Dietary supplementation in patients with alcoholic liver disease: a review on current evidence

BACKGROUND：Alcoholic liver disease（ALD）is one of the main causes of liver disease worldwide.Although the pathogenesis of ALD has not yet been well elucidated,the oxidative metabolites of ethanol such as acetaldehyde and reactive oxygen species play a pivotal role in the clinical and pathological spectrum of the disease.This review summarizes the existing evidences on dietary supplements considered to have antioxidant,and/or anti-inflammatory properties,and their role in the management of ALD and the proposed mechanisms.DATA SOURCES：The present study reviewed all studies published in Pub Med,Science Direct and Scopus,from 1959 to2015,indicating the role of different dietary supplementation in attenuation of many pathophysiological processes involved in development and progression of ALD.Full-texts of citations were used except for those that were published in languages other than English.RESULTS：Significant progress has been made to understand the key events and molecular players for the onset and progression of ALD from both experimental and clinical studies;however,there is no successful treatment currently available.The present review discussed the role of a variety of dietary supplements（e.g.vitamin A,carotenoids,vitamins B3,C and E,in addition to antioxidants and anti-inflammatory agents）in treating ALD.It has been shown that supplementation with some carotenoids,vitamin B3,vitamin C,silymarin,curcumin,probiotics,zinc,S-adenosylmethionine and garlic may havepotential beneficial effects in animal models of ALD;however,the number of clinical studies is very limited.In addition,supplementation should be accompanied with alcohol cessation.CONCLUSIONS：Since oxidative stress and inflammation are involved in the pathogenesis of ALD,dietary supplements that can modulate these pathologies could be useful in the treatment of ALD.In addition to alcohol cessation,these supplements have shown beneficial effects on animal models of ALD.Clinical trials are needed to validate the beneficiary role of these supplements in patients with ALD.

Oxidative stress,the blood-brain barrier and neurodegenerative diseases:The critical beneficial role of dietary antioxidants

In recent years,growing awareness of the role of oxidative stress in brain health has prompted antioxidants,especially dietary antioxidants,to receive growing attention as possible treatments strategies for patients with neurodegenerative diseases(NDs).The most widely studied dietary antioxidants include active substances such as vitamins,carotenoids,flavonoids and polyphenols.Dietary antioxidants are found in usually consumed foods such as fresh fruits,vegetables,nuts and oils and are gaining popularity due to recently growing awareness of their potential for preventive and protective agents against NDs,as well as their abundant natural sources,generally non-toxic nature,and ease of long-term consumption.This review article examines the role of oxidative stress in the development of NDs,explores the‘two-sidedness’of the blood-brain barrier(BBB)as a protective barrier to the nervous system and an impeding barrier to the use of antioxidants as drug medicinal products and/or dietary antioxidants supplements for prevention and therapy and reviews the BBB permeability of common dietary antioxidant suplements and their potential efficacy in the prevention and treatment of NDs.Finally,current challenges and future directions for the prevention and treatment of NDs using dietary antioxidants are discussed,and useful information on the prevention and treatment of NDs is provided.