Cytochrome Health Dictionary

Cytochrome: From 1 Different Sources


n. a compound consisting of a protein linked to *haem. Cytochromes act as electron transfer agents in biological oxidation-reduction reactions, particularly those associated with the mitochondria in cellular respiration. See electron transport chain.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Ajo

Garlic (Allium sativum).

Plant Part Used: Bulb.

Dominican Medicinal Uses: The bulb is traditionally ingested raw for high blood pressure, upper-respiratory infection, common cold, flu-like symptoms and cough, and the alcohol extract is taken internally for sinusitis. The bulb skins are traditionally prepared as a tea and taken internally for indigestion and gastro-intestinal complaints.

Safety: The bulb is generally regarded as safe for human consumption. Reported adverse effects include skin burns due to topical application (especially in children with prolonged exposure). Adverse effects associated with internal use include halitosis, body odor, gastrointestinal irritation, constipation, headache, nausea, fatigue and vertigo.

Contraindications: Not to be taken at therapeutic doses for 10 days prior to surgery due to antiplatelet activity and risk of excessive bleeding. The bulb is contraindicated during lactation.

Drug Interactions: Chlorzoxazone: garlic may reduce drug metabolism. Indomethacin and NSAIDs: risk of excessive bleeding. Protease inhibitors: reduced blood levels. Drugs metabolized by cytochrome P450 2E1: garlic may inhibit efficacy. Forskilin: garlic may potentiate antiplatelet activity.

Clinical Data: The following effects have been investigated in human clinical trials: treatment of atherosclerosis, common cold, coronary artery disease, hyperlipidemia, hypertension and unstable angina pectoris.

Laboratory & Preclinical Data: The following biological activities have been investigated in laboratory and preclinical studies (in vitro or animal models): antibacterial, anticarcinogenic, antifungal, antihypertensive, antineoplastic, antinociceptive, antioxidant, anti-platelet-aggregant, antithrombic, antiviral and immune enhancing.... ajo

Anís De Estrella

Chinese star anise (Illicium verum).

Plant Part Used: Fruit, seed.

Dominican Medicinal Uses: The fruits or seeds are traditionally prepared as a decoction and taken orally for flatulence, headache, indigestion, stomach ache, upper respiratory tract infection and cleansing the intestines.

Safety: The fruit is generally considered safe for human consumption in small amounts and is widely used as a culinary spice. When taken in excessive quantities, isolated compounds from the fruit have shown neurotoxic effects in animal studies. Caution is advised due to possible adulteration with the highly poisonous look-alike, Japanese star anise (Illicium anisatum).

Contraindications: Avoid use in small children due to potential contamination with misidentified toxic look-alike. Caution and avoidance is advised in patients with a history of convulsive disorders including epilepsy due to case reports of seizures associated with internal use of the tea. Caution advised in patients prior to surgery due to potential risk of increased bleeding.

Drug Interactions: Anticoagulants, antiplatelet medications and NSAIDS: based on animal studies in mice, star anise increases cytochrome P450 dependent 7-ethoxycoumarin O-deethylase activity which may affect the metabolism of these drugs.

Clinical Data: No human clinical trials evaluating this plant species have been identified in the available literature.

Laboratory & Preclinical Data: The following biological activities of this plant have been demonstrated in laboratory and preclinical studies using in vitro or animal models: antiangiogenic, antibacterial, antimicrobial, insecticidal, neurotropic and sepsis prevention.

* See entry for Anís de estrella in “Part 3: Dominican Medicinal Plant Profiles” of this book for more information, including references.... anís de estrella

Cyanide Poisoning

Cyanide inhibits cellular RESPIRATION by binding rapidly and reversibly with the ENZYME, cytochrome oxidase. E?ects of poisoning are due to tissue HYPOXIA. Cyanide is toxic by inhalation, ingestion and prolonged skin contact, and acts extremely quickly once absorbed. Following inhalation of hydrogen cyanide gas, death can occur within minutes. Ingestion of inorganic cyanide salts may produce symptoms within 10 minutes, again proceeding rapidly to death. On a full stomach, effects may be delayed for an hour or more. Signs of cyanide poisoning are headache, dizziness, vomiting, weakness, ATAXIA, HYPERVENTILATION, DYSPNOEA, HYPOTENSION and collapse. Loss of vision and hearing may occur, then COMA and CONVULSIONS. Other features include cardiac ARRHYTHMIA and PULMONARY OEDEMA. Patients may have a lactic ACIDOSIS. Their arterial oxygen tension is likely to be normal, but their venous oxygen tension high and similar to that of arterial blood.

Treatment Administration of oxygen when available is the most important ?rst-aid management. Rescuers should be trained, must not put themselves at risk, and should use protective clothing and breathing apparatus. In unconscious victims, establish a clear airway and give 100 per cent oxygen. If breathing stops and oxygen is unavailable, initiate expired-air resuscitation. If cyanide salts were ingested, mouth-to-mouth contact must be avoided and a mask with a one-way valve employed instead. Some commercially available ?rst-aid kits contain AMYL NITRATE as an antidote which may be employed if oxygen is unavailable.

Once in hospital, or if a trained physician is on the scene, then antidotes may be administered. There are several di?erent intravenous antidotes that may be used either alone or in combination. In mild to moderate cases, sodium thiosulphate is usually given. In more severe cases either dicobalt edetate or sodium nitrite may be used, followed by sodium thio-sulphate. Some of these (e.g. dicobalt edetate) should be given only where diagnosis is certain, otherwise serious adverse reations or toxicity due to the antidotes may occur.... cyanide poisoning

Grapefruit

(Ugli fruit)

Nutritional Profile Energy value (calories per serving): Low Protein: Low Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Moderate Sodium: Low Major vitamin contribution: Vitamin A, vitamin C Major mineral contribution: Potassium

About the Nutrients in This Food Grapefruit and ugli fruit (a cross between the grapefruit and the tangerine) have moderate amounts of dietary fiber and, like all citrus fruits, are most prized for their vitamin C. Pink or red grapefruits have moderate amounts of vitamin A. One-half medium (four-inch diameter) pink grapefruit has 1.4 g dietary fiber, 1,187 IU vitamin A (51 percent of the R DA for a woman, 40 percent of the R DA for a man), and 44 mg vitamin C (59 percent of the R DA for a woman, 49 percent of the R DA for a man). One half medium (3.75-inch diameter) white grapefruit has 1.3 g dietary fiber, 39 IU vitamin A (2 percent of the R DA for a woman, 1 percent of the R DA for a man), and 39 mg vitamin C (52 percent of the R DA for a woman, 43 percent of the R DA for a man). Pink and red grapefruits also contain lycopene, a red carotenoid (plant pigment), a strong antioxidant that appears to lower the risk of cancer of the prostate. The richest source of lycopene is cooked tom atoes.

The Most Nutritious Way to Serve This Food Fresh fruit or fresh-squeezed juice.

Buying This Food Look for: Firm fruit that is heavy for its size, which means that it will be juicy. The skin should be thin, smooth, and fine-grained. Most grapefruit have yellow skin that, depending on the variety, may be tinged with red or green. In fact, a slight greenish tint may mean that the grapefruit is high in sugar. Ugli fruit, which looks like misshapen, splotched grapefruit, is yellow with green patches and bumpy skin. Avoid: Grapefruit or ugli fruit with puff y skin or those that feel light for their size; the flesh inside is probably dry and juiceless.

Storing This Food Store grapefruit either at room temperature (for a few days) or in the refrigerator. Refrigerate grapefruit juice in a tightly closed glass bottle with very little air space at the top. As you use up the juice, transfer it to a smaller bottle, again with very little air space at the top. The aim is to prevent the juice from coming into contact with oxygen, which destroys vitamin C. (Most plastic juice bottles are oxygen-permeable.) Properly stored and protected from oxygen, fresh grapefruit juice can hold its vitamin C for several weeks.

Preparing This Food Grapefruit are most flavorful at room temperature, which liberates the aromatic molecules that give them their characteristic scent and taste. Before cutting into the grapefruit, rinse it under cool running water to flush debris off the peel. To section grapefruit, cut a slice from the top, then cut off the peel in strips—starting at the top and going down—or peel it in a spiral fashion. You can remove the bitter white membrane, but some of the vitamin C will go with it. Finally, slice the sections apart. Or you can simply cut the grapefruit in half and scoop out the sections with a curved, serrated grapefruit knife.

What Happens When You Cook This Food Broiling a half grapefruit or poaching grapefruit sections reduces the fruit’s supply of vitamin C, which is heat-sensitive.

How Other Kinds of Processing Affect This Food Commercially prepared juices. How well a commercially prepared juice retains its vitamin C depends on how it is prepared, stored, and packaged. Commercial flash-freezing preserves as much as 95 percent of the vitamin C in fresh grapefruit juices. Canned juice stored in the refrigerator may lose only 2 percent of its vitamin C in three months. Prepared, pasteurized “fresh” juices lose vitamin C because they are sold in plastic bottles or waxed-paper cartons that let oxygen in. Commercially prepared juices are pasteurized to stop the natural enzyme action that would otherwise turn sugars to alcohols. Pasteurization also protects juices from potentially harmful bacterial and mold contamination. Following several deaths attributed to unpas- teurized apple juices containing E. coli O157:H7, the FDA ruled that all fruit and vegetable juices must carry a warning label telling you whether the juice has been pasteurized. Around the year 2000, all juices must be processed to remove or inactivate harmful bacteria.

Medical Uses and/or Benefits Antiscorbutic. All citrus fruits are superb sources of vitamin C, the vitamin that prevents or cures scurvy, the vitamin C-deficiency disease. Increased absorption of supplemental or dietary iron. If you eat foods rich in vitamin C along with iron supplements or foods rich in iron, the vitamin C will enhance your body’s ability to absorb the iron. Wound healing. Your body needs vitamin C in order to convert the amino acid proline into hydroxyproline, an essential ingredient in collagen, the protein needed to form skin, ten- dons, and bones. As a result people with scurvy do not heal quickly, a condition that can be remedied with vitamin C, which cures the scurvy and speeds healing. Whether taking extra vitamin C speeds healing in healthy people remains to be proved. Possible inhibition of virus that causes chronic hepatitis C infection. In Januar y 2008, research- ers at Massachusetts General Hospital Center for Engineering in Medicine (Boston) published a report in the medical journal Hepatology detailing the effect of naringenin, a compound in grapefruit, on the behavior of hepatitis viruses in liver cells. In laborator y studies, naringenin appeared to inhibit the ability of the virus to multiply and/or pass out from the liver cells. To date, there are no studies detailing the effect of naringenin in human beings with hepatitis C.

Adverse Effects Associated with This Food Contact dermatitis. The essential oils in the peel of citrus fruits may cause skin irritation in sensitive people.

Food/Drug Interactions Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and others. Taking aspirin or NSAIDs with acidic foods such as grapefruit may intensif y the drug’s ability to irritate your stomach and cause gastric bleeding. Antihistamines, anticoagulants, benzodiazepines (tranquilizers or sleep medications), calcium channel blockers (blood pressure medication), cyclosporine (immunosuppressant drug used in organ transplants), theophylline (asthma drug). Drinking grapefruit juice with a wide variety of drugs ranging from antihistamines to blood pressure medication appears to reduce the amount of the drug your body metabolizes and eliminates. The “grapefruit effect” was first identified among people taking the antihypertensive drugs felodipine (Plendil) and nifedip- ine (Adalat, Procardia). It is not yet known for certain exactly what the active substance in the juice is. One possibility, however, is bergamottin, a naturally occurring chemical in grapefruit juice known to inactivate cytochrome P450 3A4, a digestive enzyme needed to convert many drugs to water-soluble substances you can flush out of your body. Without an effective supply of cytochrome P450 3A4, the amount of a drug circulating in your body may rise to dangerous levels. Reported side effects include lower blood pressure, increased heart rate, headache, flushing, and lightheadedness. Some Drugs Known to Interact with Grapefruit Juice* Drug Class  Generic (Brand name) Antianxiety drug  Diazepam ( Valium) Antiarrhythmics  Amiodarone (Cordarone) Blood-pressure drugs  Felodipine (Plendil), nicardipine (Cardene), nimodipine (Nimotop), nisoldipine (Sular), verapamil ( Verelan) Cholesterol-lowering drugs  Atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor), simvastatin/ezetimibe ( Vytorin) Immune Suppressants  Cyclosporine (Neoral), tacrolimus (Prograf ) Impotence Drug  Sildenafil ( Viagra) Pain Medication Methadone (Dolophine, Methadose) * This list may grow as new research appears.... grapefruit

Abiraterone Acetate

a drug used in the treatment of metastatic prostate cancer resistant to hormonal treatment. It reduces testosterone production in prostate and adrenal tissues by inhibiting an enzyme, cytochrome P450 17A1, involved in the androgen-producing pathway in these tissues (see anti-androgen). Side-effects include oedema, liver disorders, hypertension, and low potassium levels.... abiraterone acetate

Porphyrin

n. one of a number of pigments derived from *porphin, which are widely distributed in living things. All porphyrins form chelates with iron, magnesium, zinc, nickel, copper, and cobalt. These chelates are constituents of *haemoglobin, *myoglobin, the *cytochromes, and chlorophyll, and are thus important in many oxidation/reduction reactions in all living organisms. See also protoporphyrin IX.... porphyrin

Carbon Monoxide (co)

This is a colourless, odourless, tasteless, nonirritating gas formed on incomplete combustion of organic fuels. Exposure to CO is frequently due to defective gas, oil or solid-fuel heating appliances. CO is a component of car exhaust fumes and deliberate exposure to these is a common method of suicide. Victims of ?res often suffer from CO poisoning. CO combines reversibly with oxygen-carrying sites of HAEMOGLOBIN (Hb) molecules with an a?nity 200 to 300 times greater than oxygen itself. The carboxyhaemoglobin (COHb) formed becomes unavailable for oxygen transportation. In addition the partial saturation of the Hb molecule results in tighter oxygen binding, impairing delivery to the tissues. CO also binds to MYOGLOBIN and respiratory cytochrome enzymes. Exposure to CO at levels of 500 parts per million (ppm) would be expected to cause mild symptoms only and exposure to levels of 4,000 ppm would be rapidly fatal.

Each year around 50 people in the United Kingdom are reported as dying from carbon monoxide poisoning, and experts have suggested that as many as 25,000 people a year are exposed to its effects within the home, but most cases are unrecognised, unreported and untreated, even though victims may suffer from long-term effects. This is regrettable, given that Napoleon’s surgeon, Larrey, recognised in the 18th century that soldiers were being poisoned by carbon monoxide when billeted in huts heated by woodburning stoves. In the USA it is estimated that 40,000 people a year attend emergency departments suffering from carbon monoxide poisoning. So prevention is clearly an important element in dealing with what is sometimes termed the ‘silent killer’. Safer designs of houses and heating systems, as well as wider public education on the dangers of carbon monoxide and its sources, are important.

Clinical effects of acute exposure resemble those of atmospheric HYPOXIA. Tissues and organs with high oxygen consumption are affected to a great extent. Common effects include headaches, weakness, fatigue, ?ushing, nausea, vomiting, irritability, dizziness, drowsiness, disorientation, incoordination, visual disturbances, TACHYCARDIA and HYPERVENTILATION. In severe cases drowsiness may progress rapidly to COMA. There may also be metabolic ACIDOSIS, HYPOKALAEMIA, CONVULSIONS, HYPOTENSION, respiratory depression, ECG changes and cardiovascular collapse. Cerebral OEDEMA is common and will lead to severe brain damage and focal neurological signs. Signi?cant abnormalities on physical examination include impaired short-term memory, abnormal Rhomberg’s test (standing unsupported with eyes closed) and unsteadiness of gait including heel-toe walking. Any one of these signs would classify the episode as severe. Victims’ skin may be coloured pink, though this is very rarely seen even in severe incidents. The venous blood may look ‘arterial’. Patients recovering from acute CO poisoning may suffer neurological sequelae including TREMOR, personality changes, memory impairment, visual loss, inability to concentrate and PARKINSONISM. Chronic low-level exposures may result in nausea, fatigue, headache, confusion, VOMITING, DIARRHOEA, abdominal pain and general malaise. They are often misdiagnosed as in?uenza or food poisoning.

First-aid treatment is to remove the victim from the source of exposure, ensure an e?ective airway and give 100-per-cent oxygen by tight-?tting mask. In hospital, management is largely suppportive, with oxygen administration. A blood sample for COHb level determination should be taken as soon as practicable and, if possible, before oxygen is given. Ideally, oxygen therapy should continue until the COHb level falls below 5 per cent. Patients with any history of unconsciousness, a COHb level greater than 20 per cent on arrival, any neurological signs, any cardiac arrhythmias or anyone who is pregnant should be referred for an expert opinion about possible treatment with hyperbaric oxygen, though this remains a controversial therapy. Hyperbaric oxygen therapy shortens the half-life of COHb, increases plasma oxygen transport and reverses the clinical effects resulting from acute exposures. Carbon monoxide is also an environmental poison and a component of cigarette smoke. Normal body COHb levels due to ENDOGENOUS CO production are 0.4 to

0.7 per cent. Non-smokers in urban areas may have level of 1–2 per cent as a result of environmental exposure. Smokers may have a COHb level of 5 to 6 per cent.... carbon monoxide (co)

Toronja

Grapefruit (Citrus • paradisi).

Plant Part Used: Fruit.

Dominican Medicinal Uses: Fruit: juice, orally, for diabetes, constipation, indigestion and intestinal obstruction.

Safety: Fruit and juice are widely consumed and generally considered safe.

Drug Interactions: Cytochrome P450-metabolized drugs (may inhibit potency or potentiate activity).

Laboratory & Preclinical Data: In vivo: anticancer, chemopreventive (essential oil); anti-ulcer, gatroprotective (seed extract).

In vitro: inhibition of acetylcholinesterase activity (essential oil), inhibition of cytochrome P450 enzymes (fruit juice).

* See entry for Toronja in “Part 3: Dominican Medicinal Plant Profiles” of this book for more information, including references.... toronja

Protoporphyrin Ix

the most common type of *porphyrin found in nature. It is a constituent of haemoglobin, myoglobin, most of the cytochromes, and the commoner chlorophylls.... protoporphyrin ix

Trigonella Foenum-graecum

Linn.

Family: Papilionaceae; Fabaceae.

Habitat: Widely cultivated in many parts of India.

English: Fenugreek.

Ayurvedic: Methikaa, Methi, Vastikaa, Selu, Methini, Dipani, Bahupatrikaa, Bodhaini, Gand- haphala.

Unani: Hulbaa, Methi.

Siddha/Tamil: Vendhayam.

Action: Seeds—used in loss of appetite, flatulence, dyspepsia, colic; diarrhoea, dysentery; enlargement of liver and spleen; and as a lactagogue and puerperal tonic.

Key application: German Commission E reported secretolytic, hypermic and mild antiseptic activity of the seed. The British Herbal Pharmacopoeia reported its actions as demulcent and hy- poglycaemic. ESCOP and WHO monographs indicate the use of seeds in adjuvant therapy for diabetes mellitus, anorexia, also in hypercholesterolemia.

The seeds gave alkaloids, including trigonelline, gentianine and carpaine; saponins, based mainly on the sa- pogenins, diosgenin and its isomer yamogenin, gitogenin and tigogenin; flavonoids, including vitexin and its glycosides and esters and luteolin; a volatile oil in small quantities. The mucilage (25-30%) is mostly a galac- tomannan.

A C-steroidal sapogenin peptide ester, fenugreekine, exhibited hypogly- caemic activity.

About 80% of the total content of free amino acids in the seeds is present as 4-hydroxyisoleucine, which appears to directly stimulate insulin. (Eur J Pharmacol, 390, 2000; Natural Medicines Comprehensive Database, 2007.)

Saponin rich extracts reduce blood levels of the cholesterol. The fibrous fraction of seeds also causes a reduction in blood lipids.

The aqueous extract is demulcent, promoted healing of gastric ulcers produced experimentally in rats and exhibited a smooth muscle relaxing effect in rabbits without affecting either the heart or blood pressure.

Fenugreek has been reported to stimulate the liver microsomal cy- tochrome P450 dependent aryl hy- droxylase and cytochrome b5 in rats; increased bile secretion has also been observed.

Fenugreek extract containing trigo- nelline and trigonellic acid maybe used as a hair growth stimulant.

Dosage: Seed—3-5 g powder. (CCRAS.)... trigonella foenum-graecum

Iron

n. an element essential to life. The body of an adult contains on average 4 g of iron, over half of which is contained in *haemoglobin in the red blood cells, the rest being distributed between *myoglobin in muscles, *cytochromes and iron stores in the form of *ferritin and *haemosiderin. Iron is an essential component in the transfer of oxygen in the body, as well as a component of enzymes involved in the immune function. The absorption and loss of iron is very finely controlled. A good dietary source is meat, particularly liver. The RNI (see Dietary Reference Values) is 10 mg per day for men and 12 mg per day for women during their reproductive life. A deficiency of iron may lead to *anaemia. Symbol: Fe.

Many preparations of iron are used to treat iron-deficiency anaemia. These include preparations taken by mouth, such as *ferrous sulphate, and those administered by injection, such as *iron dextran.... iron




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