Evaluating the effect of garlic extract on serum inflammatory markers of peritoneal dialysis patients: a randomized double-blind clinical trial study

Immunomodulatory effect of allium sativum in type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a metabolic disorder marked by chronic hyperglycemia and low-grade inflammation, contributing to various complications. Natural agents with immunomodulatory and antioxidant properties have gained attention as adjunct therapies. To review the effects of Allium sativum on inflammatory pathways and metabolic alterations associated with T2DM. A narrative review was performed using PubMed/MEDLINE, EMBASE, and Scielo databases. The search included terms such as “allium sativum”, “inflammation", “oxidative stress”, and “diabetes mellitus”. Studies in English and Spanish - ranging from clinical trials to meta-analyses - were selected based on relevance. Bioactive compounds such as allicin, S-allyl cysteine, and diallyl disulfide exhibit anti-inflammatory, antioxidant, hypoglycemic, and lipid-lowering actions. Preclinical studies show improved glucose metabolism, insulin sensitivity, and organ function. Moreover, clinical evidence supports reductions in fasting glucose, hemoglobin A1c, blood pressure, and oxidative stress, with good safety profiles. Allium sativum appears to be a promising adjuvant in T2DM management, offering metabolic and anti-inflammatory benefits. Nonetheless, further high-quality clinical trials are needed to confirm its long-term efficacy and standardize its therapeutic use.

Potential Effects of Bioactive Compounds of Plant-Based Foods and Medicinal Plants in Chronic Kidney Disease and Dialysis: A Systematic Review

BACKGROUND

The bioactive components of plant foods and medicinal plants have attracted interest due to their potential impact on the progression of chronic kidney disease (CKD) and outcomes.

OBJECTIVE

This study aimed to conduct a critical and quantitative systematic review of randomized clinical trials (RCTs) investigating the potential effects of selected phytochemicals from plant-based foods and medicinal plants in CKD and dialysis patients.

METHODS

The review included studies that related plant-based bioactive compounds (curcumin, propolis, sulforaphane, betalain, catechins, rhein, emodin, aloe-emodin, flavonoids, and triptolide) and medicinal plants (green tea, rhubarb, Astragalus membranaceus, and Tripterygium wilfordii Hook F) in CKD and dialysis patients. A literature search was conducted in PubMed, LILACS, Embase, Scopus, and WOS between December 2022 and October 2024. This review was performed according to the PRISMA flowchart and was registered in PROSPERO (595162).

RESULTS

In the eight RCTs conducted with curcumin, anti-inflammatory, antioxidant, and microbiota-modulating properties were reported. As for propolis, in three RCTs, anti-inflammatory, anti-proteinuric, and renal-protective properties were reported. Sulforaphane in one RCT showed antioxidant and cardiovascular benefits, and in another RCT no effects were observed. In one RCT, genistein was shown to be a potential anti-inflammatory agent and improved nutritional status. Allicin in two RCTs showed cardioprotective, antioxidant, anti-inflammatory, and lipid-lowering effects. Finally, beetroot showed a vasodilator effect in one RCT. As for the medicinal plants, green tea, rhubarb, Astragalus membranaceus, and Tripterygium Wilfordii Hook F, in six RCTs they showed antioxidant, anti-inflammatory, cardioprotective, antiproteinuric, and renoprotective properties.

CONCLUSIONS

These results suggest that bioactive compounds of plant-based foods and medicinal plants have promising effects in terms of preventing or treating CKD progression and appear to improve inflammation and antioxidant capacity and support cardiovascular benefits and renoprotective effects; however, it is recommended that further studies be carried out.

Allicin Ameliorated High-glucose Peritoneal Dialysis Solution-induced Peritoneal Fibrosis in Rats via the JAK2/STAT3 Signaling Pathway

Peritoneal fibrosis (PF) is one of the most serious complications of peritoneal dialysis (PD) and is the greatest obstacle to the clinical application of PD. Chinese herbal monomers have been effective in the prevention and treatment of PF. The aim of this study was to observe the effect of allicin on PF in rats induced by high glucose and to investigate its molecular mechanism of action. A rat model of PF was established by using a 4.25% glucose-based standard peritoneal dialysis solution. The degree of peritoneal pathological damage was assessed by Hematoxylin and eosin (H&E) staining. Peritoneal collagen deposition was detected by Masson's trichrome staining. The levels of Interleukin-6 (IL-6), Tumor necrosis factor-α (TNF-α), Interleukin-1β (IL-1β) and monocyte chemoattractant protein-1 (MCP-1) in the serum were measured by Enzyme Linked Immunosorbent Assay (ELISA). The expression levels of TGF-β, α-smooth muscle actin (α-SMA) and collagen I were examined by western blotting and immunohistochemistry. The protein expression levels and mRNA levels of E-cadherin, N-cadherin, vimentin, janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3) in peritoneal tissue were determined by western blotting and qRT-PCR. TGF-β1 stimulated human peritoneal mesothelial cells (HPMCs), and the cells were treated with allicin and the JAK2/STAT3 pathway activator colivelin alone or in combination. A cell counting kit-8 (CCK-8) assay was used to measure cell viability. The role of JAK2/STAT3 in the effects of allicin was confirmed via in vitro mechanistic research by western blotting, wound healing assays and Transwell assays. Allicin relieves the inflammatory response by downregulating the levels of IL-1β, IL-6, MCP-1 and TNF-α. Furthermore, allicin decreased the expression of TGF-β, α-SMA and collagen I. Allicin also alleviated epithelial-to-mesenchymal transition (EMT), as specifically manifested by increased E-cadherin and reduced N-cadherin and vimentin. Further studies revealed that allicin reduced the protein levels of JAK2, STAT3, p-JAK2, and p-STAT3. The results of the cellular experiments verified the above results. The ability of allicin to inhibit fibrosis and the EMT process was significantly attenuated after HPMCs were treated with colivelin. Taken together, these findings suggest that allicin inhibits inflammation and EMT, thereby improving PF, and this protective effect may be achieved by inhibiting the JAK2/STAT3 signaling pathway.

Using the concept of food as medicine to mitigate inflammation in patients undergoing peritoneal dialysis

The most common kidney replacement therapy (KRT) worldwide is hemodialysis (HD), and only 5%-10% of patients are prescribed peritoneal dialysis (PD) as KRT. Despite PD being a different method, these patients also present particular complications, such as oxidative stress, gut dysbiosis, premature aging, and mitochondrial dysfunction, leading to an inflammation process and high cardiovascular mortality risk. Although recent studies have reported nutritional strategies in patients undergoing HD with attempts to mitigate these complications, more information must be needed for PD patients. Therefore, this review provides a comprehensive analysis of recent studies of nutritional intervention to mitigate inflammation in PD patients.

Effect of garlic extract on markers of lipid metabolism and inflammation in coronary artery disease (CAD) patients: A systematic review and meta-analysis

Several preclinical studies have focused on the beneficial effects of garlic on cardiovascular diseases, but the results were inconsistent. We performed a systematic review and meta-analysis on the effect of garlic powder tablets and aged garlic extract (AGE) in CAD patients, mainly focusing on blood pressure, coronary artery calcification, lipid profile, and inflammatory markers. We searched PubMed, Cochrane CENTRAL, and Google Scholar to identify randomized controlled trials which examined garlic's effect on CAD patients. The standardized mean difference with 95% CI was calculated using fixed-effect or random-effect models. Garlic has shown statistically significant changes of HDL (SMD = 0.18; 95% CI = -0.00 to 0.37; p = .05); LDL (SMD = -0.27; 95% CI = -0.46 to -0.08; p = .004), apolipoprotein-A (SMD = 0.68; 95% CI = 0.24 1.13; p = .002), C-RP (SMD = -0.59; 95% CI = -0.92 to -0.25; p = .0007), IL-6 (SMD = -1.08; 95% CI = -2.17 to 0.01; p = .05), homocysteine (SMD = -0.66; 95% CI = -1.04 to -0.28; p = .0007) and CAC score (SMD = -1.61; 95% CI = -2.66 to -0.57; p = .003). In the case of subgroup analysis, the overall effect was significantly effective in reducing TC, LDL levels and improving HDL levels in CV risk patients. Our study findings provide consistent evidence that intake of garlic reduces CVD risk factors. However, garlic could be considered a safe natural medicine to debilitate inflammation in CAD patients.

Frequency, types, and factors associated with complementary and alternative medicine use among patients on maintenance haemodialysis

BACKGROUND

Despite progress in haemodialysis and conventional medicine approaches, many patients still struggle to maintain an acceptable quality of life and turn to complementary and alternative medicine (CAM) to address their unmet needs.

OBJECTIVE

This study aims to determine the prevalence, types, indications, and factors associated with CAM use by patients on maintenance haemodialysis (MHD) in Cameroon.

MATERIALS AND METHODS

This was a multicentric cross-sectional study involving MHD patients in Cameroon from February 2019 to May 2019. We included all consenting participants on MHD for at least 3 months and excluded participants with cognitive and behavioral problems. Face-to-face interviews were conducted.

RESULTS

A total of 224 participants (145 males) with a mean age of 56.5 ± 14.2 years and a median haemodialysis vintage of 34.5 [IQR: 17.3-64.4] months were recruited. In all, 89.7% (n = 201) reported having used CAM before, while 71.6% (n = 144) were still using it. Biologically based therapies were the most popular (94%, n = 189), with herbal medicine (81.5%, n = 154) and Calabar chalk (52.4%, n = 99) being the most common. Physical well-being (57.2%), nausea (52%), and insomnia (42.7%) were the main indications for CAM use. Most respondents did not disclose their CAM use to their physicians (61.2%). Long haemodialysis vintage was associated with CAM use (AOR: 7.9; CI = 2.8-22.3; p < 0.001).

CONCLUSIONS

The use of CAM is common among Cameroon's haemodialysis population, with herbal medicines and Calabar chalk being the most frequent. The high symptom burden makes CAM attractive to them. Healthcare teams should be aware of these practices, initiate an open discussion, and appropriately advise patients about dangers, risks, and safety associated with their use.

TRIAL REGISTRATION

The institutional review board of the University of Bamenda. Reference: 2019/0038H/UBa/IRB UPM/TNCPI/RMC/1.4.18.2.

Role of Alternative Medical Systems in Adult Chronic Kidney Disease Patients: A Systematic Review of Literature

There is a growing interest in the use of alternative medical systems (AMS), such as traditional Chinese medicine (TCM), ayurveda, homeopathy, and naturopathy, among chronic kidney disease patients. This review summarizes the efficacy and safety of AMS interventions in chronic kidney disease (CKD) patients. A systematic review was conducted in MEDLINE, Embase, Scopus, CINAHL, CENTRAL, and PsycINFO in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Synthesis without meta-analysis (SWiM) guidelines. Randomized controlled trials (RCTs) which evaluated the use of AMS among adult CKD patients were included. The efficacy of each AMS was assessed based on improvement in biochemical markers or reduction in symptom severity scores. All adverse reactions were recorded. Of the 14,583 articles retrieved, 33 RCTs were included. TCM (n=20) and ayurveda (n=6) were the most well-studied. Majority of studies (66.7%) had a sample size <100. Common indications evaluated included improvement in renal function (n=12), proteinuria (n=5), and uremic pruritus (n=5). Among TCM, acupuncture and syndromes-based TCM granules formulation were shown to improve estimated glomerular filtration rate (eGFR) by 5.1-15.5% and 7.07-8.12% respectively. Acupuncture reduced uremic pruritus symptoms by 54.7-60.2% while Huangkui, Shenqi granules, and Tripterygium wilfordii Hook F reduced proteinuria by 18.6-50.7%, 61.8%, and 32.1% respectively. For Ayurveda, camel milk and Nigella sativa oil improved eGFR by 16.9% and 86.8%, respectively, while capsaicin reduced pruritus scores by 84.3%. Homeopathic verum medication reduced pruritus scores by 29.2-41.5%. Nausea was the most common adverse effect reported with alpha-keto amino acids (0.07%), Nigella sativa oil (7.04%), and silymarin (10%). TCM and ayurveda were more well-studied AMS therapies that demonstrated efficacy in CKD patients. RCTs with larger sample sizes are needed to ascertain the efficacy and safety of promising AMS.

The Role of Nutrition on Meta-inflammation: Insights and Potential Targets in Communicable and Chronic Disease Management

PURPOSE OF REVIEW

Chronic low-grade inflammation may contribute to the onset and progression of communicable and chronic diseases. This review examined the effects and eventual mediation roles of different nutritional factors on inflammation.

RECENT FINDINGS

Potential nutritional compounds influencing inflammation processes include macro and micronutrients, bioactive molecules (polyphenols), specific food components, and culinary ingredients as well as standardized dietary patterns, eating habits, and chrononutrition features. Therefore, research in this field is still required, taking into account critical aspects of heterogeneity including type of population, minimum and maximum intakes and adverse effects, cooking methods, physiopathological status, and times of intervention. Moreover, the integrative analysis of traditional variables (age, sex, metabolic profile, clinical history, body phenotype, habitual dietary intake, physical activity levels, and lifestyle) together with individualized issues (genetic background, epigenetic signatures, microbiota composition, gene expression profiles, and metabolomic fingerprints) may contribute to the knowledge and prescription of more personalized treatments aimed to improving the precision medical management of inflammation as well as the design of anti-inflammatory diets in chronic and communicable diseases.

Effects of Descurainia sophia on Oxidative Stress Markers and Thirst Alleviation in Hemodialysis Patients: A Randomized Double-Blinded Placebo-Controlled Cross-Over Clinical Trial

Background

Patients undergoing hemodialysis (HD) are regularly exposed to oxidative stress and inflammation and may suffer from thirst distress with no definitive treatment to address these complications. Descurainia sophia (DS) has been used to alleviate thirst in traditional Persian medicine. This study aimed to assess the effectiveness of DS on oxidation factors and thirst score in HD patients.

Methods

This study was conducted on fifty-three HD patients referred to Tehran Shahid Modarres hospital. The patients were randomly divided into two groups: Group 1 received DS for six weeks, then underwent four weeks of washout period followed by six weeks of placebo treatment, while group 2 received placebo initially followed by treatment with DS. Biochemistry, malondialdehyde (MDA), and total antioxidant capacity (TAC) were measured in four phases: at the beginning, before washout, after washout, and at the end of the study. The patient's body weight was recorded at the start of each session to assess interdialytic weight gain. Thirst scores also were measured using a visual analog scale.

Results

A total of 53 patients, including 23 (43.4%) male and 30 (56.6%) female subjects, were included in the study. The results showed a reduction in thirst score (p=0.001), cholesterol levels (p=0.046), triglycerides (0.003), and MDA (p < 0.001) following the four-week administration of DS treatment in HD patients. The mean levels of TAC were increased (p < 0.001), and calcium, as well as Na+, remained unchanged (p > 0.05). Also, a significant decrease in the patient's weight was observed (p value <0.001). This effect persisted after shifting to a placebo. However, the two groups had no significant difference (p value = 0.539).

Conclusion

DS powder-mixed syrup may benefit HD patients by facilitating free radical scavenging and alleviating thirst distress with minimal adverse effects. The seeds could therefore be utilized as a complementary therapy for hemodialysis patients.

Current studies and potential future research directions on biological effects and related mechanisms of allicin

Allicin, a thiosulfonate extract from freshly minced garlic, has been reported to have various biological effects on different organs and systems of animals and human. It can reduce oxidative stress, inhibit inflammatory response, resist pathogen infection and regulate intestinal flora. In addition, dozens of studies also demonstrated allicin could reduce blood glucose level, protect cardiovascular system and nervous system, and fight against cancers. Allicin was widely used in disease prevention and health care. However, more investigations on human cohort study are needed to verify the biological or clinical effects of allicin in the future. In this review, we summarized the biological effects of allicin from previous outstanding and valuable studies and provided useful information for future studies on the health effects of allicin.

The role of natural antioxidants in cisplatin-induced hepatotoxicity

Cisplatin is a potent platinum-based anticancer drug approved by the Food Drug Administration (FDA) in 1978. Despite its advantages against solid tumors, cisplatin confers toxicity to various tissues that limit its clinical uses. In cisplatin-induced hepatotoxicity, few mechanisms have been identified, which started as excess generation of reactive oxygen species that leads to oxidative stress, inflammation, DNA damage and apoptosis in the liver. Various natural products, plant extracts and oil rich in flavonoids, terpenoids, polyphenols, and phenolic acids were able to minimize oxidative stress by restoring the level of antioxidant enzymes and acting as an anti-inflammatory agent. Likewise, treatment with honey and royal jelly was demonstrated to decrease serum transaminases and scavenge free radicals in the liver after cisplatin administration. Medicinal properties of these natural products have a promising potential as a complementary therapy to counteract cisplatin-induced hepatotoxicity. This review concentrated on the protective role of several natural products, which has been proven in the laboratory findings to combat cisplatin-induced hepatotoxicity.

Potential Therapeutic Effects of Natural Plant Compounds in Kidney Disease

Background: The blockade of the progression or onset of pathological events is essential for the homeostasis of an organism. Some common pathological mechanisms involving a wide range of diseases are the uncontrolled inflammatory reactions that promote fibrosis, oxidative reactions, and other alterations. Natural plant compounds (NPCs) are bioactive elements obtained from natural sources that can regulate physiological processes. Inflammation is recognized as an important factor in the development and evolution of chronic renal damage. Consequently, any compound able to modulate inflammation or inflammation-related processes can be thought of as a renal protective agent and/or a potential treatment tool for controlling renal damage. The objective of this research was to review the beneficial effects of bioactive natural compounds on kidney damage to reveal their efficacy as demonstrated in clinical studies. Methods: This systematic review is based on relevant studies focused on the impact of NPCs with therapeutic potential for kidney disease treatment in humans. Results: Clinical studies have evaluated NPCs as a different way to treat or prevent renal damage and appear to show some benefits in improving OS, inflammation, and antioxidant capacity, therefore making them promising therapeutic tools to reduce or prevent the onset and progression of KD pathogenesis. Conclusions: This review shows the promising clinical properties of NPC in KD therapy. However, more robust clinical trials are needed to establish their safety and therapeutic effects in the area of renal damage.

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.

Cardioprotective Potential of Garlic Oil and Its Active Constituent, Diallyl Disulphide, in Presence of Carvedilol during Chronic Isoprenaline Injection-Mediated Myocardial Necrosis in Rats

In isoprenaline (ISO)-induced myocardial infarcted rats, garlic oil (GO) and its main ingredient, diallyl disulfide (DADS), were examined for cardioprotective effects when used with carvedilol (CAR). GO, DADS and CAR were given to rats in their respective groups, either alone or together, with the addition of isoprenaline (3 mg/kg/day, subcutaneously) during the last 10 days of treatment. At the end of 14 days of treatment, blood samples were collected, the hearts were excised under anesthesia and weighed. Heart tissue homogenate was used to measure superoxide dismutase (SOD), catalase (CAT), and thiobarbituric acid reactive substances (TBARS). Furthermore, the serum activities of cardiac markers, including lactate dehydrogenase, creatine kinase, and cardiac troponin, were checked. Moreover, inflammatory markers including tumor necrosis factor alpha, interleukin one beta, interleukin six, and kappa bp65 subunit were assessed. Rats that received GO, DADS, and CAR exhibited a significant increase in the cardiac antioxidant enzyme activities with a simultaneous decrease in serum cardiac markers enzymes and inflammatory markers. The TBARS were significantly reduced in rats that received treatment. The addition of carvedilol to GO or DADS significantly elevated antioxidant activities and decreased the release of cardiac enzymes into blood circulation. Both DADS and GOl were almost similar in efficacy, indicating the potential role of DADS in garlic oil-mediated cardioprotection. Combining GO or DADS with CAR increased CAR’s cardioprotective impact and protected rats from developing ISO-induced myocardial infarction.

Efficacy of Oral Administration of Allium sativum Powder "Garlic Extract" on Lipid Profile, Inflammation, and Cardiovascular Indices among Hemodialysis Patients

Background

Inflammation plays a prominent role in the deteriorating cardiovascular risk of hemodialysis patients. Utilization of herbal remedies, especially garlic extract, in these patients has resulted in promising improvement in lipid profile, inflammation, and cardiovascular markers.

Purpose

In this survey, we aimed to determine the effects of oral administration of Allium sativum powder on lipid profile, inflammation, and cardiovascular markers among hemodialysis patients.

Methods

In this interventional double-blinded randomized crossover study, 70 patients were enrolled and assigned in two groups. Each group received 300 mg of garlic powder BID or placebo for eight weeks; after a six-week wash-out period, the agents were switched between two groups so that the group who received garlic powder in the first eight weeks received placebo for the second eight weeks, and vice versa. Venous blood samples were obtained in baseline, wash-out period, and at the end of study. Following obtaining laboratory data, BUN, creatinine, Na, K, Ca, Ph, homocysteine, and lipid profile were compared.

Results

No significant differences were shown at baselines of outcomes between the garlic and placebo group (p value>0.05). However, there was a significant decrease in absolute values of OXLDL (mean placebo = 979.63, mean garlic = 676.54; p value<0.001) and HCY (mean placebo = 36.54, mean garlic = 27.78; p value<0.001). In addition, significant treatment differences were seen in change values of Ca (placebo = 1.17, garlic = 0.21; p value = 0.006), TG (placebo = −6.71, garlic = -24.14; p value = 0.014), OXLDL (placebo = −281.30, garlic = -699.78; p value<0.001), and HCY (placebo = −0.24, garlic = −6.68; p value<0.001).

Conclusion

In this study, Allium sativum powder demonstrated efficacy in lipid profile improvement and renal protective effects among hemodialysis patients.

From the distinctive smell to therapeutic effects: Garlic for cardiovascular, hepatic, gut, diabetes and chronic kidney disease

Garlic, a member of the Allium family, widely used in cooking for many centuries, displays well described antioxidant and anti-inflammatory properties, as a result of its constituent organosulfur compounds, such as alliin, allicin, ajoene S-allyl-cysteine, diallyl sulfide and diallyl disulfide, among others. Although garlic has demonstrated beneficial effects in cardiovascular disease, diabetes, and cancer, its efficacy as a therapeutic intervention in chronic kidney disease remains to be proven. This review thus focuses on the potential benefits of garlic as a treatment option in chronic kidney disease. and its ability to mitigate associated cardiovascular complications and gut dysbiosis.

Herbal antioxidants in dialysis patients: a review of potential mechanisms and medical implications

The consumption of exogenous antioxidants isolated from herbal extracts has shown beneficial effects on ameliorating dialysis-related complications through debilitating oxidative stress and inflammatory process. Many clinical studies available in public databases have reported the improved consequences of dialysis in patients supplemented with herbal antioxidants. Exploration of such data offers great possibilities for gaining insights into the potential mechanisms and medical implications of herbal antioxidants. In this work, the mechanisms and implications of some famous bioactive substances including silymarin, curcumin, resveratrol, emodin, and quercetin on the consequences of dialysis in chronic kidney disease (CKD) patients were explored. The protective features of silymarin are due to the flavonoid complex silybin. Curcumin is an active element from the root of curcuma longa with extensive beneficial properties, including antioxidant, anti-inflammatory activity, and inhibitory effects on cell apoptosis. Resveratrol can reduce the oxidative stress by neutralization of free radicals. Emodin is known as a natural anthraquinone derivative isolated from Chinese herbs. Finally, quercetin has been reported to exhibit several properties including antioxidant, anti-diabetic, analgesic, antihistaminic, antiviral, cholesterol reducer, and renal hemodynamic modulator. However, potential mechanisms and medical implications of the aforementioned herbal antioxidants seem to be more complicated, that is, more studies are required in this field.

Effects of garlic supplementation on serum inflammatory markers: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND AIMS

Previous studies have indicated that garlic consumption may be beneficial in improving inflammation. This systematic review and meta-analysis aimed to examine the effect of garlic supplementation on inflammatory biomarkers.

METHODS

PubMed/Medline, Scopus and ISI web of science were searched up to February 2019. Random effects model was used to calculate the overall effects on C-reactive protein (CRP), Interleukin-6 (IL-6), and Tumor necrosis factor- α (TNF-α).

RESULTS

17 randomized controlled trials (RCTs) were included in the meta-analyses. Garlic supplementation significantly reduced the level of circulating CRP (P < 0.05), whereas it did not have any significant effect on IL-6 level (p > 0.05). Sub-group analysis showed that aged garlic extract (AGE) was able to reduce CRP and TNF-α significantly (P < 0.05).

CONCLUSIONS

This meta-analysis showed that supplementation with garlic could reduce the level of circulating CRP and AGE could reduce the level of TNF-α and CRP, whereas it had no significant effect on the IL-6 level.

Potential Health Benefit of Garlic Based on Human Intervention Studies: A Brief Overview

Garlic is a polyphenolic and organosulfur enriched nutraceutical spice consumed since ancient times. Garlic and its secondary metabolites have shown excellent health-promoting and disease-preventing effects on many human common diseases, such as cancer, cardiovascular and metabolic disorders, blood pressure, and diabetes, through its antioxidant, anti-inflammatory, and lipid-lowering properties, as demonstrated in several in vitro, in vivo, and clinical studies. The present review aims to provide a comprehensive overview on the consumption of garlic, garlic preparation, garlic extract, and garlic extract-derived bioactive constituents on oxidative stress, inflammation, cancer, cardiovascular and metabolic disorders, skin, bone, and other common diseases. Among the 83 human interventional trials considered, the consumption of garlic has been reported to modulate multiple biomarkers of different diseases; in addition, its combination with drugs or other food matrices has been shown to be safe and to prolong their therapeutic effects. The rapid metabolism and poor bioavailability that have limited the therapeutic use of garlic in the last years are also discussed.

The effects of garlic (Allium sativum) supplementation on inflammatory biomarkers, fatigue, and clinical symptoms in patients with active rheumatoid arthritis: A randomized, double-blind, placebo-controlled trial

Based on the antiinflammatory properties of garlic, current study was conducted to evaluate the garlic supplement effects on serum levels of some inflammatory biomarkers, clinical symptoms, and fatigue in women with active rheumatoid arthritis. In this randomized, double-blind, placebo-controlled trial study, 70 women with RA were randomly divided into two groups: The intervention group was supplemented with 1,000 mg of garlic, and the control group received placebo for 8 weeks. At baseline and at the end of the study, clinical symptoms, fatigue, serum level of C-reactive protein (CRP), tumor necrosis factor-a (TNF-a), and erythrocyte sedimentation rate (ESR) were determined. After intervention, serum levels of CRP (p = .018) and TNF-a (p < .001) decreased significantly in the garlic group as compared with the placebo group. Also, pain intensity, tender joint count, disease activity score (DAS-28), and fatigue were significantly decreased in the intervention group compared with the control group (p < .001; for all). Swollen joint count was significantly decreased in the garlic group (p < .001), but not in the placebo group (p = .123). No significant changes were observed for ESR. Garlic supplementation by improving inflammatory mediators and clinical symptoms can be considered as a potential adjunct treatment in patients with RA. However, further studies with larger duration are needed.

Relation of Fruits and Vegetables with Major Cardiometabolic Risk Factors, Markers of Oxidation, and Inflammation

Noncommunicable diseases (NCDs) are considered to be the leading cause of death worldwide. Inadequate fruit and vegetable intake have been recognized as a risk factor for almost all NCDs (type 2 diabetes mellitus, cancer, and cardiovascular and neurodegenerative diseases). The main aim of this review is to examine the possible protective effect that fruit and vegetable consumption or their bioactive compounds may have on the development of NCDs such as atherosclerosis. The accumulated evidence on the protective effects of adequate consumption of fruits and vegetables in some cases, or the lack of evidence in others, are summarized in the present review. The main conclusion of this review is that well-designed, large-scale, long-term studies are needed to truly understand the role fruit and vegetable consumption or their bioactive compounds have in atherosclerosis.

Allium vegetable consumption and health: An umbrella review of meta-analyses of multiple health outcomes

Previously, our meta-analysis and other studies have suggested that allium vegetable consumption is beneficial for health, but no umbrella review has been conducted to assess the evidence of the various health benefits of allium vegetable consumption. Therefore, we conducted this umbrella review on this topic. This umbrella review included a total of 16 meta-analyses with 50 unique outcomes. The most beneficial cancer-related outcome was shown for gastric cancer (risk ratio 0.78; 95% confidence interval [CI] 0.67-0.91). In addition, only 8 weeks of garlic consumption significantly decreased serum total cholesterol (weighted mean differences -17.20 mg/dl; 95% CI -23.10 to -11.30), and patients with dyslipidemia who consumed garlic experienced more benefits than the whole population. Diabetic patients with longer durations of garlic intake experienced more benefits in terms of fasting blood glucose (FBG), HbA1c, and serum fructosamine than healthy participants, and garlic intake was associated with blood pressure reduction in hypertensive patients but not in normotensive participants. Limited side effects of garlic, such as garlic odor and gastrointestinal complaints, were reported among the included meta-analyses. Our results suggested that allium vegetables might be beneficial for cancer prevention. In particular, garlic was comparatively safe and is recommended as a long-term dietary component for patients with dyslipidemia, diabetes, and hypertension.