Coronary Heart Disease (CHD) is one of the diseases that need to be aware of and the most causes of death. At least 12.9% of deaths in Indonesia are caused by CHD. One of the causes of high mortality in CHD is the decrease in proliferation and migration of endothelial progenitor cells (Endothelial Progenitor Cells / EPCs).
These endothelial progenitor cells are unipotent cells that are clonogenesis, which can repair themselves and can differentiate into adult endothelial cells replacing injured vascular endothelium (necrosis) and cell death (apotoptosis). This endothelial function needs to be maintained, primarily related to its role in maintaining cell integrity. Endothelial progenitor cells are believed to have the potential for blood vessel regeneration, through the process of angiogenesis, especially reperfusion after ischemia in CHD.
Decreased function of EPCs in CHD patients is caused by the oxidant mechanism during the ischemic phase of heart cells (myocardial). This decrease has an impact on decreased blood vessel repair function. In later stages, this results in an increase in morbidity and mortality due to heart attacks.
Understanding the role of oxidants in exacerbating the progression of CHD, becomes the basis in the development of the use of antioxidants as companion therapy. Vitamin C (Ascorbic Acid) and E (Tocopherol) have been shown to prevent the reduction of TNF-a and the proliferation of EPCs through the expression of p38 phosphorylation.
Other studies also mention the antioxidant content of purple sweet potato can prevent endothelial dysfunction through inhibition of reactive oxygen species (ROS) and nucleotide-binding domain (NOD) -like protein 3 (NLRP3) receptors. The antioxidant content of purple sweet potatoes, namely anthocyanin, and B-carotene provide good effects in blood vessel repair.
Although research on the role of antioxidants in the repair of blood vessels in CHD patients, specifically through the improvement of proliferation, migration, and differentiation of EPC has given many positive results, research on the superiority of antioxidants and has never been done before. We made a comparison between the effects of antioxidants on purple sweet potato extract and vitamin C in improving the function of EPCs in CHD patients.
The research was conducted on 8 CHD patients who were treated at Dr. Soetomo General Hospital Surabaya with inclusion criteria: male, aged 40-59 years, stable angina, and with coronary angiography results showing stenosis> 50% on the left main coronary artery or> 70 % in other coronary branches. The research was conducted concerning the effects of purple sweet potato extract and vitamin C on the proliferation, migration, and differentiation of EPCs obtained from patients’ peripheral blood cells.
This study consisted of 5 stages: (1) acquisition of peripheral blood samples, (2) isolation and culture of EPCs, (3) evaluation of EPCs proliferation, (4) evaluation of migration of EPCs, and (5) evaluation of CFU. The study was conducted by comparing the antioxidant effects of purple sweet potato extract and vitamin C. Purple sweet potato extract using concentrations of 1 and 25 ug / mL. With this dose, at least 146 μg / mL of anthocyanin are present. Whereas the dose of vitamin C used was concentrated doses of 10 and 250 μg / mL.
The results showed purple sweet potato had a significant effect on the improvement of proliferation, migration, and differentiation of EPCs. A dose of 25 μg / mL of purple sweet potato extract and a dose of 250 μg / mL of vitamin C provides a better effect than lower concentrated doses. The result of purple sweet potato extract in improving the function of EPCs is known to be better than vitamin C. This is also caused by the improvement of the role of EPCs with a lower dose of purple sweet potato extract (25 ug / mL) giving better results than the treatment needed by vitamin C (250 μg / mL).
This research indirectly supports previous research which suggests that anthocyanin, an antioxidant possessed by purple sweet potato and it can increase migration and proliferation of EPCs through decreasing intracellular ROS formation and increasing the proliferation effect of EPCs.
From this research, it can be concluded that the use of purple sweet potato extract, especially at a dose of 25 ug / mL, provides a better effect on the proliferation, migration, and differentiation of endothelial progenitor cells compared to vitamin C. The effect of improving endothelial progenitor cell function is expected to provide vascular and clinical repair of CHD patients. (*)
Author: Yudi Her Oktaviono
Detail information from this research can be seen in our writing at https: //www.mdpi.com/2218-0532/87/3/16