Vitamina D: solução para doenças autoimunitárias e neurodegenerativas

Vitamina D: solução para doenças autoimunitárias e neurodegenerativas

16/07/2012 — Celso Galli Coimbra

fonte

http://biodireitomedicina.wordpress.com/2012/07/16/vitamina-d-solucao-para-doencas-autoimunitarias-e-neurodegenerativas/

Alois Alzheimer ca. 1910

Sobre este assunto, assista:

Vitamina D – Sem Censura – Dr. Cicero Galli Coimbra e Daniel Cunha

http://biodireitomedicina.wordpress.com/2012/06/29/vitamina-d-sem-censura-dr-cicero-galli-coimbra-e-daniel-cunha/

Vitamina D – Por uma outra terapia (Vitamin D – For an alternative therapy)

http://www.youtube.com/watch?v=erAgu1XcY-U

Informações médicas sobre a prevenção e tratamento de doenças neurodegenerativas

https://www.youtube.com/watch?v=yRQkITHjZ5k

 

Leia:

Vitamina D pode revolucionar o tratamento da esclerose múltipla

http://biodireitomedicina.wordpress.com/2010/08/03/vitamina-d-pode-revolucionar-o-tratamento-da-esclerose-multipla/

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 Estudos revelam e casos clínicos comprovam que nutriente é fundamental para prevenção e controle eficaz de moléstias graves – 16/07/2010 16:50 (Elizângela Isaque – Da equipe Medicando)

A sabedoria popular nos ensina que é sempre melhor prevenir do que remediar. Felizmente, em algumas circunstâncias, especificamente nas ligadas à saúde, a forma de prevenção é a mesma que proporciona a cura ou, no mínimo, um controle eficaz de determinados problemas. Esse é o caso da vitamina D, substância que tem sido fonte de constantes estudos e de importantes descobertas, no que se refere às doenças autoimunitárias e neurodegenerativas, como esclerose múltipla, depressão, artrite reumatóide, Parkinson, mal de Alzheimer, lúpus e vitiligo, entre outras.

De acordo com a literatura médica clássica, a vitamina D exerce um papel fundamental para a manutenção do equilíbrio de determinadas funções do organismo humano, como a inibição de problemas como o raquitismo em crianças e a osteoporose em adultos. Entretanto, de acordo com as novas descobertas, as doses diárias recomendadas até hoje, de 400 UI (Unidades Internacionais), que equivale a um micrograma, estão longe do ideal necessário para prevenir, estabilizar ou mesmo anular sintomas relacionados à carência dessa substância.

Embora alguns alimentos sejam fonte de vitamina D, a forma natural mais eficiente de obtê-la é por meio da exposição diária ao sol. “Cerca de 10 minutos, todos os dias, com 90% do corpo exposto ao sol matinal, é suficiente para que maioria das pessoas obtenha a quantidade aproximada de 20.000 UI”, explica o neurologista e professor do Departamento de Neurologia e Neurocirurgia da Universidade Federal de São Paulo (UNIFESP) Dr. Cícero Galli Coimbra.

No entanto, Dr. Cícero lembra que algumas pessoas apresentam maior dificuldade de transformar em ativa a forma da vitamina D produzida pela exposição solar, devido às particularidades de cada organismo. Devido a essas características, alguns indivíduos, mesmo com hábitos que os exponham diariamente ao sol, podem apresentar deficiência desta substância e, consequentemente, desenvolverem algum problema proveniente dessa carência. Por isso, o médico recomenda a ingestão diária da vitamina D em forma de cápsula ou gotas, em pessoas portadoras dessa característica genética, ou que tenham uma rotina diária caracterizada por baixa exposição solar.

O engenheiro ambiental Marcelo Palma está entre as pessoas que, embora sempre levasse uma rotina de práticas esportivas ao ar livre, como o surfe, começou a apresentar sintomas como paralisia facial, formigamento de membros e alteração da sensibilidade do abdômen. Após alguns diagnósticos equivocados e tratamentos que não impediam o surgimento de outros sintomas que eram de fato decorrentes da esclerose múltipla, o jovem que também dava aulas de capoeira tomou conhecimento do tratamento proposto por Dr. Cícero.

Maior autoridade brasileira sobre os benefícios da vitamina D, o nome de Dr. Cícero Coimbra é relacionado ao crescente número de pacientes que, uma vez submetidos ao seu tratamento, têm apresentado quadros de regressão de sintomas, bem como a estabilidade em doenças como a esclerose múltipla. Em todos os casos, a vitamina D sintetizada, ministrada em doses que variam de acordo com a necessidade de cada paciente, é a protagonista que atua de forma decisiva no combate aos graves sintomas apresentados pela doença.

Na internet, há centenas de artigos científicos acerca dos benefícios da “vitamina D”, relacionados às doenças neurodegenerativas como Alzheimer, e às autoimunitárias, como a esclerose múltipla, miastenia gravis, lúpus, artrite reumatóide, psoríase e diabetes do tipo 1. No entanto, segundo Dr. Cícero, a utilização deste nutriente nos tratamentos destas moléstias ainda não chegou aos consultórios do país.

“Cerca de 70% das pessoas que sofrem de esclerose múltipla apresentam níveis muito baixos de vitamina D, o que se correlaciona com uma frequência maior de exacerbações (surtos) e com a sustentação de sequelas neurológicas mais acentuadas após cada surto. A simples percepção disso remete qualquer profissional que se depare com esse quadro à obrigação ética de administrar essa substância como parte fundamental do tratamento”, explica Dr. Cícero.

Conforme expõe o neurologista, a falta de informação sobre o assunto começa pelo ambiente acadêmico e culmina na pressão mercadológica que a indústria farmacêutica exerce sobre a sociedade. Hoje, cada ampola de Tysabri (natalizumab), medicação vendida em mais de 45 países para o tratamento de esclerose múltipla, custa, em média, cerca de R$ 9.000,00.  Só em 2009, o Tysabri proporcionou ao seu fabricante a receita de um bilhão de dólares em vendas, fazendo com que, em janeiro deste ano, a empresa viesse a público declarar que busca, em 2010, como estratégia de marketing, maximizar o valor de suas ações por meio do crescimento do consumo desse remédio.

De acordo com dados da Federação Internacional de Esclerose Múltipla (MSIF, na sigla em inglês), cerca de 2,5 milhões de pessoas sofrem de EM, em todo o mundo. No Brasil, a estimativa da Associação Brasileira de Esclerose Múltipla (ABEM) é de que existam mais de 35 mil portadores no país. Além disso, a entidade alerta para as constantes faltas da medicação disponibilizada pelo governo, nos postos de saúde do Brasil.

As medicações comumente prescritas em terapias (interferons), geralmente, expõem os pacientes a efeitos colaterais tão comuns quanto desagradáveis. Esses remédios podem desencadear reações – observadas em mais de um, em cada 10 doentes – como dores de cabeça, sintomas do tipo gripal e febre. O que remete às vantagens da utilização da vitamina D nos tratamentos de doenças neurodegenerativas e autoimunitárias.

Além da ausência de efeitos colaterais, desde que as doses sejam ajustadas conforme as necessidades individuais, bem como de acordo com os exames laboratoriais, a utilização da vitamina D gera a possibilidade a regressão de sequelas recentes e a prevenção da progressão da doença. O que torna esse nutriente mais eficaz que a medicação tradicional e uma alternativa, no mínimo, considerável, se comparada à medicação até hoje ministrada.

O ajuste das doses, realizados por meio de exames laboratoriais, tem por objetivo evitar a hipervitaminose por vitamina D, já que o excesso deste nutriente no organismo pode provocar problemas graves como danos permanentes nos rins, retardo do crescimento, calcificação de tecidos moles e até mesmo a morte. Entre os sintomas leves de intoxicação estão: sede excessiva e eliminação de grande volume de urina, náuseas, fraqueza, prisão de ventre e irritabilidade. Entretanto, para alcançar essas reações, seria necessário o consumo muito superior aos recomendados pelas recentes pesquisas.

De acordo com os estudos mais recentes, para que uma pessoa adulta, com níveis normais de tolerância à vitamina D, apresente um quadro de super dosagem deste nutriente é necessária a ingestão diária, por um período de um a dois meses, de 2,5 mg (100.000 IU), aproximadamente. Já para as crianças, a quantidade considerada tóxica varia de 0,5 mg (20.000 IU) a 1,0 mg (40.000 IU), números superiores às doses mais altas indicadas para prevenção e tratamento de doenças.

“No entanto, esses limites tóxicos podem variar conforme a quantidade de alimentos ricos em cálcio, especialmente os laticínios, presentes na dieta, conforme o peso e características genéticas do indivíduo”, esclarece Dr. Cícero. Conforme explica o neurologista, os riscos de uma hiperdosagem são praticamente nulos, se o tratamento é feito com acompanhamento médico, em âmbito clínico e laboratorial. “A quantidade de vitamina D que cada paciente necessita em seu tratamento varia de acordo com o estágio da doença e com os níveis de carência deste nutriente em cada organismo, por isso é muito importante a avaliação do profissional”, explica.

Divulgação

Como a eficácia da vitamina D, em relação aos medicamentos tradicionais, ainda não é um consenso entre a comunidade científica, a difusão desta nova alternativa tem ocorrido por meio do famoso “boca a boca”. Nesse contexto, a internet tem sido a principal ferramenta utilizada pelos pacientes do Dr. Cícero, que utilizam a web para discutirem seus casos clínicos entre si e, ao mesmo tempo, propagarem resultados como a estabilização e o controle de suas enfermidades.

Com cerca de 300 membros a comunidade “Esclerose Múltipla Tem Solução” funciona em um dos mais famosos sítios de relacionamentos da web e reúne tanto pacientes sob o tratamento do Dr. Cícero, quanto pessoas que sofrem de EM e estão em busca de tratamentos com resultados mais eficazes e menos agressivos que os tradicionais. “Após descobrir a existência do Dr. Cícero e obter resultados fantásticos com minha sobrinha achei que seria importante difundir esse protocolo de tratamento”, explica Sergio Vinagre, fundador da comunidade.

Na página inicial da comunidade, criada há dois anos, Vinagre conta que sua sobrinha iniciou o tratamento com Dr. Cícero em 2006, cinco anos após receber diagnóstico de esclerose múltipla. Na época da primeira consulta a moça já se encontrava em cadeira de rodas, devido o estágio no qual se encontrava a doença. “Dois meses após o início do novo tratamento, baseado na reposição dessa vitamina, ela estava dirigindo. Hoje leva uma vida normal, sem surtos, e sem o uso da medicação convencional, que é bastante agressiva. E continua apresentando melhoras”, relata.

Fatores psicológicos

Para quem o organismo apresenta dificuldade de sintetizar a vitamina D, estresses emocionais, ou fortes traumas podem contribuir para que se desencadeiem algumas doenças. Dr. Cícero destaca que, cerca de 85% dos surtos de esclerose múltipla, por exemplo, surgem após estresses emocionais. “Imagine quantos surtos seriam evitados se fosse possível retirar ou diminuir o nível de estresse dessas pessoas”.

Foi após vivenciar um forte trauma emocional que Marcelo Palma começou a apresentar os primeiros sintomas de esclerose múltipla. Sintomas que, posteriormente, voltaram mais fortes e frequentes após uma segunda experiência que lhe acarretou novo trauma. “Na primeira consulta, que durou cerca de quatro horas, ele me explicou como seria a utilização da vitamina D, aliada à B e a óleos de peixe (ômega 3) DHA, para ‘desativar’ a auto agressão do sistema imunológico no meu próprio organismo”, relembra.

Hoje, o maior empenho do neurologista é tornar a utilização da vitamina D comum nos tratamentos das doenças neurodegenerativas e autoimunitárias. “Meu objetivo é fazer com que os demais profissionais conheçam os benefícios dessa substância e passem a ministrá-la aos pacientes em tratamento”, diz o neurologista, que acredita que, no futuro, as informações acerca da importância desse nutriente estarão ao alcance de todos. “Não há como impedir que esse conhecimento se torne comum. Pode ser que demorem mais dois, três ou vinte anos. O fato é que, cedo ou tarde, todos vão saber dos benefícios da vitamina D”.

Neurologia

 

Cícero Galli Coimbra é médico graduado pela Universidade Federal do Rio Grande do Sul (1979), possui título de especialista em medicina interna (1981) e neurologia (1983) pela mesma instituição, e em neurologia pediátrica (1985) pelo Jackson Memorial Hospital da Universidade de Miami, EUA. Obteve o título de mestre (1988) e doutor (1991) em Neurologia pela Universidade Federal de São Paulo e pós-doutorado (1993) pela Universidade de Lund, Suécia. Atualmente é Professor Livre Docente do Departamento de Neurologia e Neurocirurgia da Universidade Federal de São Paulo, onde dirige o Laboratório de Fisiopatologia Clínica e Experimental. Atua na área de Medicina (Neurologia e Clínica Médica), com ênfase em doenças neurodegenerativas e autoimunitárias.

 

Fonte:   http://www.pediatriadiadia.com.br/joomla/index.php/opniao/38-vitamina-d-solucao-para-doencas-autoimunitarias-e-neurodegenerativas-.html

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Informações médicas sobre a prevenção e tratamento de doenças neurodegenerativas

http://www.youtube.com/watch?v=yRQkITHjZ5k&feature=plcp

Assista também à entrevista de junho de 2012, no Programa Sem Censura:
https://www.youtube.com/watch?v=cIwIWim4hNM&list=UU5grjCGNi25VAR8J0eVuxVQ…

Entrevista em TV com o Dr. Cícero Galli Coimbra, professor neurologista da Universidade Federal de São Paulo – Unifesp.

“Comentário: a principal razão pela qual a medicina atual desdenha estes importantes conhecimentos médicos já antigos e com ampla fundamentação na história recente da medicina e confirmados em vários países, através de diversas publicações, é simplesmente porque ela está subordinada aos interesses extremamente gananciosos da indústria farmacêutica internacional. O SIMERS do RS costuma usar a frase de divulgação de sua existência como “A verdade faz bem para a saúde!”, nos meios de comunicação.”

“Cabe a pergunta: é verdade que os meios médicos gestores não ocultam a verdade já conhecida na medicina em prol de interesses estranhos aos dos pacientes?”

“Lembrem que há Resoluções do CFM proibindo a divulgação do conhecimento médico para a população e outras que simplesmente atropelam a realidade do conhecimento médico, como, por exemplo, a Resolução Resolução 1752/2004 do Conselho Federal de Medicina, hoje revogada, e que permitia o aborto dos anencéfalos,onde, em seus considerandos, redefinia morte encefálica como sendo morte cerebral e de exclusivo diagnóstico clínico.” [1]

http://biodireitomedicina.wordpress.com/2008/12/29/anencefalia-morte-encefalica-e-o-conselho-federal-de-medicina/

http://biodireitomedicina.wordpress.com/2010/08/03/vitamina-d-pode-revolucionar-o-tratamento-da-esclerose-multipla/

http://biodireitomedicina.wordpress.com/2010/03/20/vitamina-d-pode-combater-males-que-mais-matam-pessoas-no-mundo/

[1] Celso Galli Coimbra – OABRS 11352
http://biodireitomedicina.wordpress.com/

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SAO PAULO, BRAZIL. One of the key features of Parkinson’s disease (PD) is loss of motor control, that is, difficulty in walking and moving muscles as instructed by the brain; even turning over in bed can become increasingly difficult as PD progresses. The degree of motor function in a PD patient is often evaluated using the Hoehn and Yahr scale where 0% means that the patient requires assistance just to stand up while 100% means that the patient has full, normal motor control.

Researchers at the University of Sao Paulo now report that supplementing with riboflavin (vitamin-B2) and avoiding all red meat can markedly improve motor function in PD patients. Their study involved 31 PD patients and 10 dementia patients with no PD symptoms. Blood analysis showed that all 31 PD patients were deficient in riboflavin while only 3 of the 10 dementia patients exhibited a deficiency. The researchers also observed that the intake of red meat among the PD patients (2044 grams/week) was almost 3 times higher than that of 19 healthy random controls matched for age and similar social and cultural backgrounds (789 grams/week).

Other research has shown that a low riboflavin status is found in about 10-15% of the population and is associated with low activities of two important enzymes, erythrocyte glutathione reductase (EGR) and pyridoxin(pyridoxamine)-phosphate oxidase. Low EGR activity may be associated with the glutathione depletion and impaired antioxidant defense observed in PD patients even before their disease becomes clinically evident. Glutathione depletion would be particularly deleterious if accompanied by a high heme iron intake from red meat.

Based on the above theoretical considerations the researchers decided to supplement the PD patients with 30 mg of riboflavin every 8 hours while at the same time removing all red meat from their diet. The results were quite astounding. After just 3 months motor function had improved markedly and after 6 months the average motor capacity (Hoehn and Yahr scale) had increased from 44% to 71%. The treated patients also reported better sleep at night, improved reasoning, higher motivation, and reduced depression after as little as 2 weeks of treatment. Some very disabled patients were able to change body positions in bed as early as on the third day of treatment.

The riboflavin level in the treated patients increased from 106 ng/mL prior to treatment to 179 ng/mL after 1 month. Withholding riboflavin supplementation for a few days did not reverse the observed improvements indicating that some beneficial permanent changes had occurred due to the supplementation and total avoidance of red meat. The researchers conclude that riboflavin supplementation and red meat avoidance may be highly effective in halting and even reversing the progression of Parkinson’s disease.

Coimbra, C.G. and Junqueira, VBC. High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson’s disease patients. Brazilian Journal of Medical and Biological Research, Vol. 36, October 2003, pp. 1409-17

Riboflavin benefits Parkinson’s patients

http://neurotalk.psychcentral.com/showthread.php?s=becc080f2da9854016911cb25b94651b&t=151217

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Crianças que tomam pouco sol têm mais risco de ter asma, diz estudo

Vitamina D – Sem Censura – Dr. Cicero Galli Coimbra e Daniel Cunha – junho de 2012

http://www.youtube.com/watch?v=cIwIWim4hNM&list=UU5grjCGNi25VAR8J0eVuxVQ&index=4&feature=plcp

 

Referencias Médico-Científicas Sobre Tratamento, Cura e Prevenção, doenças neurodegenerativas e autoimunes. Vitamina D.

 

Vitamina D pode revolucionar o tratamento da esclerose múltipla*

http://biodireitomedicina.wordpress.com/category/doencas-autoimunes/

 

POR UM NOVO PARADIGMA DE CONDUTA E TRATAMENTO

http://www.institutodeautoimunidade.org.br/novo-paradigma.html

 

Por Dr. Cícero Galli Coimbra

Médico Internista e Neurologista

Professor Associado Livre-Docente da Universidade Federal de São Paulo

Presidente do Instituto de Investigação e Tratamento de Autoimunidade

 

O vídeo referido na reportagem dominical de 27.05.12  da Folha está no endereço:

Vitamina D – Por uma outra terapia (Vitamin D – For an alternative therapy)

 

http://biodireitomedicina.wordpress.com/2012/05/28/folha-de-sao-paulo-terapia-polemica-usa-vitamina-d-em-doses-altas-contra-esclerose-multipla/

 

Crianças que tomam pouco sol têm mais risco de ter asma, diz estudo

Raios UVB estão diretamente ligados à absorção de vitamina D pelo organismo

Estudo liderado por pesquisadores doPublic Health Centre, em Valência, Espanha, e publicado no International Journal of Biometeorology, afirma que avitamina D – que é principalmente absorvida do sol – desempenha importante papel na proteção contra a asma na infância. A pesquisa mostrou que crianças que vivem em cidades úmidas e frias possuem maior risco de desenvolver problemas respiratórios, devido a pouca exposição solar nesses lugares.

Foram observadas mais de 45 mil crianças de seis a sete anos de idade e adolescentes de 13 a 14 anos, de nove cidades espanholas. Para descobrir quais crianças dessas cidades tinham asma, os estudiosos usaram os dados do International Study of Asthma and Allergies (ISAAC).

Ao cruzarem a prevalência da doença com a média anual de horas de sol – um índice chamado MASH, de mean annual sunny hours – e umidade relativa, os cientistas perceberam que as crianças de seis a sete anos, que moravam em regiões com menor MASH e maior índice de umidade relativa – como no norte da Espanha -, eram as mais afetadas pela doença.

Segundo os autores do estudo, o sol é fundamental para a absorção de vitamina D pelo organismo, visto que a exposição solar é responsável por 90% de sua obtenção. Essa vitamina, continuam, é extremamente importante para a prevenção da asma, tuberculose e outras doenças infecciosas.

Aposte na Vitamina D para manter a saúde em dia

Além de ser vital para regular a pressão arterial, mantendo o sistema nervoso nos trilhos, a vitamina D entra em ação para absorver o cálcio e o fósforo, fortalecer nosso sistema auto-imune e atuar na secreção de insulina.

“Essa vitamina pode ser encontrada no leite, no salmão, sardinha, óleo de fígado de peixe, cogumelo, ovos e alguns cereais que são fortificados com essa vitamina”, explica a nutricionista Cristiane Mara Cedro.

Entretanto, uma maneira boa de manter níveis adequados dessa vitamina é tomar sol de 10 a 15 minutos duas vezes ao dia, pois a luz solar é uma das principais fontes de absorção do nutriente. O responsável por esse estímulo é ninguém menos que o raio UVB. Em outras palavras, apesar de perigoso em doses exageradas, o UVB é sim necessário à saúde. “Em algumas épocas, a exposição aos raios solares é menor, o que desfavorece a síntese de vitamina D”, afirma a dermatologista Daniela Taniguchi. Dessa forma, é importante para pessoas com limitação de exposição ao sol incluir boas fontes de Vitamina D na dieta.

A ingestão recomendada pelo U.S. Dietary Reference Intake – para crianças e adultos até 50 anos – é de cinco microgramas por dia (200 UI/dia). A recomendação aumenta para 10 microgramas/dia (400 UI/dia), para pessoas entre 50 e 71 anos de idade, e para 15 microgramas/dia para idosos acima dos 70 anos. Para saber como ingerir corretamente essas doses, vale ficar atento aos rótulos dos alimentos.

Fonte: Portal Minha Vida

http://salvemasnossascriancas.blogspot.com.br/2010/12/recem-nascidos-com-baixos-niveis-de.html

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Vitamina D: Níveis baixos aumentam risco de infecções respiratórias no bebé

 

Vitamina D – Sem Censura – Dr. Cicero Galli Coimbra e Daniel Cunha – junho de 2012

http://www.youtube.com/watch?v=cIwIWim4hNM&list=UU5grjCGNi25VAR8J0eVuxVQ&index=4&feature=plcp

Referencias Médico-Científicas Sobre Tratamento, Cura e Prevenção, doenças neurodegenerativas e autoimunes. Vitamina D.

Vitamina D pode revolucionar o tratamento da esclerose múltipla*

http://biodireitomedicina.wordpress.com/category/doencas-autoimunes/

 

POR UM NOVO PARADIGMA DE CONDUTA E TRATAMENTO

http://www.institutodeautoimunidade.org.br/novo-paradigma.html

 

Por Dr. Cícero Galli Coimbra

Médico Internista e Neurologista

Professor Associado Livre-Docente da Universidade Federal de São Paulo

Presidente do Instituto de Investigação e Tratamento de Autoimunidade

 

O vídeo referido na reportagem dominical de 27.05.12  da Folha está no endereço:

Vitamina D – Por uma outra terapia (Vitamin D – For an alternative therapy)

 

http://biodireitomedicina.wordpress.com/2012/05/28/folha-de-sao-paulo-terapia-polemica-usa-vitamina-d-em-doses-altas-contra-esclerose-multipla/

 

Níveis baixos aumentam risco de infecções respiratórias no bebé

 

Vitamina D:

 

Os níveis de vitamina D nos recém-nascidos parecem prever o risco de infecções respiratórias e ocorrência de sibilos asmáticos durante a infância, mas não o risco de desenvolver asma, de acordo com um estudo do Massachusetts General Hospital, nos EUA, publicado na revista “Pediatrics”.

Os resultados apoiam a teoria de que a deficiência de vitamina D contribui para aumentar o risco de infecções. Segundo explicou Carlos Camargo, líder da equipa de investigadores, em comunicado, “os dados sugerem que a associação entre a vitamina D e sibilância asmática – que pode ser um sintoma de muitas doenças respiratórias, e não só de asma – se deve em grande parte às infecções respiratórias”.

O investigador acrescenta que as infecções respiratórias agudas são um importante problema de saúde nas crianças, como no caso da bronquiolite. Para a investigação, os cientistas analisaram dados de um estudo sobre asma e alergia na Nova Zelândia e acompanharam mais de mil crianças das cidades de Wellington e Christchurch. Para a análise foram recolhidas amostras de sangue do cordão umbilical dos recém-nascidos de mulheres que participaram no estudo. Essas mães também foram submetidas a um questionário sobre saúde respiratória das crianças.

As amostras do sangue do cordão umbilical foram analisadas em relação aos níveis de 25-hidroxivitamina D (25OHD), considerada a melhor medida para a presença da vitamina D. Os autores foram capazes de avaliar as amostras do sangue do cordão umbilical de 922 bebés. Desses, mais de 20% tinham níveis de 25OHD menor que 25nmol / L, que é considerado muito baixo. O nível médio de 44 nmol / L ainda foi considerado deficiente e os níveis mais baixos eram mais comuns entre as crianças nascidas no Inverno, com menor nível socioeconómico e história familiar de asma e tabagismo.

Aos três meses, os bebés com valores de 25OHD abaixo de 25 nmol / L apresentaram um risco duas vezes mais elevado de desenvolver infecções respiratórias do que aqueles que tinham níveis de 75 nmol / L ou mais. Os resultados, que cobrem os cinco primeiros anos de vida dos participantes, mostraram que os níveis mais baixos de 25OHD no recém-nascido, estavam associados a um maior risco cumulativo de sibilos asmáticos durante este período.

No entanto, os autores não encontraram qualquer associação entre os níveis de 25OHD e um diagnóstico de asma aos cinco anos. Além disso, estudos anteriores sugeriram que os níveis particularmente altos de vitamina D podem aumentar o risco de alergia, mas essa associação não foi observada entre os participantes deste estudo com níveis mais elevados de 25OHD. O estado de vitamina D foi determinado principalmente pela exposição ao sol, já que muito poucos tomavam suplementos.

20 de janeiro de 2011

Fonte: ALERT

 http://saude.sapo.pt/noticias/saude-medicina/vitamina-d.htmlhttp://saude.sapo.pt/noticias/saude-medicina/vitamina-d.html

Vitamina D e problemas da respiração – asma

Vitamina D e problemas da respiração – asma

 

 Segundo um estudo publicado recentemente no Journal of Allergy & Clinical Immunology, existe uma relação entre os níveis de vitamina D e a quantidade de medicação usada pelas crianças com asma.
Segundo os autores deste estudo. as crianças asmáticas com niveis menores de vitamina D, apresentavam uma menor função pulmonar e necessitavam de mais medicação que outras crianças asmáticas, mas com niveis superiores de vitamina D.

Comentários:
  – A vitamina D é sintetizada por nós, quando a nossa pele apanha sol.
– A deficiência em vitamina D é um tema que tem vindo a ser bastante discutido, devido em parte ao importante papel desta vitamina no nosso organismo.

Sugestões:
– Agora que o tempo está a melhorar, faça mais actividades ao ar livre, de maneira que a sua criança apanhe todo o sol a que tem direito…
– Passamos demasiado tempo fechados dentro de 4 paredes, e todas as oportunidade são boas para sair. Faz bem à mente e à saude.

Nota: imagem retirada daqui

Sexta-Feira, 28 Maio, 2010

http://www.cristinasales.pt/Nutri-Conceito/Blog/Post.aspx?BID=3&PID=578&MVID=1000194

——————-

Cura do mal de Parkinson, a DP, ocorre por terapia natural

 

Cura do mal de Parkinson, a DP, ocorre por terapia natural

 

A cura com Dr. Cícero Galli Coimbra. Parkinson, Estresse emocional, depressão, doenças autoimunes e neurodegenerativas.

 

vídeo

http://www.youtube.com/watch?v=yRQkITHjZ5k&feature=player_embedded#!

 

”Terapêutica simples, não onerosa, dotada eficácia largamente superior àquelas até então disponíveis, além de não ser patenteável.”’

Prof. Dr. Cicero Galli Coimbra e Profa. Dra. Virgínia Berlanga Campos Junqueira

http://www.unifesp.br/dneuro/nexp/riboflavina/

Publicada cura do Parkinson em Revista Medica Internacional

 

Publicada cura do Parkinson em Revista Medica Internacional

 

Braz J Med Biol Res v.36 n.10 Ribeirão Preto out. 2003

doi: 10.1590/S0100-879X2003001000019

Braz J Med Biol Res, October 2003, Volume 36(10) 1409-1417

 

High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson’s disease patients

 

C.G. Coimbra1,2 and V.B.C. Junqueira3,4

1Setor de Neurologia

 

Disponivel em

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2003001000019&lng=pt&nrm=iso

 

 

Natural Treatment For Parkinson’s disease from 2003

Natural Treatment For Parkinson’s disease from 2003

 

High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson’s disease patients

 

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2003001000019

 

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Brazilian Journal of Medical and Biological Research

On-line version ISSN 1414-431X

Braz J Med Biol Res vol.36 no.10 Ribeirão Preto Oct. 2003

http://dx.doi.org/10.1590/S0100-879X2003001000019

Braz J Med Biol Res, October 2003, Volume 36(10) 1409-1417

High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson’s disease patients

C.G. Coimbra1,2 and V.B.C. Junqueira3,4

1Setor de Neurologia,Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brasil
2Departamento de Neurologia e Neurocirurgia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
3Disciplina de Geriatria, Departamento de Medicina, Centro de Estudos do Envelhecimento, Universidade Federal de São Paulo, São Paulo, SP, Brasil
4VITÆ – Cromatografia Líquida em Análises Clínicas S/C Ltda., São Paulo, SP, Brasil

Abstract
Introduction
Patients and Methods
Results
Discussion
References
Acknowledgments
Correspondence and Footnotes


Abstract

Abnormal riboflavin status in the absence of a dietary deficiency was detected in 31 consecutive outpatients with Parkinson’s disease (PD), while the classical determinants of homocysteine levels (B6, folic acid, and B12) were usually within normal limits. In contrast, only 3 of 10 consecutive outpatients with dementia without previous stroke had abnormal riboflavin status. The data for 12 patients who did not complete 6 months of therapy or did not comply with the proposed treatment paradigm were excluded from analysis. Nineteen PD patients (8 males and 11 females, mean age ± SD = 66.2 ± 8.6 years; 3, 3, 2, 5, and 6 patients in Hoehn and Yahr stages I to V) received riboflavin orally (30 mg every 8 h) plus their usual symptomatic medications and all red meat was eliminated from their diet. After 1 month the riboflavin status of the patients was normalized from 106.4 ± 34.9 to 179.2 ± 23 ng/ml (N = 9). Motor capacity was measured by a modification of the scoring system of Hoehn and Yahr, which reports motor capacity as percent. All 19 patients who completed 6 months of treatment showed improved motor capacity during the first three months and most reached a plateau while 5/19 continued to improve in the 3- to 6-month interval. Their average motor capacity increased from 44 to 71% after 6 months, increasing significantly every month compared with their own pretreatment status (P < 0.001, Wilcoxon signed rank test). Discontinuation of riboflavin for several days did not impair motor capacity and yellowish urine was the only side effect observed. The data show that the proposed treatment improves the clinical condition of PD patients. Riboflavin-sensitive mechanisms involved in PD may include glutathione depletion, cumulative mitochondrial DNA mutations, disturbed mitochondrial protein complexes, and abnormal iron metabolism. More studies are required to identify the mechanisms involved.

Key words: Parkinson’s disease, Riboflavin, Flavin-adenine dinucleotide, Glutathione, Iron, Hemin


 

Introduction

During absorption of riboflavin, flavokinase phosphorylates the vitamin to yield flavin mononucleotide (FMN) that, according to the cellular requirements, is transformed into flavin-adenine dinucleotide (FAD) by FAD synthase (1,2). Progressive deficiency of riboflavin is associated with co-factor loss in a controlled manner, apparently ensuring that essential catalytic activity such as that related to aerobic metabolism is preserved (3,4).

Low riboflavin status may also result from defective absorption. In spite of an adequate dietary intake of riboflavin (FAD, vitamin B2), 10-15% of the inhabitants of London and of Florence present low activities of two riboflavin-dependent enzymes – erythrocyte glutathione reductase (EGR) and pyridoxin(pyridoxamine)-phosphate oxidase (5). The activity of both enzymes was corrected by adding their respective co-factors (FAD or FMN) to a test tube assay or by administering high doses of riboflavin (24-30 mg per day for 5-8 weeks) to the affected individuals (6). The dependency of both FMN and FAD levels on riboflavin absorption (i.e., on flavokinase activity), and the normalization of the activities of both FMN- and FAD-dependent enzymes only at a high riboflavin intake, taken together, are consistent with the expression of flavokinase isoforms with low affinity for the substrate – riboflavin (5). Anderson et al. (5) suggested that the relatively large percent of persons with altered riboflavin absorption (10-15%) may reflect the situation in the world population rather than being a feature of a particular ethnic group.

Low EGR activity may explain glutathione depletion with impaired antioxidant defense, the earliest neurochemical abnormality in Parkinson’s disease (PD), already observed in the substantia nigra before the disorder becomes clinically evident (7). Moreover, the reduced bioavailability of FMN and/or FAD may also explain the impaired oxidative metabolism of PD patients (8-10).

The first objective of the present study was to determine the status of riboflavin in PD patients. The second was to evaluate the specificity of the alterations of riboflavin status for PD by measuring the levels of vitamin B2 and of other determinants of homocystinemia (vitamins B6, B12, and folic acid) in PD patients and comparing them with those of individuals with dementia (11-13). Third, we also determined the effect of normalization of riboflavin status on the motor capacity of PD patients. Part of the data reported here, obtained during the first 3 months of treatment, were reported at the 6th International Conference on Parkinson’s and Alzheimer’s Diseases (14).


 

Patients and Methods

This study was approved by the Ethics Committee for Clinical Research of the Hospital do Servidor Público Municipal de São Paulo (HSPM) and informed consent was obtained from all participants or persons responsible for them.

The diagnosis of sporadic PD was made according to current criteria (15) with special care taken to exclude confounding disorders, particularly in the early stages of the disease.

Vitamin and homocysteine determinations were performed on 31 sporadic PD patients (67.5 ± 9.3 years old, 13 males and 18 females): 3, 3, 3, 8, and 14 patients were assigned, early in the morning, to stages I to V of Hoehn and Yahr (16), respectively.

Ten individuals (77.5 ± 8.8 years old, 5 males and 5 females) with dementia without stroke (DwoSt) and a low Mini-Mental score (13) were used as the control group for blood chemistry. They had no history of stroke or evidence for ischemic lesions of the brain by CT or NMRI and had been consecutively attended in the Neurology Clinic of HSPM.

Blood samples were obtained after a 10- to 12-h fast for serum assays of vitamin B12 by electrochemiluminescence immunoassay (11820753 Roche Diagnostics GmbH, Mannheim, Germany) and of homocysteine by HPLC (17). Heparinized plasma was assayed for FAD (18), vitamin B6 (19), and folic acid (20)by HPLC, as well as for the determination of the EGR-activation coefficient (EGR-AC) (21) in red blood cell lysates (22).

A food questionnaire covered the weekly dietary habits of all PD and DwoSt patients from 5 years prior to the onset of PD until the appearance of spontaneous changes associated with the onset of chewing and/or swallowing impairment or until the medical interview in the absence of these impairments. The questionnaire also evaluated the adequacy of daily vitamin intake.

All PD patients received 30 mg riboflavin orally at about 8-h intervals (90 mg/day) and their usual symptomatic medications. This dosage was used to avoid decreased absorption associated with higher doses or shorter intervals between administrations. Due to the renal excretion of riboflavin (3), the treatment was only initiated after confirmation of normal blood levels of creatinine (0.5-1.4 mg/dl). Because the PD patients had a higher consumption of red meat (beef and pork) than sex-matched controls (19 healthy non-consanguineous relatives or neighbors of similar age recruited for controlling the dietary habits), all PD patients were required to eliminate all red meat from their diets. The symptomatic drugs for PD in use included L-DOPA with carbidopa (200/50 mg tablets), L-DOPA with benserazide hydrochloride (200/50 mg tablets), biperiden (2 or 4 mg tablets), amantadine hydrochloride (100 mg tablets), selegiline (5 mg tablets), and pramipexole (0.25 or 1.0 mg tablets) taken alone or in diverse combinations. The treatment paradigm with symptomatic drugs for PD for each patient when the study began was maintained.

The motor capacities of the 19 PD patients who complied with the proposed treatment for 6 months by early August 2003 were rated monthly according to a motor function scale (Table 1), and compared with their own pretreatment values. The scale was based on that of Hoehn and Yahr (16) and new categories were added in order to detect subtle changes in the patients’ motor capacity. In addition, the presence or absence of responses to symptomatic drugs for PD is also used for more accurate characterization of the residual motor capacity of PD patients (for instance, compare the descriptions corresponding to 0 and 15% of motor capacity, Table 1). Although there are no direct validation studies of this rating system, the different levels of motor capacity in Table 1 represent a simple increase in the number of components within stages I to V of the widely employed Hoehn and Yahr system (16).

After the first month of treatment, compliance with the dietary directions and vitamin intake was determined in all patients, and the fasting plasma levels of FAD and EGR-AC values were re-evaluated in 9 of them approximately 9-12 h after the latest riboflavin dose.

The blood chemistry data obtained from both groups were compared statistically by the Student t-test and the motor function data were analyzed statistically by the Wilcoxon signed rank test, with the level of significance set at P < 0.05.


 

Results

Diversified food intake, including daily ingestion of milk, which is particularly rich in vitamin B2, was confirmed in all patients, with PD patients frequently declaring a strong preference for red meat. The content of the daily family meals was usually adapted to meet the high demand for red meat of most PD patients. In contrast, all 10 DwoSt patients passively accepted the family diet. The estimated red meat consumption prior to the onset of impaired chewing/swallowing by 19 PD patients (8 males and 11 females, mean age ± SD = 66.2 ± 8.6 years) at lunch and dinner within a 7-day period was significantly higher (mean consumption = 2,044 ± 1,439 g/week, range = 0-5,100 g/week) than that of their 19 diet controls (8 males and 11 females, all healthy individuals of similar social and cultural background, recruited among non-consanguineous relatives and neighbors of PD patients of similar age; mean age = 64.6 ± 11.3 years, mean consumption = 789 ± 509 g/week, range = 150-1800 g/week; P < 0.01, Mann-Whitney U-test). The calorie intake did not differ significantly between the two groups.

The basal plasma concentrations of FAD of the PD patients (100.9 ± 22 ng/ml) were significantly lower than those observed in the patients with DwoSt (128.8 ± 25.6 ng/ml, P < 0.01, Student t-test) while other determinants of homocysteine levels (pyridoxine, folic acid, and methylcobalamin) were usually within normal limits, and did not differ significantly between the two groups (Table 2). The PD group also had significantly higher EGR-AC levels than DwoSt patients (1.43 ± 0.26 vs 1.20 ± 0.11, respectively, P < 0.01, Student t-test).

It is important to point out that all 31 PD patients (including 3 newly diagnosed individuals not on symptomatic drugs for PD) but only 3 of 10 DwoSt patients had low plasma riboflavin levels. Normalization of the plasma concentrations of riboflavin and EGR-AC values was confirmed after 1 month of treatment (from 106.4 ± 34.9 to 179.2 ± 23.0 ng/ml, and from 1.40 ± 0.25 to 1.11 ± 0.08, N = 9, respectively).

About 10 to 15 days after the beginning of high-dose riboflavin treatment, PD patients often reported better (progressively less interrupted) sleep at night, improved reasoning, higher motivation, and reduced depression. Their family members usually started noticing motor improvements after 20 days of treatment, but in some cases of advanced disability the patient was able to change body position in bed at night as early as on the third day of treatment.

By the time of writing this report in August 2003, 19 PD patients (respectively, 3, 3, 2, 5, and 6 patients initially rated as stages I to V of Hoehn and Yahr (16)) had completed 6 months of treatment with riboflavin administration and dietary red meat elimination. The data in Figure 1A show that all of them improved their motor capacity during the first 3 months and most reached a plateau, while 5/19 continued to improve in the 3- to 6-month interval. Figure 1B shows that the average motor capacity for these 19 patients increased from 44 to 71%. Their motor capacity increased significantly during the first month and every month for the next 5 months of treatment compared with their own pretreatment status, demonstrating a progressive and marked improvement (P < 0.001, Wilcoxon signed rank test). The rate of motor recovery was higher in the first 3 months than in the last 3 months of treatment. No patient on high doses of riboflavin reported adverse effects.

Because they could stand and walk with improved (although still altered) balance by 2 months of treatment, two male patients (initially in stage V (16) with associated dementia and hallucinations) started striking imaginary persons and/or often attempted to leave home unaccompanied, reacting aggressively against the relative who tried to stop them. These episodes of agitation and aggressiveness were observed less often by the end of the third month of riboflavin treatment and disappeared thereafter, but caused transient concern and distress among their family members who initially regarded them as signs of neurological worsening.

Three patients (2 individuals initially in stage II and 1 in stage I of Hoehn and Yahr (16)) reached 100% motor capacity within the first 3 months of treatment (Figure 1A). Four patients had run out of riboflavin tablets for up to 7 days between two consecutive clinical appointments, but sustained the benefit already achieved by then.

Twelve of 31 patients initially assessed for riboflavin status who either did not complete 6 months of therapy or did not comply with the proposed treatment paradigm were excluded from statistical analysis.


 

Figure 1. Motor capacity of patients with Parkinson’s disease who received 30 mg riboflavin/8 h, orally (240 mg/day) and abstained from dietary red meat for 6 months. Motor capacity was evaluated monthly for each patient by a modification of the method of Hoehn and Yahr (16) to provide a score in percent (Table 1). A, Individual data for the evolution of motor capacity of 19 patients for 0 to 3 and 3 to 6 months of treatment. *P < 0.001 for values at 3 months (month 0) compared with those before treatment; **P < 0.05 for values at 6 months compared with those obtained at 3 months (Wilcoxon signed rank test). B, The height of the columns indicates the mean motor capacity values (see Table 1) after the indicated periods of treatment. When compared with their own basal levels (month 0), highly significant and progressively higher differences were observed for each consecutive month of treatment. *P < 0.001 (Wilcoxon signed rank test).

View larger version of this image (29 K GIF file)]


 

Discussion

This study demonstrated a progressive and marked improvement of motor capacity in consecutively evaluated patients with sporadic PD who started with below normal laboratory indexes of riboflavin and who eliminated red meat from their diets while receiving high multiple daily doses of riboflavin over a period of 6 months while taking their usual symptomatic medications. The mean motor capacity of a group of 19 PD patients showed a progressive 50% recovery over a period of only 3 months – a most surprisingly high and fast improvement, considering that about 60% of nigral neurons have already been lost at the onset of manifestations of PD (15).

The initial riboflavin status was low in all 31 consecutively evaluated PD individuals, and significantly lower in PD patients compared with those with another neurodegenerative disease also associated with hyperhomocystinemia (DwoSt), suggesting that abnormal riboflavin status may be a specific feature of PD rather than a minor metabolic contributor to the degeneration of nigral neurons. Taken together with the rapid and profound neurological improvement associated with normalization of riboflavin status, this observation suggests that altered riboflavin status may be a cause of neurodegeneration in PD.

Although urinary excretion of riboflavin peaks within 1-2 h and returns to baseline within 5-6 h after a large oral dose (3), the benefit achieved did not vanish in four PD patients over a therapeutic interval of up to 7 days. This observation suggests the occurrence of steady plastic changes rather than a pharmacological effect of high-dose riboflavin treatment to account for the improved motor capacity shown in Figure 1. The steady build-up of the motor recovery observed during the first 3 months of treatment suggests that this treatment paradigm may inactivate fundamental neurodegenerative mechanisms (e.g., glutathione depletion, considered to be an early key event in the pathogenesis of PD (23,24)), possibly allowing regenerative plastic phenomena to occur.

The importance of the elimination of dietary red meat for the results reported here is not known. The content of vitamin B2 in meat in general is considerable (about 0.2 mg/100 g), and diverse cooking procedures cause only minor (7-18%) loss of this micronutrient (25). The daily requirement for individuals above the age of 14 years is £1.3 mg/day. Therefore, if the PD patients had a normal absorptive capacity for vitamin B2, their large ingestion of red meat (up to 700 g/day), associated with milk, rice and beans, fruits and vegetables, should have provided a normal riboflavin status. In contrast, 31 consecutive PD patients had laboratory evidence for riboflavin deficiency (Table 2) suggesting that patients with sporadic PD belong to the subset of the general population (10-15%) (3) that may express a flavokinase with low affinity for vitamin B2, leading to a decreased absorption.

However, the digestion of red meat releases hemin, a highly diffusible toxin that, when not properly inactivated, increases intracellular iron concentrations and enhances hydroxyl radical production (Fenton reaction). Most of the absorbed hemin is destroyed by the enzyme heme oxygenase (HO) in the digestive tract and liver (26). Because HO is oxidized during the catabolization of hemin to biliverdin, the HO molecules must be reduced through the coordinated activity of the flavoenzyme cytochrome P450 reductase for continued hemin inactivation (Figure 2) (27). Cytochrome P450 reductase is particularly sensitive to riboflavin deficiency because it requires both FMN and FAD as prosthetic groups (28). It is possible that individuals with decreased absorption of vitamin B2 may not completely inactivate high dietary levels of hemin, allowing this neurotoxic compound to reach the brain cells. Consistently, the staining for HO-1 isozyme is increased in astrocytes and reacts with neuronal Lewy bodies in the nigra of PD patients, suggesting that its overexpression may contribute to the pathological iron deposition and mitochondrial damage in PD (29). By binding glutathione (30) hemin may further decrease glutathione levels in the brains of PD patients through a direct mechanism.

Because humans lack efficient iron excretory mechanisms, iron excess is dealt with by increasing the synthesis of the iron-storage protein ferritin (31). Disturbed systemic (32) and brain (33) iron metabolism has been reported in PD, suggesting that a selective decrease in the levels of ferritin may result in an increase in intracellular free iron, thereby enhancing free radical production (34). Indeed, vitamin B2 deficiency in rodents is associated with low circulating iron concentrations, increased iron turnover and excretion into the intestinal lumen, which may occur in response to impaired ferritin synthesis (35,36). Therefore, the consistent finding of an abnormal riboflavin status in PD, as reported here, may help to explain the disturbed iron metabolism found in PD patients, with the underlying mechanisms possibly involving impaired hemin catabolism and reduced ferritin synthesis. Interestingly, the highest world prevalence of PD is found among the inhabitants of Buenos Aires (37), where the consumption of red meat is traditionally high. Similarly, the identification of high dietary animal fat as a risk factor for PD (37) may actually reflect a role of high dietary hemin in PD pathology.

Moreover, because FAD is required in the two alternative pathways of deoxynucleotide synthesis (2), DNA repair and replication are expected to be disturbed upon decreased bioavailability of riboflavin, and abnormal riboflavin status may also explain the cumulative mitochondrial DNA mutations reported in PD (38).

The present results with 19 PD patients who showed a significant improvement in motor function after treatment with riboflavin and the elimination of red meat from the diet suggest that an abnormal riboflavin status, possibly due to flavokinase deficiency, may be an essential requirement for triggering and sustaining the degeneration of dopaminergic neurons in PD. As a result of the reduced B2 bioavailability, ATP production is selectively preserved, while the less critical FAD- or FMN-dependent metabolic pathways are impaired (4). Consequently, free iron concentrations in the cytosol increase as a result of impaired ferritin synthesis and/or reduced hemin catabolism associated with hydrogen peroxide accumulation due to glutathione depletion, thereby triggering the Fenton reaction and ultimately leading to the selective formation of the potent neurotoxin 6(OH)DA in dopaminergic neurons.

Current concepts about the cause of sporadic PD suggest an inherited predisposition to environmental or endogenous toxic agents (39), and the data presented and reviewed here suggest that flavokinase deficiency should be considered in future research as a promising candidate to account for this inherited predisposition, while dietary factors such as red meat consumption may largely account for the environmental/endogenous toxicity. The administration of high doses of riboflavin combined or not with red meat elimination may be an effective therapeutic paradigm addressing the determinants of PD, capable of providing regression to earlier clinical stages, or even to the nonsymptomatic state without symptomatic drugs for PD (at least in some cases), rather than only disease stabilization or partial symptomatic relief.

Although the relentless progression of PD clearly contrasts with the results of the treatment paradigm reported here, a larger and more prolonged study is certainly required to document the steadiness and the full extent of the ongoing recovery. A scientifically desirable blinded clinical trial with a placebo would necessarily leave known riboflavin-deficient patients untreated for a long period of time, when their neurological disability may progress as a consequence of sustained loss of nigral neurons, possibly rendering the ultimate response to delayed normalization of their riboflavin levels less complete. Therefore, the need for controlled trials should be weighed ethically considering the contrast of the natural history of PD (progress of motor disability to death despite an increase in the efficacy of symptomatic drugs for PD treatment) with the outcome of the vitamin B2 treatment observed in larger and more prolonged studies without controls.


Figure 2. Dependency of hemin catabolism on riboflavin bioavailability. The elimination of hemin requires cyclic reduction of heme oxygenase by flavoprotein cytochrome P450 reductase that, in turn, utilizes both flavin mononucleotide (FMN) and flavin-adenine dinucleotide (FAD) as prosthetic groups. Average or increased red meat consumption may overload the capacity of this chain of reactions already compromised by impaired intestinal absorption of riboflavin (with decreased FMN and FAD synthesis), leading to increased hemin (iron) delivery to the CNS and increased utilization of riboflavin for hemin inactivation. Modified from Figure 1, box 21-1, page 783 of Ref. 2.

[View larger version of this image (17 K GIF file)]


 

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Acknowledgments

The authors are grateful to Mr. Terence O’Reilly (Novartis, Basel, Switzerland) for his suggestions about statistical analysis.


Correspondence and Footnotes

Address for correspondence: C.G. Coimbra, UNIFESP, Rua Pedro de Toledo, 781, 7º andar, 04039-032 São Paulo, SP, Brasil. Fax: +55-11-5539-3123. E-mail: coimbracg.nexp@epm.br

Publication supported by FAPESP. Received August 13, 2003. Accepted August 27, 2003.

 Brazilian Journal of Medical and Biological Research

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High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson’s disease patients. C.G. Coimbra and V.B.C. Junqueira. Brazilian Journal of Medical and Biological Research, 36 (10): 1409, 2003.

Figure 1. Motor capacity of patients with Parkinson’s disease who received 30 mg riboflavin/8 h, orally (240 mg/day) and abstained from dietary red meat for 6 months. Motor capacity was evaluated monthly for each patient by a modification of the method of Hoehn and Yahr (16) to provide a score in percent (Table 1). A, Individual data for the evolution of motor capacity of 19 patients for 0 to 3 and 3 to 6 months of treatment. *P < 0.001 for values at 3 months (month 0) compared with those before treatment; **P < 0.05 for values at 6 months compared with those obtained at 3 months (Wilcoxon signed rank test). B, The height of the columns indicates the mean motor capacity values (see Table 1) after the indicated periods of treatment. When compared with their own basal levels (month 0), highly significant and progressively higher differences were observed for each consecutive month of treatment. *P < 0.001 (Wilcoxon signed rank test).

High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson’s disease patients. C.G. Coimbra and V.B.C. Junqueira. Brazilian Journal of Medical and Biological Research, 36 (10): 1409, 2003.

Figure 2. Dependency of hemin catabolism on riboflavin bioavailability. The elimination of hemin requires cyclic reduction of heme oxygenase by flavoprotein cytochrome P450 reductase that, in turn, utilizes both flavin mononucleotide (FMN) and flavin-adenine dinucleotide (FAD) as prosthetic groups. Average or increased red meat consumption may overload the capacity of this chain of reactions already compromised by impaired intestinal absorption of riboflavin (with decreased FMN and FAD synthesis), leading to increased hemin (iron) delivery to the CNS and increased utilization of riboflavin for hemin inactivation. Modified from Figure 1, box 21-1, page 783 of Ref. 2.

High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson’s disease patients. C.G. Coimbra and V.B.C. Junqueira. Brazilian Journal of Medical and Biological Research, 36 (10): 1409, 2003.

Figure 2. Dependency of hemin catabolism on riboflavin bioavailability. The elimination of hemin requires cyclic reduction of heme oxygenase by flavoprotein cytochrome P450 reductase that, in turn, utilizes both flavin mononucleotide (FMN) and flavin-adenine dinucleotide (FAD) as prosthetic groups. Average or increased red meat consumption may overload the capacity of this chain of reactions already compromised by impaired intestinal absorption of riboflavin (with decreased FMN and FAD synthesis), leading to increased hemin (iron) delivery to the CNS and increased utilization of riboflavin for hemin inactivation. Modified from Figure 1, box 21-1, page 783 of Ref. 2.

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