Studies on antioxidant and lipid lowering effects on human microcirculation
Author: Lu, Qing
Date: 2002-11-08
Location: Sal 4U, Alfred Nobels allé 8, Tandläkarhögskolan, Huddinge Universitetssjukhus
Time: 10.00
Department: Institutionen för medicinsk laboratorievetenskap och teknik / Department of Laboratory Sciences and Technology
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thesis.pdf (1.231Mb)
Abstract
In previous work from this laboratory, vital microscopy was successfully
used to study rnicrocirculatcry effects of hypercholesterolemia in a
rabbit model. Hypercholesterolemia caused a dramatic depression of the
blood flow velocity in the conjunctiva microvessels of the rabbits. In
accordance with the contention that hypercholesterolemia is associated
with oxidative stress that is of importance for the microcirculation,
antioxidants were shown to have a clear preventive effect on the
cholesterol- induced changes in the microcirculation.
It was considered to be of interest to study if similar effects by
hypercholesterolemia and antioxidants might be demonstrated also in human
microcirculation. A technique for computerized video capillary microscopy
imaging was set up for evaluation of the microcirculation in the
nailfold. In two of the studies, the flying-spot technique was primarily
used for measurement of the blood cell flow velocity (CBV). In three of
the studies the Capiflow system and the time to peak (TtP) after a brief
arterial occlusion (PRH) were used. According to current concepts, the
latter technique is a more reliable assessment. In an evaluation of the
TtP method, the between-day variation was found to have a coefficient of
variation of less than 13%, provided that the mean of at least two
assessments were used.
Smoking is known to induce a considerable oxidative stress that would be
expected to affect the microcirculation. In accordance with this, smoking
a single cigarette caused a 40-50% decrease in microcirculatory blood
flow velocity in 23 of 24 subjects studied. This change was reduced by
more than 50% in the same subjects after intake of 2 g of vitamin C 2 h
before smoking. Interestingly, intake of 1 g of vitamin C was without
effect. Pretreatment for 2 weeks with N-acetylcysteine (200 mgx3 per day)
also significantly reduced the smoking-induced effect on the
microcirculation in a group of healthy volunteers with mixed smoking
habits. The preventive effect of Nacetylcysteine was however considerably
lower than the effect of the high dose of vitamin C.
Plasma apheresis offers a unique possibility to study effects in the
microcirculation of abrupt changes in plasma lipid levels. We studied
four patients regularly treated with LDL-apheresis every third week. In
spite of a reduction of the cholesterol levels by almost 50%, there was
no obvious change in time to peak at PRH registered prior to apheresis
and two days later. The smoking- induced effect on TtP did not seem to he
affected by the LDL-apheresis either. Essentially the same results were
obtained when measuring the change in the diameter of the brachial artery
(FMD) as a response to arterial occlusion and nitroglycerin. Thus the
method used for evaluation of the microcirculation and that used for
evaluation of conduit vessels showed concordant results.
Diabetes is known to be associated with a disturbed endothelial function
and microcirculation. In a double blind cross over study on 17 patients
with type 2 diabetes, microvascular reactivity was found to be markedly
reduced. Treatment for 2 weeks with a daily dose of 1g x 3 of vitamin C
did not significantly improve the vascular reactivity. A slight effect
could however be demonstrated in capillary blood flow velocity.
It is concluded that it is possible to use capillary microscopy for
evaluation of effects on the microcirculation in the nailfold,
particularly in connection with acute studies. Patients with
hypercholesterolemia and diabetes as well as volunteers inhaling
cigarette smoke had a disturbed microcirculation, probably related to an
oxidative stress. The most significant effects of antioxidants observed
in the present work appeared in connection with acute oxidative stress
(smoking) and a very high dose of the antioxidant (vitamin C).
List of papers:
I. Zhang J, Ying X, Lu Q, Kallner A, Xiu RJ, Henriksson P, Bjorkhem I (1999). "A single high dose of vitamin C counteracts the acute negative effect on microcirculation induced by smoking a cigarette. " Microvasc Res 58(3): 305-11
Pubmed
II. Lu Q, Bjorkhem I, Xiu RJ, Henriksson P, Freyschuss A (2001). "N-acetylcysteine improves microcirculatory flow during smoking: new effects of an old drug with possible benefits for smokers. " Clin Cardiol 24(7): 511-5
Pubmed
III. Lu Q, Eriksson M, Jogestrand T, Bjorkhem I, Henriksson P, Freyschuss A (2002). "Micro-and macrocirculatory effects of apheresis in patients with familiar hyperlipidemia." Therapeutic Apheresis (In Print)
IV. Lu Q, Jonsson AM, Bjorkhem I, Henriksson P, Freyschuss A (2002). "Postoperative reactive hyperemia in single nutritive capillaries of the nailfold." Scandinavian Journal of Clinical and Laboratory Investigation (In Print)
V. Ling Q, Bjorkhem I, Wretlind B, Henriksson P, Freyschuss A (2002). "Apparent lack of effect of absorbic acid on microvascular reactivity in diabetes mellitus type II patients. A randomized double-blind cross over study." (Manuscript)
I. Zhang J, Ying X, Lu Q, Kallner A, Xiu RJ, Henriksson P, Bjorkhem I (1999). "A single high dose of vitamin C counteracts the acute negative effect on microcirculation induced by smoking a cigarette. " Microvasc Res 58(3): 305-11
Pubmed
II. Lu Q, Bjorkhem I, Xiu RJ, Henriksson P, Freyschuss A (2001). "N-acetylcysteine improves microcirculatory flow during smoking: new effects of an old drug with possible benefits for smokers. " Clin Cardiol 24(7): 511-5
Pubmed
III. Lu Q, Eriksson M, Jogestrand T, Bjorkhem I, Henriksson P, Freyschuss A (2002). "Micro-and macrocirculatory effects of apheresis in patients with familiar hyperlipidemia." Therapeutic Apheresis (In Print)
IV. Lu Q, Jonsson AM, Bjorkhem I, Henriksson P, Freyschuss A (2002). "Postoperative reactive hyperemia in single nutritive capillaries of the nailfold." Scandinavian Journal of Clinical and Laboratory Investigation (In Print)
V. Ling Q, Bjorkhem I, Wretlind B, Henriksson P, Freyschuss A (2002). "Apparent lack of effect of absorbic acid on microvascular reactivity in diabetes mellitus type II patients. A randomized double-blind cross over study." (Manuscript)
Issue date: 2002-10-18
Rights:
Publication year: 2002
ISBN: 91-7349-358-9
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