REVIEW ARTICLE
Year : 2010  |  Volume : 1  |  Issue : 2  |  Page : 23-28 Table of Contents     

Multitude potential of wheatgrass juice (Green Blood): An overview


Maharaja Surajmal Institute of Pharmacy, C-4, Janakpuri. New Delhi- 110058, India

Date of Submission01-Feb-2010
Date of Acceptance05-Mar-2010
Date of Web Publication7-Oct-2010

Correspondence Address:
Swati Padalia
Maharaja Surajmal Institute of Pharmacy, C-4, Janakpuri. New Delhi- 110058
India
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Source of Support: None, Conflict of Interest: None


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  Abstract 

Wheatgrass is the young grass of the common wheat plant Triticum aestivum Linn., family Poeaceae (Graminae). It is commonly known as the "green blood" due to its high chlorophyll content which accounts for 70% of its chemical constituents. It contains a plethora of vitamins, minerals, amino acids and vital enzymes like superoxide dismutase and cytochrome oxidase. The vitamin content makes it an important adjuvant in anti-allergic and anti-asthmatic treatment, while the enzymes play a pivotal role in the anticancer approach of this herbal drug. A notable feature of the wheatgrass juice is its bioflavonoid content which are the naturally occurring antioxidants and ac­count for many of its clinical utilities such as management of inflammatory bowel disease and as a general detoxi-fier. However, the most remarkable feature of the wheatgrass juice is its high chlorophyll content. Chlorophyll bears structural similarity to hemoglobin and has been found to regenerate or act as a substitute of hemoglobin in hemoglobin deficiency conditions. This might be the reason behind the utility of wheatgrass in clinical conditions like thalassemia and hemolytic anemia. The present article focuses onto the various studies emphasizing the multi­tude potentials of wheatgrass.

Keywords: Triticum aestivum Linn., chlorophyll, green blood, bioflavonoids, antioxidant


How to cite this article:
Padalia S, Drabu S, Raheja I, Gupta A, Dhamija M. Multitude potential of wheatgrass juice (Green Blood): An overview. Chron Young Sci 2010;1:23-8

How to cite this URL:
Padalia S, Drabu S, Raheja I, Gupta A, Dhamija M. Multitude potential of wheatgrass juice (Green Blood): An overview. Chron Young Sci [serial online] 2010 [cited 2018 Apr 23];1:23-8. Available from: http://www.cysonline.org/text.asp?2010/1/2/23/70464


  Introduction Top


Wheatgrass refers to the young grass of the common wheat plant, Triticum aestivum Linn., family Poeaceae (Grami-nae), [1] which is freshly juiced or dried into powder for animal and human consumption - both the forms provide chlorophyll, amino acids, minerals, vitamins, and enzymes. It is also known as "living food" and is a superior source of chlorophyll - appropriately referred to as the "green blood" .Various chlorophyll-rich greens are being used from vari­able sources, since prehistoric times, as blood builders. Thus, wheatgrass, containing about 70% chlorophyll, has been proclaimed to improve blood flow, aid in digestion and in general detoxification of the body.

Source

Although the major Indian source is Triticum aestivum, there are several other varieties of wheatgrass in the follow­ing plant genera: Agropyron spicatum (bluebunch wheat-grass), Agropyron cristatum (Crested wheatgrass,), Agropyron trachycaulum (slender wheatgrass), Elytrigia, Eremopyrum, Pascopyrum, and Pseudoroegneria which are commonly found in temperate regions of Europe and the United States.

The environment in which wheatgrass grows determines its vitality and is thus sown in late autumn for maximum con­centration of the active principles. The nutritional vibrancy of wheatgrass is encouraged by supplementing the soil with rich vegetable compost and seaweed. At the onset of the spring season, the simple sugars produced as a result of photosynthesis, undergo conversion into proteins, carbohy­drates and fats, with the aid of the various enzymes and minerals absorbed by the plant via its roots. Due to the comparatively lower temperatures in the spring, the grass grows slowly enough for this conversion to occur before the critical jointing stage of growth. At jointing, or the repro­ductive stage of the plant, the nutrients and energy of the plant are redirected to seed formation. Wheatgrass is har­vested just prior to this jointing stage, when the tender shoots are at their peak of nutritional potency.

Chemical constituents

The name "green blood" of wheatgrass is attributable to its high chlorophyll content which accounts for 70% of its total chemical constituents. Wheatgrass juice is a rich source of Vitamins A, C, E and B complex. It contains a plethora of minerals like calcium, phosphorus, magnesium, alkaline earth metals, potassium, zinc, boron, and molybdenum. The various enzymes responsible for its pharmacological ac­tions are protease, amylase, lipase, cytochrome oxidase, transhydrogenase, super oxide dismutase (SOD). The other notable feature of wheatgrass is its high proportion of ami-no acids such as aspartic acid, glutamic acid, arginine, ala-nine and serine.

The major clinical utility of wheatgrass juice is due to its antioxidant action which is derived from its high content of bioflavonoids like apigenin, quercitin and luteolin. Other compounds present, which make this grass therapeutically effective, are the indole compounds, choline and laetrile (amygdalin). [Figure 1] and[Figure 2] The different constituents of wheatgrass occuring in different proportions are repre­sented in [Table 1].
Figure 1: Structure of Apigenin

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Figure 2: Structure of Laetrile

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Table 1: Different constituents of wheatgrass occur in the following proportion in the plant

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In a study conducted to determine the elemental concentra­tion profile of wheatgrass using instrumental neutron acti­vation analysis, it was found that the concentration of ele­ments such as K, Na, Ca and Mg increased linearly in the shoots with the growth period whereas the concentrations of the elements namely Zn, Mn and Fe remained constant in shoots after 8th day of plant growth for all three conditions of growth. However, it was observed that the shoot to root concentration ratio in all the conditions increased linearly for K, Na, Ca, Mg and Cl and decreased for Zn, Fe, Mn, and Al with growth period. [2]

Chlorophyll as green blood

The analogy between chlorophyll and hemoglobin can be demonstrated with respect to the structure of their porphy-rin heads. [Figure 3] and [Figure 4] The structure of both the com­pounds depicts a striking similarity in having a tetra pyrrole ring structure, the only difference between the two being the nature of the central metal atom - magnesium (Mg) in chlorophyll and iron (Fe) in hemoglobin. The apparent re­semblance between the two is thus considered to be respon­sible for the therapeutic effects shown by chlorophyll in conditions involving deficiency of hemoglobin.
Figure 3: Structure of Chlorophyll Molecule

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Figure 4: Structure of Tetra Pyrrole Head of Hemoglobin

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Hemoglobin and its congeners are protein bodies which act as the oxygen carrier in higher animals by binding two elec­trons attached to the oxygen molecule, whereas chlorophyll is the active metabolic agent in plants which assimilates carbon from the carbon dioxide of the atmosphere by pro­ducing two electrons which are then transmitted through electron transport chain. The structural similarity between the two compounds is stipulated to be the reason behind the limited use of chlorophyll as a blood substitute in condi­tions like chronic anemia, tissue hypoxia, thalassemia and other hemolytic disorders etc.


  Clinical utilities of wheatgrass Top


1. Blood builder in thalassemia major

Beta-thalassemia is a genetically inherited disorder that arises due to abnormal beta globin chains which are re­quired for the synthesis of adult hemoglobin (HbA). The characteristic deficiency of beta globin chains, seen in tha-lassemia, results in the production of abnormal red blood cells (RBCs) having a preponderance of alpha globin chains. This leads to destruction of such RBCs in the spleen and a decreased number of RBCs in the blood. Individuals with thalassemia may continue to produce gamma globin chains in an effort to increase the amount of fetal hemoglo­bin (HbF) and compensate for the deficiency of HbA. [3] Thus, induction of fetal hemoglobin in thalassemia can im­prove the patient's clinical condition. Drugs exhibiting this function like hydroxyurea are not used conventionally due to lack of specificity and greater degree of side effects. [4] 3-5 fold increase in the production of HbF on consumption of wheatgrass has been reported using a cellular assay. This has now been confirmed by the development of a specific assay method for HbF, which is based on detecting its pro­duction in human erythroleukemia cells using a fluorescent protein gene that replaces the genes for HbF. [5] The level and speed of induction of HbF by the wheatgrass extract is significantly greater than any of the pharmaceutical induc-ers available. Chlorophyll extracted from the wheatgrass plant or its synthetic derivative chlorophyllin has also been implicated in this clinical condition. The antioxidant mechanism of the various wheatgrass constituents may be responsible for the beneficial effects. The enhanced anti-oxidative capacity of the RBCs may prolong the survival time of not only the newly formed cells, but also of the transfused RBCs. [6]

In a clinical study, wherein the thalassemic patients were administered wheatgrass juice on a daily basis, the follow­ing conclusions were drawn -

  1. 50% patients showed upto 25% reduction in transfu­sion requirement.
  2. The mean time interval between transfusions in­ creased to 29.5%
  3. Hemoglobin levels were not compromised by reduced transfusion volumes.
  4. The patients reported general well-being, improved appetite and reduced musculo-skeletal aches and pains. [7]


2. Adjuvant therapy in hemolytic anemia

It was seen that wheatgrass juice therapy decreased the total volume of blood transfused and increased the intervals be­tween blood transfusions of the entire study cohort. These analyses suggested that not only is this therapy effective, but also that the benefit is related to the duration of the wheatgrass juice therapy. The beneficial effects of this ther­apy have been attributed to its rich nutritional content that includes antioxidant vitamins (C&E) and bioflavonoids. The effects of the wheatgrass juice therapy may be due to the action of natural antioxidants on red blood cell (RBC) antioxidant function and corresponding effects on cellular enzyme function and membrane integrity. This thought is supported by studies that show decreased antioxidant ca­pacities of RBCs of patients with hemolytic disorders as well as beneficial effects on RBC life-span by supplementa­tion of antioxidants in vivo. [8]

The response to this therapy took some months (called as the "neutral period") which may suggest that the natural antioxidants contained in the wheatgrass juice are better able to prevent cellular injury than to repair RBC en­zymes/membranes once damaged. Hence, RBCs, once damaged, would be cleared from the circulation by the re-ticuloendothelial system as they would prior to the onset of this therapy, but newly formed RBCs would not be dam­aged and would have a longer life-span.

While clinical trials are currently underway to find suitable blood substitutes for patients needing blood transfusions, they may not be readily available in developing countries nor would they be preferable to natural therapies aimed at preserving a patient's own RBCs. Therefore, wheatgrass juice and other nutritional therapies may be considered as adjuvant to drug therapy.

3. Supportive care for terminally ill cancer patients

Wheatgrass juice is an integral part of the macrobiotic diet under the complementary and alternative medicine (CAM) approach of anticancer therapy, due to its high antioxidant content. Wheatgrass juice is a highly placed source of chlo­rophyll, laetrile and antioxidant enzyme Superoxide dismu-tase (SOD). Wheatgrass intake enhances hemoglobin syn­thesis as chlorophyll bears a structural analogy to hemoglobin. This results in augmented oxygen supply to all body cells including cancer cells which are highly vulnerable to high oxygen concentration due to the deleterious effects caused by the generation of reactive oxygen species (ROS). The enzyme SOD catalyses the generation of hydrogen peroxide from superoxide radicals, and thus further ads onto this effect. [9]

Chlorophyll, like other tetrapyrroles, has the ability to in­duce mammalian phase 2 proteins that protect cells against oxidants and electrophiles. The capacity of this compound to induce the phase 2 response depends upon its ability or that of its metabolites to react with thiol groups. Its pseudo second-order rate constant is correlated with its potency in inducing the phase 2 enzyme NAD (P) H:quinone oxidoreductase 1 (NQO1) in murine hepatoma cells. One of the most potent inducers was isolated from chlorophyllin, a semisynthetic water-soluble chlorophyll derivative. Although chlorophyll itself is low in inducer potency, it may nevertheless account for some of the dis­ease-protective effects attributed to diets rich in green vege­tables like wheatgrass because it occurs in much higher concentrations in these plants. [10]

Another constituent of wheatgrass implicated as an antican-cer agent is the plant hormone abscisic acid (ABA) or dormin. This hormone is 40 times more potent 4 hours after cutting the wheatgrass plant. ABA can neutralize the effect of the hormone chorionic gonadotropin and a compound similar to this hormone has been found to be produced by the cancer cells. [11]

A novel anticancer approach utilizes high alkalinity in the cancer chemotherapy. Firstly, an alkaline diet helps to re­duce the number of microbes in the diet. This attenuates the incidence of secondary infections to a certain degree in the patient. Secondly, the cancer cells succumb in a highly al­kaline environment. As the pH of the wheatgrass juice is around 7.4, it is being considered a viable option under this approach. [12] Other postulated mechanisms by which wheatgrass juice appears beneficial include antioxidant activity preventing oxidative damage to deoxyribonucleic acid (DNA) and lipid peroxidation, stimulation of gap junc­tion communication, effects on cell transformation and dif­ferentiation, inhibition of cell proliferation and oncogene expression, effects on immune function and inhibition of endogenous formation of carcinogens. [13]

4. Management of inflammatory bowel disease

Inflammatory Bowel Disease (IBD) refers to the inflamma­tion of the intestines and includes two chronic conditions namely ulcerative colitis and Crohn's disease, both being characterized by rectal bleeding, diarrhea and abdominal pain. Although IBD is idiopathic, an increased incidence of IBD has been noted in urban areas due to the higher con­centrations of microparticles in the urban diets such as tita­nium dioxide and aluminosilicates which may combine with other substances in the intestine (such as bacterial components) and form antigenic particles. The antigenic particles so formed trigger the inflammatory cascade by stimulating gene encoding for the NOD2 protein. NOD2 is believed to play a role in the recognition of bacterial parti­cles and subsequent activation of the inflammation cascade by the activation of protein NF-kappa B. This results in the release of various mediators of inflammation such as cyto-kines, Tumour Necrosis Factor (TNF) etc. [14] Wheatgrass juice is currently under investigation as a pos­sible therapy for ulcerative colitis as it is rich in bioflavon-oids which are believed to possess both anti-inflammatory and antioxidant properties. One of these bioflavonoid, api-genin, has been shown to in TNF induced transactivation [15]

In an experiment conducted on rats to establish its role as an anti-carcinogenic compound, the animals exposed to the carcinogen N-nitrosodiethylamine were administered api-genin for 14 consecutive days. The level of lipid peroxida-tion markedly increased in carcinogen administered ani­mals, which was brought back to near normal by apigenin treatment. In contrast the activities/levels of the antioxidant status both in liver and kidney were decreased in carcino­gen administered animals, which was recouped back to near normal upon apigenin administration. [15]

A randomized controlled trial of wheatgrass juice in the management of ulcerative colitis has demonstrated that there was a significant improvement in the symptomatic indicators of disease activity. In this double-blind, placebo-controlled study, 24 people with ulcerative colitis was given a daily dose of 100 cc of wheatgrass juice daily for one month .Efficacy of treatment was assessed by a 4-fold dis­ease activity index that included rectal bleeding and number of bowel movements as determined from patient diary re­cords, a sigmoidoscopic evaluation, and global assessment by a physician. In the said study, 78% of the treatment group showed improvement compared to 30% of the con­trol group. [16] However, the results of this trial were not considered convincing as the bitter taste of wheatgrass juice is difficult to reproduce and thus the study cannot be con­sidered as truly blind.

Therefore, although the efficacy of wheatgrass juice as a primary approach in the management of IBD is question­able, it can be considered as a part of adjuvant therapy which may help in cost reduction of the primary treatment.

5. Detoxifying agent

The vitality of liver is of high concern for the overall well-being of an individual as it is the major organ implicated in detoxification. In addition to the stimulating and regenera­tive properties of chlorophyll, other constituents of wheat-grass juice like choline and its high mineral content are responsible for the therapeutic benefit. In a study conducted to observe the effect of choline on liver, it was seen that choline prevents the deposition of fats in the experimental animals' liver when they were administered a diet rich in cholesterol. [17] Choline promotes the removal of the esters of both cholesterol and glycerol, with the effect on the glyceride fraction preceding that on the cholesterol esters. The lipotropic action of choline is attributed to its in vivo conversion to an active compound which is retained within the hepatic cells and enhances oxidation of fatty acids and formation of tissue lecithins. The latter effect augments lipoprotein synthesis which acts as a transport form of fatty acids in plasma and thus helps in removal of lipids from a fatty liver. [18]

It has been demonstrated experimentally that the dietary indoles like indole-3-carbinole and ascorbigen increase the activity of phase I and phase II xenobiotic metabolic enzymes in the liver and intestinal mucosa. [19] Thus the in-dole compounds of wheatgrass may have a role in the deac-tivation of carcinogens.

6. Anti-asthmatic and Anti-allergic agent

Allergy or hypersensitivity reactions are immunologically mediated responses that are triggered in certain individuals by the presence of a variety of stimuli, which are otherwise harmless to others. Asthma is a type of bronchial hyper-reactivity which is characterized by dyspnoea and airway remodeling.

The rich vitamin and antioxidant content is accounted for the anti-allergic actions of wheatgrass juice:

  1. In an infection, phagocytic leucocytes become acti­vated and they produce oxidizing compounds which are released from the cell. By reacting with these oxidants, vitamin C may decrease the inflammatory ef­fects caused by them. [20] In a study conducted to in­vestigate the relationships between the intake of the antioxidant (pro)-vitamins C, E and β-carotene and the presence of respiratory symptoms and lung func­tion, it was found that vitamin C intake was not asso­ciated with most respiratory symptoms (cough, wheeze, shortness of breath) but was inversely related with cough. Subjects with a high intake of vitamin Chad a higher forced expiratory volume in one second (FEV1) and higher forced vital capacity (FVC) than those with a low vitamin C intake. [21]
  2. Low levels of antioxidant vitamin E have been associ­ated with asthma and wheezing illness. The gamma-tocopherols protect against inflammatory cell recruit­ment and alterations to tissue cells during an antigen challenge. Allergy treatment with these tocopherols also appears to block certain inflammatory immune cells from entering the airspace and tissue spaces of the lungs, nose and sinuses. It reduces the IgE re­sponses to allergic stimuli and thus reduces the fre­quency sensitization. [22] Vitamin E intake showed no association with most symptoms and lung function, but had a positive association with productive cough.
  3. The minerals present in this plant like Zinc reduces inflammatory cytokines in the airway while magne­sium causes bronchodilatation and arrests airway in­flammation. [23]
  4. The bioflavonoids like luteolin and quercitin inhibit the release of histamine, leukotrienes, prostaglandin D2 and granulocyte macrophage-colony stimulating factor (GM-CSF) from human cultured mast cells in a concentration-dependent manner. [24]



  Pharmacokinetics Top


The proteins, lipids and carbohydrates in wheat grass are digested, absorbed and metabolized by normal physiological processes.


  Contraindications Top


Wheat grass is contraindicated in those who are hypersensitive to any component of a wheat grass containing supplement.


  Precautions Top


  • Pregnant women and nursing mothers should avoid wheat grass containing supplements.
  • Wheatgrass supplements may contain high amounts of vitamin K. Those on warfarin should exercise caution in the use of wheat grass supplements.



  Adverse reactions Top


Wheatgrass juice is safe and the incidence of side effects is very low. It may cause nausea and headache is excessive quantities are taken. Throat swelling may occur in hyper­sensitive individuals.


  Conclusion Top


Comprehensive data from number of studies has revealed the multitude effects of wheatgrass in thalassemia, hemo-lytic anemia, cancer, asthma, allergy, inflammatory bowel disease and detoxification. The structural homology of chlorophyll with hemoglobin indicates the role of chloro­phyll as a blood builder in various clinical conditions in­volving hemoglobin deficiency - thus the name "green blood". To conclude wheatgrass seems to be very promis­ing herbal drug and extensive research work is needed in order to explore its therapeutic application in various dis­eases.


  Declaration of interest Top


The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

 
  References Top

1.http://en.wikipedia.org/wiki/wheatgrass (Cited 2010 Feb 02)  Back to cited text no. 1      
2.Kulkarni SD, Acharya R., Nair AGC, Reddy A.V.R, Determination of elemental concentration profiles in tender wheatgrass (Triticum aestivum L.) using in strumental neutron activation analysis", Food Chemis-try,2006; 4: 699-707.  Back to cited text no. 2      
3.Susan PP, Gordon DG, Douglas VF, George HD, Iku-ta T, Witkowska HE, Shi-ping Cai, Vichinsky EP, Olivieri NF, A Short-Term Trial of Butyrate to Stimulate Fetal-Globin-Gene Expression in the ί-Globin Disorders, The New England Journal of Medicine, 1993; 328: 81-86.  Back to cited text no. 3      
4.Fibach E, Burke K P, Schechter A N et al, Hydroxy-urea increases fetal hemoglobin in cultured erythroid cells derived from normal individuals and patients with sickle cell anemia or bete-thalassemia, Journal of American Society of Hematology, 1993; 81(6): 1630-1635.  Back to cited text no. 4      
5.Reynolds C, A DNA technology-based cellular assay used to measure specific biological activity in a wheatgrass extract, Journal of Australasian Integrative Medicine Association., 2005:1-3.  Back to cited text no. 5      
6.Fernandes CJ, O'Donovan DJ, Natural antioxidant therapy for patients with haemolytic anemia, Indian Pediatrics, 2005; 42: 618-619.  Back to cited text no. 6      
7.Marwaha RK, Bansal D, Kaur S, Trehan A. Wheat grass juice reduces transfusion requirement in patients with thalassemia major: A pilot study. Indian Pediatrics, 2004; 41: 716-720.  Back to cited text no. 7      
8.Radhey Shyam, Som N. Singh, Praveen Vats, Vijay K. Singh et al, Wheat Grass Supplementation Decreases Oxidative Stress in Healthy Subjects: A Comparative Study with Spirulina, Journal of Alternative and Complementary Medicine., 2007; 13(8): 789-792.  Back to cited text no. 8      
9.Mates MJ, Jimenez S, Fransisca M, Role of reactive oxygen species in apoptosis: implications for cancer therapy, The International Journal of Biochemistry and Cell Biology, 2000; 32(2): 157-170.  Back to cited text no. 9      
10.Jed WF, Katherine KS, Dinkova-Kostova AT, Egn-er PA, Kensler TW, Talalay P, Chlro-phyll, chlorophyllin and related tetrapyrroles are significant inducers of mammlian phase 2 cytoprotective genes, oxford journals : Carcinogenesis, 2005; 26(7): 1247-1255.  Back to cited text no. 10      
11.Livingston, Abscisic acid tablets and process, United States Patent 3958025, 1976.  Back to cited text no. 11      
12.Pokhrel N, Use of natural foods in preventing bone marrow depression in cancer patients who are under chemotherapy, Research Report, Institute Of Medicine, Tribhuvan University, Maharajgunj, Kath-mandu,1999.  Back to cited text no. 12      
13.Wheat J, Currie G, Herbal medicine for cancer patients: An evidence based review, Internet Journal of Alternative Medicine, 2008, 5(2).  Back to cited text no. 13      
14.Shah S, Dietary Factors in the Modulation of Inflammatory Bowel Disease Activity, Medscape General Medicine, 2007; 9(1): 60.  Back to cited text no. 14      
15.Singha V, Prince J, Selvendirana K, Mumtaz BS, Padmavathia R, Sakthisekarana D, Protective role of Apigenin on the status of lipid peroxidation and anti-oxidant defence against hepatocarcinogenesis in Wis-tar albino rats. Phytomedicine, 2004; 11(4): 309-314.  Back to cited text no. 15      
16.Ben-Arye E, Goldin E, Wengrower D, Stamper A, Kohn R, Berry E, Wheat Grass Juice in the Treatment of Active Distal Ulcerative Colitis: A Randomized Double-blind Placebo-controlled Trial. Scandinavian Journal of Gastroenterology, 2002; 37(4): 444-449.  Back to cited text no. 16      
17.Best CH, Ridout JH, The effects of cholesterol and choline on deposition of liver fat. The Journal of Physiology. 1933; 78(4): 415-418.  Back to cited text no. 17      
18.Best CH, Channon, Harold J. The action of choline and other substances in the prevention and cure of fatty livers. Biochemical Journal. 1931; 29(12): 2651-2658.  Back to cited text no. 18      
19.Christine B, Eggleston IM, Hayes JD. Dietary Indoles and Isothiocyanates That Are Generated from Cruciferous Vegetables Can Both Stimulate Apoptosis and Confer Protection against DNA Damage in Human Colon Cell Lines. Cancer Research. 2001; 61: 6120-6130.  Back to cited text no. 19      
20.Hemila H. Vitamin C and the common cold. British Journal of Nutrition. 1992; 67: 3-16.  Back to cited text no. 20      
21.Grievink L, Smit A, Ocke MC, Pieter V, Kromhout D. Dietary intake of antioxidant (pro)-vitamins, respiratory symptoms and pulmonary function: the MOR-GEN study. Thorax-Internationl Journal of Respiratory Medicine. 1998; 53(3): 166-171.  Back to cited text no. 21      
22.Andrew F, Sarah L, Weiss S, Britton J. Dietary vitamin E, IgE concentrations, and atopy. The Lancet, 2000; 9241(356): 1573-1574.  Back to cited text no. 22      
23.Prasad AS. Clinical, immunological, anti-inflammatory and antioxidant roles of zinc. Experimental Gerontology. 2008; 43(5): 370-377.  Back to cited text no. 23      
24.Kimata M, Shichijo M, Miura T, Serizava I, Inagaki N, Nagai H. Effects of luteolin, quercitin and baical-ein on immunoglobulin E- mediated mediator release from human cultured mast cells. Clin Exp Immunol, 2000; 30:501-508.  Back to cited text no. 24      


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

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