Effect of combined treatment with Methotrexate and Non-steroidal anti-inflammatory drugs on plasma alpha-tocopherol level and Rheumatoid factor among Rheumatoid Arthritis patients

Background: Oxidative stress might play a significant role in the pathogenesis of Rheumatoid Arthritis. Traditional therapies of Rheumatoid Arthritis are governed by different NSAIDs which improve symptoms of Rheumatoid Arthritis. But addition of Methotrexate (MTX) to Non-steroidal anti-inflammatory drugs (NSAIDs) has been found to be extra beneficial by halting the disease process. Objectives: To evaluate the status of anti-oxidant alpha-tocopherol and rheumatoid factor before and after treatment with MTX and NSAIDs for two months in Rheumatoid Arthritis patients. Methods: This quasi-experimental study was carried out in the Department of Pharmacology and Therapeutics of Rajshahi Medical College, Rajshahi between the periods of January 2011 to December 2011. Total ten clinically diagnosed Rheumatoid Arthritis patients were enrolled in the study. Purposive sampling technique was used to select each study subject from medicine wards of Rajshahi Medical College Hospital. Alpha-tocopherol, an anti-oxidant in plasma was measured as marker of anti-oxidant defense. The patients were then treated with oral MTX at a dose of 10 mg weekly and Indomethacin 150 mg in three divided doses daily for 2 months. After 2 months of continuous aforementioned treatment, alpha-tocopherol levels were estimated again. Moreover qualitative assessment of rheumatoid factor was done. For statistical analysis, paired t-test was done. Results: After two months of treatment with Methotrexate and Indomethacin, plasma alpha-tocopherol levels were significantly higher (P<0.05) in Rheumatoid Arthritis patients. However no significant change was observed in qualitative assessment of rheumatoid factors. Conclusion: From the findings of this study, it can be concluded that the endogenous alpha-tocopherol level increases even without any supplementation of alpha-tocopherol by combined treatment with MTX and Indomethacin in Rheumatoid Arthritis patients and thereby reduces oxidative stress. So alpha-tocopherol level is a better marker for early assessment of prognosis of Rheumatoid arthritis than Rheumatoid factor test. Mediscope 2021;8(2): 80-86

Herbal Additives Substantially Modify Antioxidant Properties and Tocopherol Content of Cold-Pressed Oils

The aim of the study was to examine combinations of base oils and herbal additives with a view to obtaining macerates with improved health benefits. Base oils were cold-pressed from the seeds of black cumin, borage, evening primrose, safflower, walnut, common hazel, and oilseed rape, as well as the flesh of sea-buckthorn fruits. They were then supplemented with herbs, including basil, thyme, and sage, in order to create macerates. Total antioxidant activity and tocopherol level were analyzed in oils, macerates, and oil cakes. Additionally, chemical properties of oil cakes—such as the level of fibre, vitamin C, β-carotene, and lutein—were also examined. Supplementation with herbs caused diversified effects on antioxidant activity and tocopherol level in macerates depending on the base oil, herb, and supplementation method. The obtained results indicate that tocopherol level does not play a decisive role in determining the antioxidant properties of oils, macerates, and oil cakes, suggesting significant involvement of other antioxidants. Among the tested macerates, the most promising one seems to be oilseed rape oil enriched with sage or basil to maximize its health benefits. The study can serve as a starting point for the development and implementation of functional macerates and oil cakes in healthy nutrition.

Vitamin E Levels in Ethnic Communities in Malaysia and Its Relation to Glucose Tolerance, Insulin Resistance and Advanced Glycation End Products: A Cross-Sectional Study

Malaysian national morbidity surveys on diabetic prevalence have shown ethnical variation among prediabetic and diabetic populations. In our attempt to understand this variation, we studied the α-tocopherol, insulin resistance, β-cell function and receptor of advanced glycation end-products (RAGE) levels, as risk factors of type 2 diabetes, among the different ethnicities. In total, 299 subjects of Malay, Chinese, Indian and aboriginal Orang Asli (OA) heritage were recruited from urban and rural areas of Malaysia by stratified random sampling. Serum α-tocopherol concentrations were measured using high performance liquid chromatography (HPLC) and insulin concentrations were measured using enzyme-linked immunosorbent assay (ELISA). In subjects with pre-diabetes, OAs had the highest α-tocopherol level, followed by Chinese and Malays (0.8938, 0.8564 and 0.6948 respectively; p < 0.05). In diabetic subjects, Malays had significantly higher RAGE levels compared to Chinese and Indians (5579.31, 3473.40 and 3279.52 pg/mL respectively, p = 0.001). Low α-tocopherol level (OR = 3.021, p < 0.05) and high insulin resistance (OR = 2.423, p < 0.05) were linked strongly to the development of pre-diabetes. Low β-cell function (OR = 5.657, p < 0.001) and high RAGE level (OR = 3.244, p < 0.05) were linked strongly to the development of diabetes from pre-diabetes. These factors might be involved in the development of diabetes, along with genetic and environmental factors.

Effect of a-tocopherol on the development of diabetic angiopathy, platelet aggregation, and prostacyclin-thromboxan system of rats with streptozotocin-induced diabetes

Under study were effects of intravenous infusions of a new emulsion, -tocopherol, on the development of diabetic microangiopathy, platelet -tocopherol level, ADP-induced platelet aggregation level, exogenic (from 14C-arachidonic acid) thromboxan (TxA2) biosynthesis in suspension of washed platelets and of prostacyclin (Pgb) one in isolated aortic rings of rats with streptozotocin-induced diabetes. Six-week injections of -tocopherol in a dose 100 mg/100 g b. w. with 48 h intervals immediately after development of streptozotocin-induced diabetes prevented the development of diabetic angiopathy but did not normalize platelet functional activity and Pgl2/TxA2 balance in vessels and platelets. Similar injections of -tocopherol in the presence of developed angiopathy resulted in its regressive development and normalization of the before-said prostanoid balance and platelet characteristics.

Chronic constipation combined with biliary tract dysfunction in children: comorbidity or clinical regularity?

Functional disorders of the gastrointestinal tract (GIT) are a common problem in children. The Roman IV criteria adopted in 2016, devoted to the problem of constipation and biliary tract dysfunction in children are developed in accordance with age and are idendoitified by the letter code. This article presents data on the correspondence of the Roman IV criteria and ICD-10 in the combined problem of constipation and biliary tract dysfunction in children. The development of upper gastrointestinal tract pathology caused by increased intracavitary pressure associated with impaired colon motility (chronic constipation) is natural during a prolonged course of chronic constipation. The study based on a specially designed questionnaire in Russia showed that an average of 54% of children in different age groups suffer from chronic constipation, that is, almost every second child. Studies showed that the frequency of biliary tract dysfunction in children with chronic constipation accounts for 42.3 to 100% cases. The survey that we conducted among pediatricians showed that a quarter of doctors found it difficult to establish diagnosis, and 41% of pediatricians struggled with prescribing therapy for persistent constipation in children, especially constipation combined with motor-tonic dysfunction of the colon in children with biliary tract dysfunction. A total of 201 children aged 6 to 15 years (96 boys and 114 girls) were enrolled in the study. In addition to pain syndrome, cellular energy exchange disorder in the form of decreased level of intracellular antioxidant catalase enzyme and plasma antioxidant activity (PAO) was identified against the background of chronic constipation and biliary tract dysfunction in this group of children, which is evidence of decompensation of antioxidant protection in the acute stage of biliary tract dysfunctional disorders in children. The identified changes make a strong case for prescribing a drug with hepatoprotective, choleretic and antioxidant effects. The use of herbal extract of fresh artichoke leaves (Chophytol®, Mayoly Spindle, France) showed the relief of pain syndrome by Day 14 of treatment in 92% of patients (75% in the comparison group), nausea in 74% of children, constipation in 88% (50% of patients in the comparison group). It is important to detect an elevated α-tocopherol level and significantly reduced catalase level, which indicates the need to choose a drug with selective antioxidant activity, which does not change the α-tocopherol level. The introduction of the herbal extract of fresh artichoke leaves (Chophytol®) in the complex therapy of the studied patients accelerated the relief of the clinical symptoms of functional biliary tract disorders and reduced the frequency of constipation in children by 4 times as compared with the control group without significant effect on the α-tocopherol level.