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Open AccessBrief Report

Antioxidant Saffron and Central Retinal Function in ABCA4-Related Stargardt Macular Dystrophy

1
Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli- IRCCS, 00168 Rome, Italy
2
Dipartimento di Malattie Cardiovascolari, endocrino-metaboliche e invecchiamento, Istituto Superiore di Sanità, 00168 Rome, Italy
3
Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA
4
Dipartimento di Oftalmologia Pediatrica, Università di Salerno, 84084 Salerno, Italy
5
Istituto di Oftalmologia, Università Cattolica del S. Cuore, 00168 Rome, Italy
6
Laboratorio di Genetica Medica e Biologia Molecolare, MAGI, 38068 Rovereto, Italy
7
Dipartimento di Scienze Cliniche Applicate e Biotecnologie, Università dell’Aquila, 67100 L’Aquila, Italy
8
Istituto Nazionale Biosistemi e Biostrutture, 00168 Rome, Italy
9
Istituto Italiano di Tecnologia, NetS3 Laboratory, Neuroscience and Brain Technologies (NBT), 16100 Genova, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(10), 2461; https://doi.org/10.3390/nu11102461
Received: 1 August 2019 / Revised: 30 September 2019 / Accepted: 1 October 2019 / Published: 15 October 2019
Retinal oxidative damage, associated with an ATP-binding cassette, sub-family A, member 4, also known as ABCA4 gene mutation, has been implicated as a major underlying mechanism for Stargardt disease/fundus flavimaculatus (STG/FF). Recent findings indicate that saffron carotenoid constituents crocins and crocetin may counteract retinal oxidative damage, inflammation and protect retinal cells from apoptosis. This pilot study aimed to evaluate central retinal function following saffron supplementation in STG/FF patients carrying ABCA4 mutations. Methods: in a randomized, double-blind, placebo-controlled study (clinicaltrials.gov: NCT01278277), 31 patients with ABCA4-related STG/FF and a visual acuity >0.25 were randomly assigned to assume oral saffron (20 mg) or placebo over a six month period and then reverted to P or S for a further six month period. Full ophthalmic examinations, as well as central 18° focal electroretinogram (fERG) recordings, were performed at baseline and after six months of either saffron or placebo. The fERG fundamental harmonic component was isolated by Fourier analysis. Main outcome measures were fERG amplitude (in µV) and phase (in degrees). The secondary outcome measure was visual acuity. Results: supplement was well tolerated by all patients throughout follow-up. After saffron, fERG amplitude was unchanged; after placebo, amplitude tended to decrease from baseline (mean change: −0.18 log µV, p < 0.05). Reverting the treatments, amplitude did not change significantly. fERG phase and visual acuity were unchanged throughout follow-up. Conclusions: short-term saffron supplementation was well tolerated and had no detrimental effects on the electroretinographic responses of the central retina and visual acuity. The current findings warrant further long-term clinical trials to assess the efficacy of saffron supplementation in slowing down the progression of central retinal dysfunction in ABCA4-related STG/FF. View Full-Text
Keywords: ABCA4 gene mutation; antioxidants; focal electroretinogram; neuroprotection; photoreceptors; saffron; retinal function; personalized medicine ABCA4 gene mutation; antioxidants; focal electroretinogram; neuroprotection; photoreceptors; saffron; retinal function; personalized medicine
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MDPI and ACS Style

Piccardi, M.; Fadda, A.; Martelli, F.; Marangoni, D.; Magli, A.; Minnella, A.M.; Bertelli, M.; Di Marco, S.; Bisti, S.; Falsini, B. Antioxidant Saffron and Central Retinal Function in ABCA4-Related Stargardt Macular Dystrophy. Nutrients 2019, 11, 2461.

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