The Effect of Intensive Dietary Intervention on the Level of RANTES and CXCL4 Chemokines in Patients with Non-Obstructive Coronary Artery Disease: A Randomised Study.

Magdalena Makarewicz-Wujec,Cezary Kępka,Łukasz Wardziak,Piotr Trochimiuk,Andrzej Parzonko,Malgorzata Kozłowska-Wojciechowska,Marcin Demkow,Mariusz Kruk,Jan Henzel,Zofia Dzielińska

doi:10.3390/biology10020156

Abstract

Simple SummaryThe dietary approaches to stop hypertension (DASH) diet contains meals with plenty of vegetables, fruits and low-fat dairy products, as well as whole grains, fish, poultry and nuts. One of the potential mechanisms of the beneficial effects of the DASH diet on the cardiovascular system may be modification of the inflammatory process. In the present study, we assessed the impact of the DASH diet on selected inflammatory markers in patients with atherosclerosis. The study lasted 12 months and involved 79 patients (40 followed the DASH diet, while 39 were in the control group). The results indicate that the DASH diet lowers the level of the inflammatory markers, which may contribute to the inhibition of atherosclerosis.Background: Inflammation is the key pathophysiological mechanism of the initiation and progression of atherosclerosis. The study objective was to assess the effects of a dietary intervention based on the model of the dietary approaches to stop hypertension (DASH) diet on the levels of chemokines RANTES and CXCL4 in patients with non-obstructive coronary artery disease. Methods: As part of Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40), where the DASH diet was introduced along with optimal pharmacotherapy, and to a control group (n = 39), with optimal pharmacotherapy alone. In the DASH group, systematic dietary counselling was provided for the follow-up period. RANTES and CXCL4 levels were determined using ELISA. Results: In the DASH group, the RANTES level insignificantly reduced from 42.70 ± 21.1 ng/mL to 38.09 ± 18.5 ng/mL (p = 0.134), and the CXCL4 concentration significantly reduced from 12.38 ± 4.1 ng/mL to 8.36 ± 2.3 ng/mL (p = 0.0001). At the same time, an increase in the level of both chemokines was observed in the control group: RANTES from 34.69 ± 22.7 to 40.94 ± 20.0 ng/mL (p = 0.06) and CXCL4 from 10.98 ± 3.6 to 13.0 5± 4.8 ng/mL (p = 0.009). The difference between the changes in both groups was significant for both RANTES (p = 0.03) and CXCL4 (p = 0.00001). The RANTES/CXCL4 ratio reduced in the control group (from 3.52 ± 2.8 to 3.35 ± 2.8; p = 0.006), while in the DASH group, an increase was observed (from 3.54 ± 1.7 to 4.77 ± 2.4; p = 0.001). Conclusions: A 12-month-long intensive dietary intervention based on DASH diet guidelines as an addition to optimal pharmacotherapy causes changes in the levels of chemokines CXCL4 and RANTES and their mutual relationship in comparison to conventional treatment.

Highlights

Studies on the dietary approaches to stop hypertension (DASH) diet show the efficacy of this nutrition model in the prevention and treatment of arterial hypertension [1,2] and reduction in the risk of common cardiovascular diseases (CVDs), such as coronary artery disease (CAD), stroke and heart failure [3,4,5,6]
The primary outcome of the trial was the reduction of percentage atheroma volume (PAV) measured between baseline and follow-up CT scans, whereas the secondary outcome was a change in pericardial fat distribution between baseline and follow-up CT scans
To the best of our knowledge, this is the first study showing the effect of an intensive dietary intervention based on the DASH diet on serial plasma levels of RANTES and

Summary

Introduction

Studies on the dietary approaches to stop hypertension (DASH) diet show the efficacy of this nutrition model in the prevention and treatment of arterial hypertension [1,2] and reduction in the risk of common cardiovascular diseases (CVDs), such as coronary artery disease (CAD), stroke and heart failure [3,4,5,6]. Activated blood platelets secrete numerous chemokines, including CXCL4, CCL5, CXCL12 and others, which initiate or promote local inflammatory processes at the sites of vascular damage [11]. It was reported that subjects with metabolic syndrome and no clinically manifested cardiovascular disease show activation of blood platelets and increased serum RANTES levels [15]. The study objective was to assess the effects of a dietary intervention based on the model of the dietary approaches to stop hypertension (DASH) diet on the levels of chemokines RANTES and CXCL4 in patients with non-obstructive coronary artery disease. Methods: As part of Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCOCT) study, patients were randomised to an intervention group (n = 40), where the DASH diet was introduced along with optimal pharmacotherapy, and to a control group (n = 39), with optimal pharmacotherapy alone.

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Conclusion