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Salica A, Cammisotto V, Scaffa R, Folino G, De Paulis R, Carnevale R, Benedetto U, Saade W, Marullo A, Sciarretta S, Sarto G, Palmerio S, Valenti V, Peruzzi M, Miraldi F, Irace FG, Frati G. Different Oxidative Stress and Inflammation Patterns of Diseased Left Anterior Descending Coronary Artery versus Internal Thoracic Artery. Antioxidants (Basel) 2024; 13:1180. [PMID: 39456434 PMCID: PMC11505158 DOI: 10.3390/antiox13101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 09/23/2024] [Accepted: 09/24/2024] [Indexed: 10/28/2024] Open
Abstract
BACKGROUND Oxidative stress and inflammation are typically implied in atherosclerosis pathogenesis and progression, especially in coronary artery disease (CAD). Our objective was to investigate the oxidative stress and inflammation burden directly associated with atherosclerotic plaque in patients with stable coronary disease undergoing coronary artery bypass graft (CABG) surgery. Specifically, markers of oxidative stress and inflammation were compared in blood samples obtained from the atherosclerotic left anterior descending artery (LAD) and blood samples obtained from the healthy left internal thoracic artery (LITA), used as a bypass graft, within the same patient. METHODS Twenty patients scheduled for off-pump CABG were enrolled. Blood samples were collected from the LITA below anastomosis and the LAD below the stenosis. Samples were analysed for oxidative stress (sNOXdp, H2O2, NO) and inflammation markers (TNFα, IL-6, IL-1β, IL-10). RESULTS The analysis showed a significant increase in oxidative stress burden in the LAD as compared to LITA, as indicated by higher sNOX2-dp and H2O2 levels and lower NO levels (p < 0.01). Also, pro-inflammatory cytokines were increased in the LAD as compared to the LITA, as indicated by higher TNFα and IL-6 amounts (p < 0.01). On the other hand, no significant differences could be seen regarding IL-1β and IL-10 levels between the two groups. CONCLUSIONS The oxidative stress and inflammatory burden are specifically enhanced in the LAD artery of stable coronary patients compared to systemic blood from the LITA of stable coronary patients.
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Affiliation(s)
- Andrea Salica
- Department of Cardiac Surgery, European Hospital, 00149 Rome, Italy
| | - Vittoria Cammisotto
- Department of Clinical, Internal Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Raffaele Scaffa
- Department of Cardiac Surgery, European Hospital, 00149 Rome, Italy
| | - Giulio Folino
- Department of Cardiac Surgery, European Hospital, 00149 Rome, Italy
| | - Ruggero De Paulis
- Department of Cardiac Surgery, European Hospital, 00149 Rome, Italy
- UniCamillus, International University of Health Sciences, Rome, Italy
| | - Roberto Carnevale
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy
- IRCCS NeuroMed, 86077 Pozzilli, Italy
| | - Umberto Benedetto
- Department of Cardiac Surgery, University “G. d’Annunzio”, 66013 Pescara, Italy
| | - Wael Saade
- Department of Clinical, Internal Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Antonino Marullo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy
| | - Sebastiano Sciarretta
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy
- IRCCS NeuroMed, 86077 Pozzilli, Italy
| | - Gianmarco Sarto
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy
| | | | - Valentina Valenti
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy
- Maria Cecilia Hospital, GVM Care & Research, 48010 Cotignola, Italy
| | - Mariangela Peruzzi
- Department of Clinical, Internal Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
- Maria Cecilia Hospital, GVM Care & Research, 48010 Cotignola, Italy
| | - Fabio Miraldi
- Department of Clinical, Internal Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Francesco Giosuè Irace
- Department of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Circ.ne Gianicolense 87, 00152 Rome, Italy
| | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy
- IRCCS NeuroMed, 86077 Pozzilli, Italy
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Carlos Kusano Bucalen F. Antioxidant and anti-atherosclerotic potential of Banana ( Musa spp): A review of biological mechanisms for prevention and protection against atherosclerosis. AVICENNA JOURNAL OF PHYTOMEDICINE 2023; 13:240-254. [PMID: 37655002 PMCID: PMC10465879 DOI: 10.22038/ajp.2022.20616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 12/28/2021] [Indexed: 09/02/2023]
Abstract
Objective To review the antioxidant and anti-atherosclerotic potential of whole banana, banana flour, and its bioactive compounds. Materials and Methods A non-systematic review of the literature covering the past 20 years, using the following databases and searching bases: PUBMED/MEDLINE: https://www.ncbi.nlm.nih.gov/pubmed/; Google Scholar: https://scholar.google.com.br/; and "Literatura Latinoamericana em Ciências da Saúde"/Latin American Literature in Life Sciences [LILACS]: http://lilacs.bvsalud.org/, was done. Studies with incomplete methodology and design were excluded. Results Bananas from different species are a good source of carbohydrates, dietary fiber, proteins, polyunsaturated fatty acids, potassium, carotenoids, flavonoids, vitamin C and E, phytosterols, gallocatechin, catechin, and other polyphenols. Some of these compounds play trigger important biological roles as antioxidants or anti-atherosclerotic and cardiovascular protective substances. This review summarizes and explains thirteen protective biological mechanisms of banana bioactive compounds and banana products. Conclusion Including banana and its products in dietary menus, in food products and nutraceuticals should improve cardiovascular health of the populations.
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Affiliation(s)
- Ferrari Carlos Kusano Bucalen
- Institute of Biological and Health Sciences (ICBS), Federal University of Mato Grosso (UFMT), Barra do Garças, Brazil
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3
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Sheng Y, Sun Y, Tang Y, Yu Y, Wang J, Zheng F, Li Y, Sun Y. Catechins: Protective mechanism of antioxidant stress in atherosclerosis. Front Pharmacol 2023; 14:1144878. [PMID: 37033663 PMCID: PMC10080012 DOI: 10.3389/fphar.2023.1144878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/15/2023] [Indexed: 04/11/2023] Open
Abstract
Tea has long been valued for its health benefits, especially its potential to prevent and treat atherosclerosis (AS). Abnormal lipid metabolism and oxidative stress are major factors that contribute to the development of AS. Tea, which originated in China, is believed to help prevent AS. Research has shown that tea is rich in catechins, which is considered a potential source of natural antioxidants. Catechins are the most abundant antioxidants in green tea, and are considered to be the main compound responsible for tea's antioxidant activity. The antioxidant properties of catechins are largely dependent on the structure of molecules, and the number and location of hydroxyl groups or their substituents. As an exogenous antioxidant, catechins can effectively eliminate lipid peroxidation products. They can also play an antioxidant role indirectly by activating the endogenous antioxidant system by regulating enzyme activity and signaling pathways. In this review, we summarized the preventive effect of catechin in AS, and emphasized that improving the antioxidant effect and lipid metabolism disorders of catechins is the key to managing AS.
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Affiliation(s)
| | - Yizhuo Sun
- *Correspondence: Fengjie Zheng, ; Yuhang Li, ; Yan Sun,
| | | | | | | | - Fengjie Zheng
- *Correspondence: Fengjie Zheng, ; Yuhang Li, ; Yan Sun,
| | - Yuhang Li
- *Correspondence: Fengjie Zheng, ; Yuhang Li, ; Yan Sun,
| | - Yan Sun
- *Correspondence: Fengjie Zheng, ; Yuhang Li, ; Yan Sun,
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Rana A, Samtiya M, Dhewa T, Mishra V, Aluko RE. Health benefits of polyphenols: A concise review. J Food Biochem 2022; 46:e14264. [PMID: 35694805 DOI: 10.1111/jfbc.14264] [Citation(s) in RCA: 179] [Impact Index Per Article: 89.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/01/2022] [Accepted: 05/23/2022] [Indexed: 12/14/2022]
Abstract
Plants produce polyphenols, which are considered highly essential functional foods in our diet. They are classified into several groups according to their diverse chemical structures. Flavanoids, lignans, stilbenes, and phenolic acids are the four main families of polyphenols. Several in vivo and in vitro research have been conducted so far to evaluate their health consequences. Polyphenols serve a vital function in the protection of the organism from external stimuli and in eliminating reactive oxygen species (ROS), which are instigators of several illnesses. Polyphenols are present in tea, chocolate, fruits, and vegetables with the potential to positively influence human health. For instance, cocoa flavan-3-ols have been associated with a decreased risk of myocardial infarction, stroke, and diabetes. Polyphenols in the diet also help to improve lipid profiles, blood pressure, insulin resistance, and systemic inflammation. Quercetin, a flavonoid, and resveratrol, a stilbene, have been linked to improved cardiovascular health. Dietary polyphenols potential to elicit therapeutic effects might be attributed, at least in part, to a bidirectional association with the gut microbiome. This is because polyphenols are known to affect the gut microbiome composition in ways that lead to better human health. Specifically, the gut microbiome converts polyphenols into bioactive compounds that have therapeutic effects. In this review, the antioxidant, cytotoxicity, anti-inflammatory, antihypertensive, and anti-diabetic actions of polyphenols are described based on findings from in vivo and in vitro experimental trials. PRACTICAL APPLICATIONS: The non-communicable diseases (NCDs) burden has been increasing worldwide due to the sedentary lifestyle and several other factors such as smoking, junk food, etc. Scientific literature evidence supports the use of plant-based food polyphenols as therapeutic agents that could help to alleviate NCD's burden. Thus, consuming polyphenolic compounds from natural sources could be an effective solution to mitigate NCDs concerns. It is also discussed how natural antioxidants from medicinal plants might help prevent or repair damage caused by free radicals, such as oxidative stress.
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Affiliation(s)
- Ananya Rana
- Department of Basic and Applied Sciences, National Institute of Food Technology Entrepreneurship and Management, Kundli, India
| | - Mrinal Samtiya
- Department of Nutrition Biology, Central University of Haryana, Mahendergarh, India
| | - Tejpal Dhewa
- Department of Nutrition Biology, Central University of Haryana, Mahendergarh, India
| | - Vijendra Mishra
- Department of Basic and Applied Sciences, National Institute of Food Technology Entrepreneurship and Management, Kundli, India
| | - Rotimi E Aluko
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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(-)-Epicatechin Alters Reactive Oxygen and Nitrogen Species Production Independent of Mitochondrial Respiration in Human Vascular Endothelial Cells. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:4413191. [PMID: 35069974 PMCID: PMC8767396 DOI: 10.1155/2022/4413191] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022]
Abstract
Introduction Vascular endothelial dysfunction is characterised by lowered nitric oxide (NO) bioavailability, which may be explained by increased production of reactive oxygen species (ROS), mitochondrial dysfunction, and altered cell signalling. (-)-Epicatechin (EPI) has proven effective in the context of vascular endothelial dysfunction, but the underlying mechanisms associated with EPI's effects remain unclear. Objective(s). Our aim was to investigate whether EPI impacts reactive oxygen and nitrogen species (RONS) production and mitochondrial function of human vascular endothelial cells (HUVECs). We hypothesised that EPI would attenuate ROS production, increase NO bioavailability, and enhance indices of mitochondrial function. Methods HUVECs were treated with EPI (0-20 μM) for up to 48 h. Mitochondrial and cellular ROS were measured in the absence and presence of antimycin A (AA), an inhibitor of the mitochondrial electron transport protein complex III, favouring ROS production. Genes associated with mitochondrial remodelling and the antioxidant response were quantified by RT-qPCR. Mitochondrial bioenergetics were assessed by respirometry and signalling responses determined by western blotting. Results Mitochondrial superoxide production without AA was increased 32% and decreased 53% after 5 and 10 μM EPI treatment vs. CTRL (P < 0.001). With AA, only 10 μM EPI increased mitochondrial superoxide production vs. CTRL (25%, P < 0.001). NO bioavailability was increased by 45% with 10 μM EPI vs. CTRL (P = 0.010). However, EPI did not impact mitochondrial respiration. NRF2 mRNA expression was increased 1.5- and 1.6-fold with 5 and 10 μM EPI over 48 h vs. CTRL (P = 0.015 and P = 0.001, respectively). Finally, EPI transiently enhanced ERK1/2 phosphorylation (2.9 and 3.2-fold over 15 min and 1 h vs. 0 h, respectively; P = 0.035 and P = 0.011). Conclusion(s). EPI dose-dependently alters RONS production of HUVECs but does not impact mitochondrial respiration. The induction of NRF2 mRNA expression with EPI might relate to enhanced ERK1/2 signalling, rather than RONS production. In humans, EPI may improve vascular endothelial dysfunction via alteration of RONS and activation of cell signalling.
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HPLC-DAD phenolics screening and in vitro investigation of haemostatic, antidiabetic, antioxidant and photoprotective properties of Centaurea tougourensis Boiss. & Reut. HERBA POLONICA 2022. [DOI: 10.2478/hepo-2021-0023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Summary
Introduction
Traditional medicine has an important place in human history and this since antiquity. Indeed, during Egyptian and Chinese civilization era, many detailed manuscripts, describing the therapeutic effect of plants, were found which suggest that folk medicine is the basis of the actual medicine.
Objective
To investigate the phytochemical and pharmacological properties of the n-butanol (n-BuOH) and ethyl acetate (EA) extracts of the aerial part of Centaurea tougourensis.
Methods
The phytochemical evaluation was done based on HPLC-DAD approach. The antioxidant activity was determined by DPPH and cupric ion reducing antioxidant capacity (CUPRAC), while the hemostatic effect was performed using plasma recalcification time (PRT) method. The antidiabetic capacity was investigated by alpha-amylase inhibition assay and the photoprotective test was evaluated by the measurement of sun protection factor (SPF).
Results
13 phenolic compounds were identified in both extracts of C. tougourensis. These extracts showed antioxidant, haemostatic, antidiabetic and photoprotective properties with a dose-dependent manner. Amounts of n-BuOH activities were found higher, with a respective IC50 value of 0.72±0.07 μg/ml in DPPH assay, an A0.50 value lower than 3.125 μg/ml in CUPRAC assay besides a shortening rate percentage of coagulation (86.71%) in haemostatic assay, a moderate inhibition effect on alpha amylase activity with an IC50 value of (711.5±0.03 μg/ml) and a maximum sun protection factor of (56.035). These results were mostly found highly significant (p<0.001) when compared to respective standards.
Conclusion
This study demonstrated some pharmacological effects of C. tougourensis which suggests that our plant could be a good candidate to treat some illnesses related to oxidative stress, bleeding or skin cancer.
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Marcińczyk N, Gromotowicz-Popławska A, Tomczyk M, Chabielska E. Tannins as Hemostasis Modulators. Front Pharmacol 2022; 12:806891. [PMID: 35095516 PMCID: PMC8793672 DOI: 10.3389/fphar.2021.806891] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/23/2021] [Indexed: 12/17/2022] Open
Abstract
The hemostasis system is often affected by complications associated with cardiovascular diseases, which results in thromboembolic events. Compounds of plant origin and plant extracts are considered as a promising source of substances that could modulate the functioning of the hemostasis system and thus reduce the risk of thromboembolism. Among them, tannins, which are plant-origin compounds with potential effects in hemostasis, deserve a special mention. This paper describes the hemostasis-modifying ability of three groups of tannins, namely ellagitannins, gallotannins, and procyanidins. The review highlights the desirable as well as undesirable influence of tannins on specific components of hemostasis, namely platelets, coagulation system, fibrinolysis system, and endothelium, and the multidirectional effect of these compounds on the thrombotic process. Studies performed under normal and pathological conditions such as diabetes or hypercoagulation are described, and the pathophysiology-dependent action of tannins is also highlighted. Most of the studies presented in the paper were performed in vitro, and due to the low bioavailability of tannins more studies should be conducted in the future to understand their actual activity in vivo.
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Affiliation(s)
- Natalia Marcińczyk
- Department of Biopharmacy, Medical University of Białystok, Białystok, Poland
| | | | - Michał Tomczyk
- Department of Pharmacognosy, Medical University of Białystok, Białystok, Poland
| | - Ewa Chabielska
- Department of Biopharmacy, Medical University of Białystok, Białystok, Poland
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Alatawi KA, Ravishankar D, Patra PH, Bye AP, Stainer AR, Patel K, Widera D, Vaiyapuri S. 1,8-Cineole Affects Agonists-Induced Platelet Activation, Thrombus Formation and Haemostasis. Cells 2021; 10:2616. [PMID: 34685597 PMCID: PMC8533741 DOI: 10.3390/cells10102616] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 02/06/2023] Open
Abstract
1,8-cineole, a monoterpenoid is a major component of eucalyptus oil and has been proven to possess numerous beneficial effects in humans. Notably, 1,8-cineole is the primary active ingredient of a clinically approved drug, Soledum® which is being mainly used for the maintenance of sinus and respiratory health. Due to its clinically valuable properties, 1,8-cineole has gained significant scientific interest over the recent years specifically to investigate its anti-inflammatory and antioxidant effects. However, the impact of 1,8-cineole on the modulation of platelet activation, thrombosis and haemostasis was not fully established. Therefore, in this study, we demonstrate the effects of 1,8-cineole on agonists-induced platelet activation, thrombus formation under arterial flow conditions and haemostasis in mice. 1,8-cineole largely inhibits platelet activation stimulated by glycoprotein VI (GPVI) agonists such as collagen and cross-linked collagen-related peptide (CRP-XL), while it displays minimal inhibitory effects on thrombin or ADP-induced platelet aggregation. It inhibited inside-out signalling to integrin αIIbβ3 and outside-in signalling triggered by the same integrin as well as granule secretion and intracellular calcium mobilisation in platelets. 1,8-cineole affected thrombus formation on collagen-coated surface under arterial flow conditions and displayed a minimal effect on haemostasis of mice at a lower concentration of 6.25 µM. Notably, 1,8-cineole was found to be non-toxic to platelets up to 50 µM concentration. The investigation on the molecular mechanisms through which 1,8-cineole inhibits platelet function suggests that this compound affects signalling mediated by various molecules such as AKT, Syk, LAT, and cAMP in platelets. Based on these results, we conclude that 1,8-cineole may act as a potential therapeutic agent to control unwarranted platelet reactivity under various pathophysiological settings.
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Affiliation(s)
- Kahdr A. Alatawi
- School of Pharmacy, University of Reading, Reading RG6 6UB, UK; (K.A.A.); (D.R.); (P.H.P.); (D.W.)
| | - Divyashree Ravishankar
- School of Pharmacy, University of Reading, Reading RG6 6UB, UK; (K.A.A.); (D.R.); (P.H.P.); (D.W.)
| | - Pabitra H. Patra
- School of Pharmacy, University of Reading, Reading RG6 6UB, UK; (K.A.A.); (D.R.); (P.H.P.); (D.W.)
| | - Alexander P. Bye
- School of Biological Sciences, University of Reading, Reading RG6 6UB, UK; (A.P.B.); (A.R.S.); (K.P.)
| | - Alexander R. Stainer
- School of Biological Sciences, University of Reading, Reading RG6 6UB, UK; (A.P.B.); (A.R.S.); (K.P.)
| | - Ketan Patel
- School of Biological Sciences, University of Reading, Reading RG6 6UB, UK; (A.P.B.); (A.R.S.); (K.P.)
| | - Darius Widera
- School of Pharmacy, University of Reading, Reading RG6 6UB, UK; (K.A.A.); (D.R.); (P.H.P.); (D.W.)
| | - Sakthivel Vaiyapuri
- School of Pharmacy, University of Reading, Reading RG6 6UB, UK; (K.A.A.); (D.R.); (P.H.P.); (D.W.)
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Ismaeel A, Greathouse KL, Newton N, Miserlis D, Papoutsi E, Smith RS, Eidson JL, Dawson DL, Milner CW, Widmer RJ, Bohannon WT, Koutakis P. Phytochemicals as Therapeutic Interventions in Peripheral Artery Disease. Nutrients 2021; 13:2143. [PMID: 34206667 PMCID: PMC8308302 DOI: 10.3390/nu13072143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/13/2021] [Accepted: 06/19/2021] [Indexed: 12/12/2022] Open
Abstract
Peripheral artery disease (PAD) affects over 200 million people worldwide, resulting in significant morbidity and mortality, yet treatment options remain limited. Among the manifestations of PAD is a severe functional disability and decline, which is thought to be the result of different pathophysiological mechanisms including oxidative stress, skeletal muscle pathology, and reduced nitric oxide bioavailability. Thus, compounds that target these mechanisms may have a therapeutic effect on walking performance in PAD patients. Phytochemicals produced by plants have been widely studied for their potential health effects and role in various diseases including cardiovascular disease and cancer. In this review, we focus on PAD and discuss the evidence related to the clinical utility of different phytochemicals. We discuss phytochemical research in preclinical models of PAD, and we highlight the results of the available clinical trials that have assessed the effects of these compounds on PAD patient functional outcomes.
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Affiliation(s)
- Ahmed Ismaeel
- Department of Biology, Baylor University, Waco, TX 76798, USA; (A.I.); (K.L.G.); (E.P.)
| | - K. Leigh Greathouse
- Department of Biology, Baylor University, Waco, TX 76798, USA; (A.I.); (K.L.G.); (E.P.)
- Department of Human Sciences and Design, Baylor University, Waco, TX 76798, USA
| | - Nathan Newton
- Department of Chemistry and Biochemistry, Baylor University, Waco, TX 76798, USA;
| | - Dimitrios Miserlis
- Department of Surgery, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA;
| | - Evlampia Papoutsi
- Department of Biology, Baylor University, Waco, TX 76798, USA; (A.I.); (K.L.G.); (E.P.)
| | - Robert S. Smith
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX 76508, USA; (R.S.S.); (J.L.E.); (D.L.D.); (C.W.M.); (W.T.B.)
| | - Jack L. Eidson
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX 76508, USA; (R.S.S.); (J.L.E.); (D.L.D.); (C.W.M.); (W.T.B.)
| | - David L. Dawson
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX 76508, USA; (R.S.S.); (J.L.E.); (D.L.D.); (C.W.M.); (W.T.B.)
| | - Craig W. Milner
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX 76508, USA; (R.S.S.); (J.L.E.); (D.L.D.); (C.W.M.); (W.T.B.)
| | - Robert J. Widmer
- Heart & Vascular Department, Baylor Scott & White Medical Center, Temple, TX 76508, USA;
| | - William T. Bohannon
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX 76508, USA; (R.S.S.); (J.L.E.); (D.L.D.); (C.W.M.); (W.T.B.)
| | - Panagiotis Koutakis
- Department of Biology, Baylor University, Waco, TX 76798, USA; (A.I.); (K.L.G.); (E.P.)
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10
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Carnevale R, Nocella C, Schiavon S, Cammisotto V, Cotugno M, Forte M, Valenti V, Marchitti S, Vecchio D, Biondi Zoccai G, Rubattu S, Martinelli O, Pignatelli P, Violi F, Volpe M, Versaci F, Frati L, Frati G, Sciarretta S. Beneficial effects of a combination of natural product activators of autophagy on endothelial cells and platelets. Br J Pharmacol 2021; 178:2146-2159. [PMID: 33512008 DOI: 10.1111/bph.15399] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 01/16/2021] [Accepted: 01/18/2021] [Indexed: 02/05/2023] Open
Affiliation(s)
- Roberto Carnevale
- Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Italy
- Mediterranea Cardiocentro‐Napoli Naples Italy
| | - Cristina Nocella
- Department of Clinical Internal, Anestesiological and Cardiovascular Sciences Sapienza University of Rome Rome Italy
| | - Sonia Schiavon
- Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Italy
| | - Vittoria Cammisotto
- Department of General Surgery and Surgical Speciality Paride Stefanini Sapienza University of Rome Rome Italy
| | - Maria Cotugno
- Department of Angio‐Cardio‐Neurology IRCCS Neuromed, Località Camerelle Pozzilli Italy
| | - Maurizio Forte
- Department of Angio‐Cardio‐Neurology IRCCS Neuromed, Località Camerelle Pozzilli Italy
| | | | - Simona Marchitti
- Department of Angio‐Cardio‐Neurology IRCCS Neuromed, Località Camerelle Pozzilli Italy
| | - Daniele Vecchio
- Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Italy
| | - Giuseppe Biondi Zoccai
- Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Italy
- Mediterranea Cardiocentro‐Napoli Naples Italy
| | - Speranza Rubattu
- Department of Angio‐Cardio‐Neurology IRCCS Neuromed, Località Camerelle Pozzilli Italy
- Clinical and Molecular Medicine, School of Medicine and Psychology Sapienza University of Rome Rome Italy
| | - Ombretta Martinelli
- Unit of Vascular Surgery, Department “Paride Stefanini” Sapienza University of Rome Rome Italy
| | - Pasquale Pignatelli
- Mediterranea Cardiocentro‐Napoli Naples Italy
- Department of Clinical Internal, Anestesiological and Cardiovascular Sciences Sapienza University of Rome Rome Italy
| | - Francesco Violi
- Mediterranea Cardiocentro‐Napoli Naples Italy
- Department of Clinical Internal, Anestesiological and Cardiovascular Sciences Sapienza University of Rome Rome Italy
| | - Massimo Volpe
- Department of Angio‐Cardio‐Neurology IRCCS Neuromed, Località Camerelle Pozzilli Italy
- Clinical and Molecular Medicine, School of Medicine and Psychology Sapienza University of Rome Rome Italy
| | | | - Luigi Frati
- Department of Angio‐Cardio‐Neurology IRCCS Neuromed, Località Camerelle Pozzilli Italy
| | - Giacomo Frati
- Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Italy
- Department of Angio‐Cardio‐Neurology IRCCS Neuromed, Località Camerelle Pozzilli Italy
| | - Sebastiano Sciarretta
- Department of Angio‐Cardio‐Neurology IRCCS Neuromed, Località Camerelle Pozzilli Italy
- Istituto Pasteur Italia‐Fondazione Cenci Bolognetti and Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome Latina, 04100 Italy
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11
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Ali MY, Sina AAI, Khandker SS, Neesa L, Tanvir EM, Kabir A, Khalil MI, Gan SH. Nutritional Composition and Bioactive Compounds in Tomatoes and Their Impact on Human Health and Disease: A Review. Foods 2020; 10:E45. [PMID: 33375293 PMCID: PMC7823427 DOI: 10.3390/foods10010045] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022] Open
Abstract
Tomatoes are consumed worldwide as fresh vegetables because of their high contents of essential nutrients and antioxidant-rich phytochemicals. Tomatoes contain minerals, vitamins, proteins, essential amino acids (leucine, threonine, valine, histidine, lysine, arginine), monounsaturated fatty acids (linoleic and linolenic acids), carotenoids (lycopene and β-carotenoids) and phytosterols (β-sitosterol, campesterol and stigmasterol). Lycopene is the main dietary carotenoid in tomato and tomato-based food products and lycopene consumption by humans has been reported to protect against cancer, cardiovascular diseases, cognitive function and osteoporosis. Among the phenolic compounds present in tomato, quercetin, kaempferol, naringenin, caffeic acid and lutein are the most common. Many of these compounds have antioxidant activities and are effective in protecting the human body against various oxidative stress-related diseases. Dietary tomatoes increase the body's level of antioxidants, trapping reactive oxygen species and reducing oxidative damage to important biomolecules such as membrane lipids, enzymatic proteins and DNA, thereby ameliorating oxidative stress. We reviewed the nutritional and phytochemical compositions of tomatoes. In addition, the impacts of the constituents on human health, particularly in ameliorating some degenerative diseases, are also discussed.
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Affiliation(s)
- Md Yousuf Ali
- Laboratory of Preventive and Integrative Biomedicine, Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (M.Y.A.); (S.S.K.); (A.K.)
- Department of Biochemistry and Molecular Biology, Gono Bishwabidyalay, Savar, Dhaka 1344, Bangladesh
| | - Abu Ali Ibn Sina
- Center for Personalized Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Shahad Saif Khandker
- Laboratory of Preventive and Integrative Biomedicine, Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (M.Y.A.); (S.S.K.); (A.K.)
| | - Lutfun Neesa
- Department of Biotechnology and Genetic Engineering, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Dhaka 8100, Bangladesh;
| | - E. M. Tanvir
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Savar, Dhaka 1349, Bangladesh;
- School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, QLD 4102, Australia
| | - Alamgir Kabir
- Laboratory of Preventive and Integrative Biomedicine, Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (M.Y.A.); (S.S.K.); (A.K.)
| | - Md Ibrahim Khalil
- Laboratory of Preventive and Integrative Biomedicine, Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (M.Y.A.); (S.S.K.); (A.K.)
- Department of Biochemistry and Molecular Biology, Gono Bishwabidyalay, Savar, Dhaka 1344, Bangladesh
| | - Siew Hua Gan
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor 47500, Malaysia
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12
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Flavonoids in adipose tissue inflammation and atherosclerosis: one arrow, two targets. Clin Sci (Lond) 2020; 134:1403-1432. [PMID: 32556180 DOI: 10.1042/cs20200356] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 02/07/2023]
Abstract
Flavonoids are polyphenolic compounds naturally occurring in fruits and vegetables, in addition to beverages such as tea and coffee. Flavonoids are emerging as potent therapeutic agents for cardiovascular as well as metabolic diseases. Several studies corroborated an inverse relationship between flavonoid consumption and cardiovascular disease (CVD) or adipose tissue inflammation (ATI). Flavonoids exert their anti-atherogenic effects by increasing nitric oxide (NO), reducing reactive oxygen species (ROS), and decreasing pro-inflammatory cytokines. In addition, flavonoids alleviate ATI by decreasing triglyceride and cholesterol levels, as well as by attenuating inflammatory mediators. Furthermore, flavonoids inhibit synthesis of fatty acids and promote their oxidation. In this review, we discuss the effect of the main classes of flavonoids, namely flavones, flavonols, flavanols, flavanones, anthocyanins, and isoflavones, on atherosclerosis and ATI. In addition, we dissect the underlying molecular and cellular mechanisms of action for these flavonoids. We conclude by supporting the potential benefit for flavonoids in the management or treatment of CVD; yet, we call for more robust clinical studies for safety and pharmacokinetic values.
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13
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Analysis of the intricate effects of polyunsaturated fatty acids and polyphenols on inflammatory pathways in health and disease. Food Chem Toxicol 2020; 143:111558. [PMID: 32640331 PMCID: PMC7335494 DOI: 10.1016/j.fct.2020.111558] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/16/2020] [Accepted: 06/24/2020] [Indexed: 02/08/2023]
Abstract
Prevention and treatment of non-communicable diseases (NCDs), including cardiovascular disease, diabetes, obesity, cancer, Alzheimer's and Parkinson's disease, arthritis, non-alcoholic fatty liver disease and various infectious diseases; lately most notably COVID-19 have been in the front line of research worldwide. Although targeting different organs, these pathologies have common biochemical impairments - redox disparity and, prominently, dysregulation of the inflammatory pathways. Research data have shown that diet components like polyphenols, poly-unsaturated fatty acids (PUFAs), fibres as well as lifestyle (fasting, physical exercise) are important factors influencing signalling pathways with a significant potential to improve metabolic homeostasis and immune cells' functions. In the present manuscript we have reviewed scientific data from recent publications regarding the beneficial cellular and molecular effects induced by dietary plant products, mainly polyphenolic compounds and PUFAs, and summarize the clinical outcomes expected from these types of interventions, in a search for effective long-term approaches to improve the immune system response.
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14
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Signorelli SS, Marino E, Scuto S, Di Raimondo D. Pathophysiology of Peripheral Arterial Disease (PAD): A Review on Oxidative Disorders. Int J Mol Sci 2020; 21:ijms21124393. [PMID: 32575692 PMCID: PMC7352779 DOI: 10.3390/ijms21124393] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/13/2020] [Accepted: 06/18/2020] [Indexed: 12/14/2022] Open
Abstract
Peripheral arterial disease (PAD) is an atherosclerotic disease that affects a wide range of the world’s population, reaching up to 200 million individuals worldwide. PAD particularly affects elderly individuals (>65 years old). PAD is often underdiagnosed or underestimated, although specificity in diagnosis is shown by an ankle/brachial approach, and the high cardiovascular event risk that affected the PAD patients. A number of pathophysiologic pathways operate in chronic arterial ischemia of lower limbs, giving the possibility to improve therapeutic strategies and the outcome of patients. This review aims to provide a well detailed description of such fundamental issues as physical exercise, biochemistry of physical exercise, skeletal muscle in PAD, heme oxygenase 1 (HO-1) in PAD, and antioxidants in PAD. These issues are closely related to the oxidative stress in PAD. We want to draw attention to the pathophysiologic pathways that are considered to be beneficial in order to achieve more effective options to treat PAD patients.
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Affiliation(s)
- Salvatore Santo Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (E.M.); (S.S.)
- Correspondence: ; Tel.: +39-09-5378-2545
| | - Elisa Marino
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (E.M.); (S.S.)
| | - Salvatore Scuto
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (E.M.); (S.S.)
| | - Domenico Di Raimondo
- Division of Internal Medicine and Stroke Care, Department of Promoting Health, Maternal-Infant. Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90127 Palermo, Italy;
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15
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Qu Z, Liu A, Li P, Liu C, Xiao W, Huang J, Liu Z, Zhang S. Advances in physiological functions and mechanisms of (-)-epicatechin. Crit Rev Food Sci Nutr 2020; 61:211-233. [PMID: 32090598 DOI: 10.1080/10408398.2020.1723057] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
(-)-Epicatechin (EC) is a flavanol easily obtained through the diet and is present in tea, cocoa, vegetables, fruits, and cereals. Recent studies have shown that EC protects human health and exhibits prominent anti-oxidant and anti-inflammatory activities, enhances muscle performance, improves symptoms of cardiovascular and cerebrovascular diseases, prevents diabetes, and protects the nervous system. With the development of modern medical and biotechnology research, the mechanisms of action associated with EC toward various chronic diseases are becoming more apparent, and the pharmacological development and utilization of EC has been increasingly clarified. Currently, there is no comprehensive systematic introduction to the effects of EC and its mechanisms of action. This review presents the latest research progress and the role of EC in the prevention and treatment of various chronic diseases and its protective health effects and provides a theoretical basis for future research on EC.
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Affiliation(s)
- Zhihao Qu
- Key Laboratory of Tea Science of Ministry of Education, Hunan Agricultural University, Changsha, Hunan, China.,National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Collaborative Innovation Centre of Utilisation of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
| | - Ailing Liu
- College of Bioscience and Biotechnology, Hunan Agricultural University, Changsha, Hunan, China
| | - Penghui Li
- Key Laboratory of Tea Science of Ministry of Education, Hunan Agricultural University, Changsha, Hunan, China.,National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Collaborative Innovation Centre of Utilisation of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
| | - Changwei Liu
- Key Laboratory of Tea Science of Ministry of Education, Hunan Agricultural University, Changsha, Hunan, China.,National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Collaborative Innovation Centre of Utilisation of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
| | - Wenjun Xiao
- Key Laboratory of Tea Science of Ministry of Education, Hunan Agricultural University, Changsha, Hunan, China.,National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Collaborative Innovation Centre of Utilisation of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
| | - Jianan Huang
- Key Laboratory of Tea Science of Ministry of Education, Hunan Agricultural University, Changsha, Hunan, China.,National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Collaborative Innovation Centre of Utilisation of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
| | - Zhonghua Liu
- Key Laboratory of Tea Science of Ministry of Education, Hunan Agricultural University, Changsha, Hunan, China.,National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Collaborative Innovation Centre of Utilisation of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
| | - Sheng Zhang
- Key Laboratory of Tea Science of Ministry of Education, Hunan Agricultural University, Changsha, Hunan, China.,National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Collaborative Innovation Centre of Utilisation of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
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16
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Biondi‐Zoccai G, Sciarretta S, Bullen C, Nocella C, Violi F, Loffredo L, Pignatelli P, Perri L, Peruzzi M, Marullo AG, De Falco E, Chimenti I, Cammisotto V, Valenti V, Coluzzi F, Cavarretta E, Carrizzo A, Prati F, Carnevale R, Frati G. Acute Effects of Heat-Not-Burn, Electronic Vaping, and Traditional Tobacco Combustion Cigarettes: The Sapienza University of Rome-Vascular Assessment of Proatherosclerotic Effects of Smoking ( SUR - VAPES ) 2 Randomized Trial. J Am Heart Assoc 2019; 8:e010455. [PMID: 30879375 PMCID: PMC6475061 DOI: 10.1161/jaha.118.010455] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/18/2018] [Indexed: 02/05/2023]
Abstract
Background Little clinical research on new-generation heat-not-burn cigarettes ( HNBC ) in comparison with electronic vaping cigarettes ( EVC ) and traditional tobacco combustion cigarettes ( TC ) has been reported. We aimed to appraise the acute effects of single use of HNBC , EVC, and TC in healthy smokers. Methods and Results This was an independent, cross-over, randomized trial in 20 TC smokers, with allocation to different cycles of HNBC , EVC , and TC . All participants used all types of products, with an intercycle washout of 1 week. End points were oxidative stress, antioxidant reserve, platelet activation, flow-mediated dilation, blood pressure, and satisfaction scores. Single use of any product led to an adverse impact on oxidative stress, antioxidant reserve, platelet function, flow-mediated dilation, and blood pressure. HNBC had less impact than EVC and TC on soluble Nox2-derived peptide (respectively, P=0.004 and 0.001), 8-iso-prostaglandin F2α- III ( P=0.004 and <0.001), and vitamin E ( P=0.018 and 0.044). HNBC and EVC were equally less impactful than TCs on flow-mediated dilation ( P=0.872 for HNBC versus EVC ), H2O2 ( P=0.522), H2O2 breakdown activity ( P=0.091), soluble CD 40 ligand ( P=0.849), and soluble P-selectin ( P=0.821). The effect of HNBC and, to a lesser extent EVC , on blood pressure was less evident than that of TC , whereas HNBC appeared more satisfying than EVC (all P<0.05). Conclusions Acute effects of HNBC , EVC, and TC are different on several oxidative stress, antioxidant reserve, platelet function, cardiovascular, and satisfaction dimensions, with TCs showing the most detrimental changes in clinically relevant features. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 03301129.
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Affiliation(s)
- Giuseppe Biondi‐Zoccai
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
- IRCCS NEUROMEDPozzilliItaly
| | - Sebastiano Sciarretta
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
- IRCCS NEUROMEDPozzilliItaly
| | - Christopher Bullen
- National Institute for Health InnovationSchool of Population HealthFaculty of Medical and Health SciencesThe University of AucklandNew Zealand
| | | | - Francesco Violi
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Lorenzo Loffredo
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Pasquale Pignatelli
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Ludovica Perri
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Mariangela Peruzzi
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Antonino G.M. Marullo
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Elena De Falco
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Isotta Chimenti
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Vittoria Cammisotto
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Valentina Valenti
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Flaminia Coluzzi
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Elena Cavarretta
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | | | - Francesco Prati
- Division of CardiologySan Giovanni Addolorata HospitalRomeItaly
- Centro Per La Lotta Contro L'InfartoRomeItaly
| | - Roberto Carnevale
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Giacomo Frati
- IRCCS NEUROMEDPozzilliItaly
- National Institute for Health InnovationSchool of Population HealthFaculty of Medical and Health SciencesThe University of AucklandNew Zealand
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17
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De Los Santos S, Palma-Flores C, Zentella-Dehesa A, Canto P, Coral-Vázquez RM. (-)-Epicatechin inhibits development of dilated cardiomyopathy in δ sarcoglycan null mouse. Nutr Metab Cardiovasc Dis 2018; 28:1188-1195. [PMID: 30143409 DOI: 10.1016/j.numecd.2018.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/18/2018] [Accepted: 06/25/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Several studies propose that (-)-epicatechin, a flavonol present in high concentration in the cocoa, has cardioprotective effects. This study aimed to evaluate the impact of (-)-epicatechin on the development of dilated cardiomyopathy in a δ sarcoglycan null mouse model. METHODS AND RESULTS δ Sarcoglycan null mice were treated for 15 days with (-)-epicatechin. Histological and morphometric analysis of the hearts treated mutant mice showed significant reduction of the vasoconstrictions in the coronary arteries as well as fewer areas with fibrosis and a reduction in the loss of the ventricular wall. On the contrary, it was observed a thickening of this region. By Western blot analysis, it was shown, and increment in the phosphorylation level of eNOS and PI3K/AKT/mTOR/p70S6K proteins in the heart of the (-)-epicatechin treated animals. On the other hand, we observed a significantly decreased level of the atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) heart failure markers. CONCLUSION All the results indicate that (-)-epicatechin has the potential to prevent the development of dilated cardiomyopathy of genetic origin and encourages the use of this flavonol as a pharmacological therapy for dilated cardiomyopathy and heart failure diseases.
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MESH Headings
- Animals
- Atrial Natriuretic Factor/metabolism
- Cardiomyopathy, Dilated/enzymology
- Cardiomyopathy, Dilated/genetics
- Cardiomyopathy, Dilated/pathology
- Cardiomyopathy, Dilated/prevention & control
- Catechin/pharmacology
- Coronary Vessels/drug effects
- Coronary Vessels/enzymology
- Coronary Vessels/physiopathology
- Disease Models, Animal
- Fibrosis
- Male
- Mice, Knockout
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/enzymology
- Myocytes, Cardiac/pathology
- Natriuretic Peptide, Brain/metabolism
- Nitric Oxide Synthase Type III/metabolism
- Phosphatidylinositol 3-Kinase/metabolism
- Phosphorylation
- Proto-Oncogene Proteins c-akt/metabolism
- Ribosomal Protein S6 Kinases, 70-kDa/metabolism
- Sarcoglycans/deficiency
- Sarcoglycans/genetics
- Signal Transduction/drug effects
- TOR Serine-Threonine Kinases/metabolism
- Vasoconstriction/drug effects
- Ventricular Function, Left/drug effects
- Ventricular Remodeling/drug effects
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Affiliation(s)
- S De Los Santos
- División de Investigación Biomédica, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico; Unidad de Investigación en Obesidad, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico; Clínica de Obesidad, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - C Palma-Flores
- División de Investigación Biomédica, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico; Catedrático CONACYT, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, México
| | - A Zentella-Dehesa
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico; Unidad de Bioquímica, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - P Canto
- Unidad de Investigación en Obesidad, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico; Clínica de Obesidad, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - R M Coral-Vázquez
- División de Investigación Biomédica, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico; Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Col. Casco de Santo Tomás, Delegación Miguel Hidalgo, Mexico City, 11340, Mexico.
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18
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Ismaeel A, Brumberg RS, Kirk JS, Papoutsi E, Farmer PJ, Bohannon WT, Smith RS, Eidson JL, Sawicki I, Koutakis P. Oxidative Stress and Arterial Dysfunction in Peripheral Artery Disease. Antioxidants (Basel) 2018; 7:antiox7100145. [PMID: 30347720 PMCID: PMC6210426 DOI: 10.3390/antiox7100145] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 02/07/2023] Open
Abstract
Peripheral artery disease (PAD) is an atherosclerotic disease characterized by a narrowing of the arteries in the lower extremities. Disease manifestations are the result of more than just reduced blood flow, and include endothelial dysfunction, arterial stiffness, and inflammation. Growing evidence suggests that these factors lead to functional impairment and decline in PAD patients. Oxidative stress also plays an important role in the disease, and a growing amount of data suggest a link between arterial dysfunction and oxidative stress. In this review, we present the current evidence for the involvement of endothelial dysfunction, arterial stiffness, and inflammation in the pathophysiology of PAD. We also discuss the links between these factors and oxidative stress, with a focus on nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2)-derived reactive oxygen species (ROS) and decreased nitric oxide (NO) bioavailability. Finally, the potential therapeutic role of NOX2 antioxidants for improving arterial function and functional status in PAD patients is explored.
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Affiliation(s)
- Ahmed Ismaeel
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA.
| | - Robert S Brumberg
- Department of Surgery, Vascular Surgery Associates, Florida State University School of Medicine, Tallahassee Memorial Hospital, Tallahassee, FL 32308, USA.
| | - Jeffrey S Kirk
- Department of Surgery, Capital Regional Medical Center, Tallahassee, FL 32308, USA.
| | - Evlampia Papoutsi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA.
| | - Patrick J Farmer
- Department of Chemistry and Biochemistry, Baylor University, Waco, TX 76798, USA.
| | - William T Bohannon
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Robert S Smith
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Jack L Eidson
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Ian Sawicki
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Panagiotis Koutakis
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA.
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Santhakumar AB, Battino M, Alvarez-Suarez JM. Dietary polyphenols: Structures, bioavailability and protective effects against atherosclerosis. Food Chem Toxicol 2018; 113:49-65. [DOI: 10.1016/j.fct.2018.01.022] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/11/2018] [Accepted: 01/13/2018] [Indexed: 01/05/2023]
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20
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The Light and Shadow of Senescence and Inflammation in Cardiovascular Pathology and Regenerative Medicine. Mediators Inflamm 2017; 2017:7953486. [PMID: 29118467 PMCID: PMC5651105 DOI: 10.1155/2017/7953486] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 09/12/2017] [Indexed: 02/06/2023] Open
Abstract
Recent epidemiologic studies evidence a dramatic increase of cardiovascular diseases, especially associated with the aging of the world population. During aging, the progressive impairment of the cardiovascular functions results from the compromised tissue abilities to protect the heart against stress. At the molecular level, in fact, a gradual weakening of the cellular processes regulating cardiovascular homeostasis occurs in aging cells. Atherosclerosis and heart failure are particularly correlated with aging-related cardiovascular senescence, that is, the inability of cells to progress in the mitotic program until completion of cytokinesis. In this review, we explore the intrinsic and extrinsic causes of cellular senescence and their role in the onset of these cardiovascular pathologies. Additionally, we dissect the effects of aging on the cardiac endogenous and exogenous reservoirs of stem cells. Finally, we offer an overview on the strategies of regenerative medicine that have been advanced in the quest for heart rejuvenation.
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21
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Measurement and Clinical Significance of Biomarkers of Oxidative Stress in Humans. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:6501046. [PMID: 28698768 PMCID: PMC5494111 DOI: 10.1155/2017/6501046] [Citation(s) in RCA: 444] [Impact Index Per Article: 63.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/26/2017] [Accepted: 05/21/2017] [Indexed: 12/11/2022]
Abstract
Oxidative stress is the result of the imbalance between reactive oxygen species (ROS) formation and enzymatic and nonenzymatic antioxidants. Biomarkers of oxidative stress are relevant in the evaluation of the disease status and of the health-enhancing effects of antioxidants. We aim to discuss the major methodological bias of methods used for the evaluation of oxidative stress in humans. There is a lack of consensus concerning the validation, standardization, and reproducibility of methods for the measurement of the following: (1) ROS in leukocytes and platelets by flow cytometry, (2) markers based on ROS-induced modifications of lipids, DNA, and proteins, (3) enzymatic players of redox status, and (4) total antioxidant capacity of human body fluids. It has been suggested that the bias of each method could be overcome by using indexes of oxidative stress that include more than one marker. However, the choice of the markers considered in the global index should be dictated by the aim of the study and its design, as well as by the clinical relevance in the selected subjects. In conclusion, the clinical significance of biomarkers of oxidative stress in humans must come from a critical analysis of the markers that should give an overall index of redox status in particular conditions.
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Forte M, Nocella C, De Falco E, Palmerio S, Schirone L, Valenti V, Frati G, Carnevale R, Sciarretta S. The Pathophysiological Role of NOX2 in Hypertension and Organ Damage. High Blood Press Cardiovasc Prev 2017; 23:355-364. [PMID: 27915400 DOI: 10.1007/s40292-016-0175-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
NADPH oxidases (NOXs) represent one of the major sources of reactive oxygen species in the vascular district. Reactive oxygen species are responsible for vascular damage that leads to several cardiovascular pathological conditions. Among NOX isoforms, NOX2 is widely expressed in many cells types, such as cardiomyocytes, endothelial cells, and vascular smooth muscle cells, confirming its pivotal role in vascular pathophysiology. Studies in mice models with systemic deletion of NOX2, as well as in transgenic mice overexpressing NOX2, have demonstrated the undeniable involvement of NOX2 in the development of hypertension, atherosclerosis, diabetes mellitus, cardiac hypertrophy, platelet aggregation, and aging. Of note, the inhibition of NOX2 has been found to be protective for cardiovascular homeostasis. Here, we review the evidence demonstrating that the modulation of NOX2 activity is able to improve vascular physiology, suggesting that NOX2 may be a potential target for therapeutic applications.
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Affiliation(s)
- Maurizio Forte
- Department of Angiocardioneurology, IRCCS Neuromed, Pozzilli, 86077, Italy
| | - Cristina Nocella
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 79 Corso della Repubblica, 04100, Latina, Italy
| | - Elena De Falco
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 79 Corso della Repubblica, 04100, Latina, Italy
| | - Silvia Palmerio
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 79 Corso della Repubblica, 04100, Latina, Italy
| | - Leonardo Schirone
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 79 Corso della Repubblica, 04100, Latina, Italy
| | - Valentina Valenti
- Department of Imaging, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Giacomo Frati
- Department of Angiocardioneurology, IRCCS Neuromed, Pozzilli, 86077, Italy.,Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 79 Corso della Repubblica, 04100, Latina, Italy
| | - Roberto Carnevale
- Department of Angiocardioneurology, IRCCS Neuromed, Pozzilli, 86077, Italy
| | - Sebastiano Sciarretta
- Department of Angiocardioneurology, IRCCS Neuromed, Pozzilli, 86077, Italy. .,Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 79 Corso della Repubblica, 04100, Latina, Italy.
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Giordano A, Peruzzi M, Frati G, Biondi-Zoccai G. Commentary: Identifying the Best Device for Infrapopliteal Revascularization Through Quantitative Evidence Synthesis. J Endovasc Ther 2016; 23:864-866. [PMID: 27708144 DOI: 10.1177/1526602816672122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Arturo Giordano
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy
- Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Mariangela Peruzzi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
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De Falco E, Carnevale R, Pagano F, Chimenti I, Fianchini L, Bordin A, Siciliano C, Monticolo R, Equitani F, Carrizzo A, Peruzzi M, Vecchione C, Rubattu S, Sciarretta S, Frati G. Role of NOX2 in mediating doxorubicin-induced senescence in human endothelial progenitor cells. Mech Ageing Dev 2016; 159:37-43. [PMID: 27181082 DOI: 10.1016/j.mad.2016.05.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 05/05/2016] [Accepted: 05/11/2016] [Indexed: 12/09/2022]
Abstract
Senescence exerts a great impact on both biological and functional properties of circulating endothelial progenitor cells (EPCs), especially in cardiovascular diseases where the physiological process of aging is accelerated upon clinical administration of certain drugs such as doxorubicin. EPC impairment contributes to doxorubicin-induced cardiotoxicity. Doxorubicin accelerates EPC aging, although mechanisms underlying this phenomenon remain to be fully clarified. Here we investigated if Nox2 activity is able to modulate the premature senescence induced in vitro by doxorubicin in human EPCs. Results showed that in conditioned media obtained from late EPC cultures, the levels of interleukin-6, isoprostanes and nitric oxide bioavailability were increased and reduced respectively after 3h of doxorubicin treatment. These derangements returned to physiological levels when cells were co-treated with apocynin or gp91ds-tat (antioxidant and specific Nox2 inhibitors, respectively). Accordingly, Nox2 activity resulted to be activated by doxorubicin. Importantly, we found that Nox2 inhibition reduced doxorubicin-induced EPC senescence, as indicated by a lower percentage of β-gal positive EPCs. In conclusion, Nox2 activity efficiently contributes to the mechanism of oxidative stress-induced increase in premature aging conferred by doxorubicin. The importance of modulation of Nox2 in human EPCs could reveal a useful tool to restore EPC physiological function and properties.
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Affiliation(s)
- Elena De Falco
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy.
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy.
| | - Francesca Pagano
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy.
| | - Isotta Chimenti
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy.
| | - Luca Fianchini
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy.
| | - Antonella Bordin
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy.
| | - Camilla Siciliano
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy.
| | - Roberto Monticolo
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy.
| | - Francesco Equitani
- Transfusion Medicine and Immuno-Hematology Unit, Santa Maria Goretti Hospital, Latina, Italy.
| | - Albino Carrizzo
- Department of AngioCardioNeurology, IRCCS NeuroMed, 86077 Pozzilli, IS, Italy.
| | - Mariangela Peruzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy.
| | - Carmine Vecchione
- Department of AngioCardioNeurology, IRCCS NeuroMed, 86077 Pozzilli, IS, Italy.
| | - Speranza Rubattu
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sant' Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy; Department of AngioCardioNeurology, IRCCS NeuroMed, 86077 Pozzilli, IS, Italy.
| | - Sebastiano Sciarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy; Department of AngioCardioNeurology, IRCCS NeuroMed, 86077 Pozzilli, IS, Italy.
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome polo pontino, C.so della Repubblica 79, 04100 Latina, Italy; Department of AngioCardioNeurology, IRCCS NeuroMed, 86077 Pozzilli, IS, Italy.
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Kerimi A, Williamson G. At the interface of antioxidant signalling and cellular function: Key polyphenol effects. Mol Nutr Food Res 2016; 60:1770-88. [PMID: 26887821 PMCID: PMC5021119 DOI: 10.1002/mnfr.201500940] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 12/18/2022]
Abstract
The hypothesis that dietary (poly)phenols promote well‐being by improving chronic disease‐risk biomarkers, such as endothelial dysfunction, chronic inflammation and plasma uric acid, is the subject of intense current research, involving human interventions studies, animal models and in vitro mechanistic work. The original claim that benefits were due to the direct antioxidant properties of (poly)phenols has been mostly superseded by detailed mechanistic studies on specific molecular targets. Nevertheless, many proposed mechanisms in vivo and in vitro are due to modulation of oxidative processes, often involving binding to specific proteins and effects on cell signalling. We review the molecular mechanisms for 3 actions of (poly)phenols on oxidative processes where there is evidence in vivo from human intervention or animal studies. (1) Effects of (poly) phenols on pathways of chronic inflammation leading to prevention of some of the damaging effects associated with the metabolic syndrome. (2) Interaction of (poly)phenols with endothelial cells and smooth muscle cells, leading to effects on blood pressure and endothelial dysfunction, and consequent reduction in cardiovascular disease risk. (3) The inhibition of xanthine oxidoreductase leading to modulation of intracellular superoxide and plasma uric acid, a risk factor for developing type 2 diabetes.
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Affiliation(s)
- Asimina Kerimi
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Gary Williamson
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
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Barokah L, Baktiyani SCW, Kalsum U. Protective effect of Theobroma cacao on nitric oxide and endothelin-1 level in endothelial cells induced by plasma from preeclamptic patients: In silico and in vitro studies. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2015.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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27
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Peruzzi M, Biondi-Zoccai G, Abbate A, Giordano A, Frati G. Commentary: which comes first, the phoenix or the flame? Reflections on the role of inflammation in patients undergoing lower limb revascularization for peripheral artery disease. J Endovasc Ther 2015; 22:240-2. [PMID: 25809369 DOI: 10.1177/1526602815573217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
| | - Giuseppe Biondi-Zoccai
- Sapienza University of Rome, Latina, Italy Eleonora Lorillard Spencer Cenci Foundation, Rome, Italy
| | | | - Arturo Giordano
- Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Giacomo Frati
- Sapienza University of Rome, Latina, Italy IRCCS Neuromed, Pozzilli, Italy
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