Sulforaphane Supplementation Did Not Modulate NRF2 and NF-kB mRNA Expressions in Hemodialysis Patients

Abstract

Patients with chronic kidney disease (CKD) have reduced expression of erythroid nuclear factor-related factor 2 (NRF2) and increased nuclear factor κB (NF-κB). "Food as medicine" has been proposed as an adjuvant therapeutic alternative in modulating these factors. No studies have investigated the effects of sulforaphane (SFN) in cruciferous vegetables on the expression of these genes in patients with CKD. The study aimed to evaluate the effects of SFN on the expression of NRF2 and NF-κB in patients on hemodialysis (HD). A randomized, double-blind, crossover study was performed on 30 patients on regular HD. Fourteen patients were randomly allocated to the intervention group (1 sachet/day of 2.5g containing 1% SFN extract with 0.5% myrosinase) and 16 patients to the placebo group (1 sachet/day of 2.5g containing corn starch colored with chlorophyll) for 2months. After a washout period of 2months, the groups were switched. NRF2 and NF-κB mRNA expression was evaluated by real-time quantitative polymerase chain reaction, and tumor necrosis factor alpha and interleukin-6 levels were quantified by enzyme-linked immunosorbent assay. Malondialdehyde was evaluated as a marker of lipid peroxidation. Twenty-five patients (17 women, 55 [interquartile range=19] years and 55 [interquartile range=74] months on HD) completed the study. There was no significant difference concerning the expression of mRNA NRF2 (P=.915) and mRNA NF-κB (P=.806) after supplementation with SFN. There was no difference in pro-inflammatory and oxidative stress biomarkers. 150μmol of SFN for 2months had no antioxidant and anti-inflammatory effect in patients with CKD undergoing HD.