ascorbic-acid and Gastroesophageal-Reflux

Dental erosion is increasingly recognized as a common condition in paediatric dentistry with complications of tooth sensitivity, altered aesthetics and loss of occlusal vertical dimension. The prevalence of erosion in children has been reported to range from 10% to over 80%. The primary dentition is thought to be more susceptible to erosion compared to the permanent dentition due to the thinner and less mineralized enamel. The aim of this paper was to critically review dental erosion in children with regards to its prevalence, aetiology, diagnosis and prevention. The associations between erosion and other common conditions in children such as caries and enamel hypoplasia are also discussed.

Topics: Ascorbic Acid; Australia; Beverages; Caseins; Child; Child, Preschool; Dental Caries; Dental Enamel Hypoplasia; Dental Pellicle; Drug-Related Side Effects and Adverse Reactions; Feeding and Eating Disorders; Fluorides, Topical; Gastroesophageal Reflux; Germany; Humans; Prevalence; Risk Factors; Tooth Erosion; Tooth, Deciduous; United Kingdom; Vomiting

This paper aims at evaluating the impact of vitamins intake in the prevention of gastroesophageal reflux disease (GERD), Barrett's oesophagus (BE), and oesophageal adenocarcinoma (EADC). It concentrates primarily on the antioxidant vitamins A, C and E. There were 180 subjects included in the trial, 109 males and 71 females, which were divided in the four groups (70 patients with GERD, 20 patients with BE, 20 patients with EADC, and 70 healthy examinees composing a control group). Their antioxidant vitamins intake was investigated through the usage of the dietary questionnaires. Concentration of the mentioned antioxidant vitamin in serum was detected by HPLC method, and although there were no major statistical differences in their levels between four groups, there existed a correlation between the vitamin serum concentration and the rephlux disease degree. The results showed that the healthy examinees had consumed the greater quantities of the vitamins A, C and E, through both the natural (fruits and vegetables) and the supplementary (industrial vitamin additives) way, than the patients with GERD, BE and EADC. This was reflected in the higher serum levels of the mentioned vitamins in the first group in the comparison with the second group. Based on this, the intake of the vitamins A, C and E through both the natural and the supplementary ways is suggested in order to prevent the development of the GERD, BE and EADC.

Topics: Adenocarcinoma; Adolescent; Adult; Aged; Aged, 80 and over; Ascorbic Acid; Barrett Esophagus; Esophageal Neoplasms; Female; Gastroesophageal Reflux; Humans; Male; Middle Aged; Vitamin A; Vitamin E; Vitamins; Young Adult

There is a strong male predominance of oesophageal adenocarcinoma, which might be related to the higher prevalence of precursor lesions such as erosive reflux oesophagitis in men compared with women. This experiment investigated the gender difference in a reflux oesophagitis model of rats and explored the potential role of oestrogen in controlling oesophageal tissue damage.. An acid-reflux oesophagitis model was surgically produced in male and female rats, and ascorbic acid in the diet and sodium nitrite in the drinking water were administered to half of either group to provoke luminal exogenous nitric oxide (NO) as an exacerbating agent. Seven days after the surgery, the oesophagus was excised, and the injury area, myeloperoxidase activity and pro-inflammatory cytokine levels were measured. Furthermore, 17β-oestradiol was administered to ovariectomised female rats or male rats, which then underwent reflux oesophagitis surgery.. While there was no gender difference in oesophageal damage in the baseline model, oesophageal damage was more intensively observed in males than in females in the presence of exogenous NO administration. While oesophageal damage was increased in ovariectomised rats compared with sham ovariectomised, exacerbated oesophageal damage was attenuated by the replacement of 17β-oestradiol. In addition, exacerbated oesophageal damage in male rats was suppressed by 17β-oestradiol.. This is the first study showing the prominent gender difference in the severity of oesophageal tissue damage in a gastro-oesophageal reflux disease-related animal model, highlighting the critical involvement of oestrogen in controlling gastro-oesophageal reflux disease-related oesophageal epithelial injury.

Topics: Animals; Ascorbic Acid; Biomarkers; Chronic Disease; Cytokines; Disease Models, Animal; Esophagitis, Peptic; Esophagus; Estradiol; Estrogens; Female; Gastroesophageal Reflux; Male; Mucous Membrane; Nitric Oxide; Ovariectomy; Peroxidase; Random Allocation; Rats; Rats, Wistar; Severity of Illness Index; Sex Factors; Sodium Nitrite; Stomach

Exposure of the esophageal mucosa to refluxed gastroduodenal contents is recognized to be an important risk factor for Barrett's esophagus (BE). At the human gastroesophageal junction, nitric oxide is generated luminally through the enterosalivary recirculation of dietary nitrate, and in cases with gastroesophageal reflux, the site of luminal nitric oxide generation could shift to the distal esophagus. The aim of this study is to investigate whether exogenous luminal nitric oxide could promote the development of BE in rats. Sodium nitrite plus ascorbic acid were administered to a rat surgical model of BE, in which the gastroduodenal contents were refluxed into the esophagus to generate exogenous luminal nitric oxide in the esophagus by the acid-catalyzed chemical reaction between the 2 reagents. The emergence of BE was evaluated histologically in the early phase (several weeks) after the surgery with or without exogenous nitric oxide administration. To elucidate the histogenesis of BE, CDX2, MUC2 and MUC6 expressions were investigated immunohistochemically. Coadministration of sodium nitrite plus ascorbic acid significantly accelerated the timing of emergence and increased the area of BE compared with controls. Administration of either reagent alone did not show any promotive effects on BE formation. Immunohistochemically, the columnar epithelium thus induced was similar to the specialized intestinal metaplasia in human BE. The results of this animal model study suggest that exogenous luminal nitric oxide could be involved in the pathogenesis of the columnar transformation of the esophagus. Further studies in human are warranted.

Topics: Animals; Ascorbic Acid; Barrett Esophagus; Disease Models, Animal; Esophagitis; Gastroesophageal Reflux; Nitric Oxide; Random Allocation; Rats; Sodium Nitrite

The role of antioxidants in the pathogenesis of reflux esophagitis (RE), Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) remains unknown. We evaluated the associations among dietary antioxidant intake and these diseases. We performed an assessment of dietary antioxidant intake in a case control study of RE (n = 219), BE (n = 220), EAC (n = 224), and matched population controls (n = 256) (the Factors Influencing the Barrett's Adenocarcinoma Relationship study) using a modification of a validated FFQ. We found that overall antioxidant index, a measure of the combined intake of vitamin C, vitamin E, total carotenoids, and selenium, was associated with a reduced risk of EAC [odds ratio (OR) = 0.57; 95% CI = 0.33-0.98], but not BE (OR = 0.95; 95% CI = 0.53-1.71) or RE (OR = 1.60; 95% CI = 0.86-2.98), for those in the highest compared with lowest category of intake. Those in the highest category of vitamin C intake had a lower risk of EAC (OR = 0.37; 95% CI = 0.21-0.66; P-trend = 0.001) and RE (OR = 0.46; 95% CI = 0.24-0.90; P-trend = 0.03) compared with those in the lowest category. Vitamin C intake was not associated with BE, and intake of vitamin E, total carotenoids, zinc, copper, or selenium was not associated with EAC, BE, or RE. In conclusion, the overall antioxidant index was associated with a reduced risk of EAC. Higher dietary intake of vitamin C was associated with a reduced risk of EAC and RE. These results suggest that antioxidants may play a role in the pathogenesis of RE and EAC and may be more important in terms of progression rather than initiation of the disease process.

Topics: Adenocarcinoma; Aged; Antioxidants; Ascorbic Acid; Barrett Esophagus; Carotenoids; Case-Control Studies; Copper; Diet; Esophageal Neoplasms; Female; Gastroesophageal Reflux; Humans; Male; Middle Aged; Minerals; Odds Ratio; Risk Factors; Selenium; Vitamin E; Zinc

The present study evaluated the associations among antioxidants, fruit and vegetable intake, and the risk of Barrett's esophagus (BE), a potential precursor to esophageal adenocarcinoma.. We conducted a case-control study within the Kaiser Permanente Northern California population. Incident BE cases (N = 296) were matched to persons with gastroesophageal reflux disease (GERD) (GERD controls N = 308) and to population controls (N = 309). Nutrient intake was measured using a validated 110-item food frequency questionnaire. The antioxidant results were stratified by dietary versus total intake of antioxidants.. Comparing cases to population controls, dietary intake of vitamin C and beta-carotene were inversely associated with the risk of BE (4th vs 1st quartile, adjusted odds ratio [OR] 0.48, 95% confidence interval [CI] 0.26-0.90; OR 0.56, 95% CI 0.32-0.99, respectively), and the inverse association was strongest for vitamin E (OR 0.25, 95% CI 0.11-0.59). The inverse trends for antioxidant index (total and dietary) and fruit and vegetable intake were statistically significant, while most total intakes were not associated with reduced risk. The use of antioxidant supplements did not influence the risk of BE, and antioxidants and fruits and vegetables were inversely associated with a GERD diagnosis.. Dietary antioxidants, fruits, and vegetables are inversely associated with the risk of BE, while no association was observed for supplement intake. Our results suggest that fruits and vegetables themselves or associated undetected confounders may influence early events in the carcinogenesis of esophageal adenocarcinoma.

Topics: Adolescent; Adult; Aged; Antioxidants; Ascorbic Acid; Barrett Esophagus; beta Carotene; Case-Control Studies; Diet; Female; Fruit; Gastroesophageal Reflux; Humans; Male; Middle Aged; Risk Factors; Surveys and Questionnaires; Vegetables; Vitamin E

When saliva, with its high nitrite content derived from the enterosalivary recirculation of dietary nitrate, meets acidic gastric juice, the nitrite is converted to nitrous acid, nitrosative species, and nitric oxide. In healthy volunteers this potentially mutagenic chemistry is focused at the gastric cardia. We have studied the location of this luminal chemistry in Barrett's patients during acid reflux.. Ten Barrett's patients were studied before and after administration of 2 mmol nitrate. Using microdialysis probes we measured nitrite, ascorbic acid, total vitamin C, and thiocyanate concentrations and pH simultaneously in the proximal oesophagus, Barrett's segment, hiatal sac, proximal stomach, and distal stomach. In a subgroup, real time nitric oxide concentrations were also measured.. During acid reflux, Barrett's segment was the anatomical site with maximal potential for acid catalysed nitrosation, with its median concentration of nitrite exceeding that of ascorbic acid in two of 10 subjects before nitrate and in four of nine after nitrate. Thiocyanate, which catalyses acid nitrosation, was abundant at all anatomical sites. On entering the acidic Barrett's segment, there was a substantial fall in nitrite and the lowest ascorbic acid to total vitamin C ratio, indicative of reduction of salivary nitrite to nitric oxide at this anatomical site. Episodes of acid reflux were observed to generate nitric oxide concentrations of up to 60 muM within the Barrett's segment.. The interaction between acidic gastric refluxate and nitrite rich saliva activates potentially mutagenic luminal nitrosative chemistry within Barrett's oesophagus.

Topics: Aged; Ascorbic Acid; Barrett Esophagus; Esophageal Neoplasms; Esophagoscopy; Female; Gastroesophageal Reflux; Humans; Hydrogen-Ion Concentration; Male; Microdialysis; Middle Aged; Nitrates; Nitric Oxide; Nitrites; Nitrosation; Precancerous Conditions; Saliva; Thiocyanates

Antioxidant vitamins have attracted considerable attention in previous studies of esophageal squamous-cell carcinoma, but dietary studies of adenocarcinoma of the esophagus and gastric cardia remain sparse. Treating these tumors as distinct diseases, we studied intakes of vitamin C, beta-carotene and alpha-tocopherol in a nationwide population-based case-control study in Sweden, with 185, 165, and 258 cases of esophageal adenocarcinoma, esophageal squamous-cell carcinoma, and gastric cardia adenocarcinoma, respectively, and 815 controls. Subjects with a high parallel intake of vitamin C, beta-carotene, and alpha-tocopherol showed a 40-50% decreased risk of both histological types of esophageal cancer compared with subjects with a low parallel intake. Antioxidant intake was not associated with the risk of gastric cardia adenocarcinoma. Separately, vitamin C and beta-carotene reduced the risk of esophageal cancers more than alpha-tocopherol. We found that antioxidant intake is associated with similar risk reductions for both main histological types of esophageal cancer. Our findings indicate that antioxidants do not explain the diverging incidence rates of the 2 histological types of esophageal cancer. Moreover, our data suggest that inverse associations with esophageal squamous-cell carcinoma and adenocarcinoma may be stronger among subjects under presumed higher oxidative stress due to smoking or gastroesophageal reflux, respectively. Our results may be relevant for the implementation of focused, cost-effective preventive measures.

Topics: Adenocarcinoma; Aged; Antioxidants; Ascorbic Acid; beta Carotene; Carcinoma, Squamous Cell; Cardia; Case-Control Studies; Diet; Dietary Supplements; Drug Synergism; Esophageal Neoplasms; Female; Gastroesophageal Reflux; Humans; Male; Multivariate Analysis; Oxidative Stress; Risk Factors; Smoking; Stomach Neoplasms; Sweden; Vitamin E

The clinical aspects, epidemiology, etiology and pathogenesis of dental erosions in man and experimental animals are reviewed. Abrasion of enamel, softened in orange juice for 3 minutes and brushed with various dentifrices, was studied with Knoop hardness measurements and scanning electron microscopy. Knoop indentations made on softened enamel surfaces were almost totally removed by 2-minute brushings with highly abrasive tooth pastes. Brushing without dentifrices only slightly changed the distinctness of the indentation outlines. Recommendations for primary and secondary prevention of erosions are given.

Topics: Animals; Ascorbic Acid; Dental Enamel; Gastric Juice; Gastroesophageal Reflux; Humans; Rats; Tooth Abrasion; Tooth Erosion; Toothbrushing