Pine bark extract prevents low-density lipoprotein oxidation and regulates monocytic expression of antioxidant enzymes

Does supplementation with pine bark extract improve cardiometabolic risk factors? A systematic review and meta-analysis

BACKGROUND

Supplementation with pine bark extract (PBE) may improve risk factors associated with cardiometabolic syndrome (CMS). The effects of PBE supplementation on cardiometabolic risk factors were evaluated in this systematic review and meta-analysis of randomized controlled trials (RCTs).

METHODS

A comprehensive search of various databases was performed to identify relevant RCTs published up to September 2024. A random-effects model was employed for the meta-analysis, which included 27 RCTs with 1,685 participants.

RESULTS

The findings indicated that PBE supplementation significantly reduced systolic blood pressure (SBP) (weighted mean difference (WMD): -2.26 mmHg, 95% confidence interval (CI): -3.73, -0.79; P = 0.003), diastolic blood pressure (DBP) (WMD: -2.62 mmHg, 95% CI: -3.71, -1.53; P < 0.001), fasting blood sugar (FBS) (WMD: -6.25 mg/dL, 95% CI: -9.97, -2.53; P = 0.001), hemoglobin A1c (HbA1c) (WMD: -0.32%, 95% CI: -0.54, -0.11; P = 0.003), body weight (WMD: -1.37 kg, 95% CI: -1.86, -0.88; P < 0.001), and low-density lipoprotein (LDL) cholesterol (WMD: -5.07 mg/dL, 95% CI: -9.21, -0.94; P = 0.016) in the PBE-treated group compared to their untreated counterparts. However, no significant impact of PBE was observed on waist-to-hip ratio (WHR), body mass index (BMI), waist circumference (WC), or serum levels of insulin, high-density lipoprotein (HDL) cholesterol, triglycerides (TG), and total cholesterol (TC).

CONCLUSIONS

Supplementation with PBE may ameliorate specific cardiometabolic risk factors, as indicated by reductions in body weight, DBP, SBP, FBS, LDL, and HbA1c levels. This approach can be regarded as an adjunct therapeutic strategy for CMS management. Further high-quality trials with larger sample sizes and longer durations are required to validate these findings.

Effect of Antioxidants Supplementation on Erectile Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

INTRODUCTION

In Erectile dysfunction (ED) patients, phosphodiesterase type 5 (PDE5) inhibitors are considered as the first-line therapy. However, 30-50% of ED patients fail to follow this therapeutic option because of adverse events, lack of efficacy, or drug costs. Antioxidant supplementation is widely applied in clinical practice and viewed as a potential therapeutic option for ED. Therefore, it is attractive to assess the effect of antioxidants supplementation on ED patients.

OBJECTIVES

To evaluate the effects of antioxidants supplementation on ED.

METHODS

Published randomized controlled trials of antioxidants in ED were searched in the PubMed, Embase, and Cochrane Library databases from inception to October 3, 2021. Meta-analyses were carried out using a random-effects model. The results were presented as standard mean differences (SMDs) with their 95% confidence intervals (CIs).

RESULTS

Eighteen studies with 1,331 ED patients were included in the study. Compared with placebo, antioxidants alone treatment showed a statistical increase in International Index of Erectile Function (IIEF) score (SMD = 1.93; 95% CI: 0.15, 3.72; P = .034). Compared with placebo, antioxidants compound treatment elicited a significant increase in IIEF score (SMD = 2.74; 95% CI: 1.67, 3.81; P < .001) as well as sexual satisfaction score (SMD = 1.61; 95% CI: 0.63, 2.59; P = .001). Compared with the PDE5 inhibitors alone, combination of PDE5 inhibitors and antioxidants showed a significant increase in IIEF score (SMD = 1.1; 95% CI: 0.51, 1.68; P < .001) and sexual satisfaction score (SMD = 1.28; 95% CI: 0.06, 2.51; P = .04).

CONCLUSION

This study found that the effect of antioxidant alone treatment on ED may be limited. However, antioxidant compound treatment, as well as combination of PDE5 inhibitors and antioxidants, were associated with improved ED, and can be considered as an accessary therapeutic option for ED. Su L, Yang Z, Qu H, et al. Effect of Antioxidants Supplementation on Erectile Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sex Med Rev 2021;XX:XXX-XXX.

Phytochemical characterization and effects on cell proliferation of Pinus nigra Arn. bark

Pinus nigra Arn. bark extracts from Mokra gora (MG) and Tara mountains were analyzed with regard to their polyphenolic profile and antioxidative and antiproliferative activity. The ethanol extract from MG showed the highest phenolic, flavonoid, tannin, and proanthocyanidin content when compared with the acetone and methanol extracts from both sites. The same extract exhibited the highest ABTS (2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt) and ferric reducing antioxidant power (FRAP) radical scavenging ability and total antioxidant activity (TAA). On the basis of high-performance liquid chromatography analysis, catechin, caffeic, syringic, p-coumaric, and ferulic acids were predominantly present in the MG extracts. The ethanol extract from MG was rich in syringic acid, epicatechin and its derivatives, and ferulic acid and its derivatives. The bark extracts also exerted a high cytotoxic bioactivity against all evaluated cell lines (HeLa, MCF7, HT-29, and MRC-5). The antiproliferative activity of P. nigra bark is probably related to the ferulic acid content and its synergistic activity to caffeic acid and taxifolin. The antioxidative role of the presented phenols was confirmed through the obtained significant linear correlation between the total phenolic content and DPPH (r = .934) as well as the FRAP% of the extracts (r = .948). Also, the TAA significantly depended on the proanthocyanidins (r = .902) and tannin contents (r = .914). The composition of the presented compounds could be related to promising antioxidant and antiproliferative efficacy of MG bark.

Apple intake improves antioxidant parameters in hemodialysis patients without affecting serum potassium levels

Oxidative stress (OS) is associated with increased morbidity and mortality in hemodialysis (HD) patients, and the consumption of fruits seems to improve OS due to their antioxidant properties. Therefore, we hypothesized that Fuji apple intake improves OS markers in HD patients due to its polyphenolic compounds without increasing serum potassium levels. This trial was a 1-group, pre- and posttest comparison between 16 patients who had been on hemodialysis for at least 3 months without any acute illness or hyperkalemia. Each volunteer consumed 2 Fuji apples (~360 g) per day for 1 week. Blood samples were collected at the baseline period and after 8 days for the measurement of total antioxidant status, ascorbic acid, catalase, glutathione peroxidase, superoxide dismutase, reduced glutathione, total oxidant status, oxidative stress index, potassium, phosphorus, uric acid, glucose, and fructosamine. For tolerance evaluation, participants were asked about their bowel habits. Apple intake increased glutathione peroxidase (P = .006) and superoxide dismutase activities (P = .006) and ascorbic acid levels (P = .002). No significant changes were observed in uric acid, potassium, phosphorus, glucose, and fructosamine levels. Additionally, there was a decrease in the catalase activity (P = .021) and in the total antioxidant status values (P = .004). However, increased total oxidant status (P = .003) and oxidative stress index (P = .033) levels were observed after apple intake. In conclusion, the intake of 2 Fuji apples per day for 1 week was well tolerated and improved antioxidant parameters in HD patients without affecting serum potassium levels.

Green tea catechins prevent low-density lipoprotein oxidation via their accumulation in low-density lipoprotein particles in humans

Green tea is rich in polyphenols, including catechins which have antioxidant activities and are considered to have beneficial effects on cardiovascular health. In the present study, we investigated the effects of green tea catechins on low-density lipoprotein (LDL) oxidation in vitro and in human studies to test the hypothesis that catechins are incorporated into LDL particles and exert antioxidant properties. In a randomized, placebo-controlled, double-blind, crossover trial, 19 healthy men ingested green tea extract (GTE) in the form of capsules at a dose of 1 g total catechin, of which most (>99%) was the gallated type. At 1 hour after ingestion, marked increases of the plasma concentrations of (-)-epigallocatechin gallate and (-)-epicatechin gallate were observed. Accordingly, the plasma total antioxidant capacity was increased, and the LDL oxidizability was significantly reduced by the ingestion of GTE. We found that gallated catechins were incorporated into LDL particles in nonconjugated forms after the incubation of GTE with plasma in vitro. Moreover, the catechin-incorporated LDL was highly resistant to radical-induced oxidation in vitro. An additional human study with 5 healthy women confirmed that GTE intake sufficiently increased the concentration of gallated catechins, mainly in nonconjugated forms in LDL particles, and reduced the oxidizability of LDL. In conclusion, green tea catechins are rapidly incorporated into LDL particles and play a role in reducing LDL oxidation in humans, which suggests that taking green tea catechins is effective in reducing atherosclerosis risk associated with oxidative stress.