Chios mastic gum modulates serum biochemical parameters in a human population
Introduction
Chios mastic gum (CMG) is derived from Pistacia lentiscus var. chia cv. Anacardiaceae, a plant which is mainly met on the Greek island of Chios.
The beneficial, healing properties of mastic have been known since antiquity. From Dioscurides and Galenus (Kolliaros, 1997) to the ‘Jerusalem Balsam’ (Moussaieff et al., 2005), Pistacia lentiscus has been traditionally considered as a medical agent and is incorporated in Mediterranean cuisine. Interestingly enough, in his essay De simplicium medicamentorum temperamentis ac facultatibus, Galenus considers Chios mastic as a therapeutic means for hepatic inflammation, and for disorders of the stomach and intestine (Kühn, 1826). Similarly, Dioscorides Pedanius, in his essay De materia medica, states that Chios mastic positively influences the process of digestion, and additionally possesses cosmetic properties and actions beneficial for the teeth (Wellmann, 1907). Nowadays, and in line with the 2000-year tradition, food products (apart from the well-established chewing gum) and cosmetics based on mastic have been created.
The process of mastic gum production from the plant is simple; longitudinal incisions are made on all over the plant surface, not only on the main trunk, but also on thick branches (Andrikopoulos et al., 2003). Recently, besides the so-called “normal collection”, another technique of mastic gum production has evolved, the “liquid collection”. In this technique, the tree is not cut and phytohormones are injected to the plant, so that the product is derived in a less viscous form (Andrikopoulos et al., 2003, Assimopoulou and Papageorgiou, 2005).
The biological activity of Pistacia lentiscus can be attributed to a variety of compounds. It contains triterpenes of the oleanane, euphane and lupine type (Andrikopoulos et al., 2003, Assimopoulou and Papageorgiou, 2005), alpha-tocopherol (Kivcak and Akay, 2005) and polyphenols (Romani et al., 2002); the latter have been associated with a hypotensive effect of mastic (Sanz et al., 1992).
Chios mastic possesses anti-bacterial activity (Iauk et al., 1996, Ali-Shtayeh et al., 1998, Magiatis et al., 1999, Koutsoudaki et al., 2005), for which verbenone, alpha-terpineol, and linalool seem to be responsible (Koutsoudaki et al., 2005). In vivo, its demonstrated antiplaque action in the oral cavity – also known by the traditional medicine in the Mediterranean region (Saez et al., 2005) since the time of Dioscorides (see above) – has been attributed to its inhibitory action against overall bacterial growth (Takahashi et al., 2003), and especially against S. mutans (Aksoy et al., 2006). As far as the effectiveness of Pistacia lentiscus against Helicobacter pylori and peptical ulcer is concerned, data remain controversial. Clinical studies have initially indicated that Chios mastic is effective against gastric and duodenal ulcer (Al-Habbal et al., 1984, Al-Said et al., 1986); then, mastic has been proven bactericidal against H. pylori in vitro (Huwez et al., 1998, Marone et al., 2001). However, recent studies show that it is unable to eradicate H. pylori in vivo in humans (Bebb et al., 2003, Loughlin et al., 2003).
Pistacia lentiscus has been traditionally regarded also as an anti-cancer agent, especially on tumours of breast, liver, stomach, spleen, and uterus (reported in Assimopoulou and Papageorgiou, 2005). Surprisingly enough, these traditional beliefs are in line with recent studies demonstrating that Chios mastic induces apoptosis (Balan et al., 2005) and possesses antiproliferative activity (Balan et al., 2006) in colon cancer cells.
Pistacia lentiscus has already been associated with cardiovascular protection and hepatoprotection. It inhibits human LDL oxidation in vitro (Andrikopoulos et al., 2003) and, thanks to the triterpenes, it acts on peripheral blood mononuclear cells to elicit an antioxidant/antiatherogenic effect (Dedoussis et al., 2004). Moreover, when an aqueous extract of Pistacia lentiscus was administered per os to rats intoxicated with carbon tetrachloride (CCl4), it was proven hepatoprotective, reducing SGOT, SGPT, ALP and bilirubin levels, especially when the extract was not boiled (Janakat and Al-Merie, 2002).
In this study, the biological activity of Chios mastic is examined, with the stress put on the liver and the cardiovascular system of human subjects. We have chosen serum parameters, i.e. cholesterol, lipids, apolipoproteins and hepatic function markers, which are easy to measure and unanimously accepted.
Section snippets
Study design
This study began in January 2003 and included 133 subjects randomly collected from a primary care center in the municipality of Kifissia, Athens, Greece. The sample comprised 93 women and 40 men, all aged over 50. Their medical history was free of cancer, myocardial infarct and hepatic disease. Subjects were randomly assigned to two groups: the high-dose (powder) group (48 patients, follow-up period of 18 months) and the low-dose (solution) group (85 patients, follow-up period of 12 months). A
Results
The initial means of the examined biochemical parameters (before the initiation of Chios mastic regimes) are shown in Table 1 for both groups. In the high-dose (powder) group, the univariable analysis revealed a significant decrease in total cholesterol (Fig. 1), LDL, total cholesterol/HDL ratio, apoA-1, apoB, Lp(a), SGOT (Fig. 2), SGPT (Fig. 3) and gamma-GT levels (Table 2). On the contrary, glucose, HDL and triglyceride levels did not exhibit significant changes during the follow-up period.
Discussion
High serum concentrations of total cholesterol and LDL represent well-established risk factors for cardiovascular disease (National Institutes of Health, 2002). Furthermore, the predictive value of total cholesterol/HDL ratio (TC/HDL, reviewed by Criqui and Golomb, 1998) has been demonstrated in men (Kinosian et al., 1995) and women (Hong et al., 1991, Castelli et al., 1992); higher values of TC/HDL are associated with coronary artery disease. To our knowledge, this study is the first one
Acknowledgements
We would like to thank the Chios Gum Mastic Growers Association for the financial support and the provision of Chios mastic products. We would also like to thank the University of Athens, Special Account for Research Grants for the financial support.
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