Abstract
Circulating microvesicles (cMV) are small phospholipid-rich vesicles that contribute to the atherothrombotic process, and are biomarkers of cardiovascular disease (CVD) burden and progression. Diet is a cornerstone for CVD prevention, but dietary effects on cMV shedding are poorly characterized. We aimed at assessing the long term effects of a Mediterranean diet compared to a low-fat diet (LFD) on MV shedding by cells of the blood and vascular compartments in patients at high cardiovascular risk treated as per guidelines. A total of 155 participants from the PREDIMED trial free of cardiovascular events after a mean follow-up of 5 years (n=53 from the Mediterranean diet supplemented with extra-virgin olive oil -EVOO-; n=49 from the Mediterranean diet supplemented with mixed nuts -Nuts-; and n=53 from the LFD) were included in the study. At baseline and after one-year intervention, cMV were quantified and characterized by flow cytometry to identify their activated parental cell origin and prothrombotic potential by Annexin V (AV) binding. After one year of dietary intervention, platelet-derived PAC-1+/AV+ and CD62P+/AV+ cMV concentrations were lower in the Nuts group compared with the LFD and EVOO interventions (P=0.036 and 0.003, respectively). In addition, prothrombotic cMV carrying tissue factor (CD142+/AV+) and CD11a+/AV+ cMV derived from activated cells, were significantly lower in both Mediterranean diet (EVOO and Nuts) interventions compared to one year of LFD (P<0.0001 and 0.028, respectively). SMAα+/AV- cMV were lower in the LFD compared to the Nuts group after one year of intervention (P=0.038). cMV are markers of cell activation and vascular injury that appear to be sensitive to dietary changes. Following a Mediterranean diet rich in EVOO or nuts is associated with lower cell activation towards a pro-atherothrombotic phenotype, suggesting a delay in the development of CV complications.
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