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https://www.arca.fiocruz.br/handle/icict/59033
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2030-12-31
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- INI - Artigos de Periódicos [3504]
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THE EFFECT OF BRAZILIAN GREEN PROPOLIS EXTRACT ON INFLAMMATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON PERITONEAL DIALYSIS: A RANDOMISED DOUBLE-BLIND CONTROLLED CLINICAL TRIAL
Author
Affilliation
Fluminense Federal University. Graduate Program in Medical Sciences. Niterói, RJ, Brazil.
Fluminense Federal University. Graduate Program in Cardiovascular Sciences. Niterói, RJ, Brazil.
Federal University of Rio de Janeiro. Graduate Program in Biological Sciences - Physiology. Rio de Janeiro, RJ, Brazil.
Fluminense Federal University. Graduate Program in Cardiovascular Sciences. Niterói, RJ, Brazil.
Fluminense Federal University. Graduate Program in Cardiovascular Sciences. Niterói, RJ, Brazil.
Fluminense Federal University. Graduate Program in Medical Sciences. Niterói, RJ, Brazil / Federal University of Rio de Janeiro. Graduate Program in Biological Sciences - Physiology. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectology Evandro Chagas. HIV/AIDS Clinical Research Center. Rio de Janeiro, RJ, Brazil.
Research, Development and Innovation Department. Apis Flora Indl. Coml. Ltda. Ribeirão Preto, SP, Brazil.
Wolfson Wohl Translational Research Centre. University of Glasgow, Garscube Estate, Switchback Road. Bearsden, Glasgow, UK.
Fluminense Federal University. Graduate Program in Medical Sciences. Niterói, RJ, Brazil / Federal University of Rio de Janeiro. Graduate Program in Biological Sciences - Physiology. Rio de Janeiro, RJ, Brazil.
Fluminense Federal University. Graduate Program in Cardiovascular Sciences. Niterói, RJ, Brazil.
Federal University of Rio de Janeiro. Graduate Program in Biological Sciences - Physiology. Rio de Janeiro, RJ, Brazil.
Fluminense Federal University. Graduate Program in Cardiovascular Sciences. Niterói, RJ, Brazil.
Fluminense Federal University. Graduate Program in Cardiovascular Sciences. Niterói, RJ, Brazil.
Fluminense Federal University. Graduate Program in Medical Sciences. Niterói, RJ, Brazil / Federal University of Rio de Janeiro. Graduate Program in Biological Sciences - Physiology. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectology Evandro Chagas. HIV/AIDS Clinical Research Center. Rio de Janeiro, RJ, Brazil.
Research, Development and Innovation Department. Apis Flora Indl. Coml. Ltda. Ribeirão Preto, SP, Brazil.
Wolfson Wohl Translational Research Centre. University of Glasgow, Garscube Estate, Switchback Road. Bearsden, Glasgow, UK.
Fluminense Federal University. Graduate Program in Medical Sciences. Niterói, RJ, Brazil / Federal University of Rio de Janeiro. Graduate Program in Biological Sciences - Physiology. Rio de Janeiro, RJ, Brazil.
Abstract
Background: Chronic kidney disease (CKD) patients on dialysis display a low-grade systemic inflammatory burden. Nutritional interventions designed to activate the cytoprotective nuclear factor erythroid-2-related factor 2 (Nrf2) and inhibit nuclear factor-kB (NF-κB) have been proposed to mitigate this burden. Several bioactive compounds have been investigated to achieve this, including propolis, a resin produced by Apis mellifera bees. Considering the safety and efficacy of propolis, it could be a strategy to benefit these patients. Still, there are no studies using propolis in patients with CKD on peritoneal dialysis (DP), and clinical studies to support this application are lacking. Hypothesis/purpose: The objective and novelty of the present study are to evaluate the effects of propolis supplementation on inflammatory markers in patients with CKD on PD. Study design: A longitudinal, double-blind, placebo-controlled trial with CKD patients on PD. Methods: The patients were randomised into two groups: propolis that received four capsules of 100 mg (400 mg/day), containing concentrated and standardised dry EPP-AF® Brazilian green propolis extract) or placebo, four capsules of 100 mg (400 mg/day), of magnesium stearate, silicon dioxide, and microcrystalline cellulose, for two months. Plasma levels of inflammatory cytokines, including tumour necrosis factor (TNF-α) and interleukin-6 (IL-6), were evaluated by ELISA. Quantitative real-time PCR analyses were performed to evaluate the transcriptional expression levels of Nrf2 and NF-κB in peripheral blood mononuclear cells (PBMCs). Plasma malondialdehyde (MDA) levels, a lipid peroxidation marker, was measured as thiobarbituric acid reactive substances (TBARS). Routine biochemical markers, including C-reactive protein (CRP), were analysed using commercial kits. Carotid Intima-Media Thickness (CIMT) was measured with a doppler ultrasonography device. The study was registered on ClinicalTrials.gov under the number NCT04411758. Results: A total of 19 patients completed the study, ten patients in the propolis group (54 ± 1.0 years, five men, 7.2 (5.1) months on PD) and 9 in the placebo group (47.5 ± 15.2 years, three men, 10.8 (24.3) months on PD). The plasma levels of TNF-α reduced significantly (p = 0.02), and expression of Nrf2 showed a trend to increase (p = 0.07) after propolis supplementation. Conclusion: EPP-AF® Green Propolis extract (400 mg/day) supplementation for two months appears as a potential strategy to mitigate inflammation, reducing TNF-α plasma levels in CKD patients on PD.
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