CASCA E POLPA DE PASSIFLORA NA SÍNDROME METABÓLICA: UMA REVISÃO SISTEMÁTICA DE ENSAIOS CLÍNICOS RANDOMIZADOS
Keywords:
Maracujá. Resistência à Insulina. Saúde do Adulto.Abstract
A síndrome metabólica (SM) caracteriza-se como um conjunto de distúrbios cardiometabólicos, que engloba alterações cardiometabólicas relacionadas diretamente a hereditariedade e ao estilo de vida. Sem tratamento especifico, porém sua terapêutica visa atenuar o risco de maiores complicações, através de estratégias comportamentais e, eventualmente, medicamentosas. Dietas ricas em alimentos in natura, melhoram o perfil lipidêmico, glicemia, níveis pressóricos e o estresse oxidativo, provendo benefícios à saúde. Frente a esta descobertas, estudiosos se debruçado no estudo de produtos naturais. Passiflora ssp. destaca-se por suas propriedades terapêuticas, devido aos compostos bioativos. Este estudo tem como objetivo identificar a utilização de Passiflora ssp. na atenuação dos componentes da SM. Trata-se de uma revisão sistemática, seguindo as diretrizes PRISMA, nas bases de dados/plataformas eletrônicas: PubMed Central, Scopus e Web of Science™, até abril de 2023. Para avaliar o risco de viés, foi utilizado a ferramenta Cochran Risk of Bias 2.0. Foram incluídos 8 ensaios clínicos randomizados, 50% investigaram a casca e 50% a polpa de Passiflora. Ambos evidenciaram efeitos anti-glicemiantes, antidislipidêmicos e anti-hipertensivos. Não houve impacto na composição corporal. Conclui-se que a utilização de Passiflora ssp. é seguro, atenuando inflamação, parâmetros glicídicos, insulinêmicos, dislipidêmicos e pressóricos, sugerindo ser uma terapia alternativa para a SM.
References
McCracken E, Monaghan M, Sreenivasan S. Pathophysiology of the metabolic syndrome. Clinics in Dermatology [Internet]. 2018 Jan;36(1):14–20. Available from: https://www.sciencedirect.com/science/article/pii/S0738081X1730158X.
Fahed G, Aoun L, Bou Zerdan M, Allam S, Bou Zerdan M, Bouferraa Y, et al. Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. International Journal of Molecular Sciences. 2022 Jan 12;23(2):786.
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabetic Medicine: A Journal of the British Diabetic Association [Internet]. 1998 Jul 1;15(7):539–53. Available from: https://pubmed.ncbi.nlm.nih.gov/9686693/
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA: The Journal of the American Medical Association. 2001 May 16;285(19):2486–97.
International Diabetes Federation. The IDF consensus worldwide definition of the Metabolic Syndrome. Obes metabol, v.2, n.3, p.47-49; 2005.
Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–5.
Yamagishi K, Iso H. The criteria for metabolic syndrome and the national health screening and education system in Japan. Epidemiology and Health. 2017 Jan 6;39:e2017003.
Duarte I de AE, Milenkovic D, Borges TKDS, Rosa AJ de M, Morand C, Oliveira L de L de, et al. Acute Effects of the Consumption of Passiflora setacea Juice on Metabolic Risk Factors and Gene Expression Profile in Humans. Nutrients [Internet]. 2020 Apr 16 [cited 2022 Dec 2];12(4):1104. Available from: https://pubmed.ncbi.nlm.nih.gov/32316129/
Atanasov AG, Zotchev SB, Dirsch VM, Supuran CT. Natural products in drug discovery: advances and opportunities. Nature Reviews Drug Discovery [Internet]. 2021 Jan 28;20:200–16. Available from: https://www.nature.com/articles/s41573-020-00114-z
Appleton KM, Hemingway A, Saulais L, Dinnella C, Monteleone E, Depezay L, et al. Increasing vegetable intakes: rationale and systematic review of published interventions. European Journal of Nutrition [Internet]. 2016 Jan 11 [cited 2019 Oct 1];55(3):869–96. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819941/
Anusooriya P, Malarvizhi D, Gopalakrishnan VK, Devaki K. Antioxidant and Antidiabetic Effect of Aqueous Fruit Extract of Passiflora ligularis Juss. on Streptozotocin Induced Diabetic Rats. International Scholarly Research Notices. 2014 Dec 21;2014:1–10.
de Araújo MFM, Veras VS, de Freitas RWJF, de Paula M do L, de Araújo TM, Uchôa LRA, et al. The effect of flour from the rind of the yellow passion fruit on glycemic control of people with diabetes mellitus type 2: a randomized clinical trial. Journal of Diabetes & Metabolic Disorders. 2017 Apr 17;16(1).
Claro MDL, Péres-Rodrigues G, Teixeira SA. PROPRIEDADES FUNCIONAIS DA CASCA DO MARACUJÁ AMARELO (PASSIFLORA EDULIS) NA SÍNDROME METABÓLICA. DEMETRA: Alimentação, Nutrição & Saúde. 2018 May 3;13(1).
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an Updated Guideline for Reporting Systematic Reviews. British Medical Journal [Internet]. 2021 Mar 29;372(71). Available from: https://www.bmj.com/content/372/bmj.n71
Santos CM da C, Pimenta CA de M, Nobre MRC. The PICO strategy for the research question construction and evidence search. Revista Latino-Americana de Enfermagem [Internet]. 2007 Jun;15(3):508–11. Available from: https://www.scielo.br/j/rlae/a/CfKNnz8mvSqVjZ37Z77pFsy/?lang=en
Higgins JPT, Sterne JAC, Savović J, Page MJ, Hróbjartsson A, Boutron I, et al. A revised tool for assessing risk of bias in randomized trials. Chandler J, McKenzie J, Boutron I, Welch V, editor. Cochrane Methods. Cochrane Database of Systematic Reviews; 2016.
Prasertsri P, Booranasuksakul U, Naravoratham K, Trongtosak P. Acute Effects of Passion Fruit Juice Supplementation on Cardiac Autonomic Function and Blood Glucose in Healthy Subjects. Preventive Nutrition and Food Science. 2019 Sep 30;24(3):245–53.
Raju IN, Reddy KK, Kumari CK, Reddy EB, Rao SD, Reddy CD, et al. Efficacy of Purple Passion Fruit Peel Extract in Lowering Cardiovascular Risk Factors in Type 2 Diabetic Subjects. Journal of Evidence-Based Complementary & Alternative Medicine. 2013 Feb 6;18(3):183–90.
Sousa DF de, Araújo MFM de, de Mello VD, Damasceno MMC, Freitas RWJF de. Cost-Effectiveness of Passion Fruit Albedo versus Turmeric in the Glycemic and Lipaemic Control of People with Type 2 Diabetes: Randomized Clinical Trial. Journal of the American College of Nutrition [Internet]. 2021 Nov 1;40(8):679–88. Available from: https://pubmed.ncbi.nlm.nih.gov/33141635/
Duarte I, Souza MCM de, Curinga RM, Mendonça HM, Oliveira L de L de, Milenkovic D, et al. Effect of Passiflora setacea juice and its phenolic metabolites on insulin resistance markers in overweight individuals and on microglial cell activity. Food & Function [Internet]. 2022 Jun 20 [cited 2024 Feb 22];13(12):6498–509. Available from: https://pubs.rsc.org/en/content/articlelanding/2022/fo/d1fo04334j
Jurairat Khongrum, Pratoomporn Yingthongchai, Kongsak Boonyapranai, Wachira Wongtanasarasin, Nowwapan Donrung, Wanida Sukketsiri, et al. Antidyslipidemic, Antioxidant, and Anti-inflammatory Effects of Jelly Drink Containing Polyphenol-Rich Roselle Calyces Extract and Passion Fruit Juice with Pulp in Adults with Dyslipidemia: A Randomized, Double-Blind, Placebo-Controlled Trial. Oxidative Medicine and Cellular Longevity. 2022 Sep 21;2022:1–12.
Zibadi S, Farid R, Moriguchi S, Lu Y, Foo LY, Tehrani PM, et al. Oral administration of purple passion fruit peel extract attenuates blood pressure in female spontaneously hypertensive rats and humans. Nutrition Research. 2007 Jul;27(7):408–16.
Rochlani Y, Pothineni NV, Kovelamudi S, Mehta JL. Metabolic syndrome: pathophysiology, management, and modulation by natural compounds. Therapeutic Advances in Cardiovascular Disease [Internet]. 2017 Jun 22;11(8):215–25. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933580/
Pereira LPA, Durans KCN, Fróes WL, Pimenta TC, Silva DS, Batista MCA, et al. Produtos naturais empregados na prevenção e/ou alívio da sintomatologia do COVID-19: uma revisão. Research, Society and Development. 2022 Jun 6;11(7):e34511730374.
Cazarin CBB, Silva JK da, Colomeu TC, Zollner R de L, Maróstica Junior MR. Capacidade antioxidante e composição química da casca de maracujá (Passiflora edulis). Ciência Rural. 2014 Sep;44(9):1699–704.
Ferreira WS, Souza MLR de. Os benefícios do maracujá (Passiflora spp.) no Diabetes Mellitus / The benefits of passion fruit (Passiflora spp.) in diabetes mellitus. Brazilian Journal of Health Review. 2020;3(6):19523–39.
De Faveri A, De Faveri R, Broering MF, Bousfield IT, Goss MJ, Muller SP, et al. Effects of passion fruit peel flour (Passiflora edulis f. flavicarpa O. Deg.) in cafeteria diet-induced metabolic disorders. Journal of Ethnopharmacology. 2020 Mar;250:112482.
Hill MA, Yang Y, Zhang L, Sun Z, Jia G, Parrish AR, et al. Insulin resistance, cardiovascular stiffening and cardiovascular disease. Metabolism. 2021 Jun;119:154766.
Khosravi Z, Hadi A, Tutunchi H, Asghari-Jafarabadi M, Naeinie F, Roshanravan N, et al. The effects of butyrate supplementation on glycemic control, lipid profile, blood pressure, nitric oxide level and glutathione peroxidase activity in type 2 diabetic patients: A randomized triple -blind, placebo-controlled trial. Clinical Nutrition ESPEN. 2022 Jun;49:79–85.30.de Queiroz M do SR, Janebro DI, da Cunha MAL, Medeiros J dos S, Sabaa-Srur AU, Diniz M de FF, et al. Effect of the yellow passion fruit peel flour (Passiflora edulis f. flavicarpa deg.) in insulin sensitivity in type 2 diabetes mellitus patients. Nutrition Journal. 2012 Oct 22;11(1).
COQUEIRO AY, PEREIRA JRR, GALANTE F. Farinha da casca do fruto de Passiflora edulis f. flavicarpa Deg (maracujá-amarelo): do potencial terapêutico aos efeitos adversos. Revista Brasileira de Plantas Medicinais [Internet]. 2016 Jun [cited 2021 Mar 10];18(2):563–9. Available from: https://www.scielo.br/pdf/rbpm/v18n2/1516-0572-rbpm-18-2-0563.pdf
Sekhon-Loodu S, Rupasinghe HPV. Evaluation of Antioxidant, Antidiabetic and Antiobesity Potential of Selected Traditional Medicinal Plants. Frontiers in Nutrition. 2019 Apr 25;6.
Barber TM, Kabisch S, Pfeiffer AFH, Weickert MO. The Health Benefits of Dietary Fibre. Nutrients [Internet]. 2020 Oct 21;12(10):3209. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589116/
Ning X, Zhou Y, Wang Z, Zheng X, Pan X, Chen Z, et al. Evaluation of passion fruit mesocarp flour on the paste, dough, and quality characteristics of dried noodles. Food Science & Nutrition. 2022 Mar;10(5):1657–66.
Braga A, Medeiros TP de, Araújo BV de. Investigação da atividade antihiperglicemiante da farinha da casca de Passiflora edulis Sims, Passifloraceae, em ratos diabéticos induzidos por aloxano. Revista Brasileira de Farmacognosia. 2010 May;20(2):186–91.
Kaur J. A Comprehensive Review on Metabolic Syndrome. Cardiology Research and Practice. 2014;2014:1–21.
Barbalho SM, Damasceno DC, Spada APM, Lima IEDRN, Araújo AC, Guiguer EL, et al. Effects of Passiflora edulis on the metabolic profile of diabetic Wistar rat offspring. Journal of Medicinal Food [Internet]. 2011 Dec 1 [cited 2024 Feb 22];14(12):1490–5. Available from: https://pubmed.ncbi.nlm.nih.gov/21663518/
Hernáez Á, Fernández-Castillejo S, Farràs M, Catalán Ú, Subirana I, Montes R, et al. Olive Oil Polyphenols Enhance High-Density Lipoprotein Function in Humans. Arteriosclerosis, Thrombosis, and Vascular Biology. 2014 Sep;34(9):2115–9.
Alonso-Castro AJ, Zapata-Bustos R, Gómez-Espinoza G, Salazar-Olivo LA. Isoorientin Reverts TNF-α-Induced Insulin Resistance in Adipocytes Activating the Insulin Signaling Pathway. Endocrinology. 2012 Nov;153(11):5222–30.
Sun L, Chen W, Meng Y, Yang X, Yuan L, Guo Y. Interactions between polyphenols in thinned young apples and porcine pancreatic α-amylase: Inhibition, detailed kinetics and fluorescence quenching. Food Chemistry. 2016 Oct;208:51–60.
dos Santos M, da Silva Filho R, Leite AC, Nascentes C, Botero W, Santos J. Evaluation of Potentially Toxic Elements in Mundaú Lagoon (Maceió, AL-Brazil): Systematic Environmental Monitoring of Water and Food Quality. Journal of the Brazilian Chemical Society. 2021;32:1762–72.
Vuolo MM, Lima GC, Batista ÂG, Carazin CBB, Cintra DE, Prado MA, et al. Passion fruit peel intake decreases inflammatory response and reverts lipid peroxidation and adiposity in diet-induced obese rats. Nutrition Research [Internet]. 2020 Apr 1 [cited 2023 Jan 11];76:106–17. Available from: https://www.sciencedirect.com/science/article/pii/S0271531719300016
Baseggio AM, Kido LA, Viganó J, Carneiro M, Lamas C de A, Martínez J, et al. Systemic antioxidant and anti‐inflammatory effects of yellow passion fruit bagasse extract during prostate cancer progression. Journal of Food Biochemistry. 2021 Aug 2;46(3).
Silva RO, Damasceno SRB, Brito TV, Dias JM, Fontenele AM, Braúna IS, et al. Polysaccharide fraction isolated from Passiflora edulis inhibits the inflammatory response and the oxidative stress in mice. The Journal of Pharmacy and Pharmacology [Internet]. 2015 Jul 1 [cited 2024 Feb 22];67(7):1017–27. Available from: https://pubmed.ncbi.nlm.nih.gov/25808583/
Cazarin CBB, Rodriguez-Nogales A, Algieri F, Utrilla MP, Rodríguez-Cabezas ME, Garrido-Mesa J, et al. Intestinal anti-inflammatory effects of Passiflora edulis peel in the dextran sodium sulphate model of mouse colitis. Journal of Functional Foods. 2016 Oct;26:565–76.
Liu C, Zhu L, Fukuda K, Ouyang S, Chen X, Wang C, et al. The flavonoid cyanidin blocks binding of the cytokine interleukin-17A to the IL-17RA subunit to alleviate inflammation in vivo. Science Signaling [Internet]. 2017 Feb 21 [cited 2024 Feb 22];10(467):eaaf8823. Available from: https://pubmed.ncbi.nlm.nih.gov/28223414/
Liu X, Li M, Tan S, Wang C, Fan S, Huang C. Harmine is an inflammatory inhibitor through the suppression of NF-κB signaling. Biochemical and Biophysical Research Communications [Internet]. 2017 Jul 29;489(3):332–8. Available from: https://pubmed.ncbi.nlm.nih.gov/28551404/
Silva J do N. Avaliação in silico de flavonoides da passiflora incarnata L. com potencial ansiolítico e antidepressivo [Internet]. repositorio.ufpb.br. 2023 [cited 2024 Feb 22]. Available from: https://repositorio.ufpb.br/jspui/handle/123456789/27379?locale=pt_BR
Carmona-Hernandez JC, Taborda-Ocampo G, Valdez JC, Bolling BW, González-Correa CH. Polyphenol Extracts from Three Colombian Passifloras (Passion Fruits) Prevent Inflammation-Induced Barrier Dysfunction of Caco-2 Cells. Molecules [Internet]. 2019 Dec 17 [cited 2020 Mar 22];24(24):4614. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943731/pdf/molecules-24-04614.pdf
Nunn AV, Bell JD, Guy GW. Lifestyle-induced metabolic inflexibility and accelerated ageing syndrome: insulin resistance, friend or foe? Nutrition & Metabolism. 2009;6(1):16.
López-López G, Moreno L, Cogolludo A, Galisteo M, Ibarra M, Duarte J, et al. Nitric Oxide (NO) Scavenging and NO Protecting Effects of Quercetin and Their Biological Significance in Vascular Smooth Muscle. Molecular Pharmacology. 2004 Mar 25;65(4):851–9.
Ichimura T, Yamanaka A, Ichiba T, Toyokawa T, Kamada Y, Tamamura T, et al. Antihypertensive effect of an extract of Passiflora edulis rind in spontaneously hypertensive rats. Bioscience, Biotechnology, and Biochemistry [Internet]. 2006 Mar 1 [cited 2020 Mar 30];70(3):718–21. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16556991
Lewis BJ, Herrlinger KA, Craig TA, Mehring-Franklin CE, Defreitas Z, Hinojosa-Laborde C. Antihypertensive effect of passion fruit peel extract and its major bioactive components following acute supplementation in spontaneously hypertensive rats. The Journal of Nutritional Biochemistry [Internet]. 2013 Jul 1;24(7):1359–66. Available from: https://pubmed.ncbi.nlm.nih.gov/23333089/
Danielle, Lopes AP, Segatto, Mateus Lodi, Stahl AM, Zuin VG. Development and application of green and sustainable analytical methods for flavonoid extraction from Passiflora waste. BMC CHEMISTRY [Internet]. 2020 [cited 2024 Feb 22];14(1):11. Available from: https://bv.fapesp.br/en/publicacao/225533/
Panelli M, Pierine D, de Souza S, Ferron A, Garcia J, Santos K, et al. Bark of Passiflora edulis Treatment Stimulates Antioxidant Capacity, and Reduces Dyslipidemia and Body Fat in db/db Mice. Antioxidants. 2018 Sep 8;7(9):120.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Arquivos Catarinenses de Medicina
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.