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1.
Effect of Passiflora setacea juice and its phenolic metabolites on insulin resistance markers in overweight individuals and on microglial cell activity.
Duarte, I, de Souza, MCM, Curinga, RM, Mendonça, HM, de Lacerda de Oliveira, L, Milenkovic, D, Hassimotto, NMA, Costa, AM, Malaquias, JV, Dos Santos Borges, TK
Food & function. 2022;(12):6498-6509
Abstract
Passiflora setacea (PS) is a species of wild Brazilian passion fruit, rich in bioactive compounds. Scientific evidence suggests that food rich in polyphenols can modulate inflammation, thereby playing an important role in preventing chronic non-communicable diseases, such as type 2 diabetes (DT2) and cardiovascular diseases (CVD). This study aimed to investigate the effect of PS consumption on metabolic and inflammatory biomarkers in overweight male volunteers and to identify the underlying mechanism of action using an in vitro study using phenolic metabolites isolated from the plasma of volunteers at physiologically relevant concentrations. Volunteers participated in a double-blind, placebo-controlled (PB) study with two phases: phase I (acute study) and phase II (chronic study). In phase I, 15 volunteers ingested a single dose of 50 g, 150 g of PS pulp and PB in three different interventions. In phase II, nine volunteers ingested 50 g of PS or PB for 14 days. Blood samples were collected before (T0 h) and 3 h (T3 h) (phase I) or 15 days after (phase II) ingestion of PS or PB. Blood biochemical markers, HOMA IR, and inflammatory markers were analyzed and data on BMI, waist circumference, and consumption of polyphenol-rich foods were collected. Phenolic metabolites were extracted from plasma by solid-phase separation and were used to treat BV-2 cells stimulated by LPS or anacardic acid to assess p50, p65 and PPAR-γ activation. It was observed that the consumption of a single dose of PS juice significantly reduced basal insulin levels and HOMA IR. After prolonged consumption for two weeks, PS contributed to the reduction of circulating levels of IL-6. BV-2 cells treated with PS phenolic metabolites showed increased PPAR-γ activity, which resulted in an anti-inflammatory and anti-diabetic effect of PS metabolites. In conclusion, PS juice consumption exerts beneficial effects on inflammatory markers in overweight individuals, being a possible and important tool in the prevention of T2D and CVD in risk groups.
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2.
Evaluation of E-Health Applications for Paediatric Patients with Refractory Epilepsy and Maintained on Ketogenic Diet.
Costa, AM, Marchiò, M, Bruni, G, Bernabei, SM, Cavalieri, S, Bondi, M, Biagini, G
Nutrients. 2021;(4)
Abstract
E-health technologies improve healthcare quality and disease management. The aim of this study was to develop a ketogenic diet management app as well as a website about this dietary treatment and to evaluate the benefits of giving caregivers access to various web materials designed for paediatric patients with refractory epilepsy. Forty families participated in the questionnaire survey, from January 2016 to March 2016. All caregivers were exposed to paper-based materials about the ketogenic diet, whereas only 22 received the app, called KetApp, and videos produced by dieticians. Caregivers with free access to web materials were more satisfied than the others with the informative material provided by the centre (p ≤ 0.001, Mann-Whitney test). Indeed, they showed a better attitude towards treatment, and they became more aware of dietary management in comparison to the control group (p ≤ 0.001). Moreover, caregivers provided with web materials were stimulated to pursue the treatment (p = 0.002) and to introduce it to their children and other people (p = 0.001). Additionally, caregivers supplied with web materials were more willing to help other families in choosing the ketogenic diet (p = 0.004). Overall, these findings indicate that web materials are beneficial for caregivers of paediatric patients with refractory epilepsy in our centres. Thus, the use of e-health applications could be a promising tool in the daily aspects of ketogenic diet management, and it is especially of value in the attempt to start or maintain the diet during the ongoing COVID-19 pandemic crisis.
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3.
Acute Effects of the Consumption of Passiflora setacea Juice on Metabolic Risk Factors and Gene Expression Profile in Humans.
Duarte, IAE, Milenkovic, D, Borges, TKDS, Rosa, AJM, Morand, C, Oliveira, LL, Costa, AM
Nutrients. 2020;(4)
Abstract
BACKGROUND Passiflora setacea (PS) is a passionfruit variety of the Brazilian savannah and is a rich source of plant food bioactives with potential anti-inflammatory activity. This study aimed to investigate the effect of an acute intake of PS juice upon inflammation, metabolic parameters, and gene expression on circulating immune cells in humans. METHODS Overweight male volunteers (n = 12) were enrolled in two double-blind placebo-controlled studies. Blood samples were collected from fasting volunteers 3 h after the consumption of 250 mL of PS juice or placebo (PB). Metabolic parameters (insulin, glucose, total cholesterol, high-density lipoprotein (LDL), high-density lipoprotein (HDL), and total triglycerides) and circulating cytokines were evaluated (study 1). Peripheral blood mononuclear cell (PBMC) from the same subjects were isolated and RNA was extracted for transcriptomic analyses using microarrays (study 2). RESULTS Insulin and homeostatic model assessment for insulin resistance (HOMA-IR) levels decreased statistically after the PS juice intake, whereas HDL level increased significantly. Interleukin (IL)-17A level increased after placebo consumption, whereas its level remained unchanged after PS juice consumption. Nutrigenomic analyses revealed 1327 differentially expressed genes after PS consumption, with modulated genes involved in processes such as inflammation, cell adhesion, or cytokine-cytokine receptor. CONCLUSION Taken together, these clinical results support the hypothesis that PS consumption may help the prevention of cardiometabolic diseases.
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4.
Ghrelin Plasma Levels After 1 Year of Ketogenic Diet in Children With Refractory Epilepsy.
Marchiò, M, Roli, L, Lucchi, C, Costa, AM, Borghi, M, Iughetti, L, Trenti, T, Guerra, A, Biagini, G
Frontiers in nutrition. 2019;:112
Abstract
The ketogenic diet (KD) is a high-fat, low carbohydrate nutritional treatment adopted in several countries for refractory epilepsy. However, the use of KD is limited by adverse events including growth retardation. In a previous investigation, we demonstrated that ghrelin is reduced in children maintained on KD for 3 months. As ghrelin regulates growth hormone (GH) secretion, it can be hypothesized that growth retardation depends on the reduced ghrelin availability. To assess this hypothesis, in this study we evaluate ghrelin and growth during 1 year of KD. We examined a small cohort of 6 children (2 males and 4 females, age range 3-10.4 years) affected by refractory epilepsy, who received the KD as add-on treatment. All patients were on drug polytherapy. Endpoints of the study were: (i) ghrelin plasma levels at 0, 15, 30, 90, and 365 days from KD onset, (ii) growth, and (iii) seizure control by ketogenesis. Ghrelin levels were -53 and -47% of basal levels, respectively, at 90 and 365 days (P < 0.05 for both). Mean height index z scores were reduced, but not significantly, by comparing basal values with those at the end of observation. Instead, body mass index z scores slightly increased. Ketosis induced by the KD was within 2-5 mmol/L and satisfactorily reduced the seizure frequency (>50%) in all patients. We show that ghrelin plasma levels are consistently reduced in children with refractory epilepsy and maintained on the KD. This change was associated with low growth indexes in the majority of patients.
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5.
Behavioral, contextual and biological factors associated with obesity during adolescence: A systematic review.
Narciso, J, Silva, AJ, Rodrigues, V, Monteiro, MJ, Almeida, A, Saavedra, R, Costa, AM
PloS one. 2019;(4):e0214941
Abstract
INTRODUCTION/OBJECTIVE Adolescence is a critical period for the development of obesity. Obesity arises from a complex interaction between several factors, which are not yet fully understood. Therefore, the purpose of this review was to identify and assess the peer-reviewed scientific literature on the behavioral, contextual and biological factors associated with obesity in adolescents. METHODS PubMed and Scopus were systematically searched to identify prospective cohort studies concerning the relation between behavioral, contextual and biological factors and obesity in adolescents aged 10 to 18 years. RESULTS 40 studies published between the year 2000 and 2018 were included. A positive consistent association between genetic factors and obesity during adolescence was found. Also, there is evidence to support the association between socioeconomic status and obesity. There was conflicting evidence for the contribution of dietary intake, physical activity, sedentary behavior, sleep, food store environment, school food environment. For the remaining factors no associations were found, or no conclusions could be drawn due to the limited number of studies identified. CONCLUSIONS Further prospective studies that assess multiple obesity determinants simultaneously and use state-of-art measures are warranted to aid in the development of effective strategies and interventions to prevent obesity during adolescence.
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6.
Concomitant radiotherapy with protracted 5-fluorouracil infusion in locally advanced carcinoma of the pancreas: a phase II study.
Osti, MF, Costa, AM, Bianciardi, F, De Nicolò, M, Donato, V, Silecchia, G, Enrici, RM
Tumori. 2001;(6):398-401
Abstract
AIMS AND BACKGROUND To evaluate the efficacy of combined radiation therapy and continuous infusion of 5-fluorouracil in patients with locally advanced carcinoma of the pancreas. METHODS Between January 1992 and June 1999, 31 patients with locally advanced adenocarcinoma of the pancreas were treated in our Institute. In 20 patients, the tumor (65%) was located in the head of the pancreas and in 11 (35%) in the body or tail; 13 cases also showed involved nodes. Radiation therapy consisted in a median dose of 63 Gy in 33-36 fractions applied to the tumor and regional lymph nodes. Chemotherapy with 5-fluorouracil in continuous infusion, 250 mg/m2 daily, was administered in the first and fifth week of the radiation therapy. Thereafter, 22 patients received 3-10 cycles of adjuvant chemotherapy with same doses. Median follow-up of the series was 20 months. The toxicity of the treatment was scored according to WHO criteria. All patients underwent nutritional assessment at the time of radiochemotherapy. RESULTS The median overall survival was 15.2 months (range, 4-42). At restaging, 17 cases (55%) showed no change and 14 (45%) a partial remission. At the end of radiochemotherapy in 8 (26%) of the cases there was indication for pancreatectomy, which was executed in 4 patients. At the time of the study, 2 patients (6.4%) were surgically proven disease free. Eleven of the 13 cases (85%) presenting involved nodes showed that the enlarged lymph nodes had disappeared. Nineteen patients (61%) are alive with clinical evidence of disease anti 2 cases are alive with liver metastases; 8 patients (26%) died for disease. In 74% of cases there was complete pain control. Tolerance to the regimen was good. Nutritional assistance was evaluated and was found to be correlated to survival. CONCLUSIONS The results of the series confirm a good tolerance with low acute toxicity. Tumor down-staging and resectability rates were high, together with prolonged survival and a good quality of life.
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7.
Necrobiotic xanthogranuloma without periorbital involvement: an ultrastructural investigation.
Betts, CM, Pasquinelli, G, Costa, AM, Fanti, PA, Misciali, C, Varotti, C
Ultrastructural pathology. 2001;(6):437-44
Abstract
A case of necrobiotic xanthogranuloma without typical periorbital involvement is described at the ultrastructural level. The patient, a 58-year-old Italian man, presented in 1995 with a brief history of nodulo-papular lesions commencing on the lower limbs, and mild paraproteinemia. During 6 years of follow-up, anemia, neutropenia with marked lymphopenia, and increased ESR were found, while serum cholesterol and triglyceride levels decreased from hyper to hypo values. Systemic diseases, such as diabetes, malignancy, or extracutaneous lesions, often associated with NXG, have not developed. Conventional histology was distinctive for NXG, and immunohistochemistry confirmed that dermal histiocytes were not of Langerhans cell lineage. At ultrastructure, regeneration and degeneration ("regen-degen") features were observed in some individual deep dermal histiocytes, which have not been previously documented in the literature. Identification of giant histiocytes showing 'regen-degen'' aspects might prove to be a useful ultrastructural diagnostic marker for NXG.