Impact of botanical oils on polyunsaturated fatty acid metabolism and leukotriene generation in mild asthmatics

Background: Dietary supplementation with botanical oils that contain n-6 and n-3 eighteen carbon chain (18C)-PUFA such as γ linolenic acid (GLA, 18:3n-6), stearidonic acid (SDA, 18:4n-3) and α linolenic acid (ALA, 18:3n-3) have been shown to impact PUFA metabolism, alter inflammatory processes including arachidonic acid (AA) metabolism and improve inflammatory disorders. Methods: The diet of mild asthmatics patients was supplemented for three weeks with varying doses of two botanical seed oils (borage oil [Borago officinalis, BO] and echium seed oil [Echium plantagineum; EO]) that contain SDA, ALA and GLA. A three week wash out period followed. The impact of these dietary manipulations was evaluated for several biochemical endpoints, including in vivo PUFA metabolism and ex vivo leukotriene generation from stimulated leukocytes. Results: Supplementation with several EO/BO combinations increased circulating 20–22 carbon (20–22C) PUFAs, including eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and dihommo-gammalinolenic acid (DGLA), which have been shown to inhibit AA metabolism and inflammation without impacting circulating AA levels. BO/EO combinations also inhibited ex vivo leukotriene generation with some combinations attenuating cysteinyl leukotriene generation in stimulated basophils by >50% and in stimulated neutrophils by >35%. Conclusions: This study shows that dietary supplementation with BO/EO alters 20–22C PUFA levels and attenuates leukotriene production in a manner consistent with a reduction in inflammation

LTC4 synthase polymorphism modifies efficacy of botanical seed oil combination in asthma

Botanical seed oils reduce the generation of leukotrienes in patients with asthma. Our objective was to determine the efficacy of a botanical seed oil combination against airflow obstruction in asthma, and to determine the pharmacogenomic effect of the leukotriene C4 synthase (LTC4S) polymorphism A-444C. We conducted a randomized, double-blind, placebo-controlled, cross-over clinical trial in mild to moderate asthmatics to determine the change in FEV1 after 6 weeks of therapy with borage and echium seed oils versus corn oil placebo. We also examined the effect of the variant LTC4S -444C allele on the change in lung function. We did not identify a difference in FEV1 in the study cohort as a whole (n = 28), nor in the group of A homozygotes. In the C allele carriers (n = 9), FEV1 improved by 3% after treatment with borage and echium seed oils and declined by 4% after placebo corn oil (p = 0.02). All 9 C allele carriers demonstrated an improvement in their FEV1 on active treatment compared to placebo as compared to only 7 out of 19 A allele homozygotes (p = 0.007). We observed transient differences in ex vivo leukotriene generation from circulating basophils and granulocytes. We did not observe significant differences in urinary LTE4 levels. We conclude that compared to corn oil, a combination of borage and echium seed oils improves airflow obstruction in mild to moderate asthmatics who carry the variant allele in the LTC4S gene (A-444C). Botanical oil supplementation may have therapeutic potential in asthma if used in a personalized manner. Trial registration: This trial was registered at http://www.clinicaltrials.gov as NCT00806442

Regional Variation in Late Preterm Births in North Carolina

Late preterm (LPT) neonates (34 0/7th to 36 6/7th weeks' gestation) account for 70% of all premature births in the United States. LPT neonates have a higher morbidity and mortality risk than term neonates. LPT birth rates vary across geographic regions. Unwarranted variation is variation in medical care that cannot be explained by sociodemographic or medical risk factors; it represents differences in health system performance, including provider practice variation. The purpose of this study is to identify regional variation in LPT births in North Carolina that cannot be explained by sociodemographic or medical/obstetric risk factors

Effects of Nasal Insufflation on Heart Rate Recovery from Exercise

Ivester, B., Miller, P., Bohlen, J., Phan, P. Dobrosielski, DA. Towson University, Towson, MD During high intensity aerobic exercise the mechanical work of breathing increases significantly. Treatment with high flow nasal insufflation (NI) has been shown to reduce the nocturnal ventilatory loads in patients with chronic conditions such as obstructive sleep apnea. Yet, it is not known whether NI influences exercise recovery kinetics in athletic persons. Purpose: Determine the effects of NI on heart rate recovery following high-intensity exercise. Methods: Aerobic capacity (VO2max) was established on competitive runners using a Bruce treadmill protocol. On separate days, subjects completed two 30-minute bouts of exercise on a treadmill at anaerobic threshold. Following each bout, subjects were fitted with a nasal cannula and exposed in random order to: 1) 35 Lmin-1 NI, or 2) 5 Lmin-1 (Sham). Heart rate was monitored for 20 minutes post-exercise to quantify rate of recovery. The start of the post-exercise period was denoted as 0% recovery, and proceeded to 100% once resting heart rate was achieved. Results: Five men (age: 27 ± 6 yrs; VO2max: 59.4 ± 4.2 mlkg-1min-1) and six women (age: 26 ± 8 yrs; VO2max: 50.4 ± 6.4 mlkg-1min-1) completed the study. Heart rate values throughout exercise did not vary between bouts, indicating equal intensities were achieved. There were no differences in relative HR recovery during the NI condition compared to Sham condition at 2 min (NI: 56 ± 27% vs. Sham: 54 ± 16%, p=0.77), 5 min (NI: 79 ± 16% vs. Sham: 75 ± 15%, p=0.77), or 15 min (NI: 100 ± 24% vs. Sham: 97 ± 18%, p=0.53) post exercise. Conclusion: Treatment with high flow NI did not facilitate heart rate recovery following a high intensity bout of exercise. Future studies incorporating direct assessment of ventilation are required in order to determine whether use of NI during exercise translates to improved athletic performance