Effects of drinking natural hydrogen sulfide (H2S) waters: a systematic review of in vivo animal studies

The effect of sulfur baths on hemorheological properties of blood in patients with osteoarthritis

Balneotherapy is an effective treatment method in various diseases and commonly used treatment modality among patients with musculoskeletal disorders. Sulfur baths are known for healing properties however effect on rheological properties is unstudied. Thus the aim of our study was to determine the effect of sulfur balneotherapy on hemorheological blood indices. A total of 48 patients with osteoarthritis were enrolled to the study. Blood samples were collected twice, before and after 3-week time period. We evaluated complete blood count, fibrinogen, hs-CRP and blood rheology parameters such as elongation index (EI), half-time of total aggregation (T_1/2) and aggregation index (AI) analyzed with the Lorrca Maxis. Mean age of studied cohort was 67 ± 5 years. After sulfur baths WBC count was significantly decreased is studied group (p = 0.021) as well as neutrophile count (p = 0.036). Red blood cell EIs were statistically higher after sulfur baths in shear stress ranging from 8.24 to 60.30 Pa. T_1/2 was significantly higher (p = 0.031) and AI lower (p = 0.003) compared to baseline. No significant changes in fibrinogen and hs-CRP were observed. It is the first study that evaluate effect of sulfur balneotherapy on rheologic properties of blood. Sulfur water baths may improve erythrocyte deformability and aggregation parameters.

Effect of Calcium-Sulphate-Bicarbonate Water in a Murine Model of Non-Alcoholic Fatty Liver Disease: A Histopathology Study

The progression of nonalcoholic fatty liver disease (NAFLD) is associated with alterations of the gut–liver axis. The activation of toll-like receptor 4 (TLR4) pathways by endotoxins, such as lipopolysaccharide (LPS), contributes to liver injury. The aim of the present study was to evaluate the possible beneficial effects of a calcium-sulphate-bicarbonate natural mineral water on the gut–liver axis by evaluating liver and terminal ileum histopathology in a murine model of NAFLD. NAFLD was induced in mice by administrating a methionine-choline-deficient (MCD) diet. The following experimental groups were evaluated: controls (N = 10); MCD+Tap water (MCD; N = 10); MCD+Calcium-sulphate-bicarbonate water (MCD/W_csb; N = 10). Mice were euthanised after 4 and 8 weeks. Liver and terminal ileum samples were collected. Samples were studied by histomorphology, immunohistochemistry, and immunofluorescence. In mice subjected to the MCD diet, treatment with mineral water improved inflammation and fibrosis, and was associated with a reduced number of activated hepatic stellate cells when compared to MCD mice not treated with mineral water. Moreover, MCD/W_csb mice showed lower liver LPS localization and less activation of TLR4 pathways compared to the MCD. Finally, W_csb treatment was associated with improved histopathology and higher occludin positivity in intestinal mucosa. In conclusion, calcium-sulphate-bicarbonate water may exert modulatory activity on the gut–liver axis in MCD mice, suggesting potential beneficial effects on NAFLD.

A Whiff of Sulfur: One Wind a Day Keeps the Doctor Away

Reactive Sulfur Species (RSS), such as allicin from garlic or sulforaphane from broccoli, are fre-quently associated with biological activities and possible health benefits in animals and humans. Among these Organic Sulfur Compounds (OSCs) found in many plants and fungi, the Volatile Sulfur Compounds (VSCs) feature prominently, not only because of their often-pungent smell, but also because they are able to access places which solids and solutions cannot reach that easily. Indeed, inorganic RSS such as hydrogen sulfide (H₂S) and sulfur dioxide (SO₂) can be used to lit-erally fumigate entire rooms and areas. Similarly, metabolites of garlic, such as allyl methyl sulfide (AMS), are formed metabolically in humans in lower concentrations and reach the airways from inside the body as part of one’s breath. Curiously, H₂S is also formed in the gastrointestinal tract by gut bacteria, and the question of if and for which purpose this gas then crosses the barriers and enters the body is indeed a delicate matter for equally delicate studies. In any case, nature is surprisingly rich in such VSCs, as fruits (for instance, the infamous durian) demonstrate, and therefore these VSCs represent a promising group of compounds for further studies.

Effect of hydrogen sulphide containing mineral water on experimental osteoporosis in rats

Background/Aim: Sulphur mineral water is widely used in the treatment of musculoskeletal diseases. Hydrogen sulphide is an important regulator of bone metabolism and its application in the treatment of osteoporosis is intensively researched. The aim of this study was to analyse biochemical and histological effects of H2S containing mineral water of "Mlječanica" spring on ovariectomy-induced experimental osteoporosis in rats. Methods: In this experiment a 14-week-old Wistar female rats were used. The animals undergone bilateral ovariectomy (OVX groups) as an experimental model for oestrogen-deficient osteoporosis. After six weeks, animals were divided into control and the experimental group. Rats from the experimental group treated with H2S (SW group) containing mineral water ad libitum during five weeks. Biochemical parameters for monitoring sulphur water effects were concentration in serum of osteocalcin, alkaline phosphatase, calcium and phosphorus. Histological analyses of the left tibia coloured with haematoxylin-eosin were carried out. Results: Regarding the biochemical parameters, a statistically significant increase was observed in the OVX group for osteocalcin, alkaline phosphatase calcium and phosphorus compared to the sham-operated (CNT) group (p < 0.01). In SW + OVX, alkaline phosphatase was statistically significantly decreased (p < 0.01) and serum osteocalcin and phosphorus increased (p < 0.01). Calcium values were increased without significance. In the OVX + SW group, histological analyses showed numerous osteoblasts along the trabecular endosteum and the growth of young chondrocytes in the central bone zone and their migration to the peripheral parts. Conclusion: Drinking the H2S containing "Mlječanica" mineral water has led to decreased alkaline phosphatase, increased osteocalcin and phosphorus concentration in serum and stimulated the bone reparation in osteoporotic rats.

Hydropinotherapy with Sulphurous Mineral Water as Complementary Treatment to Improve Glucose Metabolism, Oxidative Status, and Quality of Life

Hydropinotherapy is a salus per aquam (Spa) treatment suitable as a complementary approach to treat several diseases, which strongly affect the quality of life (QoL). Hydropinotherapy with sulphurous mineral water exerts benefits thanks to components, such as hydrogen sulphide, which is considered mainly responsible for antioxidant and hypoglycaemic effects. Such properties, linked from each other, could favour an improvement in patients’ QoL. However, data on humans are scarce. This study aimed to investigate whether a cycle of sulphurous hydropinotherapy was able to modify plasma levels of glucose and reactive oxygen metabolites (ROMs) and improve QoL in patients suffering from several chronic disorders. A prospective, observational study involved patients with gastrointestinal diseases who received a prescription of a cycle of sulphurous hydropinotherapy (S-HT). Age- and sex-matched control group was enrolled (No S-HT). Glycaemia and plasma concentration of ROMs were measured in all subjects. The impact of spa treatment on the QoL was assessed using the Short Form 36 Health Status Survey questionnaire (SF-36). All parameters were measured at baseline and at the end of a 2-week treatment. Between the groups, no differences were found in glycaemia and ROMs at baseline. In the S-HT group, a reduction in glycaemia and ROMs, both in respect to baseline (p = 0.005 and p = 0.031, respectively) and to control group, as shown by the delta value calculated, as the difference between the values at 2 weeks and baseline (p = 0.0009 and p = 0.0001, respectively). In the S-HT, delta ROMs was the best predictor of delta glycaemia with a direct linear correlation (beta = 0.559, 95% CI 0.471 to 0.647, p < 0.0001). In the S-HT, the SF-36 total score was improved both when compared with baseline (p = 0.002) and with No S-HT (p = 0.001). Sulphurous hydropinotherapy induces a decrease in glycaemia and ROM levels, also ameliorating the patients’ QoL. Therefore, it could be considered a useful complementary therapeutic approach.

Effects of Sodium Chloride-Rich Mineral Water on Intestinal Epithelium. Experimental Study

Since knowledge concerning the cellular and tissue substrate that explains the therapeutic action of mineral waters is generally very scarce, we address the different effects that Lanjarón-Capuchina mineral water exerts on the intestinal epithelium in an experimental model as a prototype of the sodium chloride-rich mineral waters used in digestive disorders. In the experimental protocol, two groups of five adult Wistar rats received unrestricted mineral water in their diet or mineral water directly into the gastrointestinal tract through a catheter. A third control group was given a standard diet and water ad libitum. Intestinal samples for scanning electron microscopy were analyzed according to standardized methods. The observations carried out by microscope after the administration of the sodium chloride-rich mineral water clearly indicate that the hypertonic action of this mineral water affects the structure of the intestinal epithelium. It modifies the microvilli absorption in terms of the groups of enterocytes and the secretion of goblet cells, but it particularly affects the epithelial renewal process, accelerating and stimulating cell extrusion. The type of extrusion mechanism observed by microscope allows us to affirm that, although this increased after direct administration, it does not generate an epithelial disruption as it occurs in other circumstances with other extrusion modalities.

Perspectives on biometeorological research on the African continent

Since the first issue of the International Journal of Biometeorology in 1957, a total of 135 papers have reported on research in or of African countries. The majority of these have been on topics of animal biometeorology (36%), and the greatest proportion (24%) are situated in Nigeria. There has been a considerable increase in papers on African biometeorology since 2011, with those from this past decade accounting for 58% of all African papers in the journal. This occurs concurrent to an increase in the total number of papers published in the journal, driven by a move to the Editorial Manager system. While 66% of the papers on African biometeorology in the journal are authored by at least one person with an affiliation in the African continent, only 15 African countries are represented in the total authorship. As much of the African continent is projected to experience climatic changes exceeding the global mean, as much of the region is involved in animal and plant farming, and as seasonally-fluctuating and climatically affected diseases are common place, this low representation of work in Africa is surprising. This points to the need for greater awareness among African researchers of the discipline of biometeorology, greater involvement of African biometeorologists in International Society of Biometeorology and Commission meetings, and the inclusion of a greater number of African academics in the review process. This would be beneficial to the Society in increasing diversity and encouraging a more cosmopolitan engagement, and to the recognition of scientific development in African countries.

Diabetes mellitus and COVID-19 in the post-acute phase patients - possible links with physical and rehabilitation medicine and balneotherapy

Background. The outbreak of COVID-19 - COronaVIrus Disease 2019 - has become a significant threat to public health worldwide, with high contagious capacity and varied mortality in different countries. Diabetes mellitus (DM/ diabetes) is among the most frequently reported comorbidities in patients with COVID-19. In the field of physical and rehabilitation medicine and balneotherapy, specific rehabilitation procedures, natural therapeutic factors, and physical activity are known to be contributive to mitigating some of the DM clinical-patho-biological consequences. Objective. This systematic review aims to rigorously select related articles and identify within their content, the main possible interferences between DM and COVID-19’s pathological mechanisms, and to discuss the value of physical and rehabilitation medicine and balneotherapy in the post-acute COVID-19 recovery of the surviving patients. Methods. This systematic review, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searched for open-access articles published in English, between January and May 2020, from the following databases: Cochrane, Elsevier, PubMed and Web of Science. The contextually searched syntax used was ”DIABETES AND COVID-19”. The selected articles were analyzed in detail regarding both pathologies: COVID-19 and DM. The meta-analysis proceeded was designated to estimate the prevalence of DM among COVID-19 patients. Results. Our search has been conducted on five stages, described by a PRISMA adapted flow diagram. Within the first stage, using the syntax mentioned above resulted in 1,133 articles. After eliminating, in the second stage, all the inevitable redundancies remained 1,058 articles. In the third stage, we performed a PEDro qualitative analysis score weighted selection of all the papers and were kept 91 articles. In the fourth stage, were selected relevant issues for a meta-analysis regarding the prevalence of DM diabetes among COVID-19 cases, resulting 32 papers. The fifth stage of the PRISMA adapted flow diagram was dedicated to the analysis of the data regarding the use of natural therapeutic factors, physical exercises within the ensemble of case-specific indicated procedures used for DM, and COVID-19 patients in rehabilitation wards. For enhancing the bibliographical sources pool, we added from external, free found sources, another 15 articles. Discussion/ Limitation. COVID-19 is an acute illness condition and DM is a chronic one. Therefore, it is difficult for now, to have enough data enabling us to see all the repercussions of COVID-19 and to completely understand the significance of physical and rehabilitation medicine and balneotherapy, which applies in COVID-19 post-acute DM patients. Conclusions. This paper overviews the current state-of-the-art knowledge in the approach of DM /diabetes as COVID-19 comorbidity, with a focal point on the roles of natural therapeutic factors, physical exercises within the ensemble of case-specific indicated procedures used for DM and COVID-19 patients in rehabilitation wards, for possible actual and future connexions with the comprehensive management/ rehabilitation of such both chronic and post-acute survivors.