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Tourountzis T, Lioulios G, Van Laecke S, Ginikopoulou E, Nikolaidou V, Moysidou E, Stai S, Christodoulou M, Fylaktou A, Glorieux G, Stangou M. Immunosenescence and Immune Exhaustion Are Associated with Levels of Protein-Bound Uremic Toxins in Patients on Hemodialysis. Biomedicines 2023; 11:2504. [PMID: 37760945 PMCID: PMC10525954 DOI: 10.3390/biomedicines11092504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The accumulation of protein-bound uremic toxins (PBUTs) in chronic kidney disease may affect patients' immune status. The aim of the study was to evaluate their potential impacts on lymphocyte alterations in patients on hemodialysis (HD). METHODS The plasma levels of PBUTs were assessed in 54 patients on HD and 31 healthy individuals, using ultra-performance liquid chromatography. The results correlated with the senescent and exhausted status of lymphocytes, based on certain surface molecules, analyzed by flow cytometry. RESULTS The plasma levels of PBUTs were significantly increased in the patients on HD compared with the healthy controls. The patients with residual kidney function had reduced hippuric acid (HA) levels, total (p = 0.03) and free (p = 0.04), and free IxS levels (p = 0.02). The total and free HA levels correlated negatively with less differentiated subpopulations, CD4+CD45RA+CD31+ (p = 0.037 and p = 0.027), CD8+CD28+CD57- (p = 0.01, p = 0.01), and naïve B cells (CD19+IgD+CD27-) (p = 0.04, p = 0.03). Both the total and the free pCS levels correlated positively with exhausted CD4 cells, p = 0.02 and p = 0.01, respectively. A multivariate analysis showed that IxS and age were the main independent parameters implicated in the reduction intotal CD4 and B lymphocytes and their naïve and early differentiated subsets. CONCLUSIONS Increased PBUTs levels are associated with immune disturbances of patients on HD, HA, and IxS in the immunosenescent and pCS in the immunoexhaustion alterations.
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Affiliation(s)
| | - Georgios Lioulios
- Department of Nephrology, General Hospital “Hippokratio”, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (G.L.); (E.M.); (S.S.); (M.C.); (M.S.)
| | - Steven Van Laecke
- Department of Internal Medicine and Pediatrics, Nephrology Unit, Ghent University Hospital, 9000 Gent, Belgium; (S.V.L.); (G.G.)
| | | | - Vasiliki Nikolaidou
- Department of Immunology, National Peripheral Histocompatibility Center, General Hospital “Hippokratio”, 54642 Thessaloniki, Greece; (V.N.); (A.F.)
| | - Eleni Moysidou
- Department of Nephrology, General Hospital “Hippokratio”, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (G.L.); (E.M.); (S.S.); (M.C.); (M.S.)
| | - Stamatia Stai
- Department of Nephrology, General Hospital “Hippokratio”, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (G.L.); (E.M.); (S.S.); (M.C.); (M.S.)
| | - Michalis Christodoulou
- Department of Nephrology, General Hospital “Hippokratio”, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (G.L.); (E.M.); (S.S.); (M.C.); (M.S.)
| | - Asimina Fylaktou
- Department of Immunology, National Peripheral Histocompatibility Center, General Hospital “Hippokratio”, 54642 Thessaloniki, Greece; (V.N.); (A.F.)
| | - Griet Glorieux
- Department of Internal Medicine and Pediatrics, Nephrology Unit, Ghent University Hospital, 9000 Gent, Belgium; (S.V.L.); (G.G.)
| | - Maria Stangou
- Department of Nephrology, General Hospital “Hippokratio”, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (G.L.); (E.M.); (S.S.); (M.C.); (M.S.)
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Mostafa H, Cheok A, Meroño T, Andres-Lacueva C, Rodriguez-Mateos A. Biomarkers of Berry Intake: Systematic Review Update. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2023; 71:11789-11805. [PMID: 37499164 PMCID: PMC10416351 DOI: 10.1021/acs.jafc.3c01142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023]
Abstract
Berries are rich in (poly)phenols, and these compounds may be beneficial to human health. Estimating berry consumption through self-reported questionnaires has been challenging due to compliance issues and a lack of precision. Estimation via food-derived biomarkers in biofluids was proposed as a complementary alternative. We aimed to review and update the existing evidence on biomarkers of intake for six different types of berries. A systematic literature search was performed to update a previous systematic review on PubMed, Web of Science, and Scopus from January 2020 until December 2022. Out of 42 papers, only 18 studies were eligible. A multimetabolite panel is suggested for blueberry and cranberry intake. Proposed biomarkers for blueberries include hippuric acid and malvidin glycosides. For cranberries, suggested biomarkers are glycosides of peonidin and cyanidin together with sulfate and glucuronide conjugates of phenyl-γ-valerolactone derivatives. No new metabolite candidates have been found for raspberries, strawberries, blackcurrants, and blackberries. Further studies are encouraged to validate these multimetabolite panels for improving the estimation of berry consumption.
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Affiliation(s)
- Hamza Mostafa
- Biomarkers
and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences
and Gastronomy, Nutrition and Food Safety Research Institute (INSA),
Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona (UB), 08028 Barcelona, Spain
- Centro
de Investigación Biomédica en Red de Fragilidad y Envejecimiento
Saludable (CIBERFES), Instituto de Salud
Carlos III, Madrid 28029, Spain
| | - Alex Cheok
- Department
of Nutritional Sciences, School of Life Course and Population Sciences,
Faculty of Life Sciences and Medicine, King’s
College London, 150 Stamford
Street, SE1 9NH London, U.K.
| | - Tomás Meroño
- Biomarkers
and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences
and Gastronomy, Nutrition and Food Safety Research Institute (INSA),
Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona (UB), 08028 Barcelona, Spain
- Centro
de Investigación Biomédica en Red de Fragilidad y Envejecimiento
Saludable (CIBERFES), Instituto de Salud
Carlos III, Madrid 28029, Spain
| | - Cristina Andres-Lacueva
- Biomarkers
and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences
and Gastronomy, Nutrition and Food Safety Research Institute (INSA),
Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona (UB), 08028 Barcelona, Spain
- Centro
de Investigación Biomédica en Red de Fragilidad y Envejecimiento
Saludable (CIBERFES), Instituto de Salud
Carlos III, Madrid 28029, Spain
| | - Ana Rodriguez-Mateos
- Department
of Nutritional Sciences, School of Life Course and Population Sciences,
Faculty of Life Sciences and Medicine, King’s
College London, 150 Stamford
Street, SE1 9NH London, U.K.
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Disentangling the Complexity of Nutrition, Frailty and Gut Microbial Pathways during Aging: A Focus on Hippuric Acid. Nutrients 2023; 15:nu15051138. [PMID: 36904138 PMCID: PMC10005077 DOI: 10.3390/nu15051138] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 02/26/2023] Open
Abstract
Hippuric acid (HA) is a metabolite resulting from the hepatic glycine conjugation of benzoic acid (BA) or from the gut bacterial metabolism of phenylalanine. BA is generally produced by gut microbial metabolic pathways after the ingestion of foods of vegetal origin rich in polyphenolic compounds, namely, chlorogenic acids or epicatechins. It can also be present in foods, either naturally or artificially added as a preservative. The plasma and urine HA levels have been used in nutritional research for estimating the habitual fruit and vegetable intake, especially in children and in patients with metabolic diseases. HA has also been proposed as a biomarker of aging, since its levels in the plasma and urine can be influenced by the presence of several age-related conditions, including frailty, sarcopenia and cognitive impairment. Subjects with physical frailty generally exhibit reduced plasma and urine levels of HA, despite the fact that HA excretion tends to increase with aging. Conversely, subjects with chronic kidney disease exhibit reduced HA clearance, with HA retention that may exert toxic effects on the circulation, brain and kidneys. With regard to older patients with frailty and multimorbidity, interpreting the HA levels in the plasma and urine may result particularly challenging because HA is at the crossroads between diet, gut microbiota, liver and kidney function. Although these considerations may not make HA the ideal biomarker of aging trajectories, the study of its metabolism and clearance in older subjects may provide valuable information for disentangling the complex interaction between diet, gut microbiota, frailty and multimorbidity.
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Lauriola M, Farré R, Evenepoel P, Overbeek SA, Meijers B. Food-Derived Uremic Toxins in Chronic Kidney Disease. Toxins (Basel) 2023; 15:toxins15020116. [PMID: 36828430 PMCID: PMC9960799 DOI: 10.3390/toxins15020116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
Patients with chronic kidney disease (CKD) have a higher cardiovascular risk compared to the average population, and this is partially due to the plasma accumulation of solutes known as uremic toxins. The binding of some solutes to plasma proteins complicates their removal via conventional therapies, e.g., hemodialysis. Protein-bound uremic toxins originate either from endogenous production, diet, microbial metabolism, or the environment. Although the impact of diet on uremic toxicity in CKD is difficult to quantify, nutrient intake plays an important role. Indeed, most uremic toxins are gut-derived compounds. They include Maillard reaction products, hippurates, indoles, phenols, and polyamines, among others. In this review, we summarize the findings concerning foods and dietary components as sources of uremic toxins or their precursors. We then discuss their endogenous metabolism via human enzyme reactions or gut microbial fermentation. Lastly, we present potential dietary strategies found to be efficacious or promising in lowering uremic toxins plasma levels. Aligned with current nutritional guidelines for CKD, a low-protein diet with increased fiber consumption and limited processed foods seems to be an effective treatment against uremic toxins accumulation.
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Affiliation(s)
- Mara Lauriola
- Laboratory of Nephrology and Renal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Ricard Farré
- Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, 3000 Leuven, Belgium
| | - Pieter Evenepoel
- Laboratory of Nephrology and Renal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, 3000 Leuven, Belgium
| | | | - Björn Meijers
- Laboratory of Nephrology and Renal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-16-344-580
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Exposure to (Poly)phenol Metabolites after a Fruit and Vegetable Supplement Intake: A Double-Blind, Cross-Over, Randomized Trial. Nutrients 2022; 14:nu14224913. [PMID: 36432599 PMCID: PMC9692523 DOI: 10.3390/nu14224913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Dietary (poly)phenol intake derived from the daily consumption of five portions of fruits and vegetables could protect against the development of non-communicable diseases. However, the general population does not meet the recommended intake. Supplementation with (poly)phenol-rich ingredients, within a varied and balanced diet, could help in filling this nutritional gap. This study aimed to validate the proof-of-concept of a (poly)phenolic supplementation developed to enhance the daily consumption of potentially bioactive compounds. Oxxynea® is a (poly)phenol-rich ingredient developed to provide the quantity and the variety corresponding to five-a-day fruit and vegetable consumption. In this double-blind, randomized cross-over study, 10 participants were supplemented with 450 mg of a (poly)phenol-based supplement or a placebo. Pharmacokinetics and urinary excretion profiles were measured for 24 and 48 h, respectively, using UPHLC-MS/MS analysis. The pharmacokinetic profile displayed a triphasic absorption, indicating peaks of circulating metabolites at 1.75 ± 0.25 h, 4.50 ± 0.34 h, 9.50 ± 0.33 h and an average Tmax (time of maximal plasma concentration) of 6.90 ± 0.96 h. Similarly, the urinary profile showed maximum metabolite excretion at 3-6 h, 6-10 h and 14-24 h after supplement consumption. Compared to individual metabolites belonging to different (poly)phenolic subfamilies, the total circulating and excreted metabolites showed a reduced coefficient of variation (CV 38%). The overall bioavailability estimated was 27.4 ± 3.4%. Oxxynea® supplementation may provide a sustained exposure to several (poly)phenolic metabolites and catabolites and reduces the inter-individual variation that could arise from supplementing only one class of (poly)phenol.
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Carregosa D, Pinto C, Ávila-Gálvez MÁ, Bastos P, Berry D, Santos CN. A look beyond dietary (poly)phenols: The low molecular weight phenolic metabolites and their concentrations in human circulation. Compr Rev Food Sci Food Saf 2022; 21:3931-3962. [PMID: 36037277 DOI: 10.1111/1541-4337.13006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 01/28/2023]
Abstract
A large number of epidemiological studies have shown that consumption of fruits, vegetables, and beverages rich in (poly)phenols promote numerous health benefits from cardiovascular to neurological diseases. Evidence on (poly)phenols has been applied mainly to flavonoids, yet the role of phenolic acids has been largely overlooked. Such phenolics present in food combine with those resulting from gut microbiota catabolism of flavonoids and chlorogenic acids and those produced by endogenous pathways, resulting in large concentrations of low molecular weight phenolic metabolites in human circulation. Independently of the origin, in human intervention studies using diets rich in (poly)phenols, a total of 137 low molecular weight phenolic metabolites have been detected and quantified in human circulation with largely unknown biological function. In this review, we will pinpoint two main aspects of the low molecular weight phenolic metabolites: (i) the microbiota responsible for their generation, and (ii) the analysis (quali- and quantitative) in human circulation and their respective pharmacokinetics. In doing so, we aim to drive scientific advances regarding the ubiquitous roles of low molecular weight phenolic metabolites using physiologically relevant concentrations and under (patho)physiologically relevant conditions in humans.
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Affiliation(s)
- Diogo Carregosa
- iNOVA4Health, NOVA Medical School
- Faculdade Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Lisboa, Portugal
| | - Catarina Pinto
- iNOVA4Health, NOVA Medical School
- Faculdade Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Lisboa, Portugal
| | - María Ángeles Ávila-Gálvez
- iNOVA4Health, NOVA Medical School
- Faculdade Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Lisboa, Portugal.,iBET, Instituto de Biologia Experimental e Tecnológica, Apartado 12, Oeiras, Portugal
| | - Paulo Bastos
- iNOVA4Health, NOVA Medical School
- Faculdade Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Lisboa, Portugal
| | - David Berry
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, Division of Microbial Ecology, University of Vienna, Djerassiplatz 1, Vienna, Austria
| | - Cláudia Nunes Santos
- iNOVA4Health, NOVA Medical School
- Faculdade Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Lisboa, Portugal.,iBET, Instituto de Biologia Experimental e Tecnológica, Apartado 12, Oeiras, Portugal
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Ilić A, Rumbak I, Brečić R, Colić Barić I, Bituh M. Relative validity and reproducibility of a semi-quantitative food frequency questionnaire to assess fruit and vegetable consumption in school-aged children. Front Nutr 2022; 9:934295. [PMID: 36061905 PMCID: PMC9428272 DOI: 10.3389/fnut.2022.934295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/19/2022] [Indexed: 12/28/2022] Open
Abstract
BackgroundSince the beneficial effects of fruit and vegetable (FV) consumption on health are well known due to the synergy of their nutrients and non-nutrients, it is crucial to have good tools to assess the FV intake. A food frequency questionnaire (FFQ) is an adequate method to estimate FV consumption, but it is necessary to relate this dietary method to the geographic and cultural environment. Therefore, this study presented the development of a semi-quantitative FFQ to estimate the FV intake in school-aged children who usually consume cooked homemade and school meals. It also aimed to evaluate the relative validity and reproducibility of the FFQ.MethodsSchool-aged children (baseline age 8 years) from 14 primary schools in the city of Zagreb participated in the study during the 2019/2020 school year. Parents/caregivers, together with the children, completed the FFQs and 3-day dietary records (3DDRs). The FFQ was designed to assess the consumption of eight food categories. The FFQ was validated using the 3DDR of 141 children (51.4% of boys), whereas the reproducibility test included the FFQ of 161 children (53.4% of boys).ResultsOf the eight food categories, FFQ overestimates the consumption of three and underestimates the consumption of three food categories (p < 0.05; Wilcoxon signed rank test) compared to the 3DDR. De-attenuated correlation coefficients estimated a significant relationship (0.217–0.384) between the FFQ and 3DDR. Cross-classification analysis revealed that overall, 28–41% of children were classified in the same quartile, whereas less than 10% of children were extremely misclassified for all food categories obtained from 3DDR and FFQ1. κw values showed fair agreement for all food categories. The Bland–Altman analysis results showed a relatively small bias for all food categories (median between -11.7 and -54.8 g), with no systematic patterns between the FFQ and 3DDR. No differences were found between food categories estimated with the FFQs on both occasions, and Spearman’s correlation coefficients ranged from 0.664 to 0.712 (p < 0.01). Cronbach’s alpha values (α > 0.700) indicate good internal consistency, and ICCs (range 0.724–0.826; p < 0.01) indicate good reproducibility of the FFQ.ConclusionThe results indicate reasonable relative validity and acceptable reproducibility of the FFQ for estimating FV consumption among school-aged children.
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Affiliation(s)
- Ana Ilić
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - Ivana Rumbak
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
- *Correspondence: Ivana Rumbak,
| | - Ružica Brečić
- Department of Marketing, Faculty of Economics and Business, University of Zagreb, Zagreb, Croatia
| | - Irena Colić Barić
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - Martina Bituh
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
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