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Alves LDF, Moore JB, Kell DB. The Biology and Biochemistry of Kynurenic Acid, a Potential Nutraceutical with Multiple Biological Effects. Int J Mol Sci 2024; 25:9082. [PMID: 39201768 PMCID: PMC11354673 DOI: 10.3390/ijms25169082] [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: 07/19/2024] [Revised: 08/16/2024] [Accepted: 08/19/2024] [Indexed: 09/03/2024] Open
Abstract
Kynurenic acid (KYNA) is an antioxidant degradation product of tryptophan that has been shown to have a variety of cytoprotective, neuroprotective and neuronal signalling properties. However, mammalian transporters and receptors display micromolar binding constants; these are consistent with its typically micromolar tissue concentrations but far above its serum/plasma concentration (normally tens of nanomolar), suggesting large gaps in our knowledge of its transport and mechanisms of action, in that the main influx transporters characterized to date are equilibrative, not concentrative. In addition, it is a substrate of a known anion efflux pump (ABCC4), whose in vivo activity is largely unknown. Exogeneous addition of L-tryptophan or L-kynurenine leads to the production of KYNA but also to that of many other co-metabolites (including some such as 3-hydroxy-L-kynurenine and quinolinic acid that may be toxic). With the exception of chestnut honey, KYNA exists at relatively low levels in natural foodstuffs. However, its bioavailability is reasonable, and as the terminal element of an irreversible reaction of most tryptophan degradation pathways, it might be added exogenously without disturbing upstream metabolism significantly. Many examples, which we review, show that it has valuable bioactivity. Given the above, we review its potential utility as a nutraceutical, finding it significantly worthy of further study and development.
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Affiliation(s)
- Luana de Fátima Alves
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Building 220, Søltofts Plads, 2800 Kongens Lyngby, Denmark
| | - J. Bernadette Moore
- School of Food Science & Nutrition, University of Leeds, Leeds LS2 9JT, UK;
- Department of Biochemistry, Cell & Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Crown St., Liverpool L69 7ZB, UK
| | - Douglas B. Kell
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Building 220, Søltofts Plads, 2800 Kongens Lyngby, Denmark
- Department of Biochemistry, Cell & Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Crown St., Liverpool L69 7ZB, UK
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Pinheiro VDS, Junior OJFR, Ortmann CF, Pande A, Conte-Junior CA, Alvares TS. Evaluation of 12-Week Standardized Beetroot Extract Supplementation in Older Participants: A Preliminary Study of Human Health Safety. Nutrients 2024; 16:1942. [PMID: 38931296 PMCID: PMC11206266 DOI: 10.3390/nu16121942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/14/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024] Open
Abstract
In recent years, there has been a notable surge in the popularity of beetroot-based dietary supplements, driven by their rich nitrate composition. Several types of beetroot-based dietary supplements can be found in markets worldwide; however, ensuring the safety of dietary supplements is a crucial consideration, as there is limited evidence on their safety, especially for older populations. Therefore, the purpose of the current study was to evaluate the safety and tolerability of a nitrate-rich beetroot extract in older participants taking supplements over 12 weeks. The participants were randomly assigned to receive 20 g daily of beetroot extract or a matching placebo. The safety and tolerability of the supplementation were evaluated as the occurrence of adverse events and anthropometric, biochemical, and hemodynamic parameters were measured. No serious adverse events were reported in any group. Anthropometric, biochemical, and hemodynamic parameter changes between the baseline and the end of the study were not statistically significant in either group. However, interestingly, the group receiving beetroot extract supplementation exhibited a notable increase in plasma nitrate levels (p = 0.076, f = 0.50) and showed a decrease in insulin levels (p = 0.026, f = 0.59). In conclusion, we found that 20 g of beetroot extract supplementation for 12 weeks was safe and well tolerated in older participants.
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Affiliation(s)
- Vivian dos Santos Pinheiro
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center, Nutrition Institute, Federal University of Rio de Janeiro, Macaé 27971-525, RJ, Brazil; (V.d.S.P.); (O.J.F.R.J.)
- Postgraduate Program in Food Science, Chemistry Institute, Federal University of Rio de Janeiro, Rio de Janeiro 21941-909, RJ, Brazil;
| | - Olavo João Frederico Ramos Junior
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center, Nutrition Institute, Federal University of Rio de Janeiro, Macaé 27971-525, RJ, Brazil; (V.d.S.P.); (O.J.F.R.J.)
- Multicenter Postgraduate Program in Physiological Sciences, Federal University of Rio de Janeiro, Macaé 27965-045, RJ, Brazil
| | | | - Anurag Pande
- Sabinsa Corporation, 20 Lake Drive, East Windsor, NJ 08520, USA;
| | - Carlos Adam Conte-Junior
- Postgraduate Program in Food Science, Chemistry Institute, Federal University of Rio de Janeiro, Rio de Janeiro 21941-909, RJ, Brazil;
| | - Thiago Silveira Alvares
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center, Nutrition Institute, Federal University of Rio de Janeiro, Macaé 27971-525, RJ, Brazil; (V.d.S.P.); (O.J.F.R.J.)
- Multicenter Postgraduate Program in Physiological Sciences, Federal University of Rio de Janeiro, Macaé 27965-045, RJ, Brazil
- Multidisciplinary Center, Food and Nutrition Institute, Federal University of Rio de Janeiro, Macaé 27930-560, RJ, Brazil
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3
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Tan Y, Xu Y, Zhang Z, Ran Z, Liu X, Jia Y, Chen Y. The Prognostic Value and Treatment Strategies of Nutritional Status in Heart Failure Patients. Curr Probl Cardiol 2023; 48:101742. [PMID: 37087080 DOI: 10.1016/j.cpcardiol.2023.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
Heart failure is a complex clinical syndrome caused by a variety of reasons leading to abnormal changes in the structure and/or function of the heart, with ventricular systolic and/or diastolic dysfunction, which is a serious manifestation or late stage of various heart diseases. The overall prognosis of patients is poor, and risk assessment of patients with HF is currently a hot topic of research due to the large heterogeneity of etiology, phenotype, and genetic background of HF patients. Besides, the nutritional level and status of HF patients are affected by various aspects. Patients with malnutrition, high saturated fatty acids and cholesterol, low minerals, and other conditions tend to have a poor prognosis. So targeted improvement of the nutritional status of HF patients is important to improve the prognosis and the quality of survival of patients. We use heart failure, nutrition, and diet therapy as the keyword method to summarize the prognostic value of indicators of nutritional status in HF patients, the effects of nutritional status on HF patients with different etiology, and potential treatment strategies for HF patients with different etiology. This review is valuable for understanding the prognostic value of nutritional levels in patients with HF and guiding clinical therapeutic approaches.
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Affiliation(s)
- Yinxi Tan
- West China School of Public Health and West China fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuanwei Xu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zixuan Zhang
- West China School of Public Health and West China fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zechao Ran
- West China School of Clinical Medicine and West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xinyue Liu
- West China School of Public Health and West China fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yunqi Jia
- West China School of Public Health and West China fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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4
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Puri V, Nagpal M, Singh I, Singh M, Dhingra GA, Huanbutta K, Dheer D, Sharma A, Sangnim T. A Comprehensive Review on Nutraceuticals: Therapy Support and Formulation Challenges. Nutrients 2022; 14:4637. [PMID: 36364899 PMCID: PMC9654660 DOI: 10.3390/nu14214637] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 08/01/2023] Open
Abstract
Nutraceuticals are the nourishing components (hybrid of nutrition and pharmaceuticals) that are biologically active and possess capability for maintaining optimal health and benefits. These products play a significant role in human health care and its endurance, most importantly for the future therapeutic development. Nutraceuticals have received recognition due to their nutritional benefits along with therapeutic effects and safety profile. Nutraceuticals are globally growing in the field of services such as health care promotion, disease reduction, etc. Various drug nutraceutical interactions have also been elaborated with various examples in this review. Several patents on nutraceuticals in agricultural applications and in various diseases have been stated in the last section of review, which confirms the exponential growth of nutraceuticals' market value. Nutraceuticals have been used not only for nutrition but also as a support therapy for the prevention and treatment of various diseases, such as to reduce side effects of cancer chemotherapy and radiotherapy. Diverse novel nanoformulation approaches tend to overcome challenges involved in formulation development of nutraceuticals. Prior information on various interactions with drugs may help in preventing any deleterious effects of nutraceuticals products. Nanotechnology also leads to the generation of micronized dietary products and other nutraceutical supplements with improved health benefits. In this review article, the latest key findings (clinical studies) on nutraceuticals that show the therapeutic action of nutraceutical's bioactive molecules on various diseases have also been discussed.
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Affiliation(s)
- Vivek Puri
- School of Pharmacy, Chitkara University, Baddi 174103, Himachal Pradesh, India
| | - Manju Nagpal
- College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Inderbir Singh
- College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Manjinder Singh
- College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Gitika Arora Dhingra
- NCRD’s Sterling Institute of Pharmacy, Nerul, Navi Mumbai 400706, Maharashtra, India
| | - Kampanart Huanbutta
- School of Pharmacy, Eastern Asia University, Pathum Thani 12110, Tanyaburi, Thailand
| | - Divya Dheer
- School of Pharmacy, Chitkara University, Baddi 174103, Himachal Pradesh, India
| | - Ameya Sharma
- School of Pharmacy, Chitkara University, Baddi 174103, Himachal Pradesh, India
| | - Tanikan Sangnim
- Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Muang, Thailand
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Creighton JV, de Souza Gonçalves L, Artioli GG, Tan D, Elliott-Sale KJ, Turner MD, Doig CL, Sale C. Physiological Roles of Carnosine in Myocardial Function and Health. Adv Nutr 2022; 13:1914-1929. [PMID: 35689661 PMCID: PMC9526863 DOI: 10.1093/advances/nmac059] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/25/2022] [Accepted: 06/08/2022] [Indexed: 01/28/2023] Open
Abstract
Carnosine is a pleiotropic histidine-containing dipeptide synthesized from β-alanine and l-histidine, with the intact dipeptide and constituent amino acids being available from the diet. The therapeutic application of carnosine in myocardial tissue is promising, with carnosine playing a potentially beneficial role in both healthy and diseased myocardial models. This narrative review discusses the role of carnosine in myocardial function and health, including an overview of the metabolic pathway of carnosine in the myocardial tissue, the roles carnosine may play in the myocardium, and a critical analysis of the literature, focusing on the effect of exogenous carnosine and its precursors on myocardial function. By so doing, we aim to identify current gaps in the literature, thereby identifying considerations for future research.
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Affiliation(s)
- Jade V Creighton
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham, United Kingdom
| | | | - Guilherme G Artioli
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Di Tan
- Natural Alternatives International, Inc., Carlsbad, CA, USA
| | - Kirsty J Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham, United Kingdom,Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Mark D Turner
- Centre for Diabetes, Chronic Diseases, and Ageing, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham, United Kingdom
| | - Craig L Doig
- Centre for Diabetes, Chronic Diseases, and Ageing, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham, United Kingdom
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Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2022; 145:e895-e1032. [PMID: 35363499 DOI: 10.1161/cir.0000000000001063] [Citation(s) in RCA: 779] [Impact Index Per Article: 389.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AIM The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure." The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure. METHODS A comprehensive literature search was conducted from May 2020 to December 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (PubMed), EMBASE, the Cochrane Collaboration, the Agency for Healthcare Research and Quality, and other relevant databases. Additional relevant clinical trials and research studies, published through September 2021, were also considered. This guideline was harmonized with other American Heart Association/American College of Cardiology guidelines published through December 2021. Structure: Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients' interests. Many recommendations from the earlier heart failure guidelines have been updated with new evidence, and new recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses.
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Affiliation(s)
| | | | | | | | | | | | - Anita Deswal
- ACC/AHA Joint Committee on Clinical Practice Guidelines Liaison
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7
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Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. J Am Coll Cardiol 2022; 79:e263-e421. [PMID: 35379503 DOI: 10.1016/j.jacc.2021.12.012] [Citation(s) in RCA: 942] [Impact Index Per Article: 471.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure." The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure. METHODS A comprehensive literature search was conducted from May 2020 to December 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (PubMed), EMBASE, the Cochrane Collaboration, the Agency for Healthcare Research and Quality, and other relevant databases. Additional relevant clinical trials and research studies, published through September 2021, were also considered. This guideline was harmonized with other American Heart Association/American College of Cardiology guidelines published through December 2021. STRUCTURE Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients' interests. Many recommendations from the earlier heart failure guidelines have been updated with new evidence, and new recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses.
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Claxton L, Simmonds M, Beresford L, Cubbon R, Dayer M, Gottlieb SS, Hartshorne-Evans N, Kilroy B, Llewellyn A, Rothery C, Sharif S, Tierney JF, Witte KK, Wright K, Stewart LA. Coenzyme Q10 to manage chronic heart failure with a reduced ejection fraction: a systematic review and economic evaluation. Health Technol Assess 2022; 26:1-128. [PMID: 35076012 DOI: 10.3310/kvou6959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Chronic heart failure is a debilitating condition that accounts for an annual NHS spend of £2.3B. Low levels of endogenous coenzyme Q10 may exacerbate chronic heart failure. Coenzyme Q10 supplements might improve symptoms and slow progression. As statins are thought to block the production of coenzyme Q10, supplementation might be particularly beneficial for patients taking statins. OBJECTIVES To assess the clinical effectiveness and cost-effectiveness of coenzyme Q10 in managing chronic heart failure with a reduced ejection fraction. METHODS A systematic review that included randomised trials comparing coenzyme Q10 plus standard care with standard care alone in chronic heart failure. Trials restricted to chronic heart failure with a preserved ejection fraction were excluded. Databases including MEDLINE, EMBASE and CENTRAL were searched up to March 2020. Risk of bias was assessed using the Cochrane Risk of Bias tool (version 5.2). A planned individual participant data meta-analysis was not possible and meta-analyses were mostly based on aggregate data from publications. Potential effect modification was examined using meta-regression. A Markov model used treatment effects from the meta-analysis and baseline mortality and hospitalisation from an observational UK cohort. Costs were evaluated from an NHS and Personal Social Services perspective and expressed in Great British pounds at a 2019/20 price base. Outcomes were expressed in quality-adjusted life-years. Both costs and outcomes were discounted at a 3.5% annual rate. RESULTS A total of 26 trials, comprising 2250 participants, were included in the systematic review. Many trials were reported poorly and were rated as having a high or unclear risk of bias in at least one domain. Meta-analysis suggested a possible benefit of coenzyme Q10 on all-cause mortality (seven trials, 1371 participants; relative risk 0.68, 95% confidence interval 0.45 to 1.03). The results for short-term functional outcomes were more modest or unclear. There was no indication of increased adverse events with coenzyme Q10. Meta-regression found no evidence of treatment interaction with statins. The base-case cost-effectiveness analysis produced incremental costs of £4878, incremental quality-adjusted life-years of 1.34 and an incremental cost-effectiveness ratio of £3650. Probabilistic sensitivity analyses showed that at thresholds of £20,000 and £30,000 per quality-adjusted life-year coenzyme Q10 had a high probability (95.2% and 95.8%, respectively) of being more cost-effective than standard care alone. Scenario analyses in which the population and other model assumptions were varied all found coenzyme Q10 to be cost-effective. The expected value of perfect information suggested that a new trial could be valuable. LIMITATIONS For most outcomes, data were available from few trials and different trials contributed to different outcomes. There were concerns about risk of bias and whether or not the results from included trials were applicable to a typical UK population. A lack of individual participant data meant that planned detailed analyses of effect modifiers were not possible. CONCLUSIONS Available evidence suggested that, if prescribed, coenzyme Q10 has the potential to be clinically effective and cost-effective for heart failure with a reduced ejection fraction. However, given important concerns about risk of bias, plausibility of effect sizes and applicability of the evidence base, establishing whether or not coenzyme Q10 is genuinely effective in a typical UK population is important, particularly as coenzyme Q10 has not been subject to the scrutiny of drug-licensing processes. Stronger evidence is needed before considering its prescription in the NHS. FUTURE WORK A new independent, well-designed clinical trial of coenzyme Q10 in a typical UK heart failure with a reduced ejection fraction population may be warranted. STUDY REGISTRATION This study is registered as PROSPERO CRD42018106189. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 4. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Lindsay Claxton
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Simmonds
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Lucy Beresford
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Richard Cubbon
- Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Mark Dayer
- Department of Cardiology, Somerset NHS Foundation Trust, University of Exeter, Exeter, UK
| | | | | | | | - Alexis Llewellyn
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Claire Rothery
- Centre for Health Economics, University of York, York, UK
| | - Sahar Sharif
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Jayne F Tierney
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | - Klaus K Witte
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Lesley A Stewart
- Centre for Reviews and Dissemination, University of York, York, UK
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Cardioprotective Effects of Nutraceuticals: Focus on Omega-3 Polyunsaturated Fatty Acids. Nutrients 2021; 13:nu13093184. [PMID: 34579059 PMCID: PMC8471922 DOI: 10.3390/nu13093184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 12/03/2022] Open
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10
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Oppedisano F, Mollace R, Tavernese A, Gliozzi M, Musolino V, Macrì R, Carresi C, Maiuolo J, Serra M, Cardamone A, Volterrani M, Mollace V. PUFA Supplementation and Heart Failure: Effects on Fibrosis and Cardiac Remodeling. Nutrients 2021; 13:nu13092965. [PMID: 34578843 PMCID: PMC8471017 DOI: 10.3390/nu13092965] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 12/11/2022] Open
Abstract
Heart failure (HF) characterized by cardiac remodeling is a condition in which inflammation and fibrosis play a key role. Dietary supplementation with n-3 polyunsaturated fatty acids (PUFAs) seems to produce good results. In fact, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have anti-inflammatory and antioxidant properties and different cardioprotective mechanisms. In particular, following their interaction with the nuclear factor erythropoietin 2 related factor 2 (NRF2), the free fatty acid receptor 4 (Ffar4) receptor, or the G-protein coupled receptor 120 (GPR120) fibroblast receptors, they inhibit cardiac fibrosis and protect the heart from HF onset. Furthermore, n-3 PUFAs increase the left ventricular ejection fraction (LVEF), reduce global longitudinal deformation, E/e ratio (early ventricular filling and early mitral annulus velocity), soluble interleukin-1 receptor-like 1 (sST2) and high-sensitive C Reactive protein (hsCRP) levels, and increase flow-mediated dilation. Moreover, lower levels of brain natriuretic peptide (BNP) and serum norepinephrine (sNE) are reported and have a positive effect on cardiac hemodynamics. In addition, they reduce cardiac remodeling and inflammation by protecting patients from HF onset after myocardial infarction (MI). The positive effects of PUFA supplementation are associated with treatment duration and a daily dosage of 1–2 g. Therefore, both the European Society of Cardiology (ESC) and the American College of Cardiology/American Heart Association (ACC/AHA) define dietary supplementation with n-3 PUFAs as an effective therapy for reducing the risk of hospitalization and death in HF patients. In this review, we seek to highlight the most recent studies related to the effect of PUFA supplementation in HF. For that purpose, a PubMed literature survey was conducted with a focus on various in vitro and in vivo studies and clinical trials from 2015 to 2021.
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Affiliation(s)
- Francesca Oppedisano
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
- Correspondence: (F.O.); (V.M.)
| | - Rocco Mollace
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Division of Cardiology, University Hospital Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Cardiology, IRCCS San Raffaele Pisana, 00166 Rome, Italy;
| | - Annamaria Tavernese
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Micaela Gliozzi
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Vincenzo Musolino
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Roberta Macrì
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Cristina Carresi
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Jessica Maiuolo
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Maria Serra
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
| | - Antonio Cardamone
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
| | | | - Vincenzo Mollace
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
- Department of Cardiology, IRCCS San Raffaele Pisana, 00166 Rome, Italy;
- Correspondence: (F.O.); (V.M.)
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11
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Todorovic N, Stajer V, Ratgeber L, Betlehem J, Acs P, Ostojic SM. Effects of 7-day supplementation with escalating doses of citrulline nitrate on resting and post-exercise blood pressure and safety biomarkers in healthy men: A randomized controlled trial. TOXICOLOGY RESEARCH AND APPLICATION 2021. [DOI: 10.1177/23978473211038632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We investigated the effects of 7-day supplementation with three different dosages of citrulline nitrate (CN) on blood pressure at rest and after exercise, biochemical safety markers, and self-reported outcome measures of adverse events in healthy men. 12 apparently healthy young men (age 25.9 ± 4.0 years; weight 78.6 ± 10.0 kg, height 181.0 ± 7.0 cm) volunteered to participate in this double-blind, randomized, placebo-controlled cross-over trial. The dosages of CN were 1.5 g per day (low dose), 3.0 g per day (medium dose), and 6.0 g per day (high dose). No significant differences were found for systolic and diastolic blood pressure and heart rate at rest and after exercise between varying doses of CN and placebo ( p > 0.05). In addition, hematological indices, biochemical variables, and clinical enzyme profiles were not affected by either intervention ( p > 0.05), and the type and frequency of side effects were comparable to the placebo group. Citrulline nitrate was safe and well tolerated when administered for 7 days in dosages up to 6 g per day.
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Affiliation(s)
- Nikola Todorovic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Valdemar Stajer
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Laszlo Ratgeber
- Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Jozsef Betlehem
- Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Pongras Acs
- Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Sergej M Ostojic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
- Faculty of Health Sciences, University of Pecs, Pecs, Hungary
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12
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Stefani GP, Capalonga L, da Silva LR, Heck TG, Frizzo MN, Sulzbacher LM, Sulzbacher MM, de Batista D, Vedovatto S, Bertoni APS, Wink MR, Dal Lago P. Effects of aerobic and resistance exercise training associated with carnosine precursor supplementation on maximal strength and V̇O 2max in rats with heart failure. Life Sci 2021; 282:119816. [PMID: 34273376 DOI: 10.1016/j.lfs.2021.119816] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Combined exercise training (CET) has been associated with positive responses in the clinical status of patients with heart failure (HF). Other nonpharmacological tools, such as amino acid supplementation, may further enhance its adaptation. The aim was to test whether CET associated with supplementing carnosine precursors could present better responses in the functional capacity and biochemical variables of rats with HF. METHODS Twenty-one male Wistar rats were subjected to myocardial infarction and allocated to three groups: sedentary (SED, n = 7), CET supplemented with placebo (CETP, n = 7), and CET with HF supplemented with β-alanine and L-histidine (CETS, n = 7). The trained animals were submitted to a strength protocol three times per week. Aerobic training was conducted twice per week. The supplemented group received β-alanine and L-histidine orally (250 mg/kg per day). RESULTS Maximum oxygen uptake, running distance, time to exhaustion and maximum strength were higher in the CET-P group than that in the SED group and even higher in the CET-S group than that in the CET-P group (P < 0.01). CET-S showed lower oxidative stress and inflammation markers and higher heat shock protein 72 kDa content and mRNA expression for calcium transporters in the skeletal muscle compared to SED. CONCLUSION CET together with β-alanine and L-histidine supplementation in rats with HF can elicit adaptations in both maximum oxygen uptake, running distance, time to exhaustion, maximum strength, oxidative stress, inflammation and mRNA expression. Carnosine may influence beneficial adjustments in the cell stress response in the skeletal muscle and upregulate the mRNA expression of calcium transporters.
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Affiliation(s)
- Giuseppe Potrick Stefani
- Laboratory of Experimental Physiology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil; School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Capalonga
- Laboratory of Experimental Physiology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Ribeiro da Silva
- Laboratory of Experimental Physiology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Thiago Gomes Heck
- Research Group in Physiology, Graduate Program in Comprehensive Health Care, Universidade Regional do Noroeste do Estado do Rio Grande do Sul (UNIJUÍ), Ijuí, Rio Grande do Sul, Brazil
| | - Matias Nunes Frizzo
- Research Group in Physiology, Graduate Program in Comprehensive Health Care, Universidade Regional do Noroeste do Estado do Rio Grande do Sul (UNIJUÍ), Ijuí, Rio Grande do Sul, Brazil
| | - Lucas Machado Sulzbacher
- Research Group in Physiology, Graduate Program in Comprehensive Health Care, Universidade Regional do Noroeste do Estado do Rio Grande do Sul (UNIJUÍ), Ijuí, Rio Grande do Sul, Brazil
| | - Maicon Machado Sulzbacher
- Research Group in Physiology, Graduate Program in Comprehensive Health Care, Universidade Regional do Noroeste do Estado do Rio Grande do Sul (UNIJUÍ), Ijuí, Rio Grande do Sul, Brazil
| | - Diovana de Batista
- Research Group in Physiology, Graduate Program in Comprehensive Health Care, Universidade Regional do Noroeste do Estado do Rio Grande do Sul (UNIJUÍ), Ijuí, Rio Grande do Sul, Brazil
| | - Samlai Vedovatto
- Laboratory of Cell Biology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Paula Santin Bertoni
- Laboratory of Cell Biology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Márcia Rosângela Wink
- Laboratory of Cell Biology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Pedro Dal Lago
- Laboratory of Experimental Physiology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
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13
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Gonçalves LDS, Sales LP, Saito TR, Campos JC, Fernandes AL, Natali J, Jensen L, Arnold A, Ramalho L, Bechara LRG, Esteca MV, Correa I, Sant'Anna D, Ceroni A, Michelini LC, Gualano B, Teodoro W, Carvalho VH, Vargas BS, Medeiros MHG, Baptista IL, Irigoyen MC, Sale C, Ferreira JCB, Artioli GG. Histidine dipeptides are key regulators of excitation-contraction coupling in cardiac muscle: Evidence from a novel CARNS1 knockout rat model. Redox Biol 2021; 44:102016. [PMID: 34038814 PMCID: PMC8144739 DOI: 10.1016/j.redox.2021.102016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/15/2021] [Accepted: 05/16/2021] [Indexed: 12/04/2022] Open
Abstract
Histidine-containing dipeptides (HCDs) are abundantly expressed in striated muscles. Although important properties have been ascribed to HCDs, including H+ buffering, regulation of Ca2+ transients and protection against oxidative stress, it remains unknown whether they play relevant functions in vivo. To investigate the in vivo roles of HCDs, we developed the first carnosine synthase knockout (CARNS1−/−) rat strain to investigate the impact of an absence of HCDs on skeletal and cardiac muscle function. Male wild-type (WT) and knockout rats (4 months-old) were used. Skeletal muscle function was assessed by an exercise tolerance test, contractile function in situ and muscle buffering capacity in vitro. Cardiac function was assessed in vivo by echocardiography and cardiac electrical activity by electrocardiography. Cardiomyocyte contractile function was assessed in isolated cardiomyocytes by measuring sarcomere contractility, along with the determination of Ca2+ transient. Markers of oxidative stress, mitochondrial function and expression of proteins were also evaluated in cardiac muscle. Animals were supplemented with carnosine (1.8% in drinking water for 12 weeks) in an attempt to rescue tissue HCDs levels and function. CARNS1−/− resulted in the complete absence of carnosine and anserine, but it did not affect exercise capacity, skeletal muscle force production, fatigability or buffering capacity in vitro, indicating that these are not essential for pH regulation and function in skeletal muscle. In cardiac muscle, however, CARNS1−/− resulted in a significant impairment of contractile function, which was confirmed both in vivo and ex vivo in isolated sarcomeres. Impaired systolic and diastolic dysfunction were accompanied by reduced intracellular Ca2+ peaks and slowed Ca2+ removal, but not by increased markers of oxidative stress or impaired mitochondrial respiration. No relevant increases in muscle carnosine content were observed after carnosine supplementation. Results show that a primary function of HCDs in cardiac muscle is the regulation of Ca2+ handling and excitation-contraction coupling.
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Affiliation(s)
- Lívia de Souza Gonçalves
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina, Divisão de Reumatologia, Universidade de São Paulo, SP, Brazil; Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Lucas Peixoto Sales
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina, Divisão de Reumatologia, Universidade de São Paulo, SP, Brazil; Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Tiemi Raquel Saito
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina, Divisão de Reumatologia, Universidade de São Paulo, SP, Brazil; Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | | | - Alan Lins Fernandes
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina, Divisão de Reumatologia, Universidade de São Paulo, SP, Brazil; Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - José Natali
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina, Divisão de Reumatologia, Universidade de São Paulo, SP, Brazil
| | - Leonardo Jensen
- Laboratório de Hipertensão do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Alexandre Arnold
- Laboratório de Hipertensão do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Lisley Ramalho
- Institute of Biomedical Sciences, University of Sao Paulo, Brazil
| | | | - Marcos Vinicius Esteca
- Laboratory of Cell and Tissue Biology, Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Brazil
| | - Isis Correa
- Laboratório de Hipertensão do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Diogo Sant'Anna
- Laboratório de Hipertensão do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Alexandre Ceroni
- Departamento de Fisiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Brazil
| | | | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina, Divisão de Reumatologia, Universidade de São Paulo, SP, Brazil; Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Walcy Teodoro
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | | | | | | | - Igor Luchini Baptista
- Laboratory of Cell and Tissue Biology, Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Brazil
| | - Maria Cláudia Irigoyen
- Laboratório de Hipertensão do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, UK
| | | | - Guilherme Giannini Artioli
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina, Divisão de Reumatologia, Universidade de São Paulo, SP, Brazil; Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil.
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