Serum Carotene Research Articles

Sustainable fodder production and optimization of cow feeding rations in the ar-id climate of southern Ukraine

In the south of Ukraine, which traditionally belongs to the zone of risky land use due to frequent droughts and the last 10–15 years of steadily progressing global warming, the production of rye silage as a basic feed ingredient is gaining the status of an excellent insurance fund, which is essential in the region's feed production, as it will help to remedy the situation with the shortage of juicy fodder. Optimisation of dairy cow feeding rations during lactation in southern Ukraine involves the use of traditional dietary ingredients (corn silage, alfalfa haylage) and innovative ones (rye silage, wet beer pellets), which is mainly due to climate change in recent years. The research used commonly available methods: zootechnical (setting up experiments, developing feed rations, assessing dairy cattle productivity, milk quality, reproduction rates); biological (morphological and biochemical composition of blood); statistical (biometric processing of data) and economic analysis of the research. Thus, in terms of actual milk yield, amount of milk fat and milk protein for 305 days of lactation, cows of all experimental groups outperformed analogues of the control group (milk yield for 305 days of lactation was 7898.0 l; amount of milk fat and protein – 278.7 and 245.1 kg, respectively) by 1.2–3.3 %, by the amount of milk fat – by 5.1–16.9 % and by the amount of milk protein – by 3.4–10.9 % for 305 days of lactation. It was found that the diets of dairy cows of the experimental groups, which included rye silage in different amounts and wet beer pellets, had a positive effect on reducing the duration of the service period, and hence the duration of the intercalation period by 5.5–27.0 days in animals of the I–IV experimental groups compared to cows of the control group. There was a tendency to increase the content of carotene in the blood serum of animals of the II experimental group by 39.5 %, as well as a significant difference of 72.7 % (P < 0.05) and 81,3% (P < 0.01), respectively, in cows of the III and IV experimental groups compared to the same indicator of the control group, which was 209.6 μg/100 ml.

Carrot and carotene and multiple health outcomes: an umbrella review of the evidence.

In recent years, the benefits of carrots and carotene in different areas of health have been examined. The purpose of this umbrella review was to identify the associations between carrots and carotene and multiple health outcomes. The review considered evidence from meta-analyses of interventional and observational studies of carrots and carotene and any health outcome. We comprehensively searched Web of Science, PubMed, and Embase. For each association, we estimated the summary effect size using random and fixed effects models and the 95% confidence interval. A total of 1329 studies were searched, and 30 meta-analyses with 26 health outcomes were identified that met the eligibility criteria. Carrot intake was associated with a lower risk of multiple cancer outcomes including breast cancer, lung cancer, pancreatic cancer, gastric cancer, urothelial cancer, and prostate cancer. Carotene intake was associated with a lower risk of fracture, age-related cataract, sunburn, Alzheimer's disease, breast cancer, lung cancer, pancreatic cancer, gastric cancer, esophageal cancer, prostate cancer, and head and neck cancer (HNC). Serum carotene was inversely associated with all-cause mortality, breast cancer, and lung cancer. Our study revealed that carrot or carotene intake could reduce the risk of various negative health outcomes. © 2023 Society of Chemical Industry.

ДЕЙСТВИЕ СЕЛЕНСОДЕРЖАЩИХ ПРЕПАРАТОВ НА ФИЗИОЛОГИЧЕСКИЙ СТАТУС БРОЙЛЕРНЫХ ЦЫПЛЯТ

The use of selenium-containing preparations "E-selenium", "Selplex" and "LovitVA + SE" in the diet of broiler chickens stimulates humoral non-specific protective factors, an increase in the number of erythrocytes, total protein, albumin, vitamin E, carotene and allows you to get high-quality products of meat origin from broiler chickens. At the first stage of research, it was established that the physiological status of Ross 308 day old chickens is characterized by a relatively high content of leukocytes and platelets in the blood, and stab and segmented pseudoeosinophils in the leukogram, which protect the body from adverse environmental factors. The content of such formed elements as erythrocytes is at the lower limits of the physiological norm. The concentration of hemoglobin in them is also low. The introduction of the drug "Selplex" into the diet contributes to an increase in such humoral non-specific protective factors as lysozyme and bactericidal activity of the blood serum of chickens. At the second stage of research, selenium-containing preparations "E-selenium" and "LovitVA + SE" were used for broiler chickens. The use of the drug "E-selenium" contributes to an increase in the content of erythrocytes and hemoglobin in the blood of chickens, the content of erythrocytes, in comparison with the control group, increases. Additional use of the drug "LovitVA + SE" leads to an increase in the level of erythrocytes in the blood of broiler chickens, hemoglobin, and also contributes to an increase in the concentration of total protein, albumin, vitamin E and carotene in the blood serum.

Pancreatogenic Diabetes, 2 Onset Forms and Lack of Metabolic Syndrome Components Differentiate It From Type 2 Diabetes.

We compared pancreatogenic (DM3c) and type 2 diabetes mellitus. We compared age-, sex-, and diabetes mellitus duration-matched DM3c cases (n = 142) and type 2 diabetes mellitus (n = 142). Pancreatogenic diabetes was considered when it appeared after the diagnosis of pancreatitis or after pancreatic surgery. Pancreatogenic diabetes presented lower body mass index (BMI) [odds ratio (OR), 1.2; 95% confidence interval (CI), 1.13-1.28; P < 0.001], worse glycemic control (OR, 1.196; 95% CI, 1.058-1.35; P = 0.004), required insulin more frequently (OR, 4.21; 95% CI, 2.57-6.93; P = 0.0001), had more hypoglycemic episodes (OR, 3.65; 95% CI, 1.64-8.16; P = 0.001) but lower frequency of dyslipidemia (OR, 0.42; 95% CI, 0.26-0.68; P = 0.001) and arterial hypertension (OR, 0.52; 95% CI, 0.32-0.86; P = 0.01). Pancreatogenic diabetes cases on pancreatic enzyme replacement therapy had lower glycosylated hemoglobin (8.52% vs 9.44%; P = 0.026), serum carotenes (79.1 vs 116.1; P = 0.03), and BMI (23.4 vs 26.1; P = 0.0005) than those not on pancreatic enzyme replacement therapy. Pancreatogenic diabetes onset occurred earlier in necrotizing pancreatitis and after pancreatic surgery. Pancreatogenic diabetes presents with low BMI and lacks metabolic syndrome components. The type of pancreatic disease or surgery defines its onset time.

Greater bioavailability of xanthophylls compared to carotenes from orange juice (high-pressure processed, pulsed electric field treated, low-temperature pasteurised, and freshly squeezed) in a crossover study in healthy individuals

This study examined the effect of the intake of orange juice provided freshly squeezed (FS) or processed using low-temperature pasteurisation (LP), high-pressure processing (HPP), or pulsed electric field (PEF) treatment on the serum carotenoid concentrations of 12 healthy individuals, aged 20–32 years, enrolled in a crossover study. Participants were instructed to consume 500 ml of orange juice/day for 14 days. Carotenoid concentrations in the orange juice as well as serum samples retrieved on days 7 and 14 were analysed via HPLC. A significant increase in serum xanthophyll concentrations, but not serum carotenes, was observed, with the highest increase in α- and β-cryptoxanthin. The processing technologies applied appeared to affect serum carotenoid concentrations, with concentrations being similar in the HPP and FS orange juice types. As high variability in serum carotenoid concentrations was observed, the effect of different technologies on serum carotenoid concentration warrants further studies with larger sample sizes.

Reproductive traits and blood biochemical parameters of sows when using a vitamin feed additive “LipoCar”

The reproductive traits of sows are of paramount importance in the production of high-quality pork. The world experience of pig farming shows the need to solve first of all the feed problem. Diets unbalanced in the content of vitamins restrain the manifestation of genetically inherent high prolificacy of sows. The purpose of the research was to study the influence of feeding the vitamin feed additive “LipoCar” on the reproductive traits of sows and the biochemical parameters of blood serum. The results of research on the introduction of vitamin feed additive “LipoCar” into the diet of pregnant sows have been presented in the article. The experiment has been carried out in the production conditions in JSC “Linevsky pedigree farm” on sows of Large White breed. Pregnant sows have received a basic diet, balanced for all the normalized elements of nutrition. Sows of the experimental group in the composition of the basic diet fed the feed additive “LipoCar”. The dosage of the drug “Lipocar” was 2,1 g/head/day. “Lipocar” has been fed for 20 days. The total duration of the experiment was 3 months. When introducing the vitamin feed additive “LipoCar” into the main diet of sows in the second half of pregnancy the increase in the number of piglets in the litter by 1,6-6,8 % and the weight of the litter – by 5,6-56,2 % (P ≤ 0,001) have been revealed in comparison with the control group of animals. There was a higher content of carotene in the blood serum of sows of the experimental group by 50,0 % (P ≤ 0,01), vitamin A - by 48,7 % (P ≤ 0,05), and total protein – by 4,9 % (P ≤ 0,05).

Serum Carotenoids Reveal Poor Fruit and Vegetable Intake among Schoolchildren in Burkina Faso.

The health benefits of fruits and vegetables are well-documented. Those rich in provitamin A carotenoids are good sources of vitamin A. This cross-sectional study indirectly assessed fruit and vegetable intakes using serum carotenoids in 193 schoolchildren aged 7 to 12 years in the Western part of Burkina Faso. The mean total serum carotenoid concentration was 0.23 ± 0.29 µmol/L, which included α- and β-carotene, lutein, and β-cryptoxanthin, and determined with serum retinol concentrations in a single analysis with high performance liquid chromatography. Serum retinol concentration was 0.80 ± 0.35 µmol/L with 46% of children (n = 88) having low values <0.7 µmol/L. Total serum carotene (the sum of α- and β-carotene) concentration was 0.13 ± 0.24 µmol/L, well below the reference range of 0.9–3.7 µmol carotene/L used to assess habitual intake of fruits and vegetables. Individual carotenoid concentrations were determined for α-carotene (0.01 ± 0.05 µmol/L), β-carotene (0.17 ± 0.24 µmol/L), β-cryptoxanthin (0.07 ± 0.06 µmol/L), and lutein (0.06 ± 0.05 µmol/L). These results confirm the previously measured high prevalence of low serum vitamin A concentrations and adds information about low serum carotenoids among schoolchildren suggesting that they have low intakes of provitamin A-rich fruits and vegetables.

The effects of zinc supplementation on zinc, retinol and carotene levels in lactating Amazonian women

The effects of zinc supplementation on levels of zinc, retinol and carotene in serum and breast milk were investigated in a double blind controlled prospective study amongst 66 poor urban Amazonian mothers in 1981. The mothers predominantly breast-fed their infants for the first five months of life and took supplements from soon after birth. Milk retinol levels were already significantly higher in zinc supplemented (ZS) than non-zinc supplemented (NZS) mothers by one month post-partum, and by four months had risen significantly in the ZS mothers but fallen in NZS mothers. At four months post-partum, milk retinol levels of ZS mothers were near normal and double those of NZS mothers. The effect of zinc supplementation on these retinol levels was possibly associated with an increased absorption and utilization of dietary carotene, since milk carotene levels also increased in ZS mothers to levels three times those of NZS mothers at four months post-partum. This impact of zinc supplementation on maternal and breast milk vitamin A levels has not been shown previously and is of potential relevance where zinc and vitamin A deficiency are common.

Seasonal fertility differences in synchronised dairy cows: Ultrasonic, metabolic and endocrine findings

The aim of this study was to identify relationships among seasonal differences of fertility, metabolic parameters and appearance of irregular luteal forms in high-yielding dairy cows. Holstein-Friesian cows were put on the Provsynch regimen in winter (n = 10) and in summer (n = 10). Blood sampling (starting 35 days post partum) and rectal ultrasound examinations (starting post insemination) were carried out once a week in each examination period. Metabolic [plasma nonesterified fatty acid (NEFA) and beta-hydroxybutyrate (BHB) levels, ferric reducing ability of plasma (FRAP) and serum beta-carotene] and endocrine parameters [plasma thyroxine (T4), triiodothyronine (T3), insulin-like growth factor (IGF-I) and insulin levels] were measured. In summer, two cows were excluded from the study because of metritis and none of the remaining animals became pregnant, but 6 of the 8 cows had irregular luteal forms (ILF) on their ovaries. In winter, one cow was excluded because of metritis and 6 of the 9 cows became pregnant, while 2 of the 3 open cows had irregular luteal forms. In summer the mean plasma NEFA and BHB concentrations were significantly higher, while serum carotene and plasma IGF-I concentrations were significantly lower than in winter. The high plasma NEFA concentration found in summer seemed to be in association with the lower body condition score (BCS) caused by depressed appetite. In conclusion, statistical analysis supports the hypothesis that increased plasma NEFA and BHB and decreased plasma IGF-I concentrations may result in reduced fertility in summer. These changes may be associated with the more frequent appearance of ILFs and probably have a negative effect on ovarian function and/or oocyte quality.

Yellow Corneal Ring Associated with Vitamin Supplementation for Age-Related Macular Degeneration

To report the first described cases of peripheral yellow corneal rings secondary to vitamin supplementation for age-related macular degeneration (ARMD). Retrospective single-center case series. The eyes of 4 patients taking vitamin supplementation for ARMD were examined at the University of Pittsburgh Medical Center Department of Ophthalmology between January 2010 and April 2011. We reviewed the medical records of 4 patients with peripheral corneal rings receiving vitamin supplementation for ARMD. The presence of peripheral yellow corneal rings, skin findings, and serum carotene levels. Each patient had circumferential, yellow, peripheral corneal rings and exhibited subtle yellowing of the skin most notable on the palms. Serum carotene levels were normal in 2 of the 3 patients and markedly elevated in the last patient in whom it was measured. It is unclear at this time how to counsel patients with this ocular finding. We suspect that these rings are more common than generally appreciated because they may have a subtle appearance or be misdiagnosed as arcus senilis. We suggest that a formal study be performed on a cohort of patients taking vitamin supplementation for macular degeneration that specifically screens for yellow rings and measures serum carotene levels when they are identified.

The Effect of β-Carotene Supplementation on the Pharmacokinetics of Nelfinavir and Its Active Metabolite M8 in HIV-1-infected Patients

β-Carotene supplements are often taken by individuals living with HIV-1. Contradictory results from in vitro studies suggest that β-carotene may inhibit or induce cytochrome P450 enzymes and transporters. The study objective was to investigate the effect of β-carotene on the steady-state pharmacokinetics of nelfinavir and its active metabolite M8 in HIV-1 infected individuals. Twelve hour nelfinavir pharmacokinetic analysis was conducted at baseline and after 28 days of β-carotene supplementation (25,000 IU twice daily). Nelfinavir and M8 concentrations were measured with validated assays. Non-compartmental methods were used to calculate the pharmacokinetic parameters. Geometric mean ratios comparing day 28 to day 1 area under the plasma concentration-time curve (AUC0–12 h), maximum (Cmax) and minimum (Cmin) concentrations of nelfinavir and M8 are presented with 90% confidence intervals. Eleven subjects completed the study and were included in the analysis. There were no significant differences in nelfinavir AUC0–12 h and Cmin (−10%, +4%) after β-carotene supplementation. The M8 Cmin was increased by 31% while the M8 AUC0–12 h and Cmax were unchanged. During the 28 day period, mean CD4+ % and CD4+:CD8+ ratio increased significantly (p < 0.01). β-carotene supplementation increased serum carotene levels but did not cause any clinically significant difference in the nelfinavir and M8 exposure.

Stability of Serum Carotene at Various Light and Temperature Conditions

To the Editor.—Carotenoids are brightly colored plant pigments that are essential for several metabolic functions including cell growth regulation and immune response. Carotene (previtamin A) is a slowly absorbed, fat-soluble, carotenoid pigment normally present in the diet. Serum carotene levels are used to determine the possibility of absorption defects that can lead to malabsorption. Decreased carotene levels are seen in several malabsorption syndromes, including, but not limited to, some pancreatic diseases, sprue, post–small intestine resection, and celiac disease.1Fat-soluble vitamins, such as carotene, are generally considered highly unstable when exposed to light, air, and ambient temperature.2 Therefore, serum carotene samples that are referred to core laboratories from satellite sites are required to be shipped frozen and protected from light at all times of handling and analysis. Recent studies indicate that fat-soluble vitamins, including carotene concentrations in whole blood, change insignificantly when stored for up to 7 days at room temperature in dark or light conditions; however, stability data for serum carotene remain scarce.3,4We prepared 5 different serum pools from healthy adult volunteers and from 7-day-old leftover laboratory specimens within our laboratory. Aliquots of 600 µL from each pool were maintained at various light and temperature conditions: room temperature–dark, room temperature–light, refrigerated-dark, refrigerated-light, frozen (−30°C)-dark, and frozen (−70°C)-dark for durations of 1 to 14 days. At the end of the timed conditions (Day 0, 1, 3, 7, 10, 14), the appropriate aliquots were removed and stored at −70°C until analysis. Serum carotene was then extracted with petroleum ether and analyzed using spectrophotometry at a wavelength of 440 nm. The procedure was performed under minimal lighting conditions. The stability of carotene under each storage condition was determined by calculating the percentage change in concentration from those of day 0, then calculating the mean percentage change (and standard error of the mean) of the 5 pools at each time point. Data were analyzed by 1-way analysis of variance using SPSS (Chicago, Illinois) and a P value < .05 was considered statistically significant.The analytic imprecision of this carotene assay is 6.6% at levels of 96.6 µg/dL (1.8 µmol/L) and 155.7 µg/dL (2.9 µmol/L). Carotene levels of the 5 serum pools ranged from 134.2 µg/dL (2.50 µmol/L) to 230.9 µg/dL (4.3 µmol/L). Serum stored at −70°C for 14 days (the end of study controls) demonstrated a minimal average change of only 3.04% compared with those measured freshly at day 0. Samples stored in the room temperature–light condition for 10 and 14 days demonstrated a significant decrease of 24.5% (P = .02) and 28.3% (P = .01) respectively in carotene levels when compared with the end-of-study controls. Except for room temperature, storage conditions did not induce clinically significant changes in serum carotene (Table).In conclusion, serum carotene levels are stable when stored at 4°C (in dark or light) or in the freezer for up to 14 days. Carotene stability is also acceptable at room temperature–dark for 7 days or room temperature–light for 3 days. In addition, repeated freezing to −70°C and thawing has been demonstrated to have no significant effects (less than 1% per freeze-thaw cycle) on the serum and plasma carotene concentrations.5 These results allow for less stringent storage, shipping, and handling conditions for serum carotene specimens.

Serum Immunoglobulin Free Light Chain in Primary Amyloidosis: Prognostic Value and Correlations with Clinical Features

Background: Immunoglobulin free light chains (FLC) form the substrate for synthesis of amyloid fibrils in patients with AL amyloidosis. Development of FLC assay (Freelite) has allowed us to better assess the clonal cell burden in patients with AL amyloid. The relationship of the light chain types and their levels in serum to the clinical feature at presentation and the eventual outcome has not been systematically studied.Methods: We identified 730 patients with biopsy proven AL amyloidosis, who were seen at Mayo Clinic between January 1980 and July 2006, who were seen within 90 days of their diagnosis and in whom FLC levels were performed or had stored serum available for analysis. Cardiac biomarkers (cTnT, NT ProBNP) were also performed on stored serum for some of the patients as part of previous studies. Clinical data and follow up status are prospectively collected into the Dysproteinemia database, which was used for the study.Results: The median age of the study population was 63 years (range; 32–90) and 463 patients (63%) were male. The median estimated survival for the entire group was 37 months from diagnosis and the median follow up for the 263 patients (37%) alive at the time of the analysis was 27.8 months (range; 1–177 months). The plasma cell clone was lambda in 528 patients (72%) and kappa in 202 (28%) patients. The median absolute difference between the FLCs was 19.6 mg/dL for the entire group (range; 0.01–2478); for the kappa patients was 29.4 mg/dL (range; 0.01–1359) and for the lambda patients was 18.2 mg/dL (range; 0.03–2478). Kappa AL was associated with more involvement of the GI tract and liver as indicated by higher alkaline phosphatase (1.8 vs. 1.3 fold; P=0.03), higher total bilirubin (0.95 vs. 0.78 mg/dL, P = 0.04) and lower serum carotene (119 vs. 155 ug/dL; P = 0.0002). On the contrary, renal involvement was more in the lambda AL with the 24 hour urinary albumin higher in the lambda AL (2.4 gm vs. 1.4 gm; P = 0.0002) and lower serum albumin (2.77 vs. 2.97 mg/dL; P = 0.001). While there was no difference in the overall survival (OS) between the kappa and lambda AL, the median OS for those without a heavy chain was significantly shorter (12.6 months vs. 29.9 months; P= 0.01) compared to those with a heavy chain identified. There was also a correlation between high FLC difference and degree of organ involvement, especially cardiac. Among the 202 kappa AL patients, the median survival for those with a high FLC difference ( > 29.4 mg/dL) was 13 months vs. 48.8 months for those with low difference (P = 0.001). Similarly among the 528 patients with lambda AL, those with high difference (> 18.2 mg/dL) had a median OS of 9.3 months compared to 33 months for those with low difference (P < 0.0001) (Figure). The FLC difference was independent of the cTnT, NT Pro BNP, uric acid and fold-increase in alkaline phosphatase, all of which were significant in the multivariable analysis.Conclusions: The type of FLC impacts the spectrum of organ involvement, with gastrointestinal involvement observed more frequently with kappa, and renal involvement with lambda FLC. The FLC burden correlates with the degree of organ involvement, and is a significant predictor of overall survival in AL amyloidosis. Lambda FLC exerts similar effect as kappa FLCs, but at lower levels confirming the increased “amyloidogenicity” of lambda FLC. Finally, lack of a chaperone heavy chain is associated with a poorer outcome. [Display omitted]

Safety Aspects and Cholesterol-Lowering Efficacy of Chitosan Tablets

Objective: The purpose of this study was to determine the effect of two different doses of chitosan on serum fat-soluble vitamin concentrations, cholesterol concentrations, and other safety parameters.Methods: A total of 65 men and women consumed 0, 4.5, 6.75 g per day of chitosan or 6.75 g per day glucomannan for eight weeks in a parallel, placebo-controlled, single-blind study. Altogether, 56 participants completed the study.Results: No differences were detected among the treatments in serum vitamins (vitamin A, vitamin E, 25-hydroxyvitamin D), carotenes (α- and β-carotene), clinical chemistry or hematology measurements. The changes in the total and LDL-cholesterol concentrations among the study groups were not statistically significant.Conclusion: In the present study, the consumption of chitosan tablets was found to be safe, but there was no significant effect on cholesterol concentration.

Oral β carotene therapy in actinic reticuloid and solar urticaria

SUMMARY It is very difficult to find effective, acceptable protective agents for patients who are sensitive to long wave ultraviolet (UV) and visible radiation. It has recently been reported that oral β carotene is a useful photoprotective agent in erythropoietic protoporphyria (EPP) where sensitivity to visible light is important. The action of this drug has therefore been investigated in other diseases where sensitivity to the same part of the spectrum exists. Two patients with actinic reticuloid and three with solar urticaria, all sensitive to long wave UV and visible radiation were investigated before, during and after therapy with β carotene. Detailed monochromator tests were carried out and serum carotene and vitamin A levels determined at regular intervals. Therapy was continued from 2 to 12 months. Results showed that there was no objective or subjective evidence of improvement in any of the patients despite high serum carotene levels. Large variations in the dose of radiation required to produce a reaction were seen in all patients and it is essential to take account of this variation when assessing any photoprotective agent. It is possible that the mechanism of photosensitivity in actinic reticuloid and solar urticaria is quite different from that in EPP thus explaining the difference in the reported results of β carotene in the last disease.

Quantitative analyses of β‐carotene and retinol in serum and feces in support of clinical bioavailability studies

Among more than 50 provitamin carotenoids, beta-carotene is the most metabolically active source of retinol. Despite diets rich in fruits and vegetables containing beta-carotene, vitamin A deficiency is the leading cause of blindness and childhood mortality in developing countries. In addition, the uncertainty of beta-carotene bioconversion into vitamin A suggests that new data are needed to update the nutritional guidelines in developed countries. Previously, we reported the development of a carotene/retinol plateau isotopic enrichment method (CarRet PIE) for the determination of beta-carotene bioavailability and bioconversion into retinol, which utilizes positive ion atmospheric pressure chemical ionization (APCI) liquid chromatography/mass spectrometry (LC/MS). While seeking to validate the CarRet PIE using a mass balance approach requiring fecal measurements of beta-carotene and retinol, interference was encountered that required substantial modifications of the LC/MS assay. Here we report a new LC/MS assay that is based on the detection of molecular anions of beta-carotene using negative ion APCI with a reversed-phase C30 column for HPLC separation. Sample preparation required saponification to eliminate interfering triglycerides. The limit of detection (LOD) of beta-carotene was 0.25 pmol calculated on the basis of an injection of 20 microL of 0.0125 microM beta-carotene, and the limit of quantitation (LOQ) was 1.0 pmol based on the injection of 20 microL of 0.050 microM beta-carotene. The linear range was 1.1 to 2179 pmol on-column. The wide linear range and low LOD and LOQ of this assay facilitated the sensitive and selective quantitative analysis of beta-carotene in both serum and fecal samples in support of an on-going clinical investigation of beta-carotene bioavailability and bioconversion into vitamin A.

A community randomized controlled clinical trial of mixed carotenoids and micronutrient supplementation of patients with acquired immunodeficiency syndrome

This clinical trial aims to evaluate if natural mixed carotenoids supplementation can improve the health and survival of acquired immunodeficiency syndrome (AIDS) patients. A placebo-controlled, prospective, randomized, double-blind, multicenter clinical trial. Community, tertiary care human immunodeficiency virus (HIV) clinics of the Canadian HIV Trials Network (CTN). Three hundred and thirty-one adults with advanced AIDS on conventional management were recruited during routine clinic visits. All participants, including 166 controls, received daily oral specially formulated multivitamins including vitamin A and trace elements; 165 treatment group participants received additional daily oral natural mixed carotenoids, equivalent to 120,000 IU (72 mg) of beta-carotene daily. Follow-up was quarterly at routine clinic visits. Mean (s.d.) follow-up was for 13 (6) months. Thirty-six participants died by 18 months. Serum carotene concentration <1.0 micromol/l was present in 16% participants at baseline. Despite variation in carotene content of the treatment medication, serum carotene concentrations increased significantly to twice the baseline levels to 18 months follow-up in participants who received carotenoids treatment compared with controls (P < 0.0001). Although not statistically significant, mortality was increased in participants who did not receive carotenoids treatment compared with those who did (HR time to death 1.76, 95% CI 0.89, 3.47, P = 0.11). In multivariate analysis, survival was significantly and independently improved in those with higher baseline serum carotene concentrations (P = 0.04) or higher baseline CD4 T-lymphocyte counts (P = 0.005). Adjusted mortality was also significantly and independently increased in those who did not receive carotenoids treatment compared with those who did (HR time to death 3.15, 95% CI 1.10, 8.98, P = 0.03). Low serum carotene concentration is common in AIDS patients and predicts death. Supplementation with micronutrients and natural mixed carotenoids may improve survival by correction of a micronutrient deficiency. Further studies are needed to corroborate findings and elucidate mechanism of action.

Rubin et al. Relationship of serum antioxidants to asthma prevalence in youth. Am J Respir Crit Care Med 2004;169:393-8

Inconsistent findings have been reported in previous studies intended to determine whether antioxidants play a protective role in asthma. This study investigated a group of children analyzed in the third National Health and Nutrition Examination Survey. An inverse association between serum antioxidant levels and asthma was found, particularly when children were exposed to environmental tobacco smoke. In such tobacco-exposed children, increasing serum selenium levels were associated with the most prominent decrease in asthma risk (50%), whereas increased serum carotene and increased vitamin C levels were associated with a 40% reduction in asthma. This association was less impressive in children without tobacco smoke exposure. The authors concluded that the level of antioxidants in the body might be a factor in protection against damaging effects on lung tissue of oxidants present in the environment, particularly in tobacco smoke. However, it is not yet clear whether the serum antioxidant levels described were present before onset of the asthma. Inconsistent findings have been reported in previous studies intended to determine whether antioxidants play a protective role in asthma. This study investigated a group of children analyzed in the third National Health and Nutrition Examination Survey. An inverse association between serum antioxidant levels and asthma was found, particularly when children were exposed to environmental tobacco smoke. In such tobacco-exposed children, increasing serum selenium levels were associated with the most prominent decrease in asthma risk (50%), whereas increased serum carotene and increased vitamin C levels were associated with a 40% reduction in asthma. This association was less impressive in children without tobacco smoke exposure. The authors concluded that the level of antioxidants in the body might be a factor in protection against damaging effects on lung tissue of oxidants present in the environment, particularly in tobacco smoke. However, it is not yet clear whether the serum antioxidant levels described were present before onset of the asthma.

Development of a simplified method for the simultaneous determination of retinol, alpha-tocopherol, and beta-carotene in serum by liquid chromatography-tandem mass spectrometry with atmospheric pressure chemical ionization.

A new and simple method for the determination of fat-soluble vitamins (retinol, alpha-tocopherol, and beta-carotene) in human serum was developed and validated by using liquid chromatography-tandem mass spectrometry with atmospheric pressure chemical ionization (LC-APCI-MS-MS). Different solvent mixtures were tested to obtain deproteinization and extraction of the analytes from the matrix. As a result, a volume of 240 microL of a 1:1 (v/v) ethanol/ethyl acetate mixture added to 60 microL of serum was found to be suitable for both protein precipitation and antioxidants solubilization, giving the best recovery for all three analytes. Deproteinized samples (20 microL) were injected after dilution, without the need for concentration or evaporation to dryness and reconstruction of the sample. Vitamins were separated on a C-8 column using a 95:5 (v/v) methanol/dichloromethane mixture and ionized in the positive-ion mode; detection was performed in the selected-reaction monitoring mode. Linearity of the LC-APCI-MS-MS method was established over 5 orders of magnitude for retinol and alpha-tocopherol, whereas in the case of beta-carotene it was limited to 4 orders. Lower limits of quantitation were 1.7, 2.3, and 4.1 nM for retinol, alpha-tocopherol, and beta-carotene, respectively. Serum concentrations of retinol, alpha-tocopherol, and alpha+beta-carotene determined in a group of healthy volunteers were 2.48, 38.07, and 0.50 microM, respectively, in samples collected in winter ( n=122) and 2.69, 45.88, and 0.90 microM during summer ( n=66).

Weight loss and anemia caused by bacterial overgrowth in a large jejunal diverticulum

Small bowel diverticulae are relatively uncommon except in the elderly (1–5%), localized to the jejunum (80%), and have few significant complications (10%). We report a case of an elderly male with prolonged diarrhea, severe weight loss (40 lbs.) and anemia secondary to bacterial overgrowth in a large jejunal diverticulum with a prompt response to antibiotics. An 86 year-old male had a 20 year history of three to four, watery, urgent bowel movements per day accompanied by occasional nocturnal fecal incontinence. In the last four years he experienced more than 40 pounds weight loss with early satiety. He denied any abdominal pain, fevers, night sweats, joint pains or travel. His past medical history was significant for benign prostatic hypertrophy, gastroesophageal reflux disease and glaucoma but denied any abdominal surgeries. His medications included Diphenoxylate/ Atropine for the diarrhea, lansoprazole, and multivitamins. Family history was non contributory. Physical examination was unremarkable. Initial diagnostic evaluation included negative stool studies for clostridium difficile, bacterial pathogens or parasites. Laboratory bloodwork revealed a macrocytic anemia and low serum carotene, but was otherwise normal. Endoscopic evaluation revealed atrophic gastritis and pan-diverticulosis on colonoscopy. Enteroscopy revealed a giant proximal jejunal diverticulum, 8–10 cm in length. Biopsies of the diverticulum revealed focal, active cryptitis with partial villous blunting and focal increased intraepithelial lymphocytes. Sterile saline aspiration of the diverticulum revealed 9106 lactose fermenting gram-negative bacilli. A barium small bowel follow through confirmed the large jejunal diverticulum. Hydrogen breath testing revealed an increase in excreted hydrogen from 7 PPM to 107 PPM at 1 hour after 25 grams of oral lactose. The patient was initiated on antibiotic therapy with metronidazole 500 mg three times a day for 6 weeks. On completion of this therapy the patient's diarrhea completely resolved. He gained weight and remained asymptomatic on 6 month follow up. We are presenting this case as an illustration of how a large jejunal diverticulum can result in clinically significant diarrhea, weight loss and anemia secondary to bacterial overgrowth. Review of the literature does not reveal any such cases of a single large diverticulum associated with such significant symptomatology from bacterial overgrowth in the diverticulum.