Red ginseng and vitamin C increase immune cell activity and decrease lung inflammation induced by influenza A virus/H1N1 infection

 

This article goes into detail about the efficacy of vitamin C and ginseng as a supplement for decreasing lung inflammation and increasing immune activity to treat influenza type A and H1N1 infection. The study was done in rats with and without influenza type A/H1N1 infection. The purpose of the study was to see how supplementation affected the disease state. The parameters being measured were T-cell activation,natural killer (NK) cells, CD25, CD69, and human peripheral blood mononuclear cells (PBMC) and sarcoma associated herpesvirus (KSHV)-infected BCBL-1 that were inserted into the mice. PBMC and KSHV were administered in separate groups.

The study was carried out over 6-24 hour periods depending on the treatment given. The study arrived at several conclusions based on the results. Red ginseng and vitamin C supplementation suppressed the replication of KSHV virus. In addition, supplementation also increased survival and decreased lung inflammation in mice with H1N1. Other findings include increased activation of t-cells and NK cells, which coincides with a better immune response. The study provides a foundation for potential antiviral uses of ginseng and vitamin C supplements.

This is related to pharmacy because it is important to keep up to date on supplement research, as supplements are usually sold in the pharmacy. Supplements may also cause drug interactions that could affect a patient’s health. H1N1 or bird flu was a big health scare that prompted a rapid search for a vaccine. If the bird flu became a bigger issue than it did, pharmacists would be on the forefront of vaccination efforts.

Do you think pharmacists should be more proactive about promoting the use of supplements?

 

Find the article here:

Kim H, Jang M, Kim Y,  Red ginseng and vitamin C increase immune cell activity and decrease lung inflammation induced by influenza A virus/H1N1 infection. J. Pharm. Pharmacol. doi: 10.1111/jphp.12529

Comparison of dietary supplement product knowledge and confidence between pharmacists and health food store employees

A common topic discussed within the pharmaceutical world is the subject of complementary and alternative medicine (CAM). In a recent study, researchers compared knowledge about the safety and efficacy of common dietary supplements between pharmacists and health food employees. In retail settings located in central and western New York, participants were told to answer a survey about CAM safety and efficacy using the Likert scale, which ranged from scores of 0, or “very hesitant,” to 4, or “very confident.” Afterward, the participants were asked to answer a knowledge assessment portion, in which the participants were asked to answer True or False questions with the responses “true”, “false”, or “I don’t know.”

A total of 31 pharmacists and 27 health food store employees participated in this study. Results determined that pharmacists’ mean score was higher than that of the health food store employees. However, the pharmacists’ response confidence was significantly lower. Because of this, it is determined that pharmacists must improve on the subject of CAM.

This study is interesting because I had recently researched about a specific supplement in relation to depression for my drug information assignment. Prior to pharmacy school, I did not realize the amount of herbal and alternative medicines that were available on the market. It is important that current and future pharmacists improve their knowledge about this subject in order to give patients a proper recommendation.

Coon SA, Stevens VW, Brown JE, et al. Comparison of dietary supplement product knowledge and confidence between pharmacists and health food store employees: J Am Pharm Assoc. 2015;55:161-8.

http://www.japha.org/article/S1544-3191(15)30037-6/abstract 

Monthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline

A major health concern for older populations is increased risk for falls. This is partly caused by reduced lower extremity function, prevention of which could save many injuries from occurring in older adults. Vitamin D has been thought to aid in lower extremity function and is especially believed to help with muscle weakness. To evaluate this, the researchers of this study conducted a double blind clinical trial to evaluate the effects of high-dose vitamin D in older adults. The study looked at 200 men and women with a low-trauma fall in the past year who were also 70 years and older. These 200 participants were separated into three study groups: one receiving 24,000 IU of vitamin D3 per month (normal dose), one receiving 60,000 IU of vitamin D3 per month, and one receiving 24,000 IU of vitamin D3 plus calcifediol per month. At the end of the study, the increase in 25-hydroxyvitamin D levels was evaluated for each group.

The results for the first group receiving 24,000 IU showed that the 25-hydroxyvitamin D levels increased by 11.7 ng/mL after 12 months. The second group receiving 60,000 IU increased its levels by 19.2 ng/mL. Finally, the third group receiving both the 24,000 IU and the calcifediol increased its 25-hydroxyvitamin D levels by 25.8 ng/mL after 12 months. The participants were also tested using the Short Physical Performance Battery (SPPB). This test assessed lower extremity function by evaluating walking speed, balance, and successive chair stands. When looking at the change in SPPB scores, it can be noted that there was no significant difference between the treatment groups. Further data collected from the study also evaluated the incidence of falls in the subjects. During the 12 month period of the study, 121 of the participants fell. The 60,000 IU group and the 24,000 IU group with calcifediol had significantly higher percentages of falls compared with the treatment group that only received the 24,000 IU of vitamin D3.

It was concluded that higher doses of vitamin D monthly do not provide benefit for the decline in lower extremity function. This was shown through the SPPB scores and the lack of improvement with higher doses. Also, high doses were shown to increase the number of falls in participants and, therefore, may be considered unsafe in older adults who have already experienced a fall.

I found this study to be interesting because we are often told how over the counter vitamins and herbals do not have much research behind them. I therefore chose to read this article to learn more information about vitamins. The study actually proved to me how little we seem to know about these supplements. The consensus on vitamin D that was used as the basis for this study was that it can improve muscle function. However, high doses of it actually seem to have done more harm than good. As a pharmacist, it is important to know this information when evaluating the medication regimen of an older adult. Doses of vitamin D should be monitored closely with someone who experiences falls, especially if they are taking other medications that may also contribute to more frequent falls.

Citation:

Bischoff-Ferrari H, Dawson-Hughes B, Orav J, et al. Monthly high-dose vitamin D treatment for the prevention of functional decline: a randomized clinical trial. JAMA Intern Med. 2016; 176(2): 175-183.

http://archinte.jamanetwork.com/article.aspx?articleid=2478897

Prebiotics and the Importance of Defining them Correctly

Paul Stangl

In this article published in Elsevier, researchers from several US and international universities collaborated to expand on the scientific definition of prebiotics and then make a case for the use of a universal, consistent definition. Prebiotics are substances usually taken in tablet, powder or capsule form that are indigestible and provide probiotics (beneficial bacteria in our gut) with a food source. Examples include Fructo-oligosaccarides (FOS) and Galacto-oligosaccardes (GOS). The benefits from prebiotics have been observed to positively impact digestive health and there is a variety of prebiotic supplements on pharmacy shelves and online.

According to the article, the problem with prebiotics occurs when different specialties have varying definitions of what a prebiotic is and does. Scientists define that prebiotics should improve host health or otherwise provide a beneficial physiological effect. Regulators, such as the FDA classify prebiotics in the same category as vitamins and mineral supplements and have different standards for use in the market. In the same vein, the food industry does not have any set definition and therefore there are inconsistencies with what regulators determine for the industry and what the scientific definitions are. This confusion escalates further when consumers and even healthcare providers have little understanding of what prebiotics actually are. The article states some surprisingly negative statistics about the understanding of even the basic definitions of prebiotics, which includes the difference between prebiotics and probiotics.

 

The main point of this study is to highlight the confusion between disciplines when the definition of a term is not well defined.

What steps could pharmacists take to promote proper understanding and use of prebiotics in the patient population?

View the article here: Prebiotics: why definitions matter

 

Hutkins RW, Krumbeck JA, Bindels BL, et al.

Prebiotics: why definitions matter:

Elsevier. 2016;37:1-7.