scholarly journals Popular functional foods and nutraceuticals with lipid lowering activity and in relation to cardiovascular disease, dyslipidemia, and related complications: an overview

2018 ◽  
Vol 2 ◽  
Author(s):  
Hui-Fang Chiu ◽  
You-Cheng Shen ◽  
Kamesh Venkatakrishnan ◽  
Chin-Kun Wang
Keyword(s):  
Cardiovascular Disease ◽  
Functional Foods ◽  
Recent Literature ◽  
Meta Analysis ◽  
Treatment Options ◽  
Current Treatment ◽  
Lipid Lowering ◽  
Food Ingredients ◽  
Shed Light ◽  
Lowering Activity

Cardiovascular disease (CVD) is the most common non-communicable ailment which claims one-third of total global death. This contribution provides an overview of cardiovascular diseases (CVDs), hypercholesterolemia and hyperlipidemia (dyslipidemia) and their related complications as well as the current treatment options with special attention to popular functional foods and nutraceuticals. Currently, many synthetic lipid-lowering drugs are available in the market. However, they trigger several adverse effects. Thus, to overcome this problem nutraceuticals and functional foods which are considered safe, and with multifaceted lipid-lowering activity are highly recommended (adjuvant therapy) for treating dyslipidemia. This review intends to shed light on how to choose the appropriate or better nutraceutical/functional food ingredients to alleviate the risk of CVD, based on recent literature survey with the inclusion of clinical trials and meta-analysis to ensure the efficacy of nutraceuticals/ functional foods on lipid profile.

scholarly journals Extraction optimisation and lipid-lowering activity of Auricularia heimuer polysaccharides

2021 ◽  
Author(s):  
Xianghui Kong ◽  
Yinpeng Ma ◽  
Yu Pan ◽  
Wei Jiang ◽  
Dingjin Li ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Enzymatic Hydrolysis ◽  
Functional Foods ◽  
Animal Experiments ◽  
Extraction Process ◽  
Extraction Methods ◽  
Lipid Lowering ◽  
Process Optimisation ◽  
Molecular Weight Range ◽  
Lowering Activity

Assessments of molecular weight distribution and activity/efficacy of Auricularia heimuer polysaccharides (AAP) are of substantial significance for its extraction process optimisation. In the present study, single-factor orthogonal test and response surface methodology were employed to optimise extraction conditions of AAP. Furthermore, a rat hyperlipidaemia model was established to compare the lipid-lowering activity of polysaccharides obtained by three extraction methods. Conditions for enzymatic hydrolysis were optimised as pH 5.0, 1% cellulase, 2.5% substrate concentration and enzymolysis time of 1.5 h, leading to an up to 31.8% polysaccharide yield and 89.13% of polysaccharides within the molecular weight range of 5 000 Da to 10 000 Da. The results of animal experiments showed that the lipid-lowering activity of enzymolysis-extracted polysaccharides was significantly higher than that of water- and ultrasonic-extracted ones (P < 0.01). So the present study revealed that enzymatic hydrolysis-extracted polysaccharides showed the strongest hypolipidaemia activity, providing a basis for the development of A. heimuer-based functional foods and drugs.

Abstract 13503: Relative Efficacy of Alirocumab, Bempedoic Acid, Evolocumab, Ezetimibe and Inclisiran Added to Statins for Reduction of Low Density Lipoprotein Cholesterol - A Network Meta-Analysis of Randomized Clinical Trials

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Peter P Toth ◽  
Sarah Bray ◽  
Gavin Worth
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Trials ◽  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Low Density ◽  
Relative Efficacy ◽  
Low Density Lipoprotein Cholesterol

Background: Many patients with hypercholesterolemia and/or cardiovascular disease are unable to achieve sufficient low-density lipoprotein cholesterol (LDL-C) reduction with statins alone (or are statin intolerant). This is increasingly the case with clinical guidelines recommending that lower LDL-C levels are beneficial for patients. This network meta-analysis (NMA) assessed the relative efficacy of lipid lowering therapies (LLTs) added to statins for reducing LDL-C. Methods: A systematic review of randomized controlled clinical trials to May 2020 identified 48 studies for inclusion in the primary NMA. The primary NMA included studies ≥12 weeks duration in which alirocumab, bempedoic acid, evolocumab, ezetimibe, or inclisiran were added to moderate-high intensity statins (or lower intensity / no statin in statin intolerant patients). Random effects NMA was used to analyse % change in LDL-C to compare the treatment effects indirectly. Results: Over 12 weeks, all non-statin LLTs significantly reduced LDL-C from baseline versus placebo. Evolocumab 140 mg Q2W / 420 mg QM and alirocumab 150 mg Q2W were associated with largest LDL-C reductions, which were greater than those achieved with lower/alternative doses of alirocumab, bempedoic acid (± ezetimibe), ezetimibe and inclisiran (Table). Consistent results were observed in sensitivity analyses to address heterogeneity (excluding familial hypercholesterolemia and east Asian studies), in the subgroup NMA of studies in predominantly atherosclerotic cardiovascular disease patients, and in the statin intolerant subgroup NMA. Conclusions: All agents reduced LDL-C, however, the PCSK9 inhibitors evolocumab 140 mg Q2W / 420 mg QM and alirocumab 150 mg Q2W were the most effective LLT regimens for reducing LDL-C when added to statins.

The Utility of Anti-Inflammatory Agents in Cardiovascular Disease

2018 ◽  
Vol 23 (6) ◽  
pp. 483-493 ◽  
Author(s):  
Santhosh J. Kottoor ◽  
Rohit R. Arora
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
New England ◽  
Treatment Options ◽  
Current Treatment ◽  
Adverse Outcomes ◽  
Treatment Modalities ◽  
Clear Understanding ◽  
Acute Phase Reactants ◽  
Increased Risk

Approximately 40% of heart attack survivors remain at increased risk of recurrent cardiovascular events, despite the current treatment options showing that atherothrombosis is not exclusively a disorder of lipoprotein aggregation in the arterial wall. Clinical and experimental data suggest that inflammation plays an important role in atherothrombosis independent of the cholesterol level. Acute-phase reactants, such as C-reactive protein, increase in patients with coronary artery disease and are known to predict adverse outcomes in such patients. The recent CANTOS trial published in The New England Journal of Medicine provides evidence that interleukin-1β along with other cytokines play central roles in the inflammatory reaction that drives the interleukin-6 signaling pathway and have profound effects on cardiovascular outcomes. Several other ongoing studies are focused on multiple immune mediators involved in this process to support the inflammatory hypothesis of cardiovascular diseases. These new classes of drugs could represent the biggest breakthrough in cardiovascular medicine, which could have the greatest impact on cardiovascular mortality since the advent of statins. The drug canakinumab has shown promise in lowering atherosclerosis, and other drugs, such as colchicine and methotrexate, are gaining interest and are being investigated in multiple ongoing trials. A major concern is the affordability of these drugs, as most cardiovascular diseases are noted among people of lower socioeconomic statuses. The LoDoCo trial showed some benefits of colchicine, and whether this old drug can be marketed with a new label for cardiovascular disease remains in question. Therefore, a clear understanding of the different inflammatory pathways involved in atherosclerosis is needed to help develop more effective treatment modalities that will benefit humankind.

scholarly journals Current Systemic Treatment Options in Metastatic Urothelial Carcinoma after Progression on Checkpoint Inhibition Therapy—A Systemic Review Combined with Single-Group Meta-Analysis of Three Studies Testing Enfortumab Vedotin

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3206
Author(s):  
Susanne Deininger ◽  
Peter Törzsök ◽  
David Oswald ◽  
Lukas Lusuardi
Keyword(s):  
Urothelial Carcinoma ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Treatment Options ◽  
Objective Response ◽  
Progression Free Survival ◽  
Current Treatment ◽  
Systemic Review ◽  
Single Group ◽  
Metastatic Urothelial Carcinoma

Background: In the first and second-line therapy of metastatic urothelial carcinoma (mUC), checkpoint inhibitors (CPI) such as Pembrolizumab and Atezolizumab have been widely implemented. Little is currently known about what therapeutic options are effective after therapy with CPI. This article presents a systemic review of current treatment options in this setting. Methods: From August 2020 to 15 April 2021, a literature search was performed through the PubMed/Medline. Subsequently, a single-group meta-analysis of three studies testing Enfortumab vedotin (EV) was conducted. Results: Five therapy regimens tested in the post-CPI setting with adequate data were identified: Chemotherapy (CT), Ramucirumab plus Docetaxel, Erdafitinib (Erd), EV, and Sacituzumab govitecan (SG). In n = 74 + 125 + 288 patients, the single-group meta-analysis showed an objective response rate of 42.1% for EV compared to 17.9% for CT in a similar setting. EV was also ahead in progression free survival (5.9 months with EV vs. 3.7 months with CT) and overall survival (12.8 months with EV vs. 9.0 months with CT). Conclusion: Most data are currently available for EV. Further research is needed on the question of which patients’ subcollectives particularly benefit from which therapeutic approach.

scholarly journals Distal Scaphoid Excision in Treatment of Symptomatic Scaphoid Nonunion: Systematic Review and Meta-analysis

Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 508-515
Author(s):  
Cory K. Mayfield ◽  
Daniel J. Gould ◽  
Marie Dusch ◽  
Amir Mostofi
Keyword(s):  
Meta Analysis ◽  
Treatment Options ◽  
Current Treatment ◽  
Complete Relief ◽  
Scaphoid Nonunion ◽  
Patient Centered ◽  
Strenuous Activity ◽  
Flexion Extension ◽  
Risk Treatment ◽  
Patients Experience

Background: Current treatment options for persistent scaphoid nonunion are limited to salvage procedures such as proximal row carpectomy (PRC) or 4-corner fusion (4CF). Several small studies have demonstrated that distal scaphoid excision may provide a simpler alternative with faster recovery. The purpose of this study was to determine the efficacy of distal scaphoid excision as a treatment option for symptomatic scaphoid nonunion. Methods: The MEDLINE and PubMed databases were searched for the use of distal scaphoid excision in scaphoid nonunions. Studies included reported on either the functional or patient-centered outcomes following distal scaphoid excision for symptomatic scaphoid nonunion. Results: Six articles described the outcomes of 70 patients with an average of 11.7 patients per study. Functional outcomes including flexion-extension arc, radial-ulnar deviation, and grip strength improved by an average of 98.95%, 58.96%, and 131.08%, respectively. Patient-derived outcomes included the Modified Mayo Wrist Score, which improved by 92.6%, and the Disabilities of the Arm, Shoulder and Hand, which improved by 137.17%. An average of 68.75% of patients experience complete relief of pain with 20.83% of patients experiencing pain with strenuous activity. The average postoperative visual analog scale (0-10) was 0.71. On average, 93.33% of patients returned to work with an average time of return being 6.89 weeks. Complete satisfaction was reported by 87.80% of patients. Complications included progression into 4CF or PRC and newly developed midcarpal arthritis. Conclusions: Given favorable outcomes, our analysis suggests that distal scaphoid excision may be a favorable, low-risk treatment for scaphoid nonunion without eliminating more extensive options such as 4CF and wrist arthrodesis.

scholarly journals Recent advances in novel therapies for lipid disorders

2019 ◽  
Vol 28 (R1) ◽  
pp. R49-R54 ◽  
Author(s):  
Annakaisa Tirronen ◽  
Krista Hokkanen ◽  
Taina Vuorio ◽  
Seppo Ylä-Herttuala
Keyword(s):  
Treatment Options ◽  
Current Treatment ◽  
Lipid Lowering ◽  
Western World ◽  
Viral Gene ◽  
Small Interfering Rnas ◽  
Unhealthy Lifestyle ◽  
Alcoholic Fatty Liver ◽  
Clinical Phase ◽  
Lipid Disorders

Abstract The prevalence of lipid disorders is alarmingly increasing in the Western world. They are the result of either primary causes, such as unhealthy lifestyle choices or inherited risk factors, or secondary causes like other diseases or medication. Atypical changes in the synthesis, processing and catabolism of lipoprotein particles may lead to severe hypercholesterolemia, hypertriglyceridemia or elevated Lp(a). Although cholesterol-lowering drugs are the most prescribed medications, not all patients achieve guideline recommended cholesterol levels with the current treatment options, emphasising the need for new therapies. Also, some lipid disorders do not have any treatment options but rely only on stringent dietary restriction. Patients with untreated lipid disorders carry a severe risk of cardiovascular disease, diabetes, non-alcoholic fatty liver disease and pancreatitis among others. To achieve better treatment outcome, novel selective gene expression and epigenetic targeting therapies are constantly being developed. Therapeutic innovations employing targeted RNA technology utilise small interfering RNAs, antisense oligonucleotides, long non-coding RNAs and microRNAs to regulate target protein production whereas viral gene therapy provides functional therapeutic genes and CRISPR/Cas technology relies on gene editing and transcriptional regulation. In this review, we will discuss the latest advances in clinical trials for novel lipid-lowering therapies and potential new targets in pre-clinical phase.

scholarly journals Lipoprotein(a) Where Do We Stand? From the Physiopathology to Innovative Terapy

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 838
Author(s):  
Gabriella Iannuzzo ◽  
Maria Tripaldella ◽  
Vania Mallardo ◽  
Mena Morgillo ◽  
Nicoletta Vitelli ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Treatment Options ◽  
Strong Association ◽  
Elevated Serum ◽  
Serum Levels ◽  
Epidemiologic Studies ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lipoprotein A ◽  
Premature Cardiovascular Disease

A number of epidemiologic studies have demonstrated a strong association between increasing lipoprotein a [Lp(a)] and cardiovascular disease. This correlation was demonstrated independent of other known cardiovascular (CV) risk factors. Screening for Lp(a) in the general population is not recommended, although Lp(a) levels are predominantly genetically determined so a single assessment is needed to identify patients at risk. In 2019 ESC/EAS guidelines recommend Lp(a) measurement at least once a lifetime, fo subjects at very high and high CV risk and those with a family history of premature cardiovascular disease, to reclassify patients with borderline risk. As concerning medications, statins play a key role in lipid lowering therapy, but present poor efficacy on Lp(a) levels. Actually, treatment options for elevated serum levels of Lp(a) are very limited. Apheresis is the most effective and well tolerated treatment in patients with high levels of Lp(a). However, promising new therapies, in particular antisense oligonucleotides have showed to be able to significantly reduce Lp(a) in phase II RCT. This review provides an overview of the biology and epidemiology of Lp(a), with a view to future therapies.

Haem oxygenase-1 and cardiovascular disease: mechanisms and therapeutic potential

2011 ◽  
Vol 120 (12) ◽  
pp. 493-504 ◽  
Author(s):  
Kim H. Chan ◽  
Martin K. C. Ng ◽  
Roland Stocker
Keyword(s):  
Cardiovascular Disease ◽  
Therapeutic Potential ◽  
Treatment Options ◽  
Current Treatment ◽  
Protective Effects ◽  
Vascular Protection ◽  
Metabolic Role ◽  
Number Of Patients ◽  
Coronary Syndromes ◽  
Haem Oxygenase

Cardiovascular disease remains the leading cause of death worldwide. Despite progress in management, there remain a significant number of patients who are not eligible for current treatment options. Traditionally, HO-1 (haem oxygenase-1), one of two isoenzymes that initiate haem catabolism, was thought to only play a metabolic role. However, HO-1 is now recognized to have additional protective activities in states of heightened noxious stimuli or stress such as acute coronary syndromes. The present review article provides an overview of the mode of action of HO-1 in vascular protection, with particular emphasis on its atheroprotective, anti-inflammatory and antioxidative properties, as well as its role in vascular repair. Furthermore, we present evidence for the protective effects of HO-1 in CVD (cardiovascular disease) in both animal and human studies. Given its potential in vascular protection and repair, strategies aimed at inducing HO-1 emerge as a novel and alternative therapeutic target in the management of CVD.

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