Elsevier

Life Sciences

Volume 76, Issue 7, 31 December 2004, Pages 775-782
Life Sciences

Artichoke juice improves endothelial function in hyperlipemia

https://doi.org/10.1016/j.lfs.2004.07.018Get rights and content

Abstract

Artichoke extracts have been shown to produce various pharmacological effects, such as the inhibition of cholesterol biosynthesis and of LDL oxidation. Endothelial dysfunction represents the first stage of atherosclerotic disease; it is usually evaluated in humans by a noninvasive ultrasound method as brachial flow-mediated vasodilation (FMV) and by the determination of several humoral markers such as vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin. Aim of the study was to investigate the effects of dietary supplementation with artichoke juice on brachial FMV of hyperlipemics. We studied 18 moderately hyperlipemic patients (LDL cholesterol > 130 <200 mg/dl and/or triglycerides >150 <250 mg/dl) of both genders and 10 hyperlipemic patients, matched for age, sex and lipid parameters. All subjects were under isocaloric hypolipidic diet. A basal determination of serum lipids, soluble VCAM-1, ICAM-1, E-selectin and brachial FMV was performed. Thereafter patients were given 20 ml/die of frozen artichoke juice. The same parameters were repeated after 6 weeks. After artichoke treatment there was an increase of triglycerides (156 ± 54 vs 165 ± 76 mg/dL, p < 0.05) and a reduction of total cholesterol (261 ± 37 vs 244 ± 38 mg/dL, p < 0.05) and LDL cholesterol (174 ± 31 vs 160 ± 34 mg/dL, p < 0.05). Controls showed a significant decrease in total and LDL cholesterol (respectively: 267 ± 22 vs 249 ± 20 mg/dL and 180 ± 24 vs 164 ± 23 mg/dL, both p < 0.001). After artichoke there was a decrease in VCAM-1(1633 ± 1293 vs 1139 ± 883 ng/mL, p < 0.05) and ICAM-1(477 ± 123 vs 397 ± 102 ng/mL, p < 0.05), brachial FMV increased (3.3 ± 2.7 vs 4.5 ± 2.4%, p < 0.01), while controls did not exhibit significant changes in VCAM-1, ICAM-1, E-selectin and brachial FMV. Univariate analysis showed that, in artichoke patients, changes of VCAM-1 and ICAM-1 were significantly related to changes in brachial FMV (respectively: r = −0.66 and r = −0.62; both p < 0.05). In conclusion, artichoke dietary supplementation seems to positively modulate endothelial function in hypercholesterolemia.

Introduction

Artichoke, Cynara Scolymus, is an herbaceous perennial plant native of North Africa, Canary isles, and Southern Europe, with countries from this area being the leading producers in the world. Artichoke leaves were used in ancient herbal medicine for a variety of diseases: it was widely used in Europe mainly for the treatment of dyspepsia; in fact it possesses a choleretic effect documented both in healthy volunteers and in people suffering from non-specific digestive disorders (Kirchoff et al., 1994, Fintelmann, 1996).

In recent years, artichoke extracts have been tested for various pharmacological activities. In rats it has been demonstrated to increase bile flow and inhibit hepatocyte cholesterol biosynthesis (Saenz Rodriguez et al., 2002, Kraft, 1997, Gebhardt, 2002); in humans, randomised controlled trials showed a moderate hypocholesterolemic effect (Pittler et al., 2002). Moreover artichoke extracts exhibit antioxidant properties in cultured endothelial cells and monocytes, mainly antagonizing lipid peroxidation (Brown and Rice-Evans, 1998, Zapolska-Downar et al., 2002).

Oxidative stress and particularly lipid peroxidation is involved in the pathogenesis of atherosclerosis through endothelial injury (Ross, 1986); in vivo, endothelial dysfunction documented in the course of cardiovascular risk factors, represents the first step of atherogenesis.

In humans, endothelial impairment may be evaluated by two ways: the assessment of arterial capacity to vasodilate (Marchesi et al., 2000) and by several humoral markers (De Caterina et al., 1997). The first is a noninvasive ultrasound method estimating posthyperemic brachial flow mediated vasodilation (FMV) (Marchesi et al., 2000, Corretti et al., 2002); the second investigates the occurrence of the endothelial interaction with leukocytes by determining plasma levels of soluble adhesion molecules (SAM), such as vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin (De Caterina et al., 1997). Lipid disorders, such as hypercholesterolemia and hypertrigliceridemia, show a reduced flow-mediated vasodilation (Lupattelli et al., 2002, Lupattelli et al., 2000) and an enhanced expression of soluble cell adhesion molecules (Lupattelli et al., 2000, Hackman et al., 1996).

It is not known whether artichoke extracts can modulate endothelium in vivo; for this reason we studied the effects of artichoke leaf extract on lipids and on endothelial function of hyperlipemic patients.

Section snippets

Patients and methods

Eighteen moderately hyperlipemic patients (LDL cholesterol > 130 <200 mg/dl and/or triglycerides >150 <250 mg/dl) of both genders, aged 35–60 years were enrolled in the study. Ten hyperlipemic patients, matched for age, sex and lipid parameters were also included.

We did not include patients with other factors potentially increasing cardiovascular risk (as soon as they are generally treated with statins, and not with diet alone), such as cigarette smoking, diabetes mellitus, hypertension

Discussion

The main result of the present study was the improvement of brachial FMV (+2.2%) along with the reduction of VCAM-1 and ICAM-1 in hyperlipemic subjects consuming juice extracted from fresh artichoke leaves. The inverse relationship between the changes of a functional marker (FMV) and a biochemical one (SAM) of endothelial function gives credence to this finding.

No differences in E-selectin were observed before and after artichoke extracts. Actually, E-selectin is expressed in the extremely

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