Phytochemical investigation and antioxidant properties of unripe tomato cultivars (Solanum lycopersicum L.).

Unripe tomatoes are among the main waste produced during tomato cultivation and processing. In this study, unripe tomatoes from seven different Italian cultivars have been investigated to evaluate their nutraceutical potential. Phytochemical investigation allowed shedding light on the identification of seventy-five bioactive compounds. The highest amount of polyphenolic and glycoalkaloids along with the high level of antioxidant activities was found in the Datterini tomatoes variety. The peculiarity of this variety is the high chlorogenic acid content, being ten times higher compared to the other cultivars examined. Moreover, the total α-tomatine amount has been found substantially higher (34.699 ± 1.101 mg/g dry weight) with respect to the other tomato varieties analyzed. Furthermore, the cultivars metabolomic profiles were investigated with the PCA approach. Based on Datterini cultivar's metabolomic profile, its waste-recovery could represent a good option for further added value products in pharmaceutical and nutraceutical areas with a high α-tomatine content.

Membrane permeabilizers enhance biofortification of Brassica microgreens by interspecific transfer of metabolites from tea (Camellia sinensis).

Interspecific metabolite transfer (ISMT) is a novel approach for plants biofortification. In this study, the effect of tea (Camellia sinensis; Cs), with or without membrane permeabilizers EDTA and Tween, as a donor plant on broccoli, cauliflower and kale sprouts was investigated. As a result, caffeine- and catechin-enriched broccoli, cauliflower and kale microgreens were produced. Kale sprouts were most permeable for catechins from Cs, while cauliflower was most permeable for caffeine. Cs + EDTA significantly increased vitamin C in broccoli and kale. Among the tested enzymes activity, pancreatic lipase was the most affected by the treatment with broccoli and cauliflower biofortified with Cs or Cs combined with permeabilizers. Broccoli sprouts biofortified with Cs most significantly inhibited α-amylase, while those biofortified with Cs combined with permeabilizers most significantly inhibited α-glucosidase. Results point to ISMT combined with membrane permeabilizers as a promising and eco-friendly biofortification strategy to improve the biopotential of Brassica microgreens.

Effect of ultra-high pressure pretreatment on the phenolic profiles, antioxidative activity and cytoprotective capacity of different phenolic fractions from Que Zui tea.

This study aims to explore whether ultra-high pressure (UHP) pre-treatment strengthened the bioaccessibility and bioactivities of the free (QF), esterified (QE) and insoluble-bound phenolics (QIB) from Que Zui tea (QT). The results revealed that the extraction yields, the total phenolic (TPC) and total flavonoid contents (TFC) of three phenolic fractions from QT were markedly increased after ultra-high pressure (UHP) processing (p < 0.05). A total of 19 and 20 compounds were characterized and quantified in non- and UHP-treated QT, respectively, including the content of 6'-O-caffeoylarbutin (11775.68 and 13248.87 µg/g of dry extract) was highest in QF, the content of caffeic acid was highest in QE (2131.58 and 7362.99 µg/g of dry extract) and QIB (9151.89 and 10930.82 µg/g of dry extract). QF, QE and QIB from QT after UHP processing had better antioxidant, ROS scavenging, and anti-apoptosis effects. The possible mechanism of cytoprotective effect was related to Keap1-Nrf2 pathway.

Coffee or tea: Anti-inflammatory properties in the context of atherosclerotic cardiovascular disease prevention.

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of premature death worldwide. Inflammation and its biomarkers, like C-reactive protein (CRP), among the risk factors, such as hypertension, lipid disorders, and diabetes, may be also responsible for the residual cardiovascular disease (CVD) risk. Modern lipid-lowering treatment with statins, ezetimibe, PCSK9 inhibitors, or bempedoic acid does not fully protect against inflammation. The recommendations of the International Lipid Expert Panel (ILEP) indicate selected nutraceuticals with anti-inflammatory properties. Diet may have a significant impact on inflammation. Especially interesting in the context of inflammation is the consumption of coffee and tea. These drinks in many observational studies significantly reduced cardiovascular risk and mortality. The question is whether the anti-inflammatory effects of these drinks contribute significantly to the observed clinical effects. Thus, in this narrative review, we primarily discuss the anti-inflammatory properties of consuming tea and coffee. Based on a comprehensive analysis of the studies and their meta-analyses, inconsistent results were obtained, which makes it impossible to conclusively state how clinically significant the potential anti-inflammatory properties of black and green tea and coffee are. A number of confounding factors can cause the inconsistency of the available results. Consumption of tea and coffee appears to increase adiponectin concentrations, decrease reactive oxygen species, decrease low density lipoprotein (LDL) cholesterol concentrations (effect of green tea, etc.). Despite the still uncertain anti-inflammatory effect of tea and coffee, we recommend their consumption as a part of the healthy diet.

Boosting the antioxidant potential of pasta by a premature stop mutation in wheat keto-acythiolase-2.

Phenolics are a class of chemical compounds possessing antioxidant activity, which are mainly located in the wheat (Triticum aestivum) bran. Different approaches have been used in food industry to increase the availability of phenolics. Compared to these methods, however, genetic improvement of the wheat antioxidant potential, is a cost-effective, easier and safer approach. Here, we showed a single premature stop mutation in the keto-acythiolase-2 (kat-2b) gene, which significantly improved the antioxidant potential of pasta by a 60 ± 16% increase in its antioxidant potential by increasing the accumulation of ferulic acid. These changes are likely determined by the increased transcription (46% higher) and activity (120% higher) of the phenylalanine lyase genes observed in the mutated line compared to the control. Even if more studies will need to be done, overall, this study suggested that the kat-2b mutant could represent an excellent genetic resource to improve wheat's antioxidant and health-promoting potential.

Comparative effectiveness of phlegm-heat clearing Chinese medicine injections for AECOPD: A systematic review and network meta-analysis.

ETHNOPHARMACOLOGICAL RELEVANCE: Qingkailing (QKL), Reduning (RDN), Xiyanping (XYP), Tanreqing (TRQ) and Yuxingcao (YXC) injections are all phlegm-heat clearing Chinese medicine (CM) injections composed of the extract from traditional CM materials. Evidence from clinical studies and animal experiments indicates that the above CM injections are effective supplementary therapy for acute exacerbation chronic obstructive pulmonary disease (AECOPD), and clinicians are faced with a difficult choice on the optimal phlegm-heat clearing CM injection for AECOPD. AIM OF THE STUDY: This systematic review and Bayesian network meta-analysis aimed to evaluate the comparative effectiveness of five commonly used phlegm-heat clearing CM injections for COPD. MATERIALS AND METHODS: A pairwise and network meta-analyses were performed to assess the effectiveness of QKL, RDN, TRQ, XYP and YXC on AECOPD. Randomized controlled trials (RCTs) were identified by searching English and Chinese databases. The primary outcome was lung function (forced expiration volume [FEV1] and forced vital capacity [FVC]), blood gas analysis index was secondary outcome measure. Winbugs and Stata 15.0 software were used for data analysis. RESULTS: A total of 57 RCTs were included. The pairwise analyses showed that each of the injections combined with routine treatment were superior to routine treatment alone [FEV1: QKL, MD 0.20, 95% CI (0.06, 0.35); RDN, MD 0.24, 95% CI (0.08, 0.40); TRQ, MD 0.24, 95% CI (0.19, 0.29); XYP, MD 0.26, 95% CI (0.20, 0.32); YXC MD 0.73, 95% CI (0.06, 1.41)]. The network meta-analysis provided the following rank of lung function improvement: FEV1: YXC > TRQ > XYP > RDN > QKL; FVC: YXC > TRQ > QKL > RDN > XYP. RDN and YXC ranked highest in blood gas analysis index. RDN was the highest ranked injection for effectiveness, followed by QKL, TRQ, XYP, then YXC. Most of the injections appeared safe, with severe adverse events rarely reported. CONCLUSION: This study suggests that YXC and TRQ are the most effective therapies in treating AECOPD patients. RDN and YXC are more effective in the alleviation of clinical symptoms. Given that the safety of YXC is controversial, TRQ and RDN may be preferable as phlegm-heat clearing CM injections in the adjuvant treatment of AECOPD.

Mulberry leaf (Morus alba L.): A review of its potential influences in mechanisms of action on metabolic diseases.

The leaves of Morus alba L. (called Sangye in Chinese, ML), which belong to the genus Morus., are highly valuable edible plants in nutrients and nutraceuticals. In Asian countries including China, Japan and Korea, ML are widely used as functional foods including beverages, noodles and herbal tea because of its biological and nutritional value. Meanwhile, ML-derived products in the form of powders, extracts and capsules are widely consumed as dietary supplements for controlling blood glucose and sugar. Clinical studies showed that ML play an important role in the treatment of metabolic diseases including the diabetes, dyslipidemia, obesity, atherosclerosis and hypertension. People broadly use ML due to their nutritiousness, deliciousness, safety, and abundant active benefits. However, the systematic pharmacological mechanisms of ML on metabolic diseases have not been fully revealed. Therefore, in order to fully utilize and scale relevant products about ML, this review summarizes the up-to-date information about the ML and its constituents effecting on metabolic disease.

Functionalization of sweet potato leaf polyphenols by nanostructured composite ß-lactoglobulin particles from molecular level complexations: A review.

Sweet potato leaf polyphenols (SPLPs) have shown potential health benefits in the food and pharmaceutical industries. Nowadays, consumption of SPLPs from animal feeds to foodstuff is becoming a trend worldwide. However, the application of SPLPs is limited by their low bioavailability and stability. ß-lactoglobulin (ßlg), a highly regarded whey protein, can interact with SPLPs at the molecular level to form reversible or irreversible nanocomplexes (NCs). Consequently, the functional properties and final quality of SPLPs are directly modified. In this review, the composition and structure of SPLPs and ßlg, as well as methods of molecular complexation and mechanisms of formation of SPLPsßlgNCs, are revisited. The modified functionalities of SPLPsßlgNCs, especially protein conformational structures, antioxidant activity, solubility, thermal stability, emulsifying, and gelling properties including allergenic potential, digestibility, and practical applications are discussed for SPLPs future development.

Phoenix dactylifera L. date tree pollen fertility effects on female rats in relation to its UPLC-MS profile via a biochemometric approach.

Date palm (Phoenix dactylifera L.) is among the most ancient cultivated crops, of special value owing to its fruits high nutritive and economic benefits. Asides, date palm pollen is a high energy material that has been used traditionally used for fertility enhancement. In this study, effects of date palm pollen crude extract and its fractions viz., petroleum ether, methylene chloride, ethyl acetate and n-butanol on the female reproductive system were evaluated for the first time in relation to its metabolite fingerprint. Fertility activity was evaluated in immature female rats by assessing their FSH-, LH- and estrogen- activities. To pinpoint active hormonal agents in crude pollen extract and fractions, UPLC- MS analysis was employed for metabolites profiling, and in correlation to extract/fraction bioassays using multivariate OPLS analysis. Results revealed that both polar n-butanol and non-polar petroleum ether fractions exhibited the strongest activities; with a significant increase in FSH (25.7 mIU/ml in n-butanol group), estradiol (414.7 pg/ml in petroleum ether group) and progesterone levels (122.4 pg/ml in n-butanol group). Correlation between UPLC-MS and fraction bioassays was attempted using multivariate OPLS analysis to reveal for bioactive hits in these fractions. This study provides the first report on the fertility effect of date palm pollen in female rats and in relation to its metabolite fingerprint.

Antioxidant action and enzyme activity modulation by bioaccessible polyphenols from jambolan (Syzygium cumini (L.) Skeels).

Jambolan is rich in antioxidant polyphenols; however, the bioactivity of these compounds remains poorly investigated. We compared changes in polyphenols and antioxidant capacity by ABTS and FRAP assays of jambolan pulp during in vitro digestion and chemical extraction and evaluated the effects of these changes on oxidative stress in wild and mutant Saccharomyces cerevisiae. Digestion and chemical extraction were performed with enzyme saline solutions, deionized water, and 50% (v/v) aqueous acetone solution. Caffeic, quinic, gallic, and ellagic acids, isomers of myricetin, catechin, and anthocyanins are bioaccessible during gastric digestion. In the duodenum, flavonoids and proanthocyanidins remained stable when the pH changed from acidic to neutral/alkaline, whereas anthocyanins were degraded when exposed to pH 7. In the colon, anthocyanins were not identified. The antioxidant activity of bioaccessible fractions is correlated with non-anthocyanin flavonoids and proanthocyanidins, reflected in the modulation of antioxidant enzymes of S. cerevisiae. The digestion process favors the release of bio-polyphenols from jambolan with preventive, scavenger, and reparative antioxidant action. They also stimulate the production and activity of Sod and Cat, strengthening the endogenous antioxidant system.

Structural elucidation, distribution and antioxidant activity of bound phenolics from whole grain brown rice.

Chemical profiles, distribution, and antioxidant activity of bound phenolics from brown rice were investigated. Four new dehydrodiferulic acid dimers (DFA) along with eighteen known phenolics were isolated from brown rice bound phenolic extracts and their structures were determined by multiple spectroscopic methods. Among them, ferulic acid and 8-5' DFA were the most abundant monomeric and dimeric bound phenolics in brown rice, rice bran and polished rice. In whole brown rice, polished rice contributed more than 50% of three phenolic monomers and six phenolic dimers, while rice bran contributed more than half of the other thirteen phenolics including eight monomers, four dimers, and one trimer. All the isolated compounds exhibited oxygen radical absorbance capacity. Thomasidioic acid, caffeic acid, methyl caffeate, and 8-5' DC DFA displayed potent peroxyl radical scavenging capacity, and the last three compounds also showed moderate cellular antioxidant activity.

Qingxue jiedu formulation ameliorated DNFB-induced atopic dermatitis by inhibiting STAT3/MAPK/NF-κB signaling pathways.

ETHNOPHARMACOLOGICAL RELEVANCE: Qingxue jiedu Formulation (QF) is composed of two classic prescriptions which have been clinically used for more than 5 centuries and appropriately modified through basic theory of traditional Chinese medicine for treating various skin inflammation such as atopic dermatitis (AD), acute dermatitis and rash. Although QF possesses a prominent clinical therapeutic effect, seldom pharmacological studies on its anti-AD activity are conducted. AIM OF THE STUDY: We used AD mice model to investigate the anti-AD activities of QF, as well as its underlying molecular mechanisms which involved signal transducer and activator of transcription 3 (STAT3), nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways. MATERIALS AND METHODS: 2,4-dinitrofluorobenzene (DNFB)-induced AD mice were used to collect serum and skin tissues for consequential determination. The levels of various inflammatory factors [interleukin (IL)-12, Interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-4, IL-6 and immunoglobulin E (IgE)] were determined by enzyme-linked immunosorbent assay (ELISA). Real-time polymerase chain reaction (RT-PCR) was contributed to detect the effects of relevant inflammatory factors on mRNA. The roles of STAT3, NF-κB and MAPK signaling pathways in AD response were analyzed by Western blotting (WB), and the thickening of mice dorsal skin and inflammatory cell infiltration were observed by hematoxylin and eosin (H&E) staining. RESULTS: QF significantly reduced the skin thickening, inflammatory cell infiltration and other symptoms in AD mice. The levels of IL-12, TNF-α, IL-4, IL-6 and IgE were decreased, while IFN-γ was increased by QF in the ELISA analysis. QF lessened the levels of lL-6 and elevated IFN-γ on the mRNA level. In addition, WB analysis showed QF thoroughly inhibited the activation of NF-κB, STAT3 and phosphorylation of JAK1, JAK2, JAK3, while partially suppressed MAPK signaling pathways. CONCLUSIONS: QF inhibited the activations of STAT3, MAPK and NF-κB signaling pathways and possessed a significant therapeutic effect on AD. Therefore, QF deserves our continuous attention and research as a prominent medicine for AD.

Allium sativum L. (Garlic) bulb enlargement as influenced by differential combinations of photoperiod and temperature.

Photoperiod and temperature are vital environmental factors that regulate plant developmental processes. However, the roles of these factors in garlic bulb enlargement are unclear. In this report, responses of garlic bulb morphology and physiology to combinations of photoperiod (light/dark: 10/14 h, 12/12 h, 14/10 h) and temperature (light/dark: 25/18 °C, 30/20 °C) were investigated. For garlic cultivar G103, bulb characteristics, phytohormones (IAA, ABA, ZT, tZR, JA), allicin and phenolic acids (p-coumaric and p-hydroxybenzoic) were highest under a photoperiod of 14 h at 30 °C. Maximum GA was observed under 14 h + 30 °C for cv. G2011-5. Maximum caffeic, ferulic and vanillic acids were detected for cv. G2011-5 at 14 h + 30 °C, 12 h + 25 °C and 14 h + 25 °C, respectively. Flavonoids (myricetin, quercetin, kaempferol and apigenin) were not detected in this trial. This is the first report describing the impact of long periods of light duration and higher temperatures on garlic morphology, phytohormones, phenolic acids and allicin content.

Arabica and Conilon coffee flowers: Bioactive compounds and antioxidant capacity under different processes.

This study presents innovative research for comparison of the effect of the different dehydration techniques and methods of extraction on the antioxidant potential and bioactive compounds of Conilon and Arabica coffee flowers. The compounds were analyzed by high performance liquid chromatography and the antioxidant capacity evaluated by the 2,2'-azinobis (3-ethylbenzthiazoline-6-sulfonic acid) (ABTS), 2,2-diphenyl-1-picrylhydrazyl (DPPH) and nitric oxide assays. Among the compounds evaluated, trigonelline, gallic acid, chlorogenic acid, and caffeine were identified, with trigonelline and caffeine being those with the highest concentration. The investigated factors significantly influenced the profile of the bioactive compounds identified, and the antioxidant capacity. The 92 °C infusion of freeze-dried Conilon coffee flowers, in general, showed greater antioxidant capacity by ABTS and DPPH assays, as well as total phenolic content. Lyophilization had a positive influence on maintaining the content of phenolic compounds and antioxidant capacity of the samples. Coffee flowers proved to be a potential raw material for making tea-like drinks.

Brazilian fruits of Arecaceae family: An overview of some representatives with promising food, therapeutic and industrial applications.

The Arecaceae family is widely distributed and comprises about 2600 species, in which 48 of them are native to Brazil and occurs in transition biomes between the Amazon, Cerrado and Caatinga. In addition to being used as a source of food and subsistence, they are also rich in lipophilic bioactive compounds, mainly carotenoids, polyunsaturated fatty acids, tocopherols and vitamin A. Moreover, they have considerable content of phenolic compounds, fibers and minerals. Therefore, the objective of this review is to present the physical-chemical and nutritional aspects, the main bioactive compounds, the biological properties and the innovative potential of four Brazilian palm-tree fruits of the Arecaceae family. Due to the presence of bioactive compounds, these fruits have the potential to promote health and can be used to prevent chronic non-communicable diseases, such as obesity, type 2 diabetes and others. Furthermore, these raw materials and their by-products can be used in the development of new food, chemical, pharmaceutical and cosmetic products. To ensure better use of these crops, promote their commercial value, benefit family farming and contribute to the country's sustainable development, it is necessary to implement new cultivation, post-harvest and processing techniques. Investing in research to publicize their potential is equally important, mainly of the ones still little explored, such as the buritirana.

Bioaccessibility and gut metabolism of phenolic compounds of breads added with green coffee infusion and enzymatically bioprocessed.

This study aimed at investigating two strategies to enhance the bioaccessibility of phenolic compounds from whole-wheat breads: enzymatic bioprocessing and addition of green coffee infusion. Although both strategies had a significant effect on increasing the contents of total soluble phenolic compounds in breads, the addition of green coffee infusion was much more relevant (19.1-fold) than enzymatic bioprocessing (1.8-fold). The phenolic compounds present as soluble forms were completely released from all breads' matrix already at the oral phase of digestion. While gastric digestion did not promote the release of insoluble phenolic compounds, intestinal conditions led to a slight release. All bread samples showed maximum phenolic compounds bioaccessibility after 4 h of gut fermentation. Upon the end of in vitro digestion and gut fermentation, the difference between the strategies was that enzymatic bioprocessing accelerated ferulic acid release, while the addition of green coffee infusion increased 10.4-fold the overall phenolic compounds bioaccessibility.

Polyphenol composition and biological activity of Thymus citriodorus and Thymus vulgaris: Comparison with endemic Iberian Thymus species.

The polyphenol compositions of Thymus × citriodorus and Thymus vulgaris extracts as obtained by exhaustive hydroethanolic (HE) extraction and aqueous decoction (AD) were compared. In addition, their compositions and bioactivities were compared to those of Thymus pulegioides and Thymus mastichina, grown under the same edaphoclimatic conditions, and Thymus carnosus. Rosmarinic acid was the most abundant polyphenol followed by luteolin-hexuronide, salvianolic acids I and K. Cluster analysis suggests a similarity of the polyphenol composition of T. citriodorus and T. vulgaris. A significant antioxidant activity was observed and correlated with their polyphenol levels. The same being observed for the higher anti-proliferative activity/cytotoxicity of HE extracts on Caco-2 and HepG2 cells as compared to AD extracts. Significant association between the total phenolic compounds with the anti-proliferative activity, for both cell lines, was observed. These results support the importance of salvianolic acids levels in Thymus extracts and their in vitro anti-proliferative/cytotoxic activities.

The impact of different filter baskets, heights of perforated disc and amount of ground coffee on the extraction of organics acids and the main bioactive compounds in espresso coffee.

Espresso coffee (EC) is a complex and much appreciated beverage among coffee consumers. The extraction phase of EC, a combination of physical and chemical variables in a very short time, has a direct effect on the flavour of the beverage. This research aims to optimize the extraction process of EC by decreasing the amount of ground coffee from 14 g to 12 g (double cup), while keeping constant the particle size of ground coffee and the physical parameters of the espresso machine, making use of the following accessories: two different filter baskets, and four different heights of perforated discs (4-7 mm). Quantitative analyses on several organic acids (acetic, citric, caffeic, malic, tartaric) and caffeine, trigonelline, nicotinic and 5-caffeoylquinic acid are carried out with HPLC-VWD through a newly developed method. This combines the quantification of organic acids, obtained through HPLC-VWD, with the results of a sensory panel evaluation on the descriptive notes of EC. The outcomes will trigger and support further studies on different extraction processes, to develop more sustainable and economically affordable coffee of high quality.

Comparison of phenolic compounds extracted from Diaphragma juglandis fructus, walnut pellicle, and flowers of Juglans regia using methanol, ultrasonic wave, and enzyme assisted-extraction.

The phenols in Diaphragma juglandis fructus (DJF), walnut pellicle (WP), and flowers of Juglans regia (FJR) from walnut were extracted using three methods (methanolic condensation reflux extraction, ultrasonic wave extraction, and enzyme assisted-extraction), and phenolics and antioxidant capacities of different extractions were compared. Overall, 50 phenolics were identified by HPLC-MS/MS with 41 compounds in DJF, 32 in WP, and 29 in FJR. It was observed that tannins in WP was higher than those in DJF and FJR. As for PCA, more than 70% of the variance was explained with the obvious comparison between the phenolic constituents. The phenolics in walnut contributed to remarkable antioxidant effect, with the highest effect observed in WP. This study presents the analysis and comparison of the phenols can be further extended for the development of functional walnut instant foods.

Vasorelaxant effects of Crataegus pentagyna: Links with arginase inhibition and phenolic profile.

ETHNOPHARMACOLOGICAL RELEVANCE: Crataegus leaves, flowers and fruits have been traditionally used to improve blood circulation, numerous preclinical and clinical studies supporting the cardiovascular benefits of Crataegus preparations. In this respect, there is very limited data on Crataegus pentagyna; in addition, the chemical profile of this species is still incompletely elucidated. AIM OF THE STUDY: The objective of this study was to examine the cardiovascular benefits of Crataegus pentagyna Waldst. et Kit. ex Willd. (small-flowered black hawthorn, Rosaceae) extracts (leaf, flower and fruit ethyl acetate extracts) and the underlying mechanisms. We hypothesized that C. pentagyna extracts might exert vasodilatory effects and inhibit arginase activity due, in large part, to their polyphenolic constituents. MATERIALS AND METHODS: C. pentagyna extracts induced-relaxation and the mechanisms involved were studied ex vivo in isolated aortic rings from Sprague-Dawley rats. The inhibitory effects on bovine liver arginase I were assessed by an in vitro assay. Metabolite profiling of C. pentagyna extracts was performed and the most endothelium- and nitric oxide synthase-dependent; flower extract additionally reduced Ca2+ entry and, to a lesser extent, Ca2+ release from the sarcoplasmic reticulum. C. pentagyna proved to be an important source of arginase inhibitors with potential benefits in endothelial dysfunction that remains to be explored.