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BIBTEX RIS

After all plant sterol feeding protects against atherosclerosis

2014; Elsevier BV; Volume: 233; Issue: 2 Linguagem: Inglês

10.1016/j.atherosclerosis.2014.01.006

ISSN

1879-1484

Autores

Ana Maria Lottenberg, Renata P.A. Bombo, E.R. Nakandakare, E.C.R. Quintão,

Tópico(s)

Fatty Acid Research and Health

Resumo

As authors of the report [[1]Bombo R.P. Afonso M.S. Machado R.M. et al.Dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2013 Dec; 231: 442-447Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar] discussed by D. Lütjohann et al. [[2]Lütjohann D. Schött H.F. Plat J. Invited commentary on the paper published by Bombo et al.: dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2014; 233: 157-159Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar], we are grateful to their favorable and encouraging remarks on our publication and wish to add a reply to it. Regarding the comments that the presence of plant sterol in the arterial wall has already been studied, we would like to clarify that these previous published data underlie how much our investigation was needed. The study conducted by Helske et al. [[3]Helske S. Miettinen T. Gylling H. et al.Accumulation of cholesterol precursors and plant sterols in human stenotic aortic valves.J Lipid Res. 2008; 49: 1511-1518Crossref PubMed Scopus (46) Google Scholar], did show accumulation of cholesterol precursors and plant sterols in human stenotic aortic valves, however, not all patients studied by them were supplemented with plant sterols(PS). Furthermore, serum concentrations of cholesterol and noncholesterol sterols did not differ significantly between patients with and without consumption of margarine or yogurt supplemented with plant stanol [[3]Helske S. Miettinen T. Gylling H. et al.Accumulation of cholesterol precursors and plant sterols in human stenotic aortic valves.J Lipid Res. 2008; 49: 1511-1518Crossref PubMed Scopus (46) Google Scholar]. Another study cited by D. Lütjohann et al., conducted in patients submitted to carotid endarterectomy fed plant stanol or sterol, showed that sitostanol is not taken up into the arterial wall in contrast to sitosterol that was slightly increased. All the patients studied in this investigation were under statin treatment and a control group was missing [[4]Miettinen T.A. Nissinen M. Lepantalo M. et al.Non-cholesterol sterols in serum and endarterectomized carotid arteries after a short-term plant stanol and sterol ester challenge.Nutr Metab Cardiovasc Dis. 2011; 21: 182-188Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar]. Therefore, the results of these studies, together with the data from other investigations discussed in a recent review published by our group [[5]Lottenberg A.M. Bombo R.P. Ilha A. Nunes V.S. Nakandakare E.R. Quintão E.C. Do clinical and experimental investigations support an antiatherogenic role for dietary phytosterols/stanols?.IUBMB Life. 2012 Apr; 64: 296-306Crossref PubMed Scopus (17) Google Scholar], showed the controversial aspects regarding serum PS increase and its accumulation in the arterial wall. We fully agree with D. Lütjohann [[2]Lütjohann D. Schött H.F. Plat J. Invited commentary on the paper published by Bombo et al.: dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2014; 233: 157-159Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar] that it is rather puzzling the fact that Campesterol prevails in plasma in our work [[1]Bombo R.P. Afonso M.S. Machado R.M. et al.Dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2013 Dec; 231: 442-447Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar] as well as in the work of others [6Ostlund Jr., R.E. McGill J.B. Zeng C.M. et al.Gastrointestinal absorption and plasma kinetics of soy Delta(5)-phytosterols and phytostanols in humans.Am J Physiol Endocrinol Metab. 2002; 282: E911-E916Crossref PubMed Scopus (220) Google Scholar, 7Gylling H. Plat J. Turley S. et al.Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease.Atherosclerosis. 2014; 232: 346-360Abstract Full Text Full Text PDF PubMed Scopus (342) Google Scholar], whereas the mass of Sitosterol prevails over Campesterol in the aortic wall (Table 1, Ref. [[2]Lütjohann D. Schött H.F. Plat J. Invited commentary on the paper published by Bombo et al.: dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2014; 233: 157-159Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar]). Interestingly, the aortic ratio Campesterol/Sitosterol is not substantially different in all investigations mentioned by D. Lütjohann et al. [[2]Lütjohann D. Schött H.F. Plat J. Invited commentary on the paper published by Bombo et al.: dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2014; 233: 157-159Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar] (Table1). A likely possibility for the latter is aortic macrophages having a more efficient process for exporting Campesterol than Sitosterol which bears no relationship whatsoever with D. Lütjohann et al. [[2]Lütjohann D. Schött H.F. Plat J. Invited commentary on the paper published by Bombo et al.: dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2014; 233: 157-159Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar] questioning the validity of the murine models as stated on their last paragraph. In vitro cell models should be useful to elucidate the reason for these findings. In our work we made it clear that PS feeding reduces plasma cholesterol therefore protecting against atherosclerosis. In this regard, contrarily to D. Lütjohann et al. interpretation of our work (Fig 3b, Ref. [[2]Lütjohann D. Schött H.F. Plat J. Invited commentary on the paper published by Bombo et al.: dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2014; 233: 157-159Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar]) the absolute amount of cholesterol expressed as μg/mg of aortic tissue was half as much on PS than on control feeding, whereas the aortic mass of Campesterol and of Sitosterol was precisely the same on both experimental groups. In other words, PS failed to accumulate in the arterial wall in spite of markedly increasing in plasma on PS feeding (Table 1, Ref. [[1]Bombo R.P. Afonso M.S. Machado R.M. et al.Dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2013 Dec; 231: 442-447Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar]). Thus, expressing arterial wall PS data as percent of aortic total sterols is irrelevant and distracts the reader from the essence of our conclusion that after all plant sterol feeding protects against atherosclerosis as clearly shown in our animal model [[1]Bombo R.P. Afonso M.S. Machado R.M. et al.Dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice.Atherosclerosis. 2013 Dec; 231: 442-447Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar]. Invited commentary on the paper published by Bombo et al.: Dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO miceAtherosclerosisVol. 233Issue 1PreviewIt is generally accepted that consumption of 2–3 g/d plant sterols and stanols lowers serum LDL cholesterol concentrations via interfering with intestinal cholesterol metabolism [1,2]. Plant sterols themselves are absorbed in minor amounts [3], however, there is an ongoing discussion about the fate of plant sterols when appearing in the circulation [4]. In this context, Helske and colleagues [5] already showed in humans that cholesterol and plant sterols present identical percentage build up in serum and in stenotic aortic valves (Fig 1 [4];). Full-Text PDF Dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO miceAtherosclerosisVol. 231Issue 2PreviewThere have been conflicting reports on the usefulness of phytosterols (PS) in preventing atherosclerosis. We evaluated the effects of dietary PS supplementation in LDLr-KO male mice on the plasma and aorta sterol concentrations and on atherosclerotic lesion development. Full-Text PDF

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