Literature DB >> 35522680

Influence of oral administration of kukoamine A on blood pressure in a rat hypertension model.

Christine A Butts1, Duncan I Hedderley1, Sheridan Martell1, Hannah Dinnan1, Susanne Middlemiss-Kraak1, Barry J Bunn1, Tony K McGhie1, Ross E Lill1.   

Abstract

The benefits of lowering blood pressure (BP) are well established for the prevention of cardiovascular disease. While there are a number of pharmaceuticals available for lowering BP, there is considerable interest in using dietary modifications, lifestyle and behaviour changes as alternative strategies. Kukoamines, caffeic acid derivatives of polyamines present in solanaceous plants, have been reported to reduce BP. We investigated the effect of orally administered synthetic kukoamine A on BP in the Spontaneously Hypertensive Rat (SHR) laboratory animal model of hypertension. Prior to the hypertension study, we determined the safety of the synthetic kukoamine A in a single oral dose (5 or 10 mg kg-1 bodyweight) 14-day observational study in mice. No negative effects of the oral administration of kukoamine A were observed. We subsequently investigated the effect of daily oral doses of kukoamine A (0, 5, 10 mg kg-1 bodyweight) for 35 days using the SHR rat model of hypertension. The normotensive control Wistar Kyoto (WKY) strain was used to provide a baseline for normal BP in rats. We observed no effect of orally administered synthetic kukoamine A on arterial hypertension in this laboratory animal model of hypertension.

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Year:  2022        PMID: 35522680      PMCID: PMC9075663          DOI: 10.1371/journal.pone.0267567

Source DB:  PubMed          Journal:  PLoS One        ISSN: 1932-6203            Impact factor:   3.752


Introduction

Hypertension is one of the leading preventable risk factors for death and disability globally [1, 2]. The management and reduction of hypertension are important for the prevention of cardiovascular diseases including stroke and ischemic heart disease, as well as renal dysfunction and other non-cardiovascular diseases such as dementia, cancer, oral health diseases and osteoporosis [1-4]. There are various blood pressure (BP)-lowering drugs regularly prescribed including thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, calcium antagonists, angiotensin receptor blockers (ARBs) and beta-blockers [5, 6]. Dietary modifications can lower BP, preventing the development of hypertension and lowering the risk of hypertension-related health effects [7]. These dietary approaches have included the DASH (Dietary Approaches to Stop Hypertension) and Mediterranean diets, reducing sodium intake, increasing potassium, magnesium or protein intake, and limiting alcohol consumption [7, 8]. Lifestyle and behavioural approaches such as weight loss, increased physical activity, yoga, meditation, and slow breathing are suggested as important components of an overall strategy to reduce BP [9]. Individual foods or food ingredients that have been found to lower BP and reduce hypertension are flaxseed; higher nitrate-containing vegetables such as beetroot and leafy greens such as spinach; vegetables such as corn, broccoli, cauliflower, Brussel sprouts, cabbage, carrots, and soybeans/tofu; and fruits such as avocado, cantaloupe, blueberries, raisins/grapes, and apples/pears [10-12]. Potato (Solanum tuberosum L.) is the third most consumed crop around the world and is grown in most countries [13]. The potato tuber supplies a wide range of nutrients and diverse bioactive compounds that are known to prevent and combat chronic diseases such as hypertension, cancer, diabetes, and heart disease [14-19]. The bioactive compounds found in potatoes are polyphenols (chlorogenic acid, apigenin, rutin, kaempferol rutinoside), terpenes (lutein and neoxanthin), alkaloids (solanine, tomatine, chaconine) and polyamines (kukoamines). A number of these compounds have demonstrated activity against heart disease and hypertension [20-23]. Chaparro et al. [24] observed relatively high levels of kukoamine in cooked russet and chipping potatoes compared to red, yellow or speciality potatoes. Enhancing the concentrations and proportions of bioactive compounds with health benefits is an important consideration in maintaining and developing potato varieties for human consumption. Kukoamines are organic compounds defined as catechol or caffeic acid derivatives of polyamines. They are found in potatoes, tomatoes and other solanaceous plants and are used in traditional Chinese herbal medicines [15, 25, 26]. Kukoamine A was measured in potatoes (S. tuberosum L.) [15, 24] and goji berries from Lycium chinense [27], and kukoamine B in gogi berries from L. chinense [26]. A recent review of the health benefits of these compounds [28] notes the association of jikoppi, the root bark of L. chinense, with hypertension, and refers to a short communication by Funayama et al. [22]. These researchers report that an intravenous administration of a crude methanol extract of L. chinense (0.5 g crude drug per kg) and a further refined extract comprising kukoamine A (5 mg per kg) induced hypotension in rats but no method description or data were presented. We have found no other references to support this bioactivity for kukoamine A or B. Evidence for the effect of potato consumption on BP is limited and contradictory. Vinson et al. [16] reported significant decreases in diastolic and systolic BP following a single meal of purple-skinned potatoes (~138 g) in healthy people while Borgi et al. [29] reported that higher intakes of baked, boiled or mashed potatoes and French fries were associated with an increased risk of developing hypertension. We hypothesised that the oral administration of kukoamine A would reduce BP in a rat model of hypertension. The aim of this study was to firstly determine the safety of a single oral dose of synthetic kukoamine A (Fig 1) to mice and observed over 14 days using Organization for Economic Co-operation and Development (OECD) methodology. This methodology was developed to assess the acute toxicity of a test substance, and has been validated in vivo, uses very few animals and is reproducible. Secondly, we investigated whether daily oral doses of kukoamine A over a 5-week period reduced BP in a laboratory animal model of hypertension (Spontaneously Hypertensive Rats; SHR). The Wistar Kyoto (WKY) rats provide baseline measures for normal rat BP.
Fig 1

Chemical structure of kukoamine A (C28H42N406 https://pubchem.ncbi.nlm.nih.gov/).

Materials and methods

Synthesis of kukoamine A

The synthesis of kukoamine A was carried out by a modification of the procedure in Piletska et al. [30]. A solution (2.18 g, 12 mmol) of 3,4-dihydroxyphenylpropionic acid (Sigma-Aldrich, USA)in 20 mL of tetrahydrofuran (THF; Fisher Chemicals, USA) was prepared at ambient temperature. Dicyclohexylcarbodiimide (2.47 g, 12 mmol; Sigma-Aldrich, USA) and 4-dimethylaminopyridine (10 mg, 0.08 mmol; Sigma-Aldrich, USA) and then N-hydroxysuccinimide (1.38 g, 12 mmol; Sigma-Aldrich, USA) were then added sequentially. The reaction mixture was stirred for 18 h at ambient temperature then solids were removed by filtration and washed with THF (2 x 50 mL). This crude reaction product solution was treated with spermine (1.21 g, 6 mmol) in THF (5 mL). After the immediate formation of a white precipitate, the reaction was stirred for 4 h whereupon solids were filtered off and washed with THF (2 x 100 mL). Solvents were removed in vacuo and the crude material was purified on an SPE C18 prepacked column (Strata x 1g/20 mL Giga 8B-S100-JEG, Phenomenex, USA) conditioned with 20 mL of methanol (MeOH), then 0.2% formic acid in water (20 mL). A typical sample loading was 61 mg dissolved in 0.2% formic acid in water (2 mL). The column was eluted successively with 0.2% formic in water (2 x 20 mL), then with 20 mL volumes of 0.1% formic acid containing successively 10, 20, 30 and 40% MeOH, and finally with 100% MeOH (20 mL). The fractions containing the product, as analysed by LCMS and by comparison with a commercial standard (Kukoamine A, TransMIT, Giessen, Germany) were combined, the methanol removed in vacuo and then freeze-dried. The NMR analysis [22, 31] confirmed the product was kukoamine A with no kukoamine B detected. The model of NMR spectrometer used was a Bruker Avance 500. For 1H the operating frequency was 500.13 MHz. H NMR (D2O) d 1.63 (8H, m), 2.50 (8H, m), 2.76 (4H, tr, J = 7.5 Hz), 2.83 (4H, br, m), 3.13 (4H, tr, J = 6.5 Hz), 6.64 (2H, dd, J = 8, 2 Hz), 6.71 (2H, d, J = 2 Hz), 6.79 (2H, d, J = 8 Hz).

Purification and gavage preparation

The kukoamine preparation (~300 mg) was dissolved in 20 ml 1% (v/v) aqueous formic acid and sonicated. Six SPE columns (Strata X 1g/20 mL Giga 8B-S100-JEG), mounted over a common collection tank, were conditioned with 1% formic acid prior to loading with the kukoamine solution. Low-affinity compounds were eluted with 1% formic acid before the kukoamine was eluted with 10% (v/v) aqueous methanol. The columns were regenerated with 100% methanol before reconditioning with formic acid in preparation for the next run. Purity of the kukoamine fraction was confirmed by LCMS. The retention time of the synthesised kukoamine A was similar to the purchased standard and the accurate mass was measured at m/z 529.3067 [M-H]-, which is consistent with the elemental formula of C28H42N4O6 (mDa +3.6, mSigma 13.0). Losses in the formic acid fraction and the methanol wash were minor. This method enabled us to produce in excess of 1 g kukoamine A. The instability of the pure compound was an appreciable problem. Any moisture in contact with the freeze-dried powder resulted in rapid discolouration. This could be managed in solution by maintaining acidic conditions. We used formic acid for the purification step and citric acid (food grade, Hawkins Watts New Zealand (NZ), Auckland, NZ) for the gavage solution. We determined the molar extinction coefficient to be 938 at 260 nM, enabling spectrophotometric measurement to be used to check kukoamine concentration for preparation of the gavage solutions. The purified kukoamine A was concentrated by rotary evaporation. The reduction was acidified by addition of citric acid and potassium citrate (food grade, Hawkins Watts NZ, Auckland, NZ) to provide an 8 mM citrate buffer pH 4.1. The concentration was checked by spectrophotometer and diluted with 8 mM citrate buffer as required to provide gavage solutions of suitable kukoamine A concentration for the treatments. These were frozen at -20°C until required. The control gavage was 8 mM citrate buffer (pH 4.1).

14-day acute oral safety study

Eight-week-old female Swiss mice were used for the oral safety study. These tests were conducted according to the principles of the OECD method 407 limit test [32], whereby the number of animals is kept to the minimum required and the dose given is administered on a body weight basis. Animal procedures were approved by AgResearch Grasslands Animal Ethics Committee (Palmerston North) according to the Animal Welfare Act 1999, New Zealand (Applications 14237, 14363). The female, non-pregnant mice were supplied by Plant & Food Research, Food Evaluation Unit, Palmerston North, New Zealand. Lipnick et al. [33] recommended females be used in fixed-dose procedure studies as they are more sensitive. They were housed in family groups in a room maintained at 22 ± 3°C, 30–70% humidity, 12 hr light:12 hr dark lighting, and fed a commercial pelleted diet (LabDiet) supplied by Fort Richards/Able Scientific. They were housed in their family groups from weaning at 3 weeks until 8 weeks of age and were weighed weekly. Mice were given a single dose of either 5 or 10 mg kg-1 bodyweight kukoamine A or citrate buffer (control) by oral gavage (less than 10 mL kg-1 bodyweight) and observed for 14 days (n = 6 per treatment). We selected the mice for testing from those available of the appropriate age and weight range (±20% of the mean weight), marked them to allow for individual identification, and weighed and housed them in their dose groups (n = 3). Food was removed 1–2 h prior to the administration of the kukoamine dissolved in citrate buffer or the citrate buffer control, and was withheld for 1–2 h post-administration. Each mouse was observed for 30 min after dosing, thereafter periodically during the first 24 h with more frequent observation during the first 4 h, and daily thereafter for 14 days. If all three mice given either the control or kukoamine treatments showed no adverse effects for 48 h then a further three mice were given each treatment (n = 6). Mouse weights were recorded prior to substance administration, and weekly thereafter. At the end of the 14-day observation period, all animals were weighed and humanely killed. This acute procedure caused no ill effects in the mice given the two kukoamine A concentrations (5 or 10 mg kg-1).

Daily dose hypertension study

Male WKY and SHR rats, aged 6 weeks, were supplied by Animal Resources Centre, Perth, Australia. Animal procedures were approved by AgResearch Grasslands Animal Ethics Committee (Palmerston North), according to the Animal Welfare Act 1999, New Zealand (Application 14437). They were housed in a room maintained at 22 ± 3°C, 30–70% humidity, 12 h light:12 h dark lighting. From six to eight weeks of age, the rats were housed in pairs and fed a commercial pelleted diet (LabDiet) supplied by Fort Richards/Able Scientific. The rats were then moved to individual cages for the duration of the study, and fed a powdered rodent diet (S1 Dataset). The rats were acclimated to the BP measuring equipment and procedures for two weeks prior to the start of the study. The rats (11 weeks of age) were randomly allocated to four experimental treatments (n = 10): control WKY, control SHR, SHR kukoamine A 5 mg kg-1 and SHR kukoamine A 10 mg kg-1. The control (citrate buffer) and kukoamine A treatments were administered by daily oral gavage (≤ 10 mL kg-1 bodyweight) for five weeks (16 weeks of age). Bodyweights and BP measurements were recorded twice weekly.

BP measurements

BP was measured using a non-invasive system tail-cuff method that uses volume-pressure recording (VPR) technology to detect changes in tail volume that correspond to systolic and diastolic BPs. The CODA non-invasive BP system was supplied by Kent Scientific (Torrington, CT, USA) with a set of cuffs and sensors (RAT-CUFFKIT, Kent Scientific) and can measure BP in up to eight animals simultaneously [34]. The VPR technology has been validated with simultaneous radiotelemetry BP measures [35]. Fifteen measurement cycles were performed for each animal at each time point. The data were cleaned by removing all readings with a blood volume less than 30 and data points that were greater than two standard deviations from the mean were excluded [35]. The remaining data were used to calculate the mean at each time point and the weekly value calculated from the two daily means taken during each week. All statistical analyses were carried out using Genstat (version 17, 2014, VSN Ltd, Hemel Hempstead, UK).

Data analysis

Baseline food intakes and body weights were compared by analysis of variance. For the repeated measures data taken during the study, mixed-effects models were fitted with fixed effects for WKY vs SHR rats, diet (0, 5 or 10 mg kg-1 kukoamine A) for the SHR animals, time, and interactions. The animal was fitted as a random effect. Several different correlations patterns between repeated observations on the same animal were tested, following Littell et al. [36]. For the food intake data, the simplest model (random effect for the animal, no autoregressive correlations, homogeneous residual variance) was chosen because it had the lowest Bayesian Information Criterion (BIC). For body weight, the best fitting model had unequal residual variance (lower in weeks 2–4 than 1, or 5 or final weight). For the BP data, the best fitting model had a random effect for the animal, no additional correlations between observations, and homogeneous residual variance.

Results

No adverse effects were observed in the mice following the oral administration of kukoamine A at 5 and 10 mg kg-1 bodyweight. The body weights and weight gains of the mice are shown in S1 Dataset. At the start of the study, the WKY rats had significantly lower body weights than the SHR rats (Table 1). All the rats gained weight during the study, and by the end of study, this difference was no longer significant. The food intakes of the WKY rats were lower than the SHR rats and remained constant over the five weeks of the study (Table 2). The food consumption of the SHR rats increased in weeks 3 and 4 but returned to the earlier amounts by the end of the study. The SHR rats had higher systolic BP at the beginning of the study as expected (Table 3). Systolic BP increased over the course of the study for both rat strains (Table 4). The BP of the SHR rats remained higher than the WKY rats but the pattern of change over time did not differ significantly between the experimental groups. Diastolic BP also increased over time for the SHR rats only (Table 5). The mean arterial BP (Table 6) increased over the course of the study for both rat strains. Among the SHR rats, there were no significant differences between groups fed different doses of kukoamine A on any of the measures.
Table 1

Weekly mean body weights (g) of the rats on the experimental treatments.

TreatmentsWeek 1Week 2Week 3Week 4Week 5Final
WKY control222 ± 4242 ± 4258 ± 5274 ± 5285 ± 6293 ± 6
SHR control235 ± 2255 ± 3271 ± 3282 ± 4293 ± 4300 ± 5
SHR Kukoamine 5239 ± 3257 ±3273 ± 4287 ± 4296 ± 4305 ± 4
SHR Kukoamine 10235 ± 3254 ± 3270 ± 3283 ± 3290 ± 4297 ± 3
Linear Mixed-effects model P values
WKY vs SHR0.007
Diet within SHR0.772
Time<0.001
Time x WKY x SHR0.005
Time x diet within SHR0.743

1 Body weights are expressed as mean ± standard error of the mean. Data were compared by analysis of variance. A least significant difference (lsd): Between Treatments lsd = 12; over time within treatment lsd = 4.

Table 2

Weekly mean food intakes (g) of the rats on the experimental treatments.

TreatmentsWeek 1Week 2Week 3Week 4Week 5Final
WKY control109 ± 2108 ± 2105 ± 2108 ± 2108 ± 3105 ± 2
SHR control125 ± 3127 ± 2133 ± 5133 ± 3130 ± 4125 ± 3
SHR Kukoamine 5129 ± 2128 ± 4131 ± 4134 ± 3128 ± 3129 ± 2
SHR Kukoamine 10125 ± 2126 ± 2129 ± 3130 ± 3120 ± 3125 ± 2
Linear Mixed-effects model P values
WKY vs SHR<0.001
Diet within SHR0.460
Time<0.001
Time x WKY x SHR0.034
Time x diet within SHR0.164

1 Food intakes are expressed as mean ± standard error of the mean. Data were compared by analysis of variance. A least significant difference (lsd): Between Treatments lsd = 8.8; over time within treatment lsd = 5.1.

Table 3

Systolic, diastolic and mean arterial blood pressure (BP) (mm Hg) of the rats at baseline.

TreatmentsWeek 1Week 2Week 3
WKY control156 ± 4a106 ± 3122 ± 3
SHR control187 ± 5b129 ± 4148 ± 4
SHR Kukoamine 5184 ± 4 b130 ± 3148 ± 3
SHR Kukoamine 10188 ± 2 b132 ± 2150 ± 2
Least significant difference1299
Time x diet within SHRP<0.001P<0.001P<0.001

1 BPs are expressed as mean ± standard error of the mean. Data were compared by analysis of variance.

Table 4

Weekly mean systolic blood pressure (BP) (mm Hg) of the rats on the experimental treatments.

TreatmentsWeek 1Week 2Week 3Week 4Week 5Final
WKY control158 ± 2159 ± 4158 ± 4161 ± 4165 ± 8162 ± 4
SHR control189 ± 2192 ± 2193 ± 2203 ± 2196 ± 4202 ± 5
SHR Kukoamine 5192 ± 3197 ± 3196 ± 3210 ± 2211 ± 2209 ± 4
SHR Kukoamine 10191 ± 3193 ± 3196 ± 3203 ± 4206 ± 3200 ± 5
Linear Mixed-effects model P values
WKY vs SHR<0.001
Diet within SHR0.201
Time<0.001
Time x WKY x SHR0.252
Time x diet within SHR0.781

1 BPs are expressed as mean ± standard error of the mean. Data were compared using mixed-effect models. A least significant difference (lsd): Between Treatments lsd = 11; over time within treatment lsd = 9.

Table 5

Weekly mean diastolic blood pressure (BP) (mmHg) of the rats on the experimental treatments.

TreatmentsWeek 1Week 2Week 3Week 4Week 5Final
WKY control103 ± 3105 ± 3101 ± 2104 ± 4114 ± 6105 ± 4
SHR control133 ± 3140 ± 3144 ± 3143 ± 5146 ± 4155 ± 4
SHR Kukoamine 5137 ± 5143 ± 4146 ± 4154 ± 3157 ± 4156 ± 7
SHR Kukoamine 10139 ± 3139 ± 4145 ± 3150 ± 5155 ± 5152 ± 5
Linear Mixed-effects model P values
WKY vs SHR<0.001
Diet within SHR0.417
Time<0.001
Time x WKY x SHR0.083
Time x diet within SHR0.890

1 BPs are expressed as mean ± standard error of the mean. Data were compared using mixed-effect models. A least significant difference (lsd): Between Treatments lsd = 12; over time within treatment lsd = 11.

Table 6

Weekly mean arterial blood pressure (BP) (mm Hg) of the rats on the experimental treatments.

TreatmentsWeek 1Week 2Week 3Week 4Week 5Final
WKY control222 ± 4242 ± 4258 ± 5274 ± 5285 ± 6293 ± 6
SHR control235 ± 2255 ± 3271 ± 3282 ± 4293 ± 4300 ± 5
SHR Kukoamine 5239 ± 3257 ±3273 ± 4287 ± 4296 ± 4305 ± 4
SHR Kukoamine 10235 ± 3254 ± 3270 ± 3283 ± 3290 ± 4297 ± 3
Linear Mixed-effects model P values
WKY vs SHR0.007
Diet within SHR0.772
Time<0.001
Time x WKY x SHR0.005
Time x diet within SHR0.743

1 Mean arterial BP = (diastolic BP + (systolic BP—diastolic BP)/3)); BPs are expressed as mean ± standard error of the mean. Data were compared using mixed-effect models. A least significant difference (lsd): Between Treatments lsd = 11; over time within treatment lsd = 10.

1 Body weights are expressed as mean ± standard error of the mean. Data were compared by analysis of variance. A least significant difference (lsd): Between Treatments lsd = 12; over time within treatment lsd = 4. 1 Food intakes are expressed as mean ± standard error of the mean. Data were compared by analysis of variance. A least significant difference (lsd): Between Treatments lsd = 8.8; over time within treatment lsd = 5.1. 1 BPs are expressed as mean ± standard error of the mean. Data were compared by analysis of variance. 1 BPs are expressed as mean ± standard error of the mean. Data were compared using mixed-effect models. A least significant difference (lsd): Between Treatments lsd = 11; over time within treatment lsd = 9. 1 BPs are expressed as mean ± standard error of the mean. Data were compared using mixed-effect models. A least significant difference (lsd): Between Treatments lsd = 12; over time within treatment lsd = 11. 1 Mean arterial BP = (diastolic BP + (systolic BP—diastolic BP)/3)); BPs are expressed as mean ± standard error of the mean. Data were compared using mixed-effect models. A least significant difference (lsd): Between Treatments lsd = 11; over time within treatment lsd = 10.

Discussion

In the present study, we investigated the effect of ingesting synthetic kukoamine A on BP in a rat model of hypertension. Firstly, we determined that the ingestion of the synthetic kukoamine A at 5 and 10 mg kg-1 was safe for mice. We then applied the SHR rat model of hypertension to determine if kukoamine A given orally would reduce BP at these doses. We found that the ingestion of kukoamine for five weeks at these doses had no effect on systolic BP in SHR rats. We found no adverse effects on food intake or body weight in the mice and rats given the synthetic kukoamine A at 5 and 10 mg kg-1 bodyweight by oral gavage. Similarly, no significant effects on body weight were observed for kukoamine B administered by daily gavage at the higher doses of 25 and 50 mg kg-for 5 weeks and 9 weeks by Zhao et al. [37] and Li et al. [38] respectively. Kukoamine A and B are positional isomers differing only in the dihydrocaffeoylation position [39] so it has been assumed they will exhibit similar physiological responses. Li et al. [39], however, reported the cytoprotective effects of kukoamine B were superior to those of kukoamine A in Fenton-damaged bone marrow-derived mesenchymal stem cells. The lack of response to the administration of kukoamine A on BP in the present study is in contrast to the earlier reports in which the intravenous administration of a crude methanol extract of L. chinense (0.5 g crude drug kg-1) and a further refined extract comprising kukoamine A (5 mg kg-1) induced hypotension in rats [22]. Kukoamine A administered at 5, 10 and 20 mg/kg intravenously has also been reported to reduce the neuro-inflammatory response and protect neurogenesis following whole-brain irradiation [40]. The doses of kukoamine A used here were based on those used previously, indicating that the method of administration (intravenous vs oral) may have influenced the bioavailability and therefore efficacy of these compounds. Administering the kukoamine A orally may have reduced or eliminated the kukoamine reaching the circulatory system due to the effects of the processes of digestion and absorption resulting in the complete or partial degradation of the kukoamine. We found no published information on the degradation and subsequent bioavailability of kukoamine following oral ingestion. The SHR rat model of hypertension is characterised by a progressive increase in arterial BP with a rapid onset from 8 weeks of age, which is greater in males than females from 8 to 20 weeks of age [41]. This is caused by elevated peripheral vascular resistance, produced by neural and kidney factors causing structural vascular changes by elevated vascular protein synthesis. In the present study, BP was recorded via the non-invasive tail-cuff method, which has been validated against the gold standard invasive intravascular simultaneous radio telemetry [42]. The BPs measured in the present study were similar to those reported in other studies using this [43-46] and other hypertension models [47]. The primary cause of the development and occurrence of hypertension remains unclear but it is known that this disease is heterogeneous, polygenic, and multifactorial. BP is controlled by several complex physiological mechanisms including baroreflex and the renin-angiotensin system (RAS) [48, 49]. In a study investigating the effect of lentil varieties on vascular function in SHR and WKY rats [50], green and red lentils reduced arterial stiffness; however, BP was not affected. BP has been effectively lowered in this model of hypertension by the inhibition of the RAS, calcium antagonists, and by direct vasodilators [51]. Diuretics and endothelin antagonists are reported to be less effective and those of β-blockers were variable in this model. The potential mechanisms by which kukoamine influences BP have not yet been identified [51]. A limitation of this study is the absence of a positive control drug treatment in this study design. There have been a number of previous studies that have included drugs as a positive control to validate or apply this model [52-55]. We used the normotensive rat strain WKY from which the SHR rats were originally bred. The use of additional animals for another positive control treatment was not warranted. The present study determined only the physiological response (BP) of this animal model. Measuring biomarkers of vascular function such as gene and protein expression that play a role in mammalian blood pressure control or the hypertension pathway may have provided information on the potential mechanisms of kukoamine A. The data presented here demonstrated there was no effect of orally administered synthetic kukoamine A on arterial hypertension. This was in contrast to the earlier study [22] using venous administration of kukoamine A extracted from L. chinense root barks. This may indicate that the bioavailability and bioactivity of kukoamine was affected by the processes of digestion and absorption. Oral treatments are preferred over injectable by patients for chronic conditions [56-58]. Investigations to confirm the results and clarify the methodology of the original study [22] reporting the hypotensive effect of kukoamine A are required. Subsequent research can then be undertaken to compare the responses of oral and intravenous administration of kukoamine A to understand the effects of gastrointestinal digestion and absorption on its impact on hypertension.

Master data.

(XLSX) Click here for additional data file. 6 Dec 2021
PONE-D-21-35268 Influence of oral administration of kukoamine A on blood pressure in a rat hypertension model
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Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly ********** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ********** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ********** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ********** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: 1. The English need improvement since there are many grammatical and syntax errors in the manuscript. For example, • in line number 16, the words “that have” may be as “have”; • in line number 28, “a rat” as “rat”; • in line number 79, “given” as “were given”; • in line number 81, “acute” as “the acute”; • in line number 97, “immediate” as “the immediate”; • in line number 104, “product” as “the product”; • in line number 191, 193 and 197, “Animal” as “The animal”; • in line number 254, “those” as “to those”; • in line number 256, “administration” as “the administration”; • in line number 275, “study were” as “study was”; • in line number 287, “pressure have” as “pressure has”; • in line number 290, “positive” as “a positive”. The grammar mistakes which are not mentioned here are also to be checked and corrected properly. 2. There are some typing mistakes as well, and authors are advised to carefully proof-read the text. For example, • in line number 34, the words “pressure lowering” may be as “pressure-lowering”; • in line number 35 and 36, “angiotension” as “angiotensin”; • in line number 36, “beta blockers” as “beta-blockers”; • in line number 45, “nitrate containing” as “nitrate-containing”; • in line number 74, “purple skinned” as “purple-skinned”; • in line number 85, “strain are” as “strains are”; • in line number 115, “Low affinity” as “Low-affinity”; • in line number 151, “post administration” as “post-administration”; • in line number 174, “tail cuff” as “tail-cuff”; • in line number all over the manuscript, “mixed effects” as “mixed-effects”; • in line number 191, “correlation” as “correlations”; • in line number 203, “of study” as “of study,”; • in line number 236, “pressue” as “pressure”; • in line number 261, “whole brain” as “whole-brain”. The typos not mentioned here are also to be checked and corrected properly. 3. Check the abbreviations throughout the manuscript and introduce the abbreviation when the full word appears the first time in the text and then use only the abbreviation (For example, blood pressure (BP), renin-angiotensin system (RAS), etc.,). And it should be in both abstract as well as in the remaining part of the manuscript. 4. The full form of the species should be given when the first time appears and followed by only the first letter of the genus in both the abstract and the remaining part of the manuscript (e.g., Solanum tuberosum; Lycium chinense when the first time appears and followed by S. tuberosum; L. chinense). 5. In the materials and methods, the author should include the source of chemicals used in this study. And also the age of the animal model chosen may be given in the materials and methods section. 6. In the result tables, when writing the significance, authors are not mentioned what is a,b,c, which are given in the superscript of values. It may be rewrite as values not sharing a common marking (a, b, c,..) differ significantly at P<0.05 or other format. 7. The table legends should be improved and a proper footnote should be given. All legends should have enough description for a reader to understand the figure without having to refer back o the main text of the manuscript. 8. The authors have mentioned that the fractions containing product was analysed by LCMS and by comparison with a commercial standard. But in the results section the results is not given and also in materials the commercial standard tried is not given. It should be given properly (in line number 105) and also in results section. 9. Similarly, the authors have given NMR analysis are also done but it is not given in the results section and it should be given properly (in line number 106) and also in results section. 10. The author should justify how the dose fixation an duration study are done (is it based on toxicity test or previous reference, if previous should be included in the reference section) in the discussion part of the manuscript. Reviewer #2: This topic “Influence of oral administration of kukoamine A on blood pressure in a rat hypertension model” is an interesting work and quite good information. However, before accepting publication, minor revision is required and some points in this manuscript need to clarify. So, the comment and suggestion to the author is a PDF attachment file, please check it out. ********** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Prof. A> Vijaya Anand Reviewer #2: Yes: UTTHAPON ISSARA [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.
Submitted filename: Comments of Manuscript ID PONE-D-21-35268.pdf Click here for additional data file. 1 Mar 2022 Firstly, our thanks to the reviewers for their suggestions, time, knowledge and interest in this manuscript. 1. 1. When submitting your revision, we need you to address these additional requirements. The journal template has been used and the formatting checked during the revision. 2. We note you have included a table to which you do not refer in the text of your manuscript. Please ensure that you refer to Table 5, and 6 in your text; if accepted, production will need this reference to link the reader to the Table. Thank you for noting this error in the text. This has now been revised and the tables are referred to in the Results section (Lines 217-218, revised manuscript with track changes accepted). 3. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. We have checked the references and made the appropriate revisions prior to resubmission. Reviewer #1: 1. The English need improvement since there are many grammatical and syntax errors in the manuscript. • in line number 16, the words “that have” may be as “have”; • in line number 28, “a rat” as “rat”; • in line number 79, “given” as “were given”; • in line number 81, “acute” as “the acute”; • in line number 97, “immediate” as “the immediate”; • in line number 104, “product” as “the product”; • in line number 191, 193 and 197, “Animal” as “The animal”; • in line number 254, “those” as “to those”; • in line number 256, “administration” as “the administration”; • in line number 275, “study were” as “study was”; • in line number 287, “pressure have” as “pressure has”; • in line number 290, “positive” as “a positive”. The grammar mistakes which are not mentioned here are also to be checked and corrected properly. Authors’ response The grammatical and syntax errors have been amended throughout the manuscript and independently reviewed as well. Thank you. 2. There are some typing mistakes as well, and authors are advised to carefully proof-read the text. For example, • in line number 34, the words “pressure lowering” may be as “pressure-lowering”; • in line number 35 and 36, “angiotension” as “angiotensin”; • in line number 36, “beta blockers” as “beta-blockers”; • in line number 45, “nitrate containing” as “nitrate-containing”; • in line number 74, “purple skinned” as “purple-skinned”; • in line number 85, “strain are” as “strains are”; • in line number 115, “Low affinity” as “Low-affinity”; • in line number 151, “post administration” as “post-administration”; • in line number 174, “tail cuff” as “tail-cuff”; • in line number all over the manuscript, “mixed effects” as “mixed-effects”; • in line number 191, “correlation” as “correlations”; • in line number 203, “of study” as “of study,”; • in line number 236, “pressue” as “pressure”; • in line number 261, “whole brain” as “whole-brain”. The typos not mentioned here are also to be checked and corrected properly. Authors’ response The typing mistakes have been amended throughout the manuscript. Thank you. 3. Check the abbreviations throughout the manuscript and introduce the abbreviation when the full word appears the first time in the text and then use only the abbreviation (For example, blood pressure (BP), renin-angiotensin system (RAS), etc.,). And it should be in both abstract as well as in the remaining part of the manuscript. Authors’ response The abbreviations have been amended throughout the manuscript as requested. 4. The full form of the species should be given when the first time appears and followed by only the first letter of the genus in both the abstract and the remaining part of the manuscript (e.g., Solanum tuberosum; Lycium chinense when the first time appears and followed by S. tuberosum; L. chinense). Authors’ response The abbreviations have been amended throughout the manuscript as requested. 5. In the materials and methods, the author should include the source of chemicals used in this study. And also the age of the animal model chosen may be given in the materials and methods section. Authors’ response The sources of the chemicals have been included as requested. The age of the rat model during the study has been added (Lines 175 and 179 in revised manuscript track changes accepted). 6. In the result tables, when writing the significance, authors are not mentioned what is a,b,c, which are given in the superscript of values. It may be rewrite as values not sharing a common marking (a, b, c,..) differ significantly at P<0.05 or other format. Authors’ response Thank you for the suggestion. Assisting the reader to understand the statistically significant effects is important. However, adding superscripts would clutter the table and create confusion as one set of superscripts are to be read down the table vertically (WHR vs SHR effect) while other superscripts would need to be applied and read horizontally. The biometrician (DIH) has recommended the current approach. 7. The table legends should be improved and a proper footnote should be given. All legends should have enough description for a reader to understand the figure without having to refer back o the main text of the manuscript. Authors’ response Further detail has been added as requested to all the table legends and footnotes. 8. The authors have mentioned that the fractions containing product was analysed by LCMS and by comparison with a commercial standard. But in the results section the results is not given and also in materials the commercial standard tried is not given. It should be given properly (in line number 105) and also in results section. Authors’ response Thank you for this suggestion. We have now included the details of the commercial standard and the results of the LCMS analysis (Lines 121-125, revised manuscript with track changes accepted). 9. Similarly, the authors have given NMR analysis are also done but it is not given in the results section and it should be given properly (in line number 106) and also in results section. Authors’ response We have now included the details of the commercial standard and the results of the NMR analysis (Lines 102-108, revised manuscript with track changes accepted). 10. The author should justify how the dose fixation an duration study are done (is it based on toxicity test or previous reference, if previous should be included in the reference section) in the discussion part of the manuscript. Authors’ response We undertook the oral safety of the kukoamine A using the material we had prepared to ensure there were no unexpected contaminants that could have negative effects on the animals. We applied the methodology endorsed by the OECD in their acute oral toxicity test (OECD 423) in which the compounds are given and the animals observed for 14 days. Other studies have successfully given kukoamine orally and intravenously so we did not undertake the more extensive testing as its intrinsic safety had been established in those studies [1-5]. Therefore, undertaking the more extensive longer-term study and blood sampling in more animals was not warranted. Reviewer #2: This topic “Influence of oral administration of kukoamine A on blood pressure in a rat hypertension model” is an interesting work and quite good information. However, before accepting publication, minor revision is required and some points in this manuscript need to clarify. So, the comment and suggestion to the author is a PDF attachment file, please check it out. 1. “For 14-day acute oral safety study section: Why the researcher uses female mice to study this effect? Generally, the animal’s sexuality has influenced the genetic transformation or variance of a hormone than a male animal, so it will be difficult to control that factor and may influence to blood pressure determination? However, researcher use the male or female mice in this study? Because in Line 145 mentioned difference mice gender?” Authors’ response The purpose of the first part of this study was to determine the oral safety of the chemically synthesised kukoamine A using OECD testing guidelines and procedures. We used female mice based on the review by Lipnick et al. [6] who recommended the use of females only as they were more sensitive in acute toxicity studies. By using only one gender we were able to reduce the number of animals being manipulated. We also ensured they were not pregnant by separating the males and females at weaning as this could influence their physiological and metabolic responses. For this part of the study we only used adult female mice (non-pregnant). Reviewer 2. “Also, the time of oral test is quite short time?? Only 2 weeks of an animal experiment may not be enough to get the cover results about the blood parameter index changing? Authors’ response We undertook the oral safety of the kukoamine A using the material we had prepared to ensure there were no unexpected contaminants that could have negative effects on the animals. We applied the methodology endorsed by the OECD in their acute oral toxicity test (OECD 423) in which the compounds are given and the animals observed for 14 days. Other studies have successfully given kukoamine orally and intravenously so we did not undertake the more extensive testing as its safety had been established in those studies [1-5]. Therefore, undertaking the more extensive longer-term study and blood sampling in more animals was not warranted. Reviewer 3. “In discussion point Line 250, previous studies already showed that higher dose oral test in mice 25 and 50 mg-1 was safe, so why researcher try to study the only a lower concentration of kukoamine A?? in which 5 and 10 mg kg-1 seems to be safe for sure” Authors’ response We agree that the earlier studies using doses of 25 and 50 mg of kukoamine B did show they were safe. However, we wanted to ensure the kukoamine A we had synthesized was safe when administered orally compared to intravenously and at the same concentration (5 mg per kg bodyweight) [3]. And secondly to investigate concentrations of kukoamines that are likely to be provided in whole foods such as potatoes [7]. Reviewer 4. “Check all the error typing and make a correction” Authors’ response Thank you, we have thoroughly checked the manuscript and amended the manuscript. Reviewer 5. “Suggestion: The present study was determined only physiological and blood characteristics of the animal model, however, to confirm the mechanisms of effects of kukoamine A on vascular function, other biomarkers need to determine such as the expression of the gene-related vascular system and the significant protein expression that play a role to control the blood pressure or hypertension pathway in the mammalian.” Authors’ response Thank you for your suggestion. We have incorporated this in the Discussion lines 306-309 of the amended manuscript. 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. Authors’ response Yes References 1. Chaparro, J.M.; Holm, D.G.; Broeckling, C.D.; Prenni, J.E.; Heuberger, A.L. Metabolomics and Ionomics of Potato Tuber Reveals an Influence of Cultivar and Market Class on Human Nutrients and Bioactive Compounds. Frontiers in Nutrition 2018, 5, 36-36, doi:10.3389/fnut.2018.00036. 2. Funayama, S.; Yoshida, K.; Konno, C.; Hikino, H. Validity of oriental medicines .21. structure of kukoamine-a, a hypotensive principle of lycium-chinense root barks. Tetrahedron Lett. 1980, 21, 1355-1356, doi:10.1016/s0040-4039(00)74574-6. 3. Funayama, S.; Yoshida, K.; Konno, C.; Hikino, H. Structure of kukoamine A, a hypotensive principle of Lycium chinense root barks. Tetrahedron Lett. 1980, 21, 1355-1356. 4. Funayama, S.; Zhang, G.-R.; Nozoe, S. Kukoamine B, a spermine alkaloid from Lycium chinense. Phytochemistry 1995, 38, 1529-1531, doi:10.1016/0031-9422(94)00826-F. 5. Wang, L.; Wang, P.; Wang, D.; Tao, M.; Xu, W.; Olatunji, O.J. Anti-Inflammatory Activities of Kukoamine A From the Root Bark of Lycium chinense Miller. Natural Product Communications 2020, 15, 1934578X20912088, doi:10.1177/1934578x20912088. 6. Lipnick, R.L.; Cotruvo, J.A.; Hill, R.N.; Bruce, R.D.; Stitzel, K.A.; Walker, A.P.; Chu, I.; Goddard, M.; Segal, L.; Springer, J.A., et al. Comparison of the up-and-down, conventional LD50, and fixed-dose acute toxicity procedures. Food Chem. Toxicol. 1995, 33, 223-231, doi:10.1016/0278-6915(94)00136-C. 7. Vinson, J.A.; Demkosky, C.A.; Navarre, D.A.; Smyda, M.A. High-Antioxidant Potatoes: Acute in Vivo Antioxidant Source and Hypotensive Agent in Humans after Supplementation to Hypertensive Subjects. J. Agric. Food Chem. 2012, 60, 6749-6754, doi:10.1021/jf2045262. Submitted filename: Response to Reviewers PONE-D-21-35268.docx Click here for additional data file. 12 Apr 2022 Influence of oral administration of kukoamine A on blood pressure in a rat hypertension model PONE-D-21-35268R1 Dear Dr. Christine Ann Butts We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Balamuralikrishnan Balasubramanian Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ********** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ********** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ********** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ********** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ********** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: 1. There are some grammatical, alignment and typographical errors are noted in the manuscript and it should be thoroughly checked and corrected throughout the manuscript. For example, • in line number 42, the word “include” may be as “including”; • in line number 54, “specialty” as “speciality”; • in line number 105, “NMR” as “the NMR”; • in line number 147, “fixed dose” as “fixed-dose”; • in line number 198, “correlation” as “correlations”; • in line number 211, “study” as “study,”; • in line number 224, 229, 239 and 245, “Least” as “A least”; • in line number 251, “mixed effect” as “mixed-effect”; • in line number 304, “instead” as “instead of”. Reviewer #2: All points of wondering have been answered and clarified. So, this manuscript could be published and it can be useful for further study. ********** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Prof. A. Vijaya Anand Reviewer #2: Yes: UTTHAPON ISSARA 21 Apr 2022 PONE-D-21-35268R1 Influence of oral administration of kukoamine A on blood pressure in a rat hypertension model Dear Dr. Butts: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Balamuralikrishnan Balasubramanian Academic Editor PLOS ONE
  48 in total

1.  Application of a molecularly imprinted polymer for the extraction of kukoamine a from potato peels.

Authors:  Elena V Piletska; Rosemary Burns; Leon A Terry; Sergey A Piletsky
Journal:  J Agric Food Chem       Date:  2011-12-16       Impact factor: 5.279

Review 2.  Interactions between ANG II, sympathetic nervous system, and baroreceptor reflexes in regulation of blood pressure.

Authors:  I A Reid
Journal:  Am J Physiol       Date:  1992-06

3.  The synthesis of symmetrical spermine conjugates using solid-phase chemistry.

Authors:  P Page; S Burrage; L Baldock; M Bradley
Journal:  Bioorg Med Chem Lett       Date:  1998-07-07       Impact factor: 2.823

Review 4.  Higher blood pressure as a risk factor for diseases other than stroke and ischemic heart disease.

Authors:  Yoshihiro Kokubo; Yoshio Iwashima
Journal:  Hypertension       Date:  2015-06-15       Impact factor: 10.190

Review 5.  Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis.

Authors:  Dena Ettehad; Connor A Emdin; Amit Kiran; Simon G Anderson; Thomas Callender; Jonathan Emberson; John Chalmers; Anthony Rodgers; Kazem Rahimi
Journal:  Lancet       Date:  2015-12-24       Impact factor: 79.321

6.  Kukoamine A Prevents Radiation-Induced Neuroinflammation and Preserves Hippocampal Neurogenesis in Rats by Inhibiting Activation of NF-κB and AP-1.

Authors:  Yaqiong Zhang; Lingyue Gao; Zhihua Cheng; Jiayi Cai; Yixuan Niu; Weihong Meng; Qingchun Zhao
Journal:  Neurotox Res       Date:  2016-11-04       Impact factor: 3.911

Review 7.  Health-beneficial properties of potato and compounds of interest.

Authors:  Rizliya Visvanathan; Chathuni Jayathilake; Barana Chaminda Jayawardana; Ruvini Liyanage
Journal:  J Sci Food Agric       Date:  2016-07-07       Impact factor: 3.638

Review 8.  Sexual dimorphism in rodent models of hypertension and atherosclerosis.

Authors:  Kristen J Bubb; Rayomand S Khambata; Amrita Ahluwalia
Journal:  Br J Pharmacol       Date:  2012-09       Impact factor: 8.739

Review 9.  Dietary Nitrate Lowers Blood Pressure: Epidemiological, Pre-clinical Experimental and Clinical Trial Evidence.

Authors:  Lorna C Gee; Amrita Ahluwalia
Journal:  Curr Hypertens Rep       Date:  2016-02       Impact factor: 5.369

10.  Antioxidant and Cytoprotective Effects of Kukoamines A and B: Comparison and Positional Isomeric Effect.

Authors:  Xican Li; Jian Lin; Ban Chen; Hong Xie; Dongfeng Chen
Journal:  Molecules       Date:  2018-04-21       Impact factor: 4.411

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