Dietetic intervention in psoriatic arthritis: the DIETA trial.

AIM: To evaluate whether dietary pattern changes, antioxidant supplementation or 5-10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA). METHODS: A total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) were evaluated at baseline and after the 12-week intervention. Statistical analysis used the intention-to-treat approach. The P value was considered to indicate significance when below 0.05. RESULTS: After 12 weeks, DAS28-CRP and BASDAI scores improved, especially in the Diet-placebo group (- 0.6 ± 0.9; p = 0.004 and - 1.39 ± 1.97; p = 0.001, respectively). In addition, a higher proportion of patients achieved minimal disease activity (MDA) in all groups. The Diet-fish group showed significant weight loss (- 1.79 ± 2.4; p = 0.004), as well as waist circumference (- 3.28 ± 3.5, p < 0.001) and body fat (- 1.2 ± 2.2, p = 0.006) reductions. There was no significant correlation between weight loss and disease activity improvement. Each 1-unit increase in the HEI value reduced the likelihood of achieving remission by 4%. Additionally, each 100-cal daily intake increase caused a 3.4-fold DAS28-ESR impairment. CONCLUSION: A 12-week hypocaloric intervention provided suitable control of joint disease activity in patients with PsA, regardless of weight loss. Adding omega-3 supplementation caused relevant body composition changes but not disease activity improvement. TRIAL REGISTRATION: The study was recorded on Clinicaltrials.gov (NCT03142503).

Isolation and characterization of flavonoids from Tapirira guianensis leaves with vasodilatory and myeloperoxidase-inhibitory activities.

The aim of this study was to perform the isolation and characterization of vasodilatory flavonoids from Tapirira guianensis Aubl. (Annacardiaceae) leaves. In this context, ethyl acetate fraction (EA fraction) was obtained and subjected to fractionation batches by HSCCC affording: myricetin 3-O-α-L-rhamnopyranoside (myricitrin, 1); quercetin 3-O-(6"-O-galloyl)-ß-D-galactopyranoside (2); quercetin 3-O-α-L-arabinofuranoside (avicularin, 3); and quercetin 3-O-α-L-rhamnopyranoside (quercitrin, 4). Myricitrin (1) induced a relaxation of 56.07 ± 13.04% at 300 µM (P < 0.05; n = 5), indicating that this flavonoid contributes to the vasodilatory activity of EA fraction. In addition, all EA fraction flavonoids were evaluated for their capacity of inhibiting myeloperoxidase activity and flavonoid (2) (IC50 1.0 ± 0.3 µM) was the strongest peroxidase inhibitor. In conclusion, it was possible to verify that myricitrin together with quercetin are mainly responsible for vasodilatory potential, besides flavonoid 2 for myeloperoxidase inhibition. Together these flavonoids seem to be responsible for Tapirira guianensis cardiovascular effects.