Abstract

Garlic and its preparations have been widely recognized as agents for prevention and treatment of cardiovascular and other metabolic diseases, atherosclerosis, hyperlipidemia, thrombosis, hypertension and diabetes. Effectiveness of garlic in cardiovascular diseases was more encouraging in experimental studies, which prompted several clinical trials. Though many clinical trials showed a positive effect of garlic on almost all cardiovascular conditions mentioned above, however a number of negative studies have recently cast doubt on the efficary of garlic specially its cholesterol lowering effect of garlic. It is a great challenge for scientists all over the world to make a proper use of garlic and enjoy its maximum beneficial effect as it is the cheapest way to prevent cardiovascular disease. This review has attempted to make a bridge the gap between experimental and clinical study and to discuss the possible mechanisms of such therapeutic actions of garlic.

Growth differentiation factor-15 (GDF-15) is a stress responsive cytokine. It is highly expressed in cardiomyocytes, adipocytes, macrophages, endothelial cells, and vascular smooth muscle cells in normal and pathological condition. GDF-15 increases during tissue injury and inflammatory states and is associated with cardiometabolic risk. Increased GDF-15 levels are associated with cardiovascular diseases such as hypertrophy, heart failure, atherosclerosis, endothelial dysfunction, obesity, insulin resistance, diabetes, and chronic kidney diseases in diabetes. Increased GDF-15 level is linked with the progression and prognosis of the disease condition. Age, smoking, and environmental factors are other risk factors that may increase GDF-15 level. Most of the scientific studies reported that GDF-15 plays a protective role in different tissues. However, few reports show that the deficiency of GDF-15 is beneficial against vascular injury and inflammation. GDF-15 protects heart, adipose tissue, and endothelial cells by inhibiting JNK (c-Jun N-terminal kinase), Bad (Bcl-2-associated death promoter), and EGFR (epidermal growth factor receptor) and activating Smad, eNOS, PI3K, and AKT signaling pathways. The present review describes the different animal and clinical studies and patent updates of GDF-15 in diabetes and cardiovascular diseases. It is a challenge for the scientific community to use GDF-15 information for patient monitoring, clinical decision-making, and replacement of current treatment strategies for diabetic and cardiovascular diseases.

Persistent mitochondrial hyperpolarization (MHP) and enhanced calcium fluxing underlie aberrant T cell activation and death pathway selection in systemic lupus erythematosus. Treatment with rapamycin, which effectively controls disease activity, normalizes CD3/CD28-induced calcium fluxing but fails to influence MHP, suggesting that altered calcium fluxing is downstream or independent of mitochondrial dysfunction. In this article, we show that activity of the mammalian target of rapamycin (mTOR), which is a sensor of the mitochondrial transmembrane potential, is increased in lupus T cells. S ystemic lupus erythematosus (SLE)3 is an autoimmune disease of unknown etiology characterized by T and B cell dysfunction and production of antinuclear Abs (1). Dysregulation of cell death is thought to play a key role in driving antinuclear Ab production, since the source of immunogenic nuclear material is necrotic or apoptotic cells in SLE (2). There is enhanced spontaneous apoptosis of circulating T cells in SLE, which has been linked to chronic lymphopenia (3) and compartmentalized release of autoantigens (4). Paradoxically, there is decreased activation-induced T cell death in SLE (5-7), which may contribute to persistence of autoreactive cells.The mitochondria play crucial roles in activation and death pathway selection in T lymphocytes (2). Lupus T cells exhibit mitochondrial dysfunction, which is characterized by the elevation of the mitochondrial transmembrane potential (⌬ m ) or persistent mitochondrial hyperpolarization (MHP) and consequential ATP depletion, resulting in decrease of activation-induced apoptosis and predisposition of T cells for necrosis (6). ATP depletion in lupus T cells was recently confirmed by Krishnan et al. (8). We proposed that increased release of necrotic materials from T cells could drive disease pathogenesis by activating macrophages and dendritic cells and enhancing their capacity to produce NO and IFN-␣ in SLE (2). Indeed, dendritic cells exposed to necrotic, but not apoptotic, cells induce lupus like-disease in MRL mice and accelerate the disease of MRL/lpr mice (9).Enhanced T cell activation-induced calcium fluxing has been identified as a central defect in abnormal activation and cytokine production by lupus T cells (10). Induction of MHP and mitochondrial biogenesis by NO augments cytoplasmic calcium levels and regenerates the enhanced rapid calcium signaling profile of lupus T cells (11). Dysregulation of signaling through the TCR has also been shown to be a critical determinant of abnormal calcium fluxing in SLE (12, 13). The TCR/CD3 -chain (TCR) expression is diminished in SLE T cells, and it is functionally replaced by the FcR type I ␥-chain (FcRI␥), a protein normally found in other cell types (14). TCR signaling through FcRI␥ and its adaptor protein Syk is associated with elevated calcium fluxing but only in the absence of TCR (12). It has been shown that forced expression of The costs of publication of this article were defrayed in part by the payment of page charges. This ...

Garlic has played an important dietary and medicinal role throughout the history of mankind. In some Western countries, the sale of garlic preparations ranks with those of leading prescription drugs. The therapeutic efficacy of garlic encompasses a wide variety of ailments, including cardiovascular, cancer, hepatic and microbial infections to name but a few. However, the elucidation of its mechanism for therapeutic action has proved to be more elusive and a unifying theory, which could account for its reported multifarious activities, is yet to emerge. Reactive oxygen species (ROS) seem to be at the core of many disease processes and it is an attractive and convenient hypothesis that garlic might exert its activities through modulatory effects on ROS. A literature search on garlic and its antioxidant potential churned up a surprisingly large amount of data, some of it good, some bad and some of its definitely ugly. Various preparations of garlic, mainly aged garlic extract (AGE), have been shown to have promising antioxidant potential. However, the presence of more than one compounds in garlic, with apparently opposite biological effects, has added to the complexity of the subject. Raw garlic homogenate has been reported to exert antioxidant potential but higher doses have been shown to be toxic to the heart, liver and kidney. So where do we stand today on this issue of garlic? Is garlic always good for health? How safe is it? Is it necessary to isolate the antioxidant compounds for its medicinal use in a more effective way? These issues are addressed in this review.

Our data suggest that cardiac SGLT1 expression and/or function are regulated by insulin and leptin, and are perturbed in disease. This is the first study to examine the regulation of cardiac SGLT1 expression by insulin and leptin and to determine changes in SGLT1 expression in cardiac disease.