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Layman AJ, Alsbrook SM, Koturbash IK, McGill MR. Natural Products That Protect Against Acetaminophen Hepatotoxicity: A Call for Increased Rigor in Preclinical Studies of Dietary Supplements. J Diet Suppl 2024:1-18. [PMID: 38562009 PMCID: PMC11442681 DOI: 10.1080/19390211.2024.2335573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Acetaminophen (APAP) overdose is one of the most common causes of acute liver injury. The current standard-of-care treatment for APAP hepatotoxicity, N-acetyl-l-cysteine, is highly effective when administered early after overdose, but loses efficacy in later-presenting patients. As a result, there is interest in the identification of new treatments for APAP overdose patients. Natural products are a promising source of new treatments because many are purported to have hepatoprotective effects. In fact, a great deal of research has been done to identify natural products that can protect against APAP-induced liver injury. However, serious concerns have been raised about the rigor and human relevance of these studies. Here, we systematically reviewed the APAP-natural product literature from 2013 to 2023 to determine the veracity of these concerns and the scope of the potential problem. The results substantiate the concerns that have been previously raised and point to concrete steps that can be taken to improve APAP-natural product research.
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Affiliation(s)
- Alexander J. Layman
- Dept. of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Scott M. Alsbrook
- Dept. of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Igor K. Koturbash
- Dept. of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR USA
- Center for Dietary Supplements Research, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Mitchell R. McGill
- Dept. of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR USA
- Center for Dietary Supplements Research, University of Arkansas for Medical Sciences, Little Rock, AR USA
- Dept. of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR USA
- Dept. of Pathology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR USA
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Nattagh-Eshtivani E, Gheflati A, Barghchi H, Rahbarinejad P, Hachem K, Shalaby MN, Abdelbasset WK, Ranjbar G, Olegovich Bokov D, Rahimi P, Gholizadeh Navashenaq J, Pahlavani N. The role of Pycnogenol in the control of inflammation and oxidative stress in chronic diseases: Molecular aspects. Phytother Res 2022; 36:2352-2374. [PMID: 35583807 DOI: 10.1002/ptr.7454] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/23/2022] [Accepted: 03/15/2022] [Indexed: 02/05/2023]
Abstract
The prevalence of chronic diseases has increased significantly with the rising trend of sedentary lifestyles, reduced physical activity, and dietary modifications in recent decades. Inflammation and oxidative stress play a key role in the pathophysiology of several chronic diseases, such as type II diabetes, cardiovascular diseases, and hepatic conditions. Therefore, reducing inflammation and oxidative stress may be beneficial in the prevention and treatment of various chronic disorders. Since chronic diseases are not completely curable, various methods have been proposed for their control. Complementary therapies and the use of natural antioxidant and antiinflammatory compounds are among these novel approaches. Pycnogenol (PYC) is a natural compound that could control inflammation and oxidative stress. Furthermore, some previous studies have shown that PYC could effectively reduce inflammation through signaling the downstream of insulin receptors, inhibiting the phosphorylation of the serine residues of insulin receptor substrate-1, reducing pro-inflammatory cytokines and oxidative stress indices through the stimulation of antioxidant pathways, increasing free radical scavenging activities, preventing lipid peroxidation, and protecting the erythrocytes in glucose-6-phosphate dehydrogenase-deficient individuals, although these effects have not been fully proved. The present study aimed to comprehensively review the evidence concerning the positive physiological and pharmacological properties of PYC, with an emphasis on the therapeutic potential of this natural component for enhancing human health.
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Affiliation(s)
- Elyas Nattagh-Eshtivani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Gheflati
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanieh Barghchi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pegah Rahbarinejad
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kadda Hachem
- Laboratory of Biotoxicology, Pharmacognosy and Biological Valorization of Plants (LBPVBP), Faculty of Sciences, University of Saida- Dr Moulay Tahar, Saida, Algeria
| | - Mohammed Nader Shalaby
- Biological Sciences and Sports Health Department, Faculty of Physical Education, Suez Canal University, Ismailia, Egypt
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Golnaz Ranjbar
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Dmitry Olegovich Bokov
- Institute of Pharmacy, Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Laboratory of Food Chemistry, Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Pegah Rahimi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Naseh Pahlavani
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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Al-Abkal F, Abdel-Wahab BA, El-Kareem HFA, Moustafa YM, Khodeer DM. Protective Effect of Pycnogenol against Methotrexate-Induced Hepatic, Renal, and Cardiac Toxicity: An In Vivo Study. Pharmaceuticals (Basel) 2022; 15:ph15060674. [PMID: 35745592 PMCID: PMC9229807 DOI: 10.3390/ph15060674] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 12/13/2022] Open
Abstract
Methotrexate (MTX) is one of the most commonly used chemotherapies for various types of cancer, including leukemia, breast cancer, hepatocarcinoma, and gastric cancers. However, the efficacy of MTX is frequently limited by serious side effects. Several studies have reported that the cytotoxic effect of MTX is not limited to cancer cells but can also affect normal tissues, leading to prospective damage to many organs. In the present study, we extensively investigated the molecular and microscopic basis of MTX-induced toxicity in different organs (liver, kidney, and heart) and explored the possible protective effect of pycnogenol, a polyphenolic component extracted from the bark of P. pinaster, to attenuate these effects. Biochemical analysis revealed that administration of MTX significantly reduced the function of the liver, kidney, and heart. Histological and immunohistochemical analysis indicated that MTX treatment caused damage to tissues of different organs. Interestingly, administration of pycnogenol (10, 20, and 30 mg/kg) significantly attenuated the deterioration effects of MTX on different organs in a dose-dependent manner, as demonstrated by biochemical and histological analysis. Our results reveal that pycnogenol successfully ameliorated oxidative damage and reduced toxicity, inflammatory response, and histological markers induced by methotrexate treatment. Taken together, this study provides solid evidence for the pharmacological application of pycnogenol to attenuate damage to different organs induced by MTX treatment.
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Affiliation(s)
- Faten Al-Abkal
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt; (F.A.-A.); (Y.M.M.)
| | - Basel A. Abdel-Wahab
- Department of Medical Pharmacology, College of Medicine, Assiut University, Assiut 7111, Egypt;
| | - Hanaa F. Abd El-Kareem
- Zoology Department, Faculty of Science, Ain Shams University, Abbasseya, Cairo 11566, Egypt;
| | - Yasser M. Moustafa
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt; (F.A.-A.); (Y.M.M.)
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Badr University, Cairo 11829, Egypt
| | - Dina M. Khodeer
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt; (F.A.-A.); (Y.M.M.)
- Correspondence: ; Tel.: +20-100-93345855
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Hepatoprotective Effect of Carob Pulp Flour (Ceratonia siliqua L.) Extract Obtained by Optimized Microwave-Assisted Extraction. Pharmaceutics 2022; 14:pharmaceutics14030657. [PMID: 35336031 PMCID: PMC8950939 DOI: 10.3390/pharmaceutics14030657] [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: 02/09/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 12/30/2022] Open
Abstract
To examine antioxidant capacity and the hepatoprotective effect of carob pulp flour, microwave-assisted extraction was performed. The influence of ethanol concentration (0–40% w/w), extraction time (5–25 min) and irradiation power (400–800 W) on DPPH, FRAP and ABTS antioxidant activity of carob pulp flour extract was evaluated. The strongest influence was that of the ethanol concentration, followed by extraction time. Optimal process parameters for maximizing total antioxidant activity were determined, using response surface methodology: ethanol concentration 40%, time 25 min and power 800 W. Carob extract obtained at optimal conditions (CE) was analyzed in vivo using a paracetamol-induced hepatotoxicity model in mice. Treatment with CE attenuated the parameters of liver injury, especially aspartate and alanine aminotransferase activity, and prevented paracetamol-induced increase in malondialdehyde levels. Pretreatment with CE reversed the activities of superoxide dismutase, catalase, glutathione peroxidase and glutathione S-transferase enzymes after the high dose of paracetamol in the liver. Hepatotoxicity induced using a toxic dose of paracetamol was also seen through histopathological alterations, which were significantly reduced in the groups treated with CE prior to paracetamol. Still, the number of Kupffer cells and macrophages did not differ among groups. Finally, pretreatment of mice with CE and paracetamol significantly decreased the expression of cytochrome P450 2E1 (CYP2E1) in hepatocytes.
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The Phenolic Content, Antioxidative Properties and Extractable Substances in Silver Fir (Abies alba Mill.) Branches Decrease with Distance from the Trunk. PLANTS 2022; 11:plants11030333. [PMID: 35161314 PMCID: PMC8839515 DOI: 10.3390/plants11030333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 01/12/2023]
Abstract
Silver fir (Abies alba Mill.) is one of the most common and valuable conifer tree species in Central Europe, with well-established usage in the construction and furniture industries, as well as the food, health products, pharmaceuticals and cosmetics industries. Silver fir branch extract, a mixture of antioxidative phenols, is produced industrially as a food supplement with a wide range of therapeutic properties. This study investigates optimization of the production of silver fir branch extract by researching its antioxidant activity (ABTS and DPPH assay), phenol content (Folin-Ciocalteu assay), lignan content (HPLC) and extractable content at various distances from the trunk (0–80 cm). The antioxidative activity, phenol content and extractable content decreased from the proximal to the distal part of the branch. The decrease in ABTS assay activity was 51%, and that of the DPPH assay was 52%; the decrease in total phenol content was 35–40%; and the decrease in lignan content was 91%. The extractable matter content was reduced by 40%. Data gained in the study herein justifies the importance of researching existing and industrially produced plant extracts for further optimization of the final product. Results shows that industry can also produce extracts with elevated content of lignans with the use of short proximal parts of the branches.
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Alshahrani S, Ashafaq M, Hussain S, Mohammed M, Sultan M, Jali AM, Siddiqui R, Islam F. Renoprotective effects of cinnamon oil against APAP-Induced nephrotoxicity by ameliorating oxidative stress, apoptosis and inflammation in rats. Saudi Pharm J 2021; 29:194-200. [PMID: 33679180 PMCID: PMC7910143 DOI: 10.1016/j.jsps.2021.01.002] [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: 10/25/2020] [Accepted: 01/05/2021] [Indexed: 12/22/2022] Open
Abstract
Acetaminophen (APAP) is used as a primary medication in relieving moderate pain and fever. However, APAP is associated with toxic effects in renal tissue that appear because of its free radicals property. The principle goal of the present work is to assess the kidney damage by APAP and its restore antioxidative property of cinnamon oil (CO). Animals were distributed into six animals each in six groups. Rats were administered with three varying doses of CO from 50 to 200 mg/kg b.w. respectively and only a single dose of APAP. APAP induced an alteration in serum biochemical markers, imbalance in oxidative parameters, morphological changes in kidney tissue along with increased interleukins cytokines (IL-1β & 6) and caspase (3, 9) levels. CO administration significantly ameliorates all the parameters and histopathological changes were restored. Moreover, it also restored the activities of antioxidative enzymes. Our work proved that an variance of oxidative markers in the kidney by APAP is ameliorated by CO in rats. Thus, CO could be used in reducing APAP-induced nephrotoxicity.
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Affiliation(s)
- Saeed Alshahrani
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Mohammad Ashafaq
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Sohail Hussain
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Manal Mohammed
- Substance Abuse Research Center (SARC), College of Pharmacy, Jazan University, Saudi Arabia
| | - Muhammad Sultan
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Saudi Arabia
| | - Abdulmajeed M. Jali
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Rahimullah Siddiqui
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Fakhrul Islam
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
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Hussain S, Ashafaq M, Alshahrani S, Siddiqui R, Ahmed RA, Khuwaja G, Islam F. Cinnamon oil against acetaminophen-induced acute liver toxicity by attenuating inflammation, oxidative stress and apoptosis. Toxicol Rep 2020; 7:1296-1304. [PMID: 33024703 PMCID: PMC7528057 DOI: 10.1016/j.toxrep.2020.09.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/10/2020] [Accepted: 09/03/2020] [Indexed: 01/08/2023] Open
Abstract
Acetaminophen (APAP) is used as a primary drug due to its antipyretic and analgesic activity. The mechanism of action of APAP toxicity in the liver is due to the depletion of glutathione which elicited free radicals generation. Therefore, the objective of our work is to investigate the APAP induced liver damage and its repair by free radical scavenging activity of cinnamon oil (CO) in male Wistar rats. To investigate the effects of CO at different doses (50, 100 and 200 mg/kg b.w.), animals were given a single oral dose of CO per day for 14 days between 12:00-1:00 PM. The biochemical changes, imbalance in oxidative markers, interleukins, caspases and histopathological studies were determined for quantifying the hepatoprotective effect of CO. One dose of APAP (2 g/kg b.w.) results in significant hepatotoxicity and marked increase the serum markers alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, albumin, total protein, content of lipid peroxidation (LPO), interleukins (IL-1β, IL-6), caspase-3, -9 expression, DNA fragmentation and histopathological changes were observed. Significant decrease in the levels of LPO, interleukins IL-1β, IL-6, caspase-3, -9 expressions, qualitative as well as quantitative determination of DNA fragments and histopathological changes were reversed by the administration of CO dose dependently. Furthermore, it also restores the depleted activity of antioxidative enzymes. Our study shows that an imbalance in the oxidative parameter in the liver by APAP is restored by treating the animals with CO.
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Key Words
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- ANOVA, analysis of variance
- APAP, N-acetyl-p-aminophenol
- AST, aspartate aminotransferase
- Acetaminophen
- BHA, butylated hydroxyanisole
- CO, cinnamon oil
- Cinnamon oil
- DNA fragmentation
- GPx, glutathione peroxidase
- GR, glutathione reductase
- GSH, glutathione
- Hepatotoxicity
- LPO, lipid peroxidation
- MDA, malondialdehyde
- MEC, molar extinction coefficient
- NAPQI, N-acetyl parabenzoquinoneimine
- Oxidative stress
- PMS, post mitochondrial supernatants
- SOD, superoxide dismutase
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Affiliation(s)
- Sohail Hussain
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Mohammed Ashafaq
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Saeed Alshahrani
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Rahimullah Siddiqui
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Rayan A. Ahmed
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Gulrana Khuwaja
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jazan University, Saudi Arabia
| | - Fakhrul Islam
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Saudi Arabia
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Anthraquinones Extract from Morinda angustifolia Roxb. Root Alleviates Hepatic Injury Induced by Carbon Tetrachloride through Inhibition of Hepatic Oxidative Stress. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9861571. [PMID: 32328146 PMCID: PMC7149410 DOI: 10.1155/2020/9861571] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/14/2020] [Accepted: 02/29/2020] [Indexed: 12/16/2022]
Abstract
In Southwestern China, the root of Morinda angustifolia Roxb. has been employed as a folk medicine for treating various types of hepatitis and jaundice. The purpose of this study was to evaluate the hepatoprotective effects of anthraquinones extract from M. angustifolia root (AEMA) in carbon tetrachloride- (CCl4-) induced liver injury in mice and identify the main bioactive components. Results indicated that AEMA pretreatment could significantly, in a dose-dependent manner, attenuate the increased levels of ALT and AST in mice serum induced by CCl4. At doses of 100 and 200 mg/kg, AEMA exhibited significant suppression of the elevated hepatic levels of malondialdehyde (MDA), as well as marked upregulatory effects on the activities of antioxidant enzymes including superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in mice exposed to CCl4. However, AEMA treatment had no effect on the antioxidant enzyme catalase (CAT) or the nonenzymatic antioxidant glutathione (GSH). Furthermore, two anthraquinone constituents were isolated from AEMA and identified as soranjidiol and rubiadin-3-methyl ether. Soranjidiol exhibited similar protective effects to those of AEMA on liver damage induced by CCl4. Overall, our research clearly demonstrated the hepatoprotective effects of the AEMA, and anthraquinones, particularly soranjidiol, should be considered as the main hepatoprotective principles of M. angustifolia. In addition, the underlying mechanism may be, at least in part, related to its antioxidant properties.
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