The beneficial effects of antioxidants combination on cardiac injury induced by tetrachloromethane

Aliah R Alshanwani, Laila M Faddah, Hanan Hagar, Ahlam M Alhusaini, Sameerah Shaheen, Raeesa A Mohammad, Fatima M B Alharbi, Alaa AlHarthii, Amira M Badr

Drug Chem Toxicol . 2020 Oct 15;1-9. doi: 10.1080/01480545.2020.1831012. Online ahead of print.

Abstract

The purpose of this research was to evaluate the efficacy of carsil (CAR) either alone or in combination with α-tocopherol (α-TOCO) and/or turmeric (TUMR) against tetrachloromethane (TCM)-induced cardiomyocyte injury in rats. Administration of CAR either alone or in combination with α-TOCO and/or TUMR post-TCM injection, significantly mitigated the increases in serum troponin T, creatine kinase-MB (CK-MB) as well as interleukin-6 (IL-6), interferon γ (IFN-γ), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP). They also decline the elevation of caspase-3, vascular endothelial growth factor (VEGF) protein expression as well as DNA damage in cardiac tissues induced by TCM. The biochemical results were confirmed by histopathological investigation. Conclusion: The combination of the three antioxidants showed greater cardioprotective potential, compared to individual drugs. Therefore, this combination may be recommended as a complementary therapy to antagonize cardiac injury induced by different insults.

Kilmer S McCully

Ann Clin Lab Sci . 2020 Sep;50(5):567-577.

Abstract

A century ago a fat-soluble vitamin from leafy vegetables, later named vitamin E, was discovered to enhance fertility in animals. Vitamin E consists of 8 isomers of tocopherols and tocotrienols, each containing chromanol groups that confer antioxidant properties and differ only in the 15-carbon saturated phytyl poly-isoprenoid side chain of tocopherols and the 15-carbon unsaturated farnesyl poly-isoprenoid side chain of tocotrienols. Although tocotrienol was first isolated from rubber plants in 1964, its importance in multiple disease processes was not recognized until two decades later, when the cholesterol-lowering and anti-cancer effects were first reported. Tocotrienol (T3) protects against radiation injury and mitochondrial dysfunction by preventing opening of the mitochondrial permeability transition pore, thereby inhibiting loss of the active site for oxidative phosphorylation, thioretinaco ozonide oxygen ATP, from mitochondria by complex formation with the active site, TR₂CoO₃O₂NAD⁺H₂PO₄ ^–T3. The preventive effects of tocotrienol on vascular disease, cancer, neurodegeneration and aging are attributed to its effects on cellular apoptosis and senescence. Geranylgeraniol is an important intermediate in the biosynthesis of cholesterol, and cholesterol auxotrophy of lymphoma cell lines and primary tumors is attributed to loss of squalene monooxygenase and accumulation of intracellular squalene. Geranylgeraniol and tocotrienol have synergistic inhibitory effects on growth and HMG CoA reductase activity, accompanied by reduction of membrane KRAS protein of cultured human prostate carcinoma cells. Since cholesterol inhibits opening of the mPTP pore of mitochondria, inhibition of cholesterol biosynthesis by these effects of tocotrienol and geranylgeraniol produces increased mitochondrial dysfunction and apoptosis from loss of the active site of oxidative phosphorylation from mitochondria.

Melanie Ziegler, Maria Wallert, Stefan Lorkowski, Karlheinz Peter

Antioxidants (Basel) . 2020 Sep 29;9(10):935. doi: 10.3390/antiox9100935.

Abstract

Cardiovascular diseases (CVD) cause about 1/3 of global deaths. Therefore, new strategies for the prevention and treatment of cardiovascular events are highly sought-after. Vitamin E is known for significant antioxidative and anti-inflammatory properties, and has been studied in the prevention of CVD, supported by findings that vitamin E deficiency is associated with increased risk of cardiovascular events. However, randomized controlled trials in humans reveal conflicting and ultimately disappointing results regarding the reduction of cardiovascular events with vitamin E supplementation. As we discuss in detail, this outcome is strongly affected by study design, cohort selection, co-morbidities, genetic variations, age, and gender. For effective chronic primary and secondary prevention by vitamin E, oxidative and inflammatory status might not have been sufficiently antagonized. In contrast, acute administration of vitamin E may be more translatable into positive clinical outcomes. In patients with myocardial infarction (MI), which is associated with severe oxidative and inflammatory reactions, decreased plasma levels of vitamin E have been found. The offsetting of this acute vitamin E deficiency via short-term treatment in MI has shown promising results, and, thus, acute medication, rather than chronic supplementation, with vitamin E might revitalize vitamin E therapy and even provide positive clinical outcomes.

Hadeel K M Alboaklah, David S Leake

Free Radic Res . 2020 Sep 16;1-11. doi: 10.1080/10715762.2020.1817912. Online ahead of print.

Abstract

Many cholesterol-laden foam cells in atherosclerotic lesions are macrophages and much of their cholesterol is present in their lysosomes and derived from low density lipoprotein (LDL). LDL oxidation has been proposed to be involved in the pathogenesis of atherosclerosis. We have shown previously that LDL can be oxidised in the lysosomes of macrophages. α-Tocopherol has been shown to inhibit LDL oxidation in vitro, but did not protect against cardiovascular disease in large clinical trials. We have therefore investigated the effect of α-tocopherol on LDL oxidation at lysosomal pH (about pH 4.5). LDL was enriched with α-tocopherol by incubating human plasma with α-tocopherol followed by LDL isolation by ultracentrifugation. The α-tocopherol content of LDL was increased from 14.4 ± 0.2 to 24.3 ± 0.3 nmol/mg protein. LDL oxidation was assessed by measuring the formation of conjugated dienes at 234 nm and oxidised lipids (cholesteryl linoleate hydroperoxide and 7-ketocholesterol) by HPLC. As expected, LDL enriched with α-tocopherol was oxidised more slowly than control LDL by Cu²⁺ at pH 7.4, but was not protected against oxidation by Cu²⁺ or Fe³⁺ or a low concentration of Fe²⁺ at pH 4.5 (it was sometimes oxidised faster by α-tocopherol with Cu²⁺ or Fe³⁺ at pH 4.5). α-Tocopherol-enriched LDL reduced Cu²⁺ and Fe³⁺ into the more pro-oxidant Cu⁺ and Fe²⁺ faster than did control LDL at pH 4.5. These findings might help to explain why the large clinical trials of α-tocopherol did not protect against cardiovascular disease.

Panagiotis Theodosis-Nobelos, Georgios Papagiouvannis, Eleni A Rekka

Mini Rev Med Chem . 2020 Aug 7. doi: 10.2174/1389557520666200807132617. Online ahead of print.

Abstract

Vitamin E, essential for human health, is widely used worldwide for therapeutic or dietary reasons. The differences in the metabolism and excretion of the multiple vitamin E forms are presented in this review. The important steps that influence the kinetics of each form and the distribution and processing of vitamin E forms by the liver are considered. The antioxidant as well as non-antioxidant properties of vitamin E forms are discussed. Finally, synthetic tocopherol and trolox derivatives, based on the design of multitarget directed compounds, are reviewed. It is demonstrated that selected derivatization of vitamin E or trolox structures can produce improved antioxidants, agents against cancer, cardiovascular and neurodegenerative disorders.

Andrew Slivka, Cameron Rink, David Paoletto, Chandan K Sen

FASEB J . 2020 Jul 20. doi: 10.1096/fj.201902216RR. Online ahead of print.

Abstract

The purpose of this study was to characterize the effects of tocotrienol form of vitamin E (TCT) on platelet function in patients with stroke or transient ischemic attack (TIA). A double blind, randomized, single center phase II clinical trial was conducted comparing placebo (PBO) and 400 and 800 mg TCT daily for a year in 150 patients with a sentinel ischemic stroke or TIA event in the prior 6 months. Platelet function was measured at baseline and then, at 3 month intervals for a year, using light transmission aggregometry. The incidence of aspirin resistance in aspirin-treated patients or platelet inhibition in patients on clopidogrel alone was compared between the three treatment groups. Results showed that in patients taking aspirin and clopidogrel, the incidence of aspirin resistance was significantly decreased from 40% in PBO-treated patients to 9% in the 400 mg TCT group and 25% in the TCT 800 mg group (P = .03). In conclusion, patients on aspirin and clopidogrel had a higher incidence of aspirin resistance than all patients treated with aspirin alone and TCT decreased the frequency of aspirin resistance in this group.

Tyler R. Kemnic, Meghan Coleman

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. 2020 Jul 10.

Excerpt

Vitamin E is all the following eight compounds alpha, beta, gamma, and delta-tocopherol and alpha, beta, gamma, and delta-tocotrienol. Alpha-tocopherol is the only compound of the eight that are known to meet human dietary needs. All of the vitamin E forms are absorbed in the small intestine, and then the liver metabolizes only alpha-tocopherol. The liver then removes and excretes the remaining vitamin E forms. Vitamin E deficiency is extremely rare in humans as it is unlikely caused by a diet consisting of low vitamin E. Rather, it tends to be caused by irregularities in dietary fat absorption or metabolism. Vitamin E is a lipid-soluble nutrient. Vitamin E may have a role in reducing atherosclerosis and lowering rates of ischemic heart disease. Premature infants have low vitamin E reserves due to vitamin E only able to cross the placenta in small amounts.

Maria Wallert, Lisa Börmel, Stefan Lorkowski

Mol Nutr Food Res . 2020 Jul 21;e2000097. doi: 10.1002/mnfr.202000097. Online ahead of print.

Abstract

Inflammation-driven diseases and related comorbidities, such as the metabolic syndrome, obesity, fatty liver disease and cardiovascular diseases cause significant global burden. There is a growing body of evidence that nutrients alter inflammatory responses and can therefore make a decisive contribution to the treatment of these diseases. Recently, the inflammasome, a cytosolic multiprotein complex, was identified as a key player in inflammation and the development of various inflammation-mediated disorders, with nucleotide-binding domain and leucine-rich repeat pyrin domain (NLRP) 3 being the inflammasome of interest. Here we provide an overview about the cellular signaling pathways underlying nuclear factor ‘kappa-light-chain-enhancer’ of activated B-cells (NF-κB)- and NLRP3-mediated inflammatory processes, the pathogenesis of the inflammatory diseases atherosclerosis and non-alcoholic fatty liver disease (NAFLD); next, we discuss the current state of knowledge for drug-based and dietary-based interventions for treating cardiovascular diseases and NAFLD. To date one of the most important antioxidant in the human diet is vitamin E. Various in vitro and in vivo studies suggest that the different forms of vitamin E and also their derivatives have anti-inflammatory activity. Recent publications suggest that vitamin E – and possibly metabolites of vitamin E – are a promising therapeutic approach for treating inflammatory diseases such as NAFLD.

Daniel U Owu, Idara A Okon, Usenobong F Ufot, Justin A Beshel

Niger J Physiol Sci . 2020 Jun 30;35(1):52-60.

Abstract

Vitamin E has been used as antioxidant and in the treatment of various ailments due to oxidative stress. The cardio-protective effect of vitamin E in dexamethasone induced oxidative stress was studied. Forty Wistar rats were randomly assigned to four groups of 10 rats each. Control group received normal rat chow. Oxidative stress was induced using 30µg/kg body weight of dexamethasone (DEX) intraperitonealy in DEX+Vit E and DEX only groups while Vitamin E was administered orally at a dose of 300 IU/kg to Vitamin E only group and DEX+Vit E group daily for 14 days. All animals were fed ad libitum and had free access to water. Blood samples were obtained by cardiac puncture for biochemical analyses while heart and kidney were processed for histological staining. The result shows a significant (p<0.05) decrease in serum nitric oxide, bilirubin and superoxide dismutase concentration in DEX-only group which was elevated following vitamin E treatment. The angiotensin converting enzyme and lactate dehydrogenase enzyme activities were significantly (p<0.01) elevated in DEX-only group compared with control and DEX+Vit E groups. These enzyme levels were significantly (p<0.01) reduced in DEX + vitamin E group. The histology of the heart and the kidney in DEX-only group showed cardiac hypertrophy and kidney injury but were ameliorated by vitamin E treatment. The results suggest that vitamin E has cardiac and renal protective effect and ameliorates oxidative injury to the heart and kidney due to oxidative stress.

Ji Han, Chunyang Zhao, Jiayi Cai, Yu Liang

Complement Ther Clin Pract . 2020 May;39:101142. doi: 10.1016/j.ctcp.2020.101142. Epub 2020 Mar 14.

Abstract

Background: Vitamins are commonly used in the prevention of major cardiovascular disease. However, the efficacy and optimum choice remain controversial.

Objective: To compare and rank the relative efficacy among all available vitamin preparations for cardiovascular disease through a network meta-analysis.

Methods: Eligible studies were identified by searching PubMed, Embase, Medline, Cochrane library and Web of Science for randomized controlled trials. A random effects model was applied within a frequentist framework.

Results: Forty-two articles (45 comparisons, 384,248 participants), including nine vitamin interventions, were identified. Vitamin D had the highest probability of being ranked best in effectiveness (0.84 [0.72, 0.98]) on prevention of cardiovascular events. With regard to reducing death of cardiovascular disease rate, vitamin E was considered better efficacy.

Conclusions: Vitamin B, D and E could reduce the incidence of cardiovascular events to varying degrees. At the same time, the combination of vitamins can not show improvement on the efficacy.