Nutraceuticals and cardiovascular risk: potential role of EPCs modulation

Abstract

According to WHO cardiovascular diseases (CVDs) are the first cause of death in the world: more people die annually from CVDs than from any other cause. Vascular endothelium plays a pivotal role in the onset and progression of these pathologies and cardiovascular risk factors are frequently associated to the levels of endothelial progenitor cells (EPCs), bone marrow-derived circulating progenitors for the endothelial lineage. Since EPCs not only preserve vascular endothelium homeostasis, but might directly participate to re-endothelization and neovascularization, these cells represent an emerging protagonist in vascular competency and as such a cell model of great interest. An unhealthy diet is one of the main cardiovascular risk factor, while there is a great interest in the potential protective effects of "nutraceuticals", food-derived compounds that exert beneficial effects on human and animal health. The characterization of the endothelial effects of different nutraceuticals may provide fresh insights into their potential role in CVDs prevention. Several studies have already showed the protective effects of natural antioxidants on EPCs levels and functionality; some examples are resveratrol, catechin and folic acid. Fermentation has recently shown interesting roles in cardiovascular prevention since this process gave origin to a new class of foods, rich in bioactive compounds, the fermented foods. Consumption of fermented legumes and cereals, but also fermented beverages (such as beer and wine) was found to protect endothelial function through both lipid-lowering, as well anti-inflammatory and antioxidative mechanisms. Little is known about the effects of fermentation-derived nutraceuticals on EPCs. Given the important role of this cardiovascular biomarker, further analysis in this field can improve opportunities for CVDs prevention and treatment. Vascular endothelium and EPCs: new insightsFor many years vascular endothelium has been considered a mere physical barrier between blood and underlying tissues; recent studies have demonstrated new and interesting roles of endothelium in vascular health [1] .Endothelial cells composing this monolayer have therefore paracrine, endocrine and autocrine functions, by secreting several factors with vasodilatory and antiproliferative effects, such as endothelium-derived hyperpolarization factor (EDHF), nitric oxide (NO) and prostacyclin (PGI 2 ), and others inducing vasoconstrictor response, for instance endothelin-1 (ET-1), angiotensin II and reactive oxygen species (ROS) [2] . These evidences make the vascular endothelium a multifunctional unit that regulates vascular homeostasis by REVIEW