Prospective assessment of taste impairment and nausea during radiotherapy for head and neck cancer

Dysgeusia and nausea are common side effects observed in head and neck cancer patients treated with either exclusive radiotherapy or combined modality treatment. The aim of the present study was to prospectively evaluate dysgeusia, during treatment and follow-up, using the chemotherapy-induced taste alteration scale (CiTAS), a metrics based on 18-items exploring three dimensions (quantitative and qualitative changes in taste perception, and diet-related issues) identified through a four-factor analysis: decline in basic taste, discomfort, phantogeusia-parageusia, and general taste alterations. Moreover, we scored, according to Common Toxicity Criteria Adverse Events, nausea and other treatment-related toxicities. Since, ginger is traditionally used to prevent and/or treat nausea and vomiting, we prophylactically employed a ginger-based supplement named Naumix/Naugin (Gamfarma, Milan, Italy), to potentially mitigate both nausea and taste impairment. Using the CiTAS scale, we highlighted a progressive increase in all dysgeusia dimensions, peaking at the VII week of treatment and a subsequent partial late recovery. In particular, we observed a recovery for discomfort, phantogeusia-parageusia, and general taste alterations at 6 months. Grade 2 nausea, observed to be as low as 12.9% potentially due to the use of ginger, peaked at the III week of treatment. Finally, for patients experiencing nausea, the dysgeusia dimension of discomfort was also relevant.

The effect of ginger powder and Chinese herbal medicine on production performance, serum metabolites and antioxidant status of laying hens under heat-stress condition

This study was done to evaluate the effects of Chinese herbal medicine (CHM) and ginger powder on layers-production performance, serum metabolites and antioxidant status under heat stress condition. Two hundred and fifty Lohmann layers were randomly divided into 5 different, including two controls and three experimental groups (H1, H2, and H3). Control groups were fed the basic diet without supplementation, while, the feed of three experimental groups was supplemented with 3.32 g CHM, 10 g ginger powder, and 10 g ginger powder+ 3.32 g CHM per kg of diet, respectively. Results showed that feed consumption and production rate were decreased in the HC group, while, feed intake and production significantly improved when birds were given supplemented diet. The production rate and feed intake of the H3 group were even significantly higher than the NC group. The birds that received supplemented diet had higher glucose level compared to HC. Triglycerides and serum cholesterol had significantly decreased level in supplemented groups compared to HC. Fungal catalase (CAT) level was significantly improved in H2 and H3 groups. Nitric oxide (NO), glutathione peroxidase (GSH-PX) and Total Protein (T-AOC) level were significantly improved in supplemented groups. Findings showed that ginger powder and CHM could be a viable alternative to the synthetic antibiotic in poultry feed.

Zingiber officinale and oxidative stress in patients with ulcerative colitis: A randomized, placebo-controlled, clinical trial

OBJECTIVES

Oxidative stress plays an essential role in ulcerative colitis (UC) initiation and severity. We aimed to investigate the effect of ginger as a well-known antioxidant agent on the quality of life, disease activity index and oxidative stress in patients with UC.

METHODS

Forty six patients with active mild to moderate UC randomly assigned to consume 2000 mg/day dried ginger powder in 4 capsules or similar placebo capsules for 12 weeks. Disease activity index, quality of life and some oxidative stress factors were measured before, at the middle and at the end of the intervention through valid and reliable questionnaires and blood sampling.

RESULTS

Ginger reduced Malondialdehyde (MDA) significantly after 6 weeks (p = 0.003) and 12 weeks (p < 0.001) of intervention, whereas it did not affect serum total anti-oxidant capacity (TAC). The scores of severity of disease activity at 12th week was significantly improved in ginger group in comparison to placebo (p = 0.017). Moreover, ginger increased patients quality of life significantly at 12th week (p = 0.039).

CONCLUSION

Our data indicate that ginger supplementation can improve treatment of patients with UC. Further clinical trials with different dosages and duration of ginger or its standard extract supplementation are needed to obtain firm conclusion.

Effects of ginger supplementation on anthropometric, glycemic and metabolic parameters in subjects with metabolic syndrome: A randomized, double-blind, placebo-controlled study

Background

Metabolic syndrome (MetS) is one of the worldwide most chronic endocrine disorders. The disease can also lead to several other chronic disorders such as type 2 diabetes mellitus, cardiovascular diseases, renal diseases and cancers. This study aimed to evaluate the safety and efficacy of ginger powder on biochemical and anthropometric parameters in patients with MetS.

Methods

This randomized controlled clinical trial was conducted on 37 patients with MetS. We supplemented the individuals with MetS with either 2 g per day ginger powder or placebo for 12 weeks. Biochemical and anthropometric parameters before and after the intervention were compared between the two groups.

Results

After 12 weeks of treatment, the levels of triglyceride (TG), FBS, and insulin resistance were significantly improved in the patients receiving ginger in compare to the placebo group (P < 0·05). Moreover, significant changes were observed in terms of weight, waist circumference, LDL, HDL, total cholesterol, systolic and diastolic blood pressure and energy intake between the groups.

Conclusion

In general, our findings demonstrated that the ginger supplementation offers beneficial effects on patients with MetS, at least, in part due to the modulatory effects on TG, FBS, and insulin resistance.

Effect of ground ginger on dough and biscuit characteristics and acrylamide content

Effect of different contents of ground ginger [0%, 1%, 3%, 5%, and 7% (w/w)] on flour quality, dough and biscuit characteristic and acrylamide content were investigated. Texture results showed that by adding 1% (w/w) ground ginger, hardness of dough, hardness and chewiness of biscuit decreased, which was beneficial for biscuit making. Moreover, the L* value of biscuit dropped while the a* and b* value rose with the increase of ginger contents, indicating darker, redder and yellower biscuits. Sensory score of biscuits became worse but acrylamide content reduced with the addition of ground ginger. The phenol hydroxyl group of gingerol played a more important role in the reaction of formation of acrylamide than the side chain. Finally, biscuit with 1% ground ginger content showed good texture, color and acceptable sensory evaluation, as well as lowering the acrylamide content by 6.2%.

The effect of an oral ginger supplementation on NF-κB concentration in peripheral blood mononuclear cells and anthropomorphic data of patients with type 2 diabetes: A randomized double-blind, placebo-controlled clinical trial

INTRODUCTION

The complications of diabetes are extensive which can be caused by excessive oxidative stress, inflammation and impaired insulin system. Plant-sourced bioactive compounds can reduce inflammation and oxidative stress. The aim of present study was to determine the effect of ginger supplementation on diabetic complications.

METHODS

The present study is a randomized double blind clinical trial which is conducted with 48 diabetic patients. The participants were randomly divided into two intervention and placebo groups which were received 2 g ginger powder and 2 g wheat flour respectively for 10 weeks. Nuclear factor kappa B (NF-κB) concentration and anthropometric measurements were evaluated at the baseline and at the end of study.

RESULTS

The effect of ginger supplementation on hip circumference was marginal and there was no significant effect on BMI and waist circumference. Mean NF-κB p65 concentrations were reduced in ginger supplementation group, however, the amount was not statistically significant.

CONCLUSION

Ginger supplementation had significant effects on anthropometric evaluations. Ginger supplementation decreased mean NF-κB concentration in comparison with placebo, however the significance level was marginal. In order to achieve reliable information, more researches should be complemented with uptake of other diagnostic tools.

The effect of frankincense (Boswellia serrata, oleoresin) and ginger (Zingiber officinale, rhizoma) on heavy menstrual bleeding: A randomized, placebo-controlled, clinical trial

OBJECTIVES

To evaluate the effect of frankincense (Boswellia serrata, oleoresin) and ginger (Zingiber officinale, rhizoma) as complementary treatments for heavy menstrual bleeding (HMB) among women of reproductive age.

DESIGN

Randomized, placebo-controlled, clinical trial.

SETTING

Gynecology outpatient clinics.

INTERVENTIONS

Patients with HMB (n = 102) were randomly assigned to three groups. All patients received ibuprofen (200 mg) and either frankincense (300 mg), ginger (300 mg), or a placebo, which contains 200 mg anhydrous lactose as the filling agent and was similar in appearance to the two other drugs. Patients received the medications three times a day for seven days of the menstrual cycle, starting from the first bleeding day and this was repeated for two consecutive menstrual cycles.

MAIN OUTCOME MEASURES

Amount and duration of menstrual bleeding and quality of life (QOL).

RESULTS

Duration of menstrual bleeding was decreased in the frankincense (-1.77 ± 2.47 days, P = 0.003) and ginger (-1.8 ± 1.79 days, P = 0.001) groups, but not in the placebo group (-0.52 ± 1.86 days, P = 0.42). Amount of menstrual bleeding was decreased in all (P < 0.05), with no difference among the study groups (P > 0.05). More improvement in QOL was observed in the frankincense (-25.7 ± 3.1; P < 0.001) and ginger (-29.2 ± 3.7: P < 0.001) groups compared to the placebo group (-15.07 ± 3.52; P < 0.001) and between the groups, differences were statistically significant (P = 0.02).

CONCLUSIONS

Ginger and frankincense seem to be effective complementary treatments for HMB. Further studies with a larger sample size and longer follow-up are warranted in this regard.

Review of herbal medications with the potential to cause bleeding: dental implications, and risk prediction and prevention avenues

Medicinal plant products have been used in health care since time immemorial. During the past three decades, the use of herbal supplements has been on the rise in the USA. A number of these products have been shown to possess the potential to interfere with blood clotting. This paper is a review of blood-thinning herbal supplements commonly used in the USA, accompanied by discussion of the dental implications of their use along with suggestions for prediction and prevention of the risk of bleeding. Twenty herbal supplements belonging to four pharmacological groups are identified and reviewed. While the majority (45%) of the supplements reviewed possesses antiplatelet properties, the remaining are dispersed among anticoagulant (15%), a combination of antiplatelet and anticoagulant (15%), and other diverse groups (25%). The literature reveals that most of the available information on blood-thinning herbs is based on in vitro experiments, animal studies, and individual clinical case reports. Some herbal effects are also speculated based on theoretical grounds. These observations, together with the deficiency of the law regulating herbal supplements, indicate limitations of the literature and the regulatory mechanisms related to these products, further implying the need for additional research and improved regulation. While emphasizing the dental implications of the findings reported in the literature, suggestions were made for prediction and prevention of the risk of bleeding caused by herbal medications, based on the concepts of predictive, preventive, and personalized medicine.

Use of alternative medicine, ginger and licorice among Danish pregnant women - a prospective cohort study

BACKGROUND

The use of alternative medicines and dietary supplements is constantly changing, as are dietary habits. One example of this phenomenon is the current popularity of ginger products as an everyday health boost. Ginger and licorice has also been shown to ameliorate nausea a common complaint in early pregnancy. Alternative medicines are often regarded as safe. However, they might affect fetal development, such as through alterations of hormone metabolism and cytochrome P450 function. Health care professionals may be unaware of the supplementation habits of pregnant women, which may allow adverse exposures to go unnoticed, especially if the rates of use in pregnancy are not known. We therefore investigated the use of alternative medicines and licorice among pregnant Danish women.

METHODS

A total of 225 pregnant women were included in a prospective cohort when attending the national prenatal screening program at gestational weeks 10-16. Participants were asked to complete a questionnaire regarding their socio-economic status and lifestyle habits, including their intake of alternative medicine and licorice.

RESULTS

We found that 22.7% of women reported taking alternative medicines, with 14.7% reporting daily consumption. Ginger supplements were consumed by 11.1%, mainly as health boost and 87.1% reported consumption of licorice. Regular or daily licorice consumption was reported by 38.2 and 7.1%, respectively. Notably, the use of licorice was reflected by an increase in blood pressure of the pregnant women.

CONCLUSIONS

The use of licorice and alternative medicines appears to be common in pregnant Danish women, supporting the need for further investigations into the safety of alternative medicine use during pregnancy and the importance of up-to-date personalized counseling regarding popular health trends and lifestyle habits.

Ginger: A Novel Strategy to Battle Cancer through Modulating Cell Signalling Pathways: A Review

Numerous studies have been performed in understanding the development of cancer. Though, the mechanism of action of genes in the development of cancer remains to be explained. The current mode of treatment of cancer shows adverse effects on normal cells and also alter the cell signalling pathways. However, ginger and its active compound have fascinated research based on animal model and laboratories during the past decade due to its potentiality in killing cancer cells. Ginger is a mixture of various compounds including gingerol, paradol, zingiberene and shogaol and such compounds are the main players in diseases management. Most of the health-promoting effects of ginger and its active compound can be attributed due to its antioxidant and anti-tumour activity. Besides, the active compound of ginger has proven its role in cancer management through its modulatory effect on tumour suppressor genes, cell cycle, apoptosis, transcription factors, angiogenesis and growth factor. In this review, the role of ginger and its active compound in the inhibition of cancer growth through modulating cell signalling pathways will be reviewed and discussed.

Effect of Hydroalcoholic Ginger Extract on Brain HMG-CoA Reductase and CYP46A1 Levels in Streptozotocin-induced Diabetic Rats

BACKGROUND

Patients with diabetes present with lipid disorders, including hypercholesterolemia, which can be a high-risk factor for atherosclerosis. Recently, increasing interest has been focused on anti-lipidemic function of herbal medicines, especially Zingiber officinale (known as ginger), in diabetes. However, the mechanism underlying the effect of ginger on some players involved in cholesterol homeostasis of Central Nervous System (CNS) among diabetic patients remains unclear. To our knowledge, this is the first study to investigate the effect of ginger on brain regulation of Hydroxymethylglutaryl-CoA Reductase (HMG-CoA reductase) and Cholesterol 24-hydroxylase (CYP46A1), which provides a rational model for understanding brain dyslipidemia mechanisms associated with diabetes.

METHODS

Brains of rats were isolated from four groups: control, non-treated diabetic, and treated diabetic groups receiving 200 or 400 mg/kg of hydroalcoholic extracts of ginger for eight weeks. HMG-CoA reductase and CYP46A1 levels in brain homogenates were determined by western-blot technique.

RESULTS

Ginger root extract caused a significant decrease in HMG-CoA reductase and an increase in CYP46A1 levels in treated diabetic groups compared to diabetic control. In comparison to diabetic group, these effects were more remarkable with 400 mg/kg concentration of ginger extract.

CONCLUSION

The findings showed that ginger extract has a regulatory effect on proteins involved in cholesterol homeostasis in CNS by a significant down- and up-regulation of HMG-CoA reductase and CYP46A1 levels, respectively. It can be suggested that adding ginger to daily diet of diabetic patients has useful effects and may ameliorate diabetes complications.

Isolation, Purification, and Characterization of Ginger-derived Nanoparticles (GDNPs) from Ginger, Rhizome of Zingiber officinale

Factors implicated in the pathophysiology of intestinal inflammation include defects in intestinal epithelial barrier function, abnormal immune responses, and activities of the gut microbiota. Current agents used to treat human Inflammatory Bowels Disease (IBD), chronic inflammation of digestive tract, have serious side effects. In addition, most of these treatments target the damaging factors while not providing pro-healing factors that repair the damaged intestine. Here we provide a method to isolate, purify and characterize a specific population from ginger (ginger-derived nanoparticles: GDNPs 2) with anti-inflammatory activities. GDNPs 2 as a drug vehicle are a novel natural, nontoxic delivery system, which target the inflamed intestinal mucosa, blocks damaging factors while promoting pro-healing factors and could easily be developed for large-scale production aimed at the treatment of IBD.

Processed Gingers: Current and Prospective Use in Food, Cosmetic, and Pharmaceutical Industry

Ginger (Zingiber officinale) has been widely used in traditional medicine, and as raw material for cosmetics, beverages, and health functional foods. However, some adverse effects of ginger have been reported. In addition, the hot and pungent taste of ginger leads to reduced consumption. To overcome these problems, methods for the production of fermented, steamed (or steamed-dried), aged, roasted and beopje ginger have been developed. This review provides an overview and summary of new ginger processing procedures, including methods to reduce the pungent flavor of ginger, extend shelf-life, increase the health-functional compound content, and improve safety. These attempts might improve the consumption of ginger as well as prospective applications of processed ginger for food, cosmetics, and the pharmaceutical industry, also as discussed in various patents.

Ameliorative and protective effects of ginger and its main constituents against natural, chemical and radiation-induced toxicities: A comprehensive review

Fatal unintentional poisoning is widespread upon human exposure to toxic agents such as pesticides, heavy metals, environmental pollutants, bacterial and fungal toxins or even some medications and cosmetic products. In this regards, the application of the natural dietary agents as antidotes has engrossed a substantial attention. One of the ancient known traditional medicines and spices with an arsenal of metabolites of several reported health benefits is ginger. This extended literature review serves to demonstrate the protective effects and mechanisms of ginger and its phytochemicals against natural, chemical and radiation-induced toxicities. Collected data obtained from the in-vivo and in-vitro experimental studies in this overview detail the designation of the protective effects to ginger's antioxidant, anti-inflammatory, and anti-apoptotic properties. Ginger's armoury of phytochemicals exerted its protective function via different mechanisms and cell signalling pathways, including Nrf2/ARE, MAPK, NF-ƙB, Wnt/β-catenin, TGF-β1/Smad3, and ERK/CREB. The outcomes of this review could encourage further clinical trials of ginger applications in radiotherapy and chemotherapy regime for cancer treatments or its implementation to counteract the chemical toxicity induced by industrial pollutants, alcohol, smoking or administered drugs.

Anti-neuroinflammatory Effects of 12-Dehydrogingerdione in LPS-Activated Microglia through Inhibiting Akt/IKK/NF-κB Pathway and Activating Nrf-2/HO-1 Pathway

Ginger, one of worldwide consumed dietary spice, is not only famous as food supplements, but also believed to exert a variety of remarkable pharmacological activity as herbal remedies. In this study, a ginger constituent, 12-dehydrogingerdione (DHGD) was proven that has comparable anti-inflammatory activity with positive control 6-shogaol in inhibiting LPS-induced interleukin (IL)-6, tumor necrosis factor (TNF)-α, prostaglandin (PG) E₂, nitric oxide (NO), inducible NO synthase (iNOS) and cyclooxygenase (COX)-2, without interfering with COX-1 in cultured microglial cells. Subsequent mechanistic studies indicate that 12-DHGD may inhibit neuro-inflammation through suppressing the LPS-activated Akt/IKK/NF-κB pathway. Furthermore, 12-DHGD markedly promoted the activation of NF-E2-related factor (Nrf)-2 and heme oxygenase (HO)-1, and we demonstrated that the involvement of HO-1 on the production of pro-inflammatory mediators such as NO and TNF-α by using a HO-1 inhibitor, Zinc protoporphyrin (Znpp). These results indicate that 12-DHGD may protect against neuro-inflammation by inhibiting Akt/IKK/IκB/NF-κB pathway and promoting Nrf-2/HO-1 pathway.

Proximate and antioxidant activities of bio-preserved ogi flour with garlic and ginger

Background: Ogi from locally available cereals remains a relatively affordable complementary food in West Africa, but has a tendency to spoil due it high moisture content. This study explored effects of garlic and ginger as biopreservatives in ogi flour. Methods:Ogi flour was prepared from sorghum and quality protein maize grains with different concentrations of garlic and ginger powder (2 and 4% w/w) by fermentation technique. These samples were stored for 16 weeks during which the total titratable acidity, pH, proximate composition, mineral content and total antioxidant activities were determined. Results: The proximate compositions of bio-preserved ogi samples were relatively stable throughout storage. The addition of garlic and ginger slightly increased the ash (0.04%), crude protein and mineral contents (mg/ 100g) of the samples.  Magnesium (10.85-13.13 and 5.17-9.72); zinc (1.37-1.78 and 7.01-8.50), manganese (1.30-1.71 and 0.45-0.86) and iron (1.53-1.77 and 0.68-2.77) contents increased on addition (of garlic and ginger) to maize ogi and sorghum ogi flours respectively. The free radical scavenging activity; total phenolic and flavonoid contents increased correspondingly with the antioxidants activity. Conclusion: Although not well known to ogi consumer, the bio-preserved ogi flours showed better nutritional values and have potential as a health food.

Proximate and antioxidant activities of bio-preserved ogi flour with garlic and ginger

Background: Ogi from locally available cereals remains a relatively affordable complementary food in West Africa, but has a tendency to spoil due it high moisture content. This study explored effects of garlic and ginger as biopreservatives in ogi flour. Methods:Ogi flour was prepared from sorghum and quality protein maize grains with different concentrations of garlic and ginger powder (2 and 4% w/w) by fermentation technique. These samples were stored for 16 weeks during which the total titratable acidity, pH, proximate composition, mineral content and total antioxidant activities were determined. Results: The proximate compositions of bio-preserved ogi samples were relatively stable throughout storage. The addition of garlic and ginger slightly increased the ash (0.04%), crude protein and mineral contents (mg/ 100g) of the samples.  Magnesium (10.85-13.13 and 5.17-9.72); zinc (1.37-1.78 and 7.01-8.50), manganese (1.30-1.71 and 0.45-0.86) and iron (1.53-1.77 and 0.68-2.77) contents increased on addition (of garlic and ginger) to maize ogi and sorghum ogi flours respectively. The free radical scavenging activity; total phenolic and flavonoid contents increased correspondingly with the antioxidants activity. Conclusion: Although not well known to ogi consumer, the bio-preserved ogi flours showed better nutritional values and have potential as a health food.

Effect of Ginger and Novafen on menstrual pain: A cross-over trial

OBJECTIVE

Menstrual pain is a periodic pain which happens during the days of menses. The menstrual disturbances as a health problem among young girls affect not only reproductive, but also psychical health and quality of life. This study was done with the goal of comparing the effect of Ginger and Novafen on the menstrual pain.

MATERIALS AND METHODS

This crossover clinical trial study was done in Iran on 168 single girl students 18-26 years old in Babol University of Medical Sciences with primary menstrual pain. The participants were randomly allocated to two groups receiving the drugs Novafen and Ginger. At the beginning of pain, in the two groups 200 mg capsule was given every 6 h for two serial cycles. Pain severity was measured by the visual scale before treatment, 1 h after consuming the drug (for 24 h) and 48 h after the onset of drug.

RESULTS

The mean age of participants was 21.83 ± 2.07 years. It has been reported that the intensity of pain from dysmenorrhea decreased in the Novafen and Ginger groups. Before treatment, the average pain intensity in Novafen and Ginger users were 7.12 ± 2.32 and 7.60 ± 1.84, respectively and after treatment pain intensity decreased to 3.10 ± 2.69 and 2.97 ± 2.69, respectively. Differences between two groups each time showed no statistical significance (p > 0.05).

CONCLUSION

Both drugs reduced menstrual pain. Ginger as well as Novafen is effective in relieving pain in girls with primary dysmenorrhea . Therefore, treatment with natural herbal medicine, non-synthetic drug, to reduce primary dysmenorrhea is recommended.

Ginger causes subfertility and abortifacient in mice by targeting both estrous cycle and blastocyst implantation without teratogenesis

BACKGROUND

Due to renowned medicinal properties, Ginger rhizomes (Zingiber officinale Roscoe) used traditionally in the treatment of arthritis, rheumatism, muscular aches, constipation, indigestion, hypertension, dementia, fever, and infectious diseases. As an antiemetic, Ginger is consumed by approximately 80% of pregnant women to treat nausea and vomiting of early pregnancy.

PURPOSE

The aim of this study is to evaluate the impact of ginger extract on the oestrous cycle and implantation in female mice.

STUDY DESIGN AND METHODS

Four experimental episodes were identified. One considered the main study of outcomes and lasted 90 days; one lasted 35 days and considered the oestrous cycle; while the third and fourth intended antifertility and abortifacient and continued 20 days for each. Mice dosed Ginger orally at 0, 250, 500, 1000 or 2000  mg/kgbw/day (GNC, GN1, GN2, GN3, GN4, respectively).

RESULTS

GN3 and GN4 dams showed maternal toxicity. High dose significantly reduced the number of live fetuses and increased fetal death and resorption. Mice treated with 2000  mg/kgbw/day displayed significant decreases in implantation sites. At a dose of 2000  mg/kgbw/day, Ginger prolonged the length of oestrous cycle with a significant decrease in the duration of diestrous-metestrus (luteal) phase, prolonged proestrus-estrus (ovulatory) phase and reduced the number of cycles as well. Therefore, Ginger impairs the normal growth of corpus luteum because of progesterone insufficiency during early pregnancy. The observed-adverse-effect dose set at 2000  mg/kgbw, but no-observed-adverse-effect dose set at 250 and 500  mg/kgbw.

CONCLUSION

These findings suggest that Ginger can disrupt the oestrous cycle and blastocyst implantation without teratogenesis.

Ginger (Zingiber officinale): An alternative for the prevention of postoperative nausea and vomiting. A meta-analysis

BACKGROUND

Postoperative nausea and vomiting (PONV) is a distressing outcome related to surgeries. Traditionally, ginger has been used in the treatment of nausea and vomiting for thousands of years. Recently, several randomized, placebo-controlled clinical trials (RCTs) have been conducted to evaluate the efficacy of ginger in PONV.

PURPOSE

To systematically evaluate the efficacy of ginger on postoperative nausea and vomiting (PONV) compared to placebo, based on RCTs.

STUDY DESIGN

The meta-analysis was reported following the PRISMA guidelines using the PICO format, and it was registered with the PROSPERO register.

METHODS

PubMed, Embase, the Cochrane Central Register of Controlled Trials and Web of Science were searched for relevant studies. Human, placebo-controlled clinical studies of patients undergoing any types of surgery, receiving pharmacological doses of ginger per os were included. Only clinical trials with explicit description of the ginger preparation used were analysed. No language or publication year restrictions was applied.

RESULTS

Ten randomized trials including a total of 918 patients were pooled for the statistical analysis. The present meta-analysis supports that ginger has a significant effect on the severity of PONV based on visual analogue scale (VAS) results: in a fixed effects model the pooled standardized mean difference (SMD) was -0.247 (favouring ginger; [LL]: -0.455, [UL]: -0.040, p-value: 0.019). Moreover, our results suggest that ginger reduces the incidence of postoperative nausea and vomiting, as well antiemetic drug demand; however, these effects are not statistically significant compared to placebo, which may be explained by underdosing.

CONCLUSIONS

According to our thorough meta-analysis ginger is safe and well tolerated, and decreases the severity of PONV, and may lower the incidence of postoperative nausea and vomiting, which in turn may reduce antiemetic drug demand, suggesting that ginger may be a useful alternative to antiemetic medications to alleviate PONV.

Therapeutic potentials of ginger for treatment of Multiple sclerosis: A review with emphasis on its immunomodulatory, anti-inflammatory and anti-oxidative properties

Multiple sclerosis (MS) is characterized by chronic inflammatory response-induced demyelination of the neurons and degeneration of the axons within the central nervous system (CNS). A complex network of immunopathological-, inflammatory- and oxidative parameters involve in the development and advancement of MS. The anti-inflammatory, immunomodulatory and anti-oxidative characteristics of the ginger and several of its components have been indicated in some of experimental and clinical investigations. The possible therapeutic potentials of ginger and its ingredients in the treatment of MS may exert mainly through the regulation of the Th1-, Th2-, Th9-, Th17-, Th22- and Treg cell-related immune responses, down-regulation of the B cell-related immune responses, modulation of the macrophages-related responses, modulation of the production of pro- and anti-inflammatory cytokines, down-regulation of the arachidonic acid-derived mediators, interfering with the toll like receptor-related signaling pathways, suppression of the inflammasomes, down-regulation of the oxidative stress, reduction of the adhesion molecules expression, and down-regulation of the expression of the chemokines and chemokine receptors. This review aimed to provide a comprehensive knowledge regarding the immunomodulatory-, anti-inflammatory and anti-oxidative properties of ginger and its components, and highlight novel insights into the possible therapeutic potentials of this plant for treatment of MS. The review encourages more investigations to consider the therapeutic potentials of ginger and its effective components for managing of MS.

Transcriptome-based mining and expression profiling of Pythium responsive transcription factors in Zingiber sp

Transcription factors (TFs) fine-tune the host defense transcriptome in response to pathogen invasions. No information is available on Zingiber zerumbet (Zz) TFs involved in defense response against Pythium myriotylum. Here, we provide a global identification, characterization, and temporal expression profiling of Zz TFs following an incompatible interaction with P. myriotylum using a transcriptome sequencing approach. We identified a total of 903 TFs belonging to 96 families based on their conserved domains. Evolutionary analysis clustered the Zz TFs according to their phylogenetic affinity, providing glimpses of their functional diversities. High throughput expression array analysis highlighted a complex interplay between activating and repressing transcription factors in fine-tuning Zz defense response against P. myriotylum. The high differential modulation of TFs involved in cell wall fortification, lignin biosynthesis, and SA/JA hormone crosstalk allows us to envisage that this mechanism plays a central role in restricting P. myriotylum proliferation in Zz. This study lays a solid foundation and provides valuable resources for the investigation of the evolutionary history and biological functions of Zz TF genes involved in defense response.

Interventions for treating nausea and vomiting in pregnancy: a network meta-analysis and trial sequential analysis of randomized clinical trials

INTRODUCTION

Several drugs were explored for their utility in treating nausea and vomiting in pregnancy (NVP). The present study is a network meta-analysis of such drugs.

METHODS

Electronic databases were searched for randomized clinical trials that have compared active interventions (with placebo or other active interventions) for treating NVP. Nausea scores were the primary outcome and changes in nausea scores, emetic episodes, adverse events, and vomiting control were the key secondary outcomes. Weighted mean difference was the effect estimate for continuous variable and odds ratio for the numerical variable. Random-effects model was used and the strength of the evidence was graded.

RESULTS

Fifty studies were included in the systematic review and 42 in the meta-analysis. Acupuncture, chamomile, dimenhydrinate, doxylamine/vitamin B6, ginger, quince, metoclopramide, and vitamin B6 were associated with reduced nausea scores compared to placebo. Of these interventions, ginger and vitamin B6 were also associated with better vomiting control and less incidence of adverse events. Adequate evidence supporting the use exists only for ginger and the quality of evidence for this comparison is moderate. Strength of evidence for all other comparisons is very low.

CONCLUSION

Present evidence is conclusive on the therapeutic benefits of ginger in treating NVP. Although favorable results were obtained for several other interventions, the strength of evidence is very low. The results of this network meta-analysis should be interpreted with extreme caution as it might change with the advent of data from future head-to-head clinical trials.

Transcriptome analysis provides novel insights into high-soil-moisture-elevated susceptibility to Ralstonia solanacearum infection in ginger (Zingiber officinale Roscoe cv. Southwest)

Ginger (Zingiber officinale Roscoe), one of the most economically valuable plants in the Zingiberaceae family, is widely used as a spice and flavoring agent for beverages, bakery, confectionary, and pharmaceutics. Bacterial wilt disease, caused by Ralstonia solanacearum, is one of the most detrimental production constraints in ginger cultivation. Field cultivation experiments indicated that soil moisture affects the incidence of bacterial wilt disease. However, the relationship between soil moisture and bacterial wilt incidence as well as the mechanism that underlie this infection remain unclear. This study confirms that high soil moisture elevates the susceptibility to R. solanacearum infection; transcriptome sequencing was performed to elucidate the underlying mechanisms. Differential expression indicates that a small number of genes is involved in both the response to high soil moisture as well as post successful R. solanacearum infection; furthermore, a large number of genes is involved in the defense of the infection. In response to high soil moisture, higher ABA contents, and higher expression levels of ABF4 may be related to higher tiller density in ginger. More importantly, WAK16 and WAK3-2 may be determinative genes that weaken the resistance to R. solanacearum in ginger under high soil moisture. The down-regulated expression levels of PRX, CPY, and XET genes indicate that in response to successful R. solanacearum infection, the normal cell wall metabolism may be disturbed and the hypersensitive response may be inhibited. In summary, our study deepens our understanding of the molecular mechanisms of the soil moisture dependent wilt susceptibility of ginger.

The Effect of Preoperative Zintoma Capsule on Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy

Background

Postoperative nausea and vomiting (PONV), as one of the complications after laparoscopic cholecystectomy, occurs in over 40% - 77% of cases. Considering the numerous complications of synthetic drugs, there is a growing tendency towards the use of herbal medicines due to their unique features. Ginger root is one of the herbal compounds effective on nausea and vomiting.

Objectives

The aim of this study was to evaluate the effect of preoperative Zintoma capsules on PONV after laparoscopic cholecystectomy.

Methods

In this quasi-experimental study, 130 eligible patients were randomly assigned to intervention (n = 65) and control (n = 65) groups using the four-block method. The intervention group received two capsules of 500 mg and one of 250 mg Zintoma. The control group received three placebo capsules. The severity of patients' PONV was recorded at 0, 2, 6, 12, and 24 hours after surgery using a checklist and a standard VAS instrument. Data were analyzed using t-test, Chi-square test, and LSD Post Hoc test (ANOVA) in SPSS 19.

Results

The severity of PONV and vomiting was significantly different between the two groups (P = 0.001) at the above time points. The mean severity of nausea (by VAS) changed in the intervention group from 7.92 ± 1.28 to 0.33 ± 0.67 and in the control group from 8.00 ± 1.20 to 2.11 ± 1.55. The postoperative vomiting was less frequent in the group receiving the Zintoma capsules. The postoperative use of chemical anti-vomiting and nausea drugs was significantly lower in the intervention group than in the placebo group (P = 0.001).

Conclusions

Zintoma capsules can be used as a supportive treatment in the prevention of nausea and vomiting by reducing the incidence rate of PONV.

A comparison between the effects of ginger, pyridoxine (vitamin B6) and placebo for the treatment of the first trimester nausea and vomiting of pregnancy (NVP)

INTRODUCTION

Nausea and vomiting of pregnancy (NVP) are one of the most common complains of the early pregnancy period and are bothersome for pregnant women. Some prefer to use herbal medicine instead of chemical agents.

OBJECTIVE

The purpose of the present study was to compare the effects of ginger, pyridoxine (vitamin B6), and placebo for the treatment of NVP.

METHOD

The study was performed as a triple blind clinical trial on pregnant women suffering mild to moderate NVP between 6 and 16 weeks of pregnancy. In these women ginger, 500 mg twice daily, vitamin B6 40 mg twice daily and placebo twice daily were administered for 4 d. Rhodes questionnaire was used for evaluation of the severity of symptoms. The severity of NVP was evaluated 24 h before entering the study and up to 4 d after using medications and results were compared among the three groups.

RESULTS

Seventy-seven women finished the study (28 in the Ginger group, 26 in the B6 group, and 23 in the placebo group). The women of the three groups did not have significant differences according to age, gestational age, parity, and severity of each symptom before treatment and educational status. Total score of Rhodes questionnaire for nausea was decreased significantly in three groups after treatment. (p < .001, p = .012, and p = .03 for ginger, vitamin B6, and placebo, respectively.) Also total score of Rhodes questionnaire for vomiting was decreased in three groups (p = .03 for ginger, p = .02 for B6, and p = .04 for placebo). Ginger and vitamin B6 could reduce the severity of all items of Rhodes questionnaire significantly; however, placebo was significantly effective only on the frequency of nausea, intensity of vomiting and frequency of retching. Ginger and vitamin B6 were more effective than placebo (p = .039 and p = .007, respectively); however, total score of Rhodes did not show significant difference between ginger and vitamin B6 (p = .128). Ginger was more effective for nausea (intensity and distress) and distress of vomit.

CONCLUSION

Ginger is more effective than placebo for the treatment of mild to moderate NVP and is comparable with vitamin B6. Trial registration number and registry website: IRCT2015020320923N1.

Ginger alleviates hyperglycemia-induced oxidative stress, inflammation and apoptosis and protects rats against diabetic nephropathy

Oxidative stress plays a major role in the development and progression of diabetic nephropathy (DN). In this study, the potential protective effect of ginger (Zingiber officinale) rhizome extract on hyperglycemia-induced oxidative stress, inflammation and apoptosis was investigated. An experimental diabetic rat model was induced by intraperitoneal injection of streptozotocin. Diabetic rats were treated orally with 400 or 800 mg/kg/day Z. officinale extract for six weeks. Diabetic animals exhibited elevated blood glucose levels and glycated hemoglobin (HbA1c) with altered lipid profile. Blood urea nitrogen, serum creatinine and urea, and urine albumin levels were significantly increased in diabetic rats. Treatment with Z. officinale ameliorated hyperglycemia, hyperlipidemia and kidney function. In addition, Z. officinale minimized the histological alterations in the kidney of diabetic rats. Chronic hyperglycemia resulted in a significant increase in malondialdehyde, protein carbonyl, pro-inflammatory cytokines, cytochrome c and caspase-3 in the kidney of rats. Z. officinale extract significantly attenuated oxidative stress, inflammation and apoptosis, and enhanced antioxidant defenses in the diabetic kidney. In conclusion, this study strongly suggests that Z. officinale rhizome extract exerts a protective role against diabetes-induced renal injury by ameliorating oxidative stress, inflammation and apoptosis.

Ginger (zingiber officinale) might improve female fertility: A rat model

BACKGROUND

Ginger (Zingiber officinale) is a well known and extensively used antioxidant in traditional remedies. In this study, we aimed to investigate the effects of ginger powder on ovarian folliculogenesis and implantation in rats.

METHODS

There were two study groups. In the 5-day treatment group (one estrous cycle), 100 mg ginger powder, 200 mg ginger powder or distilled water was given for 5 days to the three subgroups each containing seven rats. In the 10-day treatment group, same doses were given for 10 days (two estrous cycle) to the three subgroups each containing seven rats. At the end of the 5th and 10th days, ovarian volumes, ovarian weights, primordial follicles, antral follicles, atretic follicles, and corpus luteum counts were assessed. To evaluate the angiogenic effects of ginger, vascular endothelial growth factor (VEGF) and for the antioxidant effects of ginger endothelial nitric oxide synthase (eNOS) were examined in the ovaries and in the endometrium immunohistochemically.

RESULTS

In the 5-day treatment group, antral follicle count and ovarian stromal VEGF were significantly high in the 100 mg ginger subgroup in comparison to the control group (p < 0.05). In the 10-day treatment group, endometrial VEGF and ovarian stromal eNOS were significantly high in the 100 mg ginger subgroup in comparison to the control group (p < 0.05). There was no statistically significant difference at 200 mg ginger dose both in 5-day and 10-day treatment groups.

CONCLUSION

The increases in the antral follicle count and ovarian stromal VEGF in the 100 mg/5-day treatment subgroup indicate that ginger have positive effects on folliculogenesis in short term with low dose. Additionally, ginger may enhance implantation in rats in long term with low dose.

Increased hepatic FAT/CD36, PTP1B and decreased HNF4A expression contributes to dyslipidemia associated with ethanol-induced liver dysfunction: Rescue effect of ginger extract

The association between chronic alcohol consumption and the development of alcpholic liver disease is a very well known phenomenon, but the precise underlying molecular mediators involved in ethanol-induced liver disease remain elusive. This study aimed to characterize the lipid metabolism alterations and the molecular mediators which are related to lipid metabolism in liver under the heavy ethanol exposure alone or combined with ginger extract. Twenty-four male wistar rats were assigned into three groups, namely control, ethanol, and ginger extract treated ethanol (GETE) groups. Six weeks after the treatment, the ethanol group showed a significant increase in fatty acid translocase (FAT)/CD36, protein tyrosine phosphatase 1B (PTP1B) and decrease hepatocyte nuclear factor 4 Alpha (HNF4A) genes expressions compared to the control group. The ethanol administration also significantly increased plasma LDL, cholesterol, triglyceride, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) compared to the control group. Moreover, compared to the control group, the ethanol group showed liver histhological changes, such as fibrosis, focal microvesicular steatosis, some apoptotic hepatocytes, spotty necrosis, portal lymphocytic inflammation, mallory-denk bodies, giant mitochondria, piecemeal necrosis. Consumption of ginger extract along with ethanol, partially ameliorated gene expression alteration and histological changes, improved undesirable lipid profile and liver enzymes changes compare to those in the ethanol group. These findings indicate that ethanol-induced liver abnormalities may in part be associated with lipid homeostasis changes mediated by overexpression of FAT/CD36, PTP1B and downexpressionof HNF4A genes. It also show that these effects can be reduced by using ginger extract as an antioxidant and anti-inflammatory agent.

Ginger rhizome enhances the anti-inflammatory and anti-nociceptive effects of paracetamol in an experimental mouse model of fibromyalgia

BACKGROUND

The dried rhizome of ginger has been widely used for more than 2500 years in folk medicine for the treatment of various diseases that involve inflammation or are caused by oxidative stress.

AIMS

This study was designed to compare the anti-nociceptive and anti-inflammatory effect of dried powdered ginger rhizome (GR) and paracetamol (APAP) on an experimental mouse model of fibromyalgia syndrome (FMS) induced by intermittent cold stress (ICS).

METHODS

Forty-eight female C57BL/6 J mice were used for the experiments. The animals were allocated in six groups (n = 8). Each group received one of the following treatments for 8 weeks: healthy control, ICS group, ICS + APAP (40 mg/Kg/day), ICS + GR (0.5%); ICS + GR (1%), and ICS + GR (0.5%) + APAP (40 mg/Kg/day). After treatment, symptoms of FMS were induced by intermittent cold stress (ICS).

RESULTS AND CONCLUSIONS

GR consumption improved mechanical and thermal allodynia and mechanical hyperalgesia and improved behavioural changes related to cognitive disturbances, anxiety, and depression. In addition, GR also significantly decreased the inflammatory response of proinflammatory mediators such as NO, PGE2, TXB2, and IL-1β in LPS-stimulated macrophages. The effects of APAP were significantly enhanced by co-administration with GR. These findings provide evidence that the daily consumption of GR enhances the anti-nociceptive effect of APAP in mice, improves other cognitive disturbances associated with chronic pain, and reduces the inflammatory state generated in an experimental FMS model.

Inhibitory effect of chemical and natural anti-browning agents on polyphenol oxidase from ginger (Zingiber officinale Roscoe)

Food browning is undesirable as it causes deterioration in food quality and appearance. This phenomenon was related to polyphenol oxidase (PPO), which catalyzes conversion of phenolic compounds into o-quinones. The present work evaluated the use of chemical and natural anti-browning agents to prevent the browning of ginger PPO. Sodium metabisulfite (5 mM) is a better chemical inhibitor compared to l-cysteine and sodium chloride as 55.00% of ginger PPO inhibition was achieved. The percentage of inhibition increased as the concentration of anti-browning agents increases. The addition of heated onion, chili pepper and pineapple extracts exhibited a stronger inhibitory effect on ginger PPO than unheated extracts. Heated chili pepper extract was the best natural inhibitor found in this study and it inhibited the ginger PPO (47.97%) mixed-competitively. Natural anti-browning agents have potential to be used to control the browning of ginger as well as other vegetables and fruits.

Ginger attenuates inflammation in a mouse model of dextran sulfate sodium-induced colitis

This study assessed the anti-inflammatory effect of ginger extract on colitis by 5% dextran sulfate sodium (DSS) in BALB/c mice. The mice were administered either distilled water or three doses of ginger extracts for 21 days. We evaluated the change in clinical and histopathological signs and cytokine and gene expression levels. Contrary to the DSS group, the ginger groups increased body weight and inhibited shortening of the colon. DAI values and colon injury in the ginger groups were lower than that in the DSS group. Ginger groups obviously inhibited the myeloperoxidase activity and cytokine and mRNA concentrations of interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, but not of intestinal barrier proteins zonula occludens (ZO)-1, occludin, E-cadherin, mucin-1, and mucin-2 in colon tissues. Our results suggest the protective effect of ginger against DSS-induced colitis and that ginger could be utilized to prevent and treat irritable bowel disease.

Dual protective effect of ginger and rosemary extracts against CCl4-induced hepatotoxicity in rats

The present study aimed to investigate the protective effect of aqueous extracts of ginger (GE) and rosemary (RE), both individually and in combination, on carbon tetrachloride (CCl4)-induced liver injury in adult male rats. CCl4 induced significant increase in liver enzymes, bilirubin, triglycerides, and total cholesterol while total protein, albumin, and globulin were significantly decreased. Also, the activity of cytochrome P450 (CYP) and oxidative stress markers were found to be elevated with a concomitant decrease in the activity of antioxidant enzymes in hepatic tissue. Supplementation with extracts of ginger or rosemary effectively relieved most of the CCl4-induced alterations when administered singly. The joint therapy of the two extracts was more effective. The histological investigation strongly confirmed the highly protective effect of the two plant extracts in the hepatocytes. These findings suggest that rosemary and ginger extracts are effective in improving both the function and structure of the hepatocytes through their potent antioxidant effect and point out to the possibility of using a combination of both as an adjunct therapy in liver diseases.

Toxic effects of Lambda-cyhalothrin, on the rat thyroid: Involvement of oxidative stress and ameliorative effect of ginger extract

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Lambda-cyhalothrin leads to histpathological changes and DNA damage in thyroid gland.

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Lambda-cyhalothrin induces oxidative stress by decreasing the levels of thyroid hormones and antioxidant enzyme in erythrocytes.

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Ginger prevents the toxicity effect of Lambda-cyhalothrin and DNA damage in the thyroid gland.

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Ginger decreases the histopathological changes, abnormal level of thyroid hormones and antioxidant enzymes in the thyroid gland caused by LCT.

Lambda-cyhalothrin (LCT) is a synthetic pyrethroid that is widely used to control insecticide. Ginger is a traditional plant that is widely used as a spice or folk medicine. This study evaluates the antioxidant effect of ginger extract on thyroid toxicity induced by LCT in albino rats. Adult Rats were divided into 4 experimental groups: Group 1: control, Group 2: oral ginger treatment (24 mg/ml, 3 days/week for 4 weeks), Group 3: oral LCT treatment (1/100 LD₅₀, 3 days/week for 4 weeks), Group 4: oral LCT and ginger mixture treatment. The histological results of LCT group showed degenerated follicles with reduced colloids, congestion of blood vessels and hyperaemia between the follicles. Histochemically, depletion of glycogen and proteins was recorded in follicular cells and colloids. The biochemical results of LCT treated group revealed a decrease in T3, T4, SOD and CAT, while TSH and MDA were increased. The comet assay showed that LCT significantly induced DNA damage in the thyroid gland. However, treating rats with LCT plus ginger led to an improvement in the histological structure of the thyroid, with noticeable increases in glycogen and protein deposition. Also, LCT plus ginger increase in T3, T4 and the antioxidant enzymes SOD and COT were detected concomitantly with a decrease in TSH and MDA as well as a significant reduction in DNA damage. LCT affected the thyroid function and structure. On the other hand, ginger has a preventative effect against the histological damage and biochemical toxicity caused by the (LCT) insecticide.

Label-free proteomic analysis to characterize ginger from China and Ghana

Ginger is a popular spice used in food and beverages. In this study, we sought to characterize and differentiate ginger samples of Ghana and China origin using label-free proteomic and untargeted metabolomic analyses. As result, a total of 180 proteins significantly changed between the ginger samples from both studied countries. Among them, 17 proteins were specifically identified in the Chinese ginger, while 23 proteins were only identified in the Ghanaian ginger. Function and bioinformatics analyses indicated that changes in carbon metabolism, secondary metabolites biosyntheses, citrate acid cycle, and amino acids biosyntheses-related pathways contributed to the differences. These results were confirmed through the identification of 14 significantly changed metabolites including diarylheptanoids and gingerols. Importantly, change tendencies of these metabolites corresponded to changes in abundance of the protein enzymes involved in their syntheses. These results suggest that changes in metabolism-related protein enzymes are responsible for the intraspecies difference of the ginger samples.

The enrichment and characterization of ginger-derived glycoprotein using magnetic particles

Ginger-derived glycoproteins are a widely distributed group of biological macromolecules with multiple functions. To date, the structure of ginger-derived glycoproteins has not been clarified with regard to their complexity, their sequence diversity and their uneven micro-distribution. In this study, a lectin microarray was used to evaluate 37 types of lectins and determine the optimal lectins that can conjugate with glycoproteins based on the fluorescence intensity. Subsequently, the lectins were immobilized on magnetic beads, coupled with glycoproteins to enrich ginger-derived glycoproteins, and evaluated using SDS-PAGE. Our results showed that five lectins (e.g. VVA, ConA, STL, LEL, and LCA) were selected by the lectin microarray and that VVA showed the highest fluorescence intensity. In addition, it is indicated that the structure of the carbohydrate chains might contain GlaNAc, mannose, GlcNAc, and LacNAc.

Ginger extract adjuvant to doxorubicin in mammary carcinoma: study of some molecular mechanisms

PURPOSE

The present study aimed to investigate the molecular mechanisms underlying the anticancer properties of ginger extract (GE) in mice bearing solid Ehrlich carcinoma (SEC) and to evaluate the use of GE in combination with doxorubicin (DOX) as a complementary therapy against SEC.

METHODS

SEC was induced in 60 female mice. Mice were divided into four equal groups: SEC, GE, DOX and GE + DOX. GE (100 mg/kg orally day after day) and DOX (4 mg/kg i.p. for 4 cycles every 5 days) were given to mice starting on day 12 of inoculation. On the 28th day, blood samples were collected, mice were scarified, tumor volume was measured, and tumor tissues were excised.

RESULTS

The anti-cancer effect of GE was mediated by activation of adenosine monophosphate protein kinase (AMPK) and down-regulation of cyclin D1 gene expression. GE also showed pro-apoptotic properties as evidenced by elevation of the P53 and suppression of nuclear factor-kappa B (NF-κB) content in tumor tissue. Co-administration of GE alongside DOX markedly increased survival rate, decreased tumor volume, and increased the level of phosphorylated AMPK (PAMPK) and improved related pathways compared to DOX group. In addition, the histopathological results demonstrated enhanced apoptosis and absence of multinucleated cells in tumor tissue of GE + DOX group.

CONCLUSION

AMPK pathway and cyclin D1 gene expression could be a molecular therapeutic target for the anticancer effect of GE in mice bearing SEC. Combining GE and DOX revealed a greater efficacy as anticancer therapeutic regimen.

The effect of ginger supplementation on lipid profile: A systematic review and meta-analysis of clinical trials

BACKGROUND

Elevated levels of blood lipids are a major cause of atherosclerosis and consequently cardiovascular disease. Several studies used ginger as a lipid lowering agent.

PURPOSE

The aim of the present systematic review and meta-analysis was to clarify the effect of ginger supplementation on lipid parameters.

METHODS

PubMed, Scopus, Science Direct, ISI Web of Science and Google Scholar were systematically searched until May 2017 to find clinical trials which examined effect of ginger supplementation on level of lipid parameters in adult participants. Means for blood lipids and potential sources of heterogeneity were extracted. A subgroup analysis was applied to find out potential sources of inter-study heterogeneity.

RESULTS

A total of 12 trials (586 participants) were included in the meta-analysis. Pooled analysis suggested that ginger supplementation reduced triacylglycerol (TAG) (-17.59 mg/dl; 95% CI: -29.32 to -5.87) and low density lipoprotein cholesterol (LDL-C) (-4.90 mg/dl; 95% CI: -22.30 to -6.17). Ginger had no significant effect on total cholesterol (TC) (-5.13 mg/dl, 95% CI: -11.05 to 0.78; P = 0.089) and high density lipoprotein cholesterol (HDL-C) (2.18 mg/dl, 95% CI: -0.08 to 4.45; P = 0.059). As inter-study heterogeneity was high, studies were classified by ginger dosage. Stratified analysis showed a significant reduction in TC (-12.26 mg/dl; 95% CI: -22.37 to -2.16) and TAG (-38.42 mg/dl; 95% CI: -57.01 to -19.82) in studies which used ≤2 g/day of ginger. However, a similar significant effect was not observed in trials with >2 g/day of ginger. Neither studies which used ≤2 g/day nor trials which used >2 g/day of ginger showed significant changes in LDL-C or HDL-C.

CONCLUSION

The present systematic review and meta-analysis suggests that ginger had a favorable effect on TAG and LDL-C. Also, the result revealed that low dose of ginger (≤2 g/day) had greater lowering impact on TAG and TC. Further studies with large-scale and better design are needed to confirm this result.

Targeted and untargeted-metabolite profiling to track the compositional integrity of ginger during processing using digitally-enhanced HPTLC pattern recognition analysis

Tracking the impact of commonly applied post-harvesting and industrial processing practices on the compositional integrity of ginger rhizome was implemented in this work. Untargeted metabolite profiling was performed using digitally-enhanced HPTLC method where the chromatographic fingerprints were extracted using ImageJ software then analysed with multivariate Principal Component Analysis (PCA) for pattern recognition. A targeted approach was applied using a new, validated, simple and fast HPTLC image analysis method for simultaneous quantification of the officially recognized markers 6-, 8-, 10-gingerol and 6-shogaol in conjunction with chemometric Hierarchical Clustering Analysis (HCA). The results of both targeted and untargeted metabolite profiling revealed that peeling, drying in addition to storage employed during processing have a great influence on ginger chemo-profile, the different forms of processed ginger shouldn't be used interchangeably. Moreover, it deemed necessary to consider the holistic metabolic profile for comprehensive evaluation of ginger during processing.

Total phenolic and flavonoid contents and antioxidant activity of ginger (Zingiber officinale Rosc.) rhizome, callus and callus treated with some elicitors

The present study was aimed at determining total phenolic and flavonoid contents and studying the antioxidant activity of ginger (Zingiber officinale Rosc.) rhizome and callus, 6-gingerol and 6-shogaol and callus treated with elicitors. Petroleum ether (PE) and chloroform: methanol (1:1, v/v) (CM) extracts were prepared by maceration. Highest total phenolic content was obtained from the CM extract (60.34 ± 0.43 mg gallic acid/g) of rhizome while callus showed lower content detected in the CM extract (33.6 ± 0.07 mg gallic acid/g). Flavonoids were only detected in rhizome (CM extract 40.25 ± 0.21 mg quercetin/g). Both rhizome extracts exhibited good antioxidant activity with higher activity recorded in PE extract (IC₅₀ value 8.29 ± 1.73 μg/mL). Callus extracts revealed lower antioxidant activity (IC₅₀ value 1265.49 ± 59.9 μg/mL obtained from CM extract). 6-gingerol and 6-shogaol displayed high antioxidant activity in both assays with IC₅₀ 4.85 + 0.58_DPPH and 5.35 ± 0.33_ABTS μg/mL for the former and IC₅₀ 7.61 ± 0.81_DPPH and IC₅₀ 7.05 ± 0.23_ABTS μg/mL for the latter. Treatment of callus with elicitors showed significant (p < 0.05) effects in enhancing phenolic content and related antioxidant activity. The highest significant increase in phenolic content (37% and 34%) and antioxidant activity in DPPH assay (34% and 30%) was observed in callus treated with 100 mg/L yeast extract and 50 mg/L salicylic acid respectively. Therefore, studying the effect of the elicitation of ginger cultured tissues in phenolic accumulation would be of immense importance for pharmacological, cosmetic and agronomic industries.

Comparative insecticidal activity of different plant materials from six common plant species against Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae)

Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae) is one of the major insect pests of stored grains. Due to export legislation and zero-tolerance for live insect in trade commodities, extensive use of synthetic insecticides is in practice in order to eliminate pest infestations from the lots. Currently, the one and only acceptable chemical to be used in stored grain is phosphine but due to its excessive usage the stored grain pests are becoming resistant against it. Hence discovery of alternative compounds is much needed. In this study we have compared insecticidal efficacy of different plant materials from six commonly grown plants of Pakistan, viz. Allium sativum (Alliaceae), Zingiber officinale (Zingiberaceae), Cymbopogon citratus (Poaceae), Eucalyptus globulus (Myrtaceae), Nicotiana tabacum (Solanaceae), and Azadirachta indica (Meliaceae) against T. castaneum infesting stored wheat, rice, corn and gram pulse. Various plant parts were dried, powdered, and used as admixtures to the stored commodities in the experiments. The results have suggested that A. sativum (garlic) and Z. officinale (ginger) were more effective resulting into 15 times higher adult mortality and 4 to 5 times reduction in grain weight losses when mixed with rice grains. Similarly, A. indica when admixture with wheat checked the population growth in the resources resulting into 3.5 times less adult production compared to controls. A subsequent experiment was conducted to study the dose response of neem seed powder against the beetle pest infesting milled products. Surprisingly, better control was observed either at lowest (1% w/w) or the highest doses (5% w/w). This finding is of great interest to understand the underlying phenomenon which we assume is the ability of T. castaneum to feed selectively in flour mediums, however, further research on this aspect is required to be investigated. The results of this study support the use of botanicals for stored product pest management.

Effect of oral ginger on prevention of nausea and vomiting after laparoscopic cholecystectomy: a double-blind, randomized, placebo-controlled trial

Background

Postoperative nausea and vomiting (PONV) are among the most frequent complications following laparoscopic cholecystectomy. Recently, some studies have shown ginger, as an herbal medicine, to be effective and safe in PONV prevention; however, there is no evidence of its efficacy in the Iranian population.

Objective

The aim of this study was to determine the effect of oral ginger on PONV prevention after laparoscopic cholecystectomy.

Methods

This double-blind, randomized, placebo-controlled clinical trial was performed on women who were undergoing laparoscopic cholecystectomy in Imam Raza Hospital, Mashhad, Iran between April and November, 2016. Patients were divided randomly into two groups of G) intervention group (n=75, received 2 capsules containing 250 mg ginger) and P) placebo group (n=75, received 2 placebo capsules) one hour before surgery. Nausea severity and vomiting frequency were evaluated at 2, 4, 6, and 12 hours after the operation. Data analysis was done by SPSS version 16.0 software with Chi-square test, Independent-sample-t-test, repeated measure ANOVA and Mann-Whitney U test.

Results

The two groups were homogenous in terms of age, gender and surgery duration. The severity of nausea was lower in the ginger group at the 2, 4, 6, and 12 hours after the operation; however, these differences were statically significant only at 2 (p=0.034) and 12 hours (p=0.043). Although the incidence of vomiting was higher in the placebo group in the 2nd and 12th hours after surgery, the number of vomiting episodes in 2, 4, 6 and 12 hours after surgery was statistically similar in the two groups (p>0.05). The nausea severity was significantly changed during 12 hours of study in both groups (p=0.001), however the nausea severity was always lower in the ginger group (p=0.078).

Conclusion

This study demonstrated that 500mg oral ginger one hour before surgery in women who were undergoing laparoscopic cholecystectomy is effective in decreasing severity of PONV.

Trial registration

The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016122222218N2.

Funding

The study was financially supported by Deputy of Research of Mashhad University of Medical Sciences.

Chronic Dysuria Following Ginger (Zingiber officinale) Use: A Case Report

BACKGROUND

Although ginger is considered a harmless remedial substance for a wide range of medical complaints, according to Persian medicinal texts, its long-term or high-dose consumption is potentially harmful.

CASE REPORT

The case of a 43-year-old man, with a complaint of urinary stream interruption, dysuria, and flank pain, following a non-prescribed use of ginger was reported. The symptoms were reported to persist for four years, despite some medical referrals. Remarkably, the symptoms were attested to be shrinking eight weeks after ginger-intake cessation; besides, no further intervention was asserted.

CONCLUSION

The history of herbal remedies use should be considered in patients with any unexplained urinary symptoms.

The effects of ginger intake on weight loss and metabolic profiles among overweight and obese subjects: A systematic review and meta-analysis of randomized controlled trials

This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effect of ginger intake on weight loss, glycemic control and lipid profiles among overweight and obese subjects. We searched the following databases through November 2017: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The relevant data were extracted and assessed for quality of the studies according to the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as Standardized Mean Difference (SMD) with 95% Confidence Intervals (95% CI). Heterogeneity between studies was assessed by the Cochran Q statistic and I-squared tests (I2). Overall, 14 studies were included in the meta-analyses. Fourteen RCTs with 473 subjects were included in our meta-analysis. The results indicated that the supplementation with ginger significantly decreased body weight (BW) (SMD -0.66; 95% CI, -1.31, -0.01; P = 0.04), waist-to-hip ratio (WHR) (SMD -0.49; 95% CI, -0.82, -0.17; P = 0.003), hip ratio (HR) (SMD -0.42; 95% CI, -0.77, -0.08; P = 0.01), fasting glucose (SMD -0.68; 95% CI, -1.23, -0.05; P = 0.03) and insulin resistance index (HOMA-IR) (SMD -1.67; 95% CI, -2.86, -0.48; P = 0.006), and significantly increased HDL-cholesterol levels (SMD 0.40; 95% CI, 0.10, 0.70; P = 0.009). We found no detrimental effect of ginger on body mass index (BMI) (SMD -0.65; 95% CI, -1.36, 0.06; P = 0.074), insulin (SMD -0.54; 95% CI, -1.43, 0.35; P = 0.23), triglycerides (SMD -0.27; 95% CI, -0.71, 0.18; P = 0.24), total- (SMD -0.20; 95% CI, -0.58, 0.18; P = 0.30) and LDL-cholesterol (SMD -0.13; 95% CI, -0.51, 0.24; P = 0.48). Overall, the current meta-analysis demonstrated that ginger intake reduced BW, WHR, HR, fasting glucose and HOMA-IR, and increased HDL-cholesterol, but did not affect insulin, BMI, triglycerides, total- and LDL-cholesterol levels.

Pharmacotherapeutic potential of ginger and its compounds in age-related neurological disorders

Age-related neurological disorders (ANDs), including neurodegenerative diseases, are multifactorial disorders with a risk that increases with aging. ANDs are generally characterized by common neuropathological conditions of the central nervous system, such as oxidative stress, neuroinflammation, and protein misfolding. Recently, efforts have been made to overcome ANDs because of the increase in age-dependent prevalence. Ginger, the rhizome of Zingiber officinale Roscoe, is a popular food spice and has a long history of use in traditional medicine for treating various disease symptoms. The structure-activity relationships of ginger phytochemicals show that ginger can be used to treat ANDs by targeting different ligand sites. This review shows that ginger and its constituents, such as 6-gingerol, 6-shogaol, 6-paradol, zingerone, and dehydrozingerone, are effective for ameliorating the neurological symptoms and pathological conditions of ANDs through by modulating cell death or cell survival signaling molecules. From this review, we conclude that the active ingredients in ginger have therapeutic potential in ANDs.

A comparative UPLC-Q/TOF-MS-based metabolomics approach for distinguishing Zingiber officinale Roscoe of two geographical origins

Ginger, the rhizome of Zingiber officinale Roscoe, is a popular spice used in the food, beverage and confectionary industries. In this study, we report an untargeted UPLC-Q/TOF-MS-based metabolomics approach for comprehensively discriminating between ginger from two geographical locations, Ghana in West Africa and China. Forty batches of fresh ginger from both countries were discriminated using principal component analysis and orthogonal partial least squares discrimination analysis. Sixteen differential metabolites were identified between the gingers from the two geographical locations, six of which were identified as the marker compounds responsible for the discrimination. Our study highlights the essence and predictive power of metabolomics in detecting minute differences in same varieties of plants/plant samples based on the levels and composition of their metabolites.

Impact of sulphur fumigation on the chemistry of ginger

Ginger (Zingiberis Rhizoma), a commonly-consumed food supplement, is often sulphur-fumigated during post-harvest handling, but it remains unknown if sulphur fumigation induces chemical transformations in ginger. In this study, the effects of sulphur fumigation on ginger chemicals were investigated by ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS/MS)-based metabolomics. The results showed that sulphur fumigation significantly altered the holistic chemical profile of ginger by triggering chemical transformations of certain original components. 6-Gingesulphonic acid, previously reported as a naturally-occurring component in ginger, was revealed to be a sulphur fumigation-induced artificial derivative, which was deduced to be generated by electrophilic addition of 6-shogaol to sulphurous acid. Using UHPLC-QTOF-MS/MS extracting ion analysis with 6-gingesulphonic acid as a characteristic chemical marker, all the commercial ginger samples inspected were determined to be sulphur-fumigated. The research outcomes provide a chemical basis for further comprehensive safety and efficacy evaluations of sulphur-fumigated ginger.

The effect of vitamin E, L-carnitine, and ginger on production traits, immune response, and antioxidant status in two broiler strains exposed to chronic heat stress

The present study was designed to find the effect of natural and synthetic antioxidants on the performance of two broiler strains under high ambient temperature. A total of 320 day-old chicks of Hubbard and Cobb were reared for a period for 21 days under the same nutritional and management systems. On day 21 onward, one subgroup was kept as control while other subgroups were provided with vitamin E (250 mg/kg), ginger (2 g/kg), and L-carnitine (500 mg/kg) in basal diets. Body weight and feed conversion ratio (FCR) were significantly (P < 0.05) high in vitamin E-supplemented birds, while feed intake was significantly (P < 0.05) higher in L-carnitine supplemented birds irrespective of the strain. Antibody titer against infectious bursal disease (IBD) and paraoxonase (PON1) was significantly (P < 0.05) higher in vitamin E-supplemented birds compared to the other treatments. The number of heterophils and toal oxidant status (TOS) were significantly (P < 0.05) lower in vitamin E-supplemented birds. Blood glucose was significantly (P < 0.05) lower in vitamin E-supplemented birds, while total protein was significantly (P < 0.05) higher in vitamin E-supplemented group. In conclusion, the supplementation of vitamin E at the rate of 250 mg/kg improved the antioxidant status and immune response in the two broiler strains. Further, the two strains perform similarly in terms of performance and other health status parameters with no significant difference.

A putative Chondroprotective role for IL-1β and MPO in herbal treatment of experimental osteoarthritis

BACKGROUND

Herbal treatment may have a chondroprotective and therapeutic effect on Osteoarthritis (OA). We investigated the mechanism of action of ginger and curcumin rhizomes cultivated in Egypt in treatment of OA in rat model.

METHODS

Thirty-five albino rats were intra-articularly injected with Monosodium Iodoacetate in the knee joint. Ginger and curcumin was orally administered at doses of 200 and 400 mg/kg (F200 and F400). Serum levels of cartilage oligomeric matrix protein (COMP), hyaluronic acid (HA), malondialdehyde (MDA), myeloperoxidase (MPO), Interleukin-1 beta (IL-1β) and superoxide dismutase activity (SOD) were measured using ELISA. The composition of the herbal formula hydro-ethanolic extract was characterized using UPLC-ESI-MS. Histopathological changes in injected joints was examined using routine histopathology. Statistical analysis was performed using one-way ANOVA.

RESULTS

Serum levels of COMP, HA, MPO, MDA, and IL-1β were significantly decreased in F 200, F 400 and V groups when compared to OA group (P value <0.0001). On the other hand SOD levels were significantly elevated in treated groups compared to OA groups (P value <0.0001).

CONCLUSIONS

The ginger/curcumin at 1:1 had chondroprotective effect via anti-inflammatory and antioxidant effect in rat OA model. Further pharmacological and clinical studies are needed to evaluate this effect.

Modifications of fatty acids profile, lipid peroxidation and antioxidant capacity in raw and cooked rabbit burgers added with ginger

Effects of ginger powder were evaluated on fatty acid (FA) profile, lipid peroxidation (TBARS) and antioxidant capacity (ABTS, DPPH and FRAP) of rabbit burgers. Burgers were manufactured as control samples (only meat) and two additions of ginger powder (1% and 2%) and stored raw at 4°C for 7days. At day 1, 4 and 7 of storage burgers were analysed both as raw and cooked. Ginger powder affected all the tested parameters; both PUFAω3 and PUFAω6 were incremented in raw and cooked samples leading to decreased atherogenicity and thrombogenicity indexes and increased hypo/hypercholesterolemic index and peroxidability index. Lipid peroxidation values of raw and cooked burgers added with ginger were lower than control burgers, at the same time, ABTS, DPPH and FRAP values were incremented by the addition of ginger powder. The results obtained demonstrate the antioxidant capacity of ginger powder as rabbit meat products additive and highlight the capacity of this spice to maintain its characteristics after burgers' cooking.