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Biomedical subjects

R S Parker

Publications and source records attributed to R S Parker.

At least 19 recordsLinked to original sources

A novel 5'-carboxychroman metabolite of gamma-tocopherol secreted by HepG2 cells and excreted in human urine.

HepG2 cells were incubated with a medium containing fetal bovine serum enriched with RRR-gamma-tocopherol (gamma-TOH). After 48 h the medium was extracted and analyzed for gamma-TOH metabolites by gas chromatography-mass spectrometry. In addition to gamma-CEHC, the 3'-carboxychroman metabolite of gamma-TOH previously reported in human urine, these cells secreted a second substance whose extraction and mass spectral characteristics were consistent with those of the 5'-carboxychroman analog of gamma-CEHC, 2,7, 8-trimethyl-2-(delta-carboxymethylbutyl)-6-hydroxychroman. This is the first report of metabolism of gamma-TOH to carboxychroman metabolites in cell culture. Analysis of human urine samples revealed the consistent presence of the novel 5'-carboxychroman metabolite, along with that of gamma-CEHC. Oral supplementation with purified RRR-gamma-TOH resulted in elevated urinary concentrations of both metabolites, although the concentration of the 5'-gamma-carboxychroman metabolite was consistently and substantially less than that of gamma-CEHC. The presence of both metabolites is consistent with the involvement of an omega-oxidation-like process in the phytyl tail shortening of gamma-TOH to water soluble metabolites excreted in urine.

Cell Line↗

Determinants of plasma retinol concentrations of middle-aged women in rural China.

The purpose of this study was to assess the correlates and possible determinants of plasma vitamin A among middle-aged women in rural China. The vitamin A adequacy of the different diets at the five widely varying survey sites was also assessed. Patterns of correlations among dietary and biochemical measurements were strikingly different from previous studies in Western subjects. Plasma beta-carotene was uncorrelated with beta-carotene intake even after adjusting for potential confounders. In counties with low preformed vitamin A intake, plasma retinol correlated with plasma copper (P = 0.007), which in turn was correlated with dietary intake of copper (P = 0.007). In these counties plasma retinol was correlated with plasma beta-carotene (P = 0.001) and was increased 10% in women in the first 2 y of menopause (P = 0.028). Plasma retinol and C-reactive protein levels are inversely correlated (r = -0.15, P < 0.001), indicating that vitamin A status and inflammatory response may be related but the causal direction is unknown. Despite low intake of vitamin A (county averages of 13-78% of recommended daily allowance [RDA]), and particularly of preformed vitamin A, only 3% of these women had plasma retinol levels below 0.7 mumol/L, considered to indicate possible marginal deficiency. Plasma levels of retinol and beta-carotene were more influenced by intrinsic factors such as menopause, lipid status, retinol requirements, and possibly copper status and inflammation than by extrinsic factors such as diet and lifestyle.

Adult↗

Iron status of middle-aged women in five counties of rural China.

OBJECTIVE: To determine the relationships of dietary iron sources, other dietary factors, and lifestyle to iron status among premenopausal and recently postmenopausal Chinese women with widely varying regional dietary patterns. DESIGN: Cross-sectional. Subjects were interviewed, blood samples were drawn, and dietary intakes were measured by a 3-day dietary survey for subjects in the five survey counties. SETTING: Rural China. SUBJECTS: About 80 randomly selected subjects per county among women aged 32 66 y. MAIN OUTCOME MEASURES: Blood hemoglobin, plasma ferritin, and plasma iron. RESULTS: Total iron intake was relatively high (15-29 mg/d) compared to developed counties. Heme iron intake was negligible in two of the study counties. Overall levels of iron deficiency anemia were relatively low in these generally iron-stressed women. There was no clear statistical relationship between iron intake and physiological iron status. Although several measures of dietary intake (heme iron, dietary calcium, animal protein) were correlated with several measures of iron status before adjusting for survey county, only dietary animal protein was significantly positively correlated with plasma ferritin after adjusting for the possibly confounding factor of the survey county (r= 0.15, P = 0.009). Intakes of potential inhibitors of iron absorption, such as tea, even in very high amounts, were not correlated to iron status. Plasma ferritin was positively correlated with plasma retinol (P = 0.024) and cholesterol (P = 0.007). Systemic inflammatory response, as indicated by high plasma C-reactive protein levels, was shown to be raised in a group of subjects with apparently contradictory high levels of ferritin and low levels of hemoglobin (P = 0.03). CONCLUSIONS: Iron nutriture in these areas of rural China seemed more related to physiological factors such as inflammatory response, menses, plasma vitamin A and cholesterol, than to dietary factors.

Adult↗

Bioavailability of carotenoids in human subjects.

There is growing need for accurate information regarding the bioavailability of carotenoids, both with respect to carotenoids per se and to the vitamin A value of provitamin A carotenoids in foods or supplement preparations. Little quantitative information is currently available, owing primarily to the lack of adequate methods to assess carotenoid bioavailability. Methods applied to xenobiotic drugs are in most cases not useful for carotenoids, many of which circulate in appreciable quantities in human plasma. Reported ranges of carotenoid bioavailability (% dose absorbed) range from 1-99, and variability is generally high both within and between treatments. With the current methods, relative bioavailability is more readily assessed than absolute bioavailability. The most commonly applied methods include measuring the increase in plasma carotenoid concentration following chronic intervention, and use of postprandial chylomicron (PPC) carotenoid or retinyl ester response following a single dose of carotenoid. The advantages and limitations of these approaches, together with examples of each, are discussed. A new PPC approach utilizing extrinsic-stable-isotope-labelled vitamin A (2H4-labelled retinyl acetate) is under development in our laboratory, and examples of its application are presented. The currently available data suggest that oil solutions of carotenoids are more bioavailable than those from food matrices, and heating can improve the bioavailability of carotenoids from some food products. Increased availability of labelled carotenoids and retinoids should aid the development of reliable methods of carotenoid bioavailability assessment. Such data are needed for dietary recommendations, supplement formulation, and design of intervention strategies involving carotenoids.

Biological Availability↗

A model-based algorithm for blood glucose control in type I diabetic patients.

A model-based predictive control algorithm is developed to maintain normoglycemia in the Type I diabetic patient using a closed-loop insulin infusion pump. Utilizing compartmental modeling techniques, a fundamental model of the diabetic patient is constructed. The resulting nineteenth-order nonlinear pharmacokinetic-pharmacodynamic representation is used in controller synthesis. Linear identification of an input-output model from noisy patient data is performed by filtering the impulse-response coefficients via projection onto the Laguerre basis. A linear model predictive controller is developed using the identified step response model. Controller performance for unmeasured disturbance rejection (50 g oral glucose tolerance test) is examined. Glucose setpoint tracking performance is improved by designing a second controller which substitutes a more detailed internal model including state-estimation and a Kalman filter for the input-output representation. The state-estimating controller maintains glucose within 15 mg/dl of the setpoint in the presence of measurement noise. Under noise-free conditions, the model-based predictive controller using state estimation outperforms an internal model controller from literature (49.4% reduction in undershoot and 45.7% reduction in settling time). These results demonstrate the potential use of predictive algorithms for blood glucose control in an insulin infusion pump.

Algorithms↗

Urinary excretion of 2,7, 8-trimethyl-2-(beta-carboxyethyl)-6-hydroxychroman is a major route of elimination of gamma-tocopherol in humans.

Little is known of the post-absorptive, metabolic fate of gamma-tocopherol, the major form of vitamin E in North American diets. The objective of this study was to determine the extent of urinary excretion of 2,7, 8-trimethyl-2-(beta-carboxyethyl)-6-hydroxychroman (gamma-CEHC), a recently identified metabolite of gamma-tocopherol. A method for measurement of urinary gamma-CEHC was developed, using gas chromatography-mass spectrometry (GC-MS) with a deuterated internal standard, 2,7,8-trimethyl-2-(beta-carboxyethyl)-(3, 4-2H2)-6-hydroxychroman (d2-gamma-CEHC). This standard was synthesized by dehydrogenation of 6-acetyl-gamma-CEHC followed by deuteration of the resulting 3,4-double bond. The use of d2-gamma-CEHC resulted in accurate determinations of the concentration of d0-gamma-CEHC in human urine. Urine samples containing added d2-gamma-CEHC were treated with beta-glucuronidase, extracted with an organic solvent, and analyzed by GC-MS. Analysis of 24-h urine pools from healthy subjects revealed gamma-CEHC concentrations, normalized against creatinine, ranging from 2.5 to 31.5 micromol/g creatinine, or a total of 4.6 to 29.8 micromol per day. These results correspond to 2-12 mg gamma-tocopherol excreted daily as gamma-CEHC in the urine. Given an estimated mean intake of gamma-tocopherol of 20 mg/day, catabolism of gamma-tocopherol to gamma-CEHC, followed by glucuronide conjugation and urinary excretion, is a major pathway for elimination of gamma-tocopherol in humans.

Adult↗

Effect of UV exposure and beta-carotene supplementation on delayed-type hypersensitivity response in healthy older men.

OBJECTIVES: The aims of this study were to determine if ultraviolet light (UV) is immunosuppressive in healthy older males, if beta-carotene (betaC) supplementation could prevent any observed UV-induced immunosuppression, and to compare these effects with those observed previously in younger men. METHODS: The study was a placebo-controlled, randomized trial that employed a 2 x 2 factorial design. Healthy older men (mean age 65.5 years) received 30 mg betaC or placebo daily throughout the 47-day trial, while on a low carotenoid diet. After 28 days, half of each group received 12 suberythemic exposures to UV over a 16-day period. Delayed-type hypersensitivity (DTH) tests and plasma carotenoid assays were performed at baseline, pre-UV and post-UV time points, with DTH testing performed on an area of skin protected from UV exposure. RESULTS: UV exposure resulted in significantly suppressed DTH response in the placebo group but not in the betaC-UV group. While there was no significant interaction between betaC supplementation and UV on DTH response, there was a significant inverse relationship between final plasma betaC concentration and extent of UV-induced suppression of DTH response. A similar correlation existed among subjects not exposed to UV. CONCLUSIONS: Suberythemic UV exposure was immunosuppressive, as measured by DTH response, in healthy older men as in younger men. Higher plasma betaC was significantly associated with maintenance of DTH response, although the extent of protective effect of betaC appeared less than previously observed in younger subjects. The attenuated effect of betaC in the older UV-exposed subjects may have resulted in part from muted plasma betaC responses to betaC supplementation and/or higher plasma vitamin E levels than those of younger men. The finding that stronger DTH responses were associated with higher plasma betaC concentrations in both UV and non-UV subjects further supports a role for this nutrient in immunomodulation.

Adult↗

Effects of carotenoid-rich food extracts on the development of preneoplastic lesions in rat liver and on in vivo and in vitro antioxidant status.

The effect of dietary carotenoid-rich extracts of carrots, tomatoes, and orange juice on rat liver gamma-glutamyl transpeptidase-positive preneoplastic foci induced by aflatoxin B1 was investigated. Organic extracts were prepared from the foods, dissolved in tricaprylin oil to equivalent concentrations of the major food-specific carotenoids, and fed by intubation to Fischer 344 male rats. The extracts were administered during the 2-week aflatoxin-dosing (initiation) period of the study or during the subsequent 12-week post-dosing (promotion) period. Vitamin status and antioxidant activities were measured in blood and liver. Extract feeding caused an accumulation of carotenoids in the liver, a substantial decrease in spontaneous erythrocyte hemolysis, and lowered plasma glutathione, blood superoxide dismutase, and blood catalase. Differences in foci development among the three extracts were not as consistent or profound as differences between initiation and promotion dosing. The number of gamma-glutamyl transpeptidase-positive foci was decreased by extract feeding during the initiation period, whereas extract feeding during the promotion period caused a decrease in the average diameter of the foci. The total volume of foci was markedly reduced by extract feeding during either period. Extracts were compared with purified carotenoids and alpha-tocopherol in their ability to affect in vitro antioxidation activity and were nearly as effective as the pure compounds. In summary, carotenoid-rich extracts of these three foods substantially inhibited biochemical and cellular events thought to play a role in the early stages of hepatocarcinogenesis.

Aflatoxin B1↗

Evidence of a role for fat-free body mass in modulation of plasma carotenoid concentrations in older men: studies with hydrodensitometry.

We examined the relationship between body composition and changes in plasma carotenoid concentration in response to dietary carotenoid restriction or beta-carotene (betaC) supplementation in healthy older men. Subjects (mean age 65 y) were assigned randomly to supplement (30 mg betaC/d) or placebo groups, and all subjects consumed a standard low carotenoid basal diet plus 1.5 mg betaC/d as carrots. Body composition was measured at baseline by hydrodensitometry, and plasma carotenoids were measured at baseline and after 28 d of treatment by HPLC. Baseline plasma total carotenoid concentration was significantly and negatively correlated with body mass index (BMI) and fat-free mass (FFM) but not with fat mass, whereas baseline betaC concentration was negatively associated with all three variables. The increase in plasma betaC concentration in response to betaC supplementation was significantly and inversely correlated with BMI and FFM but not with fat mass. Likewise, the decline in plasma total carotenoid concentration in the placebo group was also significantly and inversely related to BMI and FFM but not to fat mass. Thus, FFM seems to be an important determinant of plasma carotenoid concentrations and to explain a substantial portion of the often-observed relationship between BMI and blood carotenoid levels. Fat-free mass seems to represent a dynamic reservoir that dampens short-term changes in plasma carotenoid concentrations during fluctuation in carotenoid intake.

Aged↗

IQ loss and emotional dysfunctions after mild head injury incurred in a motor vehicle accident.

Intelligence and personality dysfunctions after minor traumatic brain injury (TBI) (whiplash; slight head impact) incurred in a motor vehicle accident (MVA) were studied in adults after an average interval of 20 months. There was a mean loss of 14 points of Full Scale IQ from estimated preinjury baseline IQ determined from the standardization group (WAIS-R) without evidence for recovery. Personality dysfunctions included cerebral personality disorder, psychiatric diagnosis (30 of 33 patients), post-traumatic stress disorder, persistent altered consciousness, and psychodynamic reactions to impairment. Cognitive loss is caused by interaction of brain injury with distractions such as pain and emotional distress. Unreported head impact and altered consciousness at the time of accident contribute to the underestimation of brain trauma after minor TBI.

Accidents, Traffic↗

A taxonomy of neurobehavioral functions applied to neuropsychological assessment after head injury.

Neuropsychological dysfunctions after traumatic brain injury are classified into a taxonomy to plan a comprehensive examination, and organize and report findings for diagnosis and treatment: consciousness, information processing, sensorimotor, neurophysiological, cerebral personality disorders, intelligence, memory, language, stress, psychodynamic, identity and weltanschauung, adaptation, complex adaptive functions, and development of children. Wide-range sampling enhances the detection of acute and late-developing dysfunctions, and diagnosis of complex syndromes. Historical, personality, and injury data are components of the assessment. Issues discussed include underestimation of brain injury, malingering, interaction of symptoms, symptom persistence, and noncerebral lesional contributors to impairment after mild head injury.

Brain Damage, Chronic↗

Improvements in appetite and growth in helminth-infected schoolboys three and seven weeks after a single dose of pyrantel pamoate.

Appetite and growth were studied in primary schoolboys (6-10 years) infected with Ascaris lumbricoides (86%) and Trichuris trichiura (100%) who received a single dose of pyrantel pamoate (which has little or no effect on Trichuris trichiura) or a placebo. Boys were examined, allocated at random by descending Ascaris egg count to pyrantel (PR, n = 36) or placebo (PL, n = 36) groups, treated, and re-examined 3 and 7 weeks later. The 2 groups did not differ significantly before treatment in helminth infections, appetite, or growth. Three and 7 weeks after treatment, the PR group exhibited significantly greater increases than did the PL group in weight (0.2 kg and 0.4 kg more, respectively) and percentage weight-for-age (0.6% and 1.7% points more, respectively). Appetite increased significantly in the PR group at 3 and 7 weeks (P < 0.0005 and P < 0.01, respectively) but not in the PL group. The prevalence and intensity of A. lumbricoides infection were greatly reduced in the PR group at 3 and 7 weeks (both P < 0.0001) but not in the PL group. We conclude that treatment with pyrantel pamoate may improve appetite and growth in school children in areas where A. lumbricoides infections and poor growth are highly prevalent.

Animals↗

The spectrum of emotional distress and personality changes after minor head injury incurred in a motor vehicle accident.

This is a systematic presentation of the emotional and personality disorders of 33 patients who incurred minor traumatic brain injury (MTBI) in a vehicular accident. A wide spectrum of disorders was observed: cerebral personality disorder, persistent altered consciousness, post-traumatic stress, psychodynamic reactions to impairment, and complex reactions expressing neurological, somatic, and psychological dysfunctions (sexuality and somatization). Examples of each category are offered to aid identification. A total of 31/33 patients suffered an additional psychiatric disorder. Unreported head trauma and loss of consciousness (LOC) elicited by detailed interviews helped to explain the extent of impairment. Emotional disorders, added to persistent cognitive loss and other neuropsychological symptoms, greatly impair the capacity to adapt after traumatic brain injury (TBI). Clinical procedures (interview; Rorschach; observation; figure drawings; checklists) are recommended to obtain detailed personality information needed for diagnosis, prognosis, and treatment. Behavioural outcome after TBI reflects disturbance in the processing of internal and external stimulation, and disturbance of pre-existing physiological and psychological processes. Emotional distress consistent with the accident and impairment adds to the credibility of patient complaints. There is an interaction between lesion effects and various emotional disturbances, which impacts employment, social relationships, and the enjoyment of life. Prompt and sympathetic treatment will contribute to more effective treatment, and may be anticipated to reduce or prevent some persistent symptoms after minor head injury.

Accidents, Traffic↗

Evidence of cis-trans isomerization of 9-cis-beta-carotene during absorption in humans.

Absorption and metabolism of [13C]9-cis-beta-carotene ([13C]9c beta C) was studied in three subjects after a single oral dose. Subjects given 1.0 mg [13C]beta-carotene (mean: 99.4% 9-cis-beta-carotene, 0.6% all-trans-beta-carotene; dose A) had substantial concentrations of [13C]all-trans-beta-carotene ([13C]tr beta C) and [13C]all-trans retinol ([13C]retinol) but very low concentrations of [13C]cis-beta-carotene ([13C]cis beta C) in saponified plasma 5 h after dosing, as determined by HPLC and isotope-ratio mass spectrometry. There was no evidence of appreciable absorption of [13C]9-cis retinol. To determine the proportion of [13C]tr beta C and [13C]retinol derived from [13C]9c beta C, a second set of studies in the same subjects was performed with the same isomeric composition except with 13C labeling only in all-trans-beta-carotene (dose B). The results indicated that > 95% of plasma [13C]tr beta C and [13C]retinol observed after dose A was derived from [13C]9c beta C. The concentrations of [13C]tr beta C observed, in excess of that derived from the trace amounts of [13C]tr beta C in the dose, indicated that a significant proportion of the [13C]9c beta C dose was isomerized to [13C]tr beta C before entering the bloodstream. Although precise quantitative estimates of the extent of isomerization of 9-cis-beta-carotene could not be made, it is apparent that cis-trans isomerization of 9-cis-beta-carotene to all-trans-beta-carotene contributed to the near absence of postprandial plasma 9-cis-beta-carotene after its oral administration in humans. The observation of different ratios of beta-carotene to retinol between the two dosing protocols suggests that isomerization did not occur exclusively before uptake by the intestinal mucosa. These results indicate that isomerization of ingested 9-cis-beta-carotene before its secretion into the bloodstream limits the potential supply of 9-cis retinoids to tissues, and increases the vitamin A value of 9-cis-beta-carotene.

Absorption↗

Absorption, metabolism, and transport of carotenoids.

Carotenoids are currently under intense scrutiny regarding their potential to modulate chronic disease risk and prevent vitamin A deficiency, and renewed emphasis has been placed on achieving a better understanding of the metabolic fate of these compounds in humans. The development of new animal models, and use of human metabolic studies and stable tracer methods have greatly improved our knowledge of how carotenoids are absorbed, metabolized, and transported to tissues; however, many important issues remain unresolved. For example, intestinal uptake of carotenoids occurs by passive diffusion, but the lumenal or intracellular factors limiting this process are obscure. The intestinal mucosa plays a key role in the metabolism of provitamin A carotenoids such as beta-carotene, thus greatly influencing their bioavailability. Most recent evidence supports a central oxidation mechanism of cleavage of beta-carotene to retinal in the intestinal mucosa, but the extent and site(s) of postabsorptive metabolism in the human is unknown. While the human and other species clearly absorb non-provitamin A carotenoids, little is known of the extent and pathways of their metabolism and elimination. The metabolic fate of cis isomers of beta-carotene is a subject of recent interest, since 9-cis retinoic acid can apparently be formed from 9-cis beta-carotene in vitro and in vivo. Substantial cis-trans isomerization of at least small oral doses of 9-cis beta-carotene occurs in the human, although the site of isomerization is not yet known. Carotenoids are transported in plasma exclusively by lipoproteins, with the distribution among lipoprotein classes determined in large part by the physical properties of the carotenoid. The consequences of differential distribution in terms of tissue uptake and retention are not clear at present. Improved knowledge of the metabolic fate of carotenoids will assist in the development and testing of hypotheses regarding their potential to influence biological processes in the human.

Absorption↗