title: Consumption of pomegranate decreases serum oxidative stress and reduces disease activity in patients with active rheumatoid arthritis: a pilot study.
abstract: BACKGROUND
  Pomegranate extract (POMx) consumption has been shown to reduce the incidence and severity of collagen-induced arthritis in mice.
  
  
  OBJECTIVE
  To investigate whether pomegranate consumption affects disease activity in patients with rheumatoid arthritis (RA), in relation to their serum oxidative status.
  
  
  METHODS
  In this pilot 12 week open-labeled study eight patients with active RA consumed POMx (10 ml/day) for 12 weeks. Patients' joint status and serum oxidative status (lipid peroxidation, total thiols group, paraoxonase 1 activity) were evaluated at baseline and at week 12.
  
  
  RESULTS
  Six patients completed the study. POMx consumption significantly (P < 0.02) reduced the composite Disease Activity Index (DAS28) by 17%, which could be related mostly to a significant (P < 0.005) reduction in the tender joint count (by 62%). These results were associated with a significant (P < 0.02) reduction in serum oxidative status and a moderate but significant (P < 0.02) increase in serum high density lipoprotein-associated paraoxonase 1 (PON1) activity. The addition of POMx to serum from RA patients reduced free radical-induced lipid peroxidation by up to 25%.
  
  
  CONCLUSIONS
  The pomegranate consumption reduced DAS28 in RA patients, and this effect could be related to the antioxidative property of pomegranates. Dietary supplementation with pomegranates may be a useful complementary strategy to attenuate clinical symptoms in RA patients.
authors.affiliation: Rheumatology Unit, Rambam Health Care Campus, Haifa, Israel. a_balbir@rambam.health.gov.il
authors.forename: Alexandra
authors.initials: A
authors.lastname: Balbir-Gurman
authors.forename: Bianca
authors.initials: B
authors.lastname: Fuhrman
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Braun-Moscovici
authors.forename: Doron
authors.initials: D
authors.lastname: Markovits
authors.forename: Michael
authors.initials: M
authors.lastname: Aviram
mesh_terms: D001172:Arthritis, Rheumatoid / Q000628:therapy*; D043303:Aryldialkylphosphatase / Q000097:blood; D001799:Blood Sedimentation; D005260:Female; D006801:Humans; D015227:Lipid Peroxidation; D008054:Lipid Peroxides / Q000097:blood; D029561:Lythraceae; D008875:Middle Aged; D018384:Oxidative Stress; D008517:Phytotherapy; D010865:Pilot Projects; D010936:Plant Extracts / Q000627:therapeutic use; D012720:Severity of Illness Index
chemical_list: D008054:Lipid Peroxides; D010936:Plant Extracts; D043303:Aryldialkylphosphatase; C468406:PON1 protein, human