Clinical Research & Studies

Mazokopakis E., Satarakis I, Papamanolaki M., Mavroeidi N., Ganotakis E.

SOURCE:
Pathology Clinic, Naval Hospital of Crete and University Hospitals of Heraklion and Patras, Greece.

INTRODUCTION:
Spirulina (Arthrospira platensis) is an edible cyan-green filamentous photosynthetic microorganism belonging to the cyanobacteria and is used as a dietary supplement.

OBJECTIVE OF THE STUDY:
The evaluation of the effect of Spirulina on the lipid profile of newly diagnosed dyslipidemic patients in Crete (Greece) and documentation of its effectiveness as a possible alternative treatment for dyslipidemia

MATERIAL-METHODS:
Fifty-two adult patients from Crete (32 men and 20 women) of intermediate age 47 (range 37-61) years old, with newly diagnosed dyslipidemia, consumed orally 1g of Spirulina (Greek production) daily for 12 weeks. The complete lipid profile of the patients was determined in fasting blood samples at the beginning and end of the study period. Anthropometric measurements such as systolic and diastolic blood pressure, height, weight and body mass index (BMI) were also recorded. The paired t-test was used to statistically evaluate the results.

RESULTS:
At the end of the three-month intervention, intermediate rates of levels of triglycerides (TG), low-density lipoprotein (LDL-C), total cholesterol (TC), non-high-density lipoprotein (non-HDL-C) and levels atherosclerotic index (TC / HDL-C) decreased significantly: 16.3% (p <0.0001), 10.1% (p <0.0001), 8.9% (p <0.0001), 10.8% (p <0.0001) and 11.5% (p = 0.0006), respectively, while the average value of HDL-C levels did not increase significantly (3.5%). Blood pressure, body weight and BMI remained virtually unchanged.

CONCLUSIONS:
The daily administration of a small dose (1g) of Spirulina has strong hypolipidemic effects in dyslipidemic patients of Crete, especially in the levels of triglycerides (TG).
This article is copyrighted. All rights reserved⁴⁸.

You can see the complete clinical study here.

Mazokopakis EE., Stratakis IK., Papadomanolaki MG., Mavroeidi NG., Ganotakis ES..

SOURCE:
Naval Hospital of Crete, Chania; Heraklion University Hospital? Technical University of Crete, Chania, Greece

OBJECTIVE OF THE STUDY:
A pilot study on the effects of spirulina (Arthrospira platensis) on Cretan patients with non-alcoholic fatty liver disease (NAFLD). Spirulina is a complementary dietary filamentous cyanobacterium.

METHOD:
Fifteen adult Cretans, with an average age of 48 (from 29-62 years) and with NAFLD, for a period of six months, consumed daily 6g of oral spirulina (Greek production). Anthropometric measurements such as (height, weight, waist diameter), systolic and diastolic blood pressure, complete hematological examination, biochemical evaluation, homeostasis model index for insulin resistance (HOMA-IR), quality of life related to health and recording measurements of the abdomen before and after taking spirulina.

RESULTS:
By the end of the 6-month intervention, the intermediate values of aspartate aminotransferase levels, alanine aminotransferase, γ-glutamyltransferase, triglycerides, low-density lipoprotein cholesterol were significantly lower: cholesterol and total cholesterol ratio. 37.5%, 26.7%, 24.8%, 9.6%, 9.1% and 13.5% respectively. The mean density of lipoprotein-cholesterol and hemoglobin was significantly increased: 4.2% and 4.1% respectively. Spirulina also helped significantly reduce weight and HOMA-IR (8.1% and 19.6% respectively) as well as significantly improve health and quality of life. No change was observed in the ultrasound findings.

CONCLUSIONS:
Spirulina in high doses of 6g daily in NAFLD patients has a strong multiple beneficial effect on metabolism, as it improves health and quality of life⁴⁹.

You can read the complete clinical study here.

The immune system is responsible for the defence of the body against invaders such as viruses, bacteria and foreign bodies. The main function of the immune system is to detect and then destroy the above pathogens as well as to excrete damaged and modified cells.

Animal studies show that spirulina can trigger several functions of their immune system including the phagocytes from macrophages ^{1 32 33}, production of cytokine ²⁵ and chemokines⁹ and other substances required for inflammation, the reactivity of NK³³ cells as well as the production of antibodies by B lymphocytes¹¹ and proliferation of T lymphocytes.

On the other hand, spirulina seems to repress inflammatory reactions in rheumatic arthritis, colitis and severe allergic reactions^{38 45}. This shows the significant and pivotal role of spirulina in our immune system as it boosts the immunity and simultaneously protects it. As far as the impacts of spirulina in the immune system, from a few researches that have been published, it seems that it can potentially have an important role in the control of the immune system.¹⁴

Several in vitro researches that have been carried out using cyanobacteria have proven the potential ability of those organisms to act as antivirus factors. Specifically, laboratory researches proved the repressing action of warm essence of S. Platensis in the proliferation of human simplex virus type 1 (HSV-1).¹⁰

Other studies showed that spirulina has healing properties against the human cytomegalovirus (HCMV) ^{4 12}, measles virus ^{4 12}, mumps virus ^{4 12}, influenza virus A ^{4 12} and HIV ^{3 4 12 20 40}.

Spirulina’s antivirus action is possibly due to a substance which prevents the virus from entering and infecting the cell in cooperation with other not known polysaccharides and protein contents ⁴.

Iron deficiency is the most common cause of anemia. It affects newborns, children, teenagers and women in reproductive age whether they are expecting or not.

The causes that are thought to be responsible for the development of iron deficiency anemia are reduced intake or increased iron loss. Determinant of these causes is the increased need for iron. Decreased iron intake may in turn be due to a poor iron diet or reduced intestinal iron absorption.

A clinical study showed that 5g of spirulina for one month in young adult girls suffering from anemia resulted in a significant increase in hemoglobin levels in their blood, which is attributed to the high bioavailability of spirulina. Also, the administration of 1g of spirulina for fifty days in anemic preschool children resulted in an increase in the absorption of certain nutrients such as protein and iron, as well as an increase in hemoglobin levels ²². Spirulina-induced increase in hemoglobin levels in the blood of people with anemia is confirmed by previous clinical trials ²⁴

The antioxidant properties of food have the main effect of neutralizing harmful free radicals produced in the body under the influence of various factors, such as stress, environmental pollution and excessive exposure to sunlight. According to research, the synergistic action of a wide range of antioxidants is better than the action of a single antioxidant, while antioxidants derived from natural sources show greater bioavailability and consequently better protective action than synthetic antioxidants.

Spirulina as a 100% natural product and with its rich content of nutrients with antioxidant properties, such as β-carotene, vitamin E, selenium, etc., has been the center of many scientific studies regarding its possible antioxidant action. Thus, laboratory studies have shown that alcoholic extract of spirulina inhibits lipid peroxidation more potent than chemical antioxidants such as α-tocopherol, BHA (butyl hydroxyanisole) and β-carotene, while its aqueous extract shows better antioxidant effect than the aqueous extracts of gallic and chlorogenic acid⁸. Also, spirulina extracts with hot water showed strong binding capacity of hydroxyl and lipid free radicals.

The antioxidant effect of spirulina is largely attributed to the presence of the phycocyanin protein.

Phycocyanin: a major antioxidant

Phycocyanin is a pigment protein found in spirulina in large quantities. It is responsible for the cyan color of the microalgae and has strong antioxidant properties. Thus, phycocyanin inhibits the formation of reactive oxygen species (ROS), while showing a strong ability to neutralize them. More specifically, it has a strong effect against the free radicals of hydroxyl, alkoxy and peroxyl ³⁶ , the peroxynitride⁵ and the hypochlorite⁸ and the hypochlorite [8] anion, while inhibiting lipid peroxidation. The protective effect of phycocyanin against peroxyl red blood cell-induced red blood cell lysis has also been reported ³⁵ .

The following are some of the health benefits of spirulina and phycocyanin due to their strong antioxidant activity.

Inhibition of lipid peroxidation
Lipid peroxidation is an important factor in damage or destruction of cell membranes. Studies have shown that phycocyanin significantly inhibits lipid peroxidation induced by ferrous ions (Fe2+) and ascorbic acid ³⁷ or by carbon tetrachloride (CCl4) ⁶.

Spirulina and drug toxicity
Many drugs cause nephrotoxicity and cardiotoxicity through free radical scavenging mechanisms. Studies have shown that previous administration of spirulina or phycocyanin to animals has been shown to inhibit the toxic effects of various drugs ^{17 18}

Spirulina and heavy metal toxicity
Spirulina has a protective effect against toxicity caused by heavy metals such as lead, cadmium and mercury. In particular, the administration of spirulina to animals that were poisoned by toxic metals helped maintain levels of important substances such as copper, zinc, iron, selenium, glutathione, peroxidase (S) and glutathione, which are reduced under the toxic effect of heavy metals ^{16 41}

Spirulina and exercise
Research has shown that supplementing the diet with spirulina prevents oxidative damage to muscle tissue due to the formation of free radicals during exercise. Clinical studies in a sample of 16 students showed that the concentration of malondialdehyde (a product of lipid peroxidation) in their blood plasma, after exercise, decreased significantly when given spirulina, while the effect of peroxide dismutase (SOD) in the blood increased ²¹. Spirulina also delays the onset of fatigue during exercise.

Spirulina and hepatotoxicity
There are certain chemicals that are considered hepatotoxic, which is due to the formation of free radicals. An example is hepatotoxicity induced in mice by carbon tetrachloride (CCl4). Research has shown the hepatoprotective activity of phycocyanin against hepatotoxicity due to CCl4 ⁴².

Spirulina and nitrogen stress
The harmful effects of active nitrogen radicals are known as nitrogen stress. Peroxynitrite anion (ONOO) causes the inactivation of important cellular functions, while inducing oxidative DNA damage. Research has shown that phycocyanin has the potential to effectively neutralize these anions ⁵.

Spirulina and neuroprotective effect
Recent studies performed on animals have shown the neuroprotective effect of spirulina, which is attributed to its ability to neutralize free radicals and its general antioxidant properties. According to research, phycocyanin could be used to treat neurodegenerative diseases such as Parkinson’s disease, Alzheimer’s disease and Huntington’s disease ^{8 34}.

Asthma is a chronic respiratory disease which is cause by transient narrowing of the bronchi leading to dyspnoea.
It manifests by chronic inflammation of the airways and acute bronchoscopy.
The symptoms are:

• Dyspnoea
• Coughing
• Whistling

Diabetes is a metabolic disease characterised by:

• Increased concentration of blood sugar (hyperglycaemia) and
• Defects in glycose metabolism, either as decreased insulin release or cells not responding properly to the insulin produced.

Diabetes is a chronic disorder and can have acute complications such as:

• Cardiovascular disorders
• Chronic kidney failure
• Damage to the eyes
• Nerve damage etc

Clinical research showed that daily intake of 2g of spirulina for 4 months in patients diagnosed with diabetes type II resulted in decreased plasma glucose levels proved by glucose intolerance test (blood glucose measured after 2 hrs of 75g given to patients). Also, it should be mentioned that they observed a decrease in the haemoglobin HbA1c which reflects the average value of blood sugar in the last 3 months before the test²². The above research confirmed findings of previous studies ^{23 31}.

The nephrotic syndrome is a rare disorder where high protein quantities pass through the kidneys from urinary ac circulation resulting in low protein levels in the blood and accumulation of excessive amounts of fluid in the tissues of the body (oedema).

Clinical studies showed that daily administration of 1g of spirulina for 4 months in patients who were diagnosed with nephrotic syndrome resulted in increased protein levels in the blood proving spirulina’s high nutrient value²². The scientific results agree with previous findings in studies were patients were diagnosed with asthma.¹⁹

The last couple of years there is an extensive search of new natural antibiotic factors in order to face antibiotic resistance. Several scientific researches have proved that spirulina’s antimicrobic activity. Specifically, spirulina’s activity has been attributed in the polyunsaturated fatty acids it contains²⁸.

Spirulina is rich in γ-linolenic acid while it contains α-linolenic and linoleic acid. Research has proven the antibacterial activity of α-linolenic acid²⁶ and as far as the activity of γ-linolenic acid is concerned, several studies have proved its antimicrobial activity against strains such as Staphylococcus aureus, Escherichia coli, Salmonella Typhi, Pseudomonas Aeruginosa and Enterobacter Aerogenes².

Probiotics are living organisms which are consumed regularly in sufficient quantities, altering bacteria’s balance in the human intestine and have beneficial properties in health. Probiotics can be added in food such as yogurt and other dairy or can be received as supplements. Studies have shown that consuming spirulina has increase the amount of Lactobacillus in the gastrointestinal tract of humans²⁷

Furthermore, using spirulina in probiotic dairy food in combination with useful microorganisms such as bacteria strains of Lactobacillus and Streptococcus resulted in the microorganism growth and their stability during product storage.^{27 29 43 47}

It is widely known that oxidative stress impacts on cancer cell proliferation. Therefore, the antioxidant properties of spirulina make her a strong anticancer factor.

Research has shown that phycocyanin administration in mouse with liver cancer gradually increased their lifespan possible because of the antioxidant activity of phycocyanin which repressed the free radical carcinogenesis⁴⁴.

Another study concluded that phycocyanin could be a chemotherapeutic factor due to its apoptotic activity against cancer cells³⁰ while the anticancer activity of spirulina plays an important role in haematopoietic function through the increased numbers of immune cells and therefore boosting the immune system⁴⁶.

Furthermore, research in animal models showed that spirulina’s extract administered directly in tumours repressed their growth³⁹.

Lastly, clinical studies carried out in patients diagnosed with oral leucoplakia, which is the most common potentially malignant disorder affecting the oral mucosa, administered of spirulina for a year resulted in the suspension of the disorder in 45% of the participants ⁴⁴.

It should be highlighted that in order to understand the anticancer action of spirulina further research has to be done.