{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T20:17:33Z","timestamp":1771273053104,"version":"3.50.1"},"reference-count":51,"publisher":"Akademiai Kiado Zrt.","issue":"2","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["EuJMI"],"published-print":{"date-parts":[[2025,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cocoa that is abundant in dark chocolate is known for its anti-inflammatory effects that are mainly due to biologically active ingredients like polyphenols and methylxanthines. We here provide a comprehensive literature survey of both, <jats:italic>in vitro<\/jats:italic> and <jats:italic>in vivo<\/jats:italic> studies including clinical trials summarizing recent evidence on the immune-modulatory effects exerted by application of cocoa-rich dark chocolate or distinct cocoa-derived molecules. The survey revealed that dark chocolate and its derivatives could effectively dampen pro-inflammatory including oxidative stress responses in vascular diseases including atherosclerosis, hypertension, and decompression sickness, metabolic morbidities such as obesity and type 2 diabetes mellitus, celiac disease, chronic kidney diseases, and polycystic ovary syndrome, enhance gut epithelial barrier function, and modulate pain sensations. On\u00a0the other hand, dark chocolate consumption intake was found to worsen acne symptoms. In\u00a0conclusion, dietary supplementation with dark chocolate with high contents of biologically active polyphenols and methylxanthines might be promising adjunct immune-modulatory treatment options\u00a0of distinct acute as well as chronic inflammatory morbidities that need to be evaluated in more detail in future <jats:italic>in vivo<\/jats:italic> including clinical studies.<\/jats:p>","DOI":"10.1556\/1886.2025.00007","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T08:24:59Z","timestamp":1742804699000},"page":"74-82","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":1,"title":["Come to the dark side \u2013 A review on the health-beneficial and disease-alleviating effects\u00a0of cocoa-rich dark chocolate"],"prefix":"10.1556","volume":"15","author":[{"given":"Heike","family":"Muth","sequence":"first","affiliation":[{"name":"Institute of Microbiology, Infectious Diseases and Immunology, Gastrointestinal Microbiology Research Group, Charit\u00e9 \u2013 University Medicine Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Bereswill","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Infectious Diseases and Immunology, Gastrointestinal Microbiology Research Group, Charit\u00e9 \u2013 University Medicine Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6399-651X","authenticated-orcid":true,"given":"Markus M.","family":"Heimesaat","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Infectious Diseases and Immunology, Gastrointestinal Microbiology Research Group, Charit\u00e9 \u2013 University Medicine Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"issue":"11","key":"B1","series-title":"Antioxidants (Basel)","first-page":"1376","article-title":"Exploring the therapeutic potential of theobroma cacao L.: insights from in vitro, in vivo, and nanoparticle studies on anti-inflammatory and anticancer effects","volume":"13","author":"Sitarek P","year":"2024","unstructured":"Sitarek P, Merecz-Sadowska A, Sikora J, Osicka W, \u015apiewak I, Picot L, et al. Exploring the therapeutic potential of theobroma cacao L.: insights from in vitro, in vivo, and nanoparticle studies on anti-inflammatory and anticancer effects. Antioxidants (Basel). 2024;13(11):1376. https:\/\/doi.org\/10.3390\/antiox13111376."},{"issue":"2","key":"B2","series-title":"Food Funct","first-page":"514","article-title":"The effects of polyphenols and other bioactives on human health","volume":"10","author":"Fraga CG","year":"2019","unstructured":"Fraga CG, Croft KD, Kennedy DO, Tom\u00e1s-Barber\u00e1n FA. The effects of polyphenols and other bioactives on human health. Food Funct. 2019;10(2):514\u201328."},{"key":"B3","series-title":"Curr Res Food Sci","first-page":"1916","article-title":"Dark chocolate: an overview of its biological activity, processing, and fortification approaches","volume":"5","author":"Samanta S","year":"2022","unstructured":"Samanta S, Sarkar T, Chakraborty R, Rebezov M, Shariati MA, Thiruvengadam M, et\u00a0al. Dark chocolate: an overview of its biological activity, processing, and fortification approaches. Curr Res Food Sci. 2022;5:1916\u201343."},{"issue":"11\u201312","key":"B4","series-title":"Eur Food Res Technol.","first-page":"2101","article-title":"Changes in the composition and content of polyphenols in chocolate resulting from pre-treatment method of cocoa beans and technological process","volume":"245","author":"Urbanska B","year":"2019","unstructured":"Urbanska B, Derewiaka D, Lenart A, Kowalska J. Changes in the composition and content of polyphenols in chocolate resulting from pre-treatment method of cocoa beans and technological process. Eur Food Res Technol. 2019;245(11\u201312):2101\u20132112."},{"key":"B5","series-title":"Food Chem Toxicol","article-title":"Impact of cocoa flavanols on human health","volume":"151","author":"Martin M","year":"2021","unstructured":"Martin M, Ramos S. Impact of cocoa flavanols on human health. 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