Potential application of dietary polyphenols from red wine to attaining healthy ageing

Polyphenols are ubiquitous compounds present in the vegetal kingdom and endowed with an array of beneficial activities to human health. In this review, the effects of dietary polyphenols on the prevention and/or mitigation of cancer, neurodegenerative diseases, obesity, metabolic syndrome and atherosclerosis will be illustrated. Moreover, emphasis will be placed on our own data concerning the in vitro effects performed by polyphenols from an Italian red wine "Negroamaro" on human healthy peripheral blood mononuclear cells. Particularly, production of nitric oxide and maintenance of the inflammatory/anti-inflammatory cytokine network will be discussed also in relation to potential application to human age-related diseases. In conclusion, polyphenols in virtue of the plethora of protective effects manifested in various experimental models and clinical trials seem to be appropriate as dietary supplements for preventing the functional decline of organs with age.     

Nutraceutics and Delivery Systems

Medical treatment has been shifted to being more prophylactic as a recent trend. Postgenomic research has unveiled the fact that nutritional intervention has been strongly associated with genetic expressions, which are responsible for a variety of biological functions. Based on these findings, the prophylactic effects of dietary supplement and nutrient have been enthusiastically investigated. Preventing or retarding the onset of diseases has become a more attractive and cost effective strategy in the medical arena. Among other approaches to prevent diseases, antioxidants, which are found in many phytochemicals, have received much attention. However, most natural antioxidants such as α-tocopherol, ascorbic acid and others are biologically unstable, poorly soluble in water, and poorly distributed to target sites. Because of these shortcomings further prophylactic applications of dietary supplements have stagnated. This is partially due to a lack of basic awareness of drug delivery system for dietary supplements and nutrients. In this article, we strongly advocate serious consideration of the bioavailability of dietary supplements. Currently, there are some challenging works to improve their bioavailability using delivery systems such as liposomal formulations. We will discuss the target molecules of dietary supplements for prevention of diseases and also introduce the pioneering works of delivery systems for dietary supplements to promote their therapeutic value.     

Nutraceutics and delivery systems

Medical treatment has been shifted to being more prophylactic as a recent trend. Postgenomic research has unveiled the fact that nutritional intervention has been strongly associated with genetic expressions, which are responsible for a variety of biological functions. Based on these findings, the prophylactic effects of dietary supplement and nutrient have been enthusiastically investigated. Preventing or retarding the onset of diseases has become a more attractive and cost effective strategy in the medical arena. Among other approaches to prevent diseases, antioxidants, which are found in many phytochemicals, have received much attention. However, most natural antioxidants such as alpha-tocopherol, ascorbic acid and others are biologically unstable, poorly soluble in water, and poorly distributed to target sites. Because of these shortcomings further prophylactic applications of dietary supplements have stagnated. This is partially due to a lack of basic awareness of drug delivery system for dietary supplements and nutrients. In this article, we strongly advocate serious consideration of the bioavailability of dietary supplements. Currently, there are some challenging works to improve their bioavailability using delivery systems such as liposomal formulations. We will discuss the target molecules of dietary supplements for prevention of diseases and also introduce the pioneering works of delivery systems for dietary supplements to promote their therapeutic value.     

Metabolism of dietary polyphenols and possible interactions with drugs

Polyphenolic compounds are abundant in the human diet and gram quantities are ingested daily. The consumption of polyphenols is expected to rise due to the use of dietary supplements and public health initiatives promoting the consumption of more fruits and vegetables. It is known that these dietary polyphenols are extensively metabolized. Many of these compounds are therefore are expected to compete with other substrates of Phases I, II, III enzymes and transporters. In addition, some dietary polyphenols may induce certain drug metabolizing enzymes and affect the metabolism of important therapeutic agents. This review will discuss 1) the metabolism of dietary polyphenols using green tea polyphenols (catechins) as an example, 2) inhibition of drug metabolism by polyphenols, and 3) induction of drug metabolizing enzymes by dietary polyphenols. The potential consequences of these effects on drug metabolism will also be discussed.     

Molecular mechanisms of inflammation. Anti-inflammatory benefits of virgin olive oil and the phenolic compound oleocanthal

Chronic inflammation is a critical factor in the pathogenesis of many inflammatory disease states including cardiovascular disease, cancer, diabetes, degenerative joint diseases and neurodegenerative diseases. Chronic inflammatory states are poorly understood, however it is known that dietary habits can evoke or attenuate inflammatory responses. Popular methods to deal with inflammation and its associated symptoms involve the use of non steroidal anti-inflammatory drugs, however the use of these drugs are associated with severe side effects. Therefore, investigations concerned with natural methods of inflammatory control are warranted. A traditional Mediterranean diet has been shown to confer some protection against the pathology of chronic diseases through the attenuation of pro-inflammatory mediators and this has been partially attributed to the high intake of virgin olive oil accompanying this dietary regime. Virgin olive oil contains numerous phenolic compounds that exert potent anti-inflammatory actions. Of interest to this paper is the recently discovered phenolic compound oleocanthal. Oleocanthal is contained in virgin olive oil and possesses similar anti-inflammatory properties to ibuprofen. This pharmacological similarity has provoked interest in oleocanthal and the few studies conducted thus far have verified its anti-inflammatory and potential therapeutic actions. A review of the health benefits of the Mediterranean diet and anti-inflammatory properties of virgin olive oil is presented with the additional emphasis on the pharmacological and anti-inflammatory properties of the phenolic compound oleocanthal.     

Interaction of the isothiocyanate sulforaphane with drug disposition and metabolism: pharmacological and toxicological implications

Isothiocyanates (ITCs) are sulfur-containing compounds that are broadly distributed among cruciferous vegetables such as cabbages and broccoli. The consumption of ITCs is expected to rise due to the use of dietary supplements and public health initiatives promoting the consumption of more fruits and vegetables. Sulforaphane (SFN) is by far the most widely studied and characterized ITC. SFN is extensively metabolized and can therefore compete with other substrates of Phases I, II, III enzymes and transporters. In addition, it has an unusually high potency as an inducer of phase II enzymes and regulates the expression and function of different cytochrome P-450 genes. Such effects can be beneficial and may indicate a mechanism for the preventive role that SFN is believed to play against the degenerative events of aging and chronic diseases. Furthermore, these gene induction effects and the interaction with detoxification responses can modify bioavailability and in vivo bioactivity of drugs. This review will discuss 1) the metabolism of ITCs using SFN as an example, 2) inhibition of drug metabolism by SFN, and 3) induction of drug metabolizing enzymes by SFN. The potential pharmacological and toxicological implications of these effects on drug metabolism will also be discussed.     

Effect of dietary flavonoids on pathways involved in drug metabolism

Flavonoids are a large group of plant polyphenols with presumed beneficial effects on several common diseases. The use of dietary supplements enriched with flavonoids is becoming increasingly popular. These polyphenols are substrates of enzymes like cytochrome P450 monooxygenases and phase II conjugation enzymes, as well as of drug transporters involved in drug excretion. Thus, they share the same metabolic pathways with many therapeutic drugs. A number of studies have demonstrated inhibition of various cytochrome P450 monooxygenases and drug transporters by flavonoids. Flavonoid-induced effects on drug bioavailability were also shown. This raises concerns about the safe use of flavonoid supplements and flavonoid-containing remedies which are not subject to legal regulations. The challenge is to find a suitable way to predict harmful drug-flavonoid interactions.     

Emerging role of polyphenolic compounds in the treatment of neurodegenerative diseases: a review of their intracellular targets

Aging is the major risk factor for neurodegenerative diseases such as Alzheimer's and Parkinson's diseases. A large body of evidence indicates that oxidative stress is involved in the pathophysiology of these diseases. Oxidative stress can induce neuronal damages, modulate intracellular signaling, ultimately leading to neuronal death by apoptosis or necrosis. Thus antioxidants have been studied for their effectiveness in reducing these deleterious effects and neuronal death in many in vitro and in vivo studies. Increasing number of studies demonstrated the efficacy of polyphenolic antioxidants from fruits and vegetables to reduce or to block neuronal death occurring in the pathophysiology of these disorders. These studies revealed that other mechanisms than the antioxidant activities could be involved in the neuroprotective effect of these phenolic compounds. We will review some of these mechanisms and particular emphasis will be given to polyphenolic compounds from green tea, the Ginkgo biloba extract EGb 761, blueberries extracts, wine components and curcumin.     

Regulatory and ethical issues with dietary supplements

Dietary supplements are commonly used, and many are effective or hold promise for treating various conditions. However, they do not require Food and Drug Administration (FDA) approval. Impurities and adulterants have been found in the products, mostly due to the lack of requirements for good manufacturing practices. In addition, as no standardization is required, the active ingredient may be absent or highly variable among manufacturers. The FDA published its 10-year plan for dietary supplements that addresses safety, labeling, boundaries, enforcement, research, and outreach. This endeavor, if put into place, will be instrumental in providing consumers with more confidence in the safety, composition, and labeling of dietary supplements.     

Impact of Epigenetic Dietary Compounds on Transgenerational Prevention of Human Diseases

The etiology of most human diseases involves complicated interactions of multiple environmental factors with individual genetic background which is initially generated early in human life, for example, during the processes of embryogenesis and fetal development in utero. Early embryogenesis includes a series of programming processes involving extremely accurate time-controlled gene activation/silencing expressions, and epigenetic control is believed to play a key role in regulating early embryonic development. Certain dietary components with properties in influencing epigenetic processes are believed to have preventive effects on many human diseases such as cancer. Evidence shows that in utero exposure to certain epigenetic diets may lead to reprogramming of primary epigenetic profiles such as DNA methylation and histone modifications on the key coding genes of the fetal genome, leading to different susceptibility to diseases later in life. In this review, we assess the current advances in dietary epigenetic intervention on transgenerational human disease control. Enhanced understanding of the important role of early life epigenetics control may lead to cost-effective translational chemopreventive potential by appropriate administration of prenatal and/or postnatal dietary supplements leading to early disease prevention.     

Natural products to improve quality of life targeting for colon drug delivery

The colon is largely being investigated as a site for administration of protein and peptides, which are degraded by digestive enzymes in the upper GIT. Also for local diseases of the colon such as inflammatory bowel disease, colorectal cancer and ameobiasis, drug administration to the site of action can not only reduce the dose to be administered, but also decrease the side effects. Inflammatory Bowel Disease (IBD) such as Ulcerative colitis and Crohn's disease are characterized by chronic intestinal inflammation. Intestinal bacteria initiate the activation of intestinal inflammatory processes, which are mediated by pro-inflammatory cytokines and chemokine. Increased chemokine expression has also been observed in epithelial cells, endothelial cells, and smooth muscle cells. Future trials of specific agents capable of inhibiting chemokine synthesis and secretion or blocking chemokine-chemokine receptor interaction will be important to study in patients with ulcerative colitis and Crohn's disease. Many important bioactive compounds have been discovered from natural sources using bioactivity directed fractionation and isolation (BDFl) Continuing discovery has also been facilitated by the recent development of new bioassay methods. These bioactive compounds are mostly plant secondary metabolites, and many naturally occurring pure compounds have become medicines, dietary supplements, and other useful commercial products. The present review includes various approaches investigated for colon drug delivery and their site specificity. To achieve successful colonic delivery, a drug needs to be protected from absorption and the environment of the upper gastrointestinal tract and then be abruptly released into the proximal colon, which is considered the optimum site for colon targeted delivery of drugs.     

Drug use in sports: a veritable arena for pharmacists.

OBJECTIVE: To describe opportunities and obligations for pharmacists regarding doping control in sports, and to present information and resources on drugs and dietary supplements that are popular among athletes for performance enhancement. DATA SOURCES: Sports medicine journals and articles in English obtained from Medline (1966 through June 2003) using the search terms doping in sports, drugs in sports, dietary supplements, sports, amphetamine, stimulants, ephedrine, ephedra, caffeine, anabolic steroids, human growth hormone, erythropoietin, darbepoetin, androstenedione, dehydroepiandrosterone, and creatine. Information was also obtained from sports-governing agencies, such as the National Collegiate Athletic Association and the International Olympic Committee. STUDY SELECTION: Studies and reports that were credible and scientifically sound that evaluated the ergogenic effects of drugs and dietary supplements. DATA EXTRACTION: By the author. DATA SYNTHESIS: Pharmacists can participate in doping control programs in a number of ways. Pharmacists also have an obligation when counseling, advising, and treating athletes to help them avoid banned substances. Athletes use a host of drugs for their performance-enhancing effects, many of which are banned by major sports-governing bodies. Myriad dietary supplements are marketed to athletes, claiming to have ergogenic effects. Some of these popular supplements have proven performance-enhancing effects, while others do not. Adverse effects of these drugs and dietary supplements are discussed. CONCLUSION: A variety of drugs and dietary supplements have proven performance-enhancing effects in athletes. However, many of these substances have adverse effects and are banned by various sports-governing organizations. Pharmacists can play a key role in participating in doping control programs, and can prevent athletes from inadvertently consuming a banned substance.     

Presence of Mycotoxins in Milk Thistle (Silybum marianum) Food Supplements: A Review

The consumption of herbal-based supplements, which are believed to have beneficial effects on human health with no side effects, has become popular around the world and this trend is still increasing. Silybum marianum (L.) Gaertn, commonly known as milk thistle (MT), is the most commonly studied herb associated with the treatment of liver diseases. The hepatoprotective effects of active substances in silymarin, with silybin being the main compound, have been demonstrated in many studies. However, MT can be affected by toxigenic micro-fungi and contaminated by mycotoxins with adverse effects. The beneficial effect of silymarin can thus be reduced or totally antagonized by mycotoxins. MT has proven to be affected by micro-fungi of the Fusarium and Alternaria genera, in particular, and their mycotoxins. Alternariol-methyl-ether (AME), alternariol (AOH), beauvericin (BEA), deoxynivalenol (DON), enniatin A (ENNA), enniatin A₁ (ENNA₁), enniatin B (ENNB), enniatin B₁ (ENNB₁), HT-2 toxin (HT-2), T-2 toxin (T-2), tentoxin (TEN), and zearalenone (ZEA) seem to be most significant in MT-based dietary supplements. This review focuses on summarizing cases of mycotoxins in MT to emphasize the need for strict monitoring and regulation, as mycotoxins in relation with MT-based dietary supplements are not covered by European Union legislation.     

Health effects of quercetin: from antioxidant to nutraceutical

Quercetin, a member of the flavonoids family, is one of the most prominent dietary antioxidants. It is ubiquitously present in foods including vegetables, fruit, tea and wine as well as countless food supplements and is claimed to exert beneficial health effects. This includes protection against various diseases such as osteoporosis, certain forms of cancer, pulmonary and cardiovascular diseases but also against aging. Especially the ability of quercetin to scavenge highly reactive species such as peroxynitrite and the hydroxyl radical is suggested to be involved in these possible beneficial health effects. Consequently, numerous studies have been performed to gather scientific evidence for these beneficial health claims as well as data regarding the exact mechanism of action and possible toxicological aspects of this flavonoid. The purpose of this review is to evaluate these studies in order to elucidate the possible health-beneficial effects of the antioxidant quercetin. Firstly, the definitions as well as the most important aspects regarding free radicals, antioxidants and oxidative stress will be discussed as background information. Subsequently, the mechanism by which quercetin may operate as an antioxidant (tested in vitro) as well as the potential use of this antioxidant as a nutraceutical (tested both ex vivo and in vivo) will be discussed.     

Recent progress in natural dietary non-phenolic bioactives on cancers metastasis

From several decades ago to now, cancer continues to be the leading cause of death worldwide, and metastasis is the major cause of cancer-related deaths. For health benefits, there is a great desire to use non-chemical therapy such as nutraceutical supplementation to prevent pathology development. Over 10,000 different natural bioactives or phytochemicals have been known that possessing potential preventive or supplementary effects for various diseases including cancer. Previously, the in vitro and in vivo anti-invasive and anti-metastatic activities of phenolic acids, monophenol, polyphenol and their derivatives and flavonoids and their derivatives have been reviewed. However, a vast number of natural dietary compounds other than phenolics have been demonstrated to potentially possess the ability to inhibit the invasion and metastasis of various cancers. In this review, we summarize the studies in recent decade on in vitro and in vivo effects and molecular mechanisms of natural bioactives, excluding the phenolics in food, in cancer invasion and metastasis. By combining this review of non-phenolics with the previous phenolics reviews, the puzzle for the contribution of natural dietary bioactives on cancer invasive or/and metastatic progress will be almost complete and more clear.     

Epifriedelanol from the root bark of Ulmus davidiana inhibits cellular senescence in human primary cells

Since cellular senescence involves organismal aging as well as diverse diseases, aging intervention might contribute to inhibit the aging process as well as aging-associated diseases. We tried to search for effective compounds from the root bark of ULMUS DAVIDIANA that are able to inhibit cellular senescence in human fibroblasts (HDFs) and human umbilical vein endothelial cells (HUVECs). Twenty-two compounds from the root bark of U. DAVIDIANA were isolated and screened for their inhibitory effects on adriamycin-induced cellular senescence by measuring senescence-associated β-galatosidase (SA- β-gal) activity. Among twenty-two compounds isolated, epifriedelanol (3), ssioriside (15), and catechin-7-O- β-D-glucopyranoside (22) had inhibitory effects on adriamycin-induced cellular senescence in HDFs. Friedelin (2), epifriedelanol (3), and catechin-7-O- β-apiofuranoside (18) were active in HUVECs. In particular, epifriedelanol (3) suppressed adriamycin-induced cellular senescence as well as replicative senescence in HDFs and HUVECs. These results suggest that epifriedelanol (3) reduces cellular senescence in human primary cells and might be used to develop dietary supplements or cosmetics that modulate tissue aging or aging-associated diseases.