Evaluating the Effects of an Ophthalmic Solution of Coenzyme Q10 and Vitamin E in Open-Angle Glaucoma Patients: A Study Protocol

Quaranta L, Riva I, Biagioli E, Rulli E, Rulli E, Poli D, Legramandi L

Adv Ther. 2019 Sep;36(9):2506-2514. doi: 10.1007/s12325-019-01023-3. Epub 2019 Jul 12.

Abstract

INTRODUCTION:

The CoQun^® study is a multicenter, controlled trial aimed to evaluate the neuroprotective effects of Coqun^®, an ophthalmic solution of Coenzyme q10 (CoQ10) and Vitamin E (VitE), in patients affected by primary open-angle glaucoma (POAG). Pre-clinical studies and small non-controlled clinical trials have previously shown a potential role of CoQ10 and VitE in glaucoma neuroprotection, both in vitro and in vivo.

METHODS:

Randomized, parallel arm, multicenter, double-blind study. POAG patients with an IOP ranging from 17 to 21 mm Hg on monotherapy with a prostaglandin analogue (PGA) will be considered for study enrollment. Inclusion criteria will be visual field (VF) mean deviation between – 4 and – 10 dB and VF Pattern Standard Deviation between 4 and 10 dB. Eligible patients will be randomized to receive CoQun^® (Arm A) or placebo (Arm B), in addition to PGA monotherapy.

PLANNED OUTCOMES:

Primary outcome will be time to progression, defined as the time between the baseline visit and the visit with confirmed VF progression. A total of 612 patients are planned to be enrolled, to detect a hazard ratio of 0.65, with a power of 80% and an alpha error of 0.05 (two-sided). For study power calculation, 10% non-evaluable patients are assumed. This is the first study investigating, in a randomized, double-blind and controlled fashion, the neuroprotective effects of CoQ10 and VitE in POAG patients.

Wang H, Geng H, Tang H, Wang L, Yu D, Wang J, Song Y

J Oleo Sci. 2019 Sep 4;68(9):881-891. doi: 10.5650/jos.ess19060.

Abstract

Enzyme-assisted aqueous extraction of rice germ oil (RGO) was performed in this study. The physicochemical properties, fatty acid composition, bioactive substances and antioxidant activity of RGO were analyzed. An enzyme composed of alcalase and cellulase (1:1, w/w) was found to be the most effective in the extraction yield of oil. The optimal oil yield of 22.27% was achieved under the conditions of an enzyme concentration of 2% (w/w), incubation time of 5 h, incubation temperature of 50°C, water to seed ratio of 5:1, and pH 6.0. The predominant fatty acids of RGO were oleic acid (39.60%), linoleic acid (34.20%) and palmitic acid (20.10%). The total saturated fatty acid (SFA), monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA) composition of RGO were 22.50%, 39.60% and 36.00%, respectively. RGO yielded a high content of γ-oryzanol (530 mg/100 g oil), tocotrienol (62.96 mg/100 g oil), tocopherol (23.24 mg/100 g oil) and a significant amount of phytosterol (372.14 mg/100 g oil). It exhibited notable antioxidant activities with IC₅₀ values of 32.37 and 41.13 mg/mL, according to the DPPH radical scavenging assay and β-carotene/linoleic acid bleaching test, respectively.

Saw TY, Malik NA, Lim KP, Teo CWL, Wong ESM, Kong SC, Fong CW, Petkov J, Yap WN

J Nutr Sci Vitaminol (Tokyo). 2019;65(4):318-327. doi: 10.3177/jnsv.65.318.

Abstract

Ulcerative colitis (UC) is characterized by damaged colonic mucosa and submucosa layers that are caused by excessive inflammatory reactions and oxidative stress. This study aimed to examine the use of tocotrienol-rich fraction (TRF) in mitigating damages caused by UC on the colon epithelium. Dextran sulfate sodium (DSS)-induced UC mice were treated with vehicle control, TRF, alpha-tocopherol (αTP) and 5-aminosalicylic acid (5-ASA). Observable clinical signs, quality of stool, histopathological scoring, inflammatory and oxidative markers were assessed. Vitamin E levels of colons and plasma were quantified. Oral supplementation of TRF significantly reduced the severity of DSS-induced UC by lowering the disease activity index (DAI) and histopathological inflammatory scoring. TRF also attenuated the DSS-induced enlargement of spleen and shortening of the colon. TRF has demonstrated marked anti-inflammatory and antioxidative properties indicated by the attenuation of DSS-induced upregulation of inflammation and oxidative stress markers including interleukin (IL)-6, IL-17, tumor necrosis factor (TNF)-α, myeloperoxidase (MPO), cyclooxygenase-2 (COX-2), nitric oxide (NO), malondialdehyde (MDA) and pNF-κB. These improvements were similar to that of 5-aminosalicylic acid (5-ASA) treatment. In contrast, αTP did not demonstrate evident clinical and histopathological improvements. The superior protective effect of TRF may be ascribed to the preferential absorption of TRF by the gut mucosa. TRF alleviated the signs and symptoms of acute UC in murine model via the reduction of local inflammatory reactions and oxidative stress. These effects suggested that TRF could serve as a gut health supplement for preventive measures for UC condition in patients.

Machado MR, Kamp F, Nunes JC, El-Bacha T, Torres AG

Nutrients. 2019 Aug 29;11(9). pii: E2025. doi: 10.3390/nu11092025.

Abstract

Our aims were to investigate vitamin A and E status during lactation and the determinants of breast milk content for the appropriate nutrition of the infant in a study with nursing Brazilian women. We hypothesized that both inadequate intake and the lipoprotein distribution of vitamin A and E during lactation could have an impact on their breast milk levels from early- to mid-lactation. Nineteen adult lactating women participated in this longitudinal observational study, in which dietary records, blood and mature breast milk samples were collected for the analysis of vitamin A and E, and carotenoids in early- (2nd to 4th week) and mid-lactation (12th to 14th week). Nutrient intake was balanced by the Multiple Source Method (MSM), and the intake of vitamin A and E was inadequate in 74 and 100% of the women, respectively. However, these results were not reflected in low serum concentrations of retinol and only 37% of the volunteers were vitamin E deficient according to the blood biomarker. As lactation progressed, vitamin A and E status worsened, and this was clearly observed by the decrease in their content in breast milk. The reduced content of vitamin A and E in the breast milk was not related to their distribution in lipoproteins. Taken together, the contents of vitamin A and E in breast milk seemed to be more sensitive markers of maternal nutrition status than respective blood concentrations, and dietary assessment by the MSM in early lactation was sensitive to indicate later risks of deficiency and should support maternal dietary guidance to improve the infant’s nutrition.

Moosavian SP, Arab A, Mehrabani S, Moradi S, Nasirian M

Int J Vitam Nutr Res. 2019 Aug 23:1-11. doi: 10.1024/0300-9831/a000599. [Epub ahead of print]

Abstract

Background: Several studies have investigated the effect of omega-3 fatty acids and vitamin E on oxidative stress and inflammation, but their findings are inconsistent. The aim of this meta-analysis is to elucidate the overall effects of co-supplementation with omega-3 fatty acids and vitamin E on oxidative stress and inflammation. Methods: We searched titles, abstracts, and keywords of relevant articles indexed in PubMed, ISI, Scopus, and Google Scholar databases up to December 2018 to identify eligible RCT studies. Random effects model was used to estimate the pooled effect of co-supplementation with omega-3 fatty acids and vitamin E on oxidative stress and inflammation. Results:Overall, 7 RCTs with 504 participants were included in this meta-analysis. We found that co-supplementation with omega-3 fatty acids and vitamin E decreased hs-CRP (weighed mean difference (WMD) = -2.15 mg/L; 95% CI: -3.40, -0.91 mg/L; P < 0.001) concentrations and increased total antioxidant capacity (TAC) (WMD = 92.87 mmol/L; 95% CI: 31.97, 153.77 mmol/L; P = 0.03), and nitric oxide levels (NO) (WMD: 6.95 μmol/L; 95% CI: 3.86, 10.04, P < 0.001) compared with control group. Omega-3 fatty acids and vitamin E had no significant effect on malondialdehyde (MDA) (WMD: 1.54 mmol/L; 95% CI: -1.29, 4.36; P = 0.196), and glutathione (GSH) (WMD: 20.87 mmol/L; 95% CI: -20.04, 61.6, P = 0.31) levels. Conclusion: The present meta-analysis found that omega-3 fatty acids and vitamin E co-supplementation significantly decreased hs-CRP and increased NO and TAC, although it had no significant effect on MDA and GSH.

Thompson MD, Cooney RV

Nutr Cancer. 2019 Aug 22:1-18. doi: 10.1080/01635581.2019.1653472. [Epub ahead of print]

Abstract

Chronic aging-related diseases result in the greatest burden to the health care system, yet there is little agreement on optimal levels of vitamins or the functional significance of many other dietary molecules in disease prevention. This review presents accumulated information regarding the role of γ-tocopherol in the prevention of nitrogen oxide-mediated damage and its impact on aging-related diseases. γ-Tocopherol is ubiquitous in the diet and levels appear to be physiologically regulated such that levels rise in response to inflammation and deficiencies in certain key vitamins. The unique antioxidant properties of γ-tocopherol, whereby DNA-damaging nitrogen dioxide is rapidly converted to nitric oxide, suggest a mechanistic justification for a functional role in the prevention of DNA damage over time. Data from cell, animal, and human studies indicate that γ-tocopherol appears to have significant beneficial effects, protecting cells from inflammatory damage; however, interpretation of epidemiologic studies is complex due to the paradoxical rise in levels of γ-tocopherol in response to known etiologic risk factors. Current knowledge of its antioxidant mechanism of action, apparent physiological regulation, and impact on various enzymatic pathways suggests γ-tocopherol may have a functional role in maintaining human health. Its utility as a biomarker and the consequences of its deficiency deserve further study.

Kasture V, Sundrani D, Dalvi S, Swamy M, Kale A, Joshi S

Mol Cell Biochem. 2019 Aug 16. doi: 10.1007/s11010-019-03599-4. [Epub ahead of print]

Abstract

Abnormal placental vasculature is associated with preeclampsia. Preeclampsia is of two types, i.e., early- and late-onset preeclampsia (LOP), both having different etiologies. We have earlier demonstrated low levels of omega-3 fatty acids and vitamin E in women with preeclampsia. The current study examines the effect of maternal omega-3 fatty acids and vitamin E supplementation on angiogenic factors in a rat model of preeclampsia. Pregnant rats were divided into a total of five groups control, early-onset preeclampsia (EOP); LOP; EOP supplemented with omega-3 fatty acid and vitamin E and LOP supplemented with omega-3 fatty acid and vitamin E. Preeclampsia was induced by administering L-nitroarginine methylester (L-NAME) at the dose of 50 mg/kg body weight/day. The vascular endothelial growth factor gene expression and protein levels were lower (p < 0.01 for both) in animals from both EOP as well as LOP groups (p < 0.01). In the EOP group, the protein levels of VEGF receptor-1 were also lower (p < 0.01). Supplementation of omega-3 fatty acids and vitamin E to LOP improved the levels of VEGF and VEGF receptor-1 only in the LOP but not in the EOP group. In the EOP group, the gene expression of hypoxia inducible factor 1 alpha (HIF-1α) in the placenta was higher (p < 0.05) and supplementation normalized these levels. Our findings indicate that maternal supplementation of omega-3 fatty acids and vitamin E has differential effect on preeclampsia subtypes.

Fujitaka Y, Hamada H, Uesugi D, Kuboki A, Shimoda K, Iwaki T, Kiriake Y, Saikawa T

Molecules. 2019 Aug 16;24(16). pii: E2975. doi: 10.3390/molecules24162975.

Abstract

Daidzein is a common isoflavone, having multiple biological effects such as anti-inflammation, anti-allergy, and anti-aging. α-Tocopherol is the tocopherol isoform with the highest vitamin E activity including anti-allergic activity and anti-cancer activity. Hesperetin is a flavone, which shows potent anti-inflammatory effects. These compounds have shortcomings, i.e., water-insolubility and poor absorption after oral administration. The glycosylation of bioactive compounds can enhance their water-solubility, physicochemical stability, intestinal absorption, and biological half-life, and improve their bio- and pharmacological properties. They were transformed by cultured Nicotiana tabacum cells to 7-β-glucoside and 7-β-gentiobioside of daidzein, and 3′- and 7-β-glucosides, 3′,7-β-diglucoside, and 7-β-gentiobioside of hesperetin. Daidzein and α-tocopherol were glycosylated by galactosylation with β-glucosidase to give 4′- and 7-β-galactosides of daidzein, which were new compounds, and α-tocopherol 6-β-galactoside. These nine glycosides showed higher anti-allergic activity, i.e., inhibitory activity toward histamine release from rat peritoneal mast cells, than their respective aglycones. In addition, these glycosides showed higher tyrosinase inhibitory activity than the corresponding aglycones. Glycosylation of daidzein, α-tocopherol, and hesperetin greatly improved their biological activities.

Pakdel R, Vatanchian M, Niazmand S, Beheshti F, Rahimi M, Aghaee A, Hadjzadeh MA

Drug Chem Toxicol. 2019 Aug 15:1-8. doi: 10.1080/01480545.2019.1651330. [Epub ahead of print]

Abstract

The present study compared the effects of Portulaca oleracea (P. oleracea) seed hydro-alcoholic extract, valsartan, and vitamin E on hemodynamic changes, oxidative stress markers and cardiac hypertrophy in a model of thyrotoxicosis. The hyperthyroid state was induced by intraperitoneal injection of levothyroxine (100 µg/kg) for 4 weeks in male adult rats. After 2 weeks, vitamin E (20 mg/kg), valsartan (8 mg/kg), and P. oleracea seed extract (400 mg/kg) were administered in three groups of thyrotoxic rats. The control group was given a daily injection of normal saline. Systolic blood pressure and heart rate were measured on three occasions with tail cuff. At the end of the fourth week, the animals were scarified and serum samples and heart tissue were collected for biochemical and histological studies. The levothyroxine increased heart rate and systolic blood pressure. A lower heart rate and reduced systolic blood pressure were observed in groups receiving valsartan and P. oleracea extract. The heart weight/body weight ratio increased in groups treated with levothyroxine, but in a microscopic study, cardiomyocyte width was not different between the groups. Levothyroxine increased the level of malondyaldehide and NO metabolite but reduced the thiol concentration, superoxide dismutase, and catalase activities. However, treatment with vitamin E and P. oleracea extract increased the thiol concentration, superoxide dismutase and catalase activities while decreasing malondyaldehide level. In addition, treatment with P. oleracea extract and valsartan decreased NO metabolite level. Treatment with P. oleracea extract improved levothyroxine induced oxidative stress and hemodynamic changes. These effects may be for antioxidant components.

Chin KY, Wong SK, Japar Sidik FZ, Abdul Hamid J, Abas NH, Mohd Ramli ES, Afian Mokhtar S, Rajalingham S, Ima Nirwana S

Int J Environ Res Public Health. 2019 Aug 13;16(16). pii: E2897. doi: 10.3390/ijerph16162897.

Abstract

Osteoarthritis is a degenerative joint disease which primarily affects the articular cartilage and subchondral bones. Since there is an underlying localized inflammatory component in the pathogenesis of osteoarthritis, compounds like tocotrienol with anti-inflammatory properties may be able to retard its progression. This study aimed to determine the effects of oral tocotrienol supplementation on the articular cartilage and subchondral bone in a rat model of osteoarthritis induced by monosodium iodoacetate (MIA). Thirty male Sprague-Dawley rats (three-month-old) were randomized into five groups. Four groups were induced with osteoarthritis (single injection of MIA at week 0) and another served as the sham group. Three of the four groups with osteoarthritis were supplemented with annatto tocotrienol at 50, 100 and 150 mg/kg/day orally for five weeks. At week 5, all rats were sacrificed, and their tibial-femoral joints were harvested for analysis. The results indicated that the groups which received annatto tocotrienol at 100 and 150 mg/kg/day had lower histological scores and cartilage remodeling markers. Annatto tocotrienol at 150 mg/kg/day significantly lowered the osteocalcin levels and osteoclast surface of subchondral bone. In conclusion, annatto tocotrienol may potentially retard the progression of osteoarthritis. Future studies to confirm its mechanism of joint protection should be performed.