The purpose of this study was to investigate the complementary effects of polyphenolic compounds from pine bark extract (PE) as a strong antioxidative substrate on the symptoms of inattention and impulsivity in children with attention-deficit hyperactivity disorder (ADHD). This was a randomized, double-blind, crossover, placebo-controlled study that included two experimental units (4 weeks with PE supplementation and 4 weeks with placebo supplementation) separated by a 2-week washout period. ADHD participants were supplemented with 25 mg or 50 mg PE. We recruited 20 participants (17 boys and 3 girls) with a mean age of 10.0 ± 2.1 years. PE supplementation caused a significant reduction in the inattention and hyperactivity-impulsivity items of SNAP-IV. During the period of PE supplementation, the item of commissions in the Continuous Performance Test III (CPT III) significantly decreased, which was used to evaluate the symptoms of inattention and impulsivity. In addition, the erythrocytic reduced glutathione/oxidized glutathione ratio significantly increased, and the plasma TBARs level significantly decreased after 4 weeks of PE supplementation. However, there was no significant correlation between CPT III (commission) and antioxidative status indictors. PE supplementation may have potential effects of ameliorating inattention and impulsivity, and elevating the antioxidative status in children with ADHD. K E Y W O R D Sattention-deficit hyperactivity disorder, oxidative stress, pine bark extract | INTRODUCTIONAttention-deficit hyperactivity disorder (ADHD) is one of the most prevalent neurobiological disorders in the world and presents a complex, highly inheritable etiology (Polanczyk, Willcutt, Salum, Kieling, & Rohde, 2014). The global prevalence of ADHD in school-age children is 5.3%-7.1%, which varies according to different diagnostic tools, diagnostic criteria, and case samples (Thomas, Sanders, Doust, Beller, & Glasziou, 2015). On the other hand, Huang et al. used a National Health Insurance database and found that the prevalence of ADHD among Taiwanese school children was 7%-12% and was more common among boys (14.9%) than girls (4.5%) (Huang, Chu, Cheng, & Weng, 2014). This difference is partially because boys have explicit behaviors, which are more easily exhibited in early stages. Conversely, girls often show inattention, anxiety, and depression. It was reported that in around 60% of children with ADHD, the problems of inattention and hyperactivity continue to occur in adulthood (Barkley,

Our previous study also showed that ADHD children who received 1 mg/ kg BW/day of PE showed the improvement effects on inattention and impulsivity, and reduction of plasma lipid peroxidation levels during a 4-week experimental period [9]. Therefore, we hypothesized that PE also could improve symptoms of inattention and impulsivity in adults with ADHD, which are well-correlated with elevated antioxidative status. This study was carried out to verify this hypothesis. Methods Participant recruitmentThe study was approved by the Taipei Medical University (TMU)-Joint Institutional Review Board (protocol ID: N201706026, ClinicalTrails.gov ID: NCT03368690). All procedures were conducted according to principles expressed in the Declaration of Helsinki. Written informed consent was obtained from all participants.

This study investigated the beneficial effects of epidermal growth factor (EGF) on muscle loss in rats with chronic ethanol feeding. Six-week-old male Wistar rats were fed either a control liquid diet without EGF (C group, n = 12) or EGF (EGF-C group, n = 18) for two weeks. From the 3rd to 8th week, the C group was divided into two groups. One was continually fed with a control liquid diet (C group), and the other one was fed with an ethanol-containing liquid diet (E group); moreover, the EGF-C group was divided into three groups, such as the AEGF-C (continually fed with the same diet), PEGF-E (fed with the ethanol-containing liquid diet without EGF), and AEGF-E (fed with the ethanol-containing liquid diet with EGF). As a result, the E group had significantly higher plasma ALT and AST, endotoxin, ammonia, and interleukin 1b (IL-1b) levels, along with liver injuries, such as hepatic fatty changes and inflammatory cell infiltration. However, plasma endotoxin and IL-1b levels were significantly decreased in the PEGF-E and AEGF-E groups. In addition, the protein level of muscular myostatin and the mRNA levels of forkhead box transcription factors (FOXO), muscle RING-finger protein-1 (MURF-1) and atorgin-1 was increased considerably in the E group but inhibited in the PEGF-E and AEGF-E groups. According to the principal coordinate analysis findings, the gut microbiota composition differed between the control and ethanol liquid diet groups. In conclusion, although there was no noticeable improvement in muscle loss, EGF supplementation inhibited muscular protein degradation in rats fed with an ethanol-containing liquid diet for six weeks. The mechanisms might be related to endotoxin translocation inhibition, microbiota composition alteration as well as the amelioration of liver injury. However, the reproducibility of the results must be confirmed in future studies.

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