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Supplementation with gliadin‐combined plant superoxide dismutase extract promotes antioxidant defences and protects against oxidative stress

Authors:
  • IntegraCell
  • Fondation pour une culture de sécurité industrielle, Toulouse

Abstract

The potential benefits to health of antioxidant enzymes supplied either through dietary intake or supplementation is still a matter of controversy. The development of dietary delivery systems using wheat gliadin biopolymers as a natural carrier represents a new alternative. Combination of antioxidant enzymes with this natural carrier not only delayed their degradation (i.e. the superoxide dismutase, SOD) during the gastrointestinal digestive process, but also promoted, in vivo, the cellular defences by strengthening the antioxidant status. The effects of supplementation for 28 days with a standardized melon SOD extract either combined (Glisodin®) or not with gliadin, were evaluated on various oxidative-stress biomarkers. As already described there was no change either in superoxide dismutase, catalase or glutathione peroxidase activities in blood circulation or in the liver following non-protected SOD supplementation. However, animals supplemented with Glisodin® showed a significant elevation in circulated antioxidant enzymes activities, correlated with an increased resistance of red blood cells to oxidative stress-induced hemolysis. In the presence of Sin-1, a chemical donor of peroxynitrites, mitochondria from hepatocytes regularly underwent membrane depolarization as the primary biological event of the apoptosis cascade. Hepatocytes isolated from animals supplemented with Glisodin® presented a delayed depolarization response and an enhanced resistance to oxidative stress-induced apoptosis. It is concluded that supplementation with gliadin-combined standardized melon SOD extract (Glisodin®) promoted the cellular antioxidant status and protected against oxidative stress-induced cell death. Copyright © 2004 John Wiley & Sons, Ltd.
PHYTOTHERAPY RESEARCH
Phytother. Res. 18, 957-'-962 (2004)
Published online in Wiley InterScience (www.interscience.wiley.com). DOl: 10.1002/ptr.1542
Supplementation with Glladin-combined
Plant Superoxide Dismutase Extract Promotes
Antioxidant Defences and Protects Against
Oxidative Stress
Ioannis Veuldeukis-", Marc Contf; Pascal Krauss', Caroline Kamaté'r', Samantha Blazquez',
Maurel Tefif, Dominiqne Mazier", Alphonse Calenda! and Bernard Dngas
1,2*
'ISOCELL Nutra SAS. 53 bd du Général Martial Valin, 75015, Paris, France
2INSER\1 U511, Irnmunobiologie Cellulaire et Moléculaire des Infections Parasitaires, CHU-Pitié Salptérière Paris VI, 75013,
Paris, France .
'INSER"! U477, Hôpital Cochin, 75006 Paris, France
The potential benefits to health of antioxidant enzymes supplied either through dietary intake or supple-
mentation is still a matter of controversy, The development of dietary delivery systems using wheat gliadin
biopolymers as a natural carrier represents a new alternative. Combination of antioxidant enzymes with this
natural carrier not only delayed their degradation (i.e. the superoxide dismutase, SOD) during the gastrointestinal
digestive process, but also promoted,
in vivo,
the cellular defences by strengthening the antioxidant statns.
The effects of supplementation for 28 days with a standamized melon SOD extract either combined (Gllsodin"
or not with gliadin, were evaluated on various oxidarive-stress biomarkers, As already described there was no
change either in superoxide dismutase, catalase or glutathione peroxidase activities in blood circulation or in
the liver' following non-protected SOD supplementaticn, Bowever, aninIals supplemented with GlisodinllD
showed a significant elevation in circulated antioxidant enzymes activities, correlated with an increased resist-
ance of red blood cells to oxidative stress-induced hemolysis, ln the presence of Sin-I, a chemical donor of
peroxynitrltes, mitochondria from hepatocytes regularly underwent membrane depolarîzation as the primary
biological event of the apoptosis cascade. Hepatocytes isolated from animais supplemented with Glisodinll>
presented a delayed depolarîzation response and an enbanced resistance to oxidative stress-induced apoptosis.
It is concluded that supplementation with gliadin-combined standardized melon son extract (Glisodin"
promoted the cellular antioxidant statns and protected against oxidative stress-induced cell death. Copyright
© 2004 John Wiley
&
Sons, Ltd.
Keywords: antioxidant; plant superoxide dismutase; gliadin; oxidative stress.
INTRODUCTION
ln all aerobic organisms, the consumption of oxygen is
crucial for life. It also produces reactive oxygen species
involved in the regulation of many different biological
pro cesses (Forman and Torres, 2002) and survival from
invading pathogens. Under physiological conditions the
production of these pro-oxidant molecules is control-
led at different levels by the antioxidant defences that
normally !imit the excess of free radical species (Wei
and Lee, 2002). These natural defences are essentially
composed of specialized enzymes such as superoxide
dismutase (SOD), catalase (Cat) and glutathione-
peroxidase (Gpx) and also by non-enzymatic antioxi-
dant molecules such as vitamins, thiols and f3-carotene.
Inflammatory or aging processes (Wickens, 2001) are
*
Correspondence to: Professor A. B. Dugas, ISOCELL Nutra SAS, 53
blvd du Général Martial Valin, 75015, Paris, France.
E-mail: bdugasïêtibcrtysurf.ïr
Contract/grant Sponsor: CIFRE fellowship ISOCELL Pharma SAS.
Copyright
©
2004 John Wiley
&
Sons, Ltd.
associated with the disruption of the oxidant/antioxidant
(redox) balance resulting in cellular and tissue oxidative
stress and cell death by apoptosis (Lang et al., 2002;
Chandra et al., 2000). Indeed, the progressive and dis-
crete imbalance of the endogenous redox system can
lead to the development of chronic degenerative dis-
eases (Lavrovsky et al., 2000; Tak et al., 2000). Thus it
seemed evident that nutritional antioxidant supple-
mentation could have health-promoting effects if it could
control the endogenous redox system (Fang et al., 2002;
Kritharides and Stocker, 2002). It is already admitted
that dietary antioxidants are very useful in general
health either by preventing or by supplementing the
usual drug treatments in a variety of diseases (Stephens
et
al"
1996; Kritchevsky, 1999; Burk, 2002). This sug-
gests that the use of a nutritional antioxidant formula
will provide better prevention of oxidative stress-me di-
ated diseases.
Until now the development of these new functional
foods has been limited by their poor capacity to pro-
mote efficient oral delivery of antioxidant enzymes
and also by the definition of the correct health bio-
markers to follow (Branca et
al.,
2001). However, the
Received
14
May 2003
Accepteâ 4June 2004
958
1.VOULDOUKIS ET AL.
development of new drug delivery and food pack-
aging systems (Weber et al., 2002; Takata et al., 2002)
make this new functional antioxidant formula possible
(Mosca et al., 2002; Stella et al., 1995; Regnault et al.,
1996). Among various different delivery systems the
wheat gliadin biopolymers presented a dual interest:
(i) their capacity to -trap and to delay the release
of the active ingredient during the gastrointestinal
digestive process (Arangoa et al., 2001), and (ii) their
bioadhesive properties with the intestinal mucosa to
improve and/or promote the delivery of the active in-
gredient, thus defining an orally bioactive SOD (Dugas,
2002).
This study investigated the froperties of an effective
nutritional formula (Glisodin ) made from the combi-
nation of a melon (Cucumis melo Le.) standardized
superoxide dismutase extract as the active ingredient
and wheat (Triticum vulgare) gliadin biopolymers as
the carrier. The antioxidant properties of the melon
SOD contained in Glisodin" were evaluated on anti-
oxidant biomarkers currently used to assess the poten-
tial health benefits of nutrition al products.
MATERLUS AND METHODS
Reagents. Dulbecco's modified Eagle's medium
(DMEM), L-glutamine, glucose, streptomycin-penicil
lin, fetal calf serum (FCS) and most of the chemical
reagents were from Sigma Chemical Co (St Louis, MO).
Hepatocytes were cultured in DMEM medium con-
taining 10% FCS, 1% L-glutamine, 2% streptomycin-
penicillin, in 5%
CO
2
at 37 "C, The chemical donor
nitrogen peroxide (Sin-I) was the kind gift of Dr J.P.
Kolb (INSER.t\1 U311, Paris, France). 2,2'-azobis-(2-
aminopropane )-dihydrochloride (AAPH) was obtained
from Calbiochem (Meudon, France). Wheat gliadin
(Gliamine") was purchased from HITEX (Vannes,
France). The standardized melon superoxide dismutase
extract (Extramel") was obtained from the strain
Cucumis melo L.e., genetically selected for its higher
grade SOD activity (90 ill/mg of dry powder), BIONOV
(Avignon, France).
The gliadin-combined SOD preparation. Briefly,
Glisodin® is a water dispersible form of superoxide
dismutase lyophilized extract from melon (standardized
to 90 ill/mg) combined with a 40% hydro-alcoholic
soft gel of gliadin at 50 "C, It is spray-dried using
maltodextrin as a support and the various ratios were
adjusted to obtain a theoretical activity of 1 lU/mg of
final dry powder.
The superoxide dismutase activity of the Glisodin"
was certified using a specifie enzymatic assay
(Beauchamp and Fridovich, 1971; Oberley and Spitz,
1984) from 5 g of dry product sonicated into 7 mL of
water. The solution was then centrifuged at 10000 g
for 20 min and the first supernatant
(SI)
made up to
10 mL with ultra pure water. The pellet was suspended
again in 1 mL of ultra pure water, homogenized and
centrifuged at 10 000 x g for 20 min at 6°-8 "C, The sec-
ond supernatant (S2) was then adjusted to 1 mL. The
activity in both fractions
(SI
and S2) was determined
on a native polyacrylamide gel electrophoresis against
the SOD melon extract (90 lU/mg).
Copyright © 2004 John Wiley
&
Sons, Ltd.
Delayed release of loaded SOD from the gliadin com-
bination. The progressive release of the SOD activity
trapped by the gliadin polymers was compared with
the parallel degradation of the non-protected SOD
(melon extract) during a pro cess that mimicked the
digestive transit (0.1
M
hydrochloric acid at pH
1
in the
presence of 1 !lM of pepsin at
37
DC) as already de-
scribed by Stella et al. (1995).
Animal population and treatment. Balb/c mice were
purchased from IFFA-CREDO (Orleans, France), aged
6-8 weeks and weighing 25-30 g. Each group consisting
of 10 animals randomly selecte d, received either a
normal diet, or a supplementation with gliadin, or a
supplementation with non-protected SOD melon ex-
tract (10 ill/day for 28 days) or Glisodin" (0.1, 0.5, 1,
5 mg/day for 28 days) by force-feeding.
Redox status. Blood samples were collected on heparin
at different time-points along the supplementation pe-
riod (0,7,14,21 and 28 days). Plasma and erythrocytes
were immediately separated by centrifugation at 800
x
g
for 20 min at 4 "C, Superoxide dismutase (RANSOD
kit, Randox) glutathione peroxidase (RA.t~SEL kit,
Randox) and catalase activities (was assayed by a
method in which the disappearance of peroxide is
followed spectrophotometrically at 240 nm) were then
deterrnined. Red blood cell (RBC) hemolysis, induced by
the free radical generator 2,2'-azobis-(2-amidinopropane)-
dihydrochloride (AAPH), was deterrnined as previously
described (Miki et al., 1987).
Peroxynitrite-induced apoptosis in hepatocytes. Apo-
ptosis was quantified by using the ApoAlert DNA frag-
mentation detection kit (Clontech, Palo Alto, CA). At
days 0, 7 and 28, hepatic cells were isolated and incu-
bated for 48 h (5 x 105cells/mL) in complete DMEM
medium in the presence or in the absence of 100
ngl
mL of Sin-1 (3-morpholinosydnonimine hydrochloride),
a potent generator of nitrogen peroxide. Data are
presented as the percentage of apoptotic cells among
various areas of 200 cells.
Measurement of the mitochondrial depolarization,
D.
'fi
m'
The
il
'Pmof isolated hepatocytes was measured by flow
cytometry using the J-aggregate-forrning lipophilic
cation, 5,5',6,6'
-tetrachloro-Ll
,3,3'-tetraethylbenzimida-
zolocarbocyanine iodide (JC-1) (Beltran et al., 2000).
Briefiy, aliquots of the cell suspension (106cells) were
incubated with JC-1 at a final concentration of
31J.M
at 37°C in the dark for 30 min before analysis. Pre-
lirninary experiments demonstrated that under these
conditions the dye reached near equilibrium distribu-
tion and gave a maximal fluorescence response to a
fall in
il
'Pm induced by the mitochondrial uncoupler
carbonyl cyanide m-chlorophenylhydrazone (5
ILro.f).
Flow cytometry was performed on a FACScan instru-
ment (Becton Dickinson). Data were acquired and ana-
lysed by using CELLQUEST software. The results are
expressed as the mean aggregate fluorescence (red)
alone.
Statistical analysis. Mean comparisons between the vari-
ous groups (with or without supplemented diets) were
conducted using Student's t-test. Differences were
considered significant when
p
<0.05).
Pltytother.
Res.
18, 957-962 (2004)
ORAL DELfVERY OF SUPEROXIDE DISMUTASE
959
Supplementation SaD (U/g Hb)
Table 1. Effect of a supplementation with non-protected SOD on circulating antioxidants
Catalase (kU/g Hb)Gpx (U/g Hb)
Control
Non proteeted SaD extra et
1125 ±55
1220
±
40
798
±
32
810
±21 30 ±2
33 ± 6
Animais
(n
=
10) were fed every day with control diet supplemented or not with 10 mg/mouse/day
of the non-protected SOD for 28
days,
Blood sam pies were collected and SaD, Gpx and catalase
activities were evaluated in erythrocytes. Data represent the mean.
±
SD
of
ten animals/group
from
one representative experiment.
RESULTS
Wheat gliadin carrier delays the SOD release in
conditions mimicking the digestive pro cess
Many investigations (Zidenberg-Cherr et al., 1983; Giri
and Misra, 1984) now including ours, demonstrated
that oral treatment with non-protected SOD did not
induce significant changes in the circulating redox sta-
tus since the levels of erythrocyte SOD, catalase and
Gpx activities remained constant (Table 1). This is con-
sistent with the poor bioavailability or rapid degrada-
tion of proteins during the digestive process. As a matter
of fact, a rapid disappearance of the non-protected
SOD activity was observed in a medium mimicking the
digestive pro cess (Fig. 1) demonstrating that the anti-
oxidant enzyme was destroyed during gastrointestinal
transit. However, when the SOD activity was trapped
by gliadin biopolymers (Glisodin®) a significant and
progressive increase of SOD activity was observed
probably correlating with the concomitant proteoly-
sis of the gliadin biopolymers. This suggested that
gliadin might delay the release and consequently the
degradation of the. SOD activity during gastrointestinal
transit.
~
100
~
-Or-
Free SOD
'>
!
--- Glisodin
n
80
i
T
III
0
0
,
(J)
60
1
!
L
~
40
!
:~
l
.•.
0
,
tf?
20
-1
o
2
5
10 30 60
Time (min)
Figure
1. Gliadin polymers delay the release of the melon SOD
activity in a medium mimicking the digestive process. An iden-
tical amount (100 units) of melon-SOD extract was submitted
free or combined with gliadin (Glisodin·"') to conditions mimick-
ing the digestive process, for 1 h at 37°C. The medium was
periodically sampled to measure the residual SOD activity ac-
cording to the reduction of ferricytochrome C. The data repre-
sent the mean
±
SD of quadruplicate samples of one treatment
out of six different experiments.
Copyright © 2004 John Wiley
&
Sons, Ltd.
Table 2. Effect of a supplementation with SOD-gliadin combina-
tion on circulating antioxidants
Supplementation
Control Glisodin"
Antioxidant status (rnrnol/Ll
SOD (U/g Hb)
Gpx (U/g Hb)
Catalase (kU/g Hb)
1.39
±
0.03
1720
±
125
800
±
33
35
±
5
1.98
±
0.06
3250
±
255
1210
±
89
95
±
6
Animais were fed every day with control diet or with con-
trol diet supplemented with 1 mg/mouse/day of Glisodin" for
28 days. Blood samples were collected and SOD, Gpx and
catalase activities were evaluated in erythrocytes. Data repre-
sent the mean
±
SD of ten animals/group
from
one representa-
tiva
experiment.
Glisodin@ supplementation modulated the circulating
antioxidant status
Supplementation of normal mice with the gliadin-
combined standardized melon SOD extract (Glisodin®)
for 28 days was.found to promote the circulating anti-
oxidant enzymes SOD, catalase and Gpx (Table 2). This
effect was formula specifie (Glisodin"), because the non-
protected SOD extract or the gliadin alone was unable
to promote these antioxidants. This promoting effect
was time dependent (Fig. 2A) since the circulating SOD
activity began to Increase after 7 days of supplementa-
tion to reach a maximum after 28 days (SOD returned
to the baseline after an addition al 28 days, data not
shown), The promoting effect was dose dependent
(Fig. 2B) since significant effects appeared only for doses
equivalent to 0.5 mg/day or higher with a maximal
effect .obtained at 5 mg/day.
As already demonstrated for different antioxidant
dietary supplementation (Peng
et al.,
2000), the supple-
mentation with Glisodin" for 28 days increased the re-
sistance of RBC
(p
<
0.01) to oxidative stress-induced
hemolysis (Fig. 3) in response to a chemical donor of
free radicals (AAPH). After 3 h of incubation at 37°C
in the presence of 50 mMAAPH, about 48% vs 74% of
hemolysis was observed for RBC isolated, respectively,
from animaIs supplemented or not with Glisodin".
Hepatoprotective effect of Glisodln" supplementation
As previously described
in vitro
(Vouldoukis
et al.,
2000), the SOD-gliadin combination also induced
in vivo,
a time-dependent increase in SOD activity in
Phytother. Res. 18, 957-962 (2004)
-- -- ----------~.
960
1.VOULDOUKIS
ET AL.
5000
l
AI
(J) 5000]
>-
-{,.~Control
(1j
1
"0
i
..,.. Free gliadin
TT
co
~ 4000
1
--e-
Free SOD
f
11
N
L-
4000 .
-o-Glisodin
Q) 1
;::=
1
i
3000
1
(1j
:0-
:c
1
el
3000
1
:3
-
(1j
!
>-
~ 2000
J
t:;t;t:J
!
-
.:;
2000
1
:;:;
1
o
(1j
el
1000
1
0
1000 .
CI')
0
7
14 21 28 0 0.1 0.5 5
Time of treatment (days) Gllsodirr"
(mg/day)
Figure
2.
Effect of a supplementation with
Glisodin"
on circulating SOD activity. A. Mice were fed for
28
days, with either a control
diet or supplemented with (a) melon SOD extract
(10
lU of non protected SOD), (b) gliadin
(1
mg) or (e) Glisodin"
(1
mg for
1IU).
B.
Mice were fed with different doses of Glisodin"
(0.1, 0.5, 1,
or
5
mg of Glisodin"/mouse/day). Blood was periodically sampled in
the study (A) while only at day
28
for study (B). SOD activity was measured as deseribed in materials and methods. Data represent
the mean
±
SEM of the different groups.
90
80 -+-Control
T
1
70
I
-0- Glisodin-treated
T
:H<OO11
c
60
1
.!!1
!
Ul
50
.L
>-
40
1
n .
'0
1
E30
t
1
Q)
1
:x:
1
20
..L
1
10
1
1
·06/1
00,5
1
1,5 2 2,5 3
Time (Hours)
Figure
3.
Effect of a supplementation with Glisodin" on ervthro-
eyte resistanee to oxidative stress-induced hemolysis. After a
28
day peri ad of supplementation with Glisodin"
(1
mg/day),
RBC were eolleeted and exposed ta the free radical generator
AAPH
(50
mM). Hemolysis was evaluated as deseribed in mate-
rials and methods. Data represent the mean
±
SEM of the dif-
ferent groups.
hepatocytes (Fig. 4). This inducing effect appeared to be
significant
(p
<0.05) after 14 days of Glisodin" supple-
mentation and reached a maximal effect after 21-28
days
(p
<
0.001). Such stimulation was not restricted to
the SOD activity because catalase and Gpx activities
were also increased (Table 3). As shown in Fig. 5 the
improvement of the hepatocyte antioxidant defences
correlated with an increased resistance (p <0.01) to
oxidative stress-induced apoptosis (Estevez and Jordan,
2002). After 8 h in the presence of the peroxynitrites
chemical donor Sin-I, it was observed that 20% of the
hepatocytes isolated from animals supplemented with
Gliscdin" underwent apoptotsis, whereas this rate in-
creased ta 72% in hepatocytes fram
untreated
animals.
Copyright © 2004 John Wiley
&
Sons,
Ltd.
Table 3. Effect of a supplementation with SOD-gliadin combina-
tion on Iiver antioxidants
Supplementation
Activity (unit/mg of protein)
SOD Gpx Catalase
2.5
±
0.2
13.5
±
0.6 0.21 ±0.05
0.80 ±0.02 40
±
1
68
±
3
Control
Glisodin"
Animais received every day either a control diet with or with-
out supplementation with
1
mg/mouse/day of Glisodin" for
28
days. Livers were then collected and then the SOD, catalase
and Gpx activities were evaluated from the various tissue ex-
tracts. Data represent the mean
±
SD of ten animals/group.
Effect of Glisodin" supplementation on animal
hepatocytes mitchondriaI
L1
'fi
m
exposed ex vivo to
Sin-1
As the mitochondrion is a key compartment involved
in the control of oxidative stress-induced cell death
(Akao et al., 2003a) the mitochondrial functions of
hepatocytes isolated from animaIs receiving a Glisodin"
supplementation were evaluated. As aIready described
(Li et al., 2002; Kahlert and Reiser, 2002; Makani et al.,
2002) mitochondria from normal hepatocytes exposed
to Sin-l showed a gradual decrease in
LI.'Pm
as described
by the mean aggregate fluorescence of the cationic
lipophilic fluorochrome (Je-l) (Fig. 6). Analysis of
mitochondrial
LI.
'f'
ID
of Sin-l-stimulated hepatocytes from
Glisodin" supplemented animals demonstrated that the
mitochondrial depolarization was substantially delayed.
DISCUSSION
This study investigated the potential effects of a
supplement containing a gliadin-combined plant SOD
Phytother. Res. 18, 957-962 (2004)
ORAL DELIv'ERY OF SUPEROXIDE DISMUTASE
961
10
-o-Contro!
<:
--*-Gliadin
Oi
"0
8
-0-
SOO extract
...
0.
-
~Glisodin
0
01
6
2-
~
4.
~
Ü
<Il
0
2
0
rn
0
0
7
14 21
28
Time of treatment (days)
Figure 4. Effect of a supplementation with Glisodln" on liver
SOO activity. Mice were fed with a control diet supplemented
or not with
1
mg/mouse/day of
Gllsodin".
Animais were killed
periodically each 7 days. Liver proteins were extracted and the
SOO activity was evaluated. The results are expressed as units
per mg of protein and data represent the mean
±
SEM of the
different grou ps.
100
f&!l
Control
i
80
l
B Glisodin
.g
60
1
.B
0-
o
g.
40
'5
><
1
20 .
l
p
«
0.001
~
T
Figure 5. Effect of a supplementation with Glisodin"' on the
resistance of hepatocytes to nitrogen peroxide-induced
apoptosis.
Balb/c
mice
(n
=
10 per group) were fed a control
diet supplemented or not with , mg/mouse/day of Glisodin"'
and killed after
28 davs,
After isolation Iiver ceIls were submit-
ted to Sin-t. The results are expressed as a percent of apoptotic
ceIls and data represent the mean
±
SEM of four different
experiments.
extract on several redox biomarkers. The results of this
animal study were dual: the Glisodin" dietary supple-
mentation not only promoted the circulating and
tissue antioxidant defences (increased SOD, Gpx and
catalase activities) but also improved cell resistance to
oxidative stress. ln the circulation, RBC from animals
receiving Glisodin" were less susceptible to oxidative-
stress-induced hemolysis. ln addition hepatocytes from
animaIs receiving Glisodin" dietary supplementation
Copyright
©
2004
John
Wiley
&
Sons, Ltd.
140
11
il
g
1 •••••••
Control
ii
t: '
Co
~?
120 ~
1-0-
Glisodin
î.
(I)~ I~'- ~
~~1001
T ~~
a
801 ~ ~~ 1
~~ i
= }~~
~ 60 T
<ll
œ
40
1
3
4
o
1
2
Time after serum withdrawal (hours)
Figure 6. Effect of a supplementation with Glisodin"' on
sln-t-tnduced mitochondrial membrane depolarization
Ll'!'
m
in
hepatocytes. Changes in
t.\Pm
of isolated hepatocytes from
normal or Glisodin"'
(n
=
10 per group) supplemented animais
were followed after exposure to the chemical peroxynitrite
donor, Sin-l
(100
ng/mL) over a period of 4 h as described in
materials and methods. Data represent the mean
±
SO of ail
animais.
were resistant to peroxynitrite-induced apoptosis and
mitochondrial depolarization.
The combination of the melon SOD extract with
gliadin biopolymers
is
mandatory for obtaining this
health promoting effect, confirrning that the wheat
gliadin is a helpful carrier for the oral delivery of active
food ingredients (Arangoa
et al., 2001) .
Many studies have reported that a long-lasting intake
of fruit and vegetable antioxidants reduced the Iikeli-
hood of cardiovascular and proinfiammatory diseases
as weil as certain cancers (Block
et
al., 1992; Diplock
et al.,
1987;
Madar and Stark,
2002;
O'Byrne
et al., 2002;
Akao
et al.,
2003b): Soit appears that the improvement
of antioxidant defences is a biological key event in the
health promoting effects of antioxidant nutrients. The
present work not only confums and extends these
scientific and clinical studies but also provides useful
information for the development of functionally active
food ingredients.
This new formula shows real benefits for health since
functional antioxidant enzyme supplementation (here
melon SaD) is now able to promote cellular resistance
to stress by strengthening the host antioxidant defences.
Nevertheless, the mechanism by which it exerts its bio-
logical effect remains to be clarified.
The present study does not only confirms the effi-
cacy of dietary antioxidant supplementation but also
describes an orally active plant superoxide dismutase
demonstrating that functional enzymes can be used in
dietary supplementation.
Acknowledgements
Caroline Kamaté is a PhD student in receipt of a CIFRE fellowship
from Isocell Pharma SAS.
Pliytother. Res.
18, 95ï-962 (2004)
962
I. VOULDOUKIS
ET AL.
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8,
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... Oxidative stress, involved in many diseases, is an imbalance between free radical production resulting from respiration and antioxidant defences [10]. The antioxidant enzyme superoxide dismutase (SOD) is a primary enzyme in the defensive system against oxidative stress by reducing the effects of reactive oxygen species (ROS) including superoxide radicals [10][11][12]. Consequently, it seems reasonable to think that exogenous SOD could be effective for the management of inappropriate behaviours [10]. This assumption was confirmed by Vouldoukis et al. ...
... This assumption was confirmed by Vouldoukis et al. These authors showed that functional enzymes used in dietary supplementation were effective in protecting mice against oxidative stress [11]. ...
... Research in the field of natural alternative solutions to the management of inappropriate behaviours has been going on for a long time and has made many advances in recent years. Amongst the latter, a melon SOD extract has been shown to be effective in reducing oxidative stress in mice and symptoms of stress in healthy people [9,11,13]. Other studies have described the anxiolytic properties of fish protein hydrolysates in rodents [14] and in cats [15]. ...
Article
This survey assessed the effectiveness of a combination of hydrolysed fish proteins and melon superoxide dismutase in reducing inappropriate behaviours in cats. Forty-eight privately-owned cats with abnormal emotional behaviour, as reported by their owners, were administered a complementary feed (Anxivet®, MP Labo, France) once daily for 28 days. Owners completed questionnaires before (D0) and after (D2, D7, D14, and D28) initiating the product, assessing animal behaviour, interaction with surroundings, and discomfort levels. They also evaluated product effectiveness, satisfaction, and ease of administration. By D28, 12 out of 24 behavioural signs showed improvement, with a significant decrease in excessive mewing (p = 0.0485). Enhanced interaction with surroundings was observed in 19%, 29%, and 34% of cats on D2, D7, and D14, respectively, with significant improvement from D2 to D14 (p < 0.025). Discomfort decreased in 23%, 30%, and 34% of cats on D2, D7, and D14, respectively, with a significant difference between D2 and D14 (p < 0.01). Owners rated product efficacy as 7.7/10 at D28, with satisfaction scores increasing from 6.4 at D2 to 7.4 at D14 (p < 0.0339). This survey suggests the tested combination reduces cats' discomfort levels, though further confirmation via controlled randomised studies is warranted.
... It was suggested that oxidative stress might be clinically translated as physical and emotional stress [6,7]. Oxidative stress is the result of impaired balance between pro-oxidant molecules including free radicals and antioxidant defenses [8,9]. These natural defense antioxidant enzymes such as superoxide dismutase (SOD) play a key role in diminishing oxidative stress [8][9][10]. ...
... Oxidative stress is the result of impaired balance between pro-oxidant molecules including free radicals and antioxidant defenses [8,9]. These natural defense antioxidant enzymes such as superoxide dismutase (SOD) play a key role in diminishing oxidative stress [8][9][10]. Thus, the decrease of reactive oxygen species (ROS) resulting from nutritional antioxidant supplementation containing exogenous SOD, could be an effective fear and inappropriate behaviours management strategy in dogs [8,9]. ...
... These natural defense antioxidant enzymes such as superoxide dismutase (SOD) play a key role in diminishing oxidative stress [8][9][10]. Thus, the decrease of reactive oxygen species (ROS) resulting from nutritional antioxidant supplementation containing exogenous SOD, could be an effective fear and inappropriate behaviours management strategy in dogs [8,9]. ...
Article
Full-text available
Complementary feeds are identified as an additional option to behavioural therapy and pharmacological treatments for the management of inappropriate behaviours in dogs. This study aimed to investigate the benefit of a combination of hydrolysed fish proteins and melon superoxide dismutase (Anxivet ® , MP Labo, France) formulated to reduce signs of fear in dogs. Fifty dogs were administered with the combination once daily for 28 days. Pet-owners completed a questionnaire before (D0) and after (D2, D7, D14 and D28) product administration. Results showed a significant improvement of 8 out of 24 behavioural signs (0.008 < p < 0.0425) and of the overall behavioural score (p = 0.0150) at D28 compared to baseline. The interaction with the surroundings and the inappropriate behaviours evolution were enhanced in more than 50% of the dogs as soon as D2 and continued to improve significantly over time (p < 0.05). Similarly, the owner satisfaction level was almost 6 on a scale of 1 to 10 at D2, and then significantly increased throughout the study period (p < 0.0259). In conclusion, this study suggests that the tested product demonstrates rapid beneficials effects on dogs with inappropriate behaviours, providing onset of activity to complete the previous data from a double-blinded, placebo-controlled study.
... 32 Several studies have demonstrated the effect of coated-melon SOD in ROSrelated diseases, such as cancer, cardiovascular disease, degenerative diseases, and infectious diseases. 33,[35][36][37] These studies have supported the oral administration of SOD as a complementary treatment for systemic diseases. 32,33,[35][36][37] Previous studies showed the effect of Mn-SOD extracted from B. amyloliquefaciens in a model of inflammatory bowel disease. ...
... 33,[35][36][37] These studies have supported the oral administration of SOD as a complementary treatment for systemic diseases. 32,33,[35][36][37] Previous studies showed the effect of Mn-SOD extracted from B. amyloliquefaciens in a model of inflammatory bowel disease. [23][24][25] The production of Bd-SOD could be more economical, since microbial suspension culture is a more convenient method for large-scale production by mass cultivation of cells than plant cultivation. ...
... Several studies have revealed that oral supplementation with coated SOD can increase endogenous antioxidant defences. 23,33,35,36,45 However, no experimental data that elucidate the detailed mechanism that oral supplementation of coated SODs induces systemic effects have been presented to date. 32 One study suggested that the systemic effects reported after SOD intake result from a cascade of events triggered in the small intestine, depending on the transcription factors via the antioxidant response element (ARE)/nuclear factor E2-related factor(Nrf2) axis. ...
Article
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Purpose We hypothesized that antioxidative enzymes supplementation could be a treatment option for dry eye. We investigated the efficacy of oral administration of Bacillus-derived superoxide dismutase (Bd-SOD) in a murine experimental dry eye (EDE). Methods In part I, mice were randomly assigned to normal control, EDE, and mice groups that were treated with oral Bd-SOD after induction of EDE (EDE + Bd-SOD group; four mice in each group). Expression of SOD2, a major antioxidant enzyme with manganese as a cofactor, was assessed by immunofluorescence staining. In part II, mice were divided into seven groups (six mice in each group): normal control, EDE, vehicle-treated, topical 0.05% cyclosporin A (CsA)-treated, and oral Bd-SOD-treated (2.5, 5.0, and 10.0 mg/kg Bd-SOD) groups. Tear volume, tear-film break-up time (TBUT), and corneal fluorescein-staining scores (CFS) were measured at zero, five, and 10 days after treatment. Ten days after treatment, 2ʹ,7ʹ-dichlorodihydrofluorescein diacetate for reactive oxygen species (ROS), enzyme-linked immunosorbent for malondialdehyde, and TUNEL assays for corneal apoptosis, flow cytometry inflammatory T cells, and histological assessment were performed. Results Compared to the normal control group in part I, the EDE group showed significantly decreased SOD2 expression by immunofluorescence staining. However, the EDE + Bd-SOD group recovered similar to the normal control group. In part II, ROS, malondialdehyde, and corneal apoptosis were decreased in CsA and all Bd-SOD-treated groups. Corneal and conjunctival inflammatory T cells decreased, and conjunctival goblet cell density increased in CsA-treated and Bd-SOD–treated groups. Compared to the CsA-treated group, the 2.5 mg/kg Bd-SOD–treated group showed increased TBUT and decreased inflammatory T cells, and the 5.0 mg/kg Bd-SOD-treated group showed decreased CFS and increased conjunctival goblet cells. Conclusions Oral Bd-SOD administration might increase autogenous SOD2 expression in ocular surface tissue in EDE and could be developed as a complementary treatment for DE in the future.
... According to Zeng et al. (2021), the accumulation of SOD in the colon is one of the significant considerations in effective oral SOD therapy for inflammatory bowel disease (IBD). However, oral administration of SOD also has been suggested that it has poor bioavailability because of degradation in the upper digestive tract (Vouldoukis, Conti, et al., 2004;Vouldoukis, Lacan, et al., 2004). Many different encapsulation strategies have been adopted to overcome the destabilization of SOD in harsh gastric conditions, including SOD loaded into different nanoparticle carriers (Rosa et al., 2021), SOD encapsulated in the liposome (Schilrreff et al., 2019), and SOD combined with gliadin (Carillon et al., 2013;Romao, 2015). ...
... As shown in Fig. 1a, SOD completely lost activity after the aqueous solution was incubated in SGF at 37 • C for 15.00 min. This indicated that SOD was quite susceptible to the medium mimicking the digestive process, and a similar result was reported (Vouldoukis, Conti, et al., 2004). Thus, encapsulating SOD to improve oral bioavailability is necessary. ...
... The maximum EE value (52.20%) was higher than SOD loaded into highly stable liposomes (30.00%) or nanoarchaeosomes (39.00%) (Schilrreff et al., 2019), but the maximum ER value (20.52%) was lower than SOD combined with gliadin (70.00%) or encapsulated in zein-alginate nanoparticle (56.80-66.30%) (Lee, Kim, & Park, 2016;Vouldoukis, Conti, et al., 2004). The above results suggest that single chitosan coating is an effective method to improve the EE during the gelation process, though the ability to improve the stability of SOD to simulated gastric juice is relatively limited. ...
... Several studies using melon GliSODin ® have been conducted in several animal models and in human clinical trials. In animal studies, melon GliSODin ® increased the activity of antioxidant enzymes in circulating blood (13) and decreased the production of inflammatory cytokines (14). In parallel, investigations that measure SOD level in asthmatic mice show a decrease in SOD activity in mouse model of asthma (15, 16) associated with a decrease in catalase and glutathione peroxidase (17). ...
... In parallel, investigations that measure SOD level in asthmatic mice show a decrease in SOD activity in mouse model of asthma (15, 16) associated with a decrease in catalase and glutathione peroxidase (17). To the opposite, it has been demonstrated that GliSODin is able to increase SOD expression and activity (13,14). Finally, mice that were orally fed with anti-oxidative products exhibited a decrease in lung inflammation and lesions in mouse model of asthma (18,19). ...
... Frontiers in Allergy that ROS were responsible for DC-induced Th2-cell polarization. Moreover, SOD from GliSODin ® is likely to be the enzyme that detoxifies the ROS that induce DC-mediated Th2 polarization, and GliSODin ® can be biologically active throughout the mouse model timeline (13). Previous studies using GliSODin ® demonstrated its ability to successfully reduce ROS and ROSrelated outcomes such as inflammation in animal models and humans (14, 34, 35). ...
Article
Full-text available
Background: Asthma is a chronic inflammatory airway disease characterized by a prevailing type 2 inflammation, airway hyperresponsiveness, and mucus hypersecretion and is driven by various factors among which oxidative molecules, called reactive oxygen species (ROS), play a major role. Superoxide dismutases (SODs) are enzymes that constitute the first line of defense against ROS. Melon SOD-gliadin, which is known as GliSODin®, is commonly used as a nutritional supplement that has proven antioxidant properties. Objectives: In this study, we evaluated the efficacy and mechanism of action GliSODin® in the treatment of allergic asthma. Methods: House dust mite (HDM)-induced asthmatic mice were orally exposed to GliSODin®, and airway hyperresponsiveness, lung inflammation, in vitro T-cell polarization, in vivo T-cell reactivation, and blood immunoglobulin were investigated. Results: GliSODin® reduced airway hyperresponsiveness, lung innate and adaptive immune response, and HDM-specific IgE production. Coculturing CD4+ T-cell with HDM-sensitized dendritic cells and GliSODin® reduced T-cell polarization into Th2 and Th17 cells. Moreover, adoptively transferred CD4+ T cells from asthmatic mice exhibited a reduced reactivation of Th2 and Th17 cells following stimulation with HDM plus GliSODin®. Conclusion: GliSODin® abrogates asthma features and reduces CD4+ T-cell polarization and reactivation. Taken together, these data suggest that GliSODin® could be used for the management of asthma symptoms.
... ROS produced by solar irradiation produces skin aging evidenced by atrophy, relaxation, wrinkle formation, dryness, thinning, and follicular degeneration. Such visible signs of skin aging are in turn caused by a loss of elastin and collagen fibers [9][10][11] no longer produced by dysfunctional fibroblasts. As OS underlies skin aging processes, topical antioxidant agents are widely used to scavenge ROS and mitigate OS and slow the progression of skin aging. ...
... Various technologies to circumvent bioavailability challenges have been developed [13]. For example, SOD encapsulation in nano-/micro-carriers [9,31,38,40,[46][47][48][49][50][51] (e.g., liposomes, polysaccharides, gliadin, etc.), chemical modification, SOD mimetics (small molecules which mimic the catalytic properties of natural SOD molecules) collectively offer potential for treating diseases mediated by oxidative stress. These methods [52,53] improve the stability and enhance SOD membrane barrier permeability to facilitate paracellular transport. ...
Article
Full-text available
As an effective antioxidant enzyme, superoxide dismutase (SOD) has been widely used as a food supplement, cosmetic additive, and therapeutic agent. However, oral delivery of SOD is challenging due to its relative instability, limited bioavailability, and low absorption efficiency in the gastrointestinal (GI) tract. We addressed these issues using a highly stable superoxide dismutase (hsSOD) generated from a hot spring microbial sample. This SOD exhibited a specific activity of 5000 IU/mg while retaining its enzymatic activity under low pH environments of an artificial GI system and in the presence of surfactants and various proteolytic enzymes. The inhibitory effects of hsSOD against skin-aging was evaluated under both in vitro and in vivo experiments using fibroblast cell and D-galactose induced aging-mouse models, respectively. Effective oral delivery of hsSOD promises wide applicability in pharmaceutical and food industries.
... The heterogeneity of IPF may underlie these varying outcomes, but there are also several known impediments to the clinical application of the antioxidants themselves. The structural instability and degradation of the SOD protein before effective absorption has been found to be a critical shortcoming in terms of its oral administration [29]. Various approaches to overcoming this limitation have been attempted, including an albumin coating [30], diversification of the administration routes including aerosolization [9,31,32], and development of chimeric recombinant SODs [33]. ...
Article
Superoxide dismutase (SOD) can convert active oxygen to oxygen or hydrogen peroxide, and recent research has suggested that it can protect against lung damage and fibrosis. Clinical applications based on SOD remain limited however due to costs and low stability. We here investigated a potential new therapeutic delivery system for this enzyme in the form of SOD-overexpressing Bacillus amyloliquefaciens spores which we introduced into a bleomycin-induced pulmonary fibrosis mouse model. This treatment significantly alleviated the disease, as quantified using a hydroxyproline assay, at 107 colony forming unit (CFU) of Bacillus spores per day. Exposure of the mice to the spores was further found to decrease the lung mRNA levels of CTGF, Col1a1, α-SMA, TGF-β, TNF- α, and IL-6, and the protein levels of TGF-β, Smad2/3, αSMA and Col1a1, all major indicators of pulmonary fibrosis. Survival benefits, and reduced byproducts of lipid peroxidase such as malondialdehyde and 4-hydrox-ynen, were also noted in the treated animals. The beneficial effects of these Bacillus spores on pulmonary fibrosis were further found to be greater than the equivalent free SOD concentration. Immunofluorescence staining of primary pulmonary fibroblasts extracted from the bleomycin-induced model showed decreased αSMA expression following the in vivo treatment with SOD-overexpressing Bacillus. Our treatment approach SOD through Bacillus spores shows beneficial effects against pulmonary fibrosis, combined with the suppression of the SMAD/TGF-β pathway, suggesting that it is an effective novel delivery route for antioxidants.
... The combination of SOD extracted from cantaloupe melon (Cucumis melo L.C.) combined with wheat gliadin biopolymer (GliSODin ® ) significantly improves the delayed release of SOD as evidenced in vitro by the increase of its activity in a medium mimicking digestive conditions [5]. ...
Article
Full-text available
Superoxide Dismutase (SOD) constitutes part of the body’s front line in antioxidant defenses, helping to maintain the physiological oxidant-antioxidant balance. However, this balance can be disrupted by a number of factors that include aging, smoking, pollution, exposure to sunlight, high intensity exercise, infection and the subsequent immune response. The body experiences oxidative stress under these types of conditions, which has been linked to the increased risk of chronic disease. Oral supplementation of the enzyme, in order to boost the body’s antioxidant defense system, has been ineffective due to the biochemical conditions experienced as the enzyme passes through the gastrointestinal tract. This passage degrades the enzyme, rendering it useless. This publication reviews the science related to GliSODin®, a trade name for SOD extracted from cantaloupe melon and combined with wheat gliadin. Clinical research and scientific evidence is presented to demonstrate that gliadin protects SOD during passage through the stomach, thus allowing absorption of the SOD enzyme once inside the intestine.
Article
Full-text available
Skin aging is characterized by a deterioration of skin quality over time resulting from physiological changes and oxidative stress (OS). Superoxide dismutase (SOD) is an effective antioxidant enzyme widely used as a food supplement and cosmetic additive to alleviate OS and retard skin aging. However, conventional SOD delivery routes commonly yield unsatisfactory results due to limited stability, compromised bioavailability, and low absorption efficiency in the gastrointestinal (GI) tract. These issues are addressed by developing SOD‐encapsulated polymeric microneedle (PMN) patches for efficient transdermal delivery. The use of a highly stable SOD isolated from a hot spring microbe ensures its reactivity throughout PMN fabrication and application. This SOD vehicle demonstrated excellent effectiveness through inhibiting skin‐aging and promoting hair growth as validated by extensive in vivo experiments using D‐galactose (D‐gal) induced aging‐mouse model. SOD‐PMNs promoted excellent regeneration of hair follicles, increased melanin synthesis, decreased lipid oxidation, and elevated antioxidative capacity of skin tissue. The success in effective transdermal delivery of SOD promises wide applicability in pharmaceutical and cosmetic industries.
Article
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The present study aimed to evaluate the effects of SOD (superoxide dismutase)-rich melon feed supplement on some performance parameters, serum biochemical and antioxidant indexes, and meat quality characteristics of weaned Tuj lambs. An independent measures design (between groups) was used to determine these effects of treatment. After one week of the adaptation period, twenty-four weaned lambs at the age of 60 ± 5.0 days with a body weight of 23.14 ± 0.5 kg were divided into two groups, i.e., the control group (CON) fed basal diet and experimental group (EXP) fed with basal diet + SOD-rich melon (n = 12 per group). The results revealed a decrement in the (p < 0.05) feed efficiency ratio (5.88 ± 0.40 vs. 6.59 ± 0.86 kg weight gain/kg feed) and higher carcass yield (61.76 ± 0.80 vs. 60.11 ± 1.07%) in the EXP group as compared to the CON group. Additionally, the EXP group showed a significant increase (p < 0.05) in serum glucose and high-density lipoprotein levels, while there was a reduction in cholesterol, triglyceride, and low-density lipoprotein levels when compared to the CON group. The serum malondialdehyde was lowered (5.53 ± 0.47 vs. 5.98 ± 0.79 mmol/L) significantly (p < 0.05), while glutathione concentration was higher (p < 0.05) in the EXP group (17.82 ± 1.51 mmol/L) when compared to the CON group (16.54 ± 1.59 mmol/L). The cooking loss was also significantly (p < 0.05) lower in the EXP group when compared to the CON group. In conclusion, the results indicate that SOD-rich melon supplement (30 g/ton of the concentrate feed) can considerably improve carcass yield, some serum biochemical parameters, and meat quality characteristics in Tuj lambs. Thus, the supplementation of lamb diets with a SOD-rich melon additive may be used as an effective nutritional approach to improve their performance and health.
Article
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Abstract: On expose une méthode pour la préparation de capsules molles (GI.C) et de gomme masticable (GC.G) de la proteine hydrophobe du blé, la gliadine brute. Les films de Gliadine se sont révélés être plus hydrophyles que des films comparables de gélatine. La libération de paracétamol a été significativement durable, indiquant la distribution du médicament. Les profiles de libération de médicaments dans un milieu d’acide chlorhydrique à 0,1 M, ont consisté en trois zones pour GI.C: une prériode de latence initiale, suivie par une zone de libération faible et essentiellement stable: et une zone pour GCG avec une libération trés lente de paracetamol. Un mécanisme de libération de médicament est proposé, impliquant une interaction hydrophobe entre la gliadine et des ligands non-polaires. Ces résultats sont discutés et selon cette cette étude, la gliadine apparaît être une proteine trés prometteuse, de bas coût, bioacceptable, pour la réalisation de formulation de médicaments avec un potentiel trés interressant de libération contrôlée. Mots Clés de l’auteur: Gliadine; Capsule; gomme masticable: paracetamol: libération contrôlée. A method for the preparation of soft capsules (Gl.C) and chewable gums (GCG) of the hydrophobic wheat protein, crude gliadin, is reported. Gliadin films were found to be more hydrophilic than comparable gelatin films. The release of paracetamol was significantly sustained, indicating drug delivery. Drug release profiles in 0.1 M hydrochloric acid media consisted of three regions for Gl.C: these were an initial latency period, followed by a low release region and essentially constant rate; and one region for GCG with very slow release of paracetamol. A mechanism of drug release is proposed involving hydrophobic interaction between gliadin and non-polar ligands. These results are discussed and based on this study, gliadin appears to be a highly promising, low-cost, bioacceptable protein for the manufacture of drug formulations with a very interesting controlled released potency.
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The mitochondrion is a key organelle in the control of cell death. Nitric oxide (NO) inhibits complex IV in the respiratory chain and is reported to possess both proapoptotic and antiapoptotic actions. We investigated the effects of continuous inhibition of respiration by NO on mitochondrial energy status and cell viability. Serum-deprived human T cell leukemia (Jurkat) cells were exposed to NO at a concentration that caused continuous and complete (∼85%) inhibition of respiration. Serum deprivation caused progressive loss of mitochondrial membrane potential (Δψm) and apoptotic cell death. In the presence of NO, Δψm was maintained compared to controls, and cells were protected from apoptosis. Similar results were obtained by using staurosporin as the apoptotic stimulus. As exposure of serum-deprived cells to NO progressed (>5 h), however, Δψm fell, correlating with the appearance of early apoptotic features and a decrease in cell viability. Glucose deprivation or iodoacetate treatment of cells in the presence of NO resulted in a collapse of Δψm, demonstrating involvement of glycolytic ATP in its maintenance. Under these conditions cell viability also was decreased. Treatment with oligomycin and/or bongkrekic acid indicated that the maintenance of Δψm during exposure to NO is caused by reversal of the ATP synthase and other electrogenic pumps. Thus, blockade of complex IV by NO initiates a protective action in the mitochondrion to maintain Δψm; this results in prevention of apoptosis. It is likely that during cellular stress involving increased generation of NO this compound will trigger a similar sequence of events, depending on its concentration and duration of release.
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Approximately 200 studies that examined the relationship between fruit and vegetable intake and cancers of the lung, colon, breast, cervix, esophagus, oral cavity, stomach, bladder, pancreas, and ovary are reviewed. A statistically significant protective effect of fruit and vegetable consumption was found in 128 of 156 dietary studies in which results were expressed in terms of relative risk. For most cancer sites, persons with low fruit and vegetable intake (at least the lower one-fourth of the population) experience about twice the risk of cancer compared with those with high intake, even after control for potentially confounding factors. For lung cancer, significant protection was found in 24 of 25 studies after control for smoking in most instances. Fruits, in particular, were significantly protective in cancers of the esophagus, oral cavity, and larynx, for which 28 of 29 studies were significant. Strong evidence of a protective effect of fruit and vegetable consumption was seen in cancers of the pancreas and stomach (26 of 30 studies), as well as in colorectal and bladder cancers (23 of 38 studies). For cancers of the cervix, ovary, and endometrium, a significant protective effect was shown in 11 of 13 studies, and for breast cancer a protective effect was found to be strong and consistent in a meta analysis. It would appear that major public health benefits could be achieved by substantially increasing consumption of these foods.
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