ITMI20120982A1 - THE BLUEBERRY FOR THE PREVENTION OF POSTOPERATIVE COGNITIVE DYSFUNCTIONS - Google Patents
THE BLUEBERRY FOR THE PREVENTION OF POSTOPERATIVE COGNITIVE DYSFUNCTIONS Download PDFInfo
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- ITMI20120982A1 ITMI20120982A1 IT000982A ITMI20120982A ITMI20120982A1 IT MI20120982 A1 ITMI20120982 A1 IT MI20120982A1 IT 000982 A IT000982 A IT 000982A IT MI20120982 A ITMI20120982 A IT MI20120982A IT MI20120982 A1 ITMI20120982 A1 IT MI20120982A1
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- blueberry
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- 235000017537 Vaccinium myrtillus Nutrition 0.000 title claims description 14
- 208000026301 Postoperative Cognitive Complications Diseases 0.000 title claims description 7
- 230000002265 prevention Effects 0.000 title claims description 5
- 235000003095 Vaccinium corymbosum Nutrition 0.000 title description 7
- 235000021014 blueberries Nutrition 0.000 title description 7
- 240000000851 Vaccinium corymbosum Species 0.000 title 1
- 239000000284 extract Substances 0.000 claims description 19
- 235000011389 fruit/vegetable juice Nutrition 0.000 claims description 18
- 244000078534 Vaccinium myrtillus Species 0.000 claims description 13
- 240000001717 Vaccinium macrocarpon Species 0.000 claims description 12
- 235000012545 Vaccinium macrocarpon Nutrition 0.000 claims description 12
- 235000002118 Vaccinium oxycoccus Nutrition 0.000 claims description 12
- 235000004634 cranberry Nutrition 0.000 claims description 12
- 238000002695 general anesthesia Methods 0.000 claims description 6
- 238000001356 surgical procedure Methods 0.000 claims description 6
- 229940055416 blueberry extract Drugs 0.000 claims description 2
- 235000019216 blueberry extract Nutrition 0.000 claims description 2
- 238000012360 testing method Methods 0.000 description 10
- 230000015654 memory Effects 0.000 description 9
- 230000003935 attention Effects 0.000 description 7
- 238000011156 evaluation Methods 0.000 description 5
- 230000006872 improvement Effects 0.000 description 5
- LFQSCWFLJHTTHZ-UHFFFAOYSA-N Ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 description 4
- 206010002091 Anaesthesia Diseases 0.000 description 3
- 230000037005 anaesthesia Effects 0.000 description 3
- 230000013016 learning Effects 0.000 description 3
- 235000010208 anthocyanin Nutrition 0.000 description 2
- 229930002877 anthocyanin Natural products 0.000 description 2
- 239000004410 anthocyanin Substances 0.000 description 2
- 150000004636 anthocyanins Chemical class 0.000 description 2
- 230000002950 deficient Effects 0.000 description 2
- 230000001073 episodic memory Effects 0.000 description 2
- 230000010326 executive functioning Effects 0.000 description 2
- 230000006870 function Effects 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 230000007170 pathology Effects 0.000 description 2
- 230000009467 reduction Effects 0.000 description 2
- 238000012030 stroop test Methods 0.000 description 2
- 206010012289 Dementia Diseases 0.000 description 1
- 206010019196 Head injury Diseases 0.000 description 1
- 208000018737 Parkinson disease Diseases 0.000 description 1
- 208000004550 Postoperative Pain Diseases 0.000 description 1
- 230000001476 alcoholic effect Effects 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 230000003444 anaesthetic effect Effects 0.000 description 1
- 230000003110 anti-inflammatory effect Effects 0.000 description 1
- 230000000845 anti-microbial effect Effects 0.000 description 1
- 239000004599 antimicrobial Substances 0.000 description 1
- 230000003078 antioxidant effect Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000001767 chemoprotection Effects 0.000 description 1
- 230000007278 cognition impairment Effects 0.000 description 1
- 230000003930 cognitive ability Effects 0.000 description 1
- 230000001149 cognitive effect Effects 0.000 description 1
- 230000003920 cognitive function Effects 0.000 description 1
- 230000003931 cognitive performance Effects 0.000 description 1
- 230000006735 deficit Effects 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 206010013663 drug dependence Diseases 0.000 description 1
- 235000013399 edible fruits Nutrition 0.000 description 1
- 238000000605 extraction Methods 0.000 description 1
- 230000005802 health problem Effects 0.000 description 1
- 230000000055 hyoplipidemic effect Effects 0.000 description 1
- 230000002218 hypoglycaemic effect Effects 0.000 description 1
- 238000000338 in vitro Methods 0.000 description 1
- 238000001727 in vivo Methods 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 201000006417 multiple sclerosis Diseases 0.000 description 1
- 230000008447 perception Effects 0.000 description 1
- 230000000144 pharmacologic effect Effects 0.000 description 1
- 150000008442 polyphenolic compounds Chemical class 0.000 description 1
- 235000013824 polyphenols Nutrition 0.000 description 1
- 239000000843 powder Substances 0.000 description 1
- 238000011472 radical prostatectomy Methods 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 230000001172 regenerating effect Effects 0.000 description 1
- 230000002441 reversible effect Effects 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 208000011117 substance-related disease Diseases 0.000 description 1
- 230000002123 temporal effect Effects 0.000 description 1
- 230000001052 transient effect Effects 0.000 description 1
- 238000000108 ultra-filtration Methods 0.000 description 1
- 230000002227 vasoactive effect Effects 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
- 230000003313 weakening effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/185—Magnoliopsida (dicotyledons)
- A61K36/45—Ericaceae or Vacciniaceae (Heath or Blueberry family), e.g. blueberry, cranberry or bilberry
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- Health & Medical Sciences (AREA)
- Natural Medicines & Medicinal Plants (AREA)
- Life Sciences & Earth Sciences (AREA)
- Chemical & Material Sciences (AREA)
- Engineering & Computer Science (AREA)
- Alternative & Traditional Medicine (AREA)
- Biotechnology (AREA)
- Botany (AREA)
- Medical Informatics (AREA)
- Medicinal Chemistry (AREA)
- Microbiology (AREA)
- Mycology (AREA)
- Pharmacology & Pharmacy (AREA)
- Epidemiology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Eye Examination Apparatus (AREA)
Description
“IL MIRTILLO PER LA PREVENZIONE DELLE DISFUNZIONI COGNITIVE POSTOPERATORIE” "THE BLUEBERRY FOR THE PREVENTION OF POSTOPERATIVE COGNITIVE DYSFUNCTIONS"
CAMPO DELL’INVENZIONE FIELD OF THE INVENTION
La presente invenzione si riferisce al succo o agli estratti di Vaccinium myrtillus per la prevenzione delle disfunzioni cognitive postoperatorie dopo anestesia totale. The present invention relates to the juice or extracts of Vaccinium myrtillus for the prevention of postoperative cognitive dysfunctions after general anesthesia.
SFONDO TECNICO TECHNICAL BACKGROUND
Il numero di pazienti anziani sottoposti ad interventi chirurgici è notevolmente aumentato negli ultimi anni grazie all’innalzamento della vita media e ai notevoli progressi compiuti nel campo della chirurgia e anestesiologia. Tuttavia, dopo l’anestesia generale, alcuni di loro presentano uno stato di deficit, a breve o lungo termine, delle funzioni cognitive quali memoria, apprendimento, attenzione e percezione. The number of elderly patients undergoing surgery has significantly increased in recent years thanks to the increase in the average life span and the considerable progress made in the field of surgery and anesthesiology. However, after general anesthesia, some of them present a short or long-term deficit of cognitive functions such as memory, learning, attention and perception.
Tali alterazioni, definite come disfunzioni cognitive postoperatorie (POCD), risultano transitorie e reversibili nell’arco di 1 settimana - 3 mesi nel 20-30% dei casi e rappresentano un importante problema sanitario, sia per l’impatto che hanno sui costi di ospedalizzazione (un recupero più lento dopo l’intervento corrisponde ad un maggior numero di giorni di degenza) e di assistenza domiciliare, sia per l’aumento della morbilità e la conseguente riduzione della qualità di vita del paziente (Mandai PK et al. Inhaled anesthesia and cognitive performance. Drugs Today 2009; 45:47-54). These alterations, defined as postoperative cognitive dysfunctions (POCD), are transient and reversible within 1 week - 3 months in 20-30% of cases and represent an important health problem, both for the impact they have on hospitalization costs. (a slower recovery after surgery corresponds to a greater number of days in hospital) and home care, both for the increase in morbidity and the consequent reduction in the patient's quality of life (Mandai PK et al. Inhaled anesthesia and cognitive performance. Drugs Today 2009; 45: 47-54).
Il mirtillo (Vaccinium myrtillus) ha molteplici effetti benefici che sono da tempo oggetto di studi in vitro e in vivo. In particolare i frutti di mirtillo contengono polifenoli appartenenti alla classe delle antocianine. Le proprietà farmacologiche di queste sostanze vanno dalla forte attività antiossidante alle proprietà anti-infiammatorie, vasoattive, ipolipemiche, ipoglicemiche, rigeneranti cellulari, anti-microbiche, chemoprotettive ecc.. Bilberry (Vaccinium myrtillus) has multiple beneficial effects that have long been the subject of in vitro and in vivo studies. In particular, blueberry fruits contain polyphenols belonging to the anthocyanin class. The pharmacological properties of these substances range from strong antioxidant activity to anti-inflammatory, vasoactive, hypolipemic, hypoglycemic, cell regenerating, anti-microbial, chemoprotective properties, etc.
DESCRIZIONE DELL’INVENZIONE DESCRIPTION OF THE INVENTION
Si è ora inaspettatamente trovato che il succo o l’estratto di Vaccinium myrtillus è utile per la prevenzione delle disfunzioni cognitive postoperatorie dopo anestesia totale in particolare in pazienti di età superiore ai 50 anni, preferibilmente di età superiore ai 65 anni. It has now been unexpectedly found that the juice or extract of Vaccinium myrtillus is useful for the prevention of postoperative cognitive dysfunctions after general anesthesia, in particular in patients over the age of 50, preferably over the age of 65.
Il succo o l’estratto di mirtillo viene somministrato per un periodo di almeno 15 giorni prima dell’intervento chirurgico. Cranberry juice or extract is administered for a period of at least 15 days before surgery.
Preferibilmente il succo o l’estratto di mirtillo viene somministrato per via orale. Preferably the cranberry juice or extract is administered orally.
Il succo di mirtillo viene somministrato nella quantità di almeno 500 mi una volta al giorno o suddiviso in più dosi. Cranberry juice is administered in the amount of at least 500 ml once a day or divided into several doses.
L’estratto di mirtillo può essere somministrato in quantità da 100 a 500 mg una o più volte al giorno. Preferibilmente l’estratto secondo l’invenzione ha un contenuto di antocianine di almeno il 25%. Blueberry extract can be administered in quantities of 100 to 500 mg one or more times a day. Preferably, the extract according to the invention has an anthocyanin content of at least 25%.
L’estratto secondo l’invenzione può essere un estratto alcolico o secco ottenuto secondo i metodi tradizionali noti nella tecnica. Per esempio per spremitura di mirtilli freschi a dare un succo di mirtillo concentrato che viene poi sottoposto ad ultrafiltrazione ad estrazione con etanolo o etanolo/acqua. L’estratto risultante può essere concentrato ed essiccato sotto vuoto a dare una polvere che viene successivamente macinata a dare l’estratto essiccato. The extract according to the invention can be an alcoholic or dry extract obtained according to traditional methods known in the art. For example by squeezing fresh blueberries to give a concentrated blueberry juice which is then subjected to ultrafiltration by extraction with ethanol or ethanol / water. The resulting extract can be concentrated and dried under vacuum to give a powder which is subsequently ground to give the dried extract.
I pazienti sottoposti a trattamento con succo o estratto di mirtillo almeno 15 giorni prima di un trattamento chirurgico con anestesia totale mostrano un miglioramento nella memoria, attenzione, orientamento. In particolare i pazienti trattati con mirtillo mostrano un miglioramento dell’attenzione divisa e della memoria episodica, entrambe funzioni attribuibili genericamente al funzionamento esecutivo che risultano particolarmente deficitarie nei pazienti non trattati. Patients undergoing treatment with cranberry juice or extract at least 15 days prior to surgery with general anesthesia show improvement in memory, attention, orientation. In particular, patients treated with bilberry show an improvement in divided attention and episodic memory, both functions generically attributable to executive functioning that are particularly deficient in untreated patients.
Esempio Example
È stato effettuato uno studio clinico su 26 pazienti sottoposti a prostatectomia radicale in anestesia generale. A clinical study was performed on 26 patients who underwent radical prostatectomy under general anesthesia.
I pazienti inclusi nello studio sono maschi di età compresa tra i 50 e 75 anni, mai sottoposti ad interventi neurochirurgici e non affetti da patologie che direttamente o indirettamente possono determinare deficit cognitivi (demenze, M. di Parkinson, Sclerosi Multipla, traumi cranici, accidenti cerebrovascolari ecc..ecc..), senza storia di potus, tossicodipendenza o patologie psichiatriche rilevanti. The patients included in the study are males between the ages of 50 and 75, never subjected to neurosurgery and not suffering from pathologies that directly or indirectly can determine cognitive deficits (dementia, Parkinson's disease, multiple sclerosis, head trauma, accidents cerebrovascular ecc..etc ..), with no history of potus, drug addiction or relevant psychiatric pathologies.
I pazienti sono stati suddivisi in due gruppi, un gruppo di controllo non trattato e un gruppo trattato con succo di mirtillo 500 mi al giorno. Patients were divided into two groups, an untreated control group and a cranberry juice 500ml / day group.
Sono stati testati i domini cognitivi della memoria, attenzione, orientamento utilizzando le seguenti metodologie: The cognitive domains of memory, attention, orientation were tested using the following methodologies:
1 - Orientamento : 1 - Orientation:
Test di orientamento: temporale, spaziale, personale, familiare (riferimento M.O.D.A., Brazzelli, Capitani, Della Scala, Spinnler, Zuffi, 1994). Orientation test: temporal, spatial, personal, family (reference M.O.D.A., Brazzelli, Capitani, Della Scala, Spinnler, Zuffi, 1994).
2 - Attenzione : 2 - Attention:
Test delle matrici attenzionali Visual Search (Spinnler e Tognoni 1987). Test of Visual Search attentional matrices (Spinnler and Tognoni 1987).
- TMT (Trial Making Test) (Reitan 1958, adattato da Giovagnoli, Del Pesce, Mascheroni, Simoncelli, Laiacona, Capitani 1996). - TMT (Trial Making Test) (Reitan 1958, adapted by Giovagnoli, Del Pesce, Mascheroni, Simoncelli, Laiacona, Capitani 1996).
- Stroop Test (Stroop 1935). - Stroop Test (Stroop 1935).
3 - Memoria: 3 - Memory:
- Apprendimento Supra Span spaziale. - Spatial Supra Span learning.
Memoria di prosa (Spinnler e Tognoni 1987). Prose memory (Spinnler and Tognoni 1987).
Apprendimento di coppie di parole (De Rienzi 1977). Learning of word pairs (De Rienzi 1977).
Test di Corsi (De Renzi e Nichelli, 1975; Spinnler e Tognoni, 1987). Courses test (De Renzi and Nichelli, 1975; Spinnler and Tognoni, 1987).
Digit Span (Wechsler, 1945, Orsini et al., 1987). Digit Span (Wechsler, 1945, Orsini et al., 1987).
La valutazione è avvenuta in tre tempi, prima dell’intervento durante la visita anestesiologica (T1, al risveglio dell’anestesia (T2) ed a distanza di 24 ore (T3) somministrando i test di orientamento, attenzione e memoria succitati. Le performance peggiori di entrambi i gruppi(gruppo sperimentale, sottoposto a trattamento con mirtillo e gruppo di controllo) sono state riscontrate il giorno seguente l’intervento, a conferma del fatto che il dolore acuto post operatorio sia associato ad un temporaneo affievolimento delle capacità cognitive del paziente. I risultati relativi al gruppo pretrattato con succo di mirtillo hanno mostrato un miglioramento in diverse prove, tra cui quelle risultate maggiormente deficitarie proprio nel gruppo di controllo (TMT B, Memoria di prosa); le prove in questione si riferiscono rispettivamente alla valutazione dell’attenzione divisa e della memoria episodica, entrambe funzioni attribuibili genericamente al funzionamento esecutivo. The evaluation took place in three stages, before the operation during the anesthetic visit (T1, upon awakening from the anesthesia (T2) and after 24 hours (T3) by administering the aforementioned orientation, attention and memory tests. of both groups (experimental group, treated with bilberry and control group) were found the day after the operation, confirming the fact that acute postoperative pain is associated with a temporary weakening of the patient's cognitive abilities. The results relating to the group pretreated with cranberry juice showed an improvement in several tests, including those found to be most deficient in the control group (TMT B, Prose memory); the tests in question refer respectively to the assessment of attention. divided and episodic memory, both functions generically attributable to executive functioning.
Dalla valutazione effettuata tramite l anova multivariata era emersa una significatività circa il test di Memoria di Prosa e Il Trial Making test B. Al test relativo alla memoria di prosa, alla prima valutazione nei soggetti non trattati con il mirtillo, si ha un punteggio medio di 3,692 rispetto al 3,308 dei soggetti successivamente trattati. Al risveglio dall’anestesia è presente un peggioramento nei soggetti non trattati (2,538) ed un miglioramento nel gruppo sperimentale (3,385). A distanza di 24 ore è osservabile una riduzione del punteggio medio nei soggetti appartenenti al gruppo di controllo ed una media stabile nel gruppo dei soggetti trattati con mirtillo. Per quanto riguarda il TMT B è osservabile un miglioramento importante nei soggetti trattati che, dalla media di 3,538 rilevata alla prima valutazione, passano alla media di 4 nei due tempi successivi. I soggetti appartenenti al gruppo di controllo manifestano un peggioramento al T3 (2,849) rispetto alle due valutazioni precedenti (3,769). From the evaluation carried out using the multivariate anova, a significance had emerged regarding the Prose Memory test and the Trial Making test B. On the prose memory test, at the first evaluation in subjects not treated with blueberry, there was an average score of 3,692 compared to 3,308 for the subjects subsequently treated. Upon awakening from anesthesia there is a worsening in the untreated subjects (2,538) and an improvement in the experimental group (3,385). After 24 hours, a reduction in the mean score in the subjects belonging to the control group and a stable mean in the group of subjects treated with blueberry can be observed. As far as TMT B is concerned, an important improvement can be observed in the treated subjects who, from the average of 3.538 detected at the first evaluation, pass to the average of 4 in the two subsequent times. The subjects belonging to the control group showed a worsening at T3 (2.849) compared to the two previous evaluations (3.769).
Claims (6)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| IT000982A ITMI20120982A1 (en) | 2012-06-06 | 2012-06-06 | THE BLUEBERRY FOR THE PREVENTION OF POSTOPERATIVE COGNITIVE DYSFUNCTIONS |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| IT000982A ITMI20120982A1 (en) | 2012-06-06 | 2012-06-06 | THE BLUEBERRY FOR THE PREVENTION OF POSTOPERATIVE COGNITIVE DYSFUNCTIONS |
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| IT000982A ITMI20120982A1 (en) | 2012-06-06 | 2012-06-06 | THE BLUEBERRY FOR THE PREVENTION OF POSTOPERATIVE COGNITIVE DYSFUNCTIONS |
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