Artichoke juice improves endothelial function in hyperlipemia
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
References (27)
- et al.
Investigation of decreased availability of nitric oxide precursor as the mechanism responsible of impaired endothelium-dependent vasodilation in hypercholesterolemic patients
Journal of the American College of Cardiology
(1994) - et al.
Impaired endothelium-dependent vasodilation of forearm resistance vessels in hypercholesterolemia
Lancet
(1992) - et al.
International Brachial Artery Reactivity Task Force. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force
Journal of the American College of Cardiolology
(2002) Artichoke leaf extract. Recent findings reflecting effects on lipid metabolism, liver and gastrointestinal tracts
Phytomedicine
(1997)- et al.
Flow-mediated vasoactivity and circulating adhesion molecules in hypertriglyceridemia: association with small, dense LDL cholesterol particles
American Heart Journal
(2000) - et al.
Direct association between high-density lipoprotein cholesterol and endothelial function in hyperlipemia
American Journal of Cardiology
(2002) - et al.
Impaired flow-mediated vasoactivity during post-prandial phase in young healthy men
Atherosclerosis
(2000) - et al.
Choleretic activity and biliary elimination of lipids and bile acids induced by an artichoke leaf extract in rats
Phytomedicine
(2002) - et al.
Nitric oxide attenuates adhesion molecule expression in human endothelial cells
Cytokine
(1996) - et al.
Luteolin-rich artichoke extract protects low density lipoprotein from oxidation in vitro
Free Radical Research
(1998)
The simultaneous generation of superoxide and nitric oxide can initiate lipid peroxidation in human low density lipoproteins
Free Radical Research Communication
Soluble vascular cell adhesion molecule-1 as a biohumoral correlate of atherosclerosis
Arteriosclerosis Thrombosis and Vascular Biology
Antidyspeptic and lipid lowering effect of artichoke leaf extract
Zeitschrift fur Allgemeinmedizine
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2016, Journal of Herbal MedicineCitation Excerpt :Bundy et al., 2008). In another study, after 6 weeks supplementation with artichoke juice or placebo, a remarkable reduction in the concentrations of total cholesterol and LDL-c was observed in both artichoke and placebo groups and levels of triglyceride were increased by 5.7% (Table 5) (Lupattelli et al., 2004). Interestingly, the degree of the changes in total plasma cholesterol, LDL-c and HDL-c values in the current study was greater than those previously reported for artichoke (in regard to the dose and duration of the intervention) (Table 5).
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