The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent

Does ginger supplementation lower blood pressure? A systematic review and meta-analysis of clinical trials

The aim of the present systematic review and meta-analysis was to determine the efficacy of ginger supplementation on blood pressure (BP). PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar were comprehensively searched until September 2018. Human clinical trials, which reported the effect of ginger supplementation on aortic and/or brachial BP, were included. Mean differences were pooled using a random effects model. Standard methods were used for assessment of heterogeneity, sensitivity analysis, and publication bias. Total of six randomized clinical trials (345 participants) were included in the meta-analysis. Pooled analysis suggested that ginger supplementation can reduced systolic BP (MD: -6.36 mmHg, 95% confidence interval [-11.27, -1.46]; I2  = 89.8%; P = .011) and diastolic BP (MD: -2.12 mmHg, 95% confidence interval [-3.92, -0.31]; I2  = 73.4%; P = .002). When studies were categorized based on participants' mean age, ginger dosage and duration of intervention, systolic BP and diastolic BP were significantly decreased only in the subset of studies with mean age ≤ 50 years, follow-up duration of ≤8 weeks and ginger doses ≥3 g/d. Our findings revealed that ginger supplementation has favorable effects on BP. Nonetheless, further studies are warranted before definitive conclusions may be reached.

Voltammetric and spectroscopic determination of polyphenols and antioxidants in ginger (Zingiber officinale Roscoe)

Ginger (Zingiber officinale) is widely consumed as an important spice or a common condiment in food and beverages. This study focuses on the determination of pungent and bioactive components in ginger and their antioxidant activity using voltammetric and spectroscopic methods. Gas chromatography-mass spectroscopy analysis revealed that the major components of the pungent compounds were zingerone, shogaols, gingerols, paradols, wikstromol, and carinol. Using spectroscopic methods, the antioxidant capacity of ginger aqueous extract was found to be 16.0 μmol gallic acid equivalent (GAE) per gram of ginger extract, and the total phenolic and flavonoid content was estimated to be 7.8 mg GAE/g ginger extract and 15.4 mg Quercetin equivalent (QE) per gram of ginger extract, respectively. Electroanalytical quantification estimated the antioxidant capacity of the ginger infusion to be 23.5 μmol GAE/g ginger extract, which is slightly higher than that estimated using chemical assay. The results may provide useful information for the development of ginger processing and utilization as a flavoring agent, and for our understanding of ginger as a source of natural antioxidants.

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 Biological Efficacy of Natural Products against Acute and Chronic Inflammatory Diseases in the Oral Region

The oral inflammatory diseases are divided into two types: acute and chronic inflammatory diseases. In this review, we summarize the biological efficacy of herbal medicine, natural products, and their active ingredients against acute and chronic inflammatory diseases in the oral region, especially stomatitis and periodontitis. We review the effects of herbal medicines and a biscoclaurin alkaloid preparation, cepharamthin, as a therapy against stomatitis, an acute inflammatory disease. We also summarize the effects of herbal medicines and natural products against periodontitis, a chronic inflammatory disease, and one of its clinical conditions, alveolar bone resorption. Recent studies show that several herbal medicines such as kakkonto and ninjinto reduce LPS-induced PGE2 production by human gingival fibroblasts. Among herbs constituting these herbal medicines, shokyo (Zingiberis Rhizoma) and kankyo (Zingiberis Processum Rhizoma) strongly reduce PGE2 production. Moreover, anti-osteoclast activity has been observed in some natural products with anti-inflammatory effects used against rheumatoid arthritis such as carotenoids, flavonoids, limonoids, and polyphenols. These herbal medicines and natural products could be useful for treating oral inflammatory diseases.

Asymmetric dimethylarginine and soluble inter-cellular adhesion molecule-1 serum levels alteration following ginger supplementation in patients with type 2 diabetes: a randomized double-blind, placebo-controlled clinical trial

Aims Patients with type 2 diabetes mellitus (T2DM) are prone to cardiovascular disease (CVD) due to inflammation process and oxidative stress. ADMA (Asymmetric dimethylarginine) and ICAM-1 (inter-cellular adhesion molecule-1) play an important role in CVD pathogenesis. Ginger as an anti-oxidant and anti-inflammation can effect on these biomarkers. The aim of present study was to characterize the effect of ginger supplementation on ADMA and ICAM-1 serum levels in patients with T2DM. Methods The present study is a randomized double-blind clinical trial which is conducted among 45 diabetic patients (nginger=23, nplacebo=22). The participants were randomly divided into two intervention and placebo groups which were received 2 g ginger powder and 2 g wheat flour for 10 weeks, respectively. ADMA and ICAM-1 concentration were measured by ELISA method. Results Ginger supplementation decreased ADMA serum levels significantly (P=0.002) and sICAM-1 serum levels marginally (P=0.097) in supplementation group after intervention. No significant difference was observed between placebo and supplementation groups. Conclusions Present study was conducted among patients with type 2 diabetes mellitus to investigate the effect of ginger supplementation on ADMA and sICAM-1 levels. There was a significant decrement in ADMA serum concentration and slight reduction in sICAM-1 levels in intervention group. The amount of reduction in both biomarkers was not statistically significant in between-groups comparison.

Proficiencies of Zingiber officinale against spine curve and vertebral damage induced by corticosteroid therapy associated with gonadal hormone deficiency in a rat model of osteoporosis

This study was assessed to examine whether Zingiber officinale (ZO) can prevent spine disorder and trabecular microarchitecture disruption in osteoporotic murin model. Three groups of male rats were selected: Controls (CTRL), combined model of osteoporosis (CMO), in which rats were orchidectomized and treated with cortisol, and CMO treated with ZO (CMO + ZO). One month after the surgical procedures, the rats were sacrificed. Lumbar curve of the spine has been evaluated using the kyphotic method. The spines were submitted to histological and histomorphometric analysis and mineral (calcium and phosphorus) metabolism assessment. Compared to CTRL, the mean kyphotic angle (KA) was significantly higher in CMO rats. The spinal deconditioning associated decreased bone trabecular volume and a disrupted microarchitecture. A disorder was observed in the serum and bone levels of calcium and phosphorus in the combined severe osteopenia model. An increase in the level of TRAcP associated with an increase in osteoclast number and activity has been reported. These disturbances were reduced following the use of ZO in the CMO + ZO group. Finally, ginger might be an alternative therapeutic candidate for the treatment of severe osteopenia induced vertebral damage and spine curve disruption.

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.

Nutraceuticals and osteoarthritis pain

Arthritis is a chronic disease of joints. It is highly prevalent, particularly in the elderly, and is commonly associated with pain that interferes with quality of life. Because of its chronic nature, pharmacological approaches to pain relief and joint repair must be safe for long term use, a quality many current therapies lack. Nutraceuticals refer to compounds or materials that can function as nutrition and exert a potential therapeutic effect, including the relief of pain, such as pain related to arthritis, of which osteoarthritis (OA) is the most common form. Of interest, nutraceuticals have recently been shown to have potential in relieving OA pain in human clinical trials. Emerging evidence indicates nutraceuticals may represent promising alternatives for the relief of OA pain. In this paper, we will overview OA pain and the use of nutraceuticals in OA pain management, focusing on those that have been evaluated by clinical trials. Furthermore, we discuss the biologic and pharmacologic actions underlying the nutraceutical effects on pain relief based on the potential active ingredients identified from traditional nutraceuticals in OA pain management and their potential for drug development. The review concludes by sharing our viewpoints that future studies should prioritize elucidating the mechanisms of action of nutraceuticals in OA and developing nutraceuticals that not only relieve OA pain, but also mitigate OA pathology.

Evaluating the efficacy of mixture of Boswellia carterii, Zingiber officinale, and Achillea millefolium on severity of symptoms, anxiety, and depression in irritable bowel syndrome patients

Background:

Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorders (FGIDs) that affects in different aspects of life and patients experienced depression and anxiety more than others. There are several herbal medicines with positive effects in these patients. The aim of this study is to evaluate the effects of mixture of Boswellia carterii, Zingiber officinale, and Achillea Millefolium on severity of symptoms, anxiety, and depression in IBS patients.

Materials and Methods:

This clinical trial study was done in sixty IBS patients (with mild-to-moderate symptoms) divided into two case and control groups. Patients were assessed at the beginning, 1 month, and 3 months after by IBS-severity scoring system (IBS-SSS) and Hospital Anxiety and Depression Scale. IBS-SSS is used for quality of life evaluation too.

Results:

Sixty IBS patients (with mild to moderate symptoms) with a mean age of 38.75 ± 11.74 participated that 55.4% of cases and 72.8% of controls were men. The most prevalent type of IBS was the mixed type of IBS. The mean score of abdominal pain severity and frequency, bloating score, and depression and anxiety score were decreased in patients administered herbal medication, but changes in these variables in controls were not statistically significant. The changes in quality of life score between cases and controls were significant in men (P = 0.01) although it was not significant in women.

Conclusion:

A mixture of B. Carterii, Z. officinale, and A. millefolium is effective in eliminating IBS symptoms and its related depression and anxiety and using herbal medicine in IBS treatment is suggested.

Effects of shinbuto and ninjinto on prostaglandin E2 production in lipopolysaccharide-treated human gingival fibroblasts

Previously, we revealed that several kampo medicines used for patients with excess and/or medium patterns (kakkonto (TJ-1), shosaikoto (TJ-9), hangeshashinto (TJ-14), and orento (TJ-120)) reduced prostaglandin (PG)E₂ levels using LPS-treated human gingival fibroblasts (HGFs). Recently, we examined other kampo medicines used for patients with the deficiency pattern [bakumondoto (TJ-29), shinbuto (TJ-30), ninjinto (TJ-32), and hochuekkito (TJ-41)] and the herbs comprising shinbuto and ninjinto using the same experimental model. Shinbuto and ninjinto concentration-dependently reduced LPS-induced PGE₂ production by HGFs, whereas hochuekkito weakly reduced and bakumondoto did not reduce PGE₂ production. Shinbuto and ninjinto did not alter cyclooxygenase (COX) activity or the expression of molecules involved in the arachidonic acid cascade. Therefore, we next examined which herbs compromising shinbuto and ninjinto reduce LPS-induced PGE₂ production. Among these herbs, shokyo (Zingiberis Rhizoma) and kankyo (Zingiberis Processum Rhizoma) strongly and concentration-dependently decreased LPS-induced PGE₂ production. However, both shokyo and kankyo increased the expression of cytosolic phospholipase (cPL)A₂ but did not affect annexin1 or COX-2 expression. These results suggest that shokyo and kankyo suppress cPLA₂ activity. We demonstrated that kampo medicines suppress inflammatory responses in patients with the deficiency pattern, and in those with excess or medium patterns. Moreover, kampo medicines that contain shokyo or kankyo are considered to be effective for the treatment of inflammatory diseases.

Ginger and Propolis Exert Neuroprotective Effects against Monosodium Glutamate-Induced Neurotoxicity in Rats

Central nervous system cytotoxicity is linked to neurodegenerative disorders. The objective of the study was to investigate whether monosodium glutamate (MSG) neurotoxicity can be reversed by natural products, such as ginger or propolis, in male rats. Four different groups of Wistar rats were utilized in the study. Group A served as a normal control, whereas group B was orally administered with MSG (100 mg/kg body weight, via oral gavage). Two additional groups, C and D, were given MSG as group B along with oral dose (500 mg/kg body weight) of either ginger or propolis (600 mg/kg body weight) once a day for two months. At the end, the rats were sacrificed, and the brain tissue was excised and levels of neurotransmitters, ß-amyloid, and DNA oxidative marker 8-OHdG were estimated in the brain homogenates. Further, formalin-fixed and paraffin-embedded brain sections were used for histopathological evaluation. The results showed that MSG increased lipid peroxidation, nitric oxide, neurotransmitters, and 8-OHdG as well as registered an accumulation of ß-amyloid peptides compared to normal control rats. Moreover, significant depletions of glutathione, superoxide dismutase, and catalase as well as histopathological alterations in the brain tissue of MSG-treated rats were noticed in comparison with the normal control. In contrast, treatment with ginger greatly attenuated the neurotoxic effects of MSG through suppression of 8-OHdG and β-amyloid accumulation as well as alteration of neurotransmitter levels. Further improvements were also noticed based on histological alterations and reduction of neurodegeneration in the brain tissue. A modest inhibition of the neurodegenerative markers was observed by propolis. The study clearly indicates a neuroprotective effect of ginger and propolis against MSG-induced neurodegenerative disorders and these beneficial effects could be attributed to the polyphenolic compounds present in these natural products.

Acute and sub-acute toxicity study of a Pakistani polyherbal formulation

Background

Herbology is the prevailing system among the nationally-accepted alternative or complementary systems of medicine. The system is due to its general and patient-oriented methodology, is widely used in the general population exposing them to the risk of the side effects of the herbal medicines.

Method

The aim of study was to assess the acute and sub-acute toxicity of the polyherbal formulation Hab-e-Kabad Noshadri tablets. In the acute arm of the study, a single dose of 2000 mg/kg was administered to Swiss Albino mice which were observed for physical symptoms and behavioral changes for 72 h. In sub-acute toxicity study repeated doses of the polyherbal preparation was administered to Wistar rats of both genders, separately. The animals received three doses of polyherbal product (50 mg/kg/day, 100 mg/kg/day and 200 mg/kg/day) for a period of 28 days. On 28th day of experiment, blood sampling of animals was done for hematological and biochemical analysis i.e. liver and renal function parameters, lipid profile and then sacrificed for histopathological examination of liver and kidney.

Result

There was no morbidity and mortality noticed with single dose administration in acute toxicity study in mice. In sub-acute toxicity study, morphological changes with some damage in liver and kidney tissues of male and female animals were recorded at dose of 100 mg/kg/day and 200 mg/kg/day.

Conclusions

It was found that prolonged use at higher dose i.e. 200 mg/kg/day of this polyherbal formulation should be avoided and practitioners should cautiously prescribe this formulation in patients with hepatic and renal impairment.

Electronic supplementary material

The online version of this article (doi:10.1186/s12906-017-1889-7) contains supplementary material, which is available to authorized users.

Selenium nanoparticles with low-level ionizing radiation exposure ameliorate nicotine-induced inflammatory impairment in rat kidney

Occupational exposure to low-level ionizing radiation (<1 Gy) was shown to enhance cell protection via attenuating an established inflammatory process. Nicotine, a major toxic component of cigarette smoke, is responsible for smoking-mediated renal dysfunction. The present study was therefore aimed to investigate the protective impact of ginger Zingiber officinale selenium nanoparticles (SeNPs) with whole-body low-dose gamma radiation (γ-R) against nicotine-induced nephrotoxicity in male albino rats. Nicotine intoxication was induced with 0.5 mg/kg BW. Rats received 0.1 mg SeNPs/kg BW by gastric gavage concomitant with 0.5 Gy γ-R over 4 weeks. Characterization studies showed the formation of spherical SeNPs with a size ranged from 10 to 30 nm in diameter with a thin film encapsulating the nanoballs. Our data revealed that nicotine induced renal dysfunction manifested by significant abnormal levels of kidney function markers (creatinine, urea, sodium and potassium) accompanied by increased levels of malondialdehyde along with a reduction in glutathione level, glutathione peroxidase, and glutathione S-transferase activities. It is worthy to note that nicotine toxicity induced significant increments in serum inflammatory markers: tumor necrosis factor-α and vascular cell adhesion protein 1. Western blotting showed marked significant elevation in caspase-3 activities against nicotine. The mRNA gene expression of inducible cyclooxygenase-2 gene was highly increased with nicotine intoxication while that of cyclooxygenase-1 did not show any changes. Interestingly, our data demonstrated that SeNPs in synergistic interaction with γ-R are efficacious control against nicotine-induced nephrotoxicity via anti-oxidant-mediated anti-inflammatory activities. Thus, it is tempting to recommend dietary approaches with ginger SeNPs for smokers at workplaces exposed occupationally and regularly to low-level ionizing radiation.

The anti-allergic and anti-inflammatory effects of Benjakul extract (a Thai traditional medicine), its constituent plants and its some pure constituents using in vitro experiments

Benjakul (BJK), a Thai traditional medicine preparation, has long been used for balanced health, controlled abnormal of element in the body, carminative, and relief of flatulence. It is composed of five plants: Piper interruptum Opiz., Piper longum L., Piper sarmentosum Roxb., Plumbago indica L., and Zingiber officinale Roscoe. The ethanolic extracts of BJK, its five individual plants, and pure constituents of BJK were investigated for their anti-allergic activity using immunoglobulin E (IgE)-sensitized β-hexosaminidase in the rat basophilic leukemia-2H3 (RBL-2H3) cells and anti-inflammatory activity using lipopolysaccharide (LPS)-induced nitric oxide (NO) and tumor necrosis factor-alpha (TNF-α) in the murine macrophage (RAW 264.7) cells. The ethanolic extracts of BJK showed anti-allergic activity (IC₅₀=12.69μg/ml) and exhibited potent NO inhibitory effect (IC₅₀=16.60μg/ml), but inactive on TNF-α release. Moreover, 6-shogaol and plumbagin, two pure compounds from BJK, showed higher anti-allergic activity than the ethanolic BJK extract with IC₅₀ values of 0.28 and 4.03μg/ml, respectively. These compounds were significantly higher than chlorpheniramine (CPM), standard drug, with IC₅₀ value of 17.98μg/ml. Determination of the anti-inflammatory activity by measuring the inhibition of NO production presented that plumbagin and 6-shogaol exhibited higher than crude BJK extract with IC₅₀ values of 0.002 and 0.92μg/ml, respectively. In particular, plumbagin also showed higher anti-inflammatory than prednisolone, positive control, with IC₅₀ value of 0.59μg/ml. 6-Shogaol also showed inhibitory effect on TNF-α release (IC₅₀=9.16μg/ml). These preliminary results may provide some scientific support for the use of BJK for the anti-allergic treatment and inflammatory disorders through the inhibition of NO production.

Sensory evaluation of gluten-free quinoa whole grain snacks

Sensory evaluation of quinoa gluten-free whole grain low fat and salt snacks was conducted. The snacks were Quinoa, Quinoa-Cayenne Pepper, Quinoa-Ginger and Quinoa-Turmeric. Cayenne pepper, ginger and turmeric are common spices that contain health promoting nutrients. Cayenne pepper has been associated with enhancing heat production. Ginger has been reported to improve blood flow and prevent joint pains. Turmeric has been observed to have wound healing potential. All the snacks contained 6% corn oil and 2% salt. Snack dough was prepared using 120 mL water for 100 g dry ingredients. About 20 g of snack dough was placed on center of preheated KrumKake Express Baker and cooked for 2 min. Seventy in-house volunteers judged Color/Appearance of Quinoa, Quinoa-Cayenne Pepper and Quinoa-Ginger snacks significantly (p ≤ 0.05) higher than Quinoa-Turmeric snacks. Odor/Aroma of Quinoa-Ginger snacks was significantly higher than other snacks tested. Texture/Mouth-feel of Quinoa-Cayenne Pepper, Quinoa-Ginger and Quinoa-Turmeric snacks was similar and significantly higher than Quinoa snacks. Taste/Flavor and Acceptance was similar in four kinds of snacks tested. Water activity of all the snacks tested ranged from 0.41–0.55 suggesting that these snacks were crispy with good antimicrobial stability. These snacks would be quite filling due to their expansion of 2.6–3.1 times due to high porosity. Acceptance of snacks tested was Quinoa 79%, Quinoa-Cayenne Pepper 77%, Quinoa-Ginger 73% and Quinoa-Turmeric 70%. These snacks contained only 3–4 ingredients and could be made in any house kitchen or commercial production. Acceptance of 70–79% is very desirable. These healthy nutritious gluten-free quinoa snacks offer choice for all including vegetarians and individuals hypersensitive to gluten.

Studies on Shokyo, Kanzo, and Keihi in Kakkonto Medicine on Prostaglandin E2 Production in Lipopolysaccharide-Treated Human Gingival Fibroblasts

We previously demonstrated that a kampo medicine, kakkonto, decreases lipopolysaccharide- (LPS-) induced prostaglandin E₂ (PGE₂) production by human gingival fibroblasts. In this study, we examined the herbs constituting kakkonto that exhibit this effect. Shokyo strongly and concentration dependently and kanzo and keihi moderately decreased LPS-induced PGE₂ production. Shokyo did not alter cyclooxygenase-2 (COX-2) activity, cytosolic phospholipase A₂ (cPLA₂), annexin 1 and COX-2 expression, and LPS-induced extracellular signal-regulated kinase (ERK) phosphorylation. Kanzo inhibited COX-2 activity but increased annexin 1 and COX-2 expression and did not alter LPS-induced ERK phosphorylation. Keihi inhibited COX-2 activity and LPS-induced ERK phosphorylation but slightly increased COX-2 expression and did not alter cPLA₂ and annexin 1 expression. These results suggest that the mechanism of shokyo is through the inhibition of cPLA₂ activity, and that of kanzo and keihi is through the inhibition of COX-2 activity and indirect inhibition of cPLA₂ activity. Therefore, it is possible that shokyo and kakkonto are clinically useful for the improvement of inflammatory responses.

Electrochemical detection and quantification of gingerol species in ginger (Zingiber officinale) using multiwalled carbon nanotube modified electrodes

We demonstrate the potential of electrochemical detection for the analysis of the 'strength' of ginger in ginger sample. This facile and fast detection method is aimed at the quality control in food industry. Specifically, we report adsorptive stripping voltammetry (AdsSV) as a technique for detection of gingerol compounds, the pungent components of ginger rhizome. Among the gingerols, 6-gingerol is the most abundant and is chosen as a model to characterise the behaviour of a wider range of related compounds. Multiwalled carbon nanotube modified basal plane pyrolytic graphite electrodes (MWCNT-BPPG electrode) are employed to enhance the sensitivity of the measurement. A linearity range from 1 μM to 50 μM with limit of detection of 0.21 μM and limit of quantification of 0.71 μM is obtained. Further, the simple and rapid extraction procedure by simply vortexing the ginger sample with ethanol is developed for extraction of gingerol related species.

Phytoconstituents as pharmacotherapeutics in rheumatoid arthritis: challenges and scope of nano/submicromedicine in its effective delivery

Objectives

The present review explores the therapeutic application of herbals in rheumatoid arthritis (RA) therapy, and how nano/submicromedicine can be fit in the scope of its therapeutic delivery in RA has been addressed.

Key findings

Incorporation of bioactive such as polyphenols, thymoquinone, resveratrol, hesperidin, curcumin, celastrol and gambogic acid in a dose-dependent manner showed quite high efficacy for the treatment of RA. It can be attributed to their targeting ability against various inflammatory mediators including nitric oxide (NO), cytokines, chemokines, adhesion molecules, NF-kβ, lipoxygenase (LOXs) and arachidonic acid (AA). Despite the presence of significant merits, the use of these bioactives has several demerits such as poor bioavailability as a function of low aqueous solubility and higher first-pass metabolism upon oral administration. The impact of nano/submicromedicine in the delivery of these bioactives against RA has gained wider attention owing to bioavailability enhancement, higher stability and better efficacy.

Conclusion

Phytoconstituents possess immense potential in RA pharmacotherapy, but the obstacles for their effective delivery can be overcome using nano/submicrocarrier-based drug delivery technologies, which maximize the efficacy of these herbal antirheumatic drugs without any systemic adverse effects.

Dietary Phytochemicals: Natural Swords Combating Inflammation and Oxidation-Mediated Degenerative Diseases

Cumulatively, degenerative disease is one of the most fatal groups of diseases, and it contributes to the mortality and poor quality of life in the world while increasing the economic burden of the sufferers. Oxidative stress and inflammation are the major pathogenic causes of degenerative diseases such as rheumatoid arthritis (RA), diabetes mellitus (DM), and cardiovascular disease (CVD). Although a number of synthetic medications are used to treat these diseases, none of the current regimens are completely safe. Phytochemicals (polyphenols, carotenoids, anthocyanins, alkaloids, glycosides, saponins, and terpenes) from natural products such as dietary fruits, vegetables, and spices are potential sources of alternative medications to attenuate the oxidative stress and inflammation associated with degenerative diseases. Based on in vitro, in vivo, and clinical trials, some of these active compounds have shown good promise for development into novel agents for treating RA, DM, and CVD by targeting oxidative stress and inflammation. In this review, phytochemicals from natural products with the potential of ameliorating degenerative disease involving the bone, metabolism, and the heart are described.

Ginger extract modulates Pb-induced hepatic oxidative stress and expression of antioxidant gene transcripts in rat liver

CONTEXT

Spices and herbs are recognized sources of natural antioxidants that can protect from oxidative stress, thus play an important role in chemoprevention of liver diseases. Ginger is used worldwide primarily as a spicy condiment.

OBJECTIVE

This study evaluated the ability of ginger extract (GE) to ameliorate oxidative-hepatic toxicity induced by lead acetate (PbAc) in rats.

MATERIALS AND METHODS

Five groups of animals were used: group I kept as control; groups II, IV, and V received PbAc (1 ppm in drinking water daily for 6 weeks, and kept for an additional 2 weeks without PbAc exposure); group III treated orally with GE (350 mg/kg body weight, 4 d per week) for 6 weeks; group IV (protective) received GE for 2 weeks before and simultaneously with PbAc; and group V (treatment) received GE for 2 weeks after PbAc exposure.

RESULTS

GC-MS analysis of GE revealed its content of gingerol (7.09%), quercetin (3.20%), dl-limonene (0.96%), and zingiberene (0.18%). Treatment of PbAc-treated rats with GE has no effect on hepatic Pb concentrations. However, it maintained serum aspartate aminotransferase level, increased hepatic glutathione (157%), glutathione S-transferase (GST) (228%), glutathione peroxidase (GPx) (138%) and catalase (CAT) (112%) levels, and reduced hepatic malondialdehyde (80%). Co-treatment of PbAc group with GE upregulated mRNA expression of antioxidant genes: GST-α1 (1.4-fold), GPx1 (1.8-fold), and CAT (8-fold), while post-treatment with GE upregulated only mRNA expression of GPx1 (1.5-fold).

CONCLUSION

GE has an antioxidant protective efficacy against PbAc-induced hepatotoxicity, which appears more effective than its therapeutic application. However, the changes in antioxidant gene expression were not reflected at the protein level.

Anti-inflammatory and antioxidant effect of ginger in tuberculosis

BACKGROUND

Tuberculosis (TB) has reemerged to become the world's leading cause of death from a single infectious agent. Inflammatory cytokines play an important role during the course of the disease and may be responsible for tissue damage by lipid peroxidation. The study was aimed to explore the anti-inflammatory and antioxidant effect of ginger in pulmonary TB patients.

METHODS

A total of 69 pulmonary TB patients participated in a randomized and placebo-controlled study. The intervention group received 3 g of ginger extract daily for 1 month and placebo group was supplemented with starch capsule. Participants of both groups were taking standard antitubercular treatment during the study. The concentrations of tumor necrosis factor (TNF) alpha, ferritin and malondialdehyde (MDA) in blood samples were analyzed before and after the intervention by using enzyme-linked immunosorbent assay for TNF alpha and ferritin and spectrophotometry for MDA.

RESULTS

Ginger supplementation significantly reduced the levels of TNF alpha, ferritin and MDA in ginger supplemented group in comparison to baseline. Ginger supplementation with antitubercular treatment significantly lowered TNF alpha, ferritin and MDA concentrations in comparison to control group.

CONCLUSIONS

Ginger was found to be effective as an anti-inflammatory and antioxidant supplement along with anti-TB therapy as it possesses strong free radical scavenging property.

Comparison of different drying methods on Chinese ginger (Zingiber officinale Roscoe): Changes in volatiles, chemical profile, antioxidant properties, and microstructure

Nowadays, food industry is facing challenges in preserving better quality of fruit and vegetable products after processing. Recently, many attentions have been drawn to ginger rhizome processing due to its numerous health promoting properties. In our study, ginger rhizome slices were subjected to air-drying (AD), freeze drying (FD), infrared drying (IR), microwave drying (MD) and intermittent microwave & convective drying (IM&CD). Quality attributes of the dried samples were compared in terms of volatile compounds, 6, 8, 10-gingerols, 6-shogaol, antioxidant activities and microstructure. Results showed that AD and IR were good drying methods to preserve volatiles. FD, IR and IM&CD led to higher retention of gingerols, TPC, TFC and better antioxidant activities. However, FD and IR had relative high energy consumption and drying time. Therefore, considering about the quality retention and energy consumption, IM&CD would be very promising for thermo sensitive material.

Plants used during maternity, menstrual cycle and other women's health conditions among Brazilian cultures

ETHNOPHARMACOLOGICAL RELEVANCE

For innumerous clinical cases related to women's health and precarious medical care in developing countries, a large repertoire of plants have been used as popular medicines in order to fill this gap, which in a certain way creates health risks to users, since pharmacological and toxicological tests are still insufficient to guarantee their efficacy and safety. Besides therapeutic use, abortive plants are broadly used in countries where abortion is prohibited, increasing that risk even more. In this way, ethnopharmacological studies that register plants used for women's health can contribute not only to the selection of potential bioactives, enriching the repertoire of drugs available to females, above all in public health systems, but also questioning the safety of products that are used without prescription.

AIMS AND OBJECTIVES

This review aims at determining plants applied by Brazilian cultures in the treatment of conditions related to maternity, menstrual cycle and other women's health particularities, and to supplement the lack of epidemiological data available to assess the health of indigenous, rural and other populations of Brazilian women.

MATERIALS AND METHODS

A literature review was conducted of the collection at the Ethnobotanical and Ethnopharmacological Center of the Federal University of São Paulo (period covered: 1965 to 2012). All of the 343 articles were consulted and 31 articles mentioning therapeutic uses of interest were selected. Relevant information was extracted to compose Table 1 - Maternity, Table 2 - Menstrual Cycle and Table 3 - Other Conditions. Data was statistically analyzed in order to generate the discussion about plants used in healing contexts by different Brazilian ethnicities. A bibliographic review was performed using the Scopus database to collect the following information about the most cited plants: ethnobotany/ethnopharmacology of non-Brazilian cultures for women's health conditions, pharmacology, toxicology, and adverse reactions.

RESULTS

A total of 319 species were cited for 22 indications related to women's health. Ninety-seven species were indicated for conditions related to maternity, 94 to the menstrual cycle and 232 to others. The same species could be present in more than one of these three categories. The most cited family was Fabaceae (13.5%), and the species were Ruta graveolens L. (1.76%) and Strychnos pseudoquina A. St.-Hil (1.76%). The most frequent part utilized, mode of preparation and route of administration were leaves (2.0%), tea (73.38%) and oral (87. 2%), respectively. The indications that showed the highest number of species were: to treat venereal diseases (69 species), abortive (54) and anti-inflammatory for the ovaries and/or uterus (54). According to our bibliographic survey, among the 19 most indicated species in this review, only four are also used by non-Brazilian cultures for conditions related to women's health; 25% of them were pharmacologically investigated and it was possible to validate their ethnopharmacological/ethnobotanical use, 10.5% have presented well-described adverse reactions and for 42.1% of these species toxicological studies were performed.

CONCLUSION

The survey raised important data about plants implemented in healing related to women's health conditions by Brazilian cultures and their practices. The compilation presented in this study enables the realization of further investigation regarding the development of herbal medicines and contributes to the incrementation of policies focused on these cultures. Further phytochemical, pharmacological and toxicological studies should be conducted, which will allow the discovery of pharmacological properties, bioactive constituents, and moreover, adequate posology, manner of use and adverse events.

Ginger Supplementation in Nonalcoholic Fatty Liver Disease: A Randomized, Double-Blind, Placebo-Controlled Pilot Study

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. The pathogenesis of this disease is closely associated with obesity and insulin resistance. Ginger can have hypolipidemic and antioxidant effects, and act as an insulinsensitizer.

OBJECTIVES

The aim of this study was to evaluate the effects of ginger supplementation in NAFLD management.

PATIENTS AND METHODS

In a randomized, double-blind, placebo-controlled clinical trial, 44 patients with NAFLD were assigned to take either two grams per day of a ginger supplement or the identical placebo, for 12 weeks. In both groups, patients were advised to follow a modified diet and physical activity program. The metabolic parameters and indicators of liver damage were measured at study baseline and after the 12 week intervention.

RESULTS

Ginger supplementation resulted in a significant reduction in alanine aminotransferase, γ-glutamyl transferase, inflammatory cytokines, as well as the insulin resistance index and hepatic steatosis grade in comparison to the placebo. We did not find any significant effect of taking ginger supplements on hepatic fibrosis and aspartate aminotransferase.

CONCLUSIONS

Twelve weeks of two grams of ginger supplementation showed beneficial effects on some NAFLD characteristics. Further studies are recommended to assess the long-term supplementation effects.

The Effect of Ginger (Zingiber officinale) on Platelet Aggregation: A Systematic Literature Review

BACKGROUND

The potential effect of ginger on platelet aggregation is a widely-cited concern both within the published literature and to clinicians; however, there has been no systematic appraisal of the evidence to date.

METHODS

Using the PRISMA guidelines, we systematically reviewed the results of clinical and observational trials regarding the effect of ginger on platelet aggregation in adults compared to either placebo or baseline data. Studies included in this review stipulated the independent variable was a ginger preparation or isolated ginger compound, and used measures of platelet aggregation as the primary outcome.

RESULTS

Ten studies were included, comprising eight clinical trials and two observational studies. Of the eight clinical trials, four reported that ginger reduced platelet aggregation, while the remaining four reported no effect. The two observational studies also reported mixed findings.

DISCUSSION

Many of the studies appraised for this review had moderate risks of bias. Methodology varied considerably between studies, notably the timeframe studied, dose of ginger used, and the characteristics of subjects recruited (e.g. healthy vs. patients with chronic diseases).

CONCLUSION

The evidence that ginger affects platelet aggregation and coagulation is equivocal and further study is needed to definitively address this question.

MS-Based Metabolite Profiling of Aboveground and Root Components of Zingiber mioga and Officinale

Zingiber species are members of the Zingiberaceae family, and are widely used for medicinal and food purposes. In this study aboveground and root parts of Zingiber mioga and Zingiber officinale were subjected to metabolite profiling by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS) and gas chromatography time-of-flight mass spectrometry (GC-TOF-MS) in order to characterize them by species and parts and also to measure bioactivities. Both primary and secondary metabolites showed clear discrimination in the PCA score plot and PLS-DA by species and parts. Tetrahydrocurcumin, diarylheptanoid, 8-gingerol, and 8-paradol were discriminating metabolites between Z. mioga and Z. officinale that were present in different quantities. Eleven flavonoids, six amino acids, six organic acids, four fatty acids, and gingerenone A were higher in the aboveground parts than the root parts. Antioxidant activities were measured and were highest in the root part of Z. officinale. The relatively high contents of tetrahydrocurcumin, diarylheptanoid, and galanganol C in the root part of Z. officinale showed highly positive correlation with bioactivities based on correlation assay. On the basis of these results, we can suggest different usages of structurally different parts of Zingiber species as food plants.

Pilot clinical study of the effects of ginger root extract on eicosanoids in colonic mucosa of subjects at increased risk for colorectal cancer

Colorectal cancer (CRC) remains a significant cause of mortality. Inhibitors of cyclooxygenase (COX) and thus prostaglandin E2, are promising CRC preventives, but have significant toxicities. Ginger has been shown to inhibit COX, to decrease the incidence and multiplicity of adenomas, and decrease PGE2 concentrations in subjects at normal risk for CRC. This study was conducted to determine the effects of 2.0 g/d of ginger given orally on the levels of PGE2, leukotriene B4 (LTB4), 13-hydroxy-octadecadienoic acids, and 5-, 12-, & 15-hydroxyeicosatetraenoic acid, in the colonic mucosa of subjects at increased risk for CRC. We randomized 20 subjects to 2.0 g/d ginger or placebo for 28 d. At baseline and Day 28, a flexible sigmoidoscopy was used to obtain colon biopsies. A liquid chromatography mass spectrometry method was used to determine eicosanoid levels in the biopsies, and levels were expressed per amount of protein or free arachidonic acid (AA). There was a significant decrease in AA between baseline and Day 28 (P = 0.05) and significant increase in LTB4 (P = 0.04) when normalized to protein, in subjects treated with ginger versus placebo. No other changes in eicosanoids were observed. There was no difference between the groups in total adverse events (AE; P = 0.06). Ginger lacks the ability to decrease eicosanoid levels in people at increased risk for CRC. Ginger did appear to be both tolerable and safe; and could have chemopreventive effects through other mechanisms. Further investigation should focus on other markers of CRC risk in those at increased CRC risk.

The effect of ginger (Zingiber officinale) on glycemic markers in patients with type 2 diabetes

BACKGROUND

Ginger (Zingiber officinale) is one of the functional foods which contains biological compounds including gingerol, shogaol, paradol and zingerone. Ginger has been proposed to have anti-cancer, anti-thrombotic, anti-inflammatory, anti-arthritic, hypolipidemic and analgesic properties. Here, we report the effect of ginger supplementation on glycemic indices in Iranian patients with type 2 diabetes.

METHODS

A double-blind, placebo-controlled, randomized clinical trial was conducted on 20-60 -year-old patients with type 2 diabetes who did not receive insulin. Participants in the intervention and control groups were received 3 g of powdered ginger or placebo (lactose) (in capsules) daily for 3 months. Glycemic indices, total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), serum paraoxonase, dietary intake and physical activity were measured at the beginning and end of the study, and after 12 h fasting.

RESULTS

Comparison of the indices after 3 months showed that the differences between the ginger and placebo groups were statistically significant as follows: serum glucose (-19.41 ± 18.83 vs. 1.63 ± 4.28 mg/dL, p < 0.001), HbA1c percentage (-0.77 ± 0.88 vs. 0.02 ± 0.16%, p < 0.001), insulin (-1.46 ± 1.7 vs. 0.09 ± 0.34 μIU/mL, p < 0.001), insulin resistance (-16.38 ± 19.2 vs. 0.68 ± 2.7, p < 0.001), high-sensitive CRP (-2.78 ± 4.07 vs. 0.2 ± 0.77 mg/L, p < 0.001), paraoxonase-1 (PON-1) (22.04 ± 24.53 vs. 1.71 ± 2.72 U/L, p < 0.006), TAC (0.78 ± 0.71 vs. -0.04 ± 0.29 µIU/mL, p < 0.01) and MDA (-0.85 ± 1.08 vs. 0.06 ± 0.08 µmol/L, p < 0.001) were significantly different.

CONCLUSIONS

This report shows that the 3 months supplementation of ginger improved glycemic indices, TAC and PON-1 activity in patients with type 2 diabetes.

The Effects of Pre-Exercise Ginger Supplementation on Muscle Damage and Delayed Onset Muscle Soreness

Ginger possesses analgesic and pharmacological properties mimicking non-steroidal antiinflammatory drugs. We aimed to determine if ginger supplementation is efficacious for attenuating muscle damage and delayed onset muscle soreness (DOMS) following high-intensity resistance exercise. Following a 5-day supplementation period of placebo or 4 g ginger (randomized groups), 20 non-weight trained participants performed a high-intensity elbow flexor eccentric exercise protocol to induce muscle damage. Markers associated with muscle damage and DOMS were repeatedly measured before supplementation and for 4 days following the exercise protocol. Repeated measures analysis of variance revealed one repetition maximum lift decreased significantly 24 h post-exercise in both groups (p < 0.005), improved 48 h post-exercise only in the ginger group (p = 0.002), and improved at 72 (p = 0.021) and 96 h (p = 0.044) only in the placebo group. Blood creatine kinase significantly increased for both groups (p = 0.015) but continued to increase only in the ginger group 72 (p = 0.006) and 96 h (p = 0.027) post-exercise. Visual analog scale of pain was significantly elevated following eccentric exercise (p < 0.001) and was not influenced by ginger. In conclusion, 4 g of ginger supplementation may be used to accelerate recovery of muscle strength following intense exercise but does not influence indicators of muscle damage or DOMS.

Zingiberaceae extracts for pain: a systematic review and meta-analysis

Background

Members of the family Zingiberaceae including turmeric, ginger, Javanese ginger, and galangal have been used for centuries in traditional medicine. Preclinical studies of Zingiberaceae extracts have shown analgesic properties. This study aims to systematically review and meta-analyze whether extracts from Zingiberaceae are clinically effective hypoalgesic agents.

Methods

Literature was screened from electronic databases using the key words Zingiberaceae AND pain OR visual analogue score (VAS) to identify randomized trials. From this search, 18 studies were identified, and of these, 8 randomized, double-blinded, placebo-controlled trials were found that measured pain by VAS for inclusion in the meta-analysis.

Results

Findings indicated significant efficacy of Zingiberaceae extracts in reducing subjective chronic pain (SMD − 0.67; 95 % CI − 1.13 to − 0.21; P = 0.004). A linear dose-effect relationship was apparent between studies (R² = 0.71). All studies included in the systematic review reported a good safety profile for extracts, without the renal risks associated with non-steroidal anti-inflammatory drugs, and with similar effectiveness.

Conclusion

Our findings indicated that Zingiberaceae extracts are clinically effective hypoalgesic agents and the available data show a better safety profile than non-steroidal anti-inflammatory drugs. However, both non-steroidal anti-inflammatory drugs and Zingiberaceae have been associated with a heightened bleeding risk, and there have been no comparator trials of this risk. Further clinical studies are recommended to identify the most effective type of Zingiberaceae extract and rigorously compare safety, including bleeding risk.

Drying effects on the antioxidant properties of tomatoes and ginger

In this study, the effects of four different drying processes, sun drying (SD), oven drying (OD), vacuum oven drying (VOD) and freeze drying (FD) for tomatoes (Solanum lycopersicum) and ginger (Zingiber officinale) in terms of thiolic and phenolic contents have been studied. Thiol content, total phenolic content (TPC), ascorbic acid (AA) content, and cupric ion reducing antioxidant capacity (CUPRAC) were determined in fresh and dried samples. Glutathione (GSH) and cysteine (Cys) were determined as the thiol contents of tomatoes and ginger. Significant losses were observed in the contents of TPC, AA, GSH and Cys and CUPRAC values in all samples that were dried using the thermal method. There was a statistically significant difference in the losses of the TPC, AA, and thiol contents between the use of thermal drying and freeze drying (except Cys in tomatoes) methods. Freeze dried tomato and ginger samples have been found to have better antioxidant properties.

Protective effects of the standardized extract of Zingiber officinale on myocardium against isoproterenol-induced biochemical and histopathological alterations in rats

CONTEXT

Ginger [Zingiber officinale Roscoe. (Zingiberaceae)] has been universally used as a spice as well as for its health benefits.

OBJECTIVE

The present study evaluates the protective effect of the standardized extract of ginger against isoproterenol (ISO)-induced myocardial infarction (MI) in rats.

MATERIALS AND METHODS

Wistar rats were pretreated orally with three doses of standardized ginger extract (100, 200, and 400 mg/kg of body weight) or propranolol (5 mg/mL) for 28 d prior to ISO (85 mg/kg) induced MI in two doses on days 29 and 30. The rats were sacrificed 48 h after the first induction; serum and hearts were collected for biochemical and histopathological analysis.

RESULTS

Gingerols and shogaols were identified and quantitatively analyzed in the extracts using validated reversed phase HPLC methods. Pretreatment with ginger extract at 400 mg/kg showed a significant decrease (p < 0.05) in all the cardiac enzyme activities, i.e., cardiac troponin I (cTnI) (0.57 ng/mL), creatine kinase MB isoenzyme (CK-MB) (10.34 pg/mL), lactate dehydrogenase (LDH) (115.22 U/L), alanine transaminase (ALT) (15.79 U/L), and aspartate transaminase (AST) (46.72 U/L) when compared with ISO-control rats. There were significant rises (p < 0.05) in the activity of glutathione peroxide (GPx) (53.16 U/L), catalase (CAT) (210.41 U/L), and superoxide dismutase (SOD) (280.89 U/mL) of the pretreated rats when compared with the ISO-control. Histopathological examination showed an improvement in membrane cell integrity in pretreated rats compared with untreated rats.

CONCLUSION

The ethanol extract of ginger exhibited cardioprotective potential in treating myocardial injury following ISO administration.

Neuroprotective effect of 6-paradol in focal cerebral ischemia involves the attenuation of neuroinflammatory responses in activated microglia

Paradols are non-pungent and biotransformed metabolites of shogaols and reduce inflammatory responses as well as oxidative stress as shogaols. Recently, shogaol has been noted to possess therapeutic potential against several central nervous system (CNS) disorders, including cerebral ischemia, by reducing neuroinflammation in microglia. Therefore, paradol could be used to improve neuroinflammation-associated CNS disorders. Here, we synthesized paradol derivatives (2- to 10-paradols). Through the initial screening for anti-inflammatory activities using lipopolysaccharide (LPS)-stimulated BV2 microglia, 6-paradol was chosen to be the most effective compound without cytotoxicity. Pretreatment with 6-paradol reduced neuroinflammatory responses in LPS-stimulated BV2 microglia by a concentration-dependent manner, which includes reduced NO production by inhibiting iNOS upregulation and lowered secretion of proinflammatory cytokines (IL-6 and TNF-α). To pursue whether the beneficial in vitro effects of 6-paradol leads towards in vivo therapeutic effects on transient focal cerebral ischemia characterized by neuroinflammation, we employed middle cerebral artery occlusion (MCAO)/reperfusion (M/R). Administration of 6-paradol immediately after reperfusion significantly reduced brain damage in M/R-challenged mice as assessed by brain infarction, neurological deficit, and neural cell survival and death. Furthermore, as observed in cultured microglia, 6-paradol administration markedly reduced neuroinflammation in M/R-challenged brains by attenuating microglial activation and reducing the number of cells expressing iNOS and TNF-α, both of which are known to be produced in microglia following M/R challenge. Collectively, this study provides evidences that 6-paradol effectively protects brain after cerebral ischemia, likely by attenuating neuroinflammation in microglia, suggesting it as a potential therapeutic agent to treat cerebral ischemia.

Complementary and integrative medicine for older adults in palliative care

Complementary and Integrative Medicine (CIM) encompasses many diverse therapies, including natural products and mind and body practices. Use of CIM is common and can benefit patients in palliative care. However, because patients in palliative care are often frail and elderly, the clinician should consider a patient's comorbidities before recommending certain therapies, such as natural products. In this article, specific examples of CIM are provided for symptoms commonly seen in palliative care.

Effects of Cinnamon, Cardamom, Saffron, and Ginger Consumption on Markers of Glycemic Control, Lipid Profile, Oxidative Stress, and Inflammation in Type 2 Diabetes Patients

OBJECTIVES

Type 2 diabetes (T2D) may be caused by elevated oxidative stress, inflammation, and hyperglycemia. The phytochemicals in several herbal medicines are reported to effectively improve diabetes and to ameliorate diabetic complications. The aim of the present study was to determine the effects of cinnamon, cardamom, saffron, and ginger as supplementary remedies in T2D.

METHODS

This randomized controlled, clinical trial included 204 T2D patients. The participants were randomly assigned to four intervention groups receiving 3 glasses of black tea and either 3 g cardamom, or cinnamon, or ginger, or 1 g saffron and one control group which consumed only 3 tea glasses without any herbal medicine for 8 weeks. Markers of inflammation, oxidative stress, fasting blood sugar, lipid profile, and anthropometric measures were evaluated at baseline and after 8 weeks of intervention.

RESULTS

After 8 weeks of intervention, cinnamon, cardamom, ginger, and saffron consumption had significant effects on total cholesterol, LDL, and HDL levels (p < 0.05) compared with controls. However, the herbal products did not have significant effects on measures of glycemic control, anthropometry, inflammation, and oxidative stress. In within-group comparisons only, cinnamon intake significantly decreased fasting blood sugar (FBS).

CONCLUSIONS

The herbal remedies examined had significantly beneficial effects on cholesterol, but not on measures of glycemic control, oxidative stress, and inflammation. Based on the contradictory results reported in the literature, the effects of herbal medicine in diabetic patients should undergo further detailed investigation.

Role of herbal bioactives as a potential bioavailability enhancer for Active Pharmaceutical Ingredients

The current review emphasizes on the herbal bioenhancers which themselves do not possess inherent pharmacological activity of their own but when co-administered with Active Pharmaceutical Ingredients (API), enhances their bioavailability and efficacy. Herbal bioenhancers play a crucial role in enhancing the bioavailability and bioefficacy of different classes of drugs, such as antihypertensives, anticancer, antiviral, antitubercular and antifungal drugs at low doses. This paper highlights various natural compounds that can be utilized as an efficient bioenhancer. Several herbal compounds including piperine, quercetin, genistein, naringin, sinomenine, curcumin, and glycyrrhizin have demonstrated capability to improve the pharmacokinetic parameters of several potent API. This article also focuses on various United States patents on herbal bioenhancers, which has proved to be beneficial in improving oral absorption of nutraceuticals like vitamins, minerals, amino acids and certain herbal compounds. The present paper also describes proposed mechanism of action, which mainly includes absorption process, drug metabolism, and action on drug target. The herbal bioenhancers are easily available, safe, free from side effects, minimizes drug toxicity, shortens the duration of treatment, lowers the drug resistance problems and minimizes the cost of treatment. Inspite of the fact that herbal bioenhancers provide an innovative concept for enhancing the bioavailability of several potent drugs, there are numerous bioenhancers of herbal origin that are yet to be explored in several vital areas. These bioenhancers must also be implied to enhance the bioavailability and bioefficacy through routes other than the oral route of drug delivery. There is a vast array of unexploited plants which can be investigated for their drug bioenhancing potency. The toxicity profiles of these herbal bioenhancers must not be overlooked. Researches must be carried out to solve these issues and to deliver a safe and effective dose of drugs to attain desired pharmacological response.

Integrative Treatment of Reflux and Functional Dyspepsia in Children

Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are common problems in the pediatric population, with up to 7% of school-age children and up to 8% of adolescents suffering from epigastric pain, heartburn, and regurgitation. Reflux is defined as the passage of stomach contents into the esophagus, while GERD refers to reflux symptoms that are associated with symptoms or complications-such as pain, asthma, aspiration pneumonia, or chronic cough. FD, as defined by the Rome III classification, is a persistent upper abdominal pain or discomfort, not related to bowel movements, and without any organic cause, that is present for at least two months prior to diagnosis. Endoscopic examination is typically negative in FD, whereas patients with GERD may have evidence of esophagitis or gastritis either grossly or microscopically. Up to 70% of children with dyspepsia exhibit delayed gastric emptying. Treatment of GERD and FD requires an integrative approach that may include pharmacologic therapy, treating concurrent constipation, botanicals, mind body techniques, improving sleep hygiene, increasing physical activity, and traditional Chinese medicine and acupuncture.

The effect of ginger consumption on glycemic status, lipid profile and some inflammatory markers in patients with type 2 diabetes mellitus

OBJECTIVE

To assess the effect of ginger consumption on glycemic status, lipid profile and some inflammatory markers in patients with type 2 diabetes mellitus.

METHODS

In a double-blinded, placebo-controlled clinical trial, 70 type 2 diabetic patients were enrolled. They allocated randomly into ginger group and control group. They consumed 1600 mg ginger versus 1600 mg wheat flour placebo daily for 12 weeks. Serum sugar, lipids, CRP, PGE2 and TNFα were measured before and after intervention.

RESULTS

Ginger reduced fasting plasma glucose, HbA1C, insulin, HOMA, triglyceride, total cholesterol, CRP and PGE₂ significantly compared with placebo group (p < 0.05). There were no significant differences in HDL, LDL and TNFα between two groups (p > 0.05).

CONCLUSION

Ginger improved insulin sensitivity and some fractions of lipid profile, and reduced CRP and PGE₂ in type 2 diabetic patients. Therefore ginger can be considered as an effective treatment for prevention of diabetes complications.

Zingiber officinale: A Potential Plant against Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease particularly affecting elderly people which leads to massive bone destruction with consequent inflammation, pain, and debility. Allopathic medicine can provide only symptomatic relief. However, Zingiber officinale is a plant belonging to the Zingiberaceae family, which has traditionally been used for treatment of RA in alternative medicines of many countries. Many of the phytochemical constituents of the rhizomes of this plant have therapeutic benefits including amelioration of RA. This review attempts to list those phytochemical constituents with their reported mechanisms of action. It is concluded that these phytochemicals can form the basis of discovery of new drugs, which not only can provide symptomatic relief but also may provide total relief from RA by stopping RA-induced bone destruction. As the development of RA is a complex process, further research should be continued towards elucidating the molecular details leading to RA and drugs that can stop or reverse these processes by phytoconstituents of ginger.