Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
BMC Complementary Medicine and Therapies
Published in: BMC Complementary Medicine and Therapies 1/2016

Open Access 01-12-2016 | Research article

Platelet inhibitory effects of juices from Pachyrhizus erosus L. root and Psidium guajava L. fruit: a randomized controlled trial in healthy volunteers

Authors: Thitiporn Thaptimthong, Thitima Kasemsuk, Nathawut Sibmooh, Supeenun Unchern

Published in: BMC Complementary Medicine and Therapies | Issue 1/2016

Login to get access

Abstract

Background

The purpose of this study is to investigate cardiovascular benefits of juices obtained from two commonly consumed fruits in Thailand, Pachyrhizus erosus, L. (yam bean) and Psidium guajava, L. (guava), by examining their acute cardiovascular effects in healthy volunteers. Possible involvements of the dietary nitrate on their effects were investigated as well.

Method

Thirty healthy volunteers were randomly divided into three groups of 10 subjects per group and each group was allocated to drink 500 ml of freshly prepared yam bean root juice, guava fruit juice, or water. Systemic nitrate and nitrite concentrations, heart rate, systolic and diastolic blood pressure, serum K+ concentrations, ex vivo platelet aggregation, and plasma cGMP concentrations were monitored at the baseline and at various time points after the intake of juices or water. Data were compared by repeated measures ANOVA.

Results

Following the ingestion of both yam bean root juice and guava fruit juice, collagen-induced but not ADP-induced platelet aggregation was attenuated. Ingestion of yam bean root juice increased systemic nitrate and nitrite concentrations whereby elevated nitrite concentrations correlated with the extent of inhibiting collagen-induced platelet aggregation. In addition, positive correlation between systemic nitrite and plasma cGMP concentrations and negative correlation between plasma cGMP concentrations and the extent of collagen-induced platelet aggregation were revealed. Nevertheless, yam bean root juice reduced only diastolic blood pressure while guava fruit juice reduced heart rate, systolic and diastolic blood pressure.

Conclusion

The present study has illustrated, for the first time, acute inhibitory effects of yam bean root juice and guava fruit juice on ex vivo collagen-induced platelet aggregation in healthy subjects. Dietary nitrate was shown to underlie the effect of yam bean root juice but not that of guava fruit juice. Following yam bean root juice ingestion, systemic nitrate apparently converts to nitrite and further to NO which may attenuate platelet responses to collagen stimulation. Cardiovascular benefits of juices from yam bean root and guava fruit are noteworthy in term of the cardiovascular health-promoting approach.

Trial registration

Randomized controlled trial TCTR20150228001.
Literature
1.
2.
Giansante C, Fiotti N. Insights into human hypertension: the role of endothelial dysfunction. J Hum Hypertens. 2006;20(10):725–6.CrossRefPubMed
3.
Kwon O, Hong SM, Ramesh G. Diminished NO generation by injured endothelium and loss of macula densa nNOS may contribute to sustained acute kidney injury after ischemia-reperfusion. Am J Physiol Renal Physiol. 2009;296(1):F25–33.CrossRefPubMed
4.
Zhao HJ, Wang S, Cheng H, Zhang MZ, Takahashi T, Fogo AB, et al. Endothelial nitric oxide synthase deficiency produces accelerated nephropathy in diabetic mice. J Am Soc Nephrol. 2006;17(10):2664–9.CrossRefPubMedPubMedCentral
5.
6.
Quyyumi AA, Dakak N, Andrews NP, Husain S, Arora S, Gilligan DM, et al. Nitric oxide activity in the human coronary circulation. Impact of risk factors for coronary atherosclerosis. J Clin Invest. 1995;95(4):1747–55.CrossRefPubMedPubMedCentral
7.
Zand J, Lanza F, Garg HK, Bryan NS. All-natural nitrite and nitrate containing dietary supplement promotes nitric oxide production and reduces triglycerides in humans. Nutr Res. 2011;31(4):262–9.CrossRefPubMed
8.
Ito K, Chen J, Seshan SV, Khodadadian JJ, Gallagher R, El Chaar M, et al. Dietary arginine supplementation attenuates renal damage after relief of unilateral ureteral obstruction in rats. Kidney Int. 2005;68(2):515–28.CrossRefPubMed
9.
Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997;336(16):1117–24.CrossRefPubMed
10.
Bryan NS, Calvert JW, Elrod JW, Gundewar S, Ji SY, Lefer DJ. Dietary nitrite supplementation protects against myocardial ischemia-reperfusion injury. Proc Natl Acad Sci U S A. 2007;104(48):19144–9.CrossRefPubMedPubMedCentral
11.
Sobko T, Marcus C, Govoni M, Kamiya S. Dietary nitrate in Japanese traditional foods lowers diastolic blood pressure in healthy volunteers. Nitric Oxide. 2010;22(2):136–40.CrossRefPubMed
12.
Lidder S, Webb AJ. Vascular effects of dietary nitrate (as found in green leafy vegetables and beetroot) via the nitrate-nitrite-nitric oxide pathway. Br J Clin Pharmacol. 2013;75(3):677–96.CrossRefPubMedPubMedCentral
13.
Kapil V, Milsom AB, Okorie M, Maleki-Toyserkani S, Akram F, Rehman F, et al. Inorganic nitrate supplementation lowers blood pressure in humans: role for nitrite-derived NO. Hypertension. 2010;56(2):274–81.CrossRefPubMed
14.
Webb AJ, Patel N, Loukogeorgakis S, Okorie M, Aboud Z, Misra S, et al. Acute blood pressure lowering, vasoprotective, and antiplatelet properties of dietary nitrate via bioconversion to nitrite. Hypertension. 2008;51(3):784–90.CrossRefPubMedPubMedCentral
15.
Freedman JE, Parker 3rd C, Li L, Perlman JA, Frei B, Ivanov V, et al. Select flavonoids and whole juice from purple grapes inhibit platelet function and enhance nitric oxide release. Circulation. 2001;103(23):2792–8.CrossRefPubMed
16.
Mattiello T, Trifiro E, Jotti GS, Pulcinelli FM. Effects of pomegranate juice and extract polyphenols on platelet function. J Med Food. 2009;12(2):334–9.CrossRefPubMed
17.
George TW, Niwat C, Waroonphan S, Gordon MH, Lovegrove JA. Effects of chronic and acute consumption of fruit- and vegetable-puree-based drinks on vasodilation, risk factors for CVD and the response as a result of the eNOS G298T polymorphism. Proc Nutr Soc. 2009;68(2):148–61.CrossRefPubMed
18.
Ekshyyan VP, Hebert VY, Khandelwal A, Dugas TR. Resveratrol inhibits rat aortic vascular smooth muscle cell proliferation via estrogen receptor dependent nitric oxide production. J Cardiovasc Pharmacol. 2007;50(1):83–93.CrossRefPubMed
19.
de Nigris F, Williams-Ignarro S, Lerman LO, Crimi E, Botti C, Mansueto G, et al. Beneficial effects of pomegranate juice on oxidation-sensitive genes and endothelial nitric oxide synthase activity at sites of perturbed shear stress. Proc Natl Acad Sci U S A. 2005;102(13):4896–901.CrossRefPubMedPubMedCentral
20.
Morand C, Dubray C, Milenkovic D, Lioger D, Martin JF, Scalbert A, et al. Hesperidin contributes to the vascular protective effects of orange juice: a randomized crossover study in healthy volunteers. Am J Clin Nutr. 2011;93(1):73–80.CrossRefPubMed
21.
Morand C, Milenkovic D, Chanet A, Deval C, Mazur A. Nutrigenomic effects of hesperidin, the major polyphenol of orange, related to its cardiovascular protective effects. FASEB J. 2011;25:582–9.
22.
Reshef N, Hayari Y, Goren C, Boaz M, Madar Z, Knobler H. Antihypertensive effect of sweetie fruit in patients with stage I hypertension. Am J Hypertens. 2005;18(10):1360–3.CrossRefPubMed
23.
Geidam Y, Ambali A, Onyeyili P. Phytochemical Screening and Antibacterial Properties of Organic Solvent Fractions of Psidium guajava Aqueous Leaf Extracts. Int J Pharmacol. 2007;3:68–73.CrossRef
24.
Jiménez-Escrig A, Rincón M, Pulido R, Saura-Calixto F. Guava fruit (Psidium guajava L.) as a new source of antioxidant dietary fiber. J Agric Food Chem. 2001;49(11):5489–93.CrossRefPubMed
25.
Ayub M, Norazmir M, Mamot S, Jeeven K, Hadijah H. Anti-hypertensive effect of pink guava Psidium guajava puree on spontaneous hypertensive rats. Inter Food Res J. 2010;17:89–96.
26.
Yamashiro S, Noguchi K, Matsuzaki T, Miyagi K, Nakasone J, Sakanashi M, et al. Cardioprotective effects of extracts from Psidium guajava L and Limonium wrightii, Okinawan medicinal plants, against ischemia-reperfusion injury in perfused rat hearts. Pharmacology. 2003;67(3):128–35.CrossRefPubMed
27.
Gondim A, de Oliveira V, dos Santos S, da Silva B, de Vasconcelos C, Conde-Garcia E. Exract from leaf of Psidium guajava L. depresses the guinea pig atrial contractility by interfering with potassium and calcium channels. Braz J Pharm Sci. 2010;43(5):483–9.
28.
Kumalasari ID, Nishi K, Harmayani E, Raharjo S, Sugahara T. Immunomodulatory activity of Bengkoang (Pachyrhizus erosus) fiber extract in vitro and in vivo. Cytotechnology. 2014;66(1):75–85.CrossRefPubMed
29.
Yang BK, Vivas EX, Reiter CD, Gladwin MT. Methodologies for the sensitive and specific measurement of S-nitrosothiols, iron-nitrosyls, and nitrite in biological samples. Free Radic Res. 2003;37(1):1–10.CrossRefPubMed
30.
Pelletier MM, Kleinbongard P, Ringwood L, Hito R, Hunter CJ, Schechter AN, et al. The measurement of blood and plasma nitrite by chemiluminescence: pitfalls and solutions. Free Radic Biol Med. 2006;41(4):541–8.CrossRefPubMed
31.
Basu S, Wang X, Gladwin MT, Kim-Shapiro DB. Chemiluminescent detection of S-nitrosated proteins: comparison of tri-iodide, copper/CO/cysteine, and modified copper/cysteine methods. Methods Enzymol. 2008;440:137–56.CrossRefPubMed
32.
33.
Jarvis GE. Platelet aggregation: turbidimetric measurements. Methods Mol Biol. 2004;272:65–76.PubMed
34.
Fogh-Andersen N, Wimberley PD, Thode J, Siggaard-Andersen O. Determination of sodium and potassium with ion-selective electrodes. Clin Chem. 1984;30(3):433–6.PubMed
35.
Preik-Steinhoff H, Kelm M. Determination of nitrite in human blood by combination of a specific sample preparation with high-performance anion-exchange chromatography and electrochemical detection. J Chromatogr B Biomed Appl. 1996;685(2):348–52.CrossRefPubMed
36.
Dougall HT, Smith L, Duncan C, Benjamin N. The effect of amoxycillin on salivary nitrite concentrations: an important mechanism of adverse reactions? Br J Clin Pharmacol. 1995;39(4):460–2.CrossRefPubMedPubMedCentral
37.
Duncan C, Dougall H, Johnston P, Green S, Brogan R, Leifert C, et al. Chemical generation of nitric oxide in the mouth from the enterosalivary circulation of dietary nitrate. Nat Med. 1995;1(6):546–51.CrossRefPubMed
38.
Govoni M, Jansson EA, Weitzberg E, Lundberg JO. The increase in plasma nitrite after a dietary nitrate load is markedly attenuated by an antibacterial mouthwash. Nitric Oxide. 2008;19(4):333–7.CrossRefPubMed
39.
Jansson EA, Huang L, Malkey R, Govoni M, Nihlen C, Olsson A, et al. A mammalian functional nitrate reductase that regulates nitrite and nitric oxide homeostasis. Nat Chem Biol. 2008;4(7):411–7.CrossRefPubMed
40.
Richardson G, Hicks SL, O'Byrne S, Frost MT, Moore K, Benjamin N, et al. The ingestion of inorganic nitrate increases gastric S-nitrosothiol levels and inhibits platelet function in humans. Nitric Oxide. 2002;7(1):24–9.CrossRefPubMed
41.
Johnson 3rd G, Tsao PS, Mulloy D, Lefer AM. Cardioprotective effects of acidified sodium nitrite in myocardial ischemia with reperfusion. J Pharmacol Exp Ther. 1990;252(1):35–41.PubMed
42.
Srihirun S, Sriwantana T, Unchern S, Kittikool D, Noulsri E, Pattanapanyasat K, et al. Platelet inhibition by nitrite is dependent on erythrocytes and deoxygenation. PLoS One. 2012;7(1):e30380.CrossRefPubMedPubMedCentral
43.
Cosby K, Partovi KS, Crawford JH, Patel RP, Reiter CD, Martyr S, et al. Nitrite reduction to nitric oxide by deoxyhemoglobin vasodilates the human circulation. Nat Med. 2003;9(12):1498–505.CrossRefPubMed
44.
Velmurugan S, Kapil V, Ghosh SM, Davies S, McKnight A, Aboud Z, et al. Antiplatelet effects of dietary nitrate in healthy volunteers: involvement of cGMP and influence of sex. Free Radic Biol Med. 2013;65:1521–32.CrossRefPubMedPubMedCentral
45.
Tsutamoto T, Kinoshita M, Ohbayashi Y, Wada A, Maeda Y, Adachi T. Plasma arteriovenous cGMP difference as a useful indicator of nitrate tolerance in patients with heart failure. Circulation. 1994;90(2):823–9.CrossRefPubMed
46.
Roberts W, Riba R, Homer-Vanniasinkam S, Farndale RW, Naseem KM. Nitric oxide specifically inhibits integrin-mediated platelet adhesion and spreading on collagen. J Thromb Haemost. 2008;6(12):2175–85.CrossRefPubMed
47.
Beghetti M, Sparling C, Cox PN, Stephens D, Adatia I. Inhaled NO inhibits platelet aggregation and elevates plasma but not intraplatelet cGMP in healthy human volunteers. Am J Physiol Heart Circ Physiol. 2003;285(2):H637–42.CrossRefPubMed
48.
Gries A, Bode C, Peter K, Herr A, Bohrer H, Motsch J, et al. Inhaled nitric oxide inhibits human platelet aggregation, P-selectin expression, and fibrinogen binding in vitro and in vivo. Circulation. 1998;97(15):1481–7.CrossRefPubMed
49.
Mhatre M, Tilak-Jain J, De S, Devasagayam TP. Evaluation of the antioxidant activity of non-transformed and transformed pineapple: a comparative study. Food Chem Toxicol. 2009;47(11):2696–702.CrossRefPubMed
50.
Miean KH, Mohamed S. Flavonoid (myricetin, quercetin, kaempferol, luteolin, and apigenin) content of edible tropical plants. J Agric Food Chem. 2001;49(6):3106–12.CrossRefPubMed
51.
Gutierrez RM, Mitchell S, Solis RV. Psidium guajava: a review of its traditional uses, phytochemistry and pharmacology. J Ethnopharmacol. 2008;117(1):1–27.CrossRefPubMed
52.
Hubbard GP, Wolffram S, Lovegrove JA, Gibbins JM. Ingestion of quercetin inhibits platelet aggregation and essential components of the collagen-stimulated platelet activation pathway in humans. J Thromb Haemost. 2004;2(12):2138–45.CrossRefPubMed
53.
Dutta-Roy AK, Gordon MJ, Kelly C, Hunter K, Crosbie L, Knight-Carpentar T, et al. Inhibitory effect of Ginkgo biloba extract on human platelet aggregation. Platelets. 1999;10(5):298–305.CrossRefPubMed
54.
Kang W, Chung K, Chung J, Lee J, Park J, Zhang Y, et al. Antiplatelet activity of green tea catechins is mediated by inhibition of cytoplasmic calcium increase. J Cardiovasc Pharmacol. 2001;38(6):875–84.CrossRefPubMed
55.
Singh RB, Rastogi SS, Singh R, Ghosh S, Niaz MA. Effects of guava intake on serum total and high-density lipoprotein cholesterol levels and on systemic blood pressure. Am J Cardiol. 1992;70(15):1287–91.CrossRefPubMed
56.
Ojewole JA. Hypoglycemic and hypotensive effects of Psidium guajava Linn. (Myrtaceae) leaf aqueous extract. Methods Find Exp Clin Pharmacol. 2005;27(10):689–95.CrossRefPubMed
Metadata
Title
Platelet inhibitory effects of juices from Pachyrhizus erosus L. root and Psidium guajava L. fruit: a randomized controlled trial in healthy volunteers
Authors
Thitiporn Thaptimthong
Thitima Kasemsuk
Nathawut Sibmooh
Supeenun Unchern
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2016
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-016-1255-1

Other articles of this Issue 1/2016

BMC Complementary Medicine and Therapies 1/2016 Go to the issue

Research article

The effect of Vaccinium uliginosum extract on tablet computer-induced asthenopia: randomized placebo-controlled study

Research article

Complementary medicine use by the Australian population: a critical mixed studies systematic review of utilisation, perceptions and factors associated with use

Research article

Comparative analysis of four terpenoids in root and cortex of Tripterygium wilfordii Radix by different drying methods

Study protocol

Acupuncture with different acupoint combinations for chemotherapy-induced nausea and vomiting: study protocol for a randomized controlled trial

Research article

Safety evaluation of Bon-santé cleanser® polyherbal in male Wistar rats

Research article

Cat’s whiskers (Orthosiphon stamineus) tea modulates arthritis pathogenesis via the angiogenesis and inflammatory cascade