Role of Polyphenols and Carotenoids in Endothelial Dysfunction: An Overview from Classic to Innovative Biomarkers

Abstract

Nowadays, the dramatically increased prevalence of metabolic diseases, such as obesity and diabetes mellitus and their related complications, including endothelial dysfunction and cardiovascular disease, represents one of the leading causes of death worldwide. Dietary nutrients together with healthy lifestyles have a crucial role in the endothelium health-promoting effects. From a growing body of evidence, active natural compounds from food, including polyphenols and carotenoids, have attracted particular attention as a complementary therapy on atherosclerosis and cardiovascular disease, as well as preventive approaches through the attenuation of inflammation and oxidative stress. They mainly act as radical scavengers by promoting a variety of biological mechanisms, such as improvements in endothelial function, blood pressure, platelet activity, and insulin sensitivity, and by modulating various known biomarkers. The present review highlights the role of polyphenols and carotenoids in early endothelial dysfunction with attention to their beneficial effect in modulating both classical and recent technologically generated emerging biomarkers. These, alone or in combination, can play an important role in the prediction, diagnosis, and evolution of cardiovascular disease. However, a main challenge is to speed up early and prompt new interventions in order to prevent or slow down disease progression, even with an adequate intake of bioactive compounds. Hence, there is an urgent need of new more validated, appropriate, and reliable diagnostic and therapeutic biomarkers useful to diagnose endothelial dysfunction at an earlier stage.

Dietary Strawberries Improve Biomarkers of Antioxidant Status and Endothelial Function in Adults with Cardiometabolic Risks in a Randomized Controlled Crossover Trial

“…Similar decreases in inflammatory biomarkers, including interleukins and TNFα, as well as adhesion molecules, were observed in endothelial cells treated with Aronia berry extract [ 38 ]. Furthermore, Pietro et al reported a comprehensive review of dietary polyphenols by themselves or in combination with carotenoids, as found in fruits and vegetables, to significantly reduce the expression of biomarkers of endothelial dysfunction [ 39 ]. While these combined results provide some mechanistic insight into our clinical observations, there remains an urgent need for further studies to document these effects of dietary berries in adults with prediabetes and at risk for atherosclerotic CVD.…”

The Role of Polyphenol in Modulating Associated Genes in Diabetes-Induced Vascular Disorders

“…Polyphenols have previously been recognized to be a powerful free radical scavenger, particularly acting against the increased formation of ROS, which has been associated with vascular disease. Uncontrolled ROS generation is known to disrupt vascular tone, which is driven by decreased NO bioavailability, resulting in dysfunctional endothelium-dependent vasodilation [ 104 ]. There is now a growing body of evidence that polyphenolic-rich plants are able to protect against vascular dysfunction.…”

Antioxidant/Pro-Oxidant Actions of Polyphenols From Grapevine and Wine By-Products-Base for Complementary Therapy in Ischemic Heart Diseases

“…Many overlapping mechanisms characteristic for CVD, particularly IHD, were found to be influenced by polyphenols. Of these mechanisms, polyphenols were found to reduce myocardial oxygen consumption and/or to increase oxygen supply ( 8 , 53 ), to enhance myocardium metabolism following ischaemia/reperfusion ( 53 , 54 ), to inhibit platelet aggregation ( 51 , 55 ), thrombosis ( 55 ), to regulate lipid metabolism ( 52 ), to reduce inflammation ( 56 ), to inhibit atheromatous plaques formation ( 50 ), to promote endothelial cell repair ( 57 ), to protect remaining myocardial cells or to restore myocardial contraction ( 58 ). According to these mechanisms, polyphenols will act on multiple molecular targets involving different synergistic protective pathways.…”

“…Polyphenols can modulate endothelial function through the regulation of endothelial cell adhesion molecules expression. In addition, polyphenols can reduce the expression of some adhesion molecules like vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), platelet, and endothelial cell adhesion molecule 1 (PECAM-1) known for their contribution in the early plaque development ( 57 ). More than that, polyphenols radical-scavenging properties have been shown to have antioxidative and anti-inflammatory effects.…”