Aged garlic extract preserves cutaneous microcirculation in patients with increased risk for cardiovascular diseases: A double‐blinded placebo‐controlled study

Abstract

Laser Doppler velocimetry estimates tissue perfusion providing a record of microvascular blood flow. Patients with heart disease or diabetes mellitus have impaired microvascular perfusion leading to impaired wound healing. Aged garlic extract (AGE) has a positive effect on vascular elasticity. This study aimed to assess the effect of long‐term treatment with AGE on cutaneous tissue perfusion. A total of 122 patients with Framingham Risk Score ≥ 10 were randomised in a double‐blinded manner to placebo or 2400 mg AGE daily for 1 year and monitored. Cutaneous microcirculation was measured at 0 and 12 months using laser Doppler velocimetry. A repeated measures analysis of variance (ANOVA) with a Greenhouse–Geisser correction determined that mean post‐occlusive reactive hyperaemia differed significantly between time points. The mean percent change between the two time points 0 and 12 months was 102, 64 (174, 15)% change for AGE and 78, 62 (107, 92)% change for the placebo group (F[1, 120] = 5. 95, P < 0.016), 12 months of AGE increases the microcirculation in patients with an increased risk for cardiovascular events estimated using the Framingham risk score. Increased microcirculation could hypothetically facilitate wound healing.

S-1-Propenylcysteine Improves TNF-α-Induced Vascular Endothelial Barrier Dysfunction by Suppressing the GEF-H1/RhoA/Rac Pathway

“…Our study showed that S1PC decreased the phosphorylation level of GEF-H1 and suppressed the interaction of GEF-H1 with RhoA and Rac (Figure 2). Taken together, these results showed that S1PC protected the barrier dysfunction elicited by TNF-α through inhibiting the phosphorylation and activation of GEF-H1 ( Figure 5), and suggested that this effect of S1PC is associated with the bene cial effect of AGE on atherosclerotic patients observed in the clinical studies [22][23][24].…”

“…Accordingly, the proper maintenance of barrier function may help protect the blood vessels from risk factors of vascular diseases. In addition, the protective effect of S1PC on vascular cells may explain in part the bene cial effect of AGE on the atherosclerotic patients in the clinical studies [22][23][24]. Effects of S1PC on cell permeability, junctional/cytoskeletal proteins, and MLC2 phosphorylation in TNFα-stimulated HUVECs.…”

“…In the present study, we found that AGE and its sulfur-containing constituent, S1PC, improved TNF-α-and thrombin-induced endothelial barrier dysfunctions through the regulation of AJs and TJs assembly (Figure 1, Additional le 1: Figure S1a and Additional le 2: Figure S2). Previous clinical studies reported that AGE reduced low attenuation plaque in coronary arteries of diabetic patients and inhibited the progression of atherosclerotic lesion [22][23][24]. Atherosclerotic plaque is formed by the in ltration of monocytes and accumulation of oxidized low-density lipoprotein caused by endothelial barrier dysfunction [51,52].…”

“…These ndings suggested that anti-atherosclerotic effect of AGE may be attributable to its ability to protect and maintain the vascular endothelial barrier function. AGE has been reported to exert various pharmacological effects, such as anti-atherosclerotic [20,[22][23][24], anti-hypertensive [25,26] and anti-in ammatory effects [20,21], which are considered to be attributable to its sulfur-containing constituents. Therefore, we investigated whether S1PC, SAC and SAMC, three major sulfur-containing constituents in AGE, affect the endothelial barrier function.…”

“…Aged garlic extract (AGE) is a unique garlic preparation that is produced by aging of raw garlic in an aqueous ethanol solution for more than 10 months. AGE has been shown to exert various biological and pharmacological activities such as anti-in ammatory [20,21], anti-atherosclerotic [20,[22][23][24], antihypertensive [25,26] and anti-oxidative effects [27,28]. In particular, AGE prevented progression of cardiovascular diseases through the improvement of vascular endothelial dysfunction in clinical studies [24,26,[29][30][31][32].…”