Garlic and cardiovascular disease: a critical review

Essential oil supplementation improves insulin sensitivity and modulates the plasma metabolome of hyperinsulinemic horses

The objective of this study was to investigate the effect of essential oil (EO) supplementation on insulin sensitivity (IS) and the plasma metabolome in insulin dysregulated (ID) horses. Horses were blocked by degree of IS and assigned randomly to treatment: oral daily bolus (50 mL) of either a plant derived EO supplement or carrier (CON). Mares were housed in dry lots with ad libitum access to grass hay and supplemented individually twice daily with a concentrate to meet nutrient requirements for mature horses. Before and after 6 wks of treatment, mares underwent a combined glucose-insulin tolerance test (CGIT) and an oral sugar test (OST) on separate days. Global metabolome analysis was conducted on plasma samples before and after treatment. Although treatment did not affect (p > 0.4) AUC or glucose clearance during CGIT, there was a treatment*covariate interaction (p ≤ 0.08) for insulin concentrations at 75 min (INS75) and positive phase time (PT) with EO decreasing both INS75 (p ≤ 0.002) and PT (p = 0.05) in horses with more severe initial degree of ID. Similarly, EO treatment reduced (p ≤ 0.006) insulinemic response to the OST in horses exhibiting higher pre-treatment responses (treatment*covariate, p = 0.004). There were 702 metabolites identified that were uniquely changed with EO treatment. Pathway analysis and biomarkers showed EO-mediated changes in amino acid, linoleic acid, mesaconic acid, TCA-cyle intermediates and bile acid metabolism. The directional changes in these pathways or biomarkers are consistent with changes in inulin sensitivity in other models. These data show that EO shifted the plasma metabolome and improved insulin sensitivity in horses.

Randomized, double-blind clinical trial evaluating the impact of freeze-dried garlic extract capsules on blood pressure, lipid profile, and nitric oxide levels in individuals at risk for hypertension

OBJECTIVES

Hypertension, substantially heightens the risk of cardiovascular disease. This study aims to evaluate the effectiveness of freeze-dried garlic extract in blood pressure and lipid profiles in prehypertensive individuals.

METHODS

Participants (age of 30-70 years) were allocated to intervention (n=47) or control (n=49) groups. The intervention group received two capsules of freeze-dried garlic extract daily for eight weeks, while the control group received identical placebo capsules. Primary outcomes, SBP, DBP, PP, MAP, TC, TG, LDL and HDL levels, serum NO levels, were assessed at baseline, four weeks, and eight weeks.

RESULTS

At the end of study, results showed significant changes in the values of SBP, DBP, and MAP except for PP. In comparison to those who received the placebo, a significant drop in SBP, DBP (p<0.001), and MAP (p<0.001) was observed in the intervention group. Also, there were significant changes in TG, LDL, TC, and HDL levels in the interventional group. A noticeable decline was reported in TG (p<0.001), LDL (p<0.001), and TC (p<0.001), while HDL levels increased (p<0.001) in the intervention group compared to those receiving the placebo. Following garlic supplementation, a significant increase in blood NO levels was reported in the intervention group (p<0.001).

CONCLUSIONS

The study showed that garlic supplementation was effective in lowering blood pressure, improving lipid profile, and increasing nitric oxide levels in prehypertensive participants. These results indicate that garlic could be a valuable complementary therapy for managing prehypertension.

Dietary patterns and premature coronary artery disease: result from the Iran premature coronary artery disease (IPAD) study

BACKGROUND

Premature coronary artery disease (PCAD) is one of the major health concerns leading to considerable death and disabilities. This study aimed to evaluate the relationship of dietary patterns with risk of PCAD.

METHODS

Iran premature coronary diseases (IPAD) is a case-control study consists of 3159 participants. Obstructive CAD in ≥ 75% of at least one coronary artery or ≥ 50% in the left main artery based on coronary angiography in women under 70 and men under 60 years old was considered PCAD. The habitual dietary intake of participants was collected using a semi-quantitative validated food frequency questionnaire (SFFQ). Principal Component Analysis (PCA) was used to extract dietary patterns.

RESULTS

Three main dietary patterns including healthy, Western and high-fat, high-sugar were identified. Patients categorized in the last tertile of the healthy dietary pattern had a decreased risk of PCAD (OR = 0.77, 95% CI: 0.64-0.93), while those in the top tertile of Western (OR = 2.38, 95 CI:1.97-2.86) and High-fat simple carbohydrate (HFSC) (OR = 3.10, 95% CI:2.57-3.75) diets had increased risk of PCAD.

CONCLUSIONS

A healthy dietary pattern was significantly related to a decreased risk of PCAD presence, whereas Western and HFSC diets were connected to a higher risk of PCAD.

Anticoagulant Effect of Snow mountain garlic: In Vitro Evaluation of Aqueous Extract

Snow mountain garlic is traditionally eaten by Himalayan locals for its medicinal properties. Although different species of the genus Allium are known to have other biological effects, such as antiplatelet and antithrombotic activities, little is known about the anticoagulant effect of Snow mountain garlic, a member of the genus Allium. Therefore, the present study examined the in vitro anticoagulant effect of the aqueous extract, the lyophilized aqueous extract, and the isoflavone extract from the lyophilized aqueous extract of Snow mountain garlic in samples from 50 human blood donors. Compared to the control, concentrations of 25, 12.5, and 6.25 mg/100 µL lengthened the clotting times of prothrombin, and concentrations of 25 and 12.5 mg/100 µL lengthened the activated partial thromboplastin time (p ˂ 0.05). The isoflavone extract from the lyophilized aqueous extract containing isoflavones, organosulfur compounds, a polyphenol, and a steroid glycoside showed a significant effect (p ˂ 0.05) on the prothrombin time and the activated partial thromboplastin time at a dose of 20 µL (volume) compared to the control. The results regarding the use of Snow mountain garlic as a preventive measure and aid in treating thromboembolic disease are promising.

A Comprehensive Review of Cardiovascular Disease Management: Cardiac Biomarkers, Imaging Modalities, Pharmacotherapy, Surgical Interventions, and Herbal Remedies

Cardiovascular diseases (CVDs) continue to be a major global health concern, representing a leading cause of morbidity and mortality. This review provides a comprehensive examination of CVDs, encompassing their pathophysiology, diagnostic biomarkers, advanced imaging techniques, pharmacological treatments, surgical interventions, and the emerging role of herbal remedies. The review covers various cardiovascular conditions such as coronary artery disease, atherosclerosis, peripheral artery disease, deep vein thrombosis, pulmonary embolism, cardiomyopathy, rheumatic heart disease, hypertension, ischemic heart disease, heart failure, cerebrovascular diseases, and congenital heart defects. The review presents a wide range of cardiac biomarkers such as troponins, C-reactive protein, CKMB, BNP, NT-proBNP, galectin, adiponectin, IL-6, TNF-α, miRNAs, and oxylipins. Advanced molecular imaging techniques, including chest X-ray, ECG, ultrasound, CT, SPECT, PET, and MRI, have significantly enhanced our ability to visualize myocardial perfusion, plaque characterization, and cardiac function. Various synthetic drugs including statins, ACE inhibitors, ARBs, β-blockers, calcium channel blockers, antihypertensives, anticoagulants, and antiarrhythmics are fundamental in managing CVDs. Nonetheless, their side effects such as hepatic dysfunction, renal impairment, and bleeding risks necessitate careful monitoring and personalized treatment strategies. In addition to conventional therapies, herbal remedies have garnered attention for their potential cardiovascular benefits. Plant extracts and their bioactive compounds, such as flavonoids, phenolic acids, saponins, and alkaloids, offer promising cardioprotective effects and enhanced cardiovascular health. This review underscores the value of combining traditional and modern therapeutic approaches to improve cardiovascular outcomes. This review serves as a vital resource for researchers by integrating a broad spectrum of information on CVDs, diagnostic tools, imaging techniques, pharmacological treatments and their side effects, and the potential of herbal remedies.

Garlic bioactive substances and their therapeutic applications for improving human health: a comprehensive review

Garlic (Allium sativum L.) is a widely abundant spice, known for its aroma and pungent flavor. It contains several bioactive compounds and offers a wide range of health benefits to humans, including those pertaining to nutrition, physiology, and medicine. Therefore, garlic is considered as one of the most effective disease-preventive diets. Many in vitro and in vivo studies have reported the sulfur-containing compounds, allicin and ajoene, for their effective anticancer, anti-diabetic, anti-inflammatory, antioxidant, antimicrobial, immune-boosting, and cardioprotective properties. As a rich natural source of bioactive compounds, including polysaccharides, saponins, tannins, linalool, geraniol, phellandrene, β-phellandrene, ajoene, alliin, S-allyl-mercapto cysteine, and β-phellandrene, garlic has many therapeutic applications and may play a role in drug development against various human diseases. In the current review, garlic and its major bioactive components along with their biological function and mechanisms of action for their role in disease prevention and therapy are discussed.

Effects of Garlic on Glucose Parameters and Lipid Profile: A Systematic Review and Meta-Analysis on Randomized Controlled Trials

(1) Background: The effect of garlic on glucose and lipid metabolism in humans remains controversial. The aim of this study was to investigate the effects of garlic on blood lipid levels and glucose levels in humans through a systematic review and meta-analysis. (2) Methods: We extensively searched four databases, including PubMed, Web of Science, Embase, and the Cochrane Library, up to February 2024. To assess the collective impact of garlic and its supplements on fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), an analysis was conducted using a random effects model. Subgroup analyses were performed when I2 < 50%. (3) Result: We found that the garlic intervention was effective in controlling FBG (mean difference = -7.01; 95% CI: -8.53, -5.49, p < 0.001), HbA1c (mean deviation = -0.66; 95% CI: -0.76, -0.55, p < 0.001, I2 = 62.9%), TC (mean difference = -14.17; 95% CI: -19.31, -9.03, p < 0.001), and LDL-C (mean difference = -8.20; 95% CI: -15.58, -0.81, p = 0.03); moreover, it also increased the level of HDL-C in humans (mean difference = 2.06; 95% CI: 1.54, 2.59; p < 0.001). Nonetheless, the intervention involving garlic did not yield a substantial impact on triglyceride (TG) levels. (4) Conclusion: The intervention of garlic is beneficial to control blood glucose and blood lipids in humans.

Genes encoding γ‑glutamyl‑transpeptidases in the allicin biosynthetic pathway in garlic (Allium sativum)

Allicin is a thiosulphate molecule produced in garlic (Allium sativum) and has a wide range of biological actions and pharmaceutical applications. Its precursor molecule is the non-proteinogenic amino acid alliin (S-allylcysteine sulphoxide). The alliin biosynthetic pathway in garlic involves a group of enzymes, members of which are the γ-glutamyl-transpeptidase isoenzymes, Allium sativum γ-glutamyl-transpeptidase AsGGT1, AsGGT2 and AsGGT3, which catalyze the removal of the γ-glutamyl group from γ-glutamyl-S-allyl-L-cysteine to produce S-allyl-L-cysteine. This removal is followed by an S-oxygenation, which leads to the biosynthesis of alliin. The aim of the present study is to annotate previously discovered genes of garlic γ-glutamyl-transpeptidases, as well as a fourth candidate gene (AsGGT4) that has yet not been described. The annotation includes identifying the loci of the genes in the garlic genome, revealing the overall structure and conserved regions of these genes, and elucidating the evolutionary history of these enzymes through their phylogenetic analysis. The genomic structure of γ-glutamyl-transpeptidase genes is conserved; each gene consists of seven exons, and these genes are located on different chromosomes. AsGGT3 and AsGGT4 enzymes contain a signal peptide. To that end, the AsGGT3 protein sequence was corrected; four indel events occurring in AsGGT3 coding regions suggested that at least in the garlic variety Ershuizao, AsGGT3 may be a pseudogene. Finally, the use of protein structure prediction tools allowed the visualization of the tertiary structure of the candidate peptide.

Effect of aspirin on blood pressure in hypertensive patients: a systematic review and meta-analysis

INTRODUCTION

Aspirin is widely used for secondary prevention in patients with hypertension. However, previous studies mainly focused on the preventive effects of aspirin, and there has been a lack of reliable evidence on whether taking aspirin affects blood pressure This study aimed to investigate whether aspirin would affect the blood pressure in patients with hypertension.

METHODS

PubMed, Cochrane database, Embase, Scopus and Medline databases were searched until September 2023. For continuous variables (e.g., blood pressure reduction), the mean difference (MD) was selected as the effect magnitude indices. We used the Cochrane Collaboration's Risk of Bias tool to assess the risk of bias.

RESULT

A total of five studies were included, comprising 20,312 patients. We found that aspirin did not affect SBP (MD = -0.78, 95% CI: - 2.41, 0.84). A similar result was found for DBP (MD = -0.86, 95% CI: - 2.14, 0.42).

CONCLUSION

This study showed no significant difference in blood pressure between the aspirin and control groups, suggesting that aspirin does not affect blood pressure.

Effect of garlic on the components of metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials

ETHNOPHARMACOLOGICAL RELEVANCE

Metabolic diseases are the major causes of macrovascular and microvascular complications which lead to morbidity and mortality. Traditionally, garlic has been used as food and medicine for more than 5000 years. However, efficacy studies have shown conflicting results regarding the garlic effect.

AIM OF THE STUDY

This study aims to evaluate the efficacy of garlic on the components of metabolic syndrome (MetS) in metabolic disease patients.

MATERIALS AND METHODS

This study was a systematic review and meta-analysis of randomized controlled trials (RCTs). Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), and Google scholar were searched till December 25, 2021 for identifying the relevant studies that have shown the effects of garlic on components of metabolic syndrome in metabolic disease patients. The mean difference with 95% CI was calculated using fixed-effect or random-effect models.

RESULTS

The effect of garlic has shown significant changes on waist circumference (p-value= <0.0001), total cholesterol (p < 0.0001), low density lipoprotein (p = 0.01), high density lipoprotein (p < 0.00001), triglycerides (p < 0.00001), systolic blood pressure (p < 0.00001), diastolic blood pressure (p < 0.00001), glucose (p < 0.00001), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (p = 0.04), C-reactive protein (p < 0.00001), tumor necrosis factor (TNF)-α (p = 0.002), interleukin (IL)-6 (p = 0.0001). Subgroup analysis has shown the favorable effects of garlic in metabolic disease patients.

CONCLUSION

Our meta-analysis results confirm the findings that garlic could be useful as an anti-hyperlipidemic, anti-hyperglycemic, anti-hypertensive and anti-inflammatory drug.

Garlic against Heart-related Ailments: Chemistry, Pharmacology, and Future Perspective

BACKGROUND

Allium sativum L. (Garlic) is a well-recognized plant of great nutraceutical value with pharmacological evidences. It is full of dietary as well as pharmaceutical properties and has been used in traditional medications for a long time. It is known for good antioxidant, antifungal, antibacterial, anti-diabetic, anti-inflammatory, anticancer, and antiviral effects, along with other therapeutic roles in cardiovascular diseases, anti-atherosclerotic, antihypertensive, anti-thrombotic, blood pressure, bone and skin related problems etc. Objective: Considering the potential of garlic in the treatment of cardiovascular/heart-related diseases, the main objective of this study was to prepare a subject-centric mini-review focusing on its chemistry and pharmacology in heart-related issues.

METHODS

In order to prepare this mini-review article, an extensive online literature search was performed to find out the most recent studies related to this topic. These studies were briefly reviewed, assessed, and discussed to explore the possible capability of garlic for the cure of cardiovascular problems.

RESULT

Several experiments on mice models, rat models as well as on humans show the effective role of various forms of garlic in cardiovascular or heart-related ailments. After reviewing the available publications on garlic in heart-related issues, authors found that garlic and its sulfur (S)-based organic constituents may have advantageous applications in the treatment of cardiovascular diseases.

Herbal Medicine- A Friend or a Foe of Cardiovascular Disease

BACKGROUND

Herbal remedies are used by 80% of the Asian population in primary health care as per WHO. According to current research, the herbal medicine market was valued at nearly USD 166 billion in 2021 and is expected to reach approximately USD 348 billion by 2028. Increased incidence of chronic conditions such as diabetes, asthma, coronary artery disease, osteoarthritis, has fueled the growing interest in traditional herbal and plant-derived treatments among researchers. In addition, rural communities in developing nations have renewed interest in herbal treatments due to lower cost and easy availability.

OBJECTIVES

Aim of the paper is to highlight the role of five of more commonly used herbal medicines that are Ginkgo biloba, Garlic, Flaxseed, Ginseng, Salvia miltiorrhiza in cardiovascular disorders.

METHODS

A PubMed search was done using the keywords Herbal Medicine, Ginkgo biloba, Garlic, Flaxseed, Ginseng, Salvia miltiorrhiza. Articles which were available for free access were utilized. No formula inclusion or exclusion criteria was followed. A total of 42 papers were included for the study.

CONCLUSION

Although there have been encouraging outcomes with the use of these herbal medications, many of these products are poorly monitored and are yet to be studied in detail regarding their adverse effects. Moreover, these medicinal products are known to interact with various drugs. To compete with the expanding pharmaceutical industry, more medicinally helpful herbal items must be used and scientifically validated.

Oregano Essential Oil and Purple Garlic Powder Effects on Intestinal Health, Microbiota Indicators and Antimicrobial Resistance as Feed Additives in Weaning Piglets

Finding alternatives to zinc oxide is a pressing issue for the pig production sector. We studied the impact of the bioactive components degradation of oregano essential oil (OEO) and purple garlic powder (PGP) during storage in silos, their effect on the morphometry of the jejunum and ileum and the cecal microbiota as intestinal health indicators in piglets during the post-weaning period. We also monitored antimicrobial resistance in the commensal indicator E. coli. Histological parameters and intestinal microbiota were measured in 140 piglets weaned at 21 days of age. Seven dietary treatments were used: a negative control group (basal diet), a positive control group with ZnO (3000 mg/kg of food), two groups with OEO at 0.4% and 1.2%, respectively, two groups with PGP 0.4% and 2%, respectively, and a group with OEO with 1.2% combined with PGP with 2%. Each group of piglets received the treatment for seven weeks, from weaning, before samples were taken. Antibiotic resistance profiles were measured in 81 E. coli strains. On this occasion, only the control groups, ZnO, OEO 1.2%, PGP 2% and OEO 1.2% + PGP 2% were used, and the samples were obtained from the cecal content. A progressive loss of the bioactive components of OEO and PGP was observed during the 34 days of storage (p < 0.05). PGP 2%, OEO 1.2% and their combination showed results similar to ZnO (p > 0.05), or superior in the study of intestinal morphometry and the values of E. coli and Lactobacillus. All categories showed high levels of resistance. Only the strains isolated from the OEO 1.2% group did not show resistance to colistin and presented the lowest resistance values. In general, high doses of the additives studied showed the best results, obtaining levels like or higher than those offered by ZnO.

The nutritional value, bioactive availability and functional properties of garlic and its related products during processing

Garlic, a common culinary spice, is cultivated and used around the globe. Consumption of garlic and its supplements reduces the risk of diabetes and cardiovascular disease and boosts the immune system with antibacterial, antifungal, anti-aging, and anti-cancer properties. Diallyl sulfide, diallyl disulfide, triallyl trisulfide, phenolics, flavonoids, and others are the most commercially recognized active ingredients in garlic and its products. In recent years, global demand for medicinal or functional garlic has surged, introducing several products such as garlic oil, aged garlic, black garlic, and inulin into the market. Garlic processing has been demonstrated to directly impact the availability of bioactive ingredients and the functionality of products. Depending on the anticipated functional qualities, it is also recommended that one or a combination of processing techniques be deemed desirable over the others. This work describes the steps involved in processing fresh garlic into products and their physicochemical alterations during processing. Their nutritional, phytochemical, and functional properties are also reviewed. Considering the high demand for functional food, this review has been compiled to provide guidance for food producers on the industrial utilization and suitability of garlic for new product development.

Aqueous spice extracts as alternative antimycotics to control highly drug resistant extensive biofilm forming clinical isolates of Candida albicans

Candida albicans form biofilm by associating with biotic and abiotic surfaces. Biofilm formation by C. albicans is relevant and significant as the organisms residing within, gain resistance to conventional antimycotics and are therefore difficult to treat. This study targeted the potential of spice-based antimycotics to control C. albicans biofilms. Ten clinical isolates of C. albicans along with a standard culture MTCC-3017 (ATCC-90028) were screened for their biofilm-forming ability. C. albicans M-207 and C. albicans S-470 were identified as high biofilm formers by point inoculation on Trypticase Soy Agar (TSA) medium as they formed a lawn within 16 h and exhibited resistance to fluconazole and caspofungin at 25 mcg and 8 mcg respectively. Aqueous and organic spice extracts were screened for their antimycotic activity against C. albicans M-207 and S-470 by agar and disc diffusion and a Zone of Inhibition was observed. Minimal Inhibitory Concentration was determined based on growth absorbance and cell viability measurements. The whole aqueous extract of garlic inhibited biofilms of C. albicans M-207, whereas whole aqueous extracts of garlic, clove, and Indian gooseberry were effective in controlling C. albicans S-470 biofilm within 12 h of incubation. The presence of allicin, ellagic acid, and gallic acid as dominant compounds in the aqueous extracts of garlic, clove, and Indian gooseberry respectively was determined by High-Performance Thin Layer Chromatography and Liquid Chromatography-Mass Spectrometry. The morphology of C. albicans biofilm at different growth periods was also determined through bright field microscopy, phase contrast microscopy, and fluorescence microscopy. The results of this study indicated that the alternate approach in controlling high biofilm-forming, multi-drug resistant clinical isolates of C. albicans M-207 and S-470 using whole aqueous extracts of garlic, clove, and Indian gooseberry is a safe, potential, and cost-effective one that can benefit the health care needs with additional effective therapeutics to treat biofilm infections.

Allicin Inhibits Porcine Reproductive and Respiratory Syndrome Virus Infection In Vitro and Alleviates Inflammatory Responses

Porcine reproductive and respiratory syndrome virus (PRRSV) is one of the most economically important pathogens to the swine industry worldwide over the past three decades. No approved effective antiviral drug is available to control this virus. The antiviral effects of allicin (diallyl thiosulfinate) on many human and animal viruses have been documented. However, the antiviral effect of allicin on PRRSV infection remains unknown. In this study, we found that allicin exhibited an inhibitory effect on HP-PRRSV and NADC30-like PRRSV in a dose-dependent manner by interfering with viral entry, replication, and assembly. Furthermore, allicin alleviated the expression of pro-inflammatory cytokines (IFN-β, IL-6, and TNFα) induced by PRRSV infection. The pro-inflammatory signaling pathways, TNF signaling pathway and MAPK signaling pathway, up-regulated by PRRSV infection were restored by allicin treatment. Taken together, these results demonstrate that allicin has antiviral activity against PRRSV and ameliorates inflammatory responses induced by PRRSV infection, suggesting that allicin is a promising drug candidate for anti-PRRSV therapy in vivo.

Bioactive Compounds (BACs): A Novel Approach to Treat and Prevent Cardiovascular Diseases

Cardiovascular diseases (CVDs) are one of the leading disorders of serious death and cause huge economic loss to patients and society. It is estimated that about 18 million people have a high death ratio due to the incidence of CVDs such as (stroke, coronary heart disease, and non-ischemic heart failure). Bioactive compounds (BACs) are healthy nutritional ingredients providing beneficial effects and nutritional value to the human body. Epidemiological studies strongly shed light on several bioactive compounds that are favorable candidates for CVDs treatment. Globally, the high risk of CVDs and related results on human body parts made them a serious scenario in all communities. In this present review, we intend to collect previously published data concerned over the years concerning green-colored foods and their BACs that aim to work in the prevention, diagnosis, and/or systematic treating CVDs. We also comprehensively discussed the oral delivery of several bioactive compounds derived from fruits and vegetables and their bioavailability and physiological effects on human health. Moreover, their important characteristics, such as anti-inflammatory, lowering blood pressure, anti-obesity, antioxidant, anti-diabetics, lipid-lowering responses, improving atherosclerosis, and cardioprotective properties, will be elaborated further. More precisely, medicinal plants' advantages and multifaceted applications have been reported in this literature to treat CVDs. To the best of our knowledge, this is our first attempt that will open a new window in the area of CVDs with the opportunity to achieve a better prognosis and effective treatment for CVDs.

Medicinal and therapeutic properties of garlic, garlic essential oil, and garlic-based snack food: An updated review

Garlic (Allium sativum) is an edible tuber belonging to the family Liliaceae. It has been used since ancient times as a spice to enhance the sensory characteristics of food and as a household remedy for the treatment of a variety of ailments. Garlic has been studied for its medicinal and therapeutic effects in the treatment of various human diseases for a long time. Health benefits associated with the consumption of garlic are attributed to the various sulfur compounds present in it such as allicin, ajoene, vinyl-dithiin, and other volatile organosulfur compounds which are all metabolized from alliin. Several researches in the literature have shown evidence that garlic exhibits antioxidant, antiviral, anti-microbial, anti-fungal, antihypertensive, anti-anemic, anti-hyperlipidemic, anticarcinogenic, antiaggregant, and immunomodulatory properties. The present review identifies and discusses the various health benefits associated with the consumption of garlic, its essential oil, and bioactive constituents, along with exploring the various snack-food products developed by incorporating garlic.

Characterization of volatile organic compounds with anti-atherosclerosis effects in Allium macrostemon Bge. and Allium chinense G. Don by head space solid phase microextraction coupled with gas chromatography tandem mass spectrometry

Introduction

Allium macrostemon Bge. (AMB) and Allium chinense G. Don (ACGD) are both edible Allium vegetables and named officinal Xiebai (or Allii Macrostemonis Bulbus) in East Asia. Their medicinal qualities involve in lipid lowering and anti-atherosclerosis effects. And steroidal saponins, nitrogenous compounds and sulfur compounds are like the beneficial components responsible for medicinal functions. Sulfur compounds are the recognized main components both in the volatile oils of AMB and ACGD. Besides, few researches were reported about their holistic chemical profiles of volatile organic compounds (VOCs) and pharmacodynamic effects.

Methods

In this study, we first investigated the lipid-lowering and anti-atherosclerotic effects of volatile oils derived from AMB and ACGD in ApoE ^-/- mice with high fat and high cholesterol diets.

Results

The results showed the volatile oils of AMB and ACGD both could markedly reduce serum levels of TG, TC, and LDL-C (p < 0.05), and had no alterations of HDL-C, ALT, and AST levels (p > 0.05). Pathological results displayed they both could obviously improve the morphology of cardiomyocytes and the degree of myocardial fibrosis in model mice. Meanwhile, oil red O staining results also proved they could apparently decrease the lesion areas of plaques in the aortic intima (p < 0.05). Furthermore, head space solid phase microextraction coupled with gas chromatography tandem mass spectrometry combined with metabolomics analysis was performed to characterize the VOCs profiles of AMB and ACGD, and screen their differential VOCs. A total of 121 and 115 VOCs were identified or tentatively characterized in the volatile oils of AMB and ACGD, respectively. Relative-quantification results also confirmed sulfur compounds, aldehydes, and heterocyclic compounds accounted for about 85.6% in AMB bulbs, while approximately 86.6% in ACGD bulbs were attributed to sulfur compounds, ketones, and heterocyclic compounds. Multivariate statistical analysis showed 62 differentially expressed VOCs were observed between AMB and ACGD, of which 17 sulfur compounds were found to be closely associated with the garlic flavor and efficacy.

Discussion

Taken together, this study was the first analysis of holistic chemical profiles and anti-atherosclerosis effects of AMB and ACGD volatile oils, and would benefit the understanding of effective components in AMB and ACGD.

Chemical and biological properties of bio-active compounds from garlic (Allium sativum)

Garlic (Allium sativum) is one of the oldest cultivated plants. It has been used as a spice, food, and folk medicine for many years. Garlic contains about 2000 biologically active components. For centuries, scientists have obtained a variety of compositions and physiological activities of garlic, depending on the methods of processing and extraction. Many review articles were published, where the object of the study was garlic. But there are very few broad literature reviews where garlic has been fully disclosed as a medicinal raw material. The study found that some garlic products and processing procedures were not standardized or tested for safety. A broad overview of this object can direct the attention of the scientific community in the right direction. This review contains various processing methods and yields from these extracts. In addition, most of the key physiological properties of the active substances of the raw materials are prescribed.

A systematic review of randomized controlled trials related to the effects of garlic supplementation on platelet aggregation

The increment of platelet aggregation factors has been considered a key phenomenon in atherosclerosis. Studies have shown that garlic (Allium sativum) is associated with a reduction in platelet aggregation and thrombosis. Hence, the present systematic review was conducted to evaluate the effect of garlic on platelet aggregation. All randomized controlled trials (RCTs) with keywords related to garlic and platelet aggregation were thoroughly searched in electronic databases including PubMed, Scopus, ISI Web of Science, and Google Scholar up to January 2021. Moreover, the references of all related articles were screened to discover more relevant studies. The quality of each study was reported based on Cochrane Collaboration's tool. In total, 12 studies met the inclusion criteria from 18,235 identified articles (including 595 participants). Most of the studies assessed platelet aggregation in response to different inducers. Of the 12 clinical trials, six studies depicted the beneficial effect of garlic on reducing platelet aggregation. The summary of the quality assessment indicated that most of the studies had high-quality scores. Regarding the small number of RCTs and heterogeneity between studies, it is impossible to make a proper conclusion about the impacts of garlic on platelet aggregation. Therefore, further precise trials with a standard design are necessary to validate the anti-thrombotic effect of garlic.

Preparation, Characterization, and In Vitro Evaluation of Inclusion Complexes Formed between S-Allylcysteine and Cyclodextrins

The present study prepared inclusion complexes of S-allylcysteine (SAC) and cyclodextrin (α, β, γ) by the freeze-drying (FD) method and verified the inclusion behavior of the solid dispersion. Also, the study investigated the effect of SAC/CD complex formation on liver tumor cells. Isothermal titration calorimetry (ITC) measurements confirmed the exothermic titration curve for SAC/αCD, suggesting a molar ratio of SAC/αCD = 1/1, but no exothermic/endothermic reaction was obtained for the SAC/βCD and SAC/γCD system. Powder X-ray diffraction (PXRD) results showed that the characteristic diffraction peaks of SAC and CDs disappeared in FD (SAC/αCD) and FD (SAC/γCD), indicated by a halo pattern. On the other hand, diffraction peaks originating from SAC and βCDs were observed in FD (SAC/βCD). Near-infrared (NIR) absorption spectroscopy results showed that CH and OH groups derived from SAC and OH groups derived from αCD and γCD cavity were shifted, suggesting complex formation due to intermolecular interactions occurring in SAC/αCD and SAC/γCD. Stability test results showed that the stability was maintained with FD (SAC/αCD) over FD (SAC/βCD) and FD (SAC/γCD). In ¹H-¹H of NOESY NMR measurement, FD (SAC/αCD) was confirmed to have a cross peak at the CH group of the alkene of SAC and the proton (H-3, -5, -6) in the αCD cavity. In FD (SAC/γCD), a cross peak was confirmed at the alkyl group on the carbonyl group side of SAC and the proton (H-3) in the cavity of γCD. From the above, it was suggested that the inclusion mode of SAC is different on FD (SAC/CDs). The results of the hepatocyte proliferation inhibition test using HepG2 cells showed that FD (SAC/βCD) inhibited cell proliferation. On the other hand, FD (SAC/αCD) and FD (SAC/γCD) did not show a significant decrease in the number of viable cells. These results suggest that the difference in the inclusion mode may contribute to the stability and cell proliferation inhibition.

SSR markers development and their application in genetic diversity evaluation of garlic (Allium sativum) germplasm

Garlic (Allium sativum), an asexually propagated vegetable and medicinal crop, has abundant genetic variation. Genetic diversity evaluation based on molecular markers has apparent advantages since their genomic abundance, environment insensitivity, and non-tissue specific features. However, the limited number of available DNA markers, especially SSR markers, are insufficient to conduct related genetic diversity assessment studies in garlic. In this study, 4372 EST-SSR markers were newly developed, and 12 polymorphic markers together with other 17 garlic SSR markers were used to assess the genetic diversity and population structure of 127 garlic accessions. The averaged polymorphism information content (PIC) of these 29 SSR markers was 0.36, ranging from 0.22 to 0.49. Seventy-nine polymorphic loci were detected among these accessions, with an average of 3.48 polymorphic loci per SSR. Both the clustering analyses based on either the genotype data of SSR markers or the phenotypic data of morphological traits obtained genetic distance divided the 127 garlic accessions into three clusters. Moreover, the Mantel test showed that genetic distance had no significant correlations with geographic distance, and weak correlations were found between genetic distance and the phenotypic traits. AMOVA analysis showed that the main genetic variation of this garlic germplasm collection existed in the within-population or cluster. Results of this study will be of great value for the genetic/breeding studies in garlic and enhance the utilization of these garlic germplasms.

Risk assessment of heavy metals consumption through onion on human health in Iran

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Onions have medicational features such as anti-cancer, antimicrobial, antiviral, and antifungal.

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Onions are rich in edible flavonoids.

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Due to their physiology and ecosystem, onions have the property of accumulating heavy metals.

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Onion consumption per capita in Iran is higher than in neighboring countries.

Considering the importance of onions consumption in the household diet, controlling of heavy elements' concentration in foodstuffs is important to ensure the safety of an individual's health. This study aimed to evaluate the risk of heavy metals through onion consumption on human health. In this cross-sectional experimental study, 22 onion samples with varieties red, yellow, and white in the two autumn and winter seasons in 2020 were randomly collected from the different provinces of Kurdistan, Hamedan, and Kermanshah. The concentrations of heavy metals were evaluated with an atomic absorption spectrometer. The risks of human health were evaluated by the hazard quotient (HQ) and the obtained results were analyzed with one-way ANOVA and one sample t-test. The obtained findings demonstrated that all collected samples contained heavy metals. For example, the cadmium (Cd) concentration in onion samples in the province of West Azerbaijan, Kurdistan, Hormozgan, Isfahan, and Zanjan was 526.49, 274.49, 69.77, 67.39, 65.69 µg kg⁻¹, respectively. While the standard specified in Iran for the concentration of Cd in onions is 50 μg kg⁻¹. However, the rate of lead (Pb) contamination in samples collected from Isfahan, Hormozgan, Zanjan Khuzestan, Tehran (Varamin) was 296.50, 266.71, 261.49, 215.64, 106.19 µg kg⁻¹, respectively, which less than maximum allowable limit recommended by WHO-FAO (300 µg kg⁻¹). The HQ for non-cancerous diseases for Cd and Pb were 8.6 × 10⁻² and 1.6 × 10⁻¹, respectively, and the probability of carcinogenic risk for Pb (8.1 × 10⁻⁴) was at the level of acceptable. There is no concern about the non-carcinogenic diseases and carcinogenic risk of consuming heavy metals in onion. Therefore, for optimal management and prevention of further pollution, it is recommended to study the origin and determine the amounts of heavy metals for their potential contamination of foodstuffs from the region's soil, water, and dust.

Allium Vegetables, Garlic Supplements, and Risk of Cancer: A Systematic Review and Meta-Analysis

Purpose

The role of allium vegetables or garlic supplements on reducing cancer risk was inconsistent between laboratory study findings and related epidemiologic studies.

Methods

Studies assessing the effect of allium vegetables and garlic supplement consumption on cancer risk were included in our meta-analysis. We used fixed- or random-effects models to pool effect measures to evaluate the highest and lowest consumption. A dose-response regression analysis was used to assess the association between allium vegetables, garlic supplements, and cancer risk.

Results

In a pooled analysis of 22 studies with 25 reports on allium vegetables, a high consumption of allium vegetables showed no significant association with cancer risk (relative risk [RR] = 0.97, 95% confidence interval [CI] 0.92–1.03) in a fixed-effects model. Similarly, garlic supplements were not found to be significantly associated with an increased risk of cancer (RR = 0.97, 95% CI 0.84–1.12) in a random-effects model involving a pooled analysis of 10 studies with 11 reports. Consumption of allium vegetables did not significantly correspond with cancer risk (P for nonlinearity = 0.958, P for linearity = 0.907).

Conclusion

In this meta-analysis, we found no evidence that higher consumption of allium vegetables or garlic supplements reduced the risk of cancer; however, this finding requires further validation.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42021246947.

Atherosclerosis amelioration by allicin in raw garlic through gut microbiota and trimethylamine-N-oxide modulation

Cardiovascular disease (CVD) is strongly associated with the gut microbiota and its metabolites, including trimethylamine-N-oxide (TMAO), formed from metaorganismal metabolism of ʟ-carnitine. Raw garlic juice, with allicin as its primary compound, exhibits considerable effects on the gut microbiota. This study validated the benefits of raw garlic juice against CVD risk via modulation of the gut microbiota and its metabolites. Allicin supplementation significantly decreased serum TMAO in ʟ-carnitine-fed C57BL/6 J mice, reduced aortic lesions, and altered the fecal microbiota in carnitine-induced, atherosclerosis-prone, apolipoprotein E-deficient (ApoE-/-) mice. In human subjects exhibiting high-TMAO production, raw garlic juice intake for a week reduced TMAO formation, improved gut microbial diversity, and increased the relative abundances of beneficial bacteria. In in vitro and ex vivo studies, raw garlic juice and allicin inhibited γ-butyrobetaine (γBB) and trimethylamine production by the gut microbiota. Thus, raw garlic juice and allicin can potentially prevent cardiovascular disease by decreasing TMAO production via gut microbiota modulation.

Assessment of standardization of domestic commercial black garlic extract for S-allyl-l-cysteine and S-1-propenyl-l-cysteine

Aged garlic extract (AGE) contains a significant amount of bioactive compounds, including S-allyl-l-cysteine (SAC), which is associated with various health benefits. Among different AGE products, black garlic extract (BGE) is widely consumed and a common product in the Korean market. BGE products do however contain different levels of SAC and S1PC. Here, the SAC contents in commercial BGE products were found to be in the range of 0.31-27.22 mg/100 mL, while the SAC contents of commercial black garlic (BG) cloves were in the range of 22.28-63.71 mg/100 g. Recently, S-1-propenyl-l-cysteine (S1PC) has emerged as a new bioactive compound of interest in AGE products. Analysis of BG and BGE indicated that their S1PC contents were 2.24-16.58 mg/100 g and ND-3.68 mg/100 mL, respectively. Based on the significance of these compounds, standardization of the SAC and S1PC content in commercial BGE products is required.

Allium cepa: A Treasure of Bioactive Phytochemicals with Prospective Health Benefits

As Allium cepa is one of the most important condiment plants grown and consumed all over the world, various therapeutic and pharmacological effects of A. cepa were reviewed. Onion (Allium cepa) is a high dietary fiber-rich perennial herb that is placed under the family Amaryllidaceae. It contains high concentration of folic acid, vitamin B6, magnesium, calcium, potassium, and phosphorus as well as vitamins and minerals. It is widely used as an antimicrobial agent, but it showed anticancer, antidiabetic, antioxidant, antiplatelet, antihypertensive, and antidepressant effects and neuroprotective, anti-inflammatory, and antiparasitic effects and so on. It is said to have beneficial effects on the digestive, circulatory, and respiratory systems, as well as on the immune system. This review article was devoted to discussing many health benefits and traditional uses of onions in pharmacological perspectives, as well as the safety/toxicological profile. If more detailed research on this perennial herb is conducted, it will open the door to an infinite number of possibilities.

Samchulkunbi-Tang Alleviates Vascular Endothelial Disorder and Renal Dysfunction in Nitric Oxide-Deficient Hypertensive Rats

Samchulkunbi-tang (SCT, Shen Zhu Jian pi tang in Chinese) is said to have been first recorded by Zheng Zhi Zhun Sheng during the Ming Dynasty in China. Records of SCT in Korea are known to have been cited in Donguibogam (Dong Yi Bao Jian in Chinese), Uibang Hwaltu (Yi Fang Huo Tao in Chinese), and Bang Yak Hapyeon (Fang Yao He Bian in China). Although SCT is widely used in treating chronic gastritis and gastric ulcers, the beneficial effect on renal vascular function is unknown. Hypertension is a risk factor for cardiovascular disease and endothelial dysfunction in humans and experimental animal models of arterial hypertension. In addition, kidney dysfunction is characterized by hypertension diseases. This study was conducted to evaluate the effect of SCT on the vascular function in vitro (human umbilical cord endothelial cells, HUVECs) and in vivo (N^G‐nitro‐L‐arginine methyl ester, L-NAME-induced hypertensive rats). The phosphorylation of protein kinase B (Akt) and endothelial nitric oxide synthase (eNOS) is closely related to nitric oxide (NO) production in HUVECs, and SCT in this study significantly increased these. For three weeks, hypertensive rat models were induced by L-NAME administration (40 mg/kg/day) with portable water. It was followed by oral administration with 100 and 200 mg/kg/day for two weeks to confirm the effectiveness of SCT. As a result, systolic blood pressure decreased in the SCT-treated groups, compared with that in the L-NAME-induced hypertensive group. SCT treatment restored vasorelaxation by stimulating acetylcholine and cGMP production in the thoracic aorta. In addition, SCT treatment decreased intima-media thickness, attenuated the reduction of eNOS expression, and increased endothelin-1 expression. It also increased p-Akt and p-eNOS expression in hypertensive rat aorta. Furthermore, regarding renal function parameters, SCT ameliorated urine osmolality, urine albumin level, serum creatinine, and blood urea nitrogen levels. These results demonstrate that the oriental medicine SCT exerts potent vascular and renal protective effects on nitric oxide-deficient hypertensive rats and HUVECs

Effects of Nigella sativa, Camellia sinensis, and Allium sativum as Food Additives on Metabolic Disorders, a Literature Review

Objective: Metabolic disorders (MD) can disturb intracellular metabolic processes. A metabolic disorder can be resulted from enzyme deficits or disturbances in function of various organs including the liver, kidneys, pancreas, cardiovascular system, and endocrine system. Some herbs were used traditionally for spices, food additives, dietary, and medicinal purposes. Medicinal plants possess biological active compounds that enhance human health. We aimed to provide evidence about therapeutic effects of some medicinal herbs on MD.

Data Sources: PubMed, Scopus, and Google Scholar were explored for publications linked to MD until February 2021. The most literature reports that were published in the last 10 years were used. All types of studies such as animal studies, clinical trials, and in vitro studies were included. The keywords included “Metabolic disorders,” “Nigella sativa L.,” “Thymoquinone,” “White tea”OR “Camellia sinensis L.” “catechin,” and “Allium sativum L.” OR “garlic” were searched.

Results: Based on the results of scientific studies, the considered medicinal plants and their active components in this review have been able to exert the beneficial therapeutic effects on obesity, diabetes mellitus and non-alcoholic fatty liver disease.

Conclusions: These effects are obvious by inhibition of lipid peroxidation, suppression of inflammatory reactions, adjustment of lipid profile, reduction of adipogenesis and regulation of blood glucose level.

Does Curing Moisture Content Affect Black Garlic Physiochemical Quality?

This research examined the changes of black garlic (BG) quality attributes when raw materials of different initial moisture contents (iMC) were used. Fresh garlic bulbs (cv. Thai) were shade-dried for eight weeks at a controlled condition at 29 °C and relative humidity (RH) of 55% to the desired iMC (ranging from ca. 50–70%). BG processing was at 75 °C, RH = 80% for ten days. After processing, physiological characteristics and chemical properties of garlic were determined. Results illustrated that fresh garlic with higher moisture content (ca. 70%) resulted in BG of a dark brown colour, sloppy texture, and lesser acidity (pH = 4.44), while samples with lower iMCs (<50%) gave products that were completely black, elastic in texture, and with higher acidity (pH = 3.79). The analysed bioactive compounds, as well as their antioxidative potentials, suggested that the longer the curing time, the higher the functional properties of the finished products, possessing a total phenolic, total flavonoid content, and antioxidant activity of 15.54 mg/kg dry matter sample, 1.53 mg/kg dry matter sample, and 95.39%, respectively. Principle component analysis (PCA) of active metabolites confirmed that sulfur, S-allyl-L-cysteine, and flavonoid were among the main phytochemicals found in the BG. In summary, higher quality BG can be achieved by using raw materials of lower iMC.

Effects of garlic extract on lipid profile in patients with coronary artery disease: A systematic review and meta-analysis of randomised clinical trials

This meta-analysis was conducted to evaluate the effects of garlic extract on total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-c) and high-density lipoprotein-cholesterol (HDL-c), among the patients with coronary artery disease (CAD). Literature searches were conducted in EMBASE, Scopus, PubMed, Web of Science and Cochrane Library until Sep18th, 2020. Inter-study heterogeneity was examined using Cochrane's Q and I² tests. The random-effect models were utilised to pool the weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs). Six articles were enrolled in the current meta-analysis. Garlic consumption significantly reduced TC levels (WMD -16.32 mg/dL; 95% CI -31.22, -1.43; P = .032). We found no significant effects on TG (WMD -10.93 mg/dL; 95% CI -26.19, 4.32; P = .160), HDL-c (WMD 4.55 mg/dL; 95% CI -1.13, 10.23; P = .116) and LDL-c concentrations (WMD -3.65 mg/dL; 95% CI -13.21, 5.92; P = .455). Significant heterogeneity was observed for HDL-c (I²  = 76.8%). However, the findings of sensitivity analysis revealed that upon exclusion of the potential heterogeneity source, the pooled WMD on HDL-c levels were stable. Garlic supplementation may result in a decrease in TC, but will not affect TG, HDL-c and LDL-c levels among CAD patients.

Occurrence of leek yellow stripe virus and onion yellow dwarf virus from edible Allium plants in the south Marmara region of Turkey

Among edible Allium plants (leek, onion, and garlic), leek yellow stripe (LYSV) and onion yellow dwarf virus (OYDV) are the most common viruses worldwide. While the presence of these two viruses in Turkey has previously been confirmed, only a few studies on their prevalence and genetic diversity have been performed. The aim of this study, conducted in the southern Marmara region of Turkey (SMR), was to identify the presence and genetic diversity of these viruses. Samples were collected from 494 plants exhibiting virus and virus-like symptoms. Samples were tested for the relevant viruses by double-antibody sandwich enzyme-linked immunosorbent assay and reverse transcription polymerase chain reaction (DAS-ELISA and RT-PCR, respectively). Tests revealed the presence of OYDV in 95 samples and LYSV in 52, whereas 33 samples were observed to have a combined infection. To examine the genetic diversity, 10 isolates from each virus were chosen from the infected samples. Using RT-PCR, the complete coat protein (CP) gene for LYSV and a partial sequence region of the nuclear inclusion b + CP gene for OYDV were amplified, cloned, and sequenced from the selected isolates. The sequence data were compared with the isolates in GenBank; it was determined that SMR LYSV and OYDV isolates show similarities over 77% with world isolates at the nucleotide and amino acid levels. Phylogenetic analyses showed that the LYSV and OYDV isolates had some diversity with isolates from different parts of the world, and the host had an important role in the phylogenetic relationships, particularly for LYSV.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13205-021-03067-1.

Bioactive Compounds and Nanodelivery Perspectives for Treatment of Cardiovascular Diseases

Bioactive compounds are comprised of small quantities of extra nutritional constituents providing both health benefits and enhanced nutritional value, based on their ability to modulate one or more metabolic processes. Plant-based diets are being thoroughly researched for their cardiovascular properties and effectiveness against cancer. Flavonoids, phytoestrogens, phenolic compounds, and carotenoids are some of the bioactive compounds that aim to work in prevention and treating the cardiovascular disease in a systemic manner, including hypertension, atherosclerosis, and heart failure. Their antioxidant and anti-inflammatory properties are the most important characteristics that make them favorable candidates for CVDs treatment. However, their low water solubility and stability results in low bioavailability, limited accessibility, and poor absorption. The oral delivery of bioactive compounds is constrained due to physiological barriers such as the pH, mucus layer, gastrointestinal enzymes, epithelium, etc. The present review aims to revise the main bioactive compounds with a significant role in CVDs in terms of preventive, diagnostic, and treatment measures. The advantages of nanoformulations and novel multifunctional nanomaterials development are described in order to overcome multiple obstacles, including the physiological ones, by summarizing the most recent preclinical data and clinical trials reported in the literature. Nanotechnologies will open a new window in the area of CVDs with the opportunity to achieve effective treatment, better prognosis, and less adverse effects on non-target tissues.

The effect and underlying mechanisms of garlic extract against cognitive impairment and Alzheimer's disease: A systematic review and meta-analysis of experimental animal studies

ETHNOPHARMACOLOGICAL RELEVANCE

Alzheimer's disease (AD) is the main cause of dementia, and according to traditional Chinese medicine (TCM), it is leaded by the deficiency of essence, qi, and blood. Allii sativi bulbus, acrid and warm, is traditionally used as the important adjuvant and conductant drug to distribute essence-qi throughout the body, fortify the spleen and harmonize the stomach. Garlic (Allium sativum L., Alliaceae) has also been reported to display potential anti-AD effect both in vitro and in vivo studies, while no systematic review of these studies has been conducted.

AIM OF THE STUDY

This review aims to provide a comprehensive evaluation of the effect and underlying mechanism of garlic extract against cognitive impairment and AD neuropathology through meta-analysis and sensitivity analysis.

MATERIALS AND METHODS

Eligible studies were searched from PubMed, Web of Science and EMBASE from February to March in 2020, and 13 studies describing the effect of garlic extract in AD animal models (551 mice and 88 rats) were identified.

RESULTS

Analysis of these studies showed that garlic extract could reduce cerebral Aβ levels [Aβ₄₀: SMD -8.62(-11.75, -5.49), p < 0.00001 and Aβ₄₂: SMD -11.70(-18.01, -5.39), p=0.0003], and increase the number of right crossings in MWM [SMD 2.87(1.48, 4.26), p < 0.0001] in AD animals. However, moderate risk of bias (quality score ranged from 40% to 60%) is revealed by SYRCLE's checklist, mainly because of the lacks of sample size calculation, random allocation and blind assessment.

CONCLUSIONS

This review shows that garlic extract may be effective in alleviating cognitive impairment and neuropathology in AD animal models. High quality AD animal studies with enough sample size and more comprehensive evaluation of outcomes are needed to further confirm the results.

Bioactive Natural Compounds with Antiplatelet and Anticoagulant Activity and Their Potential Role in the Treatment of Thrombotic Disorders

Natural anticoagulant drugs can be obtained from plants, rich in secondary bioactive metabolites which, in addition to being effective antioxidants, also possess anticoagulant and antiplatelet properties and, for this reason, can be excellent candidates for the treatment of thrombotic diseases. This review reports an overview of the hemostatic process and thrombotic disorders together with data on plants, more and less common from around the world, containing bioactive compounds characterized by antiplatelet and anticoagulant activity. The reported literature was obtained from Medline, PubMed, Elsevier, Web of Science, Google Scholar considering only articles in the English language, published in peer-reviewed journals. The number of citations of the articles and the impact factor of the journals were other parameters used to select the scientific papers to be included in the review. The analysis of the literature data selected demonstrates that many plants' bioactive compounds show antiplatelet and anticoagulant activity that make them potential candidates to be used as new natural compounds able to interfere with both primary and secondary hemostasis. Moreover, they could be used together with anticoagulants currently administered in clinical practice to increase their efficacy and to reduce complications in the treatment of thrombotic disorders.

Diallyl Trisulfide Suppresses High-Glucose-Induced Cardiomyocyte Apoptosis by Targeting Reactive Oxygen Species-Mediated Hypoxia-Inducible Factor-1α/Insulin-like Growth Factor Binding Protein 3 Activation

It has been reported that 80% of diabetic patients die due to cardiovascular diseases. We previously demonstrated that activated hypoxia-inducible factor-1α (HIF-1 α)/insulin-like growth factor binding protein-3 (IGFBP-3) signaling by reactive oxygen species (ROS)-regulated prolyl hydroxylase domain-containing protein (PHD) is involved in high-glucose (HG)-induced cardiac apoptosis. Diallyl trisulfide (DATS), a garlic component, shows the strongest inhibitory effect on diabetic cardiomyopathy. In this study, we investigated whether HIF-1α/IGFBP-3 signaling governs the antiapoptotic effect by DATS on HG-exposed cardiomyocytes. It was observed that significantly increased levels of cell apoptosis and decreased Akt phosphorylation were reversed by DATS in HG-exposed cardiac cells. H₂O₂ and PHD small interfering RNA treatments increased HIF-1α and IGFBP-3 protein levels, which were decreased by DATS treatment. Overexpression of HIF-1α and IGFBP-3 increased HG-induced cell apoptosis, which was suppressed by DATS. The coimmunoprecipitation assay results showed that DATS not only increased the IGF-1 level and reduced IGFBP-3 level but also suppressed their extracellular association for cardiac cells exposed to HG. Experiments using neonatal cardiomyocytes and hearts showed similar results. These findings indicate that the effect of ROS-regulated PHD on the activation of HIF-1α/IGFBP-3 signaling governs the antiapoptotic effect by DATS on HG-exposed cardiomyocytes.

Pharmacotherapeutic Potential of Garlic in Age-Related Neurological Disorders

Age-related neurological disorders [ANDs] involve neurodegenerative diseases [NDDs] such as Alzheimer's disease [AD], the most frequent kind of dementia in elderly people, and Parkinson's disease [PD], and also other disorders like epilepsy and migraine. Although ANDs are multifactorial, Aging is a principal risk factor for them. The common and most main pathologic features among ANDs are inflammation, oxidative stress, and misfolded proteins accumulation. Since failing brains caused by ANDs impose a notable burden on public health and their incidence is increasing, a lot of works has been done to overcome them. Garlic, Allium sativum, has been used for different medical purposes globally and more than thousands of publications have reported its health benefits. Garlic and aged garlic extract are considered potent anti-inflammatory and antioxidants agents and can have remarkable neuroprotective effects. This review is aimed to summarize knowledge on the pharmacotherapeutic potential of garlic and its components in ANDs.

TRP Channels as Sensors of Aldehyde and Oxidative Stress

The transient receptor potential (TRP) cation channel superfamily comprises more than 50 channels that play crucial roles in physiological processes. TRP channels are responsive to several exogenous and endogenous biomolecules, with aldehydes emerging as a TRP channel trigger contributing to a cellular cascade that can lead to disease pathophysiology. The body is not only exposed to exogenous aldehydes via tobacco products or alcoholic beverages, but also to endogenous aldehydes triggered by lipid peroxidation. In response to lipid peroxidation from inflammation or organ injury, polyunsaturated fatty acids undergo lipid peroxidation to aldehydes, such as 4-hydroxynonenal. Reactive aldehydes activate TRP channels via aldehyde-induced protein adducts, leading to the release of pro-inflammatory mediators driving the pathophysiology caused by cellular injury, including inflammatory pain and organ reperfusion injury. Recent studies have outlined how aldehyde dehydrogenase 2 protects against aldehyde toxicity through the clearance of toxic aldehydes, indicating that targeting the endogenous aldehyde metabolism may represent a novel treatment strategy. An addition approach can involve targeting specific TRP channel regions to limit the triggering of a cellular cascade induced by aldehydes. In this review, we provide a comprehensive summary of aldehydes, TRP channels, and their interactions, as well as their role in pathological conditions and the different therapeutical treatment options.

Potential Interaction of Fresh Garlic with Metformin during Ischemia-Reperfusion Induced Cardiac Injury in Diabetic Rats

Methods

The study was undertaken on both normoglycemic and alloxan (90 mg/kg) induced diabetic Sprague Dawley rats weighing 150–250 g. At the completion of the treatment phase (30 days for garlic, 250 mg/kg, oral; 10 days for MET, 70 mg/kg, oral), rats were anesthetized and mounted on the modified Langendorff's apparatus. IRI was produced by myocardial no-flow global ischemia. Developed tension (DT) and heart rate (HR) were recorded both before and after ischemia. The perfusate was collected to estimate the leakage of cardiac biomarkers (Creatine Kinase-MB: CK-MB and Lactate dehydrogenase: LDH). Hearts were removed from the setup and utilized to prepare heart tissue homogenate (HTH) and histological slides. The endogenous antioxidants, superoxide dismutase (SOD) and catalase (CAT), in addition to oxidative thiobarbituric acid substances (TBS), were estimated in HTH.

Results

The hemodynamic parameters, including percentage recovery in HR and DT, were found significantly higher in animals pretreated with garlic and MET in diabetic rats (DR). Both SOD and CAT enzyme activities increased significantly while TBS levels were reduced in the HTH of animals treated with garlic and MET. The cardiac markers CK-MB and LDH levels also increased in HTH with a corresponding decrease in the perfusate. The histopathological changes in the heart and pancreas demonstrated noticeable protection of the tissues due to pretreatment with garlic and MET. Taken together, these findings advocate that reactive oxygen species derived from hyperglycemia execute an important function in myocardial global IRI; the therapy of garlic homogenate was found to be effective in alleviating these toxic effects.

Conclusion

The combined therapy of MET and garlic provided synergistic cardioprotection, implying that garlic seems to possess promise in lowering toxic parameters by protecting diabetic induced myocardial injury.

Biomedical Effects of the Phytonutrients Turmeric, Garlic, Cinnamon, Graviola, and Oregano: A Comprehensive Review

Phytonutrients are plant foods that contain many natural bioactive compounds, called phytochemicals, which show specific biological activities. These phytonutrients and their phytochemicals may play an important role in health care maintaining normal organism functions (as preventives) and fighting against diseases (as therapeutics). Phytonutrients’ components are the primary metabolites (i.e., proteins, carbohydrates, and lipids) and phytochemicals or secondary metabolites (i.e., phenolics, alkaloids, organosulfides, and terpenes). For years, several phytonutrients and their phytochemicals have demonstrated specific pharmacological and therapeutic effects in human health such as anticancer, antioxidant, antiviral, anti-inflammatory, antibacterial, antifungal, and immune response. This review summarizes the effects of the most studied or the most popular phytonutrients (i.e., turmeric, garlic, cinnamon, graviola, and oregano) and any reported contraindications. This article also presents the calculated physicochemical properties of the main phytochemicals in the selected phytonutrients using Lipinski’s, Veber’s, and Ghose’s rules. Based on our revisions for this article, all these phytonutrients have consistently shown great potential as preventives and therapeutics on many diseases in vitro, in vivo, and clinical studies.

Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing

It has been established, worldwide, that non-communicable diseases such as obesity, diabetes, metabolic syndrome, and cardiovascular events account for a high percentage of morbidity and mortality in contemporary societies. Several modifiable risk factors, such as sedentary activities, sleep deprivation, smoking, and unhealthy dietary habits have contributed to this increase. Healthy nutrition in terms of adherence to the Mediterranean diet (MD), rich in fruits, legumes, vegetables, olive oil, herbs, spices, and high fiber intake may contribute to the decrease in this pandemic. The beneficial effects of the MD can be mainly attributed to its numerous components rich in anti-inflammatory and antioxidant properties. Moreover, the MD may further contribute to the improvement of reproductive health, modify the risk for neurodegenerative diseases, and protect against depression and psychosocial maladjustment. There is also evidence highlighting the impact of healthy nutrition in female people on the composition of the gut microbiota and future metabolic and overall health of their offspring. It is therefore important to highlight the beneficial effects of the MD on metabolic, reproductive, and mental health, while shaping the overall health of future generations. The beneficial effects of MD can be further enhanced by increased physical activity in the context of a well-balanced healthy lifestyle.

Cardioprotective properties of natural medicine in isoproterenol induced myocardial damage in the male Albino rats

The main aim of this study is to investigate cardioprotective properties of natural medicine inmyocardial damage induced male Albino rats. The aqueous extractof Allium sativumwas used for the determination of phenolic compounds and flavonoids. The amount of phenol (1.39 ± 0.37 GAE/g dry weight) and flavonoids (49.1 ± 2.79 QE/g dry weight) were high in aqueous extract. A. sativumextract and showed 68.39 ± 3.6% DPPHscavenging activity. Isoproterenol was used to induce myocardial injury in Albino rats in vivo by subcutaneous injection (100 mg/kg body weight). To achieve this, experimental animals were categorized into six groups (n = 4), namely, positive, negative control, only isoproterenol administered groups, and garlic extract administered group at 100-300 mg extract/kg body weight. Oxidative stress marker and cardiac markers were assayed to analyze the cardioprotective properties of garlic extract. At 300 mg/kg doseof garlic extract, rat was recovered from various altered factors such as, aspartate aminotransferase, alkaline transminase and alkaline phosphatase. The rats treated with 300 mggarlic extract/kg body weight decreased the level of asparate aminotransferase (126 ± 6.4 IU/L) than other lower doses (100 mg extract/kg and 200 mg extract/kg). Alkaline transaminase level of rat serum level was 81 ± 4.34 IU/L. In the isoproterenol treated rats elevated level was observed (152 ± 4.42 IU/L enzyme activity). Pre-treatment of Albino rat with A. sativum extract reduced cardiac damage. Isoproterenol exposed animal showed 207.6 ± 1.2 mg/dL triglyceride and the garlic administered rat (300 mgextract/kg) reduced LDL-cholesterol level (61.3 ± 1.3 mg/dL) significantly (p < 0.05). Creatinine kinase -MB level was 269.5 ± 12.5 IU/L in the control animal and stress induced animal showed elevated level (572.3 ± 19.4 IU/L). Garlic treated experimental animal (300 µg/kg bw) decreased CK-MB level. To conclude, the aqueous extract of A. sativumshowed cardio protective properties against myocardial injury.

Flavor components, precursors, formation mechanisms, production and characterization methods: garlic, onion, and chili pepper flavors

There is an enormous demand in the food industry to shift toward natural flavors. However, most flavor molecules are significantly unstable outside their original sources. Moreover, limited studies are focused on the flavor formation mechanisms, regeneration methods, and stability, which could help facilitate this replacement by establishing a link between food processing conditions and flavor generation.This scoping review summarizes major findings related to the identification of garlic, onion, and chili pepper flavors and their precursor molecules, formation mechanisms, generation of flavors and precursors, characterization methods, and precursor stability under thermal food processing conditions. The findings confirmed that the allium flavors could be generated by alliin and isoalliin precursors through thermal processing. Also, the literature lacks detailed knowledge about chili pepper flavor's precursors, and only capsaicinoids have been reported as a thermally stable chili pepper flavor.Although numerous studies have focused on this area, there is still a lack of detailed applicable knowledge. Future investigations can be framed into (1) Development of efficient methods to generate flavors during food processing; (2) Improvement of flavors' stability; (3) Understanding the interactions of flavors and their precursors with other food ingredients and additives; and (4) Characterization of the organoleptic properties of flavors.

Influence of Thermal Processing on the Bioactive, Antioxidant, and Physicochemical Properties of Conventional and Organic Agriculture Black Garlic (Allium sativum L.)

This study examines the effect of fermentation processes (70 °C temperature; 80% humidity; 45 days) on the content of bioactive compounds (total polyphenols, selected phenolic acids, and flavonoids), antioxidant activity and physicochemical properties of conventional and organic garlic (Allium sativum L.). Raw garlic from conventional cultivation (GR) showed significantly lower content of phenolic components and antioxidant activity compared to raw garlic from organic cultivation (GREcol) (by 22.8% and 25.1%, respectively). The fermentation processes of the garlic from both the conventional (BG) and organic (BGEcol) cultivation significantly increased the content of total polyphenols (more than two times), phenolic acids (more than 1.5 times) and flavonoids (1.5 and 1.3 times, respectively). The garlic fermentation process also significantly increased antioxidant potential: two times for BG and three times for BGEcol. The content of bioactive compounds (total polyphenols, phenolic acids, and flavonoids) was significantly (p < 0.05) higher in organic black garlic (BGEcol) compared to conventional black garlic (BG). Heat treatment leading to changes in both the physicochemical, organoleptic and health-promoting properties allowed to obtain a new product gaining in sensory attractiveness and enabling a wide range of applications.

Medicinal plants and bioactive natural compounds as inhibitors of HMG-CoA reductase: A literature review

Cardiovascular diseases (CVDs) are one of the most important causes for mortality worldwide. Elevated levels of total cholesterol, and particularly LDL-cholesterol (LDL-C) are the main risk factor for acute myocardial infarction (AMI) and ischemic heart disease. The risk of CVDs could be reduced by decreasing the elevated cholesterol levels. β-hydroxy β-methylglutaryl-CoA reductase (HMGCoAR) is the primary and rate-limiting enzyme in the cholesterol biosynthesis pathway. Recently, the crucial role of nutraceuticals in maintaining normal physiological function was established. Nutraceuticals play an important role in preventing several non-communicable diseases such as obesity, CVDs, cancer, diabetes, and reducing hyperlipidemia. Although the effect of nutraceuticals and herbal medicine on CVDs and dyslipidemia was previously investigated thoroughly, the effect of these natural products on HMGCoAR as one of the important enzymes involved in CVDs etiopathogenesis has not yet been investigated. Therefore, the major aim of this paper was to review the effects of nutraceuticals and medicinal plants on HMGCoAR. Results indicate that different types of natural foods, isolated nutrients, herbal products, and dietary supplements as nutraceuticals decrease the expression and activity of HMGCoAR. This review shows that medicinal plants and nutraceuticals could be used to decrease HMGCoAR activity as accessible and convenient and economical natural compounds to prevent dyslipidemia and CVDs.