Volume 7, Issue 4 (NOV 2022)                   JNFS 2022, 7(4): 420-423 | Back to browse issues page


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Khani S, Lesani A, Gerami H. Sumac (Rhus Coriaria) and Dyslipidemia. JNFS 2022; 7 (4) :420-423
URL: http://jnfs.ssu.ac.ir/article-1-662-en.html
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Sumac (Rhus Coriaria) and Dyslipidemia

Shiva Khani; MSc 1,2, Azadeh Lesani; MSc 2 & Hadis Gerami; MSc*3,4

1 Department of Nutritional Science, Central Tehran Branch, Islamic Azad University, Tehran, Iran; 2 Department of Food and  Nutritional Sciences, University of Reading, United Kingdom; 3 Department of Nutrition, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; 4 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
ARTICLE INFO
EDITORIAL ARTICLE *Corresponding author
geramihadis@gmail.com
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Postal code: 8915173160
Tel: +98 -35-38209100
Article history:
Received: 26 Jun 2022
Revised: 4 Sep 2022
Accepted: 28 Sep 2022
 
Dyslipidemia is a crucial risk factor for atherosclerosis (Walstra et al., 2005), and an abnormal metabolic condition characterized by disorders in lipid profile (Ference et al., 2019, Rosenson et al., 2011). Dyslipidemia is a critical yet controllable risk factor in coronary vascular disease (CVD) which cause deaths (Afshin et al., 2019). Antioxidant activity of sumac fruits against lipid peroxidation and free radicals was reported previously (Pourahmad et al., 2010). These findings indicated that sumac fruit extract might prevent the development of atherosclerosis. Also, its cardioprotective and hepatoprotective activities will benefit hypercholesterolemic conditions. The bioactive component(s) responsible for the lipid-lowering effect of sumac fruits is not currently identified.  Fruit extract decreased high serum lipid concentrations, alleviated abnormally elevated cardiac lipid levels, and modulated some enzyme indices and microscopic changes in the hypercholesterolemic conditions. Various parts of sumac contain a wide variety of medicinally remarkable phytochemical components previously (Ardalani et al., 2016, Pourahmad et al., 2010). Antioxidant properties can be achieved from high amounts of water-soluble tannins in sumac (Beretta et al., 2009).
Sumac may reduce cardiovascular risk factors in patients with mild-to-moderate dyslipidemia. In a clinical trial, the participants with dyslipidemia indicated significantly diminished in Body Mass Index (BMI) and total cholesterol (TC) levels (Saberi-Karimian et al., 2020). Impacts of sumac on dyslipidemia included antioxidant effects and free radical cleaning against lipid peroxidation as the initial stage of atherosclerosis (Rayne and Mazza, 2007). Nowadays, several studies have underlined the function of herbs in the treatment of a sort of disorders, particularly the cardiovascular system (Al Mofleh, 2010). Sumac has antihyperlipidemic outcomes (Mamatkulova et al., 2012) which is used as a spice and therapeutic herb (Brunke et al., 1993). Sumac declined blood lipid profiles and the attention of several biomarkers of liver and kidney function in a dose-dependent manner (Ghafouri et al., 2021). These effects were attributed to the polyphenolic combinations present in sumac. These combinations have reduced reverse cholesterol transport, intestinal cholesterol absorption, and raised bile acid excretion. Moreover, some components of sumac, essential oils, such as limonene, may result in a diminished cholesterol synthesis as well as reducing blood cholesterol attention (Golzadeh et al., 2012). These effects emphasize the hypolipidemic action and hepatoprotective and cardioprotective activities of sumac which may be of interest for patients diagnosed with metabolic syndrome. Tannin extracted from sumac has strengthened the protective effect against atherosclerosis (Zargham, 2008). Sumac has diminished TC, low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), and blood sugar (Shafiei et al., 2011). Moreover, a clinical trial in obese adolescents with dyslipidemia revealed a reduction in TC, LDL-c, and TG (Sabzghabaee et al., 2014). Sumac fruits contain flavonoids, phenolic acids, tannins, and anthocyanins (Kurucu et al., 1993). It has been attributed to various biological activities, including antifibrogenic, anti-inflammatory, antimicrobial, antioxidant, and hypoglycemic (Rayne and Mazza, 2007). Another clinical trial study showed the positive effect of sumac consumption on serum glycemic status, apolipoprotein B (ApoB), and apolipoprotein A-I (ApoA-I) levels in patients with type 2 diabetes (Shidfar et al., 2014). A study showed a modification in measurements of endothelial vasodilator process after sumac consumption. In addition, a significant decline in systolic blood pressure (BP), diastolic BP, serum TC and LDL-c, and BMI was observed in the sumac group. Oxidative stress stimulates the expansion and hypertrophy of vascular smooth muscles and collagen deposition (Vendrov et al., 2015). Also, oxidative stress can damage the endothelium and increase vascular contractile activity (Förstermann and Sessa, 2012). These results explained how oxidative stress could be a cause of hypertension and endothelium dysfunction. Treatment with antioxidant components is suggested for improving BP and endothelial function. Sumac is a good source of natural antioxidants (Pourahmad et al., 2010), highly rich in antioxidative phenolic components, such as tannins and flavonoids. Therefore, adjunctive treatment with sumac can be a vital role in preventing free radical-induced damage in vessels’ endothelium (Kurucu et al., 1993).
Considering the protective effects of sumac has also been introduced as a vascular protective and CVD-preventive medicinal plant in conventional medicine (Rayne and Mazza, 2007). Polyphenols can effectively reduce lipid absorbance from the gastrointestinal tract due to their high resin-binding capacities. Also, moderately high portions of tannins played an antioxidant role (Beretta et al., 2009). The high inhibitory action of sumac on xanthine oxidase, presents its serum cholesterol-reducing results. Given the significance of antioxidant and free radical–scavenging activities against lipid peroxidation as the initial stage of atherosclerosis, substantial effects of sumac on hyperlipidemia can be elucidated (Canda et al., 2010). The well-described antioxidant activity of sumac (Abu-Reida et al., 2014) may help deter the development of atherosclerosis and other health issues associated with syndrome metabolic. This may be due to differing mechanisms, including inhibiting oxidative stress through the reduced blood glucose levels and lipid peroxidation (Rafieian-Kopaei et al., 2013) and the raised activity of superoxide dismutase and catalase (Rafieian-Kopaei et al., 2013).
Sumac also possesses a significant protective effect against oxidative stress (Dasgupta et al., 2008). Phenolic compounds, particularly garlic acid, which is one of the most abundant in sumac, have been deemed responsible for this effect (Ghafouri et al., 2021). However, other components, including anthocyanins, isoflavones, and flavonoids, may contribute to the antioxidative, antilipidemic and antidiabetic activities of R. Coriaria (Rafieian-Kopaei et al., 2013). Studies have shown that sumac decreased cholesterol levels. These observations offer a positive effect of sumac in the management of not only diabetes but of several related complications associated with metabolic syndrome, such as dyslipidemia, liver and kidney disorders, or obesity (Yilmaz et al., 2016).
In general, sumac treatment had benefits in relieving the cardiac damage associated with hypercholesterolemia by reducing the plasma cholesterol levels. As the number and dosage of medicines grow, the threat of side effects is inevitable, and the introduction of complementary treatments, such as herbal medicines, seems believable. An alternative dietary strategy to reducing hyperlipidemia and hypertension is nutritional adjuncts. Herbal drugs may have advantageous pharmacological properties and fewer side effects than chemical drugs by combining clinically valuable components. Therefore, optimizing modifiable cardiovascular risk factors is vital and should be considered. A decline in lipid droplets in cardiac tissue has been shown in treatment with sumac extract.
Authors’ contributions
The authors have made a direct and intellectual contribution to this article, and all of them approved the publication.

References
Abu-Reida IM, Jamous RM & Ali-Shtayeh MS 2014. Phytochemistry, pharmacological properties and industrial applications of Rhus coriaria L.(sumac). Jordan journal of biological sciences. 147 (1573): 1-12.
Afshin A, et al. 2019. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 393 (10184): 1958-1972.
Al Mofleh IA 2010. Spices, herbal xenobiotics and the stomach: friends or foes? World journal of gastroenterology. 16 (22): 2710.
Ardalani H, et al. 2016. Sumac as a novel adjunctive treatment in hypertension: a randomized, double-blind, placebo-controlled clinical trial. RSC Advances. 6 (14): 11507-11512.
Beretta G, Rossoni G, Santagati NA & Facino RM 2009. Anti-ischemic activity and endothelium-dependent vasorelaxant effect of hydrolysable tannins from the leaves of Rhus coriaria (Sumac) in isolated rabbit heart and thoracic aorta. Planta medica. 75 (14): 1482-1488.
Brunke EJ, Hammerschmidt FJ, Schmaus G & Akgül A 1993. The essential oil of Rhus coriaria L. fruits. Flavour and fragrance journal. 8 (4): 209-214.
Canda AE, et al. 2010. Effects of preoperative chemoradiotherapy on anal sphincter functions and quality of life in rectal cancer patients. International journal of colorectal disease. 25 (2): 197-204.
Dasgupta K, et al. 2008. Social ties and their relevance to churn in mobile telecom networks. In Proceedings of the 11th international conference on Extending database technology: Advances in database technology, pp. 668-677.
Ference BA, et al. 2019. Association of triglyceride-lowering LPL variants and LDL-C–lowering LDLR variants with risk of coronary heart disease. Journal of the American medical association (JAMA). 321 (4): 364-373.
Förstermann U & Sessa WC 2012. Nitric oxide synthases: regulation and function. European heart journal. 33 (7): 829-837.
Ghafouri A, et al. 2021. Sumac fruit supplementation improve glycemic parameters in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis. Phytomedicine. 90: 153661.
Golzadeh M, Farhoomand P & Daneshyar M 2012. Dietary Rhus coriaria L. powder reduces the blood cholesterol, VLDL-c and glucose, but increases abdominal fat in broilers. South African journal of animal science. 42 (4): 398-405.
Kurucu S, Koyuncu M, Güvenç A, Baser K & Özek T 1993. The essential oils of Rhus coriaria L.(Sumac). Journal of essential oil research. 5 (5): 481-486.
Mamatkulova N, et al. 2012. Polyisoprenoids from Rhus coriaria a. Chemistry of natural compounds. 48 (4): 661-662.
Pourahmad J, Eskandari MR, Shakibaei R & Kamalinejad M 2010. A search for hepatoprotective activity of aqueous extract of Rhus coriaria L. against oxidative stress cytotoxicity. Food and chemical toxicology. 48 (3): 854-858.
Rafieian-Kopaei M, et al. 2013. Efficacy of co-administration of garlic extract and metformin for prevention of gentamicin–renal toxicity
in wistar rats: A biochemical study. International journal of preventive medicine.
4 (3): 258.

Rayne S & Mazza G 2007. Biological activities of extracts from sumac (Rhus spp.): a review. Nature precedings. 1-1.
Rosenson RS, et al. 2011. HDL measures, particle heterogeneity, proposed nomenclature, and relation to atherosclerotic cardiovascular events. Clinical chemistry. 57 (3): 392-410.
Saberi-Karimian M, et al. 2020. Effects of curcuminoids on inflammatory status in patients with non-alcoholic fatty liver disease: A randomized controlled trial. Complementary therapies in medicine. 49: 102322.
Sabzghabaee AM, Kelishadi R, Golshiri K, Ghannadi A & Badri S 2014. Clinical effects of Rhus coriaria fruits on dyslipidemia in adolescents: a triple-blinded randomized placebo-controlled trial. Medical archives. 68 (5): 308.
Shafiei M, Nobakht M & Moazzam A 2011. Lipid-lowering effect of Rhus coriaria L.(sumac) fruit extract in hypercholesterolemic rats. International journal of pharmaceutical sciences. 66 (12): 988-992.
Shidfar F, et al. 2014. The effect of sumac (Rhus coriaria L.) Powder on Serum Glycemic Status, ApoB, ApoA-I and total antioxidant capacity in type 2 diabetic patients. Iranian journal of pharmaceutical research: IJPR. 13 (4): 1249.
Vendrov AE, et al. 2015. NOX4 NADPH oxidase-dependent mitochondrial oxidative stress in aging-associated cardiovascular disease. Antioxidants & redox signaling. 23 (18): 1389-1409.
Walstra P, Walstra P, Wouters JT & Geurts TJ 2005. Dairy science and technology. CRC press.
Yilmaz M, et al. 2016. Mortality predictors of Staphylococcus aureus bacteremia: a prospective multicenter study. Annals of clinical microbiology and antimicrobials. 15 (1): 1-10.
Zargham R 2008. Preventing restenosis after angioplasty: a multistage approach. Clinical science. 114 (4): 257-264.

Type of article: editorial article | Subject: public specific
Received: 2022/06/26 | Published: 2022/11/19 | ePublished: 2022/11/19

References
1. Abu-Reida IM, Jamous RM & Ali-Shtayeh MS 2014. Phytochemistry, pharmacological properties and industrial applications of Rhus coriaria L.(sumac). Jordan journal of biological sciences. 147 (1573): 1-12.
2. Afshin A, et al. 2019. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 393 (10184): 1958-1972.
3. Al Mofleh IA 2010. Spices, herbal xenobiotics and the stomach: friends or foes? World journal of gastroenterology. 16 (22): 2710.
4. Ardalani H, et al. 2016. Sumac as a novel adjunctive treatment in hypertension: a randomized, double-blind, placebo-controlled clinical trial. RSC Advances. 6 (14): 11507-11512.
5. Beretta G, Rossoni G, Santagati NA & Facino RM 2009. Anti-ischemic activity and endothelium-dependent vasorelaxant effect of hydrolysable tannins from the leaves of Rhus coriaria (Sumac) in isolated rabbit heart and thoracic aorta. Planta medica. 75 (14): 1482-1488.
6. Brunke EJ, Hammerschmidt FJ, Schmaus G & Akgül A 1993. The essential oil of Rhus coriaria L. fruits. Flavour and fragrance journal. 8 (4): 209-214.
7. Canda AE, et al. 2010. Effects of preoperative chemoradiotherapy on anal sphincter functions and quality of life in rectal cancer patients. International journal of colorectal disease. 25 (2): 197-204.
8. Dasgupta K, et al. 2008. Social ties and their relevance to churn in mobile telecom networks. In Proceedings of the 11th international conference on Extending database technology: Advances in database technology, pp. 668-677.
9. Ference BA, et al. 2019. Association of triglyceride-lowering LPL variants and LDL-C–lowering LDLR variants with risk of coronary heart disease. Journal of the American medical association (JAMA). 321 (4): 364-373.
10. Förstermann U & Sessa WC 2012. Nitric oxide synthases: regulation and function. European heart journal. 33 (7): 829-837.
11. Ghafouri A, et al. 2021. Sumac fruit supplementation improve glycemic parameters in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis. Phytomedicine. 90: 153661.
12. Golzadeh M, Farhoomand P & Daneshyar M 2012. Dietary Rhus coriaria L. powder reduces the blood cholesterol, VLDL-c and glucose, but increases abdominal fat in broilers. South African journal of animal science. 42 (4): 398-405.
13. Kurucu S, Koyuncu M, Güvenç A, Baser K & Özek T 1993. The essential oils of Rhus coriaria L.(Sumac). Journal of essential oil research. 5 (5): 481-486.
14. Mamatkulova N, et al. 2012. Polyisoprenoids from Rhus coriaria a. Chemistry of natural compounds. 48 (4): 661-662.
15. Pourahmad J, Eskandari MR, Shakibaei R & Kamalinejad M 2010. A search for hepatoprotective activity of aqueous extract of Rhus coriaria L. against oxidative stress cytotoxicity. Food and chemical toxicology. 48 (3): 854-858.
16. Rafieian-Kopaei M, et al. 2013. Efficacy of co-administration of garlic extract and metformin for prevention of gentamicin–renal toxicity in wistar rats: A biochemical study. International journal of preventive medicine. 4 (3): 258.
18. Rayne S & Mazza G 2007. Biological activities of extracts from sumac (Rhus spp.): a review. Nature precedings. 1-1.
19. Rosenson RS, et al. 2011. HDL measures, particle heterogeneity, proposed nomenclature, and relation to atherosclerotic cardiovascular events. Clinical chemistry. 57 (3): 392-410.
20. Saberi-Karimian M, et al. 2020. Effects of curcuminoids on inflammatory status in patients with non-alcoholic fatty liver disease: A randomized controlled trial. Complementary therapies in medicine. 49: 102322.
21. Sabzghabaee AM, Kelishadi R, Golshiri K, Ghannadi A & Badri S 2014. Clinical effects of Rhus coriaria fruits on dyslipidemia in adolescents: a triple-blinded randomized placebo-controlled trial. Medical archives. 68 (5): 308.
22. Shafiei M, Nobakht M & Moazzam A 2011. Lipid-lowering effect of Rhus coriaria L.(sumac) fruit extract in hypercholesterolemic rats. International journal of pharmaceutical sciences. 66 (12): 988-992.
23. Shidfar F, et al. 2014. The effect of sumac (Rhus coriaria L.) Powder on Serum Glycemic Status, ApoB, ApoA-I and total antioxidant capacity in type 2 diabetic patients. Iranian journal of pharmaceutical research: IJPR. 13 (4): 1249.
24. Vendrov AE, et al. 2015. NOX4 NADPH oxidase-dependent mitochondrial oxidative stress in aging-associated cardiovascular disease. Antioxidants & redox signaling. 23 (18): 1389-1409.
25. Walstra P, Walstra P, Wouters JT & Geurts TJ 2005. Dairy science and technology. CRC press.
26. Yilmaz M, et al. 2016. Mortality predictors of Staphylococcus aureus bacteremia: a prospective multicenter study. Annals of clinical microbiology and antimicrobials. 15 (1): 1-10.
27. Zargham R 2008. Preventing restenosis after angioplasty: a multistage approach. Clinical science. 114 (4): 257-264.

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