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Salim R, Nehvi IB, Mir RA, Tyagi A, Ali S, Bhat OM. A review on anti-nutritional factors: unraveling the natural gateways to human health. Front Nutr 2023; 10:1215873. [PMID: 37720376 PMCID: PMC10501406 DOI: 10.3389/fnut.2023.1215873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Humans are constantly facing multiple health challenges from both communicable and non-communicable diseases that significantly affect their health. Additionally, drug resistance or failure has made the situation even worse and poses serious challenges for researchers to develop new drugs. Hence, to address these problems, there is an urgent need to discover and develop timely and long-term-based therapeutic treatments from different sources. One such approach is harnessing the potential of plant secondary metabolites. Plants have been utilized for therapeutic purposes in addition to being used for nutritional benefits. In the last two decades, plant-based drug developments have been one of the effective means of treating human diseases owing to their multiple functions. More recently, anti-nutritional factors (ANFs) have emerged as one of the important targets for novel plant-based drug development due to their multifaceted and potential pharmacological properties. However, their anti-nutritional properties have been the major setback for their limited success in the pharmacological sector. In this review, we provide an overview of ANFs and their beneficial roles in preventing human diseases with multiple case studies. We also highlight the recent developments and applications of ANFs in the food industry, agriculture, and pharmaceutics with future perspectives. Furthermore, we evaluate meta-analyses on ANFs from the last 30 years in relation to their function in human health benefits. This review is an endeavor to reevaluate the merit of these natural compounds and explore their potential for both human and animal health.
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Affiliation(s)
- Rehana Salim
- Division of Food Science and Technology, SKUAST, Shalimar, India
| | | | - Rakeeb Ahmad Mir
- Department of Biotechnology, School of Life Sciences, Central University of Kashmir, Ganderbal, India
| | - Anshika Tyagi
- Department of Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
| | - Sajad Ali
- Department of Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
| | - Owais M. Bhat
- Department of Biotechnology, School of Life Sciences, Central University of Kashmir, Ganderbal, India
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Sanchis P, Prieto RM, Konieczna J, Grases F, Abete I, Salas-Salvadó J, Martín V, Ruiz-Canela M, Babio N, García-Gavilán JF, Goday A, Costa-Bauza A, Martínez JA, Romaguera D. Estimated Phytate Intake Is Associated with Bone Mineral Density in Mediterranean Postmenopausal Women. Nutrients 2023; 15:nu15071791. [PMID: 37049631 PMCID: PMC10097286 DOI: 10.3390/nu15071791] [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: 03/15/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
The main objective of this work was to explore the association of dietary phytate intake with bone mineral density (BMD) in a Mediterranean population of postmenopausal women. For this purpose, a cross-sectional analysis of 561 women aged 55-75 years with overweight/obesity and metabolic syndrome from a Mediterranean area and with data on dual-energy X-ray absorptiometry (DXA) scans in femur and lumbar spine was performed. Estimated phytate intake was calculated using a validated food frequency questionnaire. Our results indicated that phytate intake was associated with BMD [β(95%CI) per each 25 mg/100 kcal] in femoral neck [0.023(0.060-0.040) g/cm2], femoral Ward's triangle [0.033(0.013-0.054) g/cm2], total femur [0.018(0.001-0.035) g/cm2], and all the analyzed lumbar spine sites [L1-L4: 0.033(0.007-0.059) g/cm2] after adjusting for potential confounders. The sensitivity analysis showed that phytate intake was directly associated with lumbar spine BMD in women younger than 66 years, with a body mass index higher than 32.6 kg/cm2 and without type 2 diabetes (all p-for interactions < 0.05). The overall results indicated that phytate, a substance present in food as cereals, legumes and nuts, was positively associated with BMD in Mediterranean postmenopausal women. Phytate may have a protective effect on bone resorption by adsorbing on the surfaces of HAP. Nevertheless, large, long-term, and randomized prospective clinical studies must be performed to assess the possible benefits of phytate consumption on BMD in postmenopausal women.
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Grants
- NIH 1R01DK127601 NIH HHS
- Advanced Research Grant 2014-2019; agreement #34091 European Research Council
- PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462,PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722,PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919,PI14/00853,PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00 Instituto de Salud Carlos III
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Affiliation(s)
- Pilar Sanchis
- Laboratory of Renal Lithiasis Research, University Institute of Health Science Research (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Rafael María Prieto
- Laboratory of Renal Lithiasis Research, University Institute of Health Science Research (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Jadwiga Konieczna
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Félix Grases
- Laboratory of Renal Lithiasis Research, University Institute of Health Science Research (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Itziar Abete
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, Navarra Institute for Health Research (IdiSNA), University of Navarra, 31008 Pamplona, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43007 Tarragona, Spain
- Institut d'Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Miguel Ruiz-Canela
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, 31008 Pamplona, Spain
| | - Nancy Babio
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43007 Tarragona, Spain
- Institut d'Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Jesús Francisco García-Gavilán
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43007 Tarragona, Spain
- Institut d'Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Albert Goday
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Department of Medicine, University of Barcelona, 08193 Barcelona, Spain
| | - Antonia Costa-Bauza
- Laboratory of Renal Lithiasis Research, University Institute of Health Science Research (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - José Alfredo Martínez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, Navarra Institute for Health Research (IdiSNA), University of Navarra, 31008 Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
| | - Dora Romaguera
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
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Pujol A, Sanchis P, Grases F, Masmiquel L. Phytate Intake, Health and Disease: "Let Thy Food Be Thy Medicine and Medicine Be Thy Food". Antioxidants (Basel) 2023; 12:antiox12010146. [PMID: 36671007 PMCID: PMC9855079 DOI: 10.3390/antiox12010146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Phytate (myo-inositol hexakisphosphate or InsP6) is the main phosphorus reservoir that is present in almost all wholegrains, legumes, and oilseeds. It is a major component of the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets. Phytate is recognized as a nutraceutical and is classified by the Food and Drug Administration (FDA) as Generally Recognized As Safe (GRAS). Phytate has been shown to be effective in treating or preventing certain diseases. Phytate has been shown to inhibit calcium salt crystallization and, therefore, to reduce vascular calcifications, calcium renal calculi and soft tissue calcifications. Moreover, the adsorption of phytate to the crystal faces can inhibit hydroxyapatite dissolution and bone resorption, thereby playing a role in the treatment/prevention of bone mass loss. Phytate has a potent antioxidation and anti-inflammatory action. It is capable of inhibiting lipid peroxidation through iron chelation, reducing iron-related free radical generation. As this has the effect of mitigating neuronal damage and loss, phytate shows promise in the treatment/prevention of neurodegenerative disease. It is reported that phytate improves lipid and carbohydrate metabolism, increases adiponectin, decreases leptin and reduces protein glycation, which is linked with macrovascular and microvascular diabetes complications. In this review, we summarize the benefits of phytate intake as seen in in vitro, animal model, epidemiological and clinical trials, and we also identify questions to answer in the future.
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Affiliation(s)
- Antelm Pujol
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands (IdISBa), 07198 Palma de Mallorca, Spain
- Correspondence: (A.P.); (L.M.)
| | - Pilar Sanchis
- Laboratory of Renal Lithiasis Research, Deptartment of Chemistry, University of Balearic Islands, Health Research Institute of Balearic Islands, (IdISBa), 07122 Palma de Mallorca, Spain
| | - Felix Grases
- Laboratory of Renal Lithiasis Research, Deptartment of Chemistry, University of Balearic Islands, Health Research Institute of Balearic Islands, (IdISBa), 07122 Palma de Mallorca, Spain
| | - Luis Masmiquel
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands (IdISBa), 07198 Palma de Mallorca, Spain
- Correspondence: (A.P.); (L.M.)
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Pires SMG, Reis RS, Cardoso SM, Pezzani R, Paredes-Osses E, Seilkhan A, Ydyrys A, Martorell M, Sönmez Gürer E, Setzer WN, Abdull Razis AF, Modu B, Calina D, Sharifi-Rad J. Phytates as a natural source for health promotion: A critical evaluation of clinical trials. Front Chem 2023; 11:1174109. [PMID: 37123871 PMCID: PMC10140425 DOI: 10.3389/fchem.2023.1174109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 04/03/2023] [Indexed: 05/02/2023] Open
Abstract
Phytates are a type of organophosphorus compound produced in terrestrial ecosystems by plants. In plant feeds, phytic acid and its salt form, phytate, account for 60%-80% of total phosphorus. Because phytate is a polyanionic molecule, it can chelate positively charged cations such as calcium, iron, and zinc. Due to its prevalence in vegetal tissues and the fact that people consume plants, phytate was first considered a potential health benefit. This updated review aims to summarize the current data on the results of clinical trials of phytates on human health, highlighting both beneficial and undesirable effects. To obtain these updated data, published papers in electronic databases such as PubMed/MedLine, TRIP database, Wiley, Google Scholar, Baidu, and Scopus were searched. Study results have shown that phytate can have beneficial health effects such as antioxidant, anticancer potential and reduction of pathological calcifications in blood vessels and organs; but also, negative effects by reducing the absorption of minerals important for maintaining the homeostasis of the human body. According to these recent results derived from recent clinical studies, phytates may be a potential natural source for health benefits. To improve clinical efficacy and human health benefits, further dose-response studies are needed to determine effective therapeutic doses and potential interactions with conventional drugs.
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Affiliation(s)
- Sónia M. G. Pires
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Rita Silva Reis
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Susana M. Cardoso
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal
- *Correspondence: Susana M. Cardoso, ; Miquel Martorell, ; Ahmad Faizal Abdull Razis, ; Daniela Calina, ; Javad Sharifi-Rad,
| | - Raffaele Pezzani
- Phytotherapy Lab (PhT-Lab), Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
- AIROB, Associazione Italiana per la Ricerca Oncologica di Base, Padova, Italy
| | - Esteban Paredes-Osses
- Instituto de Ciencias Naturales, Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Las Américas, Chile
| | - Ainur Seilkhan
- Educational Program, Geography, Environment and Service Sector, Abai Kazakh National Pedagogical University, Almaty, Kazakhstan
| | - Alibek Ydyrys
- Biomedical Research Centre, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Miquel Martorell
- Centre for Healthy Living, Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepción, Concepción, Chile
- Unidad de Desarrollo Tecnológico, UDT, Universidad de Concepción, Concepción, Chile
- *Correspondence: Susana M. Cardoso, ; Miquel Martorell, ; Ahmad Faizal Abdull Razis, ; Daniela Calina, ; Javad Sharifi-Rad,
| | - Eda Sönmez Gürer
- Department of Pharmacognosy, Faculty of Pharmacy, Sivas Cumhuriyet University, Sivas, Türkiye
| | - William N. Setzer
- Aromatic Plant Research Center, Lehi, UT, United States
- Department of Chemistry, University of Alabama in Huntsville, Huntsville, AL, United States
| | - Ahmad Faizal Abdull Razis
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Natural Medicines and Products Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- *Correspondence: Susana M. Cardoso, ; Miquel Martorell, ; Ahmad Faizal Abdull Razis, ; Daniela Calina, ; Javad Sharifi-Rad,
| | - Babagana Modu
- Natural Medicines and Products Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Biochemistry, Faculty of Science, University of Maiduguri, Maiduguri, Borno, Nigeria
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, Romania
- *Correspondence: Susana M. Cardoso, ; Miquel Martorell, ; Ahmad Faizal Abdull Razis, ; Daniela Calina, ; Javad Sharifi-Rad,
| | - Javad Sharifi-Rad
- Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
- *Correspondence: Susana M. Cardoso, ; Miquel Martorell, ; Ahmad Faizal Abdull Razis, ; Daniela Calina, ; Javad Sharifi-Rad,
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Kaur R, Singh R. Mechanistic insights into CKD-MBD-related vascular calcification and its clinical implications. Life Sci 2022; 311:121148. [DOI: 10.1016/j.lfs.2022.121148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/22/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
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Garutti M, Nevola G, Mazzeo R, Cucciniello L, Totaro F, Bertuzzi CA, Caccialanza R, Pedrazzoli P, Puglisi F. The Impact of Cereal Grain Composition on the Health and Disease Outcomes. Front Nutr 2022; 9:888974. [PMID: 35711559 PMCID: PMC9196906 DOI: 10.3389/fnut.2022.888974] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/26/2022] [Indexed: 12/21/2022] Open
Abstract
Whole grains are a pivotal food category for the human diet and represent an invaluable source of carbohydrates, proteins, fibers, phytocompunds, minerals, and vitamins. Many studies have shown that the consumption of whole grains is linked to a reduced risk of cancer, cardiovascular diseases, and type 2 diabetes and other chronic diseases. However, several of their positive health effects seem to disappear when grains are consumed in the refined form. Herein we review the available literature on whole grains with a focus on molecular composition and health benefits on many chronic diseases with the aim to offer an updated and pragmatic reference for physicians and nutrition professionals.
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Affiliation(s)
- Mattia Garutti
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Gerardo Nevola
- Department of Anaesthesia and Intensive Care - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Roberta Mazzeo
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Linda Cucciniello
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Fabiana Totaro
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Carlos Alejandro Bertuzzi
- Department of Anaesthesia and Intensive Care - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fabio Puglisi
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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Understanding the Protective Effect of Phytate in Bone Decalcification Related-Diseases. Nutrients 2021; 13:nu13082859. [PMID: 34445019 PMCID: PMC8400850 DOI: 10.3390/nu13082859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022] Open
Abstract
Myo-inositol hexaphosphate (phytate; IP6) is a natural compound that is abundant in cereals, legumes, and nuts, and it can bind to crystal surfaces and disturb crystal development, acting as crystallization inhibitor. The adsorption of such inhibitors to crystal faces can also inhibit crystal dissolution. The binding of phytate to metal cofactors suggests that it could be used for treatment of osteoporosis. Our in-vitro study showed that phytate inhibits dissolution of hydroxyapatite (HAP). The effect of phytate was similar to that of alendronate and greater than that of etidronate. This led us to perform a cross-sectional study to investigate the impact of consumption of IP6 on bone mineral density (BMD) in post-menopausal women. Our data indicate that BMD and t-score of lumbar spine increased with increasing phytate consumption, and a phytate consumption higher than 307 mg/day was associated with a normal BMD (t-score > −1). These data suggest that phytate may have a protective effect in bone decalcification by adsorbing on the surfaces of HAP, and a daily consumption of phytate-rich foods (at least one serving/day of legumes or nuts) may help to prevent or minimize bone-loss disorders, such as osteoporosis. However, further studies are needed to gain a better understanding about the mechanism of inhibition of phytate in bone-related diseases (see graphical abstract).
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Abstract
PURPOSE OF REVIEW Vascular calcification (VC) is associated with increased cardiovascular event rates, particularly in patients with end-stage kidney disease (ESKD). Dysregulated mineral metabolism and inflammation have been shown to promote VC, however, treatment options targeting VC specifically are not available. This review outlines the pathophysiological mechanisms contributing to VC in ESKD and describes recent studies evaluating the effects of the first-in-class inhibitor of VC, SNF472. RECENT FINDINGS SNF472 directly inhibits calcium phosphate crystal formation and aggregation. SNF472 has completed early phase clinical trials with a favourable safety profile and Phase 2 clinical trial data have shown attenuation of coronary artery and aortic valve calcification in patients receiving hemodialysis. SUMMARY Therapeutic agents that directly target VC may prevent the multiple complications associated with dystrophic calcification in patients with ESKD.
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Bushinsky DA, Raggi P, Bover J, Ketteler M, Bellasi A, Rodriguez M, Sinha S, Garg R, Perelló J, Gold A, Chertow GM. Effects of Myo-inositol Hexaphosphate (SNF472) on Bone Mineral Density in Patients Receiving Hemodialysis: An Analysis of the Randomized, Placebo-Controlled CaLIPSO Study. Clin J Am Soc Nephrol 2021; 16:736-745. [PMID: 33835939 PMCID: PMC8259477 DOI: 10.2215/cjn.16931020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/22/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES In the CaLIPSO study, intravenous administration of SNF472 (300 or 600 mg) during hemodialysis significantly attenuated progression of coronary artery and aortic valve calcification. SNF472 selectively inhibits formation of hydroxyapatite, the final step in cardiovascular calcification. Because bone mineral is predominantly hydroxyapatite, we assessed changes in bone mineral density in CaLIPSO. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Patients with coronary artery calcification at screening (Agatston score of 100-3500 U) were randomized 1:1:1 to receive placebo, 300 mg SNF472, or 600 mg SNF472 as an intravenous infusion during hemodialysis three times weekly for 52 weeks. Dual-energy x-ray absorptiometry (DXA) scans were obtained at baseline (screening) and end of treatment, and between-group changes from baseline were compared using analysis of covariance. RESULTS Among 274 randomized patients, 202 had evaluable DXA scans at baseline and postrandomization (the DXA-modified intention-to-treat population). Mean (95% confidence interval) changes in total-hip bone mineral density from baseline to week 52 were -1.5% (-2.7% to -0.3%), -1.5% (-2.7% to -0.4%), and -2.5% (-3.8% to -1.2%) in the placebo, 300 mg SNF472, and 600 mg SNF472 groups, respectively. Mean (95% confidence interval) changes in femoral-neck bone mineral density from baseline to week 52 were -0.3% (-1.6% to 1.0%), -1.0% (-2.3% to 0.2%), and -2.6% (-4.0% to -1.3%), respectively. Regression analyses showed no correlation between change in coronary artery calcium volume and change in bone mineral density at either location. Changes in serum alkaline phosphatase, calcium, magnesium, phosphate, and intact parathyroid hormone levels were similar across treatment groups. Clinical fracture events were reported for four of 90, three of 92, and six of 91 patients in the placebo, 300 mg SNF472, and 600 mg SNF472 groups, respectively. CONCLUSIONS Bone mineral density decreased modestly in all groups over 1 year. In the 600 mg SNF472 group, the reduction appeared more pronounced. Reported fractures were infrequent in all groups. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER Effect of SNF472 on Progression of Cardiovascular Calcification in End-Stage-Renal-Disease (ESRD) Patients on Hemodialysis (HD), NCT02966028.
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Affiliation(s)
- David A. Bushinsky
- Department of Medicine, University of Rochester School of Medicine, Rochester, New York
| | - Paolo Raggi
- Department of Medicine, Mazankowski Alberta Heart Institute and University of Alberta, Edmonton, Alberta, Canada
| | - Jordi Bover
- Department of Nephrology, Puigvert Foundation/Autonoma University, Sant Pau Biomedical Research Institute, Red de Investigacion Renal (REDinREN), Barcelona, Spain
| | - Markus Ketteler
- Department of General Internal Medicine and Nephrology, Robert Bosch Hospital, Stuttgart, Germany
| | - Antonio Bellasi
- Research, Innovation and Brand Reputation Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Mariano Rodriguez
- Nephrology Unit, Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Red de Investigacion Renal (REDinREN), Córdoba, Spain
| | - Smeeta Sinha
- Department of Renal Medicine, Salford Royal National Health Service Foundation Trust, Salford, United Kingdom
| | - Rekha Garg
- Research and Development, Sanifit Therapeutics, San Diego, California
| | - Joan Perelló
- Research and Development, Sanifit Therapeutics, Palma, Spain,University Institute of Health Sciences Research (IUNICS-IDISBA), University of the Balearic Islands, Palma, Spain
| | - Alex Gold
- Research and Development, Sanifit Therapeutics, San Diego, California,Department of Medicine, Stanford University, Palo Alto, California
| | - Glenn M. Chertow
- Department of Medicine, Stanford University, Palo Alto, California
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Zabirnyk A, Perez MDM, Blasco M, Stensløkken KO, Ferrer MD, Salcedo C, Vaage J. A Novel Ex Vivo Model of Aortic Valve Calcification. A Preliminary Report. Front Pharmacol 2020; 11:568764. [PMID: 33390945 PMCID: PMC7773652 DOI: 10.3389/fphar.2020.568764] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/16/2020] [Indexed: 12/27/2022] Open
Abstract
Background: No pharmacological treatment exists to prevent or stop the calcification process of aortic valves causing aortic stenosis. The aim of this study was to develop a robust model of induced calcification in whole aortic valve leaflets which could be suitable for studies of the basic mechanisms and for testing potentially inhibitory drugs. Methods: Pig hearts were obtained from a commercial abattoir. The aortic valve leaflets were dissected free and randomized between experimental groups. Whole leaflets were cultured in individual wells. Two growth media were used for cultivation: standard growth medium and an antimyofibroblastic growth medium. The latter was employed to inhibit contraction of the leaflet into a ball-like structure. Calcification was induced in the growth medium by supplementation with an osteogenic medium. Leaflets were cultivated for four weeks and medium was changed every third day. To block calcification, the inhibitor SNF472 (a formulation of the hexasodium salt of myo-inositol hexaphosphate hexasodium salt) was used at concentrations between 1 and 100 µM. After cultivation for four weeks the leaflets were snap frozen in liquid nitrogen and kept at −80 °C until blind assessment of the calcium amount in leaflets by inductively coupled plasma optical emission spectroscopy. For statistical analysis, a Kruskal–Wallis test with Dunn’s post-test was applied. Results: Osteodifferentiation with calcium accumulation was in principle absent when standard medium was used. However, when the antimyofibroblastic medium was used, a strong calcium accumulation was induced (p = 0.006 compared to controls), and this was blocked in a dose-dependent manner by the calcification inhibitor SNF472 (p = 0.008), with an EC50 of 3.3 µM. Conclusion: A model of experimentally induced calcification in cultured whole leaflets from porcine aortic valves was developed. This model can be useful for studying the basic mechanisms of valve calcification and to test pharmacological approaches to inhibit calcification.
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Affiliation(s)
- Arsenii Zabirnyk
- Division of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Department of Research & Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | | | - Marc Blasco
- Sanifit Therapeutics, Palma de Mallorca, Spain
| | - Kåre-Olav Stensløkken
- Division of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | | | - Jarle Vaage
- Division of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Department of Research & Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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12
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Delimont NM, Nickel S. Salivary cystatin SN is a factor predicting iron bioavailability after phytic acid rich meals in female participants. Int J Food Sci Nutr 2020; 72:559-568. [PMID: 33179561 DOI: 10.1080/09637486.2020.1846164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Phytic acid is an inhibitor of iron bioavailability, but it has been suggested that individuals may adapt to phytic acid over time, and that the salivary protein, cystatin SN, may be involved. This study evaluated the relationship between human cystatin SN levels and iron bioavailability after a phytic acid rich meal. Three groups of ten women consumed meals with: (1) 500 mg phytate sprinkles, (2) 500 mg phytate capsules, or (3) no phytic acid. Iron bioavailability was measured by the mealtime percentage of maximum iron recovery; cystatin SN was measured pre-and post-meal by enzyme-linked immunosorbent assay. Pre-to-post meal cystatin SN was positively correlated with improved iron bioavailability in group 1. Pre-to-post meal cystatin SN was correlated with improved iron absorption in groups 1 and 2. Cystatin SN recovery after phytic acid rich meals may be a physiological factor predicting iron bioavailability.
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Affiliation(s)
| | - Sarah Nickel
- Department of Medical Laboratory Sciences, Wichita State University, Wichita, KS, USA
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13
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Is There Such a Thing as "Anti-Nutrients"? A Narrative Review of Perceived Problematic Plant Compounds. Nutrients 2020; 12:nu12102929. [PMID: 32987890 PMCID: PMC7600777 DOI: 10.3390/nu12102929] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
Plant-based diets are associated with reduced risk of lifestyle-induced chronic diseases. The thousands of phytochemicals they contain are implicated in cellular-based mechanisms to promote antioxidant defense and reduce inflammation. While recommendations encourage the intake of fruits and vegetables, most people fall short of their target daily intake. Despite the need to increase plant-food consumption, there have been some concerns raised about whether they are beneficial because of the various ‘anti-nutrient’ compounds they contain. Some of these anti-nutrients that have been called into question included lectins, oxalates, goitrogens, phytoestrogens, phytates, and tannins. As a result, there may be select individuals with specific health conditions who elect to decrease their plant food intake despite potential benefits. The purpose of this narrative review is to examine the science of these ‘anti-nutrients’ and weigh the evidence of whether these compounds pose an actual health threat.
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14
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Sanchis P, Rivera R, Fortuny R, Río C, Mas-Gelabert M, Gonzalez-Freire M, Grases F, Masmiquel L. Role of Advanced Glycation End Products on Aortic Calcification in Patients with Type 2 Diabetes Mellitus. J Clin Med 2020; 9:jcm9061751. [PMID: 32516928 PMCID: PMC7356630 DOI: 10.3390/jcm9061751] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to evaluate the relationship between serum levels of advanced glycation end products (AGEs) and abdominal aortic calcification (AAC) in patients with type 2 diabetes mellitus (DM2). This was a prospective cross-sectional study. One-hundred and four consecutive patients with DM2 were given lateral lumbar X-rays in order to quantify abdominal aortic calcification (AAC). Circulating levels of AGEs and classical cardiovascular risk factors were determined. Clinical history was also registered. Patients with higher AGEs values had higher grades of aortic calcification and higher numbers of diabetic-related complications. Multivariate logistic regression analysis showed that being older, male and having high levels of AGEs and triglycerides were the independent risk factors associated to moderate-severe AAC when compared to no-mild AAC. Our results suggest that AGEs plays a role in the pathogenesis of aortic calcifications. In addition, the measurement of AGEs levels may be useful for assessing the severity of AAC in the setting of diabetic complications.
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Affiliation(s)
- Pilar Sanchis
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
- Laboratory of Renal Lithiasis Research, Deptartment of Chemistry, University of Balearic Islands, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07122 Palma of Mallorca, Spain;
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 28046 Madrid, Spain
- Correspondence: (P.S.); (L.M.)
| | - Rosmeri Rivera
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
| | - Regina Fortuny
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
- Laboratory Department, Son Llàtzer University Hospital, 07198 Palma of Mallorca, Spain
| | - Carlos Río
- Proteomics department, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma of Mallorca, Spain;
| | - Miguel Mas-Gelabert
- Radiology Department, Son Llàtzer University Hospital, 07198 Palma of Mallorca, Spain;
| | - Marta Gonzalez-Freire
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
| | - Felix Grases
- Laboratory of Renal Lithiasis Research, Deptartment of Chemistry, University of Balearic Islands, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07122 Palma of Mallorca, Spain;
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 28046 Madrid, Spain
| | - Luis Masmiquel
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
- Correspondence: (P.S.); (L.M.)
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15
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A Pilot Randomized Crossover Trial Assessing the Safety and Short-Term Effects of Walnut Consumption by Patients with Chronic Kidney Disease. Nutrients 2019; 12:nu12010063. [PMID: 31881702 PMCID: PMC7020056 DOI: 10.3390/nu12010063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/19/2019] [Accepted: 12/21/2019] [Indexed: 02/06/2023] Open
Abstract
The aim of this study of patients with chronic kidney disease (CKD) is to assess the safety of daily consumption of walnuts on the physiological levels of phosphorous, potassium, parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23), and to assess the short-term benefits of this intervention on risk factors associated with cardiovascular events. This led us to perform a prospective, randomized, crossover, pilot clinical trial examined 13 patients with CKD. Subjects were randomly assigned to a diet of 30 g of walnuts per day or the control diet. After 30 days, each group was given a 30-day washout period, and then switched to the alternate diet for 30 days. Urinary and serum levels of phosphorous and potassium, multiple vascular risk factors, and urinary inositol phosphates (InsPs) were measured at baseline and at the end of the intervention period. Our results showed that the walnut dietary supplement led to reduced blood pressure, LDL cholesterol, and albumin excretion, but had no effect on the physiological levels of phosphorous, potassium, PTH, and FGF23. This is the first report to show that daily consumption of walnuts by patients with CKD does not alter their physiological levels of phosphorous, potassium, PTH, and FGF23 when included in a sodium-, protein-, phosphate-, and potassium-controlled diet, and it could be an effective strategy for reducing cardiovascular risk in patients with CKD.
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16
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Zabirnyk A, Ferrer MD, Bogdanova M, Pérez MM, Salcedo C, Kaljusto ML, Kvitting JPE, Stensløkken KO, Perelló J, Vaage J. SNF472, a novel anti-crystallization agent, inhibits induced calcification in an in vitro model of human aortic valve calcification. Vascul Pharmacol 2019; 122-123:106583. [PMID: 31437530 DOI: 10.1016/j.vph.2019.106583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/03/2019] [Accepted: 08/18/2019] [Indexed: 12/27/2022]
Abstract
The purpose of the present study was to investigate whether SNF472, the hexasodium salt of myo-inositol hexaphosphate (IP6 or phytate): 1. Inhibits induced calcification in cultured aortic valve interstitial cells (VIC) as an in vitro model of aortic valve stenosis and 2. Whether inhibition is different in VIC obtained from healthy and calcified aortic valves. VIC from healthy (n = 5) and calcified (n = 7) human aortic valves were seeded in basic growth medium, osteogenic differentiation medium alone, or in osteogenic medium with SNF472 (3, 10, and 30 μM) and cultivated for 3 weeks. Calcification was quantified spectrophotometrically after Alizarin Red staining. In VIC from calcified valves, a complete inhibition of calcification was observed with SNF472 concentrations of 10 and 30 μM (p < .01), significantly stronger than in VIC from healthy valves. When SNF472 was added to VIC after 1 week in osteogenic medium, 30 and 100 μM SNF472 inhibited the progression of ongoing calcification by 81 and 100% (p < .01), respectively. The same concentrations of SNF472 given after 2 weeks reduced calcification by 35 and 40% respectively (not significant). SNF472 inhibited both the formation and the progression of calcification with the strongest effect in VIC from calcified valves.
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Affiliation(s)
- A Zabirnyk
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - M D Ferrer
- Sanifit Therapeutics, Palma, Spain; Department of Fundamental Biology and Health Sciences, University of the Balearic Islands, Palma, Spain
| | - M Bogdanova
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | | | - M-L Kaljusto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - J-P E Kvitting
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - K-O Stensløkken
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - J Perelló
- Sanifit Therapeutics, Palma, Spain; Department of Chemistry, University of the Balearic Islands, Palma, Spain
| | - J Vaage
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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17
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Prediction of calcification tendency in pediatric cystic adamantinomatous craniopharyngioma by using inflammatory markers, hormone markers, and radiological appearances. Childs Nerv Syst 2019; 35:1173-1180. [PMID: 31062140 DOI: 10.1007/s00381-019-04178-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/28/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare the different levels of inflammatory markers, hormone markers, and radiological appearances between PCACP with and without calcification so as to explore the relationships between these markers and calcification. METHODS The inflammatory markers, hormone markers, and radiological appearances were compared not only between PCACP with and without calcification, but also among its different forms of calcification. The receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic significance of all markers between these groups. RESULTS It was showed that the white blood cell (WBC) count, neutrophil count, monocyte count, prognostic nutritional index (PNI), prolactin (PRL), and T1WI signal of cysts were higher in PCACP with calcification than in PCACP without calcification. The neutrophil count was significantly higher in PCACP with eggshell calcification than in other groups. The PCACP with mixed calcification had the highest PRL level in all kinds of PCACP with calcification. Only the area under curve (AUC) values of neutrophil count and PRL level were greater than 0.8. CONCLUSION It is found that inflammation and hormone are related to PCACP's calcification. High neutrophil count and PRL level may indicate possible calcification tendency in PCACP. Improved intracystic therapies based on these results may help to inhibit the formation of calcification in PCACP in future.
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18
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LOPEZ-GONZALEZ ANGELA, GRASES FELIX, MARÍ BARTOLOME, TOMÁS-SALVÁ MATIAS, RODRIGUEZ ADRIAN. Urinary phytate concentration and risk of fracture determined by the FRAX index
in a group of postmenopausal women. Turk J Med Sci 2019; 49:458-463. [PMID: 30862150 PMCID: PMC7018201 DOI: 10.3906/sag-1806-117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background/aim This study was designed to evaluate the relationship between urinary phytate concentration and risk of fracture at 10 years, determined by using the FRAX model, in women who had undergone menopause within 5 years of the time of enrollment. Materials and methods Of the 212 postmenopausal women evaluated, 69 were excluded because they had urinary phytate concentrations between 0.51 and 0.99 mg/L. Of the remaining 143 women, 91 had low (≤0.50 mg/L) and 52 had high (≥1.0 mg/L) urinary phytate concentrations. The 10-year risk of fracture was calculated by using the FRAX model. Results The risks of major osteoporotic fracture and hip fracture were higher in women with low urinary phytate levels (P < 0.001 in both cases). Evaluation of the risk of hip fracture in women with and without risk factors for osteoporosis (e.g., tobacco, alcohol, and drug consumption) and according to urinary phytate concentrations indicated that, among women with no risk factors, those with low and high urinary phytate levels had a range of risks of 0%–0.6% and 0%–0.3%, respectively (P = 0.098). Moreover, among women with at least one risk factor, those with low and high urinary phytate had a range of risks of 0.1%–0.8% and 0.1%–0.4%, respectively (P = 0.002). Similar results were observed when the risks of major osteoporotic fracture were analyzed. Conclusion These results indicate the relationship of phytate with the risks of major osteoporotic fracture and hip fracture, with these differences being more marked in women with risk factors for osteoporosis. From this study follows the importance of the consumption of phytate-rich products (nuts, legumes, whole cereals) to protect against the risk of fracture in 10 years, mainly in women with risk factors for osteoporosis.
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Affiliation(s)
- ANGEL A. LOPEZ-GONZALEZ
- Occupational Health Investigation Group, University Institute of Health Sciences Research (IUNICS), University of the Balearic Islands, PalmaSpain
| | - FELIX GRASES
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS), University of the Balearic Islands, PalmaSpain
| | - BARTOLOME MARÍ
- Occupational Health Investigation Group, University Institute of Health Sciences Research (IUNICS), University of the Balearic Islands, PalmaSpain
| | - MATIAS TOMÁS-SALVÁ
- Occupational Health Investigation Group, University Institute of Health Sciences Research (IUNICS), University of the Balearic Islands, PalmaSpain
| | - ADRIAN RODRIGUEZ
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS), University of the Balearic Islands, PalmaSpain
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Abstract
PURPOSE OF REVIEW Basic calcium phosphate (BCP) crystals are associated with two important musculoskeletal syndromes. Deposition of BCP crystals in tendons, bursae, and other soft tissues around joints causes calcific periarthritis, whereas intra-articular BCP crystals contribute to osteoarthritis and cause the highly destructive arthritis known as Milwaukee Shoulder Syndrome. The epidemiology and natural history of these syndromes are poorly understood, and because the pathogenesis remains unclear, few targeted therapies are available. I will review new developments in this field. RECENT FINDINGS I will discuss a case collection of calcific periarthritis of the hip, and evidence-based management strategies for shoulder calcific periarthritis that might be applied to calcific periarthritis at other locations. I will summarize several recent articles addressing mechanisms of crystal formation and identifying pathways through which BCP crystals produce tissue damage and explore some newly identified risk factors for pathologic mineralization. SUMMARY We are making slow, but steady progress in understanding the clinical presentation of calcific periarthritis in sites other than the shoulder. A growing appreciation of the mechanisms through which BCP crystals mediate tissue damage should lead to the development of novel management strategies for these common musculoskeletal syndromes.
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20
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Perelló J, Joubert PH, Ferrer MD, Canals AZ, Sinha S, Salcedo C. First-time-in-human randomized clinical trial in healthy volunteers and haemodialysis patients with SNF472, a novel inhibitor of vascular calcification. Br J Clin Pharmacol 2018; 84:2867-2876. [PMID: 30280390 DOI: 10.1111/bcp.13752] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/17/2018] [Accepted: 08/26/2018] [Indexed: 11/29/2022] Open
Abstract
AIMS SNF472 is a calcification inhibitor being developed for the treatment of cardiovascular calcification in haemodialysis (HD) and in calciphylaxis patients. This study investigated the safety, tolerability and pharmacokinetics (PK) of intravenous (IV) SNF472 in healthy volunteers (HV) and HD patients. METHODS This is a first-time-in-human, double-blind, randomized, placebo-controlled Phase I study to assess the safety, tolerability and PK of SNF472 after ascending single IV doses in HV and a single IV dose in HD patients. A pharmacodynamic analysis was performed to assess the capability of IV SNF472 to inhibit hydroxyapatite formation. RESULTS Twenty HV and eight HD patients were enrolled. The starting dose in HV was 0.5 mg kg-1 and the dose ascended to 12.5 mg kg-1 . The dose selected for HD patients was 9 mg kg-1 . Safety analyses support the safety and tolerability of IV SNF472 in HD patients and HV. Most treatment-emergent adverse events were mild in intensity. No clinically significant effects were observed on vital signs or laboratory tests. PK results were similar in HD patients and HV and indicate a lack of significant dialysability. Pharmacodynamic analyses demonstrated that SNF472 administration reduced hydroxyapatite crystallization potential in HD patients who received IV SNF472 9 mg kg-1 by 80.0 ± 2.4% (mean ± standard error of the mean, 95% CI, 75.3-84.8) compared to placebo (8.7 ± 21.0%, P < 0.001, 95% CI, -32.4 to 49.7). CONCLUSION The results from this study showed acceptable safety and tolerability, and lack of significant dialysability of IV SNF472. It is a potential novel treatment for cardiovascular calcification in end-stage renal disease and calciphylaxis warranting further human studies.
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Affiliation(s)
- J Perelló
- Laboratoris Sanifit, Palma, Spain.,Laboratori d'Investigació en Litiasi Renal, Universitat de les Illes Balears, Palma, Spain
| | - P H Joubert
- Laboratoris Sanifit, Palma, Spain.,King's College, London, UK
| | - M D Ferrer
- Laboratoris Sanifit, Palma, Spain.,Grup de Nutrició Comunitària i Estrès Oxidatiu, Departament de Biologia Fonamental i Ciències de la Salut, Universitat de les Illes Balears, Palma, Spain
| | | | - S Sinha
- Salford Royal NHS Foundation Trust, Salford, UK
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21
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Sanchis P, Rivera R, Berga F, Fortuny R, Adrover M, Costa-Bauza A, Grases F, Masmiquel L. Phytate Decreases Formation of Advanced Glycation End-Products in Patients with Type II Diabetes: Randomized Crossover Trial. Sci Rep 2018; 8:9619. [PMID: 29941991 PMCID: PMC6018557 DOI: 10.1038/s41598-018-27853-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/12/2018] [Indexed: 01/13/2023] Open
Abstract
Myo-inositol hexaphosphate (phytate; IP6) is a natural compound that is abundant in cereals, legumes, and nuts and it has the ability to chelate metal cations. The binding of IP6 to transition metals suggests that it could be used for the treatment of metal-catalyzed protein glycation, which appears to trigger diabetes-related diseases. Our in vitro studies showed that IP6 reduced the formation of Fe3+-catalyzed advanced glycation end-products (AGEs). This led us to perform a randomized cross-over trial to investigate the impact of the daily consumption IP6 on protein glycation in patients with type 2 diabetes mellitus (T2DM; n = 33). Thus, we measured AGEs, glycated hemoglobin (HbA1c), several vascular risk factors, and urinary IP6 at baseline and at the end of the intervention period. Patients who consumed IP6 supplements for 3 months had lower levels of circulating AGEs and HbA1c than those who did not consume IP6. This is the first report to show that consumption of IP6 inhibits protein glycation in patients with T2DM. Considering that AGEs contribute to microvascular and macrovascular complications in T2DM, our data indicates that dietary supplementation with IP6 should be considered as a therapy to prevent the formation of AGEs and therefore, the development of diabetes-related diseases in patients with T2DM.
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Affiliation(s)
- Pilar Sanchis
- Endocrinology Department, Research Unit, Hospital Son Llàtzer, Institute of Health Sciences Research [IUNICS- IdISBa], 07198, Palma of Mallorca, Spain.
- Laboratory of Renal Lithiasis Research, University of Balearic Islands, Institute of Health Sciences Research [IUNICS- IdISBa], 07122, Palma of Mallorca, Spain.
| | - Rosmeri Rivera
- Endocrinology Department, Research Unit, Hospital Son Llàtzer, Institute of Health Sciences Research [IUNICS- IdISBa], 07198, Palma of Mallorca, Spain
| | - Francisco Berga
- Laboratory of Renal Lithiasis Research, University of Balearic Islands, Institute of Health Sciences Research [IUNICS- IdISBa], 07122, Palma of Mallorca, Spain
| | - Regina Fortuny
- Laboratory Department, Hospital Son Llàtzer, 07198, Palma of Mallorca, Spain
| | - Miquel Adrover
- Department of Chemistry, University of Balearic Islands, Ctra. Valldemossa km 7.5, 07122, Palma of Mallorca, Spain
| | - Antonia Costa-Bauza
- Laboratory of Renal Lithiasis Research, University of Balearic Islands, Institute of Health Sciences Research [IUNICS- IdISBa], 07122, Palma of Mallorca, Spain
| | - Felix Grases
- Laboratory of Renal Lithiasis Research, University of Balearic Islands, Institute of Health Sciences Research [IUNICS- IdISBa], 07122, Palma of Mallorca, Spain
| | - Luis Masmiquel
- Endocrinology Department, Research Unit, Hospital Son Llàtzer, Institute of Health Sciences Research [IUNICS- IdISBa], 07198, Palma of Mallorca, Spain.
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22
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Buades Fuster JM, Sanchís Cortés P, Perelló Bestard J, Grases Freixedas F. Plant phosphates, phytate and pathological calcifications in chronic kidney disease. Nefrologia 2016; 37:20-28. [PMID: 27697413 DOI: 10.1016/j.nefro.2016.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/30/2016] [Accepted: 07/23/2016] [Indexed: 01/02/2023] Open
Abstract
Phytate, or myo-inositol 1,2,3,4,5,6-hexakis dihydrogen phosphate (InsP6), is a naturally occurring phosphorus compound that is present in many foods, mainly legumes, whole grains and nuts. Patients with chronic kidney disease (CKD) have cardiovascular disease mortality up to 30times higher than the general population. Vascular calcifications (VCs) directly contribute to overall morbidity and mortality, especially in CKD. In part, this high mortality is due to elevated levels of phosphorus in the blood. Therefore, control of dietary phosphorus is essential. Dietary phosphorus can be classified according to its structure in organic phosphorus (plant and animal) and inorganic (preservatives and additives). Plant-phosphorus (legumes and nuts), mainly associated with InsP6, is less absorbable by the human gastrointestinal tract as the bioavailability of phosphorous from plant-derived foods is very low. Recent data indicate that restriction of foods containing plant phosphates may compromise the adequate supply of nutrients that have a beneficial effect in preventing cardiovascular events, such as InsP6 or fibre found in legumes and nuts. Experimental studies in animals and observational studies in humans suggest that InsP6 can prevent lithiasis and VCs and protect from osteoporosis. In conclusion, we need prospective studies to elucidate the potential benefits and risks of phytate (InsP6) through the diet and as an intravenous drug in patients on haemodialysis.
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Affiliation(s)
| | - Pilar Sanchís Cortés
- Laboratorio de Investigación en Litiasis Renal, Instituto de Ciencias de la Salud Investigación (IUNICS-IdISPa), Departamento de Química, Universidad de las Islas Baleares, Palma de Mallorca, Islas Baleares, España
| | | | - Félix Grases Freixedas
- Laboratorio de Investigación en Litiasis Renal, Instituto de Ciencias de la Salud Investigación (IUNICS-IdISPa), Departamento de Química, Universidad de las Islas Baleares, Palma de Mallorca, Islas Baleares, España
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Joubert P, Ketteler M, Salcedo C, Perello J. Hypothesis: Phytate is an important unrecognised nutrient and potential intravenous drug for preventing vascular calcification. Med Hypotheses 2016; 94:89-92. [DOI: 10.1016/j.mehy.2016.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/26/2016] [Accepted: 07/10/2016] [Indexed: 10/21/2022]
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Sanchis P, Buades JM, Berga F, Gelabert MM, Molina M, Íñigo MV, García S, Gonzalez J, Bernabeu MR, Costa-Bauzá A, Grases F. Protective Effect of Myo-Inositol Hexaphosphate (Phytate) on Abdominal Aortic Calcification in Patients With Chronic Kidney Disease. J Ren Nutr 2016; 26:226-36. [PMID: 26975775 DOI: 10.1053/j.jrn.2016.01.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 01/04/2016] [Accepted: 01/06/2016] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the relationship between physiological levels of myo-inositol hexaphosphate (phytate) and cardiovascular (CV) calcification in patients with chronic kidney disease (CKD). DESIGN AND METHODS This was a prospective cross-sectional study conducted from December 2012 to June 2013. SUBJECTS Sixty-nine consecutive patients with CKD who were not undergoing renal replacement therapy. INTERVENTION All subjects were given lateral lumbar X-rays to quantify abdominal aortic calcification (AAC). Clinical laboratory analyses and phytate food frequency questionnaires were also performed. MAIN OUTCOME MEASURE Phytate urinary excretion, estimated phytate consumption (based on food frequency questionnaire) and AAC score. Patients were divided into two groups based on median abdominal aortic calcification (AAC) score: no/mild AAC (AAC ≤ 6, n = 35) and moderate/severe AAC (AAC > 6, n = 34). RESULTS Patients with no/mild AAC were younger, had lower pulse pressure, greater dietary intake of phytate, greater urinary phytate and the prevalence of prior CV disease was significantly lower compared to patients with moderate/severe AAC. Among the top 10 phytate-rich foods, lentil consumption was significantly greater in patients with no/mild AAC than in those with moderate/severe AAC. Multivariate logistic regression analysis indicated that age, prior CV disease, urinary phytate (or lentil consumption) were independently associated to AAC. CONCLUSION Our results suggest that adequate consumption of phytate can prevent AAC in patients with CKD. Further prospective studies must be performed to elucidate the benefits of a phytate-rich diet and the associated risk of phosphorus bioavailability in these patients.
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Affiliation(s)
- Pilar Sanchis
- Nephrology Department, Research Unit, Institute of Health Sciences Research (IUNICS-IdISPa), Hospital Son Llàtzer, Palma of Mallorca, Spain; Laboratory of Renal Lithiasis Research, Institute of Health Sciences Research (IUNICS-IdISPa), Department of Chemistry, University of Balearic Islands, Palma of Mallorca, Spain.
| | - Juan Manuel Buades
- Nephrology Department, Research Unit, Institute of Health Sciences Research (IUNICS-IdISPa), Hospital Son Llàtzer, Palma of Mallorca, Spain
| | - Francisco Berga
- Laboratory of Renal Lithiasis Research, Institute of Health Sciences Research (IUNICS-IdISPa), Department of Chemistry, University of Balearic Islands, Palma of Mallorca, Spain
| | | | - Marilisa Molina
- Nephrology Department, Research Unit, Institute of Health Sciences Research (IUNICS-IdISPa), Hospital Son Llàtzer, Palma of Mallorca, Spain
| | - María Victoria Íñigo
- Nephrology Department, Research Unit, Institute of Health Sciences Research (IUNICS-IdISPa), Hospital Son Llàtzer, Palma of Mallorca, Spain
| | - Susana García
- Nephrology Department, Research Unit, Institute of Health Sciences Research (IUNICS-IdISPa), Hospital Son Llàtzer, Palma of Mallorca, Spain
| | - Jorge Gonzalez
- Nephrology Department, Research Unit, Institute of Health Sciences Research (IUNICS-IdISPa), Hospital Son Llàtzer, Palma of Mallorca, Spain
| | - Maria Rosario Bernabeu
- Nephrology Department, Research Unit, Institute of Health Sciences Research (IUNICS-IdISPa), Hospital Son Llàtzer, Palma of Mallorca, Spain
| | - Antonia Costa-Bauzá
- Laboratory of Renal Lithiasis Research, Institute of Health Sciences Research (IUNICS-IdISPa), Department of Chemistry, University of Balearic Islands, Palma of Mallorca, Spain
| | - Felix Grases
- Laboratory of Renal Lithiasis Research, Institute of Health Sciences Research (IUNICS-IdISPa), Department of Chemistry, University of Balearic Islands, Palma of Mallorca, Spain
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