Alternative Medicine Review最新文献

Vitamins D and K are lipid-phase nutrients that are pleiotropic - endowed with versatile homeostatic capacities at the organ, tissue, and cellular levels. Their metabolic and physiologic roles overlap considerably, as evidenced in the bone and cardiovascular systems. Vitamin D₃ (cholecalciferol, D₃) is the prehormone for the vitamin D endocrine system. Vitamin D₃ undergoes initial enzymatic conversion to 25-hydroxyvitamin D (25D, calcidiol), then to the seco-steroid hormone 1alpha, 25-dihydroxyvitamin D (1,25D, calcitriol). Beyond its endocrine roles in calcium homeostasis, 1,25D likely has autocrine, paracrine, and intracrine effects. At least 17 tissues likely synthesize 1,25D, and 35 carry the vitamin D receptor (VDR). Vitamin D functional deficiency is widespread in human populations. Vitamin K₁ (phylloquinone) is more abundant in foods but less bioactive than the vitamin K₂ menaquinones (especially MK-4, menatetrenone). Menadione (vitamin K₃) has minimal K activity. Vitamin K compounds undergo oxidation-reduction cycling within the endoplasmic reticulum membrane, donating electrons to activate specific proteins via enzymatic gamma-carboxylation of glutamate groups before being enzymatically re-reduced. Warfarin inhibits this vitamin K reduction, necessitating K supplementation during anticoagulation therapy. Along with coagulation factors (II, VII, IX, X, and prothrombin), protein C and protein S, osteocalcin (OC), matrix Gla protein (MGP), periostin, Gas6, and other vitamin K-dependent (VKD) proteins support calcium homeostasis, facilitate bone mineralization, inhibit vessel wall calcification, support endothelial integrity, are involved in cell growth control and tissue renewal, and have numerous other effects. This review updates vitamin D and K skeletal and cardiovascular benefits and evidence for their synergy of action.

The silent information regulator (SIR) genes (sirtuins) comprise a highly conserved family of proteins, with one or more sirtuins present in virtually all species from bacteria to mammals. In mammals seven sirtuin genes - SIRT1 to SIRT7 - have been identified. Emerging from research on the sirtuins is a growing appreciation that the sirtuins are a very complicated biological response system that influences many other regulator molecules and pathways in complex manners. Responses of this system to environmental factors, as well as its role in health and disease, are currently incompletely characterized and at most partially understood. This article reviews the mammalian sirtuin system, discusses the dietary, lifestyle, and environmental factors that influence sirtuin activity, and summarizes research on the importance of vitamin B3 in supporting sirtuin enzyme activity, as well as the role specifically of the amide form of this vitamin - nicotinamide - to inhibit sirtuin enzyme activity. Polyphenols, especially resveratrol, influence sirtuins. Existing evidence on these nutritional compounds, as they relate to the sirtuin system, is reviewed. In Part 2 of this review, clinical situations where sirtuins might play a significant role, including longevity, obesity, fatty liver disease, cardiovascular health, neurological disease, and cancer, are discussed.

Most treatments for methicillin-resistant Staphylococcus aureus (MRSA) focus on agents to eliminate the bacterium. Since MRSA infection is not universal, susceptibility factors are possible. Immune resistance could be lowered in such individuals; therefore, locating immune-inhibiting or immune-enhancing factors might decrease susceptibility. Such seemed to be the case in a 48-year-old female who presented with recurring MRSA despite multiple rounds of a variety of antibiotics. When the patient encountered an intensely stressful situation an outbreak of MRSA occurred. The patient had additional underlying health issues that suppressed her immune system and made her more susceptible to stress. Gluten allergy and hypothyroidism were discovered and alleviated but did not end the MRSA outbreaks. Implementation of a popular treatment from the 1930s, intravenous dilute hydrochloric acid (for immune stimulation), prevented most MRSA outbreaks when administered frequently. This case provides anecdotal support for the proposition that immune enhancement is a viable approach to forestall or clear recurring MRSA.

Acute myocardial infarction (MI) is one of the most frequent causes of death in the United States. The evaluation and treatment of acute MI in conventional medicine has focused primarily on anatomical and physiological factors that lead to impaired blood flow. Less attention has been paid to metabolic factors that may influence the vulnerability of the myocardium to ischemia and to various stressors. There is evidence that in some cases inefficient cellular metabolism, rather than the availability of oxygen and other blood-borne nutrients, is an important factor determining whether cardiac pathology will develop. Metabolic dysfunction could result from intracellular deficiencies of magnesium, coenzyme Q10, carnitine, and certain B vitamins, nutrients which play a role in the synthesis of adenosine triphosphate (ATP; the body's main storage form of energy). In addition, increased oxidative stress may contribute to the pathogenesis of both MI-related myocardial damage and reperfusion injury. Consequently, administration of antioxidants might improve outcomes in patients with acute MI. Numerous clinical trials have found parenteral administration of magnesium in the early stages of acute MI can substantially reduce the death rate. In addition, several trials have shown L-carnitine is beneficial in the treatment of acute MI. Other nutrients, such as vitamin C, vitamin E, and various B vitamins, may also be of value.