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1.
Anticancer Effects of Herbal Medicine Compounds and Novel Formulations: a Literature Review.
Abdulridha, MK, Al-Marzoqi, AH, Al-Awsi, GRL, Mubarak, SMH, Heidarifard, M, Ghasemian, A
Journal of gastrointestinal cancer. 2020;(3):765-773
Abstract
INTRODUCTION Many agents disrupt the cell cycle and its signaling circuits leading to cancer progress. Cancer therapy is performed by surgery, radiation, and chemical drugs remaining some side effects. OBJECTIVE To evaluate the anticancer traits of herbal medicines. METHODS We collected previously published data in searching engines (Web of Science, PubMed, Medline, and SCOPUS) by searching key words "herbal medicine," "anticancer effect," "compounds," and "fractions." RESULTS Herbal medicines have unraveled anticancer effects mostly through cancer cells apoptosis via blocking NF-κB pathway by curcumin and terpenoides; CD95 signaling and enhancement of CD95L expression by resveratrol; and inhibiting tyrosine kinas, angiogenesis, and cell cycle arrest in G2/M phase by β-lapachone-genistein and cytochrome-c release into the cytosol and caspase-9 activation by biocalein and quercetin. Additionally, impeding cell cycle in the G1 phase in ovarian cancer cells by 7-hydroxystaurosporine, immune cells enrichment (neutrophils and NK cells activation by Viscum album L., T cells and NK cells activation and cytokines such as tumor necrosis factor release by Ganoderma lucidum and microRNAs regulation (by Sinomeniumacutum, shikonin, Oleaeuropaea, curcumin and ginseng). These effects have implications for proper cancer cells elimination. It has been revealed that cytotoxic effects of herbal compounds (mostly those secondary metabolites) have exerted anticancer properties against several cancer cell lines. In addition, targeting microRNAs, nanoparticle-assisted herbal synergism, and novel drug delivery systems and combination chemotherapies have also emerged exerting higher efficacies for specific cell targeting as novel cancer therapy approaches. CONCLUSION Considering side effects, toxicity, and higher costs of common cancer therapy approaches, application of novel herbal medicine-based therapies will confer promising insights for health outcomes.
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The comparison of therapeutic effect of Clobetasol propionate lotion and squill extract in alopecia areata: a randomized, double-blind clinical trial.
Moosavi, ZB, Aliabdi, M, Golfakhrabadi, F, Namjoyan, F
Archives of dermatological research. 2020;(3):173-178
Abstract
Alopecia areata is a chronic inflammatory disease that characterized by round or oval patches of non-scarring hair loss. From the past, Urginea maritima (white squill) was used for the treatment of hair loss in Iranian traditional medicine. We aimed the comparison of Clobetasol lotion and squill extract efficacy in treatment of alopecia areata in a randomized, double-blind clinical trial. The 42 patients were randomized into two groups. Both groups received topical squill and clobetasol lotion twice daily lotion for 12 weeks. Clinical evaluation included size of patches (using 1×1 cm2 schablone), total number of grown hair and number of terminal hair was performed every 2 weeks. Re-growth of terminal coarse hairs was evaluated using a semi-quantitative regrowth score (RGS) (0: no regrowth, 1: growth of <25%, 2: growth of 25-50%, 3: growth of 51-75%, 4: growth of >75%). There were significant differences between RGS4 in two groups after 2- and 3-month treatment (P<0.05). At the end of follow-up period, the mean hair growth rates increased significantly from 6.5 to 11.3 in squill group (P = 0.031) and it improved significantly from 10.3 to 17.9 in clobetasol group (P = 0.001). There were no significant differences between mean hair growth rates in two groups after 3-month treatment (P = 0.969). The lotion 2% of U. maritima bulbs extract showed good effect in 45% patients with patchy alopecia areata and showed moderate effect on re-growth of terminal hairs.
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3.
Can phytotherapy with polyphenols serve as a powerful approach for the prevention and therapy tool of novel coronavirus disease 2019 (COVID-19)?
Levy, E, Delvin, E, Marcil, V, Spahis, S
American journal of physiology. Endocrinology and metabolism. 2020;(4):E689-E708
Abstract
Much more serious than the previous severe acute respiratory syndrome (SARS) coronavirus (CoV) outbreaks, the novel SARS-CoV-2 infection has spread speedily, affecting 213 countries and causing ∼17,300,000 cases and ∼672,000 (∼+1,500/day) deaths globally (as of July 31, 2020). The potentially fatal coronavirus disease (COVID-19), caused by air droplets and airborne as the main transmission modes, clearly induces a spectrum of respiratory clinical manifestations, but it also affects the immune, gastrointestinal, hematological, nervous, and renal systems. The dramatic scale of disorders and complications arises from the inadequacy of current treatments and absence of a vaccine and specific anti-COVID-19 drugs to suppress viral replication, inflammation, and additional pathogenic conditions. This highlights the importance of understanding the SARS-CoV-2 mechanisms of actions and the urgent need of prospecting for new or alternative treatment options. The main objective of the present review is to discuss the challenging issue relative to the clinical utility of plants-derived polyphenols in fighting viral infections. Not only is the strong capacity of polyphenols highlighted in magnifying health benefits, but the underlying mechanisms are also stressed. Finally, emphasis is placed on the potential ability of polyphenols to combat SARS-CoV-2 infection via the regulation of its molecular targets of human cellular binding and replication, as well as through the resulting host inflammation, oxidative stress, and signaling pathways.
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Plant-derived natural agents as dietary supplements for the regulation of glycosylated hemoglobin: A review of clinical trials.
Rezaeiamiri, E, Bahramsoltani, R, Rahimi, R
Clinical nutrition (Edinburgh, Scotland). 2020;(2):331-342
Abstract
BACKGROUND & AIMS Type 2 diabetes mellitus (T2DM) is a metabolic disorder affecting a growing number of patients all over the world. T2DM complications are positively associated with HbA1c which is a long-term glycemic marker. Medicinal plants and their isolated phytochemicals have been extensively used as dietary supplements for the management of chronic disorders including T2DM. Current paper aims to review clinical trials evaluated the effect of phytochemicals for long-term management of T2DM considering the HbA1c level. METHODS Electronic databases including PubMed, Scopus and Cochrane were searched using the keywords "phytochemical", "extract", "herb", or "plant" and "HbA1c" or "glycosylated hemoglobin" in the title/abstract from the date of inception until May 2017. English and Persian language papers were included. References of the retrieved papers were also screened for relevant studies. RESULTS Of 2435 studies, 39 relevant clinical trials were finally included in which phytochemicals including berberine, curcumin, catechin, silymarin, resveratrol, pycnogenol, isoflavones, lignans, isohumulone, saponins, corn bran hemicellulose and pinitol were examined. Berberine and silymarin had the strongest evidence regarding their effectiveness in long-term management of HbA1c; however, lack of enough toxicological studies suggests to stay on the safe side for the administration of these agents in diabetic patients. CONCLUSIONS Current data regarding the efficacy of other phytochemicals are still controversial due to small follow-up period, methodological problems and small sample size. Future well-designed clinical trials are necessary to confirm the safety and efficacy of phytochemicals for long-term glycemic control of diabetic patients.
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Herbal medicine for acute bronchitis: A qualitative interview study of patients' and health professionals' views.
Soilemezi, D, Leydon, GM, Yan, R, Simpson, C, Bell, M, Bostock, J, Moore, M, Willcox, M
Complementary therapies in medicine. 2020;:102613
Abstract
BACKGROUND Antibiotics are widely prescribed for acute bronchitis in the UK. Herbal medicine could be used instead to provide symptom relief. AIM: To explore the views of patients and health professionals on using herbal medicine for acute bronchitis instead of antibiotics. DESIGN AND SETTING This was a nested qualitative study, conducted alongside a feasibility randomised clinical trial which ran from July 2018 to May 2019 in 20 GP practices in Wessex, UK. METHOD We conducted telephone semi-structured interviews with patients and with health professionals. The interview data were transcribed and analysed thematically. RESULTS Overall, 40 interviews were conducted with 29 patients, six GPs and five nurses. While some patients believed antibiotics are more effective, most were aware of resistance and were keen to try an alternative, including herbal medicine. Several patients believed herbals would be "less intrusive" than antibiotics, whereas a few disliked the taste or experienced side-effects after taking a herbal. Professionals were concerned about potential interactions with conventional medicines. Many patients trusted herbals because of their long history of use, while some did not understand them. Availability of herbals without a prescription enables patients to use them for self-care, but their cost was a barrier for some. Many patients were willing to take a herbal if advised by their GP. Most GPs were happy to recommend a herbal, if endorsed by evidence-based guidelines. CONCLUSION Many patients and health professionals would consider using herbal medicine for acute bronchitis, if based on trustworthy advice and evidence-based guidelines respectively.
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Hypoglycemic efficacy and safety of Momordica charantia (bitter melon) in patients with type 2 diabetes mellitus.
Kim, SK, Jung, J, Jung, JH, Yoon, N, Kang, SS, Roh, GS, Hahm, JR
Complementary therapies in medicine. 2020;:102524
Abstract
INTRODUCTION Momordica charantia (bitter melon) is widely used for its glucose-lowering effects. This study was conducted to assess the efficacy and safety of M. charantia as an adjuvant treatment in patients with type 2 diabetes. METHODS We performed a randomized, placebo-controlled study. Blood glucose levels, lipid profile, and adverse events were investigated after 12 weeks of treatment. Ninety subjects were included in the final analysis for glucose lowering efficacy of bitter melon. RESULTS There were no differences in age, sex, or glycated hemoglobin (HbA1c) levels between the bitter melon extract and placebo groups. After treatment with bitter melon extract for 12 weeks, the HbA1c levels of the bitter melon and placebo groups remained unchanged; however, the average fasting glucose level of the bitter melon group decreased (p = 0.014). No serious adverse events were reported during the treatment period. CONCLUSIONS Our data showed that bitter melon has effects of glucose lowering in patients with type 2 diabetes.
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A double-blind, randomized pilot study for comparison of Melissa officinalis L. and Lavandula angustifolia Mill. with Fluoxetine for the treatment of depression.
Araj-Khodaei, M, Noorbala, AA, Yarani, R, Emadi, F, Emaratkar, E, Faghihzadeh, S, Parsian, Z, Alijaniha, F, Kamalinejad, M, Naseri, M
BMC complementary medicine and therapies. 2020;(1):207
Abstract
BACKGROUND Depression has rapidly progressed worldwide, and the need for an efficient treatment with low side effect has risen. Melissa officinalis L and Lavandula angustifolia Mill have been traditionally used in Asia for the treatment of depression. Many textbooks of traditional Persian medicine refer to these herbs for the treatment of depression while there are no adequate clinical trials to support this claim. The present study aimed to evaluate the efficacy of M. officinalis and L. angustifolia compared to fluoxetine for the treatment of mild to moderate depression in an 8-week randomized, double-blind clinical trial. METHODS Forty-five adult outpatients who met the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) for major depression, were randomly assigned to 3 groups to daily receive either M. officinalis (2 g) or L. angustifolia (2 g) or fluoxetine (20 mg) and were assessed in weeks 0, 2, 4 and 8 by the Hamilton Rating Scale for Depression (HAM-D) including 17 items. RESULTS Our study showed that M. officinalis and L. angustifolia effect similar to fluoxetine in mild to moderate depression. (F = 0.131, df = 2,42, p = 0.877). CONCLUSION Due to some restrictions in this study including absence of placebo group, large-scale trials are needed to investigate the anti-depressant effect of these two herbs with more details. TRIAL REGISTRATION IRCT2014061718126N1 . Registration date: 2015-06-04-"Retrospectively registered".
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Pumpkin seeds, Centella asiatica, Boswellia, Helichrysum, acetate vitamin E, Melaleuca alternifolia and hyaluronic acid phytocomplex monotherapy effects in patients with chronic pelvic pain syndrome.
Di Vico, T, Durante, J, Polito, C, Tognarelli, A, Canale, D, Caglieresi, C, Morelli, G, Bartoletti, R
Minerva urologica e nefrologica = The Italian journal of urology and nephrology. 2020;(2):236-242
Abstract
BACKGROUND Proxelan® and antibiotics combined therapy was successfully previously used in the treatment of symptoms of patients with chronic prostatitis. Aim of the present study was to investigate the effects of Proxelan® monotherapy on pain symptoms of patients with chronic prostatitis (CP) or chronic pelvic pain syndrome (CPPS) in a prospective pilot study. METHODS Thirty consecutive patients with CP/CPPS symptoms younger than 50, without urinary obstruction, total prostate-specific antigen (PSA) <4 ng/mL, negative microbiology testing on prostate fluid and urethral swab, naïve from other treatments during the previous three months were enrolled in a pilot study. IPSS and NIH-CPSI questionnaires were administered to all the patients. Patients could choose to be investigated regarding semen quality and IL6/IL8 seminal markers for inflammatory disease prior and after the therapy course. Proxelan® suppositories were prescribed for each patient for a month with a daily dosage of 1 suppository at bed-time. The primary endpoint of the study included at least a 30% reduction of pain symptoms because similar results can be obtained in each previously investigated placebo group. Effects on semen parameters such as leukocytospermia, spermatozoa concentration and motility, cytokine levels were considered as secondary endpoints. RESULTS Subjective pain relief was obtained in all the patients with significant decrease of NIH-CPSI pain items (P=0.04). Urinary symptoms, investigated by IPSS questionnaire, decreased significantly (P=0.04) as well as quality of life items (P=0.04). Leukocytospermia was found in 5/15 patients available for further investigations. IL6 decreased by 11.55% one month after the treatment while sperm motility resulted increased by 17.3%. CONCLUSIONS Proxelan® monotherapy may represents a promising valid alternative to combined treatment with antibiotics in patients with CP/CPPS symptoms although the results obtained should be investigated in randomized controlled trials.
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Current State of Research About Chinese Herbal Medicines (CHM) for the Treatment of Coronavirus Disease 2019 (COVID-19): A Scoping Review.
López-Alcalde, J, Yan, Y, Witt, CM, Barth, J
Journal of alternative and complementary medicine (New York, N.Y.). 2020;(7):557-570
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Abstract
Background: There is currently no effective treatment against coronavirus disease 2019 (COVID-19). The optimal selection of interventions targeting the virus is unknown. Therefore, evidence from randomized controlled trials (RCTs) to support specific treatment against COVID-19 is urgently needed. The use of Chinese herbal medicines (CHMs) might have a role in the treatment and symptomatic management of patients with COVID-19. It was aimed at providing an overview of the available evidence and ongoing trials concerning the effects of CHMs for the treatment of COVID-19. Methods: This is a narrative review of relevant studies. Searches were conducted to identify documents published till April 22, 2020. Electronic databases, evidence-based collections, websites of relevant organizations, and trial registries were consulted. Results: A total of 25 guidelines on the treatment of patients with COVID-19 were identified. Four guidelines provided recommendations on the use of CHMs; these guidelines were developed in China and South Korea and were based on the consensus of experts exclusively. The remaining 21 guidelines provided no guidance on CHMs. No finished RCTs of CHMs for the treatment of patients with COVID-19 was found. According to the evidence evaluated in this review, a Cochrane review of CHMs for severe acute respiratory syndrome and five uncontrolled observational studies of the effects of CHMs in patients with COVID-19, the effects of CHMs for COVID-19 are unknown. A total of 52 ongoing clinical trials of CHM interventions for the treatment of COVID-19 were found. These trials will be carried out mostly in China (n = 51). Forty (77%) of the ongoing trials will be randomized, whereas 12 (23%) have an unclear sequence generation procedure. Forty-seven trials (90%) will have a sample size <400 participants. Conclusions: To the authors' knowledge, only the Chinese and the South Korean guidelines recommend CHMs as a treatment option for patients with COVID-19. These guidelines base their recommendations on the consensus of experts. Clinical guidelines or health authorities from other countries do not provide advice on CHMs. Due to the absence of RCT, there is currently no reliable evidence on the effects of any specific CHM intervention for the treatment of patients with COVID-19. A high number of clinical trials of different herbal products are being currently conducted in China.
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Progress and prospects in the management of bacterial infections and developments in Phytotherapeutic modalities.
Akram, M, Riaz, M, Munir, N, Rasul, A, Daniyal, M, Ali Shah, SM, Shariati, MA, Shaheen, G, Akhtar, N, Parveen, F, et al
Clinical and experimental pharmacology & physiology. 2020;(7):1107-1119
Abstract
The advent of antibiotics revolutionized medical care resulting in significantly reduced mortality and morbidity caused by infectious diseases. However, excessive use of antibiotics has led to the development of antibiotic resistance and indeed, the incidence of multidrug-resistant pathogens is considered as a major disadvantage in medication strategy, which has led the scholar's attention towards innovative antibiotic sources in recent years. Medicinal plants contain a variety of secondary metabolites with a wide range of therapeutic potential against the resistant microbes. Therefore, the aim of this review is to explore the antibacterial potential of traditional herbal medicine against bacterial infections. More than 200 published research articles reporting the therapeutic potential of medicinal plants against drug-resistant microbial infections were searched using different databases such as Google Scholar, Science Direct, PubMed and the Directory of Open Access Journals (DOAJ), etc., with various keywords like medicinal plants having antibacterial activities, antimicrobial potentials, phytotherapy of bacterial infection, etc. Articles were selected related to the efficacious herbs easily available to local populations addressing common pathogens. Various plants such as Artocarpus communis, Rheum emodi, Gentiana lutea L., Cassia fistula L., Rosemarinus officinalis, Argemone maxicana L, Hydrastis canadensis, Citrus aurantifolia, Cymbopogon citrates, Carica papaya, Euphorbia hirta, etc, were found to have significant antibacterial activities. Although herbal preparations have promising potential in the treatment of multidrug-resistant bacterial infection, still more research is required to isolate phytoconstituents, their mechanism of action as well as to find their impacts on the human body.