Vol. 5, n. 1, January-March 2009 1th International ... - Salute per tutti

90
C. Ferreri
period 36-38 . The pre/post- surgery health protocols
based on nutritional status are now entering
in the programs of important international
surgery teams.
Beside being a tool for personalized therapies,
the lipidomic analysis can be grouped according
to the pathological or physiological conditions
of subjects (sport activity, pregnancy, dermatological
diseases, cardiovascular diseases,
obesity, etc.), thus allowing for a scenario to be
obtained, accounting the most frequent metabolic
transformations observed in each group.
To this purpose, data bases can be built-up containing
analyses and information on the groups
of subjects, which allow for the statistic evaluation
and for evidencing the unbalance parameters
that are connected to the metabolic status
of the patients. These data bases, interfaced
with the discoveries of the scientific research
which clarify the biological processes at the
molecular level, can be useful to indicate possible
applications in health care, in diagnostic
and therapeutic fields.
In the case of dermatological diseases, lipidomics
evidences, among others, the omega-6/omega-3
unbalance, as previously underlined, which
favors the production of inflammatory mediators
(PGE2, series 2 prostaglandins) derived fro m
arachidonic acid, compared to the formation of
eicosapentaenoic acid (EPA) and its corre s p o n ding
anti-inflammatory prostaglandins (series 3,
PGE3).
This unbalance is seen in a more complete manner
within the lipidomic scenario: in fact, considering
the biosynthetic pathways of the
omega-6 series (see Figure 2), gamma-linolenic
acid (GLA) and its metabolite, dihomogammalinolenic
acid (DGLA, eicosatrienoic acid, 20:3
omega-6), are not only precursors of arachidonic
acid, but from DGLA the anti-inflammatory
p rostaglandins (series 1, PGE1) can be pre p a re d .
T h e re f o re, lipidomics can evidence either an
i n f l a m m a t o ry pathway, consisting of the formation
of arachidonic acid, and an antiinflammatory
omega-6 pathway, consisting of the levels of
GLA and DGLA (see Figure 2). This diff e re n t i ation
is important to establish the level of therapeutical
and nutritional intervention, with
a p p ropriated sources of various fatty acids. In
the lipidomics of dermatological diseases and in
the general condition of the skin, the clarification
of biosynthetic pathways allows a personalized
strategy to be individuated to cover individual
needs.
Journal of Plastic Dermatology 2009; 5, 1
utraceuticals in dermatology
N
So far the lipidomics of ery t h ro c y t e
membranes and the profile individuation connected
to the various diseases re p resent the
basic tools to examine the metabolic conditions
and focus intervention strategies. Lipidomics
has individuated typical unbalances in diff e re n t
conditions, which indicate the intervention to
apply in order to recover the normal conditions.
It is worth underlining that the interv e n t i o n
must include the dietary regime which, as pre v iously
explained, must allow a constant uptake
of essential and antioxidant-antiradical factors.
Together with nutrition, the functioning of
o rgans devoted to absorption (gastro - i n t e s t i n a l
apparatus) and to nutrient transformation (liver,
p a n c reas) must be taken in due consideration.
Lipidomics can indicate strategies for the recovery
of normal values of fatty acids in a specific
cell compartment, which includes a period of
use of specific fatty acid supplementation from
natural sources, choosing the most appropriate
to cover the deficit found. Lipidomics results to
be very useful for the individuation of a synergic
and specific formulation, which can also be
used to create a nutraceutical product. By
nutraceuticals it is not only intended the capability
of intervening on the deficit, but also the
real therapeutic or preventive effect for the
specific condition 39 . An innovative protocol
can result from lipidomics, to compensate the
unbalance of the membranes. Using the lipidomic
approach the nutraceutical formulation
is based not only on choosing the ingredients
on the basis of their known general mode of
action, but also on their specific capability to
satisfy and cover the unbalance of the membrane
profile. The lipidomic protocol can additionally
become a tool to test the efficacy of the
therapy. In fact, by controlling the erythrocyte
membrane condition at start and after 4-5
months of nutraceutical supplementation, the
absorption, metabolism and incorporation of
the supplemented fatty acids can be controlled,
thus combining the clinical observation with
the analytical data.
Several examples are reported in the literature
on the success of nutraceutical interventions in
pathological conditions 4 0 , including dermatolo
g y. An example is given by photopro t e c t i o n ,
which is epidemiologically related to a nutrition
rich in antioxidants, there f o re suggesting the
antioxidant cocktail as nutraceuticals in this