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Zhang X, Chen Z, Xiong Y, Zhou Q, Zhu LQ, Liu D. The emerging role of nitric oxide in the synaptic dysfunction of vascular dementia. Neural Regen Res 2025; 20:402-415. [PMID: 38819044 PMCID: PMC11317957 DOI: 10.4103/nrr.nrr-d-23-01353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/23/2023] [Accepted: 11/30/2023] [Indexed: 06/01/2024] Open
Abstract
With an increase in global aging, the number of people affected by cerebrovascular diseases is also increasing, and the incidence of vascular dementia-closely related to cerebrovascular risk-is increasing at an epidemic rate. However, few therapeutic options exist that can markedly improve the cognitive impairment and prognosis of vascular dementia patients. Similarly in Alzheimer's disease and other neurological disorders, synaptic dysfunction is recognized as the main reason for cognitive decline. Nitric oxide is one of the ubiquitous gaseous cellular messengers involved in multiple physiological and pathological processes of the central nervous system. Recently, nitric oxide has been implicated in regulating synaptic plasticity and plays an important role in the pathogenesis of vascular dementia. This review introduces in detail the emerging role of nitric oxide in physiological and pathological states of vascular dementia and summarizes the diverse effects of nitric oxide on different aspects of synaptic dysfunction, neuroinflammation, oxidative stress, and blood-brain barrier dysfunction that underlie the progress of vascular dementia. Additionally, we propose that targeting the nitric oxide-sGC-cGMP pathway using certain specific approaches may provide a novel therapeutic strategy for vascular dementia.
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Affiliation(s)
- Xiaorong Zhang
- Department of Pathology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi Province, China
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi Province, China
- Center for Cognitive Science and Transdisciplinary Studies, Jiujiang University, Jiangxi Province, China
| | - Zhiying Chen
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi Province, China
- Department of Neurology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi Province, China
| | - Yinyi Xiong
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi Province, China
- Department of Rehabilitation, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi Province, China
| | - Qin Zhou
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi Province, China
| | - Ling-Qiang Zhu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Dan Liu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Baranauskas MN, Blechschmid TH, Long EB, Coggan AR, Carter SJ. Dietary NO 3- does not enhance endothelial dependent cutaneous vascular conductance in older women. Microvasc Res 2024; 155:104706. [PMID: 38871050 DOI: 10.1016/j.mvr.2024.104706] [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: 03/29/2024] [Revised: 05/24/2024] [Accepted: 06/08/2024] [Indexed: 06/15/2024]
Abstract
Prior work has yet to determine whether the reduction of dietary nitrate (NO3-) to NO, via the enterosalivary pathway, may modify cutaneous vascular conductance (CVC) responses to local heating in older women. Changes occurring with the transition to menopause related to hormonal flux, increased adiposity, and/or decreased physical activity may further compound the negative influence of aging on nitric oxide (NO)-dependent CVC. Herein, we characterized changes in NO-dependent CVC following acute ingestion of 140 mL of NO3--rich beetroot juice in 24 older women (age: 65 ± 5 y, BMI: 31.2 ± 3.7 kg/m2). Red blood cell (RBC) flux was measured continuously via laser-Doppler flowmetry on the dorsal aspect of the forearm during local skin heating to 39 °C/44 °C before and 3 h after NO3- ingestion. NO-dependent changes in CVC were calculated as RBC flux/mean arterial blood pressure at 39 °C and normalized as a proportion of maximal CVC at 44 °C (%CVCmax). Changes (Δ) in fractional exhaled NO (FeNO) following NO3- ingestion were used an index of NO bioavailability. Despite increased FeNO (+81 ± 70 %, P < 0.001), %CVCmax at 39 °C was reduced (-16 ± 10 %, P < 0.001) following NO3- ingestion. A greater reduction in %CVCmax was weakly to moderately associated with higher body fat% (r = 0.45 [0.05-0.72], P = 0.029), central adiposity% (r = 0.50 [0.13-0.75], P = 0.012), neutrophil% (r = 0.42 [0.02-0.70], P = 0.041), and higher neutrophil to lymphocyte ratio (r = 0.49 [0.11-0.75], P = 0.016). These findings demonstrate a single dose of dietary NO3- does not promote CVC responses to local heating in sedentary older women with overweight and obesity. Correlation with multiple biomarkers suggest systemic inflammation may be involved.
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Affiliation(s)
- Marissa N Baranauskas
- Department of Human Physiology & Nutrition, University of Colorado, Colorado Springs, CO, United States of America.
| | - Tyler H Blechschmid
- Department of Kinesiology, School of Public Health, Bloomington, IN, United States of America
| | - Emily B Long
- Department of Kinesiology, School of Public Health, Bloomington, IN, United States of America
| | - Andrew R Coggan
- Department of Kinesiology, Indiana University Indianapolis, Indianapolis, IN, United States of America; Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Stephen J Carter
- Department of Kinesiology, School of Public Health, Bloomington, IN, United States of America
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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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Alharbi M, Stephan BC, Shannon OM, Siervo M. Does dietary nitrate boost the effects of caloric restriction on brain health? Potential physiological mechanisms and implications for future research. Nutr Metab (Lond) 2023; 20:45. [PMID: 37880786 PMCID: PMC10599060 DOI: 10.1186/s12986-023-00766-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/07/2023] [Indexed: 10/27/2023] Open
Abstract
Dementia is a highly prevalent and costly disease characterised by deterioration of cognitive and physical capacity due to changes in brain function and structure. Given the absence of effective treatment options for dementia, dietary and other lifestyle approaches have been advocated as potential strategies to reduce the burden of this condition. Maintaining an optimal nutritional status is vital for the preservation of brain function and structure. Several studies have recognised the significant role of nutritional factors to protect and enhance metabolic, cerebrovascular, and neurocognitive functions. Caloric restriction (CR) positively impacts on brain function via a modulation of mitochondrial efficiency, endothelial function, neuro-inflammatory, antioxidant and autophagy responses. Dietary nitrate, which serves as a substrate for the ubiquitous gasotransmitter nitric oxide (NO), has been identified as a promising nutritional intervention that could have an important role in improving vascular and metabolic brain regulation by affecting oxidative metabolism, ROS production, and endothelial and neuronal integrity. Only one study has recently tested the combined effects of both interventions and showed preliminary, positive outcomes cognitive function. This paper explores the potential synergistic effects of a nutritional strategy based on the co-administration of CR and a high-nitrate diet as a potential and more effective (than either intervention alone) strategy to protect brain health and reduce dementia risk.
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Affiliation(s)
- Mushari Alharbi
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, 22252, Saudi Arabia
| | - Blossom Cm Stephan
- Curtin Dementia Centre of Excellence, EnAble Institute, Curtin University, Kent Street, Bentley, WA, 6102, Australia
| | - Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Mario Siervo
- Curtin Dementia Centre of Excellence, EnAble Institute, Curtin University, Kent Street, Bentley, WA, 6102, Australia.
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Bielecka-Dabrowa A, Banach M, Wittczak A, Cicero AF, Kallel A, Kubilius R, Mikhailidis DP, Sahebkar A, Pantea Stoian A, Vinereanu D, Penson PE, von Haehling S. The role of nutraceuticals in heart failure muscle wasting as a result of inflammatory activity. The International Lipid Expert Panel (ILEP) Position Paper. Arch Med Sci 2023; 19:841-864. [PMID: 37560745 PMCID: PMC10408027 DOI: 10.5114/aoms/167799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/09/2023] [Indexed: 08/11/2023] Open
Abstract
Muscle wasting is one of the main causes for exercise intolerance and ventilatory inefficiency in patients with heart failure and a strong predictor of frailty and reduced survival. The prevalence of sarcopenia is at least 20% in patients with heart failure. Patients with heart failure often have subclinical systemic inflammation, which may exert sustained effects on skeletal muscle. Besides exercise, nutrition should also be carefully evaluated as an appropriate diet with selected nutraceuticals may be able to stimulate muscle anabolism and inhibit muscle catabolism. This review summarizes the epidemiological and clinical trial evidence supporting the recommendations for the use of nutraceuticals with anti-inflammatory properties in heart failure and provides an overview of the state of the evidence for nutraceutical supplementation to prevent and/or mitigate heart failure muscle wasting.
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Affiliation(s)
- Agata Bielecka-Dabrowa
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Lodz, Poland
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Lodz, Poland
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Andrzej Wittczak
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Lodz, Poland
| | - Arrigo F.G. Cicero
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Bologna, Italy
| | - Amani Kallel
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
- Laboratory of Biochemistry, Rabta University Hospital, Tunis, Tunisia
| | - Raimondas Kubilius
- Department of Rehabilitation, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Kaunas, Lithuania
- Department of Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dimitri P. Mikhailidis
- Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London Medical School, University College London (UCL) and Department of Clinical Biochemistry, Royal Free Hospital Campus, UCL, London, UK
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Medicine, The University of Western Australia, Perth, Australia
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Anca Pantea Stoian
- Faculty of Medicine, Diabetes, Nutrition and Metabolic Diseases, Carol Davila University, Bucharest, Romania
| | - Dragos Vinereanu
- University Emergency Hospital of Bucharest, Bucharest, Romania
- Cardiology and Cardiovascular Surgery Department, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Peter E. Penson
- Clinical Pharmacy and Therapeutics Research Group, School of Pharmacy & Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Göttingen, Germany
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Relative leg press strength relates to activity energy expenditure in older women: Implications for exercise prescription. Exp Gerontol 2022; 169:111956. [PMID: 36126803 DOI: 10.1016/j.exger.2022.111956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/15/2022] [Accepted: 09/14/2022] [Indexed: 12/15/2022]
Abstract
Limited work has evaluated how leg press strength (LPS), relative to body mass (i.e., rLPS), affects heart rate (HR) responses during activities of daily living. Such information would prove useful by informing a specific level of rLPS needed to promote independent mobility and physical activity. Secondary analyses were performed on baseline measures of 76 untrained older (65 ± 4 y) women. After familiarization, one-repetition maximum leg press was converted to rLPS by dividing the external load lifted (kg) by body mass (BM). Participants were stratified according to percentile of age-group norms of rLPS: ≤50 % (low, ≤0.99 kg/BM, n = 15), 51-89 % (middle, 1.0-1.31 kg/BM, n = 31), and ≥90 % (high, ≥1.32 kg/BM, n = 30). HR was measured at rest and during laboratory-based tasks including fixed-speed (0.89 m·s-1) non-graded treadmill walking, graded (2.5 %) treadmill walking, and stair stepping. Maximal oxygen uptake (V̇O2max) was measured via indirect calorimetry. Doubly labeled water was used to quantify activity energy expenditure (AEE) over a 14-d period. Relative LPS per group were: 0.85 ± 0.12 (low), 1.16 ± 0.09 (middle), and 1.55 ± 0.25 (high) (p < 0.001). Significant between-group differences in HR emerged during both walking tasks and stair stepping - with the high rLPS group having the lowest HR. AEE between-group comparisons did not yield statistical significance (p = 0.084), however, rLPS correlated with AEE (r = 0.234, p = 0.042) and V̇O2max (r = 0.430, p < 0.001). Such findings suggest a higher rLPS attenuates HR for weight-bearing activities while also demonstrating a significant, albeit modest, positive link to AEE among older women. This information may be especially relevant for informing thresholds of rLPS linked to mobility and functional independence in older women.
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Córdova-Martínez A, Caballero-García A, Bello HJ, Pons-Biescas A, Noriega DC, Roche E. l-Arginine and Beetroot Extract Supplementation in the Prevention of Sarcopenia. Pharmaceuticals (Basel) 2022; 15:ph15030290. [PMID: 35337088 PMCID: PMC8954952 DOI: 10.3390/ph15030290] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 12/13/2022] Open
Abstract
Aging is associated with a significant decline in neuromuscular function, leading to a reduction in muscle mass and strength. The aim of the present report was to evaluate the effect of supplementation with nitric oxide precursors (l-arginine and beetroot extract) in muscular function during a training period of 6 weeks in elderly men and women. The study (double-blind, placebo-controlled) involved 66 subjects randomly divided into three groups: placebo, arginine-supplemented and beetroot extract-supplemented. At the end of this period, no changes in anthropometric parameters were observed. Regarding other circulating parameters, urea levels were significantly (p < 0.05) lower in women of the beetroot-supplemented group (31.6 ± 5.9 mg/dL) compared to placebo (41.3 ± 8.5 mg/dL) after 6 weeks of training. In addition, the circulating creatine kinase activity, as an index of muscle functionality, was significantly (p < 0.05) higher in women of the arginine- (214.1 ± 162.2 mIU/L) compared to the beetroot-supplemented group (84.4 ± 36.8 mIU/L) at the end of intervention. No significant effects were noticed with l-arginine or beetroot extract supplementation regarding strength, endurance and SPPB index. Only beetroot extract supplementation improved physical fitness significantly (p < 0.05) in the sprint exercise in men after 6 weeks (2.33 ± 0.59 s) compared to the baseline (2.72 ± 0.41 s). In conclusion, beetroot seems to be more efficient during short-term training while supplementing, preserving muscle functionality in women (decreased levels of circulating creatine kinase) and with modest effects in men.
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Affiliation(s)
- Alfredo Córdova-Martínez
- Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Duques de Soria, 42004 Soria, Spain
- Correspondence: (A.C.-M.); (E.R.)
| | - Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain;
| | - Hugo J. Bello
- Department of Mathematics, School of Forestry, Agronomy and Bioenergy Engineering, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain;
| | - Antoni Pons-Biescas
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Balearic Islands, Spain;
| | - David C. Noriega
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, Hospital Clínico Universitario de Valladolid, 03010 Valladolid, Spain;
| | - Enrique Roche
- Department of Mathematics, School of Forestry, Agronomy and Bioenergy Engineering, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain;
- Department of Applied Biology-Nutrition, Institute of Bioengineering, University Miguel Hernández, 03202 Elche, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), 03010 Alicante, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: (A.C.-M.); (E.R.)
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Baranauskas MN, Freemas JA, Tan R, Carter SJ. Moving beyond inclusion: Methodological considerations for the menstrual cycle and menopause in research evaluating effects of dietary nitrate on vascular function. Nitric Oxide 2021; 118:39-48. [PMID: 34774755 DOI: 10.1016/j.niox.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/18/2021] [Accepted: 11/08/2021] [Indexed: 12/13/2022]
Abstract
Recent reports have acknowledged the underrepresentation of women in the field of dietary nitrate (NO3-) research. Undoubtedly, greater participation from women is warranted to clarify potential sex differences in the responses to dietary NO3- interventions. However, careful consideration for the effects of sex hormones - principally 17β-estradiol - on endogenous nitric oxide (NO) synthesis and dietary NO3- reductase capacity is necessary for improved interpretation and reproducibility of such investigations. From available literature, we present a narrative review describing how hormonal variations across the menstrual cycle, as well as with menopause, may impact NO biosynthesis catalyzed by NO synthase enzymes and NO3- reduction via the enterosalivary pathway. In doing so, we address methodological considerations related to the menstrual cycle and hormonal contraceptive use relevant for the inclusion of premenopausal women along with factors to consider when testing postmenopausal women. Adherence to such methodological practices may explicate the utility of dietary NO3- supplementation as a means to improve vascular function among women across the lifespan.
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Affiliation(s)
- Marissa N Baranauskas
- Department of Kinesiology, School of Public Health - Bloomington, Bloomington, Indiana University, 47405, USA.
| | - Jessica A Freemas
- Department of Kinesiology, School of Public Health - Bloomington, Bloomington, Indiana University, 47405, USA
| | - Rachel Tan
- Department of Natural Science, Seaver College, Pepperdine University, 90263, USA
| | - Stephen J Carter
- Department of Kinesiology, School of Public Health - Bloomington, Bloomington, Indiana University, 47405, USA; Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, 46202, USA
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Simultaneous Pharmacokinetic Analysis of Nitrate and its Reduced Metabolite, Nitrite, Following Ingestion of Inorganic Nitrate in a Mixed Patient Population. Pharm Res 2020; 37:235. [PMID: 33140122 DOI: 10.1007/s11095-020-02959-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/16/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE The pharmacokinetic properties of plasma NO3- and its reduced metabolite, NO2-, have been separately described, but there has been no reported attempt to simultaneously model their pharmacokinetics following NO3- ingestion. This report describes development of such a model from retrospective analyses of concentrations largely obtained from primary endpoint efficacy trials. METHODS Linear and non-linear mixed effects analyses were used to statistically define concentration dependency on time, dose, as well as patient and study variables, and to integrate NO3- and NO2- concentrations from studies conducted at different times, locations, patient groups, and several studies in which sample range was limited to a few hours. Published pharmacokinetic studies for both substances were used to supplement model development. RESULTS A population pharmacokinetic model relating NO3- and NO2- concentrations was developed. The model incorporated endogenous levels of the two entities, and determined these were not influenced by exogenous NO3- delivery. Covariate analysis revealed intersubject variability in NO3- exposure was partially described by body weight differences influencing volume of distribution. The model was applied to visualize exposure versus response (muscle contraction performance) in individual patients. CONCLUSIONS Extension of the present first-generation model, to ultimately optimize NO3- dose versus pharmacological effects, is warranted.
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