Probiotic Lactobacillus casei Zhang ameliorates high-fructose-induced impaired glucose tolerance in hyperinsulinemia rats

Aim

To evaluate the preventive and therapeutic effects of Lactobacillus casei Zhang on impaired glucose tolerance (IGT) by using fructose-induced hyperinsulinemia rats.

Methods

Rats were fed 25 % fructose solution for hyperinsulinemia with L. casei Zhang for prevention or therapy. Serum levels of insulin, glucagon-like peptide-2 (GLP-2), osteocalcin, malondialdehyde (MDA), total intestinal bile acids and hepatic glycogen contents were determined by assay kits. The major bacteria from feces and liver expression of adiponectin receptor 2 (AdipoR2), liver X receptor-α (LXR-α), peroxisome proliferator-activated receptor gamma (PPAR-γ) and vitamin K epoxide reductase complex subunit 1 mRNA were assessed by RT-PCR. Pancreas injury was evaluated by histological analysis.

Results

Lactobacillus casei Zhang significantly increased numbers of Lactobacillus and Bifidobacterium and decreased Clostridium in the intestine (p < 0.01). Meanwhile, liver glycogen contents were significantly decreased (p < 0.05). In preventive group, accompanied by significantly lower insulin and GLP-2 levels (p < 0.05), L. casei Zhang prevented rats from an increase in oral glucose tolerance area under curve (AUC) which was significant in hyperinsulinemia group (p < 0.05). In therapeutic group, L. casei Zhang administration possessed improved glucose tolerance (p < 0.05), which were associated with increased osteocalcin level (p < 0.01), improved intestinal bile acids secretion (p = 0.060), decreased serum MDA levels (p < 0.05) and upregulation of LXR-α, PPAR-γ and AdipoR2 gene expression, as well as an increase in Bacteroides fragilis (p < 0.05).

Conclusions

Lactobacillus casei Zhang administration exert both preventive and ameliorative effect on oral glucose tolerance AUC in IGT rats but may be via different mechanisms. L. casei Zhang could prevent rats from increased AUC through GLP-2 lowering, while the ameliorative effect in high-fructose-fed post-adolescent rats may be via B. fragilis enriched vitamin K2-dependent osteocalcin mechanism in which AdipoR2, LXR-α and PPAR-γ signaling were involved.     

The inhibitory activities of the edible green alga Capsosiphon fulvescens on rat lens aldose reductase and advanced glycation end products formation

Purpose

Accumulating evidence suggests that inhibitors of aldose reductase (AR) may prevent hyperglycemia-induced long-term complications in diabetes mellitus. In the present study, we evaluated the AR inhibitory potential of ethanolic (EtOH) extracts from 22 seaweed species.

Methods

AR inhibitory activities of the selected seaweed species were evaluated using the rat lens aldose reductase (RLAR) inhibitory assay.

Results

All extracts exhibited RLAR inhibitory activity, which ranged from 5.87 to 92.71 % at a concentration of 50 μg/mL. Since Capsosiphon fulvescens exhibited significant inhibitory potential and is a frequently used foodstuff, it was selected for a detailed investigation using RLAR and advanced glycation end products (AGE) formation inhibitory assays. Among the different solvent-soluble fractions, the CH₂Cl₂, EtOAc, and n-BuOH fractions showed promising RLAR and AGE formation inhibitory activities. Considering the AR inhibitory potential, CH₂Cl₂ and EtOAc fractions were selected for chromatographic separation and yielded 11 compounds in which capsofulvesin A, capsofulvesin B, and chalinasterol showed potential RLAR inhibitory activity with the respective IC₅₀ values of 52.53, 101.92, and 345.27 μM. Kinetic studies revealed that capsofulvesin A and chalinasterol exhibited mixed type inhibition, while capsofulvesin B exhibited noncompetitive inhibition. To our knowledge, this is the first report of AR inhibitory activity of the glycolipids capsofulvesin A and capsofulvesin B.

Conclusions

Our results clearly indicate the potential RLAR and AGE formation inhibitory activities of C. fulvescens as well as its isolated constituents, which could be further explored to develop therapeutic modalities for the treatment of diabetes and related complications.     

Chlorella pyrenoidosa ameliorated L-NAME-induced hypertension and cardiorenal remodeling in rats

Purpose

Hypertension is one of the main factors causing cardiovascular diseases. The aim of the study is to investigate the effects of Chlorella pyrenoidosa on blood pressure and cardiorenal remodeling in rats with N _ω-nitro-l-arginine methyl ester hydrochloride (L-NAME)-induced endothelial dysfunction.

Methods

Rats were fed a diet containing L-NAME (40 mg/kg) with or without chlorella (4 or 8 %) for 5 weeks. We found that chlorella retarded the development of hypertension and cardiorenal remodeling during the 5-week experimental period.

Results

Although there was no difference in NO _x levels or plasma arginine concentrations, plasma and tissues ACE activities were significantly lower in the chlorella groups than in the L-NAME group. Moreover, tissue tumor necrosis factor-α concentrations and renal CYP4A expression were also lower in the chlorella group.

Conclusion

These results suggest that chlorella might ameliorate the elevation of blood pressure and show cardiorenal-protective effects in nitric oxide-deficient rats, and one possible mechanism might be mediated by its ACE inhibitory activity.     

Changes in mineral status are associated with improvements in insulin sensitivity in obese patients following l-arginine supplementation

Purpose

The aim of this study is to evaluate the long-term influence of l-arginine intake on mineral concentration in patients with obesity and to assess the changes in lipid serum levels, fat content, and insulin resistance that result.

Methods

A randomized double-blind placebo-controlled study was conducted. 88 obese patients were randomly assigned to receive either 9 g of l-arginine or placebo daily, for 6 months. At baseline and after 6 months, selected anthropometrical measurements and blood biochemical analyses were performed and mineral levels were assessed. To assess insulin sensitivity, the gold-standard euglycemic clamp methodology was used.

Results

We found that 6 months of l-arginine supplementation resulted in significant increases in insulin sensitivity (Δ1.1 mg/kg/min, P < 0.01) and zinc levels (Δ1.5 μmol/L, P < 0.001). Moreover, a positive correlation between the change in zinc concentration in serum and the change in insulin sensitivity was observed (R = 0.80, P < 0.01). In the group of patients treated with l-arginine, a negative correlation between the change in zinc concentration in serum and the change in body fat content was noted (R = ?0.38, P < 0.05).

Conclusions

l-Arginine supplementation affects zinc status in obese patients. One beneficial influence is related to the improvements in insulin sensitivity.     

Comparative in vitro inhibition of urinary tract pathogens by single- and multi-strain probiotics

Purpose

Multi-species probiotic preparations have been suggested as having a wide spectrum of application, although few studies have compared their efficacy with that of individual component strains at equal concentrations. We therefore tested the ability of 4 single probiotics and 4 probiotic mixtures to inhibit the urinary tract pathogens Escherichia coli NCTC 9001 and Enterococcus faecalis NCTC 00775.

Methods

We used an agar spot test to test the ability of viable cells to inhibit pathogens, while a broth inhibition assay was used to assess inhibition by cell-free probiotic supernatants in both pH-neutralised and non-neutralised forms.

Results

In the agar spot test, all probiotic treatments showed inhibition, L. acidophilus was the most inhibitory single strain against E. faecalis, L. fermentum the most inhibitory against E. coli. A commercially available mixture of 14 strains (Bio-Kult^®) was the most effective mixture, against E. faecalis, the 3-lactobacillus mixture the most inhibitory against E. coli. Mixtures were not significantly more inhibitory than single strains. In the broth inhibition assays, all probiotic supernatants inhibited both pathogens when pH was not controlled, with only 2 treatments causing inhibition at a neutral pH.

Conclusions

Both viable cells of probiotics and supernatants of probiotic cultures were able to inhibit growth of two urinary tract pathogens. Probiotic mixtures prevented the growth of urinary tract pathogens but were not significantly more inhibitory than single strains. Probiotics appear to produce metabolites that are inhibitory towards urinary tract pathogens. Probiotics display potential to reduce the incidence of urinary tract infections via inhibition of colonisation.     

In vitro activity of ceftobiprole on 440 Staphylococcus aureus strains isolated from bronchopulmonary infections

Objective

We assessed the in vitro activity of ceftobiprole on 440 Staphylococcus aureus clinical strains isolated from bronchopulmonary infections (2010–2014).

Quality of life assessed with EQ-5D in patients undergoing glioma surgery: What is the responsiveness and minimal clinically important difference?

Purpose

To evaluate the responsiveness of EQ-5D 3L in patients undergoing intracranial glioma surgery and estimate the minimal clinically important difference (MCID).

Materials and methods

EQ-5D 3L index values from 164 patients who underwent glioma surgery in the period 2007–2012 were analysed. Responsiveness and MCID were estimated using a combination of distribution-based and anchor-based methods. Karnofsky performance status served as an anchor.

Results

Patients who improved functionally did not report significantly higher EQ-5D 3L scores post operatively with a standardized response mean (SRM) of 0.04 (p = 0.13). Patients who deteriorated functionally reported significantly lower EQ-5D 3L scores post operatively with a SRM of 0.72 (p < 0.001). With different approaches, we determined a range of MCID values from 0.13 to 0.15.

Conclusions

EQ-5D 3L is responsive to changes when glioma patients are deteriorating functionally after surgery but not responsive when the patients are improving. The MCID values for EQ-5D 3L in glioma surgery seem higher than reported MCID values for other types of cancers.     

Chronic low-level arsenic exposure reduces lung function in male population without skin lesions

Objectives

The respiratory effects of chronic low-level arsenic exposure from groundwater have been investigated in West Bengal, India.

Methods

The participants (834 non-smoking adult males) were subdivided in two groups: an arsenic-exposed group (n = 446, mean age 35.3 years) drinking arsenic-contaminated groundwater (11–50 μg/L) and a control group of 388 age-matched men drinking water containing <10 μg/L of arsenic. Arsenic in water samples was measured by atomic absorption spectroscopy. The prevalence of respiratory symptoms was documented by structured, validated questionnaire. Pulmonary function test (PFT) was assessed by portable spirometer.

Results

Compared with control, the arsenic-exposed subjects had higher prevalence of upper and lower respiratory symptoms, dyspnea, asthma, eye irritation and headache. Besides, 20.6 % of arsenic-exposed subjects had lung function deficits (predominantly restrictive and combined types) compared with 13.6 % of control (p < 0.05). A positive association was observed between arsenic concentration in drinking water and the prevalence of respiratory symptoms, while a negative association existed between arsenic level and spirometric parameters.

Conclusions

The findings suggest that even low-level arsenic exposure has deleterious respiratory effects.     

The impact of second-line agents on patients’ health-related quality of life in the treatment for non-small cell lung cancer: a systematic review

Purpose

In advanced non-small cell lung cancer (NSCLC), progressive disease burdens patients considerably. Second-line (2L) chemotherapy improves survival marginally but humanistic outcomes (i.e., quality of life, QOL) are underreported. The impact of 2L therapy remains an important consideration for patients and caregivers, and there have been QOL reviews for 1L, but not 2L, therapies. This review assessed QOL outcomes of approved, guideline-supported 2L chemotherapy with docetaxel, erlotinib, gefitinib, and pemetrexed in advanced NSCLC.

Methods

Clinical trial reports of approved, guideline-supported 2L or maintenance therapy for NSCLC published from 2000 to 2010 were identified from PubMed/Medline and clinical meetings. Outcomes were stratified by overall QOL impact, domain/symptom-specific effects, effect over time, and subgroup effects.

Results

Of 145 studies identified, 24 full-text articles were retained. Studies with docetaxel versus best supportive care (n = 1) and active comparators (n = 4) reported non-significant overall QOL improvements, as did studies of gefitinib versus placebo and active comparator (n = 7). Overall QOL improvements were seen for gefitinib versus docetaxel (n = 2) and gefitinib in a single-arm study (n = 1). At the symptom level, studies of docetaxel (n = 4/7), gefitinib (n = 7/9), and pemetrexed (n = 1) reported non-significant results. Subgroup analyses indicated improved QOL outcomes for gefitinib-treated responders versus non-responders, worse QOL for gefitinib-treated smokers versus placebo, worse QOL for gefitinib-treated Asian patients versus placebo, and longer time to symptom deterioration in erlotinib versus placebo-treated elderly patients.

Conclusions

Significant improvements in overall QOL with 2L chemotherapy for advanced NSCLC were infrequent. Single-arm studies and those with less toxic regimens more commonly provided statistically significant improvements in QOL outcomes. Methodological heterogeneity impedes cross-study QOL comparisons.     

New perspectives on vitamin D sources in Germany based on a novel mathematical bottom-up model of 25(OH)D serum concentrations

Purpose

Up-to-date knowledge about vitamin D supply and serum concentration in Germany is not sufficient. Our purpose was to compare a novel holistic bottom-up modeling of 25(OH)D concentrations with vitamin D sources such as sunlight, food and supplements for all federal states taking seasonal and geographical variations into account. The second purpose was to update and detail vitamin D supply through food in Germany.

Methods

To confirm the model of 25(OH)D concentrations, we used the population (1,763 men and 2,267 women, 18–79 years) participated in the representative German National Health Interview and Examination Survey 1998 and the integrated German Nutrition Survey.

Results

The maximum model value is 67.5 nmol/L in July and minimum model value is 29.3 nmol/L in January, while the average model value is 45.0 nmol/L. Men have a mean daily intake of 137 IU (3.42 μg) and women of 112 IU (2.79 μg). Correlation between model and actual data is 0.77 (p = 0.003).

Conclusions

A comparison of the model data with population-based values showed good agreement. None of the vitamin D sources can provide the German population with enough vitamin D.     

Reliability and validity of the Iranian version of the QAPACE in adolescents

Purpose

The aim of this study was to determine the reliability and validity of the Iranian version of the Quantification de l’Activite Physique en Altitude Chez les Enfants (QAPACE) in adolescents.

Methods

After linguistic validation, the Iranian version of the QAPACE was completed by 359 (52.4 % girls) schoolchildren, aged 15–18 years. Test–retest reliability of the questionnaire was determined by intraclass correlation coefficients (ICCs). For validation purposes, two methods were used for (1) the correlation between VO_2peak and the DEE and (2) known-group validity, which was examined by comparing the normal weight adolescents and those who were overweight/obese.

Results

ICCs for test–retest ranged from 0.79 to 0.98. The mean scores in test–retest surveys for total score and all of the subscores were significant (p < 0.05). Sex-specific analysis showed a significant correlation between VO_2peak and DEE over 12-month, school, and vacation periods in girls (p < 0.05). The mean values for all activities except for transportation, other activities in school, personal artistic activities, sport competition, and home activities were significantly lower in overweight/obese group than normal group.

Conclusion

Our results support the initial reliability and validity of the Iranian version of QAPACE as a daily physical activity measure in adolescents.     

Effects of an HIV-Care-Program on immunological parameters in HIV-positive patients in Yaoundé, Cameroon: a cluster-randomized trial

Objectives

To measure the effects of an HIV-Care-Program, focusing on nutrition and lifestyle, which can be provided at scale to HIV-infected patients, on clinical and anthropometrical parameters, and health status.

Methods

A cluster-randomized trial, including 5 health facilities randomized to intervention n = 100 (HIV-Care-Program) or control n = 101 (Usual-Care). The HIV-Care-Program consisted of counseling lessons for 6 months, on: nutrition, hygiene, coping with stigma and discrimination, embedded in practical activities. Outcome variables were CD4 count after 6 months and time to antiretroviral therapy (ARV) initiation, using analysis of covariance and Kaplan–Meier method, respectively.

Results

After 6 months, CD4 count dropped by 46.3 cells (7.7 %) (intervention) and 129 (23 %) (control) (p = 0.003). Mean time to ARV; 5.9 months 95 % CI (5.9, 6.0) (intervention); 4.9 months 95 % CI (4.7, 5.2) (control) (p < 0.004). There was a partial correlation between CD4 count and initial viral load (r = ?0.190, p = 0.017).

Conclusions

The intervention provides a low-cost alternative improving health status, slowing down CD4 cell decline, delaying initiation of ARV and thus freeing local ARV capacities for patients in urgent need.     

Postprandial glucose, insulin and gastrointestinal hormones in healthy and diabetic subjects fed a fructose-free and resistant starch type IV-enriched enteral formula

Background

Reducing the dietary glycaemic response has been proposed as a means of reducing the risk of diabetes.

Aim

To evaluate the effects of a new diabetes-specific formula (DSF) enriched with resistant starch type IV and fructose-free on postprandial glycaemia, insulinaemia and gastrointestinal hormones in healthy volunteers and in outpatient type 2 diabetics.

Methods

(1) Twenty-four healthy volunteers were divided into two groups: Group 1 ( n = 10) was provided 50 g of the carbohydrate (CHO) constituent of the new product and 50 g of glucose separated by 1 week; Group 2 ( n = 14) was provided 400 ml of the new DSF (T-Diet Plus^® Diabet NP) and 400 ml of a control product separated by 1 week. (2) Ten type 2 diabetic patients received 400 ml of the new DSF and two other commercially available DSF (Glucerna^® SR and Novasource^® Diabet) on three occasions separated by 1 week. Venous blood samples were drawn at time 0 and at different times until 120 min. Glucose, insulin and gastrointestinal hormones were determined. Glycaemic and insulinaemic indices and glycaemic load were calculated.

Results

The CHO constituent and the new DSF showed low glycaemic index and glycaemic load. In healthy subjects, insulin and C-peptide release were lower after administration of the CHO constituent as well as after the new DSF (P < 0.001). Ghrelin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) production were lower after intake of the CHO constituent (P ranging from <0.001 to 0.019) compared with glucose, and GIP was lower after ingestion of the new DSF (P = 0.002) than after the control product. In type 2 diabetic patients, glucose AUC was lower after the administration of the new DSF (P = 0.037) compared with the others.

Conclusions

Our results indicate that this new product could be beneficial for diabetic patients.     

Lactobacillus bacteremia: Pathogen or prognostic marker?

Objective

Lactobacillus bacteremia is a rare event and its epidemiology is poorly known. Whether Lactobacillus bacteremia is a contaminant, a risk factor, or a risk marker of death remains an open question.

Modulation of detoxification enzymes by watercress: in vitro and in vivo investigations in human peripheral blood cells

Background

Epidemiological studies indicate that consumption of cruciferous vegetables (CV) can reduce the risk of cancer. Supposed mechanisms are partly the inhibition of phase I and the induction of phase II enzymes.

Aim

The aim of this study was to investigate in vitro and in vivo effects of watercress (WC), a member of the CV family, on chemopreventive parameters using human peripheral blood mononuclear cells (PBMC) as surrogate cells. We investigated the hypothesis that WC reduces cancer risk by inducing detoxification enzymes in a genotype-dependent manner.

Methods

In vitro gene expression and enzyme activity experiments used PBMC incubated with a crude extract from fresh watercress (WCE, 0.1–10 μL/mL with 8.2 g WC per 1 mL extract) or with one main key compound phenethyl isothiocyanate (PEITC, 1–10 μM). From an in vivo perspective, gene expression and glutathione S-transferase (GST) polymorphisms were determined in PBMC obtained from a human intervention study in which subjects consumed 85 g WC per day for 8 weeks. The influence of WC consumption on gene expression was determined for detoxification enzymes such as superoxide dismutase 2 (SOD2) and glutathione peroxidase 1 (GPX1), whilst the SOD and GPX activities in red blood cells were also analysed with respect to GST genotypes.

Results

In vitro exposure of PBMC to WCE or PEITC (24 h) increased gene expression for both detoxification enzymes GPX1 (5.5-fold, 1 μL/mL WCE, 3.7-fold 1 μM PEITC) and SOD2 (12.1-fold, 10 μL/mL WCE, 7.3-fold, 10 μM PEITC), and increased SOD2 activity (1.9-fold, 10 μL/mL WCE). The WC intervention had no significant effect on in vivo PBMC gene expression, as high individual variations were observed. However, a small but significant increase in GPX (p = 0.025) and SOD enzyme activity (p = 0.054) in red blood cells was observed in GSTM1*0, but not in GSTM1*1 individuals, whilst the GSTT1 genotype had no impact.

Conclusion

The results indicate that WC is able to modulate the enzymes SOD and GPX in blood cells in vitro and in vivo, and suggest that the capacity of moderate intake of CV to induce detoxification is dependent in part on the GSTM1 genotype.     

Mokken scaling of the Chinese version of the Medical Outcomes Study Social Support Survey

Purpose

To validate the Chinese Mandarin version of the Medical Outcomes Study Social Support Survey (MOS-SSS-CM) using a model of ordinal unidimensional measurement known as Mokken scaling.

Methods

We administered in face-to-face interviews the MOS-SSS-CM to 200 patients with coronary heart disease. Data were analysed using Mokken scaling.

Results

The MOS-SSS-CM contains a set of items which meet the criteria of a reliable (Rho = 0.87) moderate Mokken scale (H = 0.40) with weak invariant item ordering (H = 0.39).

Conclusions

The MOS-SSS-CM has a hierarchy of items which can be interpreted in terms of concerns with the physical aspects of social support through the need for companionship to items related to more personal worries.     

Comparing PROMIS computer-adaptive tests to the Brief Symptom Inventory in patients with prostate cancer

Purpose

This study assessed whether the Patient-Reported Outcomes Measurement Information System (PROMIS) computer-adaptive tests (CATs) provided results similar to those of the Brief Symptom Inventory (BSI) with a low patient burden.

Methods

Secondary data analysis of 136 prostate cancer patients who completed the 53-item BSI and the PROMIS CATs assessing depression, anxiety, and hostility.

Results

The PROMIS CATs and BSI correlated significantly in measures of depression (.85), anxiety (.76), and anger/hostility (.66; p < .001 for all). Using our BSI cutoff points for depression, anxiety, and anger/hostility, ROC analysis yielded areas under the curve of .966 [standard error (SE) = .014, p < .001], .975 (SE = .012, p < .001), and .952 (SE = .027, p < .001), respectively.

Conclusions

PROMIS CATs were highly correlated with the BSI subscales, indicating that the CATs performed well compared with the BSI, a widely used psychosocial measure.     

Sensory impairments and their associations with functional disability in a sample of the oldest-old

Purpose

Research focusing on the consequences of sensory impairments for the everyday competence of the oldest-old is emerging. The two main goals of this study were to document the prevalence of self-reported vision, hearing, and dual sensory impairment and to explore associations of these impairments with functional disability in near-centenarians and centenarians.

Methods

Centenarians and near-centenarians (N = 119; average age = 99) were recruited, with about 80 % living in the community. In-person interviews included self-ratings of vision and hearing impairment and functional disability conceptualized as having difficulties performing personal and instrumental activities of daily livings (PADLs and IADLs).

Results

Based on self-report ratings, 17 % of participants were classified as having a visual impairment only, 18 % as having a hearing impairment only, and 38 % with both a visual and hearing impairment (dual sensory impairment). Regression analyses demonstrated that having a vision impairment only and being dual sensory impaired were the strongest predictors of functional disability. They were associated with higher levels of functional disability over and above higher levels of depressive symptomatology, interference of health with desired activities, and living in a nursing home.

Conclusions

Sensory impairments—especially dual sensory impairment—are prevalent in the oldest-old. Having dual sensory impairment or a single visual impairment among other factors are strongly associated with less-optimal everyday functioning in the oldest-old.     

Personality traits of the Five-Factor Model are associated with work-related stress in special force police officers

Purpose

The police work is particularly stressful. The aim of this work was to clarify whether the personality factors are associated with perceived stress levels or reactivity to environmental stressors in a special body of police.

Methods

The police officers in charge of guaranteeing public order at the L’Aquila G8 meeting were subjected to a control of their levels of work-related stress in anticipation of the event. Personality was assessed by the Italian version of the Five-Factor Model questionnaire, while stress was measured three times (during routine work in January 2009, preparation and imminence of the event, in April and July 2009, respectively) with the demand/control/support model of Karasek and the effort/reward imbalance model of Siegrist. A total of 289 of 294 officers took part in the survey.

Results

Some personality traits of the Five-Factor Model were associated with stress levels and stress reactivity. Neuroticism (low emotional stability) showed the strongest associations with job strain (demand/control ratio) (β = 0.115, p < 0.05) and effort/reward imbalance (β = 0.270, p < 0.001) and was associated with most of the stress variables. High agreeableness was associated with low effort/reward imbalance (β = ?0.157, p < 0.01).

Conclusions

Personality factors may mitigate or increase the strain induced by environmental stressors.