Archives for October 2011

Dimaval®: Scientific Product Monograph

The active ingredient of Dimaval®, the sodium salt of (RS)-2,3-bis(sulfanyl)propane-1-sulfonic acid, previously known as (RS)-2,3-Di-mercapto-1- propanesulfonic acid (DMPS), is a complexing agent from the group of vicinal dimercaptans.  Indications: Clinically manifested, chronic and acute poisoning with mercury (metallic mercury, vapor, inorganic and organic compounds); Chronic poisoning with lead.

By virtue of its two vicinal mercaptan groups DMPS can form stable complexes (chelates) with a variety of heavy metals. These chelates are predominantly excreted via the kidneys with the urine. In this way DMPS enhances the excretion of heavy metals, especially of those in the space outside of body cells, i.e. extracelluar space. However, the toxicity of heavy metals is already reduced by complex formation, since heavy metals in the organism are no longer available to block the SH-groups in vital enzymes.  

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Ruprecht J. Dimaval®: Scientific Product Monograph. 7th Edition. Berlin: HEYL Chem.-pharm. Fabrik, 2008.

 

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DMSA Monograph

 

Role of Mercury Toxicity in Hypertension, Cardiovascular Disease, and Stroke

Dr. Mark C. Houston is Associate Clinical Professor of Medicine at Vanderbilt University School of Medicine and Director of the Hypertension Institute at Saint Thomas Hospital in Nashville, TN. He has written an important review article on the cardiovascular consequences of mercury exposure in humans. The article discusses how mercury toxicity in humans is related to hypertension, generalized atherosclerosis, coronary heart disease (CHD), myocardial infarction (MI), cardiac arrhythmias, heart rate variability, sudden death, cerebrovascular accidents (CVA), carotid artery disease, renal dysfunction, and total mortality.

 

Mark C. Houston

Role of Mercury Toxicity in Hypertension, Cardiovascular Disease, and Stroke
J Clin Hypertens (Greenwich) 2011; 13 (8): 621-7

 

ABSTRACT

Mercury has a high affinity for sulfhydryl groups, inactivating numerous enzymatic reactions, amino acids, and sulfur-containing antioxidants (N-acetyl-L-cysteine, alpha-lipoic acid, L-glutathione), with subsequent decreased oxidant defense and increased oxidative stress. Mercury binds to metallothionein and substitute for zinc, copper, and other trace metals, reducing the effectiveness of metalloenzymes. Mercury induces mitochondrial dysfunction with reduction in adenosine triphosphate, depletion of glutathione, and increased lipid peroxidation. Increased oxidative stress and reduced oxidative defense are common. Selenium and fish containing omega-3 fatty acids antagonize mercury toxicity. The overall vascular effects of mercury include increased oxidative stress and inflammation, reduced oxidative defense, thrombosis, vascular smooth muscle dysfunction, endothelial dysfunction, dyslipidemia, and immune and mitochondrial dysfunction. The clinical consequences of mercury toxicity include hypertension, coronary heart disease, myocardial infarction, cardiac arrhythmias, reduced heart rate variability, increased carotid intima-media thickness and carotid artery obstruction, cerebrovascular accident, generalized atherosclerosis, and renal dysfunction, insufficiency, and proteinuria. Pathological, biochemical, and functional medicine correlations are significant and logical. Mercury diminishes the protective effect of fish and omega-3 fatty acids. Mercury inactivates catecholaminei-0-methyl transferase, which increases serum and urinary epinephrine, norepinephrine, and dopamine. This effect will increase blood pressure and may be a clinical clue to mercury-induced heavy metal toxicity. Mercury toxicity should be evaluated in any patient with hypertension, coronary heart disease, cerebral vascular disease, cerebrovascular accident, or other vascular disease. Specific testing for acute and chronic toxicity and total body burden using hair, toenail, urine, and serum should be performed.

 

“Anticonvulsant Action” of Vitamin D in Epileptic Patients? A Controlled Pilot Study

This pilot study by Christiansen, Rødbro, and Sjö was published in 1974 in the British Medical Journal. The frequency of epileptic seizures was observed in a controlled therapeutic trial on 23 epileptic inpatients before and after treatment with vitamin D2 or placebo in addition to anticonvulsant drugs. The number of seizures was reduced during treatment with vitamin D2 but not with placebo. The effect was unrelated to changes in serum calcium or magnesium. The results may support the concept that epileptics should be treated prophylactically with vitamin D (Br Med J 1974; 2 (5913): 258-9).

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Charlie’s Story: The Ketogenic Diet and Epilepsy

Charlie is a son of the famous American film director Jim Abrahams. When Charlie was one year old, he had numerous daily seizures. No medication for epilepsy helped, and he had also had an unsuccessful brain surgery. But everything changed when he came to Johns Hopkins Hospital, where he was cured of his epilepsy by the ketogenic diet. The diet was undertaken despite resistance from the five pediatric neurologists he had seen.

When Charlie’s parents realized that Charlie was but one of hundreds of thousands of children whose families were either not being informed, or being misinformed about dietary therapy, they started in 1994 The Charlie Foundation in order to raise awareness about the ketogenic diet as a treatment for childhood epilepsy.

 

Charlie’s Speech

On April 2, 2008 Charlie Abrahams, whose epilepsy had been cured by the ketogenic diet, addressed an audience of over 300 scientists, neurologists, dietitians, and nurses at the first “International Symposium on Dietary Therapy for Epilepsy and Other Neurological Disorders.” He presented an award to Millicent Kelly, R.D. the Johns Hopkins dietitian who taught his family the diet.

 

See Also:

…First Do No Harm

Ketogenic Diet: A Treatment for Epilepsy

 

Nutritional Support for Wound Healing

Nutrition plays a crucial role in wound healing. Nutritional status of patients at the time of trauma or surgery influences the biochemical processes necessary for the phases of normal healing to occur. Evidence exists that vitamins A and C, zinc, arginine, glutamine, glucosamine, bromelain, Aloe vera, and Centella asiatica may be beneficial to wounded or surgical patients.

 

Douglas MacKay and Alan L. Miller

Nutritional support for wound healing 
Altern Med Rev 2003; 8 (4): 359-77 

 

ABSTRACT

Healing of wounds, whether from accidental injury or surgical intervention, involves the activity of an intricate network of blood cells, tissue types, cytokines, and growth factors. This results in increased cellular activity, which causes an intensified metabolic demand for nutrients. Nutritional deficiencies can impede wound healing, and several nutritional factors required for wound repair may improve healing time and wound outcome. Vitamin A is required for epithelial and bone formation, cellular differentiation, and immune function. Vitamin C is necessary for collagen formation, proper immune function, and as a tissue antioxidant. Vitamin E is the major lipid-soluble antioxidant in the skin; however, the effect of vitamin E on surgical wounds is inconclusive. Bromelain reduces edema, bruising, pain, and healing time following trauma and surgical procedures. Glucosamine appears to be the rate-limiting substrate for hyaluronic acid production in the wound. Adequate dietary protein is absolutely essential for proper wound healing, and tissue levels of the amino acids arginine and glutamine may influence wound repair and immune function. The botanical medicines Centella asiatica and Aloe vera have been used for decades, both topically and internally, to enhance wound repair, and scientific studies are now beginning to validate efficacy and explore mechanisms of action for these botanicals. To promote wound healing in the shortest time possible, with minimal pain, discomfort, and scarring to the patient, it is important to explore nutritional and botanical influences on wound outcome.

 

Symptoms of Intoxication in Dentists Associated with Exposure to Low Levels of Mercury

The findings of this study collectively indicate that occupational exposure to mercury, even at low levels, is associated with a significant increase in the prevalence of symptoms of intoxication. Additionally, they provide circumstantial evidence in favour of the notion that the current value of TLV of this metal do not provide sufficient protection against the appearance of neuropsychological symptoms. Finally they may cast doubt on the appropriateness of current value of BEI, per-se, as a sensitive means for biomonitoring of mercury exposed individuals

 

Masoud Neghab, Alireza Choobineh, Jafar Hassan Zadeh and Ebrahim Ghaderi

Symptoms of Intoxication in Dentists Associated with Exposure to Low Levels of Mercury 
Ind Health 2011; 49 (2): 249-54 

 

ABSTRACT

The present study examined the effects of occupational exposure of a group of dentists to low levels of mercury. The study population consisted of 106 dentists and 94 general practitioners (referent group), from private and public clinics in Shiraz city. Subjects were requested to complete a questionnaire on demographic variables, suspicious symptoms of intoxication and work practices. Additionally, atmospheric and urinary concentrations of mercury were measured by Atomic Absorption Spectroscopy technique. The data were analysed by χ(2) test, independent sample t-test and multivariate logistic regression analysis, where applicable. Both groups were similar as far as most demographic and socioeconomic variables, but age and number of personal amalgam fillings, were concerned. Median of atmospheric concentration of mercury was found to be 3.35 μg/m(3). Likewise, the urinary concentration of mercury in dentists was estimated to be 3.16 μg/g creatinine. This value was significantly higher than that of the referent group. Similarly, analysis of the data revealed that neuropsychological, muscular, respiratory, cardiovascular and dermal symptoms were more prevalent in dentists. Our findings indicate that occupational exposure of dentists to mercury, even at low levels, is associated with a significant increase in the prevalence of symptoms of intoxication.

 

(Industrial Health is a scientific journal published by the National Institute of Occupational Safety and Health in Japan.)

 

Fruits and vegetables reduce risks of specific types of colorectal cancers

According to new study published in the Journal of the American Dietetic Association

The effects of fruit and vegetable consumption on colorectal cancer (CRC) appear to differ by site of origin, according to a new study published in the October issue of the Journal of the American Dietetic Association. Researchers found that within the proximal and distal colon, brassica vegetables (Brussels sprouts, cabbage, cauliflower and broccoli) were associated with decreased risk of these cancers. A lower risk of distal colon cancer was associated with eating more apples, however an increased risk for rectal cancer was found with increasing consumption of fruit juice.

“Fruits and vegetables have been examined extensively in nutritional research in relation to CRC, however, their protective effect has been subject to debate, possibly because of different effects on different subsites of the large bowel,” commented lead investigator Professor Lin Fritschi, PhD, head of the Epidemiology Group at the Western Australian Institute for Medical Research, Perth, Western Australia. “It may be that some of the confusion about the relationship between diet and cancer risk is due to the fact that previous studies did not take site of the CRC into account. The replication of these findings in large prospective studies may help determine whether a higher intake of vegetables is a means for reducing the risk of distal CRC.”

Researchers from the Western Australian Institute for Medical Research, University of Western Australia and Deakin University investigated the link between fruit and vegetables and three cancers in different parts of the bowel: proximal colon cancer, distal colon cancer, and rectal cancer. The case-control study included 918 participants with a confirmed CRC diagnosis and 1021 control participants with no history of CRC. The subjects completed extensive medical and nutritional questionnaires and were assigned a socioeconomic status based on their home address.

Consumption of brassica vegetables (e.g., broccoli, cabbage) was associated with reduced incidence of proximal colon cancer. For distal colon cancer, both total fruit and vegetable intake and total vegetable intake appeared to decrease risk. Distal colon cancer risk was significantly decreased in association with intake of dark yellow vegetables and apples, although there was an increased risk for rectal cancer with consumption of fruit juice. Risk of proximal colon cancer and rectal cancer was not associated with intakes of total fruit and vegetable, total vegetable or total fruit.

Previous studies on CRC have often failed to distinguish between the different sites of origin of cancers in the large bowel, even though it is now well established that tumors in the proximal colon develop along different pathways to those of the distal colon and rectum and that risk of cancer varies by subsite within the colorectum. The mechanisms for different effects of dietary components on different sites of the large bowel have not yet been determined.

The authors conclude that “from a public health point of view it is easier to translate food-based analyses into dietary recommendations, rather than using the intake of single nutrient.”

A video featuring commentary by Professor Fritschi and colleagues

 

Reference

Annema N, Heyworth JS, McNaughton SA, Iacopetta B, Fritschi L. Fruit and vegetable consumption and the risk of proximal colon, distal colon and rectal cancers in a case-control study in Western Australia. Journal of the American Dietetic Association 2011; 111 (10): 1479-1490.

 

Research demonstrates new breeds of broccoli remain packed with health benefits

Research performed by scientists at the U.S. Department of Agriculture (USDA) and published recently in the journal Crop Science has demonstrated that mineral levels in new varieties of broccoli have not declined since 1975, and that the broccoli contains the same levels of calcium, copper, iron, magnesium, potassium and other minerals that have made the vegetable a healthy staple of American diets for decades.

 

“This research provides data on the nutritional content of broccoli for breeders to consider as they further improve this important vegetable,” said Edward B. Knipling, administrator of the Agricultural Research Service (ARS), USDA’s principal intramural scientific research agency. “The research demonstrates how ARS is helping to find answers to agricultural problems that impact Americans every day, from field to table.”

A team of three scientists evaluated the mineral content of 14 broccoli cultivars released over a span of more than 50 years: ARS geneticist and research leader Mark Farnham at the agency’s U.S. Vegetable Laboratory in Charleston, S.C.; plant physiologist Michael Grusak at the USDA-ARS Children’s Nutrition Research Center (CNRC) in Houston, Texas; and Clemson University scientist Anthony Keinath.

The researchers grew the 14 cultivars in two field trials in 2008 and 2009, and harvested florets for testing.

“Our studies show that not much has changed in terms of mineral content in the last 35 years in a crop that has undergone significant improvement from a quality standpoint and that was not widely consumed in the United States before the 1960s,” said Farnham.

Broccoli florets in the study were tested for levels of calcium, copper, iron, potassium, magnesium, manganese, molybdenum, sodium, phosphorous, sulfur and zinc. Results indicated significant cultivar differences in floret concentrations of calcium, copper, iron, magnesium, sodium, phosphorous and zinc, but not of potassium, manganese, molybdenum or sulfur. There was no clear relationship between mineral concentration and release year.

“For broccoli cultivars grown during the past 35 years, when hybrids became the standard cultivar, evidence indicates that mineral concentrations remain unchanged,” said Farnham. “As broccoli breeders continue to improve this crop in the future, data from this study can serve as a very useful guide in helping breeders understand the variation in mineral concentrations they should expect among their breeding stocks and also provide a realistic baseline that should be maintained as other characteristics are manipulated in the future.”

 

Reference

Farnham MW, Keinathb AP, Grusakc MA. Mineral Concentration of Broccoli Florets in Relation to Year of Cultivar Release. Crop Science 2011; 51: 2716-2720.

 

Eating green veggies improves immune defenses

Researchers reporting online in the journal Cell, a Cell Press publication, on October 13th have found another good reason to eat your green vegetables, although it may or may not win any arguments with kids at the dinner table.

It turns out that green vegetables — from bok choy to broccoli — are the source of a chemical signal that is important to a fully functioning immune system. They do this by ensuring that immune cells in the gut and the skin known as intra-epithelial lymphocytes (IELs) function properly.

“It is still surprising to me,” said Marc Veldhoen of The Babraham Institute in Cambridge. “I would have expected cells at the surface would play some role in the interaction with the outside world, but such a clear cut interaction with the diet was unexpected. After feeding otherwise healthy mice a vegetable-poor diet for two to three weeks, I was amazed to see 70 to 80 percent of these protective cells disappeared.”

Those protective IELs exist as a network beneath the barrier of epithelial cells covering inner and outer body surfaces, where they are important as a first line of defense and in wound repair. Veldhoen’s team now finds that the numbers of IELs depend on levels of a cell-surface protein called the aryl hydrocarbon receptor (AhR), which can be regulated by dietary ingredients found primarily in cruciferous vegetables. Mice lacking this receptor lose control over the microbes living on the intestinal surface, both in terms of their numbers and composition.

Earlier studies suggested that breakdown of cruciferous vegetables can yield a compound that can be converted into a molecule that triggers AhRs. The new work finds that mice fed a synthetic diet lacking this key compound experience a significant reduction in AhR activity and lose IELs. With reduced numbers of these key immune cells, animals showed lower levels of antimicrobial proteins, heightened immune activation and greater susceptibility to injury. When the researchers intentionally damaged the intestinal surface in animals that didn’t have normal AhR activity, the mice were not as “quick to repair” that damage.

As an immunologist, Veldhoen says he hopes the findings will generate interest in the medical community, noting that some of the characteristics observed in the mice are consistent with those seen in patients with inflammatory bowel disease.

“It’s tempting to extrapolate to humans,” he said. “But there are many other factors that might play a role.”

For the rest of us, he says, “it’s already a good idea to eat your greens.” Still, the results offer a molecular basis for the importance of cruciferous vegetable-derived phyto-nutrients as part of a healthy diet.

 

Reference

Li Y, Innocentin S, Withers DR, Roberts NA, Gallagher AR, Grigorieva EF, Wilhelm C, Veldhoe M. Exogenous Stimuli Maintain Intraepithelial Lymphocytes via Aryl Hydrocarbon Receptor Activation. Cell 2011 Oct 13. [Epub ahead of print]

 

Health benefits of broccoli require the whole food, not supplements

New research has found that if you want some of the many health benefits associated with eating broccoli or other cruciferous vegetables, you need to eat the real thing – a key phytochemical in these vegetables is poorly absorbed and of far less value if taken as a supplement.

The study, published by scientists in the Linus Pauling Institute at Oregon State University, is one of the first of its type to determine whether some of the healthy compounds found in cruciferous vegetables can be just as easily obtained through supplements.

The answer is no.

And not only do you need to eat the whole foods, you have to go easy on cooking them.

“The issue of whether important nutrients can be obtained through whole foods or with supplements is never simple,” said Emily Ho, an OSU associate professor in the OSU School of Biological and Population Health Sciences, and principal investigator with the Linus Pauling Institute.

“Some vitamins and nutrients, like the folic acid often recommended for pregnant women, are actually better-absorbed as a supplement than through food,” Ho said. “Adequate levels of nutrients like vitamin D are often difficult to obtain in most diets. But the particular compounds that we believe give broccoli and related vegetables their health value need to come from the complete food.”

The reason, researchers concluded, is that a necessary enzyme called myrosinase is missing from most of the supplement forms of glucosinolates, a valuable phytochemical in cruciferous vegetables. Without this enzyme found in the whole food, the study found that the body actually absorbs five times less of one important compound and eight times less of another.

Intensive cooking does pretty much the same thing, Ho said. If broccoli is cooked until it’s soft and mushy, its health value plummets. However, it can still be lightly cooked for two or three minutes, or steamed until it’s still a little crunchy, and retain adequate levels of the necessary enzyme.

The new study was published in the Journal of Agricultural and Food Chemistry. It was supported by the National Institutes of Health.

Broccoli has been of particular interest to scientists because it contains the highest levels of certain glucosinolates, a class of phytochemicals that many believe may reduce the risk of prostate, breast, lung and colorectal cancer. When eaten as a raw or lightly-cooked food, enzymes in the broccoli help to break down the glucosinolates into two valuable compounds of intensive research interest – sulforaphane and erucin.

Studies have indicated that sulforaphane, in particular, may help to detoxify carcinogens, and also activate tumor suppressor genes so they can perform their proper function.

Most supplements designed to provide these glucosinolates have the enzyme inactivated, so the sulforaphane is not released as efficiently. There are a few supplements available with active myrosinase, and whose function more closely resembles that of the whole food, but they are still being tested and not widely available, Ho said.

Small amounts of the myrosinase enzyme needed to break down glucosinolates are found in the human gut, but the new research showed they accomplish that task far less effectively than does whole food consumption.

Although broccoli has the highest levels of glucosinolates, they are also found in cauliflower, cabbage, kale and other cruciferous vegetables. The same cooking recommendations would apply to those foods to best retain their health benefits, Ho said.

Many people take a variety of vitamins, minerals and phytochemicals as supplements, and many of them are efficacious in that form, researchers say. Higher and optimal levels of popular supplements such as vitamins C, E, and fish oil, for instance, can be difficult to obtain through diet alone. Some researchers believe that millions of people around the world have deficient levels of vitamin D, because they don’t get enough in their diet or through sun exposure.

But for now, if people want the real health benefits of broccoli, there’s a simple guideline.

Eat your vegetables.

 

Reference

Clarke JD, Riedl K, Bella D, Schwartz SJ, Stevens JF, Ho E. Comparison of Isothiocyanate Metabolite Levels and Histone Deacetylase Activity in Human Subjects Consuming Broccoli Sprouts or Broccoli Supplement. J Agric Food Chem 2011 Sep 19. [Epub ahead of print]