Synopsis of Biomarkers of Atheromatous Plaque Formation, Rupture and Thrombosis in the Diagnosis of Acute Coronary Syndromes.

Acute coronary syndrome is the main cause of mortality and morbidity worldwide and early diagnosis is a challenge for clinicians. Though cardiac Troponin, the most commonly used biomarker, is the gold standard for myocardial necrosis, it is blind for ischemia without necrosis. Therefore, ideal biomarkers are essential in the care of patients presenting with symptoms suggestive of cardiac ischemia. The ideal biomarker or group of biomarkers of atheromatous plaque formation, rupture and thrombosis for timely and accurate diagnosis of acute coronary syndrome is a current need. Therefore, we discuss the existing understanding and future of biomarkers of atheromatous plaque formation, rupture and thrombosis of acute coronary syndrome in this review. Keywords were searched from Medline, ISI, IBSS and Google Scholar databases. Further, the authors conducted a manual search of other relevant journals and reference lists of primary articles. The development of high-sensitivity troponin assays facilitates earlier exclusion of acute coronary syndrome, contributing to a reduced length of stay at the emergency department, and earlier treatment resulting in better outcomes. Although researchers have investigated biomarkers of atheromatous plaque formation, rupture and thrombosis to help early diagnosis of cardiac ischemia, most of them necessitate validation from further analysis. Among these biomarkers, pregnancy-associated plasma protein-A, intercellular adhesion molecule-1, and endothelial cell-specific molecule- 1(endocan) have shown promising results in the early diagnosis of acute coronary syndrome but need further evaluation. However, the use of a combination of biomarkers representing varying pathophysiological mechanisms of cardiac ischemia will support risk assessment, diagnosis and prognosis in these patients and this is the way forward.

Critical review on conventional spectroscopic α-amylase activity detection methods: merits, demerits, and future prospects.

α-Amylase is an endoenzyme that catalyses the hydrolysis of internal α-l,4 glycosidic linkages in polysaccharides to produce maltose, maltotriose, and α-limit dextrins. It is widely used in the laboratorial and industrial workflow for several applications. There are several methods utilizing different techniques and substrates to assess α-amylase activity, among which the spectroscopic methods have found widespread applicability due to their ease of use and cost-effectiveness. Depending upon the reaction principle, these assays are classified into four groups: reducing sugar, enzymatic, chromogenic, and amyloclastic methods. Despite the presence of numerous methods, there is no general reliable method to assess α-amylase activity. Each method is shown to have its own merits and demerits. Many improvements have been made to make the available methods more accurate, reliable, and easy. This communication briefly discusses the basic reaction mechanisms and critically reviews the advantages and shortcomings associated with each method. Further recommendations are made for future development. © 2020 Society of Chemical Industry.

Poor Glycaemic Control Is Associated with Increased Lipid Peroxidation and Glutathione Peroxidase Activity in Type 2 Diabetes Patients.

Glycaemic control is the main focus of managing diabetes and its complications. Hyperglycaemia induces oxidative stress favouring cellular damage and subsequent diabetic complications. The present study was conducted to compare the plasma total antioxidant capacity (TAC) and individual antioxidant marker antioxidant status of type 2 diabetics (T2D) with good ((+) GC) and poor ((-) GC) glycaemic control with prediabetic (PDM) and normoglycaemic (NG) individuals. T2D (n = 147), PDM (n = 47), and NGC (n = 106) were recruited as subjects. T2D and PDM had lower plasma TAG than NG subjects. T2D and PDM had significantly higher GPx activity and plasma MDA concentrations than NG. PDM showed the highest SOD activity. T2D (-) GC showed significantly elevated GPx activity and higher MDA level and significantly lower SOD activity among all study groups. Lower plasma TAC and higher plasma MDA indicate the presence of oxidative stress in T2D and PDM. Elevated GPx activity in T2D, PDM, and particularly in T2D (-) GC suggests a compensatory response to counteract excess lipid peroxidation in the hyperglycaemic state. Decline in SOD activity advocates the presence of glycation and excess lipid peroxidation in T2D.

Heat stability of the in vitro inhibitory effect of spices on lipase, amylase, and glucosidase enzymes.

This study investigated the effect of boiling on the inhibitory action of spices on digestive enzymes. Unboiled extracts of Trigonella foenum-graecum (seed) (25.42%), Myristica fragrans (seed) (22.70%), and Cuminum cyminum (seed) (19.17%) showed significantly (p < 0.05) a higher lipase inhibitory activity than their respective boiled extracts (20.23%, 15.74%, and 12.57%). Unboiled extracts of Cinnamomum zeylanicum (stem bark) (-16.98%) and Foeniculum officinale (seed) (-16.05%) showed an activation of lipase enzyme, and boiling significantly (p < 0.05) changed the activity into lipase inhibition as 8.47% and 9.54%, respectively. Unboiled extracts of Coriandrm sativum (seed), C. cyminum, and Elettaria cardamomum (seed) showed an activation of amylase enzyme, and boiling these extracts significantly reduced the enzyme activation. The other unboiled extracts showed a higher amylase inhibition than the boiled extracts, whereas the boiled extracts of C.longa (rhizome) and Syzygium aromaticum (flower) exhibited significantly (p < 0.05) lower values. Unboiled extracts of C. zeylanicum, M. fragrans, and S. aromaticum showed an insignificantly higher glucosidase inhibitory activity than the boiled extracts. Inhibition of digestive enzymes by nutritional intervention is one avenue to be considered in treating diet-induced obesity and in the management of postprandial hyperglycemia. Spices, used as food additives, could be a potential source of digestive enzyme inhibitors. The current study revealed that unboiled extracts of T. foenum-graecum (seed), C. cyminum (seed), and M. fragrans (seed) are more effective than the boiled extracts as an antiobesity therapy. Moreover, it endorses the use of infusion of T. foenum-graecum seeds as an antiobesity therapy.

Applicability and reliability of the glucose oxidase method in assessing α-amylase activity.

Glucose oxidase (GOD) is an enzyme widely used in glucose monitoring systems owing to its high specificity towards glucose. However, in our previous work maltose was found to show significant interaction with GOD and based on this observation, a novel microplate-based method was developed to assess α-amylase inhibitory activity (GOD method). Concerns regarding the interaction of GOD with maltose has limited the widespread use of the GOD method in assessing α-amylase activity. The present paper provides answers to concerns regarding the interaction of GOD with maltose using HPLC studies and application of the GOD method in assessing α-amylase activity. According to the results, the newly developed GOD method can be considered as a well-suited method for the determination of α-amylase activity and as an easy method to do kinetic studies compared to other available methods.

Boiled, sprouted, and raw cowpea-incorporated diets modulate high-fat diet-induced hypercholesterolemia in rats.

This study was carried out to investigate the effect of processed (boiled and sprouted) cowpea-incorporated experimental diets on serum cholesterol and serum antioxidant capacity in high-fat diet (HFD)-fed Wistar rats. Seven weeks old male Wistar rats were fed 20% fat as a control (CD), for comparison with 20% fat-enriched diets containing 20% whole raw cowpea diets (Bombay Raw Diet; BRD and MI35 Raw Diet; MRD), boiled cowpea diets (Bombay Boiled Diet; BBD and MI35 Boiled Diet; MBD) and sprouted cowpea diet (Bombay Sprouted Diet; BSD) for 6 weeks. The increase in serum total cholesterol as a result of high-fat diet was significantly countered by boiled and raw cowpea-incorporated diet-fed rats. Increased serum non-HDL-C level caused by HFD was significantly (p < 0.05) countered by raw, boiled, and sprouted cowpeas, while HDL-C was increased by raw MI and boiled Bombay incorporated diets. Boiling has improved the hypocholesterolemic ability of Bombay cowpea and BBD has significantly (p < 0.05) modulated serum HDL-C level and liver weight in rats. These findings were supported significantly high soluble fiber content in processed cowpea powder than that in raw cowpea powder. The decrease in serum antioxidant activity as a result of HFD was significantly countered by BRD. Processing has reduced the antioxidant activity in cowpeas and serum antioxidant activity in rats. Cecal lactobacilli population was significantly high in all cowpea diet-fed groups compared to control. Modulated serum cholesterol level in cowpea diet-fed rats was accompanied by dietary fiber composition, antioxidant activity in cowpeas and fecal weight, cecal weight and cecal lactobacilli population in rats compared to control. Both processed and raw cowpea-incorporated diets have modulated HFD-induced hypercholesterolemia by modulating serum antioxidative capacity, cholesterol metabolism, and cecal fermentation.

Diminished disease progression rate in a chronic kidney disease population following the replacement of dietary water source with quality drinking water: A pilot study.

AIM: Environmental toxin/s is alleged to be the contributory factor for the chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka. The potential of drinking water as a medium for the nephrotoxic agents in the affected subjects has been comprehensively discoursed in the recent past. The present study was aimed to assess the effect of replacing the habitual drinking water on the kidney function of CKDu patients residing in the North Central Province of Sri Lanka: METHODS: An interventional study was carried out to assess the disease progression rate of a CKDu population whose habitual drinking water was replaced by bottled spring water certified by Sri Lanka Standard (SLS) for a period of 18 month along with a population of CKDu patients who continued with their usual drinking water. Kidney function of subjects in both groups were monitored in terms of blood pressure, serum creatinine, serum calcium, serum phosphorus, hemoglobin, estimated glomerular filtration rate and urinary protein at 6 months intervals during the intervention and follow up periods. RESULTS: Diminished disease progression rate was observed in CKDu patients in the intervention group when compared with the non- intervention group based on serum creatinine, Hb, estimated glomerular filtration rate and urinary protein levels. Extensive interventional studies are required to generalize effect of drinking water on CKDu population. CONCLUSION: The habitual drinking water is likely to be a contributory factor towards the progression of the disease.

Comparative Analysis of Lipid Content and Fatty Acid Composition of Commercially Important Fish and Shellfish from Sri Lanka and Japan.

Sri Lanka is surrounded by the Indian Ocean, allowing plenty of fishes to be caught. Moreover, these fishes represent one of the undocumented fish resources in the world and their detailed lipid profiles have not been previously examined. In this study, the lipid content and fatty acid composition of 50 commercially important fishes from the Indian Ocean (Sri Lanka) and the Pacific Ocean (Japan) were compared. The total lipid content and fatty acid composition, including eicosapentaenoic acid (C20:5n-3, EPA) and docosahexaenoic acid (C22:6n-3, DHA), differed significantly among species. Fish from the Pacific Ocean had higher proportions of fatty acids, including EPA and DHA. Herrings and mackerels from both oceanic areas demonstrated high levels of EPA and DHA, and n-3/n-6 ratio. Brackish and freshwater fishes from both groups showed low levels of PUFAs. Fish from the Indian Ocean were high in n-6 fatty acids. Monounsaturated fatty acid levels were high in omnivorous fish from the Pacific Ocean, and saturated fatty acid levels were high in fish from the Indian Ocean. The results of this study will be of value in determining the dietary usefulness of fish caught in Sri Lanka.

Epidemiology of chronic kidney disease, with special emphasis on chronic kidney disease of uncertain etiology, in the north central region of Sri Lanka.

BACKGROUND: The aim of the study was to identify the epidemiology of chronic kidney disease of uncertain etiology in Sri Lanka. METHODS: A cross-sectional study was carried out by analyzing health statistics, and three cohort studies were conducted (n = 15 630, 3996, and 2809) to analyze the demographic information, age-specific prevalence, etiology, and stage of presentation. We screened 7604 individuals for chronic kidney disease of uncertain etiology. RESULTS: The results showed that the male:female ratio was 2.4:1, the mean age of patients was 54.7 ± 8 years, 92% of the patients were farmers, and 93% consumed water from shallow dug wells. Familial occurrence was common (36%). The prevalence of chronic kidney disease in different age groups was 3% in those aged 30-40 years; 7% in those aged 41-50 years, 20% in those aged 51-60 years, and 29% in those older than 60 years. Chronic kidney disease of uncertain etiology was diagnosed in 70.2% of patients, while 15.7% and 9.6% were due to hypertension and diabetic mellitus, respectively. The majority of patients were stage 4 (40%) at first presentation, while 31.8% were stage 3 and 24.5% were stage 5. Stage 1 and 2 presentation accounted for only 3.4%. CONCLUSIONS: Low prevalence of CKDU was noticed (1.5%) among those who consumed water from natural springs. Prevalence was highest among males, rice farming communities, and those presenting at later disease stages.

Is the staple diet eaten in Medawachchiya, Sri Lanka, a predisposing factor in the development of chronic kidney disease of unknown etiology? - A comparison based on urinary ß2-microglobulin measurements.

BACKGROUND: Exact mechanism of causation of chronic kidney disease of unknown etiology (CKDu) in Sri Lanka is not described to date, despite the identification of possible multiple risk factors. Questions have been raised as to why only some are affected while others remain intact, though they are inhabitants of the same locality. METHODS: Comparative studies were carried out, assessing urinary ß2 microglobulin (ß2m) and the dietary patterns of CKDu patients and age sex matched non-CKDu subjects. Urinary ß2m levels of spot urine samples were analyzed using the Enzyme-linked Immunosorbent assay (ELISA) and dietary patterns were studied using twenty four hour dietary recalls and frequency consumption of foods of animal origin performed on three occasions at six months intervals within a period of one and half years. RESULTS: The mean urinary ß2m level of CKDu patients from Medawachchiya was significantly (p<0.05) higher when compared with that of the non-CKDu subjects. The mean urinary ß2m level of the non-CKDu subjects was within the reference limits for spot urine samples (0 - 0.3 µg/mL). White raw rice was the staple diet of both CKDu patients and non-CKDu subjects and the level of consumption was almost the same. The consumption of fresh water fish products of CKDu patients under high (14, 14%), moderate (36, 36%), low (26, 26%) and less (20, 20%) categories did not show significant variations (p>0.05) compared to non-CKDu subjects. CONCLUSIONS: Staple food in diet and the consumption pattern of CKDu patients from Medawachchiya were similar to that of non-CKDu subjects from the same area despite their urinary ß2m concentration being significantly higher.

Chemical and functional properties of fibre concentrates obtained from by-products of coconut kernel.

The coconut kernel residues obtained after extraction of coconut milk (MR) and virgin coconut oil (VOR) were analysed for their potential as dietary fibres. VOR was defatted and treated chemically using three solvent systems to isolate coconut cell wall polysaccharides (CCWP). Nutritional composition of VOR, MR and CCWPs indicated that crude fibre, neutral detergent fibre, acid detergent fibre and hemicelluloses contents were higher in CCWPs than in VOR and MR. MR contained a notably higher content of fat than VOR and CCWPs. The oil holding capacity, water holding capacity and swelling capacity were also higher in CCWPs than in VOR and MR. All the isolates and MR and VOR had high metal binding capacities. The CCWPs when compared with commercially available fibre isolates, indicated improved dietary fibre properties. These results show that chemical treatment of coconut kernel by-products can enhance the performance of dietary fibre to yield a better product.

Cardiovascular risk factors in elderly normolipidemic acute myocardial infarct patients--a case controlled study from India.

The goal of the present study was to address the various risk factors associated in normolipidemic acute myocardial infarction (AMI) patients admitted to the intensive coronary care unit (ICCU). The study compared serum lipid profiles, lipid peroxidation markers, antioxidants and inflammatory markers in acute myocardial infarction (AMI) patients and age/sex-matched controls. A lipid profile, lipid peroxidation, enzyme antioxidants, endogenous antioxidants, ischemia modified-albumin (IscMA), ceruloplasmin, C-reactive protein (CRP), fibrinogen, lipoprotein (a) and paraoxonase-1 activities were analyzed in 330 subjects, 165 acute myocardial infarction (AMI) patients and 165 age/sex-matched controls. We observed significantly higher (p < 0.0001) total cholesterol and triglyceride levels and lower high-density lipoprotein cholesterol (HDL-C) levels in the AMI patients. The lipoprotein (a), ceruloplasmin, CRP and fibrinogen levels were higher and the bilirubin, ascorbic acid, uric acid, albumin, superoxide dismutase, catalase, glutathione peroxidase and paraoxonase-1 activities were lower in AMI patients than controls. The malondialdehyde (MDA) and conjugated diene (CD) levels were significantly higher (p < 0.0001) in AMI patients.

Oxidative stress and antioxidant status in normolipidemic AMI patients.

The objective of the study was to observe the correlation between oxidative stress and antioxidants in myocardial infarct patients with normal lipid profile. In the present study investigation of lipid peroxidation and antioxidants were done in patients. This study was carried out on 165 AMI patients, (123 males and 42 females). The control group consisted on 165 normal healthy age-sex matched subjects (123 males and 42 females). Levels of Superoxide dismutase, Glutathione Peroxidase, Catalase, Malondialdehyde and Conjugated dienes were measured. The study found Superoxide dismutase, Glutathione Peroxidase, Catalase were significantly lower in activities (p<0.001) in AMI patients compared to controls. The markers of lipid peroxidation namely Malondialdehyde and Conjugated dienes were higher in AMI patients as compared to controls (p<0.001). The present study is clearly suggestive of increased oxidative stress in AMI patients. Oxidative stress appears as an etiological factor for myocardial infraction as a consequence the free radical scavengers levels are lowered in AMI patient.