Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0313 Oslo, Norway.
Nutrients. 2024 Oct 30;16(21):3717. doi: 10.3390/nu16213717.
Backgrounds/Objectives: Abnormal platelet functions are associated with human morbidity and mortality. Platelets have emerged as critical regulators of numerous physiological and pathological processes beyond their established roles in hemostasis and thrombosis. Maintaining physiological platelet function is essential to hemostasis and preventing platelet-associated diseases such as cardiovascular disease, cancer metastasis, immune disorders, hypertension, diabetes, sickle cell disease, inflammatory bowel disease, sepsis, rheumatoid arthritis, myeloproliferative disease, and Alzheimer's disease. Platelets become hyperactive in obesity, diabetes, a sedentary lifestyle, hypertension, pollution, and smokers. Platelets, upon activation, can trawl leukocytes and progenitor cells to the vascular sites. Platelets release various proinflammatory, anti-inflammatory, and angiogenic factors and shed microparticles in the circulation, thus promoting pathological reactions. These platelet-released factors also maintain sustained activation, further impacting these disease processes. Although the mechanisms are unknown, multiple stimuli induce platelet hyperreactivity but involve the early pathways of platelet activation. The exact mechanisms of how hyperactive platelets contribute to these diseases are still unclear, and antiplatelet strategies are inevitable for preventing these diseases. Reducing platelet function during the early stages could significantly impact these diseases. However, while this is potentially a worthwhile intervention, using antiplatelet drugs to limit platelet function in apparently healthy individuals without cardiovascular disease is not recommended due to the increased risk of internal bleeding, resistance, and other side effects. The challenge for therapeutic intervention in these diseases is identifying factors that preferentially block specific targets involved in platelets' complex contribution to these diseases while leaving their hemostatic function at least partially intact. Since antiplatelet drugs such as aspirin are not recommended as primary preventives, it is essential to use alternative safe platelet inhibitors without side effects.
A systematic search of the PUBMED database from 2000 to 2023 was conducted using the selected keywords: "functional foods", "polyphenols", "fatty acids", "herbs", fruits and vegetables", "cardioprotective agents", "plant", "platelet aggregation", "platelet activation", "clinical and non-clinical trial", "randomized", and "controlled".
Potent natural antiplatelet factors have been described, including omega-3 fatty acids, polyphenols, and other phytochemicals. Antiplatelet bioactive compounds in food that can prevent platelet hyperactivity and thus may prevent several platelet-mediated diseases, including cardiovascular disease.
This narrative review describes the work during 2000-2023 in developing functional foods from natural sources with antiplatelet effects.
背景/目的：异常的血小板功能与人类发病率和死亡率有关。血小板已成为除在止血和血栓形成中发挥作用外，许多生理和病理过程的关键调节因子。维持生理血小板功能对于止血和预防血小板相关疾病（如心血管疾病、癌症转移、免疫紊乱、高血压、糖尿病、镰状细胞病、炎症性肠病、脓毒症、类风湿性关节炎、骨髓增生性疾病和阿尔茨海默病）至关重要。在肥胖、糖尿病、久坐不动的生活方式、高血压、污染和吸烟者中，血小板变得过度活跃。血小板在被激活后，可以将白细胞和祖细胞拖到血管部位。血小板在循环中释放各种促炎、抗炎和血管生成因子，并释放微颗粒，从而促进病理反应。这些血小板释放的因子也维持持续激活，进一步影响这些疾病过程。尽管机制尚不清楚，但多种刺激可诱导血小板过度反应，但涉及血小板激活的早期途径。过度活跃的血小板如何导致这些疾病的具体机制尚不清楚，抗血小板策略对于预防这些疾病是必不可少的。在疾病早期降低血小板功能可能会显著影响这些疾病。然而，尽管这是一种潜在的有价值的干预措施，但在没有心血管疾病的情况下，使用抗血小板药物限制明显健康个体的血小板功能是不推荐的，因为这会增加内出血、耐药性和其他副作用的风险。在这些疾病中进行治疗干预的挑战是确定优先阻断血小板在这些疾病中复杂贡献的特定靶点的因素，同时至少部分保留其止血功能。由于不建议将阿司匹林等抗血小板药物作为主要预防药物，因此使用没有副作用的替代安全血小板抑制剂至关重要。
从 2000 年到 2023 年，通过选择的关键词在 PUBMED 数据库中进行了系统搜索：“功能性食品”、“多酚”、“脂肪酸”、“草药”、“水果和蔬菜”、“心脏保护剂”、“植物”、“血小板聚集”、“血小板激活”、“临床和非临床试验”、“随机”和“对照”。
已经描述了有效的天然抗血小板因子，包括 ω-3 脂肪酸、多酚和其他植物化学物质。食物中的抗血小板生物活性化合物可以预防血小板过度活跃，从而可能预防几种血小板介导的疾病，包括心血管疾病。
本综述描述了 2000-2023 年期间从天然来源开发具有抗血小板作用的功能性食品的工作。
