Principles of pharmacological research of nutraceuticals

Ready to Use Therapeutical Beverages: Focus on Functional Beverages Containing Probiotics, Prebiotics and Synbiotics

The growing global interest in functional foods containing nutrients capable of adding possible beneficial health effects is rapidly increasing both interest and consumer demand. In particular, functionalized beverages for their potential positive effect on health e.g., decreasing cholesterol level, lowering sugar, high fiber content, ability to enhance the immune system, and help digestion, have recently received special attention. Among the different beverages available on the market, probiotic dairy and non-dairy products have attracted much attention because of their affordable cost and their numerous therapeutic activities. Fermented milk and yogurt are currently worth €46 billion, with 77% of the market reported in Europe, North America, and Asia. Consumption of dairy beverages has some limitations due for example to lactose intolerance and allergy to milk proteins, thereby leading consumers to use non-dairy beverages such as fruit, grains, and vegetable juices to add probiotics to diet as well as driving the manufacturers to food matrices-based beverages containing probiotic cultures. The purpose of this review article is to evaluate the therapeutic performance and properties of dairy and non-dairy beverages in terms of probiotic, prebiotic, and synbiotic activities.

Highlights into the pharmacology of nutraceuticals

LINKED ARTICLES

This article is part of a themed section on The Pharmacology of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.6/issuetoc.

An overview of the pharmacology of olive oil and its active ingredients

In addition to providing sensory stimuli, usually taste, smell and sight, olive oil contains a range of minor components, mostly phenolic in nature. These components are endowed with pharmacological or pharma‐nutritional properties that are the subject of active research worldwide. Based on our more than 25 years of experience in this field, we critically focus on what we believe are the most pharmacologically prominent actions of the constituents of olive oil. Most of the effects are due to the phenolic compounds in extra virgin olive oil, such as hydroxytyrosol and oleocanthal (which are often mis‐categorized as in vivo antioxidants) and concern the cardiovascular system. Other potentially beneficial activities are still to be investigated in depth. We conclude that—in the context of a proper diet that includes high‐quality products—the use of high‐quality olive oil contributes to achieving and sustaining overall health.

Linked Articles

This article is part of a themed section on The Pharmacology of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.6/issuetoc

Autophagy: A Potential Therapeutic Target of Polyphenols in Hepatocellular Carcinoma

Autophagy is a conserved biological phenomenon that maintains cellular homeostasis through the clearing of damaged cellular components under cellular stress and offers the cell building blocks for cellular survival. Aberrations in autophagy subsidize to various human pathologies, such as dementia, cardiovascular diseases, leishmaniosis, influenza, hepatic diseases, and cancer, including hepatocellular carcinoma (HCC). HCC is the fifth common mortal type of liver cancer globally, with an inhomogeneous topographical distribution and highest incidence tripled in men than women. Existing treatment procedures with liver cancer patients result in variable success rates and poor prognosis due to their drug resistance and toxicity. One of the pathophysiological mechanisms that are targeted during the development of anti-liver cancer drugs is autophagy. Generally, overactivated autophagy may lead to a non-apoptotic form of programmed cell death (PCD) or autophagic cell death or type II PCD. Emerging evidence suggests that manipulation of autophagy could induce type II PCD in cancer cells, acting as a potential tumor suppressor. Hence, altering autophagic signaling offers new hope for the development of novel drugs for the therapy of resistant cancer cells. Natural polyphenolic compounds, including flavonoids and non-flavonoids, execute their anticarcinogenic mechanism through upregulating tumor suppressors and autophagy by modulating canonical (Beclin-1-dependent) and non-canonical (Beclin-1-independent) signaling pathways. Additionally, there is evidence signifying that plant polyphenols target angiogenesis and metastasis in HCC via interference with multiple intracellular signals and decrease the risk against HCC. The current review offers a comprehensive understanding of how natural polyphenolic compounds exhibit their anti-HCC effects through regulation of autophagy, the non-apoptotic mode of cell death.

Trends in use, pharmacology, and clinical applications of emerging herbal nutraceuticals

The nutraceuticals market is vast, encompassing many different products with inconsistent levels of evidence available to support their use. This overview represents a Western perspective of the nutraceuticals market, with a brief comparison with that in China, as an illustration of how individual health supplements increase and decrease in popularity in regional terms. Recent changes in sales patterns, mainly taken from the US market, are summarized and a selection of five newer products, which have not been subject to extensive recent review are profiled: astaxanthin, a carotenoid found in red algae, seafood, salmon and trout, as an antioxidant; cannabidiol, a non-euphoric marijuana ingredient used as mood enhancer and for painful/inflammatory conditions; modified extracts of ginseng used in new indications including dementia and space travel; monk fruit, a non-sugar high intensity sweetener and nigella seed, a popular food ingredient and Asian medicine, which has experienced an extraordinary rise in sales recently. LINKED ARTICLES: This article is part of a themed section on The Pharmacology of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.6/issuetoc.

Nutraceuticals: An integrative approach to starve Parkinson's disease

The therapeutic approach of multifactorial complex diseases is always a challenge; Parkinson's disease (PD) is a heterogeneous neurodegenerative disorder triggered by genetic and environmental factors, contributing to its etiology. Indeed, several pathogenic mechanisms lead to selective dopaminergic neuronal injury, including oxidative stress, mitochondrial dysfunction, alteration of endoplasmic reticulum-to-Golgi protein trafficking, excitotoxicity, and neuroinflammation. Current treatment approaches include mainly dopamine replacement therapy or optimizing dopaminergic transmission; however, these strategies that do not counteract the pathogenic mechanisms underlying PD symptoms and often are less effective over time. Recently, there has been growing interest in the therapeutic use of nutraceuticals, that could represent an integrative approach to the pharmacological standard therapy and specifically affect one or more pathogenic pathways. The intake of nutraceuticals or nutritional modifications are generally safe and can be combined with current common drug therapy in most cases to improve the patient's quality of life and/or mitigate PD symptoms. The current review focuses on several key nutritional compounds and dietary modifications that are effective on several pathogenic pathways involved in PD onset and progression, and further highlights the rationale behind their potential use for the prevention and treatment of PD.

Anti-obesity effects of capsaicin and the underlying mechanisms: a review

The mechanisms of anti-obesity effects of capsaicin in cell models, rodent models and human subjects were reviewed.

Human health-related properties of chromones: an overview

Natural compounds occurring throughout the world are scientifically and practically valuable because of their unique and beneficial properties to control a wide range of disorders in the human body. Chromones are attracting increasing attention as novel therapeutic agents due to their effective bioactivities for human health. Accordingly, the present overview article was designed to scan the biological and pharmacological performance of chromones, including their anti-inflammatory, anticancer, anti-oxidant, and anti-microbial activities.

Distribution of camptothecin biosynthetic intermediates and identification the rate-limiting step of camptothecin biosynthesis

Two key biosynthetic intermediates (pumiloside and strictosamide) of camptothecin were isolated. A high performance liquid chromatography-ultraviolet (HPLC-UV) method was developed to determine four main alkaloid compounds (pumiloside, strictosamide, camptothecin and 10-hydroxycamptothecin) and estimate two minor compounds (deoxypumiloside, 9-methoxycamptothecin) simultaneously in different parts of Camptotheca acuminata, with a good linearity and R² > 0.999 for all curves. The results indicated that there was a positive correlation between the two key intermediates (strictosamide and pumiloside) and camptothecin in vivo. The speculation that the root was the synthetic position of camptothecin in vivo was confirmed. The rate-limiting step of camptothecin biosynthesis was estimated the step from pumiloside to deoxypumiloside based on its concentration fall sharply.

Egg Yolk Antioxidants Profiles: Effect of Diet Supplementation with Linseeds and Tomato-Red Pepper Mixture before and after Storage

This study evaluated the effect of dietary incorporation of linseed alone or along with dried tomato paste-pepper powder mix on egg physical characteristics, antioxidant profiles, lipid oxidative status, and yolk coloration before and after storage at 4 °C for one month. Sixty Novogen White laying hens, 27 weeks-old, were divided into three groups and given 100 g/hen/day of a standard diet (C), standard diet containing 4.5% of ground linseed (L), linseed diet containing 1% of dried tomato paste and 1% of sweet red pepper (LTP). Linseeds increased (p < 0.05) egg yolk antioxidant capacity but not lipid oxidative stability (p > 0.05). However, dietary inclusion of LTP did not improve fresh egg yolk antioxidant activity and lipid oxidation stability (p > 0.05). With reference to the stored eggs, only antioxidant activity measured by phosphomolybdenum reduction and lipid oxidative stability were influenced (p < 0.05) by the dietary treatment. Fresh egg yolk of hens fed on linseeds tended to have a slightly more yellow, redder, and less light color than the eggs of hens fed with the control diet. Dietary supplementation of LTP increased (p < 0.05) the Roche yolk color fan (RYCF) score and redness (a*) and decreased (p < 0.05) lightness (L*) without affecting (p > 0.05) saturation (C*). Storage of hens’ eggs fed on the control diet did not influence (p > 0.05) yolk color.

Small-Intestine-Specific Delivery of Antidiabetic Extracts from Withania coagulans Using Polysaccharide-Based Enteric-Coated Nanoparticles

Withania coagulans is an Indian medicinal herb, the natural extracts of which are purported to have health-benefiting properties. In this study, the extract was encapsulated in nature-derived polymers with the aim of enhancing its bioavailability. The aqueous extract obtained from the plant W. coagulans was found to elicit the glucose-lowering effect by means of promoting insulin secretion from pancreatic β cells. The cells treated with the extract showed a nearly 2-fold increase in insulin secretion compared to untreated cells. A delivery system for the extract was developed based on electrosprayed chitosan nanoparticles coated with food-based starch. The enteric starch coating retarded (by 2.5 times) the release of the extract in the stomach. The bioactivity of the encapsulated extract was subsequently tested in vitro on mouse-derived pancreatic β cells, whereby the delivery system was found to promote insulin secretion. Finally, the extract-encapsulated oral delivery system was tested on diabetic mice and was validated to decrease blood glucose levels by 60%. In summary, it could be inferred that food-grade enteric-coated polysaccharide-based particles increase the bioavailability of the extracted compounds from the plant W. coagulans.

Devil's claw (Harpagophytum procumbens) and chronic inflammatory diseases: A concise overview on preclinical and clinical data

Devil's Claw is a traditional medicine that has been long used a wide range of health conditions, including indigestion, fever, allergic reactions, and rheumatism. The main compounds are iridoid glycosides, including harpagoside, harpagide, and procumbide. However, harpagoside is the most responsible for therapeutic activity, and its content is used as reference standard. Here, we analyzed and summarized preclinical and clinical studies focusing on therapeutic efficacy of devil's claw preparations in pathological conditions in which inflammation plays a key causative role.

Phytochemicals Bridging Autophagy Induction and Alpha-Synuclein Degradation in Parkinsonism

Among nutraceuticals, phytochemical-rich compounds represent a source of naturally-derived bioactive principles, which are extensively studied for potential beneficial effects in a variety of disorders ranging from cardiovascular and metabolic diseases to cancer and neurodegeneration. In the brain, phytochemicals produce a number of biological effects such as modulation of neurotransmitter activity, growth factor induction, antioxidant and anti-inflammatory activity, stem cell modulation/neurogenesis, regulation of mitochondrial homeostasis, and counteracting protein aggregation through modulation of protein-folding chaperones and the cell clearing systems autophagy and proteasome. In particular, the ability of phytochemicals in restoring proteostasis through autophagy induction took center stage in recent research on neurodegenerative disorders such as Parkinson’s disease (PD). Indeed, autophagy dysfunctions and α-syn aggregation represent two interdependent downstream biochemical events, which concur in the parkinsonian brain, and which are targeted by phytochemicals administration. Therefore, in the present review we discuss evidence about the autophagy-based neuroprotective effects of specific phytochemical-rich plants in experimental parkinsonism, with a special focus on their ability to counteract alpha-synuclein aggregation and toxicity. Although further studies are needed to confirm the autophagy-based effects of some phytochemicals in parkinsonism, the evidence discussed here suggests that rescuing autophagy through natural compounds may play a role in preserving dopamine (DA) neuron integrity by counteracting the aggregation, toxicity, and prion-like spreading of α-syn, which remains a hallmark of PD.

Effects of curcumin supplementation on markers of inflammation and oxidative stress among healthy overweight and obese girl adolescents: A randomized placebo-controlled clinical trial

INTRODUCTION

It is well known that there is a strong linkage between obesity, systemic low-grade inflammation, and oxidative stress in the pediatric population. Possible strategies that might control obesity and its relevant problems in this crucial group are of utmost importance. Therefore, the aim of this study was to evaluate the effects of curcumin supplements on inflammation, oxidative stress, and chemerin levels in adolescent girls.

METHODS

Totally, 60 overweight and obese adolescent girls were randomly assigned to either placebo or intervention group in a randomized placebo-controlled parallel trial design. Adolescents consumed one 500-mg curcumin or placebo per day along with a slight weight loss diet for 10 weeks. High-sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), total antioxidant capacity (TAC), malondialdehyde (MDA), chemerin levels, and anthropometric measurements were assessed at the beginning and end of the trial.

RESULTS

Curcumin supplementation had a significant effect on IL-6 levels and oxidative stress markers including TAC and MDA in crude model. After controlling the effects of confounders, curcumin supplementation had a substantial effect on inflammation (hs-CRP and IL-6) and oxidative stress (TAC) marker of adolescents.

DISCUSSION

Ten weeks of curcumin supplementation had beneficial effects on inflammation and oxidative stress markers among postpubescent overweight and obese girl adolescents.

The anti-cancer activity and potential clinical application of rice bran extracts and fermentation products

Rice bran is the main by-product of rice processing and contains approximately 64% of the nutrients in rice. Its various nutrient elements include rice bran proteins, oil, oryzanol, vitamins, polysaccharides, etc. The use of fermented technology can increase the content of bioactive peptides, promote the absorption efficiency, and further improve the functionality and added value of rice bran. In recent years, the nutritional value and function of the extracts and fermented products of rice bran have been emphatically studied. Rice bran extracts and fermentation products serve a critical role in the anti-inflammatory reaction, reducing the plasma lipid effect and increasing anti-cancer activity. Moreover, few review studies have been reported on the anti-cancer activity and potential mechanism of action of rice bran extract and its fermentation products. In this review, we focused on the anti-cancer function, mechanisms, and potential clinical usage of rice bran extracts and fermentation products in the adjuvant therapy of cancer patients.

Fruit-based juices: Focus on antioxidant properties-Study approach and update

This paper proposes a perspective literature review of the antioxidant properties in fruit-based juices. The total antioxidant properties due to compounds such as carotenoids, polyphenolic compounds, flavonoids, and tannins as well as the assessment of interactions between natural active compounds and other food matrix components can be seen as the first step in the study of potential health benefits of fruit-based juices. A brief summary is given on the significance of antioxidant properties of fruit juices, the conventional methods for antioxidant activity evaluation, and on the newly emerged sample analysis and data interpretation strategies, that is, chemometric analysis based on spectroscopic data. The effect of fruit processing techniques and the addition of ingredients on the antioxidant properties of fruit-based juices are also discussed.

Long Chain Polyunsaturated Fatty Acids (LCPUFAs) in the Prevention of Food Allergy

N-3 long chain polyunsaturated fatty acids (LCPUFAs) are considered to possess protective properties for human health by impacting on immunological reactions. An “inflammation-suppressive” effect appears to be the common denominator of the beneficial effects of most of these dietary components which may protect against the development of chronic immune disorders such as (food) allergy. LCPUFAs, especially n-3 LCPUFAs, have been shown to interact with both the sensitization as well as the effector phase in food allergy in pre-clinical models. In this review, we explore the anti-allergic properties of LCPUFAs by providing an overview of clinical, in vivo and in vitro studies. Furthermore, we discuss the susceptibility of LCPUFAs to lipid oxidation and possible strategies to support the efficacy of LCPUFAs in reducing the allergy risk by using additional components with anti-oxidative and anti-inflammatory capacities such as the flavonoid quercetin. Finally, we propose new strategies to prevent (food) allergy using combinations of LCPUFAs and additional nutrients in diets or supplements, and postulate to investigate the use of LCPUFAs in allergic symptom relief.

Polyphenolic Nutraceuticals to Combat Oxidative Stress Through Microbiota Modulation

Due to their direct relationship with the activity of the gut microbiota, nutraceuticals are, at present, an effective alternative for the mitigation and alleviation of the dysfunctions governed by oxidative stress. The escalation in the number of the target group patients (diabetes, cardiovascular dysfunction, cancer, etc.) has spurred the quest for alternative action methods. The therapeutic value is determined through in vitro and in vivo methods, and involves the analysis of the therapeutic index. As the adverse outcomes are decreased, the pharmacological potential is assessed by the mechanisms, including biotransformation and the identification of the relevant biomarkers. Inflammatory action is among the principal effects that need to be reduced because it favors the presence of free radicals and dysbiosis. This article aimed at highlighting the action of the nutraceuticals in minimizing the oxidative stress by directly influencing the microbiota and slowing down the inflammatory progression. The pharmacological aspects as a therapeutic indicator of the use of nutraceuticals in improving the population health.

Antioxidant Properties of Four Commonly Consumed Popular Italian Dishes

Four popular dishes belonging to Italian cuisine and widely consumed in the country were experimentally prepared in a dedicated lab-kitchen following a validated and standardized protocol. This study provides their antioxidant properties evaluating the contribution of extractable and non-extractable bioactive compounds, and identifying the assessment of interactions between their natural active compounds and the food matrix. Ferric reducing antioxidant power (FRAP) values in aqueous-organic extract ranged from the highest antioxidant activity in torta di mele (10.72 µmol/g d.m.) to that in besciamella (2.47 µmol/g d.m.); in residue, pasta alla carbonara reached the highest value (73.83 µmol/g d.m.) following by that in pasta alla amatriciana (68.64 µmol/g d.m.). Total polyphenol content (TPC) ranged in aqueous-organic extracts between 36.50 and 64.28 mg/100 g d.m. and in residue from 425.84 to 1747.35 mg/100 g d.m. Our findings may contribute to the updating of the Italian Food Composition Database, by providing for the first time a value for the antioxidant properties. This could contribute to encourage the consumption of recipes rich in key nutrients and bioactive molecules. This information is useful and important for determining the association between diet and a healthy status.

Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis

PURPOSE

Erectile dysfunction (ED) is a common condition that significantly affects quality of life and interpersonal relationships.

OBJECTIVE

Our objective was to perform a systematic review and meta-analysis to evaluate the efficacy of herbal dietary supplements in the treatment of ED.

MATERIALS AND METHODS

We searched five databases to identify randomized controlled trials (RCTs) that evaluated the clinical efficacy of herbal medicines in ED. Quality was assessed and risk of bias was estimated using the Jadad score and the Cochrane risk-of-bias tool.

RESULTS

In total, 24 RCTs, including 2080 patients with ED, were identified. Among these, 12 evaluated monopreparations (five ginseng [n = 399], three saffron [n = 397], two Tribulus terrestris [n = 202], and one each Pinus pinaster [n = 21] and Lepidium meyenii [n = 50]), seven evaluated formulations (n = 544), and five investigated dietary supplements in combination with pure compounds (n = 410). Ginseng significantly improved erectile function (International Index of Erectile Function [IIEF]-5 score: 140 ginseng, 96 placebo; standardized mean difference [SMD] 0.43; 95% confidence interval [CI] 0.15-0.70; P < 0.01; I² = 0), P. pinaster and L. meyenii showed very preliminary positive results, and saffron and T. terrestris treatment produced mixed results. Several herbal formulations were associated with a decrease of IIEF-5 or IIEF-15, although the results were preliminary. The quality of the included studies varied, with only seven having a prevalent low risk of bias. The median methodological quality Jadad score was three out of a maximum of five. Adverse events were recorded in 19 of 24 trials, with no significant differences between placebo and verum in placebo-controlled studies.

CONCLUSIONS

Encouraging evidence suggests that ginseng may be an effective herbal treatment for ED. However, further, larger, and high-quality studies are required before firm conclusions can be drawn. Promising (although very preliminary) results have also been generated for some herbal formulations. Overall, more research in the field, adhering to the CONSORT statement extension for reporting trials, is justified before the use of herbal products in ED can be recommended.

Consuming Blackberry as a Traditional Nutraceutical Resource from an Area with High Anthropogenic Impact

The most serious quality issue of natural resources for human consumption or medicinal purposes is the contamination with pollutants harmful to consumers. Common blackberry (Rubus fruticosus L.) is a sought-after nutraceutical and an important component in herbal medicine in many places around the globe. The present study aims to analyze the level of heavy metal bioaccumulation in blackberry organs, as well as its spatial distribution in two consecutive years immediately after the interruption of the extended activity of the industrial source of pollution. The research was conducted in one of the most polluted areas in Romania and Eastern Europe, within a 26 km radius of the source of pollution. The Pb, Cd, Cu, and Zn concentrations in the leaves, flowers, and unwashed blackberry fruits were analyzed spectrophotometrically through flame atomic absorption spectroscopy (FAAS). The results show that blackberry is an important bioaccumulator of these heavy metals—71% of the Pb concentration values and 100% of the Cd concentration values exceeded the World Health Organization thresholds by up to 29 and 15 times, respectively. Also, the leaves are the largest reservoirs of Pb and Zn (the median values: 51.4 mg/kg dry weight and 105.2 mg/kg d.w., respectively), and the flowers contained the largest quantities of Cd and Cu (2.54 mg/kg d.w. and 11.3 mg/kg d.w., respectively). The Pb concentrations decreased by a power function in relation to the distance from the source of pollution. The implications of these results on the safety of the use of blackberry are discussed. The urgent necessity for food education of the local population which consumes contaminated nutraceutical products is emphasized.

Topical silymarin administration for prevention of acute radiodermatitis in breast cancer patients: A randomized, double-blind, placebo-controlled clinical trial

Radiation-induced dermatitis is one of the most common side effects of radiotherapy. Silymarin, a flavonoid extracted from the Silybum marianum, exhibits antioxidant and anti-inflammatory activities. The purpose of this study was to investigate the efficacy of silymarin gel in prevention of radiodermatitis in patients with breast cancer. During this randomized, double-blinded, placebo-controlled clinical trial, the preventive effect of silymarin 1% gel was assessed in comparison with placebo, on radiodermatitis occurrence. Forty patients randomly received silymarin gel or placebo formulation on chest wall skin following modified radical mastectomy, once daily starting at the first day of radiotherapy for 5 weeks. Radiodermatitis severity was assessed weekly based on Radiation Therapy Oncology Group (RTOG) and National Cancer Institute Common Terminology for Adverse Events (NCI-CTCAE) criteria radiodermatits grading scale for 5 weeks. The median NCI-CTCAE and RTOG scores were significantly lower in silymarin group at the end of the third to fifth weeks (p value < 0.05). The scores increased significantly in both placebo and silymarin groups during radiotherapy, but there was a delay in radiodermatitis development and progression in silymarin group. Prophylactic administration of silymarin gel could significantly reduce the severity of radiodermatitis and delay its occurrence after 5 weeks of application.

Effect of Rosmarinic Acid on the Serum Parameters of Glucose and Lipid Metabolism and Oxidative Stress in Estrogen-Deficient Rats

Rosmarinic acid is found in medicinal and spice plants such as rosemary, lemon balm, and mint. The aim of the study was to investigate the effect of rosmarinic acid on parameters of glucose and lipid metabolism and parameters of oxidative stress in rats in the early phase of estrogen deficiency. The study was carried out on mature female Wistar rats divided into the following groups: sham-operated control rats, ovariectomized control rats, and ovariectomized rats treated orally with rosmarinic acid at a dose of 10 mg/kg or 50 mg/kg daily for 28 days. The concentration of sex hormones, parameters related to glucose and lipid metabolism as well as parameters of antioxidant abilities and oxidative damage were determined in the blood serum. In the ovariectomized control rats, the homeostasis model assessment of insulin resistance (HOMA-IR) index and cholesterol concentration increased, the superoxide dismutase activity increased, and the reduced glutathione concentration decreased. Administration of rosmarinic acid at both doses induced decreases in the fructosamine concentration and HOMA-IR, an increase in the concentration of reduced glutathione, and a decrease in the concentration of advanced oxidation protein products in ovariectomized rats. Moreover, rosmarinic acid at a dose of 50 mg/kg induced a decrease in the total cholesterol and triglyceride concentrations. The results indicate that rosmarinic acid may be useful in the prevention of metabolic disorders associated with estrogen deficiency, however further studies are necessary.

The effects of Nigella sativa on quality of life, disease activity index, and some of inflammatory and oxidative stress factors in patients with ulcerative colitis

The aim of this study was to evaluate the effects of Nigella sativa (NS) supplementation in patients with ulcerative colitis. Two grams of NS powder or placebo were consumed for 6 weeks by 46 patients with active mild to moderate ulcerative colitis. Using valid and common questionnaires of colitis severity and blood sampling, we estimated disease activity index, quality of life, and some of inflammatory and oxidative stress factors at baseline and after 6 weeks of supplementation. NS-elevated tumor necrosis factor-alpha and high-sensitivity-c-reactive-protein as well as reduced malondialdehyde (p = 0.01, p = 0.02, and p = 0.005, respectively) compared with placebo. There was no significant difference between the two groups in serum total antioxidant capacity and nuclear factor kB levels. Total scores of Simple Clinical Colitis Activity Index Questionnaire and Inflammatory Bowel Disease Questionnaire-9 were not different between the two groups; however, stool frequency score decreased significantly in NS group. Further clinical trials with different pattern of NS administration (the amount of total and divided daily doses, either powder type or standard extracts/oil and different time arrangement) are needed to clarify the vision.

Milk thistle (Silybum marianum): A concise overview on its chemistry, pharmacological, and nutraceutical uses in liver diseases

Milk thistle (MT; Silybum marianum), a member of the Asteraceae family, is a therapeutic herb with a 2,000-year history of use. MT fruits contain a mixture of flavonolignans collectively known as silymarin, being silybin (also named silibinin) the main component. This article reviews the chemistry of MT, the pharmacokinetics and bioavailability, the pharmacologically relevant actions for liver diseases (e.g., anti-inflammatory, immunomodulating, antifibrotic, antioxidant, and liver-regenerating properties) as well as the clinical potential in patients with alcoholic liver disease, nonalcoholic fatty liver disease, viral hepatitis, drug-induced liver injury, and mushroom poisoning. Overall, literature data suggest that, despite encouraging preclinical data, further well-designed randomized clinical trials are needed to fully substantiate the real value of MT preparations in liver diseases.

Echinacea plants as antioxidant and antibacterial agents: From traditional medicine to biotechnological applications

The genus Echinacea consists of 11 taxa of herbaceous and perennial flowering plants. In particular, Echinacea purpurea (L.) Moench is widely cultivated all over the United States, Canada, and in Europe, exclusively in Germany, for its beauty and reported medicinal properties. Echinacea extracts have been used traditionally as wound healing to improve the immune system and to treat respiratory symptoms caused by bacterial infections. Echinacea extracts have demonstrated antioxidant and antimicrobial activities, and to be safe. This survey aims at reviewing the medicinal properties of Echinacea species, their cultivation, chemical composition, and the potential uses of these plants as antioxidant and antibacterial agents in foods and in a clinical context. Moreover, the factors affecting the chemical composition of Echinacea spp. are also covered.

Effects of curcumin consumption on human chronic diseases: A narrative review of the most recent clinical data

Numerous clinical trials have investigated the potential beneficial effects of curcumin supplementation against several human chronic diseases. Up to now, it has been claimed that curcumin consumption may exert beneficial effects against several chronic diseases by promoting human health and preventing diseases. In this aspect, the present review aims to critically collect and in-depth summarize the most recent, well-designed clinical studies evaluating the potential beneficial effects of curcumin consumption on human health promotion and disease prevention. According to recent and well-designed clinical studies, curcumin consumption may benefit against obesity, metabolic syndrome, and diabetes. Moreover, curcumin consumption seems to exert a positive effect on people suffering from various types of cancer, fatty liver disease, depression, arthritis, skin diseases, gut inflammation, and symptoms of premenstrual syndrome. Due to the strong heterogeneity among the clinical studies concerning the exact effective curcumin dose and formulation, as well as the recommended treatment duration for each chronic disease, no precise and definitive conclusions could be drawn. Further large-scale prospective studies are strongly recommended, being well-designed as far as follow-up times, dosage, formulation, and duration of curcumin supplementation are concerned. Moreover, potential confounders in each specific chronic disease should carefully be taken into account in future studies.

Pregnancy and herbal medicines: An unnecessary risk for women's health-A narrative review

The indiscriminate use of herbal medicines to prevent or to heal diseases or even the use for questionable purposes such as weight loss has received both interest and scrutiny from the scientific community and general public alike. An increasing number of women put their own and the unborn child's health at risk due to a lack of knowledge about the phytochemical properties and adequate use of herbal medicine (phytomedicines or herbal supplements) and lack of communication with their healthcare provider. The purpose of this narrative review was to summarize the use of herbal medicines during pregnancy and their potential toxic effects to highlight the importance of caution when prescribing herbal medicines or supplements for women, because, in addition to suffering interactions and a great amount of information obtained in preclinical predictive studies, assessment of nephrotoxicity, neurotoxicity, hepatotoxicity, genotoxicity, and teratogenicity of traditional medicinal herbs still remains scarce in the clinical setting.

Principles of pharmacological research of nutraceuticals

LINKED ARTICLES

This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc.

The effect of green tea ointment on episiotomy pain and wound healing in primiparous women: A randomized, double-blind, placebo-controlled clinical trial

The delayed healing of episiotomy wound and its associated pain is a major problem in obstetrics. Because green tea has analgesic and wound-healing properties, the present study was conducted to determine the effect of green tea ointment on episiotomy pain and wound-healing. The green tea extract was also standardized by measuring its Phenolic and flavonoid compounds, antioxidant activity, and one of its active components, that is, Epigallocatechin gallate. The present clinical trial was conducted on 99 primiparous women visiting Afzalipour Hospital in Kerman in 2015. The subjects were randomly divided into 3 groups, including a green tea ointment group, a placebo ointment group, and a routine care group. The 2 ointment groups smeared 2 cm of the green tea or placebo ointments onto their sutured area twice daily for a total of 10 days. The severity of pain was assessed in the subjects using the visual pain scale and wound-healing using the Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) scale before the intervention and on the 5th and 10th days after delivery. To standardize the extract, Epigallocatechin gallate was measured by high-performance liquid chromatography (HPLC). Phenolic and flavonoid compounds, as well as antioxidant activity of the extract were also determined by spectrometry methods. Before the intervention, no significant differences were observed between the 3 groups in terms of their personal and obstetric details (p > .05), the severity of pain (p = .118), and the REEDA score (p = .212). On the 5th and 10th days after delivery, the severity of pain was significantly lower in the green tea group than in the other 2 groups (p < .0001). The mean REEDA score on the 5th and 10th days showed a better and faster healing in the green tea group compared to the other 2 groups (p < .0001). Total content of phenolic and flavonoids contents of green tea were 74.2 mg/g Gallic acid equivalent and 16.3 mg/g Rutin equivalent, respectively, and its antioxidant capacity was 46% of b-carotene. Green tea ointment appears to be effective in relieving episiotomy pain and improving wound-healing in this study. Further studies are recommended to be conducted on the effectiveness and safety of the different doses of green tea ointment.

Curcumin nanomicelle improves semen parameters, oxidative stress, inflammatory biomarkers, and reproductive hormones in infertile men: A randomized clinical trial

At least 50% of infertile couple's problems are related to male factor infertility. This Randomized, Double-Blind, Placebo-Controlled Clinical Trial conducted in Urology unit of Infertility Clinic on 60 infertile men. Patients were randomly assigned to one of intervention and placebo (n = 30) groups. Finally, 28 subjects in each group completed the study. Participants in the intervention group took daily 80 mg curcumin nanomicelle and those in the placebo group took daily placebo for 10 weeks. Semen analysis, anthropometric, physical activity assessments, total antioxidant capacity, malondialdehyde, inflammatory factors, and reproductive hormones were measured at the baseline and at the end of the study. At the end of study, statistically significant differences were seen in the total sperm count, sperm concentration, and motility in the intervention group to the control group. In treatment group, the total sperm count, sperm concentration, and motility levels were also statistically increased at the end of study compared to the baseline values. Curcumin nanomicelle supplementation also resulted in a statistically significant improvement in plasma levels of total antioxidant capacity, malondialdehyde, C-reactive protein, and tumor necrosis factor a in comparison to the placebo. Medical therapy of asthenoteratospermia with curcumin nanomicelle supplement could improve quality of semen parameters. However, further investigation is suggested in this regard.

A systematic review of randomized controlled trials with herbal medicine on chronic rhinosinusitis

Chronic rhinosinusitis (CRS) is a common disease with evidence to show that its incidence and prevalence are increasing. Medicinal plants are commonly used to treat CRS. This systematic review aimed to assess the effectiveness and safety of herbal preparations for treatment of the patients with CRS. Cochran, Embase, ISI, PubMed, and Scopus databases were searched until August 1, 2016. Only randomized controlled trials were included. Four randomized controlled trials were included in this systematic review. Various medicinal plants were studied in each article. Inclusion and exclusion criteria, and outcome measures varied among different articles. The results of this trials showed that this special medicinal plants may be effective in the treatment of CRS. No serious reactions were reported during the administration of herbal remedies in the 4 studies. However, trials with a well-designed approach are needed to study the actual safety and efficacy of herbs in the treatment of CRS.

Comparative Oral Absorption of Curcumin in a Natural Turmeric Matrix with Two Other Curcumin Formulations: An Open-label Parallel-arm Study

Curcuminoids are the major bioactive molecules in turmeric, and poor bioavailability deters them from being the major components of many health and wellness applications. This study was conducted to assess the bioavailability of a completely natural turmeric matrix formulation (CNTMF) and compare its bioavailability with two other commercially available formulations, namely, curcumin with volatile oil (volatile oil formulation) and curcumin with phospholipids and cellulose (phospholipid formulation) in healthy human adult male subjects (15 each group) under fasting conditions. Each formulation was administrated orally as a single 500-mg dose in capsule form, and blood samples were analyzed by liquid chromatography mass spectrometry at various time intervals up to 24 h. The ingestion of the CNTMF was very well absorbed and resulted in a mean curcuminoids plasma C_max of 170.14 ng/mL (T_max  = 4 h) compared with 47.54 ng/mL and 69.63 ng/mL for the volatile oil (T_max  = 3 h) and phospholipid (T_max  = 2.25 h) formulations, respectively. The extent of absorption of total curcuminoids in the blood for the CNTMF was 6× greater than volatile oil formulation and 5× greater than phospholipids formulation. The results of this study indicate that curcumin in a natural turmeric matrix exhibited greater bioavailability than the two comparator products. Copyright © 2017 John Wiley & Sons, Ltd.