**Author details**

M Sauka1 , G Selga1 , A Skesters1 , A Silova1 , T Westermarck2 , A Latvus3 and F Atroshi4 [11] Baum MK, Shor-Posner G, Lu Y, Rosner B, Sauberlich HE, Fletcher MA, Szapocznik J, Eisdorfer C, Buring JE, Hennekens CH. Micronutrients and HIV-1 disease progres‐

Impact of CoQ10, L-Carnitine and Cocktail Antioxidants on Oxidative Stress Markers in HIV Patients — Mini Review…

http://dx.doi.org/10.5772/58415

249

[12] Graham NM, Sorensen D, Odaka N, Brookmeyer R, Chan D, Willett WC, Morris JS, Saah AJ. Relationship of serum copper and zinc levels to HIV-1 seropositivity and

[13] Tang AM, Graham NM, Saah AJ. Effects of micronutrient intake on survival in hu‐ man immunodeficiency virus type 1 infection. Am J Epidemiol. 1996 Jun 15;143(12):

[14] Miyamoto H, Araya Y, Ito M, Isobe H, Dosaka H, Shimizu T, Kishi F, Yamamoto I, Honma H, Kawakami Y. Serum selenium and vitamin E concentrations in families of

[15] Delmas-Beauvieux MC, Peuchant E, Couchouron A, Constans J, Sergeant C, Simon‐ off M, Pellegrin JL, Leng B, Conri C, Clerc M. The enzymatic antioxidant system in blood and glutathione status in human immunodeficiency virus (HIV)-infected pa‐ tients: effects of supplementation with selenium or beta-carotene. Am J Clin Nutr.

[16] Flax VL, Bentley ME, Combs GF Jr, Chasela CS, Kayira D, Tegha G, Kamwendo D, Daza EJ, Fokar A, Kourtis AP, Jamieson DJ, van der Horst CM, Adair LS. Plasma and breast-milk selenium in HIV-infected Malawian mothers are positively associated with infant selenium status but are not associated with maternal supplementation: results of the Breastfeeding, Antiretrovirals, and Nutrition study. Am J Clin Nutr.

[17] Mburu S, Marnewick JL, Abayomi A, Ipp H. Modulation of LPS-induced CD4+ T-cell activation and apoptosis by antioxidants in untreated asymptomatic HIV infected participants: an in vitro study. Clin Dev Immunol. 2013;2013:631063. doi:

[18] Hillesheim E, Lima LR, Silva RC, Trindade EB. Dietary intake and nutritional status of HIV-1-infected children and adolescents in Florianopolis, Brazil. Int J STD AIDS.

[19] Kaiser JD, Campa AM, Ondercin JP, Leoung GS, Pless RF, Baum MK. Micronutrient supplementation increases CD4 count in HIV-infected individuals on highly active antiretroviral therapy: a prospective, double-blinded, placebo-controlled trial. J Ac‐

[20] Baeten JM, McClelland RS, Richardson BA, Bankson DD, Lavreys L, Wener MH, Overbaugh J, Mandaliya K, Ndinya-Achola JO, Bwayo JJ, Kreiss JK. Vitamin A defi‐ ciency and the acute phase response among HIV-1-infected and -uninfected women

1996 Jul;64(1):101-7. Erratum in: Am J Clin Nutr 1996 Dec;64(6):971.

progression to AIDS. J Acquir Immune Defic Syndr. 1991;4(10):976-80.

lung cancer patients. Cancer. 1987 Sep 1;60(5):1159-62.

sion. AIDS. 1995 Sep;9(9):1051-6.

2014 Feb 5. [Epub ahead of print].

10.1155/2013/631063. Epub 2013 Nov 21.

quir Immune Defic Syndr. 2006 Aug 15;42(5):523-8

in Kenya. J Acquir Immune Defic Syndr. 2002 Oct 1;31(2):243-9.

2013 Dec 18. [Epub ahead of print].

1244-56.


### **References**


[11] Baum MK, Shor-Posner G, Lu Y, Rosner B, Sauberlich HE, Fletcher MA, Szapocznik J, Eisdorfer C, Buring JE, Hennekens CH. Micronutrients and HIV-1 disease progres‐ sion. AIDS. 1995 Sep;9(9):1051-6.

**Author details**

, G Selga1

, A Skesters1

248 Pharmacology and Nutritional Intervention in the Treatment of Disease

2 Rinnekoti Research Center, Espoo-Finalnd, Finland

3 Hankintatukku Oy, Museokatu, Helsinki, Finland

4 Pharmacology &Toxicology, University of Helsinki, Finland

[1] WHO. HIV/AIDS.Global situation and trends, 2013.

J Vitam Nutr Res. 2012 Feb;82(1):63-72.

Dis 2004;4:61.

Rev 2010; 68:671–81.

1992 May;231(5):463-9.

1 Rīga Stradiņš University, Rīga, LV, Latvia

, A Silova1

, T Westermarck2

[2] Sicotte M, Langlois EV, Aho J, Ziegler D, Zunzunegui MV. Association between nu‐ tritional status and the immune response in HIV + patients under HAART: protocol

[3] Kaio DJ, Rondó PH, Souza JM, Firmino AV, Luzia LA, Segurado AA. Vitamin A and Beta-Carotene Concentrations in Adults with HIV/AIDS on Highly Active Antiretro‐

[4] Fawzi, W. Micronutrients and human immunodeficiency virus type 1 disease pro‐ gression among adults and children. Clin. Infect. Dis., 2003, 37 Suppl 2, S 112 – 6.

[5] Nkengfack GN, Torimiro JN, Englert H. Effects of antioxidants on CD4 and viral load in HIV-infected women in sub-Saharan Africa - dietary supplements vs. local diet. nt

[6] van Lettow M, Harries AD, Kumwenda JJ, Zijlstra EE, Clark TD, Taha TE, Semba RD. Micronutrient malnutrition and wasting in adults with pulmonary tuberculosis with pulmonary tuberculosis with and without HIV co-infection in Malawi. BMC Infect

[7] Stone CA, Kawai K, Kupka R, Fawzi WW. Role of selenium in HIV infection. Nutr

[8] Campa A, Baum MK. Micronutrients and HIV infection. HIV Ther 2010;4:437–69.

[10] Odeh M. The role of zinc in acquired immunodeficiency syndrome. J Intern Med.

[9] Rayman MP. Selenium and human health. Lancet 2012;379:1256–68.

for a systematic review. Syst Rev. 2014 Feb 10;3(1):9. [Epub ahead of print]

viral Therapy. J Nutr Sci Vitaminol (Tokyo). 2013;59(6):496-502.

, A Latvus3

and F Atroshi4

M Sauka1

**References**


[21] Guo Y, Pino-Lagos K, Ahonen CA, Bennett KA, Wang J, Napoli JL, Blomhoff R, Sock‐ anathan S, Chandraratna RA, Dmitrovsky E, Turk MJ, Noelle RJ. A retinoic acid--rich tumor microenvironment provides clonal survival cues for tumor-specific CD8(+) T cells. Cancer Res. 2012 Oct 15;72(20):5230-9.

[32] Cherry CL, Mobarok M, Wesselingh SL, Fain R, Weinstock S, Tachedjian G, Srivasta‐ va S, Tyssen DP, Glass JD, Hooker DJ. Ubisol-Aqua: coenzyme Q10 prevents antire‐ troviral toxic neuropathy in an in vitro model. Curr HIV Res. 2010 Apr;8(3):232-9. [33] Xue SY, Hebert VY, Hayes DM, Robinson CN, Glover M, Dugas TR. Nucleoside re‐ verse transcriptase inhibitors induce a mitophagy-associated endothelial cytotoxicity that is reversed by coenzyme Q10 cotreatment. Toxicol Sci. 2013 Aug;134(2):323-34.

Impact of CoQ10, L-Carnitine and Cocktail Antioxidants on Oxidative Stress Markers in HIV Patients — Mini Review…

http://dx.doi.org/10.5772/58415

251

[34] Hickey, M. S. Nutritional support of patients with AIDS. Surg.Clin.North Am.

[35] Karter DL, Karter AJ, Yarrish R, Patterson C, Kass PH, Nord J, Kislak JW. Vitamin A deficiency in non-vitamin-supplemented patients with AIDS: a cross-sectional study.

[36] Timbo BB, Tollefson L. Nutrition: a cofactor in HIV disease. J Am Diet Assoc. 1994

[37] Augustus LJ. Nutritional care for patients with HIV. Am J Nurs. 1997 Oct;97(10):62-5. [38] Beach RS, Mantero-Atienza E, Shor-Posner G, Javier JJ, Szapocznik J, Morgan R, Sau‐ berlich HE, Cornwell PE, Eisdorfer C, Baum MK: Specific nutrient abnormalities in

[39] Semba RD, Graham NM, Caiaffa WT, Margolick JB, Clement L, Vlahov D: Increased mortality associated with vitamin A deficiency during human immunodeficiency vi‐

[40] Tang AM, Graham NM, Semba RD, Saah AJ: Association between serum vitamin A

[41] Jiamton S, Pepin J, Suttent R, Filteau S, Mahakkanukrauh B, Hanshaoworakul W, Chaisilwattana P, Suthipinittharm P, Shetty P, Jaffar S: A randomized trial of the im‐ pact of multiple micronutrient supplementation on mortality among HIV-infected in‐

[42] Fawzi WW, Msamanga GI, Spiegelman D, Wei R, Kapiga S, Villamor E, Mwakagile D, Mugusi F, Hertzmark E, Essex M, Hunter DJ: A randomized trial of multivitamin supplements and HIV disease progression and mortality. N Engl J Med 2004,

[43] Kameoka M, Kimura T, Ikuta K. Superoxide enhances the spread of HIV-1 infection

[44] Jaruga P, Jaruga B, Gackowski D, Olczak A, Halota W, Pawlowska M, Olinski R. Supplementation with antioxidant vitamins prevents oxidative modification of DNA in lymphocytes of HIV-infected patients. Free Radic Biol Med. 2002, 32(5):414-20. [45] Peterhans E. Oxidants and antioxidants in viral diseases: disease mechanisms and

by cell-to-cell transmission. FEBS Lett. 1993 Sep 27;331(1-2):182-6.

metabolic regulation.J Nutr. 1997 May;127(5 Suppl):962S-965S.

J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Feb 1;8(2):199-203.

asymptomatic HIV-1 infection. AIDS 1992, 6:701-708.

rus type 1 infection. Arch Intern Med 1993, 153:2149-2154.

dividuals living in Bangkok. AIDS 2003, 17:2461-2469.

and E levels and HIV-1 disease progression. AIDS 1997, 11:613-620.

71:645-664, June 1991.

Sep;94(9):1018-22.

351:23-32.


[32] Cherry CL, Mobarok M, Wesselingh SL, Fain R, Weinstock S, Tachedjian G, Srivasta‐ va S, Tyssen DP, Glass JD, Hooker DJ. Ubisol-Aqua: coenzyme Q10 prevents antire‐ troviral toxic neuropathy in an in vitro model. Curr HIV Res. 2010 Apr;8(3):232-9.

[21] Guo Y, Pino-Lagos K, Ahonen CA, Bennett KA, Wang J, Napoli JL, Blomhoff R, Sock‐ anathan S, Chandraratna RA, Dmitrovsky E, Turk MJ, Noelle RJ. A retinoic acid--rich tumor microenvironment provides clonal survival cues for tumor-specific CD8(+) T

[22] Irlam JH, Visser MM, Rollins NN, Siegfried N. Micronutrient supplementation in children and adults with HIV infection. Cochrane Database Syst Rev. 2010 Dec 8;

[23] Thorne-Lyman AL, Fawzi WW. Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analy‐ sis. Paediatr Perinat Epidemiol. 2012 Jul;26 Suppl 1:36-54. doi: 10.1111/j.

[24] Forrester JE, Wang XD, Knox TA, Borek CG, Tang AM, Johnson EJ. Factors associat‐ ed with serum retinol, alpha-tocopherol, carotenoids, and selenium in Hispanics with problems of HIV, chronic hepatitis C, and drug use. J Public Health Policy. 2009

[25] Monteiro JP, Freimanis-Hance L, Faria LB, Mussi-Pinhata MM, Korelitz J, Vannucchi H, Queiroz W, Succi RC, Hazra R. Both human immunodeficiency virus-infected and human immunodeficiency virus-exposed, uninfected children living in Brazil, Ar‐ gentina, and Mexico have similar rates of low concentrations of retinol, beta-caro‐

[26] Villamor E, Koulinska IN, Aboud S, Murrin C, Bosch RJ, Manji KP, Fawzi WW. Effect of vitamin supplements on HIV shedding in breast milk. Am J Clin Nutr. 2010 Oct;

[27] Dror DK, Allen LH. Vitamin E deficiency in developing countries. Food Nutr Bull.

[28] Isanaka S, Mugusi F, Fawzi WW. Standard-dose vs high-dose multivitamin supple‐ ments for HIV--reply. JAMA. 2013 Feb 13;309(6):546. doi: 10.1001/jama.2012.216995.

[29] Sudfeld CR, Isanaka S, Mugusi FM, Aboud S, Wang M, Chalamilla GE, Giovannucci EL, Fawzi WW. Weight change at 1 mo of antiretroviral therapy and its association with subsequent mortality, morbidity, and CD4 T cell reconstitution in a Tanzanian

[30] Abrams B, Duncan D, Hertz-Picciotto I. A prospective study of dietary intake and ac‐ quired immune deficiency syndrome in HIV-seropositive homosexual men. J Acquir

[31] Folkers K, Langsjoen P, Nara Y, Muratsu K, Komorowski J, Richardson PC, Smith TH. Biochemical deficiencies of coenzyme Q10 in HIV-infection and exploratory

HIV-infected adult cohort. Am J Clin Nutr. 2013 Jun;97(6):1278-87.

treatment. Biochem Biophys Res Commun. 1988 Jun 16;153(2):888-96.

Immune Defic Syndr. 1993 Aug;6(8):949-58.

cells. Cancer Res. 2012 Oct 15;72(20):5230-9.

250 Pharmacology and Nutritional Intervention in the Treatment of Disease

1365-3016.2012.01284.

Sep;30(3):285-99.

92(4):881-6.

2011 Jun;32(2):124-43.

(12):CD003650. doi: 10.1002/14651858.CD003650.

tene, and vitamin E. Nutr Res. 2009 Oct;29(10):716-22.


[46] Pace GW, Leaf CD. The role of oxidative stress in HIV disease. Free Radic Biol Med. 1995 Oct;19(4):523-8.

[60] Droge W, Eck HP, Gmunder H, Mihm S. Requirement for prooxidant and antioxi‐ dant states in T cell mediated immune responses. Relevance for the pathogenic

Impact of CoQ10, L-Carnitine and Cocktail Antioxidants on Oxidative Stress Markers in HIV Patients — Mini Review…

http://dx.doi.org/10.5772/58415

253

[61] Kalinowska M, Bazdar DA, Lederman MM, Funderburg N, Sieg SF. Decreased IL-7 responsiveness is related to oxidative stress in HIV disease. PLoS One.

[62] Ross AC, Leong T, Avery A, Castillo-Duran M, Bonilla H, Lebrecht D, Walker UA, Storer N, Labbato D, Khaitan A, Tomanova-Soltys I, McComsey GA. Effects of in ute‐ ro antiretroviral exposure on mitochondrial DNA levels, mitochondrial function and

[64] Diaz MN, Frei B, Vita JA, Keaney JFJ. Antioxidants and atherosclerotic heart disease.

[65] Falcone EL, Mangili A, Tang AM, et al. Micronutrient concentrations and subclinical

2013;8(3):e58764. doi: 10.1371/journal.pone.0058764. Epub 2013 Mar 7.

[63] Traber MG. Vitamin E regulatory mechanisms. Annu Rev Nutr 2007;27:347–62.

atherosclerosis in adults with HIV. Am J Clin Nutr , 2010;91:1213–9

mechanisms of AIDS? Klin Wochenschr 1991;69:118-122.

oxidative stress. HIV Med. 2012 Feb;13(2):98-106.

N Engl J Med 1997;337:408–16.


[60] Droge W, Eck HP, Gmunder H, Mihm S. Requirement for prooxidant and antioxi‐ dant states in T cell mediated immune responses. Relevance for the pathogenic mechanisms of AIDS? Klin Wochenschr 1991;69:118-122.

[46] Pace GW, Leaf CD. The role of oxidative stress in HIV disease. Free Radic Biol Med.

[47] Smit E, Tang A. Nutritional assessment in intravenous drug users with HIV/AIDS. J

[48] Tang AM, Smit E, Semba RD, Shah N, Lyles CM, Li D, Vlahov D. Improved antioxi‐ dant status among HIV-infected injecting drug users on potent antiretroviral thera‐

[49] Wong GHW, McHugh T, Weber R, Goeddel DV. Tumor necrosis factor alpha selec‐ tively sensitizes human immunodeficiency virus infected cells to heat and radiation.

[50] Kotler DP. Nutritional management of patients with AIDS-related anorexia. Semin

[51] Kupka R, Msamanga GI, Spiegelman D, Morris S, Mugusi F, Hunter DJ, Fawzi WW: Selenium status is associated with accelerated HIV disease progression among

[52] Hardy G, Hardy I. Selenium: the Se-XY nutraceutical. Nutrition. 2004 Jun;20(6):590-3.

[53] Baum MK, Shor-Posner G, Lai S, et al. High risk of HIV-related mortality is associat‐ ed with selenium deficiency. J Acquir Immune Defic Syndr Hum Retrovirol

[54] Rayman M.P. (2000).The importance of selenium to human health. Lancet.

[55] Jozanov-Stankov O, Demajo M, Djujić I, Mandić M. Selenium intake as a modulator of responsiveness to oxidative stress. J Environ Pathol Toxicol Oncol. 1998;17(3-4):

[56] Levander OA, Beck MA. Selenium and viral virulence. Br Med Bull. 1999;55(3):

[57] Grossman Z, Meier-Schellersheim M, Sousa AE, Victorino RM, Paul WE. CD4+ T-cell depletion in HIV infection: are we closer to understanding the cause? Nat Med 2002;

[58] Highleyman, L. (2003). Monitoring tests for people with HIV. Bulletin of Experimen‐ tal Treatments for AIDS: Retrieved July 2003 from Hogg, R. et. al. (2001). Rates of dis‐ ease progression based on CD4 cell count and viral load after initiating drug therapy.

[59] Sandstrom PA, Murray J, Folks TM, Diamond AM. Antioxidant defenses influence HIV-1 replication and associated cytopathic effects. Free Radic Biol Med

Journal of the American Medical Association, 286(20). 2568-2577.

HIV-1-infected pregnant women in Tanzania. J Nutr 2004, 134:2556-2560.

Acquir Immune Defic Syndr. 2000 Oct 1;25 Suppl 1:S62-9.

py.J Acquir Immune Defic Syndr. 2000 Apr 1;23(4):321-6.

Proc Natl Acad Sci U S A 1991;88:4372–6.

Gastrointest Dis. 1998 Oct;9(4):189-99.

1995 Oct;19(4):523-8.

252 Pharmacology and Nutritional Intervention in the Treatment of Disease

1997;15:370–4.

251-7.

528-33.

8:319–323.

1998;24:1485-1491.

15;356(9225):233-41.


**Chapter 10**

**Pharmacological and Clinical Effectiveness of** *Zingiber*

Osteoarthritis (OA) is a progressive degenerative joint disease that has a major impact on joint function and quality of life. OA is a painful condition caused by a gradual loss of cartilage from the joints and, in some people, joint inflammation [1]. Pain, stiffness, and difficulty moving the joint easily are common symptoms of OA. Non-drug treatments for osteoarthritis have gained popularity according to the American College of Rheumatology (ACR) [2] and can often reduce the symptoms. Therefore, there is a significant need to improve current osteoarthritis therapies and to search for novel therapies. Nutraceuticals and dietary supplements derived from herbs have long been used in traditional medicine. Though they aren't recognized as drugs, herbal and natural remedies are used for a drug-like effect, and they can potentially cause the same reactions and complications prescription drugs can cause. There is considerable evidence that nutraceuticals may play an important role in inflammation and joint destruction in OA. The World Health Organization (WHO) [3] has taken an interest in the indigenous system of medicine; particularly, plant remedies. Ginger is widely used as a spice, an antiemetic and carminative agent, and for its essential oils. Gingerols, in particular 6-gingerol, are the active components of ginger. Proposed mechanisms include direct stimulation of the gastrointestinal tract, or serotonin antagonism in the gut or central nervous system [4, 5]. A study on 6-gingerol was shown to significantly inhibit the production of nitric oxide, a highly reactive nitrogen molecule that quickly forms a very damaging free radical called peroxynitrite and greatly lessened depletion of glutathione [6]. Other reports suggest that ginger produces its

> © 2014 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

*officinale* **and** *Alpinia galanga* **in Patients with**

Guntars Selga, M. Sauka, L. Aboltina, A. Davidova,

P. Kaipainen, D. Kheder, T. Westermarck and

Additional information is available at the end of the chapter

**Osteoarthritis**

http://dx.doi.org/10.5772/58417

**1. Introduction**

F. Atroshi
