Fernández-Arroyo Salvador, Camps Jordi, Menendez Javier A, Joven Jorge
Unitat de Recerca Biomèdica, Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Campus of International excellence Southern Catalonia, Reus, Spain.
Metabolism and Cancer Group, Translational Research Laboratory, Catalan Institute of Oncology-Girona, Molecular Oncology, Girona Biomedical Research Institute, Girona, Spain.
Planta Med. 2015 Jun;81(8):624-9. doi: 10.1055/s-0034-1396310. Epub 2015 Feb 25.
Some polyphenols, obtained from plants of broad use, induce a favorable endothelial response in hypertension and beneficial effects in the management of other metabolic cardiovascular risks. Previous studies in our laboratories using the calyces of Hibiscus sabdariffa as a source of polyphenols show that significant effects on hypertension are noticeable in humans only when provided in high amounts. Available data are suggestive in animal models and ex vivo experiments, but data in humans are difficult to acquire. Additionally, and despite the low bioavailability of polyphenols, intervention studies provide evidence for the protective effects of secondary plant metabolites. Assumptions on public health benefits are limited by the lack of scientific knowledge, robust data derived from large randomized clinical trials, and an accurate assessment of the bioactive components provided by common foodstuff. Because it is likely that clinical effects are the result of multiple interactions among different polyphenols rather than the isolated action of unique compounds, to provide polyphenol-rich botanical extracts as dietary supplements is a suggestive option. Unfortunately, the lack of patent perspectives for the pharmaceutical industries and the high cost of production and release for alimentary industries will hamper the performance of the necessary clinical trials. Here we briefly discuss whether and how such limitations may complicate the extensive use of plant-derived products in the management of hypertension and which steps are the necessary to deal with the predictable complexity in a possible clinical practice.
一些从广泛使用的植物中提取的多酚，可在高血压中诱导有利的内皮反应，并对其他代谢性心血管风险的管理产生有益影响。我们实验室之前使用玫瑰茄花萼作为多酚来源的研究表明，只有大量提供时，对人类高血压才有显著影响。现有数据在动物模型和体外实验中有提示作用，但人类数据难以获得。此外，尽管多酚的生物利用度较低，但干预研究为植物次生代谢产物的保护作用提供了证据。由于缺乏科学知识、大型随机临床试验得出的可靠数据以及对常见食物中生物活性成分的准确评估，关于公共卫生益处的假设受到限制。由于临床效果可能是不同多酚之间多种相互作用的结果，而不是单一化合物的孤立作用，提供富含多酚的植物提取物作为膳食补充剂是一个有启发性的选择。不幸的是，制药行业缺乏专利前景以及食品行业生产和发布的高成本将阻碍必要的临床试验的开展。在此，我们简要讨论这些限制是否以及如何使植物衍生产品在高血压管理中的广泛应用变得复杂，以及在可能的临床实践中应对可预见的复杂性需要采取哪些必要步骤。
