Biomedical subjects

Nicolantonio D'Orazio

Publications and source records attributed to Nicolantonio D'Orazio.

10 recordsLinked to original sources

PubMed2007

The role of the antioxidant vitamin supplementation in the prevention of cardiovascular diseases.

Industrial and technological revolutions have resulted in dramatic shifts in the diseases that are responsible for illness and death. In particular, cardiovascular disease (CVD) has emerged as the dominant chronic disease in many parts of the world. Diet, tobacco smoking, physical inactivity, obesity, lipid levels, hypertension and diabetes mellitus have contributed to their wide diffusion. Oxidative damage and the production of free radicals in the endothelium are two of the main factors involved in the pathogenesis of the atherosclerotic process that causes CVD. One of the more important results of basic research on dietetic regimes has shown that people who consume large amounts of fruits and vegetables have a lower incidence of CVD, stroke and tumours, but the specific mechanisms of these foods (which have an apparently protective effect) are still not completely clear. Possible reasons could include a greater consumption of fruit and vegetables, and an increased consumption of dietetic fibres. Recently, it been proposed that micronourishments with an antioxidant activity could be responsible for the reduction of chronic diseases. Research supplies a hypothetical mechanism by which antioxidant substances may be reducing the risk of atherosclerosis through the inhibition of oxidative damage. Appropriate nutritional practices are of central importance in managing risk and treatment of CVD; in fact, many current guidelines for a healthy general population contain nutritional recommendations to reduce the risk of these diseases. A large number of descriptive and case-control studies suggests that the consumption of many antioxidant vitamins (A, C and E) reduces the risk of CVD. Such data raises the following problem of whether supplementation of vitamins A, C and E emerges as being useful in the primary prevention of CVD. Many important studies involving a great number of participants have not confirmed this hypothesis and the results are often contradictory. This review examines the studies published in the literature that document the effect of supplementation with antioxidant vitamins (A, C and E) in the primary and secondary prevention of CVD due to an atherosclerosis process.

Animals↗

PubMed2006

Is nasal polyposis a determinant of bronchial hyperresponsiveness and altered quality of life in asthmatic subjects? A case-control study.

Asthmatic patients with nasal polyposis (NP) have been reported to have a high prevalence of bronchial hyperresponsiveness (BHR) and a worsening of quality of life (QoL). The aim of this case-control study was to evaluate if NP is a determinant of BHR and is responsible for modifying the QoL in asthmatic subjects. Eighty-nine asthmatic subjects, including 24 patients with NP and 65 patients without NP (controls), underwent spirometry, methacholine challenge test (MCHt), skin prick tests, and were evaluated with the Asthma Quality of Life Questionnaire (AQLQ). Results of the MCHt test are expressed as the provocative concentration of methacholine that causes 20% (PC20) fall of forced expiratory volume at 1 sec (FEV1). The PC20 (mean +/- SD) in NP cases was 1149 +/- 668 microg/ml vs 894 +/- 691 microg/ml in controls (p <0.001). This demonstrates that BHR was not enhanced by the presence of NP in asthmatic subjects. No significant differences were found between the NP cases and controls for overall QoL or for single QoL domains. This study shows that the presence of NP did not impair the QoL of asthmatic patients, as indicated by the items included in the AQLQ questionnaire.

Adult↗

PubMed2005

The role of selenium, zinc and antioxidant vitamin supplementation in the treatment of bronchial asthma: adjuvant therapy or not?

In the last few years, nutrition has represented an important conditioning factor of many cardiovascular, gastrointestinal and pulmonary chronic diseases. Many published works have documented specific inflammatory abnormalities in the airways of subjects with mild-to-moderate persistent bronchial asthma in which the inflammation state is often associated with an increased generation of reactive oxygen species and free radical-mediated reactions. This evidence has stimulated many researchers to suppose that the oxidative stress could be an important pathogenetic determining factor in the progression of chronic diseases, and the decrease of oxidant insults to the lung can be modified with antioxidant supplementary therapy. There are many studies regarding dietary interventions that confirm the relationship to oxidative stress, bronchial inflammation, the development of asthmatic symptoms and the lowered cellular reducing capacity. Simple dietary and environmental supplementations significantly reduce the oxidant stress, minimise the development of asthmatic symptoms, and should prove to be an effective new approach to asthma management in addition to current pharmacological strategies. Many randomised controlled trials with antioxidant vitamins and trace element supplements have not confirmed the results shown in other clinical trials. The aim of this review is to focus the attention on published works discussing the relationship between asthma and nutritional supplements (some trace elements and vitamins) and the effectiveness of these supplements in the treatment of bronchial asthma.

Adjuvants, Immunologic↗

PubMed2005

Tapering dose of inhaled budesonide in subjects with mild-to-moderate persistent asthma treated with montelukast: a 16-week single-blind randomized study.

Pharmacological therapy with inhaled steroids (IS) is currently considered the gold-standard of treatment for mild-persistent asthma. Leukotriene receptor antagonist drugs (LTRAs) play an important role associated with IS, allowing dose tapering and maintaining control of asthma symptoms. The aim of this study was to determine the effectiveness of montelukast (MON) to allow tapering of the inhaled dose of budesonide (BUD) in patients with mild-moderate persistent asthma. This 16-wk single-blind randomized study included 40 asthmatic patients divided in 2 treatment groups. After a run-in period (4 wk), in which all patients inhaled 400 microg of BUD twice daily (bid), group A (20 patients) received MON (oral, 10 mg/day) combined with inhaled BUD (400 microg/bid), while group B (20 patients) was treated with BUD for the whole period of the study. In both groups, at every 4 wk the dose of BUD was halved. After 12 wk of treatment the mean value of forced expiratory volume during the first sec (FEV1, as % of predicted value) was significantly greater in group A compared with group B (94 +/- 7.5 vs 83.1 +/- 6.9; p<0.005). The mean values of peak expiratory flow (PEF), the percentages of asthmatic exacerbations, and the use of beta2-short-acting agonist (SABA) were similar in the 2 groups at 4, 8, and 12 wk. In conclusion, in patients with mild-moderate persistent asthma, MON therapy is useful in tapering the dose of IS in order to reduce its side effects and to maintain the clinical stability of the disease.

Acetates↗

PubMed2004

An update of the leukotriene modulators for the treatment of asthma.

Bronchial asthma is a chronic inflammatory airway disease involving many cells and mediators. Chronic inflammation constitutes an important predisposing condition for airway remodelling with secondary irreversible airflow obstruction. Current approaches for asthma treatment involve many classes of drugs, adequate patient education for their correct use, environmental exposure control and daily monitoring of pulmonary function. Unfortunately, the use of multiple therapies complicates treatment regimens, thus leading to a reduced compliance to therapy. Available evidence from randomised clinical trials and real-word experience derived from managing patients with asthma justifies a broader role for leukotriene receptor antagonist drugs in asthma management than that recommended in the National Asthma Education and Prevention Programme and National Health Lung and Blood Institute Treatment Guidelines. While a low dose of inhaled corticosteroids remains the reference drug as a controller in mild-to-moderate persistent asthma, oral therapy with an leukotriene-receptor antagonist drug represents a good option providing the clinical efficacy requested in common clinical practice. For this reason the recent Global Initiative for Asthma Guidelines allocate this drug to the second and third steps of asthma treatment.

Animals↗

PubMed2004

Review: Pharmacological treatment of airway remodeling: inhaled corticosteroids or antileukotrienes?

Chronic stable asthma is characterized by inflammation of the airway wall, with abnormal accumulation of basophils, eosinophils, lymphocytes, mast cells, macrophages, dendritic cells, and myofibroblasts. Airway inflammation is not limited to severe asthma, but is also found in mild and moderate asthma. This inflammation results in a peculiar type of lymphocytic infiltration whereby Th2 lymphocytes secrete cytokines that orchestrate cellular inflammation and promote airway hyper-responsiveness. The term "airway remodeling" in bronchial asthma refers to structural changes that occur in conjunction with, or because of, chronic airway inflammation. Airway remodeling results in alterations in the airway epithelium, lamina propria, and submucosa, leading to thickening of the airway wall. Consequences of airway remodeling in asthma include incompletely reversible airway narrowing, bronchial hyper-responsiveness, airway edema, and mucus hypersecretion; these effects may predispose subjects with asthma to exacerbations and even death due to airway obstruction. To avoid this progression, it is important to follow an adequate treatment aimed at interacting and modifying the inflammatory process. Inhaled corticosteroids remain the cornerstone of asthma management. Altough several drugs, such as ketotifen, sodium cromoglycate, sodium nedocromil, and theophylline have anti-inflammatory properties, they are less effective than corticosteroids. Antileukotrienes are a new class of anti-inflammatory drugs that interfere directly with leukotriene receptors. The aim of this brief review is to delineate the effects of inhaled corticosteroids and antileukotriene drugs on inflammation and remodeling.

Administration, Inhalation↗

PubMed2004

Advances in therapy with antileukotriene drugs.

Evidence from clinical trials and experience derived from managing patients with asthma justify a broader role for leukotriene (LT) blockers in asthma management than that recommended by the National Asthma Education and Prevention Program and the NIH Heart, Lung and Blood Institute treatment guidelines. Many published clinical trials, reviews, and case reports have suggested important new applications of LT blockers (ie, montelukast, zafirlukast, pranlukast, and zileuton) in several diseases in which leukotrienes play a pathogenic role. These include paranasal sinus disease, allergic fungal sinusitis, migraine, chronic urticaria, atopic dermatitis, chronic obstructive pulmonary disease, allergic conjunctivitis, mastocytosis, bronchiolitis, idiopathic pulmonary fibrosis, interstitial cystitis, and irritable bowel syndrome. Although double-blind, randomized, placebo-controlled trials are needed to confirm the effects that these drugs may have in these diseases, the aim of this short review is to delineate the future roles that these drugs may have in the management of these conditions.

Anti-Asthmatic Agents↗

PubMed2003

Body cell mass measured by total body potassium in normal-weight and obese men and women.

OBJECTIVE: Total body potassium (TBK) concentration is linearly correlated with the size of the body cell mass (BCM). The aim of this study was to compare BCM in normal-weight and obese individuals. METHODS: 271 individuals (207 males, 64 females), 20 to 67 years of age, participated in this study. Subjects were separated by body mass index (BMI): BMI < 25 kg/m(2) (BMI-L) and BMI > 25 kg/m(2) (BMI-H). (40)K was assessed using a whole-body counter and BCM was calculated. RESULTS: BCM and TBK were significantly greater in men, with a trend to be greater in women in BMI-H compared to men in BMI-L. TBK/body weight was significantly lower, while TBK/height was significantly greater for men and women in BMI-H compared to men and women in BMI-L. Fat-free mass (FFM) was significantly greater for men in BMI-H, with no significant differences in FFM between the two groups of women. CONCLUSIONS: The healthy obese subjects in the present study had a greater BCM than the non-obese subjects. These results indicate that it is important to assess BCM in obese individuals because it could influence the type of weight loss regimen that will be used in order to preserve BCM.

Adipose Tissue↗

PubMed2003

[Antileukotrienes in the therapy of bronchial asthma].

Cysteinyl-leukotrienes (Cys-LTs) are mediators released in bronchial asthma and are both direct bronchoconstriction and proinflammatory substances that mediated several steps in the pathophysiology of chronic asthma, including inflammatory cells recruitment, vascular leakage, and possibly airway remodelling. Available evidence from clinical trials and real-word experience derived from managing patients with asthma justifies a broader role for antileukotriene drugs (anti-LTs) in asthma management than that recommended in the National Asthma Education and Prevention Program and National Institute of Health treatment guidelines. Anti-LTs seem to be effective alternatives to inhaled corticosteroids (ICS) either as monotherapy or as adjunctive therapy that reduces the need for higher doses of ICS in patients with mild-to-moderate persistent asthma. This class of drugs may be used as adjunctive therapy for all levels of disease severity because they are effective in combination with ICS during long-term maintenance therapy. The anti-LTs seem especially effective in preventing aspirin-induced asthma providing an additional advantage of reducing nasal congestion in patients with both asthma and rhinitis and in the treatment of exercise induced-asthma. This class of drugs have several features that are likely to promote adherence to treatment and are generally well tolerated. The available clinical data suggest that anti-LTs should be considered as a therapeutic option or as additive therapy in patients with mild to severe asthma.

Adrenal Cortex Hormones↗

PubMedDate not supplied

[Obesity and immune function].

The perspective of obesity as a low grade systemic inflammatory condition has triggered a new interest on the many overlapping areas between this pathology and the immune system. White adipose tissue production of proteins related to the immune function has shown that many of these adipokines are implied in the ethiopathogenesis of some of the major metabolic diseases such as diabetes, hypertension, cardiovascular diseases, which share with obesity an important role in the Metabolic Syndrome. Besides, dysregulation of immune system may be present due to a dysregulation in the factors produced by adipose tissue. Weight loss through diet or surgery has proved to be beneficial for the recovery of the physiological levels of some of these pro-inflammatory molecules, but other studies are needed to clarify to which extent its possible to pursue risk reduction by this way.

Adiponectin↗