To investigate the usage patterns of complementary and alternative medicines (CAMs), as well as dietary interventions, by South Australian people with multiple sclerosis (MS).
DESIGN:
Self-administered postal survey.
SETTING:
Questionnaire mailed to recipients of the South Australian (SA) MS Society newsletter (n=1230).
MAIN OUTCOME MEASURES:
Patterns of CAMs use and dietary interventions, reasons for using/not using CAMs in MS, sources of CAMs information and monthly expenditure on CAMs/dietary interventions.
RESULTS:
A total of 428 surveys were returned (response rate 34.8%) of which 416 met the inclusion criteria for analysis. The majority of SA people with MS who responded reported using CAMs/dietary interventions (64.7%). Respondents with tertiary education and those with mild and moderate disease reported highest CAM use.
The most frequently used CAM product categories were vitamins (81.8%), essential fatty acids (80.7%) and minerals (62.5%). Commonly used herbal products included Ginkgo biloba (18.2%) and valerian (16.4%). Popular diets were the low fat (39.8%), low/no sugar (23.8%) and gluten-free (16.4%) diets.
The majority of those using CAMs/dietary interventions did so concurrently with conventional treatments (72.1%). Reasons for use included: general health and well-being; to alleviate 'general' as well as specific MS symptoms such as muscle weakness, urinary or memory problems and mobility.
Conventional health professionals, and friends/family, were the most common sources of information. Monthly expenditure was most commonly AUD$20-49/month.
CONCLUSION:
This study reports frequent use of CAM/dietary intervention amongst SA people with MS. The majority of users did so in conjunction with conventional treatments.
"Complementary and alternative medicines and dietary interventions in multiple sclerosis: What is being used in South Australia and why?"
Complement Ther Med. 2009 Aug; 17(4): 216-23Leong EM, Semple SJ, Angley M, Siebert W, Petkov J, McKinnon RA
Compound Cordyceps TCM-700C exhibits potent hepatoprotective capability in animal model.
A herbal preparation "Compound Codyceps-TCM-700C (CC-700C)" was tested for hepatoprotective effect against the carbon tetrachloride induced liver damages in Sprague-Dawley rat model for a period of 6-weeks. Two dosage levels of CC-700C, respectively 286.2mg/kg-bw (L-TCM) and 2862mg/kg-bw (H-TCM), and a positive control Silymarin (Sigma) were used to compare their therapeutic effect.
Both CC-700C's and Silymarin showed nontoxic in nature, as evidenced by body weight gain, organ weights and appearance including liver, spleen, and kidney. The activities of aspartate aminotransferase (AST) and alanine-aminotransferase (ALT) were more effectively suppressed by CC-700C than Silymarin.
In addition, all levels of serum bilirubin, serum albumin, triglyceride (TG), total cholesterol (TC), platelet count (PLT), and prothombin time (PT) except TG were shown effectively restored to normal values by CC-700C and Silymarin.
Moreover, although levels of glutathione (GSH), glutathione reductase (GSH-Rd), and superoxide dismutase (SOD) were equally maintained by these three preparations, glutathione peroxidase (GSH-Px) was suppressed only by H-TCM, and SOD only by Silymarin. In contrast, the activity of catalase efficiently recovered to control level on administration of CC-700C, being far better than Silymarin.
Finally the liver collagen content, an indication of fibrosis, was also significantly suppressed by CC-700C, better effect was by L-TCM, but both levels were superior to Silymarin. Conclusively, the herbal preparation "Compound Cordyceps TCM-700C" is a potent hepatoprotective preparation. For therapeutic use, a dosage of 286.2mg/kg-bw would be sufficiently effective.
"Compound Cordyceps TCM-700C exhibits potent hepatoprotective capability in animal model"
Fitoterapia. 2009 Jul 8; Ko WS, Hsu SL, Chyau CC, Chen KC, Peng RY
Both CC-700C's and Silymarin showed nontoxic in nature, as evidenced by body weight gain, organ weights and appearance including liver, spleen, and kidney. The activities of aspartate aminotransferase (AST) and alanine-aminotransferase (ALT) were more effectively suppressed by CC-700C than Silymarin.
In addition, all levels of serum bilirubin, serum albumin, triglyceride (TG), total cholesterol (TC), platelet count (PLT), and prothombin time (PT) except TG were shown effectively restored to normal values by CC-700C and Silymarin.
Moreover, although levels of glutathione (GSH), glutathione reductase (GSH-Rd), and superoxide dismutase (SOD) were equally maintained by these three preparations, glutathione peroxidase (GSH-Px) was suppressed only by H-TCM, and SOD only by Silymarin. In contrast, the activity of catalase efficiently recovered to control level on administration of CC-700C, being far better than Silymarin.
Finally the liver collagen content, an indication of fibrosis, was also significantly suppressed by CC-700C, better effect was by L-TCM, but both levels were superior to Silymarin. Conclusively, the herbal preparation "Compound Cordyceps TCM-700C" is a potent hepatoprotective preparation. For therapeutic use, a dosage of 286.2mg/kg-bw would be sufficiently effective.
"Compound Cordyceps TCM-700C exhibits potent hepatoprotective capability in animal model"
Fitoterapia. 2009 Jul 8; Ko WS, Hsu SL, Chyau CC, Chen KC, Peng RY
Herbals in the Control of Ageing
The significance of herbals and herbal products is gaining world wide recognition. The concept of complementary or alternative medicine is becoming much more widely accepted and there is an increasing belief in the efficacy of herbal remedies.
Recently, the role of herbal drugs, herbal products and certain phytochemicals in the control of ageing has been documented using modern scientific approaches. This review pulls together such studies and critiques the efficacy and value of herbal medicines in the control of the ageing process.
Herbals in the Control of Ageing
Drug Discov Today. 2009 Jul 8; Kapoor VK, Dureja J, Chadha RT (Hubmed)
Related :
Will Herbal Supplements Help You Get Rid of Your Wrinkle Problem?
The reality we must face is that as much as we cannot change nature, there are some things that we can deliberately do to minimize the inevitable effects of the aging process.
Make Sure Herbal Skin Care Products Can Really Help
It's not an herbal treatment for the skin, but it is the most important ingredient for preventing the signs of aging. Whatever you do, investigate the ingredients in herbal skin care lotions carefully
Fight the Effects of Age with Ease with Herbal Anti Aging Products
Herbal vitamins and anti aging supplements have now become very popular ways of fighting the effects of advancing age. Other than fulfilling the deficiencies in the body, these herbal vitamins and anti aging products also help
Herbal Anti-Aging Supplement–Why You Should Consider It?
It seems like there's an herbal anti-aging supplement on practically every shelf of health food stores today.
Herbal Life for Healthy Life
You can use Herbal Nutrition to be one step closer to the health life and it can be a great anti aging. It will fix your improper nutrition into proper nutrition.
How to Delay Aging ? Herbal Rhodiola Extract
Rhodiola rosea is now, according to recent research, becoming more widely accepted in the U.S. as a powerful anti-aging, anti-stress formula.
Recently, the role of herbal drugs, herbal products and certain phytochemicals in the control of ageing has been documented using modern scientific approaches. This review pulls together such studies and critiques the efficacy and value of herbal medicines in the control of the ageing process.
Herbals in the Control of Ageing
Drug Discov Today. 2009 Jul 8; Kapoor VK, Dureja J, Chadha RT (Hubmed)
Related :
Will Herbal Supplements Help You Get Rid of Your Wrinkle Problem?
The reality we must face is that as much as we cannot change nature, there are some things that we can deliberately do to minimize the inevitable effects of the aging process.
Make Sure Herbal Skin Care Products Can Really Help
It's not an herbal treatment for the skin, but it is the most important ingredient for preventing the signs of aging. Whatever you do, investigate the ingredients in herbal skin care lotions carefully
Fight the Effects of Age with Ease with Herbal Anti Aging Products
Herbal vitamins and anti aging supplements have now become very popular ways of fighting the effects of advancing age. Other than fulfilling the deficiencies in the body, these herbal vitamins and anti aging products also help
Herbal Anti-Aging Supplement–Why You Should Consider It?
It seems like there's an herbal anti-aging supplement on practically every shelf of health food stores today.
Herbal Life for Healthy Life
You can use Herbal Nutrition to be one step closer to the health life and it can be a great anti aging. It will fix your improper nutrition into proper nutrition.
How to Delay Aging ? Herbal Rhodiola Extract
Rhodiola rosea is now, according to recent research, becoming more widely accepted in the U.S. as a powerful anti-aging, anti-stress formula.
Role of Iodine, Selenium and Other Micronutrients in Thyroid Function and Disorders.
Endocr Metab Immune Disord Drug Targets. 2009 Sep 1; Triggiani V, Tafaro E, Giagulli VA, Sabbà C, Resta F, Licchelli B, Guastamacchia EMicronutrients, mostly iodine and selenium, are required for thyroid hormone synthesis and function. Iodine is an essential component of thyroid hormones and its deficiency is considered as the most common cause of preventable brain damage in the world. Nowadays about 800 million people are affected by iodine deficiency disorders that include goiter, hypothyroidism, mental retardation, and a wide spectrum of other growth and developmental abnormalities. Iodine supplementation, under form of iodized salt and iodized vegetable oil, produced dramatic improvements in many areas, even though iodine deficiency is still a problem not only for developing countries. In fact, certain subpopulations like vegetarians may not reach an adequate iodine intake even in countries considered iodine-sufficient. A reduction in dietary iodine content could also be related to increased adherence to dietary recommendations to reduce salt intake for preventing hypertension. Furthermore, iodine intakes are declining in many countries where, after endemic goiter eradication, the lack of monitoring of iodine nutrition can lead to a reappearance of goiter and other iodine deficiency disorders. Three different selenium-dependent iodothyronine deiodinases (types I, II, and III) can both activate and inactivate thyroid hormones, making selenium an essential micronutrient for normal development, growth, and metabolism. Furthermore, selenium is found as selenocysteine in the catalytic center of enzymes protecting the thyroid from free radicals damage. In this way, selenium deficiency can exacerbate the effects of iodine deficiency and the same is true for vitamin A or iron deficiency. Substances introduced with food, such as thiocyanate and isoflavones or certain herbal preparations, can interfere with micronutrients and influence thyroid function. Aim of this paper is to review the role of micronutrients in thyroid function and diseases.
[Effects of Liangxue Jiedu Decoction in treating psoriasis in a mouse psoriasis model.]
Zhong Xi Yi Jie He Xue Bao. 2009 Jun; 7(6): 552-6Gu MJ, Gao SP, Li YMObjective: To study the effects of Liangxue Jiedu Decoction, a compound traditional Chinese herbal medicine with the function of blood-cooling and detoxicating, in treating psoriasis in mice and to explore its mechanism. Methods: (1) Sixty mice were randomly divided into Liangxue Jiedu Decoction group, compound Indigo Naturalis capsule group, acitretin capsule group and normal saline group. Another 10 mice were selected as blank control. After 2-week administration, mice were sacrificed to obtain samples. After hematoxylin and eosin (HE) staining, tail scales with granular layers were calculated by an optical microscope. (2) Except for ten mice in blank group, sixty female mice were injected intraperitoneally with diethylstilbestrol once daily. After 3-day injection, mice were randomly divided into four groups and treated as above description. After 2-week treatment, all mice were injected intraperitoneally with colchicine (2 mg/kg), and sacrificed 6 h after the injection. The mitotic rate in virginal epithelium was calculated after HE staining. Results: Compared with normal saline, Liangxue Jiedu Decoction could significantly inhibit the mitosis of mouse vaginal epithelium (P
[Anti-inflammatory effects and quantitative study of the combinations of active ingredients of Painong powder in mice.]
Zhong Xi Yi Jie He Xue Bao. 2009 Jun; 7(6): 541-5Chen JC, Li LJ, Wen SM, He YC, Liu HX, Zheng QSObjective: To study the anti-inflammatory effects of the combinations of active components of Painong powder, a compound traditional Chinese herbal medicine, and the quantitative analysis of their interactions. Methods: The mouse model of acute inflammation with increase of capillary permeability was induced by intraperitoneal injection of acetic acid. An orthogonal design with 2 levels (used and unused) was applied to assign the combinations groups of active ingredients including naringin and neohesperidin, peoniflorin, and platycodin. Aspirin and normal saline were administered as control. The pharmacodynamic interactions were analyzed by the optical density (OD) of infiltrated Evans blue. Results: The different combinations of active ingredients showed anti-inflammatory effect with different degree, and the predicted values of OD varied from 0.115 to 0.170. The maximum anti-inflammatory effect was from the combination of naringin, neohesperidin, paeoniflorin and platycodin, better than that of the saline group (P0.05). Paeoniflorin showed a dominant contribution to the formula, and platycodin the least. The combination of all active components exhibited synergism. Conclusion: The results suggest that all the ingredients are efficacious constituents of the formula, and paeoniflorin shows a dominant contribution to the formula. More information about prescription compatibility can be obtained by the orthogonal simulation method.
Spice: A never ending story?
Forensic Sci Int. 2009 Jul 7; Lindigkeit R, Boehme A, Eiserloh I, Luebbecke M, Wiggermann M, Ernst L, Beuerle TOn January 22nd 2009, the German Health Authorities prohibited several non-traditional cannabinoids, that proved to be the active components in popular "Bio-Designer-Drugs" like "Spice" and analogous products. The recent detection of CP 47,497-C8 in Europe and Japan documents that these products have already spread world wide. We synthesized several potentially interesting alkylaminoindoles (alkylchain C(3) to C(7)) and isolated CP 47,497-C8 from "Spice Gold". The compounds were purified and characterized by NMR and mass spectrometry methods. With the aid of these authentic references we were able to detect and quantify added psychoactive compounds in different herbal blends. All samples that were acquired before the prohibition in December 2008 contained either CP 47,497-C8 (5.4-11.0mg/g) or JWH-018 (2.3mg/g). Some samples acquired in March 2009, 4 weeks after the prohibition took place, still contained CP 47,497-C8 (3.0-3.3mg/g) but JWH-018 was not detected anymore. Instead it was replaced by its non-regulated C(4)-homolog JWH-073 (5.8-22.9mg/g). Furthermore some of the new products did not contain any non-traditional cannabinoids. To our knowledge this is the first report of the appearance JWH-073 as a new designer drug. The data and method presented here will facilitate and accelerate the detection of these compounds in complex matrices.
Serenoa repens (Saw Palmetto): A Systematic Review of Adverse Events.
Drug Saf. 2009; 32(8): 637-47Agbabiaka TB, Pittler MH, Wider B, Ernst ESerenoa repens (W. Bartram) Small, also known as saw palmetto, is one of the most widely used herbal preparations for the treatment of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Although a number of randomized controlled trials (RCTs) and systematic reviews of the efficacy of S. repens for the treatment of LUTS and BPH have been published, no systematic review on its drug interactions or adverse events currently exists. This review assesses all available human safety data of S. repens monopreparations. Systematic literature searches were conducted from date of inception to February 2008 in five electronic databases; reference lists and our departmental files were checked for further relevant publications. Information was requested from spontaneous reporting schemes of the WHO and national safety bodies. Twenty-four manufacturers/distributors of S. repens preparations and four herbalist organizations were contacted for additional information. No language restrictions were imposed. Only reports of adverse events in humans from monopreparations of S. repens were included. Data from all articles, regardless of study design, reporting adverse events or interactions were independently extracted by the first author and validated by the second. Forty articles (26 randomized controlled trials, 4 non-randomized controlled trials, 6 uncontrolled trials and 4 case reports/series) were included. They suggest that adverse events associated with the use of S. repens are mild and similar to those with placebo. The most frequently reported adverse events are abdominal pain, diarrhoea, nausea, fatigue, headache, decreased libido and rhinitis. More serious adverse events such as death and cerebral haemorrhage are reported in isolated case reports and data from spontaneous reporting schemes, but causality is questionable. No drug interactions were reported. Currently available data suggest that S. repens is well tolerated by most users and is not associated with serious adverse events. The majority of adverse events are mild, infrequent and reversible, and include abdominal pain, diarrhoea, nausea and fatigue, headache, decreased libido and rhinitis. We found no evidence for drug interactions with S. repens. However, higher quality reporting of adverse events is essential if safety assessments are to be improved in future.
Remedies containing asteraceae extracts: a prospective observational study of prescribing patterns and adverse drug reactions in german primary care.
Drug Saf. 2009; 32(8): 691-706Jeschke E, Ostermann T, Lüke C, Tabali M, Kröz M, Bockelbrink A, Witt CM, Willich SN, Matthes HThe use of complementary therapies by patients has increased over the past 20 years, both in terms of self-medication and physician prescriptions. Among herbal medicines, those containing extracts of Asteraceae (Compositae), such as Echinacea spp., Arnica montana, Matricaria recutita and Calendula officinalis, are especially popular in the primary-care setting. However, there remains a gap between the growing acceptance of these remedies and the lack of data on their safety. The aim of this study was to analyse prescribing patterns and adverse drug reactions (ADRs) for Asteraceae-containing remedies in Germany. Primary-care physicians, all of whom were members of the German National Association of Anthroposophic Physicians were invited to participate in this prospective, multicentre, observational study. During the study period (September 2004 to September 2006), all prescriptions and suspected ADRs for both conventional and complementary therapies were documented using a web-based system. The study centre monitored all ADR reports and conducted a causality assessment according to Uppsala Monitoring Centre guidelines. Relative risks (RRs) and proportional reporting ratios (PRRs) were calculated. Thirty-eight physicians, 55% of whom were general practitioners and 45% were specialists, fulfilled the technical requirements and were included in the investigation. Because documenting all ADRs (i.e. serious and nonserious) was time consuming, only a subgroup consisting of seven physicians agreed to report nonserious in addition to serious ADRs. During the study period, a total of 50 115 patients were evaluated and 344 ADRs for conventional and complementary remedies were reported. Altogether, 18 830 patients (58.0% female, 60.3% children) received 42 378 Asteraceae-containing remedies. The most frequently prescribed Asteraceae was Matricaria recutita (23%), followed by Calendula officinalis (20%) and Arnica montana (20%). No serious ADRs for Asteraceae-containing remedies were reported. In the analysis of the subgroup of seven physicians who also documented nonserious ADRs, 11 nonserious ADRs for Asteraceae-containing remedies occurred in 6961 patients, resulting in an RR of 0.13 (95% CI 0.07, 0.23). The majority of reported ADRs for Asteraceae-containing remedies were classified as uncommon. A subgroup analysis comparing phytotherapeutic and homoeopathic preparations did not reveal any relevant differences. The PRR for Asteraceae-containing remedies with respect to all other prescriptions was 1.7 (95% CI 1.0, 2.0) for the system organ class 'skin and subcutaneous tissue disorders' (six ADRs) and 1.0 (95% CI 0.3, 3.6) for 'gastrointestinal disorders' (three ADRs). Neither result was significant according to the PRR criteria developed by Evans et al. This is the first study to provide a systematic overview of prescribing patterns and ADRs for Asteraceae-containing remedies in the German primary-care sector. Asteraceae-containing remedies were used frequently in this context, especially among children. Our results indicate that treatment with Asteraceae-containing remedies is not associated with a high risk of ADRs.
Genotoxicity study of Hypiran and Chamomilla herbal drugs determined by in vivo supervital micronucleus assay with mouse peripheral reticulocytes.
Acta Biol Hung. 2009 Jun; 60(2): 177-83Kalantari H, Ashrafi Dashtearjandi A, Kalantar EThe growth in popularity of Over The Counter (OTC) of medicinal products or other natural sources have taken a very large share of healthcare system therefore it is essential to determine their safety as for as public health is concerned.In this study Maximum Tolerated Dose (MTD) was obtained according to CSGMT protocol presented by the Environmental Mutagen Society of Japan. The positive group received mitomycin C in dose of 0.5 mg/kg. The peripheral blood samples before treatment (zero time) were considered as negative control. The MTD of Hypiron was 12 ml/kg and for Chamomilla was 10 ml/kg. Doses of MTD, 1/2 MTD and 1/4 MTD were considered for test groups. Then blood samples were prepared 48 hours after first administration of drugs and kept on precoated Acridine orange slides. The scoring of micronucleated reticulocytes were carried out per 2000 counted reticulocytes in each slide by fluorescent microscope. The results were statistically analyzed. Results of Hypiran were compared with negative control group and the P value was P > 0.05, but the p value of Chamomilla was P < 0.05. Also, the p value of Hypiran and Chamomilla compared with historical negative control group was less, therefore Chamomilla herbal drog can be classified as equivocul category of genotoxicity and Hypiran did not show genotoxicity.
Protection afforded by a herbal medicine, Sho-seiryu-to (TJ-19), against oleic acid-induced acute lung injury in guinea-pigs.
J Pharm Pharmacol. 2009 Jul; 61(7): 925-32Yang CQ, Ishitsuka Y, Moriuchi H, Golbidi S, Jin ZJ, Irikura M, Irie TOBJECTIVES: The effect of a herbal medicine, Sho-seiryu-to (TJ-19), on oleic acid-induced lung injury, an animal model of acute respiratory distress syndrome or acute lung injury (ARDS/ALI), was examined. METHODS: Acute lung injury was induced by an intravenous injection of 15 mul/kg oleic acid to guinea-pigs. TJ-19 was administered by a single oral dose (3 g/kg) or by multiple oral doses (0.75 g/kg). KEY FINDINGS: The decrease in partial oxygen pressure of arterial blood (Pao(2)) and the increase in airway vascular permeability induced by the oleic acid injection were attenuated by a single dose of TJ-19. When TJ-19 was administered orally twice a day for two weeks and then oleic acid was injected, a potent prophylactic effect of the drug was observed. TJ-19 also prevented airway vascular hyperpermeability, lung cell injury, oxidative stress and thromboxane A(2) generation, associated with the oleic acid injection. CONCLUSIONS: TJ-19 significantly attenuated the oleic acid-induced lung injury probably through the antioxidative effect and inhibitory effect of thromboxane A(2) generation, although the precise inhibitory mechanisms were not fully elucidated due to the diversity in constituents of the herbal medicine. We suggest that TJ-19 is a promising drug candidate and a medicinal resource for preventing ARDS/ALI.
Evaluation of symptoms and palatability in healthy volunteers after ingestion of an iced dessert by using different flavours.
J Biol Regul Homeost Agents. 2009 Apr-Jun; 23(2): 127-31Gallo A, Gasbarrini G, Nicoletti M, Montalto M, Addolorato GIt is well-known that digestion has a pivotal role in maintaining a state of wellbeing. The influence of certain foods and some herbal drugs has been ascertained. Epidemiological data show that the Mediterranean diet, with a high consumption of fresh vegetables and fruit, mainly citrus, has a beneficial effect and plays a protective gastrointestinal role. Previously, we assessed the influence on the eventual occurrence of symptoms during digestion of an iced dessert containing a mixture of digestive plant extracts, citrus juices and liquors, showing that its ingestion does not cause significant gastrointestinal symptoms in healthy volunteers. Taking into consideration that sensory properties of food may also influence digestion, we also evaluated the palatability of the product. In order to evaluate the effect of different tastes on the digestive processes, we performed a further similar evaluation with two new flavours. The ingestion of these iced desserts at the end of the meal does not cause significant gastrointestinal symptoms. Moreover, palatability median score shows a good appreciation of the products. Therefore, the combination of digestive herbs, citrus juice and liquors in different flavours gives rise to a product with a positive mix of good palatability, favourable acceptance and herbal constituents, able to maintain a good digestive condition.
sigma-1 receptors in major depression and anxiety.
Expert Rev Neurother. 2009 Jul; 9(7): 1021-34Kulkarni SK, Dhir AMajor depression and anxiety are two of the major psychiatric disorders that have some overlapping pathophysiologies, the most significant being the dysfunction in the monoaminergic, GABAergic and glutamatergic systems. A large number of drugs that alter these neurotransmitter levels/systems are effective in the treatment of major depression and anxiety. However, full remission of the clinical symptoms has not been achieved, perhaps owing to the complex pathophysiology of the diseases. Thus, the search for newer targets and target-specific drugs continues. Recently, the role of sigma-receptors, particularly the sigma-1 receptor subtype, has been identified as a target for the pathophysiology of neuropsychiatric disorders, and sigma-1 receptor modulators are considered to be the drugs of the future for the treatment of major depression and anxiety. The present review attempts to discuss the role of sigma-1 receptors in the pathophysiology of major depression and anxiety and also tries to position the use of its receptor modulators in the treatment of these two major disorders. The role of sigma-1 receptors in the mechanism of antidepressant action of venlafaxine, bupropion, neurosteroids and one of the herbal antidepressants, berberine, is reviewed. Although, sigma-1 receptor modulators may be future therapeutic options, either as individual agents or adjuvants in the treatment of mental disorders, the topic needs further preclinical and clinical exploration.
Effect of sinomenine on the in vitro intestinal epithelial transport of selected compounds.
Phytother Res. 2009 Jul 7; Lu Z, Chen W, Viljoen A, Hamman JHHerbal products can interfere with allopathic medicinal treatment through pharmacokinetic and pharmacodynamic interactions. Although pharmacokinetic interactions that alter drug absorption may cause variable and unsatisfactory drug bioavailability, a drug absorption enhancement effect of a herb may be used to ensure sufficient absorption of poorly absorbable drugs. The effect of the hydrochloride salt of sinomenine, an alkaloid obtained from the plant Sinomenium acutum, on the transepithelial electrical resistance and transport of different compounds (including cimetidine, vitamin C, rutin, luteolin and insulin) across Caco-2 epithelial cell monolayers was investigated in this study. Sinomenine HCl induced a concentration dependent lowering effect on the transepithelial electrical resistance of Caco-2 cell monolayers, which was completely reversible. Sinomenine HCl significantly increased the transport of all the test compounds in the apical-to-basolateral direction compared with the control group and decreased the transport of cimetidine, a P-glycoprotein substrate, in the basolateral-to-apical direction. From these results it can be concluded that sinomenine HCl increases drug absorption across the intestinal epithelium by means of one or more mechanisms including a transient opening of the tight junctions (as indicated by a reduction in transepithelial electrical resistance) to allow for paracellular transport and/or inhibition of active drug efflux transport (as indicated by inhibition of basolateral-to-apical transport of cimetidine). Copyright (c) 2009 John Wiley & Sons, Ltd.
Effects of Bushen Kangshuai Tang in retrieving oxidative stress-induced reproductive defects in Caenorhabditis elegans.
Zhong Xi Yi Jie He Xue Bao. 2009 Jun; 7(6): 532-40Cao XG, Hou LL, Chen JX, Lu QObjective: To explore the function of Bushen Kangshuai Tang (BKT), a compound traditional Chinese herbal medicine, in alleviating oxidative stress-induced reproductive defects in organism nematode Caenorhabditis elegans. Methods: The L4-larvae were cultured with 25%, 50%, 75%, and 100% of BKT with the final concentration of 0.33 g/mL. Ultraviolet irradiation [20 J/(m(2).min)], heat-shock (36 degrees centigrade, 2 h), and paraquat treatment (2 mmol/L, 2h) were exerted as the stresses. Reproduction was assayed by the egg number in uterus, brood size, and generation time. Results: Ultraviolet irradiation, heat-shock, and paraquat treatment could significantly reduce egg number in uterus and brood size, increase generation time, and suppress activities of catalase and superoxide dismutase of the treated wild-type N2 nematodes. Administration of BKT did not cause toxic or altered effects on reproduction under wild-type background in C. elegans. However, BKT administration at higher concentrations could not only effectively alleviate the reproductive defects induced by ultraviolet irradiation, heat-shock, and paraquat treatment, but also increase the catalase and superoxide dismutase activities suppressed by ultraviolet irradiation, heat-shock, and paraquat treatment as compared with the control. Moreover, administration of BKT at higher concentrations could largely recover the reproductive defects formed in mev-1 mutant nematodes with elevated oxidative stress. Conclusion: Oxidative stress can negatively regulate the reproductive process, and the administration of high concentrations of BKT will largely retrieve the oxidative stress-induced reproductive defects in exposed nematodes.
Methodology of pharmacodynamic evaluation on Chinese herbal medicine based on syndrome differentiation.
Zhong Xi Yi Jie He Xue Bao. 2009 Jun; 7(6): 501-4Lu AP, Liu XW, Ding XRThe clinical application of Chinese herbal medicine should be based on syndrome differentiation in traditional Chinese medicine (TCM), and the pharmacological evaluation of herbal medicine in new drug discovery should be also based on the TCM syndrome differentiation. To clarify the Chinese herbal characteristics and mechanisms of action through pharmacological experiments is not only the inevitable requirement for Chinese herb modernization and internationalization, but also the key way to direct the clinical rational administration. Thus how to characterize the syndrome type in commonly used animal disease models becomes the key issue in pharmacological evaluation. Following the development of biomedicine, one important way to clarify the syndrome characteristics of animal disease model in the pharmacological evaluation is to compare the differences between the responsive and non-responsive animals, and to find out the responsiveness-related biocharacteristics. An important approach to set up the Chinese herbal pharmacological evaluation which is suitable for Chinese medicine differentiation is to utilize the method of surveying syndrome type with Chinese herb formula and select the responsive animal model to reflect certain syndrome type, and furthermore to clear up the syndrome characteristics of the animal model by investigating its modern biological basis and establishing the correct indications of special TCM syndrome type. This pharmacological evaluation way based on finding out the responsiveness-related biocharacteristics of herbal medicine could become more effective in evaluating drug effects, further improving the new drug discovery, and developing Chinese herbal medicine.
Suspected black cohosh hepatotoxicity-Challenges and pitfalls of causality assessment.
Maturitas. 2009 Jul 6; Teschke R, Bahre R, Genthner A, Fuchs J, Schmidt-Taenzer W, Wolff AOBJECTIVES: Black cohosh (BC) is a herbal drug or herbal dietary supplement used for treatment of menopausal symptoms. Recently, however, reports have appeared about the occurrence of rare toxic liver disease in an assumed relationship with the use of BC. METHODS: We have analyzed and reviewed the data of all 69 reported cases with suspected BC hepatotoxicity. Causality for BC was assessed utilizing the scale of the original structured quantitative Council for International Organizations of Medical Sciences (CIOMS), or the main-test as its updated form. RESULTS: With the hepatotoxicity specific causality assessment methods, there was an excluded, unlikely, unrelated or unassessable causality for BC in 68 of 69 cases with liver disease. One patient had a possible causality for BC and a symptomatic cholelithiasis with confounding variables of fatty liver of unknown etiology; unknown BC brand including possible herbal mixture; unknown daily BC dosage; and an unassessable duration of BC usage. In general, the cases of the 69 patients were poorly documented. Confounding variables were: failure to identify the BC product; use of herbal mixtures with multiple ingredients in addition to BC; co-medication with synthetic drugs and dietary supplements including herbal ones; missing temporal association between BC use and development of liver disease; not specified modalities of BC treatment; failure of dechallenge after BC discontinuation; pre-existing liver diseases; insufficiently excluded other liver diseases; presence of alternative liver diseases. CONCLUSIONS: The analysis of 69 cases shows little, if any, supportive evidence for a significant hepatotoxic risk of BC.
[Effects of Xuesaitong Injection on coagulation function of gastric cancer patients undergoing laparoscopic surgery: a randomized controlled trial.]
Zhong Xi Yi Jie He Xue Bao. 2009 Jun; 7(6): 514-7Wang Y, Wang YT, Lin YH, Zou ZDObjective: To study the effects of Xuesaitong Injection, an extract from a Chinese herbal medicine, on coagulation function of gastric cancer patients undergoing laparoscopic surgery. Methods: Fifty patients undergoing laparoscopic surgery for gastric cancer were randomly divided into control group and Xuesaitong group, with 25 patients in each group. Conventional anti-infection and transfusion treatment was given to the patients in the control group, and intravenous drip infusion of 400 mg Xuesaitong Injection added into 250 mL 5% glucose injection was administered once daily to the patients in the Xuesaitong group for 6 days from the first day after laparoscopic operation besides the conventional anti-infection and transfusion treatment. The values of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and international normalized ratio (INR) were detected by using blood coagulation method, and the values of D-dimer (D-D) before operation, instantly and 3, 5, 7 days after operation were detected by using enzyme-linked immunosorbent assay in the two groups. Furthermore, the development of deep vein thrombosis on the day 7 after operation was observed by vein angiography. Results: There were no significant differences in the values of PT, APTT, INR, FIB and D-D between the two groups before operation, and there were no significant changes in APTT and INR after operation in the two groups. The values of PT decreased in the two groups on day 3 after operation, while there was no significant difference between the two groups. The value of PT in the control group decreased gradually with the extension of postoperation time (P
Milnacipran versus other antidepressive agents for depression.
Cochrane Database Syst Rev. 2009; CD006529Nakagawa A, Watanabe N, Omori IM, Barbui C, Cipriani A, McGuire H, Churchill R, Furukawa TABACKGROUND: Although pharmacological and psychological interventions are both effective for major depression, antidepressant drugs are frequently used as first-line treatment in primary and secondary care settings. Milnacipran, a dual serotonin-norepinephrine reuptake inhibitor (SNRI), is one of the antidepressant drugs that clinicians use for routine depression care. OBJECTIVES: To assess the evidence for the efficacy, acceptability and tolerability of milnacipran in comparison with tricyclic antidepressants (TCAs), heterocyclics, SSRIs and other newer antidepressive agents in the acute-phase treatment of major depression. SEARCH STRATEGY: The Cochrane Collaboration Depression, Anxiety & Neurosis review group Controlled Trials Register (CCDANCTR-Studies and CCDANCTR-References) were electronically searched in August 2008. References of relevant trials and other reviews were also checked. Trial databases of the drug-approving agencies and ongoing clinical trial registers for all published and unpublished trials were hand-searched in 2007. All relevant authors were contacted for supplemental data. No language restriction was applied. SELECTION CRITERIA: Randomised controlled trials comparing milnacipran with any other active antidepressive agents (including non-conventional agents such as herbal products like hypericum) as monotherapy in the acute phase of major depression were selected. DATA COLLECTION AND ANALYSIS: Two reviewers independently checked eligibility, assessed methodological quality and extracted data from the eligible trials using a standardised data extraction form. The number of participants who responded to treatment or those who achieved remission were calculated on an intention-to-treat basis. Random-effects meta-analyses were conducted, combining data from the included trials. MAIN RESULTS: A total of 16 randomised controlled trials (n=2277) were included in the meta-analysis.Despite the size of this sample, the pooled 95% confidence intervals were rather wide and there were no statistically significant differences in efficacy, acceptability and tolerability when comparing milnacipran with other antidepressive agents. However, compared with TCAs, patients taking milnacipran were associated with fewer dropouts due to adverse events (OR 0.55; 95%CI 0.35 to 0.85). There was also some weak evidence to suggest that patients taking milnacipran experienced fewer adverse events of sleepiness/ drowsiness, dry mouth or constipation compared with TCAs. AUTHORS' CONCLUSIONS: Currently, there is inadequate evidence to conclude whether milnacipran is superior, inferior or the same as other antidepressive agents in terms of efficacy, acceptability and tolerability in the acute phase treatment of major depression. However, there is some evidence in favour of milnacipran over TCAs in terms of dropouts due to adverse events (acceptability) and the rates of experiencing adverse events (tolerability). Information about other clinically meaningful outcomes such as cost-effectiveness and social functioning, including the ability to return to work, is lacking. Further study is needed to answer whether milnacipran would be the better choice of antidepressant for acute major depression.
Chinese herbal medicine for endometriosis.
Cochrane Database Syst Rev. 2009; CD006568Flower A, Liu JP, Chen S, Lewith G, Little PBACKGROUND: Endometriosis is characterized by the presence of tissue that is morphologically and biologically similar to normal endometrium in locations outside the uterus. Surgical and hormonal treatment of endometriosis have unpleasant side effects and high rates of relapse. In China, treatment of endometriosis using Chinese herbal medicine (CHM) is routine and considerable research into the role of CHM in alleviating pain, promoting fertility, and preventing relapse has taken place. OBJECTIVES: To review the effectiveness and safety of CHM in alleviating endometriosis-related pain and infertility. SEARCH STRATEGY: We searched the Menstrual Disorders and Subfertility Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library) and the following English language electronic databases (from their inception to the present): MEDLINE, EMBASE, AMED, CINAHL, NLH on the 30/04/09.We also searched Chinese language electronic databases: Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Sci & Tech Journals (VIP), Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), and Chinese Medical Current Contents (CMCC). SELECTION CRITERIA: Randomised controlled trials (RCTs) involving CHM versus placebo, biomedical treatment, another CHM intervention, or CHM plus biomedical treatment versus biomedical treatment were selected. Only trials with confirmed randomisation procedures and laparoscopic diagnosis of endometriosis were included. DATA COLLECTION AND ANALYSIS: Risk of bias assessment, and data extraction and analysis were performed independently by three review authors. Data were combined for meta-analysis using relative risk (RR) for dichotomous data. A fixed-effect statistical model was used, where appropriate. Data not suitable for meta-analysis are presented as descriptive data. MAIN RESULTS: Two Chinese RCTs involving 158 women were included in this review. Both these trials described adequate methodology. Neither trial compared CHM with placebo treatment.There was no evidence of a significant difference in rates of symptomatic relief between CHM and gestrinone administered subsequent to laparoscopic surgery (95.65% versus 93.87%; risk ratio (RR) 1.02, 95% confidence interval (CI) 0.93 to 1.12, one RCT). The intention-to-treat analysis also showed no significant difference between the groups (RR 1.04, 95% CI 0.91 to 1.18). There was no significant difference between the CHM and gestrinone groups with regard to the total pregnancy rate (69.6% versus 59.1%; RR 1.18, 95% CI 0.87 to 1.59, one RCT).CHM administered orally and then in conjunction with a herbal enema resulted in a greater proportion of women obtaining symptomatic relief than with danazol (RR 5.06, 95% CI 1.28 to 20.05; RR 5.63, 95% CI 1.47 to 21.54, respectively).Overall, 100% of women in all the groups showed some improvement in their symptoms.Oral plus enema administration of CHM showed a greater reduction in average dysmenorrhoea pain scores than did danazol (mean difference (MD) -2.90, 95% CI -4.55 to -1.25; P < 0.01).Combined oral and enema administration of CHM showed a greater improvement, measured as the disappearance or shrinkage of adnexal masses, than with danazol (RR 1.70, 95% CI 1.04 to 2.78). For lumbosacral pain, rectal discomfort, or vaginal nodules tenderness, there was no significant difference either between CHM and danazol. AUTHORS' CONCLUSIONS: Post-surgical administration of CHM may have comparable benefits to gestrinone but with fewer side effects. Oral CHM may have a better overall treatment effect than danazol; it may be more effective in relieving dysmenorrhea and shrinking adnexal masses when used in conjunction with a CHM enema. However, more rigorous research is required to accurately assess the potential role of CHM in treating endometriosis.
Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. a randomized controlled trial.
Phytother Res. 2009 Jul 7; Grant PHirsutism in polycystic ovarian syndrome (PCOS), consequent to elevated androgen levels leads to significant cosmetic and psychological problems. Recent research in Turkey has shown that spearmint tea has antiandrogenic properties in females with hirsutism. No research has yet been undertaken to assess whether a reduction in androgen levels brought about by spearmint tea, translates to a clinical improvement in the degree of hirsutism.This study was a two centre, 30 day randomized controlled trial. Forty two volunteers were randomized to take spearmint tea twice a day for a 1 month period and compared with a placebo herbal tea. At 0, 15 and 30 days of the study serum androgen hormone levels and gonadotrophins were checked, the degree of hirsutism was clinically rated using the Ferriman-Galwey score and a questionnaire (the modified DQLI = Dermatology Quality of Life Index) was used to assess improvements in the level of self-reported hirsutism.Forty one of 42 patients completed the study. Free and total testosterone levels were significantly reduced over the 30 day period in the spearmint tea group (p < 0.05). LH and FSH also increased (p < 0.05). Patient's subjective assessments of their degree of hirsutism scored by the modified DQLI were significantly reduced in the spearmint tea group (p < 0.05). There was, however, no significant reduction in the objective Ferriman-Galwey ratings of hirsutism between the two trial groups over the trial duration (p = 0.12). There was a clear and significant alteration in the relevant hormone levels. This is associated clinically with a reduction in the self-reported degree of hirsutism but unfortunately not with the objectively rated score.It was demonstrated and confirmed that spearmint has antiandrogen properties, the simple fact that this does not clearly translate into clinical practice is due to the relationship between androgen hormones and follicular hair growth and cell turnover time. Simply put, the study duration was not long enough. The original studies from Turkey were in fact only 5 days long. The time taken for hirsutism to resolve is significant and a much longer future study is proposed as the preliminary findings are encouraging that spearmint has the potential for use as a helpful and natural treatment for hirsutism in PCOS. Copyright (c) 2009 John Wiley & Sons, Ltd.
[Therapeutic effects of traditional Chinese herbal formula with Smilax glabra on mice's lead poisoning]
Zhong Yao Cai. 2009 Mar; 32(3): 404-6Xia DZ, Wang HM, Yang Q, Jiang LQ, Xia MOBJECTIVE: To investigate the influence of traditional Chinese herbal formula with Smilax glabra on lead expelling and oxidative damage in lead-poisoned mice. METHODS: Mice were received intraperitoneal injections of lead acetate to establish lead-poisoned models. The concentration of lead, zinc and copper in blood, brain, liver, kidney and bone were determined. The lipid peroxidation of liver was systematically evaluated. RESULTS: The traditional Chinese herbal formula had no influence on body weight and organ weight/body weight ratio of lead-poisoned mice. The traditional Chinese herbal formula might significantly reduce the concentration of lead in blood, rain, liver, kidney and bone, and the rate were 74%, 48%, 56%, 51% and 44%, but had no influence on zinc's and copper' s concentration. The decreasing rate of MDA levels in liver by the traditional Chinese herbal formula was 31%. In addition, the increase rate of GSH levels and the activities of GSH-Px and SOD in liver by traditional Chinese herbal formula were 63% ,76% and 66%, respectively. CONCLUSIONS: The traditional Chinese herbal formula with Smilax glabra can significantly advance the excretion of lead and protect liver against oxidative damage induced by lead.
Ethylacetate extract from Draconis Resina inhibits LPS-induced inflammatory responses in vascular smooth muscle cells and macrophages via suppression of ROS production.
Food Chem Toxicol. 2009 Jul 2; Heo SK, Yi HS, Yun HJ, Ko CH, Choi JW, Park SDDraconis Resina (DR) is a type of dragon's blood resin obtained from Daemomorops draco BL. (Palmae). DR has long been used as a traditional Korean herbal medicine, and is currently used in traditional clinics to treat wounds, tumors, diarrhea, and rheumatism, insect bites and other conditions. In this study, we evaluated fractionated extracts of DR to determine if they inhibited the production of interleukin-1beta (IL-1beta) and the expression of cyclooxygenase (COX)-2. The results of this analysis revealed that the ethylacetate extract of Draconis Resina (DREA) was more potent than that of other extracts. Moreover, DREA inhibited the production of nitric oxide (NO), reactive oxygen species (ROS), prostaglandin E(2) (PGE(2)), tumor necrosis factor-alpha (TNF-alpha), IL-8 and IL-6 in lipopolysaccharide (LPS)-treated human aortic smooth muscle cells (HASMC) and RAW 264.7 macrophages. Furthermore, treatment with an NADPH oxidase assembly inhibitor, AEBSF, efficiently blocked LPS-induced mitogen-activated protein kinases (MAPKs) activation, as did DREA. These findings indicate that DREA inhibits the production of NO, PGE(2), TNF-alpha, IL-8, and IL-6 by LPS via the inhibition of ROS production, which demonstrates that DREA inhibits LPS-induced inflammatory responses via the suppression of ROS production. Taken together, these results indicate that DREA has the potential for use as an anti-atherosclerosis agent.
Growth inhibition of estrogen receptor positive human breast cancer cells by Taheebo from the inner bark of Tabebuia avellandae tree.
Int J Mol Med. 2009 Aug; 24(2): 253-60Mukherjee B, Telang N, Wong GYSelective estrogen receptor (ER) modulators are used as a therapy for ER+ clinical breast cancer, but they exhibit adverse effects. Herbal medicines may provide an alternative or complementary approach. Taheebo, extracted from the inner bark of the Tabebuia avellandae tree found in the Brazilian Amazon, exhibits selective anti-proliferative effects in carcinoma cell lines. The present study identifies the mechanistic leads for the inhibitory effects of Taheebo. Human breast carcinoma derived ER+MCF-7 cells were used as the model. Aqueous extract of Taheebo was the test compound. Cell cycle analysis, clonogenic assay, and global gene expression profiles were the quantitative parameters. Taheebo treatment resulted in a dose/time-dependent growth inhibition (S phase arrest, reduced clonogenecity) and initiation of apoptosis (chromatin condensation). A 6-h treatment with 1.5 mg/ml Taheebo modulated the gene expression of G2 specific cyclin B1 (-2.0-fold); S phase specific PCNA (-2.0-fold) and OKL38 (+11.0-fold); apoptosis specific GADD-45 family (+1.9-5.4-fold), Caspases (+1.6-1.7-fold), BCL-2 family (-1.5-2.5-fold), estrogen responsive ESR1 (-1.5-fold), and xeno-biotic metabolism specific CYP 1A1 (+19.8 fold) and CYP 1B1 (+7.9-fold). The anti-proliferative effects of Taheebo correlate with down-regulated cell cycle regulatory and estrogen responsive genes, and up-regulated apoptosis specific and xeno-biotic metabolism specific genes. These data validate a rapid mechanistic approach to prioritize efficacious herbal medicines, thereby complementing the existing endocrine therapy for breast cancer.
Antiplasmodial Activity of Punica granatum L. Fruit Rind.
J Ethnopharmacol. 2009 Jul 2; Dell'agli M, Galli GV, Corbett Y, Taramelli D, Lucantoni L, Habluetzel A, Maschi O, Caruso D, Giavarini F, Romeo S, Bhattacharya DETHNOPHARMACOLOGICAL RELEVANCE: Sun-dried rind of the immature fruit of Punica granatum L. (Punicaceae) (Pg) is presently used as a herbal formulation (OMARIA) in Orissa, India, for the therapy and prophylaxis of malaria. The aims of this study were: (i) to assess in vitro the antiplasmodial activity of the methanolic extract, of a tannin enriched fraction and of compounds/metabolites of the antimalarial plant, (ii) to estimate the curative efficacy of the Pg extracts and (iii) to explore the mechanism of action of the antiplasmodial compounds. Urolithins, the ellagitannin metabolites, were also investigated for antiplasmodial activity. MATERIALS AND METHODS: Chloroquine-susceptible (D10) and - resistant (W2) strains of Pf were used for in vitro studies and the rodent malaria model P. berghei - Balb/c mice was used for in vivo assessments. Recombinant plasmepsins 2 and 4 were used to investigate the interference of Pg compounds with the metabolism of haemoglobin by malaria parasites. RESULTS: The Pg methanolic extract (Pg-MeOH) inhibited parasite growth in vitro with a IC(50) of 4.5 and 2.8mug/ml, for D10 and W2 strain, respectively. The activity was found to be associated to the fraction enriched with tannins (Pg-FET, IC(50) 2.9 and 1.5mug/ml) in which punicalagins (29.1%), punicalins, ellagic acid (13.4%) and its glycoside could be identified. Plasmepsin 2 was inhibited by Pg-MeOH extract and by Pg-FET (IC(50) 7.3 and 3.0mug/ml), which could partly explain the antiparasitic effect. On the contrary, urolithins were inactive. Both Pg-MeOH extract and Pg-FET did not show any in vivo efficacy in the murine model. CONCLUSIONS: The in vitro studies support the use of Pg as antimalarial remedy. Possible explanations for the negative in vivo results are discussed.
Simultaneous determination of eight major steroids from Polyporus umbellatus by high-performance liquid chromatography coupled with mass spectrometry detections.
Biomed Chromatogr. 2009 Jul 1; Zhao YY, Cheng XL, Zhang Y, Zhao Y, Lin RC, Sun WJPolyporus umbellatus is a widely used diuretic herbal medicine. In this study, a high-performance liquid chromatography coupled with atmospheric pressure chemical ionization-mass spectrometric detection (HPLC-APCI-MS) method was developed for qualitative and quantitative analysis of steroids, as well as for the quality control of Polyporus umbellatus. The selectivity, reproducibility and sensitivity were compared with HPLC with photodiode array detection and evaporative light scattering detection (ELSD). Selective ion monitoring in positive mode was used for qualitative and quantitative analysis of eight major components and beta-ecdysterone was used as the internal standard. Limits of detection and quantification fell in the ranges 7-21 and 18-63 ng/mL for the eight analytes with an injection of 10 microL samples, and all calibration curves showed good linear regression (r(2) > 0.9919) within the test range. The quantitative results demonstrated that samples from different localities showed different qualities. Advantages, in comparison with conventional HPLC-diode array detection and HPLC-ELSD, are that reliable identification of target compounds could be achieved by accurate mass measurements along with characteristic retention time, and the great enhancement in selectivity and sensitivity allows identification and quantification of low levels of constituents in complex Polyporus umbellatus matrixes. Copyright (c) 2009 John Wiley & Sons, Ltd.
A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity.
World J Gastroenterol. 2009 Jul 7; 15(25): 3073-3085Hasani-Ranjbar S, Nayebi N, Larijani B, Abdollahi MThis review focuses on the efficacy and safety of effective herbal medicines in the management of obesity in humans and animals. PubMed, Scopus, Google Scholar, Web of Science, and IranMedex databases were searched up to December 30, 2008. The search terms were "obesity" and ("herbal medicine" or "plant", "plant medicinal" or "medicine traditional") without narrowing or limiting search elements. All of the human and animal studies on the effects of herbs with the key outcome of change in anthropometric measures such as body weight and waist-hip circumference, body fat, amount of food intake, and appetite were included. In vitro studies, reviews, and letters to editors were excluded. Of the publications identified in the initial database, 915 results were identified and reviewed, and a total of 77 studies were included (19 human and 58 animal studies). Studies with Cissus quadrangularis (CQ), Sambucus nigra, Asparagus officinalis, Garcinia atroviridis, ephedra and caffeine, Slimax (extract of several plants including Zingiber officinale and Bofutsushosan) showed a significant decrease in body weight. In 41 animal studies, significant weight loss or inhibition of weight gain was found. No significant adverse effects or mortality were observed except in studies with supplements containing ephedra, caffeine and Bofutsushosan. In conclusion, compounds containing ephedra, CQ, ginseng, bitter melon, and zingiber were found to be effective in the management of obesity. Attention to these natural compounds would open a new approach for novel therapeutic and more effective agents.
Herbal Supplement Use and Blood Lead Levels of United States Adults.
J Gen Intern Med. 2009 Jul 3; Buettner C, Mukamal KJ, Gardiner P, Davis RB, Phillips RS, Mittleman MABACKGROUND: Some herbal supplements may contain lead. OBJECTIVE: To examine whether use of specific herbal dietary supplements during the last 30 days is associated with blood lead levels in US men and women. DESIGN: Cross-sectional analysis. STUDY POPULATION: NHANES participants from 1999-2004, a representative sample of the civilian non-institutionalized US population. MEASUREMENTS: Lead was measured in blood. Associations between lead and self-reported supplement use were estimated using multivariable regression weighted to account for NHANES sampling. Herbal supplements investigated were those previously reported to contain high heavy metal content: Ayurvedic or traditional Chinese medicine herbs, echinacea, ginkgo, ginseng, St. John's wort, and "other" herbs (specifically, kava, valerian, black cohosh, bee pollen, and nettle). MAIN RESULTS: Among 6,712 women >/=20 years, those using herbal supplements had lead levels that were 10% higher than non-users (95% CI 3%-17%, p = 0.005). Women using Ayurvedic or traditional Chinese medicine herbs, St. John's wort, and "other" herbs had lead levels 24% (95% CI 5%-45%, p = 0.01), 23% (95% CI 4%-46%), p = 0.02), and 21% (95% CI 2%-44%, p = 0.03) higher, respectively, than non-users. No significant associations were observed between herb use and lead levels among men (n = 6,095). Among reproductive-aged women (16-45 years), herbal supplement users had lead levels 20% higher than non-users (95% CI 5%-34%, p = 0.008). In contrast, garlic and other dietary supplements were not associated with higher lead levels. CONCLUSION: Use of specific herbal supplements is associated with higher blood lead levels among women. Our data suggest testing guidelines for herbal supplements and regulations limiting lead in supplements are needed.
Anti-tumor effect of Liqi, a traditional Chinese medicine prescription, in tumor bearing mice.
BMC Complement Altern Med. 2009 Jul 1; 9(1): 20Ji DB, Ye J, Jiang YM, Qian BWABSTRACT: BACKGROUND: Liqi, an herbal preparation used in traditional Chinese medicine, has been used to treat cancer in China for centuries. We investigated the anti-tumor effects of liqi and their mechanisms in mice that had been xenografted with tumors. METHODS: Sarcoma 180 tumor, Lewis lung carcinoma, and SGC-7901 cells were implanted in BALB/c mice, C57BL/6 mice, and BALB/c nude mice, respectively. Liqi was administered to subgroups of these mice. The tumor weight and size were measured. Cell cycle assay and T lymphocyte subsets were determined by flow cytometry. The activity of NK cells and TNF was tested using cytotoxicity assay on YAC-1 cells and L929 cells, respectively, and the activity of IL-2 was tested with an IL-2-dependent CTLL-2 cell proliferation assay. Platelet aggregation was monitored by measuring electric impedance, and the levels of thromboxane A2 (TXA2) and prostacyclin (PGI2) in blood were measured by 125I-TXB2 and 125I-Keto-PGF1alpha radioimmunoassay. RESULTS: The results showed that liqi inhibited tumor growth in tumor-implanted mice and arrested the cell proliferation in the G0/G1 phase and reduced the portion of cells in S and G2/M phase for SGC-7901 cells. Liqi increased the activity of NK cells and TNF-alpha, stimulated IL-2 production and activity, and regulated T lymphocyte subpopulations. Liqi inhibited the Lewis lung carcinoma metastasis by inhibiting platelet aggregation and normalizing the balance between TXA2 and PGI2. CONCLUSIONS: All these findings demonstrated that liqi has an anti-tumor effect in vivo. The mechanism may be related to immune regulation and anticoagulation effects.
Parasite control in the age of drug resistance and changing agricultural practices.
Vet Parasitol. 2009 Jun 13; Molento MBThe benefits of using antiparasitic drugs in farm animals are unquestionable. However, despite anthelmintic use as the predominant control strategy, extreme parasite infection cases are appearing in sheep and goat production; these impact productivity and have show mortality rates reaching pre-drug use levels. This was a predictable situation resulting from the loss of efficacy by all available products, particularly when some products were used as the sole intervention. The concepts of agroecology and holistic agriculture, which advocate the use of integrated management strategies, such as target selected treatment, herbal medicine, and the application of other parasite control alternatives, are not completely new, but are undergoing a resurgence because of their more sustainable appeal. The objective of this review article is to examine the problem of parasite control in the face of parasite drug resistance and to outline some strategies that may be used in parasite control programmes. Before they are accepted and recommended by the WAAVP, agroecological methods such as those listed above and described in detail herein should be validated based on scientific evidence of their efficacy for parasite control and should be tested for both host and environmental safety.
Effect of Three Herbal Extracts on NO and PGE2 Production by Activated Mouse Macrophage-like Cells.
In Vivo. 2009 Jul-Aug; 23(4): 537-44Chu Q, Hashimoto K, Satoh K, Wang Q, Sakagami HThree Chinese herbal extracts, Drynaria baronii, Angelica sinensis and Cornus officinalis Sieb. et Zucc (referred to as DB, AS, CO, respectively), were investigated for their possible anti-inflammatory activity. DB, AS and CO inhibited nitric oxide (NO) production by lipopolysaccharide (LPS)-activated mouse macrophage-like RAW264.7 cells. Western blot and RT-PCR analyses demonstrated that this was due to the inhibition of inducible NO synthase (iNOS) expression at both protein and mRNA levels. Electron-spin resonance spectroscopy showed that DB, AS and CO dose-dependently scavenged the NO radical produced by NOC-7 in the presence of carboxy-PTIO. In order to confirm the anti-inflammatory potency, effects on prostaglandin (PG) E(2) production and the expression of enzymes involved in the arachidonic acid pathway were next investigated. DB and CO effectively inhibited the PGE(2) production by LPS-stimulated RAW264.7 cells, although the extent of inhibition of PGE(2) production was slightly lower than that of NO production. AS only marginally inhibited the LPS-stimulated PGE(2) production. DB, AS and CO inhibited cyclooxygenase (COX)-2 expression at both protein and mRNA levels, but to much lesser extents as compared with that for iNOS expression. These data further substantiate the anti-inflammatory potency of DB, AS and CO.
Triptolide functions as a potent angiogenesis inhibitor.
Int J Cancer. 2009 Jun 30; He MF, Huang YH, Wu LW, Ge W, Shaw PC, But PPTriptolide is a key anti-inflammatory compound of the Chinese herbal medicine Tripterygium wilfordii Hook. f. (Celastraceae). It also possesses potent anti-tumor activity. In this study, we show that triptolide is an angiogenesis inhibitor based on various angiogenesis assays. The IC(50) in in vitro assays was 45 nM, which was much lower than the plasma concentrations of triptolide in the rat or human administered with T. wilfordii extracts for treating inflammation. When dosed in vivo, triptolide potently inhibited angiogenesis at 100 nM in Matrigel plug assay. Triptolide at 0.75 mg/kg/day significantly blocked tumor angiogenesis and tumor progression in murine tumorigenesis assay. The underlying mechanism of triptolide correlated with down-regulation of proangiogenic Tie2 and VEGFR-2 expression in HUVEC by semi-quantitative RT-PCR and Western blot analysis. Although Tie2 inhibition appeared to be a later event as compared with VEGFR-2, Tie2 over-expression significantly attenuated the inhibitory effect of triptolide on endothelial proliferation and network formation. By contrast, Tie2 knockdown mimicked the inhibitory effect of triptolide on endothelial network formation. Our findings suggest that anti-tumor action of triptolide is partly via inhibition of tumor angiogenesis by blocking two endothelial receptor-mediated signaling pathways, and triptolide can be a promising anti-angiogenic agent. (c) 2009 UICC.
Comments on serious anaphylaxis caused by nine Chinese herbal injections used to treat common colds and upper respiratory tract infections.
Regul Toxicol Pharmacol. 2009 Jun 23; Ji K, Chen J, Li M, Liu Z, Xia L, Wang C, Zhan Z, Wu XReports describing severe allergic shock and fatality following treatment of a common cold or upper respiratory tract infection (URTI) with a Chinese herbal injection were collected. Our analysis of the risks associated with this treatment suggested that the potential risk of serious, or even lethal, anaphylaxis should preclude its use in treating common colds and URTIs. In light of our findings herein, we propose the following five suggestions for improving the clinical safety of delivering Chinese herbal injections as medical treatments. First, Chinese herbal injections should not be delivered in the clinic to treat patients in accordance with Bian zheng lun zhi (broad-spectrum application based on holistic Traditional Chinese Medicine (TCM) theory and methodology), but rather they should be administered to target specific indicated disease processes. Second, Chinese herbal injection indications should be based on the results of double-blind randomized controlled clinical trials. Third, Chinese herbal injections should be used only in cases involving severe disease or to rescue patients in critical condition; they should not be used to treat mild, relatively innocuous diseases, such as common colds and upper respiratory tract infections, given the risk of doing harm. Fourth, Chinese herbal injection formulas should include materials from only a single or a small number of plant sources in known quantities. Fifth, more studies examining the toxicology and allergenic potential of Chinese herbal injections are needed.
Gastroprotective Effect of an Aqueous Suspension of Black Cumin Nigella sativa on Necrotizing Agents-Induced Gastric Injury in Experimental Animals.
Saudi J Gastroenterol. 2008 Jul; 14(3): 128-34Al Mofleh IA, Alhaider AA, Mossa JS, Al-Sohaibani MO, Al-Yahya MA, Rafatullah S, Shaik SABACKGROUND/AIM: Previous studies on "Black seed" or "Black Cumin" Nigella sativa (NS) have reported a large number of pharmacological activities including its anti-ulcer potential. These studies employed either fixed oil, volatile oil components or different solvent extracts. In folkloric practices, NS seeds are taken as such, in the form of coarse dry powder or the powdered seeds are mixed with water. This study examines the effect of NS aqueous suspension on experimentally induced gastric ulcers and basal gastric secretion in rats to rationalize its use by herbal and Unani medicine practitioners. MATERIALS AND METHODS: The study was conducted at the Medicinal, Aromatic and Poisonous Plants Research Center, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Acute gastric ulceration was produced by various noxious chemicals (80% ethanol, 0.2 M NaOH, 25% NaCl and indomethacin) in Wistar albino rats. Anti-secretory studies were undertaken in a separate group of rats. Gastric wall mucus contents and non-protein sulfhydryl concentration were estimated, and gastric tissue was examined histopathologically. RESULTS: An aqueous suspension of Black seed significantly prevented gastric ulcer formation induced by necrotizing agents. It also significantly ameliorated the ulcer severity and basal gastric acid secretion in pylorus-ligated Shay rats. Moreover, the suspension significantly replenished the ethanol-induced depleted gastric wall mucus content levels and gastric mucosal non-protein sulfhydryl concentration. The anti-ulcer effect was further confirmed histopathologically. CONCLUSION: These findings validate the use of Black seed in gastropathies induced by necrotizing agents. The anti-ulcer effect of NS is possibly prostaglandin-mediated and/or through its antioxidant and anti-secretory activities.
Abnormal Savda Munziq, an Herbal Preparation of Traditional Uighur Medicine, may Prevent 1,2-dimethylhydrazine-induced Rat Colon Carcinogenesis.
Evid Based Complement Alternat Med. 2009 Jun 26; Yusup A, Upur H, Umar A, Berke B, Yimit D, Lapham JC, Moore N, Cassand PThe study tried to assess the chemoprotective effect of abnormal Savda Munziq (ASMq) on 1,2-dimethylhydrazine (DMH)-induced rat colon carcinogenesis. Male F344 rats were randomized into eight groups: Group 1 was served as control, no DMH injection was given and treated daily with normal saline. Rats in Groups 2-8 were given a single intraperitoneal injection of DMH (20 mg/kg body weight) at the beginning of the study. Group 2 was served as negative control, administered with normal saline until the end of the experiment after the single DMH injection. Groups 3-5 were served as pretreatment group, administered with ASMq ethanol extract at 400, 800 and 1600 mg/kg body weight, respectively, until the 45th day, continued by normal saline administration for another 45 days. Groups 6-8 were served as the treatment group, administered with normal saline for the first 45 days from the day of DMH injection, ASMq ethanol extract at three different doses to be administered until the end of the second 45th day. All rats were sacrificed at 91st day and the colons were analyzed for aberrant crypt foci (ACF) formation and crypt multiplicity. Results showed that ASMq ethanol extract reduced the number of ACF, AC and crypt multiplicity significantly (P < 0.05). It suggested that ASMq ethanol extract had chemoprotective effects on DMH-induced colon carcinogenesis, by suppressing the development of preneoplastic lesions, and probably exerted protection against the initiation and promotion steps of colon carcinogenesis.
Prevalence of Polypharmacy, Polyherbacy, Nutritional Supplement Use and Potential Product Interactions among Older Adults Living on the United States-Mexico Border: A Descriptive, Questionnaire-Based
Drugs Aging. 2009; 26(5): 423-36Loya AM, González-Stuart A, Rivera JOThe use of multiple medications, herbs or nutritional supplements can lead to adverse consequences, particularly in the elderly. A significant consequence resulting from polypharmacy, polyherbacy and nutritional supplement use is the potential for interactions to occur among the various products. The primary objective of this study was to estimate the prevalence of polypharmacy, polyherbacy, nutritional supplement use and potential product interactions among older adults living on the US-Mexico border. This was a descriptive study that involved the administration of a bilingual (English/Spanish) questionnaire to a convenience sample of adults aged >/=60 years recruited from senior centres located within the most populated US-Mexico border region from June 2005 to March 2006. Participant demographics were collected in addition to information about current use of prescription medications, over-the-counter (OTC) medications, herbal products and nutritional supplements (i.e. nutraceuticals and vitamins or minerals). The outcomes measured were the number of prescription medications, OTC medications, herbal products, vitamins/minerals and nutraceuticals per participant. Furthermore, the number of potential interactions and major interactions between drugs, herbal products and nutritional supplements were identified for each participant. Additionally, product use patterns between men and women and among locations within the border region were compared. One-hundred-and-thirty participants (mean age 71.4 years) were recruited to complete the questionnaire. The prevalence of polypharmacy among all participants was 72.3% (n = 94), with 38.5% (n = 50) taking five or more concomitant medications (major polypharmacy). Twenty-one participants (16.2%) in the study sample reported taking two or more herbal products (polyherbacy). Thirty-four participants (26.2%) reported taking two or more vitamin/mineral supplements and nine (6.9%) reported using two or more nutraceuticals. Participants living on the US side of the border had higher rates of major polypharmacy, polyherbacy and use of nutritional supplements than those living on the Mexican side of the border. Overall, there were no significant differences in medication, herbal product and nutritional supplement use patterns between men and women. Evaluation of potential interactions revealed that 46.2% (n = 60) of participants were at risk of having at least one potential drug-drug interaction. Regarding drug and herbal product-supplement interactions, 31.5% (n = 41) of participants were at risk of having at least one possible interaction. The prevalence of polypharmacy among older adults living on the US side of the border was similar to national trends (estimates suggest that one-quarter to one-half of US adults aged >/=65 years take five or more medications). However, polypharmacy was less common in older adults living on the Mexican side of the border. Additionally, herb use was higher in older adults living on the US-Mexico border than has been reported in national surveys of US adults, which indicate that less than one-quarter of adults have used a herbal product within the previous 12 months. Furthermore, this study demonstrated that older adults living on the US side of the border consumed more herbs and nutritional supplements than their Mexican counterparts. In addition to describing product use patterns on the border, these findings suggest that almost half of the older adult participants were at risk for a potential drug-drug interaction, with approximately one-third having a potential interaction between their medications, herbs or nutritional supplements.
Japanese herbal medicine in functional gastrointestinal disorders.
Neurogastroenterol Motil. 2009 Jul; 21(7): 688-96Suzuki H, Inadomi JM, Hibi TManagement of functional gastrointestinal disorders is hindered by both poor efficacy and adverse effects of traditional pharmacological therapy. Herbal medicine may be an attractive alternative based on the perception of its 'natural' approach and low risk of side effects; however, the lack of standardization of drug components has limited the ability to perform rigorous clinical studies in Western countries. Japanese herbal medicine (JHM) is a standardized form of herbal medicine with regards to the quality and quantities of ingredients. While extensively studied and widely used in Asia, there is a paucity of data upon which physicians in other parts of the world may draw conclusions regarding the effectiveness of herbal medicine for gastrointestinal disorders. The aim of this study was to summarize the most recent developments in JHM for treatment of functional gastrointestinal disorders. Animal and human studies were systematically reviewed to identify published data of JHM used for treatment of gastrointestinal disorders. The herbal components of JHM were examined. Results describing the physiological and clinical effects of JHM were abstracted, with an emphasis on functional gastrointestinal disorders. JHM are associated with a variety of beneficial physiological on the gastrointestinal system. Patient-based clinical outcomes are improved in several conditions. Rikkunnshi-to reduces symptoms and reverses physiological abnormalities associated with functional dyspepsia, while dai-kenchu-to improves symptoms of postoperative ileus and constipation in children. This updated summary of JHM in the field of gastrointestinal disorders illustrates the potential for herbal medication to serve a valuable role in the management of patients with functional gastrointestinal disorders.
Prevalence of Polypharmacy, Polyherbacy, Nutritional Supplement Use and Potential Product Interactions among Older Adults Living on the United States-Mexico Border: A Descriptive, Questionnaire-Based
Drugs Aging. 2009; 26(5): 423-36Loya AM, González-Stuart A, Rivera JOThe use of multiple medications, herbs or nutritional supplements can lead to adverse consequences, particularly in the elderly. A significant consequence resulting from polypharmacy, polyherbacy and nutritional supplement use is the potential for interactions to occur among the various products. The primary objective of this study was to estimate the prevalence of polypharmacy, polyherbacy, nutritional supplement use and potential product interactions among older adults living on the US-Mexico border. This was a descriptive study that involved the administration of a bilingual (English/Spanish) questionnaire to a convenience sample of adults aged >/=60 years recruited from senior centres located within the most populated US-Mexico border region from June 2005 to March 2006. Participant demographics were collected in addition to information about current use of prescription medications, over-the-counter (OTC) medications, herbal products and nutritional supplements (i.e. nutraceuticals and vitamins or minerals). The outcomes measured were the number of prescription medications, OTC medications, herbal products, vitamins/minerals and nutraceuticals per participant. Furthermore, the number of potential interactions and major interactions between drugs, herbal products and nutritional supplements were identified for each participant. Additionally, product use patterns between men and women and among locations within the border region were compared. One-hundred-and-thirty participants (mean age 71.4 years) were recruited to complete the questionnaire. The prevalence of polypharmacy among all participants was 72.3% (n = 94), with 38.5% (n = 50) taking five or more concomitant medications (major polypharmacy). Twenty-one participants (16.2%) in the study sample reported taking two or more herbal products (polyherbacy). Thirty-four participants (26.2%) reported taking two or more vitamin/mineral supplements and nine (6.9%) reported using two or more nutraceuticals. Participants living on the US side of the border had higher rates of major polypharmacy, polyherbacy and use of nutritional supplements than those living on the Mexican side of the border. Overall, there were no significant differences in medication, herbal product and nutritional supplement use patterns between men and women. Evaluation of potential interactions revealed that 46.2% (n = 60) of participants were at risk of having at least one potential drug-drug interaction. Regarding drug and herbal product-supplement interactions, 31.5% (n = 41) of participants were at risk of having at least one possible interaction. The prevalence of polypharmacy among older adults living on the US side of the border was similar to national trends (estimates suggest that one-quarter to one-half of US adults aged >/=65 years take five or more medications). However, polypharmacy was less common in older adults living on the Mexican side of the border. Additionally, herb use was higher in older adults living on the US-Mexico border than has been reported in national surveys of US adults, which indicate that less than one-quarter of adults have used a herbal product within the previous 12 months. Furthermore, this study demonstrated that older adults living on the US side of the border consumed more herbs and nutritional supplements than their Mexican counterparts. In addition to describing product use patterns on the border, these findings suggest that almost half of the older adult participants were at risk for a potential drug-drug interaction, with approximately one-third having a potential interaction between their medications, herbs or nutritional supplements.
Determination of senkirkine and senecionine in Tussilago farfara using microwave-assisted extraction and pressurized hot water extraction with liquid chromatography tandem mass spectrometry.
Talanta. 2009 Jul 15; 79(2): 539-46Jiang Z, Liu F, Goh JJ, Yu L, Li SF, Ong ES, Ong CNTussilago farfara (Kuan Donghua) is an important Chinese herbal medicine which has been shown to contain many bioactive compounds and widely used to relieve cough and resolve phlegm. However, besides therapeutic bioactive compounds, this herb has been found to contain toxic pyrrolizidine alkaloids (PAs), mainly senkirkine and traces of senecionine. In this report, conditions for microwave-assisted extraction (MAE) and pressurized hot water extraction (PHWE) were optimized for the extraction of the PAs. The results were compared against heating under reflux. It was found that the binary mixture of MeOH:H(2)O (1:1) acidified using HCl to pH 2-3 was the optimal solvent for the extraction of the PAs in the plant materials. Liquid chromatography (LC) with ultra-violet (UV) detection and electrospray ionization mass spectrometry (ESI-MS) in the positive mode was used for the determination and quantitation of senkirkine and senecionine in the botanical extract. The proposed extraction methods with LC/MS allow for the rapid detection of the major and the minor alkaloids in T. farfara in the presence of co-eluting peaks. With LC/MS, the quantitative analysis of PAs in the extract was done using internal standard calibration and the precision was found to vary from 0.6% to 5.4% on different days. The limits of detection (LODs) and limits of quantitation (LOQs) for MAE and PHWE were found to vary from 0.26 microg/g to 1.04 micro/g and 1.32 micro/g to 5.29 microg/g, respectively. The method precision of MAE and PHWE were found to vary from 3.7% to 10.4% on different days. The results showed that major and minor alkaloids extracted using MAE and PHWE were comparable to that by heating under reflux. Our data also showed that significant ion suppression was not observed in the analysis of senkirkine and senecionine in the botanical extracts with co-eluting peaks.
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