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Mu Y, Yang Y, Jiang S, Liu C, Han Y, Jiang J, Wang Y. Benefits of Puerarin on Metabolic Syndrome and Its Associated Cardiovascular Diseases in Rats Fed a High-Fat/High-Sucrose Diet. Nutrients 2024; 16:1273. [PMID: 38732519 PMCID: PMC11085683 DOI: 10.3390/nu16091273] [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: 03/11/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular diseases (CVDs) that has become a global public health problem. Puerarin (PUE), the principal active compound of Pueraria lobata, has the effects of regulating glucose and lipid metabolism and protecting against cardiovascular damage. This study aimed to investigate whether dietary supplementation with PUE could ameliorate MetS and its associated cardiovascular damage. Rats were randomly divided into three groups: the normal diet group (NC), the high-fat/high-sucrose diet group (HFHS), and the HFHS plus PUE diet group (HFHS-PUE). The results showed that PUE-supplemented rats exhibited enhanced glucose tolerance, improved lipid parameters, and reduced blood pressure compared to those on the HFHS diet alone. Additionally, PUE reversed the HFHS-induced elevations in the atherogenic index (AI) and the activities of serum lactate dehydrogenase (LDH) and creatine kinase (CK). Ultrasonic evaluations indicated that PUE significantly ameliorated cardiac dysfunction and arterial stiffness. Histopathological assessments further confirmed that PUE significantly mitigated cardiac remodeling, arterial remodeling, and neuronal damage in the brain. Moreover, PUE lowered systemic inflammatory indices including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII). In conclusion, dietary supplementation with PUE effectively moderated metabolic disorders, attenuated systemic inflammation, and minimized cardiovascular damage in rats with MetS induced by an HFHS diet. These results provide novel insights into the potential benefits of dietary PUE supplementation for the prevention and management of MetS and its related CVDs.
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Affiliation(s)
| | | | | | | | | | - Jiandong Jiang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Yuhong Wang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
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Song Q, Jian W, Zhang Y, Li Q, Zhao Y, Liu R, Zeng Y, Zhang F, Duan J. Puerarin Attenuates Iron Overload-Induced Ferroptosis in Retina through a Nrf2-Mediated Mechanism. Mol Nutr Food Res 2024; 68:e2300123. [PMID: 38196088 DOI: 10.1002/mnfr.202300123] [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: 03/03/2023] [Revised: 07/01/2023] [Indexed: 01/11/2024]
Abstract
SCOPE Age-related increases in retinal iron are involved in the development of retinal degeneration. The recently discovered iron-dependent mechanism of cell death known as ferroptosis has been linked to a wide range of pathologies. However, its role in iron overload-induced retinal degeneration is still uncertain. Puerarin has been associated with retinal protection. The purpose of this research is to determine how puerarin prevents retinal ferroptosis under iron overload conditions. METHODS AND RESULTS Models of iron overload in Kunming mice, 661W cell, and ARPE-19 cell are established. Increased iron deposition significantly worsens retinal pathology, decreases cell viability, and induces ferroptotic changes. Puerarin mitigates iron overload-induced ferroptosis by decreasing excessive iron through the regulation of iron handling proteins and lowering lipid peroxidation through the inhibition of cyclooxygenase 2 expression and activation of the nuclear factor-E2-related factor 2 (Nrf2) signaling pathway and downstream ferroptosis-related proteins (solute carrier family 7 member 11, glutathione peroxidase 4 and heme oxygenase-1). The protective effect of puerarin on ferroptosis is diminished by the Nrf2-specific inhibitor ML385. CONCLUSION These findings suggest targeting ferroptosis may be a novel strategy for the management of retinal degeneration. Puerarin may exert some of its ocular benefits by attenuating ferroptosis.
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Affiliation(s)
- Qiongtao Song
- Eye School of Chengdu University of TCM, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Ineye Hospital of Chengdu University of TCM, No.8 Xinghui Road, Chengdu, Sichuan, 610084, China
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Guangzhou Ineye Vision Health Innovation Institute, No.2 Fenghuang 3rd Road, Guangzhou, Guangdong, 510555, China
| | - Wenyuan Jian
- Eye School of Chengdu University of TCM, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Ineye Hospital of Chengdu University of TCM, No.8 Xinghui Road, Chengdu, Sichuan, 610084, China
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Guangzhou Ineye Vision Health Innovation Institute, No.2 Fenghuang 3rd Road, Guangzhou, Guangdong, 510555, China
| | - Yuanyuan Zhang
- Hebei Key Laboratory of Integrative Medicine on Liver-Kidney Patterns, No.326 Xinshi South Road, Shijiazhuang, Hebei, 050200, China
| | - Qiang Li
- Eye School of Chengdu University of TCM, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Ineye Hospital of Chengdu University of TCM, No.8 Xinghui Road, Chengdu, Sichuan, 610084, China
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Guangzhou Ineye Vision Health Innovation Institute, No.2 Fenghuang 3rd Road, Guangzhou, Guangdong, 510555, China
| | - Ying Zhao
- Eye School of Chengdu University of TCM, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Ineye Hospital of Chengdu University of TCM, No.8 Xinghui Road, Chengdu, Sichuan, 610084, China
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
| | - Rong Liu
- Eye School of Chengdu University of TCM, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
| | - Yan Zeng
- Eye School of Chengdu University of TCM, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
| | - Fuwen Zhang
- Eye School of Chengdu University of TCM, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Ineye Hospital of Chengdu University of TCM, No.8 Xinghui Road, Chengdu, Sichuan, 610084, China
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Guangzhou Ineye Vision Health Innovation Institute, No.2 Fenghuang 3rd Road, Guangzhou, Guangdong, 510555, China
| | - Junguo Duan
- Eye School of Chengdu University of TCM, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Ineye Hospital of Chengdu University of TCM, No.8 Xinghui Road, Chengdu, Sichuan, 610084, China
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, No.37 Twelve Bridge Road, Chengdu, Sichuan, 610075, China
- Guangzhou Ineye Vision Health Innovation Institute, No.2 Fenghuang 3rd Road, Guangzhou, Guangdong, 510555, China
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Chlorogiannis DD, Pargaonkar S, Papanagiotou P, Bakogiannis NC, Bakoyiannis C, Kokkinidis DG. Inflammation, anti-inflammatory agents, and the role of colchicine in carotid artery stenosis. VASA 2024; 53:4-12. [PMID: 38079179 DOI: 10.1024/0301-1526/a001104] [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] [Indexed: 01/09/2024]
Abstract
Cardiovascular disease is a major cause of morbidity and mortality worldwide. In the last few years, the role of inflammation and inflammatory modulatory medications is investigated for the optimal treatment of coronary artery disease. It can be hypothesized that since inflammation is also involved in carotid artery stenosis development and progression, the same class of medication could be useful. Our objective with this review is to present the available evidence, published studies and promising ongoing trials on the role of anti-inflammatory medications - with a special emphasis on the most commonly used drug of this class: colchicine - in patients with carotid artery stenosis.
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Affiliation(s)
| | - Sumant Pargaonkar
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York Ciry, NY, USA
| | - Panagiotis Papanagiotou
- First Department of Radiology, School of Medicine, National & Kapodistrian University of Athens, Areteion Hospital, Athens, Greece
- Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte/Bremen-Ost, Bremen, Germany
| | - Nikolaos C Bakogiannis
- Division of Vascular Surgery, Laiko General Hospital/University of Athens School of Medicine, Athens, Greece
| | - Christos Bakoyiannis
- Division of Vascular Surgery, Laiko General Hospital/University of Athens School of Medicine, Athens, Greece
| | - Damianos G Kokkinidis
- Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA
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Elazab SA, Elsayed WE, Alrahim NM, Elsaid MA, Akab SM, Mohammed Enayet AAE, Mohamed MSE, Elazab SA, Sonbol MM, Fath Allah RM. Relationship between Triglyceride-Glucose Index and Disease Activity and Subclinical Atherosclerosis in Rheumatoid Arthritis. Curr Rheumatol Rev 2024; 20:191-199. [PMID: 37873948 DOI: 10.2174/0115733971259984230922054439] [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: 05/27/2023] [Revised: 08/11/2023] [Accepted: 08/21/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND In rheumatoid arthritis (RA), insulin resistance (IR) is related to inflammatory markers, disease activity, and progression of atherosclerotic changes. Triglyceride-glucose (TyG) index is a relatively new indicator of IR. AIMS The present study aimed to investigate the relationship between TyG index, disease activity and subclinical atherosclerosis (SCA) in RA patients. METHODS The present case-control study included 100 RA patients and 50 age- and sex-matched healthy controls. All participants were subjected to careful history taking through clinical examination and standard laboratory assessment. The TyG index was calculated as TyG index = ln (Fasting triglyceride (mg/dL) × fasting glucose (mg/dL))/2. Carotid intima-media thickness (CIMT) measurement was done using B-mode ultrasound. RESULTS Patients had significantly higher TyG index as compared to controls. Patients with high disease activity had significantly higher frequency of extraarticular manifestations (39.6% versus 51.6%, p = 0.028), higher Larsen score (3.8 ± 1.3 versus 2.8 ± 1.2, p < 0.001), higher anti-cyclic citrullinated peptide (anti-CCP) levels (median (IQR): 243.1 (205.0-408.0) U/ml versus 99.0 (78.0-332.5), p < 0.001), higher TyG index (4.8 ± 0.22 versus 4.67 ± 0.24, p = 0.006), and higher CIMT (0.87 ± 0.22 versus 0.77 ± 0.17 mm, p = 0.018). Patients with SCA had higher BMI (34.6 ± 6.2 versus 30.5 ± 5.3 Kg/m2, p < 0.001), higher Larsen score (3.7 ± 1.4 versus 3.1 ± 1.3, p = 0.028) and higher TyG index (4.89 ± 0.23 versus 4.64 ± 0.19, p < 0.001). Binary logistic regression analysis identified patients' age (OR (95% CI): 0.94 (0.89-0.99), p = 0.018), Larsen score (OR (95% CI): 1.93 (1.32-2.82), p = <0.001), anti-CCP (OR (95%): 1.04 (1.02-1.07), p = 0.032), and TyG index (OR (95% CI): 22.67 (2.14-240.4), p = 0.01) as significant predictors of high disease activity in multivariate analysis. CONCLUSION IR estimated by the TyG index is related to disease activity and SCA in RA patients.
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Long Z, Xiang W, He Q, Xiao W, Wei H, Li H, Guo H, Chen Y, Yuan M, Yuan X, Zeng L, Yang K, Deng Y, Huang Z. Efficacy and safety of dietary polyphenols in rheumatoid arthritis: A systematic review and meta-analysis of 47 randomized controlled trials. Front Immunol 2023; 14:1024120. [PMID: 37033930 PMCID: PMC10073448 DOI: 10.3389/fimmu.2023.1024120] [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: 08/21/2022] [Accepted: 01/27/2023] [Indexed: 04/11/2023] Open
Abstract
OBJECTIVE To evaluate safety and efficacy of dietary polyphenols in the treatment of rheumatoid arthritis (RA). METHODS CNKI, Pubmed, Cochrane library, Embase were searched to collect randomized controlled trials (RCTs) of dietary polyphenols in the treatment of RA. The databases were searched from the time of their establishment to November 8nd, 2022. After 2 reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies, Meta-analysis was performed using RevMan5.4 software. RESULTS A total of 49 records (47 RCTs) were finally included, involving 3852 participants and 15 types of dietary polyphenols (Cinnamon extract, Cranberry extract, Crocus sativus L. extract, Curcumin, Garlic extract, Ginger extract, Hesperidin, Olive oil, Pomegranate extract, Puerarin, Quercetin, Resveratrol, Sesamin, Tea polyphenols, Total glucosides of paeony). Pomegranate extract, Resveratrol, Garlic extract, Puerarin, Hesperidin, Ginger extract, Cinnamon extract, Sesamin only involve in 1 RCT. Cranberry extract, Crocus sativus L. extract, Olive oil, Quercetin, Tea polyphenols involve in 2 RCTs. Total glucosides of paeony and Curcumin involve in more than 3 RCTs. These RCTs showed that these dietary polyphenols could improve disease activity score for 28 joints (DAS28), inflammation levels or oxidative stress levels in RA. The addition of dietary polyphenols did not increase adverse events. CONCLUSION Dietary polyphenols may improve DAS28, reduce C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and improve oxidative stress, etc. However, more RCTs are needed to verify or modify the efficacy and safety of dietary polyphenols. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD42022315645.
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Affiliation(s)
- Zhiyong Long
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, China
- *Correspondence: Zhiyong Long, ; Wang Xiang, ; Wei Xiao, ; Zhen Huang,
| | - Wang Xiang
- The First People's Hospital of Changde City, Changde, China
- *Correspondence: Zhiyong Long, ; Wang Xiang, ; Wei Xiao, ; Zhen Huang,
| | - Qi He
- People's Hospital of Ningxiang City, Ningxiang, China
| | - Wei Xiao
- The First People's Hospital of Changde City, Changde, China
- *Correspondence: Zhiyong Long, ; Wang Xiang, ; Wei Xiao, ; Zhen Huang,
| | - Huagen Wei
- Dental Materials Science, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hao Li
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hua Guo
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuling Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mengxia Yuan
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| | - Xiao Yuan
- Hunan University of Chinese Medicine, Changsha, China
| | - Liuting Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kailin Yang
- Hunan University of Chinese Medicine, Changsha, China
| | | | - Zhen Huang
- Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou, China
- *Correspondence: Zhiyong Long, ; Wang Xiang, ; Wei Xiao, ; Zhen Huang,
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Wang D, Bu T, Li Y, He Y, Yang F, Zou L. Pharmacological Activity, Pharmacokinetics, and Clinical Research Progress of Puerarin. Antioxidants (Basel) 2022; 11:2121. [PMID: 36358493 PMCID: PMC9686758 DOI: 10.3390/antiox11112121] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 09/01/2023] Open
Abstract
As a kind of medicine and food homologous plant, kudzu root (Pueraria lobata (Willd.) Ohwi) is called an "official medicine" in Chinese folk medicine. Puerarin is the main active component extracted from kudzu root, and its structural formula is 8-β-D-grapes pyranose-4, 7-dihydroxy isoflavone, with a white needle crystal; it is slightly soluble in water, and its aqueous solution is colorless or light yellow. Puerarin is a natural antioxidant with high health value and has a series of biological activities such as antioxidation, anti-inflammation, anti-tumor effects, immunity improvement, and cardio-cerebrovascular and nerve cell protection. In particular, for the past few years, it has also been extensively used in clinical study. This review focuses on the antioxidant activity of puerarin, the therapy of diverse types of inflammatory diseases, various new drug delivery systems of puerarin, the "structure-activity relationship" of puerarin and its derivatives, and pharmacokinetic and clinical studies, which can provide a new perspective for the puerarin-related drug research and development, clinical application, and further development and utilization.
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Affiliation(s)
- Di Wang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Tong Bu
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yangqian Li
- Asset and Laboratory Management Department, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yueyue He
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Fan Yang
- Academic Affairs Office, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Liang Zou
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, Chengdu University, Chengdu 610106, China
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Kwok MK, Leung GM, Xu L, Tse HF, Lam TH, Schooling CM. Effect of puerarin supplementation on cardiovascular disease risk factors: A randomized, double-blind, placebo-controlled, 2-way crossover trial. Biomed Pharmacother 2022; 153:113472. [DOI: 10.1016/j.biopha.2022.113472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 11/15/2022] Open
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Ma R, Zhao L, Zhao Y, Li Y. Puerarin action on stem cell proliferation, differentiation and apoptosis: Therapeutic implications for geriatric diseases. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 96:153915. [PMID: 35026503 DOI: 10.1016/j.phymed.2021.153915] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/20/2021] [Accepted: 12/25/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Aging is associated with a decline in cognitive and physical functions and various geriatric diseases, such as cardiovascular and neurodegenerative diseases. Puerarin (Pue), one of the main active flavonoids of Radix Puerariae (R. pueraria), is reportedly effective in treating geriatric diseases, including cardiovascular disease and hypertension. PURPOSE This review aims to summarize and discuss the profound physiological impact of Pue on various stem cell populations and provide new insights into the use of Pue for the prevention and treatment of geriatric diseases. METHODS The literature was retrieved from the core collection of electronic databases, such as Web of Science, Google Scholar, PubMed, and Science Direct, using the following keywords and terms: Puerarin, Stem Cell, Proliferation, Differentiation, Apoptosis, and Geriatric diseases. These keywords were used in multiple overlapping combinations. RESULTS Pue is effective in the treatment and management of age-related diseases, such as cardiovascular disease, diabetes, hypertension, and cerebrovascular disease. Pue exerts significant physiological effects on various stem cell populations, including their self-renewal/proliferation, differentiation and apoptosis. Most importantly, it could improve the efficiency and accuracy of stem cell therapy for treating various geriatric diseases. Further studies are essential to improve our understanding of the underlying mechanisms and elucidate their significance for future clinical applications. CONCLUSION The effects of Pue on various stem cell populations and their regulatory mechanisms are discussed in detail to provide new insights into the use of Pue in the prevention and treatment of geriatric diseases.
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Affiliation(s)
- Ruishuang Ma
- State Key Laboratory of Component-Based Chinese Medicine, Ministry of Education Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Lucy Zhao
- Institute for Pharmacy and Molecular Biotechnology, Functional Genomics, University of Heidelberg, Im Neuenheimer Feld 364, 69120 Heidelberg, Germany
| | - Yuming Zhao
- Department of Pharmacology, School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China.
| | - Yue Li
- State Key Laboratory of Component-Based Chinese Medicine, Ministry of Education Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
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Zhou YX, Zhang H, Peng C. Effects of Puerarin on the Prevention and Treatment of Cardiovascular Diseases. Front Pharmacol 2021; 12:771793. [PMID: 34950032 PMCID: PMC8689134 DOI: 10.3389/fphar.2021.771793] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Puerarin, an isoflavone glycoside derived from Pueraria lobata (Willd.) Ohwi, has been identified as a pharmacologically active component with diverse benefits. A large number of experimental and clinical studies have demonstrated that puerarin is widely used in the treatment of a variety of diseases. Among them, cardiovascular diseases (CVDs) are the leading cause of death in the world, and therefore remain one of the most prominent global public health concerns. In this review, we systematically analyze the preclinical investigations of puerarin in CVDs, such as atherosclerosis, cardiac hypertrophy, heart failure, diabetic cardiovascular complications, myocardial infarction, stroke and hypertension. In addition, the potential molecular targets of puerarin are also discussed. Furthermore, we summarize the clinical trails of puerarin in the treatment of CVDs. Finally, the therapeutic effects of puerarin derivatives and its drug delivery systems are overviewed.
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Affiliation(s)
- Yan-Xi Zhou
- State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Library, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hong Zhang
- Institute of Interdisciplinary Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Cheng Peng
- State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Li W, Xu X, Dong D, Lei T, Ou H. Up-regulation of thioredoxin system by puerarin inhibits lipid uptake in macrophages. Free Radic Biol Med 2021; 162:542-554. [PMID: 33242606 DOI: 10.1016/j.freeradbiomed.2020.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 01/01/2023]
Abstract
Cellular oxidative stress promotes lipid accumulation in macrophages during atherogenesis. Puerarin is a natural isoflavone with beneficial effects against oxidation and atherosclerosis. In this study, we investigated the effects of puerarin on lipid uptake and explored the underlying molecular regulation. We found puerarin up-regulated thioredoxin-1 (Trx1) and Trx reductase-1 (TrxR1) expression; it increased TrxR1 activity, cellular thiols contents and decreased oxidized form of Trx1, thus inhibiting cellular ROS generation. Confocal microscope and flow cytometry analysis showed fluorescence labeled Dil-oxLDL uptake was dramatically inhibited by puerarin in RAW264.7 cells as well as in primary bone marrow derived macrophages and peritoneal macrophages. The effects were reversed when Trx1 was inhibited by treatment with Trx1 inhibitor PX-12 or Trx1 siRNA. We also found scavenger receptors such as SR-A and Lox-1, but not CD36 were involved in the Trx1-mediated lipid uptake inhibition. Moreover, measurements of foam cell accumulation and ROS production in sections of aortic roots showed those were reduced by puerarin but raised when additional treatment with PX-12 or Trx1 siRNA in apoE-/- mice, which demonstrates the lipid uptake reduction by puerarin requires Trx1 inhibition in vivo. In addition, we analyzed the upstream regulation and found puerarin induced Nrf2 activity; cooperation between Nrf2 and ATF4 facilitated the puerarin effects. PERK phosphorylation was detected to be increased by puerarin, while PERK inhibition reduced cellular Trx1, TrxR1, nuclear Nrf2 and ATF4. Altogether, puerarin modulates PERK/Nrf2 that coordinates with ATF4 to active Trx1, which causes SR-A and Lox-1 reduction and lipid uptake inhibition in macrophages. This suggests Trx1 could be an effective target by puerarin in the prevention of atherosclerosis.
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Affiliation(s)
- Wenchao Li
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, Guizhou, PR China
| | - Xiaoting Xu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, Guizhou, PR China
| | - Doudou Dong
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, Guizhou, PR China
| | - Tingwen Lei
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, Guizhou, PR China
| | - Hailong Ou
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, Guizhou, PR China.
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Chakraborty D, Gupta K, Biswas S. A mechanistic insight of phytoestrogens used for Rheumatoid arthritis: An evidence-based review. Biomed Pharmacother 2020; 133:111039. [PMID: 33254019 DOI: 10.1016/j.biopha.2020.111039] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/06/2020] [Accepted: 11/16/2020] [Indexed: 12/13/2022] Open
Abstract
Assessment of the potential therapeutic benefits offered by naturally occurring phytoestrogens necessitate inspection of their potency and sites of action in impeding the chronic, systemic, autoimmune, joint destructing disorder Rheumatoid arthritis (RA). Possessing structural and functional similarity with human estrogen, phytoestrogen promisingly replaces the use of hormone therapy in eradicating RA symptoms with their anti-inflammatory, anti-oxidative, anti-proliferative, anti-angiogenesis, immunomodulatory, joint protection properties abolishing the harmful side effects of synthetic drugs. Scientific evidences revealed that use of phytoestrogens from different chemical categories including flavonoids, alkaloids, stilbenoids derived from different plant species manifest beneficial effects on RA through various cellular mechanisms including suppression of pro-inflammatory cytokines in particular tumor necrosis factor (TNF-α), interleukin(IL-6) and nuclear factor kappa B (NF-κB) and destructive metalloproteinases, inhibition of oxidative stress, suppressing inflammatory signalling pathways, attenuating osteoclastogenesis ameliorating cartilage degradation and bone erosion. This review summarizes the evidences of different phytoestrogen treatment and their pharmacological mechanisms in both in vitro and in vivo studies along with discussing clinical evaluations in RA patients showing phytoestrogen as a promising agent for RA therapy. Further investigations and more clinical trials are mandatory to clarify the utility of these plant derived compounds in RA prevention and in managing oestrogen deficient diseases in patients.
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Affiliation(s)
- Debolina Chakraborty
- Department of Integrative and Functional Biology, CSIR - Institute of Genomics & Integrative Biology, Mall Road, Delhi, 110007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
| | - Kriti Gupta
- Department of Integrative and Functional Biology, CSIR - Institute of Genomics & Integrative Biology, Mall Road, Delhi, 110007, India.
| | - Sagarika Biswas
- Department of Integrative and Functional Biology, CSIR - Institute of Genomics & Integrative Biology, Mall Road, Delhi, 110007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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12
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Willeit P, Tschiderer L, Allara E, Reuber K, Seekircher L, Gao L, Liao X, Lonn E, Gerstein HC, Yusuf S, Brouwers FP, Asselbergs FW, van Gilst W, Anderssen SA, Grobbee DE, Kastelein JJP, Visseren FLJ, Ntaios G, Hatzitolios AI, Savopoulos C, Nieuwkerk PT, Stroes E, Walters M, Higgins P, Dawson J, Gresele P, Guglielmini G, Migliacci R, Ezhov M, Safarova M, Balakhonova T, Sato E, Amaha M, Nakamura T, Kapellas K, Jamieson LM, Skilton M, Blumenthal JA, Hinderliter A, Sherwood A, Smith PJ, van Agtmael MA, Reiss P, van Vonderen MGA, Kiechl S, Klingenschmid G, Sitzer M, Stehouwer CDA, Uthoff H, Zou ZY, Cunha AR, Neves MF, Witham MD, Park HW, Lee MS, Bae JH, Bernal E, Wachtell K, Kjeldsen SE, Olsen MH, Preiss D, Sattar N, Beishuizen E, Huisman MV, Espeland MA, Schmidt C, Agewall S, Ok E, Aşçi G, de Groot E, Grooteman MPC, Blankestijn PJ, Bots ML, Sweeting MJ, Thompson SG, Lorenz MW. Carotid Intima-Media Thickness Progression as Surrogate Marker for Cardiovascular Risk: Meta-Analysis of 119 Clinical Trials Involving 100 667 Patients. Circulation 2020; 142:621-642. [PMID: 32546049 DOI: 10.1161/circulationaha.120.046361] [Citation(s) in RCA: 227] [Impact Index Per Article: 56.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND To quantify the association between effects of interventions on carotid intima-media thickness (cIMT) progression and their effects on cardiovascular disease (CVD) risk. METHODS We systematically collated data from randomized, controlled trials. cIMT was assessed as the mean value at the common-carotid-artery; if unavailable, the maximum value at the common-carotid-artery or other cIMT measures were used. The primary outcome was a combined CVD end point defined as myocardial infarction, stroke, revascularization procedures, or fatal CVD. We estimated intervention effects on cIMT progression and incident CVD for each trial, before relating the 2 using a Bayesian meta-regression approach. RESULTS We analyzed data of 119 randomized, controlled trials involving 100 667 patients (mean age 62 years, 42% female). Over an average follow-up of 3.7 years, 12 038 patients developed the combined CVD end point. Across all interventions, each 10 μm/y reduction of cIMT progression resulted in a relative risk for CVD of 0.91 (95% Credible Interval, 0.87-0.94), with an additional relative risk for CVD of 0.92 (0.87-0.97) being achieved independent of cIMT progression. Taken together, we estimated that interventions reducing cIMT progression by 10, 20, 30, or 40 μm/y would yield relative risks of 0.84 (0.75-0.93), 0.76 (0.67-0.85), 0.69 (0.59-0.79), or 0.63 (0.52-0.74), respectively. Results were similar when grouping trials by type of intervention, time of conduct, time to ultrasound follow-up, availability of individual-participant data, primary versus secondary prevention trials, type of cIMT measurement, and proportion of female patients. CONCLUSIONS The extent of intervention effects on cIMT progression predicted the degree of CVD risk reduction. This provides a missing link supporting the usefulness of cIMT progression as a surrogate marker for CVD risk in clinical trials.
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Affiliation(s)
- Peter Willeit
- Department of Neurology, Medical University of Innsbruck, Austria (P.W., L.T., L.S., S.K., G.K.)
| | - Lena Tschiderer
- Department of Neurology, Medical University of Innsbruck, Austria (P.W., L.T., L.S., S.K., G.K.)
| | - Elias Allara
- Department of Public Health and Primary Care, University of Cambridge, United Kingdom (P.W., E.A., M.J.S., S.G.T.)
| | - Kathrin Reuber
- Department of Neurology, Goethe University, Frankfurt am Main, Germany (K.R., X.L., M. Sitzer., M.W.L.)
| | - Lisa Seekircher
- Department of Neurology, Medical University of Innsbruck, Austria (P.W., L.T., L.S., S.K., G.K.)
| | - Lu Gao
- MRC Biostatistics Unit, University of Cambridge, United Kingdom (L.G.)
| | - Ximing Liao
- Department of Neurology, Goethe University, Frankfurt am Main, Germany (K.R., X.L., M. Sitzer., M.W.L.)
| | - Eva Lonn
- Department of Medicine and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (E.L., H.C.G., S.Y.)
| | | | - Salim Yusuf
- Hamilton General Hospital, Ontario, Canada (E.L., H.C.G., S.Y.)
| | - Frank P Brouwers
- Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands (F.P.B.)
| | - Folkert W Asselbergs
- Department of Cardiology (F.W.A.), University Medical Center Utrecht, The Netherlands
| | - Wiek van Gilst
- Department of Experimental Cardiology, University Medical Center Groningen, The Netherlands (W.v.G.)
| | - Sigmund A Anderssen
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway (S.A.A.)
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care (D.E.G., M.L.B.), University Medical Center Utrecht, The Netherlands
| | - John J P Kastelein
- Department of Vascular Medicine (J.J.P.K., E.S.), Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine (F.L.J.V.), University Medical Center Utrecht, The Netherlands
| | - George Ntaios
- Department of Medicine, University of Thessaly, Larissa, Greece (G.N.)
| | - Apostolos I Hatzitolios
- 1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Greece (A.I.H., C.S.)
| | - Christos Savopoulos
- 1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Greece (A.I.H., C.S.)
| | - Pythia T Nieuwkerk
- Department of Neurology, Medical University of Innsbruck, Austria (P.W., L.T., L.S., S.K., G.K.)
| | - Erik Stroes
- Department of Vascular Medicine (J.J.P.K., E.S.), Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Matthew Walters
- School of Medicine, Dentistry and Nursing (M.W.), University of Glasgow, United Kingdom
| | - Peter Higgins
- Institute of Cardiovascular and Medical Sciences (P.H., J.D.), University of Glasgow, United Kingdom
| | - Jesse Dawson
- Institute of Cardiovascular and Medical Sciences (P.H., J.D.), University of Glasgow, United Kingdom
| | - Paolo Gresele
- Division of Internal and Cardiovascular Medicine, Department of Medicine, University of Perugia, Italy (P.G., G.G.)
| | - Giuseppe Guglielmini
- Division of Internal and Cardiovascular Medicine, Department of Medicine, University of Perugia, Italy (P.G., G.G.)
| | - Rino Migliacci
- Division of Internal Medicine, Cortona Hospital, Italy (R.M.)
| | - Marat Ezhov
- Laboratory of Lipid Disorders, National Medical Research Center of Cardiology, Moscow, Russia (M.E.), National Medical Research Center of Cardiology, Moscow, Russia
| | - Maya Safarova
- Atherosclerosis Department (M. Safarova), National Medical Research Center of Cardiology, Moscow, Russia
| | - Tatyana Balakhonova
- Ultrasound Vascular Laboratory (T.B.), National Medical Research Center of Cardiology, Moscow, Russia
| | - Eiichi Sato
- Division of Nephrology, Shinmatsudo Central General Hospital, Chiba, Japan (E.S., M.A., T.N.)
| | - Mayuko Amaha
- Division of Nephrology, Shinmatsudo Central General Hospital, Chiba, Japan (E.S., M.A., T.N.)
| | - Tsukasa Nakamura
- Division of Nephrology, Shinmatsudo Central General Hospital, Chiba, Japan (E.S., M.A., T.N.)
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, University of Adelaide, SA, Australia (K.K., L.M.J.)
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, SA, Australia (K.K., L.M.J.)
| | - Michael Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, NSW, Australia (M.Skilton)
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, (J.A.B., A.S., P.J.S.)
| | - Alan Hinderliter
- Department of Medicine, University of North Carolina, Chapel Hill (A.H.)
| | - Andrew Sherwood
- Department of Neurology, Medical University of Innsbruck, Austria (P.W., L.T., L.S., S.K., G.K.)
| | - Patrick J Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, (J.A.B., A.S., P.J.S.)
| | - Michiel A van Agtmael
- Department of Internal Medicine (M.A.v.A.) Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Peter Reiss
- Amsterdam Institute for Global Health and Development, University of Amsterdam, The Netherlands (P.R.)
| | - Marit G A van Vonderen
- Department of Internal Medicine, Medical Center Leeuwarden, The Netherlands (M.G.A.v.V.)
| | - Stefan Kiechl
- VASCage GmbH, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria (S.K.)
| | - Gerhard Klingenschmid
- Department of Neurology, Medical University of Innsbruck, Austria (P.W., L.T., L.S., S.K., G.K.)
| | - Matthias Sitzer
- Department of Neurology, Klinikum Herford, Herford, Germany (M. Sitzer)
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, The Netherlands (C.D.A.S.)
| | - Heiko Uthoff
- Department of Angiology, University Hospital Basel, Switzerland (H.U.)
| | - Zhi-Yong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China (Z.-Y.Z.)
| | - Ana R Cunha
- Department of Clinical Medicine, State University of Rio de Janeiro, Brazil (A.R.C., M.F.N.)
| | - Mario F Neves
- Department of Clinical Medicine, State University of Rio de Janeiro, Brazil (A.R.C., M.F.N.)
| | - Miles D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle-upon-Tyne Hospitals Trust, United Kingdom (M.D.W.)
| | - Hyun-Woong Park
- Department of Internal Medicine, Gyeongsang National University Hospital, Daejeon, South Korea (H.-W.P., M.-S.L.)
| | - Moo-Sik Lee
- Department of Preventive Medicine, Konyang University, Jinju, South Korea (M.-S.L.)
| | - Jang-Ho Bae
- Heart Center, Konyang University Hospital, Daejeon, South Korea (J.-H.B.)
| | - Enrique Bernal
- Infectious Diseases Unit, Reina Sofia Hospital, Murcia, Spain (E.B.)
| | - Kristian Wachtell
- Department of Cardiology, Oslo University Hospital, Norway (K.W., S.E.K.)
| | - Sverre E Kjeldsen
- Department of Cardiology, Oslo University Hospital, Norway (K.W., S.E.K.)
| | - Michael H Olsen
- Department of Internal Medicine, Holbaek Hospital, University of Southern Denmark, Odense (M.H.O.)
| | - David Preiss
- MRC Population Health Research Unit, Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom (D.P.)
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre (N.S.), University of Glasgow, United Kingdom
| | - Edith Beishuizen
- Infectious Diseases Unit, Reina Sofia Hospital, Murcia, Spain (E.B.)
| | - Menno V Huisman
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, The Netherlands (M.V.H.)
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC (M.A.E.)
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Sweden (C.S.)
| | - Stefan Agewall
- Oslo University Hospital Ullevål and Institute of Clinical Sciences, University of Oslo, Norway (S.A.)
| | - Ercan Ok
- Nephrology Department, Ege University School of Medicine, Bornova-Izmir, Turkey (E.O, G.A.)
| | - Gülay Aşçi
- Nephrology Department, Ege University School of Medicine, Bornova-Izmir, Turkey (E.O, G.A.)
| | - Eric de Groot
- Imagelabonline & Cardiovascular, Eindhoven and Lunteren, the Netherlands (E.d.G.)
| | - Muriel P C Grooteman
- Department of Nephrology (M.P.C.G.), Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Peter J Blankestijn
- Department of Nephrology (P.J.B.), University Medical Center Utrecht, The Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care (D.E.G., M.L.B.), University Medical Center Utrecht, The Netherlands
| | - Michael J Sweeting
- Department of Health Sciences, University of Leicester, United Kingdom (M.J.S.)
| | - Simon G Thompson
- Department of Public Health and Primary Care, University of Cambridge, United Kingdom (P.W., E.A., M.J.S., S.G.T.)
| | - Matthias W Lorenz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany (K.R., X.L., M. Sitzer., M.W.L.)
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13
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Kirichenko TV, Myasoedova VA, Ravani AL, Sobenin IA, Orekhova VA, Romanenko EB, Poggio P, Wu WK, Orekhov AN. Carotid Atherosclerosis Progression in Postmenopausal Women Receiving a Mixed Phytoestrogen Regimen: Plausible Parallels with Kronos Early Estrogen Replacement Study. BIOLOGY 2020; 9:biology9030048. [PMID: 32155747 PMCID: PMC7150954 DOI: 10.3390/biology9030048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/29/2020] [Accepted: 03/03/2020] [Indexed: 01/28/2023]
Abstract
This randomized double-blinded, placebo-controlled clinical trial evaluated the progression of intima-media thickness of common carotid artery (cIMT) and the effect of phytoestrogen therapy on atherosclerosis development in early and late postmenopausal women. The 2-year cIMT progression was evaluated in 315 early postmenopausal women aged 40-55 years and in 231 late postmenopausal women aged 60-69 years free of cardiovascular disease. B-mode ultrasound was done at baseline and after 12 and 24 months of follow-up. The study revealed no significant changes in the rate of cIMT progression in 315 early postmenopausal women. By contrast, a statistically significant difference in the rate of atherosclerosis development was observed in late postmenopausal women treated with phytoestrogens compared to placebo (p = 0.008). The rate of cIMT progression in the placebo group was 0.019 mm/year led to a significant increase of cIMT during the observation period (p = 0.012), while the rate of cIMT progression in phytoestrogen late postmenopausal recipients was 0.011 mm/year, and total change did not reach statistical significance during the follow-up period (p = 0.101). These results suggest that late postmenopausal women can be a suitable cohort for trials assessing the anti-atherosclerosis effects of phytoestrogen preparations. In particular, the beneficial effect of phytoestrogens on cIMT progression was demonstrated in late postmenopausal women.
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Affiliation(s)
- Tatiana V. Kirichenko
- Research Institute of Human Morphology, 3 Tsyurupy Str., 117418 Moscow, Russia; (I.A.S.); (A.N.O.)
- National Medical Research Center of Cardiology, 15A 3 Cherepkovskaya Str., 121552 Moscow, Russia
- Institute of General Pathology and Pathophysiology, 8 Baltiyskaya Str., 125315 Moscow, Russia; (V.A.M.); (V.A.O.)
- Correspondence: ; Tel.: +7-910-461-58-45
| | - Veronika A. Myasoedova
- Institute of General Pathology and Pathophysiology, 8 Baltiyskaya Str., 125315 Moscow, Russia; (V.A.M.); (V.A.O.)
- Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy; (A.L.R.); (P.P.)
| | - Alessio L. Ravani
- Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy; (A.L.R.); (P.P.)
| | - Igor A. Sobenin
- Research Institute of Human Morphology, 3 Tsyurupy Str., 117418 Moscow, Russia; (I.A.S.); (A.N.O.)
- National Medical Research Center of Cardiology, 15A 3 Cherepkovskaya Str., 121552 Moscow, Russia
- Institute of General Pathology and Pathophysiology, 8 Baltiyskaya Str., 125315 Moscow, Russia; (V.A.M.); (V.A.O.)
| | - Varvara A. Orekhova
- Institute of General Pathology and Pathophysiology, 8 Baltiyskaya Str., 125315 Moscow, Russia; (V.A.M.); (V.A.O.)
- Institute for Atherosclerosis Research, Skolkovo Innovative Center, 143025 Moscow, Russia
| | - Elena B. Romanenko
- Department of Molecular Basis of Ontogenesis, Belozersky Institute of Physical and Chemical Biology, Moscow State University, 119234 Moscow, Russia;
| | - Paolo Poggio
- Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy; (A.L.R.); (P.P.)
| | - Wei-Kai Wu
- Department of Internal Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei 108, Taiwan;
| | - Alexander N. Orekhov
- Research Institute of Human Morphology, 3 Tsyurupy Str., 117418 Moscow, Russia; (I.A.S.); (A.N.O.)
- Institute of General Pathology and Pathophysiology, 8 Baltiyskaya Str., 125315 Moscow, Russia; (V.A.M.); (V.A.O.)
- Institute for Atherosclerosis Research, Skolkovo Innovative Center, 143025 Moscow, Russia
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