Prebiotics Plus Probiotics May Favorably Impact on Gut Permeability, Endocannabinoid Receptors, and Inflammatory Biomarkers in Patients with Coronary Artery Diseases: A Clinical Trial.

While gut-to-systemic translocation of pyrogenic endotoxin due to a leaky gut elicits systemic inflammation, at the intestine, the endocannabinoid system (eCB) also plays a major role in modulating the impact of gut dysbiosis on the host system. Therefore, we hypothesized that coadministration of prebiotic inulin with probiotics would improve the eCB system, gut microbial composition, and inflammatory parameters associated with coronary artery diseases (CAD). We designed a randomized, double-blind trial with 92 CAD patients. Patients were randomly allocated to receive inulin (15 mg/day), LGG capsules 1.9 × 109 colony-forming unit (CFU) or inulin plus probiotic (synbiotics) supplements, for a duration of 60 days. We assessed gut microbiota composition, expression of cannabinoid receptors (i.e., CB1 and CB2), serum levels of interleukin-6 (IL-6), toll-like receptor 4 (TLR-4), lipopolysaccharides (LPS), total antioxidant capacity (TAC), and malondialdehyde (MDA) before and after the supplementation. Probiotic-inulin cosupplementation significantly decreased IL6, LPS, and TLR-4 and increased serum TAC concentrations compared with the placebo. While CB1 receptor expression had no difference, significant differences were observed for the CB2 receptor expression among the four treatments. CB2 receptor mRNA expression significantly (p < .05) correlated with serum levels of LPS (r = -.10) and F/B ratio (r = -.407, p = .047). Our data collectively provide preliminary evidence that gut microbiota determines gut permeability through the LPS-eCB system. We also have found that synbiotics improved the eCB receptors, and inflammatory biomarkers more than either of the two supplementations given alone.

Can omega-3 fatty acids and vitamin E co-supplementation affect obesity indices?

Background: Studies have shown that vitamin E as an antioxidant protects omega-3 fatty acids (FAs) from oxidation. Several studies have evaluated the effect of omega-3 FAs and vitamin E co-supplementation on obesity indices; however, the results are inconsistent. The present systematic review and meta-analysis was conducted to address the role of omega-3 FAs plus vitamin E on obesity indices. Methods: Cochrane Library, PubMed, Scopus, Embase, and Web of Science databases were searched up to February 2022. Among all of the qualified studies, 10 articles were selected. The effect size was presented as weighted mean difference (WMD) and 95% confidence interval (CI). Fixed-effects model was employed to perform meta-analysis. Subgroup analysis and publication bias assessment were carried out. Results: Ten eligible randomized controlled trials comprising 558 participants were included. The average dose of omega-3 FAs and vitamin E co-supplementation in studies was 1000-4000 mg/day and 400 IU, respectively. Intervention duration varied from 6 to 16 weeks. There was no significant effect of omega-3 and vitamin E co-supplementation on body weight (BW) (WMD=0.14 kg; 95% CI: -0.13 to 0.42; p=0.297), and body mass index (BMI) (WMD=0.08, 95% CI: -0.01 to 0.16, p=0.073). However, subgroup analysis showed that it might increase BMI in women over 50 years and if the intervention lasted more than 8 weeks. Conclusion: There was no significant impact of combined omega-3 FAs and vitamin E supplementation on BW and BMI; however, it should be noted that the intervention has an increasing impact when supplementation duration was >8 weeks and in individuals with type 2 diabetes mellitus, >50 years old, and BMI>25 kg/m2.

A comprehensive insight into effects of resveratrol on molecular mechanism in rheumatoid arthritis: A literature systematic review.

AIM: Rheumatoid arthritis (RA) is an inflammatory autoimmune disease, which is characterized by massive pain and destruction of synovial joints, leads to bone erosion, damage to cartilage, and disability. Several studies suggested that resveratrol supplementation may be effective in the prevention and management of RA. Therefore, a systematic review was conducted to summarize published studies that assess the effect of resveratrol supplementation on the complications of RA. METHODS: A comprehensive search to identify in vitro, animal, and human studies investigating the impact of resveratrol on the complications of RA was performed up to February 2022. Two independent reviewers evaluated studies based on inclusion/exclusion criteria and performed data extraction. RESULTS: All studies examining the effects of resveratrol supplementation on the complications of RA were included. From a total of 571 retrieved articles, 32 studies were eligible for the current systematic review. The evidence reviewed here indicates that resveratrol supplementation may exert beneficial effects on the complications of RA by attenuating inflammation and oxidative stress, modulating the immune response, and down-regulating the messenger RNA expression of genes related to inflammatory pathways. CONCLUSION: Due to the promising therapeutic effects of resveratrol on RA complications and limited number of human studies in this subject, further clinical trials are suggested.

Dietary total antioxidant capacity and its association with renal function and kidney stones: Results of a RaNCD cohort study.

There is evidence to support the hypothesis that dietary antioxidants have shown protective effects against chronic kidney disease (CKD). The purpose of this study was to determine the association between the dietary total antioxidant capacity (DTAC), renal function, and development of CKD and kidney stones in Ravansar Non-Communicable Diseases (RaNCD) cohort study, Kermanshah, Iran. This cross-sectional study was conducted using the recruitment baseline data of the RaNCD cohort study on 9,777 individuals aged 35-65 years. Food frequency questionnaire (FFQ) was performed to assess diet. DTAC scores were calculated using the ferric reducing antioxidant power (FRAP) of selected foods. Renal function was assessed by the estimated glomerular filtration rate (eGFR), blood urea nitrogen, and serum creatinine concentration. Prevalent CKD was based on an eGFR less than <60 ml/min per 1.73 m2. Incidence of kidney stones was also assessed by self-reporting. Out of 9,777 participants, 1,747 subjects (eGFR: 18.50 ml/min per 1.73 m2; 95% confidence interval (CI): 17.72-19.30) had CKD. The mean DTAC score in this study was 0.24 ± 0.16 µmol TE/100 g (micromole of Trolox Equivalents). We showed a significant trend for eGFR across quartiles of DTAC, i.e., participants in the fourth quartile had a higher glomerular filtration rate (GFR) than those in the first one (DTAC Q4 vs Q1 = 82.20 versus 72.20 ml/min per 1.73 m2, p < .001). Another finding is that high DTAC scores were not associated with having kidney stones after adjusting for confounders. We revealed that higher DTAC scores have positive effects on the renal function. Interestingly, our findings showed that a high DTAC score had nonsignificant correlation with odds of kidney stones.

Association of Dietary Inflammatory Index (DII) with disease activity and inflammatory cytokines in the patients with rheumatoid arthritis.

OBJECTIVES: This study aimed, at first, to assess Dietary Inflammatory Index (DII) in participants with rheumatoid arthritis (RA) and compare them with healthy controls. Then, to evaluate the association of DII with the risk of RA occurrence, the severity of disease, and systemic inflammation. METHODS: This case-control study enrolled 100 newly diagnosed cases with RA and 100 age and sex-matched healthy controls. DII was computed based on the individuals' FFQ-derived dietary data. Serum levels of inflammatory markers, including the high sensitivity C-reactive protein (hs-CRP) and Tumour Necrosis Factor-alpha (TNF-α), were measured using the ELISA method; and the severity of the disease was assessed based on the disease activity score 28 (DAS-28). RESULTS: The mean DII score was higher in the RA patients as compared with that in the controls (0.66 ± 0.23 vs. -0.58 ± 0.19, P = .002). Patients with the highest DII had significantly higher serum inflammatory (hs-CRP and TNF) and clinical markers (DAS-28 score and the number of tender joints). A significant univariate relationship between DII score and risk of RA incident [6.48 (95% CI: 1.79 to 23.44)] disappeared in multivariate analysis. For each 1-unit increase in DII, the DAS-28 score was raised by 1.11 times (P = .001). CONCLUSION: An inflammatory diet may act as a potential risk factor contributing to the development of RA and its severity. Therefore, dietary modification with the goal of reducing the DII score could be a beneficial strategy to improve the clinical outcomes in such patients.

Dietary Inflammatory Index in relation to psoriasis risk, cardiovascular risk factors, and clinical outcomes: a case-control study in psoriasis patients.

Psoriasis is an inflammatory skin disease. Despite the understanding of disease pathogenesis, the link between diet-induced inflammation and the risk of psoriasis remains underexplored. Therefore, we examined the capability of the literature-derived energy-adjusted Dietary Inflammatory Index (E-DII) as a predictive tool for inflammation, incidence, and severity of psoriasis (as indexed by the Psoriasis Area Severity Index (PASI)). We conducted a case-control study of 149 adults (75 cases and 74 controls). The E-DII score was calculated based on the dietary intake that was evaluated using a validated 168 item quantity food-frequency questionnaire. The E-DII tertile cut-offs were categorized based on the following cut points: tertiles 1 ≤ -1.99; tertiles 2 = -2.00 to 0.60; tertile 3 ≥ 0.61. Logistic regression models were used to estimate the multivariable odds ratio (OR) adjusted for confounders. Patients with higher pro-inflammatory E-DII had a 3.60-times increased risk of psoriasis relative to patients in tertiles 1 (E-DIIT3 vs E-DIIT1: OR = 3.64; 95% confidence interval (CI) 1.51 to 8.79, P = 0.005). The severity of disease as indexed by PASI remained associated with E-DII (E-DIIT3 vs E-DIIT1: OR = 3.64; 95% CI 1.74 to 7.57, P = 0.015). For each unit increase in E-DII, the probability of disease severity is increased 3 times. Patients consuming a more pro-inflammatory diet were at a greater risk of psoriasis. These patients also demonstrated increased disease severity relative to individuals consuming a more anti-inflammatory diet. Novelty: A pro-inflammatory diet is associated with higher psoriasis incidence. Subjects with higher DII scores had higher inflammatory markers levels.