Anti-Inflammatory, Antioxidant, and Anti-Atherosclerotic Effects of Natural Supplements on Patients with FMF-Related AA Amyloidosis: A Non-Randomized 24-Week Open-Label Interventional Study
Romano M. Garcia-Bournissen F. Piskin D. Rodoplu U. Piskin L. Elzagallaai A.A. Tuncer T. Sezer S. Ucuncuoglu D. Honca T. Poddighe D. Yavuz I. Stenvinkel P. Yilmaz M.I. Demirkaya E.
June 2022MDPI
Life
2022#12Issue 6
We aimed to evaluate the effect of a combination of natural products on parameters related to inflammation, endothelial dysfunction, and oxidative stress in a cohort of familial Mediterranean fever (FMF) patients with Serum Amyloid A amyloidosis, in a non-randomized, 24-week open-label interventional study. Morinda citrifolia (anti-atherosclerotic-AAL), omega-3 (anti-inflammatory-AIC), and extract with Alaskan blueberry (antioxidant-AOL) were given to patients with FMF-related biopsy-proven AA amyloidosis. Patients were >18 years and had proteinuria (>3500 mg/day) but a normal estimated glomerular filtration rate (eGFR). Arterial flow-mediated dilatation (FMD), carotid intima media thickness (CIMT), and serum biomarkers asymmetric dimethylarginine (ADMA), high sensitivity C-reactive protein (hs-CRP), pentraxin (PTX3), malondialdehyde (MDA), Cu/Zn-superoxide dismutase (Cu/Zn-SOD), and glutathione peroxidase (GSH-Px) were studied at baseline and after 24 weeks of treatment. A total of 67 FMF-related amyloidosis patients (52 male (77.6%); median age 36 years (range 21–66)) were enrolled. At the end of a 24-week treatment period with AAL, AIC, and AOL combination therapy, ADMA, MDA, PTX3, hsCRP, cholesterol, and proteinuria were significantly decreased compared to baseline, while CuZn-SOD, GSH-Px, and FMD levels were significantly increased. Changes in inflammatory markers PTX3, and hsCRP were negatively correlated with FMD change, and positively correlated with decreases in proteinuria, ADMA, MDA, cholesterol, and CIMT. Treatment with AAL, AIC and AOL combination for 24 weeks were significantly associated with reduction in inflammatory markers, improved endothelial functions, and oxidative state. Efficient control of these three mechanisms can have long term cardiovascular and renal benefits for patients with AA amyloidosis.
AA amyloidosis , endothelial dysfunction , familial Mediterranean fever , inflammation , natural supplementation , oxidative stress
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Department of Paediatrics, Division of Paediatric Rheumatology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, N6A 5W9, ON, Canada
Canadian Behcet and Autoinflammatory Disease Center (CAN BE AID), Schulich School of Medicine & Dentistry, University of Western Ontario, London, N6A 5W9, ON, Canada
Department of Paediatrics, Division of Paediatric Clinical Pharmacology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, N6A 5W9, ON, Canada
Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, N6A 3K7, ON, Canada
Emergency Medicine Association of Turkey of All, Izmir, 35220, Turkey
Robarts Research Institute, University of Western Ontario, London, N6A 3K7, ON, Canada
Schulich School of Medicine & Dentistry, Physiology and Pharmacology, University of Western Ontario, London, N6A 3K7, ON, Canada
Unit of Biochemistry, Epigenetic Health Solutions, Ankara, 06810, Turkey
Division of Nephrology, Faculty of Medicine, Atilim University, Ankara, 06830, Turkey
Department of Food Engineering, Faculty of Engineering, Cankiri Karatekin University, Cankiri, 18100, Turkey
Unit of Biochemistry, Gur Life Hospital, Eskisehir, 26320, Turkey
Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, 010000, Kazakhstan
Clinical Academic Department of Pediatrics, National Research Center of Maternal and Child Health, University Medical Center, Nur-Sultan, 010000, Kazakhstan
Department of Nephrology, Lokman Hekim University, Ankara, 06510, Turkey
Department of Renal Medicine M99, Karolinska Institute, Karolinska University Hospital, Stockholm, 17164, Sweden
Unit of Nephrology, Center for Epigenetic Health Solutions, Ankara, 06810, Turkey
Department of Paediatrics
Canadian Behcet and Autoinflammatory Disease Center (CAN BE AID)
Department of Paediatrics
Department of Epidemiology and Biostatistics
Emergency Medicine Association of Turkey of All
Robarts Research Institute
Schulich School of Medicine & Dentistry
Unit of Biochemistry
Division of Nephrology
Department of Food Engineering
Unit of Biochemistry
Department of Medicine
Clinical Academic Department of Pediatrics
Department of Nephrology
Department of Renal Medicine M99
Unit of Nephrology
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