Indian gooseberry extract (Capros) may counter endothelial dysfunction in diabetics: RCT

Endothelial dysfunction is said to occur in patients with diabetes much earlier than the clinical manifestations of vascular complications of the disease

Daily supplements of an extract from Indian gooseberry (Phyllanthus emblica) may improve the health of cells lining the blood vessels, and reduce levels of markers of oxidative stress in type-2 diabatics, according to results of a randomized, double-blind, controlled study.

Twelve weeks of supplementation with 250 or 500 milligrams per day of the extract were found to improve endothelial function in people with type-2 diabetes to a similar level as observed for atorvastatin, researchers report in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.

The standardized aqueous extract of Phyllanthus emblica (syn. Emblica officinalis) are commercialized by New Jersey-based Natreon, and branded as Capros for the food, beverage and dietary supplements market.

Endothelial dysfunction

The endothelium – the thin layer of cells lining the blood vessels – performs many functions including maintaining the suppleness of blood vessels and regulating the activity of neutrophils, white blood cells that form a key part of the immune system.

Dysfunction in the endothelium leads to arteries with little suppleness, raising the risk of high blood pressure (hypertension), and arteries that are chronically inflamed, leading to an overabundance of adhesion molecules.

“It has been reported that endothelial dysfunction occurs in patients with diabetes much earlier than the clinical manifestations of vascular complications of the disease,” wrote researchers from the Nizam Institute of Medical Sciences in India.

Study details

Newly published findings of a randomized, double-blind, controlled study with extracts from P. emblica indicated that the fruit extracts may benefit cardiovascular health in type-2 diabetics.

Pingali Usharani, Nishat Fatima, and Nizampatnam Muralidhar recruited 80 people with type-2 diabetes to participate in their study. The subjects were randomly assigned to one of four groups: One group received placebo, another group received atorvastatin (10 mg per day), and the other groups received Capros supplements with 250 or 500 mg of the extract twice daily.

After 12 weeks of intervention, the results showed that that all three active groups experienced significant improvements in a marker of endothelial-dependent vasodilatation called the reflection index. Specifically, the 250 mg and 500 mg Capros groups reduced the reflective index by 2.3 to 9.1%, and by 2.1 to 10.0%, respectively, compared with reductions in the atorvastatin group of between 2.7 and 11.0%.

In addition, levels of malondialdehyde, a marker of oxidative stress, decreased by 23, 28, and 30% for the 250mg Capros, 500mg Capros, and atorvastatin groups, respectively, compared with placebo.

Nitric oxide, a potent vasodilator released by the endothelial, was also significantly increased in the active groups by 43.1% for P. emblica 250 mg, 54.6% for P. emblica 500 mg, and 88% for atorvastatin, compared with placebo, said the researchers.

Increases were also observed in levels of the antioxidant glutathione, compared to placebo, they added.

Levels of inflammatory biomarkers were improved by the active groups, added the researchers, with high sensitivity C-reactive protein levels decreasing by 44.56%, 63.16%, and 64.9% in the 250 mg Capros, 500 mg Capros, and atorvastatin groups, respectively, compared with placebo.

Cholesterol levels were also improved in participants receiving the active interventions, wrote Usharani, Fatima, and Muralidhar.

“In the present study, atorvastatin and a proprietary P. emblica extract containing emblicanin A, emblicanin B, pedunculagin, and punigluconin as bioactives achieved significant improvement in endothelial function and a reduction in biomarkers of oxidative stress and systemic inflammation,” wrote the researchers.

“Addition of P. emblica to the currently available antihyperlipidemic agents may augment the activity of the statins and offer significant protection against atherosclerosis and coronary artery disease.”

A spokesperson for Natreon told us that the new study indicated that the Capros, a single ingredient derived from edible fruits, has properties to support cardiovascular health by improving endothelial function and endothelial biomarkers, reducing total, LDL and VLDL cholesterols, triglycerides and hsCRP, increasing HDL, and improving blood flow. "Six additional studies to support these claims will be published soon," they added.

Source: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
2013, Volume 6, Pages 275-284, doi: 10.2147/DMSO.S46341
“Effects of Phyllanthus emblica extract on endothelial dysfunction and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: a randomized, double-blind, controlled study”
Authors: P. Usharani, N. Fatima, N. Muralidhar

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