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Jang E, Yu H, Kim E, Hwang J, Yoo J, Choi J, Jeong HS, Jang S. The Therapeutic Effects of Blueberry-Treated Stem Cell-Derived Extracellular Vesicles in Ischemic Stroke. Int J Mol Sci 2024; 25:6362. [PMID: 38928069 PMCID: PMC11203670 DOI: 10.3390/ijms25126362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/23/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
An ischemic stroke, one of the leading causes of morbidity and mortality, is caused by ischemia and hemorrhage resulting in impeded blood supply to the brain. According to many studies, blueberries have been shown to have a therapeutic effect in a variety of diseases. Therefore, in this study, we investigated whether blueberry-treated mesenchymal stem cell (MSC)-derived extracellular vesicles (B-EVs) have therapeutic effects in in vitro and in vivo stroke models. We isolated the extracellular vesicles using cryo-TEM and characterized the particles and concentrations using NTA. MSC-derived extracellular vesicles (A-EVs) and B-EVs were round with a lipid bilayer structure and a diameter of ~150 nm. In addition, A-EVs and B-EVs were shown to affect angiogenesis, cell cycle, differentiation, DNA repair, inflammation, and neurogenesis following KEGG pathway and GO analyses. We investigated the protective effects of A-EVs and B-EVs against neuronal cell death in oxygen-glucose deprivation (OGD) cells and a middle cerebral artery occlusion (MCAo) animal model. The results showed that the cell viability was increased with EV treatment in HT22 cells. In the animal, the size of the cerebral infarction was decreased, and the behavioral assessment was improved with EV injections. The levels of NeuN and neurofilament heavy chain (NFH)-positive cells were also increased with EV treatment yet decreased in the MCAo group. In addition, the number of apoptotic cells was decreased with EV treatment compared with ischemic animals following TUNEL and Bax/Bcl-2 staining. These data suggested that EVs, especially B-EVs, had a therapeutic effect and could reduce apoptotic cell death after ischemic injury.
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Affiliation(s)
- Eunjae Jang
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun 58128, Republic of Korea; (E.J.); (H.Y.); (J.H.); (J.C.)
- Jeonnam Bioindustry Foundation Biopharmaceutical Research Center, Hwasun-gun 58141, Republic of Korea
| | - Hee Yu
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun 58128, Republic of Korea; (E.J.); (H.Y.); (J.H.); (J.C.)
- Jeonnam Bioindustry Foundation Biopharmaceutical Research Center, Hwasun-gun 58141, Republic of Korea
| | - Eungpil Kim
- Infrastructure Project Organization for Global Industrialization of Vaccine, Sejong-si 30121, Republic of Korea;
| | - Jinsu Hwang
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun 58128, Republic of Korea; (E.J.); (H.Y.); (J.H.); (J.C.)
| | - Jin Yoo
- Department of Physical Education, Chonnam National University, Gwangju 61186, Republic of Korea;
| | - Jiyun Choi
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun 58128, Republic of Korea; (E.J.); (H.Y.); (J.H.); (J.C.)
| | - Han-Seong Jeong
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun 58128, Republic of Korea; (E.J.); (H.Y.); (J.H.); (J.C.)
| | - Sujeong Jang
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun 58128, Republic of Korea; (E.J.); (H.Y.); (J.H.); (J.C.)
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Wang X, Guo AQ, Wang R, Gao W, Yang H. AnnoSM: An Automated Annotation Tool for Determining the Substituent Modes on the Parent Skeleton Based on a Characteristic MS/MS Fragment Ion Library. Anal Chem 2024; 96:3817-3828. [PMID: 38386850 DOI: 10.1021/acs.analchem.3c04946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Mass spectrometry (MS) is a powerful technology for the structural elucidation of known or unknown small molecules. However, the accuracy of MS-based structure annotation is still limited due to the presence of numerous isomers in complex matrices. There are still challenges in automatically interpreting the fine structure of molecules, such as the types and positions of substituents (substituent modes, SMs) in the structure. In this study, we employed flavones, flavonols, and isoflavones as examples to develop an automated annotation method for identifying the SMs on the parent molecular skeleton based on a characteristic MS/MS fragment ion library. Importantly, user-friendly software AnnoSM was built for the convenience of researchers with limited computational backgrounds. It achieved 76.87% top-1 accuracy on the 148 authentic standards. Among them, 22 sets of flavonoid isomers were successfully differentiated. Moreover, the developed method was successfully applied to complex matrices. One such example is the extract of Ginkgo biloba L. (EGB), in which 331 possible flavonoids with SM candidates were annotated. Among them, 23 flavonoids were verified by authentic standards. The correct SMs of 13 flavonoids were ranked first on the candidate list. In the future, this software can also be extrapolated to other classes of compounds.
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Affiliation(s)
- Xing Wang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, No. 639 Longmian Dadao, Nanjing 211198, China
| | - An-Qi Guo
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, No. 639 Longmian Dadao, Nanjing 211198, China
| | - Rui Wang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, No. 639 Longmian Dadao, Nanjing 211198, China
| | - Wen Gao
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, No. 639 Longmian Dadao, Nanjing 211198, China
| | - Hua Yang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, No. 639 Longmian Dadao, Nanjing 211198, China
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Rosiak N, Cielecka-Piontek J, Skibiński R, Lewandowska K, Bednarski W, Zalewski P. Do Rutin and Quercetin Retain Their Structure and Radical Scavenging Activity after Exposure to Radiation? Molecules 2023; 28:molecules28062713. [PMID: 36985686 PMCID: PMC10053567 DOI: 10.3390/molecules28062713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
The influence of ionizing radiation on the physicochemical properties of quercetin and rutin in the solid state was studied. Quercetin and rutin were irradiated with the standard recommended radiation dose (25 kGy) according to EN 522 standard. The samples were irradiated by electron beam radiation. EPR studies indicate the formation of a small number of free radicals due to irradiation. Moreover, some radicals recombined with the mean lifetime of 1200 and 93 h, and a stable radical concentration reached only 0.29 and 0.90 ppm for quercetin and rutin, respectively. The performed spectroscopic study (FT-IR) confirmed the radiostability of the flavonoids tested. Chromatographic tests (HPLC, HPLC-MS) showed that irradiation of quercetin and rutin with a 25 kGy dose did not change the physicochemical properties of the tested compounds. Degradation products were not observed. The antioxidant activities were determined by the 2,2-diphenyl-1-pycrylhydrazyl (DPPH) free radical scavenging activity assay, ABTS Radical Scavenging Assay (ABTS), Ferric Reducing Antioxidant Power Assay (FRAP), Cupric Ion Reducing Antioxidant Capacity Assay (CUPRAC). The conducted research confirmed that exposure to ionizing radiation does not change the chemical structure of tested flavonoids and their antioxidant properties.
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Affiliation(s)
- Natalia Rosiak
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland
| | - Robert Skibiński
- Department of Medicinal Chemistry, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland
| | - Kornelia Lewandowska
- Institute of Molecular Physics, Polish Academy of Sciences, Smoluchowskiego 17, 60-179 Poznań, Poland
| | - Waldemar Bednarski
- Institute of Molecular Physics, Polish Academy of Sciences, Smoluchowskiego 17, 60-179 Poznań, Poland
| | - Przemysław Zalewski
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland
- Correspondence: ; Tel.: +48-(61)-854-67-10
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Boscaro V, Rivoira M, Sgorbini B, Bordano V, Dadone F, Gallicchio M, Pons A, Benetti E, Rosa AC. Evidence-Based Anti-Diabetic Properties of Plant from the Occitan Valleys of the Piedmont Alps. Pharmaceutics 2022; 14:2371. [PMID: 36365189 PMCID: PMC9693256 DOI: 10.3390/pharmaceutics14112371] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/20/2022] [Accepted: 10/28/2022] [Indexed: 10/29/2023] Open
Abstract
Data on urban and rural diabetes prevalence ratios show a significantly lower presence of diabetes in rural areas. Several bioactive compounds of plant origin are known to exert anti-diabetic properties. Interestingly, most of them naturally occur in different plants present in mountainous areas and are linked to traditions of herbal use. This review will aim to evaluate the last 10 years of evidence-based data on the potential anti-diabetic properties of 9 plants used in the Piedmont Alps (North-Western Italy) and identified through an ethnobotanical approach, based on the Occitan language minority of the Cuneo province (Sambucus nigra L., Achillea millefolium L., Cornus mas L., Vaccinium myrtillus L., Fragaria vesca L., Rosa canina L., Rubus idaeus L., Rubus fruticosus/ulmifolius L., Urtica dioica L.), where there is a long history of herbal remedies. The mechanism underlying the anti-hyperglycemic effects and the clinical evidence available are discussed. Overall, this review points to the possible use of these plants as preventive or add-on therapy in treating diabetes. However, studies of a single variety grown in the geographical area, with strict standardization and titration of all the active ingredients, are warranted before applying the WHO strategy 2014-2023.
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Affiliation(s)
- Valentina Boscaro
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Matteo Rivoira
- Dipartimento di Studi Umanistici, University of Turin, Via Sant’Ottavio 20, 10124 Turin, Italy
- Atlante Linguistico Italiano (ALI), Via Sant’Ottavio 20, 10124 Turin, Italy
| | - Barbara Sgorbini
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Valentina Bordano
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Francesca Dadone
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Margherita Gallicchio
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Aline Pons
- Dipartimento di Studi Umanistici, University of Turin, Via Sant’Ottavio 20, 10124 Turin, Italy
| | - Elisa Benetti
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Arianna Carolina Rosa
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
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Ajayi AM, Adedapo ADA, Badaki VB, Oyagbemi AA, Adedapo AA. Chrysophyllum albidum fruit ethanol extract ameliorates hyperglycaemia and elevated blood pressure in streptozotocin-induced diabetic rats through modulation of oxidative stress, NF-κB and PPAR-γ. Biomed Pharmacother 2021; 141:111879. [PMID: 34225016 DOI: 10.1016/j.biopha.2021.111879] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 01/05/2023] Open
Abstract
Oxidative stress and inflammation arising from hyperglycaemia have been identified as important targets in mitigating hyperglycaemia-induced organ dysfunction in diabetics. Chrysophyllum albidum fruit is commonly consumed as fruit snacks because of its beneficial effects in diabetes management. This study aim to evaluate the protective mechanisms of Chrysophyllum albidum fruit extract (CAFE) in streptozotocin-induced rats involving attenuation of oxidative stress, nuclear factor-kappa B (NF-κB) and peroxisome proliferator-activated receptor-gamma (PPAR-γ). CAFE was investigated for in vitro antioxidant and alpha amylase inhibitory activity. Male Wistar rats were made diabetic by single intraperitoneal injection of streptozotocin (60 mg/kg). The rats were then treated with CAFE (100 and 200 mg/kg) and pioglitazone (10 mg/kg) for two weeks. Fasting blood sugar (FBS), blood pressure parameters, lipid profile, oxidative stress parameters, NF-κB and PPAR-γ were determined. The extract showed antioxidant and alpha amylase inhibitory activities. CAFE significantly reduced STZ-induced hyperglycaemia after 7 and 14 days of treatment. CAFE also reduced STZ-induced elevation of diastolic blood pressure and mean arterial pressure and as well reduced atherogenic index in diabetic rats. It significantly decreased lipid peroxidation but increased the enzymatic and non-enzymatic antioxidant markers in the plasma, liver, kidney and pancreas. The immunohistochemical analysis revealed that CAFE significantly decreased hepatic and renal tissues NF-κB while increasing PPAR-γ gene expressions. The results of this study collectively showed the protective effect of Chrysophyllum albidum fruit extract in streptozotocin-induced diabetic rats via modulation of oxidative stress and NF-κB/ PPAR-γ expressions.
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Affiliation(s)
- Abayomi M Ajayi
- Department of Pharmacology & Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
| | - Aduragbenro D A Adedapo
- Department of Pharmacology & Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
| | - Victoria B Badaki
- Department of Pharmacology & Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
| | | | - Adeolu A Adedapo
- Department of Veterinary Pharmacology and Toxicology, University of Ibadan, Ibadan, Oyo State, Nigeria.
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6
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Fernandez-Gonzalez P, Mas-Sanchez A, Garriga P. Polyphenols and Visual Health: Potential Effects on Degenerative Retinal Diseases. Molecules 2021; 26:3407. [PMID: 34199888 PMCID: PMC8200069 DOI: 10.3390/molecules26113407] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/26/2022] Open
Abstract
Dietary polyphenols are a group of natural compounds that have been proposed to have beneficial effects on human health. They were first known for their antioxidant properties, but several studies over the years have shown that these compounds can exert protective effects against chronic diseases. Nonetheless, the mechanisms underlying these potential benefits are still uncertain and contradictory effects have been reported. In this review, we analyze the potential effects of polyphenol compounds on some visual diseases, with a special focus on retinal degenerative diseases. Current effective therapies for the treatment of such retinal diseases are lacking and new strategies need to be developed. For this reason, there is currently a renewed interest in finding novel ligands (or known ligands with previously unexpected features) that could bind to retinal photoreceptors and modulate their molecular properties. Some polyphenols, especially flavonoids (e.g., quercetin and tannic acid), could attenuate light-induced receptor damage and promote visual health benefits. Recent evidence suggests that certain flavonoids could help stabilize the correctly folded conformation of the visual photoreceptor protein rhodopsin and offset the deleterious effect of retinitis pigmentosa mutations. In this regard, certain polyphenols, like the flavonoids mentioned before, have been shown to improve the stability, expression, regeneration and folding of rhodopsin mutants in experimental in vitro studies. Moreover, these compounds appear to improve the integration of the receptor into the cell membrane while acting against oxidative stress at the same time. We anticipate that polyphenol compounds can be used to target visual photoreceptor proteins, such as rhodopsin, in a way that has only been recently proposed and that these can be used in novel approaches for the treatment of retinal degenerative diseases like retinitis pigmentosa; however, studies in this field are limited and further research is needed in order to properly characterize the effects of these compounds on retinal degenerative diseases through the proposed mechanisms.
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Affiliation(s)
| | | | - Pere Garriga
- Grup de Biotecnologia Molecular i Industrial, Centre de Biotecnologia Molecular, Departament d’Enginyeria Química, Universitat Politècnica de Catalunya, Edifici Gaia, 08222 Terrassa, Spain; (P.F.-G.); (A.M.-S.)
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7
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Chavanelle V, Otero YF, Le Joubioux F, Ripoche D, Bargetto M, Vluggens A, Montaurier C, Pickering G, Ducheix G, Dubray C, Dualé C, Boulliau S, Macian N, Marceau G, Sapin V, Dutheil F, Guigas B, Maugard T, Boisseau N, Cazaubiel M, Peltier SL, Sirvent P. Effects of Totum-63 on glucose homeostasis and postprandial glycemia: a translational study. Am J Physiol Endocrinol Metab 2021; 320:E1119-E1137. [PMID: 33938234 PMCID: PMC8285600 DOI: 10.1152/ajpendo.00629.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Global prevalence of type 2 diabetes (T2D) is rising and may affect 700 million people by 2045. Totum-63 is a polyphenol-rich natural composition developed to reduce the risk of T2D. We first investigated the effects of Totum-63 supplementation in high-fat diet (HFD)-fed mice for up to 16 wk and thereafter assessed its safety and efficacy (2.5 g or 5 g per day) in 14 overweight men [mean age 51.5 yr, body mass index (BMI) 27.6 kg·m-2] for 4 wk. In HFD-fed mice, Totum-63 reduced body weight and fat mass gain, whereas lean mass was unchanged. Moreover, fecal energy excretion was higher in Totum-63-supplemented mice, suggesting a reduction of calorie absorption in the digestive tract. In the gut, metagenomic analyses of fecal microbiota revealed a partial restoration of HFD-induced microbial imbalance, as shown by principal coordinate analysis of microbiota composition. HFD-induced increase in HOMA-IR score was delayed in supplemented mice, and insulin response to an oral glucose tolerance test was significantly reduced, suggesting that Totum-63 may prevent HFD-related impairments in glucose homeostasis. Interestingly, these improvements could be linked to restored insulin signaling in subcutaneous adipose tissue and soleus muscle. In the liver, HFD-induced steatosis was reduced by 40% (as shown by triglyceride content). In the subsequent study in men, Totum-63 (5 g·day-1) improved glucose and insulin responses to a high-carbohydrate breakfast test (84% kcal carbohydrates). It was well tolerated, with no clinically significant adverse events reported. Collectively, these data suggest that Totum-63 could improve glucose homeostasis in both HFD-fed mice and overweight individuals, presumably through a multitargeted action on different metabolic organs.NEW & NOTEWORTHY Totum-63 is a novel polyphenol-rich natural composition developed to reduce the risk of T2D. Totum-63 showed beneficial effects on glucose homeostasis in HFD-fed mice, presumably through a multitargeted action on different metabolic organs. Totum-63 was well tolerated in humans and improved postprandial glucose and insulin responses to a high-carbohydrate breakfast test.
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Affiliation(s)
| | | | | | | | | | | | | | - Gisèle Pickering
- CHU Clermont-Ferrand, Centre d'Investigation Clinique, Clermont-Ferrand, France
- INSERM, Clermont-Ferrand, France
| | - Gilles Ducheix
- CHU Clermont-Ferrand, Centre d'Investigation Clinique, Clermont-Ferrand, France
- INSERM, Clermont-Ferrand, France
| | - Claude Dubray
- CHU Clermont-Ferrand, Centre d'Investigation Clinique, Clermont-Ferrand, France
- INSERM, Clermont-Ferrand, France
| | - Christian Dualé
- CHU Clermont-Ferrand, Centre d'Investigation Clinique, Clermont-Ferrand, France
- INSERM, Clermont-Ferrand, France
| | - Sylvia Boulliau
- CHU Clermont-Ferrand, Centre d'Investigation Clinique, Clermont-Ferrand, France
- INSERM, Clermont-Ferrand, France
| | - Nicolas Macian
- CHU Clermont-Ferrand, Centre d'Investigation Clinique, Clermont-Ferrand, France
- INSERM, Clermont-Ferrand, France
| | - Geoffroy Marceau
- Biochemistry and Molecular Genetics Department, University Hospital, Clermont-Ferrand, France
| | - Vincent Sapin
- Biochemistry and Molecular Genetics Department, University Hospital, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Clermont-Ferrand, France
| | - Bruno Guigas
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Thierry Maugard
- La Rochelle Université - LIENSs UMR CNRS 7266, La Rochelle, France
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Ahmed OM, AbouZid SF, Ahmed NA, Zaky MY, Liu H. An Up-to-Date Review on Citrus Flavonoids: Chemistry and Benefits in Health and Diseases. Curr Pharm Des 2021; 27:513-530. [PMID: 33245267 DOI: 10.2174/1381612826666201127122313] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 08/09/2020] [Indexed: 11/22/2022]
Abstract
Flavonoids, the main class of polyphenols, are characterized by the presence of 2-phenyl-benzo-pyrane nucleus. They are found in rich quantities in citrus fruits. Citrus flavonoids are classified into flavanones, flavones, flavonols, polymethoxyflavones and anthocyanins (found only in blood oranges). Flavanones are the most abundant flavonoids in citrus fruits. In many situations, there are structure-function relationships. Due to their especial structures and presence of many hydroxyls, polymethoxies and glycoside moiety, the flavonoids have an array of multiple biological and pharmacological activities. This article provides an updated overview of the differences in chemical structures of the classes and members of citrus flavonoids and their benefits in health and diseases. The review article also sheds light on the mechanisms of actions of citrus flavonoids in the treatment of different diseases, including arthritis, diabetes mellitus, cancer and neurodegenerative disorders as well as liver, kidney and heart diseases. The accumulated and updated knowledge in this review may provide useful information and ideas in the discovery of new strategies for the use of citrus flavonoids in the protection, prevention and therapy of diseases.
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Affiliation(s)
- Osama M Ahmed
- Physiology Division, Department of Zoology, Faculty of Science, Beni-Suef University, Egypt
| | - Sameh F AbouZid
- Pharmacognosy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Noha A Ahmed
- Physiology Division, Department of Zoology, Faculty of Science, Beni-Suef University, Egypt
| | - Mohamed Y Zaky
- Physiology Division, Department of Zoology, Faculty of Science, Beni-Suef University, Egypt
| | - Han Liu
- Second Affiliated Hospital, Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
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9
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Parrella E, Gussago C, Porrini V, Benarese M, Pizzi M. From Preclinical Stroke Models to Humans: Polyphenols in the Prevention and Treatment of Stroke. Nutrients 2020; 13:nu13010085. [PMID: 33383852 PMCID: PMC7823436 DOI: 10.3390/nu13010085] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 12/24/2020] [Indexed: 02/07/2023] Open
Abstract
Polyphenols are an important family of molecules of vegetal origin present in many medicinal and edible plants, which represent important alimentary sources in the human diet. Polyphenols are known for their beneficial health effects and have been investigated for their potential protective role against various pathologies, including cancer, brain dysfunctions, cardiovascular diseases and stroke. The prevention of stroke promoted by polyphenols relies mainly on their effect on cardio- and cerebrovascular systems. However, a growing body of evidence from preclinical models of stroke points out a neuroprotective role of these molecules. Notably, in many preclinical studies, the polyphenolic compounds were effective also when administered after the stroke onset, suggesting their possible use in promoting recovery of patients suffering from stroke. Here, we review the effects of the major polyphenols in cellular and in vivo models of both ischemic and hemorrhagic stroke in immature and adult brains. The results from human studies are also reported.
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10
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Ye Y, Gu Q, Sun X. Potential of Caenorhabditis elegans as an antiaging evaluation model for dietary phytochemicals: A review. Compr Rev Food Sci Food Saf 2020; 19:3084-3105. [PMID: 33337057 DOI: 10.1111/1541-4337.12654] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/02/2020] [Accepted: 09/24/2020] [Indexed: 12/15/2022]
Abstract
Aging is an inevitable process characterized by the accumulation of degenerative damage, leading to serious diseases that affect human health. Studies on aging aim to develop pre-protection or therapies to delay aging and age-related diseases. A preventive approach is preferable to clinical treatment not only to reduce investment but also to alleviate pain in patients. Adjusting daily diet habits to improve the aging condition is a potentially attractive strategy. Fruits and vegetables containing active compounds that can effectively delay the aging process and reduce or inhibit age-related degenerative diseases have been identified. The signaling pathways related to aging in Caenorhabditis elegans are evolutionarily conserved; thus, studying antiaging components by intervening senescence process may contribute to the prevention and treatment of age-related diseases in humans. This review focuses on the effects of food-derived extracts or purified substance on antiaging in nematodes, as well as the underlying mechanisms, on the basis of several major signaling pathways and key regulatory factors in aging. The aim is to provide references for a healthy diet guidance and the development of antiaging nutritional supplements. Finally, challenges in the use of C. elegans as the antiaging evaluation model are discussed, together with the development that potentially inspire novel strategies and research tools.
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Affiliation(s)
- Yongli Ye
- State Key Laboratory of Food Science and Technology, School of Food Science, National Engineering Research Center for Functional Foods, Synergetic Innovation Center of Food Safety and Nutrition, Jiangnan University, Wuxi, Jiangsu, P. R. China
| | - Qingyin Gu
- State Key Laboratory of Food Science and Technology, School of Food Science, National Engineering Research Center for Functional Foods, Synergetic Innovation Center of Food Safety and Nutrition, Jiangnan University, Wuxi, Jiangsu, P. R. China
| | - Xiulan Sun
- State Key Laboratory of Food Science and Technology, School of Food Science, National Engineering Research Center for Functional Foods, Synergetic Innovation Center of Food Safety and Nutrition, Jiangnan University, Wuxi, Jiangsu, P. R. China
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11
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Ellwood L, Torun G, Bahar Z, Fernandez R. Effects of flavonoid-rich fruits on hypertension in adults: a systematic review. ACTA ACUST UNITED AC 2020; 17:2075-2105. [PMID: 31464854 DOI: 10.11124/jbisrir-d-19-00050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The objective of this systematic review was to synthesize the best available research evidence on the effectiveness of flavonoid-rich fruits in the treatment of hypertension. INTRODUCTION Hypertension is a serious public health concern as it contributes to a significant burden of disease, leading to millions of deaths globally. Complementary therapies including flavonoids have generated interest in assisting the treatment of hypertension. Flavonoids are a type of polyphenol abundant in fruits and a growing body of evidence suggests antihypertensive effects of the flavonoids due to their antioxidant properties. To date, no systematic review has been performed to collate the evidence on the effects of flavonoid-rich fruits on hypertension in adults. INCLUSION CRITERIA This systematic review included randomized controlled trials (RCTs) that compared the administration of any type of flavonoid-rich fruit or equivalent supplement with a placebo or other intervention in adults with hypertension. Trials that measured blood pressure using objective outcome measures such as a manual mercury sphygmomanometer were included. Studies that did not specify the flavonoid component of the fruit or fruit supplement were excluded from the review. Secondary outcomes, including change in weight, blood glucose level, triglycerides and total blood cholesterol levels, were also assessed. METHODS A three-step search was undertaken, including a comprehensive search of the MEDLINE, Embase, Cochrane Trials (CENTRAL) and CINAHL databases, in September 2018. We also searched Dissertation Abstracts International, ProQuest Dissertations and Theses, MedNar and ClinicalTrials.gov to identify unpublished studies. The title and abstracts of the studies were reviewed by two independent reviewers against the inclusion/exclusion criteria. The methodological quality of the potential studies for inclusion were assessed using the critical appraisal checklist for randomized controlled trials as recommended by JBI. Data were pooled in a statistical meta-analysis model. Subgroup-analysis according to type of intervention and length of intervention period was performed. Where statistical pooling was not possible, the findings have been presented in a narrative form. RESULTS Fifteen randomized controlled trials involving 572 participants were included in the review. The subclasses of flavonoids assessed included: anthocyanins, naringin, narirutin and flavan-3-ols. The overall methodological quality of the trials was high. Six trials investigated the effect of the flavonoid intervention on blood pressure within four weeks. Meta-analysis of four of the trials demonstrated no effect of flavonoids on systolic or diastolic blood pressure when compared to placebo (systolic mean difference = -1.02, 95% confidence interval [CI] -3.12, 1.07; p = 0.34, I = 0%; diastolic mean difference = -0.90, 95% CI -2.10, 0.31; p = 0.15, I = 0%). Similarly, pooled results from two crossover RCTs with two-timed dosed interventions in a 24-hour period demonstrated no effect on a reduction in diastolic blood pressure (p = 0.38) but did reveal evidence of a reduction in systolic blood pressure (p = 0). Six trials assessed blood pressure following the flavonoid intervention at more than four weeks follow-up. Meta-analysis of five of the trials demonstrated evidence of no effect on either systolic blood pressure (mean difference = -0.95, 95%CI -3.58, 1.68; p = 0.478, I = 0%) or diastolic blood pressure (mean difference = 0.86, 95%CI -1.11, 2.82; p = 0.393, I = 0%). CONCLUSIONS The findings of this systematic review should be interpreted with caution, given that the results are obtained from single-center trials with small sample sizes. Flavonoids have no effect on systolic and diastolic blood pressure. Further robust RCTs using sample sizes based on power calculations are needed to provide evidence for the use of flavonoid-rich fruits for the management of hypertension.
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Affiliation(s)
- Laura Ellwood
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence.,Centre for Research in Nursing and Health, St George Hospital, Sydney, Australia
| | - Gizemnur Torun
- Koç University Hospital, Istanbul, Turkey.,School of Nursing, Koç University, Istanbul, Turkey
| | - Zuhal Bahar
- School of Nursing, Koç University, Istanbul, Turkey
| | - Ritin Fernandez
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence.,Centre for Research in Nursing and Health, St George Hospital, Sydney, Australia.,School of Nursing, University of Wollongong, Wollongong, Australia
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Parmenter BH, Croft KD, Hodgson JM, Dalgaard F, Bondonno CP, Lewis JR, Cassidy A, Scalbert A, Bondonno NP. An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk. Food Funct 2020; 11:6777-6806. [PMID: 32725042 DOI: 10.1039/d0fo01118e] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is an accumulating body of literature reporting on dietary flavonoid intake and the risk of cardiovascular disease (CVD) in prospective cohort studies. This makes apparent the need for an overview and update on the current state of the science. To date, at least 27 prospective cohorts (in 44 publications) have evaluated the association between estimated habitual flavonoid intake and CVD risk. At this time, the totality of evidence suggests long-term consumption of flavonoid-rich foods may be associated with a lower risk of fatal and non-fatal ischemic heart disease (IHD), cerebrovascular disease, and total CVD; disease outcomes which are principally, though not exclusively, composed of cases of atherosclerotic CVD (ASCVD). To date, few studies have investigated outcome specific ASCVD, such as peripheral artery disease (PAD) or ischemic stroke. Of the flavonoid subclasses investigated, evidence more often implicates diets rich in anthocyanins, flavan-3-ols, and flavonols in lowering the risk of CVD. Although inferences are restricted by confounding and other inherent limitations of observational studies, causality appears possible based on biological plausibility, temporality, and the relative consistency of the reported associations. However, whether the associations observed represent a benefit of the isolated bioactives per se, or are a signal of the bioactives acting in concert with the co-occurring nutrient matrix within flavonoid-bearing foods, are issues of consideration. Thus, the simple interpretation, and the one most relevant for dietary advice, is that consumption of flavonoid-rich foods or diets higher in flavonoids, appear nutritionally beneficial in the prevention of CVD.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Kevin D Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Frederik Dalgaard
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia and Centre for Kidney Research, School of Public Health, The University of Sydney, Sydney, Australia
| | - Aedín Cassidy
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Augustin Scalbert
- Biomarkers Group, International Agency for Research on Cancer, Lyon, France
| | - Nicola P Bondonno
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia. and School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
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Flavonoids and Mitochondria: Activation of Cytoprotective Pathways? Molecules 2020; 25:molecules25133060. [PMID: 32635481 PMCID: PMC7412508 DOI: 10.3390/molecules25133060] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/01/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023] Open
Abstract
A large number of diverse mechanisms that lead to cytoprotection have been described to date. Perhaps, not surprisingly, the role of mitochondria in these phenomena is notable. In addition to being metabolic centers, due to their role in cell catabolism, ATP synthesis, and biosynthesis these organelles are triggers and/or end-effectors of a large number of signaling pathways. Their role in the regulation of the intrinsic apoptotic pathway, calcium homeostasis, and reactive oxygen species signaling is well documented. In this review, we aim to characterize the prospects of influencing cytoprotective mitochondrial signaling routes by natural substances of plant origin, namely, flavonoids (e.g., flavanones, flavones, flavonols, flavan-3-ols, anthocyanidins, and isoflavones). Flavonoids are a family of widely distributed plant secondary metabolites known for their beneficial effects on human health and are widely applied in traditional medicine. Their pharmacological characteristics include antioxidative, anticarcinogenic, anti-inflammatory, antibacterial, and antidiabetic properties. Here, we focus on presenting mitochondria-mediated cytoprotection against various insults. Thus, the role of flavonoids as antioxidants and modulators of antioxidant cellular response, apoptosis, mitochondrial biogenesis, autophagy, and fission and fusion is reported. Finally, an emerging field of flavonoid-mediated changes in the activity of mitochondrial ion channels and their role in cytoprotection is outlined.
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Devi SA, Chamoli A. Polyphenols as an Effective Therapeutic Intervention Against Cognitive Decline During Normal and Pathological Brain Aging. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1260:159-174. [PMID: 32304034 DOI: 10.1007/978-3-030-42667-5_7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Research in animals and humans has indicated that polyphenols can delay the age-related decline in learning, memory and neurodegenerative diseases. Among the polyphenols, berry phenolics have extensive beneficial effects because of their antioxidant and anti-inflammatory properties. Long-term consumption of grapes results in accumulation of polyphenols in the brain, which modulates cell-signalling pathways and neutralises the redox imbalance in the aging brain. Here we review the in vivo and in vitro evidence for considering grape-derived polyphenolics, the flavonoids- catechins, epicatechin, anthocyanidin, and quercetin, and non-flavonoids-gallic acid and resveratrol, as effective dietary sources to facilitate cognition in adults and lessen the decline in the old and pathogenic states, Alzheimer's and Parkinson's disease. Furthermore, a combined intervention of polyphenols along with regular physical exercise provides cognitive benefits for the aging brain and holds promising venues for preclinical and clinical studies in formulating neuro-nutraceuticals as functional foods for a healthy brain.
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Affiliation(s)
- S Asha Devi
- Laboratory of Gerontology, Department of Zoology, Bangalore University, Bangalore, India.
| | - Anudita Chamoli
- Laboratory of Gerontology, Department of Zoology, Bangalore University, Bangalore, India
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15
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Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review. Nutrients 2020; 12:nu12041088. [PMID: 32326404 PMCID: PMC7231110 DOI: 10.3390/nu12041088] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 12/12/2022] Open
Abstract
Unhealthy diet is a significant risk factor for cardiovascular diseases (CVD). Therefore, this umbrella review aims to comprehensively review the effects of dietary factors, including dietary patterns, food groups, and nutrients on CVD risks. Medline and Scopus databases were searched through March 2020. Systematic reviews with meta-analyses (SRMA) of randomized controlled trials (RCTs) or observational studies measuring the effects of dietary factors on CVD risks were eligible. Fifty-four SRMAs, including 35 SRMAs of observational studies, 10 SRMAs of RCTs, and 9 SRMAs of combined RCT and observational studies, were included for review. Findings from the SRMAs of RCTs suggest the significant benefit of Mediterranean and high-quality diets for lowering CVD risk, with pooled risk ratios (RRs) ranging from 0.55 (95%CI: 0.39-0.76) to 0.64 (95%CI: 0.53-0.79) and 0.70 (95%CI: 0.57-0.87), respectively. For food nutrients, two SRMAs of RCTs found that high intake of n-3 polyunsaturated fatty acid (PUFA) significantly reduced CVD risks, with pooled RRs ranging from 0.89 (95%CI: 0.82, 0.98) to 0.90 (95%CI: 0.85-0.96), while evidence of efficacy of n-6 PUFA and combined n-3 and n-6 PUFA were inconsistent. Moreover, results from the SRMAs of RCTs did not find a significant benefit of a low-salt diet and low total fat intake for CVD prevention. For food groups, results from the SRMAs of cohort studies suggest that high intakes of legumes, nuts, and chocolate, as well as a vegetarian diet significantly reduced the risk of coronary heart disease, with pooled RRs of 0.90 (95%CI: 0.84-0.97), 0.68 (95%CI: 0.59-0.78), 0.90 (95%CI: 0.82-0.97), and 0.71 (95%CI: 0.57-0.87), respectively. Healthy dietary patterns had a significant benefit for CVD prevention. With the substitutional and synergistic interactions between different food groups and nutrients, dietary recommendations for CVD prevention should be focused more on healthy dietary patterns than single food groups or nutrients.
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17
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Dietary intake of total polyphenols and the risk of all-cause and specific-cause mortality in Japanese adults: the Takayama study. Eur J Nutr 2019; 59:1263-1271. [PMID: 31732850 PMCID: PMC7098940 DOI: 10.1007/s00394-019-02136-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/04/2019] [Indexed: 12/13/2022]
Abstract
Purpose Several epidemiological studies have demonstrated the health benefits of polyphenols, but the associations between polyphenol intake and mortality including total and major causes of death remain unclear. We investigated the associations between subjects’ total polyphenol intake and their mortality from all causes, cardiovascular disease (CVD), cancer, and other causes of death in a population-based cohort study in Japan. Methods A total of 29,079 residents of Takayama City, Japan were analyzed. Their dietary intake was assessed using a validated semi-quantitative food-frequency questionnaire (FFQ) in 1992. Mortality was ascertained over the subsequent 16 years. The dietary polyphenol intake was calculated by matching the subjects’ food consumption data with our original polyphenol content database. Results A total of 5339 deaths occurred during the follow-up. After multivariable adjustment, the highest quartile of total polyphenol intake compared with the lowest quartile was significantly associated with a lower risk of all-cause mortality (HR: 0.93, 95% CI: 0.82–0.99, p trend = 0.003). The subjects in the highest quartile showed significantly lower CVD mortality compared to those in the lowest quartile, and among the types of CVD mortality, a strong inverse association was observed for stroke mortality. Inverse associations were also observed for mortality from other causes, specifically digestive disease. The total polyphenol intake was not significantly associated with the risk of cancer mortality. Conclusions The results of this prospective study indicate that dietary total polyphenol intake in Japanese is inversely associated with all-cause mortality and mortality from cardiovascular and digestive diseases.
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18
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Krochmal-Marczak B, Sawicka B. The influence of cooking on the antioxidant properties and polyphenol content in buckwheat, barley and millet groats and the transfer of the compounds to the water. POTRAVINARSTVO 2019. [DOI: 10.5219/1171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The research subject was the influence of the cooking process on the polyphenol content and antioxidant properties of groats (buckwheat groats, barley groats, millet groats) and on the colour parameters of the products. After groats cooking, also the water was tested for the polyphenol content and antioxidant properties that permeated into the decoction of the cooked raw material. The evaluation of the antioxidant properties of groats was conducted with the DPPH radical assay, the polyphenol content was determined with the Folin-Ciocalteu reagent, and the colour was determined with the trichromatic colorimetry method using the Konica Minolta CM-5 colorimeter (Osaka, Japan). The cooking process significantly lowered the content of polyphenolic compounds and antioxidant properties of the ready products. The best antioxidant properties after cooking were found in buckwheat groats and the weakest in millet groats. The polyphenol content in cooked products depended on the type of groats. Cooking significantly decreased the polyphenol content, but only in buckwheat and barley groats, as well as causing a change of groats colour as compared to uncooked samples. The most antioxidant properties were found in the water from cooking barley groats, and the least - from cooking millet groats. The most polyphenols permeated into the water from cooking buckwheat groats, and the least from cooking millet groats. All groats, except millet groats, darkened after cooking. In all types of groats, the correlation coefficients between colour parameter and general polyphenol content and the ability to scavenge DPPH radicals showed very strong negative dependences. The conducted research can help in designing the technological process of cooking buckwheat, barley and millet groats, and a way of using the water from cooked groats for consumption.
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19
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Scicchitano P, Cortese F, Gesualdo M, De Palo M, Massari F, Giordano P, Ciccone MM. The role of endothelial dysfunction and oxidative stress in cerebrovascular diseases. Free Radic Res 2019; 53:579-595. [PMID: 31106620 DOI: 10.1080/10715762.2019.1620939] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Pietro Scicchitano
- Department of Cardiology, Hospital “F. Perinei”, Altamura, Italy
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy
| | - Francesca Cortese
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy
| | | | - Micaela De Palo
- Department of Cardiac Surgery, Mater Dei Hospital, Bari, Italy
| | | | - Paola Giordano
- Department of Biomedical Sciences and Human Oncology – Paediatric Unit, Policlinico Hospital, Bari, Italy
| | - Marco Matteo Ciccone
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy
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Fraga CG, Croft KD, Kennedy DO, Tomás-Barberán FA. The effects of polyphenols and other bioactives on human health. Food Funct 2019; 10:514-528. [PMID: 30746536 DOI: 10.1039/c8fo01997e] [Citation(s) in RCA: 559] [Impact Index Per Article: 111.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although deficiencies in polyphenol intake do not result in specific deficiency diseases, adequate intake of polyphenols could confer health benefits, especially with regard to chronic diseases. Tea, cocoa, fruits, and berries, as well as vegetables, are rich in polyphenols. Flavan-3-ols from cocoa have been found to be associated with a reduced risk of stroke, myocardial infarction, and diabetes, as well as improvements in lipids, endothelial-dependent blood flow and blood pressure, insulin resistance, and systemic inflammation. The flavonoid quercetin and the stilbene resveratrol have also been associated with cardiometabolic health. Although polyphenols have been associated with improved cerebral blood flow, evidence of an impact on cognition is more limited. The ability of dietary polyphenols to produce clinical effects may be due, at least in part, to a bi-directional relationship with the gut microbiota. Polyphenols can impact the composition of the gut microbiota (which are independently associated with health benefits), and gut bacteria metabolize polyphenols into bioactive compounds that produce clinical benefits. Another critical interaction is that of polyphenols with other phytochemicals, which could be relevant to interpreting the health parameter effects of polyphenols assayed as purified extracts, whole foods, or whole food extracts.
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Affiliation(s)
- César G Fraga
- Fisicoquímica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.
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Kennedy DO. Phytochemicals for Improving Aspects of Cognitive Function and Psychological State Potentially Relevant to Sports Performance. Sports Med 2019; 49:39-58. [PMID: 30671903 PMCID: PMC6445817 DOI: 10.1007/s40279-018-1007-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Subjective alertness and optimal cognitive function, including in terms of attention, spatial/working memory and executive function, are intrinsic to peak performance in many sports. Consumption of a number of plant-derived 'secondary metabolite' phytochemicals can modulate these psychological parameters, although there is a paucity of evidence collected in a sporting context. The structural groups into which these phytochemicals fall-phenolics, terpenes and alkaloids-vary in terms of the ecological roles they play for the plant, their toxicity and the extent to which they exert direct effects on brain function. The phenolics, including polyphenols, play protective roles in the plant, and represent a natural, benign component of the human diet. Increased consumption has been shown to improve cardiovascular function and is associated with long-term brain health. However, whilst short-term supplementation with polyphenols has been shown to consistently modulate cerebral blood-flow parameters, evidence of direct effects on cognitive function and alertness/arousal is currently comparatively weak. Terpenes play both attractant and deterrent roles in the plant, and typically occur less frequently in the diet. Single doses of volatile monoterpenes derived from edible herbs such as sage (Salvia officinalis/lavandulaefolia) and peppermint (Mentha piperita), diterpene-rich Ginkgo biloba extracts and triterpene-containing extracts from plants such as ginseng (Panax ginseng/quinquefolius) and Bacopa monnieri have all been shown to enhance relevant aspects of cognitive function and alertness. The alkaloids play toxic defensive roles in the plant, including via interference with herbivore brain function. Whilst most alkaloids are inappropriate in a sporting context due to toxicity and legal status, evidence suggests that single doses of nicotine and caffeine may be able to enhance relevant aspects of cognitive function and/or alertness. However, their benefits may be confounded by habituation and withdrawal effects in the longer term. The efficacy of volatile terpenes, triterpene-rich extracts and products combining low doses of caffeine with other phytochemicals deserves more research attention.
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Affiliation(s)
- David O Kennedy
- Brain, Performance and Nutrition Research Centre, Northumbria University, Newcastle-upon-Tyne, NE1 8ST, UK.
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Adriouch S, Lampuré A, Nechba A, Baudry J, Assmann K, Kesse-Guyot E, Hercberg S, Scalbert A, Touvier M, Fezeu LK. Prospective Association between Total and Specific Dietary Polyphenol Intakes and Cardiovascular Disease Risk in the Nutrinet-Santé French Cohort. Nutrients 2018; 10:E1587. [PMID: 30380657 PMCID: PMC6266343 DOI: 10.3390/nu10111587] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/21/2018] [Accepted: 10/23/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Epidemiological and experimental evidence support a protective effect of dietary polyphenols on chronic diseases, but high quality longitudinal data are needed, including details on categories of polyphenols. Our objective was to investigate the prospective association between total and individual classes and subclasses of dietary polyphenols and the risk of major cardiovascular disease in the NutriNet-Santé cohort. METHODS A total of 84,158 participants, who completed at least three 24 h dietary records, were included between May 2009 and June 2017. Individual polyphenols intakes were obtained by matching food consumption data from the 24 h dietary records with the Phenol-Explorer polyphenol composition database. Multivariable Cox proportional hazards models were used to characterize the associations between dietary polyphenols and the incidence of cardiovascular diseases, comparing tertile T3 vs. T1 of classes and subclasses of polyphenols. RESULTS Over a median of 4.9 years of follow-up, 602 major cardiovascular events were diagnosed. Intakes of anthocyanins, catechins, and flavonols were strongly inversely associated with cardiovascular disease risk (anthocyanins: Hazard Ratio (HR)for a 1-point increment of 10 mg/day = 0.98 (0.96⁻0.99, p = 0.03, HRT3vs.T1 = 0.66 (0.52⁻0.83), ptrend = 0.0003; catechins: HRfor a 1-point increment of 10 mg/day = 0.98 (0.96⁻0.99), p = 0.02, HRT3vs.T1 = 0.74 (0.60⁻0.91), ptrend = 0.004; flavonols: HRfor a 1-point increment of 10 mg/day = 0.94 (0.90⁻0.99), p = 0.02, HRT3vs.T1 = 0.75 (0.61⁻0.94), ptrend = 0.006). Intakes of dihydrochalcones, proanthocyaninidins, dihydroflavonols, hydroxybenzoic acids, and stilbenes were also associated with a decrease (13%, 19%, 24%, 24%, and 27%, respectively) in cardiovascular disease risk, when comparing tertile T3 to T1. CONCLUSIONS Higher intakes of polyphenols, especially of anthocyanins, catechins, and flavonols, were associated with a statistically significant decreased cardiovascular disease risk.
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Affiliation(s)
- Solia Adriouch
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Aurélie Lampuré
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Anouar Nechba
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Julia Baudry
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Karen Assmann
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Emmanuelle Kesse-Guyot
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
- Département de Santé Publique, Hôpital Avicenne, F-93017 Bobigny, France.
| | - Augustin Scalbert
- Biomarkers Group, Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 69372 Lyon CEDEX 08, France.
| | - Mathilde Touvier
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Léopold K Fezeu
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
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Murphy KJ, Walker KM, Dyer KA, Bryan J. Estimation of daily intake of flavonoids and major food sources in middle-aged Australian men and women. Nutr Res 2018; 61:64-81. [PMID: 30683440 DOI: 10.1016/j.nutres.2018.10.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 08/30/2018] [Accepted: 10/23/2018] [Indexed: 11/28/2022]
Abstract
Flavonoid consumption has reported health benefits such as reducing cardiovascular disease risk factors, improving endothelial function, and delaying age-related cognitive decline. However, there are little dietary intake data for Australians, which limit our ability to make dietary recommendations to increase intakes to a level where health benefits are seen. The aim of this cross-sectional study was to determine the intake of flavonoids, flavonoid classes, and flavonoid subclasses of 1183 Australians aged 39 to 65 years using a validated 215-item food frequency questionnaire. Based on limited global flavonoid intake data, flavanols are the major dietary flavonoid and are found predominantly in tea and cocoa. As Australians are large tea drinkers, we anticipated that flavanols would be the major flavonoid in the Australian diet. The flavonoid content of foods was determined using a combination of the United States Department of Agriculture Databases and the Phenol-Explorer Database. One-way analysis of variance was undertaken to examine differences between flavonoid intake between men and women. Total flavonoid intake was 626 ± 579 mg/d. Men and women consumed 566 ± 559 mg and 660 ± 588 mg of total flavonoids per day, respectively. Thearubigin accounted for 58% of the flavonoid intake. Women consumed more total flavonoids, thearubigins (both P < .01), anthocyanidins (P < .0001), flavan-3-ols, flavones, and flavonols (all P < .05) than men, whereas men consumed more flavanones than women (P = .01). There was no difference between sexes for the consumption of isoflavones. The data indicated that flavan-3-ols, predominantly thearubigin from tea, were the main flavonoid consumed by Australians. This information contributes to population flavonoid intakes, which should be considered when exploring flavonoid and health relationships.
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Affiliation(s)
- Karen J Murphy
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5000, Australia.
| | - Katie M Walker
- School of Psychology, Social Work and Social Policy, University of South Australian, Adelaide, SA 5000, Australia.
| | - Kathryn A Dyer
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5000, Australia.
| | - Janet Bryan
- School of Psychology, Social Work and Social Policy, University of South Australian, Adelaide, SA 5000, Australia.
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Put "gender glasses" on the effects of phenolic compounds on cardiovascular function and diseases. Eur J Nutr 2018; 57:2677-2691. [PMID: 29696400 DOI: 10.1007/s00394-018-1695-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/19/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The influence of sex and gender is particularly relevant in cardiovascular diseases (CVD) as well as in several aspects of drug pharmacodynamics and pharmacokinetics. Anatomical and physiological differences between the sexes may influence the activity of many drugs, including the possibility of their interaction with other drugs, bioactive compounds, foods and beverages. Phenolic compounds could interact with our organism at organ, cellular, and molecular levels triggering a preventive action against chronic diseases, including CVD. RESULTS This article will review the role of sex on the activity of these bioactive molecules, considering the existence of sex differences in oxidative stress. It describes the pharmacokinetics of phenolic compounds, their effects on vessels, on cardiovascular system, and during development, including the role of nuclear receptors and microbiota. CONCLUSIONS Although there is a large gap between the knowledge of the sex differences in the phenolic compounds' activity and safety, and the urgent need for more research, available data underlie the possibility that plant-derived phenolic compounds could differently influence the health of male and female subjects.
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Terao J. Factors modulating bioavailability of quercetin-related flavonoids and the consequences of their vascular function. Biochem Pharmacol 2017. [DOI: 10.1016/j.bcp.2017.03.021 pmid: 28377278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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26
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Akomolafe SF. The effects of caffeine, caffeic acid, and their combination on acetylcholinesterase, adenosine deaminase and arginase activities linked with brain function. J Food Biochem 2017. [DOI: 10.1111/jfbc.12401] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Barreca D, Gattuso G, Bellocco E, Calderaro A, Trombetta D, Smeriglio A, Laganà G, Daglia M, Meneghini S, Nabavi SM. Flavanones: Citrus phytochemical with health-promoting properties. Biofactors 2017; 43:495-506. [PMID: 28497905 DOI: 10.1002/biof.1363] [Citation(s) in RCA: 205] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 03/27/2017] [Accepted: 03/31/2017] [Indexed: 12/26/2022]
Abstract
Citrus fruit and juices represent one of the main sources of compounds with a high potential for health promoting properties. Among these compounds, flavanones (such as hesperetin, naringenin, eriodictyol, isosakuranetin, and their respective glycosides), which occur in quantities ranging from ∼180 to 740 mg/L (depending on the Citrus species and cultivar) are responsible for many biological activities. These compounds support and enhance the body's defenses against oxidative stress and help the organism in the prevention of cardiovascular diseases, atherosclerosis, and cancer. Moreover, among other properties, they also show anti-inflammatory, antiviral, and antimicrobial activities. This review analyzes the biochemistry, pharmacology, and biology of Citrus flavanones, emphasizing the occurrence in Citrus fruits and juices and their bioavailability, structure-function correlations and ability to modulate signal cascades both in vitro and in vivo. © 2017 BioFactors, 43(4):495-506, 2017.
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Affiliation(s)
- Davide Barreca
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Giuseppe Gattuso
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Ersilia Bellocco
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Antonella Calderaro
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Domenico Trombetta
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Antonella Smeriglio
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Giuseppina Laganà
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Maria Daglia
- Department of Drug Sciences, Medicinal Chemistry and Pharmaceutical Technology Section, University of Pavia, Italy
| | - Silvia Meneghini
- Department of Drug Sciences, Medicinal Chemistry and Pharmaceutical Technology Section, University of Pavia, Italy
| | - Seyed Mohammad Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Terao J. Factors modulating bioavailability of quercetin-related flavonoids and the consequences of their vascular function. Biochem Pharmacol 2017; 139:15-23. [PMID: 28377278 DOI: 10.1016/j.bcp.2017.03.021] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 03/29/2017] [Indexed: 12/31/2022]
Abstract
Nowadays dietary flavonoids attract much attention in the prevention of chronic diseases. Epidemiological and intervention studies strongly suggest that flavonoid intake has beneficial effects on vascular health. It is unlikely that flavonoids act as direct antioxidants, although oxidative stress profoundly contributes to vascular impairment leading to cardiovascular diseases. Instead, flavonoids may exert their function by tuning the cellular redox state to an adaptive response or tolerable stress. However, the optimum intake of flavonoids from supplements or diet has not been clarified yet, because a number of exogenous and endogenous factors modulating their bioavailability affect their vascular function. This review will focus on the current knowledge of the bioavailability and vascular function of quercetin as a representative of antioxidative flavonoids. Current intervention studies imply that intake of quercetin-rich onion improves vascular health. Onion may be superior to quercetin supplement from the viewpoint of quercetin bioavailability, probably because the food matrix enhances the intestinal absorption of quercetin. α-Glucosylation increases its bioavailability by elevating the accessibility to the absorptive cells. Prenylation may enhance bioaccumulation at the target site by increasing the cellular uptake. However, these chemical modifications do not guarantee health benefits to the vascular system. Dietary quercetin is exclusively present as their conjugated form in the blood stream. Quercetin may exert its vascular function as an aglycone within macrophage cells after inflammation-induced deconjugation and as conjugated metabolites by targeting endothelial cells. The relationship between the bioavailability and bio-efficacy should be clarified, to evaluate the vascular function of a wide variety of dietary flavonoids.
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Affiliation(s)
- Junji Terao
- Faculty of Nursing and Rehabilitation, Konan Women's University, Morikita-cho 6-2-23, Higashinaga-ku, Kobe City, Hyogo 658-0001, Japan.
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Menezes R, Rodriguez-Mateos A, Kaltsatou A, González-Sarrías A, Greyling A, Giannaki C, Andres-Lacueva C, Milenkovic D, Gibney ER, Dumont J, Schär M, Garcia-Aloy M, Palma-Duran SA, Ruskovska T, Maksimova V, Combet E, Pinto P. Impact of Flavonols on Cardiometabolic Biomarkers: A Meta-Analysis of Randomized Controlled Human Trials to Explore the Role of Inter-Individual Variability. Nutrients 2017; 9:E117. [PMID: 28208791 PMCID: PMC5331548 DOI: 10.3390/nu9020117] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/03/2017] [Indexed: 02/05/2023] Open
Abstract
Several epidemiological studies have linked flavonols with decreased risk of cardiovascular disease (CVD). However, some heterogeneity in the individual physiological responses to the consumption of these compounds has been identified. This meta-analysis aimed to study the effect of flavonol supplementation on biomarkers of CVD risk such as, blood lipids, blood pressure and plasma glucose, as well as factors affecting their inter-individual variability. Data from 18 human randomized controlled trials were pooled and the effect was estimated using fixed or random effects meta-analysis model and reported as difference in means (DM). Variability in the response of blood lipids to supplementation with flavonols was assessed by stratifying various population subgroups: age, sex, country, and health status. Results showed significant reductions in total cholesterol (DM = -0.10 mmol/L; 95% CI: -0.20, -0.01), LDL cholesterol (DM = -0.14 mmol/L; Nutrients 2017, 9, 117 2 of 21 95% CI: -0.21, 0.07), and triacylglycerol (DM = -0.10 mmol/L; 95% CI: -0.18, 0.03), and a significant increase in HDL cholesterol (DM = 0.05 mmol/L; 95% CI: 0.02, 0.07). A significant reduction was also observed in fasting plasma glucose (DM = -0.18 mmol/L; 95%CI: -0.29, -0.08), and in blood pressure (SBP: DM = -4.84 mmHg; 95% CI: -5.64, -4.04; DBP: DM = -3.32 mmHg; 95% CI: -4.09, -2.55). Subgroup analysis showed a more pronounced effect of flavonol intake in participants from Asian countries and in participants with diagnosed disease or dyslipidemia, compared to healthy and normal baseline values. In conclusion, flavonol consumption improved biomarkers of CVD risk, however, country of origin and health status may influence the effect of flavonol intake on blood lipid levels.
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Affiliation(s)
- Regina Menezes
- iBET/ITQB, Molecular Nutrition & Health Laboratory, 2780-157 Oeiras, Portugal;
| | - Ana Rodriguez-Mateos
- Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 9NH, UK;
| | - Antonia Kaltsatou
- FAME Laboratory, School of Exercise Science, University of Thessaly, 42100 Volos, Greece;
| | | | | | | | - Cristina Andres-Lacueva
- Biomarkers and Nutrimetabolomic Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Campus Torribera, Faculty of Pharmacy and Food Sciences, University of Barcelona, CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 08028 Barcelona, Spain; (C.A.-L.); (M.G.-A.)
| | - Dragan Milenkovic
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, Clermont Université, Université d’Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France;
| | | | - Julie Dumont
- Université Lille, INSERM, Institut Pasteur de Lille, U1167—RID-AGE—Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, F-59000 Lille, France;
| | - Manuel Schär
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6AP, UK;
| | - Mar Garcia-Aloy
- Biomarkers and Nutrimetabolomic Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Campus Torribera, Faculty of Pharmacy and Food Sciences, University of Barcelona, CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 08028 Barcelona, Spain; (C.A.-L.); (M.G.-A.)
| | | | | | | | - Emilie Combet
- Human Nutrition, University of Glasgow, Glasgow G31 2ER, UK; (S.A.P.-D.); (E.C.)
| | - Paula Pinto
- iBET/ITQB, Molecular Nutrition & Health Laboratory, 2780-157 Oeiras, Portugal;
- Polytechnic Institute of Santarem, ESA, Department of Food Technology, Biotechnology and Nutrition, 2001-904 Santarém, Portugal
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Neuroprotective diets for stroke. Neurochem Int 2017; 107:4-10. [PMID: 28161467 DOI: 10.1016/j.neuint.2017.01.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 01/20/2017] [Accepted: 01/24/2017] [Indexed: 11/22/2022]
Abstract
Stroke is one of the main causes of death and disability in the elderly. In the last few years, there has been increasing evidence that suggests the influence of the diet on the decrease of stroke risk. Probably, because of the presence of bioactive components with beneficial effects such as antioxidant or anti-inflammatory properties. This article reviews several dietary bioactive compounds from studies in models of cerebral ischemia that have obtained promising results decreasing cerebral damage. We propose that many of these compounds present in diet could be good candidates to test new neuroprotection approaches focused on reducing the damage and protecting the brain before stroke occurs.
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Abstract
CVD remain the leading cause of death globally. Effective dietary strategies for their reduction are of high priority. Increasing evidence suggests that phytochemicals, particularly dietary flavonoids and nitrates, are key modulators of CVD risk reduction through impact on multiple risk factors. The aim of this review is to explore the evidence for the impact of flavonoid- and nitrate-rich foods and supplements on CVD risk, with specific reference to their importance as mediators of vascular health and platelet function. There is accumulating evidence to support benefits of dietary flavonoids on cardiovascular health. Dose-dependent recovery of endothelial function and lowering of blood pressure have been reported for the flavanol (-)-epicatechin, found in cocoa, apples and tea, through production and availability of endothelial nitric oxide (NO). Furthermore, flavonoids, including quercetin and its metabolites, reduce in vitro and ex vivo platelet function via inhibition of phosphorylation-dependent cellular signalling pathways, although further in vivo studies are required to substantiate these mechanistic effects. Hypotensive effects of dietary nitrates have been consistently reported in healthy subjects in acute and chronic settings, although there is less evidence for these effects in patient groups. Proposed mechanisms of actions include endothelial-independent NO availability, which is dependent on the entro-salivary circulation and microbial conversion of dietary nitrate to nitrite in the mouth. In conclusion, flavonoid- and nitrate-rich foods show promising effects on vascular function, yet further randomly controlled studies are required to confirm these findings and to determine effective doses.
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Affiliation(s)
- Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition,Department of Food and Nutritional Sciences,Reading RG6 6AP,UK
| | - Alex Stainer
- Institute for Cardiovascular and Metabolic Research (ICMR),University of Reading,Whiteknights,Reading RG6 6AP,UK
| | - Ditte A Hobbs
- Hugh Sinclair Unit of Human Nutrition,Department of Food and Nutritional Sciences,Reading RG6 6AP,UK
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Affiliation(s)
- Xianwei Zeng
- Department of Neurosurgery, Affiliated Hospital of Weifang Medical College, Weifang, Shandong 261031, China.
| | - Aijun Deng
- Department of Neurosurgery, Affiliated Hospital of Weifang Medical College, Weifang, Shandong 261031, China
| | - Yi Ding
- Department of Neurosurgery, Affiliated Hospital of Weifang Medical College, Weifang, Shandong 261031, China
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Goetz ME, Judd SE, Hartman TJ, McClellan W, Anderson A, Vaccarino V. Flavanone Intake Is Inversely Associated with Risk of Incident Ischemic Stroke in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. J Nutr 2016; 146:2233-2243. [PMID: 27655760 PMCID: PMC5086785 DOI: 10.3945/jn.116.230185] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 08/26/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Flavonoids may have beneficial cerebrovascular effects, but evidence from racially and geographically representative cohorts in comprehensive flavonoid databases is lacking. Given racial and geographic disparities in stroke incidence, representative cohort studies are needed. OBJECTIVES We evaluated the association between flavonoid intake and incident ischemic stroke in a biracial, national cohort using updated flavonoid composition tables and assessed differences in flavonoid intake by sex, race, and region of residence. METHODS We evaluated 20,024 participants in the REGARDS (REasons for Geographic and Racial Differences in Stroke) study, a biracial prospective study. Participants with stroke history or missing dietary data were excluded. Flavonoid intake was estimated by using a Block98 food frequency questionnaire and the USDA's Provisional Flavonoid Addendum and Proanthocyanidin Database. Associations between quintiles of flavonoid intake and incident ischemic stroke were evaluated by using Cox proportional hazards models, adjusting for confounders. RESULTS Over 6.5 y, 524 acute ischemic strokes occurred. Flavanone intake was lower in the Southeastern United States but higher in blacks than in whites. After multivariable adjustment, flavanone intake was inversely associated with incident ischemic stroke (HR: 0.72; 95% CI: 0.55, 0.95; P-trend = 0.03). Consumption of citrus fruits and juices was inversely associated with incident ischemic stroke (HR: 0.69; 95% CI: 0.53, 0.91; P-trend = 0.02). Total flavonoids and other flavonoid subclasses were not associated with incident ischemic stroke. There was no statistical interaction with sex, race, or region for any flavonoid measure. CONCLUSIONS Greater consumption of flavanones, but not total or other flavonoid subclasses, was inversely associated with incident ischemic stroke. Associations did not differ by sex, race, or region for the association; however, regional differences in flavanone intake may contribute to regional disparities in ischemic stroke incidence. Higher flavanone intake in blacks suggests that flavanone intake is not implicated in racial disparities in ischemic stroke incidence.
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Affiliation(s)
| | - Suzanne E Judd
- Department of Epidemiology, Rollins School of Public Health,,Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL; and
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health,,Winship Cancer Institute, Emory University, Atlanta, GA
| | - William McClellan
- Department of Epidemiology, Rollins School of Public Health,,Renal Division and
| | - Aaron Anderson
- Department of Neurology, Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health,,Division of Cardiology, Department of Medicine, and
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34
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Salimikia I, Reza Monsef-Esfahani H, Gohari AR, Salek M. Phytochemical Analysis and Antioxidant Activity of Salvia chloroleuca Aerial Extracts. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e24836. [PMID: 27761269 PMCID: PMC5056592 DOI: 10.5812/ircmj.24836] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 01/18/2023]
Abstract
Background Salvia, known as Maryam Goli in the Persian language, is an important genus that includes approximately 900 species in the Lamiaceae family. There are 58 Salvia species growing naturally in Iran, including Salvia chloroleuca Rech. f. and Allen., which grows wild in the northeastern and central parts of the country. Objectives This study was designed to determine the chemical composition, in vitro antioxidant activity, and total phenol content of various extracts of S. chloroleuca. Materials and Methods Dried aerial parts of the plant were crushed, then sequentially extracted with n-hexane, ethyl acetate, and methanol. The fractions of S. chloroleuca were subjected to silica gel column chromatography and Sephedex LH-20. The antioxidant activities of these extracts were measured by ferric reducing antioxidant power (FRAP), and the total phenolic contents of the extracts were evaluated using Folin-Ciocalteu reagent. Results The separation and purification processes were carried out using different chromatographic methods. Structural elucidation was on the basis 1H-NMR and 13C-NMR spectral data, in comparison with that reported in the literature. The isolated compounds were salvigenin (1), luteolin (2), cirsiliol (3), β-sitosterol (4), and daucosterol (5). Ethyl acetate extract displayed the highest level of total antioxidants and total polyphenols compared to the other analyzed extracts (n-hexane and methanol). In the FRAP assay, ethyl acetate extract had the highest (230.4±10.5) FRAP value, followed by methanol (211.4 ± 8.3) and n-hexane (143.4 ± 12.04). Total phenol contents were calculated to be 13.8 ± 0.3, 58.25 ± 0.05, and 43.48 ± 0.38 mg of gallic acid/100 g in the n-hexane, ethyl acetate, and methanol extracts, respectively. Conclusions The above-mentioned compounds were isolated for the first time from S. chloroleuca. The antioxidant activity of this plant could be in part related to isolated flavonoids and sterols. The results of this study indicated that S. chloroleuca could be an important dietary source of phenolic compounds with high antioxidant capacity.
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Affiliation(s)
- Iraj Salimikia
- Department of Pharmacognosy, Faculty of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, IR Iran
| | - Hamid Reza Monsef-Esfahani
- Medicinal Plants Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Ahmad Reza Gohari
- Medicinal Plants Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Ahmad Reza Gohari, Medicinal Plants Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2164122330, E-mail:
| | - Mehrnoosh Salek
- Department of Pharmacognosy, Faculty of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, IR Iran
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Casamassima D, Palazzo M, Vizzarri F, Coppola R, Costagliola C, Corino C, Di Costanzo A. Dietary effect of dried bay leaves (Laurus nobilis) meal on some biochemical parameters and on plasma oxidative status in New Zealand white growing rabbit. J Anim Physiol Anim Nutr (Berl) 2016; 101:e175-e184. [PMID: 27553760 DOI: 10.1111/jpn.12584] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/24/2016] [Indexed: 12/11/2022]
Abstract
Effects of dietary supplementation of Laurus nobilis on selected biochemical parameters and plasma oxidative status in growing rabbits, fed with and without enriched-fat diet, integrated with and without dried bay leaves meal, were investigated. In the test, 120 New Zealand white 35-day-old male rabbits were divided into four homogeneous groups of 30 animals each. A negative control group (CON) received a feed that met the animal nutrient requirement; a positive control group (CG) receiving a supplement of 2.5% pig fat in feed; an experimental group (GA) feeding an integration of 2.5% pig fat and 1 g/kg of dried bay leaves (Laurus nobilis) in feed; an experimental group (CA) with dried bay leaves at the rate of 1 g/kg in feed. The dietary integration with dried bay leaves meal have resulted in a significant decrease in the blood lipid profile, glycemic profile and liver enzymes, with reduced levels of ALT and AST, glucose, total cholesterol, LDL cholesterol, triglycerides and increased HDL cholesterol. Plasma oxidative status markers have statistically improved with an increase in blood total phenols, SOD, ORAC, the FRAP and lipo-vitamin concentration, together with a significant reduction in ROMs and the MDA values. The results of present research underline that the dietary treatment with bay leaves meal, in the extend of 1 g/kg feed, confirms the lowering cholesterol activity and the epato-protective and ipo-glycemic effect in enrich-fat diet, controlling the oxidative status of plasma markers.
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Affiliation(s)
- D Casamassima
- Department of Agricultural, Environmental and Food Sciences, University of Molise, Campobasso, Italy
| | - M Palazzo
- Department of Agricultural, Environmental and Food Sciences, University of Molise, Campobasso, Italy
| | - F Vizzarri
- Department of Agricultural, Environmental and Food Sciences, University of Molise, Campobasso, Italy
| | - R Coppola
- Department of Agricultural, Environmental and Food Sciences, University of Molise, Campobasso, Italy
| | - C Costagliola
- Department of Medicine and Health Sciences, Località tappino, University of Molise, Campobasso, Italy
| | - C Corino
- Department of Health, Animal Science and Food Safety, University of Milano, Milano, Italy
| | - A Di Costanzo
- Department of Medicine and Health Sciences, Località tappino, University of Molise, Campobasso, Italy
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Amiot MJ, Riva C, Vinet A. Effects of dietary polyphenols on metabolic syndrome features in humans: a systematic review. Obes Rev 2016; 17:573-86. [PMID: 27079631 DOI: 10.1111/obr.12409] [Citation(s) in RCA: 266] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 12/13/2022]
Abstract
Dietary polyphenols constitute a large family of bioactive substances potential beneficial effect on metabolic syndrome (MetS). This review summarizes the results of clinical studies on patients with MetS involving the chronic supplementation of a polyphenol-rich diet, foods, extracts or with single phenolics on the features of MetS (obesity, dyslipidemia, blood pressure and glycaemia) and associated complications (oxidative stress and inflammation). Polyphenols were shown to be efficient, especially at higher doses, and there were no specific foods or extracts able to alleviate all the features of MetS. Green tea, however, significantly reduced body mass index and waist circumference and improved lipid metabolism. Cocoa supplementation reduced blood pressure and blood glucose. Soy isoflavones, citrus products, hesperidin and quercetin improved lipid metabolism, whereas cinnamon reduced blood glucose. In numerous clinical studies, antioxidative and anti-inflammatory effects were not significant after polyphenol supplementation in patients with MetS. However, some trials pointed towards an improvement of endothelial function in patients supplemented with cocoa, anthocyanin-rich berries, hesperidin or resveratrol. Therefore, diets rich in polyphenols, such as the Mediterranean diet, which promote the consumption of diverse polyphenol-rich products could be an effective nutritional strategy to improve the health of patients with MetS. © 2016 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.
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Affiliation(s)
- M J Amiot
- Unité Mixte de Recherche (UMR) 'Nutrition, Obesity and Risk of Thrombosis', Institut National de la Recherche Agronomique, Paris, France.,Institut National de la Santé et de la Recherche Médicale, Paris, France.,Aix-Marseille Université, Marseille, France
| | - C Riva
- LaPEC, EA4278, Université d'Avignon, Avignon, France
| | - A Vinet
- LaPEC, EA4278, Université d'Avignon, Avignon, France
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Kim JC, Shim YS. Method validation of analytical method for 12 flavonol glycosides in foods using ultra high-performance liquid chromatography coupled with photodiode array detection. Food Sci Biotechnol 2016; 25:659-664. [PMID: 30263320 DOI: 10.1007/s10068-016-0116-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 03/24/2016] [Accepted: 03/24/2016] [Indexed: 12/01/2022] Open
Abstract
An analytical method for the simultaneous determination of 12 flavonol glycosides in buckwheat, black tea, and wild parsley using ultra high-performance liquid chromatography (UHPLC) coupled with a simple liquid extraction method using dimethyl sulfoxide (DMSO) was validated in precision, accuracy, and linearity. The UHPLC separation of target compounds was performed on a C18 column using a photodiode array (PDA) detector and the wavelength was fixed at 350 nm. The recovery values for flavonol glycosides ranged from 85.44 to 108.79%. The limits of detection and limits of quantification were less than 0.32 mg/kg and less than 0.97 mg/kg, respectively. The intraday and interday precisions were less than 13.69% for all the test samples. This method coupled with UHPLCPDA detection could be expected to provide more convenient sample preparation than conventional methods in the tested foods.
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Affiliation(s)
- Jong-Chan Kim
- 1Food Standard Research Center, Korea Food Research Institute, Seongnam, Gyeonggi, 13539 Korea
| | - You-Shin Shim
- 1Food Standard Research Center, Korea Food Research Institute, Seongnam, Gyeonggi, 13539 Korea.,2Department of Food Biotechnology, University of Science & Technology, Daejeon, 34113 Korea
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Tang Z, Li M, Zhang X, Hou W. Dietary flavonoid intake and the risk of stroke: a dose-response meta-analysis of prospective cohort studies. BMJ Open 2016; 6:e008680. [PMID: 27279473 PMCID: PMC4908865 DOI: 10.1136/bmjopen-2015-008680] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To clarify and quantify the potential association between intake of flavonoids and risk of stroke. DESIGN Meta-analysis of prospective cohort studies. DATA SOURCE Studies published before January 2016 identified through electronic searches using PubMed, Embase and the Cochrane Library. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective cohort studies with relative risks and 95% CIs for stroke according to intake of flavonoids (assessed as dietary intake). RESULTS The meta-analysis yielded 11 prospective cohort studies involving 356 627 participants and more than 5154 stroke cases. The pooled estimate of the multivariate relative risk of stroke for the highest compared with the lowest dietary flavonoid intake was 0.89 (95% CI 0.82 to 0.97; p=0.006). Dose-response analysis indicated that the summary relative risk of stroke for an increase of 100 mg flavonoids consumed per day was 0.91 (95% CI 0.77 to 1.08) without heterogeneity among studies (I(2)=0%). Stratifying by follow-up duration, the relative risk of stroke for flavonoid intake was 0.89 (95% CI 0.81 to 0.99) in studies with more than 10 years of follow-up. CONCLUSIONS Results from this meta-analysis suggest that higher dietary flavonoid intake may moderately lower the risk of stroke.
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Affiliation(s)
- Zhenyu Tang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Min Li
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Xiaowei Zhang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Wenshang Hou
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
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Jumar A, Schmieder RE. Cocoa Flavanol Cardiovascular Effects Beyond Blood Pressure Reduction. J Clin Hypertens (Greenwich) 2016; 18:352-8. [PMID: 26514936 PMCID: PMC8031944 DOI: 10.1111/jch.12715] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/11/2015] [Accepted: 08/16/2015] [Indexed: 12/26/2022]
Abstract
The protective cardiovascular (CV) effect of cocoa flavanol has been a target of many recent clinical prospective and retrospective investigations. Epidemiological data in different patient cohorts revealed an association between higher intake of flavanol-rich foods and decreased incidence of CV events, especially stroke and myocardial infarction. Cocoa flavanol has been shown to reduce systolic (2.8 mm Hg) and diastolic (2.2 mm Hg) office blood pressure (BP). Greater BP reduction has been found in hypertensive patients and people younger than 50 years. Cocoa flavanol intake exerts beneficial effects on pathophysiologic mechanisms of hypertension-related organ damage, such as improved endothelial function, anti-inflammatory potency, inhibition of platelet activation, and increased vasodilatory capacity. Recent clinical trials have focused on establishing a potential link between epidemiology and pathophysiology of flavanol and identified possible mechanisms for prevention of end-organ damage in patients at CV risk. This review summarizes the available data on the antihypertensive effects of cocoa flavanol beyond BP-BP lowering lowering effects, accentuates subgroup-specific protective actions of cocoa according to patients' different CV risk profile, and outlines potential cocoa flavanol-associated clinical implications.
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Affiliation(s)
- Agnes Jumar
- Department of Nephrology and HypertensionUniversity Hospital of the Friedrich‐Alexander‐University Erlangen‐Nürnberg (FAU)ErlangenGermany
| | - Roland E. Schmieder
- Department of Nephrology and HypertensionUniversity Hospital of the Friedrich‐Alexander‐University Erlangen‐Nürnberg (FAU)ErlangenGermany
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Vetrani C, Rivellese AA, Annuzzi G, Adiels M, Borén J, Mattila I, Orešič M, Aura AM. Metabolic transformations of dietary polyphenols: comparison between in vitro colonic and hepatic models and in vivo urinary metabolites. J Nutr Biochem 2016; 33:111-8. [PMID: 27155917 DOI: 10.1016/j.jnutbio.2016.03.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/29/2016] [Accepted: 03/07/2016] [Indexed: 12/19/2022]
Abstract
Studies on metabolism of polyphenols have revealed extensive transformations in the carbon backbone by colonic microbiota; however, the influence of microbial and hepatic transformations on human urinary metabolites has not been explored. Therefore, the aims of this study were (1) to compare the in vitro microbial phenolic metabolite profile of foods and beverages with that excreted in urine of subjects consuming the same foodstuff and (2) to explore the role of liver on postcolonic metabolism of polyphenols by using in vitro hepatic models. A 24-h urinary phenolic metabolite profile was evaluated in 72 subjects participating in an 8-week clinical trial during which they were randomly assigned to diets differing for polyphenol content. Polyphenol-rich foods and beverages used in the clinical trial were subjected to human fecal microbiota in the in vitro colon model. Metabolites from green tea, one of the main components of the polyphenol-rich diet, were incubated with primary hepatocytes to highlight hepatic conversion of polyphenols. The analyses were performed using targeted gas chromatography with mass spectrometer (GCxGC-TOFMS:colon model; GC-MS: urine and hepatocytes). A significant correlation was found between urinary and colonic metabolites with C1-C3 side chain (P=.040). However, considerably higher amounts of hippuric acid, 3-hydroxybenzoic acid and ferulic acid were detected in urine than in the colon model. The hepatic conversion showed additional amounts of these metabolites complementing the gap between in vitro colon model and the in vivo urinary excretion. Therefore, combining in vitro colon and hepatic models may better elucidate the metabolism of polyphenols from dietary exposure to urinary metabolites.
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Affiliation(s)
- Claudia Vetrani
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy.
| | - Angela A Rivellese
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy
| | - Giovanni Annuzzi
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy
| | - Martin Adiels
- Sahlgrenska Center for Cardiovascular and Metabolic Research/Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Mathematical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Jan Borén
- Sahlgrenska Center for Cardiovascular and Metabolic Research/Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
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Concord Grape Juice Polyphenols and Cardiovascular Risk Factors: Dose-Response Relationships. Nutrients 2015; 7:10032-52. [PMID: 26633488 PMCID: PMC4690071 DOI: 10.3390/nu7125519] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 11/09/2015] [Accepted: 11/23/2015] [Indexed: 12/26/2022] Open
Abstract
Pure fruit juices provide nutritional value with evidence suggesting some of their benefits on biomarkers of cardiovascular disease risk may be derived from their constituent polyphenols, particularly flavonoids. However, few data from clinical trials are available on the dose-response relationship of fruit juice flavonoids to these outcomes. Utilizing the results of clinical trials testing single doses, we have analyzed data from studies of 100% Concord grape juice by placing its flavonoid content in the context of results from randomized clinical trials of other polyphenol-rich foods and beverages describing the same outcomes but covering a broader range of intake. We selected established biomarkers determined by similar methods for measuring flow-mediated vasodilation (FMD), blood pressure, platelet aggregation, and the resistance of low density lipoprotein cholesterol (LDL) to oxidation. Despite differences among the clinical trials in the treatment, subjects, and duration, correlations were observed between the dose and FMD. Inverse dose-response relationships, albeit with lower correlation coefficients, were also noted for the other outcomes. These results suggest a clear relationship between consumption of even modest serving sizes of Concord grape juice, flavonoid intake, and effects on risk factors for cardiovascular disease. This approach to dose-response relationships may prove useful for testing other individual foods and beverages.
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Nichols M, Zhang J, Polster BM, Elustondo PA, Thirumaran A, Pavlov EV, Robertson GS. Synergistic neuroprotection by epicatechin and quercetin: Activation of convergent mitochondrial signaling pathways. Neuroscience 2015; 308:75-94. [PMID: 26363153 DOI: 10.1016/j.neuroscience.2015.09.012] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 08/25/2015] [Accepted: 09/03/2015] [Indexed: 01/08/2023]
Abstract
In view of evidence that increased consumption of epicatechin (E) and quercetin (Q) may reduce the risk of stroke, we have measured the effects of combining E and Q on mitochondrial function and neuronal survival following oxygen-glucose deprivation (OGD). Relative to mouse cortical neuron cultures pretreated (24h) with either E or Q (0.1-10μM), E+Q synergistically attenuated OGD-induced neuronal cell death. E, Q and E+Q (0.3μM) increased spare respiratory capacity but only E+Q (0.3μM) preserved this crucial parameter of neuronal mitochondrial function after OGD. These improvements were accompanied by corresponding increases in cyclic AMP response element binding protein (CREB) phosphorylation and the expression of CREB-target genes that promote neuronal survival (Bcl-2) and mitochondrial biogenesis (PGC-1α). Consistent with these findings, E+Q (0.1 and 1.0μM) elevated mitochondrial gene expression (MT-ND2 and MT-ATP6) to a greater extent than E or Q after OGD. Q (0.3-3.0μM), but not E (3.0μM), elevated cytosolic calcium (Ca(2+)) spikes and the mitochondrial membrane potential. Conversely, E and E+Q (0.1 and 0.3μM), but not Q (0.1 and 0.3μM), activated protein kinase B (Akt). Nitric oxide synthase (NOS) inhibition with L-N(G)-nitroarginine methyl ester (1.0μM) blocked neuroprotection by E (0.3μM) or Q (1.0μM). Oral administration of E+Q (75mg/kg; once daily for 5days) reduced hypoxic-ischemic brain injury. These findings suggest E and Q activate Akt- and Ca(2+)-mediated signaling pathways that converge on NOS and CREB resulting in synergistic improvements in neuronal mitochondrial performance which confer profound protection against ischemic injury.
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Affiliation(s)
- M Nichols
- Department of Pharmacology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada; Brain Repair Centre, Faculty of Medicine, Dalhousie University, Life Sciences Research Institute, 1348 Summer Street, P.O. Box 15000, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada.
| | - J Zhang
- Department of Pharmacology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada; Brain Repair Centre, Faculty of Medicine, Dalhousie University, Life Sciences Research Institute, 1348 Summer Street, P.O. Box 15000, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada.
| | - B M Polster
- Department of Anesthesiology, Center for Shock Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - P A Elustondo
- Department of Physiology and Biophysics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada.
| | - A Thirumaran
- Department of Pharmacology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada; Brain Repair Centre, Faculty of Medicine, Dalhousie University, Life Sciences Research Institute, 1348 Summer Street, P.O. Box 15000, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada.
| | - E V Pavlov
- Department of Basic Sciences, College of Dentistry, New York University, 345 East 24th Street, New York, NY 10010, USA.
| | - G S Robertson
- Department of Pharmacology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada; Department of Psychiatry, 5909 Veterans' Memorial Lane, 8th Floor Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada.
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Losada-Barreiro S, Bravo-Díaz C, Romsted LS. Distributions of phenolic acid antioxidants between the interfacial and aqueous regions of corn oil emulsions: Effects of pH and emulsifier concentration. EUR J LIPID SCI TECH 2015. [DOI: 10.1002/ejlt.201400507] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Carlos Bravo-Díaz
- Departamento Química Física, Facultad de Química; Universidad de Vigo; Vigo Spain
| | - Laurence S. Romsted
- Department of Chemistry and Chemical Biology; Rutgers, the State University of New Jersey; NJ USA
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Rangel-Huerta OD, Pastor-Villaescusa B, Aguilera CM, Gil A. A Systematic Review of the Efficacy of Bioactive Compounds in Cardiovascular Disease: Phenolic Compounds. Nutrients 2015; 7:5177-216. [PMID: 26132993 PMCID: PMC4516993 DOI: 10.3390/nu7075177] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/14/2015] [Accepted: 06/12/2015] [Indexed: 01/11/2023] Open
Abstract
The prevalence of cardiovascular diseases (CVD) is rising and is the prime cause of death in all developed countries. Bioactive compounds (BAC) can have a role in CVD prevention and treatment. The aim of this work was to examine the scientific evidence supporting phenolic BAC efficacy in CVD prevention and treatment by a systematic review. Databases utilized were Medline, LILACS and EMBASE, and all randomized controlled trials (RCTs) with prospective, parallel or crossover designs in humans in which the effects of BAC were compared with that of placebo/control were included. Vascular homeostasis, blood pressure, endothelial function, oxidative stress and inflammatory biomarkers were considered as primary outcomes. Cohort, ecological or case-control studies were not included. We selected 72 articles and verified their quality based on the Scottish Intercollegiate Guidelines Network, establishing diverse quality levels of scientific evidence according to two features: the design and bias risk of a study. Moreover, a grade of recommendation was included, depending on evidence strength of antecedents. Evidence shows that certain polyphenols, such as flavonols can be helpful in decreasing CVD risk factors. However, further rigorous evidence is necessary to support the BAC effect on CVD prevention and treatment.
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Affiliation(s)
- Oscar D Rangel-Huerta
- Department of Biochemistry and Molecular Biology II, Centre of Biomedical Research, Institute of Nutrition and Food Technology "Jose Mataix", University of Granada, Conocimiento Avenue, 18006 Granada, Spain.
| | - Belen Pastor-Villaescusa
- Department of Biochemistry and Molecular Biology II, Centre of Biomedical Research, Institute of Nutrition and Food Technology "Jose Mataix", University of Granada, Conocimiento Avenue, 18006 Granada, Spain.
| | - Concepcion M Aguilera
- Department of Biochemistry and Molecular Biology II, Centre of Biomedical Research, Institute of Nutrition and Food Technology "Jose Mataix", University of Granada, Conocimiento Avenue, 18006 Granada, Spain.
| | - Angel Gil
- Department of Biochemistry and Molecular Biology II, Centre of Biomedical Research, Institute of Nutrition and Food Technology "Jose Mataix", University of Granada, Conocimiento Avenue, 18006 Granada, Spain.
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45
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Wightman JD, Heuberger RA. Effect of grape and other berries on cardiovascular health. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2015; 95:1584-1597. [PMID: 25171728 DOI: 10.1002/jsfa.6890] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 08/03/2014] [Accepted: 08/23/2014] [Indexed: 06/03/2023]
Abstract
Cardiovascular disease is a leading cause of death globally. Many cardiovascular risk factors can be modified through lifestyle modification, including dietary patterns that emphasize daily consumption of a variety of fruits and vegetables. Recent observational and clinical studies suggest that flavonoids, especially those abundant in grapes and other berries, may be associated with health benefits, particularly cardiovascular benefits. Human clinical data support cardioprotective benefits of grapes through inhibition of platelet aggregation, decreased low-density lipoprotein (LDL) oxidation, reduction in oxidative stress and improvements in endothelial function. Emerging evidence suggests that grapes may also have a favorable effect on blood lipids, decrease inflammation and reduce blood pressure in certain populations. Studies to date have shown that berries can have a beneficial effect on reducing LDL oxidation. Limited data suggest that berries may have a favorable effect on endothelial health and blood pressure. This review summarizes the current literature on human clinical studies examining the cardioprotective benefits of grapes and berries. Collectively, these data support the recommendation to incorporate products made with grapes and other berries into a heart-healthy diet.
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Affiliation(s)
- JoLynne D Wightman
- JD Wightman was employed by Welch Foods Inc. while this work was done and has a permanent address of: Welch Foods, Inc., 300 Baker Avenue, Suite 101, Concord, MA, 01742, USA
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Balentine DA, Dwyer JT, Erdman JW, Ferruzzi MG, Gaine PC, Harnly JM, Kwik-Uribe CL. Recommendations on reporting requirements for flavonoids in research. Am J Clin Nutr 2015; 101:1113-25. [PMID: 25854881 DOI: 10.3945/ajcn.113.071274] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 03/12/2015] [Indexed: 11/14/2022] Open
Abstract
Numerous observational and intervention-based human studies support the notion of a beneficial role for dietary flavonoids in human health. Despite these studies, it is not yet possible to make dietary recommendations with regard to the types and amounts of flavonoids to be consumed. The inherent diversity of flavonoid structure, chemistry, and natural distribution in foods lends itself to errors in reporting the types and/or amounts of flavonoids consumed, as well as incomplete recognition of requirements for intervention studies that aim to assess their benefits in a clinical setting. A need exists for guidelines that facilitate the design and reporting of flavonoid research. With a focus on clinical studies, this article 1) outlines limitations commonly encountered in the field of flavonoid research, including the inconsistent use of nomenclature, inappropriate analytic methods, inconsistent use of existing flavonoid databases, and the lack of full consideration in the design of test materials for intervention trials, and 2) provides guidance for future studies with a focus on clinical intervention trials. Adoption of this guidance will facilitate more accurate and interpretable research that will support the development of dietary recommendations regarding the intake of flavonoids.
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Affiliation(s)
- Douglas A Balentine
- From Unilever, Englewood Cliffs, NJ (DAB); Tufts University, Jean Mayer Human Nutrition Research Center on Aging, Boston, MA (JTD); University of Illinois at Urbana-Champaign, Urbana-Champaign, IL (JWE); Purdue University, West Lafayette, IN (MGF); The Sugar Association, Washington, DC (PCG); USDA Agricultural Research Service, Beltsville, MD (JMH); and Mars, Incorporated, McLean, VA (CLK-U)
| | - Johanna T Dwyer
- From Unilever, Englewood Cliffs, NJ (DAB); Tufts University, Jean Mayer Human Nutrition Research Center on Aging, Boston, MA (JTD); University of Illinois at Urbana-Champaign, Urbana-Champaign, IL (JWE); Purdue University, West Lafayette, IN (MGF); The Sugar Association, Washington, DC (PCG); USDA Agricultural Research Service, Beltsville, MD (JMH); and Mars, Incorporated, McLean, VA (CLK-U)
| | - John W Erdman
- From Unilever, Englewood Cliffs, NJ (DAB); Tufts University, Jean Mayer Human Nutrition Research Center on Aging, Boston, MA (JTD); University of Illinois at Urbana-Champaign, Urbana-Champaign, IL (JWE); Purdue University, West Lafayette, IN (MGF); The Sugar Association, Washington, DC (PCG); USDA Agricultural Research Service, Beltsville, MD (JMH); and Mars, Incorporated, McLean, VA (CLK-U).
| | - Mario G Ferruzzi
- From Unilever, Englewood Cliffs, NJ (DAB); Tufts University, Jean Mayer Human Nutrition Research Center on Aging, Boston, MA (JTD); University of Illinois at Urbana-Champaign, Urbana-Champaign, IL (JWE); Purdue University, West Lafayette, IN (MGF); The Sugar Association, Washington, DC (PCG); USDA Agricultural Research Service, Beltsville, MD (JMH); and Mars, Incorporated, McLean, VA (CLK-U)
| | - P Courtney Gaine
- From Unilever, Englewood Cliffs, NJ (DAB); Tufts University, Jean Mayer Human Nutrition Research Center on Aging, Boston, MA (JTD); University of Illinois at Urbana-Champaign, Urbana-Champaign, IL (JWE); Purdue University, West Lafayette, IN (MGF); The Sugar Association, Washington, DC (PCG); USDA Agricultural Research Service, Beltsville, MD (JMH); and Mars, Incorporated, McLean, VA (CLK-U)
| | - James M Harnly
- From Unilever, Englewood Cliffs, NJ (DAB); Tufts University, Jean Mayer Human Nutrition Research Center on Aging, Boston, MA (JTD); University of Illinois at Urbana-Champaign, Urbana-Champaign, IL (JWE); Purdue University, West Lafayette, IN (MGF); The Sugar Association, Washington, DC (PCG); USDA Agricultural Research Service, Beltsville, MD (JMH); and Mars, Incorporated, McLean, VA (CLK-U)
| | - Catherine L Kwik-Uribe
- From Unilever, Englewood Cliffs, NJ (DAB); Tufts University, Jean Mayer Human Nutrition Research Center on Aging, Boston, MA (JTD); University of Illinois at Urbana-Champaign, Urbana-Champaign, IL (JWE); Purdue University, West Lafayette, IN (MGF); The Sugar Association, Washington, DC (PCG); USDA Agricultural Research Service, Beltsville, MD (JMH); and Mars, Incorporated, McLean, VA (CLK-U)
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Sottero B, Gargiulo S, Russo I, Barale C, Poli G, Cavalot F. Postprandial Dysmetabolism and Oxidative Stress in Type 2 Diabetes: Pathogenetic Mechanisms and Therapeutic Strategies. Med Res Rev 2015; 35:968-1031. [PMID: 25943420 DOI: 10.1002/med.21349] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Postprandial dysmetabolism in type 2 diabetes (T2D) is known to impact the progression and evolution of this complex disease process. However, the underlying pathogenetic mechanisms still require full elucidation to provide guidance for disease prevention and treatment. This review focuses on the marked redox changes and inflammatory stimuli provoked by the spike in blood glucose and lipids in T2D individuals after meals. All the causes of exacerbated postprandial oxidative stress in T2D were analyzed, also considering the consequence of enhanced inflammation on vascular damage. Based on this in-depth analysis, current strategies of prevention and pharmacologic management of T2D were critically reexamined with particular emphasis on their potential redox-related rationale.
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Affiliation(s)
- Barbara Sottero
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, 10043, Italy
| | - Simona Gargiulo
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, 10043, Italy
| | - Isabella Russo
- Internal Medicine and Metabolic Disease Unit, Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, 10043, Italy
| | - Cristina Barale
- Internal Medicine and Metabolic Disease Unit, Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, 10043, Italy
| | - Giuseppe Poli
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, 10043, Italy
| | - Franco Cavalot
- Internal Medicine and Metabolic Disease Unit, Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, 10043, Italy
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Kapoor D, Trikha D, Vijayvergiya R, Parashar KK, Kaul D, Dhawan V. Short-Term Adjuvant Therapy with Terminalia arjuna Attenuates Ongoing Inflammation and Immune Imbalance in Patients with Stable Coronary Artery Disease: In Vitro and In Vivo Evidence. J Cardiovasc Transl Res 2015; 8:173-86. [PMID: 25827448 DOI: 10.1007/s12265-015-9620-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 03/10/2015] [Indexed: 11/30/2022]
Abstract
The present study evaluated the cardioprotective effects of Terminalia arjuna on classical and immuno-inflammatory markers in coronary artery disease (CAD) as an adjuvant therapy. One hundred sixteen patients with stable CAD were administered placebo/T. arjuna (500 mg twice a day) along with medications in a randomized, double-blind clinical trial. To understand the specificity and efficacy of T. arjuna, we evaluated its effect through microarray and in silico analysis in few representative samples. Data was further validated via real-time PCR (n = 50) each at baseline, 3 months, and 6 months, respectively. rIL-18 cytokine was used to induce inflammation in vitro to compare its effects with atorvastatin. T. arjuna significantly down-regulated TG, VLDL-C, and immuno-inflammatory markers in stable CAD versus placebo-treated subjects. Microarray and pathway analysis of a few samples from T. arjuna/placebo-treated groups and real-time PCR validation further confirmed our observations. Our data demonstrate the anti-inflammatory and immunomodulatory effects of T. arjuna that may attenuate ongoing inflammation and immune imbalance in medicated CAD subjects.
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Affiliation(s)
- Divya Kapoor
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Bondonno CP, Croft KD, Ward N, Considine MJ, Hodgson JM. Dietary flavonoids and nitrate: effects on nitric oxide and vascular function. Nutr Rev 2015; 73:216-35. [PMID: 26024545 DOI: 10.1093/nutrit/nuu014] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Emerging evidence highlights dietary flavonoids and nitrate as candidates that may explain at least part of the cardioprotective effect of a fruit and vegetable diet. Nitric oxide plays a pivotal role in cardiovascular health. Components of a fruit and vegetable diet that are cardioprotective, in part through effects on nitric oxide status, could substantially reduce the cardiovascular risk profile of the general population with increased intake of such a diet. Epidemiological evidence suggests that dietary flavonoids and nitrate have a cardioprotective effect. Clinical trials with flavonoid- and nitrate-rich foods have shown benefits on measures of vascular health. While the molecular mechanisms by which flavonoids and nitrate are cardioprotective are not completely understood, recent evidence suggests both nonspecific and specific effects through nitric oxide pathways. This review presents an overview of nitric oxide and its key role in cardiovascular health and discusses the possible vascular benefits of flavonoids and nitrate, individually and in combination, through effects on nitric oxide status.
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Affiliation(s)
- Catherine P Bondonno
- C.P. Bondonno, K.D. Croft, N.C. Ward, and J.M. Hodgson are with the School of Medicine and Pharmacology, University of Western Australia, Perth Western Australia, Australia. M.J. Considine is with the School of Plant Biology, University of Western Australia, Perth Western Australia and the Department of Agriculture and Food Western Australia, Perth, Western Australia, Australia.
| | - Kevin D Croft
- C.P. Bondonno, K.D. Croft, N.C. Ward, and J.M. Hodgson are with the School of Medicine and Pharmacology, University of Western Australia, Perth Western Australia, Australia. M.J. Considine is with the School of Plant Biology, University of Western Australia, Perth Western Australia and the Department of Agriculture and Food Western Australia, Perth, Western Australia, Australia
| | - Natalie Ward
- C.P. Bondonno, K.D. Croft, N.C. Ward, and J.M. Hodgson are with the School of Medicine and Pharmacology, University of Western Australia, Perth Western Australia, Australia. M.J. Considine is with the School of Plant Biology, University of Western Australia, Perth Western Australia and the Department of Agriculture and Food Western Australia, Perth, Western Australia, Australia
| | - Michael J Considine
- C.P. Bondonno, K.D. Croft, N.C. Ward, and J.M. Hodgson are with the School of Medicine and Pharmacology, University of Western Australia, Perth Western Australia, Australia. M.J. Considine is with the School of Plant Biology, University of Western Australia, Perth Western Australia and the Department of Agriculture and Food Western Australia, Perth, Western Australia, Australia
| | - Jonathan M Hodgson
- C.P. Bondonno, K.D. Croft, N.C. Ward, and J.M. Hodgson are with the School of Medicine and Pharmacology, University of Western Australia, Perth Western Australia, Australia. M.J. Considine is with the School of Plant Biology, University of Western Australia, Perth Western Australia and the Department of Agriculture and Food Western Australia, Perth, Western Australia, Australia
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50
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Abstract
A number of strategies are currently under investigation to prevent venous thromboembolic events in cancer cohorts. Based on the efficacy of low molecular weight heparin in the treatment of thrombosis in cancer patients, a number of clinical studies have focused on evaluating the efficacy the low molecular weight heparins in the primary thromboprophylaxis setting. Further refinements in defining which cancer cohorts are at greatest risk of suffering thromboembolic events are under investigation such as clinical-laboratory risk scores and biomarkers such as tissue factor-bearing microparticles. However, alternative approaches to primary thromboprophylaxis beyond standard anticoagulants are also being evaluated in the clinic such anti-platelet agents, statins to reduce circulating tissue factor, and scheduled monitoring for venous thromboembolic events without pharmacologic thromboprophylaxis. In addition, clinical studies are underway to evaluate the antithrombotic efficacy of targeting extracellular protein disulfide isomerase with oral flavonoids (e.g. quercetin and isoquercetin). Emerging data regarding these unconventional approaches in the prevention of thromboembolic events in cancer patients is reviewed.
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Affiliation(s)
- Jeffrey I Zwicker
- Division of Thrombosis and Hemostasis, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
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