Health Professionals' Perspectives on Commercially Available Intravenous Nutrient Therapies: A Preliminary Report.

BACKGROUND: Intravenous nutrient therapies (IVNTs) have gained popularity on the commercial market. Targeted at people with a variety of ailments and needs, the procedures allegedly offer numerous benefits and quick results, widely advertised on the websites of drip bars and health clinics as well as in the available literature. What is less often presented is the point of view of the customers of such services and the opinions of health personnel. Although the latter perspective seems to be crucial, little is known about it. Therefore, the purpose of this study was to present the opinions and experiences of health professionals (n = 188) on commercially available IVNTs dedicated to adults. METHODS: The study was conducted between April 2019 and March 2020 by means of a survey using an ad hoc questionnaire made available mainly to health professionals attending public health postgraduate courses at the Poznan University of Medical Sciences, Poland. RESULTS: As many as 91.5% of the respondents had heard of commercially available IVNTs (mostly from the media), and 47.3% knew of a facility offering such services. Among the possible situations where the use of IVNTs would be justified, the most commonly mentioned was a diagnosed nutrient deficiency (37.8%), while the least common ones were libido problems (1.1%) and the need to speed up metabolism (2.1%). For 25.5% of the respondents, there was no good rationale for using IVNTs. As many as 15.4% had no opinion on the subject. Health risks of IVNTs were recognised by 95.2% of professionals, with the biggest concerns being the lack of full information on patients' health status and medical contraindications (84%), the risk of overdose and interactions (77.1%), and hypersensitivity or allergic reactions (75.5%). Among the reasons for IVNTs' popularity, the respondents listed not only fads spread by celebrities and social media (89.4%) and the need for quick, effortless remedies (77.1%), but also reasons inherent in the Polish healthcare system. As many as 80.3% of the respondents stressed the need for public health institutions to take a stand on commercial IVNTs. Knowing of an IVNT facility was not significantly associated with the opinions of professionals in key areas. CONCLUSION: Postgraduate public health courses are a good opportunity to engage health professionals in discussions about the current challenges, trends, and needs in the area of health promotion and healthcare. This study's findings shed some light on the opinions about IVNTs held by health professionals, who are important stakeholders of the healthcare system. Thus, these findings may help to better understand the popularity of IVNTs and incorporate health professionals' perspectives in future efforts aiming to increase the awareness of IVNT-related health risks among both professionals and patients.

Nurses' Perspectives on Smoking Policies, Safety and Cessation Support in Psychiatric Wards: A Cross-Sectional Survey.

A high prevalence of smoking and low rates of smoking cessation interventions can be observed in psychiatric wards. A questionnaire-based, cross-sectional study was performed in five hospitals among 107 psychiatric ward nurses. The aim was to investigate nurses' views on patients' smoking practices and their influence on the safety of both the patients and medical personnel. In addition, we asked about the availability of smoking cessation support. Most of the respondents noticed the negative impacts of smoking on patients and medical personnel. Nearly a third of our respondents (29.0%) recalled smoking-related accidents in their facilities. In 45.2% of these accidents, a patient set someone else on fire. Around one fifth of nurses had rather permissive attitudes towards tobacco use in hospital wards. Significant associations were identified between respondents' smoking status and their opinions on amending smoking policies and on unsupervised smoking. Regarding professional help available to smoking patients, 88.8% of participants reported that interventions to address smoking were available in their wards. Psychiatric hospitalisation can be an opportunity to offer tobacco treatment to patients with mental health conditions. To make use of this opportunity, smoke-free policies need to be put in place and hospital personnel, particularly nurses, should be trained and equipped with the knowledge and skills needed to assist in the smoking care of psychiatric ward patients.

Exploring the Relationships between Children's Oral Health and Parents' Oral Health Knowledge, Literacy, Behaviours and Adherence to Recommendations: A Cross-Sectional Survey.

Although preventable, early childhood caries (ECC) is a burdening condition in all WHO regions, with Poland being one of the most affected countries in Europe. Effective home-based prevention of ECC is available and recommended by several expert bodies. Therefore, we wanted to determine how well parents were following selected oral health recommendations in preschool children. Additionally, we wanted to determine which socioeconomic factors influenced such practices the most, and how parents' oral health literacy and behaviours affected the oral hygiene and oral health status of their children. A cross-sectional survey involving 2338 parents and caregivers of children from 167 kindergartens was performed. Children's oral hygiene and oral health status were found to be associated with parents' education and economic status. They were also strongly influenced by parental health literacy and behaviours. With respect to recommendations for preschoolers, the lowest adherence was found in the use of fluoride toothpaste and its age-appropriate amount, supervision of toothbrushing, and refraining from eating after last toothbrushing. The improvement in these areas could be achieved thanks to the involvement of health professionals such as gynaecologists, midwives, and primary care personnel in efforts aimed at increasing parents' oral health knowledge and literacy.

Oral Health Behaviours, Knowledge, and Literacy of Expectant Mothers: A Cross-Sectional Study among Maternity Ward Patients.

Maternal knowledge, literacy, and behaviours in the area of oral health may greatly influence the risk of caries and the oral health status of children from the youngest age. Thus, the aim of the study was to investigate paediatric oral health knowledge and literacy as well as maternal oral health behaviours and outcomes among expectant mothers. A cross-sectional study was undertaken among 400 pregnant inpatients aged 17-48 years (mean age 29.5 ± 5.3 years) in 31 public maternity wards in the Wielkopolska region, Poland. An anonymous, self-designed questionnaire was prepared on the basis of current oral health recommendations. Pregnancy complications were reported by 195 (48.8%), and permanent tooth extractions by 158 (39.5%) women. Knowledge and literacy scores were associated with, among other things, maternal education, selected oral hygiene practices, and reported extractions of permanent teeth. Although participants had some correct information regarding oral health, they had insufficient awareness of caries as an infectious disease and of the appropriate timing for the child's first dental visit. Their self-assessment of oral health status and belief that they were under dental care tended to be overly optimistic, given their self-reported outcomes. These aspects should be considered in future health education efforts among expectant women.

How to Improve Cancer Prevention Knowledge? A Way to Identify Gaps and Tackle the Limited Availability of Health Education Services in Primary Health Care Using the European Code Against Cancer.

Introduction: The first line of action against cancer is primary and secondary prevention. Increased efforts are needed in countries where cancer mortality is high and the healthcare system is inefficient. Objectives: Our aim was to present a new solution to identify and fill gaps in health education services in accordance with the European Code Against Cancer (ECAC). Materials and Methods: This study was carried out in a rural population of 122 beneficiaries of health education workshops financed by the Polish Cancer League. A self-developed questionnaire was used. PQStat v1.6.8. was also applied. Results: Our respondents were mostly farmers (53.3%) and manual workers (16.4%). Most participants self-assessed their health knowledge as good (46.7%). While 42% of all respondents claimed to know the healthy eating pyramid, only 8.2% correctly recognised all of its principles and 23.8% realised the importance of limiting the consumption of red meat. The most commonly recognised cancer risk factor were genetics (72.1%), stimulants such as alcohol or tobacco (51.5%) and environmental pollution (45.1%). UV radiation was not commonly recognised as a risk factor by respondents despite high occupational exposure in this population. We found a high percentage of male smokers. As many as 64.8% of respondents had not been counselled on cancer prevention in their clinics. A family history of cancer (FHC) did not differentiate respondents' health knowledge, health behaviors, or frequency of receiving cancer prevention counselling. Health education and health promotion in the region were unsatisfactory. Conclusions: Primary health care (PHC) should become more involved in promoting cancer prevention knowledge. One way could be to encourage health professionals to promote the ECAC. Cancer prevention should target especially persons with FHC and focus on modifiable cancer risk factors. At the workshops we were able to adjust the strength of each ECAC recommendation to best fit the target audience. By diagnosing and targeting specific communities, we can draw the attention of PHC staff and decision-makers to local health promotion needs, which is a good starting point for improving the situation. However, larger scale projects are needed to help design specific solutions to support primary healthcare in promoting ECAC.

A Step towards Understanding and Tackling Health Inequalities: The Use of Secondary Prevention Services and the Need for Health Promotion in a Rural Setting.

Poland has recently intensified its health promotion in an effort to extend healthy life expectancy and reduce health inequalities. Our aim was to reach a deprived rural population, increase its health literacy, and explore its use of and barriers to cancer screening and public health care. A CBPR study was conducted in one of the poorest districts in Wielkopolska region, Poland, among 122 beneficiaries of health education workshops. A self-developed questionnaire was used. The reported barriers to participation in cancer screening included: lack of time, lack of need, or feeling healthy (32.8%); long waiting times (17.2%); fear of costs (9%). Physicians seldom recommended screening to their patients. Only 7.4% of respondents had ever received dermatoscopy. Among women, 18.2% did not perform any breast exams and 25% had never had smear tests. Diagnostics was often financed out of pocket (thyroid ultrasound = 58.1%; smear test = 48.5%; breast ultrasound = 36.8%). The health system needs mentioned by participants included better access to physicians (65.6%), promotion of free screening tests (54.9%), and access to public health programmes (22.1%). There is an urgent need to translate national strategies into action. Health promotion and better access to care must become priorities in deprived areas, while primary care providers should become key figures in delivering these services.

The Effect of Different Water Extracts from Platycodon grandiflorum on Selected Factors Associated with Pathogenesis of Chronic Bronchitis in Rats.

The aim of this study was to assess the activity of extracts from Platycodon grandiflorum A. DC (PG) in a model of chronic bronchitis in rats. The research was carried out on three water extracts: E1 - from roots of field cultivated PG; E2 - from biotransformed roots of PG; E3 - from callus of PG. The extracts differed in saponins and inulin levels-the highest was measured in E3 and the lowest in E1. Identification of secondary metabolites was performed using two complementary LC-MS systems. Chronic bronchitis was induced by sodium metabisulfite (a source of SO2). Animals were treated with extracts for three weeks (100 mg/kg, intragastrically) and endothelial growth factor (VEGF), transforming growth factors (TGF-ß1, -ß2, -ß3), and mucin 5AC (MUC5AC) levels were determined in bronchoalveolar lavage fluid, whereas C reactive protein (CRP) level was measured in serum. Moreover, mRNA expression were assessed in bronchi and lungs. In SO2-exposed rats, an elevation of the CRP, TGF-ß1, TGF-ß2, VEGF, and mucin was found, but the extracts' administration mostly reversed this phenomenon, leading to control values. The results showed a strong anti-inflammatory effect of the extracts from PG.

A global perspective on the costs of hypertension: a systematic review.

INTRODUCTION: Hypertension, particularly untreated, leads to serious complications and contributes to high costs incurred by the whole society. The aim of the review was to carry out a social and economic comparison of various categories of hypertension costs from different countries. MATERIAL AND METHODS: The study was a systematic review. PubMed, Cochrane Library and Google Scholar databases were searched. Hypertension costs were analyzed in 8 cost categories. An attempt was made to determine whether selected economic and social factors (such as HDI or GDP) influenced hypertension costs. RESULTS: The review included data from 15 countries: Brazil, Cambodia, Canada, China, Greece, Indonesia, Italy, Jamaica, Kyrgyzstan, Mexico, Poland, Spain, USA, Vietnam and Zimbabwe. The papers included in the review were heterogeneous with respect to cost categories, which made comparisons difficult. The average total costs of hypertension for all the studied countries, calculated per person, amounted to 630.14 Int$, direct costs - 1,497.36 Int$, and indirect costs - 282.34 Int$. The ranking of countries by costs and by selected economic and social indices points at the possible relationship between these indices and hypertension costs. CONCLUSIONS: The costs of hypertension calculated per country reached the region of several dozen billion Int$. Other sources usually showed lower costs than those presented in this review. This indicates a growth in costs from year to year and the future increasing burden on society. Globally uniform cost terminology and cost calculation standards need to be developed. That would facilitate making more informed decisions regarding fund allocation in hypertension management schemes.

A Polish Pilot Programme of Coordinated Care: A Herald of Change or a Missed Opportunity? A Critical Debate.

The part of the health system which is essential for achieving universal health coverage is primary health care. Recognising the need to reform the health system and primary care in particular, on 1 July 2018 the Polish government launched POZ Plus-a pilot programme of coordinated primary care. Its objectives are to improve the quality and coordination of care and to expand its scope. The objectives are to be delivered through preventive health checks in patients aged 20-65 years, predefined chronic disease management programmes, as well as coordination and monitoring of care carried out by primary care teams. The programme provoked a heated debate and mixed reactions from different stakeholders in Poland. On the positive side, POZ Plus improves patient experience and seems to be a promising preventive tool. During the first 14 months of programme life, 10,956 health checks resulted in 13,361 new diagnoses. The critics of the programme point out that the scope of care is too wide and unnecessary in general population, and the health checks are too long, given the scarcity of medical professionals in Poland. The programme requires significant up-front investment of time and resources, thus favouring big clinics from densely populated areas. Financing may be sufficient during the pilot phase, but the programme may turn out to be too costly for country-wide implementation. The programme is a promising start toward achieving better primary care coordination in Poland. However, its success is conditional on sound public financing, rational workforce strategy, and close collaboration of all stakeholders.

Student Volunteering as a Solution for Undergraduate Health Professions Education: Lessons From the COVID-19 Pandemic.

In response to the COVID-19 pandemic, many medical universities worldwide, including the Poznan University of Medical Sciences, launched student volunteering projects (SVPs). We examined our student volunteers' perceptions on the conditions, safety, costs and benefits of their participation in the SVP. Using this information, we attempted to assess the viability of SVPs as a solution for health professions education during and after the pandemic. The main research tool was a questionnaire on students' perceptions of their participation in the SVP. As a complementary qualitative method, we used semi-structured interviews with the volunteers. Our respondents (n = 158) perceived conditions and safety generally positively: most reported having personal protective equipment (89.24%), technical support (88.61%), and induction training (79.11%). Only 38.61% said they had access to psychological support. In our view, benefits (e.g., an opportunity to make new contacts or receiving positive reactions from patients and staff) seemed to outweigh costs. 65.82% of the respondents agreed that they learnt new interesting things. A majority noticed the development of their soft skills (social 86.08%; organisational 78.48%; stress management 68.99%), while 40.51% - the development of their medical skills. The interviews pointed to additional benefits for students such as gaining insight of the healthcare system, and costs such as distress caused by some patient interactions. We conclude that student volunteering could become a viable solution for health professions education. To maximise its educational potential, volunteers' needs must be explored, psychological support ensured, and opportunities for mentoring and reflection provided. The organisational framework of a SVP should be culturally sensitive.

The importance of the Wnt/ß-catenin pathway and LRP5 protein in bone metabolism of postmenopausal women.

BACKGROUND: Postmenopausal osteoporosis is the most common metabolic bone disease among women. The Wnt signaling pathway has been known to be the critical regulator of osteoblastogenesis. Alterations in this mechanism may have consequences for bone remodeling in humans. OBJECTIVES: The aim of the study was to evaluate the frequency of genotypes and alleles of single nucleotide polymorphism (SNP) rs4988321 and rs312009 of LRP5 in Polish postmenopausal women with osteopenia (n = 109) and osteoporosis (n = 333). Potential correlations between genetic polymorphisms, bone mineral density (BMD), risk for bone fractures, and other clinical parameters were analyzed. MATERIAL AND METHODS: Genomic DNA was extracted from the blood samples and the sequence polymorphisms of LRP5 gene were detected using real-time polymerase chain reaction (RT-PCR) methods with melting curve analysis. We also calculated the odds ratio (OR) for the LRP5 genotypes and the alleles. Then, we evaluated the effect of the LRP5 polymorphism on T-score, Z-score, L2L4AM, L2L4YA, L2L4BMD, body mass index (BMI), and other clinical parameters. RESULTS: No statistically significant differences in the distribution of LRP5 rs312009 genotypes between the groups were observed. Furthermore, our findings indicate that there is no correlation between LRP5 genotypes and the clinical characteristics of women with osteopenia/osteoporosis. In contrast, there was an increased value of OR in heterozygotes for rs4988321, both in patients with osteopenia (OR = 1.47) and in those with osteoporosis (OR = 1.33). In our study, we were not able to calculate the OR parameter for the AA genotype due to its low prevalence in the population. CONCLUSIONS: Our results suggest that the Val667Met LRP5 (rs312009) polymorphism may contribute to an elevated risk for fractures in postmenopausal Polish women.

The diagnostic potential of glutathione S-transferase (GST) polymorphisms in patients with colorectal cancer.

BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers in the world. Despite improvements in screening for early diagnosis, CRC is one of the leading causes of cancer deaths. OBJECTIVES: The aim of the study was to determine a potential association between the frequency of GSTM1 and GSTT1 null genotypes and the risk of CRC in the Polish population. Moreover, we analyzed the clinical parameters with the glutathione S-transferase (GST) gene polymorphisms in patients with CRC. MATERIAL AND METHODS: The study was conducted on 512 Caucasians, including 279 patients (105 women and 174 men) with CRC. DNA from peripheral blood was extracted and the multiplex polymerase chain reaction (PCR) technique was used for glutathione S-transferase theta (GSTT1) and mu (GSTM1) gene deletion genotyping. RESULTS: We found no statistically significant differences in the frequency of the GST gene polymorphisms in patients with CRC and controls. The prevalence of the GSTM1*0 variant in the test subjects was higher than in controls (45.9% vs 42.9%; p > 0.05). The frequency of the GSTT1*0 variant was also higher in patients with CRC compared to the control population (21.1% vs 18.9%; p > 0.05). In addition, the effect of the GSTM1 and GSTT1 polymorphisms on the incidence of CRC was also analyzed. There was a slight, but not statistically significant, increase of the risk of colon cancer for the GSTM1*0 and GSTT1*0 variants. Moreover, we examined the GST genotype due to the cancer TNM classification and the location of the primary tumor. Statistically significant differences in the distribution of the GSTT1*0 and GSTT1*1 genotypes in both the stage and the location of the primary tumor were observed. CONCLUSIONS: It is suggested that the GSTT1 polymorphism may have an impact on the severity of the tumor and its location.

The polymorphisms of methionine synthase (MTR) and methionine synthase reductase (MTRR) genes in pathogenesis of preeclampsia.

PURPOSE: The aim of the study was to determine the MTR (methionine synthase) and MTRR (mehionine synthase reductase) polymorphisms in pregnant women with preeclampsia (PE). MATERIALS AND METHODS: The group of 98 women with PE and the group of 120 healthy pregnant women were analyzed. Determination of MTR 2756A > G and MTRR 66A > G polymorphisms was performed using polymerase chain reaction (PCR)/restriction fragment length polymorphism (RFLP) method. RESULTS: The study did not show any statistically significant differences in frequency of genotypes and alleles of MTR 2756A > G polymorphism between PE group and controls. Higher frequency of 66GG genotype and 66G allele of MTRR 66A > G polymorphism was observed in the women with PE compared to control group. Moreover, the 66GG genotype correlated with higher doses of methyldopa, lower birth weight and higher placenta weight in women with PE. CONCLUSIONS: The obtained results for 66A > G polymorphism of MTRR gene suggest the predisposition to PE in carriers of mutated 66GG genotype and - 66G allele.

The effect of chronic estrogen application on bile and gallstone composition in women with cholelithiasis.

BACKGROUND: Chronic application of third generation progestagens as contraceptives or hormone replacement therapy (HRT) could influence the serum lipid profile, and consequently the bile and gallstone composition. The aim of this study was to determine components of serum, bile and gallstones in women of reproductive age or postmenopausal women using hormonal third generation for at least two years. METHODS: We enrolled 101 Caucasian women with cholelithiasis. The study included 45 women of reproductive age and 56 postmenopausal women who were divided into subgroups receiving or not exogenous female hormones. In patients we determined serum levels of 17ß-estradiol, triglycerides, HDL and LDL cholesterol as well as composition of gallstones and bile. RESULTS: The postmenopausal women showed a significant reduction in the concentration of bile acids in serum while the application of HRT caused an increase in their contents. Serum total and LDL cholesterol in postmenopausal women was higher than in women without hormonal contraception and postmenopausal patients with HRT. Moreover, women taking the exogenous hormones showed a reduced content of calcium ions in both serum, bile and gallstones. CONCLUSIONS: Our observations confirm that the chronic use of oral contraceptives and hormone replacement therapy cause an increase in bile lithogenity.

The influence of standardized Valeriana officinalis extract on the CYP3A1 gene expression by nuclear receptors in in vivo model.

Valeriana officinalis is one of the most popular medicinal plants commonly used as a sedative and sleep aid. It is suggested that its pharmacologically active compounds derived from the root may modulate the CYP3A4 gene expression by activation of pregnane X receptor (PXR) or constitutive androstane receptor (CAR) and lead to pharmacokinetic herb-drug interactions. The aim of the study was to determine the influence of valerian on the expression level of CYP3A1 (homologue to human CYP3A4) as well as nuclear receptors PXR, CAR, RXR, GR, and HNF-4α. Male Wistar rats were given standardized valerian extract (300 mg/kg/day, p.o.) for 3 and 10 days. The expression in liver tissue was analyzed by using real-time PCR. Our result showed a decrease of CYP3A1 expression level by 35% (P = 0.248) and 37% (P < 0.001), respectively. Moreover, Valeriana exhibited statistically significant reduction in RXR (approximately 28%) only after 3-day treatment. We also demonstrated a decrease in the amount HNF-4α by 22% (P = 0.005) and 32% (P = 0.012), respectively. In case of CAR, the increase of expression level by 46% (P = 0.023) was noted. These findings suggest that Valeriana officinalis extract can decrease the CYP3A4 expression and therefore may lead to interactions with synthetic drugs metabolized by this enzyme.

Effect of Epilobium angustifolium and Serenoa repens extracts on regulation of non-genomic signaling pathway of kinases.

OBJECTIVES: Changes of kinase activity of non-genomic cellular signaling pathway may influence the effectiveness of pharmacotherapy in case of hormone-dependent tumors. Our study investigated a possible interaction at the molecular level between an aqueous herbal extract of Epilobium angustifolium as well as a lipid-sterolic fruit extract of Serenoa repens and synthetic drugs used in the treatment of hormone-dependent cancers. MATERIAL AND METHODS: E. angustifolium and Serenoa repens extracts were orally administered to testosterone-induced rats for 21 days. Changes of RafA/Mapk3/Mapk1 mRNA levels were analyzed by real-time quantitative PCR using target specific primers. RESULTS: The level of RafA mRNA slightly increased in rats receiving Epilobium angustifolium (p = 0.076) and Serenoa repens (p = 0.016) extracts. Administration of these extracts resulted in significantly elevated Mapk1 and Mapk3 transcripts in the investigated animals (p < 0.05 for each extract). The levels of Mapk1 and Mapk3 mRNA strongly increased (p < 0.05 for each extract) in animals receiving concomitantly testosterone and the extracts, while RafA transcription slightly decreased (p < 0.05), as compared to controls. CONCLUSIONS: The results of our study may indicate a potential effect of S. repens and E. angustifolium extracts on the functioning of non-genomic cellular signaling kinases pathway. We investigated safety of these extracts to detect possible drug interactions between synthetic drugs used in the treatment of proliferative changes in hormone-dependent reproductive organs and herbal preparations.

The influence of a standardized soybean extract (Glycine max) on the expression level of cytochrome P450 genes in vivo.

OBJECTIVE: Soybean isoflavones are phytoestrogens that reduce menopausal symptoms and decrease the risk of certain chronic diseases, such as cancer and cardiovascular diseases. Despite the widespread use of soybean isoflavones as functional food and dietary supplements, data regarding the safety as well as herb-drug interactions, remain scarce. The aim of the study was to investigate the influence of soybean extract on the expression levels of cytochrome P450 (CYP) genes using real-time PCR (RT-PCR). MATERIALS AND METHODS: Male Wistar rats were fed a standardized soybean extract containing 37% isoflavones (100 mg/kg) for 3 and 10 days. cDNA was synthesized from total RNA isolated from the liver using reverse transcription. The level of CYP genes expression was analyzed using RT-PCR method. RESULTS: Soybean extract administration resulted in a significant increase of CYP1A1 expression level compared with the control group (1.5-fold; p < 0.05). An inductory effect was also observed for CYP2D1 by 32% (p < 0.01) after 10 days of treatment. No statistically significant differences were noted for CYPIA2, CYP2C6 and CYP3A2. In case of CYP3A1, the mRNA level of this gene was reduced by almost 35% (p < 0.05) both, after 3 and 10 days. CYP2D2 expression was also inhibited by the extract, but to a lesser degree when compared to CYP3A1. Moreover insignificant decrease of CYP2E1 expression level by 25% (p < 0.01) was observed after 3 days of treatment. CONCLUSIONS: These findings suggest that soybean extract may change the expression of CYP enzymes involved in biotransformation of xenobiotics (drugs, procarcinogens).

[The influence of a standardized soybean extract (Glycine max) on the expression level of CYP3A enzymes and pregnane X receptor in in vivo model]. / Wplyw standaryzowanego ekstraktu sojoweg (Glycine max) na poziom ekspresji enzymów CYP3A i receptora pregnanu X w modelu in vivo.

OBJECTIVE: Soybean phytoestrogens, such as genistein and daidzein, have become a popular alternative for women undergoing the treatment of menopause symptoms. These isoflavones are also commonly used in traditional medicine in the prevention and treatment of osteoporosis, cardiovascular diseases and cancer Despite the widespread use of soybean preparations as functional foods and dietary supplements, data regarding the safety as well as interactions between herbal medicines and synthetic drugs, especially with antineoplastic agents, remain scarce. Therefore, the aim of the present study was to determine the influence of soybean extract on the expression levels of CYP3A and PXR genes using real-time PCR (RT-PCR). MATERIALS AND METHODS: Male Wistar rats were given a standardized soybean extract (100 mg/kg p.o.) for 3 and 10 days. Total RNA isolated from the liver tissue was transcribed into cDNA. The level of CYP3A 1/2 and PXR mRNAs expression was analyzed by real-time quantitative PCR using SYBR Green I dye. RESULTS: Our findings showed that soybean extract containing 37% isoflavones resulted in a significant decrease of CYP3A1 expression level by almost 35% (p<0.05), both after 3 and 10 days, when compared with the control group. No statistically significant differences were noted for CYP3A2 enzyme and the PXR nuclear factor. CONCLUSIONS: These results suggest that soybean extract can decrease the CYP3A1 (homolog to human CYP3A4) expression and may participate in clinically significant interactions with drugs metabolized by CYP3A4 enzyme. Moreover it is postulated that gene expression of CYP3A1 and CYP3A2 (homolog to human CYP3A5) can be regulated indirectly by the PXR transcription factor.