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Bremer S, Weitkemper E, Häberlein H, Franken S. St. John's wort extract Ze 117 alters the membrane fluidity of C6 glioma cells by influencing cellular cholesterol metabolism. Sci Rep 2024; 14:9878. [PMID: 38684848 PMCID: PMC11059309 DOI: 10.1038/s41598-024-60562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/24/2024] [Indexed: 05/02/2024] Open
Abstract
Chronic stress is associated with major depressive disorder (MDD). Increased glucocorticoid levels caused by uncontrolled release through the hypothalamic‒pituitary‒adrenal (HPA) axis can cause changes in the lipid content of the cellular plasma membrane. These changes are suspected to be involved in the development of depressive disorders. St. John's wort extract (SJW) Ze 117 has long been used as an alternative to synthetic antidepressants. Part of its effect may be due to an effect on the cellular lipid composition and thus on the properties of plasma membranes and receptor systems embedded therein. In this study, we investigated the effect of Ze 117 on that of dexamethasone and simvastatin. Dexamethasone increases the fluidity of C6 cell plasma membranes. This effect is counteracted by administration of Ze 117. Here we demonstrate that this is not due to a change in C16:1/16:0 and C18:1/18:0 ratios in C6 cell fatty acids. On the other hand, Ze 117 increased the cellular cholesterol content by 42.5%, whereas dexamethasone reduced cholesterol levels similarly to simvastatin. Lowering cholesterol levels by dexamethasone or simvastatin resulted in decreased β-arrestin 2 recruitment to the 5-HT1a receptor. This effect was counterbalanced by Ze 117, whereas the SJW extract had little effect on β-arrestin 2 recruitment in non-stressed cells. Taken together, in C6 cells, Ze 117 induces changes in membrane fluidity through its effect on cellular cholesterol metabolism rather than by affecting fatty acid saturation. This effect is reflected in an altered signal transduction of the 5-HT1a receptor under Ze 117 administration. The current in vitro results support the hypothesis that Ze 117 addresses relevant parts of the cellular lipid metabolism, possibly explaining some of the antidepressant actions of Ze 117.
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Affiliation(s)
- Swen Bremer
- Institute of Biochemistry and Molecular Biology, Medical Faculty, University of Bonn, Nussallee 11, 53115, Bonn, Germany
| | - Eva Weitkemper
- Institute of Biochemistry and Molecular Biology, Medical Faculty, University of Bonn, Nussallee 11, 53115, Bonn, Germany
| | - Hanns Häberlein
- Institute of Biochemistry and Molecular Biology, Medical Faculty, University of Bonn, Nussallee 11, 53115, Bonn, Germany
| | - Sebastian Franken
- Institute of Biochemistry and Molecular Biology, Medical Faculty, University of Bonn, Nussallee 11, 53115, Bonn, Germany.
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Kuruvilla DE, Natbony L, Chandwani B, Jann A, Bradley BA, Zhang N. Complementary and Integrative Medicine for the Treatment of Trigeminal Neuralgia and Trigeminal Autonomic Cephalalgia. Curr Pain Headache Rep 2024; 28:195-203. [PMID: 38285128 DOI: 10.1007/s11916-024-01212-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE OF REVIEW Trigeminal neuralgia (TN) and trigeminal autonomic cephalalgias (TACs) are both painful diseases which directly impact the branches of the trigeminal nerve, which supply the face. Patients who have experienced adverse effects, have not responded to mainstream treatments, or have a personal preference for nonmedication options, often turn to complementary and integrative medicine (CIM). The aim of this review is to discuss the efficacy and safety of CIM therapies available for the treatment of TN and TACs. RECENT FINDINGS Not only are there limited therapeutic options for TN and TAC patients, but also is there a proportion of patients who are intolerant to standard medical treatments. Recent findings have illustrated that 86% of patients with headache disorders utilize CIM modalities in combination with mainstream medical therapy. CIM modalities can be helpful for these diseases and have primarily been studied in combination with standard medical therapy. There is limited evidence for CIM and behavioral therapies in managing these conditions, and more research is needed to confirm which therapies are safe and effective.
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Affiliation(s)
- Deena E Kuruvilla
- Westport Headache Institute, 1 Turkey Hill Road South, Suite 201, Westport, CT, USA, 06880.
| | - Lauren Natbony
- Integrative Headache Medicine of New York, New York, NY, 10016, USA
| | | | | | | | - Niushen Zhang
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
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Gurley BJ. Clinically Relevant Herb-Drug Interactions: A 30-Year Historical Assessment. J Diet Suppl 2024:1-27. [PMID: 38504455 DOI: 10.1080/19390211.2024.2327544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
The Dietary Supplement Health and Education Act, a legislative measure ushering in a novel class of complementary healthcare products known as dietary supplements, will mark its 30th anniversary in October 2024. Over this 30-year period, dietary supplement usage evolved from a few hundred products made up mostly of vitamins, minerals, and select botanical extracts to more than 75,000 single- and multi-ingredient products that are now regular staples in the American healthcare system and used by half of all U.S. consumers. One of the fastest-growing segments of the dietary supplement market during this 3-decade interval has been those products formulated with botanical extracts. Coincident with the growing popularity of botanical dietary supplements (BDS) has been their concomitant ingestion with conventional prescription medications. BDS are complex mixtures of phytochemicals oftentimes exhibiting complex pharmacology. Formulated as concentrated phytochemical extracts, BDS are vehicles for a host of plant secondary metabolites rarely encountered in the typical diet. When taken with prescription drugs, BDS may give rise to clinically significant herb-drug interactions (HDI). Pharmacodynamic HDI describe interactions between phytochemicals and conventional medications at the drug receptor level, while pharmacokinetic HDI stem from phytochemical-mediated induction and/or inhibition of human drug metabolizing enzymes and/or transporters. This review summarizes BDS identified over the last 30 years that pose clinically relevant HDI and whose mechanisms are either pharmacodynamically or pharmacokinetically mediated.
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Affiliation(s)
- Bill J Gurley
- National Center for Natural Products Research, School of Pharmacy, University of MS, University, MS, USA
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Kim S, Kim Y, Cho SH. Effectiveness of Shugan Jieyu capsules for psychiatric symptoms of epilepsy: a systematic review and meta-analysis. BMC Complement Med Ther 2024; 24:63. [PMID: 38287355 PMCID: PMC10825991 DOI: 10.1186/s12906-024-04361-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/16/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The relationship between epilepsy and depression is bidirectional. One condition exacerbates the other. However, there are no current guidelines for treating depression in epilepsy patients. In some cases, seizures worsen when antidepressants (AD) are prescribed or when they are discontinued due to adverse events. The Shugan Jieyu capsule, composed of Acanthopanax senticosus and Hypericum perforatum, is a widely used herbal medicine for treating depression. This study aimed to explore the effectiveness and safety of Shugan Jieyu capsules (SJC) in relieving depression in patients with epilepsy. METHODS We searched English, Korean, Japanese, and Chinese databases in October 2023 to collect all relevant randomized clinical trials (RCTs). The primary outcomes were the depression scale scores and seizure frequency. The secondary outcomes were quality of life (QoL) and adverse events. RESULTS Nine RCTs were included in this meta-analysis. Compared with AD, SJC showed significant differences in the improvement of depression (SMD: 3.82, 95% CI: 3.25, 4.39) and reduction in seizure frequency (MD: 0.39 times/month, 95% CI: 0.28, 0.50). SJC showed more beneficial results than antiepileptic drugs (AED) in terms of antidepressant effects (SMD: 1.10, 95% CI: 0.69, 1.51) and QoL (MD: 11.75, 95% CI: 10.55, 12.95). When patients were prescribed AED, the additional administration of SJC improved depression symptoms (SMD: 0.96, 95% CI: 0.28, 1.63). The SJC treatment group had a lower incidence of side effects than the control group. However, the difference was not statistically significant. CONCLUSIONS Our results suggest that SJC may be effective in treating depression in patients with epilepsy. Additionally, SJC has the potential to help reduce seizure frequency in epilepsy patients with depression.
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Affiliation(s)
- Sejin Kim
- College of Korean Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Yunna Kim
- College of Korean Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
- Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University Medical Center, Kyung Hee University, Seoul, 02447, Republic of Korea.
- Research group of Neuroscience, East-West Medical Research Institute, WHO Collaborating Center, Kyung Hee University, Seoul, 02447, Republic of Korea.
| | - Seung-Hun Cho
- College of Korean Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
- Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University Medical Center, Kyung Hee University, Seoul, 02447, Republic of Korea.
- Research group of Neuroscience, East-West Medical Research Institute, WHO Collaborating Center, Kyung Hee University, Seoul, 02447, Republic of Korea.
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Peslalz P, Kraus F, Izzo F, Bleisch A, El Hamdaoui Y, Schulz I, Kany AM, Hirsch AKH, Friedland K, Plietker B. Selective Activation of a TRPC6 Ion Channel Over TRPC3 by Metalated Type-B Polycyclic Polyprenylated Acylphloroglucinols. J Med Chem 2023; 66:15061-15072. [PMID: 37922400 DOI: 10.1021/acs.jmedchem.3c01170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
Selective modulation of TRPC6 ion channels is a promising therapeutic approach for neurodegenerative diseases and depression. A significant advancement showcases the selective activation of TRPC6 through metalated type-B PPAP, termed PPAP53. This success stems from PPAP53's 1,3-diketone motif facilitating metal coordination. PPAP53 is water-soluble and as potent as hyperforin, the gold standard in this field. In contrast to type-A, type-B PPAPs offer advantages such as gram-scale synthesis, easy derivatization, and long-term stability. Our investigations reveal PPAP53 selectively binding to the C-terminus of TRPC6. Although cryoelectron microscopy has resolved the majority of the TRPC6 structure, the binding site in the C-terminus remained unresolved. To address this issue, we employed state-of-the-art artificial-intelligence-based protein structure prediction algorithms to predict the missing region. Our computational results, validated against experimental data, indicate that PPAP53 binds to the 777LLKL780-region of the C-terminus, thus providing critical insights into the binding mechanism of PPAP53.
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Affiliation(s)
- Philipp Peslalz
- Chair of Organic Chemistry, Faculty of Chemistry and Food Chemistry, Technical University Dresden, Bergstr. 66, Dresden 01069, Germany
| | - Frank Kraus
- Institut für Organische Chemie, Universität Stuttgart , Pfaffenwaldring 55, Stuttgart 70569, Germany
| | - Flavia Izzo
- Institut für Organische Chemie, Universität Stuttgart , Pfaffenwaldring 55, Stuttgart 70569, Germany
| | - Anton Bleisch
- Chair of Organic Chemistry, Faculty of Chemistry and Food Chemistry, Technical University Dresden, Bergstr. 66, Dresden 01069, Germany
| | - Yamina El Hamdaoui
- Institut für Biomedizinische und Pharmazeutische Wissenschaften Johannes Gutenberg-Universität Mainz, Mainz 55128, Germany
| | - Ina Schulz
- Institut für Biomedizinische und Pharmazeutische Wissenschaften Johannes Gutenberg-Universität Mainz, Mainz 55128, Germany
| | - Andreas M Kany
- Helmholtz Institute for Pharm. Research Saarland (HIPS)-Helmholtz Centre for Infection Research (HZI), Saarbrücken 66123, Germany
| | - Anna K H Hirsch
- Helmholtz Institute for Pharm. Research Saarland (HIPS)-Helmholtz Centre for Infection Research (HZI), Saarbrücken 66123, Germany
- Department of Pharmacy, Saarland University, Saarbrücken 66123, Germany
| | - Kristina Friedland
- Institut für Biomedizinische und Pharmazeutische Wissenschaften Johannes Gutenberg-Universität Mainz, Mainz 55128, Germany
| | - Bernd Plietker
- Chair of Organic Chemistry, Faculty of Chemistry and Food Chemistry, Technical University Dresden, Bergstr. 66, Dresden 01069, Germany
- Institut für Organische Chemie, Universität Stuttgart , Pfaffenwaldring 55, Stuttgart 70569, Germany
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Cutler JBR, Pane O, Panesar SK, Updike W, Moore TR. Treatment of Mood and Depressive Disorders With Complementary and Alternative Medicine: Efficacy Review. J Midwifery Womens Health 2023; 68:421-429. [PMID: 37354040 DOI: 10.1111/jmwh.13527] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/12/2023] [Indexed: 06/26/2023]
Abstract
There has been a steady increase in people with symptoms of depression over the past several years (since 2011). The further increase in stress and depression in the early part of the COVID-19 pandemic was accompanied by an increase in unmet mental health needs. Many have turned to complementary and alternative medicine (CAM) therapies such as bright-light therapy, yoga, meditation, and dietary supplements like St. John's wort or folic acid. The reliability of evidence for use of CAM therapies for depression has remained low. There are few randomized controlled trials (RCTs) in the current literature and poor methodology in many of the trials that are available. This state of the science review examines current published guidelines, meta-analyses, systematic reviews, and RCTs regarding use of CAM therapies in the management of depression.
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Affiliation(s)
- Jasmine B R Cutler
- Taneja College of Pharmacy, University of South Florida, Tampa, Florida, United States
| | - Olivia Pane
- Taneja College of Pharmacy, University of South Florida, Tampa, Florida, United States
| | - Simran K Panesar
- North Florida / South Georgia Veterans System, Gainsville, Florida, United States
| | - Wendy Updike
- Taneja College of Pharmacy, University of South Florida, Tampa, Florida, United States
| | - Thea R Moore
- Taneja College of Pharmacy, University of South Florida, Tampa, Florida, United States
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Spiess D, Abegg VF, Chauveau A, Rath J, Treyer A, Reinehr M, Kuoni S, Oufir M, Potterat O, Hamburger M, Simões-Wüst AP. Transplacental passage of hyperforin, hypericin, and valerenic acid. Front Pharmacol 2023; 14:1123194. [PMID: 37063288 PMCID: PMC10103840 DOI: 10.3389/fphar.2023.1123194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
Safe medications for mild mental diseases in pregnancy are needed. Phytomedicines from St. John’s wort and valerian are valid candidates, but safety data in pregnancy are lacking. The transplacental transport of hyperforin and hypericin (from St. John’s wort), and valerenic acid (from valerian) was evaluated using the ex vivo cotyledon perfusion model (4 h perfusions, term placentae) and, in part, the in vitro Transwell assay with BeWo b30 cells. Antipyrine was used for comparison in both models. U(H)PLC-MS/MS bioanalytical methods were developed to quantify the compounds. Perfusion data obtained with term placentae showed that only minor amounts of hyperforin passed into the fetal circuit, while hypericin did not cross the placental barrier and valerenic acid equilibrated between the maternal and fetal compartments. None of the investigated compounds affected metabolic, functional, and histopathological parameters of the placenta during the perfusion experiments. Data from the Transwell model suggested that valerenic acid does not cross the placental cell layer. Taken together, our data suggest that throughout the pregnancy the potential fetal exposure to hypericin and hyperforin – but not to valerenic acid – is likely to be minimal.
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Affiliation(s)
- Deborah Spiess
- Department of Obstetrics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Division of Pharmaceutical Biology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Vanessa Fabienne Abegg
- Division of Pharmaceutical Biology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Antoine Chauveau
- Division of Pharmaceutical Biology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Joshua Rath
- Department of Obstetrics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andrea Treyer
- Division of Pharmaceutical Biology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Michael Reinehr
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Sabrina Kuoni
- Department of Obstetrics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mouhssin Oufir
- Division of Pharmaceutical Biology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Olivier Potterat
- Division of Pharmaceutical Biology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Matthias Hamburger
- Division of Pharmaceutical Biology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- *Correspondence: Matthias Hamburger, ; Ana Paula Simões-Wüst,
| | - Ana Paula Simões-Wüst
- Department of Obstetrics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- *Correspondence: Matthias Hamburger, ; Ana Paula Simões-Wüst,
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8
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Sánchez IA, Cuchimba JA, Pineda MC, Argüello YP, Kočí J, Kreider RB, Petro JL, Bonilla DA. Adaptogens on Depression-Related Outcomes: A Systematic Integrative Review and Rationale of Synergism with Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5298. [PMID: 37047914 PMCID: PMC10094590 DOI: 10.3390/ijerph20075298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/08/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Depression is considered the most important disorder affecting mental health. The aim of this systematic integrative review was: (i) to describe the effects of supplementation with adaptogens on variables related to depression in adults; and (ii) to discuss the potential combination with physical exercise to aid planning and commissioning future clinical research. An integrative review was developed complementing the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PROSPERO registration: CRD42021249682). A total of 41 articles met the inclusion criteria. With a Price index of 46.4%, we found that: (i) Hypericum perforatum (St. John's Wort) is the most studied and supported adaptogen (17/41 [41.46%], three systematic reviews with meta-analysis) followed by Crocus sativus L. or saffron (6/41 [14.63%], three systematic reviews with meta-analysis and two systematic reviews); (ii) it is possible that the significantly better performance of adaptogens over placebo is due to the reduction of allostatic load via the action of secondary metabolites on BDNF regulation; and, (iii) the number of studies reporting physical activity levels is limited or null for those that combine an exercise program with the consumption of adaptogens. Aware of the need for a multidisciplinary approach for depression treatment, this systematic integrative review provides an up-to-date view for supporting the use of St. John's Wort and saffron as non-pharmacological strategies while also help commissioning future research on the efficacy of other adaptogens. It also contributes to the design of future clinical research studies that evaluate the consumption of herbal extracts plus physical exercise, mainly resistance training, as a potentially safe and powerful strategy to treat depression.
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Affiliation(s)
- Isabel A. Sánchez
- Grupo de Investigación Ciencias Aplicadas al Ejercicio, Deporte y Salud—GICAEDS, Universidad Santo Tomás, Bogotá 205070, Colombia; (I.A.S.)
| | - Jaime A. Cuchimba
- Grupo de Investigación Ciencias Aplicadas al Ejercicio, Deporte y Salud—GICAEDS, Universidad Santo Tomás, Bogotá 205070, Colombia; (I.A.S.)
| | - María C. Pineda
- Grupo de Investigación Ciencias Aplicadas al Ejercicio, Deporte y Salud—GICAEDS, Universidad Santo Tomás, Bogotá 205070, Colombia; (I.A.S.)
| | - Yenny P. Argüello
- Grupo de Investigación Cuerpo, Sujeto y Educación—CSE, Universidad Santo Tomás, Bogotá 205070, Colombia
| | - Jana Kočí
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110311, Colombia; (J.K.); (J.L.P.)
- Department of Education, Faculty of Education, Charles University, 11636 Prague, Czech Republic
| | - Richard B. Kreider
- Exercise & Sport Nutrition Laboratory, Human Clinical Research Facility, Texas A&M University, College Station, TX 77843, USA;
| | - Jorge L. Petro
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110311, Colombia; (J.K.); (J.L.P.)
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería 230002, Colombia
| | - Diego A. Bonilla
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110311, Colombia; (J.K.); (J.L.P.)
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería 230002, Colombia
- Research Group in Biochemistry and Molecular Biology, Universidad Distrital Francisco José de Caldas, Bogotá 110311, Colombia
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Zhao T, Wang D, Wu D, Du J, Zhao M, Peng F, Zhang M, Zhou W, Hao A. Astilbin attenuates neonatal postnatal immune activation-induced long-lasting cognitive impairment in adult mice. J Funct Foods 2023. [DOI: 10.1016/j.jff.2023.105434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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10
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Ng JY. Trends in the St. John's wort ( Hypericum perforatum) research literature: a bibliometric analysis. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:172-180. [PMID: 34859971 DOI: 10.1515/jcim-2021-0417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES St. John's wort (Hypericum perforatum) has been used in traditional medicine for centuries for different conditions, including kidney and lung ailments, insomnia, depression, and to aid wound healing. The objective of the present bibliometric analysis is to capture the characteristics of research publications on the topic of St. John's wort. METHODS Searches were run on April 09, 2021, and results were exported on the same day to prevent discrepancies between daily database updates. Trends associated with this subset of publications were identified and presented. Bibliometric networks were constructed and visualized using the software tool VOSviewer. RESULTS A total of 1,970 publications were published by 5,849 authors across 961 journals from 1859 to 2021. Beginning in the late 1990s, a steep increase was found in the volume of publication on this topic. The journal that published the largest number of publications was Phytotherapy Research. The most productive countries included Germany and the United States. CONCLUSIONS The present study provides the characteristics of the St. John's wort literature that allows understanding of the past, present, and future of research in this area. It is a useful evidence-based framework on which to base future research actions and academic directions.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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11
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Hou L, Yang L, Zhu C, Miao J, Zhou W, Tang Y, Meng H, Liu S. Cuscutae semen alleviates CUS-induced depression-like behaviors in mice via the gut microbiota-neuroinflammation axis. Front Pharmacol 2023; 14:1107781. [PMID: 36909192 PMCID: PMC9998491 DOI: 10.3389/fphar.2023.1107781] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/10/2023] [Indexed: 02/26/2023] Open
Abstract
Introduction: Major depressive disorder is a mental disease with complex pathogenesis and treatment mechanisms involving changes in both the gut microbiota and neuroinflammation. Cuscutae Semen (CS), also known as Chinese Dodder seed, is a medicinal herb that exerts several pharmacological effects. These include neuroprotection, anti-neuroinflammation, the repair of synaptic damage, and the alleviation of oxidative stress. However, whether CuscutaeSemen exerts an antidepressant effect remains unknown. Methods: In this study, we evaluated the effect of CS on chronic unpredictable stress (CUS)-induced depression-like behaviors in mice by observing changes in several inflammatory markers, including proinflammatory cytokines, inflammatory proteins, and gliocyte activation. Meanwhile, changes in the gut microbiota were analyzed based on 16 S rRNA sequencing results. Moreover, the effect of CS on the synaptic ultrastructure was detected by transmission electron microscopy. Results: We found that the CS extract was rich in chlorogenic acid and hypericin. And CS relieved depression-like behaviors in mice exposed to CUS. Increased levels of cytokines (IL-1β and TNF-α) and inflammatory proteins (NLRP3, NF-κB, and COX-2) induced by CUS were reversed after CS administration. The number of astrocytes and microglia increased after CUS exposure, whereas they decreased after CS treatment. Meanwhile, CS could change the structure of the gut microbiota and increase the relative abundance of Lactobacillus. Moreover, there was a significant relationship between several Lactobacilli and indicators of depression-like behaviors and inflammation. There was a decrease in postsynaptic density after exposure to CUS, and this change was alleviated after CS treatme. Conclusion: This study found that CS treatment ameliorated CUS-induced depression-like behaviors and synaptic structural defects in mice via the gut microbiota-neuroinflammation axis. And chlorogenic acid and hypericin may be the main active substances for CS to exert antidepressant effects.
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Affiliation(s)
- Lanwei Hou
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Provincial Key Laboratory of Mental Disorder, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Liu Yang
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Provincial Key Laboratory of Mental Disorder, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Caiting Zhu
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Provincial Key Laboratory of Mental Disorder, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Jingyu Miao
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Provincial Key Laboratory of Mental Disorder, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Wenjuan Zhou
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Provincial Key Laboratory of Mental Disorder, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Yuchun Tang
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Provincial Key Laboratory of Mental Disorder, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Haiwei Meng
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Provincial Key Laboratory of Mental Disorder, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Shuwei Liu
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Provincial Key Laboratory of Mental Disorder, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
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12
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Ristevski A, Ristevski R, Jurukovska E, Jurukovska S, Petrusevska-Tozi L. Use of Hypericum perforatum as food supplement. MAKEDONSKO FARMACEVTSKI BILTEN 2022. [DOI: 10.33320/maced.pharm.bull.2022.68.04.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Angela Ristevski
- Bayer d.o.o Ljubljana representative office 1000 Skopje, North Macedonia
| | | | | | | | - Lidija Petrusevska-Tozi
- Faculty of Pharmacy, “Ss Cyril and Methodius” University in Skopje, Majka Tereza 47, 1000 Skopje, Republic of North Macedonia
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Ahn JH, Song MY, Park HJ. Discovering Influential Core-Keywords, Researcher Networks and Research Trends of Acupuncture on Depression Using Bibliometric Analysis. J Acupunct Meridian Stud 2022; 15:227-237. [PMID: 36521771 DOI: 10.51507/j.jams.2022.15.4.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/29/2021] [Accepted: 03/23/2022] [Indexed: 01/26/2023] Open
Abstract
Depression is a common illness worldwide. Acupuncture is used as an alternative to non-pharmacological therapy. This study aimed to identify the development and global trends in the study of acupuncture therapy for depression over the past two decades using a bibliometric analysis. Articles published between 2001 and 2020 on acupuncture for depression were retrieved from the Web of Science database. Extracted information included authors, organizations, countries, keywords, and journals. The VOSviewer program was used to visualize the impacts and network hubs of the keywords, authors, and affiliations. Analyses of 871 original and review articles revealed that the number of publications has continually increased over the past 20 years. China has published the maximum number of articles, followed by the United States and South Korea. As for research areas, integrative complementary medicine was most well represented in terms of the number of articles. Co-occurrence analysis of keywords indicated that each five sub-group cluster (including "pain related to depressive symptoms," "CAM therapies of depression," "comorbid disease or symptoms of depression," "clinical trials of depression," and "mechanism of acupuncture on depression") has its own impact keyword. The most recent keywords were "protocol" and "systematic review," whereas early keywords were "acupuncture analgesia" and "St john's wort." Co-authorship analysis of authors and organizations revealed 4 influential authors and 2 organizations in the field of acupuncture for depression. The present study provided influential keywords that show comorbid symptoms, treatments, and mechanism. Additionally, it revealed the influential persons or groups related to acupuncture therapy for depression.
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Affiliation(s)
- Jae-Ha Ahn
- Department of Meridian Medical Science, School of Medicine, Kyung Hee University, Seoul, Korea.,Acupuncture and Meridian Science Research Center (AMSRC), College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Mi-Yeon Song
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Hi-Joon Park
- Department of Meridian Medical Science, School of Medicine, Kyung Hee University, Seoul, Korea.,Acupuncture and Meridian Science Research Center (AMSRC), College of Korean Medicine, Kyung Hee University, Seoul, Korea
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14
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Pochet S, Lechon AS, Lescrainier C, De Vriese C, Mathieu V, Hamdani J, Souard F. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022; 12:14178. [PMID: 35986023 PMCID: PMC9391489 DOI: 10.1038/s41598-022-17704-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/29/2022] [Indexed: 12/21/2022] Open
Abstract
AbstractCancer patients could combine herbal treatments with their chemotherapy. We consulted VigiBase, a WHO database of individual case safety reports (ICSRs) which archives reports of suspected Adverse Drug Reactions (ADRs) when herbal products are used in conjunction with anti-cancer treatment. We focused on the possible interactions between antineoplastic (L01 ATC class) or hormone antagonists (L02B ATC class) with 10 commonly used herbs (pineapple, green tea, cannabis, black cohosh, turmeric, echinacea, St John’s wort, milk thistle and ginger) to compare ADRs described in ICSRs with the literature. A total of 1057 ICSRs were extracted from the database but only 134 were complete enough (or did not concern too many therapeutic lines) to keep them for analysis. Finally, 51 rationalizable ICSRs could be explained, which led us to propose a pharmacokinetic or pharmacodynamic interaction mechanism. Reports concerned more frequently women and half of the rationalizable ICSRs involved Viscum album and Silybum marianum. 5% of the ADRs described could have been avoided if clinicians had had access to the published information. It is also important to note that in 8% of the cases, the ADRs observed were life threatening. Phytovigilance should thus be considered more by health care professionals to best treat cancer patients and for better integrative care.
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Efficacy and Safety of Shuganjieyu Capsule Alone or in Combination with Other Antidepressants in the Treatment of Postpartum Depression: A Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5260235. [PMID: 35845579 PMCID: PMC9283059 DOI: 10.1155/2022/5260235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Abstract
Objective To evaluate the efficacy and safety of Shuganjieyu capsule alone or in combination with other antidepressants in the treatment of postpartum depression. Methods Related control and randomized studies till August 1, 2021, were retrieved from the following databases: PubMed, Cochrane, CNKI, CMB, Wan-Fang, and VIP. Outcomes included HAMD reduction from baseline, response rate, and adverse events rate. Review Manager 5.3 was used in the present meta-analysis. Results 16 studies including 1409 participants were included in the present study. In comparison of single Shuganjieyu capsule versus regular antidepressant, 8, 6, and 4-week HAMD reduction of the Shuganjieyu group were significantly higher (8-week MD: 3.1 (1.54, 4.66), p < 0.0001; 6-week MD: 0.71 (0.10, 1.31), p=0.02; and 4-week MD: 0.82 (0.34, 1.30), p=0.0008), response rates were comparable for the two groups (OR: 1.51 (0.87, 2.63), p=0.014), and the adverse event rate of the Shuganjieyu group was significantly lower (OR: 0.22 (0.15, 0.32), p < 0.00001). In comparison of combination of Shuganjieyu capsule with regular antidepressant versus regular antidepressant alone, the 8, 6, 4, 2, and 1-week HAMD reduction and response rate of combination of Shuganjieyu with the regular antidepressant group were significantly larger (8-week MD: 3.2 (1.34, 5.06), p=0.0007; 6-week MD: 4.00 (2.72, 5.28), p < 0.00001; 4-week MD: 3.33 (1.94,4.73), p < 0.00001; 2-week MD: 2.69 (1.34, 4.03), p < 0.0001; 1-week MD: 2.27 (0.69, 3.86), p=0.005; and response rate OR: 4.69 (2.27, 9.68), p < 0.0001) and the adverse event rate was comparable for the two groups (OR: 1.26 (0.73, 2.17), p=0.41). Conclusion Compared with regular antidepressants, single Shuganjieyu capsule has similar efficacy and better safety profile; when Shuganjieyu capsule is combined with regular antidepressants, the efficacy is improved significantly without increasing adverse events. Therefore, Shuganjieyu capsule was effective and safe for postpartum, making it worth further investigation and popularization.
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16
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Hassen G, Belete G, Carrera KG, Iriowen RO, Araya H, Alemu T, Solomon N, Bam DS, Nicola SM, Araya ME, Debele T, Zouetr M, Jain N. Clinical Implications of Herbal Supplements in Conventional Medical Practice: A US Perspective. Cureus 2022; 14:e26893. [PMID: 35978741 PMCID: PMC9375827 DOI: 10.7759/cureus.26893] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/05/2022] Open
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Cui J, Li M, Wei Y, Li H, He X, Yang Q, Li Z, Duan J, Wu Z, Chen Q, Chen B, Li G, Ming X, Xiong L, Qin D. Inhalation Aromatherapy via Brain-Targeted Nasal Delivery: Natural Volatiles or Essential Oils on Mood Disorders. Front Pharmacol 2022; 13:860043. [PMID: 35496310 PMCID: PMC9041268 DOI: 10.3389/fphar.2022.860043] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/22/2022] [Indexed: 02/05/2023] Open
Abstract
Mood disorders, also often referred to as affective disorders, are a group of psychiatric illnesses that severely impact mood and its related functions. The high medical expenditures have placed a significant financial burden on patients and their families. Aromatherapy is an alternative and complementary treatment that utilizes essential oils (EOs) or volatile oils (VOs) to achieve major therapeutic goals. In general, EOs are volatile chemicals that enter the body primarily through skin absorption and/or nasal inhalation. In addition, they can work through oral administration. Inhalation aromatherapy has shown unique advantages for treating mood disorders, especially depression, anxiety and mental disorders such as sleep disorder, which have been validated over the last decade through clinical and animal studies. Accumulating evidence has shown that EOs or VOs can bypass the blood-brain barrier to target brain tissue through the nasal-brain pathway. Subsequently, they act on the cerebral cortex, thalamus, and limbic system in the brain to improve symptoms of anxiety, depression and improve sleep quality. Here, we review the natural aromatic plants’ volatiles or essential oils used commonly as adjuncts to manage mood disorders and illustrate the mechanisms of inhalation aromatherapy, and mainly summarized the application of transnasal inhalation aromatherapy in depression, anxiety, and sleep disorders. We conclude that aromatherapy does not cause side-effects, which is vastly different from commonly used psychotropic drugs. Inhalation aromatherapy via brain-targeted nasal delivery offers potentially efficacious treatment for mental disorders and merits further study.
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Affiliation(s)
- Jieqiong Cui
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Meng Li
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Yuanyuan Wei
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Huayan Li
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Xiying He
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Qi Yang
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Zhengkun Li
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Jinfeng Duan
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Zhao Wu
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Qian Chen
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Bojun Chen
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Gang Li
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Xi Ming
- Department of TCM Pediatrics, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Lei Xiong
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
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Khushboo, Siddiqi NJ, de Lourdes Pereira M, Sharma B. Neuroanatomical, Biochemical, and Functional Modifications in Brain Induced by Treatment with Antidepressants. Mol Neurobiol 2022; 59:3564-3584. [DOI: 10.1007/s12035-022-02780-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/24/2022] [Indexed: 12/13/2022]
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19
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Yao Y, Man L, Du J, Wu D, Yang L, Peng F, Han L, Zhao T, Zhou W. Astilbin ameliorates depressive-like behavior caused by postnatal immune activation through Menin-regulated astrocyte inflammation. J Affect Disord 2022; 301:87-98. [PMID: 35026358 DOI: 10.1016/j.jad.2022.01.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/05/2022] [Accepted: 01/08/2022] [Indexed: 12/27/2022]
Abstract
Postnatal immune activation (PIA) can affect normal brain development and increase the risk of behavioral abnormalities in later life, including depressive-like behavior. Therefore, there is an urgent need to find safe and effective clinical medications for PIA. Recently, the protective effect of astilbin (ASB) in nervous system diseases has attracted much attention. However, the effect of ASB on neurodevelopmental diseases remains unclear. In this study, we used a lipopolysaccharide (LPS)-induced PIA mouse model and found that ASB specifically improved PIA-induced depressive-like behavior but not anxiety-like behavior in adult mice. Astrocytes play an essential role in regulating neuroinflammation, and are the most abundant cell type in the brain. In the PIA model, we found that ASB selectively inhibited astrocyte activation but not microglial activation in the cortex and hippocampus. Moreover, our results showed that ASB specifically upregulated the expression of menin protein in astrocytes and blocked the entry of P65 protein into the nucleus, thus inhibiting the secretion of IL-1β and TNF-α by astrocytes. Taken together, ASB reduced the occurrence of astrocyte-mediated neuroinflammation by targeting menin, thereby attenuating the PIA-induced depressive-like behavior. Our results reveal that ASB may be an attractive antidepressant drug and exert an antidepressant effect in PIA. In terms of drug selection, ASB may be a specific drug for patients with depressive symptoms.
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Affiliation(s)
- Yuan Yao
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Centre for Sports and Exercise Science, School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
| | - Lajie Man
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Jingyi Du
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Dong Wu
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Liping Yang
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Fan Peng
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Lei Han
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Tiantian Zhao
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Wenjuan Zhou
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
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Lewis M, Flood J. The transition of cannabis into the mainstream of Australian healthcare: framings in professional medical publications. J Cannabis Res 2021; 3:48. [PMID: 34802449 PMCID: PMC8606098 DOI: 10.1186/s42238-021-00105-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medicinal cannabis has been legalised for use for a range of specified medical conditions in Australia since 2016. However, the nature of the government regulations and the subsequent complexity of prescribing, as well as doctors' safety uncertainties and the stigma of the plant, remain contributing barriers to patient access. Media representations can offer insights into the nature of the discourse about new medical products and therapies and how ideas and understandings about social phenomena become constructed. Focusing on professional medical publications, this study sought to investigate how medicinal cannabis is being represented in professional medical publications. METHODS Using a content analysis approach, we investigated articles about medicinal cannabis from 2000 to the end of 2019 in the Medical Journal of Australia, Australian Doctor, Medical Observer, Australian Journal of General Practice, Australian Family Physician, and Australian Medicine. Articles were coded according to article type, framings of cannabis, headline and article tone, and key sources used in the article. We also used manifest textual analysis to search for word frequencies, and specific conditions referred to in the articles retrieved. RESULTS A total of 117 articles were retrieved for analysis, the majority of which were news stories for a physician audience. Across the longitudinal period, we found that most reports carried a positive tone towards medicinal cannabis. Cannabis is most frequently framed as a legitimate therapeutic option that is complex to prescribe and access, does not have a strong evidence base to support its use, and also carries safety concerns. At the same time, the outlook on cannabis research data is largely positive. Primary sources most frequently used in these reports are peer-reviewed journals or government reports, voices from medical associations or foundations, as well as government and university researchers. Chronic pain or pain were the conditions most frequently mentioned in articles about cannabis, followed by epilepsy, cancer or cancer pain, and nausea and chemotherapy. CONCLUSIONS This analysis offers evidence that medicinal cannabis is being framed as a valid medicine advocated by the community, with potential for addressing a range of conditions despite the lack of evidence, and a medicine that is not free of risk.
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Affiliation(s)
| | - John Flood
- Griffith University, Queensland, Australia
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21
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Ferulic acid alleviates abnormal behaviors in isolation-reared mice via 5-HT 1A receptor partial agonist activity. Psychopharmacology (Berl) 2021; 238:2147-2154. [PMID: 33829309 DOI: 10.1007/s00213-021-05839-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
RATIONALE Preclinical and clinical reports suggest that ferulic acid (FA), a plant-derived phenylpropanoid, is effective against mental health problems such as agitation, anxiety, and irritability in humans, without causing adverse side effects. However, the mechanism of action is unknown. OBJECTIVE The aim of the study is to investigate the mechanism underlying the ameliorative effects of FA on mental health problems such as agitation, anxiety, and irritability, using in vivo behavioral analysis, in vitro pharmacological analysis, and in silico binding analysis. METHODS The effects of FA (10 mg/kg, 50 mg/kg, and 250 mg/kg) on hyperactivity and aggressive behaviors of isolation-reared mice were examined. The effects of FA (50 mg/kg and 250 mg/kg) on extracellular levels of monoamines such as serotonin (5-HT), dopamine, and noradrenaline were analyzed by in vivo microdialysis. The effects of FA (10-13-10-6 M) on 5-HT1A and 5-HT2A receptors were analyzed using a luciferase reporter gene assay. Binding of FA to the mouse 5-HT1A receptor was evaluated by in silico analysis. RESULTS The behavioral analysis showed that administration of FA (50 mg/kg) 1 h before experiments significantly alleviated hyperactivity and aggressive behaviors in isolation-reared mice. These alleviative effects were abolished by pretreatment with the 5-HT1A receptor antagonist WAY-100635 (1 mg/kg). In vivo microdialysis analysis showed that FA (50 mg/kg) did not change extracellular monoamine levels in the prefrontal cortex of mice. The luciferase reporter gene assay indicated that FA activated 5-HT1A receptors, but not 5-HT2A receptors, in a dose-dependent manner. The maximal response of 5-HT1A receptors to FA was weaker than that to 8-hydroxy-2-dipropylaminotetralin (8-OH-DPAT), a 5-HT1A receptor full agonist. In silico binding analysis showed that FA binds to the orthosteric site of 5-HT1A receptors. CONCLUSION Taken together, these results suggest that FA ameliorates agitation-, anxiety-, and irritability-like behaviors such as hyperactivity and aggressive behaviors in isolation-reared mice via 5-HT1A receptor partial agonist activity. These findings support the efficacy of FA on mental health problems that have been suggested in preclinical and clinical practice.
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22
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Khushboo, Kumar A, Sharma B. Biomedical Implications of Plant-Based Principles as Antidepressants: Prospects for Novel Drug Development. Mini Rev Med Chem 2021; 22:904-926. [PMID: 33858313 DOI: 10.2174/1389557521666210415112601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/30/2020] [Accepted: 02/07/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Depression is a most common mental disorder. The symptoms of depression include loss of energy, changes in appetite, more or less sleep, anxiety, low concentration, uncertainty, restlessness, feelings of worthlessness, guilt, or despair, and thoughts of self-harm or suicide. In order to provide safe, efficient and cost-effective medication, the plants based principles in isolation or in combination with traditional antidepressants are attracting increasing attention for depression therapy. METHOD The information regarding the present review and its contents such as collected from published literature materials in different international journals. We have used different search engines such as PubMed, Medline, ResearchGate Google Semantic Scholar and ScienceDirect. For this purpose, the data obtained were properly organized and suitably analyzed to include in this article. RESULTS Most of the phytomolecules isolated from the medicinal plants display antidepressant effect through the synaptic regulation of levels of neurotransmitters such as dopamine, serotonin, and noradrenaline in different parts of the brain. The mechanism of action of phytomolecules also involves negative regulation of the activities of monoamine oxidase (MAO) and acetylcholinesterase (AChE) and prevention of hyperactivity of hypothalamic-pituitary-adrenal (HPA) axis. In addition, the strong antioxidative and antiinflamatory potential of these phytochemicals offer synergy to their antidepressant as well as antipsychosomatic functions. CONCLUSION The application of phytochemicals has proved it to be a safe, cost effective and efficient therapeutic agent to treat the patients suffering from mild to severe state of depression and other psychiatric disorders. The potential phytochemicals may be further optimized using in silico tools to develop better antidepressants and antisychotic agents in future.
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Affiliation(s)
- Khushboo
- Department of Biochemistry, University of Allahabad. India
| | - Abhishek Kumar
- Department of Biochemistry, University of Allahabad. India
| | - Bechan Sharma
- Department of Biochemistry, University of Allahabad. India
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Bonaterra GA, Mierau O, Hofmann J, Schwarzbach H, Aziz-Kalbhenn H, Kolb C, Kinscherf R. In Vitro Effects of St. John's Wort Extract Against Inflammatory and Oxidative Stress and in the Phagocytic and Migratory Activity of Mouse SIM-A9 Microglia. Front Pharmacol 2021; 11:603575. [PMID: 33628177 PMCID: PMC7898673 DOI: 10.3389/fphar.2020.603575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/10/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction: Herbal medicinal plants as Hypericum perforatum L., known as St. John’s wort (SJW) have been in use for a long time. SJW that is specifically used for the treatment of depressive disorders. Inflammatory cytokines derived from microglia play an important role in the regulation of the synthesis and reuptake of glutamate and influence synaptic function, morphology and neuronal plasticity. The present study was performed to investigate, whether STW3-VI, a special SJW extract has protective effects on mouse SIM-A9 microglia against cytotoxic and proinflammatory effects of ROS, glutamate, NMDA or cortisol. Additionally, we investigated the effects of SJW on migratory and phagocytic properties of microglia. Results: Pre-treatment (48 h) of microglia with STW3-VI (5 or 10 μg/ml)—in contrast to desipramine—inhibited the H2O2-induced TNF-α release by 20–40%. Pre-treatment (48 h) of microglia with STW3-VI (5 or 10 μg/ml) delayed the 3 or 4 mM H2O2-induced intracellular ROS level by 26.9 and 44.4%, respectively. Furthermore, pre-treatment (48 h) of microglia with STW3-VI (5 μg/ml) - in contrast to desipramine - lowered the glutamate-induced cytotoxicity by 13.2%. Besides, pre-treatment (48 h) of microglia with STW3-VI (5 or 10 μg/ml) or desipramine (5 µM) inhibited the NMDA-induced decrease of the viability by 16.5–28.8% or 12%, respectively. Finally, pre-treatment (48 h) of microglia with STW3-VI (5 or 10 μg/ml)—in contrast to desipramine - reduced the cortisol-induced cytotoxicity by 15.5 and 12.9%. Treatment of microglia with STW3-VI (10 or 100 μg/ml) increased the migratory and the phagocytic capacities by 100 and 40%. Conclusion: Our data provide evidence that STW3-VI—in contrast to desipramine - protects microglia from oxidative stress, NMDA- or glutamate-induced cytotoxicity, and has anti-inflammatory properties that are accompanied by improvement of their migratory and phagocytic capacity. These protective (particularly the anti-inflammatory) properties may be beneficial in the treatment of depressive disorders.
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Affiliation(s)
- Gabriel A Bonaterra
- Department of Medical Cell Biology, Anatomy and Cell Biology, University of Marburg, Marburg, Germany
| | - Olga Mierau
- Department of Medical Cell Biology, Anatomy and Cell Biology, University of Marburg, Marburg, Germany
| | - Johanna Hofmann
- Department of Medical Cell Biology, Anatomy and Cell Biology, University of Marburg, Marburg, Germany
| | - Hans Schwarzbach
- Department of Medical Cell Biology, Anatomy and Cell Biology, University of Marburg, Marburg, Germany
| | - Heba Aziz-Kalbhenn
- Bayer Consumer Health Division, Phytomedicines Supply and Development Center, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany
| | - Christiane Kolb
- Bayer Consumer Health Division, Phytomedicines Supply and Development Center, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany
| | - Ralf Kinscherf
- Department of Medical Cell Biology, Anatomy and Cell Biology, University of Marburg, Marburg, Germany
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Pilch NA, Sell ML, McGhee W, Venkataramanan R. Important considerations for drugs, nutritional, and herbal supplements in pediatric solid organ transplant recipients. Pediatr Transplant 2021; 25:e13881. [PMID: 33142023 DOI: 10.1111/petr.13881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 01/24/2023]
Abstract
Pediatric transplant recipients are on multiple prescription and non-prescription drugs. Many patients also use dietary, nutritional, and herbal supplements. This manuscript researched formulations of immunosuppressive drugs currently available and presents information on generic immunosuppressive drugs, commonly used non-prescription medications, dietary supplements, and herbal supplements. Immunosuppressive drugs are available in various formulations. Not all formulations are interchangeable. A number of FDA-approved generic formulations are available commercially in the United States. Generally generic formulations produce similar blood concentration vs time profiles compared to brand name products in adults and are considered to be bioequivalent. NSAID should be avoided in transplant patients due to potential drug interactions and increased risk associated with NSAID use; and appropriate doses of acetaminophen should be used for treatment of pain. Over-the-counter medications, such as guaifenesin and dextromethorphan, antihistamine medications, including diphenhydramine, loratadine, cetirizine, and fexofenadine, can be safely used in pediatric solid organ transplant population. Many safe and effective over-the-counter options exist for stool softening and as laxative. Diarrhea can lead to an increase in calcineurin inhibitor levels. Food can alter the absorption of immunosuppressive drugs. Several herbal products can alter immune status of the patients or alter the blood concentration of immunosuppressive drugs or may produce renal or hepatic toxicities and should be avoided in pediatric transplant recipients. It is important to educate pediatric transplant recipients and their families about not only immunosuppressive drug therapy but also about non-prescription drugs, dietary, and herbal supplement use.
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Affiliation(s)
- Nicole A Pilch
- Department of Pharmacy Practice and Outcomes Sciences, Transplant ICCE, Medical University of South Carolina, Charleston, SC, USA
| | - Megan L Sell
- Pediatrics/Solid Organ Transplant and Surgery, Transplant ICCE, Medical University of South Carolina, Charleston, SC, USA
| | - William McGhee
- Transplantation Ambulatory Care, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Raman Venkataramanan
- School of Pharmacy and Medicine, Thomas Starzl Transplantation Institute, UPMC, Pittsburgh, PA, USA
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Antiproliferative Effects of St. John's Wort, Its Derivatives, and Other Hypericum Species in Hematologic Malignancies. Int J Mol Sci 2020; 22:ijms22010146. [PMID: 33375664 PMCID: PMC7795730 DOI: 10.3390/ijms22010146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/03/2020] [Accepted: 12/24/2020] [Indexed: 12/14/2022] Open
Abstract
Hypericum is a widely present plant, and extracts of its leaves, flowers, and aerial elements have been employed for many years as therapeutic cures for depression, skin wounds, and respiratory and inflammatory disorders. Hypericum also displays an ample variety of other biological actions, such as hypotensive, analgesic, anti-infective, anti-oxidant, and spasmolytic abilities. However, recent investigations highlighted that this species could be advantageous for the cure of other pathological situations, such as trigeminal neuralgia, as well as in the treatment of cancer. This review focuses on the in vitro and in vivo antitumor effects of St. John’s Wort (Hypericum perforatum), its derivatives, and other Hypericum species in hematologic malignancies. Hypericum induces apoptosis in both myeloid and lymphoid cells. Other Hypericum targets include matrix metalloproteinase-2, vascular endothelial growth factor, and matrix metalloproteinase-9, which are mediators of cell migration and angiogenesis. Hypericum also downregulates the expression of proteins that are involved in the resistance of leukemia cells to chemotherapeutic agents. Finally, Hypericum and its derivatives appear to have photodynamic effects and are candidates for applications in tumor photodynamic therapy. Although the in vitro studies appear promising, controlled in vivo studies are necessary before we can hypothesize the introduction of Hypericum and its derivatives into clinical practice for the treatment of hematologic malignancies.
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Nguyen SA, LAvretsky H. Emerging Complementary and Integrative Therapies for Geriatric Mental Health. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2020; 7:447-470. [PMID: 32904865 PMCID: PMC7458879 DOI: 10.1007/s40501-020-00229-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PURPOSE The use of complementary and integrative medicine (CIM) is on the rise among diverse populations of older adults in the USA. CIM is commonly perceived as safer, less expensive, and more culturally acceptable. There is a growing body of evidence to support the use of CIM, especially mind-body therapies, diet and nutritional supplements used for mental disorders of aging. RECENT FINDINGS We summarize the results of the recent clinical trials and meta-analyses that provide the evidence for the role of CIM in treating older adults with mood or cognitive disorders that includes the use of diet and supplements, and mind-body therapies. SUMMARY Dietary and mind-body therapies have become increasingly popular and show the strongest evidence of efficacy for mood and cognitive disorders. Although the use of vitamins and supplements is the most popular CIM practice, only mixed evidence supports their use with additional concerns for herb (supplement)-drug interactions. Despite increasing use of CIM by the general population, information to guide clinicians providing care for older adults remains limited with variable scientific rigor of the available RCTs for a large number of commonly used CIM interventions for the mental health of older adults.
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Affiliation(s)
- Sarah A Nguyen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; 760 Westwood Plaza, Los Angeles, CA 90095 USA
| | - Helen LAvretsky
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; 760 Westwood Plaza, Los Angeles, CA 90095 USA
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Pilkington K, Wieland LS. Self-care for anxiety and depression: a comparison of evidence from Cochrane reviews and practice to inform decision-making and priority-setting. BMC Complement Med Ther 2020; 20:247. [PMID: 32778171 PMCID: PMC7418416 DOI: 10.1186/s12906-020-03038-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 07/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-care refers to a range of activities and approaches undertaken by an individual to maintain health and manage ill-health which may include various complementary or alternative approaches. The purpose of this study was to identify the self-care approaches used by the general public for depression and anxiety, assess the usefulness of Cochrane reviews for informing decisions on self-care and highlight any gaps in the evidence. METHODS Searches were carried out for surveys of self-care for anxiety and/or depression and for Cochrane reviews and protocols of interventions with potential for use in self-care. Data was extracted from each review and Plain Language Summaries assessed for content, consistency and readability. Interventions reported in surveys and in Cochrane reviews were compared and effectiveness of each assessed. RESULTS Surveys from 10 countries reported a variety of self-care interventions, 17 of which appeared in 2 or more surveys and which included dietary supplements, herbal medicines, mind-body therapies and various forms of exercise. Twenty-two reviews and 5 protocols on potential self-care interventions were identified, the majority in depression. Twelve interventions were judged effective or promising, most with small effect sizes. Readability of summaries was highly variable: half were written at college/university level. Several commonly used approaches were not covered by Cochrane reviews. CONCLUSIONS This study has revealed the interventions currently used by the general public which are judged effective or promising based on Cochrane reviews. Some disparity is highlighted between interventions used in practice and the availability of reliable evidence, and in the presentation of effectiveness and safety. Being able to direct patients to reliable, accessible information is a positive step in ensuring effective patient-centered, evidence-informed care. Addressing gaps, ensuring consistency and increasing usability of evidence intended for the general public will support this goal.
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Affiliation(s)
- Karen Pilkington
- School of Health and Care Professions, University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth, P01 2FR, UK.
| | - Lisa Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, 520 West Lombard Street, East Hall, Baltimore, MD, 21201, USA
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Weixlbaumer V, Draxler L, Zeitlinger M, Prantl B. From St. John's wort to tomato and from Rhodiola to cranberry : A review of phytotherapy and some examples. Wien Klin Wochenschr 2020; 132:253-259. [PMID: 32211986 PMCID: PMC7253520 DOI: 10.1007/s00508-020-01633-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 03/04/2020] [Indexed: 11/25/2022]
Abstract
Background This study evaluated the definition, the prevalence of use and the governmental regulations of phytotherapy and four examples of herbal medicine are discussed in more detail. Results This research group evaluated 4 topics: St. John’s wort for treating (mild to moderate) depression, tomato extract as a platelet inhibitor, Rhodiola against stress-related fatigue and cranberries for the treatment of urinary tract infections. Conclusion The findings were diverse and must be individually taken into account. Evidence for efficacy varies within and between the four examples. An explanation for the lack of reproducibility of findings from preclinical and clinical experiments might be the insufficient standardization of herbal medicines. There is no scientific reason why phytotherapy should not be investigated with the same rigor as conventional drugs to establish the efficacy and potential risks. Meanwhile, it is concluded that care is essential when using herbal medicine in the daily routine and informing patients about potential shortcomings and dangers of herbal medicines should be considered a duty of pharmacists and physicians.
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Affiliation(s)
| | | | - Markus Zeitlinger
- Department of Clinical Pharmacology, Vienna University Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Nicolussi S, Drewe J, Butterweck V, Meyer Zu Schwabedissen HE. Clinical relevance of St. John's wort drug interactions revisited. Br J Pharmacol 2020; 177:1212-1226. [PMID: 31742659 PMCID: PMC7056460 DOI: 10.1111/bph.14936] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/01/2019] [Accepted: 11/10/2019] [Indexed: 12/22/2022] Open
Abstract
The first clinically relevant reports of preparations of St. John's wort (SJW), a herbal medicine with anti‐depressant effects, interacting with other drugs, altering their bioavailability and efficacy, were published about 20 years ago. In 2000, a pharmacokinetic interaction between SJW and cyclosporine caused acute rejection in two heart transplant patients. Since then, subsequent research has shown that SJW altered the pharmacokinetics of drugs such as digoxin, tacrolimus, indinavir, warfarin, alprazolam, simvastatin, or oral contraceptives. These interactions were caused by pregnane‐X‐receptor (PXR) activation. Preparations of SJW are potent activators of PXR and hence inducers of cytochrome P450 enzymes (most importantly CYP3A4) and P‐glycoprotein. The degree of CYP3A4 induction correlates significantly with the hyperforin content in the preparation. Twenty years after the first occurrence of clinically relevant pharmacokinetic drug interactions with SJW, this review revisits the current knowledge of the mechanisms of action and on how pharmacokinetic drug interactions with SJW could be avoided. 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
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Affiliation(s)
- Simon Nicolussi
- Medical Research, Max Zeller Söhne AG, Romanshorn, Switzerland
| | - Jürgen Drewe
- Medical Research, Max Zeller Söhne AG, Romanshorn, Switzerland
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Kirchberger I, Maleckar B, Meisinger C, Linseisen J, Schmauss M, Baumgärtner J. Long-term outcomes in patients with severe depression after in-hospital treatment - study protocol of the depression long-term Augsburg (DELTA) study. BMJ Open 2019; 9:e032507. [PMID: 31874880 PMCID: PMC7008442 DOI: 10.1136/bmjopen-2019-032507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/26/2019] [Accepted: 12/03/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Depressive disorders are very common diseases entailing a great burden on affected people. However, comprehensive information on long-term disease course in patients with severe depression is lacking so far. The objectives of the DELTA study are to examine long-term outcomes and their predicting factors, to assess clinical response of antidepressant pharmacotherapy by applying therapeutic drug monitoring, to identify predictors of therapeutic non-response, to describe the long-term healthcare utilisation and to investigate the role of biomarkers in disease course. METHODS AND ANALYSIS A cohort study including all adult hospitalised cases (age range 18 to 75 years) of severe major depression who are admitted to the Bezirkskrankenhaus Augsburg is established. It is planned to include 300 patients. During the hospital stay, information is gathered through personal interview, self-administered questionnaires, cognitive tests and chart review. Furthermore, biomaterials are collected. After hospital discharge, patients are repeatedly re-examined over time (3, 6, 12, 24 and 36 months) to collect information about mortality, relapse, depression severity, health-related quality of life (HRQOL), perceived stigma, cognitive functions, diet, physical activity, treatment and healthcare utilisation. Follow-up blood samples are collected to determine therapeutic drug levels. The primary study aim is to investigate long-term therapeutic response, survival, relapse, HRQOL and cognitive functions. Survival time and time to relapse or re-hospitalisation will be analysed using Cox regression models. Changes of HRQOL, depressive symptoms and cognitive functions over time will be examined using generalised linear regression models for repeated measures or mixed models. Correlates of the disease course will be modelled using suitable generalised linear, mixed, estimating equation and growth curve models. ETHICS AND DISSEMINATION The study protocol was approved by the Ethics Committee of the Ludwig-Maximilians-Universität München (date of approval: 23 October 2017, reference number: 17-625). Study results will be presented at scientific conferences and published in peer-reviewed scientific journals.
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Affiliation(s)
- Inge Kirchberger
- Chair of Epidemiology at UNIKA-T, Ludwig-Maximilians-Universität München, Augsburg, Germany
| | - Barbara Maleckar
- Chair of Epidemiology at UNIKA-T, Ludwig-Maximilians-Universität München, Augsburg, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Christine Meisinger
- Chair of Epidemiology at UNIKA-T, Ludwig-Maximilians-Universität München, Augsburg, Germany
| | - Jakob Linseisen
- Chair of Epidemiology at UNIKA-T, Ludwig-Maximilians-Universität München, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München Deutsches Forschungszentrum für Umwelt und Gesundheit, Neuherberg, Germany
| | - Max Schmauss
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Jessica Baumgärtner
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
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Stute P, Spyropoulou A, Karageorgiou V, Cano A, Bitzer J, Ceausu I, Chedraui P, Durmusoglu F, Erkkola R, Goulis DG, Lindén Hirschberg A, Kiesel L, Lopes P, Pines A, Rees M, van Trotsenburg M, Zervas I, Lambrinoudaki I. Management of depressive symptoms in peri- and postmenopausal women: EMAS position statement. Maturitas 2019; 131:91-101. [PMID: 31740049 DOI: 10.1016/j.maturitas.2019.11.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Globally, the total number of people with depression exceeds 300 million, and the incidence rate is 70 % greater in women. The perimenopause is considered to be a time of increased risk for the development of depressive symptoms and major depressive episodes. AIM The aim of this position statement is to provide a comprehensive model of care for the management of depressive symptoms in perimenopausal and early menopausal women, including diagnosis, treatment and follow-up. The model integrates the care provided by all those involved in the management of mild or moderate depression in midlife women. MATERIALS AND METHODS Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS Awareness of depressive symptoms, early detection, standardized diagnostic procedures, personalized treatment and a suitable follow-up schedule need to be integrated into healthcare systems worldwide. Recommended treatment comprises antidepressants, psychosocial therapies and lifestyle changes. Alternative and complementary therapies, although widely used, may help with depression, but a stronger evidence base is needed. Although not approved for this indication, menopausal hormone therapy may improve depressive symptoms in peri- but not in postmenopausal women, especially in those with vasomotor symptoms.
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Affiliation(s)
- Petra Stute
- Department of Obstetrics and Gynecology, University Women's Hospital, Bern, Switzerland.
| | - Areti Spyropoulou
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece
| | - Vasilios Karageorgiou
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia and INCLIVA, Valencia, Spain
| | - Johannes Bitzer
- Department of Obstetrics and Gynecology, University Hospital, Basel, Switzerland
| | - Iuliana Ceausu
- Department of Obstetrics and Gynecology I, "Dr. I. Cantacuzino" Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Peter Chedraui
- Instituto de Investigación e Innovación de Salud Integral (ISAIN), Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Fatih Durmusoglu
- İstanbul Medipol International School of Medicine, Istanbul, Turkey
| | - Risto Erkkola
- Department of Obstetrics and Gynecology, University Central Hospital, Turku, Finland
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ludwig Kiesel
- Department of Gynecology and Obstetrics, University of Münster, Münster, Germany
| | - Patrice Lopes
- Nantes, France Polyclinique de l'Atlantique Saint Herblain. F 44819 St Herblain France, Université de Nantes F 44093 Nantes Cedex, France
| | - Amos Pines
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Margaret Rees
- Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Mick van Trotsenburg
- Department of Obstetrics and Gynaecology, University Hospital St. Poelten-Lilienfeld, Austria
| | - Iannis Zervas
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
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Bradley R, Harnett J, Cooley K, McIntyre E, Goldenberg J, Adams J. Naturopathy as a Model of Prevention-Oriented, Patient-Centered Primary Care: A Disruptive Innovation in Health Care. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E603. [PMID: 31540415 PMCID: PMC6780388 DOI: 10.3390/medicina55090603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 08/23/2019] [Accepted: 09/10/2019] [Indexed: 01/01/2023]
Abstract
Background and Objective: The concept of a "disruptive innovation," recently extended to health care, refers to an emerging technology that represents a new market force combined with a new value system, that eventually displaces some, or all, of the current leading "stakeholders, products and strategic alliances." Naturopathy is a distinct system of traditional and complementary medicine recognized by the World Health Organization (WHO), emerging as a model of primary care. The objective here is to describe Naturopathy in the context of the criteria for a disruptive innovation. Methods: An evidence synthesis was conducted to evaluate Naturopathy as a potentially disruptive technology according to the defining criteria established by leading economists and health technology experts: (1) The innovation must cure disease; (2) must transform the way medicine is practiced; or (3) have an impact that could be disruptive or sustaining, depending on how it is integrated into the current healthcare marketplace. Results: The fact that Naturopathy de-emphasizes prescription drug and surgical interventions in favor of nonpharmacological health promotion and self-care could disrupt the present economic model that fuels health care costs. The patient-centered orientation of Naturopathy, combined with an emphasis on preventive behaviors and popular complementary and integrative health services like natural products, mind and body therapies, and other therapies not widely represented in current primary care models increase the likelihood for disruption. Conclusions: Because of its patient-centered approach and emphasis on prevention, naturopathy may disrupt or remain a durable presence in healthcare delivery depending on policymaker decisions.
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Affiliation(s)
- Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA.
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA.
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
| | - Joanna Harnett
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney NSW 2006, Australia.
| | - Kieran Cooley
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
- Department of Research and Clinical Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, ON M2K1E2, Canada.
- Transitional Doctorate Department, Pacific College of Oriental Medicine, San Diego, CA 92108, USA.
| | - Erica McIntyre
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
| | - Joshua Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA.
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
| | - Jon Adams
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
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Abstract
OBJECTIVES As clinical practice guidelines vary widely in their search strategies and recommendations of complementary and alternative medicine (CAM) for depression, this overview aimed at systematically summarising the level 1 evidence on CAM for patients with a clinical diagnosis of depression. METHODS PubMed, PsycInfo and Central were searched for meta-analyses of randomised controlled clinical trials (RCTs) until 30 June 2018. Outcomes included depression severity, response, remission, relapse and adverse events. The quality of evidence was assessed according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) considering the methodological quality of the RCTs and meta-analyses, inconsistency, indirectness, imprecision of the evidence and the potential risk of publication bias. RESULTS The literature search revealed 26 meta-analyses conducted between 2002 and 2018 on 1-49 RCTs in major, minor and seasonal depression. In patients with mild to moderate major depression, moderate quality evidence suggested the efficacy of St. John's wort towards placebo and its comparative effectiveness towards standard antidepressants for the treatment for depression severity and response rates, while St. John's wort caused significant less adverse events. In patients with recurrent major depression, moderate quality evidence showed that mindfulness-based cognitive therapy was superior to standard antidepressant drug treatment for the prevention of depression relapse. Other CAM evidence was considered as having low or very low quality. CONCLUSIONS The effects of all but two CAM treatments found in studies on clinical depressed patients based on low to very low quality of evidence. The evidence has to be downgraded mostly due to avoidable methodological flaws of both the original RCTs and meta-analyses not following the Consolidated Standards of Reporting Trials and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Further research is needed.
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Affiliation(s)
- Heidemarie Haller
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, Universitat Duisburg-Essen, Essen, Germany
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, Universitat Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, Universitat Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, Universitat Duisburg-Essen, Essen, Germany
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Tang SW, Tang WH. Opportunities in Novel Psychotropic Drug Design from Natural Compounds. Int J Neuropsychopharmacol 2019; 22:601-607. [PMID: 31353393 PMCID: PMC6754733 DOI: 10.1093/ijnp/pyz042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/22/2019] [Accepted: 07/26/2019] [Indexed: 12/22/2022] Open
Abstract
Multiple initiatives at the national and international level support natural drug discovery. Psychiatrists and patients are not well informed about natural psychotropics in general. Existing antidepressant and antipsychotic drugs were developed from atropine, a natural product. Subsequent drug developments were largely based on extension and modification of earlier molecular scaffolds. This limits their mechanisms of action to similar neuropathways. Natural psychotropic substances, particularly those with hallucinogenic and psychedelic properties and different chemical structures, may serve as new paths to novel psychotropic drug development.
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Affiliation(s)
- Siu Wa Tang
- Department of Psychiatry, University of California, Irvine, California; North Campus Psychiatry Trailer, Irvine, California,Institute of Brain Medicine, Hong Kong,Correspondence: Siu Wa Tang, MB, PhD, Department of Psychiatry, University of California, Irvine, CA; North Campus Psychiatry Trailer, Zot 1681 Irvine, CA 92697-1681 ()
| | - Wayne H Tang
- Department of Psychiatry, University of California, Irvine, California; North Campus Psychiatry Trailer, Irvine, California
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Zahner C, Kruttschnitt E, Uricher J, Lissy M, Hirsch M, Nicolussi S, Krähenbühl S, Drewe J. No Clinically Relevant Interactions of St. John's Wort Extract Ze 117 Low in Hyperforin With Cytochrome P450 Enzymes and P-glycoprotein. Clin Pharmacol Ther 2019; 106:432-440. [PMID: 30739325 PMCID: PMC6766782 DOI: 10.1002/cpt.1392] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 01/23/2019] [Indexed: 12/12/2022]
Abstract
Hypericum perforatum L. (St. John's wort) is used to treat mild-to-moderate depression. Its potential safety risks are pharmacokinetic drug interactions via cytochrome P450 (CYP) enzymes and P-glycoprotein, presumably caused by hyperforin. In a phase I, open-label, nonrandomized, single-sequence study, the low-hyperforin Hypericum extract Ze 117 was investigated using a drug cocktail in 20 healthy volunteers. No pharmacokinetic interactions of Ze 117 were observed for CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP3A4, and P-glycoprotein. Area under the curve (AUC) and peak plasma concentration (Cmax ) of the used probe drugs showed 90% confidence intervals (CIs) of the geometric mean ratios of the drugs taken together with Ze 117 vs. probe drug alone, well within the predefined bioequivalence range of 80-125%. Though Ze 117 did not induce dextromethorphan metabolism by CYP2D6, it weakly increased dextromethorphan AUC ratio (mean 147.99, 95% CI 126.32-173.39) but not the corresponding metabolic ratio. Ze 117 does not show clinically relevant pharmacokinetic interactions with important CYPs and P-glycoprotein.
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Affiliation(s)
| | | | | | | | | | | | - Stephan Krähenbühl
- Division of Clinical Pharmacology & Toxicology, University Hospital, Basel, Switzerland
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Twenty years after ‘Listening to Prozac but hearing placebo’. Do we hear placebo even louder? HEALTH PSYCHOLOGY REPORT 2019. [DOI: 10.5114/hpr.2019.83383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Anheyer D, Haller H, Klose P, Cramer H, Dobos G. [Herbal medicines for psychiatric disorders]. DER NERVENARZT 2018; 89:1009-1013. [PMID: 29846749 DOI: 10.1007/s00115-018-0539-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND In Germany herbal medicines are traditionally frequently used. They represent an important therapeutic option, especially in self-medication. METHODS Current systematic review articles and meta-analyses were evaluated and summarized with respect to the evidence of phytotherapeutic drugs for selected psychiatric indications. RESULTS Apart from the use of St. John's wort for depression, no other herb has so far shown convincing evidence. CONCLUSION Due to the promising effects and the low side effect potential within the existing studies, further randomized controlled trials (e. g. for Passiflora incarnata, Rhodiola rosea and Lavendula officinalis) are definitely indicated.
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Affiliation(s)
- D Anheyer
- Klinik für Naturheilkunde und Integrative Medizin, Knappschafts-Krankenhaus, Kliniken Essen-Mitte, Am Deimelsberg 34a, 45276, Essen, Deutschland.
| | - H Haller
- Klinik für Naturheilkunde und Integrative Medizin, Knappschafts-Krankenhaus, Kliniken Essen-Mitte, Am Deimelsberg 34a, 45276, Essen, Deutschland
| | - P Klose
- Klinik für Naturheilkunde und Integrative Medizin, Knappschafts-Krankenhaus, Kliniken Essen-Mitte, Am Deimelsberg 34a, 45276, Essen, Deutschland
| | - H Cramer
- Klinik für Naturheilkunde und Integrative Medizin, Knappschafts-Krankenhaus, Kliniken Essen-Mitte, Am Deimelsberg 34a, 45276, Essen, Deutschland
| | - G Dobos
- Klinik für Naturheilkunde und Integrative Medizin, Knappschafts-Krankenhaus, Kliniken Essen-Mitte, Am Deimelsberg 34a, 45276, Essen, Deutschland
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Valvassori SS, Borges C, Bavaresco DV, Varela RB, Resende WR, Peterle BR, Arent CO, Budni J, Quevedo J. Hypericum perforatum chronic treatment affects cognitive parameters and brain neurotrophic factor levels. ACTA ACUST UNITED AC 2018; 40:367-375. [PMID: 30110089 PMCID: PMC6899380 DOI: 10.1590/1516-4446-2017-2271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 09/21/2017] [Indexed: 12/21/2022]
Abstract
Objective: To evaluate the effects of Hypericum perforatum (hypericum) on cognitive behavior and neurotrophic factor levels in the brain of male and female rats. Methods: Male and female Wistar rats were treated with hypericum or water during 28 days by gavage. The animals were then subjected to the open-field test, novel object recognition and step-down inhibitory avoidance test. Nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and glial cell-line derived neurotrophic factor (GDNF) levels were evaluated in the hippocampus and frontal cortex. Results: Hypericum impaired the acquisition of short- and long-term aversive memory in male rats, evaluated in the inhibitory avoidance test. Female rats had no immediate memory acquisition and decreased short-term memory acquisition in the inhibitory avoidance test. Hypericum also decreased the recognition index of male rats in the object recognition test. Female rats did not recognize the new object in either the short-term or the long-term memory tasks. Hypericum decreased BDNF in the hippocampus of male and female rats. Hypericum also decreased NGF in the hippocampus of female rats. Conclusions: The long-term administration of hypericum appears to cause significant cognitive impairment in rats, possibly through a reduction in the levels of neurotrophic factors. This effect was more expressive in females than in males.
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Affiliation(s)
- Samira S Valvassori
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.,Laboratório de Sinalização Neural e Psicofarmacologia, PPGCS, UNASAU, UNESC, Criciúma, SC, Brazil
| | - Cenita Borges
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Daniela V Bavaresco
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.,Laboratório de Sinalização Neural e Psicofarmacologia, PPGCS, UNASAU, UNESC, Criciúma, SC, Brazil
| | - Roger B Varela
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.,Laboratório de Sinalização Neural e Psicofarmacologia, PPGCS, UNASAU, UNESC, Criciúma, SC, Brazil
| | - Wilson R Resende
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.,Laboratório de Sinalização Neural e Psicofarmacologia, PPGCS, UNASAU, UNESC, Criciúma, SC, Brazil
| | - Bruna R Peterle
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.,Laboratório de Sinalização Neural e Psicofarmacologia, PPGCS, UNASAU, UNESC, Criciúma, SC, Brazil
| | - Camila O Arent
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Josiane Budni
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - João Quevedo
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.,Department of Psychiatry and Behavioral Sciences, Center for Experimental Models in Psychiatry, The University of Texas Medical School at Houston, Houston, TX, USA
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Habs M, Binder K, Krauss S, Müller K, Ernst B, Valentini L, Koller M. A Balanced Risk-Benefit Analysis to Determine Human Risks Associated with Pyrrolizidine Alkaloids (PA)-The Case of Herbal Medicinal Products Containing St. John's Wort Extracts (SJW). Nutrients 2018; 10:E804. [PMID: 29932143 PMCID: PMC6073194 DOI: 10.3390/nu10070804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/08/2018] [Accepted: 06/19/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Pyrrolizidine alkaloids (PA) exist ubiquitously in our environment. More than 6000 plants, about 3% of the world’s flowering plants, are known to synthesize PA. As a consequence, many herbal ingredients, including St. John’s wort (SJW), are contaminated with PA that can possess acute and subchronic toxic effects as well as mutagenic and genotoxic properties. Therefore, the possible benefits of SJW as an herbal remedy against depression need to be weighed against the possible risks of unwanted PA intake. METHODS We searched the literature regarding the current knowledge on PA and evaluated the evidence on the antidepressant effects of quantified SJW extract based on a Cochrane Review and the current practice guidelines on depression. Risks are depicted in form of a risk ladder and benefits in form of an icon array. RESULTS Evidence from clinical studies indicates that quantified SJW extract is an effective treatment option for mild to moderate depression with fewer side effects than conventional antidepressants. Health statistics from different countries do not quantify cases of death caused by PA intake. However, deaths due to suicide, often triggered by depression, are common (11 in 1000 in Germany in 2015) and rank between fatalities due to liver diseases (16 in 1000) and household accidents (10 in 1000). CONCLUSIONS Quantified SJW extract is a safe and effective treatment option, and its potential of treating depression outweighs the (hypothetical) risk of unwanted PA intake.
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Affiliation(s)
- Michael Habs
- Faculty of Medicine, LMU-University of Munich, 80336 Munich, Germany.
| | - Karin Binder
- Didactics of Mathematics, University of Regensburg, 93053 Regensburg, Germany.
| | - Stefan Krauss
- Didactics of Mathematics, University of Regensburg, 93053 Regensburg, Germany.
| | - Karolina Müller
- Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany.
| | - Brigitte Ernst
- General Medicine Unit, University Hospital Regensburg, 93053 Regensburg, Germany.
| | - Luzia Valentini
- Institute of Evidence-Based Dietetics, University of Applied Sciences Neubrandenburg, 17033 Neubrandenburg, Germany.
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany.
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Mischoulon D. Popular Herbal and Natural Remedies Used in Psychiatry. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2018; 16:2-11. [PMID: 31975894 DOI: 10.1176/appi.focus.20170041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Natural and herbal remedies, also known as "alternative" or "complementary" medicines, have grown tremendously in popularity over the past two decades, becoming a major component of health care and general wellness in the United States and worldwide. The ready availability of these remedies over the counter and their generally good tolerability and safety contribute to this popularity, and many people have benefited from them, often in cases when conventional treatments have failed or caused intolerable side effects. Despite many Food and Drug Administration (FDA)-approved psychotropic medications on the market, efficacy has been inconsistent for some, and many treatment responders will eventually relapse. Continued research on the efficacy and safety of these alternative therapies is, therefore, important. This article reviews six of the most commonly used natural remedies for psychiatric conditions, including the antidepressants St. John's wort, omega-3 fatty acids, and S-adenosyl methionine (SAMe); the sedative-hypnotics valerian and melatonin; and the nootropic ginkgo biloba. We outline the general indications for use, suggested doses, possible mechanisms, and adverse effects to give clinicians a good summary of the benefits and liabilities of each. Although there is growing evidence of efficacy and safety to support the use of these remedies, clinicians must be aware of the limitations of the evidence base and take that into account with all the other factors that contribute to clinical decision making.
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Affiliation(s)
- David Mischoulon
- Dr. Mischoulon is the director of the Depression Clinical and Research Program, Massachusetts General Hospital; and professor of psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston
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Bonaterra GA, Schwendler A, Hüther J, Schwarzbach H, Schwarz A, Kolb C, Abdel-Aziz H, Kinscherf R. Neurotrophic, Cytoprotective, and Anti-inflammatory Effects of St. John's Wort Extract on Differentiated Mouse Hippocampal HT-22 Neurons. Front Pharmacol 2018; 8:955. [PMID: 29403374 PMCID: PMC5778116 DOI: 10.3389/fphar.2017.00955] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/15/2017] [Indexed: 12/30/2022] Open
Abstract
Introduction: Since ancient times Hypericum perforatum L. named St. John's wort (SJW), has been used in the management of a wide range of applications, including nervous disorders. Development of mood disorders are due to alterations in glutamate metabolism, initiation of inflammatory pathways, and changes of the neuronal plasticity. Previous studies suggest that the glutamatergic system contributes to the pathophysiology of depression. Extracts of SJW have been recommended for the treatment of depression. The aim of the present in vitro study was to evaluate the action of STW3-VI, a special SJW extract in differentiated mouse hippocampal HT-22 neurons. We evaluated the stimulation of neurogenesis, the protective effect against glutamate or N-methyl-D-aspartate receptor induced-excitotoxicity and its anti-inflammatory properties in LPS-activated human macrophages. Results: After 48 h treatment, STW3-VI stimulated the neurite formation by 25% in comparison with the control and showed protective effects against glutamate- or NMDA-induced cytotoxicity by significantly increasing the viability about +25 or +50%. In conjunction with these effects, after pretreatment with STW3-VI, the intracellular reduced glutathione content was significantly 2.3-fold increased compared with the neurons incubated with glutamate alone. Additionally, pre-treatment of human macrophages with STW3-VI showed anti-inflammatory effects after 24 or 48 h concerning inhibition of LPS-induced TNF release by -47.3 and -53.8% (24 h) or -25.0 to -64.8% (48 h). Conclusions: Our data provide new evidence that STW3-VI protects hippocampal cells from NMDA- or glutamate-induced cytotoxicity. Moreover, our results indicate a morphological remodeling by increasing neurite outgrowth and activation of the anti-inflammatory defense by inhibition of the cytokine production in human macrophages after STW3-VI treatment. These protective, neurotrophic and anti-inflammatory properties may be beneficial in the treatment of depressive disorders.
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Affiliation(s)
- Gabriel A Bonaterra
- Department of Medical Cell Biology, Institute for Anatomy and Cell Biology, Philipps-University of Marburg, Marburg, Germany
| | - Anna Schwendler
- Department of Medical Cell Biology, Institute for Anatomy and Cell Biology, Philipps-University of Marburg, Marburg, Germany
| | - Julian Hüther
- Department of Medical Cell Biology, Institute for Anatomy and Cell Biology, Philipps-University of Marburg, Marburg, Germany
| | - Hans Schwarzbach
- Department of Medical Cell Biology, Institute for Anatomy and Cell Biology, Philipps-University of Marburg, Marburg, Germany
| | - Anja Schwarz
- Department of Medical Cell Biology, Institute for Anatomy and Cell Biology, Philipps-University of Marburg, Marburg, Germany
| | - Christiane Kolb
- Steigerwald Arzneimittelwerk GmbH, Scientific Department, Darmstadt, Germany
| | - Heba Abdel-Aziz
- Steigerwald Arzneimittelwerk GmbH, Scientific Department, Darmstadt, Germany
| | - Ralf Kinscherf
- Department of Medical Cell Biology, Institute for Anatomy and Cell Biology, Philipps-University of Marburg, Marburg, Germany
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Rho SS, Woo YS, Bahk WM. Ginkgo biloba induced mood dysregulation: a case report. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:14. [PMID: 29334964 PMCID: PMC5769324 DOI: 10.1186/s12906-018-2081-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 01/03/2018] [Indexed: 01/12/2023]
Abstract
Background Impairment of cognitive function as well as negative symptom is the major factor causing the decline of a patient’s functioning in chronic stages of schizophrenia. However, until now, there were no definite treatment options that could effectively reduce the impairment. Case presentation We report a case of mood dysregulation associated with use of Ginkgo biloba in a patient with schizophrenia. After Ginkgo biloba was given, the patient experienced cluster symptoms of mood dysregulation including irritability, difficulty in controlling anger, agitation and restlessness. We estimated the possibility as “probable” according to Naranjo scale considering circumstantial evidence. Conclusions This case suggests that Ginkgo biloba may have caused mood dysregulation in this patient. Although it is generally accepted as safe, more attention should be given to the adverse effect when treating with Ginkgo biloba.
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Varteresian T, Lavretsky H. Complementary and Integrative Therapies in Psychiatry. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2018; 16:54-56. [PMID: 31975900 DOI: 10.1176/appi.focus.20170056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Taya Varteresian
- Dr. Varteresian is a psychiatrist with the Los Angeles County Department of Mental Health and Assistant Clinical Professor (volunteer) of Psychiatry and Human Behavior, University of California, Irvine. Dr. Lavretsky is a Professor of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Helen Lavretsky
- Dr. Varteresian is a psychiatrist with the Los Angeles County Department of Mental Health and Assistant Clinical Professor (volunteer) of Psychiatry and Human Behavior, University of California, Irvine. Dr. Lavretsky is a Professor of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
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Abstract
Depression remains difficult to manage, despite the many registered treatments available. For many depressed individuals, particularly those who have not responded to and/or had adverse effects from standard therapies, herbal and natural medications represent a potentially valuable alternative. This chapter will review several natural remedies used in the treatment of depression. Specific remedies covered include St. John's wort (SJW), S-adenosyl-L-methionine (SAMe), omega-3 fatty acids, rhodiola, and others. We will begin by providing some historical and social context about these remedies. Then we will review efficacy and safety data, as well as biological mechanisms of action of these therapies. Finally, we will discuss the limitations of the current state of knowledge and provide suggestions for a productive research agenda focused on natural remedies. While many questions about these treatments remain unanswered and much work needs to be done before we determine their place in the psychiatric armamentarium, we believe that this chapter will give psychiatrists a good perspective on the pros and cons of herbal and natural antidepressants as part of the pharmacological armamentarium and sensible guidelines on how and when they should be used.
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Haefner J. Complementary and Integrative Health Practices for Depression. J Psychosoc Nurs Ment Health Serv 2017; 55:22-33. [PMID: 28892554 DOI: 10.3928/02793695-20170905-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/26/2017] [Indexed: 11/20/2022]
Abstract
The current article reviews selected complementary health approaches for the treatment of depressive symptoms. Complementary and integrative health (CIH) focuses on the whole person with the goal of optimal health-body, mind, and spirit. Patient use of integrative health practices and products is increasing; therefore, providers must understand these practices and products and be able to recommend or advise for or against their use based on research and guidelines. Difficulty with the current limitations of research on CIH practices is discussed, as these studies often may not have the same rigor or scientific weight as conventional treatment research. Although some individuals may use certain treatment options alone, such as massage therapy, meditation, and supplements to diet, the article discusses ways to combine CIH with allopathic care. Nurse practitioners should be open to considering complementary practices for health care and knowledgeable to guide patients in making safe health decisions. [Journal of Psychosocial Nursing and Mental Health Services, 55(12), 22-33.].
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Güneş S, Tıhmınlıoğlu F. Hypericum perforatum incorporated chitosan films as potential bioactive wound dressing material. Int J Biol Macromol 2017; 102:933-943. [DOI: 10.1016/j.ijbiomac.2017.04.080] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 04/21/2017] [Accepted: 04/22/2017] [Indexed: 11/29/2022]
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Abstract
Approximately 18% of the US adult population has a mental illness, yet only 13% with mental illness receive any treatment. Although pharmacotherapy and psychotherapy are the mainstays of treatment, treatment discontinuation and failure are common. Skepticism toward such treatments has fueled interest in and use of complementary therapies, such as acupuncture, meditation, and natural products. Many medical providers are unaware of the use of these therapies by their patients, and knowledge of the evidence base for these therapies is often lacking. This article presents current evidence-based recommendations for complementary therapies in the treatment of depression, anxiety, and posttraumatic stress disorder.
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Affiliation(s)
- Gary N Asher
- Department of Family Medicine, University of North Carolina, 590 Manning Drive, CB# 7595, Chapel Hill, NC 27599-7595, USA.
| | - Jonathan Gerkin
- Department of Psychiatry, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27759, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27759, USA
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Store-Operated Calcium Channel Complex in Postsynaptic Spines: A New Therapeutic Target for Alzheimer's Disease Treatment. J Neurosci 2017; 36:11837-11850. [PMID: 27881772 DOI: 10.1523/jneurosci.1188-16.2016] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 09/08/2016] [Accepted: 09/11/2016] [Indexed: 12/11/2022] Open
Abstract
Mushroom dendritic spine structures are essential for memory storage and the loss of mushroom spines may explain memory defects in aging and Alzheimer's disease (AD). The stability of mushroom spines depends on stromal interaction molecule 2 (STIM2)-mediated neuronal-store-operated Ca2+ influx (nSOC) pathway, which is compromised in AD mouse models, in aging neurons, and in sporadic AD patients. Here, we demonstrate that the Transient Receptor Potential Canonical 6 (TRPC6) and Orai2 channels form a STIM2-regulated nSOC Ca2+ channel complex in hippocampal mushroom spines. We further demonstrate that a known TRPC6 activator, hyperforin, and a novel nSOC positive modulator, NSN21778 (NSN), can stimulate activity of nSOC pathway in the spines and rescue mushroom spine loss in both presenilin and APP knock-in mouse models of AD. We further show that NSN rescues hippocampal long-term potentiation impairment in APP knock-in mouse model. We conclude that the STIM2-regulated TRPC6/Orai2 nSOC channel complex in dendritic mushroom spines is a new therapeutic target for the treatment of memory loss in aging and AD and that NSN is a potential candidate molecule for therapeutic intervention in brain aging and AD. SIGNIFICANCE STATEMENT Mushroom dendritic spine structures are essential for memory storage and the loss of mushroom spines may explain memory defects in Alzheimer's disease (AD). This study demonstrated that Transient Receptor Potential Canonical 6 (TRPC6) and Orai2 form stromal interaction molecule 2 (STIM2)-regulated neuronal-store-operated Ca2+ influx (nSOC) channel complex in hippocampal synapse and the resulting Ca2+ influx is critical for long-term maintenance of mushroom spines in hippocampal neurons. A novel nSOC-positive modulator, NSN21778 (NSN), rescues mushroom spine loss and synaptic plasticity impairment in AD mice models. The TRPC6/Orai2 nSOC channel complex is a new therapeutic target and NSN is a potential candidate molecule for therapeutic intervention in brain aging and AD.
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A novel multi-purpose enzymatic system and procedures for the rapid fluorescent determination of flavonoids in herbal pharmaceuticals and plant materials. Talanta 2017; 171:108-114. [PMID: 28551116 DOI: 10.1016/j.talanta.2017.04.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 04/26/2017] [Accepted: 04/28/2017] [Indexed: 01/14/2023]
Abstract
The paper presents a novel multi-purpose enzymatic system and procedures for fluorescent determination of several flavonoids in herbal pharmaceuticals and plant materials after their enzyme-catalyzed oxidation by hydrogen peroxide and further derivatization with meso-1,2-diphenylethylenediamine. This system may be used for rapid (15-30min/20 samples) simultaneous screening of samples containing a certain flavonoid in a standard microplate, or as a HPLC detection system for analyzing plant extracts with uncertain composition. In the first case, this indicator system provides sensitive and reproducible microplate determination of quercetin, epicatechin, caffeic acid, and taxifolin in the ranges 0.1-5, 1-10, 0.1-10, 0.5-5μM, respectively. In the second case, quercetin, epicatechin, and caffeic acid can be determined in the ranges 0.05-0.75, 0.05-0.75, and 0.01-0.75µg/ml (0.16-2.5, 0.17-2.6, 0.06-4.2μM), respectively. We have demonstrated the application of the system for the analysis of 3 pharmaceuticals and 3 types of plants.
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Halaburková A, Jendželovský R, Kovaľ J, Herceg Z, Fedoročko P, Ghantous A. Histone deacetylase inhibitors potentiate photodynamic therapy in colon cancer cells marked by chromatin-mediated epigenetic regulation of CDKN1A. Clin Epigenetics 2017; 9:62. [PMID: 28603560 PMCID: PMC5465463 DOI: 10.1186/s13148-017-0359-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/24/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hypericin-mediated photodynamic therapy (HY-PDT) has recently captured increased attention as an alternative minimally invasive anticancer treatment, although cancer cells may acquire resistance. Therefore, combination treatments may be necessary to enhance HY-PDT efficacy. Histone deacetylase inhibitors (HDACis) are often used in combination treatments due to their non-genotoxic properties and epigenetic potential to sensitize cells to external stimuli. Therefore, this study attempts for the first time to investigate the therapeutic effects of HDACis in combination with visible light-mediated PDT against cancer. Specifically, the colorectal cancer cell model was used due to its known resistance to HY-PDT. RESULTS Two chemical groups of HDACis were tested in combination with HY-PDT: the hydroxamic acids Saha and Trichostatin A, and the short-chain fatty acids valproic acid and sodium phenylbutyrate (NaPB), as inhibitors of all-class versus nuclear HDACs, respectively. The selected HDACis manifest a favorable clinical toxicity profile and showed similar potencies and mechanisms in intragroup comparisons but different biological effects in intergroup analyses. HDACi combination with HY-PDT significantly attenuated cancer cell resistance to treatment and caused the two HDACi groups to become similarly potent. However, the short-chain fatty acids, in combination with HY-PDT, showed increased selectivity towards inhibition of HDACs versus other key epigenetic enzymes, and NaPB induced the strongest expression of the otherwise silenced tumor suppressor CDKN1A, a hallmark gene for HDACi-mediated chromatin modulation. Epigenetic regulation of CDKN1A by NaPB was associated with histone acetylation at enhancer and promoter elements rather than histone or DNA methylation at those or other regulatory regions of this gene. Moreover, NaPB, compared to the other HDACis, caused milder effects on global histone acetylation, suggesting a more specific effect on CDKN1A chromatin architecture relative to global chromatin structure. The mechanism of NaPB + HY-PDT was P53-dependent and likely driven by the HY-PDT rather than the NaPB constituent. CONCLUSIONS Our results show that HDACis potentiate the antitumor efficacy of HY-PDT in colorectal cancer cells, overcoming their resistance to this drug and epigenetically reactivating the expression of CDKN1A. Besides their therapeutic potential, hypericin and these HDACis are non-genotoxic constituents of dietary agents, hence, represent interesting targets for investigating mechanisms of dietary-based cancer prevention.
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Affiliation(s)
- Andrea Halaburková
- Institute of Biology and Ecology, Faculty of Science, Pavol Jozef Šafárik University, Košice, Slovakia
| | - Rastislav Jendželovský
- Institute of Biology and Ecology, Faculty of Science, Pavol Jozef Šafárik University, Košice, Slovakia
| | - Ján Kovaľ
- Institute of Biology and Ecology, Faculty of Science, Pavol Jozef Šafárik University, Košice, Slovakia
| | - Zdenko Herceg
- Epigenetics Group, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France
| | - Peter Fedoročko
- Institute of Biology and Ecology, Faculty of Science, Pavol Jozef Šafárik University, Košice, Slovakia
| | - Akram Ghantous
- Epigenetics Group, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France
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