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ABSTRACT
Free radicals and antioxidant therapy have attracted a great deal of attention in recent years. Antioxidants are compounds that
destroy the free radicals in the body, thereby preventing harmful oxidation-reduction reactions. Antioxidants are critical for
maintaining optimum health and well-being. The best sources of antioxidants are fruits and vegetables, which provide a variety of
antioxidants such as Vitamins A, C, E, and carotenoids. Currently available data are compatible with the notion that these vitamins
act as chemopreventives against some important cancers, e.g., carotenoids for lung cancer, ascorbic acid for salivary gland cancer,
tocopherols for head and neck cancers, etc. Thus, a greater consumption of fruits and vegetables should be encouraged as they are
the natural sources of these chemopreventive antioxidants along with other protective factors packaged by nature.
Key words: Antioxidants, beta carotene, free radicals, lycopene, oral cancer
DOI: 10.4103/0972-1363.57770
DOI
Vitamin C
Address for Correspondence
Correspondence: Dr. Arvind Shetti, Department of Oral
Medicine and Radiology, KLE’S V. K. Institute of Dental Sciences, Belgaum, Vitamin C scavenges free radicals that are in an aqueous
Karnataka, India. E-mail: shettiarvind01@rediffmail.com environment, such as inside the cells. It is believed to be
Journal of Indian Academy of Oral Medicine and Radiology / Jan-Mar 2009 / Volume 21 / Issue 1 1
Shetti, et al.: Antioxidants
the most important antioxidant in extracellular fluids and it cells). Beta-carotene is also especially used for scavenging
has many known intracellular activities as well.[8] Vitamin C free radicals in areas of low oxygen concentration.
works synergistically with Vitamin E to quench free radicals.
Selenium
Beta-carotene Selenium is a trace element. It forms the active site of several
Beta-carotene is the best quencher of singlet oxygen (an antioxidant enzymes including glutathione peroxidase.
energized but uncharged form of oxygen that is toxic to Similar to selenium, the minerals manganese and zinc
are trace elements that form an essential part of various
antioxidant enzymes.
ANTIOXIDANTS
ANTIOXIDANT-ENZYMES
2 Journal of Indian Academy of Oral Medicine and Radiology / Jan-Mar 2009 / Volume 21 / Issue 1
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Shetti, et al.: Antioxidants
sequestering transition metal ions and preventing present in tomatoes.[4] Lycopene has been hypothesized
Fenton reactions and are therefore largely proteins by to prevent carcinogenesis and atherogenesis by protecting
nature (e.g., albumin, transferring, or lactoferrin) critical cellular biomolecules, including lipids, lipoproteins,
proteins, and DNA.[1–3] In recent studies, serum and tissue
LYCOPENE levels of lycopene were shown to be inversely associated
with the risk of breast cancer, prostate cancer, coronary
Lycopene is one of the most potent antioxidants primarily heart disease,[7] and oral premalignant lesions. According
Figure 2: Fresh fruits-rich sources of antioxidants Figure 3: Green leafy vegetables/guard against free radicals
Figure 4: Tomatoes important source of lycopene Figure 5: Lycopene guard against oral cancer
Journal of Indian Academy of Oral Medicine and Radiology / Jan-Mar 2009 / Volume 21 / Issue 1 3
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Shetti, et al.: Antioxidants
to various studies, lycopene, when given in the dosage of initial lesion or to prevent the development of a second
4–8 mg/day orally for 3 months,[6] leads to the reversal of or a separate primary
dysplastic changes in leukoplakia and when given in the
dosage of 16 mg/day[13] leads to substantials increase in ANTIOXIDANTS AND THE PREVENTION OF CANCER
the mouth opening in oral submucous fibrosis. Estimating
the daily intake of lycopene has been difficult due to the Antioxidants play a role in the later stages of cancer
variability of reported values in the food sources. On development. DNA damage is considered to be one of
average, the daily intake of lycopene is estimated to be 3.7 the most important contributors to cancer. Much of this
mg[12] [Figures 4 and 5]. damage is oxidative in nature. Antioxidants may be able
to cause the regression of premalignant lesions or inhibit
BETA CAROTENE their development into cancer. Preliminary studies have
indicated that some antioxidants, particularly ß-carotene,
The carotenoids are a group of red, orange, and yellow may be of benefit in the treatment of precancerous
pigments found in fruits and vegetables.[8] These include conditions such as oral leukoplakia, which may be a
b-carotene (carrots), lycopene (tomatoes), and lutein precursor to oral cancer.[8] Some antioxidant nutrients may
(spinach).[11] Carotenes have an excellent property of protect against cancer through mechanisms other than their
free radical trapping, especially peroxyl and hydroxyl antioxidant properties. For example, carotenoids may both
radicals, which are involved in the genesis of cancers enhance immune function and increase gap junctional
and aging. Beta carotene also increases cell mediated communication (a type of interaction between cells that
immune responses due to increased monocyte expression inhibits cell proliferation); both of these actions may be
and increased activity of the tumor necrosis factor alpha. relevant to cancer prevention.[8] In general, high intake
Serum beta carotene levels have been shown to decrease of fruits and vegetables are associated with a protective
in various oral premalignant lesions and conditions and its effect against cancer. Both biochemical and epidemiologic
supplementation (30 mg/day) [16] have led to the regression studies have indicated that antioxidant nutrients may have
of the lesions. important protective effects in the prevention of human
cancer [Figure 8].
PHYTOCHEMICALS
PROTECTIVE ROLES OF MICRONUTRIENTS IN
These are non nutrient compounds that have biological
activity inside the human body. They provide colors,
CARCINOGENESIS[18]
taste, and aromas to the fruits and vegetables. They mimic
Nutrients and their functions
hormones and suppress the development of diseases.
1. Beta-carotene
Phenolic compounds such as flavonoids have been
Precursor of Vitamin A
demonstrated to have anti-inflammatory, anti-allergenic,
Anti-oxidant and free radical scavenging
anti-viral, anti-aging, and anti-carcinogenic activity.[9,10] In
Immunomodulation, stimulation of increase in the
addition to an antioxidant effect, flavonoid compounds may
numbers of T-helper and NK cells as well as cells with
exert protection against heart disease through the inhibition
IL-2 receptors
of cyclooxygenase and lipoxygenase activities in platelets
and macrophages[10] [Figures 6 and 7].
4 Journal of Indian Academy of Oral Medicine and Radiology / Jan-Mar 2009 / Volume 21 / Issue 1
Shetti, et al.: Antioxidants
Journal of Indian Academy of Oral Medicine and Radiology / Jan-Mar 2009 / Volume 21 / Issue 1 5
Shetti, et al.: Antioxidants
9. Cody V, Middleton E, Harborne JB. Plant flavonoids in biology 2007;17:173-4.
and medicine-biochemical, pharmacological, and structure-activity 15. Meyers DG, Maloley PA, Weeks D. Safety of antioxidant vitamins.
relationships. New York, NY: Alan R. Liss; 1986. Arch Intern Med 1996;156:925-35.
10. Havsteen B. Flavonoids: A class of natural products of high 16. Kaugars, Silverman, Lovas. A clinical trial of antioxidant supplements
pharmacological potency. Biochem Pharm 1983;32:1141-8. in the treatment of oral leukoplakia. Oral Surg Oral Med Oral Path
11. Prasad KN, Kumar A. High doses of multiple antioxidant vitamins: 1994;78:462-8.
Essential ingredients in improving the efficacy of standard cancer 17. Singh, Gaby. Premalignant lesions: Role of antioxidant vitamins
therapy. J Am Coll Nutr 1999;18:13-25. and beta carotene in the risk reduction and prevention of malignant
12. Rao LG, Guns E, Venketrao A. Lycopene: Its role in human health transformation. Am J Clin Nutr 1991;53:386S-90S.
and disease. Agro Food Industry 2003;25:1-6. 18. Enwonwu, Meeks. Bionutrition and oral cancer in humans. Crit Rev
13. Kumar A, Bagewadi A, Keluskar V. Efficacy of lycopene in the Oral Biol Med 1995;6:5-17.
management of oral submucous fibrosis. Oral Surg Oral Med Oral
Path Oral Radiat Endod 2007;103:207-13.
14. Carnelio S, Khan SA. Free radicals and antioxidant therapy in Source of Support: Nil, Conflict of Interest: None declared
clinical practice: To be or not to be. J Coll Physicians Surg Pak
6 Journal of Indian Academy of Oral Medicine and Radiology / Jan-Mar 2009 / Volume 21 / Issue 1
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