Herbal Medicine

Acujoint™, a high efficient formulation with natural bioactives, exerts potent anti-arthritis effects in human osteoarthritis - A randomized clinical study Publication date: Available online 23 April 2019 Source: Journal of Herbal Medicine Author(s): Augustine Amalraj, Joby Jacob, Karthik Varma, Ajaikumar B. Kunnumakkara, Chandradhara Divya, Sreeraj Gopi Abstract The aim of the study was to evaluate the efficacy and safety of Acujoint™ - a supplement for articular cartilage degradation- in the treatment of patients with Osteoarthritis (OA) by comparing it with glucosamine and chondroitin formulation, which is a popular supplement used to treat OA. Acujoint™ is a health supplement prepared with extracts of 3-O-acetyl-11-keto-β-boswellic acid from Boswellia serrata, β-Caryophyllene from Piper nigrum, aqueous extract of Kaempferia galangal and Cureit™ - a bioavailable curcumin formulation- in a fixed ratio based on complete natural matrix, which has been used to treat osteoarthritis. A randomized, double blind, active controlled, single centre, clinical study was carried out using Acujoint™ during 90 days of treatment in 24 patients (1:1 ratio) with symptoms of moderate to mild OA along with combination of Glucosamine (1500 mg) and Chondroitin (1200 mg). The study shows that Acujoint™ can provide significant improvement in relieving the symptoms and the pain associated with active OA between the groups as well as within the groups. Active OA patients, who received Acujoint™ at 250 mg per day for a treatment period of 90 days, reported statistically significant changes/decreases in their clinical symptoms and pain. This was evident from significant changes in the total Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score, pain score, functional ability score, visual analog scale (VAS) score and Lequesne functional index values at P < 0.05 level. Acujoint™ promises the beneficial effects for the treatment of human knee osteoarthritis by controlling inflammatory responses as well as the pain without any adverse effects. Graphical abstract

Antiplaque and antimicrobial efficacy of polyherbal mouth rinse among adult human volunteers – A short term randomized controlled trial Publication date: Available online 16 April 2019 Source: Journal of Herbal Medicine Author(s): BR Chandrashekar, Ramesh Nagarajappa, K Mruthunjaya, Suma Shekar, MS Girish, Rupesh Thakur Abstract Systematic evaluation of plant extracts and their combinations offers new insights into the development of innovative drugs from plants. The authors evaluated the antiplaque and antimicrobial efficacy of a polyherbal mouth rinse, using 0.2% chlorhexidine as positive and saline based mouth rinse as negative controls among adult human volunteers. Thirty eligible adult human volunteers were recruited and pre intervention prophylaxis was carried out to reduce their plaque scores to zero. Participants were randomly assigned to three different categories and given coded mouth rinse bottles containing either saline, a poly herbal mouth rinse containing Acacia nilotica, Murraya koenigii Linn Sprengel, Eucalyptus hybrid, and Psidium Guajava combined extracts at 1%, or 0.2% chlorhexidine. Participants were requested to use 10 ml of their assigned mouth rinse twice a day and refrain from oral hygiene practices for four days. On the fifth day following intervention, plaque buildup was assessed by a blinded investigator and supragingival plaque samples were collected. Unstimulated saliva samples were collected before and 60 minutes after mouth rinsing. Plaque samples were used in microbial assay, while saliva samples were used for assessing change in salivary pH. Post intervention plaque build-up, S. mutansand total viable counts were significantly higher in saline users compared to others, with no difference in salivary flow and pH. However, the difference between the polyherbal and chlorhexidine groups was not statistically significant. We conclude that the polyherbal mouth rinse merits further investigation as a potential alternative to chlorhexidine for preventing and controlling dental caries and plaque induced dental diseases.

Ethnopharmacological survey of plants used in the traditional treatment of pain conditions in Mali Publication date: Available online 11 April 2019 Source: Journal of Herbal Medicine Author(s): Ombeline Danton, Aimé Somboro, Baba Fofana, Drissa Diallo, Lassine Sidibé, Catherine Rubat-Coudert, Fabien Marchand, Alain Eschalier, Sylvie Ducki, Pierre Chalard Abstract Pain is among the major concerns of healthcare authorities across the world. It is complicated to diagnose, manage and treat. Current western treatments are successful to some extent in relieving pain; they provide minimum improvements in terms of physical and emotional functioning and are often accompanied by side effects. Finding new solutions in pain management has thus become a priority. Natural products have always been a huge source of new active principles; traditional medicine is thus a key to innovation. In Mali, traditional remedies are more popular than pharmaceutical drugs but this knowledge, verbally transferred from generation to generation is at risk as younger generations are not taking over. Thus, this study was designed to identify plants that are used traditionally in the South of Mali for the treatment of painful conditions. Data was collected by means of semi-structured face-to-face interviews with traditional healers (N = 108) in the regions of Bamako, Sikasso and Dioïla. Two quantitative ethnopharmacological indexes were calculated: Relative Frequency of Citation (RFC) and Fidelity Level (FL) when RFC > 0.10. A total of 66 plant species distributed across 29 families were recorded during this two-month survey. Stomach aches and external pains were the most cited pain conditions followed by body pains and pain due to diseases such as diabetes and sickle cell disease. Cassia sieberiana DC. (RFC = 0,22), Zanthoxylum zanthoxyloides (Lam.) Zepren. & Timler (0,13), Pericopsis laxiflora(Benth.) Meeuwen (0,11), Flueggea virosa (Roxb. ex Willd) Royle (0,08) and Sarcocephalus latifolius (Sm.) E.A.Bruce (0,08) were the most cited plants. This ethnopharmacological survey provides preliminary data for the discovery of new analgesic molecules. Graphical abstract

Plant use as a traditional method by women against vaginal discharge in western Anatolia, Turkey: A qualitative research study Publication date: Available online 10 April 2019 Source: Journal of Herbal Medicine Author(s): Zekiye Turan, Eylem Toker, Mehtap Omaç Sönmez, Fatma Kutlar Abstract Objective The aim of this research was to gain insight into the reasons why women useCyclamen coum. and how they use it, in addition to the symptoms being treated. Material and methods The study was carried out as a qualitative research. The first case was that of an inpatient with symptoms of vaginal infection who used Cyclamen coum. Snowball sampling was used for sample selection. Fifteen women were included in the research as users and proponents of this method. The questionnaire including socio-demographic attributes and an interview form were used to obtain in-depth information. After completion of interviews, raw research data were identified by a researcher, and these were then classified by three researchers in accordance with verified themes. This data was then reported using their interpretation. Results All participants applied the treatment by placing theCyclamen coum. tuber into the vagina for a period of three days. The positive results obtained from experiences of traditional methods increases the extent to which women adopt this method. Conclusion People should be informed regarding the possible potential adverse consequences of the use of traditional methods. Also, further research should be performed on women's health and widely applied traditional applications.

Clinical efficacy of a topical polyherbal formulation in the management of fluorouracil -associated hand-foot syndrome Publication date: Available online 9 April 2019 Source: Journal of Herbal Medicine Author(s): Elnaz Karimi, Behrooz Gharib, Nematollah Rostami, Latifeh Navidpour, Minoo Afshar Abstract Aim Hand foot syndrome (HFS) is a common side effect following administration of fluoropyrimidine drugs like capecitabine and 5-flourouracil in cancer patients. This syndrome is not life threatening. However, it is the main reason for dose reduction or temporary discontinuation of these drugs. The aim of this study was evaluating the efficacy of a standardized topical polyherbal hydrogel (E.gel) containing Calendula officinalis L., Matricaria recutita L.and Salvia officinalis L. for the management of Hand Foot Syndrome (HFS) in cancer patients following administration of fluoropyrimidine drugs. Methods In the present survey, 27 patients suffering from HFS were randomized to receive the E.gel and the placebo four times a day for 2 weeks. At the baseline and at the end of trial HFS grades were determined. Results No serious adverse events occurred. Among the patients who have completed the study, 71% had a significant improvement compared to the placebo (p-value = 0.039). In 5% of the patients no changes were observed in the treatment group, while the side effects had worsened in the placebo roup. Moreover, in 10% of the patients both treatment and placebo groups showed improvement and in 14% no changes were observed in both groups. Conclusion This study shows that patients receiving the polyherbal hydrogel experienced less complications and symptoms associated with HFS. In summary, it seems that the use of the prepared polyherbal hydrogel was beneficial for cancer patients administered fluorouracil-chemotherapeutic agents. Graphical; abstract

Treating Depression Naturally: How Flower Essences can Help Rebalance your Life. Chris Phillips. Floris Books, Edinburgh, 2017, pp., £12.99/$19.95. ISBN 978-178250-427-6. Publication date: Available online 4 April 2019 Source: Journal of Herbal Medicine Author(s): Graeme Tobyn

Bioactive metabolites of Ganoderma lucidum: Factors, mechanism and broad spectrum therapeutic potential Publication date: Available online 3 April 2019 Source: Journal of Herbal Medicine Author(s): Chetan Sharma, Neha Bhardwaj, Anupam Sharma, Hardeep Singh Tuli, Priya Batra, Vikas Beniwal, Girish Kumar Gupta, Anil K. Sharma Abstract Background The global interest in edible medicinal herbs for healthcare has significantly increased during the last few years.Ganoderma lucidum is a medicinal mushroom which is known to be a potential source of many therapeutic and pharmaceutical products with significant health importance. Methodology The available literature using PubMed, Scopus and Google Scholar database was thoroughly reviewed using the keywords Natural Products,Ganoderma, secondary metabolites and therapeutics. Thisnarrative review of all the relevant papers with significant citations leads the authors to greater insight into the potential therapeutic significance of Ganoderma lucidum. Results The presence of a wide array of secondary metabolites in this herb contributes to its pharmaceutical uses.G. lucidum is rich in polysaccharides (β-glucan,mannitol), alkaloids, and a group oftriterpenes (ganoderic acid). Many cellular mechanisms have been proposed to explain the mode of action of its active metabolites and their healthcare attributes including anticancer, antiviral, antioxidant and protective effects on liver and other secondary lymphoid organs. Conclusion This review illustrates the broad spectrum therapeutic potential of secondary metabolites derived fromGanoderma and supports our understanding of the main pharmacologically active compounds present in this fungus. Insight into the actions of its secondary metabolites could further pave a way for establishing G. lucidum, as a pharmacologically important product.

Anti-inflammatory action of YHQ by regulating 5-LOX/COX-2/NF-κB/MAPKs/Akt signaling pathways in RAW 264.7 macrophage cells Publication date: Available online 3 April 2019 Source: Journal of Herbal Medicine Author(s): Bao-Hui Cheng, Tian-Yong Hu, Li Ma, Wen-Hui Hu, Yan-Yan Chen, Xian-Hai Zeng, Hai-Liang Zhao, Zhi-Qiang Liu, Shu-Qi Qiu Abstract Yan-Hou-Qing (YHQ), a traditional Chinese medicine (TCM) formula including fifteen herbal medicines has been used for acute pharyngitis and cough treatment in Oriental medicine. However, anti-inflammatory activities of YHQ are poorly understood. The anti-inflammatory activities of YHQ were evaluated via enzyme-linked immunosorbent assay (ELISA), and the underlying mechanisms were further determined using western blot in lipopolysaccharide (LPS)-stimulated RAW 264.7 murine macrophage cells in vitro. Anti-inflammation study revealed that YHQ inhibits the release of prostaglandin E2 (PGE2) potently by suppressing the protein expression of cyclooxygenase-2 (COX-2) and leukotriene B4 (LTB4) by reducing arachidonate 5-lipoxygenase (5-LOX) in LPS-stimulated RAW 264.7 macrophages. Further study demonstrated that YHQ inhibits the production of the pro-inflammatory cytokines interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α in LPS-stimulated RAW 264.7 macrophages by attenuating the phosphorylation p65 subunit of nuclear factor-kappaB (NF-κB). The suppressive effects of YHQ on LPS-stimulated inflammatory cytokines and mediators can be attributed to the suppression of YHQ on the phosphorylation of Akt and c-Jun N-terminal kinases (JNK), extracellular signal-regulated kinase (ERK), and p38 MAPKs. This study suggested that YHQ can be a preventive and potent therapeutic candidate for the management of inflammatory-mediated immune disorders. Graphical abstract

Effect of Arctium lappa linne (Burdock) root tea consumption on lipid profile and blood pressure in patients with knee osteoarthritis Publication date: Available online 1 April 2019 Source: Journal of Herbal Medicine Author(s): Leila Maghsoumi-Norouzabad, Farideh Shishehbor, Reza Abed, Ahmad Zare Javid, Bina Eftekhar-Sadat, Beitollah Alipour Abstract Background Knee Osteoarthritis (OA) is a common disabling joint disorder worldwide. This study was designed to evaluate the effect of burdock root tea consumption on lipid profile and blood pressure in patients with OA. Methods In this randomized, single-blind, placebo-controlled clinical trial 36 patients (10 males and 26 females) aged 50–70 years old suffering from bilateral knee Osteoarthritis were randomly divided into intervention and control groups. The routine treatment was considered for all patients during the study. The intervention group received 3 cups / day of Burdock root tea (2 g tea bags steeped in 150 ml of boiled water for 10 min) and control group received only 3 cups / day of boiled water (150 ml) 30 min after meals (breakfast, lunch, and dinner) for 6 weeks. Blood lipid profile and blood pressure were assessed at baseline and 6 weeks post intervention. Results Total cholesterol (TC), LDL-C, TC/HDL-C, LDL-C/HDL-C ratios, systolic and diastolic blood pressure were significantly decreased post intervention. A significant increase in HDL-C level was observed in the intervention group. At the end of the study, there was a significant difference in LDL-C, HDL-C, TC/HDL-C, LDL-C/HDL-C ratios and diastolic blood pressure between two groups. Conclusions It is suggested that consumption of burdock root tea may improve lipid profile and blood pressure status in patients with knee OA. Further studies may need to confirm these effects.

Daily date vinegar consumption improves hyperlipidemia, β-carotenoid and inflammatory biomarkers in mildly hypercholesterolemic adults Publication date: Available online 18 March 2019 Source: Journal of Herbal Medicine Author(s): Zeshan Ali, Haile Ma, Asif Wali, Ishmael Ayim, Muhammad Nauman Sharif Abstract Dates are delicious fruits with a sweet taste and a fleshy consistency. Dates also have various bioactive components which have effects on different types of diseases. The objective of this study was to determine the effects of date vinegar made from date pulp and pits on the serum lipid profile and inflammatory biomarkers of mildly hypercholesterolemic adults. Seventy-six subjects with mildly raised total cholesterol and LDL cholesterol were enrolled. Participants ingested 30 mL of either date vinegar or placebo daily together with their normal diets. Plasma lipids, inflammatory biomarkers, carotenoids, potassium, folic acid, urea and creatinine were measured at baseline after 4 weeks and after treatment. These results suggest that the date vinegar improved several serum lipid profile parameters (mg/dL: Total Cholesterol (TC) 246.40 ± 14.7 to 197.60 ± 14.7, P = 0.001; Low density lipoprotein (LDL) 166.6 ± 11.8 to 109.8 ± 11.8, P = 0.001; Triglycerides (TG) 170.30 ± 16.54 to 161.20 ± 17.8, P = 0.002; High density lipoprotein (HDL) 41.7 ± 8.08 to 44.1 ± 8.05, P = 0.003) and inflammatory biomarkers (C-reactive protein (CRP) 7.05 ± 1.23 to 4.12 ± 0.04 mg/L, P = 0.001; nitric oxide (NO) 31.06 ± 0.47 to 27.01 ± 0.14 μmol/L, P = 0.002; tumor necrosis factor alpha (TNFα) 17.2 ± 2.8 to 13.6 ± 2.4 pg/mL, P = 0.001; fibrinogen 272.54 ± 22.6 to 238.31 ± 11.7 mg/dL, P = 0.014). The findings suggest that date vinegar improved the concentration of lipid and inflammatory biomarkers.