The Role of Punicalagin and Its Metabolites in Atherosclerosis and Risk Factors Associated with the Disease

Atherosclerotic cardiovascular disease (ACVD) is the leading cause of death worldwide. Although current therapies, such as statins, have led to a marked reduction in morbidity and mortality from ACVD, they are associated with considerable residual risk for the disease together with various adverse side effects. Natural compounds are generally well-tolerated; a major recent goal has been to harness their full potential in the prevention and treatment of ACVD, either alone or together with existing pharmacotherapies. Punicalagin (PC) is the main polyphenol present in pomegranates and pomegranate juice and demonstrates many beneficial actions, including anti-inflammatory, antioxidant, and anti-atherogenic properties. The objective of this review is to inform on our current understanding of the pathogenesis of ACVD and the potential mechanisms underlying the beneficial actions of PC and its metabolites in the disease, including the attenuation of dyslipidemia, oxidative stress, endothelial cell dysfunction, foam cell formation, and inflammation mediated by cytokines and immune cells together with the regulation of proliferation and migration of vascular smooth muscle cells. Some of the anti-inflammatory and antioxidant properties of PC and its metabolites are due to their strong radical-scavenging activities. PC and its metabolites also inhibit the risk factors of atherosclerosis, including hyperlipidemia, diabetes mellitus, inflammation, hypertension, obesity, and non-alcoholic fatty liver disease. Despite the promising findings that have emerged from numerous in vitro, in vivo, and clinical studies, deeper mechanistic insights and large clinical trials are required to harness the full potential of PC and its metabolites in the prevention and treatment of ACVD.

Increased lipocalin-2 vs reduced oxytocin in relation with adiposity, atherogenicity and hematological indices in metabolic syndrome patients with and without prediabetes

OBJECTIVES

The neuropeptide hormone- Oxytocin (OXT) and glycoprotein Lipocalin-2 (LCN-2) are strongly associated with cardiometabolic risks of insulin resistance in metabolic syndrome (MetS) and prediabetes (preDM).

METHODS

In a cross sectional design we aimed to compare and correlate plasma levels of OXT and LCN-2 and a set of clinical parameters, adiposity indices, atherogenicity indices, and hematological indices in 29 MetS/preDM individuals and 29 non-diabetic MetS subjects  vs 30 normoglycemic lean controls. Colorimetric enzymatic assays of biomarkers were procured.

RESULTS

LCN-2 concentration (ng/mL) increased significantly in MetS/preDM  vs controls. Substantially in MetS recruits (both non-diabetic and pre-diabetics; n  =  58); OXT directly correlated with visceral adiposity index (VAI), non-HDL-C/HDL-C ratio, TC/HDL-C ratio, LDL-C/HDL-C ratio, lipid accumulation product (LAP), and atherogenicity index of plasma (AIP). Impressively, LCN-2 correlated proportionally with waist circumference (WC), red cell distribution width (RDW), neutrophils, and neutrophils to lymphocytes ratio (NLR), but inversely with lymphocytes in the 58 (non- and preDM) MetS participants.

CONCLUSIONS

These pronounced variations and correlations of OXT and LCN-2 emphasize their putative molecular roles in MetS and preDM pathophysiologies. Thus, OXT and LCN-2 can be surrogate prognostic/diagnostic tools for the MetS/preDM pharmacotherapy/prevention (Tab. 3, Fig. 1, Ref. 44).