Part 7 Flashcards
What immune cells does vitamin A support and how?
It supports neutrophils and Macrophages by helping phagocytosis
What part of the immune system does vitamin A help protect?
It helps protect the integrity of mucosal barriers. Low levels lead to increased infections of the eye, respiratory tract and G.I. tract
How does vitamin A affect T-helper cells?
It plays an important role in switching Th1–> Th2. This lowers IL-2, TNF alpha and interferon gamma production
How does supplementing with vitamin A help with vaccines?
It increases delayed type hypersensitivity reactions thereby producing better and safer responses to vaccines
Increased levels of glutathione reduces viral loads for what conditions?
HIV, CMV, HBV and HCV
Low levels of glutathione inhibits what immune functions?
Antigen processing and presentation
Where is NAC metabolized and what does it become?
It is metabolized in the gut wall and liver.
NAC —> L-cysteine —> glutathione
Low glutathione levels have been found in what conditions?
1) Alzheimer’s and other dementias
2) HBV and HCV
3) hypertension and cardiovascular disease
4) metabolic syndrome
Name nine predisposing factors for type two diabetes
Toxins, no exercise, visceral adiposity, chronic stress, inflammation, genetics, high glycemic load diet, smoking and poor/lack of sleep
What are 13 long-term complications of type two diabetes?
Cardiovascular disease, inability to burn fat, glycation, brain fog (decreased blood flow), fatigue (secondary to low testosterone, low thyroid and poor adrenal function), nonalcoholic fatty liver disease, musculoskeletal problems, GERD, hypochlorhydria, dysbiosis, food allergies, fluid retention (carbs and sodium) and pulmonary complications
Metabolic Syndrome (Need at least 3/5 traits)
1) Increased waist circumference (40 inches in men and 35 inches in women)
2) Low HDL (< 40 mg/dL in men, < 50 mg/dL in women)
3) Trigs > 150
4) Fasting glu > 100
5) HTN (130/85)
What is the relative risk increase in cardiovascular disease mortality secondary to metabolic syndrome in middle-aged man?
3.55
How does exercise affect muscle in metabolic syndrome?
It alters skeletal muscle metabolism and improves glucose uptake
How does exercise affect lipids?
Decreases LDL, increases HDL
True or false. Exercise decreases blood pressure, decreases inflammation and decreases oxidative stress
True
Name 2 alpha glucosidase inhibitors
Acarbose and Miglitol (Glyset)
MOA of alpha glucosidase inhibitors
Delays glucose absorption from the G.I. tract by inhibiting enzymes that convert carbohydrates into monosaccharides
Name one biguanide
Metformin (glucophage)
MOA of biguanides
It decreases hepatic glucose production and reduces liver insulin resistance
Name 2 sulfonylureas
Glipizide (glucotrol) and glyburide (micronase)
MOA of sulfonylureas and glibides
It stimulates insulin release by inhibiting the ATP dependent potassium channel on pancreatic beta cells
How does ALA affect vitamins?
It regenerates reduced vitamins C, E and glutathione from their oxidized forms
How does ALA help in diabetes?
It enhances glucose transport and improves insulin sensitivity
How does vitamin B6 (pyridoxine) help with blood pressure?
It is an antihypertensive via central alpha agonist, calcium channel blocker and diuretic effects
How does vitamin B6 help with cognitive decline?
It slows cognitive decline (in conjunction with B12 and folic acid) in people with elevated homocystine
What effect does low vitamin B6 have on the immune system?
Low levels interfere with lymphocyte maturation, growth, antibody production and T cell activity
What effect does low B6 have on T-helper cell activity?
The deficiency switches from Th1 to Th2 cytokine release
What are the active metabolites of vitamin B2 (riboflavin)?
FAD and FMN
What affect does riboflavin have on glutathione
It helps convert oxidized glutathione to reduced glutathione
What 4 conditions can occur from a riboflavin deficiency?
Anemia, cataracts, elevated homocystine and peripheral neuropathy
What are the general features of Th1 cells?
They are generally cytotoxic. They are associated with several autoimmune disorders. They operate through macrophages and produced several cytokines. They stimulate production of CD8 cytotoxic T cells
What are the general features of Th2 cells?
They’re generally anti-inflammatory and immune suppressing. They operate through B cells producing antibodies. They produce several cytokines that usually reduce the anti-inflammatory response. They make IL 10 which is important in decreasing autoimmune over reactivity
What association is there between B12 and cognitive function?
It slows cognitive decline people with elevated homocysteine
What effect does Methylcobalamin have on Bell’s palsy?
It possibly shortens recovery time
Can Methylcobalamin improved diabetic neuropathy?
Yes
How does methylcobalamin help with sleep?
It modulates melatonin secretion and helps with the synthesis of melatonin via donation of a methyl group which is needed for the active form
What is Thiamine deficiency called and what are the symptoms?
Wernecke’s encephalopathy. The symptoms are encephalopathy, ataxia, ophthalmoplegia and nystagmus.
What is Korsakoff psychosis?
Long-term Wernecke’s encephalopathy
What percentage of women can develop a biochemical thiamine deficiency during pregnancy?
50% ?
What vitamin deficiency does hyperemesis gravidarum lead to?
Thiamine (B1)
What cardiac condition can occur from thiamine deficiency?
Wet Beri-Beri (CHF)
Can vitamin B1 supplementation improve mood?
yes
Long-term use of what four medications can result in vitamin B1 deficiency?
Phenytoin, tetracycline, loop diuretics and trimethoprim
Name six vitamins and supplements that improve insulin sensitivity
Chromium, CoQ10, ALA, vitamin C, vitamin D and vitamin E
The transfer of a methyl group from methionine to S adenosyl methionine results in what?
Increased homocystine
How does homocystine go back to methionine?
By trans methylation via B 12 and folate
How does homocystine go to regenerated glutathione?
Via B6 dependent trans sulfuration. It first goes to cystathionine to cysteine which then goes to regenerate glutathione
What five diseases is an elevated homocysteine associated with?
Cardiac disease, stroke, seizure, autism and mental retardation
What are optimal levels of homocysteine?
Seven or less
What are lipid peroxides?
They are the products of damage to the lipid layer of cell membranes mediated by reactive oxygen species (ROS). They represent the bodies oxidative stress state.
How do you measure lipid peroxides?
Usually in serum but they can also be seen in urine
In what three disorders can you see elevated levels of lipid peroxides?
Schizophrenia, mild cognitive impairment and methamphetamine abuse
