Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet.

Aggressive primary brain tumors (APBT) glioblastoma multiforme and grade IV astrocytoma are treated with multimodality treatments that include surgery to remove as much tumor as possible without sacrificing neurological function followed by radiation therapy and chemotherapy usually temozolomide. Survivals in adults are in the range of 8-16 months. The addition of a ketogenic diet (KD) to rodents with transplanted brain tumors increased survival in nine of 11 animals to over 299 days compared to survival in untreated controls of 33 days and radiation only controls of 38 days. We treated humans with APBT with standard of care neurosurgery immediately followed by 6 weeks of an adjuvant ketogenic diet concurrent with radiation therapy and temozolomide. Twice daily measurements of blood ketones and glucose were recorded and the patients' diet was modified toward the goal of maintaining blood ketone levels approaching 3 mM. Of the nine patients who completed the protocol three younger patients age 32, 28, and 22 at enrollment are alive and employed with clinically stable disease and brain images 74, 58, and 52 months since diagnosis. All the six older patients mean age 55 have died with disease progression detected on average 8 months after Dx. In conclusion: 1. It is possible to implement and maintain dietary induced ketosis in patients with APBT; 2. The longer survivals observed in younger patients treated with KD need to be confirmed in larger studies that should be focused on younger patients possibly under age 40.

Insulin secretion and cyclooxygenase enzyme inhibition by cabernet sauvignon grape skin compounds.

Bioassay-guided isolation and purification of hexane and ethyl acetate extracts of Cabernet Sauvignon grape skin yielded nine compounds (1-9), which were identified as beta-sitosterol-6'-linolenoyl-3-O-beta-D-glucopyranoside (1), beta-sitosterol (2), beta-sitosterol-3-O-beta-D-glucoside (3), oleanolic acid (4), oleanolic aldehyde (5), resveratrol (6), (+)-epsilon-viniferin (7), (-)-catechin (8), and 1-triacontanol (9). The structures of these compounds were established by spectroscopic methods. The compounds were assayed for insulin production using an INS-1 cell assay. In a dose-response study, compound 4 stimulated insulin production of INS-1 cells by 20.23, 87.97, 1.13, and 6.38 ng of insulin/mg of protein at 6.25, 12.5, 25, and 50 microg/mL, respectively. This trend was similar to the dose-dependent insulin production of INS-1 cells by glucose. Compound 5 also showed a dose-dependent insulin production in this assay. The isolated compounds were also assayed for cyclooxygenase-1 and -2 (COX) enzyme inhibitory activities. At 100 microg/mL, compounds 2, 3, and 4 inhibited the COX-2 enzyme by 11, 12, and 10%, respectively, but did not show activities on the COX-1 enzyme. Compounds 6, 7, and 8 at 100 microg/mL inhibited the COX-1 enzyme by 98, 99, and 98%, respectively, and the COX-2 enzyme by 0, 47, and 72%, respectively. This is the first report of beta-sitosterol-6'-linolenoyl-3-O-beta-D-glucopyranoside (1) from grape skin and insulin secretion activities of compounds 4 and 5.