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Dark chocolate shows antioxidant activity in patients with NASH

Dark chocolate showed antioxidant activity in patients with nonalcoholic steatohepatitis, according to recent findings published in Alimentary Pharmacology & Therapeutics.

“This study shows that, compared to controls, [nicotinamide adenine dinucleotide phosphate (NADPH)] oxidase isoform NOX2 is significantly upregulated in patients with NASH,” Lorenzo Loffredo, MD, in the department of internal medicine and medical specialties at Sapienza University of Rome, and colleagues wrote. “Furthermore, we found that dark chocolate intake reduces serum sNOX2-dp, isoprostanes and [cytokeratin-18 (CK-18)] in NASH patients.”

NADPH oxidase activation is a mechanism that determines disease progression in patients with NASH, the researchers wrote. Further, polyphenols such as dark chocolate have been shown to inhibit NADPH oxidase in humans.

Loffredo and colleagues performed a cross-sectional study comparing 19 patients with NASH with 19 controls. They assessed oxidative stress with serum [NADPH oxidase isoform 2 (NOX2)] activity as well as F2-isoprostanes and assessed hepatocyte apoptosis with serum CK-18 levels. The patients with NASH received either 40 g of dark chocolate or milk chocolate each day for 2 weeks. Researchers assessed patients’ sNOX2-dp, serum isoprostanes and CK-18 levels at baseline and after 2 weeks.

The researchers found that these patients had high sNOX2-dp, serum isoprostanes and CK-18 levels compared with controls at baseline. After 2 weeks, the pairwise comparisons showed that patients taking dark chocolate had a significant reduction in sNOX2-dp (from 37.3 to 31.2 pg/mL; P < .001), serum isoprostanes (from 273.5 to 230.2 pg/mL; P < .001) and CK-18 M30 (from 143.7 to 116.4 pg/mL; P = .02). However, no reduction occurred for patients taking milk chocolate. Linear regression analysis showed that the change of sNOX2-dp was associated with the change of serum isoprostanes.

The researchers concluded that dark chocolate down-regulates NOX2 and therefore has antioxidant activity in patients with NASH.

“The overall data support a role of nutraceutical supplementations for the treatment of NASH, especially those with antioxidants and with polyphenols,” Loffredo and colleagues wrote. “In particular, we suggest that polyphenols contained in cocoa could be potentially useful to reduce oxidative stress in NASH, although results cannot be transferred to clinical practice because of the small sample size.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.