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Khayatan D, Zare K, Khanahmadi M, Momtaz S, Butler AE, Jamialahmadi T, Almahmeed W, Abdolghaffari AH, Sahebkar A. The role of natural products as PCSK9 modulators: A review. Phytother Res 2024. [PMID: 38899632 DOI: 10.1002/ptr.8260] [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: 02/03/2023] [Revised: 04/25/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024]
Abstract
A variety of mechanisms and drugs have been shown to attenuate cardiovascular disease (CVD) onset and/or progression. Recent researchers have identified a potential role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in modulating lipid metabolism and reducing plasma low density lipoprotein (LDL) levels. PCSK9 is the central protein in the metabolism of LDL cholesterol (LDL-C) owing to its major function in LDL receptor (LDLR) degradation. Due to the close correlation of cardiovascular disease with lipid levels, many in vivo and in vitro investigations are currently underway studying the physiological role of PCSK9. Furthermore, many studies are actively investigating the mechanisms of various compounds that influence lipid associated-disorders and their associated cardiovascular diseases. PCSK9 inhibitors have been shown to have significant impact in the prevention of emerging cardiovascular diseases. Natural products can effectively be used as PCSK9 inhibitors to control lipid levels through various mechanisms. In this review, we evaluate the role of phytochemicals and natural products in the regulation of PCSK9, and their ability to prevent cardiovascular diseases. Moreover, we describe their mechanisms of action, which have not to date been delineated.
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Affiliation(s)
- Danial Khayatan
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Kimia Zare
- School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Maryam Khanahmadi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Saeideh Momtaz
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Tehran, Iran
- Department of Toxicology and Pharmacology, School of Pharmacy, and Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Tannaz Jamialahmadi
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Amir Hossein Abdolghaffari
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amirhossein Sahebkar
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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McGee KC, Sullivan J, Hazeldine J, Schmunk LJ, Martin-Herranz DE, Jackson T, Lord JM. A combination nutritional supplement reduces DNA methylation age only in older adults with a raised epigenetic age. GeroScience 2024:10.1007/s11357-024-01138-8. [PMID: 38528176 DOI: 10.1007/s11357-024-01138-8] [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: 01/05/2024] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
An increase in systemic inflammation (inflammaging) is one of the hallmarks of aging. Epigenetic (DNA methylation) clocks can quantify the degree of biological aging and this can be reversed by lifestyle and pharmacological intervention. We aimed to investigate whether a multi-component nutritional supplement could reduce systemic inflammation and epigenetic age in healthy older adults.We recruited 80 healthy older participants (mean age ± SD: 71.85 ± 6.23; males = 31, females = 49). Blood and saliva were obtained pre and post a 12-week course of a multi-component supplement, containing: Vitamin B3, Vitamin C, Vitamin D, Omega 3 fish oils, Resveratrol, Olive fruit phenols and Astaxanthin. Plasma GDF-15 and C-reactive protein (CRP) concentrations were quantified as markers of biological aging and inflammation respectively. DNA methylation was assessed in whole blood and saliva and used to derive epigenetic age using various clock algorithms.No difference between the epigenetic and chronological ages of participants was observed pre- and post-treatment by the blood-based Horvath or Hannum clocks, or the saliva-based InflammAge clock. However, in those with epigenetic age acceleration of ≥ 2 years at baseline, a significant reduction in epigenetic age (p = 0.015) and epigenetic age acceleration (p = 0.0058) was observed post-treatment using the saliva-based InflammAge clock. No differences were observed pre- and post-treatment in plasma GDF-15 and CRP, though participants with CRP indicative of an elevated cardiovascular disease risk (hsCRP ≥ 3µg/ml), had a reduction in CRP post-supplementation (p = 0.0195).Our data suggest a possible benefit of combined nutritional supplementation in individuals with an accelerated epigenetic age and inflammaging.
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Affiliation(s)
- Kirsty C McGee
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Jack Sullivan
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Jon Hazeldine
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | | | | | - Thomas Jackson
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedcial Research Centre, University Hopsital Birmingham and University of Birmingham, Birmingham, UK
| | - Janet M Lord
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
- NIHR Birmingham Biomedcial Research Centre, University Hopsital Birmingham and University of Birmingham, Birmingham, UK.
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Bianconi V, Cafaro G, Mannarino MR, Perricone C, Cosentini E, Bistoni O, Paltriccia R, Lombardini R, Gerli R, Pirro M, Bartoloni E. Exploring the Link between Plasma Levels of PCSK9, Immune Dysregulation and Atherosclerosis in Patients with Primary Sjögren's Syndrome. Biomolecules 2023; 13:1384. [PMID: 37759784 PMCID: PMC10527459 DOI: 10.3390/biom13091384] [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: 06/18/2023] [Revised: 08/12/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates lipid metabolism contributing to cardiovascular (CV) risk in the general population. The relationship between PCSK9 and CV risk in systemic autoimmune diseases has been poorly explored. We investigated the association between plasma PCSK9, measures of immune-inflammatory status and markers of atherosclerosis in 52 consecutive patients with primary Sjögren's syndrome (pSS) in comparison to healthy controls (HCs). Median plasma PCSK9 levels were significantly higher in pSS patients versus HCs (162 (79-255) vs. 53 (39-99) ng/mL). Significantly higher prevalence of subclinical atherosclerosis and lower of dyslipidaemia (61% vs. 85%, p = 0.042) characterized pSS patients versus HCs. In pSS, no significant correlation emerged between PCSK9 and disease activity, atherosclerosis and lipid levels. In HCs, PCSK9 significantly correlated with lipid levels and atherosclerosis. Interestingly, significantly higher PCSK9 levels were found in HCs with high-to-very-high as compared to low-to-moderate CV risk (p = 0.018) while a non-significant trend towards higher PCSK9 levels was detected in pSS patients with low-to-moderate as compared to high-to-very-high CV risk (p = 0.060). This is the first demonstration that pSS patients, despite lower prevalence of dyslipidaemia and higher CV risk profile, are characterized by a 3-fold increase in PCSK9 levels in comparison to HCs. As PCSK9 does not correlate with measures of CV risk, its role in CV morbidity in pSS needs further investigation.
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Affiliation(s)
- Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (V.B.); (M.R.M.); (E.C.); (R.P.); (R.L.); (M.P.)
| | - Giacomo Cafaro
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (G.C.); (C.P.); (O.B.); (E.B.)
| | - Massimo Raffaele Mannarino
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (V.B.); (M.R.M.); (E.C.); (R.P.); (R.L.); (M.P.)
| | - Carlo Perricone
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (G.C.); (C.P.); (O.B.); (E.B.)
| | - Elena Cosentini
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (V.B.); (M.R.M.); (E.C.); (R.P.); (R.L.); (M.P.)
| | - Onelia Bistoni
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (G.C.); (C.P.); (O.B.); (E.B.)
| | - Rita Paltriccia
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (V.B.); (M.R.M.); (E.C.); (R.P.); (R.L.); (M.P.)
| | - Rita Lombardini
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (V.B.); (M.R.M.); (E.C.); (R.P.); (R.L.); (M.P.)
| | - Roberto Gerli
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (G.C.); (C.P.); (O.B.); (E.B.)
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (V.B.); (M.R.M.); (E.C.); (R.P.); (R.L.); (M.P.)
| | - Elena Bartoloni
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (G.C.); (C.P.); (O.B.); (E.B.)
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Bianconi V, Mannarino MR, Ramondino F, Fusaro J, Giglioni F, Braca M, Ricciutelli F, Lombardini R, Paltriccia R, Greco A, Lega IC, Pirro M. Lipoprotein(a) Does Not Predict Thrombotic Events and In-Hospital Outcomes in Patients with COVID-19. J Clin Med 2023; 12:jcm12103543. [PMID: 37240653 DOI: 10.3390/jcm12103543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
The prothrombotic and proinflammatory properties of lipoprotein(a) (Lp(a)) have been hypothesized to play a role in the pathogenesis of severe COVID-19; however, the prognostic impact of Lp(a) on the clinical course of COVID-19 remains controversial. This study aimed to investigate whether Lp(a) may be associated with biomarkers of thrombo-inflammation and the occurrence of thrombotic events or adverse clinical outcomes in patients hospitalized for COVID-19. We consecutively enrolled a cohort of patients hospitalized for COVID-19 and collected blood samples for Lp(a) assessment at hospital admission. A prothrombotic state was evaluated through D-dimer levels, whereas a proinflammatory state was evaluated through C-reactive protein (CRP), procalcitonin, and white blood cell (WBC) levels. Thrombotic events were marked by the diagnosis of deep or superficial vein thrombosis (DVT or SVT), pulmonary embolism (PE), stroke, transient ischemic attack (TIA), acute coronary syndrome (ACS), and critical limb ischemia (CLI). The composite clinical end point of intensive care unit (ICU) admission/in-hospital death was used to evaluate adverse clinical outcomes. Among 564 patients (290 (51%) men, mean age of 74 ± 17 years) the median Lp(a) value at hospital admission was 13 (10-27) mg/dL. During hospitalization, 64 (11%) patients were diagnosed with at least one thrombotic event and 83 (15%) patients met the composite clinical end point. Lp(a), as either a continuous or categorical variable, was not associated with D-dimer, CRP, procalcitonin, and WBC levels (p > 0.05 for all correlation analyses). In addition, Lp(a) was not associated with a risk of thrombotic events (p > 0.05 for multi-adjusted odds ratios) nor with a risk of adverse clinical outcomes (p > 0.05 for multi-adjusted hazard ratios). In conclusion, Lp(a) does not influence biomarkers of plasma thrombotic activity and systemic inflammation nor has any impact on thrombotic events and adverse clinical outcomes in patients hospitalized for COVID-19.
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Affiliation(s)
- Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Massimo R Mannarino
- Women's College Research Institute, Women's College Hospital, Toronto, ON M5G 1N8, Canada
| | - Federica Ramondino
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Jessica Fusaro
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Francesco Giglioni
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Marco Braca
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Federica Ricciutelli
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Rita Lombardini
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Rita Paltriccia
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Alessia Greco
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Iliana C Lega
- Women's College Research Institute, Women's College Hospital, Toronto, ON M5G 1N8, Canada
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
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Hernandez AV, Hwang J, Nasreen I, Sicignano D, Pasupuleti V, Snow-Caroti K, White CM. Impact of Berberine or Berberine Combination Products on Lipoprotein, Triglyceride and Biological Safety Marker Concentrations in Patients with Hyperlipidemia: A Systematic Review and Meta-Analysis. J Diet Suppl 2023; 21:242-259. [PMID: 37183391 DOI: 10.1080/19390211.2023.2212762] [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: 05/16/2023]
Abstract
Monoclonal antibody Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) inhibitors reduce total cholesterol (TC), low density lipoproteins (LDL), high density lipoproteins (HDL), and triglycerides (TG). We assessed the ability of berberine, a natural PCSK9 inhibitor, to reduce lipid concentrations either alone or combined with other nutraceuticals. We searched PubMed, Scopus and EMBASE from inception to September 30th, 2022 for randomized controlled trials (RCTs) assessing 8-18 wk of berberine therapy on. A total of 41 RCTs with 4,838 patients met our inclusion criteria. Berberine containing products significantly reduced TC (MD -17.42 mg/dL [95%CI: -22.91 to -11.93]), LDL (MD -14.98 mg/dL [95%CI: -20.67 to -9.28]), and TG (MD -18.67 mg/dL [95%CI: -25.82 to -11.51]) while raising HDL (MD 1.97 mg/dL [95%CI: 1.16 to 2.78]) versus control (I2 > 72% for all analyses). Products with berberine alone had less robust effects on TC (MD -12.08 mg/dL [95%CI: -21.79 to -2.37]), LDL (MD -9.26 mg/dL [95%CI: -20.31 to 1.78]), and HDL (MD 1.38 mg/dL [95%CI: -1.27 to 4.03]) but TG effects were similar (MD -17.40 mg/dL [95%CI: -32.57 to -2.23]). Berberine along with red yeast rice reduced TC (MD -19.62 mg/dL [95%CI: -28.56 to -10.68]) and LDL (MD -18.79 mg/dL [95%CI: -28.03 to -9.54]) as did combination therapy with Silybum maranium for TC (MD -31.81 mg/dL [95%CI: -59.88 to -3.73]) and LDL (MD -30.82 mg/dL [95%CI: -56.48 to -5.16]). Berberine, alone or with other nutraceuticals, can provide a modest positive impact on lipid concentrations.
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Affiliation(s)
- Adrian V Hernandez
- University of Connecticut School of Pharmacy, Storrs, CT, USA
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola (USIL), Lima, Peru
| | - Jennifer Hwang
- University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Iram Nasreen
- University of Connecticut School of Pharmacy, Storrs, CT, USA
| | | | | | - Kimberly Snow-Caroti
- University of Connecticut School of Pharmacy, Storrs, CT, USA
- Department of Research Administration, Hartford Hospital, Hartford, CT, USA
| | - C Michael White
- University of Connecticut School of Pharmacy, Storrs, CT, USA
- Department of Research Administration, Hartford Hospital, Hartford, CT, USA
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Sadeghi-Dehsahraei H, Esmaeili Gouvarchin Ghaleh H, Mirnejad R, Parastouei K. The effect of bergamot (KoksalGarry) supplementation on lipid profiles: A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2022; 36:4409-4424. [PMID: 36251526 DOI: 10.1002/ptr.7647] [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: 01/27/2022] [Revised: 08/20/2022] [Accepted: 09/18/2022] [Indexed: 12/13/2022]
Abstract
This systematic review and meta-analysis were conducted to evaluate the impact of bergamot (KoksalGarry) and its nutraceutical compounds on lipid profiles. PubMed, Web of Knowledge, Scopus, and Google Scholar searched for relevant articles. Trials investigating the effect of oral bergamot supplementation on serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in adults were included. The mean differences and standard deviations were pooled using a random-effects model. Fourteen trials were included in this systematic review and meta-analysis. Bergamot supplementation significantly decreased serum levels of TC (weighted mean difference (WMD): -63.60 mg/dL; 95% CI: -78.03 to -49.18; p < .001), TG (WMD: -74.72 mg/dL; 95% CI: -83.58 to -65.87; p < .001), LDL-C (WMD: -55.43 mg/dL; 95% CI: -67.26 to -43.60; p < .001), and increased HDL-C (WMD: 5.78 mg/dL; 95% CI: 3.27 to 8.28; p < .001), respectively. Our systematic review of the effects of nutraceuticals containing bergamot on lipid markers showed inconsistent results. The results showed that bergamot supplementation might improve lipid profiles. The findings for nutraceutical compounds containing bergamot were inconsistent. However, the clinical efficacy of bergamot on lipid profiles needs to be further established through higher-quality studies.
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Affiliation(s)
| | | | - Reza Mirnejad
- Molecular Biology Research Center, System Biology and Poisoning Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Karim Parastouei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Zhang L, Li X, Chen H, Wu Z, Hu M, Yao M. Haze Air Pollution Health Impacts of Breath-Borne VOCs. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:8541-8551. [PMID: 35559607 DOI: 10.1021/acs.est.2c01778] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Here, we investigated the use of breath-borne volatile organic compounds (VOCs) for rapid monitoring of air pollution health effects on humans. Forty-seven healthy college students were recruited, and their exhaled breath samples (n = 235) were collected and analyzed for VOCs before, on, and after two separate haze pollution episodes using gas chromatography-ion mobility spectrometry (GC-IMS). Using a paired t-test and machine learning model (Gradient Boosting Machine, GBM), six exhaled VOC species including propanol and isoprene were revealed to differ significantly among pre-, on-, and post-exposure in both haze episodes, while none was found between clean control days. The GBM model was shown capable of differentiating between pre- and on-exposure to haze pollution with a precision of 90-100% for both haze episodes. However, poor performance was detected for the same model between two different clean days. In addition to gender and particular haze occurrence influences, correlation analysis revealed that NH4+, NO3-, acetic acid, mesylate, CO, NO2, PM2.5, and O3 played important roles in the changes in breath-borne VOC fingerprints following haze air pollution exposure. This work has demonstrated direct evidence of human health impacts of haze pollution while identifying potential breath-borne VOC biomarkers such as propanol and isoprene for haze air pollution exposure.
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Affiliation(s)
- Lu Zhang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Xinyue Li
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Haoxuan Chen
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Zhijun Wu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Min Hu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Maosheng Yao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
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Berberine, a Herbal Metabolite in the Metabolic Syndrome: The Risk Factors, Course, and Consequences of the Disease. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27041351. [PMID: 35209140 PMCID: PMC8874997 DOI: 10.3390/molecules27041351] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/13/2022]
Abstract
In recent years, the health of patients exposed to the consequences of the metabolic syndrome still requires the search for new solutions, and plant nutraceuticals are currently being intensively investigated. Berberine is a plant alkaloid possessing scientifically determined mechanisms of the prevention of the development of atherosclerosis, type 2 diabetes, and obesity, as well as cardiovascular complications and cancer. It positively contributes to elevated levels of fasting, postprandial blood glucose, and glycosylated hemoglobin, while decreasing insulin resistance. It stimulates glycolysis, improving insulin secretion, and inhibits gluconeogenesis and adipogenesis in the liver; by reducing insulin resistance, berberine also improves ovulation. The anti-obesity action of berberine has been also well-documented. Berberine acts as an anti-sclerotic, lowering the LDL and testosterone levels. The alkaloid exhibits an anti-inflammatory property by stalling the expression of cyclooxygenase 2 (COX-2) and prostaglandin E2. Berberine is neuroprotective and acts as an antidepressive. However, the outcomes in psychiatric patients are nonspecific, as it has been shown that berberine improves metabolic parameters in schizophrenic patients, acting as an adjuvant during antipsychotic treatment. Berberine acts as an anticancer option by inducing apoptosis, the cell cycle arrest, influencing MAPK (mitogen-activated protein kinase), and influencing transcription regulation. The inhibition of carcinogenesis is also combined with lipid metabolism.
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Kaushal N, Dhadwal S, Kaur P. Ameliorative effects of hempseed (Cannabis sativa) against hypercholesterolemia associated cardiovascular changes. Nutr Metab Cardiovasc Dis 2020; 30:330-338. [PMID: 31668458 DOI: 10.1016/j.numecd.2019.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/23/2019] [Accepted: 09/06/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM Hypercholesterolemia (HC) is a major risk factor for cardiovascular (CV) diseases, that are the major cause of mortality worldwide. Free radicals mediated oxidative stress is a critical player in HC-associated pathophysiological insults including atherosclerosis. Unwanted side effects associated with statins, COX-2 inhibitors, and other synthetic drugs limit their use. Thus, modulation of oxidative stress during HC using green pharmaceuticals seems an appropriate approach against deleterious CV consequences without noticeable side-effect. In this regard, owing to an abundance of proteins, fiber and optimal ratios of omega 6 PUFA: omega-3 PUFA in Hempseed (HS), we aim to exploit its anti-inflammatory and antioxidant properties to ameliorate HC- associated CV effects. METHODS AND RESULTS Comparing the antioxidant capacity of protein and lipid fractions of HS using ABTS and DPPH assays, HS was supplemented to high-fat diets (HFD) induced hypercholesterolemic wistar rats. After treatment schedules, lipid profiles, histological and ultrastructural investigations, gene and protein expressions of inflammatory markers, markers of oxidative stress were studied and correlated with biophysical parameters such as ECG and impedance/conductance across the aorta. HS demonstrating in vitro free radical scavenging activity, ameliorated the signs of HC as seen with improved lipid profiles, aortic tissue damage and ECG patterns compared to HFD groups. HS administration also relieved the COX-2 mediated inflammation, which correlated well with the improved redox status in the tissue. CONCLUSIONS Current study evidently demonstrates that the anti-hypercholesterolemic effects of HS are mediated through redox-sensitive modulation of inflammatory pathways.
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Affiliation(s)
- Naveen Kaushal
- Department of Biophysics, Panjab University, Chandigarh, 160014, India.
| | - Shallu Dhadwal
- Department of Biophysics, Panjab University, Chandigarh, 160014, India
| | - Parminder Kaur
- Department of Biotechnology, University Institute of Engineering and Technology (UIET), Panjab University, Chandigarh, India
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Brendler T, Williamson EM. Astaxanthin: How much is too much? A safety review. Phytother Res 2019; 33:3090-3111. [DOI: 10.1002/ptr.6514] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/12/2019] [Accepted: 09/04/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Thomas Brendler
- Plantaphile Collingswood NJ USA
- Department of Botany and Plant BiotechnologyUniversity of Johannesburg Johannesburg South Africa
- Traditional Medicinals Rohnert Park CA USA
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Farsi F, Heshmati J, Keshtkar A, Irandoost P, Alamdari NM, Akbari A, Janani L, Morshedzadeh N, Vafa M. Can coenzyme Q10 supplementation effectively reduce human tumor necrosis factor-α and interleukin-6 levels in chronic inflammatory diseases? A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2019; 148:104290. [DOI: 10.1016/j.phrs.2019.104290] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/23/2019] [Accepted: 05/29/2019] [Indexed: 02/05/2023]
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Commentary to “The Possible Role of Nutraceuticals in the Prevention of Cardiovascular Disease”. High Blood Press Cardiovasc Prev 2019; 26:259-261. [DOI: 10.1007/s40292-019-00317-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 04/23/2019] [Indexed: 11/26/2022] Open
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Patti AM, Giglio RV, Papanas N, Rizzo M, Rizvi AA. Future perspectives of the pharmacological management of diabetic dyslipidemia. Expert Rev Clin Pharmacol 2019; 12:129-143. [PMID: 30644763 DOI: 10.1080/17512433.2019.1567328] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Diabetic dyslipidemia is frequent among patients with type 2 diabetes mellitus (T2DM) and is characterized by an increase in triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and small-dense (atherogenic) particles, and by a decrease in low high-density lipoprotein cholesterol (HDL-C) and apolipoprotein (Apo) A1 that are strongly related to insulin resistance. The increased flux of free fatty acids from adipose tissue to the liver aggravates hepatic insulin resistance and promotes all of aspects of the dyslipidemic state. Areas covered: Statins are the first-line agents for treatment while other lipid-lowering drugs (ezetimibe, fibrate and proprotein convertase subtilisin/kexin type 9) or novel anti-diabetic agents (dipeptidyl peptidase-4 inhibitors (DPP-4is), glucagon like peptide-1 receptor agonist (GLP-1RA), sodium/glucose cotransporter 2 inhibitors (SGLT2is)) or nutraceuticals (berberine, omega 3 fatty acid, red yeast rice) can be used alone or in combination. Expert commentary: In patients with T2DM, lipid abnormalities should be identified and treated as part of the overall diabetic treatment, in order to prevent cardiovascular disease. The choice of drugs to be used is mainly based on the lipid profile and on the characteristic lipoprotein abnormalities; the use of new drugs for the treatment of hyperglycemia and lipids alteration in these patients can improve diabetic dyslipidemia.
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Affiliation(s)
- Angelo Maria Patti
- a Biomedical Department of Internal Medicine and Medical Specialties , University of Palermo , Palermo , Italy
| | - Rosaria Vincenza Giglio
- a Biomedical Department of Internal Medicine and Medical Specialties , University of Palermo , Palermo , Italy
| | - Nikolaos Papanas
- b Diabetes Centre, Second Department of Internal Medicine , Democritus University of Thrace, University Hospital of Alexandroupolis , Alexandroupolis , Greece
| | - Manfredi Rizzo
- a Biomedical Department of Internal Medicine and Medical Specialties , University of Palermo , Palermo , Italy.,c Division of Endocrinology , Diabetes and Metabolism University of South Carolina School of Medicine Columbia , South Carolina , SC , USA
| | - Ali A Rizvi
- c Division of Endocrinology , Diabetes and Metabolism University of South Carolina School of Medicine Columbia , South Carolina , SC , USA
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Momtazi-Borojeni AA, Katsiki N, Pirro M, Banach M, Rasadi KA, Sahebkar A. Dietary natural products as emerging lipoprotein(a)-lowering agents. J Cell Physiol 2019; 234:12581-12594. [PMID: 30637725 DOI: 10.1002/jcp.28134] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 12/07/2018] [Indexed: 12/13/2022]
Abstract
Elevated plasma lipoprotein(a) (Lp(a)) levels are associated with an increased risk of cardiovascular disease (CVD). Hitherto, niacin has been the drug of choice to reduce elevated Lp(a) levels in hyperlipidemic patients but its efficacy in reducing CVD outcomes has been seriously questioned by recent clinical trials. Additional drugs may reduce to some extent plasma Lp(a) levels but the lack of a specific therapeutic indication for Lp(a)-lowering limits profoundly reduce their use. An attractive therapeutic option is natural products. In several preclinical and clinical studies as well as meta-analyses, natural products, including l-carnitine, coenzyme Q 10 , and xuezhikang were shown to significantly decrease Lp(a) levels in patients with Lp(a) hyperlipoproteinemia. Other natural products, such as pectin, Ginkgo biloba, flaxseed, red wine, resveratrol and curcuminoids can also reduce elevated Lp(a) concentrations but to a lesser degree. In conclusion, aforementioned natural products may represent promising therapeutic agents for Lp(a) lowering.
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Affiliation(s)
- Amir Abbas Momtazi-Borojeni
- Department of Medical Biotechnology, Nanotechnology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Matteo Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland.,Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Khalid Al Rasadi
- Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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15
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Esposito R, Sorrentino R, Giugliano G, Avvedimento M, Paolillo R, Santoro C, Scalamogna M, Esposito M, Ilardi F, Rozza F, Esposito G, Galderisi M, Trimarco V. Different age-independent effects of nutraceutical combinations on endothelium-mediated coronary flow reserve. IMMUNITY & AGEING 2018; 15:30. [PMID: 30479642 PMCID: PMC6251089 DOI: 10.1186/s12979-018-0138-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 11/06/2018] [Indexed: 12/04/2022]
Abstract
Background Some components of Nutraceuticals (NUT) such as red yeast rice and Morus alba have demonstrated positive effects on the endothelial function in hypercholesterolemic subjects. Our aim was to compare the effects of two different NUT combinations on cold pressure test (CPT) derived coronary flow reserve (CFR) assessed by transthoracic echo-Doppler. Results In a randomized, single-blind study, 28 consecutive patients with a variety of cardiovascular risk factors received NUT A (LopiGLIK®: berberine, red yeast rice powder, and leaf extract of Morus alba) or B (Armolipid Plus®: policosanol, red yeast rice, berberine, astaxantine, folic acidandcoenzyme Q10). An echo-Doppler exam with evaluation of CFR was performed at baseline, 2 h (acute test) and 30 days after daily NUT assumption. Blood sampling for metabolic profile and platelet aggregometry was performed at baseline and after 30 days of daily NUT assumption. CFR was not significantly modified at the acute test. After 30 days, CFR improved with NUT A (p < 0.0001), because of the increase of hyperemic flow velocity (p = 0.007), but not with NUT B. CFR was comparable between the two groups at baseline but became significantly higher after 30 days in NUT A (p < 0.02), with a higher CFR percent variation versus baseline (p = 0.008). Total cholesterol and LDL-cholesterol were reduced with both NUT A (p < 0.001 and p < 0.002, respectively) and B (both p < 0.02), whereas platelet aggregation did not significantly change. In the pooled group of patients, after adjusting for age and percent changes of systolic blood pressure, heart rate, LDL-cholesterol and glycemia, NUT A – but not NUT B - was independently associated with CFR changes (β = 0.599, p = 0.003). Conclusions LopiGLIK® improved endothelial-derived CFR, independently of the beneficial effects exerted on the lipid profile. These findings can have clinical reflections on the prevention of age-related inflammatory diseases including coronary artery disease. Trial registration (NUTRENDO)″(ClinicalTrials.gov, NCT02969070).
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Affiliation(s)
- Roberta Esposito
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Regina Sorrentino
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Giuseppe Giugliano
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Marisa Avvedimento
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Roberta Paolillo
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Ciro Santoro
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Maria Scalamogna
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Mafalda Esposito
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Federica Ilardi
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Francesco Rozza
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Giovanni Esposito
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Maurizio Galderisi
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy.,2Interdepartmental Laboratory of Cardiac Imaging, Federico II University Hospital, Via Pansini 5, 80131 Naples, Italy
| | - Valentina Trimarco
- 1Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
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Pirro M, Francisci D, Bianconi V, Schiaroli E, Mannarino MR, Barsotti F, Spinozzi A, Bagaglia F, Sahebkar A, Baldelli F. NUtraceutical TReatment for hYpercholesterolemia in HIV-infected patients: The NU-TRY(HIV) randomized cross-over trial. Atherosclerosis 2018; 280:51-57. [PMID: 30471555 DOI: 10.1016/j.atherosclerosis.2018.11.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/06/2018] [Accepted: 11/13/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Despite hypercholesterolemia has been recognized to increase cardiovascular risk in human immunodeficiency virus (HIV)-infected patients, cholesterol-lowering therapy is underused in this population, due to fear of drug-drug interactions with antiretroviral therapy (ART). We investigated the effects of a nutraceutical combination (NC) on lipid profile, proprotein convertase subtilisin/kexin type 9 (PCSK9), subclinical inflammation and arterial stiffness in ART-treated HIV-infected patients. METHODS This was a prospective randomized open-label trial with a cross-over design including 30 stable HIV-infected patients on ART with low-density lipoprotein cholesterol (LDL-C) >115 mg/dL, not taking lipid-lowering treatment. After a 3-week lipid stabilization period, the effects associated with 3 months of an oral NC containing red yeast rice and berberine vs. no active treatment (noNC) were assessed for plasma total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), lipoprotein(a), PCSK9, high-sensitivity C-reactive protein (hs-CRP) levels and aortic pulse wave velocity (aPWV). RESULTS At baseline, significant correlations between PCSK9 levels, age (rho = -0.51, p=0.004), waist circumference (rho = 0.36, p=0.005) and CD4+ cell count (rho = -0.40, p=0.027) were observed. NC treatment effects corrected for noNC were significant for TC (-14%, p<0.001), LDL-C (-19%, p<0.001), PCSK9 (-12%, p=0.02), hs-CRP (-14%, p=0.03) and aPWV (-6%, p=0.005). No significant effects were observed for HDL-C, TG and lipoprotein(a). NC treatment was safe and no significant alterations in muscle, liver and immunovirological parameters were observed. No carry over effect was recorded. CONCLUSIONS The tested NC significantly reduced plasma cholesterol and PCSK9 levels, attenuated subclinical inflammation and improved arterial stiffness in stable HIV-infected patients on ART.
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Affiliation(s)
- Matteo Pirro
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy.
| | - Daniela Francisci
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Elisabetta Schiaroli
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Massimo R Mannarino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Francesco Barsotti
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Andrea Spinozzi
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Francesco Bagaglia
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran
| | - Franco Baldelli
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, 06129, Italy
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Banach M, Patti AM, Giglio RV, Cicero AFG, Atanasov AG, Bajraktari G, Bruckert E, Descamps O, Djuric DM, Ezhov M, Fras Z, von Haehling S, Katsiki N, Langlois M, Latkovskis G, Mancini GBJ, Mikhailidis DP, Mitchenko O, Moriarty PM, Muntner P, Nikolic D, Panagiotakos DB, Paragh G, Paulweber B, Pella D, Pitsavos C, Reiner Ž, Rosano GMC, Rosenson RS, Rysz J, Sahebkar A, Serban MC, Vinereanu D, Vrablík M, Watts GF, Wong ND, Rizzo M. The Role of Nutraceuticals in Statin Intolerant Patients. J Am Coll Cardiol 2018; 72:96-118. [PMID: 29957236 DOI: 10.1016/j.jacc.2018.04.040] [Citation(s) in RCA: 175] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 02/08/2023]
Abstract
Statins are the most common drugs administered for patients with cardiovascular disease. However, due to statin-associated muscle symptoms, adherence to statin therapy is challenging in clinical practice. Certain nutraceuticals, such as red yeast rice, bergamot, berberine, artichoke, soluble fiber, and plant sterols and stanols alone or in combination with each other, as well as with ezetimibe, might be considered as an alternative or add-on therapy to statins, although there is still insufficient evidence available with respect to long-term safety and effectiveness on cardiovascular disease prevention and treatment. These nutraceuticals could exert significant lipid-lowering activity and might present multiple non-lipid-lowering actions, including improvement of endothelial dysfunction and arterial stiffness, as well as anti-inflammatory and antioxidative properties. The aim of this expert opinion paper is to provide the first attempt at recommendation on the management of statin intolerance through the use of nutraceuticals with particular attention on those with effective low-density lipoprotein cholesterol reduction.
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Affiliation(s)
- Maciej Banach
- Department of Hypertension, Medical University of Lodz, and the Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.
| | - Angelo Maria Patti
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Rosaria Vincenza Giglio
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
| | - Atanas G Atanasov
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland; Department of Pharmacognosy, University of Vienna, Vienna, Austria
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, and the Medical Faculty, University of Prishtina, Prishtina, Kosovo
| | - Eric Bruckert
- Institute of Cardiometabolism and Nutrition (ICAN), Endocrinology Department, Hopital Pitié Salpetrière, Paris, France
| | - Olivier Descamps
- Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul, Belgium; Department of Cardiology, Cliniques Universitaires Saint-Luc, Bruxells, Belgium
| | - Dragan M Djuric
- Institute of Medical Physiology "Richard Burian" Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marat Ezhov
- National Cardiology Research Center, Moscow, Russia
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany
| | - Niki Katsiki
- Second Propaedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium
| | - Gustavs Latkovskis
- Faculty of Medicine and Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia
| | - G B John Mancini
- Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, United Kingdom
| | - Olena Mitchenko
- Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Kiev, Ukraine
| | - Patrick M Moriarty
- Division of Clinical Pharmacology, Division of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Paul Muntner
- Department of Epidemiology, University of Alabama Birmingham, Birmingham, Alabama
| | - Dragana Nikolic
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Demosthenes B Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Bernhard Paulweber
- First Department of Internal Medicine, Paracelsus Private Medical University, Salzburg, Austria
| | - Daniel Pella
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia
| | - Christos Pitsavos
- Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine University of Zagreb, Department of Internal Medicine, Zagreb, Croatia
| | - Giuseppe M C Rosano
- Cardiovascular Clinical Academic Group St. George's Hospitals NHS Trust University of London, London, United Kingdom; IRCCS San Raffaele Roma, Rome, Italy
| | - Robert S Rosenson
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jacek Rysz
- Department of Hypertension, Medical University of Lodz, and the Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute and Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria-Corina Serban
- Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Dragos Vinereanu
- University of Medicine and Pharmacy "Carol Davila," and Department of Cardiology, University and Emergency Hospital, Bucharest, Romania
| | - Michal Vrablík
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic
| | - Gerald F Watts
- Cardiometabolic Service, Department of Cardiology, Royal Perth Hospital, and School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Nathan D Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, California
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
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Bianconi V, Mannarino MR, Sahebkar A, Cosentino T, Pirro M. Cholesterol-Lowering Nutraceuticals Affecting Vascular Function and Cardiovascular Disease Risk. Curr Cardiol Rep 2018; 20:53. [PMID: 29802549 DOI: 10.1007/s11886-018-0994-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW The aim of this review is to provide an update on the effects of the dietary supplementation with cholesterol-lowering nutraceuticals and nutraceutical combinations affecting vascular function and CV risk in clinical interventional studies. RECENT FINDINGS Current evidence supports the mild-to-moderate cholesterol-lowering efficacy of red yeast rice, berberine, plant sterols, fibers, and some nutraceutical combinations whereas data on the individual cholesterol-lowering action of other nutraceuticals are either less striking or even inconclusive. There is also promising evidence on the vascular protective effects of some of the aforementioned nutraceuticals. However, except for red yeast rice, clinical interventional studies have not investigated their impact on CV outcomes. Evidence of both cholesterol-lowering and vascular protection is a prerogative of few single nutraceuticals and nutraceutical combinations, which may support their clinical use; however, caution on their uncontrolled adoption is necessary as they are freely available on the market and, therefore, subject to potential misuse.
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Affiliation(s)
- Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
- Hospital "Santa Maria della Misericordia", Piazzale Menghini, 1, 06129, Perugia, Italy
| | - Massimo Raffaele Mannarino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
- Hospital "Santa Maria della Misericordia", Piazzale Menghini, 1, 06129, Perugia, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Teresa Cosentino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
- Hospital "Santa Maria della Misericordia", Piazzale Menghini, 1, 06129, Perugia, Italy
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
- Hospital "Santa Maria della Misericordia", Piazzale Menghini, 1, 06129, Perugia, Italy.
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Scicali R, Di Pino A, Ferrara V, Urbano F, Piro S, Rabuazzo AM, Purrello F. New treatment options for lipid-lowering therapy in subjects with type 2 diabetes. Acta Diabetol 2018; 55:209-218. [PMID: 29260404 DOI: 10.1007/s00592-017-1089-4] [Citation(s) in RCA: 30] [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: 10/20/2017] [Accepted: 12/11/2017] [Indexed: 12/15/2022]
Abstract
Dyslipidemias represent a variety of quantitative and/or qualitative lipoprotein abnormalities. According to etiology, we distinguish primary dyslipidemias with strictly genetic background and secondary ones with their origin in other disease or pathological states. Diabetic dyslipidemia is a type of secondary dyslipidemia and plays an important role in determining the cardiovascular risk of subjects with type 2 diabetes. In these patients, insulin resistance is responsible for overproduction and secretion of atherogenic very low density lipoprotein. In addition, insulin resistance promotes the production of small dense low-density lipoprotein (LDL) and reduces high-density lipoprotein (HDL) production. Cardiovascular disease remains a leading cause of morbidity and mortality in diabetic patients. Previous results support the role for small, dense LDL particles in the etiology of atherosclerosis and their association with coronary artery disease. Moreover, lowering LDL cholesterol reduces the risk of cardiovascular death. Therefore, the European guidelines for the management of dyslipidemias recommend an LDL cholesterol goal < 100 mg/dL in diabetic subjects without cardiovascular events. Moreover, if triglycerides (TG) are elevated (> 400 mg/dL), they recommend a non-HDL cholesterol goal < 130 mg/dL in diabetic individuals without cardiovascular events. Statins are the first line of LDL-lowering therapy in diabetic patients and combined therapy with ezetimibe and statins could be useful in very high cardiovascular risk diabetic subjects. Furthermore, the effect of a fibrate as an add-on treatment to a statin could improve the lipid profile in diabetic individuals with high TG and low HDL cholesterol. Regarding new therapies, recent data from phase III trials show that proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors considerably decrease LDL cholesterol. Thus, they may be useful in diabetic patients with concomitant diseases such as familial dyslipidemia, recurrent cardiovascular events, and elevated LDL cholesterol after second drug administration in addition to maximal statin dose or statin intolerance.
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Affiliation(s)
- Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Viviana Ferrara
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Francesca Urbano
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agata Maria Rabuazzo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy.
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20
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Trimarco V, Battistoni A, Tocci G, Coluccia R, Manzi MV, Izzo R, Volpe M. Single blind, multicentre, randomized, controlled trial testing the effects of a novel nutraceutical compound on plasma lipid and cardiovascular risk factors: Results of the interim analysis. Nutr Metab Cardiovasc Dis 2017; 27:850-857. [PMID: 28965797 DOI: 10.1016/j.numecd.2017.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/14/2017] [Accepted: 08/07/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS The clustering of high levels of LDL cholesterol (LDL-C) and other risk factors represents a predisposing condition for atherosclerotic disease development. Cardiovascular prevention is based on effective control of these conditions. In adult subjects with mild hypercholesterolemia we compared in the real life the effects of a new combination of nutraceuticals on lipid and glucose metabolism and blood pressure with those of an established nutraceutical combination. METHOD AND RESULTS This multicenter, controlled, randomized, single-blind trial was designed to compare the effect of Armolipid Plus® versus that of LopiGLIK® on lipid and glucose levels and blood pressure (BP) in subjects with mild hypercholesterolemia not on statin therapy. Primary outcome was the proportion of subjects achieving therapeutic targets of LDL-C (<130 mg/dl); secondary outcomes were the effects on HDL-C, glycated haemoglobin and insulin levels. Data from an overall sample of 359 adult individuals (age 55.2 ± 11.1 years, women 57.7%, LDL-C 157.3 ± 22.6 mg/dl, HDL-C 50.7 ± 13.0 mg/dl) are reported. 72% of subjects treated with LopiGLIK® and 43% treated with Armolipid Plus® achieved the primary endpoint (p < 0.0001). Both treatments reduced plasma levels of total and LDL-C and triglycerides (p < 0.001 for all comparisons). The treatments also reduced systolic and diastolic blood pressure, plasma levels of glycated haemoglobin, insulin and HOMA index. The changes induced by LopiGLIK® in all these metabolic parameters were greater than those obtained with Armolipid Plus®. CONCLUSIONS The present analysis shows that LopiGLIK® may represent a more effective tool for clinical management of CV risk factors in subjects with mild hypercholesterolemia.
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Affiliation(s)
- V Trimarco
- Hypertension Research Center, Federico II University, Naples, Italy; Department of Neurosciences, Federico II University, Naples, Italy
| | - A Battistoni
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - G Tocci
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | | | - M V Manzi
- Hypertension Research Center, Federico II University, Naples, Italy
| | - R Izzo
- Hypertension Research Center, Federico II University, Naples, Italy.
| | - M Volpe
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
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Cicero AFG, Colletti A, Bajraktari G, Descamps O, Djuric DM, Ezhov M, Fras Z, Katsiki N, Langlois M, Latkovskis G, Panagiotakos DB, Paragh G, Mikhailidis DP, Mitchenko O, Paulweber B, Pella D, Pitsavos C, Reiner Ž, Ray KK, Rizzo M, Sahebkar A, Serban MC, Sperling LS, Toth PP, Vinereanu D, Vrablík M, Wong ND, Banach M. Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Nutr Rev 2017; 75:731-767. [PMID: 28938795 DOI: 10.1093/nutrit/nux047] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity. However, the clinical evidence supporting the use of a single lipid-lowering nutraceutical or a combination of them is largely variable and, for many of the nutraceuticals, the evidence is very limited and, therefore, often debatable. The purpose of this position paper is to provide consensus-based recommendations for the optimal use of lipid-lowering nutraceuticals to manage dyslipidemia in patients who are still not on statin therapy, patients who are on statin or combination therapy but have not achieved lipid goals, and patients with statin intolerance. This statement is intended for physicians and other healthcare professionals engaged in the diagnosis and management of patients with lipid disorders, especially in the primary care setting.
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Affiliation(s)
- Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; and Italian Society of Nutraceuticals
| | - Alessandro Colletti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; and Italian Society of Nutraceuticals
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo; and Kosovo Society of Cardiology
| | - Olivier Descamps
- Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul, Belgium; and Belgian Atherosclerosis Society
| | - Dragan M Djuric
- Institute of Medical Physiology "Richard Burian," Faculty of Medicine, University of Belgrade, Belgrade, Serbia; and Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Marat Ezhov
- Russian Cardiology Research and Production Centre, Moscow, Russia; and Russian National Atherosclerosis Society
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; Chair for Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; and Slovenian Society of Cardiology
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium; and Belgian Atherosclerosis Society
| | - Gustavs Latkovskis
- Faculty of Medicine and Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia; and Baltic Atherosclerosis Society
| | - Demosthenes B Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; and Hungarian Atherosclerosis Society
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, UK
| | - Olena Mitchenko
- Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Kiev, Ukraine; and Ukrainian Atherosclerosis Society
| | - Bernhard Paulweber
- 1st Department of Internal Medicine, Paracelsus Private Medical University, Salzburg, Austria; and Austrian Atherosclerosis Society
| | - Daniel Pella
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia; and Slovak Association of Atherosclerosis
| | - Christos Pitsavos
- Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece; and Hellenic Atherosclerosis Society
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine University of Zagreb, Department of Internal Medicine, Zagreb, Croatia; and Croatian Atherosclerosis Society
| | - Kausik K Ray
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; and Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria-Corina Serban
- Center for Interdisciplinary Research, and Department of Functional Sciences, University of Medicine and Pharmacy "Victor Babes," Timisoara, Romania
| | - Laurence S Sperling
- Division of Cardiology, Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia, USA
| | - Peter P Toth
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland, USA; and Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA
| | - Dragos Vinereanu
- University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania; Department of Cardiology, University and Emergency Hospital, Bucharest, Romania; and Romanian Society of Cardiology
| | - Michal Vrablík
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic; and Czech Atherosclerosis Society
| | - Nathan D Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, California, USA
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute, Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland; Lipid and Blood Pressure Meta-Analysis Collaboration Group; and Polish Lipid Association
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22
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Cicero AF, Colletti A, Bajraktari G, Descamps O, Djuric DM, Ezhov M, Fras Z, Katsiki N, Langlois M, Latkovskis G, Panagiotakos DB, Paragh G, Mikhailidis DP, Mitchenko O, Paulweber B, Pella D, Pitsavos C, Reiner Ž, Ray KK, Rizzo M, Sahebkar A, Serban MC, Sperling LS, Toth PP, Vinereanu D, Vrablík M, Wong ND, Banach M. Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Arch Med Sci 2017; 13:965-1005. [PMID: 28883839 PMCID: PMC5575230 DOI: 10.5114/aoms.2017.69326] [Citation(s) in RCA: 189] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 07/28/2017] [Indexed: 02/05/2023] Open
Affiliation(s)
- Arrigo F.G. Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; Italian Society of Nutraceuticals (SINut)
| | - Alessandro Colletti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; Italian Society of Nutraceuticals (SINut)
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo; Kosovo Society of Caridology
| | - Olivier Descamps
- Institute of Medical Physiology “Richard Burian“, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Dragan M. Djuric
- Institute of Medical Physiology “Richard Burian“, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Marat Ezhov
- Russian Cardiology Research and Production Centre, Moscow, Russia; Russian National Atherosclerosis Society
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, Slovenia; Chair for Internal Medicine, Faculty of Medicine, University of Ljubljana, Slovenia; Slovenian Society of Cardiology
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium; Belgian Atheroclerosis Society
| | - Gustavs Latkovskis
- Faculty of Medicine and Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia; Baltic Atherosclerosis Society
| | - Demosthenes B. Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Hungarian Atherosclerosis Society
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, Medical School, University College London (UCL), London, UK
| | - Olena Mitchenko
- 13Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Ukraine; Ukrainian Atherosclerosis Society
| | - Bernhard Paulweber
- First Department of Internal Medicine, Paracelsus Private Medical University, Salzburg, Austria; Austrian Atheroclerosis Society (AAS)
| | - Daniel Pella
- 1 Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia; Slovak Association of Atherosclerosis
| | - Christos Pitsavos
- Cardiology Clinic, School of Medicine, University of Athens, Greece; Hellenic Atherosclerosis Society
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine University of Zagreb, Department of Internal Medicine, Zagreb, Croatia; Croatian Atherosclerosis Society
| | - Kausik K. Ray
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria-Corina Serban
- Center for Interdisciplinary Research, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania; Department of Functional Sciences, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Laurence S. Sperling
- Division of Cardiology, Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia, USA
| | - Peter P. Toth
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA
| | - Dragos Vinereanu
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania; Department of Cardiology, University and Emergency Hospital, Bucharest, Romania; Romanian Society of Cardiology
| | - Michal Vrablík
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic; Czech Atherosclerosis Society
| | - Nathan D. Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, USA
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland; Lipid and Blood Pressure Meta-Analysis Collaboration (LBPMC) Group; Polish Lipid Association (PoLA)
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23
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Phan MAT, Paterson J, Bucknall M, Arcot J. Interactions between phytochemicals from fruits and vegetables: Effects on bioactivities and bioavailability. Crit Rev Food Sci Nutr 2017; 58:1310-1329. [DOI: 10.1080/10408398.2016.1254595] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Minh Anh Thu Phan
- Food Science and Technology, School of Chemical Engineering, UNSW Sydney, Sydney, Australia
| | - Janet Paterson
- Food Science and Technology, School of Chemical Engineering, UNSW Sydney, Sydney, Australia
| | - Martin Bucknall
- Mark Wainwright Analytical Centre, UNSW Australia, Sydney, Australia
| | - Jayashree Arcot
- Food Science and Technology, School of Chemical Engineering, UNSW Sydney, Sydney, Australia
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24
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Caliceti C, Rizzo P, Ferrari R, Fortini F, Aquila G, Leoncini E, Zambonin L, Rizzo B, Calabria D, Simoni P, Mirasoli M, Guardigli M, Hrelia S, Roda A, Cicero AFG. Novel role of the nutraceutical bioactive compound berberine in lectin-like OxLDL receptor 1-mediated endothelial dysfunction in comparison to lovastatin. Nutr Metab Cardiovasc Dis 2017; 27:552-563. [PMID: 28511903 DOI: 10.1016/j.numecd.2017.04.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/31/2017] [Accepted: 04/10/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS Oxidized LDL (oxLDL) or pro-inflammatory stimuli lead to increased oxidative stress linked to endothelial dysfunction and atherosclerosis. The oxLDL receptor-1 (LOX1) is elevated within atheromas and cholesterol-lowering statins inhibit LOX1 expression. Berberine (BBR), an alkaloid extracted from plants of gender Berberis, has lipid-lowering and anti-inflammatory activity. However, its role in regulating LOX1-mediated signaling is still unknown. The aim of this study was to investigate the effect of BBR on oxLDL- and TNFα-induced endothelial dysfunction in human umbilical vein endothelial cells (HUVECs) and to compare it with that of lovastatin (LOVA). METHODS AND RESULTS Cytotoxicity was determined by lactate dehydrogenase assay. Antioxidant capacity was measured with chemiluminescent and fluorescent method and intracellular ROS levels through a fluorescent dye. Gene and protein expression levels were assayed by qRT-PCR and western blot, respectively. HUVECs exposure to oxLDL (30 μg/ml) or TNFα (10 ng/ml) for 24 h led to a significant increase in LOX1 expression, effect abrogated by BBR (5 μM) and LOVA (5 μM). BBR but not LOVA treatment abolished the TNFα-induced cytotoxicity and restored the activation of Akt signaling. In spite of a low direct antioxidant capacity, both compounds reduced intracellular ROS levels generated by treatment of TNFα but only BBR inhibited NOX2 expression, MAPK/Erk1/2 signaling and subsequent NF-κB target genes VCAM and ICAM expression, induced by TNFα. CONCLUSIONS These findings demonstrated for the first time that BBR could prevent the oxLDL and TNFα - induced LOX1 expression and oxidative stress, key events that lead to NOX, MAPK/Erk1/2 and NF-κB activation linked to endothelial dysfunction. CHEMICAL COMPOUNDS STUDIED IN THIS ARTICLE Berberine (PubChem CID: 2353); Lovastatin (PubChem CID: 53232).
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Affiliation(s)
- C Caliceti
- Department of Chemistry "Giacomo Ciamician" - Alma Mater Studiorum, University of Bologna, Bologna, Italy; Centro Interdipartimentale di Ricerca Industriale Energia e Ambiente (CIRI EA) - Alma Mater Studiorum, University of Bologna, Bologna, Italy; Istituto Nazionale Biostrutture e Biosistemi (INBB), Roma, Italy.
| | - P Rizzo
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy; Maria Cecilia Hospital, GVM Care&Research, E.S: Health Science Foundation, Cotignola, Italy
| | - R Ferrari
- Department of Medical Sciences, Cardiology and Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy; Maria Cecilia Hospital, GVM Care&Research, E.S: Health Science Foundation, Cotignola, Italy
| | - F Fortini
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - G Aquila
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - E Leoncini
- Department for Life Quality Studies - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - L Zambonin
- Department of Pharmacy and Biotechnology - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - B Rizzo
- Department for Life Quality Studies - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - D Calabria
- Centro Interdipartimentale di Ricerca Industriale Energia e Ambiente (CIRI EA) - Alma Mater Studiorum, University of Bologna, Bologna, Italy; Istituto Nazionale Biostrutture e Biosistemi (INBB), Roma, Italy
| | - P Simoni
- Department of Medical and Surgical Sciences-DIMEC, Sant'Orsola Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - M Mirasoli
- Department of Chemistry "Giacomo Ciamician" - Alma Mater Studiorum, University of Bologna, Bologna, Italy; Centro Interdipartimentale di Ricerca Industriale Energia e Ambiente (CIRI EA) - Alma Mater Studiorum, University of Bologna, Bologna, Italy; Istituto Nazionale Biostrutture e Biosistemi (INBB), Roma, Italy
| | - M Guardigli
- Department of Chemistry "Giacomo Ciamician" - Alma Mater Studiorum, University of Bologna, Bologna, Italy; Istituto Nazionale Biostrutture e Biosistemi (INBB), Roma, Italy
| | - S Hrelia
- Department for Life Quality Studies - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - A Roda
- Department of Chemistry "Giacomo Ciamician" - Alma Mater Studiorum, University of Bologna, Bologna, Italy; Centro Interdipartimentale di Ricerca Industriale Energia e Ambiente (CIRI EA) - Alma Mater Studiorum, University of Bologna, Bologna, Italy; Istituto Nazionale Biostrutture e Biosistemi (INBB), Roma, Italy
| | - A F G Cicero
- Department of Medical and Surgical Sciences-DIMEC, Sant'Orsola Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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25
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Pirro M, Bianconi V, Paciullo F, Mannarino MR, Bagaglia F, Sahebkar A. Lipoprotein(a) and inflammation: A dangerous duet leading to endothelial loss of integrity. Pharmacol Res 2017; 119:178-187. [DOI: 10.1016/j.phrs.2017.02.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/08/2017] [Accepted: 02/02/2017] [Indexed: 12/15/2022]
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Preventing cardiovascular heart disease: Promising nutraceutical and non-nutraceutical treatments for cholesterol management. Pharmacol Res 2017; 120:219-225. [PMID: 28408313 DOI: 10.1016/j.phrs.2017.04.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/20/2017] [Accepted: 04/07/2017] [Indexed: 11/24/2022]
Abstract
Hypercholesterolemia is one of the major risk factors for the development of cardiovascular disease. Atherosclerosis resulting from hypercholesterolemia causes many serious cardiovascular diseases. Statins are generally accepted as a treatment of choice for lowering low-density lipoprotein (LDL) cholesterol, which reduces coronary heart disease morbidity and mortality. Since statin use can be associated with muscle problems and other adverse symptoms, non-adherence and discontinuation of statin therapy often leads to inadequate control of plasma cholesterol levels and increased cardiovascular risk. Moreover, there is compelling evidence on the presence of still considerable residual cardiovascular risk in statin-treated patients. Ezetimibe improves cholesterol-lowering efficacy and provides mild additional cardiovascular protection when combined with statin treatment. Despite a favorable safety profile compared to statins, ezetimibe-induced cholesterol-lowering is modest when used alone. Hence, there is a critical need to identity additional effective hypolipidemic agents that can be used either in combination with statins, or alone, if statins are not tolerated. Thus, hypolipidemic agents such as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, apolipoprotein B-100 antisense oligonucleotides, cholesteryl ester transfer protein (CETP) inhibitors, and microsomal triglyceride transfer protein (MTTP) inhibitors, as well as yeast polysaccharides (beta-glucans and mannans) and compounds derived from natural sources (nutraceuticals) such as glucomannans, plant sterols, berberine, and red yeast rice are being used. In this review, we will discuss hypercholesterolemia, its impact on the development of cardiovascular disease (CVD), and the use of yeast polysaccharides, various nutraceuticals, and several therapeutic agents not derived from 'natural' sources, to treat hypercholesterolemia.
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27
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Momtazi AA, Banach M, Pirro M, Katsiki N, Sahebkar A. Regulation of PCSK9 by nutraceuticals. Pharmacol Res 2017; 120:157-169. [PMID: 28363723 DOI: 10.1016/j.phrs.2017.03.023] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 03/27/2017] [Indexed: 12/19/2022]
Abstract
PCSK9 (proprotein convertase subtilisin kexin type 9) is a liver secretory enzyme that regulates plasma low-density lipoprotein (LDL) cholesterol (LDL-C) levels through modulation of LDL receptor (LDLR) density on the surface of hepatocytes. Inhibition of PCSK9 using monoclonal antibodies can efficiently lower plasma LDL-C, non-high-density lipoprotein cholesterol and lipoprotein (a). PCSK9 inhibition is also an effective adjunct to statin therapy; however, the cost-effectiveness of currently available PCSK9 inhibitors is under question. Nutraceuticals offer a safe and cost-effective option for PCSK9 inhibition. Several nutraceuticals have been reported to modulate PCSK9 levels and exert LDL-lowering activity. Mechanistically, those nutraceuticals that inhibit PCSK9 through a SREBP (sterol-responsive element binding protein)-independent pathway can be more effective in lowering plasma LDL-C levels compared with those inhibiting PCSK9 through the SREBP pathway. The present review aims to collect available data on the nutraceuticals with PCSK9-inhibitory effect and the underlying mechanisms.
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Affiliation(s)
- Amir Abbas Momtazi
- Nanotechnology Research Center, Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Zeromskiego 113, Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Matteo Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
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Fan L, Feng Y, Chen GC, Qin LQ, Fu CL, Chen LH. Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2017; 119:128-136. [PMID: 28179205 DOI: 10.1016/j.phrs.2017.01.032] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/20/2017] [Accepted: 01/27/2017] [Indexed: 12/17/2022]
Abstract
The aims of this meta-analysis were to evaluate the effects of coenzyme Q10 (CoQ10) supplementation on inflammatory mediators including C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) by analyzing published randomized controlled trials (RCTs). A systematic search in PubMed, Cochrane Library and Clinicaltrials.gov was performed to identify eligible RCTs. Data synthesis was performed using a random- or a fixed-effects model depending on the results of heterogeneity tests, and pooled data were displayed as weighed mean difference (WMD) and 95% confidence interval (CI). Seventeen RCTs were selected for the meta-analysis. CoQ10 supplementation significantly reduced the levels of circulating CRP (WMD: -0.35mg/L, 95% CI: -0.64 to -0.05, P=0.022), IL-6 (WMD: -1.61pg/mL, 95% CI: -2.64 to -0.58, P=0.002) and TNF-α (WMD: -0.49pg/mL, 95% CI: -0.93 to -0.06, P=0.027). The results of meta-regression showed that the changes of CRP were independent of baseline CRP, treatment duration, dosage, and patients characteristics. In the meta-regression analyses, a higher baseline IL-6 level was significantly associated with greater effects of CoQ10 on IL-6 levels (P for interaction=0.006). In conclusion, this meta-analysis of RCTs suggests significant lowering effects of CoQ10 on CRP, IL-6 and TNF-α. However, results should be interpreted with caution because of the evidence of heterogeneity and limited number of studies.
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Affiliation(s)
- Li Fan
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Dushu Lake Higher Education Town, Suzhou 215123, China.
| | - Yu Feng
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Dushu Lake Higher Education Town, Suzhou 215123, China; The Second Affiliated Hospital of Soochow University,1055 Sanxiang Road, Suzhou 215004, China.
| | - Guo-Chong Chen
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Dushu Lake Higher Education Town, Suzhou 215123, China.
| | - Li-Qiang Qin
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Dushu Lake Higher Education Town, Suzhou 215123, China.
| | - Chun-Ling Fu
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Dushu Lake Higher Education Town, Suzhou 215123, China.
| | - Li-Hua Chen
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Dushu Lake Higher Education Town, Suzhou 215123, China.
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Barrios V, Escobar C, Cicero AFG, Burke D, Fasching P, Banach M, Bruckert E. A nutraceutical approach (Armolipid Plus) to reduce total and LDL cholesterol in individuals with mild to moderate dyslipidemia: Review of the clinical evidence. ATHEROSCLEROSIS SUPP 2017; 24:1-15. [DOI: 10.1016/j.atherosclerosissup.2016.10.003] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Pirro M, Vetrani C, Bianchi C, Mannarino MR, Bernini F, Rivellese AA. Joint position statement on "Nutraceuticals for the treatment of hypercholesterolemia" of the Italian Society of Diabetology (SID) and of the Italian Society for the Study of Arteriosclerosis (SISA). Nutr Metab Cardiovasc Dis 2017; 27:2-17. [PMID: 27956024 DOI: 10.1016/j.numecd.2016.11.122] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 11/17/2016] [Accepted: 11/17/2016] [Indexed: 12/19/2022]
Abstract
AIM Evidence showed that LDL-cholesterol lowering is associated with a significant cardiovascular risk reduction. The initial therapeutic approach to hypercholesterolemia includes dietary modifications but the compliance to recommendations is often inadequate. Some dietary components with potential cholesterol-lowering activity are present in small amounts in food. Therefore, in recent years the use of "nutraceuticals" (i.e., nutrients and/or bioactive compounds with potential beneficial effects on human health) has become widespread. Such substances may be added to foods and beverages, or taken as dietary supplements (liquid preparations, tablets, capsules). In the present manuscript, the cholesterol-lowering activity of some nutraceuticals (i.e. fiber, phytosterols, soy, policosanol, red yeast rice and berberine) will be discussed along with: 1) the level of evidence on the cholesterol-lowering efficacy emerging from clinical trial; 2) the possible side effects associated with their use; 3) the categories of patients who could benefit from their use. DATA SYNTHESIS Based on the current literature, the cholesterol-lowering effect of fiber, phytosterols and red yeast rice is consistent and supported by a good level of evidence. Over berberine, there is sufficient evidence showing significant cholesterol-lowering effects, although the results come from studies carried out almost exclusively in Asian populations. Data on the effects of soy are conflicting and, therefore, the strength of recommendation is quite low. The evidence on policosanol is inconclusive. CONCLUSION Although health benefits may arise from the use of nutraceuticals with cholesterol-lowering activity, their use might be also associated with possible risks and pitfalls, some of which are common to all nutraceuticals whereas others are related to specific nutraceuticals.
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Affiliation(s)
- M Pirro
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy; Italian Society for the Study of Arteriosclerosis (SISA), Italy
| | - C Vetrani
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy; Italian Society of Diabetology (SID), Italy
| | - C Bianchi
- Italian Society of Diabetology (SID), Italy; Unit of Diabetology and Metabolic Diseases, Department of Medical Area "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy
| | - M R Mannarino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy; Italian Society for the Study of Arteriosclerosis (SISA), Italy
| | - F Bernini
- Italian Society for the Study of Arteriosclerosis (SISA), Italy; Department of Pharmacy, University of Parma, Parma, Italy
| | - A A Rivellese
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy; Italian Society of Diabetology (SID), Italy.
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