Atherosclerosis Clinical Trial
Official title:
Effects of Dietary Amino Acids on Serum and Macrophage Atherogenicity
Recently, the investigators have been screening for anti-atherogenic or pro-atherogenic amino acids (AAs) in the macrophage model system to better understand their role in atherogenesis. The findings so far suggest that specific AAs induce selective anti-atherogenic effects (glycine, alanine, leucine and cysteine) or pro-atherogenic effects (glutamate and glutamine) in macrophages. Taking together the above previous reports with the mechanisms behind macrophage foam cell formation and atherogenesis, it is possible that AAs could be anti-atherogenic or pro-atherogenic via their mechanism of action on macrophage foam cell formation. This paradigm may serve as a basis for the development of novel cardio-protective, anti-atherogenic nutritional, or therapeutic approaches, that should be studied in human trials.
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. Although much progress has been made in understanding the role of
different lipids (fatty acids, cholesterol, phospholipids or triglycerides) in macrophage
foam-cell formation and atherosclerosis development, little is known about the potential
impact of other nutrients, such as amino acids (AAs).
Previous studies have demonstrated an association between specific AAs and increased CVD
risk or higher prevalence of coronary artery disease (CAD). For instance, the role of the
branched chain AAs (BCAAs; valine, leucine, and isoleucine) in atherogenesis and CVD has
been recently studied. Association studies showed that the plasma levels of BCAAs
significantly and independently correlated with dyslipidemia and CAD. However, BCAAs were
found to possess cardio-protective effects in a heart failure rat model. Specifically,
leucine was reported to attenuate atherosclerosis development in the atherosclerotic
apoE-deficient (apoE-/-) mice model, by improving the plasma lipid profile and by reducing
systemic inflammation. Other studies have indicated the ability of some AAs to exert
anti-atherogenic effects. Glycine, the simplest AA, was inversely associated with the risk
of acute myocardial infarction (AMI) in patients with high apolipoprotein B (apoB) and
LDL-cholesterol levels. Cysteine is an essential AA in the biosynthesis of glutathione, a
key endogenous anti-oxidant known for its anti-atherogenic properties in macrophage lipid
metabolism leading to the attenuation of atherosclerosis development. Cysteine analogues
such as N-acetyl cysteine (NAC) or ribose cysteine were shown to be anti-atherogenic.
Arginine, a basic AA, is the main precursor for nitric oxide production in the vascular
endothelium. Arginine was shown to protect endothelial cells from lipid peroxidation, and to
delay or reduce atheroma formation. Arginine anti-atherogenicity includes its anti-oxidant
properties and its ability to improve endothelial function in CVD or overweight patients.
The aim of the proposed study is to investigate the effects of one month of supplementation
with specific AAs on changes in the macrophage atherogenicity and lipid metabolism together
with other risk markers of atherosclerosis development, such as serum oxidative status and
lipid levels, on healthy subjects. Findings from the current proposed study may shed light
on yet unknown mechanisms by which specific AAs affect atherosclerosis development and CVD
risk and hence could possibly assist in the future development of anti-atherogenic
strategies
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