Comparison of a dietary antiplatelet (Fruitflow )
with an established antiplatelet medication (aspirin)
®
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Dr Niamh O’Kennedy c/o The University of Aberdeen, Rowett Institute of Nutrition and Health, UK.
Dr Daniel Raederstorff, Principal Scientist, DSM Nutritional Products, Switzerland.
Introduction
A body of work now exists to demonstrate the antiplatelet effects of a bioactive
tomato extract trade named Fruitflow®. Mechanisms of action and effects on target
populations consuming Fruitflow® daily have been elucidated. However the likely
physiological benefit of the demonstrated antiplatelet action (up to 18% reduction
in platelet aggregability, on average) can be difficult to judge in isolation. To attempt
to put the effects into clinical context, a comparison with the effects of aspirin was
undertaken, in healthy subjects over the age of 40.
Arachidonic acid
ADP
A 150mg dose of Fruitflow® can reduce overall TxA2
generation by activated platelets approximately one
third as effectively as 7-day aspirin.
Collagen
0
To compare
-20
the overall
-30
effects of
-40
-50
the two
-60
antiplatelets
-70
on platelet
-80
-90
function,
-100
irrespective
-110
C A 7-day A 1-day t3 FF t3
-120
of activation
pathway, the
amount of platelet TxA2 produced after platelets
aggregated was measured. The figure shows the
reduction in TxA2 measured after treatments. A
single 150mg dose of Fruitflow® reduced TxA2
approximately half as effectively as a single dose
of 75mg aspirin, or about one third as effectively as
7-day aspirin.
% change from TO in TxA2 aggregation
% change from TO in
platelet aggregation % AUC
Arachidonic acid
0
-10
-20
-30
-40
-50
-60
-70
-80
-90
Collagen
C
A 7-day
A 1-day t3
FF t3
Comparing effects of Fruitflow® and 75mg aspirin
on platelet aggregation, different aggregation
pathways are affected to different extents by the
two treatments. Aspirin shows greatest effects on
arachidonic acid and collagen-mediated pathways,
while Fruitflow® primarily affects ADP and
collagen-mediated pathways.
Time to form a primary haemostatic clot (PFA-100)
is lengthened approximately one third as much by a
150mg dose of Fruitflow® as by 7-day aspirin.
-10
140
The pattern observed for
120
TxA2 generation was also
100
observed in a measurement
of overall primary
80
haemostasis, the time to clot
60
in the PFA-100 point of care
40
analyser. This measurement
20
can be considered the most
physiologically relevant of
0
C A 7-day A 1-day t3 FF t3
the parameters studied, as
it measures time to form a
platelet plug in an aperture under conditions of
flow, similar to conditions in blood vessels.
%change from T0 in PFA-100 closure time
Fruitflow® and aspirin affect individual platelet
aggregation pathways to different extents.
A total of 47 healthy subjects completed a double blinded randomized
controlled trial following a crossover design. Acute (A 1-day) and seven-day
(A 7-day) treatments with 75 mg aspirin were compared to control (C) with and
without concomitant Fruitflow® (FF). Platelet aggregation in response to agonist,
platelet thromboxane A2 release (TxA2), plasma clotting times and time to
make a primary haemostatic clot (PFA-100 time to clot) were measured.
Many subjects taking 7-day aspirin still exhibit significant generation of TxA2, and
a functional platelet ADP response. This results in a reduced response to aspirin
in those subjects. Overall 19% of the study population had a less than average
response to 7-day aspirin.
Daily use of 150mg Fruitflow®, resulting in platelet suppression of up to 18%
of baseline platelet function, or approximately one third that achieved by
aspirin, has been authorised as safe by the European Food Safety Authority and
accorded a health claim.
For those subjects responding strongly to aspirin, daily use can be associated
with increased risk of bleeding. These issues with aspirin limit its usefulness as a
primary preventative measure in CVD.
‘Helps to maintain a healthy blood flow and benefits circulation’.
References:
Scientific opinion: Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies. The EFSA Journal (2009) 1101, 1-15.
O’Kennedy et al, unpublished work (in preparation for submission 2015).
Fruitflow® may have a role as a dietary antiplatelet in primary prevention of CVD.