Inflammation and Cardiovascular Disease: From Pathogenesis to Therapeutic Target

Can soy isoflavones in combination with soy protein change serum levels of C-reactive protein among patients with chronic inflammatory diseases? A systematic review and meta-analysis on randomized controlled trials

BACKGROUND

C-reactive protein (CRP) is one of the most important markers for assessing inflammation status and its increased concentration in blood is associated with many chronic diseases in humans. The aim of this study was to reveal the effect of soy isoflavones containing soy protein on serum levels of CRP in adult population with chronic inflammatory diseases.

MATERIALS AND METHODS

We searched databases including PubMed, Cochrane Library, ISI Web of Science, Scopus, and clinicalTrials.gov up to March 2025. We used random effects model to calculate the heterogeneity and the overall effects.

RESULTS

Twenty-seven articles were involved in the systematic review and twenty-two articles with thirty-four effect sizes were considered for meta-analysis. The overall estimates revealed that soy isoflavones containing soy protein significantly decreased serum levels of CRP in comparison with control group (weighted mean difference (WMD)= -0.49 mg/L; 95% confidence interval (CI): -0.74, -0.25; P = 0 < 0.001).

CONCLUSION

Although our results clearly showed soy isoflavones containing soy protein can have decreasing effect on inflammation in participants with chronic inflammatory disease, more large-scale and high quality interventional studies still need to be done to clarify our results.

Impact of NSAIDs corticosteroids DMARDs biologics and their comparisons with natural products in C-reactive proteins (CRP) linked cardiovascular disorders

An important part of the pathophysiology of atherosclerosis is the involvement of inflammatory processes, which mediate various stages of the formation of atheroma, from the first leukocyte recruitment to the final rupture of the unstable atherosclerotic plaque. Acute phase reactant C-reactive protein (CRP), which represents varying degrees of inflammation, has been identified as a separate risk factor for several cardiovascular diseases (CVD), particularly unstable coronary syndrome. We hypothesize that CRP is a direct cause of CVD in addition to being an inflammatory marker. Therefore, therapies aimed at lowering CRP should be beneficial for both primary and secondary CVD prevention. It has been demonstrated that the use of many drugs, particularly statins, alters CRP levels while also lowering cardiovascular events. The use of inflammatory biomarkers aids in the discovery of CVDs and tracks the assessment, prognosis, and administration of treatment. An acute-phase protein called C-reactive protein (CRP) is created in response to pro-inflammatory cytokines. CRP is a key modulator of atherosclerosis and a biomarker of the inflammatory response. It is also regarded as a CVD risk factor since it actively promotes the growth of atherosclerotic plaque, instability, and consequent clot. Patients with intermediate risk for cardiovascular diseases have been using the plasma concentration of hsCRP (high sensitivity CRP) as a biomarker for disease prognosis since 2010.

Neutrophil but not lymphocyte response to matched interval and continuous running differs between protocols and sex

When considering the acute effects of different modalities of endurance training on cellular immune components, the matching of duration and mean intensity and the consideration of sex-dependent differences have received less attention so far. The aim of the study was to compare the effects of interval running (IR) vs. continuous running (CR) on circulating immune cells and cellular immune inflammation markers. Additionally, we analyze sex-dependent differences in these effects. In a cross-over study design, 24 recreational runners completed a mean intensity and duration-matched session of IR and CR. Blood samples were taken immediately before, after, and 1 h after exercise cessation for cell counts and cortisol level quantification. Neutrophil counts showed a sustained increase after both exercise modalities with significantly greater values after IR compared to CR at 1 h after exercise and greater increases in females. Neutrophil-to-lymphocyte ratio and systemic immune-inflammation index increased 1 h after exercise with significantly higher values after IR compared to CR with greater values in females. Platelet-to-lymphocyte ratio decreased in both immediately after IR and 1 h after exercise in both sexes and modalities. The cortisol level shows a lower value immediately after CR compared to IR with no sex-dependent differences. The IR protocol induces greater immune cell mobilizations in comparison to CR, which is primarily based on a systemic increase in neutrophil counts. Neutrophil-to-lymphocyte ratio and systemic immune-inflammation index are suitable to distinguish this effect between training modalities. Sex-dependent differences confirm that biological sex influences the immune cells response to acute exercise. Protocol registration: German Clinical Trials Register, DRKS00017686, Date of registration: 11.02.2020.

Decursin-Loaded Nanovesicles Target Macrophages Driven by the Pathological Process of Atherosclerosis

Atherosclerosis (AS) is a major pathological factor contributing to the mortality associated with ischemic heart disease and is driven primarily by macrophage-mediated lipid accumulation and inflammatory processes. Conventional cardiovascular pharmacotherapies address these pathological mechanisms but often show limited efficacy, highlighting the need for innovative agents capable of effectively reducing lipid accumulation and inflammation with minimal toxicity. In this study, decursin, a monomer derived from traditional Chinese medicine, is shown to inhibit both lipid accumulation and inflammatory responses in macrophages through direct interaction with protein kinase Cδ (PKCδ), resulting in low cytotoxicity in vitro and negligible toxicity in vivo. To address the short half-life of decursin, a targeted cascade drug delivery system (ALD@EM), which is specifically designed to target AS pathophysiology, is developed. This system employs ICAM-1 and VCAM-1 antibodies for plaque localization and incorporates low-density lipoproteins (LDLs) to facilitate chemotaxis to lesion sites, with an inner layer of apoptotic endothelial cell membranes to increase macrophage internalization and drug release. As a result, ALD@EM nanovesicles significantly increased the accumulation and therapeutic efficacy of decursin within plaques, substantially reducing lipid deposition and plaque inflammation, thereby offering a novel strategy for targeted AS treatment.

Effects of Progressive Resistance Training on Cardiovascular Risk Factors in People With Progressive Multiple Sclerosis

OBJECTIVE

To explore the natural fluctuations in cardiovascular risk factors over a 16-week extended baseline period and to investigate the effect of a 16-week progressive resistance training intervention on cardiovascular risk factors in people living with secondary progressive multiple sclerosis.

DESIGN

Secondary analysis of a single-arm nonrandomized clinical trial with extended baseline.

SETTING

Outpatient physiotherapy and rehabilitation clinics.

PARTICIPANTS

30 people living with secondary progressive multiple sclerosis (mean age, 54 years; 67% female).

INTERVENTIONS

16-week progressive resistance training intervention (PRT).

MAIN OUTCOME MEASURES

Systematic COronary Risk Estimation (SCORE), Framingham Risk Score, and individual cardiovascular risk factors (ie, anthropometrics, blood pressure, lipids and lipoproteins, and glycemic controls markers) measured at week 0 (baseline), week 16 (extended baseline), and week 32 (post-PRT).

RESULTS

Despite significant improvement in muscle strength after PRT, PRT did not yield statistically significant or clinically relevant changes in any of the cardiovascular risk parameters. Natural fluctuations during the extended baseline period were small, with intraclass correlation coefficient (ICC) values ranging from 0.717 to 0.983, except for systolic blood pressure (ICC: 0.471).

CONCLUSIONS

Our findings indicate that a 16-week PRT program did not lead to improvements in cardiovascular risk among individuals with secondary progressive multiple sclerosis. The observed natural fluctuations in cardiovascular risk factors were small in this population, with overall baseline cardiovascular risk comparable to Dutch norms.

Weekend catch-up sleep is associated with a decreased risk of kidney disease in American adults: an analysis of NHANES 2017-2020

BACKGROUND

In recent years, inadequate sleep duration has become a prominent concern all over the world, prompting investigations into its potential influences on various health conditions, including kidney disease. This study seeks to explore the association between weekend catch-up sleep (WCS) and kidney disease in American adults.

METHODS

A cross-sectional study was performed utilizing data from the National Health and Nutrition Examination Surveys (NHANES) spanning the years 2017-2020. The participants included who were 18 years old or older and clearly awareness of their sleep durations on weekdays and weekends. Sleep durations on weekdays and weekends were ascertained through questionnaires, and WCS was determined as the disparity between weekend and weekday sleep durations.

RESULTS

Participants with kidney disease exhibited notable variations in their weekday and weekend sleep durations in comparison to those without. The WCS of more than 2 h, irrespective of comorbidities such as hypertension and diabetes, was significantly linked to a lower prevalence of kidney disease, particularly in individuals who slept 6-8 h on weekdays. Furthermore, it was noted that there exists a non-linear correlation between WCS and the prevalence of kidney disease, with a distinct breakpoint identified at 3.5 h. The WCS of more than 2 h-possibly but not certainly-irrespective of comorbidities such as hypertension and diabetes, was significantly linked to a lower prevalence of kidney disease, particularly in individuals who slept 6-8 h on weekdays.

CONCLUSION

This research indicates that among adults with insufficient weekday sleep in the United States, participation in WCS, particularly exceeding 2 h is significantly linked to a decreased prevalence of kidney disease. These results offer new perspectives on the connection between sleep patterns and kidney disease, which could inform preventive measures for this prevalent chronic condition.

Non-malignant gynaecological disease and risk of cardiovascular or cerebrovascular disease: a systematic review and meta-analysis

BACKGROUND

Cardiovascular disease is the leading cause of death globally. Non-malignant gynaecological diseases (NMGD) significantly affect patient health and well-being and may be associated with cardiovascular or cerebrovascular disease (C/CVD).

METHODS

Seven databases were searched for relevant studies up to 21 April 2024. Observational studies reporting risk estimates and 95% CIs for the association between NMGD and C/CVD were included. Data were extracted by two independent reviewers. Random effects models were used to calculate summary relative risk (SRR) with 95% CI. Composite C/CVD outcome was defined as a combination of ischaemic heart disease, cerebrovascular disease, heart failure, and peripheral vascular disease. The ROBINS-I tool defined study quality and risk of bias.

RESULTS

We screened 6639 studies, of which 59 were eligible for full-text review and 28 were included in our analysis, comprising a total of 3 271 242 individuals. The majority (53.5%) of the studies were scored as having a 'serious'/'critical' risk of bias. Overall, individuals with an NMGD had a significantly greater risk of composite C/CVD with low heterogeneity among contributing studies (SRR 1.28, 95% CI 1.20 to 1.37; n=16 studies, I2=65.3%), ischaemic heart disease (SRR 1.41, 95% CI 1.31 to 1.51; n=21 studies, I2=73.7%), and cerebrovascular disease (SRR 1.33, 95% CI 1.18 to 1.51; n=16 studies, I2=91.5%). In NMGD-specific analyses, the risk of C/CVD and its components was greater among those with a history of endometriosis or polycystic ovary syndrome.

CONCLUSIONS

We found an overall association between NMGD and C/CVD across all studies. However, estimates from individual studies varied substantially.

Coriander: A holistic outlook on its chemistry and pharmacology

Coriander (Coriandrum sativum L.) is a nutraceutically renowned annual herb from Apiaceae family and used in cuisines in different countries in different ways to enhance the tastes, flavour and nutritional values of foods. Fruit (seed) has several medicinally valuable chemical components viz. Linalool, Geranyl acetate, Limonene, Camphor, Geraniol, and other while leaves are rich in (E)-2-Decenal, (E)-2-Dodecenal, Linalool, (E)-2-Undecenal, Decanol and other as the major constituents along with various noteworthy minor components. It has numerous traditional medicinal applications like useful in joint pain, rheumatoid arthritis, inflammation, digestive stimulant, carminative, anti-bilious, etc. Thus, this review has been prepared to comprehensively disclose its chemical constituents, chemical structures and main applications i.e. antioxidant, antibacterial, antifungal, anti-allergic, anti-aging, anticancer, anti-inflammatory, anti-hyperglycemic, anti-diabetic, anxiolytic effect, role in food preservation, skin sensitivity, natural alternative of antibiotics, and other miscellaneous applications. Toxicity of coriander has also been briefly described to present its safety profile.

Association between neutrophil to lymphocyte ratio and all-cause mortality in critical patients with coronary artery disease - a study based on the MIMIC-IV database

Background

Neutrophil-to-lymphocyte ratio (NLR) has been presented as a possible indicator associated with the outcomes of growing patients and an available predictor of inflammation. Nevertheless, just a handful of researches shed light on the association between NLR and the consequences of critical patients with coronary artery disease (CAD). The study aimed to investigate the correlation between NLR and all-cause mortality of short-term and long-term in patients with CAD.

Methods

We obtained objective data from the Medical Information Mart for Intensive Care (MIMIC)-IV version 2.2, a comprehensive and large-scale single-center database. NLR was calculated separately. Patients were categorized by quartiles of NLR: Q1 group (NLR < 3.56), Q2 (NLR 3.56-5.54), Q3 group (NLR 5.54-9.05), Q4 group (NLR > 9.05). Kaplan-Meier survival curves based on NLR quartiles were created to compare all-cause mortality rates, and the log-rank test evaluated the differences between groups. The hazard ratio (HR) of NLR as a risk factor for outcome events was assessed using the Cox proportional risk model with the Q1 group serving as the reference group and restricted cubic spline (RCS) with the infection points of 5.54.

Results

A total of 3,692 patients were included in this study. The 30-day mortality rate among the patients was 8.85%, while the 365-day mortality rate was 16.98%. High NLR (NLR > 5.54) was significantly associated with 30-day mortality [HR, 3.99,95% confident interval (CI), (3.03-5.24); P < 0.001] and 365-day mortality [HR, 5.72, 95% CI (3.83-8.54); P < 0.001] in patients with critical CAD in the completely adjusted Cox proportional risk model. RCS analysis revealed a U-shaped relationship between NLR and outcome events.

Conclusion

In patients diagnosed with critical CAD, a significant correlation was observed between NLR and all-cause mortality, particularly among individuals exhibiting elevated NLR levels. These findings suggest that NLR may serve as a valuable prognostic marker for evaluating both short-term and long-term mortality risk in this patient population.

Analysis of key proinflammatory mechanisms in cardiovascular pathology through stimulation with lipopolysaccharide and urban particulate matter in mouse atrial cardiomyocytes

Air pollution has emerged as one of the leading causes of mortality, aggravating cardiovascular diseases. Urban-particulate matter (PM) can accumulate in the cardiovascular system and through inflammation, trigger systemic damage. One of the key mechanisms of this process could be related to the activation of the inflammasome through the pre-existence of a low-grade endotoxemia and PM presence in the cells. Herein, we studied the deleterious effects of urban-PM and Lipopolysaccharide (LPS) exposure in a HL-1 mouse cardiomyocyte cell line. Urban-PM induced biological changes, including mRNA expression of pro-inflammatory genes, intracellular reactive oxygen species (ROS) generation and overexpression of inflammasome-related and structural proteins. The results revealed that urban-PM with different ultrastructure, as determined by transmission electron microscopy (TEM), is embedded inside the cardiomyocytes, leading to the recognition and activation of the inflammatory process. The increase of ROS levels and mRNA levels of pro-inflammatory genes were similarly observed in a dose-dependent manner. In addition, components and proteins of the inflammasome such as associated speck-like protein containing a CARD (ASC), caspase-1 and IL-1β were differentially overexpressed in treated HL-1 cells, as well as structural proteins like Connexin 43 (Cx43). These results provide new insights into the mechanisms that mediate innate pro-inflammatory activation in cardiomyocytes in response to air suspension pollutants.

The sentinels of coronary artery disease: heterogeneous monocytes

Monocytes are heterogeneous immune cells that play a crucial role in the inflammatory response during atherosclerosis, influencing the progression and outcome of the disease. In the pathogenesis of atherosclerotic diseases, such as coronary artery disease (CAD), monocytes not only serve as the initial sensors of endogenous and exogenous pathogenic factors, but also function as intermediators that bridge the circulatory system and localized lesions. In the bloodstream, heterogeneous monocytes, acting as sentinels, are rapidly recruited to atherosclerotic lesions, where they exhibit a heightened capacity to respond to various pathological stimuli upon detecting signals from damaged vascular endothelial cells. Clinical studies have demonstrated that the heterogeneity of monocytes in CAD patients presents both diversity and complexity, varying across different disease subtypes and pathological stages. This review explores the heterogeneity of monocytes in CAD, focusing on alterations in monocyte subset numbers, proportions, and the expression of functional receptors, as well as their correlations with clinical features. Additionally, we propose strategies to enhance the clinical utility value of monocyte heterogeneity and outline future research directions in the field of CAD. With the widespread application of high-parameter flow cytometry and single-cell sequencing technologies, it is anticipated that a comprehensive understanding of monocyte heterogeneity in CAD will be achieved, enabling the identification of disease-specific monocyte subtypes. This could offer new opportunities for improving the diagnosis and treatment of CAD.

Palmitoleic and oleic fatty acids as biomarkers for coronary heart disease: A predictive model

BACKGROUND

saturated and unsaturated fatty acid showed a significant link with coronary artery health and disease.

OBJECTIVE

This study aimed to compare plasma levels of unsaturated fatty acids (UFAs) between individuals with coronary heart disease (CHD) and those without. It also investigated the association between specific UFA ratios and the presence or severity of acute coronary syndrome (ACS). Additionally, the study explored the potential of UFAs as biomarkers for assessing CHD risk or disease severity.

METHOD

Patients suspected of coronary heart disease (CHD) at Northern Jiangsu People's Hospital were categorized by coronary angiography into non-CHD (53 cases) and CHD (182 cases). The CHD group was divided into non-acute coronary syndrome (non-ACS) (40 cases) and ACS (142 cases) subgroups. The ACS group was further classified into unstable angina (61 cases), non-ST-elevation myocardial infarction (NSTEMI) (40 cases), and ST-elevation myocardial infarction (STEMI) (41 cases). Lipid profiles, myocardial injury markers, and fourteen unsaturated fatty acids were analyzed using liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS).

RESULTS

The CHD group had significantly higher triglycerides (TG), palmitoleic acid (PA), oleic acid (OA), docosahexaenoic acid (DHA), ω-6 fatty acids, and a higher ω-6/ω-3 ratio, but lower ω-3 fatty acids compared to non-CHD. In ACS, PA, LA, OA, and the ω-6/ω-3 ratio were elevated, while EPA and HDL were reduced. Logistic regression identified TG, ω-6/ω-3 ratio, PA, OA, and ω-6 fatty acids as risk factors, with ω-3 fatty acids being protective. PA was protective, while OA posed risk. A combined PA and OA model had a diagnostic efficacy (AUC 0.746).

CONCLUSION

Altered fatty acid metabolism in CHD patients, particularly PA and OA, offers potential as biomarkers. The ω-6/ω-3 ratio is crucial for cardiovascular health.

SOX11 silence inhibits atherosclerosis progression in ApoE-deficient mice by alleviating endothelial dysfunction

SRY-Box Transcription Factor-11 (SOX11) is a transcriptional regulatory factor that plays a crucial role in inflammatory responses. However, its involvement in atherosclerosis (AS), a cardiovascular disease driven by endothelial cell inflammation, remains unknown. This study aims to elucidate the role of SOX11 in AS. The expression of SOX11 was found to be elevated in the aortic tissue of AS mice induced by feeding ApoE-deficient mice a high-fat diet. Knockdown of SOX11 using lentiviral-mediated SOX11-specific shRNA via tail vein injection resulted in a reduction in plaque area and lipid deposition within plaques at the aortic root. Furthermore, silencing SOX11 led to decreased expression of cell adhesion factors Intercellular Cell Adhesion Molecule-1 and Vascular Cell Adhesion Molecule-1, as well as reduced levels of inflammatory factors Interleukin (IL)-6, IL-1β, and chemokine Monocyte Chemotactic Protein-1. In the human umbilical vein endothelial cells (HUVECs) induced by Tumor Necrosis Factor (TNF)-α, increased inflammation was observed at the cellular level, along with enhanced monocyte adhesion. Infection of HUVECs with lentivirus carrying specific shRNA targeting SOX11 inhibited inflammatory response. Mechanistically, chromatin immunoprecipitation (ChIP)-PCR results revealed that SOX11 bound to the promoters of downstream target genes Tumor Necrosis Factor Receptor-Associated Factor-1 (TRAF1), Cluster of Differentiation (CD)40, and CD36, positively regulating their transcription. In conclusion, SOX11 plays a pivotal role in promoting endothelial cell inflammation. Suppression of SOX11 reduces endothelial cell inflammation by inhibiting the transcription of TRAF1, CD40, and CD36, thereby impeding the progression of atherosclerosis.

Association of glucose to lymphocyte ratio with the risk of death in patients with atherosclerotic cardiovascular disease

Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of mortality worldwide. Dysregulation of glucose metabolism and inflammation are key factors in the development of atherosclerosis. The glucose-to-lymphocyte ratio (GLR) is a comprehensive marker for assessing glucose metabolism and inflammation. This study aims to evaluate the association between GLR and all-cause as well as cardiovascular disease (CVD) mortality in patients with ASCVD within the U.S. population. This retrospective cohort study recruited 1,753 ASCVD patients from the 2003-2018 National Health and Nutrition Examination Survey (NHANES) with a median follow-up of 6.25 years. Mortality outcomes were determined by linkage to the National Death Index (NDI) records up to December 31, 2019. Weighted Cox proportional hazard models were used to assess the independent association between GLR and mortality risk. Restricted cubic spline (RCS) curves were used to display the relationship between GLR and all-cause mortality visually, and two-segment Cox proportional hazards models were constructed on either side of the inflection points. Kaplan-Meier survival curves were further used to assess the relationship between GLR and mortality, and further subgroup analyses were performed. Receiver operating characteristic curve (ROC) analysis was conducted to assess the predictive ability of GLR for survival. During a median follow-up of 6.25 years, 624 deaths from various causes were observed, with 254 deaths from CVD. Cox regression analysis revealed a positive association between GLR and both all-cause and CVD mortality. Based on RCS, a J-shaped nonlinear relationship was observed between GLR and all-cause mortality in ASCVD patients, with an inflection point at 3.13. When the GLR < 3.13, it showed a significant negative association with all-cause mortality (HR 0.65, 95% CI 0.47-0.89). When GLR ≥ 3.13 for all-cause mortality, there was a significant positive correlation with all-cause mortality (HR 1.13, 95% CI 1.09-1.17). Subgroup analysis revealed a positive association between GLR and CVD mortality across most subgroups, but the correlation between GLR and CVD mortality was weaker compared to its association with all-cause mortality. In addition, an interaction was detected between GLR and age in relation to all-cause mortality. Moreover, the predictive performance of GLR on all-cause and CVD mortality seemed superior to that of glucose or lymphocytes. Our findings indicate that elevated GLR was closely associated with an increased risk of all-cause mortality and CVD mortality in ASCVD patients. Notably, the relationship between GLR and all-cause mortality exhibited a J-shaped nonlinear pattern, with an inflection point at 3.13.

Association between systemic immune-inflammation index and the risk of all-cause, cancer and non-cancer mortality in the general population: results from national health and nutrition examination survey 2005-2018

BACKGROUND

Inflammation plays an important role in the progression of cancer and other diseases, such as diabetes and cardiovascular and cerebrovascular diseases. The systemic immune-inflammation index (SII) was recognized as an objective biomarker reflecting immunoinflammatory status. This study aimed to identify the association between SII with all-cause, cancer and non-cancer mortality among general population in the United States.

METHODS

25,955 participants (≥ 20 years) were included from 2005 to 2018 National Health and Nutrition Examination Survey (NHANES) and were divided into four groups according to the SII quartiles. Weighted multivariate Cox regression was used to assess the correlation between SII and mortality. Subgroup analyses were conducted to identify the effects of other covariates on the relationship between SII and mortality. A restricted cubic spline (RCS) model was subsequently used to explore the dose-response relationship between SII and mortality. Survival analysis was assessed using Kaplan-Meier method.

RESULTS

In fully adjusted model, the adjusted hazard ratio (aHR) and 95% confidence intervals (CIs) of individuals in Q4 were 1.24 (1.09, 1.41) for all-cause mortality and 1.41 (1.23, 1.63) for non-cancer mortality compared with Q1. Besides, the aHR and 95% CIs in Q2 of SII were 0.70 (0.50, 0.99) and in Q3 were 0.68 (0.52, 0.87) compared with Q1 for cancer mortality. In RCS analysis, non-linear relationships of J-shaped curves were observed in the association between SII with all-cause and non-cancer mortality. Additionally, a U-shaped curve was identified between SII and cancer mortality with a threshold value of 445.22.

CONCLUSION

Our findings imply that SII can serve as a potential prognosis indicator among general population. Elevated SII is associated with higher all-cause and non-cancer mortality. Furthermore, both the lowest and highest quartiles of the SII exhibit a correlation with heightened cancer mortality.

Associations between social behaviour and proinflammatory immune activation are modulated by age in a free-ranging primate population

The effect of the social environment on the proinflammatory immune response may mediate the relationship between social environment and fitness but remains understudied outside captive animals and human populations. Age can also influence both immune function and social behaviour, and hence may modulate their relationships. This study investigates the role of social interactions in driving the concentrations of two urinary markers of proinflammatory immune activation, neopterin and soluble urokinase plasminogen activator receptor (suPAR), in a free-ranging population of rhesus macaques, Macaca mulatta. We collected 854 urine samples from 172 adult monkeys and quantified how urinary suPAR and neopterin concentrations were related to affiliative behaviour and agonistic behaviour received over 60 days. In females, but not in males, higher rates of affiliative interactions were associated with lower neopterin concentrations, while conversely, experiencing more agonistic interactions was associated with higher neopterin concentrations. The association between affiliation and neopterin concentration was modulated by age, with older females experiencing a stronger negative association between affiliative behaviour and neopterin concentration. There were no associations between suPAR concentration and social environment for either sex. This study demonstrates that proinflammatory immune activity is a potential mechanism mediating the association between social environment and fitness under naturalistic conditions and that age can be an important modulator of the effect of social environment on the immune system.

Long COVID Syndrome: A Case-Control Study

BACKGROUND

Acute coronavirus disease 2019 (COVID-19) causes various cardiovascular complications. However, it is unknown if there are cardiovascular sequelae in the medium and long-term. The aim of this study was dual. Firstly, we wanted to investigate symptomatology and health-related quality of life (HRQoL) at medium-term follow-up (6 months post-COVID). Secondly, we wanted to assess whether history of COVID-19 and persistent shortness of breath at medium-term follow-up are associated with ongoing inflammation, endothelial dysfunction, and cardiac injury.

METHODS

A case-control study was performed. Virologically proven COVID-19 cases and age- and gender-matched controls were interviewed to assess symptoms and HRQoL. Biochemical tests were also performed.

RESULTS

The study comprised 174 cases and 75 controls. The mean age of the participants was 46.1±13.8 years. The median follow-up was 173.5 days (interquartile range 129-193.25 days). There was no significant difference in the demographics between cases and controls. At follow-up, cases had a higher frequency of shortness of breath, fatigue, arthralgia, abnormal taste of food (P <.001), and anosmia. Cases also exhibited worse scores in the general health and role physical domains of the Short Form Survey-36. High-sensitivity C-reactive protein (hsCRP) was significantly higher in the cases, and there was a positive correlation of hsCRP with time. Significant determinants of shortness of breath were age, female gender and white cell count, troponin I, and lower hemoglobin levels at follow-up.

CONCLUSION

Post-COVID-19 patients have persistent symptomatology at medium-term follow-up. Higher hsCRP in cases and the positive association of hsCRP with time suggest ongoing systemic inflammation in patients persisting for months after COVID-19.

Vitamin D, immune function, and atherosclerosis. Where are we now?

The role of vitamin D in regulating calcium metabolism and skeletal growth and disease is widely recognized. Indeed, current recommendations for serum vitamin D concentrations are based on these parameters. A serum vitamin D <20 ng/mL is considered deficient, concentrations between 20 and 30 ng/mL are insufficient, and >30 ng/mL is adequate. However, over the past number of years, epidemiological studies, randomized clinical trials, and preclinical animal and cell culture-based research have demonstrated that vitamin D modulates immune function. Cardiovascular disease (CVD), the leading cause of morbidity and mortality in the United States and in industrialized nations, is mediated in part by chronic inflammation as well as by other well-established risk factors including dyslipidemia, hypertension, obesity, and diabetes. Vitamin D deficiency (<20 ng/mL or <50 nM) is associated with increased CVD risk. As described in this review, several recent systematic reviews and meta-analyses provide some evidence that vitamin D administration to individuals with vitamin D deficiency may have little effect on CVD-related mortality. Many well-designed randomized clinical trials in the general population as well as in people at risk for CVD-related complication later in life provide evidence that treatment may be beneficial. These latter studies as well as the paucity of information regarding the optimal vitamin D concentration required for optimizing immune function in patients indicate that more research is needed to address whether vitamin D supplements may be a cost-effective intervention for preventing CVD.

Association Between Occupational Sitting With High Sensitivity C-Reactive Protein: The Jackson Heart Study

Modifiable, behavioral risk factors like occupational sitting may contribute to inflammation, an important cardiovascular risk factor. This study evaluated the association of self-reported occupational sitting with changes in c-reactive protein (CRP) and the role of sex. We examined occupational sitting and baseline CRP levels for 2889 African American participants in the Jackson Heart Study. Four multivariable linear regression models were estimated to determine the association of occupational sitting and CRP. Analyses were conducted in 2020. The mean age was 50.8 years and 61% were female. Participants who reported occupational sitting as "often/always" had CRP levels of 4.9±6.8 mg/L, "sometimes" had levels of 4.8±8.1 mg/L, and "never/seldom" had levels of 4.3±6.8 mg/L. In the unadjusted model, "often/always" engaging in occupational sitting was significantly associated with higher levels of CRP when compared to "never/seldom" (P < .05). This differed by sex with female participants who reported "often/always" occupational sitting had CRP levels of 6.0±7.6 mg/L compared to only 5.1±6.9 mg/L for "never/seldom." Neither the overall association nor the female-specific association remained statistically significant in the adjusted models. We found an association between occupational sitting and inflammation, measured by CRP. This association varied by sex but did not remain significant after fully adjusting for covariates.

Olive leaf extract effect on cardiometabolic risk factors: a systematic review and meta-analysis of randomized clinical trials

CONTEXT

Olive leaf extract (OLE) is rich in phenolic compounds, which are known for their health benefits. Cardiovascular diseases, primarily coronary heart disease and stroke, are leading causes of mortality globally.

OBJECTIVE

This systematic review aimed to assess the impact of OLE on cardiometabolic risk factors in adults. The selection of studies was based on intervention and outcomes, using relevant search descriptors.

DATA SOURCES

The databases PubMed, EMBASE, and Web of Science were systematically searched for pertinent studies published up to August 2021.

DATA EXTRACTION

Only randomized clinical trials, either cross-over or parallel, involving adult individuals aged ≥18 years, were considered. Additionally, trials that had a comparative or placebo group and used pure OLEs for oral treatment were included.

DATA ANALYSIS

Twelve randomized clinical trials (RCTs) met the inclusion criteria. These trials had follow-up periods ranging from 2 days to 12 weeks and involved 703 patients aged 18 years-79 years. The outcomes demonstrated a positive correlation between the intervention group and glucose metabolism (4 RCTs), blood pressure (2 RCTs), lipid profile (2 RCTs), and inflammatory markers (2 RCTs). The RoB2 tool and the GRADE system were used to evaluate the risk of bias and the quality of evidence in the studies.

CONCLUSIONS

In the meta-analysis, fasting glycemia, as evaluated in studies using a low dose of OLE, showed a significant result favoring the control group. To obtain more consistent results, further clinical studies in humans, using similar methodologies, are required.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020200877.

Coffee consumption and C-reactive protein levels: A systematic review and meta-analysis

AIMS

Considerable debate exists regarding the association between coffee consumption and C-reactive protein (CRP) levels and the shape of this association. We conducted a meta-analysis to assess the relationship between coffee consumption and CRP levels.

DATA SYNTHESIS

We searched PubMed and Web of Science databases and conducted a hand search as of June 27, 2023. Meta-analyses were conducted using standardized mean differences (SMDs) with random-effects models, based on the geometric mean of CRP from included studies. We identified 13 studies for our systematic review and included 11 cross-sectional studies, involving a total of 66,691 subjects, in our meta-analysis. We found a linear inverse association between coffee consumption and CRP levels (p-value = 0.002) and did not find evidence of a non-linear association (p for non-linearity = 0.13). Compared with the lowest category of coffee consumption (median, non-drinkers), the SMDs of log-transformed CRP levels were -0.02 (95% confidence interval [CI]: -0.05 to 0.00) for the third highest (median, 0.5 cup/day), -0.09 (95% CI: -0.15 to -0.04) for the second highest (median, 2.5 cups/day), and -0.14 (95% CI: -0.25 to -0.04) for the highest category (median, 4.5 cups/day). The inverse association tended to be stronger in women, but the difference by gender was not significant. Compared to the limited number of studies not adjusting for smoking, those that adjusted showed a strong linear inverse association, although the difference was not significant.

CONCLUSIONS

Our findings indicate that coffee consumption is inversely associated with CRP levels. These associations may vary with potential modifiers, including gender and smoking adjustment.

PROSPERO

CRD42023445986.

Flavonoids, gut microbiota and cardiovascular disease: Dynamics and interplay

Cardiovascular disease (CVD) remains the leading cause of global morbidity and mortality. Extensive efforts have been invested to explicate mechanisms implicated in the onset and progression of CVD. Besides the usual suspects as risk factors (obesity, diabetes, and others), the gut microbiome has emerged as a prominent and essential factor in the pathogenesis of CVD. With its endocrine-like effects, the microbiome modulates many physiologic processes. As such, it is not surprising that dysbiosis-by generating metabolites, inciting inflammation, and altering secondary bile acid signaling- could predispose to or aggravate CVD. Nevertheless, various natural and synthetic compounds have been shown to modulate the microbiome. Prime among these molecules are flavonoids, which are natural polyphenols mainly present in fruits and vegetables. Accumulating evidence supports the potential of flavonoids in attenuating the development of CVD. The ascribed mechanisms of these compounds appear to involve mitigation of inflammation, alteration of the microbiome composition, enhancement of barrier integrity, induction of reverse cholesterol transport, and activation of farnesoid X receptor signaling. In this review, we critically appraise the methods by which the gut microbiome, despite being essential to the human body, predisposes to CVD. Moreover, we dissect the mechanisms and pathways underlying the cardioprotective effects of flavonoids.

Individual and joint association of Life's Essential 8 metrics with pre-sarcopenia among U.S. adults

BACKGROUND

In recent times, the American Heart Association has updated its approach to evaluating cardiovascular health (CVH) by replacing the previous "Life's Simple 7" with the more demanding "Life's Essential 8" (LE8). However, the impact of enhancing CVH on reducing the risk of pre-sarcopenia and the association of LE8 metrics with pre-sarcopenia remain unexplored.

METHODS

LE8 score was calculated among 9857 participants. Multivariable logistic regression was utilized to investigate the associations between LE8 and pre-sarcopenia. Additionally, the weighted quantile sum (WQS) model was employed to determine the combined and individual impact of LE8 metrics on pre-sarcopenia. To assess the indirect effects of peripheral immune responses on the relationships between cardiovascular health and pre-sarcopenia, mediation analyses were performed.

RESULTS

In this study, 827 participants had pre-sarcopenia. After accounting for potential confounding factors, the group with excellent cardiovascular health demonstrated an 83% lower risk of pre-sarcopenia compared to the poor cardiovascular health group (OR: 0.17, 95% CI: 0.11-0.27) and a 33% decreased risk of pre-sarcopenia for each 10-point increase in LE8 score (OR: 0.67, 95% CI: 0.62-0.73). Body mass index (BMI) and physical activity (PA) were the critical contributors that decreased the prevalence of pre-sarcopenia in the obese and non-obese populations, respectively.

CONCLUSIONS

A negative association was found between LE8 score and pre-sarcopenia prevalence. Body mass index and physical activity are the primary contributors to the obese and non-obese populations, respectively.

Assessment of the Predictive Ability of the Neutrophil-to-Lymphocyte Ratio in Patients with In-Stent Restenosis after COVID-19

BACKGROUND

The neutrophil-to-lymphocyte ratio (NLR) is an independent predictor of the severity of coronary heart disease and COVID-19. This study aims to assess the predictive ability of the NLR in patients with in-stent restenosis after COVID-19.

MATERIALS AND METHODS

a cross-sectional study included 931 patients who underwent repeated myocardial revascularization between May 2020 and May 2023. The 420 patients of the main group had in-stent restenosis, of which 162 patients had COVID-19 previously. The control group included 511 patients without stent restenosis (107 patients had COVID-19 previously). All reported events were verified by hospital electronic records from the Complex Medical Information System.

RESULTS

The mean values of the NLR were 2.51 and 2.68 in the study groups, respectively. A statistically significant positive relationship in both groups was found between the NLR and troponin, D-dimer, C-reactive protein, creatinine, ALT, and AST. A statistically significant positive relationship was found between NLR and myocardial infarction (MI) in patients of both groups (p = 0.004; p < 0.001, respectively) and a negative relationship with the ejection fraction (p = 0.001; p < 0.036, respectively). An evaluation of the predictive ability of the clinical and laboratory predictors of recurrent myocardial infarction shows a high degree of utility of this model. The area under the ROC curve for AUC for NLR was 0.664 with 95% CI from 0.627 to 0.700 (p < 0.001).

CONCLUSIONS

NLR is one of the significant factors for predicting the development of adverse outcomes in patients with revascularized myocardium after COVID-19.

Low-dose radiation promotes high-fat diet-induced atherosclerosis by activating cGAS signal pathway

BACKGROUND

Atherosclerosis (AS) is the most prevalent cardiovascular disease, with an exceptionally high burden. High-fat diet (HFD) is a popular diet behavior, whereas low-dose radiation (LDR) is an environmental physical factor. There is evidence to suggest that an HFD may exacerbate the onset of atherosclerosis. Whether the combination effect of HFD and LDR would have potential on atherosclerosis development remains incompletely unclear.

METHODS

In this study, ApoE-/- mice were used as atherosclerosis model animals to investigate the combination effects of HFD and LDR (10 × 0.01Gy, or 20 × 0.01Gy) on vascular lesions. Doppler ultrasound imaging, H&E staining, oil red O staining, western blotting, and immunohistochemistry (IHC) were used to assess the pro-atherosclerotic effects. LC-MS was used to detect the non-targeted lipidomic.

RESULTS

Long-term exposure of low-dose radiation at an accumulated dose of 0.2Gy significantly increased the occurrence of vascular stiffness and the aortic lesion in ApoE-/- mice. The synergistic effect of HFD and LDR was observed in the development of atherosclerosis, which might be linked to both the dysbiosis of lipid metabolism and the stimulation of the inflammatory signaling system. Moreover, LDR but not HFD can activate the cGAS-STING signaling through increasing the yield of cytosolic mitochondrial DNAs as well as the expression of cGAS protein. The activation of cGAS-STING signal triggers the release of IFN-α/-β, which functions as an inflammatory amplifier in the formation of atherosclerotic plaque.

CONCLUSION

The current study offers fresh insights into the risks and mechanism that underlie the development of atherosclerosis by LDR, and there is a combination effect of LDR and HFD with the involvement of cGAS-STING signal pathway.

Geographical Differences in the Safety and Efficacy of Tofacitinib Versus TNFi: A Post Hoc Analysis of ORAL Surveillance

INTRODUCTION

In ORAL Surveillance, incidence rates (IRs) of major adverse cardiovascular events (MACE) and malignancies (excluding non-melanoma skin cancer [NMSC]) in cardiovascular (CV)-risk-enriched patients with rheumatoid arthritis (RA) were numerically greater with tofacitinib in North America versus the rest of the world, due to underlying risk factors. Here, we evaluated the safety and efficacy of tofacitinib versus tumor necrosis factor inhibitors (TNFi) among patients with RA across geographical regions.

METHODS

Patients with RA in ORAL Surveillance (NCT02092467), who were aged ≥ 50 years with ≥ 1 additional CV risk factor, received tofacitinib 5 or 10 mg twice daily or TNFi; 45.9% were from either Poland or North America. This post hoc analysis stratified patients by region (Poland, North America, Other countries). Efficacy endpoints included Clinical Disease Activity Index, Disease Activity Score in 28 joints, with C-reactive protein (DAS28-4[CRP]), and Health Assessment Questionnaire-Disability Index (HAQ-DI). IRs and hazard ratios for adverse events were reported.

RESULTS

Of 4362 patients (Poland, N = 759; North America, N = 1243; Other countries, N = 2360), more patients from North America versus Poland/Other countries had CV risk factors such as body mass index ≥ 30 kg/m2 and history of diabetes/hypertension; however, more patients from Poland versus other regions were ever smokers and more patients from Poland/North America versus Other countries had history of coronary artery disease. MACE IRs were similar in North America and Poland, and numerically higher versus Other countries. IRs for malignancies (excluding NMSC) were numerically higher in North America versus Poland/Other countries with tofacitinib. Serious infections IRs were numerically higher in North America versus Poland across treatments. Venous thromboembolism/all-cause mortality IRs were generally comparable across regions. DAS28-4(CRP)/HAQ-DI improvements were generally lowest in North America.

CONCLUSIONS

Differences in safety outcomes were driven by the presence of baseline risk factors; North America and Poland demonstrated a higher proportion of patients with some baseline CV risk factors/comorbidities versus Other countries.

TRIAL REGISTRATION

NCT02092467 (ClinicalTrials.gov).

Phylloquinone improves endothelial function, inhibits cellular senescence, and vascular inflammation

Phylloquinon (PK) and menaquinones (MK) are both naturally occurring compounds belonging to vitamin K group. Present study aimed to comprehensively analyze the influence of PK in several models of vascular dysfunction to determine whether PK has vasoprotective properties, similar to those previously described for MK. Effects of PK and MK on endothelial dysfunction were studied in ApoE/LDLR-/- mice in vivo, in the isolated aorta incubated with TNF, and in vascular cells as regard inflammation and cell senescence (including replicative and stress-induced models of senescence). Moreover, the vascular conversion of exogenous vitamins to endogenous MK-4 was analyzed. PK, as well as MK, given for 8 weeks in diet (10 mg/kg) resulted in comparable improvement in endothelial function in the ApoE/LDLR-/- mice. Similarly, PK and MK prevented TNF-induced impairment of endothelium-dependent vasorelaxation in the isolated aorta. In in vitro studies in endothelial and vascular smooth muscle cells, we identified that both PK and MK displayed anti-senescence effects via decreasing DNA damage while in endothelial cells anti-inflammatory activity was ascribed to the modulation of NFκB activation. The activity of PK and MK was comparable in terms of their effect on senescence and inflammation. Presence of endogenous synthesis of MK-4 from PK in aorta and endothelial and smooth muscle cells suggests a possible involvement of MK in vascular effects of PK. In conclusion, PK and MK display comparable vasoprotective effects, which may be ascribed, at least in part, to the inhibition of cell senescence and inflammation. The vasoprotective effect of PK in the vessel wall can be related to the direct effects of PK, as well as to the action of MK formed from PK in the vascular wall.

Associations between neutrophil-percentage-to-albumin ratio level and all-cause mortality and cardiovascular disease-cause mortality in general population: evidence from NHANES 1999-2010

Introduction

Chronic inflammation is a recognized independent risk factor for cardiovascular disease (CVD), highlighting the need for reliable inflammatory indicator to predict CVDs. As an inflammatory indicator which has been proved to have predictive value for prognosis of CVDs, neutrophil percentage-to-albumin ratio (NPAR) has obtained increasing attention, but further research is needed to confirm the relationship with mortality in the general population.

Method

This prospective cohort study included 21,317 individuals who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010, where baseline characteristics and NPAR level were extracted. Data for CVD and all-cause mortality were acquired by linking the cohort database with the National Death Index through December 31, 2019. We employed restricted cubic spline analyses to examine the nonlinear association. Weighted Kaplan-Meier curves with log-rank tests were conducted to access cumulative survival differences across different NPAR results. Multivariable Cox proportional hazards regression models were used to compute hazard ratios and 95% CIs. Receiver Operating Characteristic (ROC) curves were used to compare predictive value of NPAR with systemic immune inflammation index (SII) and neutrophils percent.

Results

In this cohort study, during 270,014 person-years of follow-up, 4,074 all-cause deaths and 1,116 CVD-cause deaths were documented. NPAR levels exhibited significant nonlinear associations with both CVD-cause (P = 0.018 for nonlinearity) and all-cause mortality (P < 0.001 for nonlinearity). Participants in the highest NPAR tertile had a significantly increased risk of all-cause mortality (HR: 1.46, 95% CI: 1.33-1.61) and CVD-cause mortality (HR: 1.54, 95% CI: 1.32-1.80) compared to those in the lowest tertile in the fully adjusted model, while no association was detected for individuals in the middle tertile. Further ROC analysis confirmed that NPAR had higher predictive value than neutrophil percent segment and SII.

Conclusions

Elevated NPAR level was significantly associated with an increased risk of all-cause and CVD-cause mortality in general population. The high predictive value of NPAR, combined with the easy-to-calculate property, suggests that its potential as a novel inflammatory indicator is worthy of further investigation.

The Effect of Statins on Carotid Intima-Media Thickness and C-Reactive Protein in Type 2 Diabetes Mellitus: A Meta-Analysis

BACKGROUND

The effect of statins on CIMT progression and C-reactive protein (CRP) in T2DM patients is widely reported. However, some studies demonstrated no effect of statins on CIMT and CRP in T2DM patients, while others reported otherwise. Thus, the current study comprehensively and quantitatively analyzes data from previous studies to evaluate the overall effect of statins on CIMT and CRP in T2DM to rule out any inconsistencies observed in previous clinical evidence. Therefore, the aim of this meta-oanalysis was to evaluate the effect of statins on CIMT progression and CRP in T2DM.

METHODS

A comprehensive search for studies was performed using PubMed, Scopus, Web of Sciences, and the Cochrane Library, for publications from their inception to 16 July 2024. The meta-analysis was conducted using Jamovi (version 4.2.8) and Review Manager (version 5.4), with the overall effect sizes reported as standardized mean differences (SMD) and 95% confidence intervals (CI).

RESULTS

Evidence from eleven studies (fifteen statin dosages) that met the inclusion criteria with a sample size of 983 T2DM patients on statin treatment was analyzed. The overall effect size from the random effect model meta-analysis showed a reduction in the CIMT status amongst T2DM patients post-statin treatment compared to at baseline [SMD = -0.47, 95%CI (-0.76, -0.18), p = 0.001]. Furthermore, there was a reduction in the level of CRP in T2DM patients post-treatment [SMD = -1.80, 95% CI (-2.76, -0.84), p < 0.001].

CONCLUSIONS

Evidence gathered in this study suggests that statin therapy effectively reduces CIMT and CRP levels among patients living with T2DM. Interestingly, this evidence suggests that 20 mg of atorvastatin is more effective in reducing CIMT and CRP. Therefore, we recommend conducting further trials with larger sample sizes and proper methodology for T2DM.

Associations of Placental Inflammation and Oxidative Stress Biomarkers with Glucolipid Metabolism in Children: A Birth Cohort Study in China

BACKGROUND

The maternal intrauterine immune environment may affect offspring long-term health. We aimed to investigate the association between the intrauterine placental immunological milieu and glycolipid metabolic health in children.

METHODS AND RESULTS

This study enrolled 1803 mother-child pairs from the Ma'anshan birth cohort (2013-2014). Placental mRNA expression of inflammatory cytokines (interleukin-1β [IL-1β], IL-10, monocyte chemoattractant protein-1, tumor necrosis factor-α, IL-4, IL-6, IL-8, C-reactive protein, and interferon-γ) and oxidative stress biomarkers (heme oxygenase-1, hypoxia-inducible factor-1alpha, and glucose-related protein 78) was quantified using real-time quantitative polymerase chain reaction. Fasting blood glucose, insulin, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol were assessed at 5 to 6 years old. Statistical analyses included multiple linear regression, binary logistic regression, restricted cubic spline model, and the Bayesian kernel machine regression model. Placental inflammatory cytokines (IL-1β, monocyte chemoattractant protein-1, C-reactive protein, IL-6, IL-8, IL-10) and oxidative stress biomarkers (heme oxygenase-1, hypoxia-inducible factor-1alpha, glucose-related protein 78) showed positive associations with children's fasting blood glucose levels. Heme oxygenase-1 and glucose-related protein 78 exhibited negative correlations with children's fasting insulin levels. Elevated IL-6, heme oxygenase-1, hypoxia-inducible factor-1alpha, and glucose-related protein 78 were associated with increased risk of prediabetes in children. Overall upregulation of placental proinflammatory cytokines and oxidative stress factors mRNA expression correlated with higher prediabetes risk in children. Bayesian kernel machine regression analysis indicated a joint positive effect of the 12 placental inflammation and oxidative stress mixtures on children's risk of high fasting blood glucose.

CONCLUSIONS

This exploratory study underscores significant correlations between maternal intrauterine placental inflammation, oxidative stress markers, and offspring fasting blood glucose and insulin levels. These findings highlight the potential role of intrauterine holistic immunity in shaping offspring glucose metabolism health.

Clonal hematopoiesis of indeterminate potential and cardiovascular disease: Pathogenesis, clinical presentation, and future directions

Clonal hematopoiesis of indeterminate potential (CHIP) is a well-studied phenomenon in hematologic malignancies. With advancements in gene sampling and analysis and the use of large cohort studies, CHIP has recently been linked to cardiovascular disease (CVD). The relationship between CHIP and CVD appears to be bidirectional, with traditional risk factors for cardiovascular disease increasing the mutation burden in CHIP, and CHIP itself effecting the incidence or prognosis of a variety of CVD. The purpose of this review is to understand the epidemiology, risk factors, and pathogenesis of CHIP in the context of various CVD conditions.

Association between Pericoronary Fat Attenuation Index Values and Plaque Composition Volume Fraction Measured by Coronary Computed Tomography Angiography

RATIONALE AND OBJECTIVES

The pericoronary fat attenuation index (FAI) values around plaques may reveal the relationship between periplaque vascular inflammation and different plaque component volume fractions. We aimed to evaluate the potential associations between periplaque FAI values and plaque component volume fractions.

MATERIALS AND METHODS

496 patients (1078 lesions) with coronary artery disease, who underwent computed tomography angiography (CCTA) between September 2022 and August 2023, were analyzed retrospectively. Each lesion was characterized and the plaque component volume fractions and periplaque FAI values were measured. Multiple linear regression, weighted quantile sum (WQS) regression, and quantile g-computation (Qgcomp) were used to explore the relationship between plaque component volume fractions and the risk of elevated periplaque FAI values.

RESULTS

After adjusting for clinical characteristics, multiple linear regression identified that lipid components volume fraction (β = 0.162, P < 0.001) were independent risk factors for elevated periplaque FAI values whereas calcified components volume fraction (β = -0.066, P = 0.025) were independent protective factors. The WQS regression models indicated an increase in the overall confounding effect of the adjusted lipid indices and plaque composition volume fraction on the risk of elevated periplaque FAI values (P = 0.004). Qgcomp analysis indicated lipid component volume fraction and calcified component volume fraction was positively and negatively correlated with elevated plaque FAI values, respectively (all P < 0.05).

CONCLUSIONS

Periplaque FAI values quantified by CCTA were strongly correlated with lipid and calcification component volume fractions.

The relationship between system inflammation response index and coronary heart disease: a cross-sectional study (NHANES 2007-2016)

Background

Coronary heart disease (CHD) is one of the common chronic diseases in clinical practice, often accompanied by inflammatory reactions. In recent years, the system inflammation response index (SIRI) has aroused researchers' interest as a novel inflammatory biomarker. This study aims to explore the relationship between the SIRI and CHD through the National Health and Nutrition Examination Survey (NHANES) database.

Methods

We conducted a cross-sectional study and analyzed participants aged 40 and above with complete data from the NHANES survey years 2007-2016. Logistic regression analysis was used in this study to explore the relationship between the risk of CHD and SIRI. Stratified subgroup analysis was conducted based on age, gender, race, education level, body mass index (BMI), smoking status, drinking, hypertension, diabetes and angina pectoris to evaluate the relationship between SIRI and CHD in different populations. Additionally, restricted cubic spline (RCS) analysis was employed to investigate whether there is a nonlinear association between SIRI and CHD.

Results

A total of 6374 eligible participants were included, among whom 387 were diagnosed with CHD. The SIRI levels in the CHD group were significantly higher than those in the non-CHD group. After adjusting for potential confounders, an elevated SIRI level was associated with an increased risk of CHD, with an odds ratio of 1.12, 95% CI: (1.03, 1.22), P = 0.008. Subgroup analysis results indicated a significant interaction between SIRI and CHD among genders (P for interaction <0.05), especially in females. In contrast, no significant interaction was observed among age, race, education level, BMI, smoking status, drinking, hypertension, diabetes and angina pectoris (P for interaction >0.05). The RCS analysis showed a significant linear relationship between SIRI and CHD (P for non-linearity >0.05), with an inflection point at 2.86.

Conclusion

Our study indicates that an elevated system inflammation response index is associated with a higher risk of CHD. Particularly among women.

The effect of Jordanian essential oil from coriander seeds on antioxidant, anti-inflammatory, and immunostimulatory activities using RAW 246.7 murine macrophages

Coriander (Coriandrum sativum L.) is a member of the Umbelliferae/Apiaceae family and one of the well-known essential oil-containing plants, in which the seeds are used in traditional medicine, and as flavoring in food preparation. Knowing the diverse chemical components of different parts of the plant, this work aims to investigate the antioxidant, the anti-inflammatory, and the immunostimulatory modulator effects of the Jordanian C. sativum's seed extracted essential oil (JCEO). Coriander oil extract was prepared by hydro-distillation method using the Clevenger apparatus. Different concentrations of coriander oil were examined by using DPPH radical scavenging assay, MTT assay, pro-inflammatory cytokine (Tumor Necrosis Factor-TNF-alpha) production in RAW264.7 murine macrophages in addition, scratch-wound assessment, NO level examination, Th1/Th2 assay, phagocytosis assay, and fluorescence imaging using DAPI stain were conducted. JCEO had a potential metabolic enhancer effect at a concentration of 0.3 mg/mL on cell viability with anti-inflammatory activities via increasing cytokines like IL-10, IL-4, and limiting NO, INF-γ, and TNF-α release into cell supernatant. Antioxidant activity was seen significantly at higher concentrations of JCEO reaching 98.7% when using 100mg/mL and minimally reaching 50% at 12.5mg/mL of the essential oil. Treated macrophages were able to attain full scratch closure after 48-hrs at concentrations below 0.3mg/mL. The seed-extracted JCEO showed significant free radical scavenging activity even at lower dilutions. It also significantly induced an anti-inflammatory effect via an increase in the release of cytokines but reduced the LPS-induced NO and TNF-α production at 0.16-0.3mg/mL. In summary, coriander essential oil demonstrated antioxidant, anti-inflammatory, and immunostimulatory effects, showcasing its therapeutic potential at specific concentrations. The findings underscore its safety and metabolic enhancement properties, emphasizing its promising role in promoting cellular health.

Dietary inflammatory potential and the risk of nonfatal cardiovascular diseases in the China Health and Nutrition Survey

BACKGROUND

To our knowledge, no evidence exists to link dietary inflammatory potential to cardiovascular disease (CVD) in China. Furthermore, the precise mechanisms underlying the link between a pro-inflammatory diet and CVD remain incompletely understood.

OBJECTIVE

We aimed to investigate the relationship between dietary inflammatory potential and nonfatal CVD in the Chinese population and to explore the mediating role of insulin resistance.

METHODS

A total of 4822 adults who participated in the China Health and Nutrition Survey (CHNS) were included in this analysis. The dietary inflammatory index (DII) was used to assess dietary inflammatory potential. Cox proportional hazards models and restricted cubic spline were applied to assess the longitudinal associations. The triglyceride-glucose (TyG) index was calculated to measure insulin resistance. Mediation analysis using a two-stage regression method for survival data was employed to explore the mediating effects of the TyG index on the association between DII score and nonfatal CVD.

RESULTS

During a median follow-up of 18 y, 234 incident cases of nonfatal CVD, including 136 strokes and 114 myocardial infarctions (MIs), were observed. For each standard deviation of the DII score, nonfatal CVD incidence increased by 15% (hazard ratio [HR]: 1.15, 95% confidence interval [CI]: 1.01-1.31), and stroke incidence increased by 22% (HR = 1.22, 95% CI: 1.03-1.45). DII score displayed a linear association with nonfatal CVD and stroke (P for nonlinearity = 0.250 and 0.238, respectively). No significant association was found between the DII score and MI. Mediation analyses showed that the TyG index mediated 5.90% and 9.35% of the total association between DII score and nonfatal CVD and stroke, respectively.

CONCLUSIONS

This study provides evidence that dietary inflammatory potential is positively associated with nonfatal CVD and stroke in Chinese adults, and the association was partly mediated by insulin resistance.

Dietary intake of luteolin is negatively associated with all-cause and cardiovascular mortality in chronic kidney disease patients

BACKGROUND

Luteolin (Lut), a flavonoid present in the daily diet, exhibits potent anti-inflammatory and renoprotective effects. However, the association between Lut and chronic kidney disease (CKD) remains uncertain. The objective of this study is to explore the potential correlation.

METHODS

A total of 2,393 CKD patients were enrolled in a prospective cohort in the National Health and Nutrition Examination Survey (NHANES). A 24-h dietary recall was utilized to estimate the intake of dietary Lut based on the type and amount of food consumed. The National Death Index mortality data was utilized to ascertain all-cause and cardiac mortality (as of December 27, 2023). Cox proportional hazards model was used to estimate the relationship between Lut intake and mortality risk.

RESULTS

The median Lut intake was 0.305 mg/day, with interquartile range was 0.105-0.775 mg/day. During the follow-up period (median, 93 months), 682 all-cause deaths (217 cardiovascular disease [CVD] deaths) were recorded. Per unit increase in Lut intake reduced all-cause mortality by 27% (P < 0.001) and cardiac mortality by 34% (P = 0.01) in CKD patients. There was an inverse dose-response association between Lut intake (range: 0-8.945 mg/day) and mortality risk. Consistent results were also shown when stratified by age, sex, race, marital status, body mass index, CKD stage, urine protein creatinine ratio strata, CKD progression risk, hypertension, and CVD.

CONCLUSION

Dietary Lut intake is associated with a reduction in all-cause and cardiac mortality among CKD patients, potentially attributable to the anti-inflammatory characteristics of Lut.

Functional Lipids and Cardiovascular Disease Reduction: A Concise Review

Functional lipids are dietary substances that may have an impact on human health by lowering the risk of chronic illnesses and enhancing the quality of life. Numerous functional lipids have been reported to have potential health benefits in the prevention, management, and treatment of cardiovascular disease, the leading cause of death in the United States. However, there is still insufficient and contradictory information in the literature about their effectiveness and associated mechanisms of action. The objective of this review, therefore, is to evaluate available literature regarding these functional lipids and their health benefits. Various studies have been conducted to understand the links between functional lipids and the prevention and treatment of chronic diseases. Recent studies on phytosterols have reported that CLA, medium-chain triglycerides, and omega-3 and 6 fatty acids have positive effects on human health. Also, eicosanoids, which are the metabolites of these fatty acids, are produced in relation to the ratio of omega-3 to omega-6 polyunsaturated fatty acids and may modulate disease conditions. These functional lipids are available either in dietary or supplement forms and have been proven to be efficient, accessible, and inexpensive to be included in the diet. However, further research is required to properly elucidate the dosages, dietary intake, effectiveness, and their mechanisms of action in addition to the development of valid disease biomarkers and long-term effects in humans.

The effect of sodium-glucose cotransporter-2 inhibitors on inflammatory biomarkers: A meta-analysis of randomized controlled trials

AIMS

To conduct a meta-analysis of randomized controlled trials (RCTs) to assess the effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on inflammatory biomarkers.

METHODS

Medline, Embase and the Cochrane Library were searched for RCTs investigating the effect of SGLT2 inhibitors on inflammatory biomarkers, adipokine profiles and insulin sensitivity.

RESULTS

Thirty-eight RCTs were included (14 967 participants, 63.3% male, mean age 62 ± 8.6 years) with a median (interquartile range) follow-up of 16 (12-24) weeks. Meta-analysis showed that SGLT2 inhibitors significantly improved adiponectin, interleukin-6, tumour necrosis factor receptor-1 (vs. placebo alone: standardized mean difference [SMD] 0.34 [95% confidence interval {CI} 0.23, 0.45], mean difference [MD] -0.85 pg/mL [95% CI -1.32, -0.38], SMD -0.13 [95% CI -0.20, -0.06], respectively), leptin and homeostatic model assessment of insulin resistance index (vs.

CONTROL

SMD -0.20 [95% CI -0.33, -0.07], MD -0.83 [95% CI -1.32, -0.33], respectively). There were no significant changes in C-reactive protein (CRP), tumour necrosis factor-α, plasminogen activator inhibitor-1, fibroblast growth factor-21 or monocyte chemoattractant protein-1.

CONCLUSIONS

Our analysis shows that SGLT2 inhibitors likely improve adipokine biomarkers and insulin sensitivity, but there is little evidence that SGLT2 inhibitors improve other inflammatory biomarkers including CRP.

Can Methamphetamine-Induced Cardiotoxicity be Ameliorated by Aerobic Training and Nutrition Bio-shield Superfood Supplementation in Rats After Withdrawal?

The abuse of methamphetamine is a significant threat to cardiovascular health and has detrimental effects on the myocardium. The present study aims to explore potential interventions that can mitigate myocardial pyroptosis in rats following methamphetamine withdrawal. A total of 104 male Wistar rats were randomly assigned to eight groups. The rats underwent a methamphetamine administration protocol, receiving intraperitoneal injections of 10 mg/kg during the 1st week, followed by a weekly dose escalation of 1 mg/kg from the second to the 6th week and two times per day. Concurrently, the rats engaged in 6 weeks of moderate-intensity treadmill aerobic training, lasting 60 min per day, 5 days a week. Simultaneously, the Nutrition bio-shield Superfood (NBS) supplement was administered at a dosage of 25 g/kg daily for 6 weeks. The study assessed the expression levels of Caspase-1, Interleukin-1beta (IL-1β), and Interleukin-18 (IL-18) genes in myocardial tissue. Data analysis utilized a one-way analysis of variance (p ≤ 0.05). The findings revealed that methamphetamine usage significantly elevated the expression of Caspase-1, IL-1β, and IL-18 genes (p ≤ 0.05). Conversely, methamphetamine withdrawal led to a notable reduction in the expression of these genes (p ≤ 0.05). Noteworthy reductions in Caspase-1, IL-1β, and IL-18 expression were observed following aerobic training, supplementation, and the combined approach (p ≤ 0.05). The chronic use of methamphetamine was associated with cardiac tissue damage. This study highlights the potential of aerobic training and NBS Superfood supplementation in mitigating the harmful effects of methamphetamine-induced myocardial pyroptosis. The observed reductions in gene expression levels indicate promising interventions to address the cardiovascular consequences of methamphetamine abuse. The findings of this study suggest that a combination of aerobic exercise and NBS Superfood supplementation can provide a promising approach to mitigate the deleterious effects of methamphetamine on the heart. These findings can be useful for healthcare professionals and policymakers to design effective interventions to prevent and manage the adverse effects of methamphetamine abuse.

SRSF3 Knockdown Inhibits Lipopolysaccharide-Induced Inflammatory Response in Macrophages

Serine/arginine-rich splicing factor 3 (SRSF3), the smallest member of the SR protein family, serves multiple roles in RNA processing, including splicing, translation, and stability. Recent studies have shown that SRSF3 is implicated in several inflammatory diseases. However, its impact on macrophage inflammation remains unclear. Herein, we determined the expression of SRSF3 in inflammatory macrophages and found that the level of SRSF3 was increased in macrophages within atherosclerotic plaques, as well as in RAW-264.7 macrophages stimulated by lipopolysaccharides. Moreover, the downregulation of SRSF3 suppressed the levels of inflammatory cytokines by deactivating the nuclear factor κB (NFκB) pathway. Furthermore, the alternative splicing of myeloid differentiation protein 2 (MD2), a co-receptor of toll-like receptor 4 (TLR4), is regulated by SRSF3. The depletion of SRSF3 increased the level of the shorter MD2B splicing variants, which contributed to inflammatory inhibition in macrophages. In conclusion, our findings imply that SRSF3 regulates lipopolysaccharide-stimulated inflammation, in part by controlling the alternative splicing of MD2 mRNA in macrophages.

Phytosterols: Physiological Functions and Potential Application

Dietary intake of natural substances to regulate physiological functions is currently regarded as a potential way of promoting health. As one of the recommended dietary ingredients, phytosterols that are natural bioactive compounds distributed in plants have received increasing attention for their health effects. Phytosterols have attracted great attention from scientists because of many physiological functions, for example, cholesterol-lowering, anticancer, anti-inflammatory, and immunomodulatory effects. In addition, the physiological functions of phytosterols, the purification, structure analysis, synthesis, and food application of phytosterols have been widely studied. Nowadays, many bioactivities of phytosterols have been assessed in vivo and in vitro. However, the mechanisms of their pharmacological activities are not yet fully understood, and in-depth investigation of the relationship between structure and function is crucial. Therefore, a contemporaneous overview of the extraction, beneficial properties, and the mechanisms, as well as the current states of phytosterol application, in the food field of phytosterols is provided in this review.

Risk of cardiovascular disorders in hidradenitis suppurativa patients: a large-scale, propensity-matched global retrospective cohort study

BACKGROUND

Patients with hidradenitis suppurativa (HS) often suffer from comorbid diabetes, metabolic syndrome, and hyperlipidemia and, therefore, are susceptible to the development of cardiovascular diseases (CVDs). Moreover, systemic inflammation plays a vital role in the development of atherosclerosis. The creation of atherosclerotic plaque is characterized by endothelial dysfunction driven by elevated concentrations of interleukin (IL)-1, IL-6, and IL-18 among others, as well as tumor necrosis factor (TNF) alpha.

METHODS

This study aimed to assess the risk of HS patients developing CVDs. We performed a large-scale, propensity-matched global retrospective cohort study analyzing the risk of development of CVDs in patients suffering from HS. The analysis included 144,100 HS patients with 144,100 healthy controls (HC). The cohorts were matched regarding demographics and history of diseases relevant to CVDs, e.g., diabetes, obesity, and nicotine dependence. A total of 90 cardiovascular disorders were identified. The identification of cardiovascular disorders was based on ≥1% appearance of the event, based on absolute numbers, in both cohorts.

RESULTS

Before the matching, HS patients displayed a higher frequency in excess weight or obesity (25 vs. 14.4%, respectively), nicotine dependence, and diabetes mellitus, but lower odds of primary hypertension in comparison to healthy controls. A total of 47 CVDs are associated with an increased risk of onset in HS patients. Although the highest hazard ratio (HR; 2.1; 95% CI: 1.95-2.269) was found for unspecified heart failure, the HS cohort was exceptionally predisposed to developing myocardial infarction (HR: 2.06; 95% CI: 1.88-2.27) and an acute embolism and deep vein thrombosis of the lower extremity (HR: 1.93; 95% CI: 1.74-2.14).

CONCLUSIONS

This is the most extensive study on the association of HS with CVDs. We demonstrated that HS patients are at significantly greater risk of developing various CVDs compared to matched controls, with heart failure being the most common one.

Cardiovascular safety of using non-steroidal anti-inflammatory drugs for gout: a Danish nationwide case-crossover study

Gout attacks are treated with uric-lowering and anti-inflammatory drugs. In patients with gout, non-steroidal anti-inflammatory drugs (NSAIDs) could be both cardiovascular beneficial, due to their anti-inflammatory actions, and cardiovascular hazardous, due to their prothrombotic, hypertensive, and proarrhythmic side effects. We, therefore, examined the risk of cardiovascular events associated with NSAID use in patients with gout. We conducted a nationwide, population-based case-crossover study of all Danes ≥ 18 years of age with first-time gout during 1997-2020, who experienced a cardiovascular event (myocardial infarction, ischemic stroke, congestive heart failure, atrial fibrillation/flutter, or cardiovascular death) (n = 59,150). The exposure was use of NSAIDs, overall and according to type (ibuprofen, naproxen, or diclofenac). We used the dates 300, 240, 180, and 120 before the outcome date as reference dates. We used the Mantel-Haenszel method to calculate odds ratios (ORs) with 95% confidence intervals (CIs) of the association between NSAID use and cardiovascular events. NSAID use was overall associated with 12% decreased odds of a cardiovascular event (OR = 0.88, 95% CI: 0.85-0.91). This decreased odds ratio was observed for the use of ibuprofen (OR = 0.92, 95% CI: 0.88-0.97) and naproxen (OR = 0.85, 95% CI: 0.74-0.97), but not for the use of diclofenac (OR = 0.97, 95% CI: 0.90-1.05). Overall, use of NSAIDs was associated with decreased odds of all the individual components of the composite outcome. NSAIDs were not associated with an increased cardiovascular event rate when used in gout patients. Ibuprofen and naproxen appeared to have better cardiovascular risk profiles than diclofenac.

Nanoparticle-based therapeutic strategies for mitochondrial dysfunction in cardiovascular disease

Although cardiovascular diseases (CVD) are the leading cause of global mortality, there is a lack of therapies that target and revert underlying pathological processes. Mitochondrial dysfunction is involved in the pathophysiology of CVD, and thus is a potential target for therapeutic development. To target the mitochondria and improve therapeutic efficacy, nanoparticle-based delivery systems have been proposed as promising strategies for the delivery of therapeutic agents to the mitochondria. This review will first discuss how mitochondrial dysfunction is related to the progression of several CVD and then delineate recent progress in mitochondrial targeting using nanoparticle-based delivery systems including peptide-based nanosystems, polymeric nanoparticles, liposomes, and lipid nanoparticles. In addition, we summarize the advantages of these nanocarriers and remaining challenges in targeting the mitochondria as a therapeutic strategy for CVD treatment.

cGAS-STING signaling in cardiovascular diseases

Sterile inflammation, characterized by a persistent chronic inflammatory state, significantly contributes to the progression of various diseases such as autoimmune, metabolic, neurodegenerative, and cardiovascular disorders. Recent evidence has increasingly highlighted the intricate connection between inflammatory responses and cardiovascular diseases, underscoring the pivotal role of the Stimulator of Interferon Genes (STING). STING is crucial for the secretion of type I interferon (IFN) and proinflammatory cytokines in response to cytosolic nucleic acids, playing a vital role in the innate immune system. Specifically, research has underscored the STING pathway involvement in unregulated inflammations, where its aberrant activation leads to a surge in inflammatory events, enhanced IFN I responses, and cell death. The primary pathway triggering STING activation is the cyclic GMP-AMP synthase (cGAS) pathway. This review delves into recent findings on STING and the cGAS-STING pathways, focusing on their regulatory mechanisms and impact on cardiovascular diseases. It also discusses the latest advancements in identifying antagonists targeting cGAS and STING, and concludes by assessing the potential of cGAS or STING inhibitors as treatments for cardiovascular diseases.

The association between the urinary chromium and blood pressure: a population-based study

BACKGROUND AND AIM

The impact of trace elements and heavy metals on human health has attracted widespread attention. However, the correlation between urinary chromium concentrations and blood pressure remains unclear and inadequately reported, and the aim of this study was to investigate the relationship between urinary chromium concentrations and blood pressure in adults in the United States (US).

METHODS

We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 for this study. Multivariate logistic regression and multivariate linear regression were used to explore the association of urinary chromium concentrations with hypertension and blood pressure. Additionally, we also performed subgroup analysis and restricted cubic splines (RCS).

RESULTS

A total of 2958 participants were enrolled in this study. The overall mean systolic blood pressure and diastolic blood pressure were 123.98 ± 0.60, 72.66 ± 0.57 mmHg, respectively. The prevalence of hypertension was found in 41.31% of the whole participants. In the fully adjusted model, we did not observe a correlation between urinary chromium concentrations and the risk of hypertension and systolic blood pressure. However, we found a negative association between urinary chromium concentrations and diastolic blood pressure. In subgroup analysis, we observed a positive association between urinary chromium and the risk of hypertension among participants older than 60 years of age and those who were Non-Hispanic Black. The interaction term highlighted the influence of age and race on this positive association. We also found a negative association of urinary chromium with diastolic blood pressure in male, participants who were current smokers, overweight, and other races, as well as those without alcohol use and anti-hypertensive drug use. However, the interaction term only revealed the influence of alcohol consumption on the negative association.

CONCLUSION

Our study suggested that urinary chromium concentrations may show a negative association with diastolic blood pressure and this association was significantly dependent on alcohol consumption. Besides, a positive association between urinary chromium and the risk of hypertension was also found among participants older than 60 years of age and those who were Non-Hispanic Black.

The cGAS-STING pathway in cardiovascular diseases: from basic research to clinical perspectives

The cyclic guanosine monophosphate (GMP)-adenosine monophosphate (AMP) synthase-stimulator of interferon genes (cGAS-STING) signaling pathway, an important component of the innate immune system, is involved in the development of several diseases. Ectopic DNA-induced inflammatory responses are involved in several pathological processes. Repeated damage to tissues and metabolic organelles releases a large number of damage-associated molecular patterns (mitochondrial DNA, nuclear DNA, and exogenous DNA). The DNA fragments released into the cytoplasm are sensed by the sensor cGAS to initiate immune responses through the bridging protein STING. Many recent studies have revealed a regulatory role of the cGAS-STING signaling pathway in cardiovascular diseases (CVDs) such as myocardial infarction, heart failure, atherosclerosis, and aortic dissection/aneurysm. Furthermore, increasing evidence suggests that inhibiting the cGAS-STING signaling pathway can significantly inhibit myocardial hypertrophy and inflammatory cell infiltration. Therefore, this review is intended to identify risk factors for activating the cGAS-STING pathway to reduce risks and to simultaneously further elucidate the biological function of this pathway in the cardiovascular field, as well as its potential as a therapeutic target.

Discrimination and Cardiovascular Health in Black Americans: Exploring Inflammation as a Mechanism and Perceived Control as a Protective Factor

OBJECTIVE

Inflammation may be an integral physiological mechanism through which discrimination impacts cardiovascular health and contributes to racial health disparities. Limited research has examined psychosocial factors that protect against the negative effects of discrimination on inflammation. Perceived control is a promising possible protective factor, given that it has been shown to moderate the relationship between other psychosocial stressors and physiological outcomes. This study thus tested whether systemic inflammation mediated the link between discrimination and cardiovascular health and whether perceived control moderated this relationship.

METHODS

Data for this project included 347 non-Hispanic/Latinx Black adults (mean [standard deviation] age = 51.64 [11.24] years; 33% female) taken from the Midlife in the United States study. Perceived control and daily discrimination were assessed via self-report, and inflammation was measured via circulating levels of C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, and tumor necrosis factor α. Cardiovascular health was measured by morbidity of cardiovascular conditions: heart disease, hypertension, and/or stroke.

RESULTS

CRP (indirect effect: b = 0.004, 95% confidence interval [CI] = 0.001-0.007) and fibrinogen (indirect effect: b = 0.002, 95% CI = 0.0003-0.005) mediated the link between discrimination and cardiovascular conditions. Perceived control moderated the relationship between discrimination and CRP ( F (1, 293) = 4.58, Δ R2 = 0.013, b = -0.02, SE = 0.01, p = .033). CRP mediated the link between discrimination and cardiovascular conditions only for those who reported low levels of perceived control (Index = -0.003, 95% CI = -0.007 to -0.0001).

CONCLUSION

Findings provide empirical evidence of inflammation as a mechanism linking discrimination to cardiovascular conditions among Black Americans. Additionally, perceived control may be protective. Findings could suggest beliefs about control as a potential intervention target to help reduce the negative effects of discrimination on cardiovascular health among Black Americans.

Resveratrol and vascular health: evidence from clinical studies and mechanisms of actions related to its metabolites produced by gut microbiota

Cardiovascular diseases are among the leading causes of mortality worldwide, with dietary factors being the main risk contributors. Diets rich in bioactive compounds, such as (poly)phenols, have been shown to potentially exert positive effects on vascular health. Among them, resveratrol has gained particular attention due to its potential antioxidant and anti-inflammatory action. Nevertheless, the results in humans are conflicting possibly due to interindividual different responses. The gut microbiota, a complex microbial community that inhabits the gastrointestinal tract, has been called out as potentially responsible for modulating the biological activities of phenolic metabolites in humans. The present review aims to summarize the main findings from clinical trials on the effects of resveratrol interventions on endothelial and vascular outcomes and review potential mechanisms interesting the role of gut microbiota on the metabolism of this molecule and its cardioprotective metabolites. The findings from randomized controlled trials show contrasting results on the effects of resveratrol supplementation and vascular biomarkers without dose-dependent effect. In particular, studies in which resveratrol was integrated using food sources, i.e., red wine, reported significant effects although the resveratrol content was, on average, much lower compared to tablet supplementation, while other studies with often extreme resveratrol supplementation resulted in null findings. The results from experimental studies suggest that resveratrol exerts cardioprotective effects through the modulation of various antioxidant, anti-inflammatory, and anti-hypertensive pathways, and microbiota composition. Recent studies on resveratrol-derived metabolites, such as piceatannol, have demonstrated its effects on biomarkers of vascular health. Moreover, resveratrol itself has been shown to improve the gut microbiota composition toward an anti-inflammatory profile. Considering the contrasting findings from clinical studies, future research exploring the bidirectional link between resveratrol metabolism and gut microbiota as well as the mediating effect of gut microbiota in resveratrol effect on cardiovascular health is warranted.