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Biomedical subjects

S Devaraj

Publications and source records attributed to S Devaraj.

At least 37 records · Page 2Linked to original sources
PubMed2000

Antioxidants and vitamins to reduce cardiovascular disease.

Cardiovascular disease is the leading cause of morbidity and mortality in Western populations. Several lines of evidence support the role of oxidative stress in atherogenesis. Dietary micronutrients with antioxidant properties and vitamins have also been shown to have a benefit with regards to cardiovascular disease. The most persuasive evidence relates to alpha tocopherol and folate and vitamin B(12). Although the evidence is mounting for supplementation with alpha tocopherol and folate and B(12) for secondary prevention of cardiovascular disease, no clear consensus can be reached for primary prevention of cardiovascular disease. This will have to await results of ongoing clinical trials.

Animals↗
PubMed2000

Alpha-tocopherol supplementation decreases the oxidative susceptibility of LDL in renal failure patients on dialysis therapy.

Atherosclerotic cardiovascular disease is the leading cause of death in patients with end stage renal disease (ESRD) who have undergone dialysis treatment. The oxidation of low density lipoprotein (LDL) appears to be a crucial step in the pathogenesis of atherosclerosis. The increased oxidative stress and attendant increased oxidizability of lipoproteins, such as LDL could contribute to the accelerated atherosclerosis in dialysis patients. Since alpha-tocopherol (AT) is the major antioxidant in LDL, the aim of the present study was to test the effectiveness of RRR-AT supplementation (800 I.U. per day) for 12 weeks on the susceptibility of LDL to oxidation. The study subjects comprised patients with chronic renal failure on hemodialysis (HD), peritoneal dialysis (PD), and age and sex matched controls (C). Plasma fatty acids, lipoproteins and AT levels were measured in these subjects before and after supplementation. Also, LDL AT and oxidizability was studied. LDL was isolated by ultracentrifugation at baseline and after 12 weeks of supplementation, and subjected to a 5-h time course of copper catalyzed oxidation. Oxidation was measured by the formation of conjugated dienes (CD) and lipid peroxides (LP). Supplementation with AT did not alter the plasma lipid or lipoprotein profile of these subjects. Plasma lipid-standardized AT and LDL AT concentrations were not different among the groups at baseline. AT supplementation significantly increased plasma lipid-standardized AT (C=150%, HD=149%, PD=217%, P<0.001) and LDL AT concentrations (C=94%, HD=94%, PD=135%, P<0.003). AT enrichment of LDL resulted in a significant prolongation in conjugated diene lag phase in all groups (C=34%, HD=21%, PD=54%, P<0.02). Lipid peroxide lag phase was also increased significantly in C (27%,) and PD (40%) groups after AT supplementation (P<0.01). There was a significant positive correlation between plasma lipid standardized AT and lag phase (r=0. 54, P=0.0003). Overall, AT decreased the susceptibility of LDL to oxidation in patients with chronic renal failure but the benefit appears to be greater in patients on PD. Therefore, AT supplementation may also provide a measure of protection against CAD in patients with chronic renal failure on dialysis therapy.

Adult↗
PubMed2000

Remnant-like particle-cholesterol concentrations in patients with type 2 diabetes mellitus and end-stage renal disease.

BACKGROUND: Lipid abnormalities contribute significantly to the increased risk of cardiovascular disease in diabetic and end-stage renal disease (ESRD) patients. Accumulating evidence supports a proatherogenic role for remnant lipoproteins. Thus, the aim of the present study was to compare remnant-like particle-cholesterol (RLP-C) in type 2 diabetic and ESRD patients with age- and gender-matched controls. METHODS: Using an immunoaffinity assay, we measured RLP-C concentrations in 48 type 2 diabetic patients with (n = 24) and without (n = 24) macrovascular complications, and 24 age- and gender-matched controls, as well as in 38 ESRD patients on hemodialysis (n = 19) and peritoneal dialysis (n = 19), and 19 age- and gender-matched controls. RESULTS: RLP-C correlated significantly with plasma triglycerides (TGs; r = 0.8). When compared with controls, RLP-C concentrations were significantly higher in type 2 diabetic patients with and without macrovascular complications (median, 0.22 and 0.17 mmol/L vs 0.14 mmol/L; P <0.0002 and <0.01, respectively); diabetic patients with macrovascular complications also had significantly higher RLP-C than diabetic patients without macrovascular complications (P <0.05). However, when RLP-C/TG ratios were computed, only diabetic patients with macrovascular complications showed significantly higher RLP-C/TG ratios compared with controls (P <0.05). Regarding ESRD, RLP-C concentrations were significantly increased in patients on both hemodialysis and peritoneal dialysis compared with controls (median, 0.23 and 0.21 mmol/L vs 0.13 mmol/L; P <0.0001). Whereas RLP-C was increased in ESRD patients on hemodialysis with TGs <2.26 mmol/L compared with controls, RLP-C/TG ratios were not significantly increased in these patients. CONCLUSIONS: Type 2 diabetic patients with macrovascular disease demonstrated increased RLP-C and RLP-C/TG ratios, whereas ESRD patients showed only increased RLP-C concentrations.

Aged↗
PubMed1999

Cyclosporin A does not increase the oxidative susceptibility of low density lipoprotein in vitro.

Accelerated atherosclerosis is the leading cause of morbidity in renal transplant recipients. The pathogenic mechanisms responsible for the progression of atherosclerosis in renal transplant recipients have not been elucidated. Cyclosporin A (CsA) is an immunosuppressive agent used post-transplant and may contribute to increased oxidative susceptibility of low density lipoprotein (LDL). There is a paucity of data testing the effect of CsA on LDL oxidation. Hence, the aim of this study was to test the effect of in vitro enrichment of LDL with CsA on LDL oxidation. LDL oxidation in presence of different concentrations of CsA was tested using metal-dependent (copper), metal-independent (AAPH) and cell-mediated (macrophages) oxidation systems. In all 3 systems, CsA had no significant effect on LDL oxidation. Also, pre-incubation of LDL with CsA did not affect LDL oxidation and LDL alpha tocopherol levels. Thus, the results of our studies with CsA indicate that it is not a direct pro-oxidant.

Amidines↗
PubMed1999

Comparison of the effect of alpha-lipoic acid and alpha-tocopherol supplementation on measures of oxidative stress.

In vitro studies have shown that alpha-lipoic acid (LA) is an antioxidant. There is a paucity of studies on LA supplementation in humans. Therefore, the aim of this study was to assess the effect of oral supplementation with LA alone and in combination with alpha-tocopherol (AT) on measures of oxidative stress. A total of 31 healthy adults were supplemented for 2 months either with LA (600 mg/d, n = 16), or with AT (400 IU/d, n = 15) alone, and then with the combination of both for 2 additional months. At baseline, after 2 and 4 months of supplementation, urine for F2-isoprostanes, plasma for protein carbonyl measurement and low-density lipoprotein (LDL) oxidative susceptibility was collected. Plasma oxidizability was assessed after incubation with 100 mM 2,2'-azobis (2-amidinopropane) hydrochloride (AAPH) for 4 h at 37 degrees C. LDL was subjected to copper- and AAPH-catalyzed oxidation at 37 degrees C over 5 h and the lag time was computed. LA significantly increased the lag time of LDL lipid peroxide formation for both copper-catalyzed and AAPH-induced LDL oxidalion (p < .05), decreased urinary F2-isoprostanes levels (p < .05), and plasma carbonyl levels after AAPH oxidation (p < .001). AT prolonged LDL lag time of lipid peroxide formation (p < .01 ) and conjugated dienes (p < .01) after copper-catalyzed LDL oxidation, decreased urinary F2-isoprostanes (p < .001), but had no effect on plasma carbonyls. The addition of LA to AT did not produce an additional significant improvement in the measures of oxidative stress. In conclusion, LA supplementation functions as an antioxidant, because it decreases plasma- and LDL-oxidation and urinary isoprostanes.

Administration, Oral↗
PubMed1999

Validation of an immunoassay for measurement of plasma total homocysteine.

Hyperhomocysteinemia is an evolving cardiovascular risk factor. It is imperative that a simple, precise, and accurate assay be available in the clinical laboratory. The aim of this study was to evaluate an automated fluorescence polarization immunoassay for homocysteine. The assay had excellent precision at normal and high levels (intra-assay and interassay coefficients of variation < 5%). The method was linear from 0.24 to 50 mumol/L and displayed good correlation with a high-performance liquid chromatography (HPLC) method. There was no significant interference detectable in icteric and hyperlipidemic samples, but hemolysis resulted in a significant negative bias. While homocysteine levels were not increased in smokers, patients with renal failure had significantly higher levels compared with control subjects. This automated assay requires no sample preparation, displays excellent precision, shows good correlation with HPLC, and, thus, is favored over HPLC for use in the clinical laboratory. The main indications for measuring plasma homocysteine levels will be in the early diagnosis of cobalamin deficiency, patients with cardiovascular disease and few or no established risk factors, and patients with unexplained venous thromboembolic disease.

Autoanalysis↗
PubMed1999

Alpha-tocopherol decreases interleukin-1 beta release from activated human monocytes by inhibition of 5-lipoxygenase.

Cardiovascular disease is the leading cause of morbidity and mortality in westernized populations. Low levels of alpha-tocopherol (AT) are associated with increased incidence of atherosclerosis and increased intakes appear to be protective. Recently, we showed that supplementation with AT resulted in significant decreases in monocyte superoxide anion release, lipid oxidation, interleukin-1 beta (IL-1 beta) release, and adhesion to endothelium. The reduction in superoxide and lipid oxidation by AT seemed to be mediated by inhibition of protein kinase C. The aim of this study was to investigate the mechanism(s) by which AT inhibits IL-1 beta release. Potential mechanisms examined included its effect as an antioxidant and its inhibitory effects on protein kinase C and the cyclooxygenase-lipoxygenase pathways. Although AT decreased superoxide release from activated monocytes, superoxide dismutase and catalase had no effect on IL-1 beta release. Also, a similar antioxidant, beta-tocopherol, had no effect on IL-1 beta release. The protein kinase C inhibitor, bisindolylmaleimide, did not inhibit IL-1 beta release from activated monocytes, in spite of AT decreasing protein kinase C activity. Leukotriene B4, a major product of 5-lipoxygenase, has been shown to augment IL-1beta release. In the presence of AT, a significant reduction in leukotriene B4 and IL-1 beta levels was observed, which was reversed by the addition of leukotriene B4. Similar observations were seen with specific inhibitors of 5-lipoxygenase. The product of cyclooxygenase, prostaglandin E2, has been shown to inhibit IL-1 beta activity in some systems. However, AT had no significant effect on prostaglandin E2 levels in activated monocytes. In the presence of indomethacin, a cyclooxygenase inhibitor, AT inhibited IL-1 beta activity. Also, AT had no effect on IL-1 beta mRNA levels or stability, suggesting a posttranscriptional effect. Thus, in activated human monocytes, AT exerts a novel biological effect of inhibiting the release of the proinflammatory cytokine, IL-1 beta, via inhibition of the 5-lipoxygenase pathway.

Humans↗
PubMed1998

alpha-Tocopherol enrichment of monocytes decreases agonist-induced adhesion to human endothelial cells.

BACKGROUND: Monocyte-endothelium adhesion is a crucial early event in atherogenesis. Several reports indicate that alpha-tocopherol (AT) is a potent antioxidant in plasma and LDL and also has intracellular effects that are antiatherogenic. Recently, it has been shown that AT supplementation results in decreased monocyte-endothelial cell adhesion. However, there is a paucity of data on the mechanisms by which AT inhibits adhesion of monocytes. We studied the effect of AT enrichment of a human monocytic cell line, U937, on adhesion to human umbilical vein endothelial cells (HUVECs). METHODS AND RESULTS: Both lipopolysaccharide (LPS)- and N-formyl-methionyl-leucyl-phenylalanine (FMLP)-stimulated U937 adhesion to HUVECs were studied. AT (50 and 100 micromol/L) significantly decreased adhesion of both LPS- and FMLP-stimulated U937 cells to HUVECs (LPS-treated cells, P<0.0125; FMLP-treated cells, P<0.05). Expression of the adhesion molecules CD11a, CD11b, CD11c, very late antigen-4 (VLA-4), and L-selectin, as assessed by flow cytometry, was increased in the stimulated U937 cells, and AT resulted in significant reduction in the expression of CD11b and VLA-4. In addition, activation of the transcription factor nuclear factor-kappaB (NF-kappaB), as assessed by gel shift assays, was inhibited by pretreatment with AT in LPS-treated U937 cells. CONCLUSIONS: AT significantly decreases adhesion of activated monocytes to endothelial cells by decreasing expression of CD11b and VLA-4 on monocytes, possibly by inhibiting the activation of NF-kappaB.

Cell Adhesion↗
PubMed1998

Remnant-like particle cholesterol levels in patients with dysbetalipoproteinemia or coronary artery disease.

PURPOSE: Several studies have provided support for a proatherogenic role for remnant lipoproteins. Thus, the aim of this study was to compare remnant-like particle (RLP) cholesterol levels in patients with coronary artery disease who were normolipidemic with those in controls of similar age and gender. We also assessed the usefulness of measuring RLP-cholesterol levels in patients with type III dyslipidemia. SUBJECTS AND METHODS: Remnant-like particle cholesterol levels were measured in 63 normolipidemic men with coronary artery disease and 23 male controls of similar age as well as in 15 patients with type III dyslipidemia and 103 controls, using an immunoaffinity method. RESULTS: Remnant-like particle cholesterol levels were significantly increased in men with coronary artery disease compared with controls (7.6 +/- 3.8 mg/dL versus 5.7 +/- 1.9 mg/dL, P < 0.01). In patients with coronary artery disease, RLP-cholesterol levels were correlated with total triglyceride and nonhigh-density-lipoprotein (HDL) cholesterol levels, but not with HDL-cholesterol levels. RLP-cholesterol levels were significantly elevated in patients with type III dyslipidemia (median 119, range 31 to 240 mg/dL) compared with controls (median 5.6, range 2.2 to 10.5 mg/dL, P < 0.001). CONCLUSION: Normolipidemic men with coronary artery disease have increased levels of RLP-cholesterol that is not detected with conventional lipid screening. The RLP-cholesterol assay is a simple method for detecting high concentrations of remnant lipoproteins in patients with type III dyslipidemia.

Adult↗
PubMed1998

Evaluation of a rapid homogeneous method for direct measurement of high-density lipoprotein cholesterol.

We evaluated the performance of a direct Liquid N-geneous HDL-C assay (N-HDL; Genzyme Diagnostics, Cambridge, Mass) and compared it with a Centers for Disease Control and Prevention (CDC) modified reference procedure (M-REF) and phosphotungstic acid (PTA) precipitation method in patients with normotriglyceridemia (triglyceride level, <400 mg/dL) and hypertriglyceridemia (triglyceride level, > or =400 mg/dL). Excellent intra-assay and interassay coefficients of variation were obtained (<2.0%) using the N-HDL assay. The N-HDL and PTA assays correlated well with M-REF in normotriglyceridemic samples. In hypertriglyceridemic samples, however, the N-HDL method exhibited better correlation with M-REF than the PTA assay. In addition, compared with M-REF, the mean absolute percentage bias of N-HDL was lower than the PTA assay in normotriglyceridemic (4.9% vs 5.8%) and hypertriglyceridemic (5.4% vs 12.9%) samples. Hemolysis, ascorbic acid, and bilirubin did not interfere with the N-HDL assay. On the basis of these findings, the N-HDL assay compares favorably with the modified CDC reference method and seems superior to the PTA assay. It also has the advantage of being suited for complete automation and, thus, would prove useful in large clinical laboratories.

Cholesterol, HDL↗
PubMed1998

The effects of alpha-tocopherol on critical cells in atherogenesis.

Low levels of alpha tocopherol have been associated with increased risk for coronary artery disease and increased intake has been shown to be protective. Data support a proatherogenic role for oxidized LDL in atherosclerosis and several studies show that alpha tocopherol decreases the susceptibility of LDL to oxidation. In addition, alpha tocopherol can partition in the artery wall in critical cells such as smooth muscle cells, monocyte-macrophages, endothelial cells, and platelets, exerting beneficial effects. In this review, the anti-atherogenic effects of alpha tocopherol on crucial cells in atherogenesis have been highlighted, such as the inhibition of smooth muscle cell proliferation, preservation of endothelial function, inhibition of monocyte-endothelial adhesion, inhibition of monocyte reactive oxygen species and cytokine release, and inhibition of platelet adhesion and aggregation.

Arteriosclerosis↗
PubMed1998

Comparison of 2 homogeneous high-density lipoprotein cholesterol assays.

BACKGROUND: High-density lipoprotein cholesterol (HDL-C) is an independent inverse risk factor for coronary artery disease. Current methodologies for measurement of HDL-C in most clinical laboratories involve chemical precipitation-based methods. However, these methods are time-consuming, affected by high triglycerides, are not suitable for complete automation, and require a large sample size. New direct homogeneous methods are now available that do not have these constraints. DESIGN: We evaluated the performance of 2 direct homogeneous methods, Liquid N-geneous HDL-C assay (LN-HDL) and Boehringer Mannheim HDL Cholesterol assay (BM-HDL), and compared these methods against a modified Centers for Disease Control and Prevention reference method (MR-HDL) in 126 patients with normotriglyceridemia (triglycerides < 4.5 mmol/L, range 0.6-4.3 mmol/ L) and 50 patients with hypertriglyceridemia (triglycerides > or =4.5 mmol/L, range 4.5-18.8 mmol/L). RESULTS: Excellent precision profiles were exhibited by both homogeneous methods. Both LN-HDL and BM-HDL correlated well with MR-HDL in normotriglyceridemia (r = 0.98, slope = 0.93 and r = 0.97, slope = 1.0, respectively). However, compared with the modified reference method, the LN-HDL correlated better than the BM-HDL in hypertriglyceridemic samples (r = 0.97, slope = 1.0 and r = 0.91, slope = 0.9, respectively). The 1998 National Cholesterol Education Program guidelines for accuracy (bias < +/-5%) were met by LN-HDL in both normotriglyceridemic and hypertriglyceridemic samples (bias = 1.3% and 3.3%, respectively); however, BM-HDL failed to meet the National Cholesterol Education Program accuracy criteria in both triglyceride subgroups (bias = 8.2% and 11.3%, respectively). In addition, the total error for LN-HDL in both normotriglyceridemia (6.6%) and hypertriglyceridemia (8.6%) was well within the National Cholesterol Education Program guidelines for total error (< or =13%); BM-HDL exhibited a higher total error than LN-HDL in normotriglyceridemia (11.9%) and failed to meet the National Cholesterol Education Program guidelines in hypertriglyceridemia (15.0%). CONCLUSION: Although both homogeneous methods are precise, the LN-HDL assay is superior in accuracy to the BM-HDL assay when compared with the modified reference method.

Cholesterol↗
PubMed1997

Dose-response comparison of RRR-alpha-tocopherol and all-racemic alpha-tocopherol on LDL oxidation.

Much data have accrued in support of the concept that oxidation of LDL is a key early step in atherogenesis. The most consistent data with respect to micronutrient antioxidants and atherosclerosis appear to relate to alpha-tocopherol (AT), the predominant lipid-soluble antioxidant in LDL. There are scant data on the direct comparison of RRR-AT and all-racemic (rac)-AT on LDL oxidizability. Hence, the aim of the present study was to examine the relative effects of RRR-AT and all-rac-AT on plasma antioxidant levels and LDL oxidation in healthy persons in a dose-response study. The effect of RRR-AT and all-rac-AT at doses of 100, 200, 400, and 800 IU/d on plasma and LDL AT levels and LDL oxidation was tested in a randomized, placebo-controlled study of 79 healthy subjects. Copper-catalyzed oxidation of LDL was monitored by measuring the formation of conjugated dienes and lipid peroxides over an 8-hour time course at baseline and again after 8 weeks. Plasma AT, lipid-standardized AT, and LDL AT levels rose in a dose-dependent fashion in both the RRR-AT and all-rac-AT groups compared with baseline. There were no significant differences in plasma, lipid-standardized, and LDL AT levels between RRR-AT and all-rac-AT supplementation at any dose comparison. The lag phases of oxidation were significantly prolonged with doses > or = 400 IU/d of RRR-AT and all-rac-AT, as measured by conjugated-dienes assay and at 400 IU/d of RRR-AT and 800 IU/d of both forms of AT by lipid peroxide assay. Again, there were no significant differences in the lag phase of oxidation at each dose for RRR-AT when compared with all-rac-AT. Also, there were no significant differences in LDL oxidation after in vitro enrichment of LDL with RRR-AT and all-rac-AT. Thus, supplementation with either RRR-AT or all-rac-AT resulted in similar increases in plasma and LDL AT levels at equivalent IU doses, and the degree of protection against copper-catalyzed LDL oxidation was only evident at doses > or = 400 IU/d for both forms.

Adult↗
PubMed1997

Oxalate binding protein from the kidney of rat and human mitochondria: studies on properties.

The oxalate binding protein of rat and human kidney mitochondria were extracted by Triton X-100 and purified on Sephadex G-200 column followed by HPLC. Their molecular masses were found to be 62 kD and 58 kD respectively, rich with arginine and acidic amino acids, 7% of carbohydrates and 1% of inorganic ions. Antibodies raised to the rat protein inhibited the oxalate binding and cross-reacted to the human protein as well as rat liver protein. The binding of oxalate to the protein was rapid, reversible, dependent on concentration of oxalate, temperature sensitive and inhibited by oxalate analogues. The saturation reached at 175 nM oxalate for rat protein with a Kd of 33.3 nM and Bmax of 21 nmoles while for human protein the saturation reached at 183 nM oxalate and had a Kd of 41 nM and Bmax of 14 n moles. The half-saturation concentration of inhibitor (IC50) of oxalate was 0.25 microM for rat protein and 0.225 microM for human protein while the structural analogues of oxalate had higher IC50 values. Proteoliposomes showed accumulation of oxalate confirming transport function of the protein. The rat protein promoted calcium oxalate crystallization in vitro better than that of human protein and antibody inhibited the crystal growth in vitro.

Animals↗
PubMed1996

The effects of alpha tocopherol supplementation on monocyte function. Decreased lipid oxidation, interleukin 1 beta secretion, and monocyte adhesion to endothelium.

Low levels of alpha tocopherol are related to a higher incidence of cardiovascular disease and increased intake appears to afford protection against cardiovascular disease. In addition to decreasing LDL oxidation, alpha tocopherol may exert intracellular effects on cells crucial in atherogenesis, such as monocytes. Hence, the aim of this study was to test the effect of alpha tocopherol supplementation on monocyte function relevant to atherogenesis. Monocyte function was assessed in 21 healthy subjects at baseline, after 8 wk of supplementation with d-alpha tocopherol (1,200 IU/d) and after a 6-wk washout phase. The release of reactive oxygen species (superoxide anion, hydrogen peroxide), lipid oxidation, release of the potentially atherogenic cytokine, interleukin 1 beta, and monocyte-endothelial adhesion were studied in the resting state and after activation of the monocytes with lipopolysaccharide at 0, 8, and 14 wk. There was a 2.5-fold increase in plasma lipid-standardized and monocyte alpha tocopherol levels in the supplemented phase. After alpha tocopherol supplementation, there were significant decreases in release of reactive oxygen species, lipid oxidation, IL-1 beta secretion, and monocyte-endothelial cell adhesion, both in resting and activated cells compared with baseline and washout phases. Studies with the protein kinase C inhibitor, Calphostin C, suggest that the inhibition of reactive oxygen species release and lipid oxidation is due to an inhibition of protein kinase C activity by alpha tocopherol. Thus, this study provides novel evidence for an intracellular effect of alpha tocopherol in monocytes that is antiatherogenic.

Adult↗