1) The study investigated the association between preoperative levels of EPA, DHA, and AA in plasma and red blood cells, and changes in inflammatory markers after open heart surgery.
2) They found the postoperative concentrations of TNF-β decreased and hs-CRP, IL-6, IL-8, IL-18, and IL-10 increased compared to preoperative levels.
3) Preoperative EPA and AA levels were associated with changes in both pro-inflammatory and anti-inflammatory mediators, suggesting a complex role in the postoperative inflammatory response.
1) The study examined the association between levels of n-3 and n-6 fatty acids in plasma phospholipids and the incidence of postoperative atrial fibrillation (POAF) in 125 patients undergoing coronary artery bypass grafting (CABG).
2) By univariate analysis, the incidence of POAF increased with higher levels of the n-3 fatty acid docosahexaenoic acid (DHA) and decreased with higher levels of the n-6 fatty acid arachidonic acid (AA).
3) In multivariate analysis adjusting for covariates, higher levels of DHA were associated with increased risk of POAF, while higher levels of AA were associated with decreased risk of POAF.
Platelet function and constituents of platelet rich plasma.Angad Malhotra
Int J Sports Med. 2013 Jan;34(1):74-80. doi: 10.1055/s-0032-1316319. Epub 2012 Aug 14.
Platelet function and constituents of platelet rich plasma.
Pelletier MH, Malhotra A, Brighton T, Walsh WR, Lindeman R.
This document provides information about the January 2014 issue of the Biomed newsletter from the Department of Biochemistry at Adichunchanagiri Institute of Medical Sciences. It includes an editorial welcoming the fourth issue and focusing on cardiovascular disease. It also features several articles on biomarkers for cardiovascular disease such as D-dimer, lipoprotein(a), heart-type fatty acid binding protein, and serum paraoxonase. The editorial board members and department staff are pictured.
A Thesis Submitted to the College of Medicine and the Committee of Postgraduate Studies of the University of Al-Mustansiriya in Partial Fulfillment of the Requirements for the Degree of Master of Science in Pharmacology
Lipoproteins and Lipid Peroxidation in Thyroid disordersIOSR Journals
1) The study evaluated lipids and oxidative stress in 80 patients with thyroid dysfunction, including 53 hypothyroid and 27 hyperthyroid patients, compared to 40 healthy controls.
2) In hypothyroid patients, T3, T4 levels were significantly decreased while TSH was elevated. Total cholesterol, triglycerides, LDL, and VLDL were significantly increased compared to controls.
3) MDA levels were higher in both hypothyroid and hyperthyroid patients compared to controls, indicating oxidative damage in thyroid disorders.
This study investigated the regulation of human class I alcohol dehydrogenase (ADH1) genes by the nuclear receptor farnesoid X receptor (FXR). The researchers found that both the endogenous FXR ligand chenodeoxycholic acid and the synthetic FXR agonist GW4064 increased ADH1 mRNA, protein levels, and activity in human hepatocytes. Overexpression of a constitutively active FXR induced ADH1A and ADH1B expression, while silencing FXR abolished the effects of FXR agonists on ADH1 expression and activity. Transient transfection and electrophoretic mobility shift assays revealed functional FXR response elements in the ADH1A and ADH1B promoters, indicating
ABSTRACT- This study was undertaken to evaluate the serum levels of Oxidant (MDA) & antioxidant (SOD & Vitamin E) and compare oxidative stress (MDA) level among normotensive and hypertensive subjects. Oxidative stress has been relationship with mechanisms of EH (essential hypertension). A total number of 70 subjects were taken including both sex (Men and Women) between the ages of 35-70 years taken in this study. Exclusion criteria were chronic diseases, alcohol consumer, obesity, smoking/tobacco consumer and current use of any medication. Antioxidant enzymes activity and lipid peroxidation (malondialdehyde) were determined in serum. In 70 subjects out of 35 were found as an controls normotensive individuals and the cases 35 hypertensive patients. Serum MDA levels were highly significantly elevated in hypertensive patients in compared to normotensive individuals (4.39±0.98 µmol/l vs 1.51±0.70µmol/l and p < 0.0001). SOD acts as an antioxidant was highly significantly decrease in hypertensive patients in compared to normotensive individuals (0.44±0.06U/mg protein/min vs 0.96±0.04 U/mg protein/min and p <0.0001).>< 0.001). These findings demonstrate the strong association of SOD and Vitamin E level decrease in hypertensive patients and by MDA level increase in hypertensive patients. Oxidative stress in hypertensive patients increasing over time may play a role in the improvement of atherosclerosis and cardiovascular disease, should be considered in further research.
Key Words: Hypertensive, Normotensive individuals, MDA, SOD, Vitamin E
Liver ischemia/reperfusion injury, a setting in which the functional mass is ...Prof. Hesham N. Mustafa
The document discusses a study on the effects of the phosphodiesterase type-5 (PDE5) inhibitor tadalafil on liver ischemia/reperfusion injury in rats. The study found that tadalafil treatment before ischemia/reperfusion injury helped restore normal liver enzyme levels, reduced oxidative stress and inflammation in liver tissue, and decreased levels of tumor necrosis factor-alpha, interleukin-6, and intercellular adhesion molecule-1. Histological analysis also showed tadalafil treatment helped protect against liver damage. The findings suggest that modulating the inflammatory response may be one mechanism by which tadalafil provides hepatoprotection against ischemia/reperfusion injury.
1) The study examined the association between levels of n-3 and n-6 fatty acids in plasma phospholipids and the incidence of postoperative atrial fibrillation (POAF) in 125 patients undergoing coronary artery bypass grafting (CABG).
2) By univariate analysis, the incidence of POAF increased with higher levels of the n-3 fatty acid docosahexaenoic acid (DHA) and decreased with higher levels of the n-6 fatty acid arachidonic acid (AA).
3) In multivariate analysis adjusting for covariates, higher levels of DHA were associated with increased risk of POAF, while higher levels of AA were associated with decreased risk of POAF.
Platelet function and constituents of platelet rich plasma.Angad Malhotra
Int J Sports Med. 2013 Jan;34(1):74-80. doi: 10.1055/s-0032-1316319. Epub 2012 Aug 14.
Platelet function and constituents of platelet rich plasma.
Pelletier MH, Malhotra A, Brighton T, Walsh WR, Lindeman R.
This document provides information about the January 2014 issue of the Biomed newsletter from the Department of Biochemistry at Adichunchanagiri Institute of Medical Sciences. It includes an editorial welcoming the fourth issue and focusing on cardiovascular disease. It also features several articles on biomarkers for cardiovascular disease such as D-dimer, lipoprotein(a), heart-type fatty acid binding protein, and serum paraoxonase. The editorial board members and department staff are pictured.
A Thesis Submitted to the College of Medicine and the Committee of Postgraduate Studies of the University of Al-Mustansiriya in Partial Fulfillment of the Requirements for the Degree of Master of Science in Pharmacology
Lipoproteins and Lipid Peroxidation in Thyroid disordersIOSR Journals
1) The study evaluated lipids and oxidative stress in 80 patients with thyroid dysfunction, including 53 hypothyroid and 27 hyperthyroid patients, compared to 40 healthy controls.
2) In hypothyroid patients, T3, T4 levels were significantly decreased while TSH was elevated. Total cholesterol, triglycerides, LDL, and VLDL were significantly increased compared to controls.
3) MDA levels were higher in both hypothyroid and hyperthyroid patients compared to controls, indicating oxidative damage in thyroid disorders.
This study investigated the regulation of human class I alcohol dehydrogenase (ADH1) genes by the nuclear receptor farnesoid X receptor (FXR). The researchers found that both the endogenous FXR ligand chenodeoxycholic acid and the synthetic FXR agonist GW4064 increased ADH1 mRNA, protein levels, and activity in human hepatocytes. Overexpression of a constitutively active FXR induced ADH1A and ADH1B expression, while silencing FXR abolished the effects of FXR agonists on ADH1 expression and activity. Transient transfection and electrophoretic mobility shift assays revealed functional FXR response elements in the ADH1A and ADH1B promoters, indicating
ABSTRACT- This study was undertaken to evaluate the serum levels of Oxidant (MDA) & antioxidant (SOD & Vitamin E) and compare oxidative stress (MDA) level among normotensive and hypertensive subjects. Oxidative stress has been relationship with mechanisms of EH (essential hypertension). A total number of 70 subjects were taken including both sex (Men and Women) between the ages of 35-70 years taken in this study. Exclusion criteria were chronic diseases, alcohol consumer, obesity, smoking/tobacco consumer and current use of any medication. Antioxidant enzymes activity and lipid peroxidation (malondialdehyde) were determined in serum. In 70 subjects out of 35 were found as an controls normotensive individuals and the cases 35 hypertensive patients. Serum MDA levels were highly significantly elevated in hypertensive patients in compared to normotensive individuals (4.39±0.98 µmol/l vs 1.51±0.70µmol/l and p < 0.0001). SOD acts as an antioxidant was highly significantly decrease in hypertensive patients in compared to normotensive individuals (0.44±0.06U/mg protein/min vs 0.96±0.04 U/mg protein/min and p <0.0001).>< 0.001). These findings demonstrate the strong association of SOD and Vitamin E level decrease in hypertensive patients and by MDA level increase in hypertensive patients. Oxidative stress in hypertensive patients increasing over time may play a role in the improvement of atherosclerosis and cardiovascular disease, should be considered in further research.
Key Words: Hypertensive, Normotensive individuals, MDA, SOD, Vitamin E
Liver ischemia/reperfusion injury, a setting in which the functional mass is ...Prof. Hesham N. Mustafa
The document discusses a study on the effects of the phosphodiesterase type-5 (PDE5) inhibitor tadalafil on liver ischemia/reperfusion injury in rats. The study found that tadalafil treatment before ischemia/reperfusion injury helped restore normal liver enzyme levels, reduced oxidative stress and inflammation in liver tissue, and decreased levels of tumor necrosis factor-alpha, interleukin-6, and intercellular adhesion molecule-1. Histological analysis also showed tadalafil treatment helped protect against liver damage. The findings suggest that modulating the inflammatory response may be one mechanism by which tadalafil provides hepatoprotection against ischemia/reperfusion injury.
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is an open access international journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Introduction to Screening Models of Anti-Atherosclerosis
Atherosclerosis, Screening models, In vitro models, In vivo models
Presented by
SHAIK FIRDOUS BANU
Department of Pharmacology
Introduction to Screening Models of Hepatoprotective Drugs
Liver toxicity, Drugs causing DILI, Markers of hepatotoxicity
List of hepatoprotectives, Functions of liver
Screening models of hepatoprotective drugs
Presented by
I. Sai Reddemma
Department of Pharmacology
This document summarizes a novel LC-MS/MS method developed at Cleveland Clinic to simultaneously quantify 20 drugs and metabolites in urine, monitoring use of 16 prescription and illicit drugs. Sample preparation involves enzymatic hydrolysis followed by online turbulent flow extraction. The method has been validated and successfully used to analyze over 85,000 samples from pain management clinics over six years. It provides benefits over previous methods by simultaneously measuring a large panel of drugs in one run with improved sensitivity, accuracy and reproducibility.
Ethyl icosapentate purified from fish oils was found to significantly decrease plasma total cholesterol and triglyceride levels, as well as the activity of coagulation factors VII and X and plasminogen activator inhibitor-1 content, in patients with familial combined hyperlipidemia after 8 weeks of treatment. These decreases occurred without any deleterious effects on other lipid levels such as LDL-C and HDL-C. Coagulation factor activity and plasminogen activator inhibitor-1 content were correlated with triglyceride levels at baseline but not with changes in lipids after treatment. The results suggest ethyl icosapentate has an antiatherogenic effect by lowering lipids and increasing antithrombot
A study of Paraoxonase-1 levels and other related parameters in sera of Iraqi...iosrjce
IOSR Journal of Applied Chemistry (IOSR-JAC) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of applied chemistry and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Chemical Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Macitentan is a dual endothelin receptor antagonist approved for the treatment of pulmonary arterial hypertension. The SERAPHIN study found that macitentan 10mg once daily significantly reduced the risk of disease progression or death by 45% compared to placebo in patients with PAH over a median treatment duration of 115 weeks. Macitentan treatment also significantly reduced the risk of PAH-related death or hospitalization by 50% relative to placebo. Macitentan is a potent inhibitor of endothelin receptors with effects on vasoconstriction, proliferation and fibrosis relevant to PAH.
SCREENING MODELS OF ANTIDYSLIPIDEMIC AGENT.docxTUSHARUNDHAD3
SCREENING MODELS OF ANTIDYSLIPIDEMIC AGENT.docx
1.INTRODUCTION
2.LIPOPROTEIN
3.RISK FACTORS
4.DIETARY SOURCE OF 5.CHOLESTEROL
6.CLASSIFICATION OF ANTIHYPERLIPIDEMIC AGENT
7.SCREENING MODELS OF ANTIDYSLIPIDEMIC AGENT
(A) In Vivo Models:
1.Triton induced hyperlipidemia in Wistar rat
2.Cholesterol diet induced atherosclerosis in rabbits (High fat diet)
3.Hereditary hyperlipidemia in rabbits
4.Hypolipidemic activity in Syrian hamsters
5.Transgenic animal model
6.Hereditary hypercholesteremia in rats
7. IV lipid tolerance test in rat
8.Efect of HMG COA reduction inhibition in vivo
9.Fructose induce hyperglycemia in rat
10.Cholestylamine binding
(B) In Vitro Models:
1.Inhibition of isolated HMG COA reductase inhibitors
2.ACAT inhibitory model
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Anti-Mullerian hormone (AMH) is a glycoprotein, a member of the transforming growth factor-B super family. This hormone is a sensitive marker of ovarian reserve. The present study aims to measure the Anti-Mullerian hormone in thalassemic females receiving the regular blood transfusion as well as patients of chronic idiopathic thrombocgtopenic purpura and age and sex matched controls. Serum Anti-Mullerian hormone was measured by ELISA and Ferritin were measured by RIA. Clinical evaluation was done for all patients including anthropometric measurements, pubertal staging and history taking. Results of the study were analyzed by appropriate statistical methods. Obtained results revealed that the values of Body Mass Index as well as Anti-Mullerian were significantly higher in controls than thalassemics and chronic idiopathic thrombocytopenic purpura and there was a negative correlation between serum Ferritin and Anti-Mullerian hormone. Moreover, Anti-Mullerian hormone was significantly higher in patients receiving Desferal than in those receiving Deferriprone. Reduced Anti-Mullerian hormone in thalassemics as well as chronic ITP patients are considered an important indicator declines in ovarian function which entail modification in the therapeutic plans for thalassemic and chronic ITP patients.
This document discusses regulatory and clinical perspectives on the interchangeability of biologicals and biosimilars. It notes that while generics are considered to be therapeutically equivalent, biosimilars are similar but not identical to the reference product. Regulators do not generally determine a biosimilar to be interchangeable without additional clinical evidence from switching studies demonstrating equivalent safety and efficacy when switching between the biosimilar and reference product. The clinical considerations around switching studies and their design are complex given the nature of biological products.
Steroids are compounds containing a cyclic steroid nucleus. They include mineralocorticoids like aldosterone, glucocorticoids like cortisol, and sex hormones. Glucocorticoids have effects on metabolism, inflammation, immunity, and more. They are used to treat conditions like inflammatory bowel disease. Long term steroid use can suppress the HPA axis and cause adverse effects, so tapering is important. During stress and surgery, steroids may need to be increased or supplemented to avoid adrenal insufficiency.
This document discusses the rational use of steroids. It describes the three classes of steroids and their functions. It provides examples of irrational steroid use for conditions like asthma exacerbations and status asthmaticus. For asthma exacerbations, dividing the daily dose into multiple smaller doses is irrational as it risks HPA axis suppression and inadequate immunosuppression. For status asthmaticus, frequent high doses of IV hydrocortisone or methylprednisolone risks salt and water retention and HPA axis suppression. The document recommends optimal dosing regimens for different conditions to allow for adequate treatment while avoiding side effects.
Glutathione-s-transferase, reduced glutathione and oxidized glutathione: An a...iosrjce
Halothane and enflurane administration increased the plasma GSH-Px activity and reduced zinc
levels. In addition, they lowered SOD and GSH-Px activities and trace element levels on erythrocytes.
Isoflurane had no effect on plasma antioxidant enzymes, but, similar to the other, isoflurane decreased the
plasma zinc levels, erythrocyte SOD and GSH-Px activities and trace element levels.
This presentation discusses liver anatomy, functions, and causes of damage. It outlines in vivo and in vitro studies used to evaluate hepatoprotective plants, including two recent studies on Boerrhavia diffusa and Andrographis peniculata. Experimental models for screening hepatoprotective activity are also presented.
Protective effects of commelina benghalensis linn (root) extract on ethanol i...IJSIT Editor
The present study was undertaken to investigate the protective effect and possible mechanism of
alcoholic (AlE) and aqueous extract (AqE) from Commelina benghalensis root (CB) on EtOH-induced hepatic
injury in Wistar rat. Hepatotoxic parameters studied in vivo include serum transaminases (AST, and ALT),
ALP, bilirubin, protein, lipid profile (Cholesterol, triglyceride, VLDL and HDL) and level of antioxidants
together with histopathological examination. Liv 52® was used as a reference hepatoprotective agent
(5ml/kg-1b.w.). AlE and AqE (200 mg/kg-1b.w.) on oral administration decreased the level of AST, ALP, ALT,
bilirubin, cholesterol, triglyceride, VLDL, MDA and increased the level of protein, HDL and antioxidants (SOD,
GSH and CAT) in rats being treated with ethanol (EtOH). Pentobarbitone -induced sleeping time study was
carried out to verify the effect on microsomal enzymes Histopathological observations confirmed the
beneficial roles of MF against EtOH-induced liver injury in rats. Possible mechanism may involve their
antioxidant activity
Efficacy Studies of Hepatoprotective Drug Isolated from Eclipta prostrata. L.IOSR Journals
In the commercial market, medicinal herbs are used as raw drugs, extracts or tinctures. Isolated
active constituents are used for applied research. Medicinal herbs are significant source of hepatoprotective
drugs, Eclipta prostrata. L. with active principle Wedelolactone is the prime focus. In the present study to derive
hepatoprotective drug, the herb E. prostrata was grown in the Periyar Maniammai College Campus, Vallam
and 1kg of the plant leaves were collected and shade dried. Dried and powdered maetria l of E. prostrata was
extracted with 80% ethanol. The active principle was isolated and identified by chromatographic technique. The
protective effect of E. prostrata on Carbon tetrachloride induced acute liver damage was also studied with male
wistar albino rats (180-230g). The protective effect was also undergone for histological studies.
This study examined the effects of psyllium husk on HDL-cholesterol levels. Forty hyperlipidemic patients were divided into two groups - one group took 3 grams of psyllium husk daily for 3 months, while the other group took a placebo. The results showed that psyllium husk significantly increased HDL-cholesterol levels on average from 34.61 mg/dl to 36.77 mg/dl. In contrast, the placebo group showed a non-significant average increase from 35.50 mg/dl to 35.75 mg/dl. Therefore, this placebo-controlled study suggests that psyllium husk can effectively increase HDL-cholesterol levels and potentially reduce heart disease risk.
This document discusses various in vitro and in vivo methods for evaluating drugs used in congestive cardiac failure (CCF). It describes isolated tissue experiments using hamster and cat hearts to assess drug effects on contractile force. It also outlines several animal models of CCF including rat coronary ligation and aortic banding, as well as dog, rabbit, guinea pig and hamster heart failure models induced by techniques like rapid pacing or volume/pressure overload. The models aim to mimic human CCF pathophysiology for testing new treatments.
The document is the 2011 Prohibited List published by the World Anti-Doping Agency (WADA). It lists all substances and methods prohibited in sport. It is divided into substances and methods prohibited at all times and those prohibited in-competition only. The list includes anabolic agents, peptide hormones, beta-2 agonists, hormone antagonists, diuretics, methods of enhancing oxygen transfer, chemical/physical manipulation, and stimulants. It provides the official text of prohibited substances in several categories and notes exceptions for certain substances like salbutamol and salmeterol inhalants. The list comes into effect on January 1, 2011.
Este documento describe un taller sobre trabajo en equipo realizado por estudiantes. Los estudiantes discuten conceptos como aprendizaje colaborativo y cómo aplicarlo. Luego, proponen un plan para abordar el problema de la pesca con dinamita que afecta a varias especies marinas. Se dividen los roles de líder, relator, comunicador, utilero y vigilante del tiempo. Finalmente, ejecutan con éxito el plan propuesto para salvar su hábitat.
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is an open access international journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Introduction to Screening Models of Anti-Atherosclerosis
Atherosclerosis, Screening models, In vitro models, In vivo models
Presented by
SHAIK FIRDOUS BANU
Department of Pharmacology
Introduction to Screening Models of Hepatoprotective Drugs
Liver toxicity, Drugs causing DILI, Markers of hepatotoxicity
List of hepatoprotectives, Functions of liver
Screening models of hepatoprotective drugs
Presented by
I. Sai Reddemma
Department of Pharmacology
This document summarizes a novel LC-MS/MS method developed at Cleveland Clinic to simultaneously quantify 20 drugs and metabolites in urine, monitoring use of 16 prescription and illicit drugs. Sample preparation involves enzymatic hydrolysis followed by online turbulent flow extraction. The method has been validated and successfully used to analyze over 85,000 samples from pain management clinics over six years. It provides benefits over previous methods by simultaneously measuring a large panel of drugs in one run with improved sensitivity, accuracy and reproducibility.
Ethyl icosapentate purified from fish oils was found to significantly decrease plasma total cholesterol and triglyceride levels, as well as the activity of coagulation factors VII and X and plasminogen activator inhibitor-1 content, in patients with familial combined hyperlipidemia after 8 weeks of treatment. These decreases occurred without any deleterious effects on other lipid levels such as LDL-C and HDL-C. Coagulation factor activity and plasminogen activator inhibitor-1 content were correlated with triglyceride levels at baseline but not with changes in lipids after treatment. The results suggest ethyl icosapentate has an antiatherogenic effect by lowering lipids and increasing antithrombot
A study of Paraoxonase-1 levels and other related parameters in sera of Iraqi...iosrjce
IOSR Journal of Applied Chemistry (IOSR-JAC) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of applied chemistry and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Chemical Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Macitentan is a dual endothelin receptor antagonist approved for the treatment of pulmonary arterial hypertension. The SERAPHIN study found that macitentan 10mg once daily significantly reduced the risk of disease progression or death by 45% compared to placebo in patients with PAH over a median treatment duration of 115 weeks. Macitentan treatment also significantly reduced the risk of PAH-related death or hospitalization by 50% relative to placebo. Macitentan is a potent inhibitor of endothelin receptors with effects on vasoconstriction, proliferation and fibrosis relevant to PAH.
SCREENING MODELS OF ANTIDYSLIPIDEMIC AGENT.docxTUSHARUNDHAD3
SCREENING MODELS OF ANTIDYSLIPIDEMIC AGENT.docx
1.INTRODUCTION
2.LIPOPROTEIN
3.RISK FACTORS
4.DIETARY SOURCE OF 5.CHOLESTEROL
6.CLASSIFICATION OF ANTIHYPERLIPIDEMIC AGENT
7.SCREENING MODELS OF ANTIDYSLIPIDEMIC AGENT
(A) In Vivo Models:
1.Triton induced hyperlipidemia in Wistar rat
2.Cholesterol diet induced atherosclerosis in rabbits (High fat diet)
3.Hereditary hyperlipidemia in rabbits
4.Hypolipidemic activity in Syrian hamsters
5.Transgenic animal model
6.Hereditary hypercholesteremia in rats
7. IV lipid tolerance test in rat
8.Efect of HMG COA reduction inhibition in vivo
9.Fructose induce hyperglycemia in rat
10.Cholestylamine binding
(B) In Vitro Models:
1.Inhibition of isolated HMG COA reductase inhibitors
2.ACAT inhibitory model
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Anti-Mullerian hormone (AMH) is a glycoprotein, a member of the transforming growth factor-B super family. This hormone is a sensitive marker of ovarian reserve. The present study aims to measure the Anti-Mullerian hormone in thalassemic females receiving the regular blood transfusion as well as patients of chronic idiopathic thrombocgtopenic purpura and age and sex matched controls. Serum Anti-Mullerian hormone was measured by ELISA and Ferritin were measured by RIA. Clinical evaluation was done for all patients including anthropometric measurements, pubertal staging and history taking. Results of the study were analyzed by appropriate statistical methods. Obtained results revealed that the values of Body Mass Index as well as Anti-Mullerian were significantly higher in controls than thalassemics and chronic idiopathic thrombocytopenic purpura and there was a negative correlation between serum Ferritin and Anti-Mullerian hormone. Moreover, Anti-Mullerian hormone was significantly higher in patients receiving Desferal than in those receiving Deferriprone. Reduced Anti-Mullerian hormone in thalassemics as well as chronic ITP patients are considered an important indicator declines in ovarian function which entail modification in the therapeutic plans for thalassemic and chronic ITP patients.
This document discusses regulatory and clinical perspectives on the interchangeability of biologicals and biosimilars. It notes that while generics are considered to be therapeutically equivalent, biosimilars are similar but not identical to the reference product. Regulators do not generally determine a biosimilar to be interchangeable without additional clinical evidence from switching studies demonstrating equivalent safety and efficacy when switching between the biosimilar and reference product. The clinical considerations around switching studies and their design are complex given the nature of biological products.
Steroids are compounds containing a cyclic steroid nucleus. They include mineralocorticoids like aldosterone, glucocorticoids like cortisol, and sex hormones. Glucocorticoids have effects on metabolism, inflammation, immunity, and more. They are used to treat conditions like inflammatory bowel disease. Long term steroid use can suppress the HPA axis and cause adverse effects, so tapering is important. During stress and surgery, steroids may need to be increased or supplemented to avoid adrenal insufficiency.
This document discusses the rational use of steroids. It describes the three classes of steroids and their functions. It provides examples of irrational steroid use for conditions like asthma exacerbations and status asthmaticus. For asthma exacerbations, dividing the daily dose into multiple smaller doses is irrational as it risks HPA axis suppression and inadequate immunosuppression. For status asthmaticus, frequent high doses of IV hydrocortisone or methylprednisolone risks salt and water retention and HPA axis suppression. The document recommends optimal dosing regimens for different conditions to allow for adequate treatment while avoiding side effects.
Glutathione-s-transferase, reduced glutathione and oxidized glutathione: An a...iosrjce
Halothane and enflurane administration increased the plasma GSH-Px activity and reduced zinc
levels. In addition, they lowered SOD and GSH-Px activities and trace element levels on erythrocytes.
Isoflurane had no effect on plasma antioxidant enzymes, but, similar to the other, isoflurane decreased the
plasma zinc levels, erythrocyte SOD and GSH-Px activities and trace element levels.
This presentation discusses liver anatomy, functions, and causes of damage. It outlines in vivo and in vitro studies used to evaluate hepatoprotective plants, including two recent studies on Boerrhavia diffusa and Andrographis peniculata. Experimental models for screening hepatoprotective activity are also presented.
Protective effects of commelina benghalensis linn (root) extract on ethanol i...IJSIT Editor
The present study was undertaken to investigate the protective effect and possible mechanism of
alcoholic (AlE) and aqueous extract (AqE) from Commelina benghalensis root (CB) on EtOH-induced hepatic
injury in Wistar rat. Hepatotoxic parameters studied in vivo include serum transaminases (AST, and ALT),
ALP, bilirubin, protein, lipid profile (Cholesterol, triglyceride, VLDL and HDL) and level of antioxidants
together with histopathological examination. Liv 52® was used as a reference hepatoprotective agent
(5ml/kg-1b.w.). AlE and AqE (200 mg/kg-1b.w.) on oral administration decreased the level of AST, ALP, ALT,
bilirubin, cholesterol, triglyceride, VLDL, MDA and increased the level of protein, HDL and antioxidants (SOD,
GSH and CAT) in rats being treated with ethanol (EtOH). Pentobarbitone -induced sleeping time study was
carried out to verify the effect on microsomal enzymes Histopathological observations confirmed the
beneficial roles of MF against EtOH-induced liver injury in rats. Possible mechanism may involve their
antioxidant activity
Efficacy Studies of Hepatoprotective Drug Isolated from Eclipta prostrata. L.IOSR Journals
In the commercial market, medicinal herbs are used as raw drugs, extracts or tinctures. Isolated
active constituents are used for applied research. Medicinal herbs are significant source of hepatoprotective
drugs, Eclipta prostrata. L. with active principle Wedelolactone is the prime focus. In the present study to derive
hepatoprotective drug, the herb E. prostrata was grown in the Periyar Maniammai College Campus, Vallam
and 1kg of the plant leaves were collected and shade dried. Dried and powdered maetria l of E. prostrata was
extracted with 80% ethanol. The active principle was isolated and identified by chromatographic technique. The
protective effect of E. prostrata on Carbon tetrachloride induced acute liver damage was also studied with male
wistar albino rats (180-230g). The protective effect was also undergone for histological studies.
This study examined the effects of psyllium husk on HDL-cholesterol levels. Forty hyperlipidemic patients were divided into two groups - one group took 3 grams of psyllium husk daily for 3 months, while the other group took a placebo. The results showed that psyllium husk significantly increased HDL-cholesterol levels on average from 34.61 mg/dl to 36.77 mg/dl. In contrast, the placebo group showed a non-significant average increase from 35.50 mg/dl to 35.75 mg/dl. Therefore, this placebo-controlled study suggests that psyllium husk can effectively increase HDL-cholesterol levels and potentially reduce heart disease risk.
This document discusses various in vitro and in vivo methods for evaluating drugs used in congestive cardiac failure (CCF). It describes isolated tissue experiments using hamster and cat hearts to assess drug effects on contractile force. It also outlines several animal models of CCF including rat coronary ligation and aortic banding, as well as dog, rabbit, guinea pig and hamster heart failure models induced by techniques like rapid pacing or volume/pressure overload. The models aim to mimic human CCF pathophysiology for testing new treatments.
The document is the 2011 Prohibited List published by the World Anti-Doping Agency (WADA). It lists all substances and methods prohibited in sport. It is divided into substances and methods prohibited at all times and those prohibited in-competition only. The list includes anabolic agents, peptide hormones, beta-2 agonists, hormone antagonists, diuretics, methods of enhancing oxygen transfer, chemical/physical manipulation, and stimulants. It provides the official text of prohibited substances in several categories and notes exceptions for certain substances like salbutamol and salmeterol inhalants. The list comes into effect on January 1, 2011.
Este documento describe un taller sobre trabajo en equipo realizado por estudiantes. Los estudiantes discuten conceptos como aprendizaje colaborativo y cómo aplicarlo. Luego, proponen un plan para abordar el problema de la pesca con dinamita que afecta a varias especies marinas. Se dividen los roles de líder, relator, comunicador, utilero y vigilante del tiempo. Finalmente, ejecutan con éxito el plan propuesto para salvar su hábitat.
Las imágenes representan diferentes aspectos del romanticismo como la búsqueda de libertad, la expresión de emociones a través de la naturaleza, el amor trágico, la angustia existencial, la evasión a través de la imaginación y el gusto por lo tétrico y misterioso.
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El documento explora temas como la libertad, la naturaleza, el amor trágico, el sentimiento de angustia y la evasión a través del gusto por lo tétrico.
A small research vessel was abandoned in the Gulf of Mexico and five scientists who were onboard were found dead on a nearby barrier island. A wealthy maritime lawyer hires private investigator Tony Lowell, a laid back former Navy SEAL, to investigate why the scientists died after government agencies fail to take jurisdiction. Lowell, a pot-smoking environmentalist, is the only one willing and able to take a crew back out to the abandoned vessel to face the unknown threat and prevent an environmental disaster.
La Tierra es el tercer planeta del Sistema Solar y único lugar donde se conoce la existencia de vida. Se formó hace aproximadamente 4,500 millones de años y la vida surgió hace unos 3,500-4,000 millones de años. La Tierra es el hogar de millones de especies de plantas y animales, incluidos los seres humanos. Gira alrededor del Sol una vez cada 365 días y posee una única Luna que influye en las mareas y la rotación terrestre.
DERECHOS QUE PENDEN DE UN HILO Zonas francas textiles frente a cooperativas d...Crónicas del despojo
INFORME TEMÁTICO DE OXFAM INTERMON ABRIL 2015
El propósito de este documento es informar sobre el incumplimiento de derechos laborales, así como de las pésimas condiciones de trabajo a las que se enfrentan las trabajadoras en Zonas Francas (o maquilas) dedicadas a la producción de prendas de vestir para la exportación en
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Este documento resume la investigación realizada por Laura Páez Castañeda durante el primer semestre de 2010 sobre el lenguaje de la moda. Incluye secciones sobre diseñadores excéntricos, los insectos como inspiración, el perfil del cliente, categorías y principios del lenguaje de la moda, y ejercicios creativos. El objetivo es servir como apoyo para los siguientes semestres y documentar el proceso de diseño para una colección que se realizará en el segundo semestre.
The document discusses idioms and their meanings. It begins by defining idioms as combinations of words used in a non-literal or metaphorical way, whose meanings cannot be deduced by the individual words. The document then provides examples of common English idioms and their meanings. It also provides Spanish idioms and their English translations. The purpose is to familiarize the reader with idioms and how their meanings differ from the literal meanings of the words.
Sniffers são programas de computador que monitoram e analisam o tráfego de rede para coletar informações. Eles podem ser usados para fins legítimos como solução de problemas ou para fins maliciosos como roubo de senhas. É importante proteger as redes contra sniffers não autorizados para manter a privacidade e segurança dos dados.
Este documento presenta una lección sobre aspectos generales del derecho penal. Cubre temas como el abolicionismo, el garantismo, los principios que rigen el control penal como la legalidad y la intervención mínima, y la relación entre el derecho penal y la constitución en un estado democrático de derecho. Explica que el derecho penal debe respetar los derechos fundamentales y limitarse a la prevención de delitos y castigos arbitrarios.
This study investigated the effects of antioxidant supplementation on oxidative stress in patients with intermittent claudication. 16 patients performed a standard walking test before and after taking daily vitamins E and C for 4 weeks. Biomarkers were measured before, during, and after the tests. The study found that oxidative stress, as measured by the ortho-APOH biomarker, significantly increased during reperfusion after the initial walking test but did not increase after 4 weeks of antioxidant supplementation. This suggests that antioxidants reduce oxidative stress in claudicants caused by ischemia-reperfusion from walking.
This triple-blind, randomized controlled trial investigated the effects of consuming a grape extract supplement containing resveratrol on oxidized LDL (LDLox) and apolipoprotein B (ApoB) levels in 75 patients undergoing primary prevention of cardiovascular disease who were taking statin medications. Patients consumed capsules daily for 6 months containing either resveratrol-enriched grape extract, grape extract without resveratrol, or a placebo. Results showed that the resveratrol group experienced decreases in LDLc, ApoB, LDLox, and the LDLox/ApoB ratio, as well as an increase in the non-HDLc/ApoB ratio, indicating reduced cardiovascular risk
ABSTRACT- Background: Several studies demonstrated relationship between dyslipidemia and various
antipsychotic drugs after treatment of psychotic disorders. Our study aimed to compare the effects of commonly
prescribed antipsychotic drugs Risperidone and Olanzapine on serum lipid profile of psychiatric patients.
Materials and Methods: This current study was conducted on 30 psychiatric patients, divided in to two groups
according to the antipsychotic drug prescribed by doctor Risperidone or Olanzapine. All the patients were assessed for
changes in serum lipid profile Total cholesterol (TC), Triglycerides (TG), High Density Lipoprotein (HDL-C), Low
Density Lipoprotein (LDL-C), Very Low Density Lipoprotein (VLDL-C) & Risk Factors for coronary artery
disease (CAD Risk Factor I &II) after 16 weeks of treatment.
Results: Patients taking Olanzapine therapy were showed significant (p<0.05) increase in all lipid parameters, whereas
Risperidone treated patients were showed significant increase in serum triglyceride and VLDL-C only.
Conclusion: Olanzapine therapy is strongly associated with dyslipidemia than Risperidone.
Key-words- Dyslipidemia, Lipid profile, Coronary artery disease, Risk factors, Schizophrenia
This randomized controlled trial tested the effects of eicosapentaenoic acid (EPA) supplementation on major coronary events in 18,645 Japanese patients taking statins. Patients received either EPA capsules totaling 1,800 mg daily or a placebo in addition to statin treatment for an average of 4.6 years. The primary endpoint was major coronary events including sudden cardiac death and heart attacks. The EPA group had a 19% lower relative risk of major coronary events compared to the control group. Specifically, EPA reduced non-fatal coronary events such as unstable angina. EPA supplementation showed benefits for both primary and secondary prevention of major coronary events in hypercholesterolemic patients taking statins.
Estudio clínico randomizado para prevenir fibrilación auricular post operator...Cirugias
This randomized controlled trial tested whether supplementation with n-3 polyunsaturated fatty acids, vitamin C, and vitamin E could reduce the incidence of postoperative atrial fibrillation in patients undergoing cardiac surgery. The study found that postoperative atrial fibrillation occurred in 10 of 103 supplemented patients (9.7%) compared to 32 of 100 placebo patients (32%), a significant reduction. Supplemented patients also had lower levels of biomarkers for oxidative stress and inflammation after surgery. The results suggest that this antioxidant regimen can favorably impact postoperative atrial fibrillation by increasing antioxidant defenses and decreasing oxidative stress.
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Alterations of Mitochondrial Functions and DNA in Diabetic Cardiomyopathy of CCK1 Receptors-Deficient Rats by Abdelbary Prince, Magdy A Ghoneim, Abdallah M El-Ebidi, Hala A Mousa and Jin Han in Interventions in Obesity & Diabetes
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IOSR Journal of Biotechnology and Biochemistry (IOSR-JBB) covers studies of the chemical processes in living organisms, structure and function of cellular components such as proteins, carbohydrates, lipids, nucleic acids and other biomolecules, chemical properties of important biological molecules, like proteins, in particular the chemistry of enzyme-catalyzed reactions, genetic code (DNA, RNA), protein synthesis, cell membrane transport, and signal transduction. IOSR-JBB is privileged to focus on a wide range of biotechnology as well as high quality articles on genetic engineering, cell and tissue culture technologies, genetics, microbiology, molecular biology, biochemistry, embryology, cell biology, chemical engineering, bioprocess engineering, information technology, biorobotics.
The document describes a study that evaluated the effects of administering a mixture of 11 amino acids to patients with chronic heart failure over 3 months. The study found that amino acid supplementation significantly improved exercise tolerance as measured by increased peak VO2 and VO2 at anaerobic threshold on cardiopulmonary stress tests, as well as increased 6-minute walk test distances. However, it did not significantly change patients' quality of life scores. The study suggests amino acid supplementation may improve some measures of functional capacity in patients with chronic heart failure.
1) A study examined the effects of EPA supplementation on coronary artery disease (CAD) risk in patients with multiple risk factors enrolled in the Japan EPA Lipid Intervention Study.
2) The risk of CAD increased with the number of risk factors present, including high cholesterol, obesity, abnormal triglycerides/HDL levels, diabetes, and hypertension.
3) EPA supplementation reduced CAD risk across all risk factor levels but had an especially large effect in patients with high triglycerides and low HDL cholesterol, reducing their CAD risk by 53%.
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Introduction Psoriasis is a chronic inflammatory & most common dermatologic diseases. It is related to several diseases but most common is cardiovascular disease. Lipid abnormalities are observed in psoriasis patients at the earliest stages of the disease and so it may be genetically determined.Hence there is a great need to study lipid abnormalities in psoriatic patients, which will help us to evaluate the level of risk individuals may experience for developing atherosclerosis and vascular obstructive disorders, as well as associated morbidity and mortality. Aim: To estimate lipoproteins levels & related risk of cardiovascular diseases in psoriasis patients Materials and Methods: This is a community-based cross sectional analytical study. The study population was derived from the healthy ambulatory person in and around Pimpri area & was conducted in Dr. D.Y.Patil Medical College & Hospital, Pimpri Pune. Study group consist of 40 psoriatic patients with mean age of 50.68 ± 8.86 years and control group consisted of 40 healthy individual of either sex with mean age of 50.15 ± 9.6 years. 55 % males & 45 % females were present in control group while test group comprises of 59 % males & 41 % females. estimation of Serum total cholesterol, Serum triglyceride, Serum High-Density Lipoprotein-cholesterol & Serum Low density Lipoprotein levels were done the same day. Estimation of lipoproteins levels done by Enzymatic End Point Method. Tha data was analysed by calculating mean, standard deviation, p-value and Chi-square test. Results : Findings of this show that, total cholesterol ,VLDL was significantly increased in psoriasis compared to control(p<0.05).Difference between psoriasis cases(6.8 ± 1.49) and control (3.08 ± 1.3) in findings of serum TGs were highly significant(p<0.001).However, difference in between serum LDL level in psoriasis cases and control was not significant. There were no significant changes shown in serum HDL level in both psoriasis cases and control . LDL/HDL ration has not shown any significant changes in both psoriasis case and control, while in TC/HDL ratio, difference was statistically significant(p<0.05). Conclusion: Present study suggests that patients with psoriasis were associated with hyperlipidaemia. So have high risk of developing the cardiovascular diseases. We suggest that screening of serum lipid profile in psoriatic patients will help in evaluating risk at early stage. Impromptu treatment in these patients will prevent the risk of cardiovascular diseases.
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(PCSK9) is one of the candidate gene that regulate lipoprotein retention pathway of CAD development. It is a newly
discovered serine protease that plays a key role in LDL-C homeostasis by mediating LDL receptor (LDLR). The LDL
receptor is breakdown through a post transcriptional mechanism and induces the production of very low-density
lipoprotein in the fasting state. The aim of this study was to investigate the frequency of single nucleotide
polymorphism (SNP) of PCSK9 gene of 155 CAD patients and 102 ages matched healthy controls. Serum lipids
including total cholesterol (TC), triglycerides (TG), HDL, LDL, and VLDL were analyzed. PCR-RFLP analysis was
carried out to genotype regions carrying Eam 1104I restriction site in the PCSK9. Gene considering significant
difference in serum TC, TG, HDL-C, LDL-C and VLDL-C levels (P<0.001, <0.0001) of patients and control samples.
In CAD patients, G allele frequency is less than A allele frequency. G allele is responsible for decreasing the
LDL: HDL ratio which shows evidence in having its protecting effect on the occurrence of CAD in West Bengal Population.
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To evaluate the diagnostic value of Copeptin as a novel biomarker in early diagnosis of Acute Myocardial Infarction. 56 patients with acute Myocardial Infarction (STEMI) and 25 healthy controls who were admitted to the Cardiology and Clinical Pathology Departments, national heart institute (NHI) from October 2015 to April 2016. The kit used a double-antibody sandwich enzyme-linked immune-sorbent assay (ELISA) to assay the level of Human Copeptin in samples. As regard copeptin, the median range of copeptin level was 242.5pg/ml in patient group and 75pg/ml in control group. The comparative study between the two groups shows a significant difference (p < 0.05) Conclusion: Copeptin is a reliable diagnostic tool in patients with AMI (STEMI) with sensitivity 85.7%, specificity 86.7%, PPV 96% and NPV 61.9%.
The document discusses the importance of preoperative evaluation and optimization of patient health before surgery. The key purposes are to document medical conditions requiring surgery, assess overall health status, uncover hidden conditions that could cause problems during or after surgery, determine perioperative risk, and develop an appropriate perioperative care plan. This involves a thorough medical history, physical exam, and laboratory tests to evaluate organ function and minimize surgical risks. The goal is to reduce postoperative complications and facilitate a quick recovery.
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This study compared the efficacy of international and local simvastatin products in lowering lipid levels in patients with primary hyperlipidemia. Fifty patients were divided into two groups, with one group receiving the international simvastatin product and the other receiving the local product, both at 10 mg per day for 4 weeks. Lipid levels including total cholesterol, triglycerides, HDL, and LDL were measured before and after treatment. Both products significantly lowered total cholesterol, triglycerides, and LDL levels with no significant changes in HDL. The international product lowered total cholesterol by 23 mg/dL and LDL by 3.76 mg/dL, while the local product lowered total cholesterol by 13 mg/dL and LDL by 5.52
1. Inflammatory response following heart surgery and association
with nÀ3 and nÀ6 long-chain polyunsaturated fatty acids in plasma
and red blood cell membrane lipids
L. Bjorgvinsdottir a
, O.S. Indridason b
, R. Heidarsdottir a
, K. Skogstrand c
, D.O. Arnar a,b,d
,
B. Torfason a,e
, D.M. Hougaard c
, R. Palsson a,b
, G.V. Skuladottir a,n
a
Faculty of Medicine, School of Health Sciences, University of Iceland, Vatnsmyrarvegur 16, IS-101 Reykjavik, Iceland
b
Internal Medicine Services, Landspitali—The National University Hospital of Iceland, Hringbraut, IS-101 Reykjavik, Iceland
c
Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Copenhagen, Denmark
d
Cardiovascular Research Center, Landspitali—The National University Hospital of Iceland, Hringbraut, IS-101 Reykjavik, Iceland
e
Landspitali—The National University Hospital of Iceland, Hringbraut, IS-101 Reykjavik, Iceland
a r t i c l e i n f o
Article history:
Received 8 April 2013
Received in revised form
12 July 2013
Accepted 26 July 2013
Keywords:
Heart surgery
Inflammatory mediators
Inflammatory response
nÀ3 long-chain polyunsaturated fatty acids
Postoperative period
Red blood cell membranes
a b s t r a c t
Background: Open heart surgery is associated with a systemic inflammatory response. The nÀ3 long-
chain polyunsaturated fatty acids (LC-PUFA), eicosapentaenoic acid (EPA) and docosahexaenoic acid
(DHA), and the nÀ6 LC-PUFA arachidonic acid (AA) may contribute to modulation of the inflammatory
response.
Objective: We investigated whether the preoperative levels of EPA, DHA and AA in plasma phospholipids
(PL) and red blood cell (RBC) membrane lipids in patients (n¼168) undergoing open heart surgery were
associated with changes in the plasma concentration of selected inflammatory mediators in the
immediate postoperative period.
Results and conclusions: The postoperative concentration of TNF-β was lower (Po0.05) and those
of hs-CRP, IL-6, IL-8, IL-18 and IL-10 higher (Po0.05) than the respective preoperative concentrations.
We observed that the preoperative levels of EPA and AA in plasma PL and RBC membrane lipids were
associated with changes in the concentration of pro-inflammatory and anti-inflammatory mediators,
suggesting a complex role in the postoperative inflammatory process.
& 2013 Elsevier Ltd. All rights reserved.
1. Introduction
Heart surgery provokes a vigorous inflammatory response that
propagates within the injured tissue to initiate the healing process
[1–4]. However, excessive systemic inflammation may result in
adverse outcomes during the postoperative period [5]. The inflam-
matory response is modulated by a balance between pro-
inflammatory and anti-inflammatory mediators secreted by a vari-
ety of cell types, including activated monocytes, tissue macrophages,
lymphocytes and endothelial cells [5–7].
The nÀ3 long-chain polyunsaturated fatty acids (LC-PUFA), eico-
sapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been
shown to evoke anti-inflammatory responses [8], while the nÀ6 LC-
PUFA aracidonic acid (AA) generally induce a more pronounced
pro-inflammatory effect [9,10]. The fatty acid composition of plasma
phospholipids (PL), which are merely transporters of circulating fatty
acids, is believed to reflect short-term dietary nÀ3 LC-PUFA con-
sumption [11]. In contrast, the fatty acid composition of red blood cell
(RBC) membrane lipids is considered a good indicator of a long-term
dietary nÀ3 LC-PUFA consumption [11]. Furthermore, fatty acid
composition of RBC membrane lipids has been shown to reflect the
fatty acid composition of other cell membrane lipids, including those
of cardiac myocytes in the intraventricular septum [12], and atria [13].
Several pro-inflammatory and anti-inflammatory mediators, as
well as the acute-phase reactant C-reactive protein (CRP) have
been implicated in the inflammatory response early in the post-
operative course following open heart surgery [6,7,14–16]. Human
studies have demonstrated that dietary EPA and DHA may attenu-
ate postoperative concentrations of circulating pro-inflammatory
mediators [17,18]. To investigate the role of EPA, DHA and AA in
the inflammatory response following open heart surgery, we
examined the association between the preoperative levels of
EPA, DHA and AA in plasma PL and RBC membrane lipids and
the postoperative changes in plasma concentrations of 12 selected
inflammatory mediators.
Contents lists available at ScienceDirect
journal homepage: www.elsevier.com/locate/plefa
Prostaglandins, Leukotrienes and Essential
Fatty Acids
0952-3278/$ - see front matter & 2013 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.plefa.2013.07.007
n
Correspondence to: Department of Physiology, Faculty of Medicine, School of
Health Sciences, University of Iceland, Vatnsmyrarvegur 16, IS-101 Reykjavik,
Iceland. Tel.: +354 525 4825; fax: +354 525 4886.
E-mail address: gudrunvs@hi.is (G.V. Skuladottir).
Prostaglandins, Leukotrienes and Essential Fatty Acids 89 (2013) 189–194
2. 2. Patients and methods
2.1. Subjects
This study was based on data collected as part of a prospective,
randomized, double-blinded, placebo-controlled clinical trial on
the use of nÀ3 LC-PUFA therapy for one week prior to open heart
surgery for the prevention of postoperative atrial fibrillation. The
fatty acid analysis was pre-specified in the study protocol whereas
the measurement of the inflammatory markers other than CRP
was added post-hoc. This study was approved by the Bioethics
Committee of Landspitali—The National University Hospital of
Iceland (62/2004), and the Icelandic Data Protection Authority.
The details of the study design have been published previously
[19,20]. In brief, 168 patients scheduled for elective or semi-
emergent open heart surgery were included in this study. Patients
younger than 40 years of age, those with a history of any form of
supraventricular arrhythmias or using the antiarrhythmic medica-
tions amiodarone and/or sotalol, and patients undergoing emer-
gency surgery were excluded. Prior to surgery, all participants
answered a questionnaire on lifestyle and health-releated issues,
including consumption of fish, intake of liquid cod liver oil and
nÀ3 LC-PUFA capsules, smoking habit, height, body weight, and
medication use. All patients participating in the study gave written
informed consent. One week prior to the surgical procedure, the
patients were randomly assigned to one of two groups initiating
the study treatment and were asked to discontinue intake of liquid
cod liver oil and supplemental nÀ3 LC-PUFA capsules, but were
otherwise advised to remain on their usual diet. The nÀ3 LC-PUFA
treatment consisted of 1240 mg of EPA and 1000 mg of DHA in the
form of ethyl esters administered once daily, while the identical
placebo capsules contained 2000 mg of olive oil, also administered
once daily. The nÀ3 LC-PUFA capsules are commercially available
in Iceland (Omega-3 Forte, Lysi Inc, Reykjavík, Iceland).
2.2. Blood plasma and red blood cells
Venous blood samples were obtained from the patients before
initiating the study medication (baseline), immediately before the
surgery (preoperatively) and on the third postoperative day (post-
operatively). The blood samples were collected into disodium
EDTA tubes and the plasma separated from RBC by immediate
centrifugation at 1000g for 10 min. The RBC were washed three
times with an isotonic saline solution and the antioxidant buty-
lated hydroxytoluene (BHT), dissolved in methanol, was added to
the cells at a final concentration of 50 mg/L. The plasma and RBC
samples were frozen at À76 1C and stored until the analysis of the
inflammatory mediators and the fatty acids was carried out.
2.3. Inflammatory mediators
The plasma samples were analysed for inflammatory mediators
tumor necrosis factor-α (TNF-α), TNF-β, interleukin-1β (IL-1β), IL-6,
IL-8, IL-10, IL-12, IL-18, interferon-γ (IFN-γ), macrophage inflam-
matory protein-1α (MIP-1α) and transforming growth factor-β
(TGF-β) as previously described [21], and determined using the
Luminex 100™ platform (Luminex Corp, TX, USA). These media-
tors were selected based on their potential role in the acute
inflammatory response following major surgery (6,7,14,15,16).
The samples were measured in duplicate and standard curves
were fitted with a five parameter logistic equation (Logistic-5PL)
using BioPlex™ Manager 5.0 (Bio-Rad Laboratories, CA, USA).
Plasma CRP concentration was determined using a commer-
cially available high sensitivity (hs)-CRP latex-enhanced immuno-
turbidimetric assay (Roche Diagnostics, Mannheim, Germany) and
Hitachi 911 analyser. The lower detection limit of the assay is
0.1 mg/L. The total coefficient of variation for hs-CRP measure-
ments of internal controls was 1.1% at a concentration of 3.73 mg/L
and 1.9% at a concentration of 0.68 mg/L.
2.4. Fatty acid composition of plasma phospholipids and RBC
membranes lipids
Total lipids were extracted from plasma using the Folch method
[22], and the phospholipid (PL) fraction isolated using thin layer
chromatography. The lipid fraction was extracted from RBC mem-
brane lipids using a method described by Bligh and Dyer [23]
except that isopropanol was used instead of methanol (isopropa-
nol/chloroform 2:1, v/v). BHT (50 mg/L) was added to the extrac-
tion medium. Fatty acid methyl esters (FAME) of plasma PL and
RBC membrane lipids were formed using 14% boron trifluoride/
methanol (Sigma Chemical Co., St. Louis, MO, USA) at 110 1C for
45 min. The FAME of plasma PL were analysed by gas–liquid
chromatography as previously described [19], but those of the
RBC membrane lipids were analysed by gas chromatography
(Agilent 6890N, Agilent, Palo Alto, CA, USA) using a Chrompack
CP-SIL 8CB column (25 m  250 mm i.d.  0.12 mm film thickness).
The oven was programmed to provide an initial temperature of
150 1C for 4 min, then increasing temperature by 4 1C/min to
230 1C and then by 20 1C/min to 280 1C, and finally the oven was
held isothermal for 4 min. The injector and detector temperatures
were maintained at 280 1C and 300 1C, respectively. Hydrogen was
used as the carrier gas. The FAME peaks were identified and
calibrated against commercial standards (Sigma Chemical Co.; Nu-
Chek-Prep, Elysian, MN, USA). Fatty acid values in plasma PL and
RBC membrane lipids are presented as % weight of total fatty acids
with chain length from C14 to C24. Instrumental control and data
handling was performed using HP 3365 Chemstation, Version
A.02.12. (Hewlett Packard Co., Palo Alto, CA, USA).
2.5. Statistical analysis
The main objective was to examine the relationship between
fatty acid levels in plasma PL and RBC membrane lipids preopera-
tively and the changes in concentrations of inflammatory media-
tors from immediately prior to surgery to the third postoperative
day. Independent samples t-test was used to compare groups with
respect to the levels of EPA, DHA and AA in plasma PL and RBC
membrane lipids at baseline and preoperatively, and paired t-test
to examine the significance of changes between time points within
groups. Due to non-normal distribution, Wilcoxon signed rank test
was used to compare the difference in median concentrations of
inflammatory mediators between time points. Spearman's corre-
lation coefficient was employed to examine the relationship
between continuous variables. Multivariable linear regression
was used to assess the relationship between preoperative levels
of fatty acids in plasma PL and RBC membrane lipids and changes
in the concentrations of inflammatory mediators following sur-
gery, adjusting for age, body mass index (BMI) and smoking, as
these variables were a priori assumed to have a potential con-
founding effect on the relationship.
Data are presented as median and range, percentages or mean7
standard error of the mean (SEM). A two-sided P valueo0.05 was
considered statistically significant. All statistical analyses were carried
out using SPSS software (version 17.0, IBM Corporation, Somers,
NY, USA).
L. Bjorgvinsdottir et al. / Prostaglandins, Leukotrienes and Essential Fatty Acids 89 (2013) 189–194190
3. 3. Results
3.1. Characteristics of the patients
The median plasma concentrations of the inflammatory med-
iators did not differ between the groups of patients receiving nÀ3
LC-PUFA or placebo (P40.05; data not shown). Thus, all patients
were combined for analysis of the association between preopera-
tive levels of fatty acids in plasma PL and RBC membrane lipids
and postoperative changes in plasma concentrations of inflamma-
tory mediators. Baseline and surgical characteristics of the patients
(n¼168) are outlined in Table 1. The median age of the patients
was 67 (range, 43–82) years, 79.2% were men, and their median
BMI was 27.4 (range, 17.2–41.3) kg/m2
. Seventy-two percent of the
patients consumed fish once or more each week, 55% used cod
liver oil and one-quarter nÀ3 LC-PUFA capsules as daily
supplements.
3.2. EPA, DHA and AA levels of plasma PL and RBC membrane lipids
As shown in Table 2, our patients had relatively high baseline
levels of EPA and DHA in plasma PL and RBC membrane lipids.
Table 2 also demonstrates how the one-week nÀ3 LC-PUFA or
placebo treatment affected the levels of EPA, DHA and AA in
plasma PL and RBC membrane lipids of our patients, i.e. the
preoperative levels.
3.3. Preoperative and postoperative plasma concentrations of
inflammatory mediators
Fig. 1 shows the plasma concentrations of the inflammatory
mediators in the patients preoperatively and on postoperative day
three. The postoperative concentration of the pro-inflammatory
cytokine TNF-β was significantly lower (Po0.05), and those of
the pro-inflammatory mediators hs-CRP, IL-6, IL-8 and IL-18 and
the anti-inflammatory cytokine IL-10 were significantly higher
(Po0.05) than the preoperative concentrations. No changes were
observed in the concentrations of the pro-inflammatory mediators
TNF-α, IL-1β, IL-12, IFN-γ, MIP-1α, and the anti-inflammatory
cytokine TGF-β.
3.4. Relationship between preoperative levels of EPA, DHA, and AA in
plasma PL and RBC membrane lipids and postoperative changes in
inflammatory mediators
A separate multivariable linear regression model was used to
assess the relationship between the preoperative levels of AA, EPA
and DHA in plasma PL and RBC membrane lipids and the intra-
individual change in the plasma concentration of each inflamma-
tory mediator, observed on the third postoperative day. The
changes in the plasma concentrations of TNF-β, IL-1β, IL-10,
IFN-γ and TGF-β were significantly (Po0.05) associated with the
levels of one or more of the fatty acids in plasma PL and/or in RBC
membrane lipids when adjusted for age, BMI and smoking
(Table 3). A more conspicuous decrease in the concentration of
TNF-β was associated with a higher AA level (β¼ À0.240), and a
smaller decrease with a higher ratios of DHA/AA and EPA+DHA/AA
(β¼0.196 and 0.170, respectively) in RBC membrane lipids. A more
pronounced increase in the IL-1β concentration was associated
with higher ratios of DHA/AA and EPA+DHA/AA in plasma PL
(β¼0.221 and 0.191, respectively), and with a higher level of EPA,
as well as with higher ratios of EPA/AA, DHA/AA and EPA+DHA/AA
in RBC membrane lipids. A greater increase in IL-10 was associated
with a higher AA level, a lower EPA level and lower ratios of EPA/
AA and EPA+DHA/AA in plasma PL. A greater increase in IFN-γ was
associated with a higher EPA level, and with a higher ratio of EPA/
AA in RBC membrane lipids. A smaller increase in TGF-β was
associated with a higher level of AA, and a greater increase was
associated with higher ratios of DHA/AA and EPA+DHA/AA in
plasma PL. Furthermore, a smaller increase in TGF-β was asso-
ciated with a higher AA level, and a greater increase with higher
EPA and DHA levels, and higher ratios of EPA/AA, DHA/AA and EPA
+DHA/AA in RBC membrane lipids. The relationship between post-
operative changes in the plasma concentrations of hs-CRP, IL-6, IL-8,
Table 1
Baseline and surgical characteristics of the patients.
Characteristic Value (n¼168)
Age (years) 67 (43–82)
Gender (% men) 79.2
BMI (kg/m2
) 27.4 (17.2–41.3)
Diabetes (%) 14.9
Smoking (%) 19.0
Fish intake (%, 4once a week) 72.0
Liquid cod liver oil (%) 54.8
nÀ3 LC-PUFA capsules (%) 26.8
Use of statins (%) 80.4
ECC time (min) 96 (0–261)
On-pump surgery (%) 88.1
Aortic cross-clamp time (min) 48 (0–208)
Blood volume in drains (mL) 765 (96–4980)
Data are presented as median (range) or percentage. BMI,
body mass index; LC-PUFA, long-chain polyunsaturated
fatty acids; ECC, extracorporeal circulation.
Table 2
Fatty acid levels (% of total fatty acids) in plasma PL and RBC membrane lipids at
baseline and preoperatively after one week of placebo or nÀ3 LC-PUFA treatment.
Fatty acids Placebo (n¼79) nÀ3 LC-PUFA (n¼80)
Plasma PL
EPA (20:5nÀ3)
Baseline 2.7570.20 2.5470.15
Preoperative 2.3470.12a
4.4370.16a,b
DHA (22:6nÀ3)
Baseline 6.0670.16 6.1770.16
Preoperative 5.9870.14 6.9870.13 a,b
AA (20:4nÀ6)
Baseline 8.8570.26 8.6070.25
Preoperative 9.0770.25 a
8.9370.24 a
RBC membrane lipids
EPA (20:5nÀ3)
Baseline 1.9670.09 1.9270.10
Preoperative 1.8870.08 a
2.3270.09 a,b
DHA (22:6nÀ3)
Baseline 7.3170.13 7.4870.14
Preoperative 7.3570.13 7.5870.14 a,b
AA (20:4nÀ6)
Baseline 12.2270.19 12.0770.20
Preoperative 12.1670.18 12.0870.20
Data are expressed as mean7SEM. PL, phospholipids; RBC, red blood cell;
LC-PUFA, long-chain polyunsaturated fatty acids; EPA, eicosapentaenoic acid;
DHA, docosahexaenoic acid; AA, arachidonic acid.
a
Po0.05, compared with the baseline levels within groups. Paired t-test.
b
Po0.05, compared with the placebo group at the same time period.
Independent samples t-test.
L. Bjorgvinsdottir et al. / Prostaglandins, Leukotrienes and Essential Fatty Acids 89 (2013) 189–194 191
4. IL-12, IL-18, TNF-α and MIP-1α and the preoperative levels of AA, EPA
and DHA in plasma PL or RBC membrane lipids was not statistically
significant.
4. Discussion and conclusions
In this study we observed a vigorous systemic inflammatory
response following open heart surgery. More importantly, we
found this response to be related to the preoperative fatty acid
composition of plasma PL and/or RBC membrane lipids.
During cardiac surgery, tissue injury and other factors induce a
robust systemic inflammatory reaction [5]. Animal and human
studies have demonstrated that the inflammatory response can be
modulated through changes in dietary intake of nÀ3 LC-PUFA,
which predominantly have anti-inflammatory properties [8].
Moreover, it has been demonstrated that patients undergoing
major non-cardiac surgery who received fish oil parenterally for
7 days postoperatively, had lower serum concentrations of the
pro-inflammatory mediators IL-1β, IL-8 and IFN-γ on postoperative
day 4 compared with patients receiving soybean oil-based lipid
emulsion, which is rich in the AA precursor linoleic acid [17].
In the present study, we observed marked postoperative changes
in the concentrations of several pro-inflammatory and anti-
inflammatory mediators, consistent with previous reports
[14,24], although no difference was observed between the nÀ3
LC-PUFA- and placebo-treated patients. The relatively high base-
line levels of EPA and DHA in plasma PL and RBC membrane lipids,
reflect the daily use of cod liver oil and/or nÀ3 LC-PUFA supple-
ments by a large proportion of patients in our study. The one-week
course of nÀ3 LC-PUFA treatment resulted in modest changes in
the levels of plasma PL EPA and DHA and almost no change in the
levels of RBC membrane EPA and DHA compared with the baseline
levels. Thus, short-term supplementation with moderate doses of
Fig. 1. Median plasma concentrations of the inflammatory mediators TNF-β, IL-6, hs-CRP, IL-8, IL-10, IL-18, TNF-α, IL-1β, IL-12, IFN-γ, MIP-1α, and TGF-β preoperatively and on
the third postoperative day in patients undergoing open heart surgery. n
Po0.02 and nn
Po0.001 compared with preoperative concentrations. Wilcoxon signed rank test.
L. Bjorgvinsdottir et al. / Prostaglandins, Leukotrienes and Essential Fatty Acids 89 (2013) 189–194192
5. nÀ3 LC-PUFA did not have an effect on the inflammatory response
as measured by the changes in the concentration of inflammatory
mediators on postoperative day 3 in the present study.
A more detailed analysis of fatty acid levels in plasma PL and RBC
membrane lipids suggested a potential role for EPA, DHA and/or AA
in the inflammatory process. We found the alterations in the plasma
concentrations of the pro-inflammatory mediators TNF-β, IL-1β,
IFN-γ, and the anti-inflammatory mediators IL-10 and TGF-β in
response to surgery to be significantly, albeit weakly, associated
with the preoperative levels of AA, EPA, and the ratios of EPA/AA,
DHA/AA and EPA+DHA/AA in either plasma PL and RBC membrane
lipids or both, whereas no such association was found with DHA. It
is known that EPA can compete with AA, as the same enzymes,
cyclooxygenase and lipoxygenase, are involved in the metabolism of
these fatty acids, and that eicosanoids derived from EPA have
weaker inflammatory effects than those derived from AA [9,10].
Existing evidence also suggesting that during an acute inflamma-
tory response, macrophages generate the potent anti-inflammatory
and proresolving lipid mediator lipoxin A4 from AA, which in turn
stimulates the production of the anti-inflammatory mediator IL-10
[25]. Consistent with this notion, we observed that higher AA level
and lower EPA level in plasma PL were associated with a greater
increase in IL-10. In contrast, we did not find a significant associa-
tion between AA or EPA in RBC membrane lipids with the changes
in IL-10, suggesting that the content of these fatty acids in plasma
PL may play a greater role in this process.
However, higher levels of AA and lower ratios of DHA/AA and
EPA+DHA/AA in RBC membrane lipids were associated with a
greater decline in TNF-β concentration, again suggesting a poten-
tial anti-inflammatory effect of AA. While the average concentra-
tions of the other three mediators, IL-1β, IFN-γ and TGF-β, did not
change following surgery, the intra-individual variability in
changes of their concentration associated significantly with pre-
operative fatty acid levels. This association was most consistent for
TGF-β as lower AA levels and higher ratios of DHA/AA and EPA
+DHA/AA in both plasma PL and RBC membrane lipids as well as a
higher EPA level in RBC membrane lipids were associated with an
increase in the concentration of this anti-inflammatory cytokine. It
has been demonstrated that TGF-β is produced by numerous cell
types and is one of the most potent chemoattractant for mono-
cytes and other cell types within wounds [26]. TGF-β also down-
regulates the production of pro-inflammatory mediators [5],
inhibits cell proliferation and induces apoptosis [27]. Though these
findings would suggest a possible anti-inflammatory effect of EPA,
the relationship observed between EPA in RBC membrane lipids
and IL-1β implies a pro-inflammatory effect. Taken together, our
findings suggest that the involvement of circulating and mem-
brane EPA and AA in the production of inflammatory mediators
following open heart surgery is greater than that of DHA. More-
over, the role of these fatty acids seems to be complex since EPA
and AA associate with both pro-inflammatory and anti-
inflammatory mediators.
Despite a careful design of the present study, there were several
notable limitations. First, it should be emphasized that the findings
are largely confined to elderly patients undergoing open heart
surgery who have relatively high baseline levels of nÀ3 LC-PUFA
in plasma PL and RBC membrane lipids and may not be representa-
tive for other populations. It should also be noted that we did only
measure the concentrations of inflammatory mediators immedi-
ately prior to surgery and on the third postoperative day. Systemic
inflammatory response following cardiac surgery is complex and
time-dependent, as it involves multiple cell types and a large
network of mediators. Earlier work has demonstrated that cardiac
myocytes are capable of synthesizing inflammatory mediators [1,2],
and that epicardial adipose tissue is a source of several such agents
[4]. Thus, the LC-PUFA EPA, DHA and AA may have local inflamma-
tory effects that are not necessarily reflected by circulating inflam-
matory mediators or the plasma PL or RBC membrane fatty acid
composition although the latter has been shown to correlate well
with the fatty acid composition of atrial myocytes [13]. However, it
might be considered a limitation that we did not measure the fatty
acid levels of cells in pericardial or atrial tissues or in other cell
types, e.g. white blood cells. In addition, it has been well documen-
ted that the inflammatory cascade is initiated immediately after
tissue injury and, therefore, many inflammatory mediators may
peak very early in the postoperative course [6,7,16]. Due to multiple
comparisons our analysis may by chance show a statistically
significant association between the changes in inflammatory med-
iators concentrations and the preoperative levels of the fatty acids in
plasma PL and RBC membrane lipids. We did not adjust for multiple
testing because the design of our study was exploratory in nature
and primarily hypothesis generating. Therefore, additional studies
are needed to examine how EPA, DHA and AA may be associated
with inflammatory mediators in the first hours and 24–48 h
Table 3
Relationship between preoperative levels of fatty acids in plasma phospholipids (PL) or red blood cell (RBC) membrane lipids and the postoperative change in the plasma
concentrations of selected inflammatory mediators, measured immediately before surgery and on the third postoperative day.
dTNF-β (pg/mL) dIL-1β (pg/mL) dIL-10 (pg/mL) dIFN-γ (pg/mL) dTGF-β (pg/mL)
Betaa
P R2
Beta P R2
Beta P R2
Beta P R2
Beta P R2
Plasma PL
AA À0.013 0.868 0.029 À0.101 0.214 0.031 0.163 0.044 0.047 0.000 0.997 0.022 À0.217 0.007 0.065
EPA À0.016 0.847 0.029 0.058 0.478 0.025 À0.191 0.018 0.057 0.127 0.116 0.037 À0.013 0.873 0.021
DHA 0.130 0.118 0.044 0.159 0.055 0.045 À0.034 0.683 0.023 0.158 0.057 0.044 0.101 0.226 0.030
EPA/AA ratio À0.359 0.991 0.029 0.129 0.117 0.037 À0.195 0.017 0.057 0.116 0.158 0.034 0.072 0.384 0.025
DHA/AAratio 0.096 0.255 0.037 0.221 0.008 0.065 À0.132 0.117 0.037 0.107 0.204 0.032 0.234 0.005 0.069
EPA+DHA/AA ratio 0.052 0.532 0.031 0.191 0.022 0.054 À0.177 0.034 0.050 0.122 0.147 0.035 0.167 0.046 0.045
RBClipids
AA À0.240 0.003 0.091 À0.154 0.061 0.042 0.072 0.383 0.026 À0.110 0.181 0.030 À0.264 0.001 0.080
EPA 0.072 0.385 0.042 0.221 0.008 0.063 À0.064 0.447 0.025 0.182 0.030 0.049 0.198 0.018 0.050
DHA 0.144 0.102 0.054 0.121 0.176 0.031 À0.035 0.693 0.022 0.011 0.907 0.019 0.165 0.064 0.037
EPA/AA ratio 0.107 0.198 0.048 0.227 0.006 0.066 À0.062 0.457 0.025 0.168 0.044 0.045 0.219 0.009 0.058
DHA/AA ratio 0.196 0.021 0.070 0.175 0.041 0.046 À0.064 0.459 0.000 0.077 0.368 0.024 0.237 0.005 0.063
EPA+DHA/AA ratio 0.170 0.044 0.062 0.203 0.017 0.055 À0.063 0.463 0.025 0.144 0.180 0.030 0.239 0.005 0.065
a
Standardized beta coefficient (β) for the fatty acid from each regression model. The analysis of the relationship between arachidonic acid (AA), eicosapentaenoic acid
(EPA) and docosahexaenoic acid (DHA) and selected inflammatory mediators is adjusted for age, body mass index (BMI) and smoking. Bold P values indicate significant
relationship by multivariable linear regression analysis. R2
represents the proportion of the variability in the change in an inflammatory mediator which is explained by
the model.
L. Bjorgvinsdottir et al. / Prostaglandins, Leukotrienes and Essential Fatty Acids 89 (2013) 189–194 193
6. following open heart surgery in both young and elderly patients.
Finally, we only examined a limited number of inflammatory
mediators so that additional studies will be required to explore
the role of other mediators of inflammation.
In conclusion, our findings support the notion that the levels of
EPA and AA in plasma PL and/or cell membrane lipids may affect
the inflammatory response following open heart surgery. How-
ever, both these fatty acids associate with pro-inflammatory and
anti-inflammatory mediators, suggesting a complex role in the
inflammatory process that occurs during the postoperative period.
Additional studies are needed to better characterize the influence
of nÀ3 LC-PUFA on the postoperative inflammatory response,
which may be better elucidated by measuring the concentrations
of inflammatory mediators earlier following surgery and at multi-
ple time points.
Acknowledgements
The contribution to this work by the patients, the staff at
Landspitali—The National University Hospital of Iceland, and Lilja
G. Steinsdottir, Laboratory Assistant at the University of Iceland, is
greatly appreciated.
Sources of support: Supported by grants from the Icelandic
Research Fund (RANNIS, Grant No. 080411021), the University of
Iceland Research Fund, and the Landspitali—The National Univer-
sity Hospital of Iceland Research Fund.
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