Asian Pacific Journal of Tropical Biomedicine

Issue 1,2017 Table of Contents

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  • 1  Epitope finding in Zika virus molecule: The first world report
    Somsri Wiwanitkit Viroj Wiwanitkit
    2017(1):1-3. DOI: 10.1016/j.apjtb.2016.04.015
    [Abstract](10) [HTML](0) [PDF 258.81 K](109)
    Zika virus infection is a new problematic virus infection that becomes the present public health problem. Now this mosquito borne infectious disease can be seen worldwide and can cause dengue-like infection. In addition, it can also induce trans- placental infection and result in congenital neurological defect. To prevent this infec- tion, there is still no specific vaccine. To find a new vaccine, finding epitope is the first step. Here, the authors report the study to find epitope within Zika virus molecule. According to this study, the appropriate epitopes can be seen. This is the first world report on epitope finding for Zika virus. The data can be useful for further vaccine development.
    2  Clinical features of severe malaria: Protective effect of mixed plasmodial malaria
    Bagus Hermansyah Loeki Enggar Fitri Teguh Wahju Sardjono Agustina Tri Endharti Samsul Arifin Niniek Budiarti Didi Candradikusuma Erma Sulistyaningsih Nicole Berens-Riha
    2017(1):4-9. DOI: 10.1016/j.apjtb.2016.11.001
    [Abstract](41) [HTML](0) [PDF 323.43 K](97)
    Objective: To investigate clinically severe malaria patients with Plasmodium falciparum (P. falciparum), Plasmodium vivax (P. vivax) and mixed species infections. Methods: This study was conducted at Dr. Saiful Anwar General Hospital, Malang, Indonesia, from December 2011 to May 2013. Twenty nine patients (mean age of 41 years, 22% female), who suffered from severe malaria according to World Health Organization criteria (major and minor) and other criteria based on previous studies, were selected by consecutive sampling. Blood samples were obtained at admission from pe- ripheral blood for microscopic diagnostic, nested PCR and laboratory examination of blood chemistry. Laboratory results were compared between the groups and correlated to each other. Results: From 29 samples, eight (28%) were diagnosed as P. falciparum mono-infection, 12 (41%) as P. vivax mono-infection and nine (31%) as mixed infections, confirmed by PCR. Cerebral malaria occurred in P. falciparum or mixed species infection only. Parasitaemia was highest in P. falciparum mono-infection. Mean haemoglobin was signifi cantly lower in P. falciparum than P. vivax infection (P = 0.01). Mean thrombocyte count (77138/ m L) was low in all groups. Mean urea, creatinine, total and direct bilirubin were significantly higher in P. falciparum mono-infection compared to other groups, whereas aspartate aminotransferase and alanine aminotransferase showed no significant differences. Parasitaemia was positively correlated with an increase in urea, creatinine, bilirubin and leucocytosis in all species. Conclusions: Both Plasmodium species can solely or in combination cause severe ma-laria. Mixed infection was generally more benign than P. falciparum mono-infection and seemed to have some protective effects.
    3  Molecular identification of Nosema species in provinces of Fars, Chaharmahal and Bakhtiari and Isfahan (Southwestern Iran)
    Fatemeh Aroee Hamidreza Azizi Behrouz Shiran Khodadad Pirali Kheirabadi
    2017(1):10-13. DOI: 10.1016/j.apjtb.2016.11.004
    [Abstract](31) [HTML](0) [PDF 308.36 K](107)
    Objective: To molecularly identify Nosema species in provinces of Isfahan, Fars, Chaharmahal and Bakhtiari. Methods: One hundred and eighty adult honey bees suspected with nosemosis from provinces of Fars (different counties), Isfahan, and Chaharmahal and Bakhtiari were tested. In order to determine the species of Nosema, previously developed PCR and primers based on 16S rRNA gene were used. PCR products were purified and sent to the Korean company of Macrogen for sequencing. Results: Only Nosema ceranae was determined in all samples based on their molecular profile. Sequences of the 16S rRNA gene were sent to GenBank/NCBI (samples acces- sion numbers KP318660–KP318663). Conclusions: This species currently exists in European honeybee apiaries of Apis mel- lifera in the studied provinces.
    4  Cytotoxic effect of Spirulin platensis extracts on human acute leukemia Kasumi-1 and chronic myelogenous leukemia K-562 cell lines
    Flor Yohana Flores Hernandez Sanghamitra Khandual Inocencia Guadalupe Ramírez López
    2017(1):14-19. DOI: 10.1016/j.apjtb.2016.10.011
    [Abstract](34) [HTML](0) [PDF 806.10 K](103)
    Objective: To evaluate the cytotoxic effects of Spirulina platensis extracts on acute leukemia Kasumi-1 and chronic leukemia K-562 cancer cell lines. Methods: Various concentrations of Spirulina platensis extracts (0.25–50.00 mg/mL) obtained with different solvents were used to treat cell lines for 72 h. For cytotoxic effect studies, cell viability test with trypan blue solution, MTT assay and microscopic cyto- morphological assessment were done. Results: Spirulina extract obtained with 70% ethanol showed significant cytotoxicity in K562 and Kasumi-1 cell lines. With trypan blue solution, IC 50 values were found to be 4.64 mg/mL for K-562 and 3.68 mg/mL for Kusumi-1 cell lines. Spirulina aqueous extract also showed cytotoxicity with trypan blue method, at a slightly higher dose; where IC 50 values were 12.68 mg/mL for K-562 and 2.13 mg/mL for Kusumi-1 cell lines. The IC 50 values were found 0.40 mg/mL for K-562 and 0.31 mg/mL for Kusumi-1 cell lines for the 70% ethanol extract according to the MTT assay. Spirulina extract obtained with water also showed cytotoxicity but the dose was a little higher where IC 50 values were 15.77 mg/mL for K-562 and 9.44 mg/mL for Kusumi-1 cell lines. The effect of cyto- toxicity with ethanol extract is quite comparable with that observed for cyclophospha- mide, which is a chemical used as anticancer agent. Conclusions: The cytotoxicity exhibited by Spirulina extract to cancer cell lines might be due to the presence of phytopigments (carotenoids, chlorophyll, phycocyanin) as well as polysaccharides that were reported previously as constituents of the extract. So crude extracts of Spirulina can be used as a source to develop anticancer drugs.
    5  Anxiolytic and free radical scavenging potential of Chinese celery (Apium graveolens) extract in mice
    Supita Tanasawet Phetcharat Boonruamkaew Wanida Sukketsiri Pennapa Chonpathompikunlert
    2017(1):20-26. DOI: 10.1016/j.apjtb.2016.11.003
    [Abstract](19) [HTML](0) [PDF 1.06 M](168)
    Objective: To elucidate the anxiolytic and free radical scavenging effect of methanolic extract of Apium graveolens (A.graveolens) in adult C57BL/6 mice. Methods: Sixty male mice were divided into 6 groups: control, vehicle, positive control and A. graveolens (125, 250 and 500 mg/kg). Different behavioral models of elevated plus maze, open field, light/dark, hole-board and pentobarbital-induced sleep were used to assess anxiety-like behavior. Biochemical parameters including monoamine oxidase-A (MAO-A) activity, lipid peroxidation, % inhibition of superoxide anion and glutathione peroxidase activity were measured. Histologic studies were also examined. Results: Mice receiving various doses of A. graveolens (125, 250 and 500 mg/kg) showed an alleviation of anxiety-like behavior as evidenced by the battery of behavioral tests. Likewise, A. graveolens treatment was found to significantly decrease MAO-A activity, lipid peroxidation as well as cause a significant increase of % inhibition of su- peroxide anion and glutathione peroxidase activity in both cortex and striatum. The total number of survival neurons found in the frontal cortex and striatum was significantly higher than that of the vehicle-treated group. Conclusions: Taken together, we showed that A. graveolens improve the behavioral changes which might be related to the inhibition of free radicals and modulation of MAO- A activity resulting in an increased number of survival neurons. Our findings suggest the therapeutic potential of A. graveolens in the treatment of anxiety.
    6  The potential of standardized quassinoid-rich extract of Eurycoma longifolia in the regulation of the oestrous cycle of rats
    Suzanah Abdul Rahman Nur Amalina Ahmad Nadia Hanis Abdul Samat Syazana Zahri Afif Raihan Abdullah Kit-Lam Chan
    2017(1):27-31. DOI: 10.1016/j.apjtb.2016.07.016
    [Abstract](19) [HTML](0) [PDF 929.59 K](103)
    Objective: To evaluate the effects of Eurycoma longifolia (E. longifolia) standardized extract on the oestrous cycle, levels of reproductive hormones and histology of the ovaries of Sprague-Dawley rats. Methods: Female rats were orally treated with E. longifolia standardized extract at the dose levels of 2.5, 5.0, 10.0, 25.0, 50.0 and 100.0 mg/kg of body weight over 5 days. Vaginal smears were monitored daily within the duration and after withdrawal of the treatment before being sacrificed. The body weights of the females were recorded before and after the 5 days treatment. At the end of the experiments, blood samples were collected for determination of testosterone, oestradiol and progesterone levels. Ovaries were removed, weighed and examined for histomorphological changes. Results: The administration of E. longifolia standardized extract did not significantly alter the oestrous cycle of the rats during the 5 days treatment and after withdrawal of the treatments. This was supported by normal testosterone, oestradiol and progesterone levels as well as normal morphology of the ovaries. Conclusions: The data obtained showed that E. longifolia standardized extract did not exhibit any toxic effect on reproductive activities of female rats suggesting potential use in the management of infertility.
    7  Antioxidant capacity and genoprotective effect of ethanol fruit extract from Detarium microcarpum Guill. and Perr. (Caesalpiniaceae)
    Ablassé Rouamba Maurice Ouedraogo Martin Kiendrebeogo
    2017(1):32-36. DOI: 10.1016/j.apjtb.2016.10.009
    [Abstract](21) [HTML](0) [PDF 334.30 K](99)
    Objective: To evidence the ability of ethanol fruit extract from Detarium microcarpum (D. microcarpum) to preserve DNA integrity against oxidative genomic damage. Methods: Ethanol extract from D. microcarpum fruit pulp was analyzed for its antiox- idant capacity using ferric reducing antioxidant power, 2,2-diphenyl-1-picrylhydrazyl, 2,2’-azinobis-3-ethyl-ethylbenzothiazoline-6-sulphonate, superoxide anion, deoxyribose degradation and lipid peroxidation models. The genoprotective activity was assessed ex vivo by comet assay, on liver cells of NMRI female mice using cyclophosphamide (CP) as genotoxic agent. Results: Ethanol extract from D. microcarpum fruit pulp exhibited interesting antioxi- dant activity in 2,2-diphenyl-1-picrylhydrazyl, deoxyribose degradation and lipid per- oxidation assays. The extract did not present any genotoxic effect but protected DNA against CP-induced damages with a dose-dependent manner. The genoprotective effect observed was related to the antioxidant molecules of the fruit that scavenged the hydroxyl radical (generated by the metabolism of CP) as well as the peroxyl and alkoxyl radicals issued from lipid peroxidation. Other mechanisms such as inactivation of CP metabolism to genotoxic end products, induction of the expression of antioxidant and DNA repair enzymes have been discussed. Conclusions: Our results suggest that the wild edible fruit from D.microcarpum could be beneficial on consumer's health by its antioxidant and genoprotective effects, partic- ularly during chemotherapies exhibiting genotoxic effects like CP in cancer treatment.
    8  In vitro and in vivo susceptibility of Leishmania major to some medicinal plants
    Fatemeh Maleki Mitra Zarebavani Mehdi Mohebali Mohammad Saaid Dayer Fateme Hajialiani Fatemeh Tabatabaie
    2017(1):37-42. DOI: 10.1016/j.apjtb.2016.11.008
    [Abstract](58) [HTML](0) [PDF 335.64 K](100)
    Objective: To evaluate the efficacy of some medicinal plants and systemic glucantime in a comparative manner against the causative agent of cutaneous leishmaniasis both in vitro and in BALB/c mice. Methods: For in vivo testing, inbred mice were challenged with Leishmania major parasites and the resultant ulcers were treated with extract based-ointments applied topically two times per day for a period of 20 days. A group of 56 mice were randomly divided into 7 subgroups. The control group received the ointment void of extracts, whereas the reference group received glucantime only. The efficacy of treatments was evaluated by measuring ulcer diameter, parasite burden and NO production. Results: Our results indicated that plant extract based-ointments were effective in reducing ulcer size and parasite burden in spleens, but their effects did not differ significantly from that of glucantime. The plant extracts tested in this study were able to increase NO production that helped parasite suppression. Conclusions: Our findings indicate that the tested plant extracts are effective against Leishmania major both during in vitro and in vivo experiments, but further researches are required to recommend a potential plant extract as an alternative drug.
    9  Anticaries and antimicrobial activities of methanolic extract from leaves of Cleistocalyx operculatus L.
    Phuong Thi Mai Nguyen Nadin Schultze Christin Boger Christin Boger Zeyad Alresley Albert Bolhuis Ulrike Lindequist
    2017(1):43-48. DOI: 10.1016/j.apjtb.2016.11.009
    [Abstract](29) [HTML](0) [PDF 1.09 M](106)
    Objective: To investigate antimicrobial activities of methanolic extract of leaves of Cleistocalyx operculatus L. (C. operculatus) grown in Vietnam. Methods: The methanolic extract of C. operculatus leaves was phytochemically screened and tested for its antimicrobial activity against six Gram-positive bacteria (three of which were antibiotic multiresistant Staphylococcus spp.), two Gram-negative bacteria, and one fungal species using an agar diffusion method. Anticaries activity was tested using pH drop and biofilm assays formed in 96-well plastic plates. Results: Phytochemical screening revealed the presence of flavonoids and terpenes, in which flavonoid content was 6.8 mg/g dry material. Antibacterial activity of the C. operculatus extract was shown only against Gram-positive bacteria Staphylococcus aureus, Bacillus subtilis and Streptococcus mutans GS-5 (S.mutans), and three multiresistant bacteria being Staphylococcus epidermidis 847, Staphylococcus haemolyticus 535 and Staphylococcus aureus North German epidemic strain. Interestingly, methanolic extract of C. operculatus leaves exhibited the anticaries activity against S.mutansinterms of inhibition of acid production and biofilm formation. Activity of two key enzymes responsible for acidogenicity of S. mutans, F-ATPase and phosphotran sferase system were inhibited by the extract with IC 50 of 51.0 and 98.0 m g/mL, respectively. Cytotoxicity of the extract against keratinocytes was found only for higher concentrations [IC 50 = (119.98 ± 4.63) mg/mL]. Conclusions: The methanolic extract of C. operculatus leaves has the potential for development of antimicrobial preparations, especially anticaries products.
    10  Phytochemical screening and evaluation of cytotoxic and hypoglycemic properties of Mangifera indica peels
    Sabiha Chowdhury Saikat Kumar Poddar Sarah Zaheen Farah Ashrafi Noor Najneen Ahmed Sanjana Haque Abhijit Sukul Sauda Binte Sunjida Md. Mahabob Ullah Mazumder Nusrat Akbar
    2017(1):49-52. DOI: 10.1016/j.apjtb.2016.09.009
    [Abstract](38) [HTML](0) [PDF 403.68 K](114)
    Objective: To investigate the presence of different phytoconstituents in Mangifera indica (M. indica) peel and evaluate its cytotoxicity to Artemia salina and hypoglycemic potential in Swiss albino mice. Methods: The methanolic extract of M. indica peel was used to determine the presence of phytoconstituents. Brine shrimp lethality bioassay method was followed to determine the cytotoxic potential of plant extract. In the case of hypoglycemic activity, oral administration of extract at 200 and 400 mg/kg and standard glibenclamide at 10 mg/kg was done, followed by determining the percentage of reduction of plasma glucose from the initial level. Results: The methanolic extract of M. indica peel showed the presence of flavonoid, saponin, steroid, tannins, terpenoids, glycosides and alkaloids. In brine shrimp lethality bioassay, the LC 50 of the extract and standard vincristine sulfate was found to be 2.04 and 0.41 m g/mL, respectively. After 90 and 150 min, the methanolic extract at 200 and 400 mg/kg showed prominent plasma glucose reduction of 13.95%, 22.48% and 14.16%, 26.18% respectively compared to standard glibenclamide showing 14.90% and 20.67% plasma glucose reduction. Conclusions: This current research affirms prominent cytotoxic and moderate hypoglycemic potential of M. indica peel. Further bioactivity guided isolation of phytoconstituents and investigation on higher animals can lead to development of new drug molecules.
    11  Fate of polyphenols in pili (Canarium ovatum Engl.) pomace after in vitro simulated digestion
    Elizabeth Hashim Arenas Trinidad Palad Trinidad
    2017(1):53-58. DOI: 10.1016/j.apjtb.2016.11.002
    [Abstract](32) [HTML](0) [PDF 722.88 K](120)
    Objective: To evaluate the stability and bioavailability of polyphenols in pili (Canarium ovatum Engl.) pomace during simulated in vitro digestion. Methods: Freeze-dried pili pomace was subjected to in vitro digestion simulating conditions inthestomach,smallintestineandcolon.Totalpolyphenols,anthocyanins,flavonoids and condensed tannins, and its antioxidant activity – 1,1-diphenyl-2-picrylhydrazyl, 2,2 0 - azinobis-3-ethylbenzothiozoline-6-sulfonic acid, and ferric reducing antioxidant power were measured using standard spectrophotometric methods. Results: In vitro digestion of pili pomace resulted in reduction of phenolic compounds. Condensed tannins and anthocyanins were released in the gastric and intestinal stages, while total polyphenols and flavonoids after fermentation simulating colonic conditions. Antioxidant values of the bioavailable fractions showed that more than 90% of activity was lost during simulated digestion. Conclusions: Findings indicate that pili pomace is a promising functional ingredient for food and dietary supplements which can furnish potentially bioavailable phenolic antioxidants to the body.
    12  In vivo study of pomegranate (Punica granatum) peel extract efficacy against Giardia lamblia in infected experimental mice
    Wafa Abdullah Al-Megrin
    2017(1):59-63. DOI: 10.1016/j.apjtb.2016.08.018
    [Abstract](32) [HTML](0) [PDF 342.31 K](98)
    Objective: To investigate the efficacy of pomegranate (Punica granatum) peel extract as an alternative treatment on the white laboratory mice against giardiasis. Methods: Experimental animals were divided into five groups, including Group A: control (infected untreated), Group B: infected and fed with pectin 7 days before infection, Group C: infected and fed with pectin starting from 7th day of infection, Group D: infected and fed with pomegranate peel extract 7 days before infection, and Group E: infected and fed with pomegranate peel extract starting from 7th day of infection. Results: Results from this study revealed that the prevention rate in the experimental groups reached approximately 50% by the 10th day of using pomegranate peel extract. Moreover, stool cyst counts of groups showed a significant reduction in the shedding of cysts approximately 75.6% by day 20 post-infection. ELISA test showed a reduction in Giardia antigen in the stools of the experimental groups which received pomegranate peel extract. The cure rate of these groups was approximately 97.4% by 28th day of infection. Conclusions: Our present findings indicated that the pomegranate peel extract proved to be valuable in prevention and treatment of Giardia lamblia infection. Further studies are required to determine the effective dose of pomegranate peel extract against Giardia lamblia infection.
    13  Antioxidative and neuroprotective activities of peanut sprout extracts against oxidative stress in SK-N-SH cells
    Pranee Lertkaeo Apinun Limmongkon Metawee Srikummool Tantip Boonsong Wisa Supanpaiboon Damratsamon Surangkul
    2017(1):64-69. DOI: 10.1016/j.apjtb.2016.11.007
    [Abstract](15) [HTML](0) [PDF 948.91 K](100)
    Objective: To evaluate the protective effect of peanut sprout extract (PSE) against paraquat (PQ) induced SK-N-SH cells. Methods: Three groups of cells were used in the experiment, together with a fourth, control group. One group was treated with PQ, the second group was treated with PSE, and the third group was pre-treated with PSE. The control group was untreated. Cell viability and toxicity were detected by MTT assay, cellular reactive oxygen species (ROS) was detected by Muse Cell Analyzer, quantitative RT-PCR was applied to investigate the expression of SIRT1 and a -synuclein genes, and A b 42 was detected by western blot. Results: The 50% effective concentration of PQ was 0.75 mmol/L. PSE had no sig- nificant cytotoxicity at a concentration of 1.5 mg/mL. In the group of cells pre-treated with PSE, cell death was significantly inhibited. In the PQ treated group, PQ was increased in the intracellular ROS in the cells. Intracellular ROS was significantly decreased in the cells treated with PSE and also those pre-treated with PSE. PSE significantly downregulated the expression of SIRT1 and α -syn genes, and it was found that PQ significantly increased ß -amyloid 42 levels whereas this action was inhibited by PSE. Conclusions: PSE has neuroprotective activities against oxidative stress in SK-N-SH cells induced by PQ, suggesting that PSE is a highly promising agent in the preven- tion of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease.
    14  Therapeutic effect of soluble worm protein acting as immune regulatory on colitis
    Agustina Tri Endharti Aswin Djoko Baskoro Eviana Norahmawati
    2017(1):70-77. DOI: 10.1016/j.apjtb.2016.11.006
    [Abstract](29) [HTML](0) [PDF 1.24 M](100)
    Objective: To investigate the anti-inflammatory effect of the protein derived from the soluble factor of Heligmosomoides polygyrus (H. polygyrus) excretory-secretory in a colitis model. Methods: Colitis was induced by providing drinking water containing 3% dextran so- dium sulfate (DSS) for a week. DSS was administrated in a cycle protocol, each cycle consisted of 7 days of 3% DSS in the drinking water and followed by 7 days of regular water. This study consisted of five treatment groups, including Groups A (control) received untreated water, B (DSS only, without excretory-secretory), and C–E injected (i.p.) with excretory-secretory protein (H. polygyrus excretory-secretory total, excretory- secretory 28 kDa and excretory-secretory 55 kDa, respectively). Mice received injection every week. The injection of excretory-secretory was started from the 6th weeks and continued until 11 weeks. At the end of 11 weeks of the experiment, mice were sacrificed, colon tissue was removed and then subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis, flow cytometry, real-time PCR and histology examination. Results: Mice received H. polygyrus excretory-secretory 55 kDa reduced mono-nuclear cell infiltrations. H. polygyrus excretory-secretory 55 kDa induced the down-regulation of mRNA interferon- γ expression. There were significant differences in the expression of mRNA interferon in the colon of mice after the administration of the excretory-secretory 55 kDa protein fraction compared with other groups (P < 0.001), whereas mRNA transforming growth factor- ß expression up regulated in the colon of mice after the administration of the excretory-secretory 55 kDa protein fraction compared with total excretory-secretory group (P < 0.05). The treatment of colitis in mice with excretory- secretory 55 kDa protein fractions modulated interleukin-10 (IL-10) expression, whereas excretory-secretory total and excretory-secretory 28 kDa protein fractions insufficient promoted IL-10 expression. Excretory-secretory 55 kDa proteins fraction promoted IL-10 expression via Foxp3-independent pathways. Conclusions: Excretory-secretory 55 kDa protein could reduce inflammation and have potential therapy. H. polygyrus excretory-secretory 55 kDa was the soluble factor that may help in the development of novel treatments to cure colitis.
    15  Ethnobotanical and phytopharmacological review of Scindapsus officinalis (“Gajapippali”)
    Kuljeet Kaur Rajiv Gupta
    2017(1):78-85. DOI: 10.1016/j.apjtb.2016.10.010
    [Abstract](46) [HTML](0) [PDF 637.19 K](216)
    Scindapsus officinalis (S. officinalis) holds a reputed position in Ayurvedic system of medicine. It has been ethanobotanically used to treat diarrhea (“atisara”), worm infes- tation (“krmiroga”), and as antipyretic. Literature survey on S. officinalis was carried out via electronic search in PubMed, SciFinder, Scirus, Google Scholar, Agricola and Web of Science and a library search. Results revealed that a very specific botanical description of the plant is still not available. The plant is mistaken within the hybrids and other plants of genus Scindapsus and family Araceae. Since ethnobotanically the plant is of much importance, chemistry of the plant yet needs to be fully explored. Thus the need of the hour is to comprehend the fragmented information available on the botany, traditional uses, phytochemistry and pharmacology of S. officinalis which could help in the correct identification of the sample and avoid adulteration due to mistaken identity.
    16  Nutrition and exercise can attenuate inflammatory and psychobiological changes in hypoxia?
    Aline Venticinque Caris Wanessa Ysis Valdir de Aquino Lemos Ricardo Bottura Ronaldo Vagner Thomatieli dos Santos
    2017(1):86-90. DOI: 10.1016/j.apjtb.2016.11.005
    [Abstract](10) [HTML](0) [PDF 338.04 K](103)
    Exposure to hypoxia causes damage in several physiological systems, whose tissues are dependent on the O 2 supply. Recently, there has been growing attention on the immu- nosuppressive and inflammatory potential of the hypoxia, including stimulation, nuclear factor kappa B pathway in macrophages and Th2 response from lymphocytes. These changes may result in transient immunosuppression and happen at the same time to worsening of cognition and other psychobiological aspects. Furthermore, exercise and nutrition, especially glutamine supplementation may provide important role, not pharmacological partially reversing the effects of hypoxia. In fact, recent studies show that moderate exercise can improve cognition in people exposed to hypoxia while the exercise associated with glutamine supplementation can reverse the increase in inflammatory markers and the Th1/Th2 balance. This review aims to bring the light of the discussion about nonpharmacological ways to prevent the effects of hypoxia on the connection between the immune system and the central nervous system.

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