AIM OF THE STUDY: To assess the effectiveness of miswak in maintaining periodontal health among adults.
MATERIALS AND METHODS: We searched for randomised controlled trials (RCTs) investigating the effect of miswak published in PubMed, EBSCOHOST (Dentistry & Oral Sciences), SCOPUS, and Cochrane Database for Systematic Review (CDSR) from inception to May 08, 2022. The primary outcomes of interest were changes in the periodontal health measured with plaque and gingivitis scores as well as subgingival bacteria load. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach while the estimates of effect were pooled using a random-effects model.
RESULTS: Ten eligible articles were identified, of which 9 could be analysed quantitatively. The remaining report was included as part of the qualitative analysis. The meta-analysis showed that miswak was comparable with the toothbrush in reducing the mean plaque score (p= 0.08, SMD: 0.39, and 95% CI: -0.05 to 0.83) and mean gingivitis score (p= 0.37, SMD: 0.13, and 95% CI: -0.16 to 0.43). Even higher certainty of evidence for the effect of miswak on mean plaque reduction on labial surface of anterior teeth. However, the adjunctive effect of miswak was significantly more superior for reducing plaque (p= 0.01, SMD: 0.68, and 95% CI: 0.14 to 1.22) and gingivitis score (p= 0.04, SMD: 0.66, and 95% CI: 0.03 to 1.29).
CONCLUSIONS: Miswak effectively reduced plaque and gingivitis scores to a level comparable to toothbrush when used exclusively. Adjunctive miswak use was particularly effective in improving periodontal health. However, the included studies inadequately reported on the method of toothbrushing using miswak and the frequency of miswak use. Therefore, further clinical studies are recommended to explore on the advantages and proper method of miswak practice for optima outcome and safety.
AIM OF THE STUDY: However, there are no scientific reports documented on the wound healing activities of this plant against Staphylococcus aureus infections in the Sprague Dawley male rat model. Thus, the present study was conducted to evaluate the wound healing potential of E. guineensis extract leaves.
MATERIALS AND METHODS: The crude extract was prepared in 10% (w/w) ointment and evaluated for wound healing activity using excision and infected wound models in Sprague Dawley rats. The wound healing activity was evaluated from wound closure rate, CFU reduction, histological analysis of granulation tissue and matrix metalloprotease expression.
RESULTS: The results show that the E. guineensis extract has potent wound healing ability, as manifest from improved wound closure and tissue regeneration supported by histopathological parameters. Assessment of granulation tissue every fourth day showed a significant reduction in the microbial count. The expression of matrix metalloproteinases was well correlated with the other results, hence confirming E. guineensis wound healing activity's effectiveness.
CONCLUSIONS: E. guineensis enhanced infected wound healing in rats, thus supporting its traditional use.
AIM OF THIS REVIEW: The present study is a critical assessment of the state-of-the-art concerning the traditional uses, the phytochemistry and the pharmacology of species belonging to the genus Hedyosmum to suggest further research strategies and to facilitate the exploitation of the therapeutic potential of Hedyosmum species for the treatment of human disorders.
MATERIALS AND METHODS: The present review consists of a systematic overview of scientific literature concerning the genus Hedyosmum published between 1965 and 2018. Moreover, an older text, dated from 1843, concerning the traditional uses of H. bonplandianum Kunth has also been considered. Several databases (Francis & Taylor, Google Scholar, PubMed, SciELO, SciFinder, Springer, Wiley, and The Plant List Database) have been used to perform this work.
RESULTS: Sixteen species of the genus Hedyosmum have been mentioned as traditional remedies, and a large number of ethnomedicinal uses, including for the treatment of pain, depression, migraine, stomach-ache and ovary diseases, have been reported. Five species have been used as flavouring agents, tea substitutes or foods. Sesterterpenes, sesquiterpene lactones, monoterpenes, hydroxycinnamic acid derivatives, flavonoids, and neolignans have been reported as the most important compounds in these species. Studies concerning their biological activities have shown that members of the Hedyosmum genus possesses promising biological properties, such as analgesic, antinociceptive, antidepressant, anxiolytic, sedative, and hypnotic effects. Preliminary studies concerning the antibacterial, antioxidant, antiplasmodial, and antifungal activities of these plants as well as their cytotoxic activities against different tumour cell lines have been reported. Some active compounds from the Hedyosmum genus have been used as starting points for the innovative and bioinspired development of synthetic molecules. A critical assessment of these papers has been performed, and some conceptual and methodological problems have been identified regarding the materials and methods and the experimental design used in these studies, including a lack of ethnopharmacological research.
CONCLUSIONS: The present review partially confirms the basis for some of the traditional uses of Hedyosmum species (mainly H. brasiliense) through preclinical studies that demonstrated their antinociceptive and neuroprotective effects. Due to promising preliminary results, further studies should be conducted on 13-hydroxy-8,9-dehydroshizukanolide and podoandin. Moreover, several essential oils (EOs) from this genus have been preliminarily investigated, and the cytotoxic and antibacterial activities of H. brasiliense and H. sprucei EOs certainly deserve further investigation. From the promising findings of the present analysis, we can affirm that this genus deserves further research from ethnopharmacological and toxicological perspectives.
OBJECTIVE: Our study aimed to determine the clinical effects and safety of D. scandens for musculoskeletal pain treatment compared with standard regimen, nonsteroidal anti-inflammatory drugs (NSAIDs).
METHODS: International and Thai databases were searched from inception through August 2015. Comparative randomized controlled trials investigating oral D. scandens for musculoskeletal pain were included. Outcomes of interest included level of pain and adverse event. Mean changes of the outcomes from baseline were compared between D. scandens and NSAIDs by calculating mean difference.
RESULTS: From 42 articles identified, 4 studies involving a total of 414 patients were included for efficacy analysis. The effects of oral D. scandens on reducing pain score were no different from those of non-steroidal anti-inflammatory drugs at any time points (3, 7, 14 days and overall). The overall pain reduction in the D. scandens group was not inferior to treatment with NSAIDs (weighted mean difference 0.06; 95% CI: -0.20, 0.31) without evident of heterogeneity (I(2)=0.00%, p=0.768). When compared, the adverse events (AEs) of D. scandens showed no different relative risk with NSAIDs. The major adverse events were gastrointestinal symptoms.
CONCLUSION: D. scandens may be considered as an alternative for musculoskeletal pain reduction.
AIM OF THE STUDY: The present study was carried out to examine the potential modulatory effects of three commercially available active components (asiaticoside, asiatic acid and madecassic acid) and four extracts (aqueous, ethanol, dichloromethane and hexane) of CA on three major cDNA-expressed human cytochrome P450 (CYP) isoforms.
MATERIALS AND METHODS: High-performance liquid chromatography (HPLC)-based enzyme assays, namely tolbutamide 4-methyhydroxylase, dextromethorphan O-demethylase and testosterone 6beta-hydroxylase assays were developed to probe activities of CYP2C9, CYP2D6 and CYP3A4, respectively. Probe substrates were incubated with or without each active component and extract for each isoform, followed by examination of the kinetics parameters, IC(50) and K(i), to characterize modulatory effects.
RESULTS: CYP2C9 was more susceptible to inhibitory effects by CA extracts compared to CYP2D6 and CYP3A4. Moderate degree of inhibition was observed in ethanol (K(i)=39.1 microg/ml) and dichloromethane (K(i)=26.6 microg/ml) extracts implying potential risk of interaction when CYP2C9 substrates are consumed with CA products. The two extracts however showed negligible inhibition towards CYP2D6 and CYP3A4 (IC(50)'s of 123.3 microg/ml and above). Similarly CA aqueous and hexane extracts did not significantly inhibit all three isoforms investigated (IC(50)'s of 117.9 microg/ml and above). Among the active constituents investigated, asiatic acid and madecassic acid appeared to selectively inhibit CYP2C9 and CYP2D6 more than CYP3A4. Of particular interest is the potent inhibitory effect of asiatic acid on CYP2C9 (K(i)=9.1 microg/ml). This signifies potential risk of interaction when substrates for this isoform are taken together with CA products with high asiatic acid content. Inhibitions of asiatic acid with the other isoforms and that of madecassic acid with all isoforms were only moderate (K(i)'s ranged from 17.2 to 84.4 microg/ml). On the other hand, the IC(50) values for asiaticoside were high (1070.2 microg/ml or above) for all three isoforms, indicating negligible or low potential of this compound to modulate CYP enzymatic activity.
CONCLUSION: Centella asiatica extracts and active constituents inhibited CYP2C9, CYP2D6 and CYP3A4 activities with varying potency with CYP2C9 being the most susceptible isoform to inhibition. Significant inhibition was observed for asiatic acid and CA ethanol and dichloromethane extracts, implying involvement of semipolar constituents from CA in the effect. This study suggested that CA could cause drug-herb interactions through CYP2C9 inhibition.
AIMS OF THE STUDY: The compounds were quantified from 21 hydrolyzed extracts of the phytotherapies for gout. The activity-content contributions of the compounds to the potent extracts were determined.
MATERIALS AND METHODS: The anti-hyperuricemic activities of the extracts and the compounds were determined using a xanthine oxidase inhibitory assay. Ultra-Performance Liquid Chromatography (UPLC) coupled with Photodiode Array Detector (PDA) was used to quantify the compounds in the extracts.
RESULTS: The results revealed higher activity of the hydrolyzed extracts. The hydrolyzed extract of the flower bud of Syzygium aromaticum Merr. & L.M.Perry exhibited the highest activity (EC50 = 39.58 ± 0.10 μg/mL) due to the highest content of myricetin (42,297.55 ± 159.47 μg/g). The activity-content contribution of myricetin was 7.69%. Due to the highest activity of apigenin (EC50 = 3.27 ± 0.09 μg/mL), the highest contribution of this flavone (29.96%) to the hydrolyzed extract of Orthosiphon aristatus (Blume) Miq. was observed.
CONCLUSION: The results revealed different contents and activities of xanthine oxidase inhibitors in the hydrolyzed extracts of anti-hyperuricemic plants can play a major role to influence the activity.
AIM OF THE STUDY: To assess wildlife for sale for medicinal purposes, and document their medicinal use at Kyaiktiyo, a pilgrimage site at a 1100m tall mountain, with many of the pilgrims climbing to the top. In addition we address legal issues relating to the production and sale of traditional medicine that contain legally protected animals.
MATERIAL AND METHODS: Four visits were made to Kyaiktiyo, Myanmar, between 2000 and 2017 to quantify animal parts on display and through discussions with vendors to obtain information on medicinal use of these parts.
RESULTS: Twenty-three species, mostly mammals, were recorded to be used for traditional medicine. The most common were Chinese serow Capricornis milneedwardsii, Asian elephant Elephas maximus, and Asiatic black bear Ursus thibetanus. Over 600 bodies or body parts were present. Combined, these parts purportedly provided cures or relief for at least 15 ailments or diseases. The most commonly mentioned treatment was that of using rendered animal fats/oils externally to relieve/cure aching joints or muscles. This treatment allegedly provides instant relief to pilgrims after an arduous climb up the mountain. Purported cures for various skin diseases was the next common use for the animal species on offer. Ten of the species observed for sale at Kyaiktiyo are listed as globally threatened, and 15 are protected and cannot be legally traded. Ambiguities in Myanmar's legislation mean that protected animals or their body parts cannot be traded, however traditional medicines can be made out of them provided rules relating to the manufacturing of traditional medicines are adhered to.
CONCLUSION: This study indicated that animals and their parts continue to be openly offered for sale at Kyaiktiyo to treat various illnesses. Despite these products potential medical, traditional or cultural importance, solutions have to been found on how to ensure that, in line with Myanmar's laws, use of traditional local medicine does not impede the conservation of imperilled species.
AIM OF STUDY: This study aimed to examine the anti-tumor activities of L. rhinocerus TM02®, using two different sample preparations [cold water extract (CWE) and fraction] via various routes of administration (oral and intraperitoneal) on an MCF7-xenograft nude mouse model. This study also investigated the inhibitory effect of TM02® CWE and its fractions against COX-2 in vitro using LPS-induced RAW264.7 macrophages, on the basis of the relationship between COX-2 and metastasis, apoptosis resistance, as well as the proliferation of cancer cells.
MATERIALS AND METHODS: The first preparation, L. rhinocerus TM02® sclerotium powder (TSP) was dissolved in cold water to obtain the cold water extract (CWE). It was further fractionated based on its molecular weight to obtain the high (HMW), medium (MMW) and low (LMW) molecular weight fractions. The second preparation, known as the TM02® rhinoprolycan fraction (TRF), was obtained by combining the HMW and MMW fractions. TSP was given orally to mimic the daily consumption of a supplement; TRF was administered intraperitoneally to mimic typical tumorous cancer treatment with a rapid and more thorough absorption through the peritoneal cavity. Another experiment was conducted to examine changes in COX-2 activity in LPS-induced RAW264.7 macrophages after a 1-h pre-treatment with CWE, HMW, and MMW.
RESULTS: Our results revealed that intraperitoneal TRF-injection (90 μg/g BW) for 20 days reduced initial tumor volume by ∼64.3% (n = 5). The percentage of apoptotic cells was marginally higher in TRF-treated mice vs. control, suggesting that induction of apoptosis as one of the factors that led to tumor shrinkage. TSP (500 μg/g BW) oral treatment (n = 5) for 63 days (inclusive of pre-treatment prior to tumor inoculation) effectively inhibited tumor growth. Four of the five tumors totally regressed, demonstrating the effectiveness of TSP ingestion in suppressing tumor growth. Although no significant changes were found in mouse serum cytokines (TNF-α, IL-5, IL-6 and CCL2), some increasing and decreasing trends were observed. This may suggest the immunomodulatory potential of these treatments that can directly or indirectly affect tumor growth. Pre-treatment with CWE, HMW and MMW significantly reduced COX-2 activity in RAW264.7 macrophages upon 24 h LPS-stimulation, suggesting the potential of L. rhinocerus TM02® extract and fractions in regulating M1/M2 polarization.
CONCLUSION: Based on the findings of our investigation, both the rhinoprolycan fraction and crude sclerotial powder from L. rhinocerus TM02® demonstrated tumor suppressive effects, indicating that they contain substances with strong anticancer potential. The antitumor effects of L. rhinocerus TM02® in our study highlights the potential for further explorations into its mechanism of action and future development as a prophylactic or adjunct therapeutic against tumorous cancer.