Introduction: Eryptosis (the suicidal programmed death of erythrocytes) is associated with elevated adhesion to the vascular endothelium, and therefore, with a worsening of cardiovascular health. Statins, used for hypercholesterolemia treatment, can increase eryptosis, while plant sterols (PSs) have shown an anti-eryptotic effects ex vivo.
Methodology: A double-blind randomized controlled parallel trial involving statin-treated hypercholesterolemic patients was performed. Participants were randomized into treated (n=13) and placebo (n=13) groups, and they tooka food supplement enriched with PSs (2 g) daily or had a non-enriched daily diet, respectively. Blood samples were extracted before and after 6-week treatment, and erythrocytes were isolated. Flow cytometry analyses were performed for the evaluation of the externalization of phosphatidylserine and cell sizes (as markers of eryptosis), as well as for reduced glutathione (as a redox status marker).
Results: No statistically significant differences (p>0.05) were observed between treated and placebo patients in the % of cells with externalized phosphatidylserine (Δ final–initial measure) (-1.3±2.1 vs. -1.1±2.0 % of cells in the treated and placebo groups, respectively). Furthermore, no statistically significant (p>0.05) differences were found between the treated and placebo groups regarding cell size change (-1±7.9 vs. -8±10.3 arbitrary units), or glutathione levels (13±42.9 vs. 47±50.2 arbitrary units). Patients with lower adherence to treatment (> 4 days without supplement consumption) were excluded from the statistical analysis without creating any changes in the results. The data were also evaluated, stratifying patients according to sex, age and BMI, without observing any differences.
Conclusions: The results suggest that chronic PS food supplement consumption may not affect the eryptotic status in statin-treated hypercholesterolemic patients, although its effect on adhesion to the endothelium of eryptotic erythrocytes, as well as other markers of cardiovascular health (such as plasma cholesterol reduction), should be investigated for deeper knowledge. Furthermore, a higher n would be of great interest to be investigated in future trials to obtain conclusive results.
