Pycnogenol® effects on skin elasticity and hydration coincide with increased gene expressions of collagen type I and hyaluronic acid synthase in women.

INTRODUCTION AND OBJECTIVES: In recent years there has been an increasing interest in the use of nutritional supplements to benefit human skin. Molecular evidence substantiating such effects, however, is scarce. In the present study we investigated whether nutritional supplementation of women with the standardized pine bark extract Pycnogenol® will improve their cosmetic appearance and relate these effects to expression of corresponding molecular markers of their skin. MATERIALS AND METHODS: For this purpose 20 healthy postmenopausal women were supplemented with Pycnogenol for 12 weeks. Before, during and after supplementation, their skin condition was assessed (i) by employing non-invasive, biophysical methods including corneometry, cutometry, visioscan and ultrasound analyses and (ii) by taking biopsies and subsequent PCR for gene expression analyses related to extracellular matrix homeostasis. RESULTS: Pycnogenol supplementation was well tolerated in all volunteers. Pycnogenol significantly improved hydration and elasticity of skin. These effects were most pronounced in women presenting with dry skin conditions prior to the start of supplementation. The skin-physiological improvement was accompanied by a significant increase in the mRNA expression of hyaluronic acid synthase-1 (HAS-1), an enzyme critically involved in the synthesis of hyaluronic acid, and a noticeable increase in gene expression involved in collagen de novo synthesis. CONCLUSIONS: This study provides skin-physiological and for the first time molecular evidence that Pycnogenol supplementation benefits human skin by increasing skin hydration and skin elasticity. These effects are most likely due to an increased synthesis of extracellular matrix molecules such as hyaluronic acid and possibly collagen. Pycnogenol supplementation may thus be useful to counteract the clinical signs of skin aging.

Inhaled nitric oxide versus intravenous vasodilators in severe pulmonary hypertension after cardiac surgery.

UNLABELLED: Inhaled nitric oxide (iNO) is superior to i.v. vasodilators for treatment of pulmonary hypertension (PH) after cardiac surgery, but iNO is a potentially toxic gas, and patient subsets who benefit from iNO are not yet clearly defined. We administered iNO 40 ppm, prostaglandin E1 (PGE1) 0.1 microg x kg(-1) min(-1), and nitroglycerin (NTG) 3 to 5 microg x kg(-1) min(-1), in a randomized crossover study to 14 adult patients with severe PH after cardiac surgery. iNO, PGE1, and NTG were of similar efficacy in reducing pulmonary vascular resistance (P = 0.003). iNO induced selective pulmonary vasodilation, while PGE1 and NTG had significant concomitant systemic vasodilatory effects. iNO led to an increase in cardiac index (CI) (P = 0.012), and PGE1 increased CI (P = 0.006) and right ventricular (RV) ejection fraction (P = 0.015), while NTG had no effect on CI and RV performance. After study completion, patients continued with PGE1 administration with favorable in-hospital outcome. We conclude that PH per se, even if severe, does not necessarily imply postoperative RV dysfunction, and selective pulmonary vasodilation with iNO may not be superior to PGE1 with regard to CI and RV performance. IMPLICATIONS: In a prospective, randomized crossover study of inhaled nitric oxide (iNO) versus IV vasodilators, performed in adult patients with severe pulmonary hypertension but preserved right ventricular function after cardiac surgery, iNO was not superior to IV prostaglandin E1 with regard to cardiac index and right ventricular performance. Considering the potential toxicity of iNO, better definition of patient subsets with a positive benefit/risk ratio is warranted.

Substance P in the auditory hair cells in the guinea pig.

Previous immunohistochemical and electrophysiological studies on various neurotransmitters revealed the tachykinin substance P (SP) as a neuromodulator in the auditory system of mammals. This study was performed in order to determine the immunohistochemical expression and distribution pattern of SP in the organ of Corti, especially in the inner (IHC) and outer hair cell (OHC) region of the guinea pig. We examined the immunoreactivity of SP of surface preparations by means of a fluorescence and a laser scanning microscope. The electrophysiological action of SP, N-methyl-D-aspartate (NMDA) and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) were recorded at the subsynaptic afferent region of the IHCs using micro-iontophoretic techniques. The SP-like immunostaining could be detected at the basal and apical pole of the IHCs with a gradient distribution pattern from the basal to the apical turn. Furthermore, we could demonstrate SP-like immunoreactivity in OHCs with different occurrence in turns as well as in rows. Electrical activity was induced by applying SP, NMDA and AMPA perisynaptically to the IHCs. The selective SP antagonist spantide (D-Arg1, D-Trp7,9, Leu11-substance P) specifically blocked the SP-induced activity but without altering the activity of NMDA and AMPA. In contrast, specific NMDA or AMPA antagonists reversibly blocked either the NMDA- or AMPA-induced responses without affecting the SP-induced activity. These immunohistochemical and electrophysiological results confirm that SP may represent a neuromodulator function at the synapses of the IHCs in the guinea pig.

Enkephalin suppresses afferent cochlear neurotransmission.

The effects of enkephalin and naloxone, applied iontophoretically, were tested on induced firing activity of the afferent dendrites on inner hair cells in the guinea pig. Enkephalin strongly depresses the depolarizing effect of N-methyl-D-aspartate (NMDA), quisqualate and kainate. Enkephalin exerted a stronger inhibitory effect on non-NMDA-induced fibre activity than on NMDA-induced activity. It was possible to block this inhibitory effect by applying the opiate antagonist naloxone, which suggests a specific enkephalin action. Our results appear to demonstrate that enkephalin acts as a neurotransmitter or a neuromodulator in the efferent neurones of inner hair cells which have synaptic contact to the afferents of the inner hair cells.

Coping with breast cancer--a longitudinal prospective study.

In a prospective longitudinal study over several years, 58 patients with breast cancer are compared to 52 patients with fibrocystic disease and 24 patients with mastodynia. Results of coping (as assessed with the Bernese Coping Modes) are presented for the illness course of the first 6 months: (1) There is considerable variation of coping depending on illness situation and illness state. A core group of coping modes is predominant in most situations: 'attention & care', 'problem analysis', and 'Tackling'. In average 10 different coping modes were used by patients per given illness situation. (2) The different aspects of illness (in the same organ) ask for different coping. In the initial evaluation phase, however, the possibly fatal diagnosis overrides these differences. (3) Change over time (first 6 months) is net. Besides the core group of coping modes mentioned above, there is more variability in coping; in cancer a trend from a more fighting to a more accepting attitude is obvious; in fibrocystic disease more restricted coping is observed. Interdependence of coping with emotional stability and social adaptation will be studied as well.