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Stroke Genetics And Risk Factors | Your Health Our Priority - 0 views

www.fnfdoc.com/...stroke-genetics-risk-factors

Genetics Ischemic Stroke

shared by fnfdoc on 03 May 18 - No Cached
  • fnfdoc on 03 May 18
     
    Stroke is a cerebrovascular syndrome that involves the blockage and bursting of blood vessels in the brain. It shows a multifactorial pattern of inheritance. High cholesterol levels, high blood pressure, hypertension and obesity are the key causes of stroke besides inherited genes.
Nathan Goodyear

Severe oxidative damage in multiple sclerosis lesions coincides with enhanced antioxida... - 0 views

www.sciencedirect.com/...S0891584908005455

blood-brain barrier MS multiple sclerosis ROS reactive oxygen species antioxidants antioxidant SOD superoxide disumutase catalase

shared by Nathan Goodyear on 19 Mar 14 - No Cached
  • Nathan Goodyear on 19 Mar 14
     
    This article proposes that increased antioxidant enzymatic activity is an adaption to the increased ROS found in MS.  This increased ROS disrupts the blood-brain barrier.
Nathan Goodyear

EDTA Chelation Therapy: Efficacy in Brain Disorders - 0 views

drcranton.com/...study4.htm

EDTA therapy brain disorders chelation

shared by Nathan Goodyear on 07 Jul 11 - No Cached
  • Nathan Goodyear on 07 Jul 11
     
    EDTA chelation benefits cerebral blood flow.  Has important implications in many brain disorders
Nathan Goodyear

Wiley: Regular Exercise May Boost Brain Health in Adults - 0 views

www.wiley.com/...pressReleaseId-115432.html

exercise brain cognitive function health

shared by Nathan Goodyear on 08 Mar 16 - No Cached
  • Nathan Goodyear on 08 Mar 16
     
    Study finds that exercise increases cognitive function through increased blood flow in brain.  This study only looked at women.  Now we know why we do our best thinking when we exercise.
Nathan Goodyear

Citrobacter freundii Invades and Replicates in Human Brain Microvascular Endothelial Cells - 0 views

iai.asm.org/...4208.full

citrobacter Freundii brain

shared by Nathan Goodyear on 12 Jan 16 - No Cached
  • Nathan Goodyear on 12 Jan 16
     
    Citrobacter Freundii is found to be significantly associated with opportunistic infections; also, C freundii has been found to cross the blood brain barrier.
Nathan Goodyear

Home: Cell Press - 0 views

www.cell.com/...S0896-6273(17)30287-8

omega-3 omega 3 DHA brain brain health

shared by Nathan Goodyear on 15 May 17 - No Cached
  • Nathan Goodyear on 15 May 17
     
    study finds that omega 3, particularly DHA, protects and preserves the blood brain barrier
onlinemedzonline

buy adderall online at onlinemedzonline .com - 0 views

Adderall is a drug which is composed of two closely related components - amphetamine and dextroamphetamine. The drug mainly contains amphetamine in the percentage of 25% and dextroamphetamine in th...

health Disease hormones hormone cancer Testosterone Men inflammation obesity low Male

started by onlinemedzonline on 12 Mar 19 no follow-up yet
Nathan Goodyear

ScienceDirect - Life Sciences : Methylphenidate decreases regional cerebral blood flow ... - 0 views

www.sciencedirect.com/...0024320594008736

ritalin ADD ADHD methylphenidate

shared by Nathan Goodyear on 02 Sep 11 - No Cached
  • Nathan Goodyear on 02 Sep 11
     
    ritalin decreases blood flow to brain.  And why do we give this to so many of our children today?
Nathan Goodyear

Nutrients | Free Full-Text | Vitamin C Status Correlates with Markers of Metabolic and ... - 0 views

www.mdpi.com/...htm

vitamin C health cognition

shared by Nathan Goodyear on 28 Feb 18 - No Cached
  • vitamin C deficiency is the fourth most prevalent nutrient deficiency reported in the United States
  • Hypovitaminosis C (defined as a plasma concentration ≤23 µmol/L)
  • The CHALICE (Canterbury Health, Ageing and Lifecourse) study is a unique New Zealand study comprising a comprehensive database of determinants of health
  • ...17 more annotations...
  • The CHALICE cohort of 404 individuals aged 50 years had an average vitamin C intake of ~110 mg/day, which should provide adequate plasma concentrations [14]. Despite this, a significant proportion of the participants had inadequate plasma vitamin C status
  • inadequate plasma vitamin C concentrations (i.e., <50 µmol/L)
  • adequate plasma levels (i.e., >50 µmol/L)
  • Higher plasma vitamin C status was associated with lower weight, BMI and waist circumference
  • plasma vitamin C was negatively associated with blood triglycerides, HbA1c and insulin, and positively associated with HDL levels.
  • No correlation was found between plasma vitamin C and the two indicators of heart health; blood pressure and cardiovascular risk score.
  • 2.4% of 50-year-olds were deficient in vitamin C (i.e., <11 µmol/L)
  • hypovitaminosis C (i.e., <23 µmol/L)
  • A high proportion (63%) of our participants had inadequate plasma vitamin C concentrations (i.e., <50 µmol/L)
  • The association of low vitamin C with obesity in this study replicates results in the literature [35,40,41,42,43,44], and it is apparent that individuals with higher weight require higher intakes of vitamin C to reach adequate vitamin C status
  • higher plasma vitamin C status is associated with lower circulating levels of blood triglycerides, insulin and HbA1c
  • A role for vitamin C in the prevention or management of diabetes and/or metabolic syndrome has been suggested
  • In this study, we also demonstrate lower levels of mild cognitive impairment in those with high vitamin C status
  • The odds of mild cognitive impairment were twice as high for those below 23 μmol/L plasma vitamin C concentration.
  • Vitamin C is present at very high concentrations in the brain
  • animal models have shown that the brain is the last organ to be depleted of the vitamin during prolonged deficiency
  • A recent animal study has shown that moderate vitamin C deficiency may play a role in accelerating amyloid plaque accumulation in Alzheimer’s disease
  • Nathan Goodyear on 28 Feb 18
     
    New study: vitamin C levels correlate with cognitive and metabolic health. What is your vitamin C level? Despite the adequate levels of vitamin C intake, a large % of the individuals had inadequate vitamin C levels which points to a demand issue.  Higher oxidative stress, chronic inflammation... would drive demand for vitamin C higher. Lower vitamin C levels were associated with more metabolic disease, ie. DM, and more cognitive decline.
Nathan Goodyear

Comparison of Blood and Brain Mercury Levels in Infant Monkeys Exposed to Methylmercury... - 0 views

www.ncbi.nlm.nih.gov/...PMC1280342

ethylMercury ethyl Mercury Hg brain methylMercury Thimerosal vaccines vaccinations heavy metals toxicity

shared by Nathan Goodyear on 17 Feb 14 - No Cached
  • Nathan Goodyear on 17 Feb 14
     
    Animal study finds that methyl Hg is not useful in determining effects of ethyl mercury.  According to this study, the conclusion is that the ethyl Mercury from Thimerosal is converted to inorganic Hg as evident in the results.  So, in essence, the ethyl mercury, considered less toxic than methyl mercury, is converted to inorganic Mercury a more toxic compound.  The results of the study revealed a higher % of inorganic Hg in the brains of those exposed to thimerosal to those exposed to methylMercury.
Nathan Goodyear

Dehydroascorbic acid, a blood-brain barrier transportable form of vitamin C, mediates p... - 0 views

www.ncbi.nlm.nih.gov/...PMC58796

vitamin C IV vitamin C dehydroascorbic acid brain stroke

shared by Nathan Goodyear on 22 Aug 17 - No Cached
  • Nathan Goodyear on 22 Aug 17
     
    vitamin C does not cross the BBB, but its oxidize form, dehydroascorbic acid does.  This experimental model looked at IV DHA. The findings was that IV DHA resulted in higher brain C levels compared to IV vitamin C.
Nathan Goodyear

Triglycerides Induce Leptin Resistance at the Blood-Brain Barrier - 0 views

diabetes.diabetesjournals.org/...1253.full

leptin resistance triglycerides

shared by Nathan Goodyear on 12 Apr 11 - No Cached
  • Obesity is associated with leptin resistance
  • Resistance arises from impaired leptin transport across the blood-brain barrier (BBB)
  • Decreasing triglycerides may potentiate the anorectic effect of leptin by enhancing leptin transport across the BBB.
  • ...2 more annotations...
  • Starvation, like obesity, is accompanied by a decreased BBB transport rate of exogenous leptin
  • hypertriglyceridemia could explain impaired transport of leptin across the BBB in both starvation and obesity
  • Nathan Goodyear on 12 Apr 11
     
    elevated triglycerides and leptin resistance
Nathan Goodyear

The river blindness drug Ivermectin and related macrocyclic lactones inhibit WNT-TCF pa... - 0 views

www.ncbi.nlm.nih.gov/...PMC4287931

ivermectin cancer WTF Selamectin

shared by Nathan Goodyear on 19 Mar 18 - No Cached
  • WNT signaling
  • early colon cancers commonly display loss of function of the tumor suppressor Adenomatous polyposis coli (APC), a key component of the β-CATENIN destruction complex
  • Other cancers also show an active canonical WNT pathway; these include carcinomas of the lung, stomach, cervix, endometrium, and lung as well as melanomas and gliomas
  • ...31 more annotations...
  • In normal embryogenesis and homeostasis, the canonical WNT pathway is activated by secreted WNT ligands produced in highly controlled context-dependent manners and in precise amounts. WNT activity is transduced in the cytoplasm, inactivates the APC destruction complex, and results in the translocation of activate β-CATENIN to the nucleus, where it cooperates with DNA-binding TCF/LEF factors to regulate WNT-TCF targets and the ensuing genomic response
  • beyond the loss of activity of the APC destruction complex, for instance throughAPC mutation, phosphorylation of β-CATENIN at C-terminal sites is required for the full activation of WNT-TCF signaling and the ensuing WNT-TCF responses in cancer.
  • The WNT-TCF response blockade that we describe for low doses of Ivermectin suggests an action independent to the deregulation of chloride channels
  • involve the repression of the levels of C-terminally phosphorylated β-CATENIN forms and of CYCLIN D1, a critical target that is an oncogene and positive cell cycle regulator.
  • the Avermectin single-molecule derivative Selamectin, a drug widely used in veterinarian medicine (Nolan & Lok, 2012), is ten times more potent acting in the nanomolar range
  • Ivermectin also diminished the protein levels of CYCLIN D1, a direct TCF target and oncogene, in both HT29 and H358 tumor cells
  • Activated Caspase3 was used as a marker of apoptosis by immunohistochemistry 48 h after drug treatment. Selamectin and Ivermectin induced up to a sevenfold increase in the number of activated Caspase3+ cells in two primary (CC14 and CC36) and two cell line (DLD1 and Ls174T) colon cancer cell types (Fig​(Fig2C).2C). All changes were significative
  • The strong downregulation of the expression of the intestinal stem cell genesASCL2 andLGR5 (van der Flieret al, 2009; Scheperset al, 2012; Zhuet al, 2012b) by Ivermectin and Selamectin (Fig​(Fig2D)2D) raised the possibility that these drugs could affect WNT-TCF-dependent colon cancer stem cell behavior
  • Pre-established H358 tumors responded to Ivermectin showing a ˜ 50% repression of growth
  • Ivermectin hasin vivo efficacy against human colon cancer xenografts sensitive to TCF inhibition with no discernable side effects
  • Ivermectin (Campbellet al, 1983), an off-patent drug approved for human use, and related macrocyclic lactones, have WNT-TCF pathway response blocking and anti-cancer activities
  • these drugs block WNT-TCF pathway responses, likely acting at the level of β-CATENIN/TCF function, affecting β-CATENIN phosphorylation status.
  • anti-WNT-TCF activities of Ivermectin and Selamectin
  • Ivermectin has a well-known anti-parasitic activity mediated via the deregulation of chloride channels, leading to paralysis and death (Hibbs & Gouaux, 2011; Lynagh & Lynch, 2012). The same mode of action has been suggested to underlie the toxicity of Ivermectin for liquid tumor cells and the potentiation or sensitization effect of Avermectin B1 on classical chemotherapeutics
  • the specificity of the blockade of WNT-TCF responses we document, at low micromolar doses for Ivermectin and low nanomolar doses for Selamectin, indicate that the blockade of WNT-TCF responses and chloride channel deregulation are distinct modes of action
  • What is key then is to find a dose and a context where the use of Ivermectin has beneficial effects in patients, paralleling our results with xenografts in mice.
  • Cell toxicity appears at doses greater (> 10 μM for 12 h or longer or > 5 μM for 48 h or longer for Ivermectin) than those required to block TCF responses and induce apoptosis.
  • Our data point to a repression of WNT-β-CATENIN/TCF transcriptional responses by Ivermectin, Selamectin and related macrocylic lactones.
  • (i) The ability of Avermectin B1 to inhibit the activation of WNT-TCF reporter activity by N-terminal mutant (APC-insensitive) β-CATENIN as detected in our screen
  • (ii) The ability of Avermectin B1, Ivermectin, Doramectin, Moxidectin and Selamectin to parallel the modulation of WNT-TCF targets by dnTCF
  • (iii) The finding that the specific WNT-TCF response blockade by low doses of Ivermectin and Selamectin is reversed by constitutively active TCF
  • (iv) The repression of key C-terminal phospho-isoforms of β-CATENIN resulting in the repression of the TCF target and positive cell cycle regulator CYCLIN D1 by Ivermectin and Selamectin
  • (v) The specific inhibition ofin-vivo-TCF-dependent, but notin-vivo-TCF-independent cancer cells by Ivermectin in xenografts.
  • These results together with the reduction of the expression of the colon cancer stem cell markersASCL2 andLGR5 (e.g., Hirschet al, 2013; Ziskinet al, 2013) raise the possibility of an inhibitory effect of Ivermectin, Selamectin and related macrocyclic lactones on TCF-dependent cancer stem cells.
  • the capacity of cancer cells to form 3D spheroids in culture, as well as the growth of these, is also WNT-TCF-dependent (Kanwaret al, 2010) and they were also affected by Ivermectin treatment
  • If Ivermectin is specific, it should only block TCF-dependent tumor growth. Indeed, the sensitivity and insensitivity of DLD1 and CC14 xenografts to Ivermectin treatment, respectively, together with the desensitization to Ivermectin actionin vivo by constitutively active TCF provide evidence of the specificity of this drug to block an activated WNT-TCF pathway in human cancer.
  • Ivermectin has a good safety profile since onlyin-vivo-dnTCF-sensitive cancer xenografts are responsive to Ivermectin treatment, and we have not detected side effects in Ivermectin-treated mice at the doses used
  • previous work has shown that side effects from systemic treatments with clinically relevant doses in humans are rare (Yang, 2012), that birth defects were not observed after exposure of pregnant mothers (Pacquéet al, 1990) and that this drug does not cross the blood–brain barrier (Kokozet al, 1999). Similarly, only dogs with mutantABCB1 (MDR1) alleles leading to a broken blood–brain barrier show Ivermectin neurotoxicity (Mealeyet al, 2001; Orzechowskiet al, 2012)
  • Indications may include treatment for incurable β-CATENIN/TCF-dependent advanced and metastatic human tumors of the lung, colon, endometrium, and other organs.
  • Ivermectin, Selamectin, or related macrocyclic lactones could also serve as topical agents for WNT-TCF-dependent skin lesions and tumors such as basal cell carcinomas
  • they might also be useful as routine prophylactic agents, for instance against nascent TCF-dependent intestinal tumors in patients with familial polyposis and against nascent sporadic colon tumors in the general aging population
  • Nathan Goodyear on 19 Mar 18
     
    Ivermectin, a common anti-parasitic, found to inhibit WTF-TCF pathway and decrease c-terminal phosophorylaiton of Beta-CATENIN all resulting in increased aptosis and inhibition of cancer growth in colon cancer cell lines and lung cancer cell lines.
Nathan Goodyear

Corticosteroids compromise survival in glioblastoma in part through their elevation of ... - 0 views

academic.oup.com/...2715227

glioblastoma glioblastoma multiforme "brain cancer" cancer glucose

shared by Nathan Goodyear on 23 Dec 18 - No Cached
  • Nathan Goodyear on 23 Dec 18
     
    Corticosteroids elevate glucose in patients with glioblastomas, compromising treatment and shortening survival.
Nathan Goodyear

Spike Proteins of SARS-CoV-2 Induce Pathological Changes in Molecular Delivery and Meta... - 0 views

www.ncbi.nlm.nih.gov/...PMC8538996

toxin spike protein spike proteins SARS-CoV-2 blood brain barrier brain

shared by Nathan Goodyear on 19 Dec 21 - No Cached
  • Nathan Goodyear on 19 Dec 21
     
    Spike protein crosses BBB and causes mitochondrial damage-what else can you call it other than a toxin.
Nathan Goodyear

Immune activation of peripheral blood and mucosal CD3+ lymphocyte cytokine profiles in ... - 0 views

mercola.fileburst.com/...Ileal%20cytokines.pdf

ASD autism inflammation

shared by Nathan Goodyear on 29 Jan 12 - No Cached
  • Nathan Goodyear on 29 Jan 12
     
    immune dysfunction found in children with autism. This again, suggests a gut-brain link in autism.
Nathan Goodyear

Diet-induced obesity and low testosterone increase neuroinflammation and impair neural ... - 0 views

www.ncbi.nlm.nih.gov/...PMC4190446

Testosterone neuroinflammation glia insulin resistance obesity diabetes brain CNS PNS inflammation low T low Testosterone TNF-alpha IL-1beta

shared by Nathan Goodyear on 28 Apr 15 - No Cached
  • both obesity and low testosterone are also risk factors for neural dysfunction, including cognitive impairment [58–61] and development of AD
  • Levels of obesity and testosterone are often inversely correlated
  • diet-induced obesity causes significant metabolic disturbances and impairs central and peripheral nervous systems.
  • ...23 more annotations...
  • both obesity and low testosterone are linked with promotion of inflammatory pathways [70–72] and exert harmful actions on the central [73–75] and peripheral [29,76] nervous systems
  • In general, obesity-related changes were worsened by low testosterone and improved by testosterone treatment; however, this relationship was not statistically significant in several instances. Further, our data suggest that a common pathway that may contribute to obesity and testosterone effects is regulation of inflammation
  • fasting blood glucose levels were independently and additively increased by GDX-induced testosterone depletion and high-fat diet
  • testosterone treatment significantly reduced fasting glucose under both the normal and high-fat diets, demonstrating potential therapeutic efficacy of testosterone supplementation
  • fasting insulin, insulin resistance (HOMA index), and glucose tolerance, low testosterone tended to exacerbate and or testosterone treatment improved outcomes.
  • testosterone status did not significantly affect body weight
  • testosterone’s effects likely do not indicate an indirect result on adiposity but rather regulatory action(s) on other aspects of metabolic homeostasis
  • Prior work in rodents has shown diet-induced obesity induces insulin resistance in rat brain [63] and that testosterone replacement improves insulin sensitivity in obese rats [64]. Our findings are consistent with the human literature, which indicates that (i) testosterone levels are inversely correlated to insulin resistance and T2D in healthy [30,65] as well as obese men [66], and (ii) androgen therapy can improve some metabolic measures in overweight men with low testosterone
  • it has been shown that TNFα has inhibitory effects on neuron survival, differentiation, and neurite outgrowth
  • Our data demonstrate that low testosterone and obesity independently increased cerebrocortical mRNA levels of both TNFα and IL-1β
  • Testosterone status also affected metabolic and neural measures
  • many beneficial effects of testosterone, including inhibition of proinflammatory cytokine expression
  • neuroprotection [80,81], are dependent upon androgen receptors, the observed effects of testosterone in this study may involve androgen receptor activation
  • testosterone can be converted by the enzyme aromatase into estradiol, which is also known to exert anti-inflammatory [82] and neuroprotective [83] actions
  • glia are the primary sources of proinflammatory molecules in the CNS
  • poorer survival of neurons grown on glia from mice maintained on high-fat diet
  • Since testosterone can affect glial function [86] and improve neuronal growth and survival [87–89], it was unexpected that testosterone status exhibited rather modest effects on neural health indices with the only significant response being an increase in survival in the testosterone-treated, high-fat diet group
  • significantly increased expression of TNFα and IL-1β in glia cultures derived from obese mice
  • testosterone treatment significantly lowered TNFα and IL-1β expression to near basal levels even in obese mice, indicating a protective benefit of testosterone across diet conditions
  • IL-1β treatment has been shown to induce synapse loss and inhibit differentiation of neurons
  • Testosterone status and diet-induced obesity were associated with significant regulation of macrophage infiltration
  • testosterone prevented and/or restored thermal nociception in both diet groups
  • a possible mechanism by which obesity and testosterone levels may affect the health of both CNS and PNS
  • Nathan Goodyear on 28 Apr 15
     
    Study points to obesity and low Testosterone contribution of neuroinflammation.  No effect of body weight was seen with TRT.  This animal model found similar positive effects of TRT in insulin sensitivity.  Obesity and low T increase inflammatory cytokine production: this study found an increase in TNF-alpha and IL-1beta and TRT reduced TNF-alpha and IL-1beta to near base-line.  Testosterone is neuroprotective and this study reviewed the small volume of evaded that pointed to benefit from estradiol.  Testosterone's effect on glial survival was positive but not significant.  Obesity and low T were found to be associated with increased macrophage infiltration in the PNS with increased TNF-alpha and IL-1beta.   Testosterone therapy improved peripheral neuropathy via its positive effects on nocicieption.
Nathan Goodyear

Branched Chain Amino Acid Supplementation for Patients with Cirrhosis | Clinical Correl... - 0 views

www.clinicalcorrelations.org/?p=3544

BCCA branched chain amino acids liver cirrhosis hepatitis amino acids

shared by Nathan Goodyear on 05 Oct 15 - No Cached
  • low level of BCAAs in patients with cirrhosis is hypothesized to be one of multiple factors responsible for development of hepatic encephalopathy
  • supplementation of BCAAs is thought to facilitate ammonia detoxification by supporting synthesis of glutamine, one of the non-branched chain amino acids, in skeletal muscle and in the brain as well as diminishing the influx of AAAs across the blood-brain barrier
  • oral BCAA supplementation is more useful in chronic encephalopathic patients than is parenteral BCAA supplementation in patients with acute encephalopathy
  • ...35 more annotations...
  • malnutrition progressing to cachexia is another common manifestation of cirrhosis
  • Malnutrition can be mitigated with BCAA supplementation
  • Studies show that administration of amino acid formulas enriched with BCAAs can reduce protein loss, support protein synthesis, and improve nutritional status of patients with chronic liver disease
  • Leucine has been shown to be the most effective of the BCAAs because it acts via multiple pathways to stimulate protein synthesis
  • BCAAs metabolites inhibit proteolysis
  • Patients with cirrhosis have both insulin deficiency and insulin resistance
  • BCAAs (particularly leucine) help to reverse the catabolic, hyperglucagonemic state of cirrhosis both by stimulating insulin release from the pancreatic β cells and by decreasing insulin resistance allowing for better glucose utilization
  • Coadministration of BCAAs and glucose has been found to be particularly useful
  • BCAA supplementation improves protein-energy malnutrition by improving utilization of glucose, thereby diminishing the drive for proteolysis, inhibiting protein breakdown, and stimulating protein synthesis
  • Cirrhotic patients have impaired immune defense, characterized by defective phagocytic activity and impaired intracellular killing activity
  • another effect of BCAA supplementation is improvement of phagocytic function of neutrophils and possibly improvement in natural killer T (NKT) cell lymphocyte activity
  • BCAA supplementation may reduce the risk of infection in patients with advanced cirrhosis not only through improvement in protein-energy malnutrition but also by directly improving the function of the immune cells themselves
  • BCAA administration has also been shown to have a positive effect on liver regeneration
  • A proposed mechanism for improved liver regeneration is the stimulatory effect of BCAAs (particularly leucine) on the secretion of hepatocyte growth factor by hepatic stellate cells
  • BCAAs activate rapamycin signaling pathways which promotes albumin synthesis in the liver as well as protein and glycogen synthesis in muscle tissue
  • Chemical improvement with BCAA treatment is demonstrated by recovery of serum albumin and lowering of serum bilirubin levels
  • long-term oral BCAA supplementation was useful in staving off malnutrition and improving survival by preventing end-stage fatal complications of cirrhosis such as hepatic failure and gastrointestinal bleeding
  • The incidence of death by any cause, development of liver cancer, rupture of esophageal varices, or progression to hepatic failure was decreased in the group that received BCAA supplementation
  • Patients receiving BCAA supplementation also have a lower average hospital admission rate, better nutritional status, and better liver function tests
  • patients taking BCAA supplementation report improved quality of life
  • BCAAs have been shown to mitigate hepatic encephalopathy, cachexia, and infection rates, complications associated with the progression of hepatic cirrhosis
  • BCAAs make up 20-25% of the protein content of most foods
  • Highest levels are found in casein whey protein of dairy products and vegetables, such as corn and mushrooms. Other sources include egg albumin, beans, peanuts and brown rice bran
  • In addition to BCAAs from diet, oral supplements of BCAAs can be used
  • Oral supplementation tends to provide a better hepatic supply of BCAAs for patients able to tolerate PO nutrition as compared with IV supplementation, especially when treating symptoms of hepatic encephalopathy
  • Coadministration of BCAAs with carnitine and zinc has also been shown to increase ammonia metabolism further reducing the encephalopathic symptoms
  • Cirrhotic patients benefit from eating frequent, small meals that prevent long fasts which place the patient in a catabolic state
  • the best time for BCAA supplementation is at bedtime to improve the catabolic state during starvation in early morning fasting
  • A late night nutritional snack reduces symptoms of weakness and fatigability, lowers postprandial hyperglycemia, increases skeletal muscle mass,[25] improves nitrogen balance, and increases serum albumin levels.[26] Nocturnal BCAAs even improve serum albumin in cirrhotic patients who show no improvement with daytime BCAAs
  • Protein-energy malnutrition (PEM), with low serum albumin and low muscle mass, occurs in 65-90% of cases of advanced cirrhosis
  • hyperglucagonemia results in a catabolic state eventually producing anorexia and cachexia
  • BCAAs are further depleted from the circulation due to increased uptake by skeletal muscles that use the BCAAs in the synthesis of glutamine, which is produced in order to clear the ammonia that is not cleared by the failing liver
  • patients with chronic liver disease, particularly cirrhosis, routinely have decreased BCAAs and increased aromatic amino acids (AAAs) in their circulation
  • Maintaining a higher serum albumin in patients with cirrhosis is associated with decreased mortality and improved quality of life
  • the serum BCAA concentration is strongly correlated with the serum albumin level
  • Nathan Goodyear on 05 Oct 15
     
    great review of cirrhosis and BCCA supplementation.
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