Abstract
Oxidative stress is present in patients with Inflammatory Bowel Disease (IBD), and natural supplements with antioxidant properties have been investigated as a non-pharmacological approach. The objective of the present study was to assess the effects of a natural Pistacia lentiscus (PL) supplement on oxidative stress biomarkers and to characterise the plasma-free amino acid (AA) profiles of patients with active IBD (Crohn’s disease (CD) N = 40, ulcerative colitis (UC) N = 20). The activity was determined according to 5 ≤ Harvey Bradshaw Index ≤ 16 or 2 ≤ Partial Mayo Score ≤ 6. This is a randomised, double-blind, placebo-controlled clinical trial. IBD patients (N = 60) were randomly allocated to PL (2.8 g/day) or to placebo for 3 months being under no treatment (N = 21) or under stable medical treatment (mesalamine N = 24, azathioprine N = 14, and corticosteroids N = 23) that was either single medication (N = 22) or combined medication (N = 17). Plasma oxidised, low-density lipoprotein (oxLDL), total serum oxidisability, and serum uric acid were evaluated at baseline and follow-up. OxLDL/LDL and oxLDL/High-Density Lipoprotein (HDL) ratios were calculated. The plasma-free AA profile was determined by applying a gas chromatography/mass spectrometry analysis. oxLDL (p = 0.031), oxLDL/HDL (p = 0.020), and oxLDL/LDL (p = 0.005) decreased significantly in the intervention group. The mean change differed significantly in CD between groups for oxLDL/LDL (p = 0.01), and, in the total sample, both oxLDL/LDL (p = 0.015) and oxLDL/HDL (p = 0.044) differed significantly. Several changes were reported in AA levels. PL ameliorated a decrease in plasma-free AAs seen in patients with UC taking placebo. In conclusion, this intervention resulted in favourable changes in oxidative stress biomarkers in active IBD.
Highlights
Inflammatory bowel disease (IBD) is a chronic gastrointestinal disease that includes Crohn’s disease (CD) and ulcerative colitis (UC)
Out of the 60 patients, 27 (45.0%) were randomised to the placebo group and 33 (55.0%) to the verum group, while 40 (66.7%) of them were diagnosed with CD and 20 (33.3%) with UC
24-h recalls were analysed applying the Nutritionist Pro software and no significant differences were observed in macronutrient or micronutrient intake between the mean changes in groups (Supplementary Material, Table S2)
Summary
Inflammatory bowel disease (IBD) is a chronic gastrointestinal disease that includes Crohn’s disease (CD) and ulcerative colitis (UC). IBD patients in relapse are at increased risk of acute arterial events even at a young age [1] and at increased risk of acute myocardial infarction and heart failure even if they do not meet the traditional risk factors for cardiovascular disease [2]. Oxidative stress has been proposed as both a putative causal and perpetuating factor for IBD [3]. Oxidative stress plays a critical role in the pathogenesis, progression, and severity of IBD, serving as an immunoregulatory factor. Chronic inflammation of the intestinal mucosa stimulates excessive reactive oxygen species (ROS)/reactive nitrogen species (RNS) production leading to oxidative stress [4,5]
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