Atherosclerosis Clinical Trial
Official title:
Effects of Dietary Interventions (Sugars, Amino Acids and Artificial Sweeteners) on Serum and Macrophage Atherogenicity
While previous atherosclerosis-related studies have focused mainly on the atherogenicity of lipids, the proposed study aims to investigate the effects of other dietary factors, i.e. monosaccharides, disaccharides, amino acids, or artificial sweeteners, on the atherogenicity of serum or macrophages. Findings from the current proposed study may shed light on yet unknown mechanisms by which the above dietary factors could affect atherosclerosis development and CVD risk and hence could possibly assist in the future development of anti-atherogenic strategies.
Atherosclerosis is the underlying cause of cardiovascular diseases (CVD), the major cause of
death worldwide. Atherosclerosis is an inflammatory disease of the arteries in which
activated macrophages are abundant in the atherosclerotic lesions.
Macrophages play key roles during early atherogenesis. After differentiating from peripheral
blood monocytes, the formed intimal macrophages take up oxidized/modified lipoproteins and
are transformed into lipid-rich foam cells, the hallmark feature of early atherogenesis. In
addition to lipoprotein uptake, lipid accumulation in macrophages can also result from
alterations in cellular lipid metabolism, e.g. attenuated reverse lipid transport or
enhanced rates of lipid biosynthesis. CVD and atherosclerosis development are significantly
affected by nutritional factors. Although much progress has been made in understanding the
role of different lipids (fatty acids, cholesterol, phospholipids or triglycerides) in
atherosclerosis development and macrophage foam-cell formation, little is known about the
potential impact of other nutrients, i.e. sugars or amino acids. For instance, hyperglycemia
is known to enhance atherosclerosis development, and high glucose levels increases
macrophage atherogenicity via pro-inflammatory and oxidative stress-related mechanisms.
However, the role of monosaccharides other than glucose (fructose, galactose or mannose) and
that of various disaccharides (maltose, sucrose or lactose) in macrophage foam-cell
formation, the key event during early atherogenesis, is currently unknown. As for amino
acids, a specific subgroup - the branched-chain amino acids (BCAAs), has recently been
associated with increased CVD risk. The BCAA subgroup, composed of leucine, isoleucine, and
valine, is characterized by an aliphatic structure of their side chains and by a common
catabolic pathway. Recent reports have demonstrated an association between BCAAs, CVD and
coronary artery disease (CAD). Serum BCAA levels have been positively associated with
various CAD risk factors and with the development as well as the severity of CAD, even after
controlling for other risk factors. Nevertheless, the role of BCAAs in atherosclerosis
development and macrophage foam-cell formation is currently unclear. In recent decades, the
availability and the consumption of various artificial sweeteners have increased
considerably. In the USA for instance, approximately 30% of adults and 15% of children,
report consumption of artificial sweeteners. Although the consumption of artificial
sweeteners was previously associated with elevated risk for coronary heart disease (CHD),
the effects of different artificial sweeteners, e.g. saccharin, aspartame, sucralose,
steviol, cyclamate, and mannitol, on atherosclerosis development and their possible impact
on macrophage foam-cell formation have not been investigated yet..
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Allocation: Non-Randomized, Intervention Model: Crossover Assignment, Masking: Open Label
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