AuSPEN NEWSLETTER JANUARY 1998

AuSPEN NEWSLETTER

January 1998 : Issue #1 for 1998

REPORT FROM THE PRESIDENT

The Annual Scientific Meeting in Freemantle was a great success both academically and socially. On behalf of the AuSPEN Membership I would like to thank the West Australian Committee of Paul Woods, Lilianna Sputore, Geoff Dobb, Julie McMorrow, Heather Wellwood, Cameron Platell and Susan Adler for the hard work in providing a friendly and rewarding meeting. Well done !

Planning for the 1998 Conference is already well advanced. This will be a joint meeting of AuSPEN with the Gastroenterological Society of Australia and offers a terrific opportunity for AuSPEN Members to expand their knowledge and alliances with health professionals and researchers in the gastroenterological field. The 1998 AuSPEN Meeting is planned as a two day meeting on Friday 23rd and Saturday 24th October at the Canberra Convention Centre. The Gastroenterological Society will meet with AuSPEN for Friday which will provide an opportunity for two joint Symposia plus a combined Free Paper Session. We are very fortunate to have two prominent international speakers planning to attend the AuSPEN Meeting in 1998. Speakers will include Prof Alan Walker and Professor Ken Kudsk. Prof Alan Walker is Professor of Nutrition, Harvard Medical School and Harvard School of Public Health, and Chief of Paediatric Gastroenterology, Children's Hospital in Boston. Professor Ken Kudsk is Professor of Surgery at the University of Tennessee and current President of the American Society for Parenteral and Enteral Nutrition. An excellent clinical programme has been planned. Mark the 23rd and 24th of October 1998 in your diaries now as this promises to be a special meeting for AuSPEN.

Strategic Planning Initiatives

In response to the recommendations of the AuSPEN Strategic Planning Meeting in September 1997, the following Task Groups have been formed. These Task Groups have specific aims and priorities which are very briefly outlined below. We are actively seeking enthusiastic people who would like to make a contribution to Clinical Nutrition in Australia and to AuSPEN to call and find out more about involvement in these Task Groups. We plan to finalise the membership of these Task Groups by 16th February 1998. Please call Maragaret Allman or Julie Bines for further information and nomination. (Their Contact Numbers etc. are shown in the panel following this item.)

(1) Scientific Programme Committee

This Committee will be responsible for the scientific content and integrity of the Annual Scientific Meeting. They will be involved with the local organising committee in the nomination of speakers, topics and review of research presentations.

(2) Research and Clinical Advisory Committee.

This committee will coordinate collaborative research in a variety of areas related to nutrition. It will also assess and advise on new and existing therapies and develop recommendations related to nutritional therapy.

(3) Professional Development Committee

This committee will develop educational material and accreditation courses and programmes. It will also focus on the marketing, promotion and finance activities of the Society.

These three Task Groups offer a great opportunity for you to become involved in the development of Clinical Nutrition in Australia. We invite you to make your contribution.

Wishing you all a Happy and Healthy 1998 !

Dr Julie Bines,

President of AuSPEN.

Jan. 1998.


CONTACT ADDRESSES

Dr Julie Bines, President of AuSPEN, Dept. of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne.

Ph +61-3-9345-5060.

Fax +61-3-9345-6240

email bines@cryptic.rch.unimelb.edu.au

Dr Margaret Allman, Honorary Secretary of AuSPEN, Human Nutrition Unit, Biochemistry Dept.,The University of Sydney, Sydney 2006.

Ph +61-2-9351-3758

Fax +61-2-9351-6022

email m.allman@biochem.usyd.edu.au


24th ANNUAL SCIENTIFIC MEETING OF AuSPEN

23rd and 24th OCTOBER 1998

National Convention Centre : Canberra

To be held in conjunction with Australian Gastroenterology Week.

The international faculty will include

Professor W. Allan Walker : Professor of Nutrition, Harvard Medical School, Harvard School of Public Health

Professor Ken Kudsk : Professor of Surgery at the University of Tennessee and current President of the American Society for Parenteral and Enteral Nutrition.

Features of this meeting will include :

The impact of nutrients and growth factors on gastrointestinal development and function.

The role of enteral and parenteral nutrition after severe trauma and surgery

For more information contact :

Dr Julie Bines Ph : +61-3-9345-5060

Fax +61-3-9345-6240

Dr Margaret Allman : Ph : +61-2-9351-3758

Fax +61-2-9351-6022


POSTERS PRESENTED AT 1997 ANNUAL SCIENTIFIC MEETING

These titles were only available to attendees and are reproduced here for the benefit of Members who were unable to attend.

Short Chain Fatty Acids (SCFA) and Gas Production of a New Fibre Mix Using an in vitro Technique : K A van Hoeij and C J Green, Nutricia Corporate Research, PO Box 1, 2700 MA Zoetermeer, The Netherlands.

Long Term Nutritional Status of Patients Undergoing Oesophagectomy for Oesophageal Cancer : Anita Commacchio : Dept of Nutrition and Food Science, Royal Adelaide Hospital, South Australia 5000

A Pilot Project in Nutrition Assessment and Screening : Annette Byron, Anita Commachio, Catherine Leu : Clinical Dietetics, Royal Adelaide Hospital North Terrace, Adelaide SA 5000 and Cugy, Switzerland

Barriers to Optimal Nutrition in Cancer Patients Receiving Chemotherapy : Nazafarin Zarshenas, Lesley McSharry and Margaret Allman-Farinelli : Human Nutrition Unit, University of Sydney, NSW 2006 and Department of Nutrition, Concord Hospital, Concord 2137.

Fibronectin Levels in Burn Patients : What Role in Management ? : Christine Kiddell, Alan Clague, Sandra Klinberg, Karin Kaiser and Michael Muller : Burns / Trauma Research Unit, Depts of Nutrition and Dietetics, Pathology, Surgery, Royal Brisbane Hospital, Herston Road, Herston, QLD 4029

Strategies for the Rationalization and Improvement of Parenteral Nutrition Administration. Julie Bines, Deborah Jessen and Thirza Titchen : Nutrition Support Service, Dept of Gastroenterology and Clinical Nutrition and Dept of Pharmacy, Royal Children's Hospital, Parkville, Victoria 3052.

Vital Statistics in Total Parenteral Nutrition : Tom Hartley, Cate Law and Bill Flukes : TPN Team, Royal Hobart Hospital.

Taste Sensitivity in Patients with Renal Failure on Continuous Ambulatory Peritoneal Dialysis. Robyn Middleton and Margaret Allman-Farinelli : Human Nutrition Unit, University of Sydney, NSW 2006

The Calculation of Energy Requirements in a Critically Ill Child : A Dietitians Survey : M S White, R W Shepherd and J McEniery : Children's Nutrition Research Centre, Dept of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane

Abstracts of these and other presentations at the 1998 Conference will be viewable on the AuSPEN Homepage; see Internet News section of this Newsletter for further details.


PRIZE WINNERS

The following awards were made at the 1997 Annual Scientific Meeting

The three Travel Grants went to

Indi Richardson who presented the paper on 'Nutritional Status of the Adult Victorian Cystic Fibrosis Population'.

Kathryn Marshall who presented the paper on 'An Audit of Trauma Patients Receiving Enteral Nutrition'.

Deborah Jessen who presented a poster on 'Strategies for the Rationalization and Improvement of Parenteral Nutrition Administration'.

The Bob McMahon Prize for best oral presentation went to Julie Bines, F Justice, P J Fuller, M Sourial, M Wolvekamp, R Taylor of the Royal Children's Hospital and Prince Henry Institute of Medical Research, Melbourne, for their paper on 'Development of a Large Animal Model for Intestinal Adaptation Following Small Intestinal Resection'

The David Russell Prize for best poster went to Robyn Middleton and M A Allman-Farinell, University of Sydney, for their poster 'Taste Sensitivity in Patients with Renal Failure on Continuous Ambulatory Peritoneal Dialysis'.


NEW BOOKS

Treatment of the Hospitalized Cystic Fibrosis Patient Edited by David M Orenstein and Robert C Stern Published by Dekker as Volume 109 in their Lung Biology in Health and Disease Series. $224 : ISBN 0-8247-9500-8

Dietary Reference Intakes : Calcium, Magnesium, Phosphorus, Vitamin D and Fluoride. From the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Institute of Medicine. Published by National Academic Press, 1997, $48 : ISBN 0-309-05484-2

A Practical Guide to Paediatric Nutrition Support by Julie Bines, Thirza Titchen, Maureen Humprey and Deborah Jessen Published by Royal Children's Hospital, Melbourne; $19.95

Flavenoids in Health and Disease. Edited by Catherine Rice-Evans and Lester Packer. Published by Dekker, 1997, $264 : ISBN 0-8247-0096-1


NEW JOURNAL

Current Opinion in Clinical Nutrition and Metabolic Care has been launched by Rapid Science Publishers, ITPS Ltd., Cheriton House, North Way, Andover, Hants SP10 5BE, UK. It will be published bi-monthly with the first issue for 1998 appearing in January. The Editors are Yvon Carpentier from Belgium, John Kinney from the USA and Luc Cynober from France.

Publication plans for the first issue include an article by Peter Furst and T Ziegler on 'Protein Metabolism and Therapy' and an article by S P Allison and John Kinney on 'Perioperative Nutrition'.

This journal promises to provide another European perspective on clinical nutrition support.

The journal will be providing additional services to subscriber via the Internet and email: see INTERNET NEWS for further details.


INTERNET NEWS

The AuSPEN Homepage

www.southcom.com.au/~hartley/home.htm

is now becoming quite full of information as each issue of the Newsletter is added along with information on the Multivitamin Shortage and the 1997 and 1998 Annual Scientific Meetings are added. Work is underway to add all the Abstracts of the 1997 Annual Scientific Meeting to the site.

Readers will be interested in visiting the www site of the CSIRO Division of Human Nutrition at

www.dhn.csiro.au/

This is a professionally produced site with a wealth of information about the Division, their research programs, factsheets and publications amongst other interesting pages and links.

The new journal Current Opinion in Clinical Nutrition and Metabolism Care will include internet access to the text for subscribers. According to their advertising material there will be full electronic text and email alert services for subscribers. A sample copy can be downloaded now from their website :

www.thomsonscience.com

Finally some links to ASPEN - the American Society for Parenteral and Enteral Nutrition :

www.clinnutr.org

email : aspen@access.digex.net

surface mail : ASPEN, 8630 Fenton St., Suite 412, Silver Spring, MD 20910-3805, USA.


FROM THE JOURNALS

The Annals of Clinical Biochemistry Vol 34 #6 November 1997 included a number of articles that will be of interest :

Poor glycaemic control is associated with reduced serum free radical scavenging (antioxidant) activity in non insulin dependent diabetes mellitus : S R J Maxwell et al., page 638 - 644.

Biochemical effect of antioxidants on lipids and liver function in experimentally induced liver damage : A-B Halim et al., page 656 - 663

The total antioxidant capacity of human serum measured using enhanced chemiluminescence is almost completely accounted for by urate : M Ryan et al., page 688 - 689

The most interesting, however, was a review of 'Vitamin Analysis' by C J Bates from the MRC Dunn Nutrition Unit, Cambridge UK. This extensive article, pages 599 - 626, contains a wealth of information likely to be of interest. His Table 5 contains Reference Values for Vitamin Status Assays and is reproduced in part here :


                                    Published Ranges       Ranges from UK Surveys
                                    ---------------------  --------------------
Vitamin              Sample Type    Fidanza     Gunter     Adults     Preschool

Retinol umol/L       Serum/Plasma   1.30-2.80   0.87-4.02  1.3-3.0    0.54-1.56
                                    1.26-2.94

b-Carotene umol/L    Serum/Plasma               0.04-1.50  0.09-0.75  0.13-1.86

25(OH) Vit D nmol/L  Serum/Plasma   23.3-115.2  25-100                30-110

Vitamin E umol/L     Serum/Plasma   20-43.1     9.06-48    15.4-42.6  10.9-28.1

Vitamin K1 nmol//L   Serum/Plasma   0.7-4.9

Vitamin B1 (ratio)   Erythrocytes   1.00-1.16

Vitamin B2 (ratio)   Erythrocytes   0.95-1.24              1.02-1.19  1.06-1.50

Vitamin B6 nmol/L    Plasma         21-86

Niacin (ratio)       Urine          >1.0
Niacin umol/L        Blood          37-61

Folic Acid nmol/L    Serum/Plasma   5.5-29.4    6-28                  7.04-47.6
                     Erythrocytes               236-945    182-830    429-1749

Vitamin B12 pmol/L   Serum/Plasma   150-519                151-497    263-1336

Biotin nmol/L        Serum/Plasma   0.7-2.2

Pantothenate umol/L  Serum/Plasma   0.9-1.5

Vitamin C umol/L     Serum/Plasma   13-62       28-85                 8.8-124.5


Refs :

Fidanza, F, ed. Vitamin Nutriture Methodology. In 'Nutritional Status Assessment: A Manual For Population Studies'. London: Chapman and Hall, 1991 : 185-330

Gunter, E W, et al. Laboratory Procedures Used for the Third National Health and Nutrition Examination Survey (NHANES III), 1988 - 1994. Atlanta, GA : US Dept of Health and Human Services PHS, CDC, NCEH; Hyattsville, MD : NCHS

UK Surveys :

Adults - Gregory, J, et al. The Dietary and Nutritional Survey of British Adults, (Office of Population Censuses and Surveys. Social Survey Division). London : HMSO 1990.

Preschool - Gregory, J R, et al. In : Report of the Diet and Nutrition Survey. 'National Diet and Nutrition Survey : Children Aged 1.5 to 4.5 Years', Vol. 1, London : HMSO 1995.

For those readers who are comtemplating collecting samples for vitamin assays Table 3 in Bates' paper will be of additional interest because it lists the sample requirements, stability and preliminary preparation details relevant to all the preferred methods of analysis.


CALENDAR OF MEETINGS

1998

February 6th - 8th 1998 : 6th International Nurse Practitioner Conference will be held at the World Congress Centre, Melbourne. For more details contact Royal College of Nursing Australia, 1 Napier Close, DEAKIN ACT 2600. Ph 06-282-5633.

February 8th - 12th 1998 : 23rd Lorne Conference on Protein Structure and Function, Lorne, Victoria. Secretary : Richard Simpson, Tel 03-9347-6389

email : simpson@licre.ludwig.edu.au

March 29th - April 1st 1998 : 2nd International Conference of the Asia Pacific Clinical Nutrition Society : 'Clinical Nutrition and Public Health : Towards the Next MIllenium'; to be held at Hotel Riverside Majestic, Kuching, Sarawak.

Conference Secretariat : Assoc Prof Geok Lin Khor, Department of Nutrition and Community Health, Faculty of Biomedical and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malysia.

Tel 603-9486101 Fax 603-9426957

email khorgl@eco2.upm.edu.my.

(Conference Chairperson : Prof Mark Wahlqvist, Dept of Medicine, Monash Medical Centre, 246 Clayton Road, Melbourne, VIC 3168)

April 15th - 18th 1998 : International Training Course on Trace Elements: Analysis, Biology and Nutritional Aspects, Monastir, Tunisia. Contact Arlette Alcaraz, CHU A Michallon, Laboratoire de Biochimie C, 38043 Grenoble Cedex 9, France.

Tel 33 4 7676 5754.

Fax 33 4 76 76 56 64.

email: cerlib@ujf-grenoble.fr.

April 17th - 18th 1998 : Second International Congress on Trace Elements and Free Radicals in Oxidative Diseases, Monastir, Tunisia. Contact Arlette Alcaraz, CHU A Michallon, Laboratoire de Biochimie C, 38043 Grenoble Cedex 9, France.

Tel 33 4 7676 5754.

Fax 33 4 7676 5664.

email: cerlib@ujf-grenoble.fr.

April 18th - 22nd 1998 : 38th Annual Meeting of The American Society for Clinical Nutrition, San Francisco. Contact ASCN Secretariat, 9650 Rockville Pike, Bethesda, MD 20814-3998. (301) 530-7110. Fax 301-571-1863.

email: secretar@ascn.faseb.org.

Internet: http://www.faseb.org/ascn.

April 30th - May 2nd 1998 : 8th Beijing International Symposium of Parenteral and Enteral Nutrition. Beijing International Hotel, Beijing, China. Contact : Dr Zhu-Ming Jiang, Department of Surgery, Peking Union Medical College Hospital, Geij ing 100730, China.

Tel 8610-6513-4563 Fax 8610-6512-4876

email zmj@sun.ihcp.ac.cn

May 6th - 9th 1998 : Third International Conference on Dietary Assessment Methods, Arnhem, Netherlands. Contact Conference on Dietary Assessment Methods, contact L de Groot or W de Maar, Department of Human Nutrition, Wageningen Agricultural University, Bomenweg 2, 6703 HD Wageningen, Netherlands.

Tel 31 317 482577. Fax 31 317 483342.

email: lisette.degroot@et3.voed.wau.nl.

June 24th - 28th 1998 : 2nd International Conference on Natural Antioxidants and Anticarcinogens in Nutrition, Health and Disease. Helsinki, Finland. Contact Congress Team Fax 358-9-477-5811

September 16th - 19th 1998 : 20th ESPEN Congress on Clinical Nutrition and Metabolism will be held in Nice, France. Contact : Nice Acropolis, Development Dept., 1 Esplanade Kennedy, BP 83, 06302 Nice Cedex 4, France.

Ph 33-04-9392-8300 Fax 33-04-9392-8255

September 27th - 30th : 5th Conference of the International Society for Trace Element Research in Humans. Lyon, France. Contact Trace Element Institut for UNESCO, Immeuble Le Condorcet, 1 place de l'Ecole.

October 19th - 22nd 1998 : The American Dietetic Association Annual Meeting and Exhibition, Kansas City Convention Center, Kansas City, MO. Contact The American Dietetic Association, 216 West Jackson Boulevard, Chicago, IL 60606-6995.

Tel 312- 899-0040. Fax 312-899-0008.

email: mtgsinfo@eatright.org.

Internet: http://www.eatright.org.

23rd and 24th OCTOBER 1998

24th ANNUAL SCIENTIFIC MEETING OF AuSPEN

National Convention Centre : Canberra

To be held in conjunction with Australian Gastroenterology Week.
Tel Dr Julie Bines +61-3-9345-5060 or
Fax +61-3-9345-6240 or
email bines@cryptic.rch.unimelb.edu.au

October 31st - November 3rd 1998 : Growth Factors and Nutrients in Intestinal Health and Disease. International GUT Symposium, Osaka, Japan. Contact : Dr Kinya Sando, Dept of Paediatric Surgery, Osaka University Medical School, 2-2 Yamadaoka , Sui ta, Osaka, 656, Japan. Ph 81-06-8793-753 Fax 81-06-7893-759


OXIDATIVE STRESS IN HEALTH AND DISEASE : PART 2

Peter Vervaart

Gastroenterology and Nutrition Section
Clinical Chemistry Dept
Women’s and Children’s Healthcare Network
Parkville, Victoria.

Laboratory Markers of Oxidative Stress

Oxidative stress occurs in most if not all human diseases. Our understanding of the role played by ROS in disease pathology is still weak largely because of the lack of accurate methods applicable to human patients. Antioxidant therapy still has promise as the therapeutic approach, particularly in diseases in which other treatments are ineffective. It must, however, be combined with accurate methods of measuring oxidative damage that are now beginning to become availiable. Investigation of oxidative stress in the laboratory focuses on determining either increased oxidant generation, impaired antioxidant defence, the presence of oxidative damage, or more recently the evidence of an effective the oxidative `stress response'; {63}.

Markers of Oxidant Generation

Free radicals are extremely short lived compounds and as such simple methods for measuring them do not exist. Tests for markers of free radical generation do exist and include cytochrome c reduction assays, the measurement of oxidised/reduced ratios of a number of stable substrates and products involved in reactions with free radicals. The ratios that have been used include dehydroascorbate/ascorbate, allantoin/uric acid, and oxidised glutathione (GSSG)/reduced glutathione (GSH). From a purely research perspective complex molecules known as spin traps can be utilised in a technique known as Electron Spin Resonance Spectroscopy (ESR). An example of a spin trap is the compound DMSO which is commonly used in these type of experiments; {63}

Markers of Antioxidant Defence

A number of assays for individual antioxidants exists and include assays for Vitamin C and E, Carotenoids, Glutathione and the antioxidant enzymes SOD, Glutathione Peroxidase and Glutathione Reductase. None of these assays take into account the complex interactions that occur between individual antioxidants in vivo and so in some cases may be misleading. The most interesting development in this regard is the development of relatively simple assays for serum total antioxidant capacity (SAOC). These assays measure the ability of serum to "quench" free radical production stimulated by adding compounds such as Cu2+ or azobis (2-amidinopropane) hydrochloride (AAPH) to the serum and then measuring the lag phase of the reactions. During the lag phase antioxidants are consumed and the longer this is correlates with an increasing net antioxidant activity in patient's serum. Detection systems for these type of assays include absorbance at 234nm which is specific for dienes {64}, oxygen consumption {65}, and chemiluminescence {38}. The assay with most promise from a routine perspective is the ABTS assay which is a spectrophotometric assay based on the long-lived radical of 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulphonic acid) - ABTS.+ . When serum is incubated with with a mixture of ABTS, a peroxidase (eg. met-myoglobin) and hydrogen peroxide, the absorbance change, proportional to SAOC, is read on a spectrophotometer. The method is readily adaptable to automated analysers, {66}.

Markers of Oxidant Damage:

Methods for the measurements of markers of oxidant damage are available for Lipid Peroxidation, Protein Carbonyl formation, Nucleic Acid oxidation and Carbohydrate oxidation

Markers of Lipid Peroxidation:

Markers of lipid peroxidation are available which measure each of the metabolic stages of lipid peroxidation and clearance. The methods include the measurement of diene conjugates by absorbance at 235-240nm {64} and lipid hydroperoxides by the ferrous oxide/xylenol orange (FOX) assays {67}. The most commonly used method is to measure malonyldialdehyde by the thiobarbituric acid (TBAR) assay, {68}. The breath hydrocarbons, ethane, which is an end product of omega 3 PUFA oxidation, and pentane, which is an end product of omega 6 PUFA oxidation, have also been used as measurements. Other more specific markers include 4-hydroxynonenal (4-HNE), which is an oxidised phospholipid, the measurement of oxidised LDL particles, and the measurement of antibodies to oxidised LDL; {69}.

Markers of Protein Carbonyl Formation

The amino acids which are susceptible to oxidation include phenylalanine, tyrosine, tryptophan, cysteine, proline and methionine. Methods for analysis of oxidised proteins are less common than those for lipids. The major criticism of the TBAR assay for malonyldialdehyde is that thiobarbituric acid will also react with some protein carbonyls making it less specific as a marker of lipid peroxidation; {69}. The most interesting development in this area has been monoclonal assays which have been developed for nitrotyrosine which is the end product of peroxynitrite oxidation of tyrosine. Increased levels of nitrotyrosine has been described in a number of diseases including lung disease; {70}.

Markers of Nucleic Acid Oxidation

The major bases susceptible to oxidation are thymine and guanine. A useful clinical marker of oxidative damage to DNA is the determination of 8-OH-deoxyguanosine, (8DG), levels in urine by HPLC; {71}. Thymine oxidation products include thymine glycol, and 4-hydroxymethyluracil which can be determined by GC/MS assays, {72}. Assays also exist for the presence of mitochondrial DNA damage using PCR for deletions and oxidative changes to the DNA; {73}.

Markers of Carbohydrate Oxidation

Major examples of carbohydrate oxidation include autooxidation of glucose, mannose and deoxy sugars to form hydrogen peroxide. In rheumatoid arthritis, free radicals are responsible for the depolymerisation of the high molecular weight polysaccharide hyaluronan, decreasing the viscosity of the synovial fluid in the knee joint and other joints of the body; {74}. Free radicals have also been implicated as catalysts of the glycosylation of haemoglobin, {75}

Markers of Oxidative `Stress Response'

As the type of proteins induced by the oxidative stress response become more apparent assays for these proteins take on a new meaning. The best example of this is assays for the commonly measured enzyme gamma glutamyl transpeptidase, (GGT). It is now apparent that GGT is an enzyme with an important role in maintaining intracellular glutathione levels and is also induced as part of the oxidative stress response; see Figure 4; {76}. Other proteins that are induced include the antioxidant proteins such as SOD; {77}.

The other physiological response to oxidative stress is apoptosis and a number of methods for detecting apoptosis now exist. They include the TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling) technique, {78}, the detection of DNA `laddering' by gel electrophoresis, {79}, and the detection of apoptotic cells by flow cytometry (FACS) techniques; {80}.

Summary

Although free radicals are potentially damaging it should always be remembered that they are also essential for normal cell function. In this regard we should try to use the term oxidative stress when we describe the pathological sequalae to alterations in the oxidant/antioxidant status of a cell. A tremendous amount of research remains to be done before we can fully understand both the preventative and therapeutic application of antioxidants in clinical medicine. However what can be concluded from our understanding today is that oxidant stress and its association with ROS plays a significant role in the modulation of diseases associated with free radical damage. There is acceptance among the scientific and medical communities that enhanced antioxidant intake in the diet and specific application of antioxidants in certain states of oxidative stress may provide both preventative and therapeutic advantage. The challenge for the future then is to be able to decide when to use antioxidant therapy and nutritional intervention as part of the treatment regime for the many disease processes now associated with oxidative stress.

REFERENCES FOR PART 2

63. Vervaart. P, Knight KR. Oxidative stress and the cell. Clinical Biochem Reviews. 1996; 17:3-16

64. Esterbauer H, Streigl G, Puhl H, Rotheneder M. Continuous monitoring of in vitro oxidation of human low-density lipoprotein. Free Rad Res Commun 1989; 6:67-75.

65. Tsai EC, Hirsch IB, Brunzell JD, Chait A. Reduced plasma peroxyl radical trapping capacity and increased susceptibility of LDL to oxidation in poorly controlled IDDM. Diabetes 1994; 43:1010- 1014.

66. Miller NJ, Rice-Evans C, Davies MJ, Gopinathan V, Milner A. A novel method for measuring antioxidant capacity and its application to monitoring the antioxidant status in premature neonates. Clin Sci 1993; 84:407-412.

67. Wolff SP. Ferrous Ion Oxidation in Presence of Ferric Ion Indicator Xylenol Orange for Measurement of Hydroperoxides. Method Enzymol 1994, 105:182-189.

68. Schlenzig JS, et al. Urinary malondialdehyde concentration in preterm neonates: is there a relationship to disease entities of neonatal intensive care. Acta Paediatr. 1993; 82:202- 205.

69. Esterbauer H. Estimation of peroxidative damage. A critical review. Pathol Biol (Paris), 1996 Jan, 44:1, 25-8

70. Haddad IY, Ischiropoulos H, Holm BA, Beckman JS, Baker JR, Matalon S. Mechanisms of peroxynitrite-induced injury to pulmonary surfactants. Am J Physiol 1993; 265:L555- L564.

71. Floyd RA, Watson JJ, Wong PK, Miller DH, Richard RC. Hydroxyl free radical adduct of deoxyguanosine: sensitive detection and mechanism of formation. Free Rad Res Commun 1986; 1:163-172.

72. Wang YJ; Ho YS; Lo MJ; Lin JK. Oxidative modification of DNA bases in rat liver and lung during chemical carcinogenesis and aging. Chem Biol Interact, 1995 Feb, 94:2, 135-45

73. Lee CM; Weindruch R; Aiken JM. Age-associated alterations of the mitochondrial genome. Free Radic Biol Med, 1997, 22:7, 1259-69

74. McCord JM. Free radicals and inflammation. Protection of synovial fluid by superoxide dismutase. Science 1974; 185:529-531.

75. Odetti P et al. Good glycaemic control reduces oxidation and glycation end-products in collagen of diabetic rats. Diabetologia, 1996 Dec, 39:12, 1440-7

76. Hull j, Vervaart P, Grimwood K, Phelan P. Pulmonary Oxidative Stress Response in Young Children with Cystic Fibrosis. Thorax.1997;52:557-560.

77. Stralin P and Marklund SL. Effects of oxidative stress on expression of extracellular superoxide dismutase, CuZn superoxide dismutase and Mn superoxide dismutase in human dermal fibroblasts. Biochem J 1994; 298:347-352.

78. Negoescu A et al. In situ apoptotic cell labeling by the TUNEL method: improvement and evaluation on cell preparations. J Histochem Cytochem, 1996 Sep, 44:9, 959-68

79. Eldadah BA; Yakovlev AG; Faden AI. A new approach for the electrophoretic detection of apoptosis. Nucleic Acids Res, 1996 Oct 15, 24:20, 4092-3

80. Fraker PJ; King LE; Lill-Elghanian D; Telford WG. Quantification of apoptotic events in pure and heterogeneous populations of cells using the flow cytometer. Methods Cell Biol, 1995, 46:, 57-76

PART 1 OF THIS ARTICLE WAS PUBLISHED IN THE OCTOBER 1997 ISSUE OF THE AuSPEN NEWSLETTER.


SPONSOR

This issue of the Newsletter has received significant sponsorship towards production costs from National Analytical Laboratories, 585 Blackburn Road, Notting Hill 3168.


PUBLICATION DATES FOR 1998

The next Newsletter for 1998 will be published in April and thereafter in July and October. If contributors could get items to the Editor by the middle of the third week of the month preceeding that will assist greatly with the planning of the issue. If copy is not ready at that time but will be by the end of that month please let me know so that I can reserve the space.

Contributions on any relevant subject are always very welcome. If you have an idea for an article but are not too sure about its relevance do not hesitate to give the Editor a call or email to discuss and develop the idea first.


DISCLAIMER

The views and opinions expressed in this Newsletter are not necessarily the views and opinions of the Australian Society of Parenteral and Enteral Nutrition. Reports and articles on techniques, procedures and products are provided for the information of the Members of the Society and their inclusion does not imply any endorsements from the Australian Society of Parenteral and Enteral Nutrition. No liability can or will be accepted by AuSPEN or its agents for the third party use of information in this Newsletter.

Dr Tom Hartley, Editor, 14/01/98.


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