal cords on inspiration, observed on direct laryngoscopy. It is also believed that her laryngeal dysfunction is an isolated clinical entity not related to her underlying asthma, which has been shown, at times, to be associated with non-compensatory adduction of the vocal cords on inspiration. The patient described is known to have an anxious and hysterical personality and was also diagnosed to have a major depression. Episodes of paradoxical motion of the vocal cords on inspiration are acute and are usually precipitated by an emotional event and the shortness of breath may or may not be associated with stridor. Treatment of this condition, which can be mistaken for asthma, involves speech/vocal cord exercises to be used at the advent of an attack. It is thus important to recognize this condition so that appropriate treatment can be given.(ABSTRACT TRUNCATED AT 250 WORDS)