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Zare H, Amiri Ardekani E, Tavakoli A, Bradley R, Tavakoli F, Pasalar M. Reporting of adverse effects of pomegranate in clinical studies: a systematic review. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2024; 21:154-166. [PMID: 37116077 DOI: 10.1515/jcim-2022-0247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/04/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES Numerous studies have shown the pharmacological effects of pomegranate, such as: anti-cancer, cholesterol-lowering, anti-diabetic, and antihypertensive features. Pomegranate consumption has also revealed some adverse effects. This systematic review aimed to explore the adverse effects of pomegranate reported in clinical studies. CONTENT The keywords "pomegranate", "Punica granatum", "side effect", "clinical trial", and "case report or case series" were searched for in valid databases. Reports about adverse effects of pomegranate were also collected from several international registries. SUMMARY This systematic review included a total of 66 clinical articles. Eleven articles have reported side effects of pomegranate. Twenty-one articles have recorded no side effects in the pomegranate group while 34 articles have not mentioned any side effects for this plant. The study also included 7 case report studies. The most common side effects included gastrointestinal problems, flu-like symptoms, and urinary problems. In case report studies, the most significant reported side effect was allergic reaction. OUTLOOK In summary, pomegranate and its extract seem to be safe according to the reported adverse effects. Meanwhile, conducting more robust controlled trials with pomegranate products and documentation of any probable side effect is warranted.
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Affiliation(s)
- Hamid Zare
- Department of Traditional Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Amiri Ardekani
- Department of Phytopharmaceuticals (Traditional Pharmacy), Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
- Iranian Association of Indigenous Knowledge, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Tavakoli
- Department of Traditional Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, USA
| | - Fatemeh Tavakoli
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Jazinaki MS, Rashidmayvan M, Pahlavani N. The effect of pomegranate juice supplementation on C-reactive protein levels: GRADE-assessed systematic review and dose-response updated meta-analysis of data from randomized controlled trials. Phytother Res 2024; 38:2818-2831. [PMID: 38553998 DOI: 10.1002/ptr.8188] [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: 09/17/2023] [Revised: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 06/13/2024]
Abstract
Pomegranate juice (PJ) has a possible anti-inflammatory effect because of its polyphenol content and antioxidants. However, the anti-inflammatory effect of PJ in randomized controlled trials (RCTs) has not been consistent. A previous meta-analysis conducted in 2016 reported a nonsignificant lowering effect of PJ on C-reactive protein (CRP) levels. This systematic review and meta-analysis aim to update the pooled effect size of PJ supplementation on CRP levels in RCT studies. PubMed, Scopus, and Web of Science databases were comprehensively searched until July 2023. Eligible studies were found by screening, their relevant data was extracted, and a risk of bias assessment was performed. The pooled effect size was calculated using a random effect model as the weighted mean difference (WMD) with a 95% confidence interval. This systematic review included 11 studies with 13 effect sizes and 696 participants. Meta-analysis showed that PJ supplementation led to a significant decrease in CRP levels compared to control groups (WMD: -2.55 mg/L; 95%CI: -3.44 to -1.66; p < 0.001). Subgroup analysis demonstrated the significant reduction effect of PJ on CRP levels in studies conducted on the both sexes or only females as well as Iranian population, individuals with 40 years≤, type 2 diabetes, polycystic ovary syndrome, or trials that intervened with PJ dosage of <250 ml/day. Meta-regression and dose-response analysis reported a nonsignificant linear and nonlinear relationship between intervention characteristics (duration and dose of PJ) and CRP changes. The current meta-analysis revealed that PJ supplemantation has a beneficial effect in improving CRP levels. It is recommended to understand this effect better, and find the optimal dose and duration of PJ supplementation to reduce CRP levels in the blood, and repeat meta-analysis after related RCTs are available. For the final proof of these effects, more detailed human studies are needed.
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Affiliation(s)
| | - Mohammad Rashidmayvan
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran
| | - Naseh Pahlavani
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Social Determinants of Health Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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Laurindo LF, Rodrigues VD, Minniti G, de Carvalho ACA, Zutin TLM, DeLiberto LK, Bishayee A, Barbalho SM. Pomegranate (Punica granatum L.) phytochemicals target the components of metabolic syndrome. J Nutr Biochem 2024; 131:109670. [PMID: 38768871 DOI: 10.1016/j.jnutbio.2024.109670] [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: 07/09/2023] [Revised: 04/08/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024]
Abstract
Pomegranate (Punica granatum L.) is a multipurpose dietary and medicinal plant known for its ability to promote various health benefits. Metabolic syndrome (MetS) is a complex metabolic disorder driving health and socioeconomic challenges worldwide. It may be characterized by insulin resistance, abdominal obesity, hypertension, and dyslipidemia. This study aims to conduct a review of pomegranate's effects on MetS parameters using a mechanistic approach relying on pre-clinical studies. The peel, juice, roots, bark, seeds, flowers, and leaves of the fruit present several bioactive compounds that are related mainly to anti-inflammatory and antioxidant activities as well as cardioprotective, antidiabetic, and antiobesity effects. The use of the juice extract can work as a potent inhibitor of angiotensin-converting enzyme activities, consequently regulating blood pressure. The major bioactive compounds found within the fruit are phenolic compounds (hydrolysable tannins and flavonoids) and fatty acids. Alkaloids, punicalagin, ellagitannins, ellagic acid, anthocyanins, tannins, flavonoids, luteolin, and punicic acid are also present. The antihyperglycemia, antihyperlipidemia, and weight loss promoting effects are likely related to the anti-inflammatory and antioxidant effects. When considering clinical application, pomegranate extracts are found to be frequently well-tolerated, further supporting its efficacy as a treatment modality. We suggest that pomegranate fruit, extract, or processed products can be used to counteract MetS-related risk factors. This review represents an important step towards exploring potential avenues for further research in this area.
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Affiliation(s)
- Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, Faculdade de Medicina de Marília (FAMEMA), São Paulo, São Paulo, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil
| | - Victória Dogani Rodrigues
- Department of Biochemistry and Pharmacology, School of Medicine, Faculdade de Medicina de Marília (FAMEMA), São Paulo, São Paulo, Brazil
| | - Giulia Minniti
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil
| | - Antonelly Cassio Alves de Carvalho
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil
| | - Tereza Laís Menegucci Zutin
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil; Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil
| | - Lindsay K DeLiberto
- Department of Pharmacology, College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL USA
| | - Anupam Bishayee
- Department of Pharmacology, College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL USA.
| | - Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil; Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil; Department of Biochemistry and Nutrition, School of Food and Technology of Marília (FATEC), São Paulo, São Paulo, Brazil.
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Colombijn JM, Hooft L, Jun M, Webster AC, Bots ML, Verhaar MC, Vernooij RW. Antioxidants for adults with chronic kidney disease. Cochrane Database Syst Rev 2023; 11:CD008176. [PMID: 37916745 PMCID: PMC10621004 DOI: 10.1002/14651858.cd008176.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) is a significant risk factor for cardiovascular disease (CVD) and death. Increased oxidative stress in people with CKD has been implicated as a potential causative factor. Antioxidant therapy decreases oxidative stress and may consequently reduce cardiovascular morbidity and death in people with CKD. This is an update of a Cochrane review first published in 2012. OBJECTIVES To examine the benefits and harms of antioxidant therapy on death and cardiovascular and kidney endpoints in adults with CKD stages 3 to 5, patients undergoing dialysis, and kidney transplant recipients. SEARCH METHODS We searched the Cochrane Kidney and Transplant Register of Studies until 15 November 2022 using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal, and ClinicalTrials.gov. SELECTION CRITERIA We included all randomised controlled trials investigating the use of antioxidants, compared with placebo, usual or standard care, no treatment, or other antioxidants, for adults with CKD on cardiovascular and kidney endpoints. DATA COLLECTION AND ANALYSIS Titles and abstracts were screened independently by two authors who also performed data extraction using standardised forms. Results were pooled using random effects models and expressed as risk ratios (RR) or mean difference (MD) with 95% confidence intervals (CI). Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. MAIN RESULTS We included 95 studies (10,468 randomised patients) that evaluated antioxidant therapy in adults with non-dialysis-dependent CKD (31 studies, 5342 patients), dialysis-dependent CKD (41 studies, 3444 patients) and kidney transplant recipients (21 studies, 1529 patients). Two studies enrolled dialysis and non-dialysis patients (153 patients). Twenty-one studies assessed the effects of vitamin antioxidants, and 74 assessed the effects of non-vitamin antioxidants. Overall, the quality of included studies was moderate to low or very low due to unclear or high risk of bias for randomisation, allocation concealment, blinding, and loss to follow-up. Compared with placebo, usual care, or no treatment, antioxidant therapy may have little or no effect on cardiovascular death (8 studies, 3813 patients: RR 0.94, 95% CI 0.64 to 1.40; I² = 33%; low certainty of evidence) and probably has little to no effect on death (any cause) (45 studies, 7530 patients: RR 0.95, 95% CI 0.82 to 1.11; I² = 0%; moderate certainty of evidence), CVD (16 studies, 4768 patients: RR 0.79, 95% CI 0.63 to 0.99; I² = 23%; moderate certainty of evidence), or loss of kidney transplant (graft loss) (11 studies, 1053 patients: RR 0.88, 95% CI 0.67 to 1.17; I² = 0%; moderate certainty of evidence). Compared with placebo, usual care, or no treatment, antioxidants had little to no effect on the slope of urinary albumin/creatinine ratio (change in UACR) (7 studies, 1286 patients: MD -0.04 mg/mmol, 95% CI -0.55 to 0.47; I² = 37%; very low certainty of evidence) but the evidence is very uncertain. Antioxidants probably reduced the progression to kidney failure (10 studies, 3201 patients: RR 0.65, 95% CI 0.41 to 1.02; I² = 41%; moderate certainty of evidence), may improve the slope of estimated glomerular filtration rate (change in eGFR) (28 studies, 4128 patients: MD 3.65 mL/min/1.73 m², 95% CI 2.81 to 4.50; I² = 99%; low certainty of evidence), but had uncertain effects on the slope of serum creatinine (change in SCr) (16 studies, 3180 patients: MD -13.35 µmol/L, 95% CI -23.49 to -3.23; I² = 98%; very low certainty of evidence). Possible safety concerns are an observed increase in the risk of infection (14 studies, 3697 patients: RR 1.30, 95% CI 1.14 to 1.50; I² = 3%; moderate certainty of evidence) and heart failure (6 studies, 3733 patients: RR 1.40, 95% CI 1.11 to 1.75; I² = 0; moderate certainty of evidence) among antioxidant users. Results of studies with a low risk of bias or longer follow-ups generally were comparable to the main analyses. AUTHORS' CONCLUSIONS We found no evidence that antioxidants reduced death or improved kidney transplant outcomes or proteinuria in patients with CKD. Antioxidants likely reduce cardiovascular events and progression to kidney failure and may improve kidney function. Possible concerns are an increased risk of infections and heart failure among antioxidant users. However, most studies were of suboptimal quality and had limited follow-up, and few included people undergoing dialysis or kidney transplant recipients. Furthermore, the large heterogeneity in interventions hampers drawing conclusions on the efficacy and safety of individual agents.
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Affiliation(s)
- Julia Mt Colombijn
- Department of Nephrology and Hypertension, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Min Jun
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Angela C Webster
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Westmead Applied Research Centre, The University of Sydney at Westmead, Westmead, Australia
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Department of Transplant and Renal Medicine, Westmead Hospital, Westmead, Australia
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Marianne C Verhaar
- Department of Nephrology and Hypertension, University of Utrecht, Utrecht, Netherlands
| | - Robin Wm Vernooij
- Department of Nephrology and Hypertension, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
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Baghdadi G, Shidfar F, Dehnad A. The effect of pomegranate consumption on cardiovascular risk factors in hemodialysis patients: A systematic review of clinical trials. Phytother Res 2023; 37:4963-4975. [PMID: 37485775 DOI: 10.1002/ptr.7961] [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: 03/15/2022] [Revised: 04/12/2023] [Accepted: 06/30/2023] [Indexed: 07/25/2023]
Abstract
Patients undergoing maintenance dialysis have a significantly higher incidence of cardiovascular disease (CVD) compared with the general population. CVD is the most common cause of morbidity and mortality among hemodialysis patients, and has been attributed, among other causes, to increased oxidative stress, inflammation, hypertension and dyslipidemia. Pomegranate, a popular fruit worldwide, has demonstrated health benefits such as antioxidative, antidiabetic, antihypertensive, antihyperlipidemic and anti-inflammatory effects. In this systematic review of clinical trials, we aim to summarize the effect of different parts of pomegranate and the effects of its use on CVD risk factors in hemodialysis patients. PubMed/MEDLINE, EMBASE, Scopus, and Web of Science were searched to identify eligible clinical trials up to December 2021. Ultimately, seven clinical trials were included in this study. Different parts of pomegranate used in these trials were pomegranate juice, pomegranate extract and pomegranate peel extract. The duration of the studies varied from one dialysis session to 1 year. Our results showed that different parts of pomegranate may have anti-hypertensive, antioxidant, anti-inflammatory effects and improve lipid profile by decreasing TG (triglycerides) and increasing HDL-C (high-density lipoprotein cholesterol) in hemodialysis patients. However, due to limited number of studies, more clinical trials need to be performed.
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Affiliation(s)
- Ghazal Baghdadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Dehnad
- Department of English Language, School of Health Management and Information Sciences, Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
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Dormal V, Pachikian B, Debock E, Buchet M, Copine S, Deldicque L. Evaluation of a Dietary Supplementation Combining Protein and a Pomegranate Extract in Older People: A Safety Study. Nutrients 2022; 14:nu14235182. [PMID: 36501211 PMCID: PMC9739468 DOI: 10.3390/nu14235182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/28/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Malnutrition is a highly prevalent condition in older adults. It is associated with low muscle mass and function and increased occurrence of health problems. Maintaining an adequate nutritional status as well as a sufficient nutrient intake in older people is therefore essential to address this public health problem. For this purpose, protein supplementation is known to prevent the loss of muscle mass during aging, and the consumption of various pomegranate extracts induces numerous health benefits, mainly through their antioxidant properties. However, to our knowledge, no study has to date investigated the impact of their combination on the level of malnutrition in older people. The objective of this preliminary study was thus to evaluate the safety of a combination of protein and a pomegranate extract in healthy subjects aged 65 years or more during a 21-day supplementation period. Thirty older participants were randomly assigned to receive protein and a pomegranate extract (Test group) or protein and maltodextrin (Control group) during a 21-day intervention period. The primary outcomes were the safety and tolerability of the supplementation defined as the occurrence of adverse events, and additional secondary outcomes included physical examination and hematological and biochemical parameters. No serious adverse events were reported in any group. Changes in physical, hematological, and biochemical parameters between the initial screening and the end of the study were equivalent in both groups, except for glutamate-pyruvate transaminase (GPT) and prealbumin, for which a decrease was observed only in the Test group. Our initial findings support the safety of the combination of protein and a pomegranate extract in healthy elderly people. Future clinical trials on a larger sample and a longer period are needed to determine the efficacy of this combination.
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Affiliation(s)
- Valérie Dormal
- Center of Investigation in Clinical Nutrition, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
- Institute of Neuroscience, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
| | - Barbara Pachikian
- Center of Investigation in Clinical Nutrition, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
| | - Elena Debock
- Center of Investigation in Clinical Nutrition, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
| | - Marine Buchet
- Center of Investigation in Clinical Nutrition, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
| | - Sylvie Copine
- Center of Investigation in Clinical Nutrition, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
| | - Louise Deldicque
- Center of Investigation in Clinical Nutrition, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
- Institute of Neuroscience, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
- Correspondence:
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Laurindo LF, Barbalho SM, Marquess AR, Grecco AIDS, Goulart RDA, Tofano RJ, Bishayee A. Pomegranate ( Punica granatum L.) and Metabolic Syndrome Risk Factors and Outcomes: A Systematic Review of Clinical Studies. Nutrients 2022; 14:nu14081665. [PMID: 35458227 PMCID: PMC9032502 DOI: 10.3390/nu14081665] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 02/04/2023] Open
Abstract
Pomegranate (Punica granatum L.) can be considered a multipurpose medicinal and dietary plant due to its anti-inflammatory and antioxidant actions. Pomegranate can be used to prevent or treat metabolic syndrome (MetS) risk factors. Although previously published reviews addressed the effects of pomegranate on different diseases, there is no systematic review that exclusively focuses on clinical trials related to all MetS-related risk factors. In view of this limitation, the objective of this up-to-date, comprehensive, and systematic review is to critically evaluate the potential of pomegranate (P. granatum) on various MetS risk factors on the basis of clinical studies. PubMed, EMBASE, MEDLINE, Google Scholar, COCHRANE, and Clinical Trials.gov databases were searched on 15 October 2021. The Preferred Reporting Items for a Systematic Review and Meta-Analysis guidelines were followed, and the bias risk evaluation was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. We identified 5683 studies in the databases. After removing the duplicates, 3418 studies remained. Of these, 147 studies met the eligibility criteria, and finally, only 20 were included in the qualitative analysis. The included studies suggest that pomegranate can be beneficial to reduce body weight, blood pressure, glycemia, triglycerides, total cholesterol, and low-density lipoprotein cholesterol. Moreover, it can augment high-density lipoprotein cholesterol levels and improve insulin resistance. Although relevant effects were observed, additional well-designed clinical trials are needed to determine the correct formulations and doses to be used to prevent or treat MetS components.
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Affiliation(s)
- Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília, Marília 17525-902, SP, Brazil; (L.F.L.); (A.I.d.S.G.); (R.J.T.)
| | - Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília, Marília 17525-902, SP, Brazil; (L.F.L.); (A.I.d.S.G.); (R.J.T.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília, Marília 17525-902, SP, Brazil;
- Department of Biochemistry, School of Food and Technology of Marilia, Marília 17500-000, SP, Brazil
- Correspondence: (S.M.B.); or (A.B.)
| | - Alexis R. Marquess
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA;
| | - Annik Ianara de Souza Grecco
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília, Marília 17525-902, SP, Brazil; (L.F.L.); (A.I.d.S.G.); (R.J.T.)
| | - Ricardo de Alvares Goulart
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília, Marília 17525-902, SP, Brazil;
| | - Ricardo José Tofano
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília, Marília 17525-902, SP, Brazil; (L.F.L.); (A.I.d.S.G.); (R.J.T.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília, Marília 17525-902, SP, Brazil;
| | - Anupam Bishayee
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA;
- Correspondence: (S.M.B.); or (A.B.)
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Therapeutic Effects of Punica granatum (Pomegranate): An Updated Review of Clinical Trials. J Nutr Metab 2021; 2021:5297162. [PMID: 34796029 PMCID: PMC8595036 DOI: 10.1155/2021/5297162] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 12/22/2022] Open
Abstract
Punica granatum L. belongs to the Punicaceae family which is distributed around the world. Different parts of pomegranate like seed, peel, juice, and leaves are rich in potential bioactive compounds. These plants have found application in traditional medicine such as in treatment of gastrointestinal, cardiovascular, and endocrine diseases, among others. The present review aimed to summarize the current research on the traditional and scientific applications of P. granatum with regard to the phytochemical content and clinical applications that may be useful for future drug development. Information about P. granatum was obtained from local classic herbal literature and electronic databases, such as PubMed, Scopus, and ScienceDirect. Several phytochemical constituents including polyphenolics, flavonoids, anthocyanosides, alkaloids, lignans, and triterpenes have been reported from the plant. Randomized clinical trials have provided evidence as to the pharmacological activities of pomegranate in several diseases including diabetes, cardiovascular disease, oral cavity disorders, endocrine disorders, and cancer. The present review has provided an insight into the traditional applications of the plants, and some of them have been validated by scientific evidence, particularly their applications as treatment of cardiovascular and endocrine diseases.
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Wong TL, Strandberg KR, Croley CR, Fraser SE, Nagulapalli Venkata KC, Fimognari C, Sethi G, Bishayee A. Pomegranate bioactive constituents target multiple oncogenic and oncosuppressive signaling for cancer prevention and intervention. Semin Cancer Biol 2021; 73:265-293. [DOI: 10.1016/j.semcancer.2021.01.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/01/2020] [Accepted: 01/14/2021] [Indexed: 02/07/2023]
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Giménez-Bastida JA, Ávila-Gálvez MÁ, Espín JC, González-Sarrías A. Evidence for health properties of pomegranate juices and extracts beyond nutrition: A critical systematic review of human studies. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.06.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Xu J, Cao K, Zhao L, Feng Z, Dong Z, Li J, Liu J. The effects and mechanisms of pomegranate in the prevention and treatment of metabolic syndrome. TRADITIONAL MEDICINE AND MODERN MEDICINE 2021. [DOI: 10.1142/s2575900020300064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Metabolic syndrome, such as obesity, diabetes and cardiovascular disease, is becoming epidemic both in developing and developed countries in recent years. Vegetable and fruit consumptions have been associated with the prevention of metabolic syndrome. Pomegranate is a widely consumed fruit in Middle East and Asia. Currently, accumulating data showed that pomegranate exhibits antioxidant, anti-inflammatory, hypolipidemic and hypoglycemic activities in experimental and clinical studies. The beneficial effects of pomegranate may come from its rich polyphenols and be mediated by increasing the activity of AMPK, upregulating GLUT4, activating PPAR[Formula: see text]- ABCA1/CYP7A1 pathways and improving mitochondrial function. This review provides a systematical presentation of findings on the beneficial effects as well as the possible mechanisms of pomegranate and its major components on prevention and treatment of metabolic syndrome.
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Affiliation(s)
- Jie Xu
- Center for Mitochondrial Biology & Medicine, The Key Laboratory of Biomedical Information, Engineering of Ministry of Education, School of Life Science and Frontier Institute of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, P. R. China
| | - Ke Cao
- Center for Mitochondrial Biology & Medicine, The Key Laboratory of Biomedical Information, Engineering of Ministry of Education, School of Life Science and Frontier Institute of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, P. R. China
| | - Lin Zhao
- Center for Mitochondrial Biology & Medicine, The Key Laboratory of Biomedical Information, Engineering of Ministry of Education, School of Life Science and Frontier Institute of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, P. R. China
| | - Zhihui Feng
- Center for Mitochondrial Biology & Medicine, The Key Laboratory of Biomedical Information, Engineering of Ministry of Education, School of Life Science and Frontier Institute of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, P. R. China
| | - Zhizhong Dong
- Nutrition & Health Research Institute, COFCO Corporation; Beijing Engineering, Laboratory of Geriatric Nutrition & Foods and Beijing Key Laboratory of Nutrition, Health and Food Safety, Beijing 102209, P. R. China
| | - Jianke Li
- College of Food Engineering and Nutritional Science, Shaanxi Normal University, P. R. China
- University Key Laboratory of Food Processing Byproducts for Advanced Development and High Value Utilization, Xi’an 710119, Shaanxi, P. R. China
| | - Jiankang Liu
- Center for Mitochondrial Biology & Medicine, The Key Laboratory of Biomedical Information, Engineering of Ministry of Education, School of Life Science and Frontier Institute of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, P. R. China
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12
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Jafari T, Fallah AA, Bahrami M, Lorigooini Z. Effects of pomegranate peel extract and vitamin E on oxidative stress and antioxidative capacity of hemodialysis patients: A randomized controlled clinical trial. J Funct Foods 2020. [DOI: 10.1016/j.jff.2020.104069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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13
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Barati Boldaji R, Akhlaghi M, Sagheb MM, Esmaeilinezhad Z. Pomegranate juice improves cardiometabolic risk factors, biomarkers of oxidative stress and inflammation in hemodialysis patients: a randomized crossover trial. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2020; 100:846-854. [PMID: 31646650 DOI: 10.1002/jsfa.10096] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 09/28/2019] [Accepted: 10/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Pomegranate has antioxidant, cardioprotective and anti-inflammatory properties. We designed a crossover study aimed at determining if consumption of pomegranate juice (PJ) improves lipid profile and oxidative and inflammatory biomarkers of hemodialysis patients. Forty-one hemodialysis patients were randomly assigned to one of two groups: PJ-treated group receiving 100 mL of natural PJ immediately after their dialysis session three times a week and the control group receiving the usual care. After 8 weeks, a 4-week washout period was established and then the role of the groups was exchanged. Lipid profile, blood pressure and oxidative and inflammatory biomarkers were measured before and after each sequence. RESULTS Based on the results of intention-to-treat analysis, triglycerides were decreased in PJ condition and increased in the controls. Conversely, high-density lipoprotein cholesterol was increased in PJ and decreased in the control group. Total and low-density lipoprotein cholesterol did not significantly change in either condition. Systolic and diastolic blood pressure significantly decreased in PJ condition. Total antioxidant capacity increased in PJ condition (P < 0.001) and decreased in the controls (P < 0.001). Conversely, malondialdehyde and interleukin-6 decreased in PJ (P < 0.001) and increased in the control group (P ≤ 0.001). The changes of these biomarkers were significantly different between the two conditions. CONCLUSIONS Eight-week PJ consumption showed beneficial effects on blood pressure, serum triglycerides, high-density lipoprotein cholesterol, oxidative stress and inflammation in hemodialysis patients. © 2019 Society of Chemical Industry.
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Affiliation(s)
- Reza Barati Boldaji
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mahdi Sagheb
- Department of Nephrology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Esmaeilinezhad
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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14
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van 't Erve TJ. Strategies to decrease oxidative stress biomarker levels in human medical conditions: A meta-analysis on 8-iso-prostaglandin F 2α. Redox Biol 2018; 17:284-296. [PMID: 29775960 PMCID: PMC6007822 DOI: 10.1016/j.redox.2018.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 02/07/2023] Open
Abstract
The widespread detection of elevated oxidative stress levels in many medical conditions has led to numerous efforts to design interventions to reduce its effects. Efforts have been wide-ranging, from dietary changes to administration of antioxidants, supplements, e.g., omega-3-fatty acids, and many medications. However, there is still no systemic assessment of the efficacy of treatments for oxidative stress reduction across a variety of medical conditions. The goal of this meta-analysis is, by combining multiple studies, to quantitate the change in the levels of the popular oxidative stress biomarker 8-iso-prostaglandin F2α (8-iso-PGF2α) after a variety of treatment strategies in human populations. Nearly 350 unique publications with 180 distinct strategies were included in the analysis. For each strategy, the difference between pre- or placebo and post-treatment levels calculated using Hedges' g value of effect. In general, administration of antibiotics, antihyperlipidemic agents, or changes in lifestyle (g = - 0.63, - 0.54, and 0.56) had the largest effect. Administration of supplements, antioxidants, or changes in diet (g = - 0.09, - 0.28, - 0.12) had small quantitative effects. To fully interpret the effectiveness of these treatments, comparisons to the increase in g value for each medical condition is required. For example, antioxidants in populations with coronary artery disease (CAD) reduce the 8-iso-PGF2α levels by g = - 0.34 ± 0.1, which is quantitatively considered a small effect. However, CAD populations, in comparison to healthy populations, have an increase in 8-iso-PGF2α levels by g = 0.38 ± 0.04; therefore, the overall reduction of 8-iso-PGF2α levels is ≈ 90% by this treatment in this specific medical condition. In conclusion, 8-iso-PGF2α levels can be reduced not only by antioxidants but by many other strategies. Not all strategies are equally effective at reducing 8-iso-PGF2α levels. In addition, the effectiveness of any strategy can be assessed only in relation to the medical condition investigated.
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Affiliation(s)
- Thomas J van 't Erve
- Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, 27709 NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, 27709 NC, USA.
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15
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Li G, Ma H, Yin Y, Wang J. CRP, IL‑2 and TNF‑α level in patients with uremia receiving hemodialysis. Mol Med Rep 2017; 17:3350-3355. [PMID: 29257244 DOI: 10.3892/mmr.2017.8197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/06/2017] [Indexed: 11/05/2022] Open
Abstract
Uremia is a serious threat to health. Infection associated with inflammation frequently occurs in patients with uremia during hemodialysis. This study aimed to investigate the association between serum inflammatory factors and uremia in patients prior to and following hemodialysis. Patients with uremia (n=200) receiving continuous high throughput hemodialysis that had hospital‑acquired infection were enrolled between August 2013 and August 2015. Additionally, 200 cases of healthy volunteers were selected as the control. Reverse transcription‑polymerase chain reaction, ELISA and western blotting were performed to determine serum C‑reactive protein (CRP), interleukin 2 (IL‑2), and tumor necrosis factorα levels (TNF‑α) prior to hemodialysis and 8 months after hemodialysis to explore the association of CRP, IL‑2 and TNF‑α with uremia. CRP, IL‑2 and TNF‑α levels were lower at 8 months after hemodialysis than before, and the difference was statistically significant. CRP, IL‑2 and TNF‑α levels in uremia patients at 8 months after hemodialysis were similar with that in the normal control. CRP expression in patients with uremia was positively correlated with IL‑2 and TNF‑α expression. Patients with uremia with hospital‑acquired infection receiving continuous high throughput blood purification presented increased levels of inflammatory factor in the serum. In conclusion, uremia patients receiving maintenance hemodialysis with hospital‑acquired infection had increased serum inflammatory factors and high throughput hemodialysis significantly decreased CRP, IL‑2 and TNF‑α levels in the serum, suggesting that high throughput hemodialysis may be beneficial for the prevention of the infections in uremia patients.
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Affiliation(s)
- Guohui Li
- Department of Blood Purification Center, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan 471003, P.R. China
| | - Haijun Ma
- Department of Blood Purification Center, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan 471003, P.R. China
| | - Yaoyao Yin
- Department of Blood Purification Center, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan 471003, P.R. China
| | - Junxia Wang
- Department of Blood Purification Center, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan 471003, P.R. China
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16
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Danesi F, Ferguson LR. Could Pomegranate Juice Help in the Control of Inflammatory Diseases? Nutrients 2017; 9:nu9090958. [PMID: 28867799 PMCID: PMC5622718 DOI: 10.3390/nu9090958] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 08/19/2017] [Accepted: 08/26/2017] [Indexed: 12/13/2022] Open
Abstract
Fruits rich in polyphenols, such as pomegranates, have been shown to have health benefits relating to their antioxidant and anti-inflammatory properties. Using data obtained from PubMed and Scopus, this article provides a brief overview of the therapeutic effects of pomegranate on chronic inflammatory diseases (CID) such as inflammatory bowel disease (IBD), rheumatoid arthritis (RA), metabolic and cardiovascular disorders, and other inflammatory-associated conditions, with an emphasis on fruit-derived juices. Most studies regarding the effects of pomegranate juice have focused on its ability to treat prostate cancer, diabetes, and atherosclerosis. However, pomegranate juice has shown therapeutic potential for many other illnesses. For instance, a small number of human clinical trials have highlighted the positive effects of pomegranate juice and extract consumption on cardiovascular health. The beneficial effects of pomegranate components have also been observed in animal models for respiratory diseases, RA, neurodegenerative disease, and hyperlipidaemia. Furthermore, there exists strong evidence from rodent models suggesting that pomegranate juice can be used to effectively treat IBD, and as an anti-inflammatory agent to treat CID. The effects of pomegranate intake should be further investigated by conducting larger and more well-defined human trials.
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Affiliation(s)
- Francesca Danesi
- Department of Agri-Food Science and Technology (DISTAL), University of Bologna, Piazza Goidanich 60, 47521 Cesena, Italy.
| | - Lynnette R Ferguson
- Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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17
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Evidence for the effectiveness of pomegranate supplementation for blood pressure management is weak: A systematic review of randomized clinical trials. Nutr Res 2017; 46:38-48. [PMID: 29173650 DOI: 10.1016/j.nutres.2017.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/18/2017] [Accepted: 07/20/2017] [Indexed: 12/25/2022]
Abstract
Hypertension is one of the most important preventable causes of premature death. Studies have been conducted assessing the impact of pomegranate on blood pressure, with varying results. The aim of this review was to critically appraise and evaluate the effect of pomegranate on blood pressure in adults, using evidence from randomized clinical trials (RCTs). We conducted electronic searches in Medline, Embase, Amed, and The Cochrane Library, and included RCTs assessing the effectiveness of pomegranate on blood pressure. We assessed the reporting quality using the Cochrane criteria. We included 8 RCTs comprising 619 participants. The studies varied in their reporting quality, and compared pomegranate juice or capsules with a control. Two studies reported significant reductions in systolic blood pressure favoring pomegranate: p = .002 and p < .001 respectively; 3 studies reported no significant differences between groups; and 3 studies failed to report between-group differences. Two studies reported significant reductions in diastolic blood pressure favoring pomegranate: p = .038, p < .001, respectively; 4 studies reported no significant between-group differences; and 2 studies did not report between group differences. No adverse events were observed. The limited evidence from clinical trials to date fails to convincingly show a beneficial effect of pomegranate on blood pressure. We have identified evidence gaps and highlight areas for future research to be conducted, including performing studies of high quality and longer duration.
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Moazzen H, Alizadeh M. Effects of Pomegranate Juice on Cardiovascular Risk Factors in Patients with Metabolic Syndrome: a Double-Blinded, Randomized Crossover Controlled Trial. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2017; 72:126-133. [PMID: 28303364 DOI: 10.1007/s11130-017-0605-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The aim of this study is to investigate the simultaneous effect of pomegranate juice on components of the metabolic syndrome, including high sensitive C-reactive protein (hs-CRP) as an inflammatory index and glycemic and lipid profile indices in patients with metabolic syndrome. In a double- blind 2*2 crossover study, 30 individuals suffering from metabolic syndrome received a daily dose of 500 mL pomegranate juice for a period of one week. After one week of wash out period, they received a placebo for one week. Lipid profile, blood glucose control indices including fasting blood glucose, fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR), systolic and diastolic blood pressure, and hs-CRP were measured at the beginning and end of the study. To analyze the data, a repeated measure analysis of variance and a t-test were performed. The results indicated that in comparison to the placebo, pomegranate juice was more effective in reducing the systolic and diastolic blood pressure (p = 0.00) and hs-CRP (p = 0.018). The level of triglyceride (p = 0.030) and very low-density lipoproteins cholesterol (VLDL-C) (p = 0.014) were increased after the consumption of pomegranate juice, as opposed to the baseline condition. The rest of lipid profile, fasting blood glucose (FBS), insulin, and HOMA-IR of the participants did not show any significant difference. Natural pomegranate juice supplementation lowered the level of systolic and diastolic blood pressure in patients with metabolic syndrome as well as their blood hs-CRP. However, it also increased their triglyceride and VLDL-C.
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Affiliation(s)
- Hossein Moazzen
- Student Research Committee, Urmia University of Medical Sciences, Serow Highway, Nazloo, PO Box: 5756115111, Urmia, Iran
| | - Mohammad Alizadeh
- Department of Nutrition, Food and Beverages Safety Research Center, Faculty of Medicine, Urmia University of Medical Sciences, Serow Highway, Nazloo, PO Box: 5756115111, Urmia, Iran.
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19
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Sahebkar A, Gurban C, Serban A, Andrica F, Serban MC. Effects of supplementation with pomegranate juice on plasma C-reactive protein concentrations: A systematic review and meta-analysis of randomized controlled trials. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:1095-1102. [PMID: 26922037 DOI: 10.1016/j.phymed.2015.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 12/05/2015] [Accepted: 12/08/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Pomegranate juice (PJ) has a high content of antioxidants and bioactive polyphenols, being widely used for its antioxidant, anti-inflammatory and chemopreventive effects. PURPOSE The objective of this meta-analysis consisted in investigating the impact of PJ on plasma C-reactive protein (CRP) concentrations. METHODS The search included SCOPUS, Medline and two Iranian bibliographic databases namely MagIran and Scientific Information Database (from inception to December 09, 2014) to identify prospective trials for investigating the impact of pomegranate preparations on serum concentrations of CRP. Two independent reviewers extracted data on study characteristics, methods and outcomes. RESULTS Among 427 participants in the selected studies, 216 were allocated to PJ groups, and 211 to control group. Meta-analysis of data from 5 eligible randomized controlled trials (RCTs) arms did not provide compelling evidence as to a significant CRP-lowering effect of supplementation with pomegranate juice (WMD: -0.22 mg/l, 95% CI: -0.45, 0.01, p = 0.061). The impact of pomegranate juice on plasma CRP levels was found to be independent of duration of supplementation (slope: 0.003; 95% CI: -0.005, 0.011; p = 0.444). CONCLUSION In conclusion, this meta-analysis of data from 5 prospective trials did not indicate a significant effect of PJ on plasma CRP levels, and this effect was independent of duration of supplementation.
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Affiliation(s)
- Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | - Camelia Gurban
- Department of Biochemistry and Pharmacology, Discipline of Biochemistry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
| | - Alexandru Serban
- Department Automation and Applied Informatics, University Politehnica Timisoara, Romania
| | - Florina Andrica
- Faculty of Pharmacy, Discipline of Pharmaceutical Chemistry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Maria-Corina Serban
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
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20
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Tomé-Carneiro J, Visioli F. Polyphenol-based nutraceuticals for the prevention and treatment of cardiovascular disease: Review of human evidence. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:1145-1174. [PMID: 26776959 DOI: 10.1016/j.phymed.2015.10.018] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/28/2015] [Accepted: 10/30/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND In addition to prescription drugs, nutraceuticals/functional foods/medical foods are being increasingly added as adjunct treatment of cardiovascular disease (CVD), even though most of them have been exclusively studied in vitro. HYPOTHESIS/PURPOSE We review the available evidence (focusing on when the amount of polyphenols' intake was measured) coming from randomized controlled trials (RCTs) of (poly)phenol-based supplements. CONCLUSION We conclude that (poly)phenol-based nutraceuticals and functional foods might be indeed used as adjunct therapy of CVD, but additional long-term RCTs with adequate numerosity and with clinically relevant end points are needed to provide unequivocal evidence of their clinical usefulness.
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Affiliation(s)
- Joao Tomé-Carneiro
- Laboratory of Functional Foods, Madrid Institute for Advanced Studies (IMDEA) - Food, CEI UAM+CSIC, Madrid, Spain
| | - Francesco Visioli
- Laboratory of Functional Foods, Madrid Institute for Advanced Studies (IMDEA) - Food, CEI UAM+CSIC, Madrid, Spain; Department of Molecular Medicine, University of Padova, Viale G. Colombo 3, 35121 Padova, Italy .
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Cuyamendous C, de la Torre A, Lee YY, Leung KS, Guy A, Bultel-Poncé V, Galano JM, Lee JCY, Oger C, Durand T. The novelty of phytofurans, isofurans, dihomo-isofurans and neurofurans: Discovery, synthesis and potential application. Biochimie 2016; 130:49-62. [PMID: 27519299 DOI: 10.1016/j.biochi.2016.08.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/07/2016] [Indexed: 01/15/2023]
Abstract
Polyunsaturated fatty acids (PUFA) are oxidized in vivo under oxidative stress through free radical pathway and release cyclic oxygenated metabolites, which are commonly classified as isoprostanes and isofurans. The discovery of isoprostanes goes back twenty-five years compared to fifteen years for isofurans, and great many are discovered. The biosynthesis, the nomenclature, the chemical synthesis of furanoids from α-linolenic acid (ALA, C18:3 n-3), arachidonic acid (AA, C20:4 n-6), adrenic acid (AdA, 22:4 n-6) and docosahexaenoic acid (DHA, 22:6 n-3) as well as their identification and implication in biological systems are highlighted in this review.
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Affiliation(s)
- Claire Cuyamendous
- Institut des Biomolécules Max Mousseron, UMR 5247 CNRS, Université de Montpellier, ENSCM, Faculté de Pharmacie de Montpellier, 15 Avenue Charles Flahault, Bâtiment D, 34093, Montpellier Cedex 05, France
| | - Aurélien de la Torre
- Institut des Biomolécules Max Mousseron, UMR 5247 CNRS, Université de Montpellier, ENSCM, Faculté de Pharmacie de Montpellier, 15 Avenue Charles Flahault, Bâtiment D, 34093, Montpellier Cedex 05, France
| | - Yiu Yiu Lee
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong Special Administrative Region
| | - Kin Sum Leung
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong Special Administrative Region
| | - Alexandre Guy
- Institut des Biomolécules Max Mousseron, UMR 5247 CNRS, Université de Montpellier, ENSCM, Faculté de Pharmacie de Montpellier, 15 Avenue Charles Flahault, Bâtiment D, 34093, Montpellier Cedex 05, France
| | - Valérie Bultel-Poncé
- Institut des Biomolécules Max Mousseron, UMR 5247 CNRS, Université de Montpellier, ENSCM, Faculté de Pharmacie de Montpellier, 15 Avenue Charles Flahault, Bâtiment D, 34093, Montpellier Cedex 05, France
| | - Jean-Marie Galano
- Institut des Biomolécules Max Mousseron, UMR 5247 CNRS, Université de Montpellier, ENSCM, Faculté de Pharmacie de Montpellier, 15 Avenue Charles Flahault, Bâtiment D, 34093, Montpellier Cedex 05, France
| | - Jetty Chung-Yung Lee
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong Special Administrative Region
| | - Camille Oger
- Institut des Biomolécules Max Mousseron, UMR 5247 CNRS, Université de Montpellier, ENSCM, Faculté de Pharmacie de Montpellier, 15 Avenue Charles Flahault, Bâtiment D, 34093, Montpellier Cedex 05, France
| | - Thierry Durand
- Institut des Biomolécules Max Mousseron, UMR 5247 CNRS, Université de Montpellier, ENSCM, Faculté de Pharmacie de Montpellier, 15 Avenue Charles Flahault, Bâtiment D, 34093, Montpellier Cedex 05, France.
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Serafini M, Peluso I. Functional Foods for Health: The Interrelated Antioxidant and Anti-Inflammatory Role of Fruits, Vegetables, Herbs, Spices and Cocoa in Humans. Curr Pharm Des 2016; 22:6701-6715. [PMID: 27881064 PMCID: PMC5427773 DOI: 10.2174/1381612823666161123094235] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/15/2016] [Indexed: 01/18/2023]
Abstract
The health benefits of plant food-based diets could be related to both integrated antioxidant and antiinflammatory mechanisms exerted by a wide array of phytochemicals present in fruit, vegetables, herbs and spices. Therefore, there is mounting interest in identifying foods, food extracts and phytochemical formulations from plant sources which are able to efficiently modulate oxidative and inflammatory stress to prevent diet-related diseases. This paper reviews available evidence about the effect of supplementation with selected fruits, vegetables, herbs, spices and their extracts or galenic formulation on combined markers of redox and inflammatory status in humans.
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Affiliation(s)
- Mauro Serafini
- Functional Foods and Metabolic Stress Prevention Laboratory, Centre for Food and Nutrition, Council for Agricultural Research and Economics, Rome, Italy
| | - Ilaria Peluso
- Functional Foods and Metabolic Stress Prevention Laboratory, Centre for Food and Nutrition, Council for Agricultural Research and Economics, Rome, Italy
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