Herbal Science Research - gastrointestinal

Some phytochemical, pharmacological and toxicological properties of ginger (Zingiber officinale Roscoe): A review [...]

Site Editor — Fri, 02 Nov 2007 15:49:24 -0700

Some phytochemical, pharmacological and toxicological properties of ginger (Zingiber officinale Roscoe): A review of recent research.: Food Chem Toxicol. 2007 Sep 18; Ali BH, Blunden G, Tanira MO, Nemmar A

Ginger (Zingiber officinale Roscoe, Zingiberacae) is a medicinal plant that has been widely used in Chinese, Ayurvedic and Tibb-Unani herbal medicines all over the world, since antiquity, for a wide array of unrelated ailments that include arthritis, rheumatism, sprains, muscular aches, pains, sore throats, cramps, constipation, indigestion, vomiting, hypertension, dementia, fever, infectious diseases and helminthiasis. Currently, there is a renewed interest in ginger, and several scientific investigations aimed at isolation and identification of active constituents of ginger, scientific verification of its pharmacological actions and of its constituents, and verification of the basis of the use of ginger in some of several diseases and conditions. This article aims at reviewing the most salient recent reports on these investigations. The main pharmacological actions of ginger and compounds isolated therefrom include immuno-modulatory, anti-tumorigenic, anti-inflammatory, anti-apoptotic, anti-hyperglycemic, anti-lipidemic and anti-emetic actions. Ginger is a strong anti-oxidant substance and may either mitigate or prevent generation of free radicals. It is considered a safe herbal medicine with only few and insignificant adverse/side effects. More studies are required in animals and humans on the kinetics of ginger and its constituents and on the effects of their consumption over a long period of time.

Effects of warm water sitz bath on symptoms in post-anal sphincterotomy in chronic anal fissure [...]

Site Editor — Mon, 22 Oct 2007 18:21:51 -0700

Effects of warm water sitz bath on symptoms in post-anal sphincterotomy in chronic anal fissure--a randomized and controlled study.: World J Surg. 2007 Jul;31(7):1480-4 Authors: Gupta PJ

BACKGROUND: Sitz bath is frequently recommended by physicians for a variety of anal disorders including anal fissure. The aim of the present study was to determine whether sitz bath does have any therapeutic properties improving upon a patient's postoperative symptoms after a closed lateral sphincterotomy. MATERIALS AND METHODS: Forty-six patients were randomly assigned to receive analgesics and fiber supplement alone (control patients) or a twice-daily sitz bath along with identical fiber and analgesics (sitz bath group). A 24-h pain score--post-defecation anal burning and symptom improvement--was evaluated on a visual analog scale (VAS). RESULTS: The groups were equally matched for age, gender distribution, and duration of disease. No significant difference in mean pain score between groups (p = 0.284) was noticed after one week. However, the patients from the control group experienced significant anal burning compared with patients from sitz bath group (p < 0.0001). The improvement score was higher in the sitz bath group when compared with the control group; however, it did not reached a statistically significant level. CONCLUSIONS: Patients after sphincterotomy for anal fissure receiving sitz bath experienced similar levels of pain when compared with those not receiving sitz bath. However, they reported a significant relief in anal burning and a marginally better satisfaction score and no reported adverse side effects.

PMID: 17534541 [PubMed - indexed for MEDLINE]

[STW 5/Iberogast: multi-target-action for treatment of functional dyspepsia and irritable bowel syndrome]

Site Editor — Sun, 21 Oct 2007 05:52:12 -0700

[STW 5/Iberogast: multi-target-action for treatment of functional dyspepsia and irritable bowel syndrome]: Wien Med Wochenschr. 2007;157(13-14):301-7 Authors: Allescher HD, Wagner H

Functional gastro-intestinal diseases such as functional dyspepsia and irritable bowel syndrome are a therapeutic challenge, as they are not only characterized by a multitude of symptoms, some of them with severe consequences for affected patients, but are also caused by a multitude of factors. The clinical efficacy of the therapeutics STW 5/Iberogast in these diseases has been proven in a number of randomized prospective clinical studies. Several preclinical studies suggest that its efficacy could be due to its complex composition of nine standardized herbal extracts, which act differently on multiple sites. This principle, which is quite popular in clinical medicine, was introduced as a multi-target therapy for functional bowel disorders. Components of STW 5/Iberogast reduce gastro-intestinal hypersensitivity and act spasmolytic on spastic, tonicising on atonic gastro-intestinal muscle. In addition a stimulating effect on reduced mucus-secretion, an inhibitory effect on enhanced gastric acid secretion and an anti-inflammatory effect have been shown. These effects could explain the clinical efficacy of STW5/Iberogast in a large range of symptoms.

PMID: 17704976 [PubMed - indexed for MEDLINE]

[Time and again it hits the little ones: herbal therapy for childhood diarrhea]

Site Editor — Sun, 21 Oct 2007 05:46:49 -0700

[Time and again it hits the little ones: herbal therapy for childhood diarrhea]: Wien Med Wochenschr. 2007;157(13-14):308-11 Authors: Biller A

Acute diarrhea is amongst the most common childhood illnesses. Of paramount importance is an oral rehydration with glucose-electrolyte solutions. A number of herbal therapies are available to shorten the duration of the diarrhea and to alleviate the unpleasant symptoms. Although herbal preparations are generally well tolerated, only a few have been tested on children and adjusted to their needs. Various therapies for diarrhea in childhood are highlighted with regard to the clinical trials with children, and their user-friendliness.

PMID: 17704977 [PubMed - indexed for MEDLINE]

Traditional kava beverage consumption and liver function tests in a predominantly Tongan population in Hawaii.

Site Editor — Thu, 04 Oct 2007 06:14:11 -0700

Traditional kava beverage consumption and liver function tests in a predominantly Tongan population in Hawaii.: Clin Toxicol (Phila). 2007 Jun-Aug;45(5):549-56 Authors: Brown AC, Onopa J, Holck P, Kaufusi P, Kabasawa D, Craig WJ, Dragull K, Levine AM, Baker JD

PURPOSE: To determine the effects of traditionally prepared kava beverages on the liver function tests of regular kava beverage consumers in a population of Tongan and non-Tongan residents of Hawaii (Oahu). METHODS: The liver function tests of 31 healthy adult kava drinkers were compared against a control group of 31 healthy adult non-kava drinkers. Subjects were recruited from the general population, a kava bar, and Tongan kava drinking circles. The liver function profile included AST, ALT, ALP, GGT, and bilirubin (total and direct). Other tests included total protein, albumin, and screens for viral hepatitis and hemochromatosis when indicated. RESULTS: Chronic kava beverage consumption was associated with elevation of GGT in 65% of the kava drinkers versus 26% in the controls (P = .005). ALP was elevated in 23% of kava drinkers versus 3% in the controls (P = .053). CONCLUSION: Heavy kava beverage consumption was associated with significantly elevated GGT levels.

PMID: 17503265 [PubMed - indexed for MEDLINE]

Metabolic activation of herbal and dietary constituents and its clinical and toxicological implications: an update.

Site Editor — Thu, 04 Oct 2007 06:07:49 -0700

Metabolic activation of herbal and dietary constituents and its clinical and toxicological implications: an update.: Curr Drug Metab. 2007 Aug;8(6):526-53 Authors: Zhou SF, Xue CC, Yu XQ, Wang G

In recent years, there has been a globally increasing application of herbal medicines and dietary supplements to treat various chronic diseases and to promote health. However, there are increasing clinical reports on the organ toxicities associated with consumption of herbal medicines. This review updates the knowledge on metabolic activation of herbal components and its clinical and toxicological implications. Like many synthetic drugs undergoing metabolic activation to form reactive metabolites which are often associated with drug toxicity, it is recognized that some herbal components may also be converted to toxic, or even mutagenetic and carcinogenic metabolites by cytochrome P450s (CYPs) and less frequently by Phase II conjugating enzymes. This is exemplified by aristolochic acids (AAs) in Aristolochia spp, which undergo reduction of the nitro group by hepatic CYP1A1/2 or peroxidases in extrahepatic tissues to generate highly reactive cyclic nitrenium ions. The latter can react with macromolecules (DNA and protein), resulting in activation of H-ras oncogene and gene mutation in renal cells and finally carcinogenesis of the kidneys. Some naturally occurring flavonoids (e.g. quercetin) and alkenylbenzenes (e.g. safrole, methyleugenol and estragole) can undergo metabolic activation by sequential 1-hydroxylation and sulfation, resulting in reactive intermediates capable of forming DNA adducts and finally genotoxicity. Additional examples are pulegone present in essential oils from many mint species; and teucrin A, a diterpenoid found in germander (Teuchrium chamaedrys) used as an adjuvant to slimming dietary supplements but caused severe hepatotoxicity. Extensive pulegone metabolism generated p-cresol that was a glutathione depletory, whereas the furan ring of the diterpenoids in germander was oxidized by CYP3A4 to reactive epoxide which can inactivate hepatic CYP3A and epoxide hydrolase through covalent binding. The hepatotoxic and carcinogenic species of plant pyrrolizidine alkaloids (e.g. echimidine and jacobine), namely pyrrole-type metabolites, are generated by hepatic CYP2B6 and CYP3A4. Potential mechanisms underlying the hepatotoxicity of kava have been related to intracellular glutathione depletion and/or quinone formation. Some herbal constituents (e.g. capsaicin from chili peppers, glabridin from licorice root, oleuropein in olive oil, dially sulfone in garlic, and resveratrol found in red wine) behave as mechanism-based inhibitors of various CYPs. This may provide an explanation for some reported herb-drug interactions. In addition, the inhibition of CYPs by herbal constituents may decrease the formation of toxic metabolites and thus inhibit carcinogenesis, as CYPs play an important role in procarcinogen activation. Due to the wide use and easy availability of herbal medicines, further research should be conducted to ensure the safety and quality of herbal medicine.

PMID: 17691916 [PubMed - indexed for MEDLINE]

Plants of the American continent with antiulcer activity.

Site Editor — Thu, 04 Oct 2007 05:38:08 -0700

Plants of the American continent with antiulcer activity.: Phytomedicine. 2007 Sep 27; Authors: Falcão HS, Mariath IR, Diniz MF, Batista LM, Barbosa-Filho JM

Peptic ulcer is a chronic and appalling disease. Today, it is dominant among the diseases that affect the world's population. The principal factors causing this disease are inadequate dietetic habits, prolonged use of non-steroidal anti-inflammatory drugs, stress and infection by Helicobacter pylori, in addition to other factors of genetic origin. The present work is a literature survey of plant extracts from the American continent that have been reported to show antiulcer activity. This review refers to 58 plants with their families, parts used, type of extract used, model bioassays and their activity. This work intends to aid the researchers in the study of natural products appropriate to the treatment of stomach and intestinal diseases, in general, and peptic ulcer in particular.

PMID: 17904832 [PubMed - as supplied by publisher]

Plant folk medicines for gastrointestinal disorders among the main tribes of Sonora, Mexico.

Site Editor — Sat, 22 Sep 2007 18:12:26 -0700

Plant folk medicines for gastrointestinal disorders among the main tribes of Sonora, Mexico.: Fitoterapia. 2007 Aug 9; Moreno-Salazar SF, Robles-Zepeda RE, Johnson DE

This paper describes the herbal remedies used by ethnic groups from Sonora, Mexico, for treatment of gastrointestinal diseases. Twelve types of these illnesses are cured using 85 different species which belong to 38 families. Thirty nine spp. are used to treat diarrhea, 28 for stomach-ache, 12 for constipation, 9 for intestinal parasites, 6 for indigestion, 3 for stomach or intestinal cancer, 3 for stomach inflammation and only 1 to treat gastrointestinal sicknesses, ulcers, gastritis, colitis and colic. Regarding the use of species of plant per ethnic group the following was observed: Mayo 47; Seri, 27; Yaqui, 13; Guarijio, 12, Pima, 5 and Papago, 3. The plants are used by two or more tribes, for the same or different illness but always related to the gastrointestinal system.

An updated systematic review of the pharmacology of silymarin.

Site Editor — Fri, 13 Jul 2007 18:19:17 -0700

An updated systematic review of the pharmacology of silymarin.: Forsch Komplementarmed. 2007 Apr;14(2):70-80 Authors: Saller R, Melzer J, Reichling J, Brignoli R, Meier R

BACKGROUND: Recent years have seen an explosion of scientific papers that deal with drugs from the fruits of milk thistle and its active substances silymarin (standardized mixture of flavonolignanes), thus justifying an updated systematic review. METHODS: Electronic databases identified silymarin, silibinin, silicristin or milk thistle as descriptors in >700 papers (34% published in last 5 years; 92% dealt with animal pharmacological). Only papers adequately reporting on experimental conditions, dosing, variables tested and statistics were analysed. RESULTS: Silymarin was found to modify specifically the functions related to various transporters and receptors located in the cell membranes; that is, organic anion uptake transporter peptides (OATP), ABC transporters (P-gp), bile salt export pump, as well as TNF-alpha-dependent and possibly selectin-dependent phenomena. In the cytoplasm, some antioxidant properties and the inhibition of the lipoxygenase pathway seem quite selective and could concur to the antitoxic effects. Some effects like the inhibition of inducible nitric-oxide synthase, of nuclear factor kappa B, and reduction of collagen synthesis are indicative of DNA/RNA-mediated effects. Several studies using 'in vitro' and 'in vivo' cancer models suggest a potential of silymarin in such diseases. Topical and systemic silymarin has skin protective properties against UV-induced damage in epidermis and causes an up-regulation of tumour-suppressor genes p53- and p21CIP1. There were no data on hepatic viral replication, viremia or spontaneous tumours in the data examined. CONCLUSIONS: Data presented here do not solve the question about the complex mechanism(s) of action of the medicinal herbal drug silymarin. Silymarin may be a natural multi-functional and multi-target drug.

PMID: 17464157 [PubMed - indexed for MEDLINE]

Herbal medicine in the treatment of liver diseases.

Site Editor — Sat, 23 Jun 2007 05:18:54 -0700

Herbal medicine in the treatment of liver diseases.:

Herbal medicine in the treatment of liver diseases.

Dig Liver Dis. 2007 Apr;39(4):293-304

Authors: Stickel F, Schuppan D

Herbal drugs have become increasingly popular and their use is widespread. Licensing regulations and pharmacovigilance regarding herbal products are still incomplete and clearcut proof of their efficacy in liver diseases is sparse. Nevertheless, a number of herbals show promising activity including silymarin for antifibrotic treatment, phyllantus amarus in chronic hepatitis B, glycyrrhizin to treat chronic viral hepatitis, and a number of herbal combinations from China and Japan that deserve testing in appropriate studies. Apart from therapeutic properties, reports are accumulating about liver injury after the intake of herbals, including those advertised for liver diseases. Acute and/or chronic liver damage occurred after ingestion of some Chinese herbs, herbals that contain pyrrolizidine alkaloids, germander, greater celandine, kava, atractylis gummifera, callilepsis laureola, senna alkaloids, chaparral and many others. Since the evidence supporting the use of botanicals to treat chronic liver diseases is insufficient and only few of them are well standardised and free of potential serious side effects, most of these medications are not recommended outside clinical trials. Particularly with regard to the latter, adequately powered randomised-controlled clinical trials with well-selected end points are needed to assess the role of herbal therapy for liver diseases.

PMID: 17331820 [PubMed - indexed for MEDLINE]

[Prevention and alternative methods for prophylaxis of recurrent urinary tract infections in women]

Site Editor — Mon, 11 Jun 2007 06:43:56 -0700

[Prevention and alternative methods for prophylaxis of recurrent urinary tract infections in women]: Urologe A. 2006 Apr;45(4):443-4, 446-50 Authors: Vahlensieck W, Bauer H

General recommendations to prevent recurrent urinary tract infections (rUTI) result in about one-third of patients remaining free of recurrences. Oral and parenteral immunotherapy were effective in several controlled studies for prevention of rUTI. These therapies can be combined with acute antibiotic therapy. Vaginal prophylaxis with oestriol has proven its positive effect without serious gynaecological side effects. Also there is increasing evidence that cranberries prevent rUTI. The exact mode (juice, tablets or preserved berries), dosage and duration of this therapy remain to be defined. There are also promising therapy modalities such as changing bacterial gut flora, general immune response (acupuncture, inpatient rehabilitation) and urine acidity.

Research on biomodulatory effect of natural compounds.

Site Editor — Mon, 11 Jun 2007 06:20:26 -0700

Research on biomodulatory effect of natural compounds.: Neuro Endocrinol Lett. 2006 Dec;27 Suppl 2:53-6 Authors: Miadoková E, Nadová S, Trebatická M, Grolmus J, Kopásková M, Rauko P, Mucaji P, Grancai D

OBJECTIVES: The purpose of this study was to determine whether the extract isolated from the artichoke Cynara cardunculus L. (ECC) had antimutagenic effect and was able to enhance the therapeutic effect of cytostatic drug cis-platinum (cis-Pt). METHODS: The potential antimutagenic activity of ECC was assayed by a test on sex-linked recessive lethal mutations detection in Drosophila melanogaster males treated with ethylmethane sulfonate (EMS). The possible enhancement of cytostatic/cytotoxic effect of cis-Pt by ECC was evaluated in the cell revitalization assay by measuring cell viability via Trypan blue exclusive assay using mouse leukemia cells L1210. RESULTS: EMS was both toxic and genotoxic in D. melanogaster males. It statistically significantly increased the frequency of sex-linked recessive lethal mutations in comparison to the negative control. Furthermore, ECC statistically significantly reduced the genotoxic effect of EMS. It acted in a desmutagenic manner via EMS inactivation. In the cell revitalization assay, ECC enhanced the cytotoxic/cytostatic effect of cis-Pt. The therapeutic potential of ECC was established on the basis of statistically significantly lowered recovery of cis-Pt pre-treated mouse leukemia cells in the presence of ECC. CONCLUSIONS: The results imply that the extract isolated from artichoke C. cardunculus L. has marked beneficial activities antimutagenic and therapeutic effect enhancing) and its potential biomedical application in the combination therapy of cancer and some neurodegenerative diseases may be suggested.

Role of P-glycoprotein in the intestinal absorption of glabridin, an active flavonoid from the root of Glycyrrhiza glabra.

Site Editor — Mon, 11 Jun 2007 06:19:10 -0700

Role of P-glycoprotein in the intestinal absorption of glabridin, an active flavonoid from the root of Glycyrrhiza glabra.: Drug Metab Dispos. 2007 Apr;35(4):539-53 Authors: Cao J, Chen X, Liang J, Yu XQ, Xu AL, Chan E, Wei D, Huang M, Wen JY, Yu XY, Li XT, Sheu FS, Zhou SF

Glabridin is a major constituent of the root of Glycyrrhiza glabra, which is commonly used in the treatment of cardiovascular and central nervous system diseases. This study aimed to investigate the role of P-glycoprotein (PgP/MDR1) in the intestinal absorption of glabridin. The systemic bioavailability of glabridin was approximately 7.5% in rats, but increased when combined with verapamil. In single-pass perfused rat ileum with mesenteric vein cannulation, the permeability coefficient of glabridin based on drug disappearance in luminal perfusates (P(lumen)) was approximately 7-fold higher than that based on drug appearance in the blood (P(blood)). Glabridin was mainly metabolized by glucuronidation, and the metabolic capacity of intestine microsomes was 1/15 to 1/20 of that in liver microsomes. Polarized transport of glabridin was found in Caco-2 and MDCKII monolayers. Addition of verapamil in both apical (AP) and basolateral (BL) sides abolished the polarized transport of glabridin across Caco-2 cells. Incubation of verapamil significantly altered the intracellular accumulation and efflux of glabridin in Caco-2 cells. The transport of glabridin in the BL-AP direction was significantly higher in MDCKII cells overexpressing PgP/MDR1 than in the control cells. Glabridin inhibited PgP-mediated transport of digoxin with an IC(50) value of 2.56 microM, but stimulated PgP/MDR1 ATPase activity with a K(m) of 25.1 microM. The plasma AUC(0-24h) of glabridin in mdr1a(-/-) mice was 3.8-fold higher than that in wild-type mice. These findings indicate that glabridin is a substrate for PgP and that both PgP/MDR1-mediated efflux and first-pass metabolism contribute to the low oral bioavailability of glabridin.

Randomised clinical trial of a laxative alone versus a laxative and a bulking agent [...]

Site Editor — Mon, 11 Jun 2007 05:37:58 -0700

Randomised clinical trial of a laxative alone versus a laxative and a bulking agent after primary repair of obstetric anal sphincter injury.: BJOG. 2007 Jun;114(6):736-40 Authors: Eogan M, Daly L, Behan M, O'Connell PR, O'Herlihy C

OBJECTIVE: To compare two postpartum laxative regimens in women who have undergone primary repair of obstetric anal sphincter injury. DESIGN: Randomised controlled trial. SETTING: National Maternity Hospital, Dublin. POPULATION: A total of 147 postpartum women who had sustained anal sphincter injury at vaginal birth. METHODS: Women were randomised to receive either lactulose alone thrice daily for the first three postpartum days followed by sufficient lactulose to maintain a soft stool over the following 10 days (lactulose group, n = 77) or the lactulose regimen combined with a sachet of ispaghula husk daily for the first 10 postpartum days (Fybogel group, n = 70). All patients kept a diary of bowel habit for the first 10 postpartum days and were invited to return for review at 3 months postpartum. MAIN OUTCOME MEASURES: Patient discomfort with first postpartum bowel motion, incidence of postnatal constipation and incontinence and incontinence score in postnatal period. RESULTS: Pain scores were similar in the two treatment groups; but incontinence in the immediate postnatal period was more frequent with the two preparations compared with lactulose alone (32.86% versus 18.18%, P = 0.03). CONCLUSIONS: This study does not support routine prescribing of a stool-bulking agent in addition to a laxative in the immediate postnatal period for women who have sustained anal sphincter injury at vaginal delivery.

Advances in the Use of Milk Thistle (Silybum marianum).

Site Editor — Mon, 11 Jun 2007 05:32:46 -0700

Advances in the Use of Milk Thistle (Silybum marianum).: Integr Cancer Ther. 2007 Jun;6(2):104-9 Authors: Post-White J, Ladas EJ, Kelly KM

Milk thistle (Silybum marianum) is an herbal supplement used to treat liver and biliary disorders. Silymarin, a mixture of flavanoid complexes, is the active component that protects liver and kidney cells from toxic effects of drugs, including chemotherapy. Although milk thistle has not significantly altered the course of chronic liver disease, it has reduced liver enzyme levels and demonstrated anti-inflammatory and T cell-modulating effects. There is strong preclinical evidence for silymarin's hepatoprotective and anticarcinogenic effects, including inhibition of cancer cell growth in human prostate, skin, breast, and cervical cells. Milk thistle is considered safe and well-tolerated, with gastrointestinal upset, a mild laxative effect, and rare allergic reaction being the only adverse events reported when taken within the recommended dose range. More clinical trials of rigorous methodology, using standardized and well-defined products and dosages, are needed to evaluate the potential of silymarin against liver toxicity, chronic liver disease, and human cancers.

A mechanistic study on altered pharmacokinetics of irinotecan by St. John's wort.

Site Editor — Fri, 11 May 2007 15:35:53 -0700

A mechanistic study on altered pharmacokinetics of irinotecan by St. John's wort.: Curr Drug Metab. 2007 Feb;8(2):157-71 Authors: Hu ZP, Yang XX, Chen X, Cao J, Chan E, Duan W, Huang M, Yu XQ, Wen JY, Zhou SF

Irinotecan (CPT-11) is an important anticancer drug in management of advanced colon cancer. A marked protective effect on CPT-11-induced blood and gastrointestinal toxicity is obtained by combination of St. John's wort (SJW) in recent clinical and rat studies. However, the mechanism is unclear. This study aimed to explore the effects of SJW on the pharmacokinetics of CPT-11 and its major metabolites (SN-38 and SN-38 glucuronide) in rats and the underlying mechanisms using several in vitro models. Short-term (3 days) and long-term (14 days) pretreatment with SJW were conducted in rats to examine the effects of co-administered SJW on the plasma pharmacokinetics of CPT-11, SN-38 and SN-38 glucuronide. Rat liver microsomes and a rat hepatoma cell line, H4-II-E cells, were utilized to study the effects of aqueous and ethanolic extracts (AE and EE) and major active components (hyperforin, hypericin and quercetin) of SJW on CPT-11 and SN-38 metabolism and intracellular accumulation. Co-administered SJW for consecutive 14 days significantly decreased the initial plasma concentration (C0) of CPT-11, the area under the concentration-time curve (AUC(0-10hr)) and maximum plasma concentration (Cmax) of SN-38. The ethanolic extracts (EE) of SJW at 5 microg/ml significantly decreased SN-38 glucuronidation by 45% (P < 0.05) in rat hepatic microsomes. Pre-incubation of aqueous SJW extracts (AE) at 10 microg/ml, SJW EE at 5 microg/ml, and quercetin at 10 microM significantly increased the glucuronidation of SN-38 in H4-II-E cells. A 2-hr pre-incubation of quercetin (100 microM) significantly increased the intracellular accumulation of CPT-11 (P < 0.05). However, pre-incubation of hypericin (20 nM and 200 nM) and hyperforin (1 microM) significantly decreased the intracellular accumulation of CPT-11. In addition, pre-incubation of hypericin, SJW EE and quercetin significantly increased the intracellular accumulation of SN-38. Aqueous and ethanolic SJW extracts and its major active components did not alter the plasma protein binding of CPT-11 and SN-38. These results indicated that the aqueous and ethanolic extracts of SJW and its major active components could markedly alter glucuronidation of SN-38 and intracellular accumulation of CPT-11 and SN-38, which probably provides partial explanation for the altered plasma pharmacokinetics of CPT-11 and SN-38 and the antagonizing effects on the toxicities of CPT-11. Further studies are needed to explore the role of both pharmacokinetic and pharmacodynamic components in the protective effect of SJW against the toxicities of CPT-11.

Taraxacum--a review on its phytochemical and pharmacological profile.

Site Editor — Thu, 01 Feb 2007 16:31:57 -0800

Taraxacum--a review on its phytochemical and pharmacological profile.: J Ethnopharmacol. 2006 Oct 11;107(3):313-23 Authors: Schütz K, Carle R, Schieber A

The genus Taraxacum is a member of the family Asteraceae, subfamily Cichorioideae, tribe Lactuceae and widely distributed in the warmer temperate zones of the Northern Hemisphere. The perennial weed has been known since ancient times for its curative properties and has been utilized for the treatment of various ailments such as dyspepsia, heartburn, spleen and liver complaints, hepatitis and anorexia. However, its use has mainly been based on empirical findings. This contribution provides a comprehensive review of the pharmacologically relevant compounds of Taraxacum characterized so far and of the studies supporting its use as a medicinal plant. Particular attention has been given to diuretic, choleretic, anti-inflammatory, anti-oxidative, anti-carcinogenic, analgesic, anti-hyperglycemic, anti-coagulatory and prebiotic effects. Finally, research needs such as quantification of individual Taraxacum constituents and assessment of their pharmacological activities in humans have briefly been outlined.

Effects of choleretics on bile compositions drained from patients with pigment gallstone.

Site Editor — Thu, 01 Feb 2007 16:28:26 -0800

Effects of choleretics on bile compositions drained from patients with pigment gallstone.: Chin J Integr Med. 2006 Jun;12(2):101-6 Authors: Sun BJ, Cui NQ, Li DH, Wang Q

OBJECTIVE: To provide evidence for three-level prevention of cholelithiasis by means of observing the effects of some choleretics on bile compositions drained from patients with pigment gallstone. METHODS: Twenty-seven patients suffering from primary pigment gallstones and having received treatment of choledochostomies plus T-tube or endoscopic nasal bile drainage (ENBD) were divided equally into three groups, and administered respectively with Lidanling (the LDL group), ursodesoxycholic acid (the UDA group) and combination of LDL and UDA (the LDL + UDA group) through oral intake (7 patients in each group). Besides, 6 post-operational patients got no treatment with any drug were allocated in the control group. Bile of all the patients was collected before treatment and on the 1, 3, 5, 7 th day after the treatment started to detect levels of total bile acid (TBA), glycocholic acid (GCA), taurocholic acid (TCA), glycocholic cheno-desoxycholic acid (GCDCA), total bilirubin (TBIL), uncombined bilirubin (UCB), concentration of calcium ion (Ca(2+)) as well as the bacterio-genetic and endogenous beta-glucuronidase activity for comparing. RESULTS: Levels of TBA, GCA, TCA and GCDCA got gradually increased in the UDA group and the LDL + UDA group after treatment (P < 0.05), while those in the LDL group remained unchanged, showing an insignificant difference as compared with those in the control group. In the LDL group and the LDL + UDA group, TBIL gradually increased while UCB gradually decreased in the course of treatment (P < 0.05). Moreover, levels of Ca(2+) and endogenous beta-glucuronidase activity got significantly lowered (P < 0.05). CONCLUSION: Combined use of LDL and UDA could elevate levels of TBA, GCA, TCA, GCDCA, enhance the excretion of TBIL in patients with pigment gallstone after bile drainage, lower levels of UCB and Ca(2+) and the activity of endogenous beta-glucuronidase in the bile, so as to reduce the possibility of stone formation of bile, and therefore, it could be used to prevent the production of pigment gallstone, especially to prevent post-operative recurrence of stones.

Herbal diterpenoids induce growth arrest and apoptosis in colon cancer cells...

Site Editor — Wed, 31 Jan 2007 19:02:10 -0800

Herbal diterpenoids induce growth arrest and apoptosis in colon cancer cells with increased expression of the nonsteroidal anti-inflammatory drug-activated gene.: Eur J Pharmacol. 2006 Dec 23; Authors: Ko JK, Leung WC, Ho WK, Chiu P

Novel chemotherapeutic agents derived from active phytochemicals could be used as adjuvants and improve the anti-carcinogenicity of standard drug treatments. However, their precise mechanisms of action are sometimes unclear. In this study, the anti-carcinogenic effect of the herbal diterpenoid pseudolaric acid B (PAB) on the growth and apoptosis of colon cancer cells was investigated, and to compare that with the more toxic compound triptolide. PAB induced growth inhibition and apoptosis in HT-29 cells, which were associated with cell cycle arrest at the G(2)/M phase, modulation of cyclin expression and downregulation of the protooncogene c-myc. In addition, PAB also inhibited bcl-x(L) expression, induced cleavage of procaspase-3 and its substrate poly(ADP-ribose) polymerase (PARP), which together caused DNA fragmentation and nuclear chromatin condensation. Concomitantly, the modulation of the growth-related and apoptotic factors by PAB was accompanied by the increased protein and gene expression of the nonsteroidal anti-inflammatory drug-activated gene (NAG-1), which occurred along with cyclooxygenase-2 inhibition. The effects of PAB on PARP cleavage and NAG-1 overexpression were not reversible upon removal of the drug from the culture medium. Similar cytotoxic and pro-apoptotic effects were also attained by treating the HT-29 cells with another diterpenoid triptolide, but its actions on cell cycle progression and on the upstream transcriptional regulation of NAG-1 both took place in a less coherent manner. These findings exemplify the potential of herbal terpenoids, particularly PAB, in modulating colon cancer carcinogenesis through known molecular targets and precise mechanism of action.

Efficacy of an herbal dietary supplement (Smooth Move) in the management of constipation in nursing home residents...

Site Editor — Wed, 10 Jan 2007 21:44:48 -0800

Efficacy of an herbal dietary supplement (Smooth Move) in the management of constipation in nursing home residents: A randomized, double-blind, placebo-controlled study.: J Am Med Dir Assoc. 2006 Nov;7(9):556-61 Authors: Bub S, Brinckmann J, Cicconetti G, Valentine B

OBJECTIVE: To investigate the efficacy and cost effectiveness of an herbal tea, Smooth Move, in nursing home residents with chronic constipation. DESIGN: Double-blind, placebo-controlled, 2-armed, parallel-group clinical trial. SETTING: A 483-bed nursing home in Allentown, Pennsylvania, operated by Lehigh County Government. PARTICIPANTS: A total of 86 nursing home residents with chronic constipation. INTERVENTIONS: Participants (n = 86) were randomly assigned to receive Smooth Move (n = 42) or a placebo (n = 44), once daily, in addition to standard treatment for chronic constipation. The study period was 28 days. MEASUREMENTS: The primary efficacy parameter was the difference in total number of bowel movements. Secondary parameters included the difference in average number of standard treatment doses dispensed, and the difference in total medication costs. RESULTS: Compared to placebo, in the intention to treat (ITT analysis) there was a statistically significant increase in the number of bowel movements in the Smooth Move group. The Smooth Move group (n = 42) compared with the placebo group (n = 44) experienced an average of 4.14 more bowel movements during the 28-day study period versus the 28-day pre-study period (P = .017). CONCLUSION: Smooth Move herbal tea, when added to the standard treatment regimen for nursing home residents with chronic constipation, increased the average number of bowel movements compared to the addition of a placebo tea.

Echinacea purpurea supplementation stimulates select groups of human gastrointestinal tract microbiota.

Site Editor — Wed, 03 Jan 2007 19:02:30 -0800

Echinacea purpurea supplementation stimulates select groups of human gastrointestinal tract microbiota.: J Clin Pharm Ther. 2006 Dec;31(6):599-604 Authors: Hill LL, Foote JC, Erickson BD, Cerniglia CE, Denny GS

Background and objective: The objective of this research was to determine the effects of the dietary supplement Echinacea purpurea on aerobic and anaerobic bacteria common to the human gastrointestinal (GI) tract. Botanical extracts have shown in vitro antimicrobial effects against certain pathogenic bacteria. It is uncertain if medicinal herbs have any effect against pathogenic bacteria or on the native GI microbiota. Methods: Fifteen human subjects consumed 1000 mg of standardized E. purpurea for 10 days. Faecal samples were collected at baseline, 10 days and 17-18 days following supplementation. Samples were tested for select aerobic and anaerobic bacteria using plate culture microbiological methods. Results and discussion: Significant increases were found for total aerobic bacteria, Bacteroides group and Bacteroides fragilis after E. purpurea exposure. Supplementation did not significantly alter the number of enteric bacteria, enterococci, lactobacilli, bifidobacteria or total anaerobic bacteria. Conclusion: Echinacea supplementation has altered the GI microbiota. The health consequences associated with this change are unknown but previous research has shown increased Bacteroides concentrations associated with diarrhoea, inflammatory bowel disease and increased risk of colon cancer. Additional research should delineate the role of Echinacea in the stimulation of Bacteroides and describe the effects of other botanical supplements to the GI microbiota.

Cytotoxic and antitumor activity of liposome-incorporated sclareol against cancer cell lines and human colon cancer xenografts.

Site Editor — Fri, 09 Jun 2006 07:20:26 -0700

Cytotoxic and antitumor activity of liposome-incorporated sclareol against cancer cell lines and human colon cancer xenografts.: Pharmacol Res. 2006 Jan;53(1):80-7 Authors: Hatziantoniou S, Dimas K, Georgopoulos A, Sotiriadou N, Demetzos C

The aim of this study was to design and prepare liposome-incorporated sclareol--a highly lipophilic natural product-to overcome its water insolubility and develop suitable formulations for in vivo administration. The bioactive labdane-type diterpene sclareol was incorporated into liposomes composed of egg phosphatidylcholine and dipalmitoylphosphatidylglycerol prepared by the thin-film hydration method followed by sonication. A formulation of egg phosphatidylcholine/dipalmitoylphosphatidylglycerol/sclareol (9:0.1:5 molar ratio) was developed and characterized. The lipid recovery and the sclareol to lipid molar ratio were measured using high-performance thin-layer chromatography/flame ionization detection. In vitro drug release was measured in supplemented RPMI-1640 at 37 degrees C. The liposomal and the free sclareol were initially tested in vitro for their activity against human cancer cell lines using the sulphorhodamine B assay. Liposomes incorporating sclareol at a drug to lipid molar ratio of 0:43, suggesting an incorporation efficiency of almost 80%, showed reduced growth rate of human colon cancer tumors (HCT116) developed in SCID mice, without any significant side effects.

Eupatilin, a pharmacologically active flavone derived from Artemisia plants, induces apoptosis in human gastric cancer...cells.

Site Editor — Fri, 09 Jun 2006 07:19:53 -0700

Eupatilin, a pharmacologically active flavone derived from Artemisia plants, induces apoptosis in human gastric cancer (AGS) cells.: J Environ Pathol Toxicol Oncol. 2005;24(4):261-9 Authors: Kim MJ, Kim DH, Na HK, Oh TY, Shin CY, Surh Ph D Professor YJ

Extracts of Artemisia asiatica Nakai (Asteraceae) possess anti-inflammatory and antioxidative activities. Eupatilin (5,7-dihydroxy-3',4', 6-trimethoxyflavone), one of the pharmacologically active ingredients derived from A. asiatica was shown to induce apoptosis in human promyelocytic leukemia (HL-60) cells. In the present study, we examined the ability of eupatilin to induce apoptosis in human gastric cancer (AGS) cells. Eupatilin induced the apoptosis of AGS cells as revealed by a decrease in the ratio of pro-apoptotic Bax and anti-apoptotic Bcl-2, as well as the cleavage of caspase-3 and poly(ADP-ribose)polymerase (PARP).The pro-apoptotic effects of eupatilin were further verified by its perturbation of the mitochondrial transmembrane potential (DeltaPsim). In addition, eupatilin treatment led to an elevated expression of p53 and p21. Eupatilin inhibited the activation of ERK1/2 and Akt, which are important components of cell-survival pathways.

Inhibition of Helicobacter pylori and associated urease by oregano and cranberry phytochemical synergies.

Site Editor — Fri, 09 Jun 2006 07:18:56 -0700

Inhibition of Helicobacter pylori and associated urease by oregano and cranberry phytochemical synergies.: Appl Environ Microbiol. 2005 Dec;71(12):8558-64

Authors: Lin YT, Kwon YI, Labbe RG, Shetty K

Ulcer-associated dyspepsia is caused by infection with Helicobacter pylori. H. pylori is linked to a majority of peptic ulcers. Antibiotic treatment does not always inhibit or kill H. pylori with potential for antibiotic resistance. The objective of this study was to determine the potential for using phenolic phytochemical extracts to inhibit H. pylori in a laboratory medium. Our approach involved the development of a specific phenolic profile with optimization of different ratios of extract mixtures from oregano and cranberry. Subsequently, antimicrobial activity and antimicrobial-linked urease inhibition ability were evaluated. The results indicated that the antimicrobial activity was greater in extract mixtures than in individual extracts of each species. The results also indicate that the synergistic contribution of oregano and cranberry phenolics may be more important for inhibition than any species-specific phenolic concentration. Further, based on plate assay, the likely mode of action may be through urease inhibition and disruption of energy production by inhibition of proline dehydrogenase at the plasma membrane.

Systematic review: complementary and alternative medicine in the irritable bowel syndrome.

Site Editor — Fri, 09 Jun 2006 04:35:01 -0700

Systematic review: complementary and alternative medicine in the irritable bowel syndrome.: Aliment Pharmacol Ther. 2006 Feb;23(4):465-71 Authors: Hussain Z, Quigley EM

Background Complementary and alternative medical therapies and practices are widely employed in the treatment of the irritable bowel syndrome. Aim To review the usage of complementary and alternative medicine in the irritable bowel syndrome, and to assess critically the basis and evidence for its use. Methods A systematic review of complementary and alternative medical therapies and practices in the irritable bowel syndrome was performed based on literature obtained through a Medline search. Results A wide variety of complementary and alternative medical practices and therapies are commonly employed by irritable bowel syndrome patients both in conjunction with and in lieu of conventional therapies. As many of these therapies have not been subjected to controlled clinical trials, some, at least, of their efficacy may reflect the high-placebo response rate that is characteristic of irritable bowel syndrome. Of those that have been subjected to clinical trials most have involved small poor quality studies. There is, however, evidence to support efficacy for hypnotherapy, some forms of herbal therapy and certain probiotics in irritable bowel syndrome. Conclusions Doctors caring for irritable bowel syndrome patients need to recognize the near ubiquity of complementary and alternative medical use among this population and the basis for its use. All complementary and alternative medicine is not the same and some, such as hypnotherapy, forms of herbal therapy, specific diets and probiotics, may well have efficacy in irritable bowel syndrome. Above all, we need more science and more controlled studies; the absence of truly randomized placebo-controlled trials for many of these therapies has limited meaningful progress in this area.

Modulation of MPP+ uptake by tea and some of its components in Caco-2 cells.

Site Editor — Fri, 09 Jun 2006 04:29:43 -0700

Modulation of MPP+ uptake by tea and some of its components in Caco-2 cells.: Naunyn Schmiedebergs Arch Pharmacol. 2005 Aug;372(2):147-52 Authors: Monteiro R, Calhau C, Martel F, Faria A, Mateus N, Azevedo I

The entry of most xeno/endobiotics into the organism is limited by their intestinal absorption. The interference of certain foods with the therapeutic efficacy of drugs or with chemical toxicity is becoming evident and growing attention is being given to these subjects. The aim of this work was to study the effect of green tea (GT) and black tea (BT), as well as some of their components, on the transport of organic cation molecules. For this purpose, 3H-MPP+ (radiolabeled 1-methyl-4-phenylpyridinium) was used as a model organic cation and Caco-2 cells were used as an intestinal epithelial model. Our results showed that both GT and BT significantly increased 3H-MPP+ absorption in these cells. Additionally, we studied the effect of epigallocatechin-3-gallate (EGCG), myricetin, caffeine, and theophylline. Whereas EGCG (2 mM) increased, myricetin (50 microM) and caffeine (1 mM) decreased, and theophylline (1 mM) had no effect on the uptake of 3H-MPP+ into Caco-2 cells. When GT was supplemented with caffeine or theophylline, we observed a partial loss of its effect. When BT was supplemented with EGCG, its ability to increase 3H-MPP+ uptake was much more pronounced than that observed with BT alone. In conclusion, this study showed that GT and BT might interfere with the absorption of the model organic cation MPP+ by the intestinal epithelium. Since important compounds are organic cations, the consequences of this interference may have an impact on human health. Although this constitutes only preliminary work and further studies are needed, tea should be included in the growing list of foodstuffs that have the potential to be involved in food-drug interactions.

Crohn's disease leading to bowel cancer may be avoided by consumption of soya isoflavones: Adjunct-chemotherapy with oxaliplatin

Site Editor — Fri, 09 Jun 2006 04:26:43 -0700

Crohn's disease leading to bowel cancer may be avoided by consumption of soya isoflavones: Adjunct-chemotherapy with oxaliplatin.: Med Hypotheses. 2006 Jan 20; Authors: Wiseman A

Crohn's disease (inflammatory bowel syndrome) is caused by gut exposure to harmful reactive oxygen species (ROS) derived from oxygen, such as the superoxide anion (()O(2)(')), the hydroxyl radical (()OH) or the peroxide anion (O(2)('')): the superoxide anion is generated by breakdown of oxygen-peroxidised phospholipids membranes. Crohn's disease predisposes to bowel cancer in susceptible human sub-populations. It may be preventable in these as yet unpredictable sub-populations by dietary-based intervention strategies, such as the daily consumption of appropriate quantities of soya isoflavones. These isoflavonoids are ROS-directed antioxidants, and they include the phytoestrogens, daidzin and genistin present in soya foods (consumed also in dietary supplements). Oxaliplatin is a platinum-containing Pt(II) organometallic therapeutic agent that binds to tumour DNA. Oxaliplatin may provide, therefore, a form of chemotherapy for some bowel cancers especially when administered in adjunct-chemotherapies that employ inhibitors of proliferation of the tumour cell. Such inhibitors include 5-fluorouracil, which prevents the correct replication of tumour cell DNA that is an essential prerequisite for bowel tumour growth. Furthermore, the therapeutic index for adjunct-chemotherapy with toxic inhibitors of DNA replication and expression could potentially be raised significantly by an associated dietary regime. This should include supplementation daily, per or, with antioxidant isoflavones (or other bioflavonoids) in selected cases of unresponsive cancer of the bowel, to possibly seek to trigger the pathway of apoptosis (programmed cell death) in the tumour cells preferentially.

Plant extracts affect in vitro rumen microbial fermentation.

Site Editor — Fri, 09 Jun 2006 04:24:47 -0700

Plant extracts affect in vitro rumen microbial fermentation.: J Dairy Sci. 2006 Feb;89(2):761-71 Authors: Busquet M, Calsamiglia S, Ferret A, Kamel C

Different doses of 12 plant extracts and 6 secondary plant metabolites were incubated for 24 h in diluted ruminal fluid with a 50:50 forage:concentrate diet. Treatments were: control (no additive), plant extracts (anise oil, cade oil, capsicum oil, cinnamon oil, clove bud oil, dill oil, fenugreek, garlic oil, ginger oil, oregano oil, tea tree oil, and yucca), and secondary plant metabolites (anethol, benzyl salicylate, carvacrol, carvone, cinnamaldehyde, and eugenol). Each treatment was supplied at 3, 30, 300, and 3,000 mg/L of culture fluid. At 3,000 mg/L, most treatments decreased total volatile fatty acid concentration, but cade oil, capsicum oil, dill oil, fenugreek, ginger oil, and yucca had no effect. Different doses of anethol, anise oil, carvone, and tea tree oil decreased the proportion of acetate and propionate, which suggests that these compounds may not be nutritionally beneficial to dairy cattle. Garlic oil (300 and 3,000 mg/L) and benzyl salicylate (300 and 3,000 mg/L) reduced acetate and increased propionate and butyrate proportions, suggesting that methane production was inhibited. At 3,000 mg/L, capsicum oil, carvacrol, carvone, cinnamaldehyde, cinnamon oil, clove bud oil, eugenol, fenugreek, and oregano oil resulted in a 30 to 50% reduction in ammonia N concentration. Careful selection and combination of these extracts may allow the manipulation of rumen microbial fermentation.

Monitoring of immune responses to a herbal immuno-modulator in patients with advanced colorectal cancer.

Site Editor — Fri, 09 Jun 2006 04:24:22 -0700

Monitoring of immune responses to a herbal immuno-modulator in patients with advanced colorectal cancer.: Int Immunopharmacol. 2006 Mar;6(3):499-508 Authors: Chen X, Hu ZP, Yang XX, Huang M, Gao Y, Tang W, Chan SY, Dai X, Ye J, Ho PC, Duan W, Yang HY, Zhu YZ, Zhou SF

Many herbal medicines are widely used as immuno-modulators in Asian countries. Ganoderma lucidum (Lingzhi) is one of the most commonly used herbs in Asia and preclinical studies have established that the polysaccharide fractions of G. lucidum have potent immuno-modulating effects. However, clinical evidence for this is scanty. The present open-labeled study aimed to evaluate the effects of G. lucidum polysaccharides on selected immune functions in patients with advanced colorectal cancer. Forty-seven patients were enrolled and treated with oral G. lucidum at 5.4 g/day for 12 weeks. Selected immune parameters were monitored using various immunological methods throughout the study. In 41 assessable cancer patients, treatment with G. lucidum tended to increase mitogenic reactivity to phytohemagglutinin, counts of CD3, CD4, CD8 and CD56 lymphocytes, plasma concentrations of interleukin (IL)-2, IL-6 and interferon (IFN)-gamma, and NK activity, whereas plasma concentrations of IL-1 and tumor necrosis factor (TNF)-alpha were decreased. For all of these parameters, no statistical significance was observed when a comparison was conducted between baseline and those values after a 12-week treatment with G. lucidum. The changes of IL-1 were correlated with those for IL-6, IFN-gamma, CD3, CD4, CD8 and NK activity (p<0.05) and IL-2 changes were correlated with those for IL-6, CD8 and NK activity. The results indicate that G. lucidum may have potential immuno-modulating effect in patients with advanced colorectal cancer. Further studies are needed to explore the benefits and safety of G. lucidum in cancer patients.

[Effect of intestinal cytochrome P450 3A on phytochemical presystemic metabolism.]

Site Editor — Fri, 09 Jun 2006 04:21:09 -0700

[Effect of intestinal cytochrome P450 3A on phytochemical presystemic metabolism.]: Chin J Integr Med. 2005 Sep;11(3):232-6 Authors: Xia F, Chen XY

Phytochemicals, orally administered substances, are found to undergo presystemic metabolism mainly in the intestine. Although early researches confirmed the role of intestinal bacteria in phytochemical presystemic metabolism, along with the development of molecular biology in investigating intestinal metabolism, a breakthrough has been won in research into metabolizing enzymes and transporters in intestine, which demands more attention and further studies. Recently, Cytochrome P450 3A has been found to be the most effective enzyme in mediating both oxidative (PhaseI) and conjugative (PhaseII) metabolism in the intestine. The present review summarizes the current findings correlated with the effect of intestinal cytochrome P450 3A on phytochemical presystemic metabolism, which provides a good basis for further research on phytochemical pharmacokinetics.