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Strategies to delay the onset and ameliorate the sequelae of type 2 diabetes are urgently needed in Singapore. Diabetes is accompanied by severe oxidative stress (especially lipid peroxidation) due to increased oxygen free radical production. Oxidative stress in part results from hyperglycaemia, but it may also precede, and accelerate the development of overt type 2 diabetes and then of diabetic complications. Epidemiological evidence indicates low vitamin E intake as a risk factor for development of type 2 diabetes, and small scale human intervention studies have indicated benefit of vitamin E in improving endothelial function, retinal blood flow and renal dysfunction. Animal studies also support its usefulness. The weight of evidence available supports the suggestion that a major double-blind controlled clinical trial of antioxidants in prevention and treatment of type 2 diabetes should be undertaken.
Abstract Oxygen radicals and hydrogen peroxide are constantly produced in the human body. Some of this production is a chemical accident, such as generation of hydroxyl radicals (OH”) by our constant exposure to low levels of radiation from the environment (see Chapter 1) and of superoxide (O2·™) by leakage of electrons from electron transport chains (see Chapter 2). Other production of these species is deliberate, including the generation of H2O2 by such enzymes as o-amino acid oxidase (see Chapter 2). Perhaps the best-known examples of deliberate production of radicals in the human body are the generation of2·™ by activated phagocytic cells (see the Appendix to this chapter) and the generation of nitric oxide by the cells lining blood vessel walls (see Chapter 1).
Oxidant species such as superoxide radical (), hydrogen peroxide (H2O2), hydroxyl radical (HO.), and lipid peroxides (LOOH) are becoming increasingly implicated in human disease. However, the question of whether such oxidants are a major cause of tissue injury in human disease or are merely produced during such injury has been difficult to answer because of inadequate experimental techniques, and possibly because of an overemphasis on lipid peroxidation as a mechanism of oxidant injury. Recent developments in methodology, in our understanding of the primary mechanism of oxidant toxicity to cells, and in concepts of antioxidant protection are reviewed. Good evidence now exists for some role of oxidant damage to tissues in the pathology of several human diseases, including rheumatoid arthritis, reperfusion injury, immune injury to lung and kidney, and cerebral trauma or ischemia. These have led to promising suggestions for new therapeutic approaches.— Halliwell, B. Oxidants and human disease: some new concepts. FASEB J. 1: 358-364; 1987.
Since its discovery, the unique properties of the naturally occurring amino acid, L-ergothioneine (EGT; 2-mercaptohistidine trimethylbetaine), have intrigued researchers for more than a century. This widely distributed thione is only known to be synthesized by non-yeast fungi, mycobacteria and cyanobacteria but accumulates in higher organisms at up to millimolar levels via an organic cation transporter (OCTN1). The physiological role of EGT has yet to be established. Numerous in vitro assays have demonstrated the antioxidant and cytoprotective capabilities of EGT against a wide range of cellular stressors, but an antioxidant role has yet to be fully verified in vivo. Nevertheless the accumulation, tissue distribution and scavenging properties, all highlight the potential for EGT to function as a physiological antioxidant. This article reviews our current state of knowledge. This article is part of a Special Issue entitled: Antioxidants and Antioxidant Treatment in Disease.
This article looks back to the antioxidant/free radical field in 1994 and discusses how it has progressed in the past 18 years. In some areas, there has been little change: the role of oxygen radicals and other reactive oxygen species (ROS) in the origin or progression of most human diseases remains uncertain, with cancer and neurodegenerative disease being likely exceptions. Even in diseases in which ROS are involved there has been little progress in developing effective antioxidant treatments. Mega-doses of dietary antioxidants have also generally failed to prevent human disease, in part because they do not decrease oxidative damage in vivo (as revealed by robust biomarkers). However, some strategies that are known to delay disease onset may act, at least in part, by decreasing oxidative damage levels. Nevertheless, far more is known today about endogenous antioxidant defenses and how they are regulated, which has led to a deeper understanding of how some ROS can act as signaling molecules. Increasing endogenous antioxidant levels (e.g., by supplying "pro-oxidants") may be a better approach to therapeutics and disease prevention than consuming large doses of "dietary antioxidants."
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