POS1352 ANTIINFLAMMATORY, ANTIOXIDANT AND ANTI-ATHEROSCLEROTIC EFFECTS OF A COMBINATION OF NATURAL SUPPLEMENTS ON PATIENTS WITH FMF RELATED AA AMYLOIDOSIS: A NON-RANDOMIZED 24 WEEKS OPEN LABEL INTERVENTIONAL STUDY

Background: Few studies have focused on Familial Mediterranean Fever (FMF)-related AA amyloidosis and cardiovascular disease event risk. Systemic inflammation stimulates the development progression of atherosclerosis which is accelerated by vascular endothelial enhanced oxidative stress. Excessive reactive oxygen species (ROS) generation has been reported in FMF, correlated with attack severity. ROS may also be involved amyloid formation, pathogenesis progressive renal injury. Objectives: In this non-randomized, 24 weeks open label interventional study, we aimed to evaluate effect a combination natural products parameters related inflammation, dysfunction stress cohort FMF patients amyloidosis. Methods: Morinda citrifolia (anti-atherosclerotic liquid- AAL), omega-3 (anti-inflammatory capsules- AIC) extract Alaskan blueberry (anti-oxidant AOL) were given We included biopsy proven amyloidosis, older than 18 years who normal estimated glomerular filtration rate (eGFR) proteinuria [>3500mg/day]. Flow-mediated dilatation (FMD), asymmetric dimethylarginine (ADMA), hs-CRP, serum PTX3, Carotis intima media thickness (CIMT), malondialdehyde (MDA), Cu/Zn-superoxide dismutase (Cu/Zn-SOD), glutathione peroxidase (GSH-Px) levels studied baseline after weeks. Results: 67 FMF-related [52 male (77.6%); median recruitment age 36 (range 21-66)] enrolled. M694V mutation was most common found (74%), 50.7% homozygosity. All treated colchicine, them (83.6%) colchicine treatment at time enrollment. Serum ADMA, MDA, hsCRP, cholesterol, significantly decreased compared baseline, while CuZn-SOD, GSH-Px FMD increased following AAL, AIC AOL therapies (Table 1). The change inflammatory markers hsCRP negatively positively proteinuria, cholesterol CIMT. Conclusion: combined supplementation associated reduction (PTX3 hsCRP), improved functions (FMD, ADMA), state (MDA). Our findings highlight link among three pathogenetic mechanisms including function status injury Efficient control these can long term benefits from perspective References: [1]Romano M et al. Sci Rep, 2020 [2]Yilmaz Table 1. Comparison clinical laboratory characteristics Baseline Mean (SD) 24th week Delta p Total Cholesterol (mg/dl) 221.2 (60.3) 155.8 (35.4**) -65.3 (55.5) <0.001 eGFR (ml/min/ 1.73 m2) 110.2 (12.8) 104.1 (11.2**) -6.1 (11.9) Malondialdehyde (MDA) (nmol/ml) 4.2 (1.8) 1.8 (0.5**) -2.2 CuZn-SOD (U/ml) 431.5 (154.7) 538.1 (146.4**) 159.7 (211.8) 47.8 (13.2) 74.1 (20.3**) 26.3 (21.1) ADMA (µmol/l) 4.5 (2.6) 1.3 (0.6**) -3.2 (2.5) (%) 5.0 (0.7) 6.4 (0.8**) (0.9) CIMT (mm) 0.9 (0.2) 0.7 (0.1) -0.2 Proteinuria (mg/24h) 6855.3 (3116.9) 4079.9 (2359.6) -2775.3 (2874.5) hs-CRP (mg/l) 25.5 (4.4-48.0) 3.0 (1.0-9.1)* -20.8 (11.2) PTX3 (ng/ml) 13.4 (2.3-67.0) 2.3 (0.4-14.5)* -17.5(17.5) Disclosure Interests: None declared