X-Message-Number: 28001 Date: Sun, 28 May 2006 20:48:18 -0700 (PDT) From: Doug Skrecky <> Subject: modulating HO-1 & TNF-a may boost human longevity II [The main weapons against atherosclerosis include neither medications to lower cholesterol nor lower blood pressure. Although a lot of good research has been done promoting statins and ACE inhibitors for example, typical reductions in human mortality found in intervention trails testing these medications are quite modest. The reason for this is because the main driver of atherosclerosis is aging, and not cholesterol or blood pressure. Indeed, even the modest benefit of statins has been attributed largely to non-cholesterol mediated mechanisms. Prescription medications can slow the deterioration of measurements of atherosclerosis such as intima-media thickness (IMT), but they generally can not halt, much less reverse it. To obtain large reductions in human mortality an actual reduction in IMT is an absolute requirement. This has been achieved in humans (below) by pomegranate juice for example, which lowers neither cholesterol nor (initially) blood pressure.] [A class of flavonoid called anthocyanidins was found to be associated with a reduced risk of a heart attack. Within the range of (low) normal dietary intake these food pigments reduced risk by over half. Notable sources include red cabbage, red & black rice, berrys, grapes, plums - and pomegranates.] Public Health Nutr. 2006 May;9(3):369-374. Intake of specific flavonoids and risk of acute myocardial infarction in Italy. Objective: As intake of flavonoids has been associated with reduced risk of coronary heart disease but data on the relation with specific classes of flavonoids are scarce, we assessed the relation between dietary intake of specific classes of flavonoids and the risk of acute myocardial infarction (AMI) in an Italian population.Design: Case-control study. Dietary information was collected by interviewers on a questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple logistic regression models including terms for energy and alcohol intake, as well as sociodemographic factors, tobacco and other major recognised risk factors for AMI.Setting: Milan, Italy, between 1995 and 2003.Subjects: Cases were 760 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 682 patients admitted to hospital for acute conditions unrelated to diet. Results: A reduced risk of AMI was found for increasing intake of anthocyanidins (OR=0.45, 95% CI 0.26-0.78 for the highest vs. the lowest quintile, Ptrend=0.003) and flavonols (OR=0.65, 95% CI 0.41-1.02, Ptrend=0.02). A tendency towards reduced risks, although not significant, was observed for flavan-3-ols (OR=0.73, 95% CI 0.48-1.10) and total flavonoids (OR=0.74, 95% CI 0.49-1.14). No meaningful heterogeneity was found between the sexes. No association emerged for other flavonoids, including isoflavones, flavanones and flavones.Conclusions: High intake of anthocyanidins reduced the risk of AMI even after allowance for alcohol, fruit and vegetables, supporting a real inverse association between this class of flavonoids and AMI risk. [Although numerous animal trials have detected reductions in atherosclerosis with dietary derived anthocyanidins, these are not the only items of interest. Below a combination of policosanol and red yeast extract offered only a modest 33% reduction in atherosclerosis. The addition of astaxanthin boosted this reduction to a remarkable 92%.] Arzneimittelforschung. 2005;55(6):312-7. Antiatherosclerotic efficacy of policosanol, red yeast rice extract and astaxanthin in the rabbit. The effects of policosanol (P), of extract of red yeast rice (rice fermented with Monascus purpureus) (RYE) and of astaxanthin (A) (constituents of Armolipid) were investigated in a model of experimental atherosclerosis provoked in the rabbit by atherogenic cholesterol-enriched feed (ACEF). P and RYE and their combination were able to lower the increase of serum total cholesterol and of LDL cholesterol elicited by 3-month feeding with ACEF. They also were able to reduce the increase of blood malondialdehyde (MDA), a tracer of lipid peroxidation by the free radicals released by ACEF. When combined, the substances developed either additive or potentiated effects, supporting the rationale of their combination. Remarkable was the protective effect on lipid infiltration in the aortic wall provoked by ACEF, which was reduced by P and by RYE and almost completely prevented by the addition of A to the P-RYE combination. The results support the rationale of a combination of P, RYE and A as a useful food supplement in hyperlipemic patients. [Not all antioxidant combinations offer synergism. N-acetylcysteine antagonises the protective HO-1 inducing effect of piceatannol.] Pharmacol Res. 2006 Feb;53(2):113-22. Epub 2005 Oct 21. Piceatannol upregulates endothelial heme oxygenase-1 expression via novel protein kinase C and tyrosine kinase pathways. Piceatannol is an anti-inflammatory and anti-proliferative plant-derived stilbene. Heme oxygenase-1 (HO-1) is a cytoprotective enzyme to activate by various phytochemicals. In this study, we examined the ability of piceatannol to upregulate HO-1 expression in endothelial cells. We found piceatannol at micromolar (10-50 microM) concentrations dramatically increased HO-1 protein levels in a time-dependent manner. Piceatannol was similarly potent in the induction of HO-1 as hemin, arsenate, and 15d-PGJ2, and was more potent than some other phytochemicals including curcumin, EGCG, baicalein, and quercetin. In contrast, the similar chemical structure compounds, trans-stilbene, stilbene oxide, and resveratrol had no HO-1-inducing effects, suggesting a critical role for the hydroxyl groups in HO-1 induction. No cytotoxicity and superoxide production was observed after 10-50 microM piceatannol treatments. Piceatannol-mediated HO-1 induction was abrogated in the presence of N-acetylcysteine and glutathione, but not by other antioxidants. Induction of HO-1 by piceatannol was further enhanced by using buthionine sulfoximine. In addition, we determined that tyrosine kinase was involved in the induction of HO-1 by using tyrosine kinase inhibitors, herbimycin A, erbstatin, and genistein; in contrast, no significant changes in the pretreatment of PI3 kinase or MAP kinase inhibitors was determined. HO-1 induction was blocked by the protein kinase C inhibitors calphostin C, rottlerin, and long PMA pretreatment, whereas conventional PKC inhibitors, Go6976, and Ca2+ chelator BAPTA/AM, had no effect. Elevated HO-1 protein levels were associated with the inhibition of tumor necrosis factor-alpha (TNFalpha)-induced intercellular adhesion molecule-1 (ICAM-1) expression. Treating ECs with zinc protoporphyrin, an HO-1 inhibitor blocked the anti-inflammatory effect of piceatannol. In summary, this study identified piceatannol as a novel phytochemical inducer of HO-1 expression and identified the mechanisms involved in this process. [The report below has generated little discussion in medical journals. However the fact that pomegranate juice actually reduced IMT by 30% in a year is a result beyond the capabilites of either statins or ACE inhibitors. Indeed 60% of control subjects were taking these medications, yet still experienced a progressive deterioration in this atherosclerosis measurement. Pomegranate has no immediate effect on blood pressure, yet over a year reduced systolic from 174 to 153 mm, probably as a side effect of the reduction in atherosclerosis. Pomegranate juice contains anthocyanidins, but the main active ingrediants are believed to be tannins. Subjects drank a mere 50 ml of juice daily containing 1979 mg of tannins, and 384 mg of anthocyanidins.] Clin Nutr. 2004 Jun;23(3):423-33. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Dietary supplementation with polyphenolic antioxidants to animals was shown to be associated with inhibition of LDL oxidation and macrophage foam cell formation, and attenuation of atherosclerosis development. We investigated the effects of pomegranate juice (PJ, which contains potent tannins and anthocyanins) consumption by atherosclerotic patients with carotid artery stenosis (CAS) on the progression of carotid lesions and changes in oxidative stress and blood pressure. Ten patients were supplemented with PJ for 1 year and five of them continued for up to 3 years. Blood samples were collected before treatment and during PJ consumption. In the control group that did not consume PJ, common carotid intima-media thickness (IMT) increased by 9% during 1 year, whereas, PJ consumption resulted in a significant IMT reduction, by up to 30%, after 1 year. The patients' serum paraoxonase 1 (PON 1) activity was increased by 83%, whereas serum LDL basal oxidative state and LDL susceptibility to copper ion-induced oxidation were both significantly reduced, by 90% and 59%, respectively, after 12 months of PJ consumption, compared to values obtained before PJ consumption. Furthermore, serum levels of antibodies against oxidized LDL were decreased by 19%, and in parallel serum total antioxidant status (TAS) was increased by 130% after 1 year of PJ consumption. Systolic blood pressure was reduced after 1 year of PJ consumption by 21% and was not further reduced along 3 years of PJ consumption. For all studied parameters, the maximal effects were observed after 1 year of PJ consumption. Further consumption of PJ, for up to 3 years, had no additional beneficial effects on IMT and serum PON1 activity, whereas serum lipid peroxidation was further reduced by up to 16% after 3 years of PJ consumption. The results of the present study thus suggest that PJ consumption by patients with CAS decreases carotid IMT and systolic blood pressure and these effects could be related to the potent antioxidant characteristics of PJ polyphenols. Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=28001