Phase 2 trial of daily, oral epigallocatechin gallate in patients with light-chain amyloidosis.

Previous studies have suggested that an increase in mitochondrial reactive oxygen species may cause organ damage in patients with light-chain (AL) amyloidosis; however, this damage can be decreased by antioxidant-agent treatment. Epigallocatechin gallate (EGCG), the major natural catechin in green tea, has potent antioxidant activity. Because EGCG has recently been reported to have a favorable toxicity profile for treating amyloidosis, we sought to examine the clinical efficacy and toxicity of EGCG in patients with AL amyloidosis. Fifty-seven patients were randomly assigned to the EGCG and observation groups and observed for six months. There were no increases in grade 3-5 adverse events and EGCG therapy was well tolerated. Although a decrease in the urinary albumin level was found in the EGCG group in patients with obvious albuminuria after treatment initiation, its antioxidant activity may not be sufficient to clarify the potential effect of EGCG in patients with AL amyloidosis. Because some of the biological markers responsible for organ damage were well correlated to the level of antioxidant potential in patients' plasma, the status of oxidative stress in the blood may indicate the extent of organ damage in clinical situations.

Effects of green tea consumption on cognitive dysfunction in an elderly population: a randomized placebo-controlled study.

BACKGROUND: Green tea is a beverage with potential effects on cognitive dysfunction, as indicated by results of experimental studies. However, its effects in humans, especially at real-world (typical) consumption levels, are unclear. METHODS: A double-blind, randomized controlled study was conducted to assess the effects of green tea consumption on cognitive dysfunction (Mini-Mental State Examination Japanese version (MMSE-J) score <28) in Japan. Participants were randomly allocated to the green tea or placebo group, and consumed either 2 g/day of green tea powder (containing 220.2 mg of catechins) or placebo powder (containing 0.0 mg of catechins), respectively, for 12 months. Cognitive function assessments were performed every 3 months using the MMSE-J and laboratory tests. RESULTS: Thirty-three nursing home residents with cognitive dysfunction were enrolled (four men, 29 women; mean age ± SD, 84.8 ± 9.3; mean MMSE-J score ± SD, 15.8 ± 5.4), of whom 27 completed the study. Changes of MMSE-J score after 1 year of green tea consumption were not significantly different compared with that of the placebo group (-0.61 [-2.97, 1.74], least square mean (LSM) difference [95 % CI]; P = 0.59). However, levels of malondialdehyde-modified low-density lipoprotein (U/L), a marker of oxidative stress, was significantly lower in the green tea group (-22.93 [-44.13, -1.73], LSM difference [95 % CI]; P = 0.04). CONCLUSIONS: Our results suggest that 12 months green tea consumption may not significantly affect cognitive function assessed by MMSE-J, but prevent an increase of oxidative stress in the elderly population. Additional long-term controlled studies are needed to clarify the effects. TRIAL REGISTRATION: UMIN000011668.

Green tea catechins prevent low-density lipoprotein oxidation via their accumulation in low-density lipoprotein particles in humans.

Green tea is rich in polyphenols, including catechins which have antioxidant activities and are considered to have beneficial effects on cardiovascular health. In the present study, we investigated the effects of green tea catechins on low-density lipoprotein (LDL) oxidation in vitro and in human studies to test the hypothesis that catechins are incorporated into LDL particles and exert antioxidant properties. In a randomized, placebo-controlled, double-blind, crossover trial, 19 healthy men ingested green tea extract (GTE) in the form of capsules at a dose of 1 g total catechin, of which most (>99%) was the gallated type. At 1 hour after ingestion, marked increases of the plasma concentrations of (-)-epigallocatechin gallate and (-)-epicatechin gallate were observed. Accordingly, the plasma total antioxidant capacity was increased, and the LDL oxidizability was significantly reduced by the ingestion of GTE. We found that gallated catechins were incorporated into LDL particles in nonconjugated forms after the incubation of GTE with plasma in vitro. Moreover, the catechin-incorporated LDL was highly resistant to radical-induced oxidation in vitro. An additional human study with 5 healthy women confirmed that GTE intake sufficiently increased the concentration of gallated catechins, mainly in nonconjugated forms in LDL particles, and reduced the oxidizability of LDL. In conclusion, green tea catechins are rapidly incorporated into LDL particles and play a role in reducing LDL oxidation in humans, which suggests that taking green tea catechins is effective in reducing atherosclerosis risk associated with oxidative stress.

Green tea beverages enriched with catechins with a galloyl moiety reduce body fat in moderately obese adults: a randomized double-blind placebo-controlled trial.

Objective To determine whether ingesting a green tea beverage enriched with catechins with a galloyl moiety during a meal reduces body fat in moderately obese adults. Design Randomized double-blind placebo-controlled study. Subjects A total of 126 obese subjects (25 ≤ body mass index < 30 kg m(-2)) were randomly assigned to a group receiving green tea beverages without catechins (placebo), or a group receiving green tea beverages with a low or high content of catechins with a galloyl moiety. Each subject ingested 500 mL bottled green tea beverages containing 25, 180, or 279.5 mg green tea catechins (0, 149.5, or 246.5 mg catechins with a galloyl moiety, respectively), at mealtimes for 12 weeks; the subjects were instructed to ingest the beverage during the meal that had the highest fat content on that day. Methods Anthropometric measurements and blood chemistry analysis were performed during the run-in period; at weeks 0, 4, 8, and 12 of the intake period; and at the end of the withdrawal period. Abdominal fat area was measured by computed tomography at weeks 0, 8, and 12 of the intake period and at the end of the withdrawal period. Results Both the low- and high-dose groups exhibited significant reductions in visceral and subcutaneous fat areas compared to the control group at 12 weeks post-intervention. Conclusion Ingestion of a green tea beverage enriched with catechins with a galloyl moiety during a high-fat meal reduces body fat in moderately obese adults.

Green tea consumption affects cognitive dysfunction in the elderly: a pilot study.

Green tea is known to have various health benefits for humans. However, the effect of green tea consumption on cognitive dysfunction remains to be clinically verified. We conducted a clinical study to investigate the effects of green tea consumption on cognitive dysfunction. Twelve elderly nursing home residents with cognitive dysfunction (Mini-Mental State Examination Japanese version (MMSE-J) score: <28) participated in the study (2 men, 10 women; mean age, 88 years). The participants consumed green tea powder 2 g/day for 3 months. After three months of green tea consumption, the participants' MMSE-J scores were significantly improved (before, 15.3 ± 7.7; after, 17.0 ± 8.2; p = 0.03). This result suggests that green tea consumption may be effective in improving cognitive function or reducing the progression of cognitive dysfunction; however, long-term large-scale controlled studies are needed to further clarify the effect.

Epigallocatechin gallate decreases the micellar solubility of cholesterol via specific interaction with phosphatidylcholine.

The mechanisms underlying the effect of epigallocatechin gallate (EGCG) on the micellar solubility of cholesterol were examined. EGCG eliminated both cholesterol and phosphatidylcholine (PC) from bile salt micelles in a dose-dependent manner in vitro. When the bile salt micelles contained a phospholipid other than PC, neither cholesterol nor the phospholipid was eliminated following the addition of EGCG. When vesicles comprised of various phospholipids were prepared and, EGCG was added to the vesicles, EGCG effectively and exclusively eliminated only PC. An intermolecular nuclear Overhauser effect (NOE) was observed between PC and EGCG in bile salt micelles with EGCG added, but not between cholesterol and EGCG, by using a NOE-correlated spectroscopy nuclear magnetic resonance method. The results of binding analyses using surface plasmon resonance (SPR) showed that EGCG did not bind to cholesterol. These observations strongly suggest that EGCG decreases the micellar solubility of cholesterol via specific interaction with PC.

Effects of green tea catechins and theanine on preventing influenza infection among healthcare workers: a randomized controlled trial.

BACKGROUND: Experimental studies have revealed that green tea catechins and theanine prevent influenza infection, while the clinical evidence has been inconclusive. This study was conducted to determine whether taking green tea catechins and theanine can clinically prevent influenza infection. DESIGN, SETTING, AND PARTICIPANTS: A randomized, double-blind, placebo-controlled trial of 200 healthcare workers conducted for 5 months from November 9, 2009 to April 8, 2010 in three healthcare facilities for the elderly in Higashimurayama, Japan. INTERVENTIONS: The catechin/theanine group received capsules including green tea catechins (378 mg/day) and theanine (210 mg/day). The control group received placebo. MAIN OUTCOME MEASURES: The primary outcome was the incidence of clinically defined influenza infection. Secondary outcomes were (1) laboratory-confirmed influenza with viral antigen measured by immunochromatographic assay and (2) the time for which the patient was free from clinically defined influenza infection, i.e., the period between the start of intervention and the first diagnosis of influenza infection, based on clinically defined influenza infection. RESULTS: Eligible healthcare workers (n = 197) were enrolled and randomly assigned to an intervention; 98 were allocated to receive catechin/theanine capsules and 99 to placebo. The incidence of clinically defined influenza infection was significantly lower in the catechin/theanine group (4 participants; 4.1%) compared with the placebo group (13 participants; 13.1%) (adjusted OR, 0.25; 95% CI, 0.07 to 0.76, P = 0.022). The incidence of laboratory-confirmed influenza infection was also lower in the catechin/theanine group (1 participant; 1.0%) than in the placebo group (5 participants; 5.1%), but this difference was not significant (adjusted OR, 0.17; 95% CI, 0.01 to 1.10; P = 0.112). The time for which the patient was free from clinically defined influenza infection was significantly different between the two groups (adjusted HR, 0.27; 95% CI, 0.09 to 0.84; P = 0.023). CONCLUSIONS: Among healthcare workers for the elderly, taking green tea catechins and theanine may be effective prophylaxis for influenza infection. TRIAL REGISTRATION: ClinicalTrials (NCT): NCT01008020.

Phase II randomized, placebo-controlled trial of green tea extract in patients with high-risk oral premalignant lesions.

Epidemiologic and preclinical data support the oral cancer prevention potential of green tea extract (GTE). We randomly assigned patients with high-risk oral premalignant lesions (OPL) to receive GTE at 500, 750, or 1,000 mg/m(2) or placebo thrice daily for 12 weeks, evaluating biomarkers in baseline and 12-week biopsies. The OPL clinical response rate was higher in all GTE arms (n = 28; 50%) versus placebo (n = 11; 18.2%; P = 0.09) but did not reach statistical significance. However, the two higher-dose GTE arms [58.8% (750 and 1,000 mg/m(2)), 36.4% (500 mg/m(2)), and 18.2% (placebo); P = 0.03] had higher responses, suggesting a dose-response effect. GTE treatment also improved histology (21.4% versus 9.1%; P = 0.65), although not statistically significant. GTE was well tolerated, although higher doses increased insomnia/nervousness but produced no grade 4 toxicity. Higher mean baseline stromal vascular endothelial growth factor (VEGF) correlated with a clinical (P = 0.04) but not histologic response. Baseline scores of other biomarkers (epithelial VEGF, p53, Ki-67, cyclin D1, and p16 promoter methylation) were not associated with a response or survival. Baseline p16 promoter methylation (n = 5) was associated with a shorter cancer-free survival. Stromal VEGF and cyclin D1 expression were downregulated in clinically responsive GTE patients and upregulated in nonresponsive patients at 12 weeks (versus at baseline). An extended (median, 27.5 months) follow-up showed a median time to oral cancer of 46.4 months. GTE may suppress OPLs, in part through reducing angiogenic stimulus (stromal VEGF). Higher doses of GTE may improve short-term (12-week) OPL outcome. The present results support longer-term clinical testing of GTE for oral cancer prevention.

Black-tea polyphenols suppress postprandial hypertriacylglycerolemia by suppressing lymphatic transport of dietary fat in rats.

Administration of black-tea polyphenols (BTP) at 100 and 200 mg/kg of body weight in rats suppressed postprandial hypertriacylglycerolemia in a dose-dependent manner. Administration of BTP also suppressed lymphatic recovery of (14)C-trioleoylglycerol in rats that were cannulated in the thoracic duct. BTP dose-dependently inhibited the activity of pancreatic lipase in vitro with an IC50 of 0.254 mg/mL. When purified theaflavins, which are components of BTP, were used, theaflavins with galloyl moieties, but not those without galloyl moiety, inhibited the activity of pancreatic lipase. Theaflavin-3,3'-digallate (TFDG) was more effective in inhibiting the activity of pancreatic lipase than epigallocatechin gallate (EGCG), epicatechin gallate (ECG), and a mixture of EGCG and ECG. BTP and TFDG had a similar effect in inhibiting the activity of pancreatic lipase when the total polyphenol amount was adjusted to the same. BTP had no effect on micellar solubility of hydrolysis products of triacylglycerol. These results suggest that BTP suppressed postprandial hypertriacylglycerolemia by reducing triacylglycerol absorption via the inhibition of pancreatic lipase activity.

Endothelium-dependent vasorelaxation effect of rutin-free tartary buckwheat extract in isolated rat thoracic aorta.

The aim of this study was to point out the potential of tartary buckwheat on vascular functions. A nonabsorbed fraction of hot-water extract of tartary buckwheat on a SP70 column (TBSP-T), which was free from rutin, was used for this aim. In a contractile experiment using Sprague-Dawley rat thoracic aorta rings contracted by 1.0 microM phenylephrine (PE) or 50 mM KCl, TBSP-T evoked a significant vasorelaxation [EC50 (mg/ml): PE; 2.2; KCl, 1.9]. By a further fractionation of TBSP-T by liquid-liquid partitioning into basic, neutral and acidic fractions, a marked enhancement of vasorelaxation effect was observed only for acidic fraction (EC50, 0.25 mg/ml). The action of acidic fraction was significantly attenuated in endothelium-denuded aortic rings and in the presence of nitric oxide synthase inhibitor, NG-monomethyl-L-arginine (100 microM). The fraction also enhanced the cyclic guanosine monophosphate (cGMP) production in aortic rings contracted with PE [cGMP (pmol/mg protein): PE, 7.2+/-2.3; PE+Acidic fraction, 35+/-8]. These results indicate that acidic fraction could mediate NO/cGMP pathways, thereby exerting endothelium-dependent vasorelaxation action. In conclusion, tartary buckwheat was proven to regulate vascular tones and have latent acidic candidates except for rutin.

Tea catechins attenuate chronic ventricular remodeling after myocardial ischemia in rats.

Tea catechins have many biological functions; these effects are induced by the suppression of several inflammatory factors. However, the effects of catechins on ventricular remodeling after myocardial ischemia have not been well investigated. To test the hypothesis that catechins can attenuate chronic ventricular remodeling after myocardial ischemia, we performed oral administration of catechins into rat myocardial ischemia models. We analyzed the mechanisms using physiological, pathological and molecular examinations. Although severe myocardial fibrosis with enhancement of inflammatory factors were observed in the non-treated ischemia group on day 28, catechins attenuated these changes with suppressed NF-kappaB and matrix metalloproteinases without systemic adverse effects. Catechins are potent for the suppression of chronic ventricular remodeling after myocardial ischemia because they are critically involved in the suppression of several inflammatory genes.

Tea catechins improve left ventricular dysfunction, suppress myocardial inflammation and fibrosis, and alter cytokine expression in rat autoimmune myocarditis.

BACKGROUND: Myocarditis is a clinically serious disease. Tea catechins have been shown to reduce inflammation; however the effects of catechins on the development of myocarditis have not been well studied. AIMS: To clarify the role of catechins, using an experimental autoimmune myocarditis (EAM) model. METHODS AND RESULTS: Lewis rats were immunized with porcine cardiac myosin to establish EAM. Tea catechins were administered orally from day 0 to day 21 (Group A, n=12), from day 14 to day 21 (Group B, n=8), or saline (Group C, n=9) daily. Rats were killed on day 21. Echocardiograms indicated that Group A showed significantly improved cardiac function compared to Group C. Pathologically, non-treated EAM hearts showed severe myocardial cell infiltration and fibrosis; however Group A showed significantly less area. Immunohistochemistry revealed enhanced expression of NF-kappaB and ICAM-1 in non-treated EAM hearts, which was suppressed by catechin administration in Group A. mRNA levels of TNF-alpha were decreased and Th2 cytokines were markedly enhanced in Group A compared with the control group. Late catechin administration (Group B) showed limited effects on EAM. CONCLUSION: The catechins suppressed ventricular remodelling in EAM; thus catechin treatment might be a promising option for the prevention of EAM myocarditis.

Tea catechins attenuate ventricular remodeling and graft arterial diseases in murine cardiac allografts.

OBJECTIVE: Tea catechins have many biological functions; these effects are induced by the suppression of several inflammatory factors. However, effects of catechins on cardiac allograft rejection have not been well investigated. METHODS AND RESULTS: To test the hypothesis that catechins can attenuate ventricular remodeling and graft arterial diseases (GAD) in cardiac rejection, we orally administered catechins to murine cardiac recipients. We analyzed the mechanisms using immunohistochemistry, RNase protection, gel mobility shift, and cell proliferation assays. Although severe myocardial cell infiltration, fibrosis, and GAD with enhancement of inflammatory factors were observed in untreated class II mismatch allografts at day 60, catechins attenuated these changes with altered Th1/Th2 cytokine balance and suppressed NF-kappaB activation and cell proliferation. CONCLUSION: Catechins are potent agents for the suppression of chronic rejection because they are critically involved in the suppression of proinflammatory signaling pathways.

Analysis of tea catechins in human plasma by high-performance liquid chromatography with solid-phase extraction.

Accurate monitoring of tea catechins in biological samples might provide a means of better evaluation of their benefits. The aim of the present study was to develop a rapid method for extracting tea catechins from human plasma samples with a solid-phase extraction technique and to subsequently measure their concentrations using an HPLC system. A human plasma sample spiked with known concentrations of the analyte standards was passed through a Waters Oasis HLB cartridge. After repeated washing, tea catechins were eluted with 70% dimethylformamide containing 0.1% phosphoric acid, and the resulting eluate was injected into an HPLC system. Analytes were separated on a reverse-phase C18 column using an isocratic mobile phase and detected electrochemically. The coefficient of variation for inter- and intraday reproducibility was less than 5.0% and 6.4%, respectively. Linearity was established for the concentration range of 0.01-1.0 microM. The method was successfully applied to measure tea catechin concentrations in the plasma of two healthy subjects who received a single ingestion of a green tea beverage. The proposed method enables the rapid and accurate quantitation of plasma tea catechins and might prove useful for the evaluation of beneficial health effects of tea consumption.

Heat-epimerized tea catechins have the same cholesterol-lowering activity as green tea catechins in cholesterol-fed rats.

Tea catechins are known to be epimerized by heat treatment. The effect of heat-epimerized tea catechins on serum cholesterol concentration was compared with that of green tea catechins. Our observations strongly suggest that both tea catechins and heat-epimerized tea catechins lower serum cholesterol concentration by inhibiting cholesterol absorption in the intestine. There was no differential effect between the two catechin preparations.

Dietary consumption of green tea catechins attenuate hyperlipidaemia-induced atherosclerosis and systemic organ damage in mice.

OBJECTIVE: The effects of consuming green tea catechins on the development of hyperlipidaemia-induced systemic organ damage have not been well studied; we investigated the effect using low density lipoprotein receptor knockout mice. METHODS AND RESULTS: Mice were treated with high cholesterol food containing 0.2 or 4% catechins and they were supplemented for 35 weeks. High plasma cholesterol levels, liver and renal dysfunctions were observed in no catechin fed mice, while chow containing catechin suppressed these levels and damages. Severe atherosclerosis of the aorta, fatty liver and renal injury were also shown in the control mice; inflammatory factors were enhanced in these lesions of nontreated mice. The lesions were attenuated with suppression of the inflammatory factors in the chow-contained catechin treatment group. CONCLUSION: Dietary consumption of tea catechins attenuated the development of the systemic organ damage; thus, this has a clinical effect against systemic inflammatory diseases.

Dose-dependent suppression of tea catechins with a galloyl moiety on postprandial hypertriglyceridemia in rats.

Tea has long been believed to be a healthy beverage, and its beneficial effects are almost all attributed to catechins. The effect of catechins on postprandial hypertriglyceridemia in rats was investigated in this study. A lipid emulsion administered orally to rats with (-)-epigallocatechin gallate at a dose of 100 mg/kg resulted in the increase in plasma triacylglycerol being significantly inhibited after 1 and 2 h compared to the case without (-)-epigallocatechin gallate. The effect of (-)-epigallocatechin was weaker than that of (-)-epigallocatechin gallate. A tea extract (THEA-FLAN 90S), mainly composed of catechins with a galloyl moiety, dose-dependently suppressed postprandial triacylglycerol after the administration of a lipid emulsion at doses of 50-200 mg/kg. The administration of the tea extract alone at a dose of 200 mg/kg had no effect on the plasma triacylglycerol level. These results strongly suggest that catechins with a galloyl moiety would be promising agents for suppressing dietary fat absorption through the small intestine.

Effect of tea catechins on postprandial plasma lipid responses in human subjects.

Epidemiological surveys suggest that a higher intake of tea may be associated with a lower risk of CHD. There is accumulating evidence that postprandial lipaemia makes a substantial contribution to the incidence of CHD. Our aim was, therefore, to evaluate the effect of tea catechins (major ingredients in green tea) on postprandial lipid responses in human subjects after the consumption of test meals. In a randomized triple-crossover design, nine male subjects with mild or borderline hypertriacylglycerolaemia consumed 10 (control), 224 (moderate dose) and 674 mg (high dose) of the assigned tea catechins three times each along with a standardized light meal consisting of a piece of bread spread with 20 g butter. Plasma lipids were measured in the fasting state and 1, 2, 3, 4 and 6 h after consuming the light meal. Results showed that, compared with the control, moderate and high doses of tea catechins reduced the incremental area under the plasma triacylglycerol curves by 15.1 and 28.7%, respectively. Next, the rapid elevation of remnant-like particle cholesterol was significantly inhibited by a high dose of tea catechins 2 h after consuming the light meal (P<0.01). In the range of tea catechin dosages, no significant differences were observed in the postprandial responses for plasma total cholesterol or NEFA at any time point. In conclusion, this trial demonstrated that tea catechins attenuated the postprandial increase in plasma triacylglycerol levels following a fat load. These results may provide evidence for one of the possible mechanisms involved in lowering the incidence of CVD, and may prove useful in further studies on the beneficial health effects of tea drinking.