1
|
Antonopoulou S, Mitsou EK, Kyriacou A, Fragopoulou E, Detopoulou M. Does Yogurt Enriched with Platelet-Activating Factor Inhibitors from Olive Oil By-Products Affect Gut Microbiota and Faecal Metabolites in Healthy Overweight Subjects? (A randomized, parallel, three arm trial.). FRONT BIOSCI-LANDMRK 2024; 29:159. [PMID: 38682205 DOI: 10.31083/j.fbl2904159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/27/2024] [Accepted: 03/14/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE The effect of the daily consumption of a low-fat yogurt (150 g) enriched with Platelet-Activating Factor receptor (PAF-R) antagonists, or the plain one, on gut microbiota and faecal metabolites was investigated in healthy overweight subjects. METHODS A randomized, three-arm, double-blind, placebo-controlled, parallel-group study was performed that lasted 8 weeks. Blood and stools were collected and analyzed before and after the intervention. RESULTS Our findings revealed that the intake of the enriched yogurt resulted in a significant increase in the levels of Bifidobacterium spp., Clostridium perfringens group and Firmicutes-to-Bacteroidetes (F/B) ratio. On the other hand, a significant increase in the levels of Lactobacillus and C. perfringens group was detected after the intake of the plain yogurt. The increase in the levels of C. perfringens group was inversely associated with the plasma catabolic enzyme of PAF, namely LpPLA2 (lipoprotein-associated phospholipase A2), a cardiovascular risk marker that has been linked with inflammation and atherosclerosis. Moreover, in the enriched with PAF-R antagonists yogurt group, the increased levels of C. perfringens group were also associated with lower PAF action assessed as ex vivo human platelet-rich plasma (PRP) aggregation. Additionally, a higher % increase in molar ratio of Branched Short Chain Fatty Acids (BSCFAs) was detected for both yogurt groups after the 8 week-intervention compared to control. The consumption of the enriched yogurt also resulted in a significant drop in faecal caproic levels and a trend for lower ratio of butyrate to total volatile fatty acids (VFAs) compared to baseline levels. CONCLUSION Yogurt consumption seems to favorably affect gut microbiota while its enrichment with PAF-R antagonists from olive oil by-products, may provide further benefits in healthy overweight subjects. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT02259205).
Collapse
Affiliation(s)
- Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 15234 Athens, Greece
| | - Evdokia K Mitsou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 15234 Athens, Greece
| | - Adamantini Kyriacou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 15234 Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 15234 Athens, Greece
| | - Maria Detopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 15234 Athens, Greece
| |
Collapse
|
2
|
Lekka P, Fragopoulou E, Terpou A, Dasenaki M. Exploring Human Metabolome after Wine Intake-A Review. Molecules 2023; 28:7616. [PMID: 38005338 PMCID: PMC10673339 DOI: 10.3390/molecules28227616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Wine has a rich history dating back to 2200 BC, originally recognized for its medicinal properties. Today, with the aid of advanced technologies like metabolomics and sophisticated analytical techniques, we have gained remarkable insights into the molecular-level changes induced by wine consumption in the human organism. This review embarks on a comprehensive exploration of the alterations in human metabolome associated with wine consumption. A great number of 51 studies from the last 25 years were reviewed; these studies systematically investigated shifts in metabolic profiles within blood, urine, and feces samples, encompassing both short-term and long-term studies of the consumption of wine and wine derivatives. Significant metabolic alterations were observed in a wide variety of metabolites belonging to different compound classes, such as phenolic compounds, lipids, organic acids, and amino acids, among others. Within these classes, both endogenous metabolites as well as diet-related metabolites that exhibited up-regulation or down-regulation following wine consumption were included. The up-regulation of short-chain fatty acids and the down-regulation of sphingomyelins after wine intake, as well as the up-regulation of gut microbial fermentation metabolites like vanillic and syringic acid are some of the most important findings reported in the reviewed literature. Our results confirm the intact passage of certain wine compounds, such as tartaric acid and other wine acids, to the human organism. In an era where the health effects of wine consumption are of growing interest, this review offers a holistic perspective on the metabolic underpinnings of this centuries-old tradition.
Collapse
Affiliation(s)
- Pelagia Lekka
- Food Chemistry Laboratory, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zographou, 15771 Athens, Greece;
| | - Elizabeth Fragopoulou
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece;
| | - Antonia Terpou
- Department of Agricultural Development, Agrofood and Management of Natural Resources, School of Agricultural Development, Nutrition & Sustainability, National and Kapodistrian University of Athens, 34400 Psachna, Greece;
| | - Marilena Dasenaki
- Food Chemistry Laboratory, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zographou, 15771 Athens, Greece;
| |
Collapse
|
3
|
Detopoulou P, Fragopoulou E, Nomikos T, Antonopoulou S. Associations of phase angle with platelet-activating factor metabolism and related dietary factors in healthy volunteers. Front Nutr 2023; 10:1237086. [PMID: 38024339 PMCID: PMC10655008 DOI: 10.3389/fnut.2023.1237086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Phase angle (PA) is derived from bioelectrical impedance analysis (BIA). It reflects cell membrane function and decreases in disease. It is affected by inflammation, oxidative stress, and diet. Platelet-activating factor (PAF) is a potent inflammatory lipid mediator. Its levels, along with the activity of its metabolic enzymes, including CDP-choline:1-alkyl-2-acetyl-sn-glycerol-cholinephosphotransferase, acetyl-CoA:lyso-PAF-acetyltransferases, and PAF-AH/Lp-PLA2 are also related to dietary factors, such as the dietary antioxidant capacity (DAC). The aim of the study was to estimate whether the PAF metabolic circuit and related dietary factors are associated with PA in healthy volunteers. Methods In healthy subjects, PAF, its metabolic enzyme activity, and erythrocyte fatty acids were measured, while desaturases were estimated. Food-frequency questionnaires and recalls were used, and food groups, macronutrient intake, MedDietScore, and DAC were assessed. Lifestyle and biochemical variables were collected. DXA and BIA measurements were performed. Results Lp-PLA2 activity was positively associated with PA (rho = 0.651, p < 0.001, total population; rho = 0.780, p < 0.001, women), while PAF levels were negatively associated with PA only in men (partial rho = -0.627, p = 0.012) and inversely related to DAC. Estimated desaturase 6 was inversely associated with PA (rho = -0.404, p = 0.01, total sample). Moreover, the DAC correlated positively with PA (rho = 0.513, p = 0.03, women). All correlations were adjusted for age, body mass index, and sex (if applicable). Conclusion PA is associated with PAF levels and Lp-PLA2 activity in a gender-dependent fashion, indicating the involvement of PAF in cell membrane impairment. The relationship of PA with DAC suggests a protective effect of antioxidants on cellular health, considering that antioxidants may inhibit PAF generation.
Collapse
Affiliation(s)
| | | | | | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education. Harokopio University, Athens, Greece
| |
Collapse
|
4
|
Detopoulou P, Damigou E, Antonopoulou S, Fragopoulou E, Chysohoou C, Pitsavos C, Panagiotakos D. Food Compass Score and its association with inflammatory markers and homocysteine in cardiovascular disease-free adults: a cross-sectional analysis of the ATTICA epidemiological study. Eur J Clin Nutr 2023; 77:998-1004. [PMID: 37400562 DOI: 10.1038/s41430-023-01300-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND/OBJECTIVES Several nutrient profiling systems have been developed to assist in food choices and policy. Food Compass Score (FCS) is a novel holistic food score assessing 54 parameters. The aim was to assess the relation of FCS with inflammatory and lipid markers in cardiovascular disease-free volunteers. SUBJECTS/METHODS Information from the ATTICA epidemiological study participants, with complete data on lipid, inflammatory markers and dietary intake were studied (n = 1018). C-reactive protein (CRP) and amyloid A were determined by immunonephelometry, fibrinogen by nephelometry, homocysteine by fluorometry, while tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), adiponectin and leptin were determined by ELISA in fasting blood samples. Dietary intake was assessed through a semi-quantitative validated food frequency questionnaire. Each food was assigned a FCS value from the published values and then individual's FCS values were calculated. RESULTS Mean FCS was 56 (standard deviation: 5.7) and it was similar in men and women. FCS was inversely correlated with age (r = -0.06, p = 0.03). In multiple linear regression models, FCS was inversely associated with CRP (-0.03, 0.01), TNF-a (-0.04, 0.01), amyloid A (-0.10, 0.04) and homocysteine (-0.09, 0.04) (b coefficients, standard errors, all p < 0.05) and was not associated with IL-6, fibrinogen, adiponectin, leptin, or lipids levels (all p > 0.05). CONCLUSIONS The inverse correlations of the FCS with inflammatory markers suggest that a diet containing foods with high FCS might be protective against inflammation process. Our results support the usefulness of the FCS, but future studies should evaluate its relation to cardiovascular and other inflammation-related chronic diseases.
Collapse
Affiliation(s)
- Paraskevi Detopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Christina Chysohoou
- First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.
| |
Collapse
|
5
|
Georgoulis M, Kontogianni MD, Kechribari I, Tenta R, Fragopoulou E, Lamprou K, Perraki E, Vagiakis E, Yiannakouris N. Associations between serum vitamin D status and the cardiometabolic profile of patients with obstructive sleep apnea. Hormones (Athens) 2023; 22:477-490. [PMID: 37322405 PMCID: PMC10449975 DOI: 10.1007/s42000-023-00456-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE Obstructive sleep apnea (OSA) and the metabolic syndrome (MetS) frequently coexist. Low serum vitamin D has been positively associated with OSA presence and severity; however, data on its link to cardiometabolic features in patients with OSA remain scarce. We aimed to assess serum 25-hydroxyvitamin D [25(OH)D] and explore its association with cardiometabolic parameters in OSA. METHODS This was a cross-sectional study among 262 patients (49 ± 9 years old, 73% men) with polysomnography-diagnosed OSA. Participants were evaluated in terms of anthropometric indices, lifestyle habits, blood pressure, biochemical, plasma inflammatory and urinary oxidative stress markers, and the presence of MetS. Serum 25(OH)D was assessed by chemiluminescence, and vitamin D deficiency (VDD) was defined as 25(OH)D < 20 ng/mL. RESULTS Median (1st, 3rd quartile) serum 25(OH)D levels were 17.7 (13.4, 22.9) ng/mL and 63% of participants had VDD. Serum 25(OH)D correlated negatively with body mass index (BMI), homeostasis model of assessment of insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein (hsCRP), and urinary oxidized guanine species (oxG), and positively with high-density lipoprotein cholesterol (all P < 0.050). In logistic regression analysis, serum 25(OH)D was associated with lower odds of MetS [odds ratio (95% confidence interval): 0.94 (0.90-0.98)], after adjustment for age, sex, season of blood sampling, Mediterranean diet score, physical activity, smoking, apnea-hypopnea index, HOMA-IR, hsCRP, and oxG. In the same multivariate model, VDD was associated with ~ twofold greater odds of MetS [2.39 (1.15, 4.97)]. CONCLUSION VDD is highly prevalent and is associated with a detrimental cardiometabolic profile among patients with OSA.
Collapse
Affiliation(s)
- Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Ioanna Kechribari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Roxane Tenta
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Kallirroi Lamprou
- Center of Sleep Disorders, Evangelismos General Hospital, 1st Department of Critical Care and Pulmonary Services, Medical School, National and Kapodistrian University of Athens, 10676, Athens, Greece
| | - Eleni Perraki
- Center of Sleep Disorders, Evangelismos General Hospital, 1st Department of Critical Care and Pulmonary Services, Medical School, National and Kapodistrian University of Athens, 10676, Athens, Greece
| | - Emmanouil Vagiakis
- Center of Sleep Disorders, Evangelismos General Hospital, 1st Department of Critical Care and Pulmonary Services, Medical School, National and Kapodistrian University of Athens, 10676, Athens, Greece
| | - Nikos Yiannakouris
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece.
| |
Collapse
|
6
|
Kechribari I, Kontogianni MD, Fragopoulou E, Tenta R, Georgoulis M, Lamprou K, Vagiakis E, Yiannakouris N. Adherence to a "Western-type" dietary pattern is positively associated with the Apnea-Hypopnea Index in adults with obstructive sleep apnea. Nutr Res 2023; 117:56-65. [PMID: 37480783 DOI: 10.1016/j.nutres.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/24/2023] [Accepted: 06/24/2023] [Indexed: 07/24/2023]
Abstract
Dietary habits have been associated with obstructive sleep apnea (OSA); however, the underlying mechanisms remain unclear. We hypothesized that adherence to dietary patterns may be associated with Apnea-Hypopnea Index (AHI) and OSA severity and that insulin resistance, oxidative stress, and inflammation may act as potential mediators of these associations. This was a cross-sectional study among 269 adult participants with polysomnography-diagnosed moderate-to-severe OSA. Dietary and physical activity habits were assessed through validated questionnaires, and biochemical, inflammatory, and oxidative stress markers were measured for all volunteers. Dietary patterns were identified using principal component analysis, and mediation analyses was also performed. A "Western-type" dietary pattern (characterized by high intakes of full-fat dairy, refined grains, potatoes, red meat, sweets, salty snacks, and soft drinks and low intakes of low-fat dairy and whole grains) was positively associated with AHI. Mediation analyses also revealed that insulin resistance partially explained this association. In multivariable models controlling for age, sex, smoking, socioeconomic status, obesity presence, energy intake, and physical activity level, participants in the highest quartile of adherence to the Western-type dietary pattern had ∼3.5 times higher likelihood of suffering from severe OSA, compared with participants in the lowest quartile of adherence (odds ratio [95% confidence interval]: 3.45 [1.21-9.94], P trend across quartiles: 0.024). After further adjustment for Homeostasis Model of Assessment-Insulin Resistance and high-sensitivity C-reactive protein, this association lost significance. Higher adherence to a less healthy, Western-type dietary pattern is positively associated with AHI and OSA severity, which may partially be mediated through insulin resistance.
Collapse
Affiliation(s)
- Ioanna Kechribari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Roxane Tenta
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Kallirroi Lamprou
- Center of Sleep Disorders, 1st Department of Critical Care, "Evangelismos" General Hospital, Athens, Greece
| | - Emmanouil Vagiakis
- Center of Sleep Disorders, 1st Department of Critical Care, "Evangelismos" General Hospital, Athens, Greece
| | - Nikos Yiannakouris
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| |
Collapse
|
7
|
Fragopoulou E, Gkotsi K, Petsini F, Gioti K, Kalampaliki AD, Lambrinidis G, Kostakis IK, Tenta R. Synthesis and Biological Evaluation of Resveratrol Methoxy Derivatives. Molecules 2023; 28:5547. [PMID: 37513418 PMCID: PMC10386404 DOI: 10.3390/molecules28145547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
Resveratrol, a naturally occurring stilbene, exhibits numerous beneficial health effects. Various studies have demonstrated its diverse biological actions, including anti-oxidant, anti-inflammatory, and anti-platelet properties, thereby supporting its potential for cardio protection, neuroprotection, and anti-cancer activity. However, a significant limitation of resveratrol is its weak bioavailability. To overcome this challenge, multiple research groups have investigated the synthesis of new resveratrol derivatives to enhance bioavailability and pharmacological activities. Nevertheless, there are limited data on the effects of resveratrol derivatives on platelet function. Therefore, the objective of this study was to synthesize resveratrol methoxy derivatives and evaluate their anti-platelet and anti-proliferative activity. Platelet-rich plasma (PRP) obtained from healthy volunteers was utilized to assess the derivatives' ability to inhibit platelet aggregation induced by platelet activating factor (PAF), adenosine diphosphate (ADP), and thrombin receptor activating peptide (TRAP). Additionally, the derivatives' anti-tumor activity was evaluated against the proliferation of PC-3 and HCT116 cells. The results revealed that some methoxy derivatives of resveratrol exhibited comparable or even superior anti-platelet activity compared to the original compound. The most potent derivative was the 4'-methoxy derivative, which demonstrated approximately 2.5 orders of magnitude higher anti-platelet activity against TRAP-induced platelet aggregation, indicating its potential as an anti-platelet agent. Concerning in silico studies, the 4'-methyl group of 4'-methoxy derivative is oriented similarly to the fluorophenyl-pyridyl group of Vorapaxar, buried in a hydrophobic cavity. In terms of their anti-tumor activity, 3-MRESV exhibited the highest potency in PC-3 cells, while 3,4'-DMRESV and TMRESV showed the greatest efficacy in HCT116 cells. In conclusion, methoxy derivatives of resveratrol possess similar or improved anti-platelet and anti-cancer effects, thereby holding potential as bioactive compounds in various pathological conditions.
Collapse
Affiliation(s)
- Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17676 Athens, Greece
| | - Katerina Gkotsi
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17676 Athens, Greece
| | - Filio Petsini
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17676 Athens, Greece
| | - Katerina Gioti
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17676 Athens, Greece
| | - Amalia D Kalampaliki
- Department of Pharmacy, Division of Pharmaceutical Chemistry, National and Kapodistrian University of Athens, 15771 Athens, Greece
| | - George Lambrinidis
- Department of Pharmacy, Division of Pharmaceutical Chemistry, National and Kapodistrian University of Athens, 15771 Athens, Greece
| | - Ioannis K Kostakis
- Department of Pharmacy, Division of Pharmaceutical Chemistry, National and Kapodistrian University of Athens, 15771 Athens, Greece
| | - Roxane Tenta
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17676 Athens, Greece
| |
Collapse
|
8
|
Arvaniti OS, Tsolou A, Sakantani E, Milla S, Kallinikou E, Petsini F, Choleva M, Detopoulou M, Fragopoulou E, Samaras Y. Quality characteristics, polyphenol profile and antioxidant capacity in red, rosé and white monovarietal wines from Ionian Islands of Greece [pdf]. Acta Sci Pol Technol Aliment 2022. [DOI: 10.17306/j.afs.2022.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
|
9
|
Arvaniti OS, Tsolou A, Sakantani E, Milla S, Kallinikou E, Petsini F, Choleva M, Detopoulou M, Fragopoulou E, Samaras Y. Quality characteristics, polyphenol profile and antioxidant capacity in red, rosé and white monovarietal wines from Ionian Islands of Greece. Acta Sci Pol Technol Aliment 2022. [DOI: 10.17306/j.afs.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
|
10
|
Tsiailanis AD, Vrettos EI, Choleva M, Kiriakidi S, Ganai AM, Patha TK, Karpoormath R, Mavromoustakos T, Fragopoulou E, Tzakos AG. Development of a DHA-Losartan hybrid as a potent inhibitor of multiple pathway-induced platelet aggregation. J Biomol Struct Dyn 2022; 40:13889-13900. [PMID: 34791990 DOI: 10.1080/07391102.2021.1996461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Despite the scientific progression in the prevention and treatment of cardiovascular diseases (CVDs) they remain the leading cause of mortality and disability worldwide. The classic treatment involves the simultaneous dosing of two antiplatelet drugs, aspirin and clopidogrel/prasugrel. However, besides drug resistance, severe side effects have been also manifested including acute bleeding and toxicity. Thus, new therapeutic agents with enhanced efficacy and diminished side effects are of importance. Towards this end, omega-3 (ω-3) fatty acids have demonstrated potent efficacy against CVDs through inhibiting platelet aggregation that bears a pivotal role in atherothrombosis. Another factor that displays a critical role in the pathogenesis of cardiovascular diseases is the renin-angiotensin system (RAS), and especially the AT1R blocker losartan that has been reported to exert antiplatelet activity mediated by this receptor. Along these lines, we envisaged developing a molecular hybrid consisted of docosahexaenoic acid (ω-3 fatty acid) and losartan, that could exert a notable antiplatelet effect against CVDs. The design and synthesis of the new DHA-losartan hybrid, designated DHA-L, bestowed with the additive properties of the parent compounds, is reported. In silico studies were first exploited to validate the potential of DHA-L to retain losartan's ability to bind AT1R. The antiplatelet activity of DHA-L was evaluated against in vitro platelet aggregation induced by several platelet agonists. Notably, the hybrid illustrated a pleiotropic antiplatelet profile inhibiting platelet aggregation through multiple platelet activation pathways including P2Y12, PAR-1 (Protease-Activated Receptor-1), PAF (Platelet Activating Factor), COX-1 (cyclooxygenase-1) and collagen receptors. The stability of DHA-L in human plasma and in a wide range of pH values was also evaluated over time using an HPLC protocol. The hybridization approach described herein could pave the way for the development of novel potent multitargeted therapeutics with enhanced antiplatelet profile.Communicated by Ramaswamy H. Sarma.
Collapse
Affiliation(s)
- Antonis D Tsiailanis
- Section of Organic Chemistry and Biochemistry, Department of Chemistry, University of Ioannina, Ioannina, Greece
| | - Eirinaios I Vrettos
- Section of Organic Chemistry and Biochemistry, Department of Chemistry, University of Ioannina, Ioannina, Greece
| | - Maria Choleva
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Sofia Kiriakidi
- Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Ab Majeed Ganai
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville), Durban, South Africa
| | - Tabasum Khan Patha
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville), Durban, South Africa
| | - Rajshekhar Karpoormath
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville), Durban, South Africa
| | - Thomas Mavromoustakos
- Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Elizabeth Fragopoulou
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Andreas G Tzakos
- Section of Organic Chemistry and Biochemistry, Department of Chemistry, University of Ioannina, Ioannina, Greece.,Institute of Materials Science and Computing, University Research Center of Ioannina (URCI), Ioannina, Greece
| |
Collapse
|
11
|
Petsini F, Ntzouvani A, Detopoulou M, Papakonstantinou VD, Kalogeropoulos N, Fragopoulou E, Nomikos T, Kontogianni MD, Antonopoulou S. Consumption of Farmed Fish, Fed with an Olive-Pomace Enriched Diet, and Its Effect on the Inflammatory, Redox, and Platelet-Activating Factor Enzyme Profile of Apparently Healthy Adults: A Double-Blind Randomized Crossover Trial. Foods 2022; 11:foods11142105. [PMID: 35885348 PMCID: PMC9318848 DOI: 10.3390/foods11142105] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/05/2023] Open
Abstract
A fish-rich diet has a beneficial effect on cardiovascular health. The platelet activating factor (PAF) is involved in the development of atherosclerosis, and in vitro results support the regulating action of bioactive nutrients on PAF metabolism. The purpose of this study is to examine whether the consumption of farmed fish fed with an olive-pomace enriched diet (EF) affects PAF metabolism and the markers of inflammation and oxidative stress compared to the consumption of conventionally fed farmed fish (CF). Thirty apparently healthy adults completed a randomized double-blind crossover trial, during which they consumed both CF and EF twice a week for 8 weeks with a six-week washout period in between. The activities of PAF acetylhydrolase (PAF-AH), lysoPAF acetyltransferase (lysoPAF-AT), DTT-insensitive CDP-choline: 1-alkyl-2-acetyl-sn-glycerol-choline-phosphotransferase (PAF-CPT) in leukocytes, and lipoprotein-associated phospholipase A2 (LpPLA2) in serum were determined. The quantities of interleukin-6 (IL-6), high sensitivity C-reactive protein (hsCRP), oxidized LDL (ox-LDL), thiobarbituric acid-reactive substances (TBARS), and glutathione peroxidase (GPx), as well as the serum oxidation, were also determined. Both types of fish exerted similar effects as there were no statistically significant differences between the two interventions except for an elevated PAF-CPT and reduced arachidonic acid (AA) in the red blood cell (RBC) membrane lipids after the EF intake.
Collapse
Affiliation(s)
- Filio Petsini
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University,17671 Athens, Greece; (F.P.); (A.N.); (M.D.); (N.K.); (E.F.); (T.N.); (M.D.K.)
| | - Agathi Ntzouvani
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University,17671 Athens, Greece; (F.P.); (A.N.); (M.D.); (N.K.); (E.F.); (T.N.); (M.D.K.)
| | - Maria Detopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University,17671 Athens, Greece; (F.P.); (A.N.); (M.D.); (N.K.); (E.F.); (T.N.); (M.D.K.)
| | - Vasiliki D Papakonstantinou
- Laboratory of Biochemistry, Department of Chemistry, National and Kapodistrian University of Athens, 15771 Athens, Greece;
| | - Nick Kalogeropoulos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University,17671 Athens, Greece; (F.P.); (A.N.); (M.D.); (N.K.); (E.F.); (T.N.); (M.D.K.)
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University,17671 Athens, Greece; (F.P.); (A.N.); (M.D.); (N.K.); (E.F.); (T.N.); (M.D.K.)
| | - Tzortzis Nomikos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University,17671 Athens, Greece; (F.P.); (A.N.); (M.D.); (N.K.); (E.F.); (T.N.); (M.D.K.)
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University,17671 Athens, Greece; (F.P.); (A.N.); (M.D.); (N.K.); (E.F.); (T.N.); (M.D.K.)
| | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University,17671 Athens, Greece; (F.P.); (A.N.); (M.D.); (N.K.); (E.F.); (T.N.); (M.D.K.)
- Correspondence:
| |
Collapse
|
12
|
Fragopoulou E, Argyrou C, Detopoulou M, Tsitsou S, Seremeti S, Yannakoulia M, Antonopoulou S, Kolovou G, Kalogeropoulos P. The effect of moderate wine consumption on cytokine secretion by peripheral blood mononuclear cells: A randomized clinical study in coronary heart disease patients. Cytokine 2021; 146:155629. [PMID: 34247040 DOI: 10.1016/j.cyto.2021.155629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 12/14/2022]
Abstract
Many studies conclude that wine consumption is related to lower risk for cardiovascular diseases partially through the amelioration of inflammatory biomarkers. The aim of the present study was to examine the effects of wine consumption on the inflammatory response and to compare these effects with the consumption of similar amount of alcohol without the wine micro-constituents in cardiovascular disease patients. Therefore, a randomized, single-blind, controlled, three-arm parallel intervention study was designed. Cardiovascular disease patients were randomly assigned to one of the three groups. In Group A participants consumed no alcohol, in Group B (ethanol group) and Group C (wine group) participants consumed 27 g of alcohol per day. Biological samples were collected at the beginning, on the 4th and 8th week and several biomarkers were measured. Peripheral blood mononuclear cells that were isolated from patients were incubated under basal and inflammatory conditions for 4 and 24 h and the secretion of interleukin 1β (IL-1β) and tumor necrosis factor α (TNFα) was measured. No significant difference was observed among the three groups before the initiation or during the intervention in the most soluble biomarkers. Higher TNFα secretion by peripheral blood mononuclear cells was observed at basal conditions in the ethanol group both at 4 and 24 h of incubation versus baseline secretion. Furthermore, lower secretion of the ΤNFα was observed after 8 weeks of intake in the wine group versus the ethanol group, both at 4 and 24 h of incubation. In conclusion, the light to moderate wine consumption for 8 weeks revealed an attenuation of the ethanol consumption effect on cytokine secretion at basal conditions from the patients' peripheral blood mononuclear cells.
Collapse
Affiliation(s)
- Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece.
| | - Chrysa Argyrou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Maria Detopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Sofia Tsitsou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Sotiria Seremeti
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens. Greece
| | | |
Collapse
|
13
|
Detopoulou P, Nomikos T, Fragopoulou E, Antonopoulou S. Association of PAF and its metabolic enzymes with GGT and the Fatty Liver Index in healthy volunteers. Curr Vasc Pharmacol 2021; 19:663-672. [PMID: 34182909 DOI: 10.2174/1570161119666210628125239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/18/2021] [Accepted: 05/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Platelet-activating factor (PAF) is a lipid inflammatory mediator implicated in liver disease. Its main biosynthetic enzymes are cytidine diphosphate (CDP)-choline:1-alkyl-2-acetyl-sn-glycerol-cholinephosphotransferase (PAF-CPT) and acetyl-coenzyme A: lyso-PAF-acetyltransferases (Lyso-PAF-AT), while PAF acetylhydrolase (PAF-AH) and lipoprotein-associated phospholipase A2 (Lp-PLA2) degrade PAF. OBJECTIVE To explore the relation of PAF metabolism with liver diseases and non-alcoholic fatty liver disease, as reflected by the fatty liver index (FLI). METHODS In 106 healthy volunteers, PAF concentration, the activity of its metabolic enzymes, and gamma-glutamyl transferase (GGT) were measured in whole blood, leukocytes, and serum, respectively, and the FLI was calculated. Partial correlations and linear regression models were used. RESULTS In males, serum GGT activity was positively correlated with abdominal fat (as assessed by analysis of a manually defined region of interest in dual-energy X-ray absorptiometry), triacylglycerols, bound-PAF, and Lp-PLA2, while the FLI was positively correlated with Lp-PLA2 activity. In females, serum GGT activity was negatively associated with high-density lipoprotein cholesterol (HDL-C) (age-adjusted correlations, all p<0.05). Lp-PLA2 was a significant determinant of serum GGT activity in males after controlling for age, low-density lipoprotein cholesterol (LDL-C), and abdominal fat. The addition of bound-PAF in the model significantly increased the explained variance of serum GGT activity (total variance explanation 30%). CONCLUSION Bound-PAF and Lp-PLA2 activity predicted serum GGT activity, while Lp-PLA2 was also related to FLI. Our findings shed light on the metabolic pathways linking Lp-PLA2 to other atherosclerosis and/or oxidative markers, such as HDL-C, LDL-C, GGT, and FLI, and underline the important role of PAF.
Collapse
Affiliation(s)
- Paraskevi Detopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University; 70, El. Venizelou St. Kallithea, 17671 Athens, Greece
| | - Tzortzis Nomikos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University; 70, El. Venizelou St. Kallithea, 17671 Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University; 70, El. Venizelou St. Kallithea, 17671 Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University; 70, El. Venizelou St. Kallithea, 17671 Athens, Greece
| |
Collapse
|
14
|
Detopoulou M, Ntzouvani A, Petsini F, Gavriil L, Fragopoulou E, Antonopoulou S. Consumption of Enriched Yogurt with PAF Inhibitors from Olive Pomace Affects the Major Enzymes of PAF Metabolism: A Randomized, Double Blind, Three Arm Trial. Biomolecules 2021; 11:biom11060801. [PMID: 34071485 PMCID: PMC8227157 DOI: 10.3390/biom11060801] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 01/02/2023] Open
Abstract
Platelet-activating factor (PAF), a proinflammatory lipid mediator, plays a crucial role in the formation of the atherosclerotic plaque. Therefore, the inhibition of endothelium inflammation by nutraceuticals, such as PAF inhibitors, is a promising alternative for preventing cardiovascular diseases. The aim of the present study was to evaluate the impact of a new functional yogurt enriched with PAF inhibitors of natural origin from olive oil by-products on PAF metabolism. Ninety-two apparently healthy, but mainly overweight volunteers (35-65 years) were randomly allocated into three groups by block-randomization. The activities of PAF's biosynthetic and catabolic enzymes were measured, specifically two isoforms of acetyl-CoA:lyso-PAF acetyltransferase (LPCATs), cytidine 5'-diphospho-choline:1-alkyl-2-acetyl-sn-glycerol cholinephosphotransferase (PAF-CPT) and two isoforms of platelet activating factor acetylhydrolase in leucocytes (PAF-AH) and plasma (lipoprotein associated phospholipase-A2, LpPLA2). The intake of the enriched yogurt resulted in reduced PAF-CPT and LpPLA2 activities. No difference was observed in the activities of the two isoforms of lyso PAF-AT. In conclusion, intake of yogurt enriched in PAF inhibitors could favorably modulate PAF biosynthetic and catabolic pathways.
Collapse
|
15
|
Georgoulis M, Yiannakouris N, Tenta R, Fragopoulou E, Kechribari I, Lamprou K, Perraki E, Vagiakis E, Kontogianni MD. A weight-loss Mediterranean diet/lifestyle intervention ameliorates inflammation and oxidative stress in patients with obstructive sleep apnea: results of the "MIMOSA" randomized clinical trial. Eur J Nutr 2021; 60:3799-3810. [PMID: 33839919 DOI: 10.1007/s00394-021-02552-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/30/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE Inflammation and oxidative stress are implicated in obstructive sleep apnea (OSA) pathophysiology. We aimed at exploring whether the combination of a weight-loss Mediterranean diet/lifestyle intervention with OSA standard care, i.e., continuous positive airway pressure (CPAP) prescription, can lead to greater improvements in inflammation and oxidative stress, compared to standard care alone. METHODS This was a randomized controlled clinical trial in 187 adult, overweight patients with moderate-to-severe OSA. Participants were randomized to a standard care (SCG, n = 65), a Mediterranean diet (MDG, n = 62) or a Mediterranean lifestyle group (MLG, n = 60). All groups received OSA standard care. Intervention arms participated in a 6-month behavioral weight-loss intervention based on the Mediterranean diet, while the MLG also received counselling on physical activity and sleep habits. RESULTS Seven patients were excluded and 53/180 were lost to follow-up. In intention to treat analysis (n = 180), the SCG did not exhibit changes in any of the markers assessed. Post-intervention age-, sex-, baseline- and CPAP use-adjusted plasma high sensitivity C-reactive protein levels (mg/L) were lower in the MDG and the MLG compared to the SCG (mean difference - 1.33, P = 0.039 and - 1.68, P = 0.007, respectively). The MLG also exhibited lower urinary 8-iso prostaglandin F2a levels (ng/mg creatinine) compared to the SCG and the MDG (mean difference - 1.10, P < 0.0001 and - 0.80, P = 0.001, respectively). Adiponectin and oxidized guanine levels were not altered in any of the study groups. Results were similar in per protocol analysis (n = 127). CONCLUSION A weight-loss Mediterranean diet/lifestyle intervention on top of CPAP has anti-inflammatory and antioxidant benefits in OSA. REGISTRATION The trial was prospectively registered at ClinicalTrials.gov (NCT02515357) on August 4, 2015.
Collapse
Affiliation(s)
- Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Str., 17671, Athens, Greece
| | - Nikos Yiannakouris
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Str., 17671, Athens, Greece
| | - Roxane Tenta
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Str., 17671, Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Str., 17671, Athens, Greece
| | - Ioanna Kechribari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Str., 17671, Athens, Greece
| | - Kallirroi Lamprou
- Center of Sleep Disorders, 1st Department of Critical Care and Pulmonary Services, Evangelismos Hospital, Medical School of Athens University, 45-47 Ipsilantou Str., 10676, Athens, Greece
| | - Eleni Perraki
- Center of Sleep Disorders, 1st Department of Critical Care and Pulmonary Services, Evangelismos Hospital, Medical School of Athens University, 45-47 Ipsilantou Str., 10676, Athens, Greece
| | - Emmanοuil Vagiakis
- Center of Sleep Disorders, 1st Department of Critical Care and Pulmonary Services, Evangelismos Hospital, Medical School of Athens University, 45-47 Ipsilantou Str., 10676, Athens, Greece
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Str., 17671, Athens, Greece.
| |
Collapse
|
16
|
Ntzouvani A, Antonopoulou S, Fragopoulou E, Kontogianni MD, Nomikos T, Mikellidi A, Xanthopoulou Μ, Kalogeropoulos N, Panagiotakos D. Effect of Differently Fed Farmed Gilthead Sea Bream Consumption on Platelet Aggregation and Circulating Haemostatic Markers among Apparently Healthy Adults: A Double-Blind Randomized Crossover Trial. Nutrients 2021; 13:nu13020286. [PMID: 33498445 PMCID: PMC7909403 DOI: 10.3390/nu13020286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 01/21/2023] Open
Abstract
Fish consumption beneficially affects coagulation markers. Few dietary intervention studies have investigated differently fed farmed fish against these cardio-metabolic risk factors in humans. This double-blind randomized crossover trial evaluated differently fed farmed gilthead sea bream consumption against platelet aggregation and circulating haemostatic markers among apparently healthy adults. Subjects aged 30-65 years, with a body mass index 24.0-31.0 kg/m2, consuming less than 150 g cooked fish per week, were recruited in Attica, Greece. Participants were randomized (n = 38, 1:1) to one of two sequences; consumption of fish fed with fish oil diet (conventional fish, CF)/fish fed with olive pomace-enriched diet (enriched fish, EF) versus EF/CF. The primary outcomes were ex vivo human platelet aggregation and circulating plasminogen activator inhibitor-1 (PAI-1) and P-selectin (sP-selectin) concentrations. EF consumption had no significant effect on platelet sensitivity or haemostatic markers compared to CF. Platelet sensitivity to platelet-activating factor (PAF) decreased after CF consumption during the second period (p < 0.01). Plasma PAI-1 and sP-selectin concentrations increased after CF consumption during both periods (p < 0.01 for both). Based on current findings, consumption of enriched farmed gilthead sea bream had no greater effect on coagulation markers in adults compared to the conventionally fed fish.
Collapse
|
17
|
Fragopoulou E, Detopoulou P, Alepoudea E, Nomikos T, Kalogeropoulos N, Antonopoulou S. Associations between red blood cells fatty acids, desaturases indices and metabolism of platelet activating factor in healthy volunteers. Prostaglandins Leukot Essent Fatty Acids 2021; 164:102234. [PMID: 33373961 DOI: 10.1016/j.plefa.2020.102234] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 11/18/2020] [Accepted: 12/15/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Platelet-activating-factor is an inflammatory lipid mediator. Key enzymes of its biosynthesis are CDP-choline:1-alkyl-2-acetyl-sn-glycerol-cholinephosphotransferase (PAF-CPT) and acetyl-CoA:lyso-PAF-acetyltransferases (Lyso-PAF-AT) while PAF-AH/Lp-PLA2 degrade PAF. The interplay between PAF and fatty acids metabolism was explored. MATERIAL AND METHODS In a healthy population, PAF levels, its metabolic enzymes activity and RBC fatty acids were measured while desaturases indices (D) were estimated. A principal component analysis was also applied to assess patterns of RBC fatty acids. RESULTS SFA were related to increased PAF biosynthesis and decreased Lp-PLA2 only in women. MUFA were inversely associated with PAF biosynthesis and positively with Lp-PLA2. Omega-6 fatty acids were positively correlated only with PAF-CPT while no significant correlations were observed with n3 fatty acids. D6 index was positively related with PAF biosynthetic enzymes and inversely with Lp-PLA2 while D9 correlated positively with Lp-PLA2. The pattern of high MUFA and low n6 was associated with reduced PAF biosynthesis and/or increased catabolism in both sexes. CONCLUSION The role of fatty acids in amplifying or reducing inflammation seems to be also reflected in PAF metabolism.
Collapse
Affiliation(s)
- E Fragopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Street, 17671, Athens, Greece
| | - P Detopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Street, 17671, Athens, Greece
| | - E Alepoudea
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Street, 17671, Athens, Greece
| | - T Nomikos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Street, 17671, Athens, Greece
| | - N Kalogeropoulos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Street, 17671, Athens, Greece
| | - S Antonopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Street, 17671, Athens, Greece.
| |
Collapse
|
18
|
Fragopoulou E, Antonopoulou S. The French paradox three decades later: Role of inflammation and thrombosis. Clin Chim Acta 2020; 510:160-169. [PMID: 32653485 DOI: 10.1016/j.cca.2020.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022]
Abstract
Although, three decades have pasted from the introduction of "French Paradox", is still an issue for debate. Epidemiology supports the J-shaped relationship between wine consumption and vascular events as well as cardiovascular mortality with a maximum protection at 21 g of alcohol consumption in the form of wine per day. Nevertheless, the aforementioned studies have used an observational design that raises concerns about potential confounding. Randomized clinical studies may provide data to end the controversy and in parallel with in vitro experiments to elucidate the mechanisms by which wine affects cardiovascular disease. In this concept, this review aims to address the presence of bioactive wine micro constituents, their potential mechanisms of action and also to summarize the cardio-protective effects of wine intake based on clinical trials. The role of wine micro-constituents in inflammation and haemostasis is discussed in detail.
Collapse
Affiliation(s)
- Elizabeth Fragopoulou
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Greece.
| | - Smaragdi Antonopoulou
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Greece
| |
Collapse
|
19
|
Choleva M, Boulougouri V, Panara A, Panagopoulou E, Chiou A, Thomaidis NS, Antonopoulou S, Fragopoulou E. Evaluation of anti-platelet activity of grape pomace extracts. Food Funct 2020; 10:8069-8080. [PMID: 31761914 DOI: 10.1039/c9fo02138h] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Platelets aggregation plays a crucial role in atherothrombosis. Therefore, the aim of the present study was to examine the anti-platelet activity of winery by-products extracts, to find the most potent one and to be further analyzed in order to be used for food fortification. For this purpose, grape pomace from four red varieties was extracted with four solvents of different polarity. The extracts' phenolic content, antioxidant capacity and their ability to inhibit human platelet aggregation against PAF, ADP, TRAP were determined by Light Transmission Aggregometry. The ethanolic extract was further analyzed concerning its anti-platelet effect and its chemical composition by LC-MS/MS and GC-MS. The ethanolic and Bligh-Dyer water phase extracts showed the highest phenolic compounds/anthocyanin content and the best antioxidant activity. However, the most potent inhibition of platelet aggregation was revealed by ethanol extracts, followed by the Bligh-Dyer lipoid phase extracts. Ethanolic extract, found to contain micro-constituents such as phospho-compounds, phenolic compounds and fatty acids. The most abundant phenolic compounds were catechin, epicatechin and quercetin and the most abundant fatty acids were linoleic acid (C18:2n6), linolenic acid (C18:3n3) and palmitic acid (C16:0). Ethanolic extract was capable of inhibiting platelets aggregation in a wide range of agonist concentrations and it also seems that its action is sustained when platelets from coronary heart disease patient were used. Ethanol extract of winery by-products exerts a potent anti-platelet effect and its valorization could lead to the production of functional foods with cardioprotective properties.
Collapse
Affiliation(s)
- Maria Choleva
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Mitsou E, Detopoulou M, Kakali A, Fragopoulou E, Nomikos T, Antonopoulou S, Panagiotakos D, Kyriacou A. Mining possible associations of faecal A. muciniphila colonisation patterns with host adiposity and cardiometabolic markers in an adult population. Benef Microbes 2019; 10:741-749. [DOI: 10.3920/bm2019.0033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We aimed to evaluate colonisation patterns of Akkermansia muciniphila in a Greek adult population and to investigate model-adjusted associations of A. muciniphila with host adiposity and cardiometabolic markers. Participants (n=125) underwent anthropometric, dietary, physical activity and lifestyle evaluation. Blood sampling for determination of blood lipid indices, glucose metabolism, adiponectin, lipoprotein-associated phospholipase A2 (Lp-PLA2), inflammation and oxidative stress parameters was also performed. Stool A. muciniphila presence and levels were determined by quantitative PCR and subjects were grouped based on bimodal distribution of levels (Low vs High). A. muciniphila was detected in 88.6% of participants. Overweight/obese (OW/OB) subjects were more prone in low bimodal levels of A. muciniphila compared to normal-weight (NW) individuals (58.75 vs 27.59%, P=0.004), with a 4-time greater likelihood after multi-adjusted logistic regression analysis (P=0.016). Levels of A. muciniphila were negatively associated with total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio (log10:-0.009±0.004, P=0.033), whereas detection of this bacterium was negatively associated with both TC/HDL-C ratio (log10: -0.049±0.023, P=0.036) and low-density lipoprotein cholesterol/HDL-C ratio (-0.407±0.176, P=0.023). Furthermore, low bimodal levels of A. muciniphila were positively associated with fasting blood glucose (log10: 0.018±0.009, P=0.037). In terms of inflammation markers, levels of A. muciniphila were positively associated with soluble cluster of differentiation-14 (sCD14) (log10: 0.012±0.004, P=0.003) and faecal detection of this bacterium had a positive association with anti-inflammatory interleukin 10 levels (log10: 0.325±0.131, P=0.015). In addition, A. muciniphila levels were positively associated with total adiponectin (log10: 0.046±0.015, P=0.002), whereas low bimodal levels of A. muciniphila had an inverse relationship with this blood marker (log10: -0.131±0.053, P=0.016). In conclusion, we confirmed the previously reported association of A. muciniphila with metabolic health for the first time in a Greek urban population; furthermore, we shed some light to novel atherosclerotic risk markers with rather unexplored connections with A. muciniphila colonisation patterns in human subjects.
Collapse
Affiliation(s)
- E.K. Mitsou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70. El. Venizelou str., 17671 Kallithea, Greece
| | - M. Detopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70. El. Venizelou str., 17671 Kallithea, Greece
| | - A. Kakali
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70. El. Venizelou str., 17671 Kallithea, Greece
| | - E. Fragopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70. El. Venizelou str., 17671 Kallithea, Greece
| | - T. Nomikos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70. El. Venizelou str., 17671 Kallithea, Greece
| | - S. Antonopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70. El. Venizelou str., 17671 Kallithea, Greece
| | - D.B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70. El. Venizelou str., 17671 Kallithea, Greece
| | - A. Kyriacou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70. El. Venizelou str., 17671 Kallithea, Greece
| |
Collapse
|
21
|
Ntzouvani A, Giannopoulou E, Fragopoulou E, Nomikos T, Antonopoulou S. Energy Intake and Plasma Adiponectin as Potential Determinants of Lipoprotein-Associated Phospholipase A 2 Activity: A Cross-Sectional Study. Lipids 2019; 54:629-640. [PMID: 31489677 DOI: 10.1002/lipd.12191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/05/2019] [Accepted: 08/12/2019] [Indexed: 12/15/2022]
Abstract
Lipoprotein-associated phospholipase A2 (Lp-PLA2 ) is associated with increased risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus. Lp-PLA2 activity is positively associated with male sex, Caucasian race, the presence of metabolic syndrome (MetS) and low-density lipoprotein (LDL)-cholesterol, but it is negatively associated with high-density lipoprotein (HDL)-cholesterol. Associations with other cardiometabolic risk factors, inflammation markers, and lifestyle factors are few or inconsistent. We investigated potential determinants of Lp-PLA2 activity among both nonmodifiable and modifiable CVD risk factors in a middle-aged Greek cohort without overt CVD. Two hundred eighty four subjects (159 men, 53 ± 9 years and 125 women 52 ± 9 years) participated in a cross-sectional study carried out during 2011-2012 in Athens, Attica. Cardiometabolic risk factors, inflammation markers, lifestyle factors, and Lp-PLA2 activity were evaluated with established methods. The American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criteria were used to define MetS. Lp-PLA2 activity was not associated with MetS, but was associated with MetS components, markers of liver function, and macronutrient intake. Increased total energy intake was associated with increased Lp-PLA2 activity (odds ratio, 95% confidence interval: 1.07, 1.01-1.14 and 1.10, 1.03-1.16 for the 4th and 3rd quartiles, respectively, compared to the 1st quartile) after adjustments for sex, pack-years of smoking, LDL-cholesterol, and statin treatment. Adiponectin tended to be inversely associated with Lp-PLA2 activity (0.91, 0.82-1.00, and 4th versus 1st quartile). Our results suggested that total energy intake and adiponectin levels are potential determinants of Lp-PLA2 activity.
Collapse
Affiliation(s)
- Agathi Ntzouvani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Eleftheriou Venizelou 70, Athens, 17671, Greece
| | - Efstathia Giannopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Eleftheriou Venizelou 70, Athens, 17671, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Eleftheriou Venizelou 70, Athens, 17671, Greece
| | - Tzortzis Nomikos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Eleftheriou Venizelou 70, Athens, 17671, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Eleftheriou Venizelou 70, Athens, 17671, Greece
| |
Collapse
|
22
|
Fragopoulou E, Gavriil L, Argyrou C, Malagaris I, Choleva M, Antonopoulou S, Afxentiou G, Nikolaou E. Suppression of DNA/RNA and protein oxidation by dietary supplement which contains plant extracts and vitamins: a randomized, double-blind, placebo-controlled trial. Lipids Health Dis 2018; 17:187. [PMID: 30115068 PMCID: PMC6097198 DOI: 10.1186/s12944-018-0836-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 07/30/2018] [Indexed: 11/10/2022] Open
Abstract
Background Excessive oxidative stress may impair bio-molecules and cellular function. Multi antioxidant supplementation is thought to be more effective than a single antioxidant probably through the synergistic or complementary action of natural substances that could enhance the prospective effect. Methods In order to estimate the effect of a plant extract based supplement in apparently healthy volunteers’ oxidative stress markers, a double-blind and placebo controlled intervention was performed. 62 apparently healthy volunteers, overweight with medium adherence to the Mediterranean diet, were recruited and randomly allocated into two intervention groups (supplement or placebo) for 8 weeks. Basic biochemical markers, oxidized LDL (oxLDL), resistance of serum in oxidation, protein carbonyls in serum and 8-isoprostane and DNA/RNA damage in urine were measured. Results No differentiation was observed in basic biochemical markers, in oxLDL levels as well as in serum resistance against oxidation, during intervention in the examined groups. A significant resistance regarding urine isoprostanes levels in the supplement group compared to the placebo one, was observed. Reduction on DNA/RNA damage and on protein carbonyls levels (almost 30% and 20% respectively, at 8 weeks) was detected in volunteers who consumed the supplement compared to the control group. Conclusion Consumption of plant extract based supplement seems to reduce DNA/RNA and protein oxidation and in less extent lipids peroxidation. Trial registration ClinicalTrials.gov Identifier for this study is: NCT02837107.
Collapse
Affiliation(s)
- Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671, Athens, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Fragopoulou E, Choleva M, Antonopoulou S, Demopoulos CA. Wine and its metabolic effects. A comprehensive review of clinical trials. Metabolism 2018; 83:102-119. [PMID: 29408458 DOI: 10.1016/j.metabol.2018.01.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 01/11/2018] [Accepted: 01/25/2018] [Indexed: 12/18/2022]
Abstract
The introduction of the term "French Paradox" motivated an extensive and in-depth research into health benefits of moderate wine consumption. The superiority of wine is thought to be attributed to its micro-constituents and consequent effort was made to isolate and identify these bioactive compounds as well as to elucidate the mechanisms of their action. Controlled trials offer more concrete answers to several raised questions than observational studies. Under this perspective, clinical trials have been implemented, mainly in healthy volunteers and rarely in patients, in order to investigate the acute or chronic effect of wine consumption on metabolism and physio-pathological systems, which are mainly associated with cardiovascular diseases. The aim of this review is to update the knowledge about the acute and long term effect of wine consumption on lipid and glucose/insulin metabolism as well as on the inflammatory and haemostatic systems, based on the reported data of controlled clinical trials. In conclusion, the most repeated result of wine consumption is on lipid metabolism, attributed mainly to ethanol, while wine micro-constituents seem to have an important role mainly in haemostatic and inflammatory/endothelial systems.
Collapse
Affiliation(s)
- Elizabeth Fragopoulou
- Department of Nutrition -Dietetics, Harokopio University, 70 El. Venizelou Street, 17671 Athens, Greece.
| | - Maria Choleva
- Department of Nutrition -Dietetics, Harokopio University, 70 El. Venizelou Street, 17671 Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition -Dietetics, Harokopio University, 70 El. Venizelou Street, 17671 Athens, Greece
| | - Constantinos A Demopoulos
- Department of Chemistry, National and Kapodistrian University of Athens, Panepistimioupolis, 15771 Athens, Greece
| |
Collapse
|
24
|
Abstract
The purpose of this review is to collect and compare fish intervention studies. Prospective studies have outlined the beneficial effect of frequent fish consumption on cardiovascular incidents that is attributed to n-3 fatty acids incorporated in fish, mainly eicosapentaenoic (EPA), and docosahexaenoic (DHA) acids. This outcome triggered clinical trials to examine the effect of either fish intake or consumption of n-3 fatty acids via capsules on biomarkers related to cardiovascular disease (CVD). The absence of a recent review focusing on clinical trials regarding fish intake and not n-3 fatty acids supplements rendered necessary the composition of this article. In total, 28 studies on healthy volunteers were found to meet the inclusion criteria. With EPA and DHA intake varying between 0.03 to 5 g per day, biomarkers, such as triglycerides, high-density lipoprotein and platelet aggregation, tended to ameliorate when daily intake exceeded 1 g per day, while the most common inflammatory marker, C-reactive protein, was not affected. In all, fish consumption gives promising results; yet fish micronutrients, total diet fat, as well as other dietary habits may also affect biomarkers. Therefore, all these factors should be considered in future clinical trials in order for one to draw more reliable conclusions.
Collapse
Affiliation(s)
- Filio Petsini
- a Department of Nutrition and Dietetics , Harokopio University , Athens , Greece
| | | | | |
Collapse
|
25
|
Ntzouvani A, Nomikos T, Panagiotakos D, Fragopoulou E, Pitsavos C, McCann A, Ueland PM, Antonopoulou S. Amino acid profile and metabolic syndrome in a male Mediterranean population: A cross-sectional study. Nutr Metab Cardiovasc Dis 2017; 27:1021-1030. [PMID: 28958693 DOI: 10.1016/j.numecd.2017.07.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/08/2017] [Accepted: 07/17/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS The metabolic syndrome (MetS) refers to a cluster of clinically relevant factors that increases the risk of cardiovascular diseases and all-cause mortality. Circulating levels of several amino acids and metabolites related to one-carbon metabolism have been associated with cardiometabolic risk factors and MetS. We aimed to identify the amino acid profile that is significantly associated with MetS among an all male Mediterranean population. METHODS AND RESULTS One hundred middle-aged men (54.6 ± 8.9 years) participated in a cross-sectional study carried out during 2011-2012. The International Diabetes Federation (IDF) criteria were used to define MetS. Fasting plasma levels of 20 common amino acids and 15 metabolites related to amino acid and one-carbon metabolism were measured using gas chromatography (GC-MS/MS) and liquid chromatography tandem mass spectrometry (LC-MS/MS). Principal components analysis was applied. Fifty-six participants fulfilled the IDF criteria for defining MetS. Five factors were extracted from the 35 measured metabolites. The branched-chain amino acids/aromatic amino acids (BCAA/AAA) related pattern and the glutamine/glycine/serine/asparagine (Gln/Gly/Ser/Asn) related pattern were significantly associated with MetS (odds ratio, 95% confidence interval; 6.41, 2.43-16.91, and 0.47, 0.23-0.96, respectively) after adjustment for age, current smoking status, physical activity level and medical treatment for hypertension, dyslipidaemia, type 2 diabetes mellitus. Further adjustment for liver function markers (i.e. glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, and γ-glutamyltransferase), and plasma adiponectin levels did not significantly affect the associations. CONCLUSION The BCAA/AAA pattern was positively associated, while the Gln/Gly/Ser/Asn pattern was inversely associated with established cardiometabolic risk factors and MetS. Plasma adiponectin levels or markers of liver function did not significantly affect these associations.
Collapse
Affiliation(s)
- A Ntzouvani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens 17671, Greece
| | - T Nomikos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens 17671, Greece
| | - D Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens 17671, Greece
| | - E Fragopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens 17671, Greece
| | - C Pitsavos
- First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Athens 11527, Greece
| | | | - P M Ueland
- Department of Clinical Science, University of Bergen, Bergen 5020, Norway; Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen 5020, Norway
| | - S Antonopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens 17671, Greece.
| |
Collapse
|
26
|
Tenta R, Fragopoulou E, Tsoukala M, Xanthopoulou M, Skyrianou M, Pratsinis H, Kletsas D. Antiproliferative Effects of Red and White Wine Extracts in PC-3 Prostate Cancer Cells. Nutr Cancer 2017; 69:952-961. [DOI: 10.1080/01635581.2017.1340489] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Roxane Tenta
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Magafoula Tsoukala
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Maria Skyrianou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Harris Pratsinis
- Laboratory of Cell Proliferation and Ageing, Institute of Biosciences and Applications, National Centre for Scientific Research “Demokritos”, Athens, Greece
| | - Dimitris Kletsas
- Laboratory of Cell Proliferation and Ageing, Institute of Biosciences and Applications, National Centre for Scientific Research “Demokritos”, Athens, Greece
| |
Collapse
|
27
|
Katsagoni C, Alexopoulou A, Deutsch M, Papadopoulos N, Papageorgiou M, loannidou P, Papagianni E, Fragopoulou E, Papatheodoridis G, Kontogianni M. SUN-P119: Improvement of Metabolic Syndrome after Intervention Based on Mediterranean Diet in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD): A Randomised-Controlled Clinical Trial. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30462-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
28
|
Choleva M, Alexandraki E, Afxediou G, Gabrihl L, Argyrou C, Malagaris I, Fragopoulou E. The consumption of dietary supplement which contains plant extracts affects superoxide dismutase activity in healthy adults. Clin Nutr ESPEN 2016. [DOI: 10.1016/j.clnesp.2016.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
29
|
Kelesidis T, Papakonstantinou V, Detopoulou P, Fragopoulou E, Chini M, Lazanas MC, Antonopoulou S. The Role of Platelet-Activating Factor in Chronic Inflammation, Immune Activation, and Comorbidities Associated with HIV Infection. AIDS Rev 2015; 17:191-201. [PMID: 26616844 PMCID: PMC5056589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
With the advent of highly effective antiretroviral therapy, cardiovascular disease has become an important cause of morbidity and mortality among people with treated HIV-1, but the pathogenesis is unclear. Platelet-activating factor is a potent lipid mediator of inflammation that has immunomodulatory effects and a pivotal role in the pathogenesis of inflammatory disorders and cardiovascular disease. Limited scientific evidence suggests that the platelet-activating factor pathway may be a mechanistic link between HIV-1 infection, systemic inflammation, and immune activation that contribute to pathogenesis of chronic HIV-related comorbidities, including cardiovascular disease and HIV-associated neurocognitive disorders. In this review, we examine the mechanisms by which the cross-talk between HIV-1, immune dysregulation, inflammation, and perturbations in the platelet-activating factor pathway may directly affect HIV-1 immunopathogenesis. Understanding the role of platelet-activating factor in HIV-1 infection may pave the way for further studies to explore therapeutic interventions, such as diet, that can modify platelet-activating factor activity and use of platelet-activating factor inhibitors that might improve the prognosis of HIV-1 infected patients.
Collapse
Affiliation(s)
| | | | | | | | - Maria Chini
- Third Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | - Marios C. Lazanas
- Third Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | | |
Collapse
|
30
|
Vlachogianni IC, Fragopoulou E, Stamatakis GM, Kostakis IK, Antonopoulou S. Platelet Activating Factor (PAF) biosynthesis is inhibited by phenolic compounds in U-937 cells under inflammatory conditions. Prostaglandins Other Lipid Mediat 2015; 121:176-83. [PMID: 26358846 DOI: 10.1016/j.prostaglandins.2015.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/03/2015] [Accepted: 09/03/2015] [Indexed: 11/24/2022]
Abstract
Interleukin 1 beta (IL-1β) induced platelet activating factor (PAF) synthesis in U-937 cells through stimulation of acetyl-CoA:lysoPAF-acetyltransferase (lyso PAF-AT) at 3 h and DTT-independentCDP-choline-1-alkyl-2-acetyl-sn-glycerol cholinophosphotransferase (PAF-CPT) at 0.5 h. The aim of this study was to investigate the effect of tyrosol (T), resveratrol (R) and their acetylated derivatives(AcDs) which exhibit enhanced bioavailability, on PAF synthesis in U-937 after IL-1β stimulation. The specific activity of PAF enzymes and intracellular levels were measured in cell homogenates. T and R concentration capable of inducing 50% inhibition in IL-1β effect on lyso PAF-AT was 48 μΜ ± 11 and 157 μΜ ± 77, for PAF-CPT 246 μΜ ± 61 and 294 μΜ ± 102, respectively. The same order of concentration was also observed on inhibiting PAF levels produced by IL-1β. T was more potent inhibitor than R (p<0.05). AcDs of T retain parent compound inhibitory activity, while in the case of R only two AcDs retain the activity. The observed inhibitory effect by T,R and their AcDs, may partly explain their already reported beneficial role.
Collapse
Affiliation(s)
- Ioanna C Vlachogianni
- Department of Nutritional Science and Dietetics, Harokopio University, Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutritional Science and Dietetics, Harokopio University, Athens, Greece
| | | | - Ioannis K Kostakis
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, National and Kapodistrian University of Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutritional Science and Dietetics, Harokopio University, Athens, Greece.
| |
Collapse
|
31
|
Katsagoni C, Egkomiti A, Ioannidou P, Fragopoulou E, Papatheodoridis G, Kontogianni M. MON-PP045: A Mediterranean Diet Versus a Mediterranean Lifestyle Interventention in Patients with Nonalcoholic Fatty Liver Disease (NAFLD): Preliminary Results from an Ongoing Clinical Trial. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30477-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
32
|
Vlachogianni IC, Fragopoulou E, Kostakis IK, Antonopoulou S. In vitro assessment of antioxidant activity of tyrosol, resveratrol and their acetylated derivatives. Food Chem 2015; 177:165-73. [PMID: 25660873 DOI: 10.1016/j.foodchem.2014.12.092] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 11/23/2014] [Accepted: 12/22/2014] [Indexed: 02/07/2023]
Abstract
Consumption of phenolic compounds is associated with beneficial effects in humans even though many of them are poorly absorbed. The aim of this study was to investigate the in vitro antioxidant activity of tyrosol (T), resveratrol (R) and their acetylated derivatives (AcD), as increased lipophilicity has been reported to improve absorption. The chemically synthesized AcDs were evaluated by their ability to scavenge DPPH radicals, inhibit non-enzymatic linoleic acid peroxidation, inhibit human serum oxidation in the presence of copper ions and inhibit lipoxygenase activity. T showed an inhibitory effect only in serum oxidation, where the T-acetylated at aromatic-OH was the most active. The T-acetylated at aliphatic-OH and 3,5-diacetyl-R exhibited the most powerful effect in non-enzymatic linoleic acid peroxidation with IC50 values 2.4 mM ± 0.21 and 0.055 mM ± 0.0018, respectively. In all other tests R was the most potent among all its AcD and T. Increasing lipophilicity by acetylation improves antioxidant activity of phenolic compounds in non-enzymatic lipid peroxidation assays.
Collapse
Affiliation(s)
- Ioanna C Vlachogianni
- Department of Nutritional Science and Dietetics, Harokopio University, Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutritional Science and Dietetics, Harokopio University, Athens, Greece
| | - Ioannis K Kostakis
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, National and Kapodistrian University of Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutritional Science and Dietetics, Harokopio University, Athens, Greece.
| |
Collapse
|
33
|
Georgoulis M, Kontogianni MD, Margariti A, Tiniakos D, Fragopoulou E, Zafiropoulou R, Papatheodoridis G. Associations between dietary intake and the presence of the metabolic syndrome in patients with non-alcoholic fatty liver disease. J Hum Nutr Diet 2015; 28:409-15. [PMID: 25988570 DOI: 10.1111/jhn.12323] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although dietary habits have been associated with the likelihood of the metabolic syndrome (MetS) in the general population, similar associations in non-alcoholic fatty liver disease (NAFLD) patients have not been explored. The aim of this cross-sectional study was to assess the presence of the MetS and to explore its potential association with dietary habits in a sample of NAFLD patients. METHODS Seventy-three adult patients with recent NAFLD diagnosis based on elevated liver enzyme levels and evidence of hepatic steatosis on ultrasound were enrolled. Participants' habitual food consumption was retrospectively assessed through a food frequency questionnaire and adherence to the Mediterranean diet (MD) was assessed via the Mediterranean Diet Score (MedDietScore). The presence of the MetS was defined as the concomitant presence of at least three of its individual components, according to the criteria proposed by a recent joint statement of several major organisations. RESULTS The MetS was present in 46.5% of the sample, with increased waist circumference values and decreased high-density lipoprotein cholesterol levels being the most prevalent disorders (63% and 88.7%, respectively). Consumption of refined grains [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.00-1.05] and red meat and products (OR = 1.10, 95% CI = 1.01-1.21) were positively associated with the presence of the MetS, whereas the consumption of whole grains (OR = 0.92, 95% CI = 0.84-0.99) and MedDietScore (OR = 0.87, 95% CI = 0.76-0.99) were negatively associated, after adjusting for participants' age, sex, daily energy intake and time spent in sedentary activities. CONCLUSIONS Low refined grain and red meat intake, high whole grain intake and high adherence to the MD were associated with lower odds of the MetS in NAFLD patients.
Collapse
Affiliation(s)
- M Georgoulis
- Department of Nutrition & Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - M D Kontogianni
- Department of Nutrition & Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - A Margariti
- Second Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Athens, Greece
| | - D Tiniakos
- Laboratory of Histology & Embryology, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - E Fragopoulou
- Department of Nutrition & Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - R Zafiropoulou
- Second Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Athens, Greece
| | - G Papatheodoridis
- Second Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Athens, Greece.,Department of Gastroenterology, Athens University Medical School, Laiko Hospital of Athens, Athens, Greece
| |
Collapse
|
34
|
Xanthopoulou M, Asimakopoulos D, Antonopoulou S, Demopoulos C, Fragopoulou E. Effect of Robola and Cabernet Sauvignon extracts on platelet activating factor enzymes activity on U937 cells. Food Chem 2014; 165:50-9. [DOI: 10.1016/j.foodchem.2014.05.085] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 04/10/2014] [Accepted: 05/15/2014] [Indexed: 10/25/2022]
|
35
|
Letsiou S, Nomikos T, Panagiotakos DB, Pergantis SA, Fragopoulou E, Pitsavos C, Stefanadis C, Antonopoulou S. Gender-specific distribution of selenium to serum selenoproteins: associations with total selenium levels, age, smoking, body mass index, and physical activity. Biofactors 2014; 40:524-35. [PMID: 25185791 DOI: 10.1002/biof.1176] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The epidemiology of selenium (Se) is mainly based on the determination of total serum selenium levels (TSe) which by many aspects is an inadequate marker of Se status. In this study we applied a recently developed LC-ICP-MS method, for the determination of the selenium content of the three main serum selenium-containing proteins, in a subcohort of the ATTICA study. This enables us to investigate whether the selenium distribution to selenoproteins may correlate with demographic (age, gender) and lifestyle variables (smoking, physical activity) that are crucial for the development of chronic diseases. A sub-sample from the ATTICA Study, consisted of 236 males (40 ± 11 years) and 163 females (38 ± 12 years), was selected. The selenium content of glutathione peroxidase (GPx-3), selenoprotein P (SelP) and selenoalbumin (SeAlb) was determined in serum by LC-ICP/MS method. We found that 26% of TSe is found in GPx-3, 61% in SelP and 13% in SeAlb. We have assessed the different ratios of selenoproteins' selenium content (Se-GPX-3/Se-SelP, Se-GPX-3/Se-SeAlb, Se-SelP/Se-SeAlb), showing that people with similar TSe may have different distribution of this selenium to selenoproteins. Total selenium levels and gender are the variables that mostly affect selenium distribution to selenoproteins while age, smoking, physical activity and BMI do not significantly influence selenium distribution. In conclusion, the simultaneous determination of the selenium content of serum selenium-containing selenoproteins is necessary for a thorough estimation of selenium status. The ratio of the Se content between selenoproteins may be proven a novel, valid marker of selenium status.
Collapse
Affiliation(s)
- S Letsiou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Department of Chemistry, University of Crete, Heraklio, Crete, Greece
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Kalimeris K, Zerva A, Matsota P, Nomikos T, Fragopoulou E, Politi AN, Karamitopoulou E, Kostopanagiotou G. Pretreatment with sevoflurane attenuates direct lung injury. Minerva Anestesiol 2014; 80:635-644. [PMID: 24299917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Sevoflurane exerts effects on pulmonary cells that could protect against lung injury. We evaluated the potential of pretreatment with sevoflurane to attenuate lipopolysaccharide (LPS)-induced lung injury. METHODS LPS was administered intratracheally in Wistar rats to induce lung injury. Sevoflurane was administered for 30 min at 0.25, 0.5 or 1.0 MAC 15 min before LPS or for 30 min at 0.5 MAC 24 hours before LPS. After initial analysis of bronchoalveolar lavage fluid (BALF) cells and total protein, the group of 0.5 MAC 15 min before LPS was further analyzed for surfactant aggregates subfractions, plasma malondialdehyde levels and lung histology. RESULTS LPS instillation resulted in neutrophils sequestration in the lungs, loss of alveolar macrophages, increased BALF total protein and decreased large surfactant aggregates. Only inhalation of sevoflurane for 30 min at 0.5 MAC 15 min before LPS installation effectively reduced neutrophil accumulation, preserved alveolar epithelial cells and reduced total protein content in BALF. This regimen also reduced plasma malondialdehyde levels and increased large surfactant aggregates, despite the application of mechanical ventilation. This effect was preserved after LPS instillation and the favorable composition of surfactant was maintained. CONCLUSION Pretreatment with sevoflurane effectively attenuates direct severe lung injury, possibly by inhibition of neutrophil accumulation and alteration of the surfactant composition.
Collapse
Affiliation(s)
- K Kalimeris
- Second Department of Anesthesiology, School of Medicine, University of Athens, "Attiko" Hospital, Athens, Greece -
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Papakonstantinou VD, Chini M, Mangafas N, Stamatakis GM, Tsogas N, Tsoupras AB, Psarra K, Fragopoulou E, Antonopoulou S, Gargalianos P, Demopoulos CA, Lazanas MC. In vivo effect of two first-line ART regimens on inflammatory mediators in male HIV patients. Lipids Health Dis 2014; 13:90. [PMID: 24884881 PMCID: PMC4055908 DOI: 10.1186/1476-511x-13-90] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 05/24/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Persistent immune activation and inflammation are lying behind HIV-infection even in the setting of ART mediated viral suppression. The purpose of this study is to define the in vivo effect of two first-line ART regimens on certain inflammatory mediators in male HIV patients. METHODS Male, naive, HIV-infected volunteers were assigned either to tenofovir-DF/emtricitabine/efavirenz (Group_T) or abacavir/lamivudine/efavirenz (Group_A). Platelet Activating Factor (PAF) levels and metabolic enzymes together with HIV-implicated cytokines (IL-1beta, IL-6, IL-8, IL-10, IL-12p70, TNFa) and VEGF were determined for a 12-month period. Differences within each group were determined by non-parametric Friedman and Wilcoxon test, while the differences between the groups were checked by ANOVA repeated measures. RESULTS Both ART regimens present pronounced effect on inflammatory mediators, resulting in decreased PAF levels and Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity for tenofovir-containing regimen and same as baseline PAF levels with a peak though at the 3rd month as well as elevated Lp-PLA2 activity for abacavir-containing regimen. CONCLUSIONS Studies regarding the effect of first-line ART regimens on inflammation may be beneficial in preventing chronic morbidities during HIV-treatment. From this point of view, the present study suggests an anti-inflammatory effect of tenofovir-containing ART, while the temporary increase of PAF levels in abacavir-containing ART may be the link between the reported cardiovascular risk and abacavir administration.
Collapse
Affiliation(s)
- Vasiliki D Papakonstantinou
- Faculty of Chemistry, National & Kapodistrian University of Athens, Panepistimioupolis Zografou, 15771 Athens, Greece
| | - Maria Chini
- 3rd Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | - Nikos Mangafas
- 3rd Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | - George M Stamatakis
- Faculty of Chemistry, National & Kapodistrian University of Athens, Panepistimioupolis Zografou, 15771 Athens, Greece
| | - Nickolaos Tsogas
- 3rd Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | - Alexandros B Tsoupras
- Faculty of Chemistry, National & Kapodistrian University of Athens, Panepistimioupolis Zografou, 15771 Athens, Greece
| | - Katherina Psarra
- Department of Immunology and Histocompatibility, Evangelismos Hospital, Athens, Greece
| | | | | | - Panagiotis Gargalianos
- 1st Internal Medicine Department-Infectious Diseases Unit, “G. Gennimatas” Hospital, Athens, Greece
| | - Constantinos A Demopoulos
- Faculty of Chemistry, National & Kapodistrian University of Athens, Panepistimioupolis Zografou, 15771 Athens, Greece
| | - Marios-C Lazanas
- 3rd Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| |
Collapse
|
38
|
Detopoulou P, Fragopoulou E, Nomikos T, Yannakoulia M, Stamatakis G, Panagiotakos DB, Antonopoulou S. The relation of diet with PAF and its metabolic enzymes in healthy volunteers. Eur J Nutr 2014; 54:25-34. [DOI: 10.1007/s00394-014-0682-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 03/06/2014] [Indexed: 12/19/2022]
|
39
|
Detopoulou P, Nomikos T, Fragopoulou E, Chrysohoou C, Antonopoulou S. Platelet activating factor in heart failure: potential role in disease progression and novel target for therapy. Curr Heart Fail Rep 2013; 10:122-9. [PMID: 23389700 DOI: 10.1007/s11897-013-0131-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Heart failure (HF) is a complex syndrome with cardiac, renal, neurohormonal and sympathetic nervous system's manifestations, the pathogenesis of which among others is connected to inflammation. PAF has local and systemic effects pertaining to HF progression since it causes a negative inotropic effect, it induces arrhythmias, it induces apoptosis and it is involved in inflammation and atherosclerosis. In the present review the role of PAF in HF will be thoroughly presented along with the relevant data on PAF enzymes and the potential role of PAF metabolic circuit as a novel pharmacological target.
Collapse
Affiliation(s)
- Paraskevi Detopoulou
- Department of Nutrition, General Hospital Korgialenio-Benakio, Athanasaki 1, Athens, Greece.
| | | | | | | | | |
Collapse
|
40
|
Gavrieli A, Fragopoulou E, Mantzoros CS, Yannakoulia M. Gender and body mass index modify the effect of increasing amounts of caffeinated coffee on postprandial glucose and insulin concentrations; a randomized, controlled, clinical trial. Metabolism 2013; 62:1099-106. [PMID: 23498899 DOI: 10.1016/j.metabol.2013.02.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/31/2013] [Accepted: 02/06/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To examine the effects of different coffee amounts on blood glucose and insulin concentrations of healthy volunteers, and to assess potential effect modification by sex and body mass index category. MATERIALS/METHODS Thirty-three volunteers [16 ♀/17 ♂, 16 normal-weight and 17 overweight/obese, 27.3 ± 7.2 (19-44) y] took part in this randomized, crossover study. Ιn the morning of each experimental day volunteers received a standardized meal along with 200 mL of water or instant coffee containing either 3 or 6 mg of caffeine/kg body weight. Blood samples were obtained and analyzed for glucose and insulin concentrations in the fasting state, immediately after meal/drink consumption and at standard time points for the next 3h thereafter. RESULTS Coffee delayed the rise of insulin in response to the standardized meal and the fall of glucose concentrations from its maximum levels in the entire study sample. Glucose incremental area under the curve (IAUC) was significantly different between interventions (P=.009) with both coffee amounts inducing a greater area compared to water. Secondary, subgroup analysis at the nominal level showed that this might be more evident among females (PIAUC=.05) and overweight/obese participants (PIAUC=.03). Furthermore, coffee, mainly the 6 mg dose, could be lowering insulin concentrations the first 30 min after its consumption compared to water in men and overweight/obese participants. CONCLUSIONS Coffee exerts an acute effect on postprandial glucose and insulin concentrations. This effect may be modified by sex and overweight/obese status. Future research is necessary to elucidate underlying mechanisms.
Collapse
Affiliation(s)
- Anna Gavrieli
- Department of Nutrition and Dietetics, Harokopio University, 176 71 Athens, Greece
| | | | | | | |
Collapse
|
41
|
Vlachogianni IC, Nomikos T, Fragopoulou E, Stamatakis GM, Karantonis HC, Antonopoulou S, Demopoulos CA. Interleukin-1beta stimulates platelet-activating factor production in U-937 cells modulating both its biosynthetic and catabolic enzymes. Cytokine 2013; 63:97-104. [DOI: 10.1016/j.cyto.2013.04.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 03/26/2013] [Accepted: 04/15/2013] [Indexed: 10/26/2022]
|
42
|
Gavrieli A, Karfopoulou E, Kardatou E, Spyreli E, Fragopoulou E, Mantzoros CS, Yannakoulia M. Effect of different amounts of coffee on dietary intake and appetite of normal-weight and overweight/obese individuals. Obesity (Silver Spring) 2013; 21:1127-32. [PMID: 23671022 DOI: 10.1002/oby.20190] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 11/07/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the effects of different coffee amounts on dietary intake and appetite feelings in normal-weight and overweight/obese individuals. DESIGN AND METHODS Thirty-three volunteers (16 normal-weight, 17 overweight/obese) participated in three trials: they consumed a standard breakfast along with 200 ml of either coffee with 3 or 6 mg caffeine/kg body weight (Coffee 3 and Coffee 6, respectively), or water. At fasting and at standard time points for the 3 h following breakfast/drink consumption participants recorded their appetite feelings on visual analogue scales. At 180 min, participants consumed an ad libitum meal and the next day they recalled their food intake during the experimental day. RESULTS A significant intervention effect was found for the energy intake of the ad libitum meal (P = 0.05) and of the whole day (P = 0.02) only in overweight/obese individuals. Specifically, Coffee 6 resulted in a reduced energy intake during the ad libitum meal compared to Coffee 3 (P = 0.03) and in the total day compared to both water (P = 0.04) and Coffee 3 (P = 0.008). No effect was observed for the appetite feelings. CONCLUSIONS A moderate coffee amount can effectively reduce energy intake in the following meal and in the total day compared to lower or no coffee intake in overweight/obese participants.
Collapse
Affiliation(s)
- A Gavrieli
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | | | | | | | | |
Collapse
|
43
|
Verouti SN, Tsilibary EC, Fragopoulou E, Iatrou C, Demopoulos CA, Charonis AS, Charonis SA, Drossopoulou GI. Vitamin D receptor activators upregulate and rescue podocalyxin expression in high glucose-treated human podocytes. Nephron Clin Pract 2013; 122:36-50. [PMID: 23548800 DOI: 10.1159/000346562] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Accepted: 12/11/2012] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Vitamin D is beneficial in human and experimental chronic kidney disease, the leading cause of which is diabetic nephropathy. Vitamin D through its receptor, VDR, provides renal protection in diabetic nephropathy, but limited data exist about its effect on podocytes. Renal podocytes form the main filtration barrier possessing a unique phenotype maintained by proteins including podocalyxin and nephrin, the expression of which is suppressed in pathological conditions. METHODS We used immortalized human podocytes (human glomerular epithelial cells, HGEC) to assess podocalyxin and nephrin expression after treatment with 1,25-dihydroxyvitamin D3 (calcitriol) and its analogue paricalcitol. The involvement of VDR was investigated by silencing with hVDR-siRNA and ChIP analysis. RESULTS HGEC exhibit high glucose-mediated downregulation of podocalyxin and nephrin, loss of which has been linked with loss of the permselective renal barrier and proteinuria. Calcitriol and paricalcitol reversed high glucose-induced decrease of nephrin and significantly enhanced podocalyxin expression in podocytes cultured in high glucose. HGEC express VDR and retinoid X receptor (RXR). In the presence of calcitriol and paricalcitol, VDR expression was upregulated and VDR colocalized with RXR in the nucleus. VDR knockdown abolished the protective action of calcitriol and paricalcitol on podocalyxin expression indicating that podocalyxin activation of expression is partly mediated by VDR. Furthermore, VDR specifically regulates podocalyxin expression by bounding to a site upstream of the podocalyxin promoter. CONCLUSION Vitamin D analogues maintain and, furthermore, re-activate the expression of specialized components of podocytes including podocalyxin, hence they provide protection against loss of the permselective renal barrier, with molecular mechanisms elucidated herein.
Collapse
Affiliation(s)
- S N Verouti
- Faculty of Chemistry, National and Kapodistrian University of Athens, Panepistimioupolis, Athens, Greece
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Detopoulou P, Fragopoulou E, Nomikos T, Antonopoulou S, Kotroyiannis I, Vassiliadou C, Panagiotakos DB, Chrysohoou C, Pitsavos C, Stefanadis C. Baseline and 6-Week follow-up levels of PAF and activity of its metabolic enzymes in patients with heart failure and healthy volunteers--a pilot study. Angiology 2012; 64:522-8. [PMID: 23000600 DOI: 10.1177/0003319712458536] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This study aimed at evaluating the changes in platelet-activating factor (PAF) and its metabolic enzymes over a 6-week follow-up period in patients with newly diagnosed heart failure ([HF] n = 12) compared with age-, sex-, and BMI-matched apparently healthy volunteers (n = 10). The PAF, its key biosynthetic enzymes (lyso-PAF acetyltransferase [lyso-PAF-AT] and dithiothreitol [DTT]-insensitive CDP choline: 1-alkyl-2-acetyl-sn-glycerol cholinephosphotransferase [PAF-CPT]), and its catabolic isoenzymes (PAF-acetylhydrolase [PAF-AH] and lipoprotein-associated phospholipase A2 [Lp-PLA2]) were measured in serum and leukocytes of participants. At baseline, patients with HF had lower median activities of lyso-PAF-AT (P < .001) and PAF-CPT (P = .07) in parallel with PAF levels (P = .05) and higher activities of PAF-AH (P = .02) and Lp-PLA2 (P < .001) than controls. At follow-up, PAF-CPT and PAF levels marginally increased (P = .1), lyso-PAF-AT (P < .001) remained downregulated, while PAF-AH (P = .004) and Lp-PLA2 (P < .001) remained elevated compared with the controls. Newly diagnosed patients with HF under drug treatment have an affected profile of PAF biosynthetic enzymes and especially lyso-PAF-AT.
Collapse
|
45
|
Chini M, Tsoupras AB, Mangafas N, Tsogas N, Papakonstantinou VD, Fragopoulou E, Antonopoulou S, Gargalianos P, Demopoulos CA, Lazanas MC. Effects of HAART on platelet-activating factor metabolism in naive HIV-infected patients I: study of the tenofovir-DF/emtricitabine/efavirenz HAART regimen. AIDS Res Hum Retroviruses 2012; 28:766-75. [PMID: 22050695 DOI: 10.1089/aid.2011.0202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Platelet-activating factor (PAF) is implicated in human immunodeficiency virus (HIV)-related manifestations. Increased PAF synthesis has been recently detected in HIV-infected patients. In this study, we examined in naive HIV-infected patients the in vivo effects of a highly active antiretroviral therapy (HAART) regimen, containing tenofovir-DF/emtricitabine/efavirenz, on PAF metabolism. The specific activities of PAF basic biosynthetic enzymes, PAF-cholinephosphotransferase (PAF-CPT) and lyso-PAF-acetyltransferase (lyso-PAF-AT), but also the ones of PAF-basic catabolic enzymes, PAF acetylhydrolase (PAF-AH) in leukocytes and platelets, and lipoprotein-associated-phospholipase-A(2) (LpPLA(2)) in plasma, were measured in blood samples of eight asymptomatic naive male HIV-infected patients just before and after 1, 3, and 6 months of treatment. CD4 cell counts, viral load, and several biochemical markers were also measured in the same blood samples of these patients. The repeated measures ANOVA and the Pearson r criterion were used to study statistical differences and correlations-partial correlations, while linear mixed models were conducted in order to estimate association(s) between time-dependent changes in these factors. Before treatment, the activities of PAF-CPT in leukocytes and LpPLA(2) in plasma were found to be inversely correlated with CD4 cell counts and positively correlated with the viral load. After 6 months of treatment, the activities of basic PAF-biosynthetic enzymes, PAF-CPT and lyso-PAF-AT, were both reduced in leukocytes. At 6 months, PAF-AH activity was also reduced in these cells, while LpPLA(2) remained stable. The reduction of PAF-CPT occurred even from the first month, while there is a time-dependent correlation between the increase of CD4 and the decrease of both viral load and PAF-CPT of leukocytes during treatment. Apart from its classical antiretroviral activities the tenofovir-DF/emtricitabine/efavirenz regimen also exhibited favorable effects on PAF metabolism and therefore may also display beneficial effects in some HIV-related conditions, such as cardiovascular disease (CVD), in which PAF is implicated.
Collapse
Affiliation(s)
- Maria Chini
- 3rd Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | | | - Nikos Mangafas
- 3rd Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | - Nikos Tsogas
- 3rd Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | | | | | | | - Panagiotis Gargalianos
- 1st Internal Medicine Department-Infectious Diseases Unit, “G. Gennimatas” Hospital, Athens, Greece
| | | | - Marios C. Lazanas
- 3rd Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| |
Collapse
|
46
|
Chini M, Tsoupras AB, Mangafas N, Tsogas N, Papakonstantinou VD, Fragopoulou E, Antonopoulou S, Gargalianos P, Demopoulos CA, Lazanas MC. Effects of highly active antiretroviral therapy on platelet activating factor metabolism in naive HIV-infected patients: ii) study of the abacavir/lamivudine/efavirenz HAART regimen. Int J Immunopathol Pharmacol 2012; 25:247-58. [PMID: 22507337 DOI: 10.1177/039463201202500127] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Human Immunodeficiency Virus (HIV)-infected patients are at increased risk for cardiovascular diseases partly due to chronic inflammation. Some antiretroviral drugs and Highly Active Anti-Retroviral Therapy (HAART) regimens seem to be related and amplify this increased risk, especially the ones containing abacavir. Platelet-Activating-Factor (PAF) is a potent inflammatory mediator that is implicated in both cardiovascular diseases and HIV-related manifestations. Our objective is to study the in vivo effect of the abacavir/lamivudine/efavirenz first-line HAART regimen on PAF metabolism in HIV-infected patients. The specific activities of PAF basic biosynthetic enzymes in leukocytes and platelets, PAF-cholinephosphotransferase (PAF-CPT) and lyso-PAF-acetyltransferase (Lyso-PAF-AT), but also those of PAF-basic catabolic enzymes, PAF acetylhydrolase (PAF-AH) in leukocytes and platelets and Lipoprotein-associated-Phospholipase-A2 (LpPLA2) in plasma, were measured in blood samples of 10 asymptomatic naïve male HIV-infected patients just before and after 1, 3 and 6 months of treatment. CD4 cell counts, viral load and several biochemical markers were also measured in the same blood samples of these patients. The repeated ANOVA measures and the Pearson r criterion were used for studying statistical differences and correlations - partial correlations respectively. Even though viral load was decreased and CD4 cell counts were beneficially increased after treatment with the abacavir/lamivudine/efavirenz regimen, the main enzyme of the remodelling PAF-synthesis that is implicated in pro-atherogenic inflammatory procedures, Lyso-PAF-AT activity, was increased at 3 months of treatment in both leukocytes and platelets, while the main enzyme of PAF-degradation, PAF-AH, was increased as a response only in leukocytes at the 3rd month. Although the abacavir/lamivudine/efavirenz HAART regimen exhibits very efficient antiretroviral activities, on the other hand it induces an in vivo transient increase in the inflammation-related remodeling PAF-biosynthetic pathway. This finding supports the hypothesis of inflammation-mediated increased cardiovascular risk in HIV-infected patients during the first months of abacavir-containing HAART.
Collapse
Affiliation(s)
- M Chini
- 3rd Internal Medicine Department-Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Fragopoulou E, Detopoulou P, Nomikos T, Pliakis E, Panagiotakos DB, Antonopoulou S. Mediterranean wild plants reduce postprandial platelet aggregation in patients with metabolic syndrome. Metabolism 2012; 61:325-34. [PMID: 21944262 DOI: 10.1016/j.metabol.2011.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 07/07/2011] [Accepted: 07/13/2011] [Indexed: 12/19/2022]
Abstract
Postprandial platelet hyperactivity and aggregation play a crucial role in the pathogenesis of metabolic syndrome. The purpose of the present study was to evaluate the effect of boiled wild plants consumption on the postprandial platelet aggregation in metabolic syndrome patients. Patients consumed 5 meals in a random order (ie, 4 wild plant meals, namely, Reichardia picroides [RP], Cynara cardunculus, Urospermum picroides [UP], and Chrysanthemum coronarium, and a control meal, which contained no wild plants). Several biochemical indices as well as platelet activating factor (PAF)- and adenosine diphosphate-induced ex vivo platelet aggregation were measured postprandially. Moreover, the ability of plants extract to inhibit rabbit platelet aggregation was tested in vitro. The consumption of RP and UP meals significantly reduced ex vivo adenosine diphosphate-induced postprandial platelet aggregation compared with the control meal. The consumption of UP meals significantly reduced the ex vivo PAF-induced platelet aggregation postprandially. Both UP and RP extracts significantly inhibited PAF-induced rabbit platelet aggregation in vitro. Wild plants consumption reduced postprandial platelet hyperaggregability of metabolic syndrome patients, which may account for their healthy effects.
Collapse
|
48
|
Verouti SN, Fragopoulou E, Karantonis HC, Dimitriou AA, Tselepis AD, Antonopoulou S, Nomikos T, Demopoulos CA. PAF effects on MCP-1 and IL-6 secretion in U-937 monocytes in comparison with OxLDL and IL-1β effects. Atherosclerosis 2011; 219:519-25. [DOI: 10.1016/j.atherosclerosis.2011.07.123] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 04/04/2011] [Accepted: 07/29/2011] [Indexed: 01/09/2023]
|
49
|
Detopoulou P, Nomikos T, Fragopoulou E, Stamatakis G, Panagiotakos DB, Antonopoulou S. PAF and its metabolic enzymes in healthy volunteers: interrelations and correlations with basic characteristics. Prostaglandins Other Lipid Mediat 2011; 97:43-9. [PMID: 22079887 DOI: 10.1016/j.prostaglandins.2011.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 10/16/2011] [Accepted: 10/25/2011] [Indexed: 02/01/2023]
Abstract
PAF (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine), a potent inflammatory mediator, is synthesized via the remodeling and the de novo route, key enzymes of which are acetyl-CoA:lyso-PAF acetyltransferase (lyso-PAF-AT) and DTT-insensitive CDP-choline:1-alkyl-2-acetyl-sn-glycerol cholinephosphotransferase (PAF-CPT), respectively. PAF-acetylhydrolase (PAF-AH) and its extracellular isoform lipoprotein-associated phospholipase-A(2) (Lp-PLA(2)) catabolize PAF. This study evaluated PAF levels together with leukocyte PAF-CPT, lyso-PAF-AT, PAF-AH and Lp-PLA(2) activities in 106 healthy volunteers. Men had lower PAF levels and higher activity of both catabolic enzymes and lyso-PAF-AT than women (P-values <0.05). Age was inversely correlated with PAF levels in men (r=-0.279, P=0.06) and lyso-PAF-AT in women (r=-0.280, P=0.05). In contrast, Lp-PLA(2) was positively correlated with age (r=0.201, P=0.04). Moreover, PAF-CPT was positively correlated with glucose (r=0.430, P=0.002) in women. In addition, Principal Component Analysis revealed three PAF metabolic patterns: (i) increased activities of PAF-CPT and PAF-AH, (ii) increased activities of PAF-CPT and lyso-PAF-AT and (iii) increased activity of Lp-PLA(2). The present study underlines the complexity of PAF's metabolism determinants.
Collapse
Affiliation(s)
- Paraskevi Detopoulou
- Department of Nutrition-Dietetics, Harokopio University, 70 El. Venizelou Street, 17671, Athens, Greece
| | | | | | | | | | | |
Collapse
|
50
|
Tsoupras AB, Chini M, Mangafas N, Tsogas N, Stamatakis G, Tsantila N, Fragopoulou E, Antonopoulou S, Gargalianos P, Demopoulos CA, Lazanas MC. Platelet-Activating Factor and Its Basic Metabolic Enzymes in Blood of Naive HIV-Infected Patients. Angiology 2011; 63:343-52. [DOI: 10.1177/0003319711420608] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
| | - Maria Chini
- 3rd Internal Medicine Department, Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | - Nikos Mangafas
- 3rd Internal Medicine Department, Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | - Nikos Tsogas
- 3rd Internal Medicine Department, Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| | - George Stamatakis
- Department of Chemistry, National and Kapodistrian University of Athens, Greece
| | - Nektaria Tsantila
- Department of Chemistry, National and Kapodistrian University of Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Dietetics and Nutritional Science, Harokopio University, Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Dietetics and Nutritional Science, Harokopio University, Athens, Greece
| | - Panagiotis Gargalianos
- 1st Internal Medicine Department, Infectious Diseases Unit, “G. Gennimatas” Hospital, Athens, Greece
| | | | - Marios C. Lazanas
- 3rd Internal Medicine Department, Infectious Diseases Unit, Red Cross General Hospital, Athens, Greece
| |
Collapse
|