title: Dietary plant stanols or sterols neither accumulate in stenotic aortic valves nor influence their structure or inflammatory status.
abstract: OBJECTIVE
  Consumption of plant stanols and plant sterols decreases LDL cholesterol level and increases serum concentrations of plant stanols/sterols, but it is practically unexplored whether also their tissue concentrations increase. Thus, the aim of this study was to assess whether consuming plant stanols/sterols increases their concentrations in stenotic aortic valves and affect the valvular structure (collagen and elastin) or inflammation (macrophages and mast cells).
  
  
  METHODS
  In a randomized, double-blind controlled intervention patients with severe aortic stenosis consumed margarine without (n = 11) or with 2 g of plant stanols (n = 12) or sterols (n = 13) until valve replacement surgery (2.6 months, on average). The effects of sitostanol and sitosterol on the expression and secretion of proinflammatory cytokines by cultured aortic valve myofibroblasts were also assessed.
  
  
  RESULTS
  Control-related LDL-cholesterol was diminished by 16% (p < 0.05) by plant stanol and by 11% (NS) by plant sterol consumption, respectively. In the resected valves, cholesterol, plant stanol and sterol levels were similar in all groups. Consumed plant stanols or sterols had no effect on valvular structure or mast cell or macrophage numbers in valves. Incubation of cultured myofibroblasts derived from stenotic valves with sitostanol or sitosterol decreased mRNA expression of the monocyte chemotactic protein-1 (p < 0.05) and interleukin-1 beta (p < 0.05).
  
  
  CONCLUSIONS
  In this study, plant stanol/sterol consumption did not affect cholesterol, plant stanol or sterol levels in stenotic aortic valves; neither did they influence the structure or the inflammatory status of the valves. However, these findings need to be confirmed in a larger-scale intervention. ClinicalTrials.govRegister #NCT00738933.
authors.affiliation: Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland. Electronic address: piia.simonen@hus.fi.
authors.forename: Piia
authors.initials: P
authors.lastname: Simonen
authors.affiliation: Wihuri Research Institute, Helsinki, Finland. Electronic address: jaakko.lommi@helsinki.fi.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Lommi
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. Electronic address: maarit.hallikainen@uef.fi.
authors.forename: Maarit
authors.initials: M
authors.lastname: Hallikainen
authors.affiliation: Wihuri Research Institute, Helsinki, Finland. Electronic address: satu.helske@wri.fi.
authors.forename: Satu
authors.initials: S
authors.lastname: Helske-Suihko
authors.affiliation: Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland. Electronic address: kalervo.werkkala@hus.fi.
authors.forename: Kalervo
authors.initials: K
authors.lastname: Werkkala
authors.affiliation: Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland. Electronic address: markku.kupari@hus.fi.
authors.forename: Markku
authors.initials: M
authors.lastname: Kupari
authors.affiliation: Wihuri Research Institute, Helsinki, Finland. Electronic address: petri.kovanen@wri.fi.
authors.forename: Petri T
authors.initials: PT
authors.lastname: Kovanen
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Department of Medicine, Division of Internal Medicine, University of Helsinki, Helsinki, Finland. Electronic address: helena.gylling@hus.fi.
authors.forename: Helena
authors.initials: H
authors.lastname: Gylling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000187:drug effects* / Q000473:pathology / Q000601:surgery; D018932:Chemokine CCL2 / Q000235:genetics / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D004311:Double-Blind Method; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D053583:Interleukin-1beta / Q000235:genetics / Q000378:metabolism; D008297:Male; D008383:Margarine; D008875:Middle Aged; D058628:Myofibroblasts / Q000187:drug effects / Q000378:metabolism; D010840:Phytosterols / Q000008:administration & dosage* / Q000097:blood; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D012855:Sitosterols / Q000008:administration & dosage / Q000097:blood
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D008078:Cholesterol, LDL; C508585:IL1B protein, human; D053583:Interleukin-1beta; D010840:Phytosterols; D012333:RNA, Messenger; D012855:Sitosterols; C025473:gamma-sitosterol; D008383:Margarine; C021255:stigmastanol
keywords: Cholesterol; Clinical trial; Cytokines; Macrophages; Sitostanol; Sitosterol