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Chronic Smokeless Tobacco Consumption Contributes to the Development of Renal Diseases in the Human Male Volunteers

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Chronic Smokeless Tobacco Consumption Contributes to the Development of Renal Diseases in the Human Male Volunteers Journal of Analytical & Pharmaceutical Research Research Article Open Access Chronic smokeless tobacco consumption contributes to the development of renal diseases in the human male volunteers Abstract Volume 7 Issue 6 - 2018 Smokeless tobacco may able to induce microalbuminuria. The present study S Fareeda Begum,1 G Nagajothi,2 K investigates the relation between nicotine and cotinine with renal function in gutkha Swarnalatha,1 C Suresh Kumar,1 Narendra and khaini users. Methods: The levels of nicotine and cotinine were estimated by HPLC 1 methods and other urine variables were detected by spectrophotometric methods. Maddu 1 Current smokeless tobacco users have shown that significantly elevated levels of Department of Biochemistry, Sri Krishnadevaraya University, India nicotine, cotinine, and epinephrine excretion in the urine than non-tobacco users. 2Department of Corporate Secretaryship, Queen Mary’s Renal function was assessed by glomerular filtration rate (GFR), levels of urea, and College (Autonomous), India creatinine. Among the kidney function measures that we examined, microalbuminuria, decreased glomerular filtration rate, and creatinine clearance were found associated Correspondence: Narendra Maddu, Assistant Professor, with gutkha and khaini users. Significantly decreased proteinuria, urea and increased Department of Biochemistry, Sri Krishnadevaraya University, levels of uric acid and creatinine excretion with the concomitant increase in plasma Ananthapuramu-515003, Andhra Pradesh, India, Tel 91+ total proteins, urea, and decreased uric acid levels were observed in the group I and 9441983797, Email group II users compared to group III users. The products of smokeless tobacco are regarded as good predictors of assessing the free radical levels in the cells. The active Received: June 01, 2018 | Published: November 26, 2018 markers of nitroxidative stress have been elevated progressively with the uptake of nicotine and exposure. The nicotine and cotinine were significantly positive correlated with renal markers (creatinine, urea, and GFR), nitric oxide, malondialdehyde, and epinephrine. Increased excretion of nicotine and epinephrine indicated that the renal related complications may occur. The smokeless tobacco products were significantly and directly proportional to the levels of kidney dysfunction. Keywords: albuminuria, cotinine, glomerular filtration rate, nicotine, renal diseases Abbreviations: SLT, smokeless tobacco; MDA, lipid peroxidation process and used as a marker of oxidative stress. malondialdehyde; CKD, chronic kidney disease; iNOS, inducible The reactive nitrogen species include nitric oxide and peroxynitrites nitric oxide synthase; GFR, glomerular filtration rate with active groups disrupts and damage the DNA and proteins in the cells.9 The adverse effects of smokeless tobacco on renal function Introduction have gained more attention. Uric acid is the end product of purine metabolism in blood and marked it acts as an early sign of kidney Tobacco is consumed mainly in two forms named as smoking 10 1 injuries. Oral intake of tobacco by chewing also increased the tobacco and smokeless tobacco. The smokeless tobacco (SLT) excretion as nicotine which can be absorbed from oral mucosa.11 consumption is greatly prevalent in at least 70 low, middle and high 2 Urinary excretion of nicotine and cotinine can be used as an index of income countries, consumed by more than 300 million people. smokeless tobacco consumption and prevalence. Urinary albumin is a Smokeless tobacco is ingested as chewing, sucking and through the sensitive marker of glomerular injury and microalbuminuria indicates nasal mucosa, but not smoked. Smoking bans in public places has renal damage induced by smokeless tobacco. The aim of the present increased, the consumption of smokeless tobacco has risen as an 3 study was to determine the excretion of nicotine and cotinine in the alternative source of cigarettes. Smokeless tobacco products are urine of gutkha and khaini users and their relationship with renal available in Indian market in multiple forms like khaini, gutkha, complications. mawa, panmasala with tobacco, betel containing lime, catechu, zarda, and dry leaves of tobacco.4 Nicotine is major alkaloid and acts as drug Materials and methods specific present in the leaves of Nicotiana tubacum tertiary amine consists of pyridine and a pyrrolidine rings.5 The major portion of Chemicals metabolism in nicotine is convert the cotinine and 3-hydroxycotinine Nicotine with purity of ≥99% and cotinine with purity of 98% was in smoker users.6,7 Different people convert different percentage of used as internal standards for analysis by HPLC method. Standard nicotine to cotinine and metabolize cotinine differently at different epinephrine, Methanol, Dichloromethane, Diethyl ether, Acetonitrile, rates.8 Cotinine acts as a marker of nicotine exposure and a major Sodium n-Heptane sulponic acid, Potassium dihydrogen phosphate metabolite and its detection is performed in blood, saliva and urine (KH PO ), Ammonium acetate and Acetic acid (HPLC grade), N-1- samples. Smokeless tobacco products could promote the production 2 4 naphthylethylene diamine (NED), Trichloroacetic acid (TCA), of oxygen derived free radicals that enhance the higher rates of lipid Thiobarbituric acid (TBA) and all other fine chemicals were purchased peroxidation. Urinary malondialdehyde is one of the products of from Sigma Aldrich, Bangalore. Submit Manuscript | http://medcraveonline.com J Anal Pharm Res. 2018;7(6):652‒662. 652 © 2018 Begum et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Chronic smokeless tobacco consumption contributes to the development of renal diseases in the human 653 male volunteers ©2018 Begum et al. Study area and data collection described earlier. The values obtained by this procedure represent the sum of nitrite and nitrate levels in the form of nitric oxide (NO). Ninety human male volunteers were included in this study. The entire studied population was subdivided into three groups: Determination of lipid peroxidation Gutkha and khaini users are the experimental groups which include The extent of lipid peroxidation was measured by the formation of mainly auto drivers, car mechanics and house builders by using a 14 questionnaire and the control group or non-tobacco users, individuals malondialdehyde (MDA) by the method of Buege. One millilitre of who do not consume any form of tobacco were enrolled in this study. urine was taken in a test tube to which 2ml of reagent (15% w/v TCA, The inclusion criteria are the habitual use of only gutkha and khaini 0.375% w/v TBA and 0.25N HCl) was added and kept in boiling packets by the gutkha and khaini users respectively, and the unmarried water bath for 15 min and the contents were allowed to cool and then and low economic status people were chosen. The exclusion criteria centrifuged at 1000g for 10 min. The supernatant was transferred are the consumed either alcohol or smoking groups or religious of the into a separate test tube and the absorbance of the sample was read at 535nm by a UV-Visible spectrophotometer against the reagent blank people are not preferred. Each group consisted of thirty volunteers 5 and the baseline information for the category of SLT users was that assuming the molar extinction coefficient to be 1.56 X 10 . individuals used smokeless tobacco products habitually, at least 5 HPLC times of 4-5 g per day for 4 years. This study was approved by the Institutional Ethical Committee. HPLC system (Shimadzu, Japan) is equipped with a binary gradient system with variable UV/VIS detector (SPD-20A) and Group I - Gutkha users Rheodyne injector with a 20µl loop and LC-20AD pumps and Group II - Khaini users integrator. Reversed phase chromatographic analysis was performed in isocratic condition using C18 reverse phase column (5µ) at 37°C. Group III- Normal controls. HPLC operating conditions of nicotine and cotinine Urine collection and analysis Resolution of peaks was performed with the mobile phase First urine samples in morning were collected in a sterile flask consisting a mixture of 0.272g of KH2PO4, 0.184g of sodium covered with aluminium foil to keep out stray light and processed n-heptane sulfonate, 820ml of water (HPLC-grade), and 180ml of within 2h of the collection. The collected samples were centrifuged at methanol (HPLC grade). The pH of the mobile phase was adjusted 2000g for 10min for further analysis. by drop wise addition of ortho phosphoric acid (pH=3.2). The flow rate used was 1.0ml/min, and the wavelength was fixed at 256nm Biochemical estimations for nicotine and 262nm for cotinine as per the modified method of The concentrations of nicotine, cotinine and epinephrine in urine Massadeh et al.15 Nicotine and cotinine at the concentration of 20µM/ samples were estimated by HPLC method. Spectrophotometric ml were used as standards. methods were used to determine the levels of creatinine, lipid Sample analysis of nicotine and cotinine peroxiation and nitric oxide (nitrite and nitrates). Total proteins, albumins, urea and uric acid levels were estimated by auto analyzer kit Sample analysis was processed by the modified method of methods. Glomerular filtration rate (GFR), urea clearance, creatinine Massadeh et al.15 An aliquot of urine (0.1ml) was placed into a glass clearance, albumin creatinine ratio and protein creatinine
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