Dietary supplements and fatigue in patients with breast cancer: a systematic review.

PURPOSE: Cancer-related fatigue (CRF) is defined as a distressing, persistent, and subjective sense of physical or emotional and/or cognitive exhaustion. The treatment of CRF includes pharmacological and non-pharmacological therapies; dietary strategies with promising results have also been used. This study aimed to identify dietary supplements that improve fatigue in patients with breast cancer. METHODS: A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were obtained from PubMed, Scopus, MEDLINE, CENTRAL, and CINAHL databases using the following MeSH terms: breast neoplasms, dietary supplements, diet, and fatigue. In addition, the Google and Google Scholar search engines were used to find grey literature. Methodological quality was evaluated using the risk of bias in randomised clinical trials in the systematic Cochrane reviews, and the quality of the evidence was also analysed using the GRADE system. RESULTS: A total of 893 studies were assessed, of which eight were included in the review, with 932 women diagnosed with breast cancer. The most commonly used supplements that improve fatigue were guarana, acetyl-L-carnitine, and co-enzyme Q10. Two studies had a low risk of bias in all categories and three had high-quality evidence. CONCLUSIONS: Dietary supplements or diet patterns are seldom used to treat fatigue in patients with breast cancer. The results of this review showed that guarana extract and a diet rich in whole foods, omega-3 fatty acids, fruits, and vegetables could be used to treat CRF in patients with breast cancer. The studies had a low risk of bias with high-quality evidence on the efficacy of the interventions in treating fatigue in the study population.

MMP-8 in Periodontal Sites of Postpartum and without-Any-Pregnancy Women.

The hypothesis that physiological changes in women can affect periodontal tissues is the subject of this study, and inflammatory markers such as matrix metalloproteinase-8 can measure susceptibility to inflammation. The study aimed to analyze MMP-8 levels in periodontal sites of postpartum women and women without a history of pregnancy, comparing health parameters and periodontal disease. This is a case-control study with 40 participants, 20 cases (women in the postpartum period) and 20 controls (women without any pregnancy), who underwent clinical periodontal examination and the collection of crevicular gingival fluid. The ELISA test was used to detect MMP-8 levels. Postpartum women had worse periodontal parameters, such as bleeding index on probing, number of sites with CAL ≥ 3, and fewer teeth present. In the group of women without a history of pregnancy, a significantly lower MMP-8 level was observed in healthy sites and a higher one was observed in periodontal pockets (p < 0.01). In contrast, in postpartum women, MMP-8 levels were elevated in both healthy sites and periodontal pockets (p > 0.01). The MMP-8 levels in gingival fluid appear to be related to periodontal clinical parameters and may be a possible marker of enzymatic changes involved in periodontal tissue destruction in postpartum women.

Prevalence of airborne fungi in Brazil and correlations with respiratory diseases and fungal infections. / Prevalência de fungos anemófilos no Brasil e a correlação com doenças respiratórias e infecções fúngicas.

Airborne fungi are dispersed through the air. The aim of this study was to determine the prevalence of airborne fungi in Brazil and understand the relationship between fungal growth and respiratory diseases and infections. We conducted an integrative literature review of studies conducted in Brazil based on searches of the PubMed, MEDLINE-BIREME, SciELO, and LILACS databases for full-text articles published between 2000 and 2022. The searches returned 147 studies, of which only 25 met the inclusion criteria. The most prevalent genera of airborne fungi in Brazil are Aspergillus, Penicillium, Cladosporium, Curvularia, and Fusarium. The studies were conducted in the states of Maranhão, Ceará, Piauí, Sergipe, Mato Grosso, Pernambuco, Rio Grande do Sul, Santa Catarina, Rio de Janeiro, São Paulo, and Minas Gerais. The findings also show the relationship between fungi and meteorological factors and seasonality, the sensitivity of atopic individuals to fungi, and the main nosocomial mycoses reported in the literature. This work demonstrates the importance of maintaining good microbiological air quality to prevent potential airborne diseases.

Fungos anemófilos se dispersam na natureza através do ar atmosférico. O presente estudo objetivou caracterizar a prevalência da microbiota fúngica anemófila no Brasil e correlacionar o crescimento fúngico com doenças respiratórias e quadros infecciosos. Este trabalho é uma revisão integrativa de literatura construída a partir da busca nas bases de dados PubMed, BIREME, SciELO e LILACS, com inclusão de trabalhos brasileiros publicados entre 2000 e 2022, em língua portuguesa ou inglesa com texto online integral. O universo do estudo foi constituído por 147 publicações, das quais 25 compuseram a amostra por atenderem aos critérios de inclusão. Os gêneros de fungos aerotransportados mais prevalentes no Brasil são: Aspergillus sp., Penicillium sp., Cladosporium sp., Curvularia sp. e Fusarium sp. Os locais de origem dos estudos incluem Maranhão, Ceará, Piauí, Sergipe, Mato Grosso, Pernambuco, Rio Grande do Sul, Santa Catarina, Rio de Janeiro, São Paulo, Minas Gerais. Além disso, foi possível determinar a relação dos fungos com parâmetros meteorológicos e sazonalidade, a sensibilização de indivíduos atópicos aos fungos e as principais micoses nosocomiais relatadas na literatura. Assim, o trabalho destaca a importância da manutenção da qualidade microbiológica do ar com vistas a se prevenir possíveis doenças transmitidas pelo ar.

Colostrum Antibodies and Cytokines in Puerperal Women with Diabetes Before and During the COVID-19 Pandemic: A Systematic Review.

BACKGROUND: Breastfeeding maintains the maternal-fetal immune link after birth, favors the transmission of immunological competence, and is considered an important contributing factor to the development of the babies' immune system. OBJECTIVE: This study aimed to obtain data related to the effects of gestational diabetes on immunoglobulin A (IgA) and cytokines levels in the colostrum, before and during the pandemic of the new coronavirus, in order to study the possible outcomes regarding the immunological characteristics of human milk. METHODS: This systematic review was registered in PROSPERO CRD42020212397, and the question elaborated using the PICO strategy was: does maternal hyperglycemia associated or not with Covid-19 influence the immunological composition of colostrum? Electronic searching and reference lists of published reports were used to identify studies that reported the influence of gestational diabetes on colostrum and milk composition. RESULTS: Seven studies were selected from the 51 found, six of them were cross-sectional and one was a case report. Six studies included Brazilian groups and only one was conducted in USA. The mothers with gestational diabetes presented a reduced level of IgA and other immunoreactive proteins in colostrum. Those alterations could be related to changes in macronutrient metabolism and cellular oxidative metabolism. CONCLUSION: It was possible to conclude that diabetes changes the immunological composition of breast milk; however, data on the impact of the association between gestational diabetes and Covid-19 infection on the composition of antibodies and cytokines present in human milk are still scarce and inconclusive.

Impact of HPV-16 Lineages Infection in Response to Radio-Chemotherapy in Cervical Cancer.

BACKGROUND: HPV is strongly related to cervical cancer. HPV lineages can contribute to a response to cervical cancer therapy. The aim of this research was to estimate the frequency of human papillomavirus (HPV)-16 lineages in specimens of cervical cancer, relate the pathological factors in these variants, and assess their response to treatment with radical chemoradiotherapy. METHODS: Samples of cervical cancer were collected from women who were referred to a reference cancer hospital to test the presence of human papillomavirus-type DNA. The standard protocol of this service consisted of cisplatin-based chemotherapy of 40 mg/m2, plus conventional pelvic irradiation in doses of 45-50.4 Gy and high dose-rate brachytherapy of 28-30 Gy to Point A. The response to chemotherapy was evaluated after three months in patients with the HPV-16 lineage. RESULTS: HPV DNA was detected in 104 (88.1%) of the 118 patients. HPV-16 was present in 63 patients (53%). Lineages of HPV-16 were identified in 57 patients and comprised 33 instances of (57.8%) lineage A, 2 instances of lineage B (3.5%), 2 instances of lineage C (3.5%), and 20 instances of (35.0%) lineage D. The median age of the patients was 48.4 years (range 25-85 years). Squamous cell carcinoma was detected 48 times (84.2%). Adenocarcinoma was more likely to occur in lineage D, as three of the four cases occurred in this lineage. A total of 11 patients with the HPV-16 variant were treated with chemoradiotherapy. After three months, it was observed that nine of the eleven patients (81.8%) achieved a complete response, five with the lineage A type, two with the lineage C type, and two with the lineage D type. The two cases of partial response and disease progression, one of each, occurred in lineage A. CONCLUSIONS: In addition to the small number of patients and HPV variants, we noticed a better response in patients with the HPV-16 lineage A. Increasing the sample size could be helpful to better assess the impact of HPV variants on cervical cancer treatment.

Brazilian green propolis: anti-inflammatory property by an immunomodulatory activity.

The immunomodulatory and anti-inflammatory activities of green propolis extracts from Apis mellifera were investigated using acute and chronic inflammation models. Swiss mice were anesthetized and a cotton pellet granuloma was implanted in subcutaneous tissue. Then the mice were divided into six groups and received apyrogenic water or different propolis extracts by oral route (5 mg/kg). According to the treatment the groups were designated as E1A, E1B, E10, E11, and E12. The control group received apyrogenic water. The treatment was performed by six days when the mice were killed. The blood and the bronchoalveolar lavage (BAL) were collected to measure the leukocyte recruitment. In acute pulmonary inflammation, Balb/c mice received lipopolysaccharide (LPS) of Escherichia coli by intranasal route for three days. Concomitantly the mice received by oral route apyrogenic water (control) or E10 and E11 propolis extracts. BAL was performed to assess the inflammatory infiltrate and cytokine quantification. The results showed that the E11 extract has anti-inflammatory property in both models by the inhibition of proinflammatory cytokines and increase of anti-inflammatory cytokines suggesting an immunomodulatory activity.

Anti-Candida albicans Activity of Ononin and Other Secondary Metabolites from Platonia Insignis MART.

Candida albicans is a human pathogen that is part of the healthy microbiome. However, it is often associated with opportunistic fungal infections. The treatment of these infections is challenging because prolonged exposure to antifungal drugs can culminate in fungal resistance during therapy, and there is a limited number of available drugs. Therefore, this study investigated the antifungal activity of ononin by in silico and in vitro assays, and in Tenebrio molitor as an alternative in vivo model of infection caused by C. albicans. Ononin is an isoflavone glycoside derived from formononetin that has various biological activities. According in silico evaluation, ononin showed the best electron affinity in molecular docking with CaCYP51, with a binding free energy of -10.89 kcal/mol, superior to that of the antifungal drugs fluconazole and posaconazole. The ononin + CaCYP51 complex formed hydrogen bonds with Tyr132, Ser378, Phe380, and Met508, as well as hydrophobic connections with Tyr118, Leu121, Phe126, Leu131, Ile304, and Leu309, and interactions with the heme group. Ononin exerted anti-Candida albicans activity, with MIC between 3.9 and 7.8 µg/mL, and inhibited young and mature biofilms, with a reduction in cell density and metabolic activity of 50 to 80%. The compound was not cytotoxic to sheep red blood cells at concentrations up to 1000 µg/mL. Larvae of the mealworm T. molitor were used as an alternative in vivo model of C. albicans infection. Ononin was able to prolong larval survival at concentrations of 0.5, 1, and 5 mg/kg, and was not toxic up to a concentration of 20 mg/kg. Moreover, ononin reduced the fungal charge in treated animals. In conclusion, our results suggest that ononin has anti-Candida albicans activity and is a potential candidate for the development of new therapeutic alternatives.

Effect of Babassu Mesocarp As a Food Supplement During Resistance Training.

The population widely uses babassu mesocarp (Attalea speciosa) as food and medicine. This study evaluated the use of babassu mesocarp as a food supplement during resistance training (RT). Male Swiss mice, 60 days old (weight 35-40 g), were divided into four groups (n = 8): control, untreated and untrained; babassu (babassu aqueous extract [BAE]), treated orally with aqueous extract of babassu mesocarp (25 mg/kg), five times a week, for 8 weeks; training (RT), submitted to RT consisting of stair climbing with progressive loads; and resistance training treated with babassu aqueous extract (RTBAE): RT and treatment with BAE. After 8 weeks, we analyzed the biochemistry of serum, the immunological, and histological parameters. The RT group showed maximum strength after the second week. A reduction in body weight, retroperitoneal and interstitial fat deposits, and activated helper T lymphocytes (TCD4+ CD69+) occurred in RT and RTBAE groups. The RTBAE group showed increased levels of aspartate aminotransferase, alanine aminotransferase, and macrophage and helper T lymphocyte count, whereas a reduction occurred in triglyceride levels and the total number of lymphocytes. Supplementation with BAE always reduced cholesterol and the population of activated macrophages but increased activated B lymphocytes and interleukin-6 levels. The combination of supplementation and RT resulted in a decreased production of tumor necrosis factor-α. We propose the use of babassu mesocarp as a food supplement during exercise because of its immunomodulatory effect on lymphocyte and macrophage populations and cytokine production. The additional impact on the control of cholesterol and triglyceride levels suggests its use, particularly for the treatment of dyslipidemias.

Prevalência de fungos anemófilos no Brasil e a correlação com doenças respiratórias e infecções fúngicas / Prevalence of airborne fungi in Brazil and correlations with respiratory diseases and fungal infections

Resumo Fungos anemófilos se dispersam na natureza através do ar atmosférico. O presente estudo objetivou caracterizar a prevalência da microbiota fúngica anemófila no Brasil e correlacionar o crescimento fúngico com doenças respiratórias e quadros infecciosos. Este trabalho é uma revisão integrativa de literatura construída a partir da busca nas bases de dados PubMed, BIREME, SciELO e LILACS, com inclusão de trabalhos brasileiros publicados entre 2000 e 2022, em língua portuguesa ou inglesa com texto online integral. O universo do estudo foi constituído por 147 publicações, das quais 25 compuseram a amostra por atenderem aos critérios de inclusão. Os gêneros de fungos aerotransportados mais prevalentes no Brasil são: Aspergillus sp., Penicillium sp., Cladosporium sp., Curvularia sp. e Fusarium sp. Os locais de origem dos estudos incluem Maranhão, Ceará, Piauí, Sergipe, Mato Grosso, Pernambuco, Rio Grande do Sul, Santa Catarina, Rio de Janeiro, São Paulo, Minas Gerais. Além disso, foi possível determinar a relação dos fungos com parâmetros meteorológicos e sazonalidade, a sensibilização de indivíduos atópicos aos fungos e as principais micoses nosocomiais relatadas na literatura. Assim, o trabalho destaca a importância da manutenção da qualidade microbiológica do ar com vistas a se prevenir possíveis doenças transmitidas pelo ar.

Abstract Airborne fungi are dispersed through the air. The aim of this study was to determine the prevalence of airborne fungi in Brazil and understand the relationship between fungal growth and respiratory diseases and infections. We conducted an integrative literature review of studies conducted in Brazil based on searches of the PubMed, MEDLINE-BIREME, SciELO, and LILACS databases for full-text articles published between 2000 and 2022. The searches returned 147 studies, of which only 25 met the inclusion criteria. The most prevalent genera of airborne fungi in Brazil are Aspergillus, Penicillium, Cladosporium, Curvularia, and Fusarium. The studies were conducted in the states of Maranhão, Ceará, Piauí, Sergipe, Mato Grosso, Pernambuco, Rio Grande do Sul, Santa Catarina, Rio de Janeiro, São Paulo, and Minas Gerais. The findings also show the relationship between fungi and meteorological factors and seasonality, the sensitivity of atopic individuals to fungi, and the main nosocomial mycoses reported in the literature. This work demonstrates the importance of maintaining good microbiological air quality to prevent potential airborne diseases.

Antileishmanial and Immunomodulatory Effect of Babassu-Loaded PLGA Microparticles: A Useful Drug Target to Leishmania amazonensis Infection.

The immunological and the anti-Leishmania amazonensis activity of babassu-loaded poly(lactic-co-glycolic acid) [PLGA] microparticles was evaluated. The anti-Leishmania activity was evaluated against promastigotes or amastigotes forms, in Balb/c macrophages. The size of the microparticles ranged from 3 to 6.4 µm, with a zeta potential of -25 mV and encapsulation efficiency of 48%. The anti-Leishmania activity of the PLGA microparticles loaded with the aqueous extract of babassu mesocarp (MMP) (IC50) was 10-fold higher than that free extract (Meso). MMP exhibited overall bioavailability and was very effective in eliminating intracellular parasites. MMP also reduced ex vivo parasite infectivity probably by the increased production of nitric oxide, hydrogen peroxide, and TNF-α indicating the activation of M1 macrophages. The overexpression of TNF-α did not impair cell viability, suggesting antiapoptotic effects of MMP. In conclusion, babassu-loaded microparticles could be useful for drug targeting in the treatment of leishmaniasis, due to the immunomodulatory effect on macrophage polarization and the increased efficacy as an anti-Leishmania product after the microencapsulation. These findings are of great relevance since the development of new drugs for the treatment of neglected diseases is desirable, mainly if we consider the high morbidity and mortality rates of leishmaniasis worldwide.