The Role of Antioxidants Supplementation in Clinical Practice: Focus on Cardiovascular Risk Factors

In Pakistan, chickpeas (Cicer arietinum L.) are the largest grown legume crops, especially in desert areas. Along with an excellent source of nutrition, chickpea seeds have discernible medicinal and antioxidant characteristics. The diverse set of 90 chickpea genotypes (66 desi and 24 kabuli) were collected from different research zones in Pakistan, and seed flour was used for biochemical profiling. Genotypes were significantly different (Tukey HSD test, P < 0.05) for the traits under investigation. In non-enzymatic antioxidants, highest seed total phenolic contents (TPC) (34725 ± 275 μM/g s. wt.) was found in CM-98 (desi), ascorbic acid (AsA) (69.23 ± 2.25 μg/g s. wt.) in WH-3 (desi), and total flavonoid content (TFC) (394.98 ± 13.06 μg/mL sample) was detected in WH-11 (desi). In the class of enzymatic antioxidants, the highest seed ascorbate peroxidase (APX) (1680 ± 40 Units/g s. wt.) was detected in Tamman-2013 (kabuli), peroxidases (POD) (2564.10 ± 233.10 Units/g s. wt.) activity in CM1235/08 (desi), and superoxide dismutase (SOD) (279.76 ± 50 Units/g s. wt.) was detected in CH24/11 (desi). Highest seed catalase activity (CAT) (893 ± 50 Units/g s. wt.) and proline content (272.50 ± 20.82 μg/g s. wt.) was detected in an ICC-4951 (desi). In hydrolytic enzymes, the highest activity of esterase (37.05 μM/min/g s. wt) was found in, CH56/09(Kabuli), protease (11080 ± 10 Units/g s. wt.) in Karak-2 (desi), and α-amylase (213.02 ± 3.20 mg/g s. wt.) was observed in CH74/08 (kabuli). In other biochemical parameters, the highest seed total oxidant status (TOS) (356 ± 17.50 μM/g s. wt.) was detected in CM3457/91 (desi); malondialdehyde (MDA) content (295.74 ± 3.097 uM/g s. wt.) was observed in CM-2008 (kabuli), and total antioxidant capacity (TAC) (8.36 ± 0.082 μM/g s. wt.) was found in CM-72 (desi). In case of pigment analysis, Sheenghar-2000 (desi) depicted highest lycopene (12.579 ± 0.313 μg/g s. wt.) and total carotenoids (58.430.23 ± 0.569 μg/g s. wt.) contents. For seed therapeutic potential, the highest seed α-amylase inhibition (82.33 ± 8.06%) was observed in CM-88 (desi), while WH-1, WH-6, and ICCV-96030 (desi) depicted the highest value for seed anti-inflammatory potential (78.88 ± 0.55%). Genotypes with the highest antioxidant and therapeutic potential can be utilized as a natural antioxidant source and in breeding programs aimed at improving these traits in new breeding lines.

Advancements in cancer therapy increased the cancer free survival rates and reduced the malignant related deaths. Therapeutic options for patients with thoracic cancers include surgical intervention and the application of chemotherapy with ionizing radiation. Despite these advances, cancer therapy-related cardiopulmonary dysfunction (CTRCPD) is one of the most undesirable side effects of cancer therapy and leads to limitations to cancer treatment. Chemoradiation therapy or immunotherapy promote acute and chronic cardiopulmonary damage by inducing reactive oxygen species, DNA damage, inflammation, fibrosis, deregulation of cellular immunity, cardiopulmonary failure, and non-malignant related deaths among cancer-free patients who received cancer therapy. CTRCPD is a complex entity with multiple factors involved in this pathogenesis. Although the mechanisms of cancer therapy-induced toxicities are multifactorial, damage to the cardiac and pulmonary tissue as well as subsequent fibrosis and organ failure seem to be the underlying events. The available biomarkers and treatment options are not sufficient and efficient to detect cancer therapy-induced early asymptomatic cell fate cardiopulmonary toxicity. Therefore, application of cutting-edge multi-omics technology, such us whole-exome sequencing, DNA methylation, whole-genome sequencing, metabolomics, protein mass spectrometry and single cell transcriptomics, and 10 X spatial genomics, are warranted to identify early and late toxicity, inflammation-induced carcinogenesis response biomarkers, and cancer relapse response biomarkers. In this review, we summarize the current state of knowledge on cancer therapy-induced cardiopulmonary complications and our current understanding of the pathological and molecular consequences of cancer therapy-induced cardiopulmonary fibrosis, inflammation, immune suppression, and tumor recurrence, and possible treatment options for cancer therapy-induced cardiopulmonary toxicity.

Background Common variable immunodeficiency (CVID) is an inborn errors of immunity, that leads to recurrent chronic infections and autoimmune/ inflammatory diseases and neoplasms. It is considered that these condition is related to persistent this immune-inflammatory stimulation and increased oxidative stress. A positive impact on the survival of patients with an inborn error of immunity was observed with advanced clinical care protocols, thus raising concerns about the risk of developing other associated chronic diseases, such as atherosclerosis. Studies suggest that selenium (Se) is a protective trace element against damage caused by oxidative stress. Thus, it is postulated that adequate consumption reduces the risk of some chronic diseases. Results Se median levels (ug/L) [45.6 (37.3–56.2) vs. 57.8 (46.0–66.0); p = 0.004] and GPX activity (U/L) [7682 (6548–8446) vs. 9284(8440–10,720); p = 0,002) were significantly lower in patients compared to controls. Inadequacy of Se levels was observed in 50% of the patients. There was a higher percentage of high values of C-reactive protein in the group of CVID patients compared to controls [8 (36.4%) vs. 2 (11.1%); p = 0.082]. Higher concentrations of oxidized LDL (45.3 mg/dL vs. 33.3 mg/dL; p = 0.016) and lower concentrations of Apo A-1 (98.5 mg/dL) vs. 117.0 mg/dL; p = 0.008) were observed in the CVID group compared to the control. There was a significant and positive correlation between Se plasma levels and apolipoprotein A-1 concentrations in CVID group (rho = 0.577; p = 0.001). Se values less than 46 μg / L (OR = 3.590; 95% CI 1.103 to 11.687; p = 0.034) and GPX activity below the 4th quartile (OR = 21.703; 95% CI 2.534 to 185.914; p = 0.005) were independently associated, after adjustment for age, overweight and dyslipidemia, with the CVID group (Table 5). Conclusion This study showed an higher percentage of high us-CRP, lower values of plasma Se and GPX activity, higher concentrations of LDLox and lower levels of Apo A-1 in CVID patients in comparison to controls, suggesting oxidative stress and cardiovascular risk.These data point to the importance of assessing the Se status and cardiovascular risk in these patients.