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The thromboxane A2 pathway plays a major role in governing the reactions involved in both the inflammatory and hemostatic biological mechanisms. Cyclooxygenases 1 & 2 act to convert arachidonic acid to thromboxane A2. Scientific studies report cyclooxygenase-2 is up-regulated in many different chronic disease states as well as in chronic inflammation. This explains one major causes of residual thromboxane risk, “aspirin resistance.” Levels of urinary 11-dehydrothromboxane B2 reflect activity of components of the thromboxane A2 pathway that result n thromboxane A2 generation. The assay is normalized to the patient’s urine creatinine concentration and is non-invasive and normalized utilizing standard controls.

The Current and Future Landscape of Urinary Thromboxane Testing to Evaluate Atherothrombotic Risk


"Biomarker testing for efficacy of therapy is an accepted way for clinicians to individualize dosing to genetic and/or environmental factors that may be influencing a treatment regimen.  Aspirin is used by nearly 43 million Americans on a regular basis to reduce risks associated with various artherothrombotic diseases.  Despite its widespread use, many clinicians are unaware of the link between suboptimal response to aspirin therapy and increased risk for inferior clinical outcomes in several disease states, and biomarker testing for efficacy of aspirin therapy is not performed as routinely as efficacy testing in other therapeutic areas.  This article reviews the clinical and laboratory aspects of determining whole-body thromboxane production, particularly as it pertains to efficacy assessment of aspirin responsiveness."

"Aspirin use has been shown to cause a dose-dependent reduction in urinary levels of 11-dehydroTxB2."

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Curcumin May Help Lower Inflammation in metabolic syndrome

"Adding spice- in the form of curcumin supplements - to the daily diets of people with risk factors for heart disease may lower inflammation, a new study suggests."

"Inflammation is implicated in a wide range of illnesses, from heart disease to cancer and joint pain.  In the eight week trial, researchers found significant reductions in signs of inflammation, such as C-Reactive protein and other blood markers."

"Curcumin is the active ingredient of the famous spice turmeric and has a long history of culinary and medicinal use in the Asian countries," said the study's senior author Amirhossein Sahebkar."

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Communicating clinical research to reduce cancer risk through diet: Walnuts as a case example

"The connection between diet and cancer has been well established, as affirmed by the considerable international consistency among dietary and lifestyle recommendations for reducing risk of cancer and other chronic diseases. The World Cancer Research Fund, American Institute for Cancer Research, and the American Cancer Society guidance each emphasize a plant-based diet, a physically active lifestyle, limited alcohol, and maintaining a healthy weight."

“Both the walnut and fish diets inhibited prostaglandin E metabolite (PGEM) and 11-dehydro thromboxane B2, but had no effect on IL-1β, IL-6, TNF-α, CRP, or the number of circulating lymphocyte subsets.”

“A plant-based diet is associated with decreased risk for cancer and other chronic diseases, due in part to reduced chronic inflammation.”

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Molecular targets of dietary polyphenols with anti-inflammatory properties

"Inflammation is the immunological defense mechanism by which the body fights infection or injury from bacteria, viruses and other pathogens.  The defining clinical features of inflammation are known in Latin as rubor (redness), calor (warmth), tumor (swelling) and dolor (pain)."

"In the early 1970's, aspirin and other non-steroidal anti-inflammatory drugs were found to inhibit cyclooxygenase (COX), which produces prostaglandins (PG's), a class of physiological and pathophysiological inflammatory mediators.  Since then, the biosynthetic cascade of arachadonic acid (AA) has been the subject of intense research.  This is because AA, having been previously liberated from phospholipids using various stimuli, can be metabolized by the COX pathway into PG's and thromboxane A2, or by the lipoxygenase pathways to hydroperoxyeicosateraenoic acids, (HpETEs), hydroxyeicosateraenoic acids (HETEs), and leukotrienes (LTs).  These proteins play a vital role in inflammation by controlling the intensitry and duration of pain, as well as the occurrence of fever, swelling and heat of an affected area."

“Given that certain polyphenols are known to affect more than one protein, it is necessary consider the possibility that any single com- pound may affect multiple mechanisms.”

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Impact of commonly prescribed exercise interventions on platelet activation in physically inactive and overweight men

"The exercise paradox infers that, despite the well-established cardioprotective effects of repeated episodic exercise (training), the risk of acute atherothrombotic events may  be transiently increased during and soon after an exercise bout.  However, the acute impact of different exercise modalities on platelet function has not previously been addressed.  We hypothesized that distinct modalities of exercise would have differing effects on in vivo platelet activation and reactivity to agonists which induce monocyte-platelet aggregate (MPA) formation."

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A Japanese cross-sectional multicenter study of biomarkers associated with cardiovascular disease in smokers and non-smokers

“The mean hs-CRP concentration was not significantly different between the two groups of subjects.”

“We found that the 11-DTXB2 concentration was about 24% greater in smokers than in non-smokers, supporting the use of 11-DTXB2 as a potential biomarker for smoking and CVD.”

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Nicotine effects on eicosanoid formation and hemostatic function: comparison of transdermal nicotine and cigarette smoking

“Cigarette smoking increased the urinary excretion of 11-dehydrothromboxane B2 (reflecting thromboxane A2 generation).”

“Cigarette smoking was also associated with higher levels of fibrinogen in plasma.”

“Cigarette smoking and transdermal nicotine treatment were both associated with a higher white blood cell count compared with the placebo patch.”

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Molecular targets of tea polyphenols in the cardiovascular system

"Tea-derived polyphenols have attracted considerable attention in the prevention of cancer and cardiovascular diseases.  In comparison to tumour cells, the elucidation of their molecular targets in cardiovascular relevant cells is still at the beginning.  Although promising, experimental and clinical data demonstrate protective effects for the cardiovasclar system, little information is actually available on how these beneficial effects of tea polyphenols are mediated at the cellular level.  By affecting the activity of receptor and signal transduction kinases, both catechins and theaflavins - the major ingredients of green and black tea, respectively - exert a variety of cardiovascular beneficial effects."

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Effects of pomegranate juice and extract polyphenols on platelet function

"Several clinical and In Vitro studies showed that polyphenols are able to inhibit platelet activation, preventing cerebro- and cardiovascular disease.  The Mediterranean diet includes fruit and vegetables rich in polyphenols known as effective protective agents.  Fruits and vegetables contain polyphenols such as tannins found in red wine and phenolic acid, flavonones, anthoscyanin, flavonols, stilbenes, and lignans found in pomegranates as protective agents from the hot Meditarranean sunshine."

“We have shown that pomegranate juice reduces every step of platelet activation, such as platelet aggregation, calcium mobilization, hydrogen peroxide formation, and TxA2 production induced by collagen and arachidonic acid.”

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Natural sources of resveratrol and mechanisms of action with emphasis on cardiovascular disease: a brief review

“Epidemiological studies indicate that the consumption of red wine reduces the mortality and morbidity from CAD. Muscadine grapes contain high levels of antioxidants, including resveratrol, a polyphenol with multiple cardioprotective effects.” 

"These antioxidants are thought to be the effective agents behind the so-called "French Paradox," the low mortality rate from CAD amongs the French population desipite their high-fat diet and smoking."

"Resveratrol has been shown to inhibit lipid peroxidation of LDL, prevent the cytoxicity of oxidized LDL, protect cells against lipid peroxidation, reduce platelet aggregation, and inhibit vascular SMC proliferation".

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