NUTRARET: Effect of 2-Year Nutraceutical Supplementation on Redox Status and Visual Function of Patients With Retinitis Pigmentosa: A Randomized, Double-Blind, Placebo-Controlled Trial

Oxidative stress plays a major role in the pathogenesis of retinitis pigmentosa (RP). The main goal of this study was to evaluate the effect of 2-year nutritional intervention with antioxidant nutraceuticals on the visual function of RP patients. Secondly, we assessed how nutritional intervention affected ocular and systemic redox status. We carried out a randomized, double-blind, placebo-controlled study. Thirty-one patients with RP participated in the study. RP patients randomly received either a mixture of nutraceuticals (NUT) containing folic acid, vitamin B6, vitamin A, zinc, copper, selenium, lutein, and zeaxanthin or placebo daily for 2 years. At baseline and after 2- year of the nutritional supplementation, visual function, dietetic-nutritional evaluations, serum concentration of nutraceuticals, plasma and aqueous humor concentration of several markers of redox status and inflammation were assessed. Retinal function and structure were assessed by multifocal electroretinogram (mfERG), spectral domain-optical coherence tomography (SD-OCT) and automated visual field (VF) tests. Nutritional status was estimated with validated questionnaires. Total antioxidant capacity, extracellular superoxide dismutase (SOD3), catalase (CAT), and glutathione peroxidase (GPx) activities, protein carbonyl adducts (CAR) content, thiobarbituric acid reactive substances (TBARS) formation (as indicator of lipid peroxidation), metabolites of the nitric oxide (NOX) and cytokine (interleukin 6 and tumor necrosis factor alpha) concentrations were assessed by biochemical and immunological techniques in aqueous humor or/and blood. Bayesian approach was performed to determine the probability of an effect. Region of practical equivalence (ROPE) was used. At baseline, Bayesian analysis revealed a high probability of an altered ocular redox status and to a lesser extent systemic redox status in RP patients compared to controls. Twenty-five patients (10 in the treated arm and 15 in the placebo arm) completed the nutritional intervention. After 2 years of supplementation, patients who received NUT presented better retinal responses (mfERG responses) compared to patients who received placebo. Besides, patients who received NUT showed better ocular antioxidant response (SOD3 activity) and lower oxidative damage (CAR) than those who received placebo. This study suggested that long-term NUT supplementation could slow down visual impairment and ameliorate ocular oxidative stress.This work was supported by the Spanish Ministry of Economy, Industry, and Competitiveness (MINECO) Carlos III Health Institute (ISCIII) (Grant numbers: PI15/00052 and PI18/00252) and co-funded by the European Regional Development Fund (FEDER)/European Social Fund “A way to make Europe”/”Investing in your future.” It was also supported by the IIS La Fe-UV PROGRAMA VLC-BIOMED-I (NUTRARET) and by RETINA COMUNIDAD VALENCIANA. LO-G had an ISCIIIMedicin

Tratamiento dietético nutricional en enfermedad cerebrovascular

Seminario de graduación "Nutrición Clínica"El presente trabajo recopila información actual sobre la Enfermedad Cerebro Vascular, así como factores de riesgo, clasificación, signos y síntomas, causas y prevención de la patología.El desarrollo de la presente se basó en un estudio de caso real de un paciente con Enfermedad Cerebrovascular, se llevó a cabo en el Hospital Provincial Martín Icaza de Babahoyo Provincia de Los Ríos. La paciente fue seleccionada del área deconsulta externa a la cual se le evaluó el estado nutricional incluyendo una entrevista dietética con el recordatorio de 24 horas. Además se realizó un análisis químico de la dieta consumida regularmente observando un déficit en ciertos nutrientes los cuales pueden afectar negativamente en la evolución de su patología. Por lo que se elaboró un plan de alimentación para cinco días de evolución cubriendo sus requerimientos nutricionales. Se tomó en cuenta los alimentos permitidos y prohibidos para la patología que padece controlando también los niveles de sodio y potasio con el fin de prevenir próximos eventos de ECV. La importancia de este estudio radica en la modificación de los hábitos alimentarios y estilo de vida del paciente que promueven cambios definitivos que pueden reducir el riesgo de Enfermedades Cerebrovasculares futuras