BACKGROUND:Patients irradiated for brain tumors often suffer from cerebral edema and are usually treated with dexamethasone, which has various side effects. To investigate the activity of Boswellia serrata (BS) in radiotherapy-related edema, we conducted a prospective, randomized, placebo-controlled, double-blind, pilot trial.

METHODS:Forty-four patients with primary or secondary malignant cerebral tumors were randomly assigned to radiotherapy plus either BS 4200 mg/day or placebo. The volume of cerebral edema in the T2-weighted magnetic resonance imaging (MRI) sequence was analyzed as a primary endpoint. Secondary endpoints were toxicity, cognitive function, quality of life, and the need for antiedematous (dexamethasone) medication. Blood samples were taken to analyze the serum concentration of boswellic acids (AKBA and KBA).

RESULTS:Compared with baseline and if measured immediately after the end of radiotherapy and BS/placebo treatment, a reduction of cerebral edema of>75% was found in 60% of patients receiving BS and in 26% of patients receiving placebo (P = .023). These findings may be based on an additional antitumor effect. There were no severe adverse events in either group. In the BS group, 6 patients reported minor gastrointestinal discomfort. BS did not have a significant impact on quality of life or cognitive function. The dexamethasone dose during radiotherapy in both groups was not statistically different. Boswellic acids could be detected in patients' serum.

CONCLUSIONS:BS significantly reduced cerebral edema measured by MRI in the study population. BS could potentially be steroid-sparing for patients receiving brain irradiation. Our findings will need to be further validated in larger studies.

Dexamethasone-induced hypertension may be caused by baroreflex alterations or renin-angiotensin system (RAS) exacerbation. Aerobic training has been recommended for hypertension treatment, but the mechanisms responsible for reduction of arterial pressure (AP) in dexamethasone (DEX) treated rats are still inconclusive.This study evaluated whether mechanisms responsible for training-induced attenuation of hypertension involve changes in autonomic nervous system and in RAS components. Rats underwent aerobic training protocol on treadmill or were kept sedentary for 8 weeks. Additionally, animals were treated with DEX during the last 10 days of exercise. Body weight (BW), AP and baroreflex activity were analyzed. Tibialis anterior (TA), soleus (SOL) and left ventricle (LV) were collected for evaluation of RAS components gene expression and protein levels. Dexamethasone decreased BW (20%), caused TA atrophy (16%) and increased systolic AP (SAP, 16%) as well as decreased baroreflex activity. Training attenuated SAP increase and improved baroreflex activity, although it did not prevent DEX-induced BW reduction and muscle atrophy. Neither DEX nor training caused expressive changes in RAS components. In conclusion, exercise training was effective in attenuating hypertension induced by DEX and this response may be mediated by a better autonomic balance through an improvement of baroreflex activity rather than changes in RAS components.

This study was conducted to determine the effect of supplemental dietary vitamin C (VC) and vitamin E (VE) on improving semen quality and antioxidative status in breeder roosters challenged with dexamethasone (DEX). 120 45-week-old Lveyang black-boned breeder roosters were divided into 5 experimental treatments, including negative group, positive group, and three trial groups, which were fed basal diet supplemented with 300mg/kg VC, 200mg/kg VE, or 300mg/kg VC and 200mg/kg VE (VC+VE). At 49 weeks of age, the positive control and trial groups were subcutaneously injected 3 times every other day with DEX 4 mg/kg body weight, the negative control group was sham injected with saline. At 50 weeks of age, average daily feed intake of birds challenged with DEX significantly increased (P<0.05), however, serum testosterone significantly decreased (P<0.05). Dietary supplementation of VC+VE enhanced serum testosterone and sperm motility remarkably (P<0.05). There were no differences in sperm viability between the DEX-treated groups. During the post-stress recovery period (52 weeks of age), dietary supplementation of VE and VC+VE significantly increased the body weight of birds under oxidative stress (P<0.01). VC, VE, and VC+VE groups had greater sperm viability than control group (P<0.01). Additionally, there was a decrease in the semen plasma malondialdehyde content (P<0.05) of the VC and VC+VE groups, and in the testicular malondialdehyde content (P<0.01) of the VE and VC+VE groups. In summary, VC, VE, especially their combination alleviate the oxidative stress induced by DEX and are favorable for the fertility of breeder roosters.