9-cis β-carotene-rich powder of the alga Dunaliella bardawil increases plasma HDL-cholesterol in fibrate-treated patients

Aviv Shaish*, Ayelet Harari, Lea Hananshvili, Hofit Cohen, Rafael Bitzur, Tamar Luvish, Esfir Ulman, Moria Golan, Ami Ben-Amotz, Dov Gavish, Zeev Rotstein, Dror Harats

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


The effect of fibrates on high density lipoprotein (HDL)-cholesterol levels is suggested to be mediated by its binding to peroxisome proliferator-activated receptor-α (PPARα). Upon ligand binding, PPARα heterodimerizes with the 9-cis retinoic acid receptor (RXR) and it is this heterodimer which regulates gene expression. We assessed the hypothesis that a combined treatment with fibrate plus 9-cis β-carotene-rich powder of the alga Dunaliella bardawil, as a source of 9-cis retinoic acid, would improve the drug's effect on HDL-cholesterol levels. In an open-labeled first trial, 20 fibrate-treated men with plasma HDL-cholesterol levels below 40 mg/dl were given Dunaliella capsules, providing 60 mg β-carotene/day, containing all-trans and 9-cis β-carotene (1:1 ratio, w/w). Twenty-two fibrate-treated patients participated in a double-blind placebo-controlled second trial. Eleven patients were treated with Dunaliella capsules, and 11 patients were treated with β-carotene-deficient Dunaliella capsules. Following 6 weeks of the dual treatment plasma HDL-cholesterol increased by 24.5 and 12.7% in the first and second trials, respectively (P = 0.002 and 0.012). The dual treatment also increased HDL-cholesterol levels in human apolipoprotein A-I transgenic mice by 87.5% (P = 0.021). The results show that a combination treatment of fibrate plus 9-cis β-carotene-rich Dunaliella powder amplifies the effect of the drug on HDL-cholesterol levels.

Original languageEnglish
Pages (from-to)215-221
Number of pages7
Issue number1
StatePublished - Nov 2006


  • 9-cis retinoic acid
  • 9-cis β-carotene
  • ApoA-I
  • Atherosclerosis
  • HDL-cholesterol
  • Human apoA-I


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