Inhibitory Effect of Crocin(s) on Lens α-Crystallin Glycation and Aggregation, Results in the Decrease of the Risk of Diabetic Cataract

Dichloroacetate ameliorates apoptosis, EMT and oxidative stress in diabetic cataract via inhibiting the IDO1-dependent p38 MAPK pathway

As an oral antidiabetic agent, dichloroacetate (DCA) has been proven to improve diabetes and related complications. However, its functional role in diabetic cataract (DC) remains to be elucidated. This study was to define the role of DCA and its underlying molecular mechanism in DC in vitro and in vivo. In this study, it was shown that DCA dose-dependently ameliorated DC formation and development in DM rats. In addition, DCA significantly increased cell viability, reduced apoptosis, and inhibited EMT and oxidative stress of high glucose (HG)-treated SRA-01/04 cells in a concentration-dependent manner. Besides, it was revealed that Indoleamine 2,3-dioxygenase 1 (IDO1) expression was upregulated in lenses of DM rats and HG-treated SRA-01/04 cells, which was reversed by DCA. In addition, DCA abrogated the activation of the p38 MAPK signaling in the lenses of DM rats and HG-treated SRA-01/04 cells. Further experiments showed that IDO1 upregulation activated the p38 MAPK signaling in HG-challenged SRA-01/04 cells. Moreover, IDO1 overexpression partially reversed DCA-mediated inactivation of p38 MAPK signaling and suppression of HG-induced damage to SRA-01/04 cells. To sum up, our findings showed that DCA prevented DC-related apoptosis, EMT, and oxidative stress via inactivating IDO1-dependent p38 MAPK signaling.

Metabolic memory: mechanisms and diseases

Metabolic diseases and their complications impose health and economic burdens worldwide. Evidence from past experimental studies and clinical trials suggests our body may have the ability to remember the past metabolic environment, such as hyperglycemia or hyperlipidemia, thus leading to chronic inflammatory disorders and other diseases even after the elimination of these metabolic environments. The long-term effects of that aberrant metabolism on the body have been summarized as metabolic memory and are found to assume a crucial role in states of health and disease. Multiple molecular mechanisms collectively participate in metabolic memory management, resulting in different cellular alterations as well as tissue and organ dysfunctions, culminating in disease progression and even affecting offspring. The elucidation and expansion of the concept of metabolic memory provides more comprehensive insight into pathogenic mechanisms underlying metabolic diseases and complications and promises to be a new target in disease detection and management. Here, we retrace the history of relevant research on metabolic memory and summarize its salient characteristics. We provide a detailed discussion of the mechanisms by which metabolic memory may be involved in disease development at molecular, cellular, and organ levels, with emphasis on the impact of epigenetic modulations. Finally, we present some of the pivotal findings arguing in favor of targeting metabolic memory to develop therapeutic strategies for metabolic diseases and provide the latest reflections on the consequences of metabolic memory as well as their implications for human health and diseases.

Effects of Angiotensin Receptor Blockers on Streptozotocin-Induced Diabetic Cataracts

This study aimed to determine the role of oxidative stress produced by the renin-angiotensin system (RAS) in cataract formation in streptozotocin-induced diabetic rats (STZ) using angiotensin II receptor blockers (ARBs). Rats were treated with streptozotocin and orally administered candesartan (2.5 mg/kg/day) or a normal diet for 10 weeks until sacrifice. Cataract progression was assessed through a slit-lamp examination. Animals were euthanized at 18 weeks, and the degree of cataract progression was evaluated. Oxidative stress was also assessed. In STZ-treated rats, lens opacity occurred at 12 weeks. Cataract progression was inhibited in the ARB-treated group compared with the placebo group (p < 0.05). STZ-treated rats exhibited upregulated angiotensin-converting enzyme (ACE) gene expression than control rats. Oxidative stress-related factors were upregulated in the placebo-treated group but suppressed in the ARB-treated group. A correlation coefficient test revealed a positive correlation between ACE gene expression and oxidative stress-related factors and a negative correlation between ACE and superoxide dismutase. Immunostaining revealed oxidative stress-related factors and advanced glycation end products in the lens cortex of the placebo-treated group. The mechanism of diabetic cataracts may be related to RAS, and the increase in focal ACE and angiotensin II in the lens promotes oxidative stress-related factor production.

Inhibition of notch signalling and mesangial expansion by combined glucagon like peptide-1 agonist and crocin therapy in animal model of diabetic nephropathy

Diabetic nephropathy (DN) is one of the devastating complications in diabetes mellitus (DM). Glucagon-like peptide-1 (GLP-1) is one of the incretins secreted from L cells in the intestine. Crocin (a carotenoid component of saffron) has antioxidants properties. We investigated the renal effects of Exendin-4 as a GLP-1 agonist and Crocin in DN.Thirty male rats were divided into five groups: control, type II DM, type II DM + Exendin-4, type II DM + Crocin ‏ and type II DM + Exendine-4 + Crocin. At the end of the experimental period, systolic and diastolic blood pressures were measured, and GFR was calculated. Blood and urine samples were collected for biochemical analysis. Tissue samples were collected from the kidney for histological examination and biochemical measurements of protein expression.Treatment with GLP-1 agonist or Crocin caused a significant improvement in renal function. Better results were achieved with simultaneous administration of both drugs with inhibition of notch signalling pathway and the related proteins.

Crocin as a vision supplement

Crocin is a natural ingredient of saffron (Crocus sativus L.) flower that has shown potential for application as a supplement in eye health and preserving vision. Crocin has been examined for its potential to treat various eye diseases such as glaucoma, macular dystrophies, diabetic retinopathy, and age-related macular degeneration. This review briefly discusses the role of crocin in different eye diseases. The underlying pathophysiological pathways involved in the effect of crocin on ophthalmic diseases are also reviewed. Preclinical evidence shows the cytoprotective, antioxidative, anti-inflammatory, and blood-flow enhancing effects of crocin in retinal tissue. Crocin also affects the retinal pathologies by activating PI3K/Akt and inhibiting NF-κB signalling pathways. Clinical evidence suggests that crocin improves outcomes in patients with retinal degenerations, retinal dystrophies, and glaucoma. Overall, crocin can be suggested as a potential vision supplement in healthy populations and patients with eye diseases. However, more clinical studies with larger sample sizes and longer follow-up durations are needed to confirm the current evidence.

Fundamentals of Diabetic Cataractogenesis and Promising Ways of its Pharmacological Correction

Cataracts in diabetes mellitus lead to decreased visual function and blindness. Cataract surgery for diabetes mellitus has limitations and complications. The search for effective means of conservative cataract therapy continues. The review presents the analysis of data from scientific sources, mainly for 2015–2020 using Internet resources (PubMed, Web of Science, Medline, eLibrary.Ru, Cyberleninka). In the work, diabetic cataractogenesis is presented as a sum of interrelated pathobiochemical processes. The main ones are the polyol pathway of glucose conversion, non-enzymatic glycation and oxidative modification of lens proteins, which are enhanced in diabetes mellitus. The lens has a high protein content. The formation of high molecular weight protein aggregates is of particular importance for the appearance of light scattering zones and a decrease in lens transparency. This review presents data on anti-cataract compounds that affect post-translational crystallin modification, prevent osmotic and oxidative stress in the lens, and exhibit antiglycation properties. This information shows that the search for means of pharmacological correction of cataractogenesis should be carried out among compounds with antioxidant and antiglycation activity. 

Pharmacological Effects of Saffron and its Constituents in Ocular Disorders from in vitro Studies to Clinical Trials: A Systematic Review

Introduction:

Some medicinal plants have shown promising therapeutic potential for the management of the diseases. We aimed to systematically review the literature wherein the therapeutic effects of saffron have been studied on eye disorders.

Methods

A systematic literature search was performed in PubMed, Scopus, Web of Science, Google scholar and other databases using eye disorders and saffron as key terms. No strict inclusion criteria were defined, and almost all clinical studies, as well as in vivo and in vitro studies were included. The reported data in each study were extracted and then qualitatively described.

Results

Finally, 78 articles were found but only 29 relevant articles were included. Nine articles were clinical trials and 20 articles were studies conducted on cellular and molecular aspects of saffron on eye disorders. According to the included studies, crocin prevented the pro-inflammatory response in retinal cells and decreased glucose levels in diabetic mice. Also, crocetin prevented retinal degeneration and saffron protected photoreceptors from light-induced damage in retinal cells. Saffron also improved visual function in age-related macular edema and decreased intraocular pressure in patients with glaucoma. In addition, it was shown that crocin can improve best corrected visual acuity and decrease central macular thickness in patients with diabetic maculopathy.

Conclusion

The results of this review indicated that saffron and its main ingredients such as crocin could be a potential candidate for the treatment of ocular disease especially eye inflammation; however, further clinical studies are needed to confirm such efficiency.

Klotho ameliorates the onset and progression of cataract via suppressing oxidative stress and inflammation in the lens in streptozotocin-induced diabetic rats

Increased oxidative stress and inflammation play an important role in the pathogenesis of diabetic cataract. Klotho, known as an anti-ageing protein, has antioxidative and anti-inflammatory properties. Klotho is expressed in limited tissues including the lens. Here we examined whether klotho expression is decreased in diabetic lens and, if so, whether klotho treatment can prevent diabetic cataract formation. Streptozotocin (STZ)-induced diabetic rats and age-matched control rats were treated with vehicle or klotho protein, starting at 1 week after STZ injection. Twelve weeks after treatment, cataract formation was observed in diabetic rats but not control rats. Cataract formation and scores were significantly less in klotho-treated diabetic rats than vehicle-treated diabetic rats. Levels of klotho in plasma, aqueous humor and lens were significantly decreased in vehicle-treated diabetic rats, compared with control rats, but were restored in klotho-treated diabetic rats. Additionally, vehicle-treated diabetic rats had increased oxidative stress and inflammation in the lens, which were associated with decreased antioxidant transcriptional master regulator Nrf2 activity and increased transcription factor NF-κB activity. All of these findings were ameliorated in klotho-treated diabetic rats. Notably, klotho treatment did not alter blood glucose in diabetic rats. These results indicate that klotho reduction may increase susceptibility of the lens to oxidative and inflammatory insults, promoting cataract formation under diabetic conditions. Klotho treatment can ameliorate the onset and progression of diabetic cataract via enhancing Nrf2-mediated antioxidant defense and suppressing NF-κB-mediated inflammatory responses. Klotho in the lens may be a novel therapeutic target for prevention of cataract formation in diabetes.

Clinical/Translational Aspects of Advanced Glycation End-Products

Advanced glycation end-products (AGEs) have been implicated in chronic hyperglycemia and age-related diseases. Endogenous AGEs produced by humans generate oxidative stress and activation of inflammatory signaling pathways via AGE-specific receptors. The present review summarizes current knowledge on the pathogenic role of AGEs in chronic noncommunicable diseases. Although correlations exist between glycation and the pathogenesis of these diseases, uncertainties remain in light of recurrent intervention failures of apparently promising animal models to be translated into clinically useful anti-AGE strategies. Future intervention of AGEs or their receptors should embrace more carefully executed clinical trials. Nevertheless, suppressing symptoms via lifetime drug application is unlikely to eliminate the burden of chronic diseases unless deep-rooted lifestyle issues that cause these diseases are simultaneously addressed.

The effect of crocetin supplementation on markers of atherogenic risk in patients with coronary artery disease: a pilot, randomized, double-blind, placebo-controlled clinical trial

BACKGROUND AND PURPOSE

Molecular mechanisms of atherogenesis are considered to be emerging therapeutic targets for atherosclerosis prevention. Cell and animal studies have shown that crocetin can decelerate atherogenesis. However, the anti-atherogenic properties of crocetin in humans are still ambiguous.

METHODS AND RESULTS

Fifty clinically diagnosed CAD patients were randomly divided into two parallel groups, crocetin and placebo, who received one capsule of crocetin (10 mg) and placebo per day, respectively, for two months. Serum circulating homocysteine (Hcy) [-1.09 (-1.64 to -0.54) μM, P = 0.001], heart-type fatty acid binding protein (h-FABP) [-2.07 (-2.72 to -1.43) ng mL^-1, P = 0.001], intercellular adhesion molecule 1 [-14.92 (-21.92 to -7.92) ng mL^-1, P = 0.001], vascular cell adhesion molecule 1 [-18.61 (-29.73 to -7.49) ng mL^-1, P = 0.002], and monocyte chemoattractant protein 1 [-4.67 (-6.50 to -2.83) pg mL^-1, P = 0.001] decreased significantly after the trial in the crocetin group, while high-density lipoprotein (HDL) significantly increased [+4.21 (0.68 to 7.73) mg mL^-1, P = 0.021]. Also, systolic [-0.21 (-0.32 to -0.10) mmHg, P = 0.001] and diastolic [-0.20 (-0.34 to -0.07) mmHg, P = 0.004] blood pressures decreased significantly in the crocetin group. Nevertheless, clinically significant percentage changes were only observed in Hcy (-15.25 ± 3.15, μM), HDL (-10.70 ± 5.06, mg dL^-1), and h-FABP (-21.10 ± 3.09, ng mL^-1) in the crocetin group. Furthermore, the relative increase in the gene expressions of sirtuin1 and AMP-activated protein kinase and a decrease in the lectin-type oxidized LDL receptor 1 and nuclear factor-kappa B expression in isolated peripheral blood mononuclear cells in the crocetin group were significant at the end of the trial in comparison with the placebo.

CONCLUSION

As the first human study, we showed the ability of crocetin to alter the expression of atherogenic genes and endothelial cell adhesion molecules in CAD patients. It appears that crocetin could be considered as a promising anti-atherogenic candidate for future studies.

Interaction of saffron carotenoids with catalase: in vitro, in vivo and molecular docking studies

The effects of saffron carotenoids, crocetin (Crt) and crocin (Cro) on the structure, function and kinetics of catalase (CAT) were investigated. Both Crt and Cro quenched the fluorescence emission of CAT through the dynamic mechanism, but Crt (Ksv= 8.1 × 10⁴ mol^-1) was more effective than Cro (Ksv= 0.6 × 10⁴ mol^-1) at 300 °K. The UV-vis and circular dichroism spectra showed conformational changes of CAT in the presence of both carotenoids, but with different degrees. Kinetic studies showed strong inhibition of CAT by Crt, while, different concentrations of Cro showed different effects. Our in vitro data showed that Crt treatment significantly (p = 0.002) reduced the CAT activity in MCF-7, up to 24 h. The in vivo results showed that both Crt and Cro significantly increased the CAT activity in the tumor (p = 0.000 for both), and liver (p = 0.000 and p = 0.026 for Crt and Cro, respectively) tissues of 4T1-induced breast cancer in BALB/c mice, after 4 weeks of treatment. These findings are consistent with the binding, thermodynamic and molecular docking data. In conclusion, Crt and Cro with some differences in the structure affect CAT structure, function and activity, but in a slightly different manner.Communicated by Ramaswamy H. Sarma.

Broccoli sprouts juice prevents lens protein aggregation in streptozotocin-induced diabetic rat

AIM

To investigate the effect of broccoli sprouts juice in preventing lens protein aggregation in diabetic rat model.

METHODS

Totally 25 male Wistar rats were divided into negative control group, diabetic group without juice treatment as positive control and diabetic group given broccoli sprouts juice 0.25, 0.5 and 1 g/d for 28d. Diabetic rat model was obtained by administering a single dose streptozotocin 65 mg/kg intraperitoneal. At the end of the study, all rats were examined for fasting blood sugar level (FBS), visual cataract score using slit lamp biomicroscope and lens αB-crystallin expression using Western blot method. Statistical analysis was performed using one way ANOVA with post hoc test, correlation test, and simple linear regression.

RESULTS

Positive control group had the highest cataract score and lens aggregated αB-crystallin expression. Broccoli sprout juice dose of 1 g/d group had the mildest cataract score, as well as the expression of lens aggregated αB-crystallin compared to treatments groups 1 and 2, opposite to lens native αB-crystallin expression. The broccoli sprout juice groups gave a significant decrease in cataract score, and also in lens aggregated αB-crystallin expression in diabetic rat models (P<0.05).

CONCLUSION

Broccoli sprout juice has a significant effect in preventing lens protein aggregation in diabetic rat model. The higher dose gives better visual cataract scores, lower lens aggregated αB-crystallin expression and higher lens native αB-crystallin expression.

Prevention of α-crystallin glycation and aggregation using l-lysine results in the inhibition of in vitro catalase heat-induced-aggregation and suppression of cataract formation in the diabetic rat

The principle role of α-crystallin is chaperoning activity that protect s other proteins against different stresses. High glucose concentration induces the osmotic stress and results in biomacromolecules glycation, which is subsequently cause their conformational and functional changes. Here, the roles of l-lysine (Lys) on the prevention of α-crystallin glycation in both in vitro and in vivo conditions are investigated. The catalase (CAT) activity was considered as a marker of α-crystallin functionality in both conditions. Streptozotocin-induced diabetic rats were treated with 0.1% of the Lys in drinking water. The purified α-crystallin was also incubated with glucose, in the presence or absence of the Lys and its structure-function was compared. The results showed that the visual cataract score was significantly lower in the diabetic rats treated with Lys. After Lys treatment, CAT, superoxide dismutase, aldose reductase and other biochemical parameters in the lens and serum of the diabetic rats returned to the normal value. Formation of the advanced glycation endproducts (AGEs), protein cross-linking, and the hydrophobicity of α-crystallin were changed due to glycation, but they were reversed by Lys treatment. The glycated α-crystallin lost its chaperone activity against heat denatured-CAT, but in the presence of Lys, it preserved its activity and prevented CAT aggregation. In conclusion, Lys treatment significantly inhibited the progression of diabetic cataract in rats. These effects were due to the Lys antiglycating and antioxidant effects, in addition to its protective effect against α-crystallin chaperoning activity.

Ursodeoxycholic acid suppresses the formation of fructose/streptozotocin-induced diabetic cataract in rats

The main objective of this study was to investigate the potential protective effect of ursodeoxycholic acid (UDCA) on fructose/streptozotocin-induced diabetic cataract in rats. The diabetic model (DM) was induced through the administration of 10% fructose in drinking water for 2 weeks followed by streptozotocin injection (intraperitoneal). One week later, hyperglycemia was assisted and diabetic animals were treated with UDCA either as local eye drops (0.5% solution, four times/day) or orally (100 mg/kg b.w.). Cataract formation was monitored biweekly and scored into four stages. After 12 weeks of treatment, rats were subjected to ophthalmological examination, and then, their blood and lenses were prepared for biochemical analysis of glucose, insulin, reduced glutathione, total antioxidant capacity, malondialdehyde, hydrogen peroxide, caspase-12, and lenticular total proteins. In addition, tertiary structure and conformational changes of lenticular soluble proteins were analyzed using SDS-PAGE and UV absorption while changes in lenticular α-crystallin structure were investigated using intrinsic tryptophan fluorescence. Results demonstrated that both local and oral UDCA restored the normal levels of lens T-AOC, MDA, H₂ O₂ , and caspase-12 and improved noticeably the levels of the lens GSH and total proteins. In addition, conformational and tertiary structure changes of soluble lens proteins were significantly reduced in UDCA-treated groups. Morphological examination of lenses revealed decreased score of cataract progression in UDCA-treated groups compared to DM animals. It was concluded that UDCA decreased the incidence of diabetic cataract by maintaining the antioxidant status, reducing the endoplasmic reticulum stress, and suppressing the structural changes of soluble lens proteins.

Effects of Crocin on Diabetic Maculopathy: A Placebo-Controlled Randomized Clinical Trial

OBJECTIVE

Diabetic macular edema (DME) is one of the most important sight-threatening complications in patients with diabetes. Owing to neuroprotective properties, crocin, as the main constituent in saffron, is thought to be useful in the treatment and prevention of diabetic maculopathy. The aim of this trial was to evaluate the effects of crocin as a supplement on reducing inflammation in patients with diabetic maculopathy.

DESIGN

Double-masked, placebo controlled, phase 2 randomized clinical trial.

METHODS

Participants: In this study, 101 eyes of 60 patients with refractory diabetic maculopathy to conventional therapy including macular photocoagulation and intravitreal injection of anti-vascular endothelial growth factor agent (bevacizumab) with or without steroid (triamcinolone) were studied in 3 groups.

INTERVENTION

Patients in the crocin groups received 5 mg or 15 mg crocin tablets per day for 3 months, whereas patients in the placebo group received 1 placebo tablet per day during the study. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured before, every month during, and 3 months after intervention. Biochemical blood tests were also evaluated before and after trial.

MAIN OUTCOME MEASURES

The BCVA and CMT were evaluated as the primary outcomes, whereas HbA1c and fasting blood sugar (FBS) were studied as the secondary outcomes in this trial.

RESULTS

One hundred and one eyes were enrolled in this trial and were divided into 3 groups (crocin 5 mg, n = 34; crocin 15 mg, n = 33; and placebo, n = 34). According to our data, administration of crocin 15 mg tablet per day could significantly decrease HbA1c (P value = .024; 95% confidence interval [CI] 0.3-0.96), and CMT (P value = .005; 95% CI, 32.75-126.99) and improve BCVA (logMAR changes; P value = .012; 95% CI, 0.23-0.69) compared to the placebo group. Although administration of crocin 5 mg tablet per day could clinically improve HbA1c, FBS, CMT, and BCVA, the difference was not significant compared to the placebo group.

CONCLUSION

This study indicated the effect of crocin as a potent antioxidant and neuroprotective for treatment of refractory DME in the short term; however, the clinical significance is yet to be proved in a study with larger sample size and longer duration of follow-up and also in treatment-naïve patients.

Latest advances in the extraction and determination of saffron apocarotenoids

Saffron, the dried red stigmas of Crocus sativus L. plant, is the most expensive spice in the world. It is highly valued not only for the color and flavor that exerts to various foods and drinks but also for its functional properties. Various classes of apocarotenoids such as crocetin sugar esters, picrocrocin and safranal are responsible for these characteristics. In the present review, the evolution of the methods proposed by the ISO standard for extraction and determination of saffron apocarotenoids since 1980 is presented in parallel to other approaches proposed by various scientists to overcome limitations of the standard. Moreover, the latest advances regarding applications of novel extraction techniques and powerful analytical tools that require limited or no sample preparation are critically discussed.