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New Concepts in Our Understanding of Glaucoma

How dynamic pulsatile mechanisms determine aqueous outflow.
By Murray Johnstone, MD

This is some of the most important research in the last 60 years in the medical specialty of glaucoma.

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A wide range of neurodegenerative diseases (NDs), including Glaucoma, Alzheimer's disease, Parkinson's disease, Huntington's disease, and prion diseases, share common mechanisms such as neuronal loss, apoptosis, mitochondrial dysfunction, oxidative stress, and inflammation.

Intervention strategies using plant-derived bioactive compounds have been offered as a form of treatment for these debilitating conditions, as there are currently no remedies to prevent, reverse, or halt the progression of neuronal loss. Rutin, a glycoside of the flavonoid quercetin, is found in many plants and fruits, especially buckwheat, apricots, cherries, grapes, grapefruit, plums, and oranges.

Pharmacological studies have reported the beneficial effects of rutin in many disease conditions, and its therapeutic potential in several models of NDs has created considerable excitement.

In the attached scientific paper, published in 2018, the authors summarize the current knowledge on the neuroprotective mechanisms of rutin in various experimental models of neurodegenerative diseases. The mechanisms of action reviewed in this article include reduction of proinflammatory cytokines, improved antioxidant enzyme activities, activation of the mitogen-activated protein kinase cascade, downregulation of mRNA expression of PD-linked and proapoptotic genes, upregulation of the ion transport and antiapoptotic genes, and restoration of the activities of mitochondrial complex enzymes.

Taken together, these findings suggest that rutin may be a promising neuroprotective compound for the treatment of glaucoma and other neurodegenerative diseases. Additionally, there are two studies on intraocular pressure and the combination of rutin plus forskolin (an herbal extract) which show this combination has the potential to reduce intraocular pressure.

Coleus Forskolii Extract 250 mg 60 caps by Paradise Herbs – FitEyes eStore https://estore.fiteyes.com/products/coleus-forskolii-extract-60-caps-by-...

Rutin 450 mg 100 vcaps by NOW Foods – FitEyes eStore https://estore.fiteyes.com/products/rutin-450-mg-100-vcaps-by-now-foods

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Abstract

Aims

Gut microbiota-derived metabolite trimethylamine-N-oxide (TMAO) is emerging as a new potentially important cause of increased cardiovascular risk. The purpose of this meta-analysis was to systematically estimate and quantify the association between TMAO plasma levels, mortality, and major adverse cardio and cerebrovascular events (MACCE).

Introduction by Vegsource.com

There has recently been a flurry of discussion prompted by an article by raw-animal-product advocate Denise Minger, which criticizes The China Study and attacks its author, Dr. T. Colin Campbell. Minger questions Dr. Campbell's personal motives and attempts to impugn his character.

Dr. Campbell recently took time to review Minger's observations and respond. You can read Minger's original article below, linked at the start of Dr. Campbell's response.

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Abstract

This is part of our discussion about publications by Stephen T. Sinatra M.D. I am attaching his publication, which is a letter to the editor in regard to another study. Log in to download the PDF, or use the link below to obtain it from Wiley Online Library.

Apolipoprotein E is the "Alzheimer's gene". It is also widely known to be important in cardiovascular disease. Now we see it may have some bearing on glaucoma (at least in some populations). Log in to download the full text paper and read the FitEyes member-only portion of this blog post (below).

Abstract

Epidemiological studies have evaluated the association between Apolipoprotein E (APOE) gene ε2/ε3/ε4 polymorphism and glaucoma susceptibility. However, the published data are still inconclusive. The aim of the present study is to evaluate the impact of APOE gene ε2/ε3/ε4 polymorphism on glaucoma risk by using meta-analysis.

Methods

A comprehensive literature search of PubMed, EMBASE, Cochrane, Elsevier Science Direct and CNKI databases was conducted to identify relevant articles, with the last report up to January 5, 2014. Pooled odds ratio (OR) and 95% confidence interval (CI) were used to assess the strength of association by using the fixed or random effect model.

Results

Fifteen separate studies including 2,700 cases and 2,365 controls were included in the meta-analysis. We did not detect a significant association between APOE gene ε2/ε3/ε4 polymorphism and glaucoma in overall population (P > 0.0083). In Asians, we detected an association of the ε4ε4 genotype with elevated risk for glaucoma (OR = 5.22, 95% CI = 1.85-14.68, P = 0.002), mainly for primary open angle glaucoma (OR = 4.98, 95% CI = 1.75-14.20, P = 0.003).

Conclusions

The meta-analysis suggests that APOE gene ε4ε4 may be associated with elevated risk for primary open angle glaucoma in Asians. However, more epidemiologic studies based on larger sample size, case–control design and stratified by ethnicity as well as types of glaucoma are suggested to further clarify the relationship between APOE gene ε2/ε3/ε4 polymorphism and genetic predisposition to glaucoma.

Keywords: Glaucoma, APOE, Genetic, Meta-analysis

Abstract

All five papers in the series. Log in to download.

Thematic review series: The Pathogenesis of Atherosclerosis
An interpretive history of the cholesterol controversy
by Daniel Steinberg
Department of Medicine, University of California–San Diego, La Jolla, CA

This post has Fred Pollack's four papers attached. Log in to download. If you think you may not have time to read all 4 parts, I suggest reading Part 3 first. Part 3 alone may be sufficient to answer your questions.

1. A Preliminary Evaluation of Chowdhury Meta-Analysis on the Association of Fatty Acids with Coronary Risk: Part 1

2. Evaluation of Chowdhury Meta-Analysis on the Association of Fatty Acids with Coronary Risk, Part 2

Diet to Halt and Reverse Heart-Disease/Atherosclerosis Info

About 9 years ago, I did a deep dive into the diet/health medical research.  I was more concerned about heart disease and my wife Iris was more concerned about getting cancer.  The research clearly showed that a low-fat, whole-food plant-based diet addressed both issues.  We made the switch 9 years ago.  I have continued to read the peer reviewed research.

Results showed that the risk for death from any cause was reduced by about 33% comparing in participants with highest omega-3 blood levels

Study shows omega-3 levels are better predictors of risk for death than serum cholesterol

Most FitEyes discussion happens on our very active mailing list. If you want the latest news, subscribe to our mailing list.

I took part in a mailing list discussion today. A number of people asked me to post the following message on my blog for easy reference. For context I will include the comments I was responding to first, followed by my response. (I'm editing parts of this for privacy and clarity.)