1
|
Yuan X, Yu T, Zhang Z, Li S. Non-invasive assessment of proarrhythmic risks associated with isoprenaline and the dietary supplement ingredient synephrine using human induced pluripotent stem cell-derived cardiomyocytes. Front Cardiovasc Med 2024; 11:1407138. [PMID: 38911513 PMCID: PMC11190318 DOI: 10.3389/fcvm.2024.1407138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/23/2024] [Indexed: 06/25/2024] Open
Abstract
Background There have been conflicting reports about the proarrhythmic risk of p-synephrine (SYN). To address this, human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) combined with the microelectrode array (MEA) system have been utilized to assess arrhythmia risks, particularly in the context of adrenomimetic drugs. Aim This study aims to determine whether MEA recordings from hiPSC-CMs could predict the proarrhythmic risk of adrenomimetic drugs and to investigate the cardiovascular effects and mechanisms of SYN. Materials and methods We employed MEA recordings to assess the electrophysiological properties of hiPSC-CMs and conducted concentration-response analyses to evaluate the effects of SYN and Isoprenaline (ISO) on beating rate and contractility. A risk scoring system for proarrhythmic risks was established based on hiPSC-CMs in this study. ISO, a classic beta-adrenergic drug, was also evaluated. Furthermore, the study evaluated the risk of SYN and recorded the concentration-response of beating rate, contractility and the change in the presence or absence of selective β1, β2 and β3 adrenergic blockers. Results Our results suggested that ISO carries a high risk of inducing arrhythmias, aligning with existing literature. SYN caused a 30% prolongation of the field potential duration (FPD) at a concentration of 206.326 μM, a change significantly different from baseline measurements and control treatments. The half maximal effective concentration (EC50) of SYN (3.31 μM) to affect hiPSC-CM beating rate is much higher than that of ISO (18.00 nM). The effect of SYN at an EC50 of 3.31 μM is about ten times more potent in hiPSC-CMs compared to neonatal rat cardiomyocytes (34.12 μM). SYN increased the contractility of cardiomyocytes by 29.97 ± 11.65%, compared to ISO's increase of 50.56 ± 24.15%. β1 receptor blockers almost eliminated the beating rate increase induced by both ISO and SYN, while neither β2 nor β3 blockers had a complete inhibitory effect. Conclusion The MEA and hiPSC-CM system could effectively predict the risk of adrenomimetic drugs. The study concludes that the proarrhythmia risk of SYN at conventional doses is low. SYN is more sensitive in increasing beating rate and contractility in human cardiomyocytes compared to rats, primarily activating β1 receptor.
Collapse
Affiliation(s)
| | | | | | - Sen Li
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
2
|
Dodonova SA, Zhidkova EM, Kryukov AA, Valiev TT, Kirsanov KI, Kulikov EP, Budunova IV, Yakubovskaya MG, Lesovaya EA. Synephrine and Its Derivative Compound A: Common and Specific Biological Effects. Int J Mol Sci 2023; 24:17537. [PMID: 38139366 PMCID: PMC10744207 DOI: 10.3390/ijms242417537] [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: 11/25/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
This review is focused on synephrine, the principal phytochemical found in bitter orange and other medicinal plants and widely used as a dietary supplement for weight loss/body fat reduction. We examine different aspects of synephrine biology, delving into its established and potential molecular targets, as well as its mechanisms of action. We present an overview of the origin, chemical composition, receptors, and pharmacological properties of synephrine, including its anti-inflammatory and anti-cancer activity in various in vitro and animal models. Additionally, we conduct a comparative analysis of the molecular targets and effects of synephrine with those of its metabolite, selective glucocorticoid receptor agonist (SEGRA) Compound A (CpdA), which shares a similar chemical structure with synephrine. SEGRAs, including CpdA, have been extensively studied as glucocorticoid receptor activators that have a better benefit/risk profile than glucocorticoids due to their reduced adverse effects. We discuss the potential of synephrine usage as a template for the synthesis of new generation of non-steroidal SEGRAs. The review also provides insights into the safe pharmacological profile of synephrine.
Collapse
Affiliation(s)
- Svetlana A. Dodonova
- Research Institute of Experimental Medicine, Department of Pathophysiology, Kursk State Medical University, 305041 Kursk, Russia; (S.A.D.); (A.A.K.)
| | - Ekaterina M. Zhidkova
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
| | - Alexey A. Kryukov
- Research Institute of Experimental Medicine, Department of Pathophysiology, Kursk State Medical University, 305041 Kursk, Russia; (S.A.D.); (A.A.K.)
| | - Timur T. Valiev
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
| | - Kirill I. Kirsanov
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
- Faculty of Oncology, Ryazan State Medical University Named after Academician I.P. Pavlov, 390026 Ryazan, Russia
| | - Evgeny P. Kulikov
- Laboratory of Single Cell Biology, Russian University of People’s Friendship (RUDN) University, 117198 Moscow, Russia;
| | - Irina V. Budunova
- Department of Dermatology, Northwestern University, Chicago, IL 60611, USA;
| | - Marianna G. Yakubovskaya
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
- Faculty of Oncology, Ryazan State Medical University Named after Academician I.P. Pavlov, 390026 Ryazan, Russia
| | - Ekaterina A. Lesovaya
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
- Faculty of Oncology, Ryazan State Medical University Named after Academician I.P. Pavlov, 390026 Ryazan, Russia
- Laboratory of Single Cell Biology, Russian University of People’s Friendship (RUDN) University, 117198 Moscow, Russia;
| |
Collapse
|
3
|
Pasdaran A, Hamedi A, Shiehzadeh S, Hamedi A. A review of citrus plants as functional foods and dietary supplements for human health, with an emphasis on meta-analyses, clinical trials, and their chemical composition. Clin Nutr ESPEN 2023; 54:311-336. [PMID: 36963879 DOI: 10.1016/j.clnesp.2023.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/10/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023]
Abstract
Fruits, flowers, leaves, essential oils, hydrosols, and juices of citrus spp. Are utilized to prepare various forms of food products. Along with their nutritional values, in the health industry, different parts of the plants of the citrus genus have been used as supplements or remedies to prevent or control diseases. This review focused on reported meta-analyses and clinical trials on the health benefits of citrus plants as functional foods. Also, chemical compounds of various citrus species were reviewed. The following information sources were used for data collection: Google Scholar, the Web of Science, Scopus, and PubMed. Various keywords, including "citrus AND chemical compounds," "citrus AND phytochemicals," "citrus species," "citrus AND meta-analysis," "nutritional and therapeutical values of citrus spp.," "clinical trials AND citrus," "clinical trials AND Rutaceae," "health benefits of citrus spp.," "citrus edible or non-edible applications," and scientific names of the citrus plants were utilized to collect data for the review. The scientific name and common name of all twenty-eight citrus species, along with any of the above keywords, were also searched in the mentioned databases. Scientific papers and data sources were sought to review and discuss the citrus plant's nutritional and therapeutic importance. Several meta-analyses and clinical trials have reported beneficial effects of citrus spices on a variety of cancer risks, cardiovascular risk factors, neurologic disorders, urinary tract conditions, and gastrointestinal tract conditions. They have shown anxiolytic, antimicrobial, and pain-alleviating effects. Some of them can be helpful in managing obesity and cardiovascular risk factors.
Collapse
Affiliation(s)
- Ardalan Pasdaran
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azar Hamedi
- School of Agriculture, Shiraz University, Shiraz, Iran
| | - Sara Shiehzadeh
- Student Research Committee, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Hamedi
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
4
|
The Safety and Efficacy of Citrus aurantium (Bitter Orange) Extracts and p-Synephrine: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14194019. [PMID: 36235672 PMCID: PMC9572433 DOI: 10.3390/nu14194019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
Synephrine has been used to promote weight loss; however, its safety and efficacy have not been fully established. The goals of our study were to give an overview of the safety and efficacy of p-synephrine, to systematically evaluate its efficacy regarding weight loss and to assess its safety, focusing on its cardiovascular side effects in a meta-analysis. PubMed, the Cochrane Library, Web of Science and Embase were searched for relevant studies. Only placebo-controlled, human clinical trials with synephrine intervention were included in the meta-analysis. The meta-analysis was reported according to the PRISMA guidelines using the PICOS format and taking into account the CONSORT recommendations. Altogether, 18 articles were included in the meta-analysis. Both systolic and diastolic blood pressure (DBP) increased significantly after prolonged use (6.37 mmHg, 95% CI: 1.02–11.72, p = 0.02 and 4.33 mmHg, 95% CI: 0.48–8.18, p = 0.03, respectively). The weight loss in the synephrine group was non-significant after prolonged treatment, and it did not influence body composition parameters. Based on the analyzed clinical studies, synephrine tends to raise blood pressure and heart rate, and there is no evidence that synephrine can facilitate weight loss. Further studies are needed to confirm evidence of its safety and efficacy.
Collapse
|
5
|
Benjamim CJR, Júnior FWDS, Porto AA, Rocha ÉMB, Santana MD, Garner DM, Valenti VE, Bueno Júnior CR. Bitter Orange (Citrus aurantium L.) Intake Before Submaximal Aerobic Exercise Is Safe for Cardiovascular and Autonomic Systems in Healthy Males: A Randomized Trial. Front Nutr 2022; 9:890388. [PMID: 35694173 PMCID: PMC9184817 DOI: 10.3389/fnut.2022.890388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/26/2022] [Indexed: 12/18/2022] Open
Abstract
Background There are still no studies of the cardiovascular safety of the isolated use of Citrus aurantium in aerobic submaximal exercise. Objective To evaluate the effect of C. aurantium supplementation on the recovery of cardiorespiratory and autonomic parameters following a session of submaximal aerobic exercise. Methods Twelve healthy male adults achieved a crossover, randomized, double-blind, and placebo-controlled trial. C. aurantium (600 mg, p-synephrine at 30% amount [180 mg]) or placebo (600 mg of starch) were ingested 90 min before evaluation in randomized days. We evaluated systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), heart rate (HR) and, HR variability indexes at Rest and during 60 min of recovery from exercise. Results Citrus aurantium ingestion accelerated the reduction in SBP after exercise, anticipated the return of vagal modulation of the heart after exercise via the HF (ms2), pNN50 (%), and 2 UV% indices. Moreover, rushed the output of sympathetic modulation after exercise via the 0V% index. No unfavorable cardiovascular effects were achieved for HR, DBP, PP, and MAP parameters. Conclusions Citrus aurantium was shown to be safe for the cardiovascular and autonomic systems alongside submaximal aerobic exercise in healthy males.
Collapse
Affiliation(s)
- Cicero Jonas R. Benjamim
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- *Correspondence: Cicero Jonas R. Benjamim
| | | | - Andrey Alves Porto
- Autonomic Nervous System Center, São Paulo State University (UNESP), Marilia, São Paulo, Brazil
| | | | - Milana D. Santana
- University Center of the Juazeiro do Norte, Juazeiro do Norte, Brazil
| | - David M. Garner
- Autonomic Nervous System Center, São Paulo State University (UNESP), Marilia, São Paulo, Brazil
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Vitor E. Valenti
- Autonomic Nervous System Center, São Paulo State University (UNESP), Marilia, São Paulo, Brazil
| | - Carlos Roberto Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- School of Physical Education of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| |
Collapse
|
6
|
Pradhan SK, Li Y, Gantenbein AR, Angst F, Lehmann S, Shaban H. Wen Dan Tang: A Potential Jing Fang Decoction for Headache Disorders? MEDICINES 2022; 9:medicines9030022. [PMID: 35323721 PMCID: PMC8955743 DOI: 10.3390/medicines9030022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022]
Abstract
Background: Chinese herbal medicine is considered relatively safe, inexpensive, and easily accessible. Wen Dan Tang (WDT), a Jing Fang ancient classical Chinese herbal formula with a broad indication profile has been used for several centuries in China to treat various illnesses. Question: Are there evidence-based clinical trials that show that WDT has a significant impact on the treatment of various diseases, especially in patients with migraine and tension-type headaches (TTH)? Methods: This study is based on an online database search using PubMed, Medline, Cochrane Library, AcuTrials, Embase, Semantic Scholar, Jstor, internet research, and review of ancient and modern Chinese medical textbooks regarding WDT and its compounds. Results: There were no studies on WDT in migraine and TTH; therefore, this work gathers and describes data for every single compound in the formula. Conclusion: This study suggests that the bioactive compounds found in WDT composition show potential in treating patients with neurological, psychiatric disorders, cardiovascular diseases, metabolic syndrome, and digestive disorders. Some coherence between WDT in headache reduction and improvements in the quality of life in patients with migraines and TTH could be evaluated, showing positive results of WDT in these patients.
Collapse
Affiliation(s)
- Saroj K. Pradhan
- Research Department Rehaklinik, TCM Ming Dao, ZURZACH Care, 5330 Bad Zurzach, Switzerland;
- Research Department, Swiss TCM Academy, 5330 Bad Zurzach, Switzerland
- Research Department, Nanjing University of Chinese Medicine, Nanjing 210029, China
- Correspondence:
| | - Yiming Li
- Research Department Rehaklinik, TCM Ming Dao, ZURZACH Care, 5330 Bad Zurzach, Switzerland;
- Research Department, Swiss TCM Academy, 5330 Bad Zurzach, Switzerland
- Research Department, Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Andreas R. Gantenbein
- Neurology & Neurorehabilitation Department Rehaklinik, ZURZACH Care, 5330 Bad Zurzach, Switzerland;
| | - Felix Angst
- Research Department Rehaklinik, ZURZACH Care, 5330 Bad Zurzach, Switzerland; (F.A.); (S.L.)
| | - Susanne Lehmann
- Research Department Rehaklinik, ZURZACH Care, 5330 Bad Zurzach, Switzerland; (F.A.); (S.L.)
| | - Hamdy Shaban
- Department of Private Psychiatry Clinic of UPK, University Psychiatric Clinics, 4002 Basel, Switzerland;
| |
Collapse
|
7
|
McLester CN, Bailey P, Bechke EE, Williamson CM, McLester JR, Kliszczewicz B. The Effects of Caffeine and Citrus Aurantium on Performance During Repeated Maximal Anaerobic Exercise Bouts in Habitual Caffeine Users. J Strength Cond Res 2021; 35:3394-3399. [PMID: 31490424 DOI: 10.1519/jsc.0000000000003360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
ABSTRACT McLester, CN, Bailey, P, Bechke, EE, Williamson, CM, McLester, JR, and Kliszczewicz, B. The effects of caffeine and Citrus aurantium on performance during repeated maximal anaerobic exercise bouts in habitual caffeine users. J Strength Cond Res 35(12): 3394-3399, 2021-The combination of caffeine (CAF) and Citrus aurantium (CA) have demonstrated the potential to improve various types of performance. To date, few studies have explored this relationship in purely anaerobic-based exercise. Therefore, the purpose of this study was to examine the influence of an acute dose of CAF + CA on peak anaerobic performance and the attenuation of power over multiple anaerobic bouts and to determine any differences in perceived effort or fatigue. Ten active men (25.1 ± 3.9 years) who habitually consumed caffeine volunteered to perform repeated anaerobic bouts on a cycle ergometer on 2 separate days, consuming either a placebo or 100 mg CAF + 100 mg CA. Significance was set at p ≤ 0.05 and repeated measures analysis of variance showed no main effects for peak power p = 0.520, mean power p = 0.926, minimum power p = 0.321, total work p = 0.924, time to peak power p = 0.536, or rate of fatigue p = 0.284. There was a time effect for all variables (p ≤ 0.05) with the exception of time to peak power (p = 0.181). There were no differences in any measures of perceived effort or fatigue between conditions (p ≥ 0.05), but there were time-dependent differences observed each day (p ≤ 0.05). Overall, an acute dosage of 100 mg CAF and 100 mg CA did not elicit any differences in anaerobic performance or in perceived measures of effort and fatigue in young males who habitually consume caffeine. Therefore, caution should be used when pairing CAF and CA for the goal of improving anaerobic performance, because no clear benefit was realized in this population at this dosage.
Collapse
Affiliation(s)
- Cherilyn N McLester
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, Georgia
| | | | | | | | | | | |
Collapse
|
8
|
Zibaee E, Kamalian S, Tajvar M, Amiri MS, Ramezani M, Moghadam AT, Emami SA, Sahebkar A. Citrus species: A Review of Traditional Uses, Phytochemistry and Pharmacology. Curr Pharm Des 2020; 26:44-97. [PMID: 31775593 DOI: 10.2174/1381612825666191127115601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/25/2019] [Indexed: 12/23/2022]
Abstract
The Citrus species from family Rutaceae has worldwide applications such as cardiovascular and gastrointestinal problems. Phytochemical investigations have shown that these plants have constituents including flavonoids, limonoids and carotenoids. There are many reports on a wide range of activities such as antiinflammatory, anti-oxidant, immunomodulatory, metabolic, cardiovascular and neuroprotective effects. In the current review, we discuss information regarding botany, phytochemistry, ethnobotany uses, traditional knowledge and pharmacological aspects of the Citrus species.
Collapse
Affiliation(s)
- Elaheh Zibaee
- Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Safa Kamalian
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrangiz Tajvar
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mahin Ramezani
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali T Moghadam
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed A Emami
- Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Halal Research Center of IRI, FDA, Tehran, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
9
|
Gutiérrez-Hellín J, Baltazar-Martins G, Rodríguez I, Lara B, Ruiz-Moreno C, Aguilar-Navarro M, Del Coso J. p-Synephrine, the main protoalkaloid of Citrus aurantium, raises fat oxidation during exercise in elite cyclists. Eur J Sport Sci 2020; 21:1273-1282. [PMID: 32859142 DOI: 10.1080/17461391.2020.1817154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this study was to investigate the acute effects of p-synephrine ingestion on substrate oxidation during exercise in elite cyclists. Fifteen elite cyclists volunteered to participate in a double blind, crossover, randomized and placebo-controlled experimental trial. During two different trials, participants either ingested a placebo (cellulose) or 3 mg/kg of p-synephrine. After 60 min for substances absorption, participants performed an incremental maximal cycle ergometer test until volitional fatigue (25 W/min). Breath-by-breath gas exchange data was continuously recorded during the entire test to estimate energy expenditure, carbohydrate oxidation, and fat oxidation rates by stoichiometric equations. Heart rate was continuously measured by using a heart rate monitor. The ingestion of p-synephrine had no significant effects on energy expenditure (F = 0.71, P = 0.40) or heart rate (F = 0.66, P = 0.43) during exercise. However, there was a main effect of p-synephrine to increase the rate of fat oxidation over the placebo (F = 5.1, P = 0.04) and the rate of fat oxidation was higher with p-synephrine in the following loads: 45 ± 2%, 51 ± 3%, 62 ± 3%, 67 ± 4%, 79 ± 5% and 85 ± 5% of the maximum wattage obtained in the test (all P < 0.05). The ingestion of p-synephrine did not modify the maximal rate of fat oxidation during the ramp test (mean value; 95%CI = 0.91; 0.79-1.03 vs 1.01; 0.91-1.11 g/min, respectively, P = 0.06) nor the exercise intensity at which maximal fat oxidation was achieved (i.e. Fatmax = 49; 48-53 vs 50; 47-51% Wmax, P = 0.52). Acute p-synephrine ingestion moved the fat oxidation-exercise intensity curve upwards during an incremental cycling test without affecting Fatmax.
Collapse
Affiliation(s)
| | | | - Iván Rodríguez
- Sports performance Lab, Reebok Sport Club, Madrid, Spain
| | - Beatriz Lara
- Camilo José Cela University, Exercise Physiology Laboratory, Madrid, Spain
| | - Carlos Ruiz-Moreno
- Camilo José Cela University, Exercise Physiology Laboratory, Madrid, Spain
| | | | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University
| |
Collapse
|
10
|
Stohs SJ, Shara M, Ray SD. p-Synephrine, ephedrine, p-octopamine and m-synephrine: Comparative mechanistic, physiological and pharmacological properties. Phytother Res 2020; 34:1838-1846. [PMID: 32101364 PMCID: PMC7496387 DOI: 10.1002/ptr.6649] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 01/23/2023]
Abstract
Confusion and misunderstanding exist regarding the lack of cardiovascular and other adverse health effects of p-synephrine and p-octopamine relative to ephedrine and m-synephrine (phenylephrine) which are known for their effects on the cardiovascular system. These four molecules have some structural similarities. However, the structural and stereochemical differences of p-synephrine and p-octopamine as related to ephedrine and m-synephrine result in markedly different adrenergic receptor binding characteristics as well as other mechanistic differences which are reviewed. p-Synephrine and p-octopamine exhibit little binding to α-1, α-2, β-1 and β-2 adrenergic receptors, nor are they known to exhibit indirect actions leading to an increase in available levels of endogenous norepinephrine and epinephrine at commonly used doses. The relative absence of these mechanistic actions provides an explanation for their lack of production of cardiovascular effects at commonly used oral doses as compared to ephedrine and m-synephrine. As a consequence, the effects of ephedrine and m-synephrine cannot be directly extrapolated to p-synephrine and p-octopamine which exhibit significantly different pharmacokinetic, and physiological/pharmacological properties. These conclusions are supported by human, animal and in vitro studies that are discussed.
Collapse
Affiliation(s)
- Sidney J Stohs
- School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, Nebraska.,Department of Pharmaceutical & Biomedical Sciences, Kitsto Consulting LLC, Frisco, Texas
| | - Mohd Shara
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | | |
Collapse
|
11
|
Guo LX, Chen G, Yin ZY, Zhang YH, Zheng XX. p-Synephrine exhibits anti-adipogenic activity by activating the Akt/GSK3β signaling pathway in 3T3-L1 adipocytes. J Food Biochem 2019; 43:e13033. [PMID: 31486092 DOI: 10.1111/jfbc.13033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 11/29/2022]
Abstract
This work aimed to investigate the effects of p-synephrine on the differentiation of adipocyte and explore the underlying mechanism. We found that p-synephrine suppressed the 3T3-L1 cell adipogenesis by reducing the expression level of CCAAT/enhancer-binding protein α (C/EBPα) and peroxisome proliferator-activated receptor γ (PPARγ), which subsequently led to a reduction in the fatty acid-binding protein 4 (aP2) expression. p-Synephrine treatment markedly activated the protein kinase B (PKB/Akt) pathway and sequentially inhibited glycogen synthase kinase 3β (GSK3β) activity. Inhibition of GSK3β activity by LiCl was found to partially ameliorate the above-mentioned effects. All these data suggested that p-synephrine exhibited the anti-adipogenic effects via the regulation of Akt signaling pathway and the suppression of adipogenesis-related proteins. PRACTICAL APPLICATIONS: Citrus aurantium often uses as herbal or dietary supplement in various countries around the world, including in Seville, Spain and South Africa. In traditional Chinese herbs, it is referred to as "Fructus aurantii immaturus," "Zhi shi," or "Zhi ke," and has been used for hundreds of years for various digestive problems. Its primary protoalkaloid, p-synephrine, exhibited lipolytic effects and energy expenditure, which has rapidly replaced ephedrine as an "ephedra-free" alternative dietary supplement. The current study firstly demonstrated the anti-adipogenic effects of p-synephrine in 3T3-L1 preadipocytes, which was due to the regulation of Akt signaling pathway and the subsequent suppression of adipogenesis-related proteins. The present study may offer invaluable opinions into the mechanisms of body weight/fat-losing activities of p-synephrine in theory, and scientific experimental evidence on dietary supplement in practice. p-Synephrine could be utilized for the preventive and therapeutic uses against metabolic syndrome.
Collapse
Affiliation(s)
- Li-Xia Guo
- Chongqing Key Lab of Natural Medicine Research, Engineering Research Centre of Waste Oil Recovery Technology and Equipment of Chinese Ministry of Education, Chongqing Technology and Business University, Chongqing, China
| | - Gang Chen
- Chongqing Key Lab of Natural Medicine Research, Engineering Research Centre of Waste Oil Recovery Technology and Equipment of Chinese Ministry of Education, Chongqing Technology and Business University, Chongqing, China
| | - Zhong-Yi Yin
- Chongqing Key Lab of Natural Medicine Research, Engineering Research Centre of Waste Oil Recovery Technology and Equipment of Chinese Ministry of Education, Chongqing Technology and Business University, Chongqing, China
| | - Yong-Hong Zhang
- College of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Xu-Xu Zheng
- Chongqing Key Lab of Natural Medicine Research, Engineering Research Centre of Waste Oil Recovery Technology and Equipment of Chinese Ministry of Education, Chongqing Technology and Business University, Chongqing, China
| |
Collapse
|
12
|
Pyke RE. Sexual Performance Anxiety. Sex Med Rev 2019; 8:183-190. [PMID: 31447414 DOI: 10.1016/j.sxmr.2019.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Sexual performance anxiety (SPA) is one of the most prevalent sexual complaints; yet, no diagnosis is recognized for either gender. Thus, research into treatment has been minimal. AIM Review the prevalence of SPA and its relation to sexual dysfunctions and anxiety disorders. Compare SPA to (non-sexual) performance anxiety and social anxiety (PA/SA). Apply pharmacologic principles to the known properties of drugs and phytotherapies to hypothesize treatments for SPA. METHODS Review SPA and PA/SA through PubMed searches for relevant literature from 2000 to 2018. MAIN OUTCOME MEASURE Prevalence was estimated using population-representative surveys. For treatment results, controlled clinical trial results were prioritized over open-label trial results. RESULTS SPA affects 9-25% of men and contributes to premature ejaculation and psychogenic erectile dysfunction (ED). SPA affects 6-16% of women and severely inhibits sexual desire. Cognitive behavior therapy and mindfulness meditation training have been proven effective for PA/SA and are recommended for SPA, but controlled studies are lacking. Phosphodiesterase type 5 inhibitors are effective for psychogenic ED and premature ejaculation, both of which include SPA as a major element. Drugs proven for PA/SA have adverse sexual and sedative effects, but serotonergic anxiolytics with prosexual effects (buspirone ± testosterone, trazodone ± bupropion) may have potential, and sage, passionflower, l-theanine, and bitter orange are anxiolytic. Nitric oxide boosters (l-citrulline, l-arginine, Panax ginseng) have the potential for increasing genital tumescence and lubrication, and plant-based alpha-adrenergic antagonists may aid sexual arousal (yohimbine/yohimbe, Citrus aurantium/p-synephrine). CONCLUSION SPA causes or maintains most common sexual dysfunction. No treatments are well proven, although cognitive behavior therapy, mindfulness meditation training, and serotonergic anxiolytics (buspirone, trazodone, gepirone) have potential, and phosphodiesterase type 5 inhibitors are effective for psychogenic ED and premature ejaculation. Several phytotherapies also appear to have potential. Pyke RE. Sexual Performance Anxiety. J Sex Med 2020;8:183-190.
Collapse
|
13
|
Moslemi F, Alijaniha F, Naseri M, Kazemnejad A, Charkhkar M, Heidari MR. Citrus aurantiumAroma for Anxiety in Patients with Acute Coronary Syndrome: A Double-Blind Placebo-Controlled Trial. J Altern Complement Med 2019; 25:833-839. [DOI: 10.1089/acm.2019.0061] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Farhad Moslemi
- Traditional Medicine Clinical Trial Research Center, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
| | - Fatemeh Alijaniha
- Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran
| | - Mohsen Naseri
- Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mahsa Charkhkar
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Heidari
- Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
| |
Collapse
|
14
|
Gutiérrez-Hellín J, Del Coso J. Effects of p-Synephrine and Caffeine Ingestion on Substrate Oxidation during Exercise. Med Sci Sports Exerc 2019; 50:1899-1906. [PMID: 29727404 DOI: 10.1249/mss.0000000000001653] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE Caffeine and p-synephrine are substances usually included in commercially available products for weight loss because of their purported thermogenic effects. However, scientific information is lacking about the effects of combining these substances on substrate oxidation during exercise. The purpose of this investigation was to determine the isolated and combined effects of p-synephrine and caffeine on fat oxidation rate during exercise. METHODS In a double-blind randomized experiment, 13 healthy subjects participated in four experimental trials after the ingestion of a capsule containing a placebo, 3 mg·kg of caffeine, 3 mg·kg of p-synephrine, or the combination of these doses of caffeine and p-synephrine. Energy expenditure and substrate oxidation rates were measured by indirect calorimetry during a cycle ergometer ramp test from 30% to 90% of V˙O2max. RESULTS In comparison with the placebo, the ingestion of caffeine, p-synephrine, or p-synephrine + caffeine did not alter total energy expenditure or heart rate during the whole exercise test. However, the ingestion of caffeine (0.44 ± 0.15 g·min, P = 0.03), p-synephrine (0.43 ± 0.19 g·min, P < 0.01), and p-synephrine + caffeine (0.45 ± 0.15 g·min, P = 0.02) increased the maximal rate of fat oxidation during exercise when compared with the placebo (0.30 ± 0.12 g·min). The exercise intensity that elicited maximal fat oxidation was similar in all trials (~46.2% ± 10.2% of V˙O2max). CONCLUSION Caffeine, p-synephrine, and p-synephrine + caffeine increased the maximal rate of fat oxidation during exercise compared with a placebo, without modifying energy expenditure or heart rate. However, the coingestion of p-synephrine and caffeine did not present an additive effect to further increase fat oxidation during exercise.
Collapse
|
15
|
Ribeiro DL, Machado ART, da Silva Machado C, Santos PWDS, Aissa AF, Barcelos GRM, Antunes LMG. Analysis of the cytotoxic, genotoxic, mutagenic, and pro-oxidant effect of synephrine, a component of thermogenic supplements, in human hepatic cells in vitro. Toxicology 2019; 422:25-34. [PMID: 31004705 DOI: 10.1016/j.tox.2019.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 04/09/2019] [Accepted: 04/16/2019] [Indexed: 12/11/2022]
Abstract
Thermogenic supplements containing synephrine (SN) are widely used to weight loss. SN is a proto-alkaloid naturally found in the bark of immature fruits of Citrus aurantium (bitter orange) that has been added to thermogenic supplements due to its chemical and pharmacological similarity with adrenergic amines, such as ephedrine and amphetamines. Although orally ingested SN is mainly metabolized in the liver, it remains unclear whether it affects the redox status and genetic material of human hepatic cells. The present study aims to examine whether SN affects cell viability, cell cycle, redox balance, genomic stability, and expression of the DNA damage response (DDR)-related genes ATM, ATR, CHEK1, CHECK2, TP53, and SIRT1 in HepG2 cells - used as in vitro hepatocyte model. SN induced overproduction of intracellular reactive oxygen species (ROS) after 6 h of treatment with the three concentrations tested (2, 20 and 200 μM). After 24 h of treatment, SN at 200 μM induced intracellular ROS overproduction and exerted cytostatic effects, while SN at 20 and 200 μM increased the levels of GPx and GSH. SN was not cytotoxic (2-5000 μM), genotoxic, and mutagenic and did not alter the expression of DDR-related genes (2-200 μM), indicating that the fast/specific SN metabolization and upregulation of antioxidant defense components to detoxify intracellular ROS were sufficient to prevent intracellular damage in HepG2 cells. In conclusion, SN showed no cytotoxic, genotoxic, and mutagenic potential at relevant concentrations for thermogenic users in human hepatic cells in vitro, although, it plays pro-oxidative action, and cytostatic effects. Taken together, our results suggest that other investigations about the hazard absence of this thermogenic compound should be performed.
Collapse
Affiliation(s)
- Diego Luís Ribeiro
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes, 3900, 14040-901, Ribeirão Preto, São Paulo, Brazil
| | - Ana Rita Thomazela Machado
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n°, 14040-903, Ribeirão Preto, São Paulo, Brazil
| | - Carla da Silva Machado
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes, 3900, 14040-901, Ribeirão Preto, São Paulo, Brazil
| | - Patrick Wellington da Silva Santos
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n°, 14040-903, Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Ferro Aissa
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n°, 14040-903, Ribeirão Preto, São Paulo, Brazil
| | - Gustavo Rafael Mazzaron Barcelos
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, Rua Silva Jardim, 136, 11015-020, Santos, São Paulo, Brazil
| | - Lusânia Maria Greggi Antunes
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n°, 14040-903, Ribeirão Preto, São Paulo, Brazil.
| |
Collapse
|
16
|
Hirai T, Takagi M, Nakashima KI, Inoue M. [Evaluation of Naturally Occurring Compounds Regulating Brown/Beige Adipocyte Differentiation]. YAKUGAKU ZASSHI 2019; 139:861-866. [PMID: 31155526 DOI: 10.1248/yakushi.18-00173-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Brown adipose tissue is a critical regulator of metabolic health, and contributes to thermogenesis by uncoupling oxidative phosphorylation through the action of mitochondrial uncoupling protein 1 (Ucp1). Recent studies have shown that cold exposure and the stimulation of β3-adrenergic receptors induce the development of brown cell-like "beige" adipocytes in white adipose tissue. Brown and/or beige adipocyte-mediated thermogenesis suppresses high-fat diet-associated obesity. Therefore, the development of brown/beige adipocytes may prevent obesity and metabolic diseases. In the present study, we elucidated whether naturally occurring compounds contribute to regulating the cellular differentiation of brown/beige adipocytes. We screened for the up-regulated expression of Ucp1 during beige adipogenesis using extracts of crude herbal drugs frequently used in Kampo prescriptions (therapeutic drugs in Japanese traditional medicine). This screening revealed that the extract prepared from Citri Unshiu Pericarpium [the peel of Citrus unshiu (Swingle) Marcov.] increased the expression of Ucp1 in beige adipocytes. We also focused on the function of clock genes in regulating brown/beige adipogenesis. Therefore, another aim of the present study was to evaluate naturally occurring compounds that regulate brain and muscle Arnt-like 1 (Bmal1) gene expression. In this review, we focus on naturally occurring compounds that affect regulatory processes in brown/beige adipogenesis, and discuss better preventive strategies for the management of obesity and other metabolic disorders.
Collapse
Affiliation(s)
- Takao Hirai
- Laboratory of Medicinal Resources, School of Pharmacy, Aichi-Gakuin University
| | - Michiyo Takagi
- Laboratory of Medicinal Resources, School of Pharmacy, Aichi-Gakuin University
| | - Ken-Ichi Nakashima
- Laboratory of Medicinal Resources, School of Pharmacy, Aichi-Gakuin University
| | - Makoto Inoue
- Laboratory of Medicinal Resources, School of Pharmacy, Aichi-Gakuin University
| |
Collapse
|
17
|
Risks associated with fat burners: A toxicological perspective. Food Chem Toxicol 2019; 123:205-224. [DOI: 10.1016/j.fct.2018.10.051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/16/2018] [Accepted: 10/22/2018] [Indexed: 12/18/2022]
|
18
|
An Overview on Citrus aurantium L.: Its Functions as Food Ingredient and Therapeutic Agent. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:7864269. [PMID: 29854097 PMCID: PMC5954905 DOI: 10.1155/2018/7864269] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/24/2018] [Accepted: 04/01/2018] [Indexed: 01/01/2023]
Abstract
Citrus aurantium L. (Rutaceae), commonly known as bitter orange, possesses multiple therapeutic potentials. These biological credentials include anticancer, antianxiety, antiobesity, antibacterial, antioxidant, pesticidal, and antidiabetic activities. The essential oil of C. aurantium was reported to display marked pharmacological effects and great variation in chemical composition depending on growing locations but mostly contained limonene, linalool, and β-myrcene. Phytochemically, C. aurantium is rich in p-synephrine, an alkaloid, and many health-giving secondary metabolites such as flavonoids. Animal studies have demonstrated a low affinity of p-synephrine for adrenergic receptors and an even lower affinity in human models. The present review focuses on the different biological activities of the C. aurantium in animal and human models in the form of extract and its pure secondary metabolites. Finally, it is concluded that both the extract and isolated compounds have no unwanted effects in human at therapeutic doses and, therefore, can confidently be used in various dietary formulations.
Collapse
|
19
|
Bush JA, Ratamess NA, Stohs SJ, Ellis NL, Vought IT, O'Grady EA, Kuper JD, Kang J, Faigenbaum AD. Acute hematological and mood perception effects of bitter orange extract (p-synephrine) consumed alone and in combination with caffeine: A placebo-controlled, double-blind study. Phytother Res 2018; 32:1593-1607. [PMID: 29672965 DOI: 10.1002/ptr.6090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/02/2018] [Accepted: 03/17/2018] [Indexed: 11/09/2022]
Abstract
The purpose of this study was to examine acute hematological and mood perception responses to supplementation with p-synephrine alone and in combination with caffeine during quiet sitting. Sixteen subjects visited the laboratory on 6 occasions and were given (in randomized double-blind manner) 103-mg p-synephrine (S), 233-mg caffeine + 104-mg p-synephrine, 240-mg caffeine, 337-mg caffeine + 46-mg p-synephrine, 325-mg caffeine, or a placebo (PL). The subjects sat quietly for 3 hr while completing mood state questionnaires every 30 min. Venous blood samples were collected at baseline (pre) and 3 hr (post) to determine immune, lipid, and chemistry panels. Compared with PL, no significant supplement differences were observed during the S trial with the exception of differential time effects seen in hematocrit (decrease in PL, no change in S), triglycerides and very low-density lipoproteins (no changes in PL, significant decreases in S), and iron (no change in PL, significant elevation in S). Supplements containing caffeine showed increased feelings of attention, excitement, energy, and vigor. These data indicate that consumption of 103-mg p-synephrine does not negatively impact acute blood parameters, does not augment the effects of caffeine, or produce stimulant-like perceptual mood effects.
Collapse
Affiliation(s)
- Jill A Bush
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Nicholas A Ratamess
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Sidney J Stohs
- School of Pharmacy and Health Professions, Creighton University, Omaha, NE, 68178, USA
| | - Nicole L Ellis
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Ira T Vought
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Elizabeth A O'Grady
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Jeremy D Kuper
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Jie Kang
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Avery D Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| |
Collapse
|
20
|
Shara M, Stohs SJ, Smadi MM. Safety evaluation of p-synephrine following 15 days of oral administration to healthy subjects: A clinical study. Phytother Res 2017; 32:125-131. [PMID: 29130542 DOI: 10.1002/ptr.5956] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 08/17/2017] [Accepted: 09/24/2017] [Indexed: 01/14/2023]
Abstract
Extracts of bitter orange (BOE, Citrus aurantium L.) and its primary protoalkaloid p-synephrine are extensively consumed as dietary supplements. p-Synephrine is also present in foods and juices prepared from various Citrus species. The safety of p-synephrine has been questioned as a result of structural similarities with ephedrine. This study assessed the cardiovascular (stimulant) and hemodynamic effects of BOE (49 mg p-synephrine) daily given to 16 healthy subjects for 15 days in a placebo-controlled, cross-over, double-blinded study. A physical evaluation by a cardiologist, as well as heart rates, blood pressures, and electrocardiograms were determined, and blood samples were drawn at baseline, and Days 5, 10, and 15. Serum levels for caffeine and p-synephrine were measured at 1 and 2 weeks. Subjects completed a 10-item health and metabolic questionnaire at baseline and on Day 15. No significant changes occurred in heart rate, electrocardiograms, systolic blood or diastolic pressures, blood cell counts, or blood chemistries in either the control or p-synephrine treated groups at any time point. No adverse effects were reported in response to the bitter orange (p-synephrine). Caffeine consumed by the participants varied markedly. Under these experimental conditions, BOE and p-synephrine were without stimulant (cardiovascular) and adverse effects.
Collapse
Affiliation(s)
- Mohd Shara
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Sidney J Stohs
- Creighton University Medical Center, Omaha, NE 68178, NE, USA
| | - Mahmoud M Smadi
- Faculty of Sciences, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
21
|
Ratamess NA, Bush JA, Stohs SJ, Ellis NL, Vought IT, O'Grady EA, Kuper JD, Hasan SB, Kang J, Faigenbaum AD. Acute cardiovascular effects of bitter orange extract (p-synephrine) consumed alone and in combination with caffeine in human subjects: A placebo-controlled, double-blind study. Phytother Res 2017; 32:94-102. [PMID: 29047215 DOI: 10.1002/ptr.5953] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/07/2017] [Accepted: 09/21/2017] [Indexed: 01/09/2023]
Abstract
The purpose was to examine cardiovascular responses to supplementation with p-synephrine alone and in combination with caffeine during quiet sitting. Sixteen subjects were given (in double-blind manner) either 103 mg of p-synephrine (S), 233 mg of caffeine +104 mg of p-synephrine (LC + S), 240 mg of caffeine (LC), 337 mg of caffeine +46 mg of p-synephrine (HC + S), 325 mg of caffeine (HC), or a placebo. The subjects sat quietly for 3 hr while heart rate (HR) and blood pressure were measured. Only HC + S and HC significantly increased mean systolic blood pressure (SBP) during the second hour and tended to increase mean SBP during the third hour. Mean diastolic blood pressure in S was significantly lower than the other trials during the first and second hours, and mean arterial pressure was significantly lower in S compared to the LC, LC + S, HC, and HC + S trials. No differences were observed in HR. Consumption of p-synephrine may acutely reduce diastolic blood pressure and mean arterial pressure and not affect SBP or HR during quiet sitting. The addition of p-synephrine to caffeine did not augment SBP or HR indicating that consumption of up to 104 mg of p-synephrine does not induce cardiovascular stress during quiet sitting.
Collapse
Affiliation(s)
- Nicholas A Ratamess
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Jill A Bush
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Sidney J Stohs
- School of Pharmacy and Health Professions, Creighton University, Omaha, NE, 68178, USA
| | - Nicole L Ellis
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Ira T Vought
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Elizabeth A O'Grady
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Jeremy D Kuper
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Saif B Hasan
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Jie Kang
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Avery D Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| |
Collapse
|
22
|
Gutiérrez-Hellín J, Del Coso J. Dose-Response Effects of p
-Synephrine on Fat Oxidation Rate During Exercise of Increasing Intensity. Phytother Res 2017; 32:370-374. [DOI: 10.1002/ptr.5937] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Jorge Gutiérrez-Hellín
- Exercise Physiology Laboratory, Sport Science Institute; Camilo José Cela University; Madrid Spain
| | - Juan Del Coso
- Exercise Physiology Laboratory, Sport Science Institute; Camilo José Cela University; Madrid Spain
| |
Collapse
|
23
|
Stohs SJ. Safety, Efficacy, and Mechanistic Studies Regarding Citrus aurantium (Bitter Orange) Extract and p-Synephrine. Phytother Res 2017; 31:1463-1474. [PMID: 28752649 PMCID: PMC5655712 DOI: 10.1002/ptr.5879] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 06/21/2017] [Accepted: 07/01/2017] [Indexed: 12/25/2022]
Abstract
Citrus aurantium L. (bitter orange) extracts that contain p-synephrine as the primary protoalkaloid are widely used for weight loss/weight management, sports performance, appetite control, energy, and mental focus and cognition. Questions have been raised about the safety of p-synephrine because it has some structural similarity to ephedrine. This review focuses on current human, animal, in vitro, and mechanistic studies that address the safety, efficacy, and mechanisms of action of bitter orange extracts and p-synephrine. Numerous studies have been conducted with respect to p-synephrine and bitter orange extract because ephedra and ephedrine were banned from use in dietary supplements in 2004. Approximately 30 human studies indicate that p-synephrine and bitter orange extracts do not result in cardiovascular effects and do not act as stimulants at commonly used doses. Mechanistic studies suggest that p-synephrine exerts its effects through multiple actions, which are discussed. Because p-synephrine exhibits greater adrenergic receptor binding in rodents than humans, data from animals cannot be directly extrapolated to humans. This review, as well as several other assessments published in recent years, has concluded that bitter orange extract and p-synephrine are safe for use in dietary supplements and foods at the commonly used doses. Copyright © 2017 The Authors Phytotherapy Research Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- Sidney J. Stohs
- Creighton University Medical CenterKitsto Consulting LLCFriscoTXUSA
| |
Collapse
|
24
|
Deshmukh NS, Stohs SJ, Magar CC, Kadam SB. Citrus aurantium (bitter orange) extract: Safety assessment by acute and 14-day oral toxicity studies in rats and the Ames Test for mutagenicity. Regul Toxicol Pharmacol 2017; 90:318-327. [PMID: 28966104 DOI: 10.1016/j.yrtph.2017.09.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 09/21/2017] [Accepted: 09/27/2017] [Indexed: 12/01/2022]
Abstract
The primary active constituent in bitter orange extract (BOE) is p-synephrine. This study assessed the safety of a BOE standardized to 50% p-synephrine following short-term exposure to rats and by the Ames Test. Following 5000 mg/kg of the extract orally to female rats all animals survived. Administration at 2000 mg/kg to female rats for four days yielded no signs of toxicity. Five male and five female rats were administered the BOE at 0, 250, 500, 1000 and 2000 mg/kg/day for 14 days. No significant effects were observed at any dose with respect to body weights, food intake, absolute and relative organ weights, hematology, clinical chemistry, and pathology. Two male rats died after 2000 mg/kg with gastrointestinal impaction at necropsy. During week two of 1000 mg/kg and 2000 mg/kg/day, rats exhibited transient signs of repetitive burrowing of heads in the bedding material (hypoactivity) for about 15 and 45 min, respectively. The no-observed-effect-level (NOEL) was 500 mg/kg/day. The mutagenic potential was assessed at and up to the limit dose of 5000 μg/plate in a Salmonella typhimurium reverse mutation (Ames) test, performed in duplicate as a pre-incubation assay in the presence and absence of metabolic activation (S9). The BOE did not induce an increase in the frequency of revertant colonies at any dose in the five tester strains, and was therefore non-mutagenic.
Collapse
Affiliation(s)
- N S Deshmukh
- INTOX Private LTD., 375, Urawade, Tal. Mulshi, Maharashtra, India
| | - S J Stohs
- Creighton University Medical Center, Omaha, NE 68178, USA.
| | - C C Magar
- INTOX Private LTD., 375, Urawade, Tal. Mulshi, Maharashtra, India
| | - S B Kadam
- INTOX Private LTD., 375, Urawade, Tal. Mulshi, Maharashtra, India
| |
Collapse
|
25
|
Bakhiya N, Ziegenhagen R, Hirsch-Ernst KI, Dusemund B, Richter K, Schultrich K, Pevny S, Schäfer B, Lampen A. Phytochemical compounds in sport nutrition: Synephrine and hydroxycitric acid (HCA) as examples for evaluation of possible health risks. Mol Nutr Food Res 2017; 61. [DOI: 10.1002/mnfr.201601020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/10/2017] [Accepted: 02/13/2017] [Indexed: 01/17/2023]
Affiliation(s)
- Nadiya Bakhiya
- Department of Food Safety; Federal Institute for Risk Assessment (BfR); Berlin Germany
| | - Rainer Ziegenhagen
- Department of Food Safety; Federal Institute for Risk Assessment (BfR); Berlin Germany
| | - Karen I. Hirsch-Ernst
- Department of Food Safety; Federal Institute for Risk Assessment (BfR); Berlin Germany
| | - Birgit Dusemund
- Department of Food Safety; Federal Institute for Risk Assessment (BfR); Berlin Germany
| | - Klaus Richter
- Department of Food Safety; Federal Institute for Risk Assessment (BfR); Berlin Germany
| | - Katharina Schultrich
- Department of Food Safety; Federal Institute for Risk Assessment (BfR); Berlin Germany
| | - Sophie Pevny
- Department of Food Safety; Federal Institute for Risk Assessment (BfR); Berlin Germany
| | - Bernd Schäfer
- Department of Food Safety; Federal Institute for Risk Assessment (BfR); Berlin Germany
| | - Alfonso Lampen
- Department of Food Safety; Federal Institute for Risk Assessment (BfR); Berlin Germany
| |
Collapse
|
26
|
Gesundheitliche Risiken von Synephrin in Nahrungsergänzungsmitteln. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60:323-331. [DOI: 10.1007/s00103-016-2506-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|