Effect of onion peel extract on endothelial function and endothelial progenitor cells in overweight and obese individuals

The Association between Food Groups, Nutraceuticals, and Food Supplements Consumption on Vascular Health Outcomes: A Literature Review

Vascular aging, marked by alterations in the structure and function of blood vessels, including heightened arterial stiffness and impaired endothelial function, is linked to a higher likelihood of developing cardiovascular and age-associated pathological conditions. Oxidative stress and inflammation are key stimulation factors in vascular aging. Engaging in healthy dietary habits could enhance the functioning of blood vessels. The aim of this study was to conduct a literature review of the evidence regarding the relationship between food regimens, nutraceuticals, and dietary supplements and vascular health. A search of electronic databases, including PubMed, Scopus, and Web of Science Core Collection, was performed. Experimental and observational studies evaluating the association between food groups, nutraceuticals, supplements, and endothelial function and/or arterial stiffness were deemed eligible for this narrative review. Based on the current body of the included studies, food groups, nutraceuticals, and dietary supplements may not demonstrate superiority over placebos in enhancing markers of vascular health. To obtain more reliable evidence on the effectiveness of interventions in vascular health, additional RCTs with larger sample sizes, extended follow-up periods, and multi-center participation are necessary. Enhancing the credibility of these RCTs requires better control of dietary variables and more precise measurement of vascular health markers.

The Anti-Diabetic Effects of Medicinal Plants Belonging to the Liliaceae Family: Potential Alpha Glucosidase Inhibitors

Background

Diabetes mellitus is a complex metabolic disorder that has an enormous impact on people's quality of life and health. Although there is no doubt about the effectiveness of oral hypoglycemic agents combined with lifestyle management in controlling diabetes, no individual has ever been reported to have been completely cured of the disease. Globally, many medicinal plants have been used for the management of diabetes in various traditional systems of medicine. A deep look in the literature has revealed that the Liliaceae family have been poorly investigated for their antidiabetic activity and phytochemical studies. In this review, we summarize medicinal plants of Liliaceae utilized in the management of type II diabetes mellitus (T2DM) by inhibition of α-glucosidase enzyme and phytochemical content.

Methods

The literature search was conducted using databases including PubMed, ScienceDirect, and Google Scholar to find the significant published articles about Liliaceae plants utilized in the prevention and treatment of antidiabetics. Data were filtered to the publication period from 2013 to 2023, free full text and only English articles were included. The keywords were Liliaceae OR Alliaceae OR Amaryllidaceae AND Antidiabetic OR α-glucosidase.

Results

Six medicinal plants such as Allium ascalonicum, Allium cepa, Allium sativum, Aloe ferox, Anemarrhena asphodeloides, and Eremurus himalaicus are summarized. Phytochemical and α-glucosidase enzymes inhibition by in vitro, in vivo, and human studies are reported.

Conclusion

Plants of Liliaceae are potential as medicine herbs to regulating PPHG and prevent the progression of T2DM and its complication. In silico study, clinical application, and toxicity evaluation are needed to be investigated in the future.

Natural H2S-donors: A new pharmacological opportunity for the management of overweight and obesity

The prevalence of overweight and obesity has progressively increased in the last few years, becoming a real threat to healthcare systems. To date, the clinical management of body weight gain is an unmet medical need, as there are few approved anti-obesity drugs and most require an extensive monitoring and vigilance due to risk of adverse effects and poor patient adherence/persistence. Growing evidence has shown that the gasotransmitter hydrogen sulfide (H2S) and, therefore, H2S-donors could have a central role in the prevention and treatment of overweight/obesity. The main natural sources of H2S-donors are plants from the Alliaceae (garlic and onion), Brassicaceae (e.g., broccoli, cabbage, and wasabi), and Moringaceae botanical families. In particular, polysulfides and isothiocyanates, which slowly release H2S, derive from the hydrolysis of alliin from Alliaceae and glucosinolates from Brassicaceae/Moringaceae, respectively. In this review, we describe the emerging role of endogenous H2S in regulating adipose tissue function and the potential efficacy of natural H2S-donors in animal models of overweight/obesity, with a final focus on the preliminary results from clinical trials. We conclude that organosulfur-containing plants and their extracts could be used before or in combination with conventional anti-obesity agents to improve treatment efficacy and reduce inflammation in obesogenic conditions. However, further high-quality studies are needed to firmly establish their clinical efficacy.

An ethnopharmacological, phytochemical, and pharmacological overview of onion (Allium cepa L.)

ETHNOPHARMACOLOGICAL RELEVANCE

Onion (Allium cepa L.) is one of the most widely distributed species within the Allium genus of family Amaryllidaceae. Onion has been esteemed for its medicinal properties since antiquity. It has been consumed for centuries in various indigenous cultures for the management of several ailments including microbial infections, respiratory, gastrointestinal, skin and cardio-vascular disorders, diabetes, renal colic, rheumatism, sexual impotence, menstrual pain, and headache. However, so far, there is a scarcity of recent data that compiles the plant chemistry, traditional practices, biological features, and toxicity.

AIM OF THE WORK

The aim of this review is to provide a comprehensive and analytical overview of ethnopharmacological uses, phytochemistry, pharmacology, industrial applications, quality control, and toxicology of onion, to offer new perspectives and broad scopes for future studies.

MATERIALS AND METHODS

The information gathered in this review was obtained from various sources including books, scientific databases such as Science Direct, Wiley, PubMed, Google Scholar, and other domestic and foreign literature.

RESULTS

Onion has a long history of use as a traditional medicine for management of various conditions including infectious, inflammatory, respiratory, cardiovascular diseases, diabetes, and erectile dysfunction. More than 400 compounds have been identified in onion including flavonoids, phenolic acids, amino acids, peptides, saponins and fatty acids. The plant extracts and compounds showed various pharmacological activities such as antimicrobial, antidiabetic, anti-inflammatory, anti-hyperlipidemic, anticancer, aphrodisiac, cardioprotective, and neuroprotective activities. In addition to its predominant medicinal uses, onion has found various applications in the functional food industry.

CONCLUSION

Extensive literature analysis reveals that onion extracts and bioactive constituents possess diverse pharmacological activities that can be beneficial for treating various diseases. However, the current research primarily revolves around the documentation of ethnic pharmacology and predominantly consists of in vitro studies, with relatively limited in vivo and clinical studies. Consequently, it is imperative for future investigations to prioritize and expand the scope of in vivo and clinical research. Additionally, it is strongly recommended to direct further research efforts towards toxicity studies and quality control of the plant. These studies will help bridge the current knowledge gaps and establish a solid basis for exploring the plant's potential uses in a clinical setting.

Onion supplementation and health metabolic parameters: A systematic review and meta-analysis of randomized controlled trials

INTRODUCTION

Functional foods, such as onions, have been the center of many recent investigations. In this systematic-review and meta-analysis, we aimed to gather up the existing information with regard to the impact of onion supplementation on anthropometric measurements/indices, lipid profile, indices of glycemic control and hepatic health, systolic and diastolic blood pressures (SBP and DBP), and adiponectin and leptin.

METHODS

All major online datasets (PubMed, Web of Science, Cochrane, and Scopus) were thoroughly searched from inception up to October 2022. Relevant randomized controlled trials (RCTs) were obtained using the eligibility criteria. Weighted mean differences (WMDs) were calculated and reported. Statistical significance was set as p-values <0.05.

RESULTS

Among all the retrieved data, 14 RCTs were eligible to be included. The results of the crude analysis showed that onion supplementation significantly improved body fat percentage (BFP), low-density lipoprotein-cholesterol (LDL-c), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-c), systolic blood pressure, adiponectin, and aspartate aminotransferase (AST). Subgroup analysis revealed that interventions lasting more than 12 weeks can significantly alter weight, waist circumference (WC), body mass index (BMI), BFP, LDL-c, TC, SBP, and DBP. Moreover, the intake of dosages of >300 mg/day of onion supplementation could significantly improve weight, WC, BMI, BFP, LDL-c, HDL-C, TC, AST, ALT, SBP and DBP.

CONCLUSION

It seems that the intake of onion supplementation can improve health metabolic parameters. We observed that with either longer follow-up periods or higher dosages of onion supplementation, improvements in cardio-metabolic parameters could be expected.

Endothelial progenitor cells as an emerging cardiovascular risk factor in the field of food and nutrition research: advances and challenges

Dietary modifications can help prevent many cardiovascular disease (CVD) events. Endothelial progenitor cells (EPCs) actively contribute to cardiovascular system maintenance and could function as surrogate markers for evaluating improvement in cardiovascular health resulting from nutritional interventions. This review summarizes the latest research progress on the impact of food and nutrients on EPCs, drawing on evidence from human, animal, and in vitro studies. Additionally, current trends and challenges faced in the field are highlighted. Findings from studies examining cells as EPCs are generally consistent, demonstrating that a healthy diet, such as the Mediterranean diet or a supervised diet for overweight people, specific foods like olive oil, fruit, vegetables, red wine, tea, chia, and nutraceuticals, and certain nutrients such as polyphenols, unsaturated fats, inorganic nitrate, and vitamins, generally promote higher EPC numbers and enhanced EPC function. Conversely, an unhealthy diet, such as one high in sugar substitutes, salt, or fructose, impairs EPC function. Research on outgrowth EPCs has revealed that various pathways are involved in the modulation effects of food and nutrients. The potential of EPCs as a biomarker for assessing the effectiveness of nutritional interventions in preventing CVDs is immense, while further clarification on definition and characterization of EPCs is required.

Antiobesity effects of onion (Allium cepa) in subjects with obesity: Systematic review and meta-analysis

Onions are rich in bioactive compounds and have been found to prevent various chronic diseases, including obesity. We performed a systematic review and meta-analysis to investigate the antiobesity effect of onions. Studies were identified in PubMed/MEDLINE, Embase, Web of Science, and CENTRAL focusing on clinical trials evaluating the antiobesity effects of onion in obese subjects. The risk of bias in the studies was evaluated using Cochrane's Risk of Bias tool. The effect of onions was analyzed using data from the selected studies, and the results were indicated by weighted mean difference with 95% CI. The I 2 static test was used to examine heterogeneity between the studies. A total of 38 studies were reviewed, of which five clinical trials meeting the criteria were selected. As investigational products, onion peels were used in four studies and onions were used in one study. Following systematic review, it was determined that the risk of bias was generally low, and body weight, BMI, waist circumference, and triglyceride levels were significantly reduced in the onion groups compared to the placebo. In conclusion, onion intake had an antiobesity effect by reducing body weight and body fat, and this effect was particularly pronounced with onion peel.

Pharmacological Activity of Flavonoid Quercetin and Its Therapeutic Potential in Testicular Injury

Quercetin is a natural flavonoid widely found in natural fruits and vegetables. Recent studies have shown that quercetin mediates multiple beneficial effects in a variety of organ damage and diseases, and is considered a healthcare supplement with health-promoting potential. Male infertility is a major health concern, and testicular damage from multiple causes is an important etiology. Previous studies have shown that quercetin has a protective effect on reproductive function. This may be related to the antioxidant, anti-inflammatory, and anti-apoptotic biological activities of quercetin. Therefore, this paper reviews the mechanisms by which quercetin exerts its pharmacological activity and its role in testicular damage induced by various etiologies. In addition, this paper compiles the application of quercetin in clinical trials, demonstrating its practical effects in regulating blood pressure and inhibiting cellular senescence in human patients. However, more in-depth experimental studies and clinical trials are needed to confirm the true value of quercetin for the prevention and protection against testicular injury.

Potential Role of Quercetin Glycosides as Anti-Atherosclerotic Food-Derived Factors for Human Health

Quercetin is a monomeric polyphenol of plant origin that belongs to the flavonol-type flavonoid subclass. Extensive studies using cultured cells and experimental model animals have demonstrated the anti-atherosclerotic effects of dietary quercetin in relation to the prevention of cardiovascular disease (CVD). As quercetin is exclusively present in plant-based foods in the form of glycosides, this review focuses on the bioavailability and bioefficacy of quercetin glycosides in relation to vascular health effects. Some glucose-bound glycosides are absorbed from the small intestine after glucuronide/sulfate conjugation. Both conjugated metabolites and deconjugated quercetin aglycones formed by plasma β-glucuronidase activity act as food-derived anti-atherogenic factors by exerting antioxidant, anti-inflammatory, and plasma low-density lipoprotein cholesterol-lowering effects. However, most quercetin glycosides reach the large intestine, where they are subject to gut microbiota-dependent catabolism resulting in deglycosylated aglycone and chain-scission products. These catabolites also affect vascular health after transfer into the circulation. Furthermore, quercetin glycosides may improve gut microbiota profiles. A variety of human cohort studies and intervention studies support the idea that the intake of quercetin glycoside-rich plant foods such as onion helps to prevent CVD. Thus, quercetin glycoside-rich foods offer potential benefits in terms of cardiovascular health and possible clinical applications.

Complementary and alternative medicine for alopecia areata: A systematic review

BACKGROUND

Despite high use of complementary and alternative medicine (CAM) for alopecia areata (AA), efficacy and safety remain unclear.

OBJECTIVE

To identify all CAM therapies studied for treatment of AA. Outcomes of interest included disease course and psychologic well-being.

METHODS

PubMed and Embase were searched to identify English articles containing original data investigating CAM in individuals with AA from 1950-2018. Quality was assessed with Oxford Centre for Evidence Based Medicine criteria.

RESULTS

Of 1015 initial citations, 16 articles met inclusion criteria: 5 randomized controlled trials, 5 prospective controlled cohorts, 4 prospective noncontrolled cohorts, 1 retrospective cohort, and 1 case series. CAM therapies with best evidence and efficacy for hair growth in AA include essential oil aromatherapy, topical garlic, and oral glucosides of peony with compound glycyrrhizin. Hypnosis and mindfulness psychotherapy represent low-quality evidence for improvement of psychologic and quality of life outcomes. Adverse events were rare and mild for all therapies evaluated.

LIMITATIONS

Inconsistent or poorly reported study methodology and nonstandardized outcomes limit the conclusions that can be made from these studies.

CONCLUSIONS

This work serves to inform physician treatment of patients with AA seeking CAM while encouraging further investigation into these therapies to address some of the therapeutic challenges of AA.

Ageing, Metabolic Dysfunction, and the Therapeutic Role of Antioxidants

The gradual ageing of the world population has been accompanied by a dramatic increase in the prevalence of obesity and metabolic diseases, especially type 2 diabetes. The adipose tissue dysfunction associated with ageing and obesity shares many common physiological features, including increased oxidative stress and inflammation. Understanding the mechanisms responsible for adipose tissue dysfunction in obesity may help elucidate the processes that contribute to the metabolic disturbances that occur with ageing. This, in turn, may help identify therapeutic targets for the treatment of obesity and age-related metabolic disorders. Because oxidative stress plays a critical role in these pathological processes, antioxidant dietary interventions could be of therapeutic value for the prevention and/or treatment of age-related diseases and obesity and their complications. In this chapter, we review the molecular and cellular mechanisms by which obesity predisposes individuals to accelerated ageing. Additionally, we critically review the potential of antioxidant dietary interventions to counteract obesity and ageing.

The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature

Dysglycemia is a disease state preceding the onset of diabetes and includes impaired fasting glycemia and impaired glucose tolerance. This review aimed to collect and analyze the literature reporting the results of clinical trials evaluating the effects of selected nutraceuticals on glycemia in humans. The results of the analyzed trials, generally, showed the positive effects of the nutraceuticals studied alone or in association with other supplements on fasting plasma glucose and post-prandial plasma glucose as primary outcomes, and their efficacy in improving insulin resistance as a secondary outcome. Some evidences, obtained from clinical trials, suggest a role for some nutraceuticals, and in particular Berberis, Banaba, Curcumin, and Guar gum, in the management of prediabetes and diabetes. However, contradictory results were found on the hypoglycemic effects of Morus, Ilex paraguariensis, Omega-3, Allium cepa, and Trigonella faenum graecum, whereby rigorous long-term clinical trials are needed to confirm these data. More studies are also needed for Eugenia jambolana, as well as for Ascophyllum nodosum and Fucus vesiculosus which glucose-lowering effects were observed when administered in combination, but not alone. Further trials are also needed for quercetin.

Red onion skin active ingredients, extraction and biological properties for functional food applications

Onion is an important vegetable in the world and the second most important vegetable crop after tomato.Hence, the onion waste, such as onion skin, is produced in abundance causing environmental problems. Due to its bioactive compounds, especially phenolics and flavonoids, red onion skin can be used through appropriate methods for producing value-added products. These phytochemicals are proven to prevent oxidative stress and broad spectrum of microorganisms beside having diverse beneficial biological properties. Extraction step is the most critical processing in making phytonutrient available. Various approaches including conventional and non-conventional technologies applied for extracting different compounds from red onion wastes was summarized in this study. To evaluate the industrial application potential, the use of natural bioactives derived from red onion skin for elaboration of various food systems has been also investigated.

Natural Products in Cardiovascular Diseases: The Potential of Plants from the Allioideae Subfamily (Ex-Alliaceae Family) and Their Sulphur-Containing Compounds

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide and, together with associated risk factors such as diabetes, hypertension, and dyslipidaemia, greatly impact patients' quality of life and health care systems. This burden can be alleviated by fomenting lifestyle modifications and/or resorting to pharmacological approaches. However, due to several side effects, current therapies show low patient compliance, thus compromising their efficacy and enforcing the need to develop more amenable preventive/therapeutic strategies. In this scenario, medicinal and aromatic plants are a potential source of new effective agents. Specifically, plants from the Allioideae subfamily (formerly Alliaceae family), particularly those from the genus Allium and Tulbaghia, have been extensively used in traditional medicine for the management of several CVDs and associated risk factors, mainly due to the presence of sulphur-containing compounds. Bearing in mind this potential, the present review aims to gather information on traditional uses ascribed to these genera and provide an updated compilation of in vitro and in vivo studies validating these claims as well as clinical trials carried out in the context of CVDs. Furthermore, the effect of isolated sulphur-containing compounds is presented, and whenever possible, the relation between composition and activity and the mechanisms underlying the beneficial effects are pointed out.

Impact of following a healthy dietary pattern with co-consuming wolfberry on number and function of blood outgrowth endothelial cells from middle-aged and older adults

Blood outgrowth endothelial cells (BOECs) have received growing attention in relation to cardiovascular disease (CVD). However, the effect of diet intervention, a primary strategy for CVD prevention, on BOECs is not reported. This study aims to investigate the effect of following a healthy dietary pattern (HDP) with or without wolfberry consumption, healthy food with potential cardiovascular benefits, on the number and function of BOECs in middle-aged and older adults. Twenty-four subjects consumed either an HDP only (n = 9) or an HDP supplemented with 15 g day^-1 wolfberries (n = 15) for 16 weeks. At pre- and post-intervention, vascular health biomarkers and composite CVD risk indicators were assessed. BOECs were derived from peripheral blood mononuclear cells and their angiogenic and migration activities were measured. Isolated BOECs have typical endothelial cobblestone morphology, express von Willebrand factor and KDR. Consuming an HDP improved the BOEC colony's growth rate, which was demonstrated by significant time effects in the colony's culture time between passages 1 and 2 (P = 0.038). Both interventions increased BOECs' tube formation capacity. Moreover, HDP intervention contributed to a time effect on BOEC migration activity (P = 0.040 for t_1/2gap). Correlation analysis revealed that BOEC colony number was positively associated with blood pressure, atherogenic index, vascular age, and Framingham risk score. In conclusion, adherence to an HDP improved BOECs' function in middle-aged and older populations, while additional wolfberry consumption did not provide an enhanced effect. Our results provide mechanistic dissection on the beneficial effects on BOECs of dietary pattern modification.

Onion (Allium cepa L.) peels: A review on bioactive compounds and biomedical activities

Huge quantities of byproducts/wastes generated in onion processing are usually discarded, but they are excellent sources of bioactive compounds and phytochemicals. However, with growing interest in the sustainable use of resources and the circular economy to reduce adverse impacts on the environment, food processing wastes such as onion peel/skin can be extracted and employed as inputs in developing or reformulating nutrient supplements, and pharmacological drugs. This review highlights major bioactive components, especially total phenolics, total flavonoid, quercetin and its derivatives present in onion peel/skin and their therapeutic applications as cardioprotective, neuroprotective, antiobesity, antidiabetic, anticancer and antimicrobial agents. The present review emphasized that onion peel is one of the important agricultural by-products which is rich in bioactive compounds and can be utilized as health promoting ingredient especially in pharmacological and biomedical fields. Thus, with increasing burden of life style disorders/non-communicable diseases, finding suitable natural alternative for their treatment is one major concern of the researchers and onion peel and its extract can be exploited as a prime ingredient.

Therapeutic Targets for Phenolic Compounds from Agro-industrial Byproducts against Obesity

BACKGROUND

Obesity is considered as a global epidemic worldwide. This disorder is associated to several health effects such as metabolic disturbances that need both prevention and treatment actions. In this sense, bioactive secondary metabolites can be obtained from cheap sources such as agro-industrial waste providing a sustainable alternative against obesity. Among these secondary metabolites, phenolic compounds present a common chemical structure core with different substitutions that provides them biological properties such as antioxidant, inflammatory, anti-aging capacities.

OBJECTIVE

The aim of this review is to compile anti-obesity therapeutic targets for phenolic compounds from agro-industrial byproducts.

METHOD

Scientific information has been obtained from different databases such as Scopus, PubMed and Google Scholar in order to select the available full text studies in last years.

RESULTS

This review shows that peel, seed, pomace and other byproducts from agro-industry have different effects inhibiting enzymes related to lipid or glucose metabolism and modulating biomarkers, genes and gut microbiota in animal models.

CONCLUSION

Revalorizing actions of agro-industrial byproducts in the prevention or treatment of obesity or associated disorders can be considered to develop new high value products that act on lipid, glucose and energy metabolisms, oxidative stress, inflammation, adipose tissue or gut microbiota. However, further human studies are need in order to stablish the optimal administration parameters.

Effect of onion on blood lipid profile: A meta-analysis of randomized controlled trials

BACKGROUND

Studies indicate that onion supplementation may be effective in the treatment of dyslipidemia; however, the results remain controversial. This meta-analysis was conducted to evaluate potential benefits of onion on lipid profile.

METHODS

Up to 12 October 2020, PubMed, Cochrane Library, Web of Science, and Scopus were searched for randomized controlled trials evaluating the effects of onion on lipid profile. Mean differences (MD) and 95% confidence intervals (CI) were calculated. Meta-analysis was conducted using the fixed-effects model.

RESULTS

Ten trials with 446 participants in total were included in the meta-analysis. The pooled findings of 10 studies suggested that onion supplementation significantly improved high-density lipoprotein cholesterol (HDL) (MD: 2.29 mg/dl; 95% CI: 0.87, 3.72; I 2 = 0%) and low-density lipoprotein cholesterol (LDL) (MD: -6.64 mg/dl; 95% CI: -10.91, -2.36; I 2 = 32%),while onion supplementation did not significantly lower triglycerides (TG) (MD: -6.55 mg/dl; 95% CI: -15.64, 2.53; I 2 = 45%). Analysis of nine trials showed a significant reduction in total cholesterol (TC) (MD: -5.39 mg/dl; 95% CI: -10.68, -0.09; I 2 = 49%) in patients with onion supplementation compared to the control group.

CONCLUSION

In summary, supplementation of onion was beneficial to control dyslipidemia, including improving levels of HDL, LDL, and TC, but could not reduce TG level. The therapeutic benefits of onion for dyslipidemia need to be treated with caution considering that some of the results are not robust.

Dietary Plant Polyphenols: Effects of Food Processing on Their Content and Bioavailability

Dietary plant polyphenols are natural bioactive compounds that are increasingly attracting the attention of food scientists and nutritionists because of their nutraceutical properties. In fact, many studies have shown that polyphenol-rich diets have protective effects against most chronic diseases. However, these health benefits are strongly related to both polyphenol content and bioavailability, which in turn depend on their origin, food matrix, processing, digestion, and cellular metabolism. Although most fruits and vegetables are valuable sources of polyphenols, they are not usually consumed raw. Instead, they go through some processing steps, either industrially or domestically (e.g., cooling, heating, drying, fermentation, etc.), that affect their content, bioaccessibility, and bioavailability. This review summarizes the status of knowledge on the possible (positive or negative) effects of commonly used food-processing techniques on phenolic compound content and bioavailability in fruits and vegetables. These effects depend on the plant type and applied processing parameters (type, duration, media, and intensity). This review attempts to shed light on the importance of more comprehensive dietary guidelines that consider the recommendations of processing parameters to take full advantage of phenolic compounds toward healthier foods.

Phytotherapy for Cardiovascular Disease: A Bench-to-Bedside Approach

At present, cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and global trends suggest that this panorama will persist or worsen in the near future. Thus, optimization of treatment strategies and the introduction of novel therapeutic alternatives for CVD represent key objectives in contemporary biomedical research. In recent years, phytotherapy-defined as the therapeutic use of whole or minimally modified plant components-has ignited large scientific interest, with a resurgence of abundant investigation on a wide array of medicinal herbs (MH) for CVD and other conditions. Numerous MH have been observed to intervene in the pathophysiology of CVD via a myriad of molecular mechanisms, including antiinflammatory, anti-oxidant, and other beneficial properties, which translate into the amelioration of three essential aspects of the pathogenesis of CVD: Dyslipidemia, atherosclerosis, and hypertension. Although the preclinical data in this scenario is very rich, the true clinical impact of MH and their purported mechanisms of action is less clear, as large-scale robust research in this regard is in relatively early stages and faces important methodological challenges. This review offers a comprehensive look at the most prominent preclinical and clinical evidence currently available concerning the use of MH in the treatment of CVD from a bench-to-bedside approach.

Iron (III)-Quercetin Complex: Synthesis, Physicochemical Characterization, and MRI Cell Tracking toward Potential Applications in Regenerative Medicine

In cell therapy, contrast agents T1 and T2 are both needed for the labeling and tracking of transplanted stem cells over extended periods of time through magnetic resonance imaging (MRI). Importantly, the metal-quercetin complex via coordination chemistry has been studied extensively for biomedical applications, such as anticancer therapies and imaging probes. Herein, we report on the synthesis, characterization, and labeling of the iron (III)-quercetin complex, "IronQ," in circulating proangiogenic cells (CACs) and also explore tracking via the use of a clinical 1.5 Tesla (T) MRI scanner. Moreover, IronQ had a paramagnetic T1 positive contrast agent property with a saturation magnetization of 0.155 emu/g at 1.0 T and longitudinal relaxivity (r1) values of 2.29 and 3.70 mM-1s-1 at 1.5 T for water and human plasma, respectively. Surprisingly, IronQ was able to promote CAC growth in conventional cell culture systems without the addition of specific growth factors. Increasing dosages of IronQ from 0 to 200 μg/mL led to higher CAC uptake, and maximum labeling time was achieved in 10 days. The accumulated IronQ in CACs was measured by two methodologies, an inductively coupled plasma optical emission spectrometry (ICP-EOS) and T1-weighted MRI. In our research, we confirmed that IronQ has excellent dual functions with the use of an imaging probe for MRI. IronQ can also act as a stimulating agent by favoring circulating proangiogenic cell differentiation. Optimistically, IronQ is considered beneficial for alternative labeling and in the tracking of circulation proangiogenic cells and/or other stem cells in applications of cell therapy through noninvasive magnetic resonance imaging in both preclinical and clinical settings.

Effect of quercetin supplementation on plasma lipid profiles, blood pressure, and glucose levels: a systematic review and meta-analysis

CONTEXT

Clinical trials examining the cardiovascular protective effects of quercetin in humans have reported conflicting results.

OBJECTIVE

The aim of this systematic review was to summarize evidence of the effects of quercetin supplementation on plasma lipid profiles, blood pressure (BP), and glucose levels in humans by performing a meta-analysis of randomized controlled trials.

DATA SOURCES

MEDLINE, Embase, and Scopus databases were searched electronically from their inception to July 2018 to identify randomized controlled trials that assessed the impact of quercetin on lipid profiles, BP, and glucose levels.

STUDY SELECTION

Randomized controlled trials assessing the effects of quercetin or a standardized quercetin-enriched extract on plasma lipid profiles, BP, and glucose levels in humans were eligible for inclusion.

DATA EXTRACTION

A random-effects model was used for data analysis. Continuous variables were expressed as weighted mean differences (WMDs) and 95%CIs. Subgroup analyses were conducted to explore possible influences of study characteristics. Sensitivity analyses were also performed, as were analyses of publication bias.

RESULTS

Seventeen trials (n = 896 participants total) were included in the overall analysis. Pooled results showed that quercetin significantly lowered both systolic BP (WMD, -3.09 mmHg; 95%CI, -4.59 to -1.59; P = 0.0001) and diastolic BP (WMD, -2.86 mmHg; 95%CI, -5.09 to -0.63; P = 0.01). Neither lipid profiles nor glucose concentrations changed significantly. In subgroup analyses, significant changes in high-density lipoprotein cholesterol and triglycerides were observed in trials with a parallel design and in which participants consumed quercetin for 8 weeks or more.

CONCLUSION

Quercetin intake resulted in significantly decreased BP in humans. Moreover, participants who consumed quercetin for 8 weeks or more showed significantly changed levels of high-density lipoprotein cholesterol and triglycerides in trials with a parallel design.

Integrated Skin Transcriptomics and Serum Multiplex Assays Reveal Novel Mechanisms of Wound Healing in Diabetic Foot Ulcers

Nonhealing diabetic foot ulcers (DFUs) are characterized by low-grade chronic inflammation, both locally and systemically. We prospectively followed a group of patients who either healed or developed nonhealing chronic DFUs. Serum and forearm skin analysis, both at the protein expression and the transcriptomic level, indicated that increased expression of factors such as interferon-γ (IFN-γ), vascular endothelial growth factor, and soluble vascular cell adhesion molecule-1 were associated with DFU healing. Furthermore, foot skin single-cell RNA sequencing analysis showed multiple fibroblast cell clusters and increased inflammation in the dorsal skin of patients with diabetes mellitus (DM) and DFU specimens compared with control subjects. In addition, in myeloid cell DM and DFU upstream regulator analysis, we observed inhibition of interleukin-13 and IFN-γ and dysregulation of biological processes that included cell movement of monocytes, migration of dendritic cells, and chemotaxis of antigen-presenting cells pointing to an impaired migratory profile of immune cells in DM skin. The SLCO2A1 and CYP1A1 genes, which were upregulated at the forearm of nonhealers, were mainly expressed by the vascular endothelial cell cluster almost exclusively in DFU, indicating a potential important role in wound healing. These results from integrated protein and transcriptome analyses identified individual genes and pathways that can potentially be targeted for enhancing DFU healing.

Allium Flavonols: Health Benefits, Molecular Targets, and Bioavailability

Allium species are revered worldwide as vegetables, condiments, and spices as well as the therapeutic agents in traditional medicine. The bioactive compounds in alliums mainly include organosulfur compounds, polyphenols, dietary fibers, and saponins. Flavonoids, particularly flavonols from alliums, have been demonstrated to have the antioxidant, anticancer, hypolipidemic, anti-diabetic, cardioprotective, neuroprotective, and antimicrobial activities. However, flavonols are mostly characterized from onions and have not been comprehensively reviewed across different species. This article therefore focuses on flavonol profiles from different Allium species, their health effects, underlying molecular mechanisms, and bioavailability. Intriguingly, the functional health effects of flavonols were mainly ascribed to their antioxidant and anti-inflammatory activities involving a cascade of multiple signaling pathways. Although the Allium-derived flavonols offer tremendous potential in preventing chronic disease risks, in-depth studies are needed to translate their clinical application.

Anti-Obesity Effects of Polyphenol Intake: Current Status and Future Possibilities

The prevalence of obesity has steadily increased worldwide over the past three decades. The conventional approaches to prevent or treat this syndrome and its associated complications include a balanced diet, an increase energy expenditure, and lifestyle modification. Multiple pharmacological and non-pharmacological interventions have been developed with the aim of improving obesity complications. Recently, the use of functional foods and their bioactive components is considered a new approach in the prevention and management of this disease. Due to their biological properties, polyphenols may be considered as nutraceuticals and food supplement recommended for different syndromes. Polyphenols are a class of naturally-occurring phytochemicals, some of which have been shown to modulate physiological and molecular pathways involved in energy metabolism. Polyphenols could act in the stimulation of β-oxidation, adipocyte differentiation inhibition, counteract oxidative stress, etc. In this narrative review, we considered the association between polyphenols (resveratrol, quercetin, curcumin, and some polyphenolic extracts) and obesity, focusing on human trials. The health effects of polyphenols depend on the amount consumed and their bioavailability. Some results are contrasting, probably due to the various study designs and lengths, variation among subjects (age, gender, ethnicity), and chemical forms of the dietary polyphenols used. But, in conclusion, the data so far obtained encourage the setting of new trials, necessary to validate benefic role of polyphenols in obese individuals.

Screening of Inhibitory Effects of Polyphenols on Akt-Phosphorylation in Endothelial Cells and Determination of Structure-Activity Features

Polyphenols exert beneficial effects in type 2 diabetes mellitus (T2DM). However, their mechanism of action remains largely unknown. Endothelial Akt-kinase plays a key role in the pathogenesis of cardiovascular complications in T2DM and therefore the modulation of its activity is of interest. This work aimed to characterize effects of structurally different polyphenols on Akt-phosphorylation (pAkt) in endothelial cells (Ea.hy926) and to describe structure-activity features. A comprehensive screening via ELISA quantified the effects of 44 polyphenols (10 µM) on pAkt Ser473. The most pronounced inhibitors were luteolin (44 ± 18%), quercetin (36 ± 8%), urolithin A (35 ± 12%), apigenin, fisetin, and resveratrol; (p < 0.01). The results were confirmed by Western blotting and complemented with corresponding experiments in HUVEC cells. A strong positive and statistically significant correlation between the mean inhibitory effects of the tested polyphenols on both Akt-residues Ser473 and Thr308 (r = 0.9478, p = 0.0003) was determined by immunoblotting. Interestingly, the structural characteristics favoring pAkt inhibition partially differed from structural features enhancing the compounds’ antioxidant activity. The present study is the first to quantitatively compare the influence of polyphenols from nine different structural subclasses on pAkt in endothelial cells. These effects might be advantageous in certain T2DM-complications involving over-activation of the Akt-pathway. The suggested molecular mode of action of polyphenols involving Akt-inhibition contributes to understanding their effects on the cellular level.

The beneficial effects of subcutaneous Allium cepa injection on random flap survival in rats

Random flaps are frequently used in the practice of reconstructive surgery. The aim of this experimental study was to investigate the effects of Allium cepa on random flap survival in rats. Fourteen Wistar rats were used for this experimental study. The subjects were divided into experiment and control groups. Rats in the experiment group received daily injections of A. cepa extract for 7 d before the elevation of the flaps. Following the treatment period, elevation and reinsertion of the dorsal flaps were performed. Necrotic and total flaps areas were marked and calculated 7 d after the flap elevation. Histological examinations and microangiography were performed to evaluate the results. The mean value of the proportion of necrotic flap areas to the total flap area was 25.06 and 50.6% in the A. cepa and control group, respectively (p = .0079). In the histological examination, number of vessels identified in the dermis were 23.75 ± 0.7 and 33.75 ± 9 in the A. cepa and control group, respectively (p = .7457). In angiographic images, vessels formations were more noticeable in the A. cepa group. We conclude that preoperative subcutaneous A. cepa injection increases dorsal flap survival in rats.

Effects of quercetin supplementation on glycemic control among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials

This systematic review and meta-analysis of randomized controlled trials was performed to determine the effect of quercetin supplementation on glycemic control among patients with metabolic syndrome and related disorders. Databases including PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were searched until August 30, 2018. Nine studies with 10 effect sizes out of 357 selected reports were identified eligible to be included in current meta-analysis. The pooled findings indicated that quercetin supplementation did not affect fasting plasma glucose (FPG), homeostasis model of assessment-estimated insulin resistance, and hemoglobin A1c levels. In subgroup analysis, quercetin supplementation significantly reduced FPG in studies with a duration of ≥8 weeks (weighted mean difference [WMD]: -0.94; 95% confidence interval [CI; -1.81, -0.07]) and used quercetin in dosages of ≥500 mg/day (WMD: -1.08; 95% CI [-2.08, -0.07]). In addition, subgroup analysis revealed a significant reduction in insulin concentrations following supplementation with quercetin in studies that enrolled individuals aged <45 years (WMD: -1.36; 95% CI [-1.76, -0.97]) and that used quercetin in dosages of ≥500 mg/day (WMD: -1.57; 95% CI [-1.98, -1.16]). In summary, subgroup analysis based on duration of ≥8 weeks and used quercetin in dosages of ≥500 mg/day significantly reduced FPG levels.

Polyphenol Health Effects on Cardiovascular and Neurodegenerative Disorders: A Review and Meta-Analysis

Several studies have demonstrated that polyphenol-enriched diets may have beneficial effects against the development of degenerative diseases, including atherosclerosis and disorders affecting the central nervous system. This activity has been associated not only with antioxidant and anti-inflammatory properties, but also with additional mechanisms, such as the modulation of lipid metabolism and gut microbiota function. However, long-term studies on humans provided controversial results, making the prediction of polyphenol impact on health uncertain. The aim of this review is to provide an overview and critical analysis of the literature related to the effects of the principal dietary polyphenols on cardiovascular and neurodegenerative disorders. We critically considered and meta-analyzed randomized controlled clinical trials involving subjects taking polyphenol-based supplements. Although some polyphenols might improve specific markers of cardiovascular risk and cognitive status, many inconsistent data are present in literature. Therefore, definitive recommendations for the use of these compounds in the prevention of cardiovascular disease and cognitive decline are currently not applicable. Once pivotal aspects for the definition of polyphenol bioactivity, such as the characterization of pharmacokinetics and safety, are addressed, it will be possible to have a clear picture of the realistic potential of polyphenols for disease prevention.

Clinical effectiveness of quercetin supplementation in the management of weight loss: a pooled analysis of randomized controlled trials

Purpose: The previous investigations which considered the possible effect of the quercetin supplementation for overweight and obesity have led to inconsistent results. Here, we aimed to evaluate the effects of quercetin on weight loss using a meta-analysis of randomized controlled clinical trials (RCTs). Methods: Relevant studies were systematically searched from the MEDLINE, EMBASE, Google Scholar, and Scopus databases. RCTs that investigated the effects of quercetin on weight loss in humans were included for quality assessment, meta-analyses, sensitivity analysis, subgroup analyses, and publication bias assessment. Effect size was expressed as weighted mean difference (WMD) and 95% CI by using a random-effects model. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to rate the level of evidence. Results: Nine RCTs (11 treatment arms) with 525 participants were finally included for data pooling. Our meta-analysis revealed that daily quercetin supplementation did not significantly affect the body weight (WMD: -0.35 kg, 95% CI: -2.03, 1.33; P=0.68), body mass index (WMD: -0.04 kg/m², 95% CI: -0.54, 0.45; P=0.87), waist circumference (WMD: -0.37 cm, 95% CI: -1.81, 1.06; P=0.61), and waist to hip ratio (WMD: -0.01, 95% CI: -0.03, 0.01; P=0.48). Subgroup analysis could not identify factors significantly influencing these parameters. These results were robust in sensitivity analysis, and no significant publication bias was found. Conclusion: The current evidence suggests that quercetin intake did not show a notably favorable effect on weight loss. Future well-designed and long-term clinical trials are required to confirm these results.

Biological Properties and Bioactive Components of Allium cepa L.: Focus on Potential Benefits in the Treatment of Obesity and Related Comorbidities

Common onion (Allium cepa L.) is one of the oldest cultivated plants, utilized worldwide as both vegetable and flavouring. This species is known to contain sulphur amino acids together with many vitamins and minerals. A variety of secondary metabolites, including flavonoids, phytosterols and saponins, have also been identified. Despite the predominant use of this plant as food, a wide range of beneficial effects have also been proved. Different biological properties, such as antioxidant, antimicrobial and antidiabetic, have been reported. The aim of this review is to provide an overview of the studies concerning the beneficial effects of this species against obesity and its related comorbidities, such as hyperlipidaemia, hypertension and diabetes. Both in vitro and in vivo results about onion dietary supplementation have been taken into account. Furthermore, this review examines the possible role of onion bioactive components in modulating or preventing weight-gain or related diseases, as well as the possible mechanisms behind their activity.

Potential mechanisms underlying cardiovascular protection by polyphenols: Role of the endothelium

Epidemiological studies have indicated that regular intake of polyphenol-rich diets such as red wine and tea, are associated with a reduced risk of cardiovascular diseases. The beneficial effect of polyphenol-rich products has been attributable, at least in part, to their direct action on the endothelial function. Indeed, polyphenols from tea, grapes, cacao, berries, and plants have been shown to activate endothelial cells to increase the formation of potent vasoprotective factors including nitric oxide (NO) and to delay endothelial ageing. Moreover, intake of such polyphenol-rich products has been associated with the prevention and/or the improvement of an established endothelial dysfunction in several experimental models of cardiovascular diseases and in Humans with cardiovascular diseases. This review will discuss both experimental and clinical evidences indicating that polyphenols are able to promote endothelial and vascular health, as well as the underlying mechanisms.

Flavanols are potential anti-obesity agents, a systematic review and meta-analysis of controlled clinical trials

BACKGROUND

The anti-obesity potential of flavonoids has been shown by animal and human studies. In this meta-analysis, we systematically reviewed controlled clinical trials and quantified the effects of flavonoids and flavonoid subclasses on obesity-related anthropometric measures.

METHODS AND RESULTS

PubMed, EMBASE, Scopus, Web of Science, and ProQuest databases were searched to identify trials examining the effect of flavonoids on body mass index (BMI), waist circumference, and body fat percentage. Fifty eight trials passed the eligibility process. Analysis endpoints were calculated as the mean difference between baseline and post-treatment. Flavonoids were in subclasses of flavanols, flavonols, isoflavones, flavanones, anthocyanins, and proanthocyanidins. They were mostly in the form of supplements and dosages varying from 40 to 1300 mg/day. Among flavonoid subclasses, flavanols showed potential for decreasing BMI, in the overall population (mean difference (MD) = -0.28 kg/m², P = 0.04; n = 21) and in the subgroups of Asians (MD = -0.42 kg/m²; P = 0.046; n = 13), ages < 50 years (MD = -0.50 kg/m²; P = 0.008; n = 14), BMI ≥ 25 kg/m² (MD = -0.30 kg/m²; P = 0.049; n = 15), and at doses ≥ 500 mg/day (MD = -0.36 kg/m²; P = 0.049; n = 12). Isoflavones also decreased BMI of non-Asian populations (MD = -0.26 kg/m²; P = 0.035; n = 13) and doses ≥ 75 mg/day (MD = -0.34 kg/m²; P = 0.027; n = 8). In the overall assessment, flavanols also decreased waist circumference (MD = -0.60 cm; P = 0.02; n = 18) but had no significant effect on body fat percentage. The available trials did not reveal significant effects from flavonols, flavanones, and anthocyanins on the specified anthropometric measures.

CONCLUSIONS

Overall results of this meta-analysis showed that flavanols have potential against obesity.

Endothelial Progenitor Cells for Ischemic Stroke: Update on Basic Research and Application

Ischemic stroke is one of the leading causes of human death and disability worldwide. So far, ultra-early thrombolytic therapy is the most effective treatment. However, most patients still live with varying degrees of neurological dysfunction due to its narrow therapeutic time window. It has been confirmed in many studies that endothelial progenitor cells (EPCs), as a kind of adult stem cells, can protect the neurovascular unit by repairing the vascular endothelium and its secretory function, which contribute to the recovery of neurological function after an ischemic stroke. This paper reviews the basic researches and clinical trials of EPCs especially in the field of ischemic stroke and addresses the combination of EPC application with new technologies, including neurovascular intervention, synthetic particles, cytokines, and EPC modification, with the aim of shedding some light on the application of EPCs in treating ischemic stroke in the future.

Electroacupuncture prevents endothelial dysfunction induced by ischemia-reperfusion injury via a cyclooxygenase-2-dependent mechanism: A randomized controlled crossover trial

Objective

Exploring clinically effective methods to reduce ischemia-reperfusion (IR) injury in humans is critical. Several drugs have shown protective effects, but studies using other interventions have been rare. Electroacupuncture (EA) has induced similar protection in several animal studies but no study has investigated how the effects could be translated and reproduced in humans. This study aimed to explore the potential effect and mechanisms of EA in IR-induced endothelial dysfunction in humans.

Methods

This is a prospective, randomized, crossover, sham-controlled trial consisting of two protocols. Protocol 1 was a crossover study to investigate the effect of EA on IR-induced endothelial dysfunction. Twenty healthy volunteers were randomly assigned to EA or sham EA (sham). Flow mediated dilation (FMD) of the brachial artery (BA), nitroglycerin-mediated endothelial independent dilation, blood pressure before and after IR were measured. In protocol 2, seven volunteers were administered COX-2 inhibitor celecoxib (200 mg orally twice daily) for five days. After consumption, volunteers underwent FMD before and after IR identical to protocol 1.

Results

In protocol 1, baseline BA diameter, Pre-IR BA diameter and FMD were similar between the two groups (p = NS). After IR, sham group showed significantly blunted FMD (Pre-IR: 11.41 ± 3.10%, Post-IR: 4.49 ± 2.04%, p < 0.001). However, EA protected this blunted FMD (Pre-IR: 10.96 ± 5.30%, Post-IR: 9.47 ± 5.23%, p = NS, p < 0.05 compared with sham EA after IR). In protocol 2, this protective effect was completely abolished by pre-treatment with celecoxib (Pre-IR: 11.05 ± 3.27%; Post-IR: 4.20 ± 1.68%, p = 0.001).

Conclusion

EA may prevent IR-induced endothelial dysfunction via a COX-2 dependent mechanism.

Impact of Flavonols on Cardiometabolic Biomarkers: A Meta-Analysis of Randomized Controlled Human Trials to Explore the Role of Inter-Individual Variability

Several  epidemiological  studies  have  linked  flavonols  with  decreased  risk  of  cardiovascular  disease  (CVD).  However,  some  heterogeneity  in  the  individual  physiological  responses to the consumption of these compounds has been identified. This meta-analysis aimed to  study the effect of flavonol supplementation on biomarkers of CVD risk such as, blood lipids, blood  pressure and plasma glucose, as well as factors affecting their inter-individual variability. Data from  18 human randomized controlled trials were pooled and the effect was estimated using fixed or  random effects meta-analysis model and reported as difference in means (DM). Variability in the  response of blood lipids to supplementation with flavonols was assessed by stratifying various  population subgroups: age, sex, country, and health status. Results showed significant reductions  in total cholesterol (DM = -0.10 mmol/L; 95% CI: -0.20, -0.01), LDL cholesterol (DM = -0.14 mmol/L;  Nutrients 2017, 9, 117  2 of 21  95% CI: -0.21, 0.07), and triacylglycerol (DM = -0.10 mmol/L; 95% CI: -0.18, 0.03), and a significant  increase in HDL cholesterol (DM = 0.05 mmol/L; 95% CI: 0.02, 0.07). A significant reduction was also  observed in fasting plasma glucose (DM = -0.18 mmol/L; 95%CI: -0.29, -0.08), and in blood pressure  (SBP: DM = -4.84 mmHg; 95% CI: -5.64, -4.04; DBP: DM = -3.32 mmHg; 95% CI: -4.09, -2.55).  Subgroup analysis showed a more pronounced effect of flavonol intake in participants from Asian  countries and in participants with diagnosed disease or dyslipidemia, compared to healthy and  normal baseline values. In conclusion, flavonol consumption improved biomarkers of CVD risk,  however, country of origin and health status may influence the effect of flavonol intake on blood  lipid levels.

Therapeutic Role of Functional Components in Alliums for Preventive Chronic Disease in Human Being

Objectives. Functional components in alliums have long been maintained to play a key role in modifying the major risk factors for chronic disease. To obtain a better understanding of alliums for chronic disease prevention, we conducted a systematic review for risk factors and prevention strategies for chronic disease of functional components in alliums, based on a comprehensive English literature search that was conducted using various electronic search databases, especially the PubMed, ISI Web of Science, and CNKI for the period 2007-2016. Allium genus especially garlic, onion, and Chinese chive is rich in organosulfur compounds, quercetin, flavonoids, saponins, and others, which have anticancer, preventive cardiovascular and heart diseases, anti-inflammation, antiobesity, antidiabetes, antioxidants, antimicrobial activity, neuroprotective and immunological effects, and so on. These results support Allium genus; garlic and onion especially may be the promising dietotherapeutic vegetables and organopolysulfides as well as quercetin mechanism in the treatment of chronic diseases. This review may be used as scientific basis for the development of functional food, nutraceuticals, and alternative drugs to improve the chronic diseases.

Randomized clinical trial on the efficacy of hesperidin 2S on validated cardiovascular biomarkers in healthy overweight individuals

BACKGROUND

Endothelial dysfunction (ED) is involved in the development of atherosclerosis. Hesperidin, a citrus flavonoid with antioxidant and other biological properties, potentially exerts beneficial effects on endothelial function (EF).

OBJECTIVE

We investigated the effect of hesperidin 2S supplementation on EF in overweight individuals.

DESIGN

This was a randomized, double-blind, placebo-controlled study in which 68 individuals were randomly assigned to receive hesperidin 2S (450 mg/d) or a placebo for 6 wk. At baseline and after 6 wk of intervention, flow-mediated dilation (FMD), soluble vascular adhesion molecule-1 (sVCAM-1), soluble intracellular adhesion molecule-1 (sICAM-1), soluble P-selectin (sP-selectin), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed. Acute, reversible ED was induced by intake of a high-fat meal (HFM). A second FMD scan was performed 2 h postprandially, and adhesion molecules were assessed 2 and 4 h postprandially. An additional exploratory analysis was performed in subjects with baseline FMD ≥3%.

RESULTS

No significant change in fasting or postprandial FMD was observed after 6 wk of hesperidin intake compared with placebo intake. However, there was a trend for a reduction of sVCAM-1, sICAM-1, sP-selectin, SBP, and DBP after 6 wk of hesperidin treatment. In the FMD ≥3% group, hesperidin protected individuals from postprandial ED (P = 0.050) and significantly downregulated sVCAM-1 and sICAM-1 (all P ≤ 0.030). The results reported in the current article were not adjusted for multiplicity.

CONCLUSIONS

Six weeks of consumption of hesperidin 2S did not improve basal or postprandial FMD in our total study population. There was a tendency toward a reduction of adhesion molecules and a decrease in SBP and DBP. Further exploratory analyses revealed that, in subjects with baseline FMD ≥3%, hesperidin 2S improved ED after an HFM and reduced adhesion molecules. These results indicate the cardiovascular health benefits of hesperidin 2S in overweight and obese individuals with a relatively healthy endothelium. This trial was registered at clinicaltrials.gov as NCT02228291.