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INTRODUCTION: Hypertension is considered to be among the most important risk factors for cardiovascular and cerebrovascular diseases. In recent years, several investigators have reported that high plasma levels of total homocysteine (t-hcy) has a key role in the development of hypertension, and the deficiency of B complex vitamins could increase the risk of hypertension. The purpose of this study was to investigate the relationship between plasma homocysteine, folate and vitamin B12 in hypertensive patients. MATERIALS AND METHODS: In 116 patients with hypertension and 81 healthy subjects, total plasma homocysteine, vitamin B12 and folate levels were measured. RESULTS AND DISCUSSION: Homocysteine was significantly higher in patients than in control subjects (22.9±3.5 versus 9.0±2.3 μmol/L respectively, p0.05). Our results confirmed that, as previously observed, elevated t-hcy levels and low folate levels, but not vitamin B12 levels, are significantly associated with hypertension.

BETANIN INHIBITS MYELOPEROXIDASE/NITRITE-MEDIATED PEROXIDATION OF HUMAN LOW-DENSITY LIPOPROTEIN M. Allegra, L. Tesoriere, D. Butera, A.M. Pintaudi, M.A. Livrea Dipartimento Farmacochimico Tossicologico e Biologico - Facoltà di Farmacia - Università di Palermo - Via C. Forlanini 1 - 90134 Palermo INTRODUCTION: Betanin, the betalain red pigment occurring in the Cariophillalae order plants, including cactus pear, has recently been reported to posses reducing properties and to behave as lipoperoxyl radical-scavenger in vitro (1). In addition, this phytochemical is bioavailable, accumulates in human LDL after ingestion of cactus pear fruits, and is able to protect LDL against copper-induced oxidation in vitro (2,3). Myeloperoxidase (MPO) has been implicated in the in vivo LDL modification and atherogenesis (4). The enzyme, in the presence of nitrite, generates two powerful oxidizing agents, the tyrosyl radical and the nitrosyl one, both of which promote LDL lipid oxidation (4). Taking all this into account we have decided to investigate weather betanin could counteract MPO/nitrite-induced oxidation of LDL. MATERIALS AND METHODS: Human MPO was purchased from Calbiochem and Glucose oxidase from Sigma. All other chemical and solvents were purchased from Sigma Aldrich or Merck. Preparation of LDL. LDL was prepared from blood serum of healthy volunteers according to Kleinveld et al. (5) with minor modification and stored in the presence of 4mM EDTA at -80°C. Lipid peroxidation of LDL. Reactions were carried out according to Kostyuk et al. (6). RESULTS: Our results, indicate that betanin is able to inhibit the MPO/nitrite-induced LDL lipid peroxidation, in a dose-dependent manner in the range 1 to 10 μM (Fig.1). We have compared the effectiveness of betanin with that of two well-known physiological antioxidants: α-tocopherol and ascorbic acid. As reported (4), α-tocopherol, the most powerful radical-scavenger, is only able to partially protect LDL lipids from oxidation by the MPO/nitrite system and has scarce or no effect on the powerful hydrophilic oxidants generated by nitrite. On the contrary, vitamin C, which is able to scavenge the peroxidase-generated nitrating species, was very efficient in counteracting the MPO/nitrite-sustained lipid peroxidation. Betanin, was even more effective than vitamin C, at inhibiting the oxidative damage to LDL. The IC50 calculated for betanin (1.4 μM) was more than 10-fold lower than that for ascorbic acid (15.6 μM). Nitrite, an oxidation product of nitric oxide metabolism, and MPO are considered mediators of the LDL oxidation process in vivo. Our study shows that betanin, a phytochemical occurring in the cactus pear fruit, is able to protect LDL, in an experimental set-up of physiological relevance. In addition, the molecule acts at micromolar concentrations, and appears much more effective than ascorbic acid. Our data collectively indicate a favourable modulation of the oxidation process of LDL and may contribute to the supposed beneficial effect of cactus fruit (2). 1. Lievrea M.A. et al. (2003) in Herbal Medicines, Marcel Dekker, Inc. 537-556. 2. Tesoriere L. et al. The American Journal of Clinical Nutrition (in press). 3. Tesoriere L. et al. (2003). Free Radical Research 37, 689-696. 4. Carr A.C. et al. (2000). Arterioscler Thromb Vasc Biol. 1716-1723. 5. Kleinveld, H.A. et al. (1992). Clin. Chem. 38, 2066-2072. 6. Kostyuk V.A. et al. (2003) FEBS Letters 537:146-50. 7. Kleinveld H.A. et al. (1992). Clinical Chemistry, 38. 2006-2072. 8. Kostyuk V.A. et al. (2003). FEBS Letters, 146-153.

The atherosclerotic Cardiovascular Disease (CVD) is frequently observed in End-Stage Renal Disease (ESRD) patients; according to the hypothesis of non-traditional risk factors for CVD, accelerated atherogenesis in these patients could be linked to both vascular calcification and inflammation. 2-Heremans-Schmid Glycoprotein (AHSG) also known as Fetuin-A, is considered a negative marker of inflammation and represents one of the in vivo circulating calcification modulators; these molecules are proteins working as endogenous inhibitors of Ca×PO4 precipitation and are probably involved in the pathogenesis vascular calcification. Aim of this study is to evaluate the differences in serum Fetuin-A levels between 2 Haemodialysis (HD) patient groups distinguished on the basis of history of cardio and/or cerebrovascular events. All patients took part in clinical data collection and 2 patient groups were identified as no cardiovascular and cardiovascular on the basis of history of cardio and/or cerebrovascular events. Serum Fetuin-A levels were determined using sandwich immunoenzymatic assay, ELISA (Epitope Diagnostics Inc., San Diego, CA, USA). Serum Fetuin-A levels were significantly lower in cardiovascular HD patients than in those without cardiovascular event. The role of Fetuin A in the context of the different pathogenetic moments of atherosclerosis remains unclearly assessed; it would be of some interest to investigate the hypothesis, almost unexplored, of a relationship between low Fetuin A levels and endothelial dysfunction.

Cervical cancer is the fourth most common neoplasm in women. In locally advanced cervical cancers, the international guidelines recommend nodal aortic assessment. Two techniques have been described to perform laparoscopic aortic lymphadenectomy: transperitoneal laparoscopic lymphadenectomy (TLL) and extraperitoneal laparoscopic lymphadenectomy (ELL). This meta-analysis aims to compare the surgical outcomes of TLL and ELL for staging purposes. The systematic review was carried out in agreement with the preferred reporting items for systematic reviews and meta-analyses statement (PRISMA). Two hundred and twenty studies were analyzed, and 19 studies were included in the review (7 for TLL and 12 for ELL group). 1112 patients were included in the analysis: 390 patients were included in group 1 and 722 patients in group 2.38 patients (9.7%) in the TLL group and 69 (9.5%) patients in the ELL group developed major complications. The analysis of all complications (intraoperative and postoperative) rate through pooled analysis did not show a significant difference between the two groups (p = 0.979), although a significantly higher intraoperative complication rate (p = 0.018) occurred in the TLL group compared to ELL. No significant differences were found between groups for BMI (p = 0.659), estimated blood loss (p = 0.889), length of stay (p = 0.932), intraoperative time (p = 0.932), conversion to laparotomy rate (p = 0.404), number of lymph node excised (p = 0.461) and postoperative complication (p = 0.291). TLL approach shows a higher rate of intraoperative complications, while no significant difference was found between the two techniques when postoperative complications were analyzed.

Antioxidant phytochemicals are investigated as novel treatments for supportive therapy in beta-thalassemia. The dietary indicaxanthin was assessed for its protective effects on human beta-thalassemic RBCs submitted in vitro to oxidative haemolysis by cumene hydroperoxide. Indicaxanthin at 1.0-10 microM enhanced the resistance to haemolysis dose-dependently. In addition, it prevented lipid and haemoglobin (Hb) oxidation, and retarded vitamin E and GSH depletion. After ex vivo spiking of blood from thalassemia patients with indicaxanthin, the phytochemical was recovered in the soluble cell compartment of the RBCs. A spectrophotometric study showed that indicaxanthin can reduce perferryl-Hb generated in solution from met-Hb and hydrogen peroxide (H2O2), more effectively than either Trolox or vitamin C. Collectively our results demonstrate that indicaxanthin can be incorporated into the redox machinery of beta-thalassemic RBC and defend the cell from oxidation, possibly interfering with perferryl-Hb, a reactive intermediate in the hydroperoxide-dependent Hb degradation. Opportunities of therapeutic interest for beta-thalassemia may be considered.

Le proteine sono macromolecole che svolgono svariate e importanti funzioni sia dinamiche che strutturali all’interno degli organismi viventi. Le funzioni dinamiche comprendono la catalisi enzimatica, il trasporto, il controllo metabolico e la contrazione. Dal punto di vista strutturale, le proteine sono componenti fondamentali del tessuto muscolare, connettivo e della matrice delle ossa. Tutte le proteine sono polimeri non ramificati formati dalla combinazione di soli 20 diversi amminoacidi, detti proteici, uniti tra loro tramite il legame peptidico. La vasta gamma di attività che possono svolgere le proteine dipende proprio dalla loro composizione amminoacidica variabile. Lo studio delle proteine è uno dei principali rami della biochimica. In questo capitolo, tratteremo lo studio delle proteine imparando a conoscere i loro costituenti: gli amminoacidi.

Unopened flower buds of Capparis spinosa L. (capers), generally used in the Mediterranean area as food flavoring, are known to be a good source of bioactive compounds. The aim of this work was to evaluate the nutraceutical value of salt-fermented capers collected from different areas of Pantelleria Island (Italy), testing their methylglyoxal and glyoxal trapping capacity and antioxidant activity by 2,2-diphenyl-1-picryl hydrazyl (DPPH), [2,2-azinobis(3-ethylben- zothiazoline-6-sulfonic acid)] diammonium salt (ABTS), and oxygen radical absorbance capacity (ORAC) assays. Hydrophilic extracts were also characterized by high-performance liquid chromatography–electrospray ionization/mass spectrometry. Among 24 detected compounds, several flavonol derivatives and glucosinolates were identified. The levels of kaempferol and quercetin derivatives varied considerably among the five accessions considered (6.46 to 267.93 and 22.39 to 367.14 mg kaempferol and quercetin equivalent /g fresh weight, respectively), with kaempferol derivatives more representative than quercetin ones. Person's coefficient indicated a high correlation between total phenolic content and anti-DPPH radical capacity (R2 = 0.665), as well as between total flavonoid content and antioxidant capacity (by ORAC assay; R2 = 0.888) and between total flavonoid content and glyoxal and methylglyoxal trapping capacity (R2 = 0.918). Results indicate that capers from Pantelleria Island represent a rich source of bioactive compounds with potential nutraceutical relevance. Practical Application: The findings of this study highlight the health benefits of Pantelleria capers consumption due to their composition in antioxidants and their biological properties (antiradical and alpha-dicarbonyls trapping) correlated with the development of a high number of chronic–degenerative diseases. These results are also important for the agricultural and commercial sectors involved in the production of capers from Pantelleria, which received the Protected Geographical Indications recognition.

Introduction: Multiple Myeloma (MM) is a clonal disorder characterized by proliferation and accumulation of malignant plasma cells in the bone marrow. Bone disease occurs in approximately 80% of patients with newly diagnosed MM. The cervical spine is the least common site of disease involvement. Case presentation: A 60-year-old female patient was referred to the Department of Neurosurgery for bone pain. A magnetic resonance imaging (MRI) scan showed a pathological fracture of the sixth cervical vertebra (C6). The laboratory tests and the bone marrow examination led to a diagnosis of IgA χ MM (Durie Salmon stage IIIA). The patient underwent a cervical arthrodesis and started systemic Bortezomib-Thalidomide-Dexamethasone (VTD) combination chemotherapy. During chemiotherapic treatment the patient underwent a vertebroplasty of L4-L5. After 4 VTD cycles, the patient was dismissed showing a very good partial remission (VGPR). Later the patient subjected herself to hematopoietic stem cell transplantation (HSCT) obtaining a complete remission. Discussion: We report a clinical case of MM in which the fracture of cervical spine represents the clinical onset. Indeed this clinical presentation is not common in this type of monoclonal gammopathy. This case underlines the importance of suspecting MM in all cases of compromised bone.

Objectives The protective role of saliva in the case of oesophageal exposition to gastric acid has long been studied but some contradictions still remain. The main end-point of this study was to evaluate if a qualitative and quantitative alteration in salivary secretion exists in patients affected by GERD. Methods One hundred and twenty patients (T group) with clinically and endoscopically diagnosed GERD, and 98 healthy subjects (C group) have been evaluated; salivary tests (i.e. basal flow rate, stimulated flow rate, pH, [Na + ] and [K + ]) were performed, socio-demographical variables and oral GERD-related symptoms were taken into account. SPSS 10.5 software was used for statistical univariate and multivariate analyses. Results GERD patients and controls were found to have a similar basal flow rate but different stimulated salivary function [T group mean value 0.989 ml/min (±0.48718) vs . C group 1.2197 ml/min (±0.6108), pH [T group mean value 8.935 (±0.471) vs . C group 7.879 (±0.526)] and a higher K + concentration. In GERD patients we also registered a significant association with xerostomia [69/120 (57.5%) vs . 28/98 (28.7%)] and an oral burning sensation [58/120 (48.3%) vs . 19/98 (19.3%)]. Conclusions Our findings assess that salivary secretion is altered in GERD patients and highlight the need for further investigations in order to define the role of saliva in the etiopathogenesis of GERD.

Pistacia vera L. is the only species of Pistacia genus producing edible nuts. This paper investigates the antioxidant potential of a Sicilian variety of pistachio nut by chemical as well as biological assays and measured antioxidant vitamins and a number of antioxidant polyphenols in either the hydrophilic and/or the lipophilic nut extract. In accordance with the majority of foods, the total antioxidant activity, measured as a TAA test, was much higher (50-fold) in the hydrophilic than in the lipophilic extract. Substantial amounts of total phenols were measured. The hydrophilic extract inhibited dose- dependently both the metal-dependent and -independent lipid oxidation of bovine liver microsomes, and the Cu+2-induced oxidation of human low-density lipoprotein (LDL). Peroxyl radical-scavenging as well as chelating activity of nut components may be suggested to explain the observed inhibition patterns. Among tocopherols, γ-tocopherol was the only vitamin E isomer found in the lipophilic extract that did not contain any carotenoid. Vitamin C was found only in a modest amount. The hydrophilic extract was a source of polyphenol compounds among which trans-resveratrol, proanthocyanidins, and a remarkable amount of the isoflavones daidzein and genistein, 3.68 and 3.40 mg per 100 g of edible nut, respectively, were evaluated. With the exception of isoflavones that appeared unmodified, the amounts of other bioactive molecules were remarkably reduced in the pistachio nut after roasting, and the total antioxidant activity decreased by about 60%. Collectively, our findings provide evidence that the Sicilian pistachio nut may be considered for its bioactive components and can effectively contribute to a healthy status.

An increasing body of evidence on the association between adherence to the Mediterranean diet and healthy status is being accumulated. Floral buds of Capparis spinosa L. are commonly used in the Mediterranean cuisine as flavoring for meat and other foods. The present study evaluated bioactive components and antioxidant activity of Sicilian capers stabilized in salt. Whereas alpha-tocopherol was absent, low levels of gamma-tocopherol and vitamin C were measured. With reference to one serving size (8.6 g of capers), rutin was 13.76 mg, isothiocyanates, recently acknowledged as anticarcinogen phytochemicals, were 42.14 micromol, total phenols were 4.19 mg of gallic acid equivalents (GAE), and the total antioxidant potential measured using the [2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid)] diammonium salt (ABTS) cation radical decolorization assay was 25.8 micromol of Trolox equivalents. The antioxidative activity of a caper hydrophilic extract was assessed in a number of assays. The extract at 3.5 and 7.0 microM GAE exhibited a dose-dependent peroxyl radical scavenging activity in a methyl linoleate methanol solution oxidized by azo initiator, and reduced hypervalent iron myoglobin species formed from met-Mb an H 2O 2, at 180 microM GAE. The hydrophilic extract, at 70-280 microM GAE, caused a dose-dependent inhibition of lipid autoxidation in heated red meat, incubated with simulated gastric fluid for 180 min. In the same model rutin tested at a concentration corresponding to its content in the extract was ineffective, and alpha-tocopherol at 25 microM was poorly effective. The hydrophilic extract (70 microM GAE) prevented the consumption of the co-incubated alpha-tocopherol, whereas lipid oxidation was inhibited for the experimental time, suggesting cooperative interactions between extract components and the vitamin. The findings encourage the use of caper with foods that contribute oxidizable lipids in view of the association between dietary oxidized lipids and risk of oxidative stress-based diseases.