Relatório de estágio em farmácia comunitária

Relatório de estágio realizado no âmbito do Mestrado Integrado em Ciências Farmacêuticas, apresentado à Faculdade de Farmácia da Universidade de Coimbr

The Influence of Mango Fruit Intake on Skin and Vascular Health in Humans

The role of nutrition in dermatology has been investigated for a long time, with a history of research focused on the effects of nutritional disorders on the skin. Some classic examples include pellagra, scurvy, and acrodermatitis enteropathica. Although these conditions have been mainly eradicated from developed countries due to fortification of food with the essential nutrients of concern or supplementation upon early detection, they can still be found among individuals or communities who are not receiving adequate nutrition due to factors such as economic instability, alcoholism, or eating disorders. As skin diseases caused by nutrition deficiencies become under control, current research focuses on managing dermal disorders such as dermatitis and acne, or promoting esthetics by decreasing wrinkles and hyperpigmentation as well as increasing hydration, collagen, and elasticity. Epidemiological studies suggest that a diet pattern rich in plant-based foods such as fruits and vegetables is associated with improved skin esthetics, such as fewer wrinkles, and lowers the risk of dermatological disorders. Plant-based foods are typically rich in bioactive compounds such as carotenoids, vitamins, and polyphenols that provide oxidant defense, protect against DNA damage and promote structural integrity to the skin. Deficiencies of select micronutrients such as vitamin A, C, E, and K have also been associated with certain skin disorders such as thickening of the skin, poor wound healing, and dermatitis. Unlike health conditions such as cardiovascular disease and diabetes, official dietary recommendations for specific skin disorders or esthetic concerns do not currently exist. The 2020 – 2025 Dietary Guidelines for Americans recommend consuming whole fruits and a variety of vegetables, with specific reference amounts for those with dark green, red, and orange colors, which are typically rich in carotenoids. This general recommendation aligns with the epidemiological studies that suggest beneficial effects to the skin by adopting a dietary pattern that consists of more plant-based foods. However, each fruit and vegetable has a unique nutrition profile and may elicit different skin benefits. This dissertation aimed to explore and understand the benefits of different plant-based food consumption on the skin. A particular emphasis was placed on mango, a tropical fruit that is widely consumed, and its relation to skin and inflammation. Chapter I provides some historical background on nutrition and skin, contextual information on the structure and functions of the skin, as well as a literature review of the reported effects of dietary carotenoids, vitamins, and polyphenols that can be found in mango on skin health and their potential mechanisms. The promising effects of mango intake led to the development of a study as detailed in Chapter II, which is a published manuscript that reported on a clinical trial that investigated the effects of fresh-frozen mango fruit intake on facial wrinkles in the lateral canthi and erythema in the cheeks of postmenopausal women with fair to beige skin tones. Chapter III is a manuscript that will be submitted for publication that reviewed the current evidence for consumption of plant-based foods and extracts, including fruits, vegetables, nuts, and legumes, on skin protection assessing parameters related to collagen, elasticity, erythema, hydration, roughness, and wrinkle. The narrative review focused on clinical dietary interventions with an aim to enable dietitians to provide better dietary recommendations with regards to select dermatological concerns. Chapter IV discussed the role of inflammatory markers on cardiovascular health and describes a study that investigated the effects of mango intake on endothelial function and pro-inflammatory markers. Appendix A is an accepted manuscript that described the development, utilization, and efficiency of a nutrition education game that aimed to elicit and reinforce healthier snack choices in children aged 9 to 13 years old. Appendix B details a newly funded proposed study to investigate the effects of mango intake on wrinkles and other skin measurements and changes in the gut microbiome by comparing it to a control group. In part, to confirm the findings from the study reported in Chapter II as the lack of a control group was a major limitation. Finally, a summary of this work and a discussion on future research directions will be presented in the Perspectives and Conclusions section

Prospective Evaluation of Mango Fruit Intake on Facial Wrinkles and Erythema in Postmenopausal Women: A Randomized Clinical Pilot Study

Mangos are rich in β-carotene and other carotenoids, along with several phenolic acids that may provide oxidant defense and photoprotection to the skin. The objectives of this study are to investigate the effects of Ataulfo mango intake on the development of facial wrinkles and erythema. A randomized two-group parallel-arm study was conducted to assess 16 weeks of either 85 g or 250 g of mango intake in healthy postmenopausal women with Fitzpatrick skin type II or III. Facial photographs were captured at weeks 0, 8, and 16, and wrinkles at the lateral canthi and erythema at the cheeks were quantified. Skin carotenoid values were measured with reflection spectroscopy. Deep wrinkle severity decreased significantly in the 85 g group after 8 (p = 0.007) and 16 (p = 0.03) weeks compared to baseline measures. In contrast, those in the 250 g group showed an increase after 16 weeks in average wrinkle severity (p = 0.049), average wrinkle length (p = 0.007), fine wrinkle severity (p = 0.02), and emerging wrinkle severity (p = 0.02). Erythema in the cheeks increased with 85 g of mango intake (p = 0.04). The intake of 85 g of mangos reduced wrinkles in fair-skinned postmenopausal women, while an intake of 250 g showed the opposite effect. Further studies feeding 85 g of mangos are warranted

Prospective Evaluation of Mango Fruit Intake on Facial Wrinkles and Erythema in Postmenopausal Women: A Randomized Clinical Pilot Study

Mangos are rich in β-carotene and other carotenoids, along with several phenolic acids that may provide oxidant defense and photoprotection to the skin. The objectives of this study are to investigate the effects of Ataulfo mango intake on the development of facial wrinkles and erythema. A randomized two-group parallel-arm study was conducted to assess 16 weeks of either 85 g or 250 g of mango intake in healthy postmenopausal women with Fitzpatrick skin type II or III. Facial photographs were captured at weeks 0, 8, and 16, and wrinkles at the lateral canthi and erythema at the cheeks were quantified. Skin carotenoid values were measured with reflection spectroscopy. Deep wrinkle severity decreased significantly in the 85 g group after 8 (p = 0.007) and 16 (p = 0.03) weeks compared to baseline measures. In contrast, those in the 250 g group showed an increase after 16 weeks in average wrinkle severity (p = 0.049), average wrinkle length (p = 0.007), fine wrinkle severity (p = 0.02), and emerging wrinkle severity (p = 0.02). Erythema in the cheeks increased with 85 g of mango intake (p = 0.04). The intake of 85 g of mangos reduced wrinkles in fair-skinned postmenopausal women, while an intake of 250 g showed the opposite effect. Further studies feeding 85 g of mangos are warranted

Soy Protein Containing Isoflavones Improves Facial Signs of Photoaging and Skin Hydration in Postmenopausal Women: Results of a Prospective Randomized Double-Blind Controlled Trial.

Preliminary findings from multiple studies indicate that dietary intake of soy-derived isoflavones exert beneficial effects on the skin including defense against oxidant damage, stimulation of collagen synthesis, and increased hydration. This study aims to investigate how oral supplementation of a soy protein isolate with added isoflavones (SPII) affects components of photoaging such as facial wrinkles and dyspigmentation, and skin biophysical measures such as skin hydration and sebum excretion in postmenopausal women. This 6-month prospective, randomized double-blind controlled study was conducted on 44 postmenopausal women with Fitzpatrick skin types I, II, and III who were randomized to receive either casein protein or SPII. A high-resolution facial photography system was used to measure wrinkle severity and pigmentation at 0, 8, 16, and 24 weeks. Skin biophysical measurements included skin hydration and sebum production. The average wrinkle severity was decreased in the SPII intervention group at week 16 and week 24 by 5.9% and 7.1%, respectively, compared to the baseline. Compared to the casein group, average wrinkle severity was significantly decreased at week 16 (p < 0.05) and week 24 (p < 0.0001). Facial pigment intensity was decreased by -2.5% (p < 0.05) at week 24, whereas there was no significant change in the casein group. Compared to baseline, skin hydration in the SPII group was significantly increased by 39% and 68% on the left and right cheeks (p < 0.05), respectively, at 24 weeks. There were no significant differences in sebum production. Dietary soy protein supplementation with isoflavones may improve skin photoaging, including wrinkles and dyspigmentation, and increase skin hydration in postmenopausal women with Fitzpatrick skin types I, II, and III

Structural and Spatial Determinants Regulating TC21 Activation by RasGRF Family Nucleotide Exchange Factors

RasGRF family guanine nucleotide exchange factors (GEFs) promote guanosine diphosphate (GDP)/guanosine triphosphate (GTP) exchange on several Ras GTPases, including H-Ras and TC21. Although the mechanisms controlling RasGRF function as an H-Ras exchange factor are relatively well characterized, little is known about how TC21 activation is regulated. Here, we have studied the structural and spatial requirements involved in RasGRF 1/2 exchange activity on TC21. We show that RasGRF GEFs can activate TC21 in all of its sublocalizations except at the Golgi complex. We also demonstrate that TC21 susceptibility to activation by RasGRF GEFs depends on its posttranslational modifications: farnesylated TC21 can be activated by both RasGRF1 and RasGRF2, whereas geranylgeranylated TC21 is unresponsive to RasGRF2. Importantly, we show that RasGRF GEFs ability to catalyze exchange on farnesylated TC21 resides in its pleckstrin homology 1 domain, by a mechanism independent of localization and of its ability to associate to membranes. Finally, our data indicate that Cdc42-GDP can inhibit TC21 activation by RasGRF GEFs, demonstrating that Cdc42 negatively affects the functions of RasGRF GEFs irrespective of the GTPase being targeted

Universal Dependencies 2.7

Universal Dependencies is a project that seeks to develop cross-linguistically consistent treebank annotation for many languages, with the goal of facilitating multilingual parser development, cross-lingual learning, and parsing research from a language typology perspective. The annotation scheme is based on (universal) Stanford dependencies (de Marneffe et al., 2006, 2008, 2014), Google universal part-of-speech tags (Petrov et al., 2012), and the Interset interlingua for morphosyntactic tagsets (Zeman, 2008)