Marfan syndrome (MFS) is an autosomal dominant genetic disorder manifesting in persistent oxidative stress and malfunction of connective tissue in the cardiovascular and skeletal systems. Previous studies of hibiscus (Hibiscus sabdariffa, Malvaceae) calyx drinks showed improvements in circulating antioxidant levels in healthy humans. Anthocyanins and organic acids like ascorbic acid are water-soluble antioxidants that are uncharacteristically rich in the hibiscus calyx, the ripened flowering body that is typically dark red in color. The goal of this prospective, observational, single-cohort study was to evaluate if a water infusion of hibiscus consumed daily could improve oxidative stress in patients with MFS.
The 3-month study took place at the National Institute of Cardiology Ignacio Chávez; Mexico City, Mexico. Seventeen patients with MFS and 10 healthy, control subjects were recruited through physical examination at the National Institute of Cardiology Ignacio Chávez. Additional echocardiography, computerized tomography, or magnetic resonance was done to ensure no aortic damage, and none of the enrolled patients were on anti-inflammatory medication.
Each patient consumed 1L daily for 3 months of a beverage made from boiling 20 g hibiscus calyces in a liter of boiling water (95-100°C) for 10 minutes, then left to cool. Hibiscus calyces were acquired in Chilapa de Álvarez (high zone from Guerrero, Mexico). Anthocyanins, flavonoids, and ascorbic acid (vitamin C) were estimated in the beverage by ultraviolet spectrometry, although composition data were not included in the study. Circulating levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione-S-transferase (GST), glutathione reductase (GSHR), glutathione (GSH), lipid peroxidation (LPO) index, total antioxidant capacity (TAC), and ascorbic acid were measured in plasma from patients with MFS.
Levels of all oxidative stress markers were significantly different in patients with MFS versus control subjects. After 3 months of treatment, significant improvements in SOD (P = 0.03), GPx (P = 0.02), GST (P = 0.01), GSHR (P = 0.03), GSH (P = 0.05), LPO index (P = 0.001), and TAC (P = 0.04) were observed in patients with MFS. [Note: The P values in the abstract do not match those found in the text and figures.]
This study adds to existing clinical research on the antioxidant effects of hibiscus calyx beverages in humans. More research should be done to determine whether high-elevation hibiscus could have a different composition than other varieties. Admitted limitations include the small sample size, which was in large part due to the rarity of MFS (occurring in 2 or 3 individuals per 10,000). The long-term effects of hibiscus on slowing the progression of chronic disease related to oxidative stress should be investigated further.
Soto ME, Zuñiga-Muñoz A, Guarner Lans V, Duran-Hernández EJ, Pérez-Torres I. Infusion of Hibiscus sabdariffa L. modulates oxidative stress in patients with Marfan syndrome. Mediators Inflamm. 2016;2016:8625203. doi: 10.1155/2016/8625203.