Vitamin Cocktail Research Articles

Modulating the Wnt Signaling Pathway in Wound Healing: The Potential of L-Carnosine, Zinc Sulfate, and B-Complex Vitamins Cocktail

Background: The process of wound healing is a dynamic event that starts with inflammation, proliferation, and migration of various types of fibroblast cells and aims to restore the integrity and functionality of damaged tissue. One crucial signaling pathway involved in wound healing is the Wnt signaling pathway. This study aimed to investigate the effects of a cocktail consisting of L-carnosine, zinc sulfate, and B-complex vitamins on the modulation of the Wnt signaling pathway during wound healing. Methods: The optimal dosages of L-carnosine, zinc sulfate, and B-complex were used to prepare the cocktail. Then, the cocktail-mediated wound healing was measured through scratch assay on human dermal fibroblast (HDF) cells. Finally, the effects of the cocktail on the expression of SFRP1, SFRP2, SFRP4, MMP7, and RSPO2 genes involved in the Wnt signaling pathway were measured during the wound closure phenomenon by real-time quantitative polymerase chain reaction (RT-qPCR). Results: The scratch assay demonstrated the wound-healing effects of the prepared cocktail on HDF cells. Additionally, the RT-qPCR results showed that the cocktail can activate the Wnt signaling pathway by down-regulating the expression of SFRP1, SFRP2, SFRP4, and MMP7 and up-regulating the expression of RSPO2. Conclusions: The data suggest that the L-carnosine, zinc sulfate, and B-complex vitamin cocktail exhibits wound healing properties by increasing fibroblast proliferation via the activation of the Wnt pathway.

Adult-onset Leigh syndrome due to m.9176T>C mutation with cortical involvement

We describe the case of a 22-year-old female complaining of ophthalmoplegia, which deteriorated with seizure. Leigh syndrome (LS) was diagnosed by identifying the m.9176T>C mutation. She improved with vitamin cocktail therapy plus intravenous methylprednisolone, and had an excellent prognosis. This was the first case of an adult patient with LS presenting with the m.9176T>C mutation and reporting cortical symptoms, which in this case comprised cortical vision loss, and cortical, basal ganglia, and brainstem signal changes on magnetic resonance imaging.

Effects of early growth rate and fat soluble vitamins on glucose tolerance, feed transit time, certain liver and pancreas-related parameters, and their share in intra-flock variation in performance indices in broiler chicken

Three hundred fifty 18-day-old Ross 308 male chicks were used to examine the effects of early growth rate (x̄-3SD, x̄-2SD, x̄-SD, x̄, x̄+SD, x̄+2SD and x̄+3SD) and a fat soluble vitamin (FSV) cocktail on glucose tolerance, whole tract feed transit time (FFT), certain liver, and pancreas related traits as well as their share in intra-flock variance of body weight (BW) at d 42 and feed intake (FI) and feed conversion ratio (FCR) in d 21 to 42 of age. Birds with a greater initial BW (21 d) showed greater FI during d 21 to 42 of age and gained a higher final BW at d 42 of age. The broilers injected with a FSV cocktail consumed more feed with an improved FCR and achieved a noticeable greater BW at d 42 of age compared with the untreated birds (P < 0.05). Blood glucose at 15 min after oral gavageing of a glucose solution was elevated in all birds faster than those with a body weight close to the mean population BW. Lipase activity increased by 9.75% and amylase activity decreased by 14.9% in the birds treated with FSV injections compared with those received no vitamin. Multivariate step-wise regression analysis showed liver percentage as the leading variable accounting for about 75 and 62.77% of BW and FI variance, respectively. Serum cholesterol concentration was the major predictor in a poor model (R2 = 52.07) generated for FCR, explaining 29.3 of the FCR viability (P < 0.150). It was concluded that the slow and fast growing birds within a flock showed the same efficiency in dietary glucose absorbing and blood glucose clearing. The faster-growing birds demonstrated slower FTT. Liver percentage was the major parameter explaining a significant fraction of the intra-flock variance in BW at marketing age and FI during days 21 to 42 d.

NUTRITIONAL MANAGEMENT TO AVOID METABOLIC DECOMPENSATION AT MAJOR SURGERIES IN A PATIENT WITH PROPIONIC ACIDEMIA RELATED CARDIOMYOPATHY: A CASE REPORT

Introduction: Propionic acidemia (PA) is a rare autosomal recessive metabolic disorder, which is rarely associated with cardiomyopathy. Since the serious metabolic decompensation, acidosis, ketonuria, and hyperammonemia, are triggered by catabolic stress such as infection, surgery, or inadequate nutrition, nutritional management is important and contributes to treatment. We report a case with PA related cardiomyopathy who required special nutritional management to prevent metabolic decompensation at implantation and removal of left ventricular assist device (LVAD) and heart transplantation (HTx). Case: A 19-year-old previously healthy man experienced the first episode of heart failure at 16 years of age. He underwent LVAD (Jarvik2000) implantation as bridge to transplantation at 18. He had recurrent LVAD driveline infections and subsequent sepsis triggering acidosis and hyperammonemia 1.5 years after implantation. He was diagnosed with late onset PA and special nutritional management for PA was started. He underwent LVAD removal due to pump infection 2 months later and required inotropes until he underwent HTx at 19 years of age. Nutritional management after LVAD removal and heart transplant, were carefully performed based on the previous experience. To prevent metabolic decompensation triggered by surgical catabolic stress, vitamin cocktail (Vitamin B1, B2, B12, C, and Ubidecarenone), biotin, L-carnitine, and parenteral nutrition consisting of glucose and amino acid were given immediately after surgery. Elevation of blood lactate and ammonia early post-op were resolved by higher glucose intake and lower protein intake and mechanical ventilation was discontinued 5 days after LVAD removal. Therefore, intravenous high dose glucose administration was started the day before HTx and no increase in blood ammonia was observed and he was exutubated 1 days after HTx. After starting oral intake, protein restricted diet and special milk formula for PA without isoleucine, valine, methionine, or threonine were gradually increased. Glucose infusion was continued until he had adequate dietary intake. Medium chain triglyceride (MCT)-oil administration waited for improved ketoacidosis to avoid ketone synthesis. Although lactate slightly increased for several days after surgery, the postoperative course was uneventful. Discussion: In patients with PA related cardiomyopathy, meticulous nutritional management based on pathophysiology of PA is useful to prevent metabolic crisis at major surgery, such as LVAD implantation and HTx.

Features of the course of contemporary intestinal amebiasis

Acute intestinal infections, including intestinal amebiasis, remain a pressing public health problem. Amebiasis still represents an important and partially solved problem to health care. In the Astrakhan region, intestinal amebiasis is being continuously recorded. We analyzed the clinical picture of acute intestinal amebiasis in 150 adult patients dominated by female patients comprising 60.7%, aged 18 to 79 years old, and treated within 2010–2016 at the Regional Infectious Clinical Hospital. All patients were mostly of young and middle age (up to 50 years) — 108 patients. More than 50% of patients were admitted to the hospital within the first three days of the disease. However, in 35 cases (23.3%), late hospitalization was carried out (5 days after the onset). Proper diagnosis was made to 44 patients (29.3%), most commonly diagnosing preliminarily with acute gastroenteritis and acute dysentery. All cases of intestinal amebiasis were confirmed by detecting in the feces of patients with a vegetative form of entamoeba histolytica. The disease was featured with sporadic course, being mostly recorded during the summer-autumn period (78.0%). In 142 patients (94.7%), the moderate severity was observed. Cardiovascular disorders were mainly found in severe amebiasis as well as patients comorbid with cardiovascular diseases. A coprological method was used to confirm the diagnosis. Microscopic examination of feces was carried out immediately after defecation (warm type). A combination therapy was applied to patients with intestinal amebiasis. A great attention was paid to patient nutrition: high-protein sparing diet, grated food. Patients with ulcerative colitis received individualized diet (restricted carbohydrates, exclusion of milk and fiber). Etiotropic therapy was carried out with using 5-nitroimidazole preparations: metronidazole (Trichopol, Flagin, Tiberal), MacGioror, Tinidazole (Phasycin) combined with tetracycline. The treatment included group B vitamin cocktail, methyluracil (suppository), enzymes (creon, mezim, pancreatin), enterosorbents (smecta, polyphepan, enterosgel), antispasmodics (no-spa, drotaverin). Patients were administered with therapeutic microenemas containing furacilin solution, rosehip oil, and sea buckthorn oil. Infusion therapy consisting of polyionic solutions was applied by assessing blood electrolyte level. Fresh frozen plasma and albumin were transfused upon decline of serum protein and albumin level. Packed erythrocytes Erythrocyte mass and hemostatic drugs were injected in case of severe intestinal amebiasis if indicated: dicynone, cryoprecipitate, and calcium preparations. Finally, anemia cases were treated as well. In all cases, the disease outcome was favorable, without any mortality. Complications were noted in the form of intestinal bleeding observed in 6 patients (4.0%), wherein amebiasis proceeded together with ulcerative colitis. Acute intestinal amebiasis is currently featured with typical clinical picture that proceeds with less severe symptoms. Intestinal bleeding was observed in patients with intestinal amoebiasis in combination with ulcerative colitis. Chronization of intestinal amebiasis occurs in single cases (3.9%).

СОВРЕМЕННЫЕ НАПРАВЛЕНИЯ МЕДИКАМЕНТОЗНОЙ ТЕРАПИИ ХРОНИЧЕСКОГО ГЕНЕРАЛИЗОВАННОГО ПАРОДОНТИТА

The review deals with the analysis of modern methods of treatment of chronic generalized parodontitis from the perspective of differentiated principle of treatment of this disease. Particular attention is paid to methods of medical treatment, their diversity on the efficiency and mechanisms of therapeutic effects to select appropriate treatment, taking into account all the individual characteristics of the patient, aetiology, pathogenesis and severity of chronic generalized parodontitis. It has been demonstrated that an important aspect to achieve high efficiency of treatment is a method of drug delivery. The most effective method is a transmembrane dialysis, which makes it possible simultane-ously to obtain the maximum concentration of the therapeutic substances in the inflammatory focus and to eliminate from the inflammatory focus the low-medium weight tissue decomposition products, products of metabolism, while maintaining factors of regeneration and protection against infection. It has been evinced the advantages of sanogenetic therapy using vitamin cocktail and some higher plants BAS containing terpenoids (bornylacetate and its semisynthetic stereoisomer – isobornyl acetate), as the least toxic, having analgesic and anti-bacterial properties comparable with antibiotics, and capable to stimulate repair processes. The good water solubility of these substances provides ample pos-sibility of using these drugs in the form of solutions for rinsing, transmembrane dialysis, as liquid at ultrasonic curettage.

Development of a Single Bovine Embryo Improved by Co-culture with Trophoblastic Vesicles in Vitamin-supplemented Medium

To improve the development of singly cultured bovine embryos, we developed a co-culture method with trophoblastic vesicles. The growth of trophoblastic cells was markedly increased in vitamin-supplemented medium 199 compared with medium 199. Upon co-culture of a single embryo with trophoblastic vesicles in vitamin-supplemented medium 199, embryo development to the blastocyst stage was significantly higher than in embryos co-cultured with trophoblastic vesicles in RPMI 1640 or with cumulus cells in medium 199 (control). In the absence of the vitamin cocktail, co-culture with trophoblastic vesicles in medium 199 did not improve embryo development compared with that of the control. The vitamin cocktail was effective in embryo development when co-cultured with trophoblastic vesicles, but not with cumulus cells. Embryo development was not improved in the absence of co-cultured trophoblastic vesicles, even in the presence of vitamin cocktail. In conclusion, the co-culture system with trophoblastic vesicles in vitamin-supplemented medium 199 efficiently enhances the development of singly cultured embryos.

Oxidative stress during coronary artery by-pass grafting – a vitamin cocktail attenuates ischemia-reperfusion induced oxidative stress – a pilot investigation

Effects of a Protein Optimized Diet Combined with Moderate Resistance Training on the Postoperative Course in Older Patients with Hip Fracture

Epilepsia de inicio entre el mes y los tres meses de vida: nuestra experiencia de 11 años

IntroductionThe prognosis of epilepsy is basically determined by its aetiology. Early onset of seizures is generally associated with poor progress. Material and methodsWe review our experience in epilepsy with children born after 1 January 1997 and who had their first seizure between 1 and 3 months of age before January 2008. ResultsEighteen cases diagnosed with epilepsy and a first seizure between 1 and 3 months of age were included. One case was within the Dravet syndrome spectrum with the c829 T>G c277G heterozygous mutation of the SCN1A gene. Four were cryptogenic epilepsies and thirteen were asymptomatic: 2 were inborn errors of metabolism (biotinidase deficiency with a response to biotin and Leigh's syndrome); 2 were of infectious origin and the remaining nine prenatal encephalopathy. Nine (50%) currently have a severe psychomotor delay and 2 died. The cryptogenic cases had a relatively poor progress. ConclusionsOur experience corroborates the poor prognosis associated with early onset, between 1 and 3 months, of epileptic seizures. Given the wide aetiological range and the poor prognosis in the absence of specific treatment, an appropriate diagnostic-therapeutic strategy is required to avoid diagnostic uncertainties and can identify potentially treatable cases, such as some inborn errors of metabolism. In this age group, the protocol for convulsions of unknown cause must be the same as that for neonatal convulsions, including treatment with a vitamin cocktail, after collecting biological samples.

Epilepsy onset between one month and three months of life: Our 11 years experience

Introduction The prognosis of epilepsy is basically determined by its aetiology. Early onset of seizures is generally associated with poor progress. Material and methods We review our experience in epilepsy with children born after 1 January 1997 and who had their first seizure between 1 and 3 months of age before January 2008. Results Eighteen cases diagnosed with epilepsy and a first seizure between 1 and 3 months of age were included. One case was within the Dravet syndrome spectrum with the c829 T>G c277G heterozygous mutation of the SCN1A gene. Four were cryptogenic epilepsies and thirteen were asymptomatic: 2 were inborn errors of metabolism (biotinidase deficiency with a response to biotin and Leigh's syndrome); 2 were of infectious origin and the remaining nine prenatal encephalopathy. Nine (50%) currently have a severe psychomotor delay and 2 died. The cryptogenic cases had a relatively poor progress. Conclusions Our experience corroborates the poor prognosis associated with early onset, between 1 and 3 months, of epileptic seizures. Given the wide aetiological range and the poor prognosis in the absence of specific treatment, an appropriate diagnostic-therapeutic strategy is required to avoid diagnostic uncertainties and can identify potentially treatable cases, such as some inborn errors of metabolism. In this age group, the protocol for convulsions of unknown cause must be the same as that for neonatal convulsions, including treatment with a vitamin cocktail, after collecting biological samples.

Preventing cell death induced by carbonyl stress, oxidative stress or mitochondrial toxins with vitamin B anti‐AGE agents

Carbonyls generated by autoxidation of carbohydrates or lipid peroxidation have been implicated in advanced glycation end product (AGE) formation in tissues adversely affected by diabetes complications. Tissue AGE and associated pathology have been decreased by vitamin B(1)/B(6) in trials involving diabetic animal models. To understand the molecular cytoprotective mechanisms involved, the effects of B(1)/B(6) vitamers against cytotoxicity induced by AGE/advanced lipid end product (ALE) carbonyl precursors (glyoxal/acrolein) have been compared to cytotoxicity induced by oxidative stress (hydroperoxide) or mitochondrial toxins (cyanide/copper). Thiamin was found to be best at preventing cell death induced by carbonyl stress and mitochondrial toxins but not oxidative stress cell death suggesting that thiamin pyrophosphate restored pyruvate and alpha-ketoglutarate dehydrogenases inhibited by mitochondrial toxicity. However, B(6) vitamers were most effective at preventing oxidative stress or lipid peroxidation cytotoxicity suggesting that pyridoxal or pyridoxal phosphate were antioxidants and/or Fe/Cu chelators. A therapeutic vitamin cocktail could provide maximal prevention against carbonyl stress toxicity associated with diabetic complications.

Pre‐operative delivery of a vitamin cocktail diminished oxidative stress after vascular surgery in PAD patients — a pilot investigation

BioFactorsVolume 24, Issue 1-4 p. 299-303 Article Pre-operative delivery of a vitamin cocktail diminished oxidative stress after vascular surgery in PAD patients — a pilot investigation W. Wonisch, W. Wonisch Department of Laboratory Medicine, University Medical Center, Graz, AustriaSearch for more papers by this authorK. Uhl, K. Uhl Department of Surgery, Medical Center, Leoben, AustriaSearch for more papers by this authorW. Schimetta, W. Schimetta Institute of Systems Sciences, University of Linz, AustriaSearch for more papers by this authorH. Rabl, Corresponding Author H. Rabl hans.rabl@lkh-leoben.at Department of Surgery, Medical Center, Leoben, AustriaHans Rabl, M.D., Professor of Surgery, Department of Surgery, Medical Center Leoben, Vordernberger Strasse 42, A-8700 Leoben, Austria. Tel.: +43 3842 401 2310Search for more papers by this author W. Wonisch, W. Wonisch Department of Laboratory Medicine, University Medical Center, Graz, AustriaSearch for more papers by this authorK. Uhl, K. Uhl Department of Surgery, Medical Center, Leoben, AustriaSearch for more papers by this authorW. Schimetta, W. Schimetta Institute of Systems Sciences, University of Linz, AustriaSearch for more papers by this authorH. Rabl, Corresponding Author H. Rabl hans.rabl@lkh-leoben.at Department of Surgery, Medical Center, Leoben, AustriaHans Rabl, M.D., Professor of Surgery, Department of Surgery, Medical Center Leoben, Vordernberger Strasse 42, A-8700 Leoben, Austria. Tel.: +43 3842 401 2310Search for more papers by this author First published: 19 December 2008 https://doi.org/10.1002/biof.5520240135Citations: 6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume24, Issue1-42005Pages 299-303 RelatedInformation

Combined l-arginine and antioxidative vitamin treatment mollifies ischemia-reperfusion injury of skeletal muscle

Enhanced production of superoxide in l-arginine–depleted environments and concomitant reduction of nitric oxide (NO) concentration are involved in ischemia-reperfusion (I/R) injury. Treatment with l-arginine or antioxidative vitamins alone and in combination was used to mollify I/R injury in skeletal muscle. Untreated rabbits were compared with those treated with l-arginine/antioxidative vitamin cocktail Omnibionta only, or a combination of l-arginine/ antioxidative vitamins during hind limb I/R (2.5 hours/2 hours). NO was continuously measured in vivo. Plasma malondialdehyde (MDA) served as the measure of oxygen free radical formation. Interstitial edema formation, microvessel diameter alterations, microvessel plugging, and blood flow changes were used as indicators of I/R injury. The MDA level in untreated animals 2 hours after reperfusion was significantly higher than in control animals (0.81 μmol/L ± 0.14 μmol/L vs 0.57 μmol/L ± 0.11 μmol/L; P < .05), indicating enhanced production of oxygen free radicals. This sequela paralleled the decreasing concentration of NO, which dropped below the detection limit (1 nmol/L) after reperfusion. Microvascular changes during I/R injury were expressed as a 40% decrease in microvessel diameter and adhesion of neutrophils in 20% of microvessels, which led to a consequent 60% reduction in blood flow, demonstrating “no reflow” (reperfusion failure after restoration of blood flow). The increase in the fraction of muscle interfiber area by 85% indicated prominent edema formation. Treatment with antioxidative vitamins alone had a minimally positive effect on edema formation and microvascular plugging, possibly by suppression of oxygen free radical production, as expressed by the reduction in plasma MDA levels. However, this therapy failed to preserve basal NO production and to protect from microvascular constriction and no reflow. Treatment with l-arginine alone had a stronger protective effect, maintaining basal NO production, further reduction of neutrophil plugging, abolition of microvascular constriction, and no reflow. The combination of antioxidative vitamins and l-arginine was the best treatment against I/R injury, expressed not only by the protection of microvessel constriction, but also by abolition of microvascular plugging, increase in NO production (68 nmol/L ± 5 nmol/L) over the basal level (52 nmol/L ± 7 nmol/L), and higher blood flow, as compared with treatment with l-arginine or antioxidative vitamins alone.

A complex of antioxidant vitamins effectively inhibits free-radical oxidation of LDL phospholipids in blood plasma and membrane structures of the liver and myocardium.

Antioxidant effect of a complex preparation including antioxidant vitamins C, E, provitamin A and selenium was studied on the model of Cu(2+)-initiated free-radical oxidation of LDL isolated from human blood plasma. The antioxidant effect of combined administration of alpha-tocopherol+ascorbic acid and alpha-tocopherol+beta-carotene is far more pronounced that the antioxidant effect of individual components of these cocktails. Moreover, in the model system the combined action of all antioxidant components completely inhibited free-radical oxidation of LDL. A 30-day course of peroral administration of antioxidant vitamin cocktail and selenium to rats pronouncedly enhanced the antioxidant potential of liver and completely suppressed free-radical processes in the myocardium. It is suggested that preparations containing antioxidant vitamins and selenium can be perspective for prevention and complex therapy of atherosclerosis.

Improving ethanol production and viability of Saccharomyces cerevisiae by a vitamin feeding strategy during fed-batch process.

Several bottlenecks in the alcoholic fermentation process must be overcome to reach a very high and competitive performance of bioethanol production by the yeast Saccharomyces cerevisiae. In this paper, a nutritional strategy is described that allowed S. cerevisiae to produce a final ethanol titre of 19% (v/v) ethanol in 45 h in a fed-batch culture at 30 degrees C. This performance was achieved by implementing exponential feeding of vitamins throughout the fermentation process. In comparison to an initial addition of a vitamin cocktail, an increase in the amount of vitamins and an exponential vitamin feeding strategy improved the final ethanol titre from 126 g l(-1) to 135 g l(-1) and 147 g l(-1), respectively. A maximum instantaneous productivity of 9.5 g l(-1) h(-1) was reached in the best fermentation. These performances resulted from improvements in growth, the specific ethanol production rate, and the concentration of viable cells in response to the nutritional strategy.

THE MRC/BHF HEART PROTECTION STUDY: PRELIMINARY RESULTS

SUMMARYThe Heart Protection Study (HPS), with over 20,500 subjects, is the largest trial of statin therapy ever conducted. It provides important and definitive new information on women, the elderly, diabetics, and people with low baseline cholesterol pre‐treatment and those with prior occlusive non‐coronary vascular disease. It is a prospective double blind randomised controlled trial with a 2×2 factorial design investigating prolonged use (&gt;5 years) of simvastatin 40 mg and a cocktail of antioxidant vitamins (650 mg vitamin E, 250 mg vitamin C and 20 mg beta‐carotene). The HPS specifically included patients with high risk for coronary heart disease (CHD) but characteristics that excluded them from participation in previous statin trials. Simvastatin 40 mg treatment showed benefit across all patient groups regardless of age, gender or baseline cholesterol value and proved safe and well tolerated. Results show a 12% reduction in total mortality, a 17% reduction in vascular mortality, a 24% reduction in CHD events, a 27% reduction in all strokes and a 16% reduction in non‐coronary revascularisations. Among high‐risk patients in this western population (with a minimum total cholesterol [TC] ≥3.5 mmol/l at entry) there appears to be no threshold cholesterol value below which statin therapy is not associated with benefit; even among those with pre‐treatment cholesterol levels below current national recommended targets. Over the 5.5 year study period patients and their doctors were encouraged to add an active non‐study statin to the study regimen if they wished to do so. Thus the trial eventually had only two‐thirds complying with the original intention‐to‐treat design. Nevertheless, results were highly significant for the study statin – simvastatin 40 mg once daily. Preliminary results of the HPS are negative for the antioxidant vitamin cocktail but provide reassurance that vitamins do no harm.

Effect of niacin, warfarin, and antioxidant therapy on coagulation parameters in patients with peripheral arterial disease in the Arterial Disease Multiple Intervention Trial (ADMIT)

Background Patients with peripheral arterial disease (PAD) have high rates of cardiovascular morbidity and mortality, including that caused by associated coronary heart disease and cerebrovascular disease. Previous studies have shown that coagulation parameters are altered in PAD and that altered coagulation may play a critical role in the susceptibility to cardiovascular complications in PAD. It is therefore important to assess the effect of secondary prevention measures on coagulation in patients with PAD. The Arterial Disease Multiple Intervention Trial (ADMIT), a multicenter, randomized, placebo-controlled trial, was conducted to determine the feasibility of a combined lipid-modifying, antioxidant, and antithrombotic treatment regimen in patients with PAD. The objective of this study was to assess the effect of the ADMIT interventions on coagulation. Methods ADMIT participants were randomly assigned to low-dose warfarin, niacin, and antioxidant vitamin cocktail or corresponding placebos in a 2 × 2 × 2 factorial design. Specialized coagulation studies were performed in a subset of 80 ADMIT participants at baseline and after 12 months of treatment. Results Low-dose warfarin (1 to 4 mg/d) resulted in a significant decrease in factor VIIc (P < .001) and in plasma F1.2 (P = .001). Unexpectedly, niacin treatment also resulted in significant decrease in both fibrinogen (48 mg/dL; P < .001) and F1.2 (P = .04). von Willebrand factor increased after antioxidant vitamin treatment (P = .04). Conclusions A regimen of low-dose warfarin effectively modifies coagulation in patients with PAD. Niacin also favorably modifies fibrinogen and plasma F1.2. Niacin, in addition to its lipid effects, modifies abnormal coagulation factors that accompany PAD. (Am Heart J 2000;140:631-6.)

Ascorbate is depleted by smoking and repleted by moderate supplementation: a study in male smokers and nonsmokers with matched dietary antioxidant intakes

Lack of reliable dietary data has hampered the ability to effectively distinguish between effects of smoking and diet on plasma antioxidant status. As confirmed by analyses of comprehensive food-frequency questionnaires, the total dietary intakes of fruit and vegetables and of dietary antioxidants were not significantly different between the study groups in the present study, thereby enabling isolation of the effect of smoking. Our objective was to investigate the effect of smoking on plasma antioxidant status by measuring ascorbic acid, alpha-tocopherol, gamma-tocopherol, beta-carotene, and lycopene, and subsequently, to test the effect of a 3-mo dietary supplementation with a moderate-dose vitamin cocktail. In a double-blind, placebo-controlled design, the effect of a vitamin cocktail containing 272 mg vitamin C, 31 mg all-rac-alpha-tocopheryl acetate, and 400 microg folic acid on plasma antioxidants was determined in a population of smokers (n = 37) and nonsmokers (n = 38). The population was selected for a low intake of fruit and vegetables and recruited from the San Francisco Bay area. Only ascorbic acid was significantly depleted by smoking per se (P < 0.01). After the 3-mo supplementation period, ascorbic acid was efficiently repleted in smokers (P < 0.001). Plasma alpha-tocopherol and the ratio of alpha- to gamma-tocopherol increased significantly in both supplemented groups (P < 0.05). Our data suggest that previous reports of lower concentrations of plasma vitamin E and carotenoids in smokers than in nonsmokers may primarily have been caused by differences in dietary habits between study groups. Plasma ascorbic acid was depleted by smoking and repleted by moderate supplementation.

Antigoitrogenic effect of combined supplementation with dl-alpha-tocopherol, ascorbic acid and beta-carotene and of dl-alpha-tocopherol alone in the rat.

The effects of the vitamins dl-alpha-tocopherol, ascorbic acid and beta-carotene, free radical scavengers and lipid peroxidation inhibitors, were analyzed in male Wistar rats made goitrous by feeding a low iodine diet (< 20 micrograms iodine/kg) and perchlorate (1% in drinking water) for 4, 8, 16, and 32 days. Groups of control or goitrous rats received for at least 16 days before killing a diet containing 0.6% vitamin E (as dl-alpha-tocopherol acetate), 1.2% vitamin C (ascorbic acid) and 0.48% beta-carotene, either simultaneously (vitamin cocktail) or separately. This treatment led to a 5-fold increase of vitamin E in the thyroid gland, a 24-fold increase in the liver and a 3-fold increase in the plasma. In control rats, vitamin cocktail administration increased slightly the thyroid weight with little changes in thyroid function parameters. During iodine deficiency, administration of the vitamin cocktail or vitamin E alone reduced significantly the rate of increase in thyroid weight, and DNA and protein contents, as well as the proportion of [3H]thymidine labeled thyroid follicular cells, but not that of labeled endothelial cells. Plasma tri-iodothyronine, thyroxine, TSH levels, thyroid iodine content and concentration as well as relative volumes of glandular compartments were not modified. The proportion of necrotic cells rose from 0.5% in normal animals to about 2% after 16 days of goiter development. No significant protective effect of the vitamins was observed. These results suggest that these vitamins, particularly vitamin E, modulate one of the regulatory cascades involved in the control of thyroid follicular cell growth, without interfering with the proliferation of endothelial cells.

Antioxidative vitamin treatment: effect on lipid peroxidation and limb swelling after revascularization operations.

The objective of this study was to evaluate the antioxidative properties of the multivitamin cocktail Omnibionta (alpha-tocopherol, ascorbic acid, retinol, vitamin B complex) in terms of diminishing lipid peroxidation with improvement of leg edema performance after limb revascularization operations in humans. Fifty-one subjects were selected; the control group contained 27 patients and the treatment group 24 patients, who received the vitamin cocktail intravenously before the start of reperfusion. All patients suffered from acute or chronic arterial occlusive disease, except two subjects with arterial trauma. MDA-TBARS in plasma, quantified by HPLC, taken as a measure of lipid peroxidation was significantly increased (p < 0.001) in the control group 1 hour after reperfusion onset and decreased to its baseline value within the following 2 hours (0.73 +/- 0.26, 1.21 +/- 0.48, 0.99 +/- 0.48, 0.73 +/- 0.33 nmol/ml). In contrast, in the treatment group MDA-TBARS did not exceed the baseline value during the reperfusion period (0.93 +/- 0.30, 0.70 +/- 0.29, 0.65 +/- 0.23, 0.70 +/- 0.37 nmol/ml). Leg edema, expressed by extremity circumference, was significantly (p < 0.008) elevated in the control group (30.7 +/- 4.04 cm versus 35.35 +/- 4.12 cm) compared to a lack of increase in the treatment group (29.25 +/- 5.13 cm versus 29.76 +/- 5.70 cm). These results suggest that antioxidative vitamin treatment might be valuable in preventing lipid peroxidation and decreasing extremity edema.