Birgitta Strandvik - Academia.edu (original) (raw)

Papers by Birgitta Strandvik

Scandinavian Journal of Clinical and Laboratory Investigation, 1987

Reliable reference values need to be collected under standardized conditions. In order to enable ... more Reliable reference values need to be collected under standardized conditions. In order to enable comparison of values observed on patients with reference values, it is also desirable to use the same standardized conditions on patients. The present recommendation was produced as a joint effort of representatives of the clinical chemists and paediatricians of Scandinavia and describes the following details. Preparation of the child before specimen collection (food intake, time of day, physical activity, posture, environment), preparation of skin puncture site (warming, disinfection, ointment), instruments for blood collection (lancet, blood collection vessel), site of puncture (plantar surface of foot, finger, ear lobe), collection of emerging blood and handling and storage of the specimen.

Life Sciences, Apr 1, 2022

AIMS Medulloblastoma (MB) is one of the most common malignant central nervous system tumors of ch... more AIMS Medulloblastoma (MB) is one of the most common malignant central nervous system tumors of childhood. Despite intensive treatments that often leads to severe neurological sequelae, the risk for resistant relapses remains significant. In this study we have evaluated the effects of the ω3-long chain polyunsaturated fatty acids (ω3-LCPUFA) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on MB cell lines and in a MB xenograft model. MAIN METHODS Effects of ω3-LCPUFA treatment of MB cells were assessed using the following: WST-1 assay, cell death probes, clonogenic assay, ELISA and western blot. MB cells were implanted into nude mice and randomized to control, DHA, or a combination of DHA and EPA treatment. Treatment effects in tumor tissues were evaluated with: LC-MS/MS, RNA sequencing and immunohistochemistry, and tumors, erythrocytes and brain tissues were analyzed with gas chromatography. KEY FINDINGS ω3-LCPUFA decreased prostaglandin E2 (PGE2) secretion from MB cells, and impaired MB cell viability and colony forming ability and increased apoptosis in a dose-dependent manner. DHA reduced tumor growth in vivo, and both PGE2 and prostacyclin were significantly decreased in tumor tissue from treated mice compared to control animals. All ω3-LCPUFA and dihomo-γ-linolenic acid increased in tumors from treated mice. RNA-sequencing revealed 10 downregulated genes in common among ω3-LCPUFA treated tumors. CRYAB was the most significantly altered gene and the downregulation was confirmed by immunohistochemistry. SIGNIFICANCE Our findings suggest that addition of DHA and EPA to the standard MB treatment regimen might be a novel approach to target inflammation in the tumor microenvironment.

Prostaglandins, Leukotrienes and Essential Fatty Acids, 2021

Omega-3 fatty acids have been suggested as a complement in cancer treatment, but doses are not es... more Omega-3 fatty acids have been suggested as a complement in cancer treatment, but doses are not established. We performed a dose-finding study in 33 children in remission from cancer. Participants were allocated to a body surface area (BSA) adjusted dose (mg/m2) of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (40:60), ranging 233-3448 mg/m2 daily for 90 days. Fatty acid concentration in plasma phospholipids and red blood cells were determined by GC. Supplementation was well tolerated and correlated strongly with blood ω3-fatty acid concentrations and EPA showed the highest increase. Using the ω3-index disregards docosapentaenoic acid (DPA), which increased 30-43% in our study motivating an EDD-index (∑EPA,DPA,DHA). The ratio between arachidonic acid and EPA or DHA showed negative exponential trends. Dose per BSA enabled an individualized omega-3 supplementation decreasing the variation referred to interindividual differences. Based on our results, we suggest a dose of 1500 mg/m2 BSA for further studies.

Diet and Exercise in Cystic Fibrosis, 2015

Abstract Increased fat intake is a standard nutritional recommendation in the care of patients wi... more Abstract Increased fat intake is a standard nutritional recommendation in the care of patients with cystic fibrosis (CF) in order to prevent malnutrition. Despite this advice essential fatty acid (EFA) deficiency remains a well-known complication in most patients with low concentrations of linoleic acid and docosahexaenoic acid in tissues. This chapter explains what is known about the background of this advice. It highlights the association of EFA with the clinical presentation and summarizes the current knowledge concerning the different etiological hypotheses of the lipid abnormality in CF. Furthermore some remarks are given concerning optimal treatment of this problem, highlighting the newly arising problem of obesity in a minority of CF patients. Different considerations regarding the dietary advice and other treatment possibilities are made.

Journal of Cystic Fibrosis, 2021

BACKGROUND The efficacy and safety of ursodeoxycholic acid (UDCA) for the treatment of liver dise... more BACKGROUND The efficacy and safety of ursodeoxycholic acid (UDCA) for the treatment of liver disease associated with cystic fibrosis (CF) are under discussion, and clinical practice varies among centers. The study aimed at evaluating if the incidence of severe liver disease differs between CF centers routinely prescribing or not prescribing UDCA. METHODS We carried out a retrospective multicenter cohort study including 1591 CF patients (1192 patients from UDCA-prescribing centers and 399 from non-prescribing centers) born between 1990 and 2007 and followed from birth up to 31 December 2016. We computed the crude cumulative incidence (CCI) of portal hypertension (PH) at the age of 20 years in the two groups and estimated the subdistribution hazard ratio (HR) through a Fine and Gray model. RESULTS Over the observation period, 114 patients developed PH: 90 (7.6%) patients followed-up in UDCA prescribing centers and 24 (6.0%) in non-prescribing centers. The CCI of PH at 20 years was 10.1% (95% CI: 7.9-12.3) in UDCA-prescribing and 7.7% (95% CI: 4.6-10.7) in non-prescribing centers. The HR among patients followed in prescribing centers indicated no significant difference in the rate of PH either in the unadjusted model (HR: 1.21, 95% CI: 0.69-2.11) or in the model adjusted for pancreatic insufficiency (HR: 1.28, 95% CI: 0.77-2.12). CONCLUSIONS CF patients followed-up in UDCA prescribing centers did not show a lower incidence of PH as compared to those followed in centers not prescribing UDCA. These results question the utility of UDCA in reducing the occurrence of severe liver disease in CF.

Journal of Pediatric Gastroenterology & Nutrition, 2016

Acta Paediatrica, 2007

To analyze dietary intake in healthy 4-year-old children. Families from three Paediatric Health C... more To analyze dietary intake in healthy 4-year-old children. Families from three Paediatric Health Care Centres in different socio-economic areas in Göteborg completed 7-day food records and questionnaires about socio-economy. One hundred thirty two/153 completed the study, 49% of parents were university educated. Eighteen percent of children were overweight/obese. Energy intake was high; 67% had sucrose intake exceeding Nordic Nutrition Recommendations (NNR) but 36% had n-3 fatty acid intake < 0.5 energy percent. Significant negative correlations were found between sucrose and fat and between BMI and fat intake. Junk food supplied 24% of energy. Ninety-two percent had low vitamin D intake, 70% low iron and 21% low calcium intake. Gruel, which was consumed by 28%, had a positive impact on micronutrient intake. Child care and mother's origin seemed to influence dietary intake. In 4-year olds from well-educated urban families, 18% was overweight/obese. Total energy intake was above present NNR but lower than 20 years ago, when overweight was rare. Fat energy intake was negatively associated with BMI, and low n-3 fatty acid intake was associated with higher body weight. In several aspects dietary intake was not optimal in the children.

PLOS ONE

Factors for initiating hibernation are unknown, but the condition shares some metabolic similarit... more Factors for initiating hibernation are unknown, but the condition shares some metabolic similarities with consciousness/sleep, which has been associated with n-3 fatty acids in humans. We investigated plasma phospholipid fatty acid profiles during hibernation and summer in free-ranging brown bears (Ursus arctos) and in captive garden dormice (Eliomys quercinus) contrasting in their hibernation patterns. The dormice received three different dietary fatty acid concentrations of linoleic acid (LA) (19%, 36% and 53%), with correspondingly decreased alpha-linolenic acid (ALA) (32%, 17% and 1.4%). Saturated and monounsaturated fatty acids showed small differences between summer and hibernation in both species. The dormice diet influenced n-6 fatty acids and eicosapentaenoic acid (EPA) concentrations in plasma phospholipids. Consistent differences between summer and hibernation in bears and dormice were decreased ALA and EPA and marked increase of n-3 docosapentaenoic acid and a minor incr...

Prostaglandins, Leukotrienes and Essential Fatty Acids, 2016

Myelination is important perinatally and highly dependent on long-chain saturated and monounsatur... more Myelination is important perinatally and highly dependent on long-chain saturated and monounsaturated fatty acids. Long-chain polyunsaturated fatty acids, nowadays often supplemented, inhibit oleic acid synthesis. Using data from a premature cohort, we studied if nervonic, lignoceric and oleic acids correlated to growth and early development up to 18 months corrected age. Small for gestational age infants had lower concentrations than infants appropriate for gestational age. Only oleic acid was negatively correlated to long-chain polyunsaturated fatty acids. Oleic and lignoceric acids correlated to social interaction at one month, and nervonic acid to mental, psychomotor and behavioral development at 6, 10 and 18 months, also when adjusted for several confounders. Negative association between oleic acid and long-chain polyunsaturated fatty acids suggests inhibition of delta-9 desaturase, and nervonic acid´s divergent correlation to lignoceric and oleic acids suggests different metabolism in neonatal period. Our results may have implications for the supplementation of premature infants.

Primary Prevention by Nutrition Intervention in Infancy and Childhood, 2006

The importance of the essential fatty acids (EFAs) for early development has been illustrated in ... more The importance of the essential fatty acids (EFAs) for early development has been illustrated in numerous studies. The essentiality of linoleic acid (C18:2n-6) and -linolenic acid (C18:3n-3) depends on the fact that they can-not be produced by animal cells and that ...

Pharmacology and Toxicology, 2002

Nutrients, 2022

Nutrition is important in cystic fibrosis (CF) because the disease is associated with a higher en... more Nutrition is important in cystic fibrosis (CF) because the disease is associated with a higher energy consumption, special nutritional deficiencies, and malabsorption mainly related to pancreatic insufficiency. The clinical course with deterioration of lung function has been shown to relate to nutrition. Despite general recommendation of high energy intake, the clinical deterioration is difficult to restrain suggesting that special needs have not been identified and specified. It is well-known that the CF phenotype is associated with lipid abnormalities, especially in the essential or conditionally essential fatty acids. This review will concentrate on the qualitative aspects of fat metabolism, which has mainly been neglected in dietary fat recommendations focusing on fat quantity. For more than 60 years it has been known and confirmed that the patients have a deficiency of linoleic acid, an n-6 essential fatty acid of importance for membrane structure and function. The ratio betwee...

British Journal of Nutrition, 2006

Background: The need to promote breastfeeding is unquestionable for the health and development of... more Background: The need to promote breastfeeding is unquestionable for the health and development of infants. The aim of this study was to investigate prevalence, duration and promotion of breastfeeding status in Iran with respect to the Baby Friendly Hospital, government actions and activities by the Breastfeeding Promotion Society including comparison with European countries. Methods: This retrospective study is based on data from 63,071 infants less than 24 months of age in all the 30 urban and rural provinces of Iran. The data of breastfeeding rates were collected in 20052006 by trained health workers in the Integrated Monitoring Evaluation System in the Family Health Office of the Ministry of Health to evaluate its subordinate offices. A translated version of a questionnaire, used to assess the current breastfeeding situation in Europe, was used. Results: At a national level, 90 % and 57 % of infants were breastfed at one and two-years of age, respectively. Exclusive breastfeeding...

International Journal of Molecular Sciences

While approximately 2000 mutations have been discovered in the gene coding for the cystic fibrosi... more While approximately 2000 mutations have been discovered in the gene coding for the cystic fibrosis transmembrane conductance regulator (CFTR), only a small amount (about 10%) is associated with clinical cystic fibrosis (CF) disease. The discovery of the association between CFTR and the hyperactive epithelial sodium channel (ENaC) has raised the question of the influence of ENaC on the clinical CF phenotype. ENaC disturbance contributes to the pathological secretion, and overexpression of one ENaC subunit, the β-unit, can give a CF-like phenotype in mice with normal acting CFTR. The development of ENaC channel modulators is now in progress. Both CFTR and ENaC are located in the cell membrane and are influenced by its lipid configuration. Recent studies have emphasized the importance of the interaction of lipids and these proteins in the membranes. Linoleic acid deficiency is the most prevailing lipid abnormality in CF, and linoleic acid is an important constituent of membranes. The i...

Clinical nutrition (Edinburgh, Scotland), Jun 15, 2016

Malnutrition is both a frequent feature and a comorbidity of cystic fibrosis (CF), with nutrition... more Malnutrition is both a frequent feature and a comorbidity of cystic fibrosis (CF), with nutritional status strongly associated with pulmonary function and survival. Nutritional management is therefore standard of care in CF patients. ESPEN, ESPGHAN and ECFS recommended guidelines to cover nutritional management of patients with CF. The guidelines were developed by an international multidisciplinary working group in accordance with officially accepted standards. The GRADE system was used for determining grades of evidence and strength of recommendation. Statements were discussed, submitted to Delphi rounds, reviewed by ESPGHAN and ECFS and accepted in an online survey among ESPEN members. The Working Group recommends that initiation of nutritional management should begin as early as possible after diagnosis, with subsequent regular follow up and patient/family education. Exclusive breast feeding is recommended but if not possible a regular formula is to be used. Energy intake should ...

Prostaglandins, Leukotrienes and Essential Fatty Acids, 1994

To investigate the effects of glucocorticoids on leukotriene (LT) generation in patients with cys... more To investigate the effects of glucocorticoids on leukotriene (LT) generation in patients with cystic fibrosis (CF), we evaluated calcium ionophore A23187-induced LTB4 and LTC4 production by leukocytes with and without pretreatment with dexamethasone. The CF patients were in good condition and did not have acute infection. There were no significant differences in LTB4 and LTC4 production without dexamethasone pretreatment between the CF patients and controls. However, the ratios of LTB4 and LTC4 production by leukocytes preincubated with dexamethasone to those of leukocytes without dexamethasone pretreatment were significantly higher in the CF patients than in the controls (both p < 0.05). Our data suggest that the response of LTB4 and LTC4 production to dexamethasone is disturbed in patients with CF. The generation of LTs may be enhanced due to a disturbance in glucocorticoid suppression.

Nutrition <html_ent glyph="@amp;" ascii="&"/> Dietetics, 2006

Scandinavian Journal of Gastroenterology - SCAND J GASTROENTEROL, 2001

Patients with cystic fibrosis (CF) have been claimed to have defect intestinal motility and gastr... more Patients with cystic fibrosis (CF) have been claimed to have defect intestinal motility and gastric acid secretion. The aim of this work was to study the interdigestive motility and the motility-related secretions in the upper gastrointestinal tract in patients with CF compared to healthy controls. Concomitant gastroduodenal manometry combined with intragastric perfusion was performed in 12 healthy volunteers and 10 patients with CF. Eight CF patients showed a normal migrating motor complex. Motility-related gastric secretion of acid and bicarbonate was evaluated in six patients and did not differ from healthy subjects. Gastric net fluid secretion was significantly decreased in the CF patients and bilirubin reflux was significantly increased. The CF patients with pancreatic insufficiency lacked motility-related variations in plasma levels of motilin and pancreatic peptide. No defect in fasting motility or gastric secretion of acid or bicarbonate could be seen in well-nourished adult CF patients. The main finding was a significantly lower net fluid secretion and higher bilirubin reflux compared to healthy subjects. Indications of a genetic relationship could be seen.