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Wang C, Sun W, Dalbeth N, Wang Z, Wang X, Ji X, Xue X, Han L, Cui L, Li X, Liu Z, Ji A, He Y, Sun M, Li C. Efficacy and safety of tart cherry supplementary citrate mixture on gout patients: a prospective, randomized, controlled study. Arthritis Res Ther 2023; 25:164. [PMID: 37679816 PMCID: PMC10483724 DOI: 10.1186/s13075-023-03152-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/27/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Low urine pH, which may be mediated by metabolic syndrome (MetS), is common in gout. Tart cherries are shown to improve MetS symptoms and possess anti-inflammatory properties. However, the efficacy of tart cherry supplements on urine pH has yet to be studied. OBJECTIVES This study aimed to investigate the efficacy and safety of tart cherry supplementary citrate (TaCCi) mixture on urine pH, serum urate (sUA), C-reactive protein (CRP), and gout flares in gout patients initiating urate-lowering therapy (ULT), in comparison to citrate mixture and sodium bicarbonate. METHODS A prospective, randomized (1:1:1), open-label, parallel-controlled trial was conducted among 282 men with gout and fasting urine pH ≤ 6, who were initiating ULT with febuxostat (initially 20 mg daily, escalating to 40 mg daily if serum urate ≥ 360 μmol/L). Participants were randomized to groups taking either sodium bicarbonate, citrate mixture, or TaCCi mixture. All participants were followed every 4 weeks until week 12. Urine pH and sUA were co-primary outcomes, with various biochemical and clinical secondary endpoints. RESULTS Urine pH increased to a similar extent in all three groups. SUA levels declined in all three groups as well, with no significant differences observed between the groups. At week 12, the TaCCi mixture group exhibited a greater reduction in the urine albumin/creatinine ratio (UACR) compared to the other two groups (p < 0.05). Participants taking TaCCi mixture or citrate mixture experienced fewer gout flares than those in the sodium bicarbonate group over the study period (p < 0.05). Additionally, the TaCCi mixture group had a lower CRP level at week 12 relative to the other two groups (p < 0.01). Adverse events were similar across all three groups. CONCLUSION The TaCCi mixture had similar efficacy and safety on urine alkalization and sUA-lowering as the citrate mixture and sodium bicarbonate in patients with gout. However, the TaCCi mixture resulted in greater improvements in UACR and CRP, which suggests that tart cherry supplements may provide additional benefits for renal protection and reduce inflammation in gout, particularly when starting ULT. TRIAL REGISTRATION This project was registered in ChiCTR ( www.chictr.org.cn ), with the registration number: ChiCTR2100050749.
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Affiliation(s)
- Can Wang
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Wenyan Sun
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Zhongjun Wang
- Department of Clinical Laboratory, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xuefeng Wang
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Xiaopeng Ji
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Xiaomei Xue
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Lin Han
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Lingling Cui
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Xinde Li
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Zhen Liu
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Aichang Ji
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Yuwei He
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Mingshu Sun
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China.
- Department of Rheumatology, the Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Changgui Li
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China.
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China.
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China.
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Rahn C, Bakuradze T, Stegmüller S, Galan J, Niesen S, Winterhalter P, Richling E. Polyphenol-Rich Beverage Consumption Affecting Parameters of the Lipid Metabolism in Healthy Subjects. Int J Mol Sci 2023; 24:ijms24010841. [PMID: 36614281 PMCID: PMC9821765 DOI: 10.3390/ijms24010841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/21/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023] Open
Abstract
Polyphenols are a diverse and widely distributed class of secondary metabolites, which possess numerous beneficial properties including a modulation of glucose and lipid metabolism. This placebo-controlled human intervention study was performed to explore effects of polyphenol-rich beverage (PRB) uptake on lipid metabolism, as well as DNA integrity. In this case, 36 healthy men were randomly divided to consume either 750 mL of a PRB (containing 51% chokeberry, cranberry, and pomegranate) or a placebo drink daily for eight weeks. Only PRB consumption was found to decrease fat and protein intakes significantly compared to the preceding one-week washout period. During the intervention with PRB an increased fat-free mass was shown after four weeks, whereas a significant elevation in body weight and leptin was observed in placebo group. Blood lipids were not significantly altered after PRB consumption, while triglyceride levels increased after placebo drink intake. In platelets, a significant inhibition of phosphodiesterase (PDE) activity was observed, more pronounced in test group. Consuming the PRB decreased total DNA strand breaks in whole blood as well as H2O2-induced breaks in isolated lymphocytes. Overall, our study suggested beneficial effects on lipid metabolism by reduced energy intake, modulation of biomarkers such as PDE activity and improved DNA integrity associated with PRB consumption.
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Affiliation(s)
- Celina Rahn
- Division of Food Chemistry and Toxicology, Department of Chemistry, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Erwin-Schrödinger-Straße 52, D-67663 Kaiserslautern, Germany
| | - Tamara Bakuradze
- Division of Food Chemistry and Toxicology, Department of Chemistry, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Erwin-Schrödinger-Straße 52, D-67663 Kaiserslautern, Germany
| | - Simone Stegmüller
- Division of Food Chemistry and Toxicology, Department of Chemistry, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Erwin-Schrödinger-Straße 52, D-67663 Kaiserslautern, Germany
| | - Jens Galan
- Medical Institute, Hochgewanne 19, D-67269 Grünstadt, Germany
| | - Sonja Niesen
- Institute of Food Chemistry, Technische Universität Braunschweig, Schleinitzstraße 20, D-38106 Braunschweig, Germany
| | - Peter Winterhalter
- Institute of Food Chemistry, Technische Universität Braunschweig, Schleinitzstraße 20, D-38106 Braunschweig, Germany
| | - Elke Richling
- Division of Food Chemistry and Toxicology, Department of Chemistry, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Erwin-Schrödinger-Straße 52, D-67663 Kaiserslautern, Germany
- Correspondence: ; Tel.: +49-631-205-4061
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Sautner J, Eichbauer-Sturm G, Gruber J, Lunzer R, Puchner R. [2022 Update of the Austrian Society for Rheumatology and Rehabilitation nutrition and lifestyle recommendations for patients with gout and hyperuricemia]. Z Rheumatol 2023; 82:71-81. [PMID: 36424414 PMCID: PMC9895016 DOI: 10.1007/s00393-022-01286-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Gout is the most frequent inflammatory joint disease in the western world and has a proven genetic background. Additionally, lifestyle factors, such as increasing life expectation and standard of living, sufficient or excess nutrition and a growing prevalence of obesity in the population as well as e.g. alcohol consumption, contribute to the rising incidence of hyperuricemia and gout. Apart from an adequate medication, medical consultation on nutrition and lifestyle is an essential part of the management of gout patients, who have a high risk of internal comorbidities. OBJECTIVE In 2015 the Austrian Society for Rheumatology and Rehabilitation (ÖGR) working group for osteoarthritis and crystal arthropathies published nutrition and lifestyle recommendations for patients with gout and hyperuricemia. Since then, a multitude of studies have been published addressing this topic, which necessitated an update. METHODS First, the authors performed a hierarchical literature search to screen for the literature published since 2015. Considering references given in the first publication, the relevant literature was selected and the recommendations from 2015 were either kept as published, reformulated or recreated. Finally, the evidence level and the level of agreement for each recommendation were added by the authors. RESULTS Based on this process, 10 recommendations were generated instead of the initial 9. As in the original publication, a graphical presentation with symbols was constructed to complement the written text. CONCLUSION The ÖGR recommendations on nutrition and lifestyle for patients with gout and hyperuricemia were updated in accordance with the most recent relevant literature. These are supposed to serve as information and education material for patients and updated information for physicians.
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Affiliation(s)
- J. Sautner
- 2. Med. Abteilung mit Schwerpunkt Rheumatologie, Niederösterreichisches Kompetenzzentrum für Rheumatologie, LK Korneuburg-Stockerau, Landstr.18, 2000 Stockerau, Österreich ,Medizinische Universität Wien, Wien, Österreich
| | - G. Eichbauer-Sturm
- Rheumatologie und Nephrologie, Ordination für Innere Medizin, Linz, Österreich
| | - J. Gruber
- Univ. Klinik für Innere Medizin II, Med. Universität Innsbruck, Innsbruck, Österreich
| | - R. Lunzer
- Rheumatologische Spezialambulanz, KH der Barmherzigen Brüder, Graz, Österreich
| | - R. Puchner
- Schwerpunktpraxis Rheumatologie und Gastroenterologie, Ordination für Innere Medizin, Wels, Österreich
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Scanu A, Luisetto R, Ramonda R, Spinella P, Sfriso P, Galozzi P, Oliviero F. Anti-Inflammatory and Hypouricemic Effect of Bioactive Compounds: Molecular Evidence and Potential Application in the Management of Gout. Curr Issues Mol Biol 2022; 44:5173-5190. [PMID: 36354664 PMCID: PMC9688861 DOI: 10.3390/cimb44110352] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 07/21/2023] Open
Abstract
Gout is caused by the deposition of monosodium urate crystals in the joint and represents the most common form of inflammatory arthritis in men. Its prevalence is rising worldwide mainly due to the increase of risk factors associated with the disease, in particular hyperuricemia. Besides gout, hyperuricemia leads to an increased inflammatory state of the body with consequent increased risk of comorbidities such as cardiovascular diseases. Increasing evidence shows that bioactive compounds have a significant role in fighting inflammatory and immune chronic conditions. In gout and hyperuricemia, these molecules can exert their effects at two levels. They can either decrease serum uric acid concentrations or fight inflammation associated with monosodium urate crystals deposits and hyperuricemia. In this view, they might be considered valuable support to the pharmacological therapy and prevention of the disease. This review aims to provide an overview of the beneficial role of bioactive compounds in hyperuricemia, gout development, and inflammatory pathways of the disease.
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Affiliation(s)
- Anna Scanu
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
| | - Roberto Luisetto
- Department of Surgery, Oncology and Gastroenterology—DISCOG, University of Padova, 35128 Padova, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
| | - Paolo Spinella
- Clinical Nutrition Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
| | - Paolo Sfriso
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
| | - Paola Galozzi
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
| | - Francesca Oliviero
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
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Li J, Li J, Fan L. Recent Advances in Alleviating Hyperuricemia Through Dietary Sources: Bioactive Ingredients and Structure–activity Relationships. FOOD REVIEWS INTERNATIONAL 2022. [DOI: 10.1080/87559129.2022.2124414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jun Li
- State Key laboratory of Food Science & Technology, Jiangnan University, Wuxi, Jiangsu, China
- Institute of Food Processing Technology, Guizhou Academy of Agricultural Sciences, Guiyang, China
| | - Jinwei Li
- State Key laboratory of Food Science & Technology, Jiangnan University, Wuxi, Jiangsu, China
- School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
| | - Liuping Fan
- State Key laboratory of Food Science & Technology, Jiangnan University, Wuxi, Jiangsu, China
- School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
- Collaborat Innovat Ctr Food Safety & Qual Control, Jiangnan University, Wuxi, Jiangsu, China
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6
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2022 update of the Austrian Society of Rheumatology and Rehabilitation nutrition and lifestyle recommendations for patients with gout and hyperuricemia. Wien Klin Wochenschr 2022; 134:546-554. [PMID: 35817987 PMCID: PMC9300548 DOI: 10.1007/s00508-022-02054-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/07/2022] [Indexed: 11/14/2022]
Abstract
Background Gout is the most frequent inflammatory joint disease in the western world and has a proven genetic background. Additionally, lifestyle factors like increasing life span and wealth, sufficient to excess nutritional status and a growing prevalence of obesity in the population, as well as e.g. alcohol consumption contribute to the rising incidence of hyperuricemia and gout. Apart from an adequate medication, medical advice on nutrition and lifestyle is an essential part of the management of gout patients, being at high risk of internal comorbidities. Objective In 2015, the ÖGR (Österreichische Gesellschaft für Rheumatologie und Rehabilitation) working group for osteoarthritis and crystal arthropathies already published nutrition and lifestyle recommendations for patients with gout and hyperuricemia. Since then, a multitude of literature has been published addressing this topic, what required an update. Methods First, the authors performed a hierarchical literature search to screen the meanwhile published literature. Also considering references of the first publication, the relevant literature was selected, and the 2015 recommendations were either kept as published, reformulated or newly produced. Finally, the evidence level and the level of agreement with each recommendation were added. Results Following this process, ten recommendations were generated instead of the initial nine. Like in the original publication, a colored icon presentation was provided to complement the written text. Conclusion The Austrian nutrition and lifestyle recommendations for patients with gout and hyperuricemia were updated incorporating the most recent relevant literature, serving as education material for patients and updated information for physicians.
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Feng S, Wu S, Xie F, Yang CS, Shao P. Natural compounds lower uric acid levels and hyperuricemia: Molecular mechanisms and prospective. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Hillman AR, Chrismas BCR. Thirty Days of Montmorency Tart Cherry Supplementation Has No Effect on Gut Microbiome Composition, Inflammation, or Glycemic Control in Healthy Adults. Front Nutr 2021; 8:733057. [PMID: 34604282 PMCID: PMC8481367 DOI: 10.3389/fnut.2021.733057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/19/2021] [Indexed: 01/14/2023] Open
Abstract
Tart cherries possess properties that may reduce inflammation and improve glycemic control, however human data on supplementation and the gut microbiota is equivocal. Processing (i.e., juice concentrate, dried, frozen) may affect the properties of tart cherries, and therefore alter their efficacious health benefits. Therefore, the purpose of this study was to investigate the effect of 30 days of supplementation with Montmorency tart cherry (MTC) in concentrate or freeze-dried form on the gut microbiome and markers of inflammation and glycemic control. Healthy participants with no known disease (n = 58, age: 28 ± 10 y, height: 169.76 ± 8.55 cm, body mass: 72.2 ± 12.9 kg) were randomly allocated to four groups and consumed either concentrate or freeze-dried capsules or their corresponding placebos for 30 days. Venous blood samples were drawn at baseline, day 7, 14, and 30 and analyzed for inflammatory markers TNF-alpha, uric acid, C-reactive protein, and erythrocyte sedimentation rate and glycemic control markers glycated albumin, glucose and insulin. A fecal sample was provided at baseline, day 14 and 30 for microbiome analysis. TNF-alpha was significantly lower at 30 vs. 14 days (p = 0.01), however there was no other significant change in the inflammatory markers. Insulin was not changed over time (p = 0.16) or between groups (p = 0.24), nor was glycated albumin different over time (p = 0.08) or between groups (p = 0.56), however glucose levels increased (p < 0.001) from baseline (4.79 ± 1.00 mmol·L-1) to 14 days (5.21 ± 1.02 mmol·L-1) and 30 days (5.61 ± 1.22 mmol·L-1) but this was no different between groups (p = 0.33). There was no significant change in composition of bacterial phyla, families, or subfamilies for the duration of this study nor was there a change in species richness. These data suggest that 30 days of MTC supplementation does not modulate the gut microbiome, inflammation, or improve glycemic control in a healthy, diverse group of adults. Clinical Trail Registration:https://clinicaltrials.gov/ct2/show/NCT04467372, identifier: NCT04467372.
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Affiliation(s)
- Angela R Hillman
- School of Applied Health Sciences and Wellness, Division of Exercise Physiology, Ohio University, Athens, OH, United States
| | - Bryna C R Chrismas
- College of Education, Department of Physical Education, Qatar University, Doha, Qatar
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Kozłowska A, Dzierżanowski T. Targeting Inflammation by Anthocyanins as the Novel Therapeutic Potential for Chronic Diseases: An Update. Molecules 2021; 26:4380. [PMID: 34299655 PMCID: PMC8304181 DOI: 10.3390/molecules26144380] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023] Open
Abstract
Low-grade chronic inflammation (LGCI) and oxidative stress act as cooperative and synergistic partners in the pathogenesis of a wide variety of diseases. Polyphenols, including anthocyanins, are involved in regulating the inflammatory state and activating the endogenous antioxidant defenses. Anthocyanins' effects on inflammatory markers are promising and may have the potential to exert an anti-inflammatory effect in vitro and in vivo. Therefore, translating these research findings into clinical practice would effectively contribute to the prevention and treatment of chronic disease. The present narrative review summarizes the results of clinical studies from the last 5 years in the context of the anti-inflammatory and anti-oxidative role of anthocyanins in both health and disease. There is evidence to indicate that anthocyanins supplementation in the regulation of pro-inflammatory markers among the healthy and chronic disease population. Although the inconsistencies between the result of randomized control trials (RCTs) and meta-analyses were also observed. Regarding anthocyanins' effects on inflammatory markers, there is a need for long-term clinical trials allowing for the quantifiable progression of inflammation. The present review can help clinicians and other health care professionals understand the importance of anthocyanins use in patients with chronic diseases.
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Affiliation(s)
| | - Tomasz Dzierżanowski
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-776 Warsaw, Poland;
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