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.

Dietary fish oil alters the lysophospholipid metabolomic profile and decreases urinary 11-dehydro-thromboxane B2 concentration in healthy Beagles

"After dietary treatment with different amounts of fish oil, age (increases 11-dehydro TXB2) was followed by EPA concentration as a significant negative predictor of urine 11-dehydro TXB2 concentration (increasing serum concentrations of EPA decrease 11-dehydro TXB2), and then lean-body mass (decreases 11-dehydro TXB2)."

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Pharmacological activities of flavonoids: a review

"It is well known that arachidonic acid, which is released in inflammatory conditions, is metabolized by platelets to form prostaglandin, endoperoxides, and thromboxane A2 leading to platelet activation and aggregation. The main antiaggregatory effect of flavonoids is thought to be by inhibition of thromboxane A2 formation."

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Adaptive regression modeling of biomarkers of potential harm in a population of U.S. adult cigarette smokers and nonsmokers

"This article describes the data mining analysis of a clinical exposure study of 3,585 adult smokers and 1077 nonsmokers.  The analysis focused on developing models for four biomarkers of potential harm:  white blood cell count (WBC), 24 h urine 8-ep-prostaglandin F2a, (EP18), 24 h urine 11-dehydro-thromboxane B2 (DEH11),  and high-density lipoprotein cholesterol (HDL)."

"Levels of WBC, EPI8, DEH11 and HDL were statistically associated with biomarkers of exposure to cigarette smoking and demographics and lifestyle factors."

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Nutraceuticals in diabetes and metabolic syndrome

"Metabolic syndrome represents a clustering of risk factors related to an elevated risk of cardiovascular disease and type 2 diabetes.  Occurrence of both metabolic syndrome and diabetes and their vascular complications share several pathogenetic features including subclinical, low-grade inflammation, alterred oxidative/antioxidant status, and persistent platelet activation."

"We examined the effects of short-term vitamin E supplementation (600 mg daily for 2 week) on the urinary excretion of 8-iso-PGF2alpha and 11-dehydro-TXB2. Vitamin E supplementation was associated with detectable changes in plasma vitamin E levels and caused virtually complete normalization of 8-iso-PGF2alpha excretion. Moreover, changes in F2-isoprostane formation were accompanied by similar reductions in thromboxane metabolite excretion."

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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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Cardiovascular biomarkers in groups of established smokers after a decade of smoking

"Significant statistical differences between smokers with approximately 10 years of smoking history and non-smokers in white cell count, hemoglobin and thromboxane turnover were seen, although they did not reach levels associated with overt diseases."

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Incomplete Inhibition of Thromboxane Biosynthesis by Acetylsalicylic Acid Determinants and Effect on Cardiovascular Risk

"Incomplete inhibition of platelet thromboxane generation, as measured by elevated urinary 11-dehydrothromboxane B2 concentrations, has been associated with an increased risk of cardiovascular events.  We aimed to determine the external validity of this association in aspirin-treated patients enrolled in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) trial and to determine whether thare are any modifiable factors or interventions that lower urinary 11-dehydro thromboxane B2 concentrations that could thereby reduce cardiovascular risk."

"In aspirin-treated patients, urinary concentrations of 11-dehydrothromboxane B2 are an externally valid and potentially modifiable determinant of stroke, myocardial infarction, or cardiovascular death in patients at risk for atherothrombotic events."

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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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Casual chocolate consumption and inhibition of platelet function

"Observational studies have associated reduced cardiovascular mortality with chocolate consumption.  Feeding studies of high-dose, flavanol-rich chocolate show antiplatelet effects, but the effect of casual chocolate consumption on platelet function is unknown."

"Despite having similar baseline characteristics, chocolate consumers had longer PFA closure times (130 vs 123 seconds, P=05) and decreased Tx-M levels (175 vs 290 ng/molcreatinine, P=.03). Chocolate remained a significant independent predictor of both ex-vivo and in vivo platelet function testing after adjusting for confounders."

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