Objective: This randomized controlled trial examined the efficacy and safety of N-acetylcysteine as an adjunctive treatment for smoking cessation. Methods: Heavy smokers were recruited from smoking cessation treatment for this 12- week randomized controlled trial. Eligible tobacco use disorder outpatients (n=34) were randomized to N-acetylcysteine or placebo plus first-line treatment. Abstinence was verified by exhaled carbon monoxide (COexh). The assessment scales included the Fagerström Test for Nicotine Dependence, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Minnesota Nicotine Withdrawal Scale, and the Medication Adherence Rating Scale. We also assessed anthropometrics, blood pressure, lipid profile, and soluble tumor necrosis factor receptor (sTNF-R) levels 1 and 2. Results: First-line treatment for smoking cessation plus adjunctive N-acetylcysteine or placebo significantly reduced COexh (p < 0.01). In the N-acetylcysteine group, no significant changes were found in nicotine withdrawal symptoms, depressive and anxiety symptoms, anthropometric measures, blood pressure, or glucose compared to placebo. However, there was a significant reduction in sTNF-R2 levels between baseline and week 12 in the N-acetylcysteine group. Conclusions: These findings highlight the need to associate N-acetylcysteine with first-line treatment for smoking cessation, since combined treatment may affect inflammation and metabolism components. Clinical trial registration: NCT02420418
FUNDAMENTO: O papel do estresse oxidativo em pacientes idosos hipertensos com síndrome de apneia-hipopneia obstrutiva do sono (SAHOS) é desconhecido. Objetivo: O objetivo foi avaliar os níveis de Big Endotelina-1 (Big ET-1) e Óxido Nítrico (NO) em pacientes idosos hipertensos com e sem SAHOS moderada a grave. MÉTODOS: Os voluntários permaneceram internados durante 24 horas. Obtivemos os seguintes dados: índice de massa corporal (IMC), Monitorização Ambulatorial da Pressão Arterial (MAPA) - 24 horas, e medicação atual. Sangue arterial foi coletado às 7:00 h e às 19:00 h para determinar níveis plasmáticos de NO e Big ET-1. A oximetria de pulso foi realizada durante o sono. A correlação de Pearson, Spearman e análise de variância univariada foram utilizadas para a análise estatística. RESULTADOS: Foram estudados 25 sujeitos com SAHOS (grupo 1) e 12 sem SAHOS (grupo 2), com idades de 67,0 ± 6,5 anos, 67,8 ± 6,8 anos, respectivamente. Não foram observadas diferenças significativas entre os grupos em IMC; no número de horas de sono; PA diastólica e sistólica em 24 h; PA de vigília; PA no sono; ou medicamentos usados para controlar a PA. Não foram detectadas diferenças nos níveis de NO e Big ET-1 plasmáticos às 19:00 h, mas às 7:00 h os níveis de de Big ET-1 foram mais altos (p = 0,03). No grupo 1, correlação negativa também foi observada entre a saturação de oxihemoglobina arterial média e a PA sistólica - 24 horas (p = 0,03, r = -0,44), e Big ET-1 (p = 0,04, r = 0,41). CONCLUSÕES: Na comparação entre idosos hipertensos com e sem SAHOS com PA e IMC semelhantes, observou-se níveis mais elevados de Big ET-1 após o sono no grupo SAHOS. Os níveis de NO não diferiram entre os pacientes hipertensos com ou sem SAHOS.
BACKGROUND: The role of oxidative stress in hypertensive elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) is unknown. OBJECTIVE: The purpose was to evaluate the levels of big endothelin-1 (Big ET-1) and nitric oxide (NO) in elderly hypertensive patients with and without moderate to severe OSAHS. METHODS: Volunteers were hospitalized for 24 h. We obtained the following data: body mass index (BMI); 24-ambulatory blood pressure monitoring; and current medication. Arterial blood was collected at 7pm and 7am for determining plasma NO and Big ET-1 levels. Pulse oximetry was performed during sleep. Pearson's or Spearman's correlation and univariate analysis of variance were used for statistical analysis. RESULTS: We studied 25 subjects with OSAHS (group 1) and 12 without OSAHS (group 2) aged 67.0 ± 6.5 years and 67.8±6.8 years, respectively. No significant differences were observed between the groups in BMI; number of hours of sleep; 24-h systolic and diastolic BPs; awake BP, sleep BP and medications to control BP between groups. No differences were detected in plasma Big ET-1 and NO levels at 19:00 h, but plasma Big ET-1 levels at 7:00 h were higher in group 1 (p =0.03). In group 1, a negative correlation was also observed between the mean arterial oxyhemoglobin saturation level, 24-h systolic BP (p = 0.03, r = -0.44), and Big ET-1 (p = 0.04, r = -0.41). CONCLUSIONS: On comparing elderly hypertensive patients with and without OSAHS having similar BP and BMI, we observed higher Big ET-1 levels After sleep in the OSAHS group. NO levels did not differ between the hypertensive patients with or without OSAHS.
Tephrosia toxicaria (Sw.) Pers., which is currently known as T. sinapou (Buc'hoz) A. Chev., Fabaceae, is a source of compounds such as flavonoids, however, few studies addressed the anti-inflammatory and antioxidant effects of T. sinapou. Therefore, we evaluated the antioxidant mechanisms of the T. sinapou ethyl acetate extract in vitro, and whether the extract affects leukocyte recruitment in four models of inflammation and the involvement of nitric oxide and cytokines in its mechanism. In vitro, it was observed that the extract presented hydrogen donating ability to 2,2-diphenyl-1-picryl-hydrazyl radical (DPPH<img src="/img/revistas/rbfar/2012nahead/aop23011img01.jpg" />), 2,2'-azino-di-(3-ethylbenzthiazoline-6-sulphonic acid) radical (ABTS+), and also efficiently inhibited iron-dependent and independent lipid peroxidation and iron chelation assays. In vivo, it inhibited the recruitment of total leukocytes and neutrophil induced by carrageenin, zymosan, glycogen and lipopolysaccharide in the peritoneal cavity of mice. Two mechanisms were detected: 1) T. sinapou effect on leukocyte recruitment depends on nitric oxide since was dose-dependently inhibited by treatment with L-NAME (nitric oxide synthase inhibitor), and 2) the extract also inhibited the production of crucial cytokines for the leukocyte recruitment; tumor necrosis factor α and interleukin-1β. Concluding, T. sinapou ethyl acetate extract reduces oxidative stress in vitro, and inflammatory leukocyte recruitment by a mechanism related to inhibition of cytokine production, and in a nitric oxide dependent manner in vivo.
This study validated a high performance liquid chromatography (HPLC) method for the quantitative evaluation of quercetin in topical emulsions. The method was linear within 0.05 - 200 μg/mL range with a correlation coefficient of 0.9997, and without interference in the quercetin peak. The detection and quantitation limits were 18 and 29 ng/mL, respectively. The intra- and inter-assay precisions presented R.S.D. values lower than 2%. An average of 93% and 94% of quercetin was recovered for non-ionic and anionic emulsions, respectively. The raw material and anionic emulsion, but not non-ionic emulsion, were stable in all storage conditions for one year. The method reported is a fast and reliable HPLC technique useful for quercetin determination in topical emulsions.