**Acknowledgements**

*Tannins - Structural Properties, Biological Properties and Current Knowledge*

are essential to corroborate the real effect of urolithins on cancer.

*5.2.3 Reducing risks of cardiovascular disease (CVD)*

notable only in UM-B patients [48].

cyte chemotactic protein, respectively [77].

**6. Concluding remarks**

of genes regulated by the experimental protocol, these results were not associated with the individual metabotypes or the levels of urolithins and EA in the colon tissues. Consequently, the in vitro effects were not reproduced in vivo evidencing discrepancy between results [70]. In general, we can conclude that there is a lack of clinical interventions with ET-rich food in humans; besides, these kinds of studies

The gut microbiota is frequently presented as a key factor in the evolution of obesity and cardiovascular disorders (CVD) [74]. One clinical study clustered urolithin metabotypes (UMs) of 18 healthy overweight/obese subjects with the aim of correlating metabotype status with CVD biomarkers after pomegranate extract consumption. In baseline and before UM clustering, the whole group exhibited mild dyslipidemia, and after clustering, only the serum lipid profile of UM-B individuals (n = 15) showed moderate risk values in total cholesterol, intermediate-LDLcholesterol, as well as other serum lipids related to CVD risk. After ET intervention, only blood biomarkers of UM-B subjects were improved after pomegranate extract intake, reducing their CVD risk. Interestingly, a dose-dependent behavior was

Another experiment comparing healthy patients with patients with metabolic syndrome (MetS), both consuming walnuts, showed that urolithin A only was inversely correlated with glycaemia in MetS individuals. Additionally, when MetS patients with UM-A were treated with statin, their lipid profile became similar to

Endothelial dysfunction and inflammation are both usual events that occur in the development of atherosclerosis. The correlation between the plasma urolithin metabolites and improvement in endothelial function after red raspberry intake was reported. Endothelial function measured as flow media vasodilation (FMD) presented two peaks, first at 1–2 h after intake, linked with EA plasma peak concentration, and second peak at 24 h, associated with urolithin-3-glucuronide and urolithin-A-sulfate absorption peaks. Similar results were reported by other authors in cranberry and blueberry juice interventions [75], but it was shown that effect was the same when consuming 200 or 400 g of raspberries. Additional distinctive key factors in atherosclerosis development have been reported, as the capacity of monocytes to adhere to endothelial cells and the uptake and efflux of cholesterol by macrophages. In vitro, urolithins and EA were able to reduce adhesion of THP-1 monocytes to human umbilical vein endothelial cells and reduce secretion of sVCAM-1 and IL-6, a cellular adhesion molecule and a pro-inflammation cytokine, respectively. Also, urolithin C and EA were associated with decreased accumulation of cholesterol in THP-1–derived macrophages [76]. Attenuation of THP-1 also was reported in the presence of urolithin A in endothelial cells and also reduced considerably the expressions of ICAM-1 and MCP-1, an intercellular adhesion molecule and a mono-

Ellagitannins are present in considerable amounts only in some specific food sources such as berries and nuts, but some tropical fruits deserve attention. Their

healthy individuals. This was not the case for individuals with UM-B [74]. Another study showed that the increasing relative importance within the microbiota of bacteria from the Coriobacteriaceae family such as *Olsenella, Senegalimassilia, and Slackia*, which characterized UM-B status, was positively cor-

related with blood cholesterol levels and normal BMI [49].

**32**

This publication was jointly financed by the International Research Center in Agronomy for Development (CIRAD), Montpellier, France, and the Colombian Research Cooperation in Agronomy (AGROSAVIA), Colombia. Karen Johana Ortega is a PhD student with a scholarship granted by the Colombian government through Colciencias 727-2015 announcement.
