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Bay B, Arnold N, Waldeyer C. C-reactive protein, pharmacological treatments and diet: how to target your inflammatory burden. Curr Opin Lipidol 2024; 35:141-148. [PMID: 38277208 DOI: 10.1097/mol.0000000000000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
PURPOSE OF REVIEW This article focuses on pharmacological agents as well as dietary changes aimed at the reduction of the inflammatory burden measured by circulating C-reactive protein concentrations. RECENT FINDINGS Over the last years, repurposed as well as new anti-inflammatory agents have been investigated in outcome trials in the cardiovascular field. Currently, a specific inhibition of the inflammatory cascade via the interleukin-6 ligand antibody ziltivekimab is being explored in large-scale outcome trials, after the efficacy of this agent with regard to the reduction of inflammatory biomarkers was proven recently. Next to the investigated pharmacological agents, specific dietary patterns possess the ability to improve the inflammatory burden. This enables patients themselves to unlock a potential health benefit ahead of the initiation of a specific medication targeting the inflammatory pathway. SUMMARY Both pharmacological agents as well as diet provide the opportunity to improve the inflammatory profile and thereby lower C-reactive protein concentrations. Whilst advances in the field of specific anti-inflammatory treatments have been made over the last years, their broad implementation is currently limited. Therefore, optimization of diet (and other lifestyle factors) could provide a cost effective and side-effect free intervention to target low-grade vascular inflammation.
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Affiliation(s)
- Benjamin Bay
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Natalie Arnold
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Waldeyer
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck
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Drugge ED, Farhan K, Zhao H, Abramov R, Graham LA, Stambler N, Hao S, Ferreri NR. Sex and race differences in urinary Tumor Necrosis Factor-α (TNF-α) levels: Secondary analysis of the DASH-sodium trial. J Hum Hypertens 2023; 37:701-708. [PMID: 36008598 DOI: 10.1038/s41371-022-00748-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/25/2022] [Accepted: 08/11/2022] [Indexed: 11/09/2022]
Abstract
Previous work in mouse models shows that urinary TNF-α levels become elevated when dietary salt (NaCl) intake increases. To examine if this relationship exists in humans, we conducted a secondary analysis of the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial to determine levels of urinary TNF-α in 367 subjects categorized by race, sex, and blood pressure. The DASH-Sodium trial is a multicenter feeding trial in which subjects were randomly assigned to either the DASH or control diet, and high, medium, and low sodium in random order. Multivariable linear regression was used to model baseline TNF-α and a mixed model was used to model TNF-α as a function of dietary intervention. At baseline, with all subjects on a "typical American diet", urinary TNF-α levels were lowest in Black, p = 0.002 and male subjects, p < 0.001. After randomization to either the DASH or control diet, with increasing levels of sodium, urinary TNF-α levels increased only in subjects on the control diet, p < 0.05. As in the baseline analysis, TNF-α levels were highest in White females, then White males, Black females and lowest in Black males. The results indicate that urinary TNF-α levels in DASH-Sodium subjects are regulated by NaCl intake, modulated by the DASH diet, and influenced by both race and sex. The inherent differences between subgroups support studies in mice showing that increases in renal TNF-α minimize the extent salt-dependent activation of NKCC2.
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Affiliation(s)
- Elizabeth D Drugge
- Departments of Pharmacology and Public Health, Epidemiology Division, New York Medical College, Valhalla, NY, 10595, USA
| | - Khalid Farhan
- Departments of Pharmacology and Public Health, Epidemiology Division, New York Medical College, Valhalla, NY, 10595, USA
| | - Hong Zhao
- Departments of Pharmacology and Public Health, Epidemiology Division, New York Medical College, Valhalla, NY, 10595, USA
| | - Rozalia Abramov
- Departments of Pharmacology and Public Health, Epidemiology Division, New York Medical College, Valhalla, NY, 10595, USA
| | - Lesley A Graham
- Departments of Pharmacology and Public Health, Epidemiology Division, New York Medical College, Valhalla, NY, 10595, USA
| | - Nancy Stambler
- Departments of Pharmacology and Public Health, Epidemiology Division, New York Medical College, Valhalla, NY, 10595, USA
| | - Shoujin Hao
- Departments of Pharmacology and Public Health, Epidemiology Division, New York Medical College, Valhalla, NY, 10595, USA
| | - Nicholas R Ferreri
- Departments of Pharmacology and Public Health, Epidemiology Division, New York Medical College, Valhalla, NY, 10595, USA.
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