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Role of carotenoids in
lung diseases

Carotenoids
are natural pigments ranging from yellow to red that are present in fruits and
vegetables. In carotenoids A-Carotene, b-carotene, b-cryptoxanthin, lutein,
zeaxanthin, and lycopene are most predominant and consisting of 90% of
circulating carotenoids. Carotenoids play an important role in carcinogenesis
and used as medications for cancer treatment. Carotenoids have anti-cancer
properties by following different mechanisms including anti-oxidation, immunity
increasing, suppression of tumorigenesis and malignant transformation,
suppression of cell proliferation, and metabolism to retinoids which
successively contribute to cellular differentiation.

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Dietary antioxidants
have tendency to enhance host antioxidant defenses by suppression of oxidative
stress. Lycopene is a carotenoid with powerful antioxidant that is used in
asthma. In asthmatic patient’s lycopene or lycopene-rich supplement decrease
bronchoconstriction and neutrophil influx and also elastase activity in airway.
Dietary antioxidants have potential effects when used with other nutrients as a
part of whole food other than separately use them.

Tuberculosis
and lung cancer are serious health problems worldwide that cause significant
morbidity and mortality. Lung cancer is most common malignancy that causes
deaths around the world. It is estimated that 1.35 million people diagnosed
from lung cancer as well as 1.18 million people die every year. Due to cigarette
smoking 90 to 95% people acquire lung cancer in North America and Europe.
According to the world health organization, in 2009 9.4 million incident cases
of tuberculosis and 1.7 million people died. Tuberculosis that is caused by Mycobacterium tuberculosis is infects
one third of world’s population.

In treatment
pharmacological dose of beta-carotene give no protection against lung cancer as
compared to placebo. In fact supplemental beta-carotene enhanced lung cancer
risk in heavy smokers. But beta-carotene at dietary level has been inverse
effect with lung cancer treatment. High consumption of fruits and vegetables
with beta-carotene has beneficial affects against lung cancer.

Impact of carotenoids
on tuberculosis risk

Over the past
150 years, although incidence and mortality of tuberculosis have fallen
steadily in North America and Europe, but it remains top global cause of deaths
from infections. The World Health Organization reported that 10.4 million cases
reported in 2015 by which 1.8 million dies due to tuberculosis in low and
middle income countries. The death rate of tuberculosis decreases before the
availability of either BCG or effective chemotherapy in high income countries.
The country level data also showed that with the passage of time the incidence
of tuberculosis strongly decline with human development.

Multiple lines
of evidence propose that the link between tuberculosis and socioeconomic status
arbitrated by nutritional status. Studies in humans give information that under
nutrition enhance the chances of tuberculosis and also documented that
micronutrient deficiencies in persons have tuberculosis disease. Notably,
studies of vitamin A and tuberculosis that have been done in populations have
low risk of tuberculosis and nutritional deficits, and their results were
inconclusive.

Despite low
data availability on tuberculosis risk, various previous knowledge supports the
role of vitamin A in tuberculosis infections. First time in 1920 Green,
Mellanby, and colleagues proposed that vitamin A is an “anti-infective”
agent.  Vitamin A supplementation
decrease death rate in children with measeles by 58% and deficiency of vitamin
A in children contributes to mortality from diarrheal diseases and measles,
about 1.7% of all deaths in children <5 year old in low income countries. Asthma, lung inflammation and carotenoids Allergic asthma is a severe and infectious disease that relatively increasing worldwide. In developed countries, the death rate is decline but still it is a serious disease in developing countries. Allergic asthma is a serious disease of airway passage that is characterized by inflammation in airway, hyper reactivity, reversible airway blockage and hyper secretion of allergic agents. Many effector cells like mast cells, Th2 lymphocytes and eosinophils and inflammatory mediators like adhesion molecules cytokines and chemokine's can contribute to development, maintenance as well as exasperation of asthma. For the treatment of allergic asthma glucocorticoids are still most effected substances that rarefying airway inflammation and remodeling airway passage. But long term use of glucocorticoids produce side effects like slow growth rate in children, lowering the bone mineral density in young's, high blood sugar level and high blood pressure in eye. For this should find effective anti-allergic asthma agent with no or lower side effects with less cytotoxicity. In European folk for the treatment of allergic asthma an herb Crocus sativus is commonly used that proven to be effective against allergic asthma. The flowers of Crocus sativus contain a primary compound crocin, a diterpenoid glucoside that possess properties such as anti-allergic, anti-inflammatory, ant-oxidation, anti-hyperplasia that also decreased blood glucose and lipid level with smooth muscle relaxant and regulation of immune system. Crocin is a carotenoid that would be an effective agent for the treatment of allergic asthma. Evidence for carotenoids and lung cancers Lung cancer also known as lung carcinoma is a malignant lung tumor that is characterized by unlimited cell growth and proliferation. Lung cancer is the biggest cause of mortality for cancer related deaths. For the patients with high risk of lung cancer a single agent is found to be very affective that is retinoids that provide primary chemoprevention in those patients that have existing premalignant changes in bronchial epithelium or sputum, and secondary chemoprevention in those patients that have history of lung cancer. The agent reinoids can found to be effective against lung cancer treatment.             Lung cancer remains the biggest cause of cancer related deaths in United States. About 30% of all cancer related deaths are caused due to lung cancer. Despite too much investigations about cancer treatment and many therapeutic modalities, the survival rate of patient with lung cancer in last five years remain 15% and has witnessed less progress in past 30 years.  The fast-growing nature of lung cancer and its tendency for hematogenous spread are considered as major causing factors to its poor victims. For aimed to reduce lung cancer incidence should stop smoking habits, reducesd occupational insults such as asbestos with many forms of nutritional supplementations. For regard to cancer treatment carotenoids have been examined as broad spectrum anti-neoplastic activity basically against lung cancer. Carotenoids are pigments naturally found in fruits and vegetables with yellow orange and red color with fat soluble properties. Carotenoids are naturally present in all photosynthetic organism and they serve as a photosynthetic accessory pigments and also maintain photo-protective effect by their anti-oxidant properties. There are more than 600 carotenoids identified that are naturally present from this six are significant for human body that are alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin, and cryptoxanthin. In addition, alpha- and beta-carotene have tendency to change into retinol (Vitamin A) in intestinal mucosa. These compounds are referred as pro-vitamin A carotenoids. Vitamin A in human body plays many important functions and necessary for vision epithelial regulation, immunomodulation as well as embryonic development. The exact function of pro-vitamin A carotenoids is still unclear as they may give protective effect against aging, stroke, molecular degeneration, ischemic heart disease, and cancer. Carotenoids and its role in lung cancer prevention             On the basis risk of lung cancer in association with consumption of fruits and vegetables and basic science findings the hypothesis can be created that is many specific micronutrients would be give protection and used as effective agents that reduce the chances of lung cancer. For this several trials have been done to prove this hypothesis for the prevention of lung cancer. The surprising result was obtained by these trials that challenged many ideas about micronutrients consumptions and risk of lung cancer.  In cancer prevention study, Alpha-Tocopherol Beta-Carotene were used to control primary prevention trials to check weather supplementation of Alpha-Tocopherol or Beta-Carotene or both could reduce the risk of lung cancer and other cancers and used as cancer preventive agents. For these trials on patients they found that there is no decrease the incidence of lung cancer with use of alpha-tocopherol. They found that the men who receive beta-carotene have higher chances of lung cancer than those who did not take beta-carotene. The death rate also increases in those that take beta-caroteneand they did not found any correlation between alpha-tocopherol and beta-carotene on chances of cancer. In later analysis of Alpha-Tocopherol Beta-

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