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Basista H, Saxena R, Pathak VK, Awasthi S. A Comparative Analysis of the Efficacy of Ginkgo Biloba and Caroverine in the Management of Idiopathic Tinnitus. Indian J Otolaryngol Head Neck Surg 2024; 76:4386-4392. [PMID: 39376418 PMCID: PMC11456053 DOI: 10.1007/s12070-024-04868-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/08/2023] [Indexed: 10/09/2024] Open
Abstract
Aim The sound sensation that is experienced in the ears or brain and is unrelated to any external sources of stimulus is known as tinnitus. Tinnitus Functional Index (TFI) is used to establish the presence of the condition and determine symptom severity, its impact on the patient's quality of life, thus in this study, we aim to compare the efficacy of caroverine and Ginkgo Biloba in the management of idiopathic tinnitus using TFI. Methods This clinical study was conducted in at a tertiary care hospital in North India, for a duration of one year, among patients with chronic tinnitus. The sample size for this study consisted of 60 patients in each of three groups (caroverine, gingko biloba, and multivitamin). Assessments of TFI and pure-tone audiometry were performed to evaluate the efficacy of the two medications. The information pertaining to the subjects was kept anonymous and confidential. During data analysis, an association was significant for p value < 0.05. Results The patients in three groups were matched for the age, gender and duration of tinnitus. At 6 months of medication with Ginkgo Biloba, patients experienced a significant (p < 0.0001) decrease of 50.0% in tinnitus of moderate severity, and a complete resolution of severe tinnitus symptoms with a percentage change of -100.0%. Conclusion In our study, Ginkgo Biloba Group has significantly improved the severity of idiopathic tinnitus. Tinnitus has diverse underlying mechanisms, can be a symptom of various underlying diseases, and is challenging to measure. Further research is warranted to validate and explore these treatment options further.
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Affiliation(s)
- Hitender Basista
- Department of ENT and HNS, School of Medical Sciences and Research (SMSR), Sharda University, Greater Noida, India
| | - Rohit Saxena
- Department of ENT and HNS, School of Medical Sciences and Research (SMSR), Sharda University, Greater Noida, India
| | - Vivek Kumar Pathak
- Department of ENT and HNS, School of Medical Sciences and Research (SMSR), Sharda University, Greater Noida, India
| | - Sanjeev Awasthi
- Department of ENT and HNS, School of Medical Sciences and Research (SMSR), Sharda University, Greater Noida, India
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Liu Y, Niu P, Yan J, Ji H, Wang Z, Jin X, Lv L, Feng C, Du X, Yang F, Pang W. Efficacy and safety of Ginkgo biloba extract in the treatment of unstable angina pectoris: A systematic review and network meta-analysis. JOURNAL OF ETHNOPHARMACOLOGY 2024; 331:118297. [PMID: 38718890 DOI: 10.1016/j.jep.2024.118297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 04/17/2024] [Accepted: 05/04/2024] [Indexed: 05/28/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ginkgo biloba is a traditional Chinese medicine extracted from the Ginkgophyta and is commonly used in the treatment of cardiovascular diseases in China. Clinical trials have demonstrated the clinical benefits of Ginkgo biloba extract (GBE) preparations for patients with unstable angina pectoris (UAP). AIM OF THE STUDY The efficacy of different GBE preparations in treating UAP may vary, leading to a lack of guidance for physicians when choosing GBE preparations. How to make choices among different GBE preparations is a topic worthy of investigation. In order to clarify the efficacy differences among different GBE preparations, provide a reference for their optimal use conditions, this study was conducted. MATERIALS AND METHODS This study included literature from eight databases from inception to November 2023. It included UAP patients, with the control group receiving conventional treatment and the treatment group receiving different GBE preparations in addition to conventional treatment. Angina efficacy, electrocardiogram (ECG) improvement, and frequency of angina were chosen as outcomes. This study employed a systematic review and Bayesian network meta-analysis, and the surface under the cumulative ranking (SUCRA) curve was used for estimating the efficacy ranking. RESULTS A total of 98 studies involving 9513 patients and 9 interventions were included. Compared with conventional treatment, GBE preparations combined with conventional treatment had better efficacy in angina symptoms and ECG improvement. According to the SUCRA ranking, Shuxuening injection was most effective in improving angina symptoms and reducing the frequency of angina. Among oral GBE preparations, Ginkgo tablets had the best performance in improving angina symptoms and ECG manifestations, and reducing the frequency of angina. There was no significant difference in the incidence of adverse events between the treatment group and the control group, and all adverse events were mild and self-limiting. Compared with oral preparations, the incidence of adverse events for injections was higher. CONCLUSIONS GBE preparations may alleviate angina symptoms and myocardial ischemia in the treatment of UAP with favorable safety. Shuxuening injection may be the most effective among all GBE preparations in improving angina symptoms, while Ginkgo tablets may perform best among oral formulations. The optimal use of GBE injection may be for rapidly alleviating angina symptoms and myocardial ischemia in patients with UAP, and oral formulation of GBE may be more suitable for the long-term treatment of patients with milder symptoms. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022361487, ID: CRD42022361487.
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Affiliation(s)
- Yaoyuan Liu
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
| | - Puyu Niu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
| | - Jingxian Yan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
| | - Hongchang Ji
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
| | - Zhaoqi Wang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Xinyao Jin
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Ling Lv
- Shunyi Hospital, Beijing Hospital of Traditional Chinese Medicine, Beijing, China.
| | - Chaonan Feng
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Xuechen Du
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Fengwen Yang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Wentai Pang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Langguth B, Reineke T, Burkart M, Kostev K. Ginkgo biloba extract prescriptions are associated with less frequent repeat visits to ENT doctors due to tinnitus: a retrospective cohort study. Front Neurol 2024; 15:1402978. [PMID: 39144706 PMCID: PMC11323687 DOI: 10.3389/fneur.2024.1402978] [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: 03/19/2024] [Accepted: 07/17/2024] [Indexed: 08/16/2024] Open
Abstract
Objectives We aimed to evaluate the drug utilization of Ginkgo biloba extract (Gbe), systemic corticosteroids (CSs), and pentoxifylline (PTXF) for the treatment of acute tinnitus by analyzing electronic patient health record data. In addition, we assessed whether the different drug treatments were associated with different frequencies of repeat visits to ear, nose, and throat (ENT) doctors. Methods This retrospective cohort study used data from the IQVIA Disease Analyzer (DA) database. It included patients with an initial diagnosis of tinnitus between January 2005 and December 2021, treated by ENT specialists in Germany. Results Of 111,629 patients meeting all selection criteria, 51,205 received prescriptions of Gbe, 34,817 of systemic CSs, and 25,607 of PTXF. Gbe prescription was associated with significantly lower odds of a repeat consultation due to tinnitus compared to systemic CSs [odds ratio (OR) 0.91; 95% confidence interval (CI): 0.88-0.95] as well as PTXF (OR 0.74; 95% CI: 0.72-0.77). This association was significant in both men and women and in some age groups. Conclusion Gbe is the most frequently ENT specialist-prescribed drug for the treatment of acute tinnitus. It is associated with a reduced likelihood of patients consulting their ENT specialist for tinnitus again compared to systemic CSs and PTXF.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Thorsten Reineke
- Research & Development, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
| | - Martin Burkart
- Global Medical Affairs, Dr. Schwabe Holding SE & Co. KG, Karlsruhe, Germany
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Sun SY, Li Y, Gao YY, Ran XW. Efficacy and Safety of Pentoxifylline for Venous Leg Ulcers: An Updated Meta-Analysis. INT J LOW EXTR WOUND 2024; 23:264-274. [PMID: 34779680 DOI: 10.1177/15347346211050769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The venous leg ulcers are debilitating, painful, and often unresponsive to advanced dressing treatments, so drugs used locally and systematically are essential adjuvant therapy-pentoxifylline (PTX) whose anti-inflammatory effects may offer a promising avenue to treat venous leg ulcers. However, the current results are controversial. To further evaluate the efficacy and safety of PTX, we performed an updated meta-analysis of randomized placebo-controlled trials of PTX in the treatment of venous leg ulcers. We systematically searched multiple electronic databases PubMed, Web of Science, Embase, the Cochrane Library, the Cochrane Central Register of Controlled Trials, China Science and Technology Journal Database, WanFang Data, China National Knowledge Infrastructure, and the Chinese Biomedical Literature Database to identify eligible studies. Randomized clinical trials of pentoxifylline versus placebo treatment in patients with venous leg ulcers were considered for inclusion. The primary outcomes included ulcer healing rate and the incidence of adverse events after treatment. The secondary outcomes were the ulcer significant improvement (the ulcer size shrank by more than 60% after treatment) rate, mean duration of complete wound healing and changes in mean ulcer size. A meta-analysis and qualitative analysis were conducted to estimate endpoints. A total of 13 randomized clinical trials, including 921 individuals, were finally included. Compared with placebo, pentoxifylline significantly improved the ulcer healing rate (RR = 1.59, 95%CI 1.22 to 2.07, P < .001) and significant improvement rate (RR = 2.36, 95%CI 1.31 to 4.24, P = .004) while increased the incidence of gastrointestinal disturbances (RR = 2.29, 95%CI 1.04 to 5.03, P = .04) at the same time. Moreover, pentoxifylline also shortened mean duration of complete wound healing (P = .007) and shrank ulcer size (P = .02). Currently available evidence suggests that pentoxifylline could help venous leg ulcers heal more quickly and effectively. However, the evidence is insufficient to prove the results due to moderate-certainty evidence. Large-scale, well-designed randomized clinical trials are warranted.
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Affiliation(s)
- Shi-Yi Sun
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu 610041, Sichuan, People's Republic of China
| | - Yan Li
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu 610041, Sichuan, People's Republic of China
| | - Yun-Yi Gao
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu 610041, Sichuan, People's Republic of China
| | - Xing-Wu Ran
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu 610041, Sichuan, People's Republic of China
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Balatsouras DG, Papitsi I, Koukoutsis G, Katotomichelakis M. The effect of MemoVigor 2 on recent-onset idiopathic tinnitus: a randomized double-blind placebo-controlled clinical trial. Front Pharmacol 2024; 15:1252343. [PMID: 38327985 PMCID: PMC10847223 DOI: 10.3389/fphar.2024.1252343] [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: 07/17/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
Background: Tinnitus is a common symptom associated with the conscious perception of sound in the absence of a corresponding external or internal sound source, which can severely impact quality of life. Because of the current limited understanding of the precise pathophysiological mechanism of idiopathic tinnitus, no curable treatment has been attained yet. A food supplement trading as MemoVigor 2, which contains a combination of therapeutic ingredients with mainly antioxidant activity, has been used in the treatment of tinnitus. The objective of our study was to evaluate the effectiveness of MemoVigor 2 in the treatment of recent-onset idiopathic tinnitus. Methods: In a prospective single-centre randomized, double-blind, placebo-controlled clinical trial we studied 204 patients with idiopathic tinnitus divided into two groups: 104 patients who received MemoVigor 2 and 100 patients treated with placebo. To evaluate changes in tinnitus we used (1) audiometry/tympanometry; (2) specific measures of tinnitus perception, including tinnitus pitch, loudness at tinnitus pitch, loudness at 1 kHz, minimum masking level, and residual inhibition; (3) questionnaires of tinnitus handicap inventory, mini tinnitus questionnaire and patients' global impression of change. All patients underwent this test battery at the beginning of the study and in a repeat post-3-month session. Results: All tinnitus measures, including pitch, loudness, minimum masking level and residual inhibition improved significantly in the intervention group. Most of these measures improved in the placebo group too, but in a lesser degree. All questionnaire scores diminished significantly in both groups, but the degree of decrease was greater in the intervention group. The participants' tinnitus outcome reported after treatment using the patients' global impression of change score differed significantly between the two groups, with greater improvement observed in the intervention group. Conclusion: We found that the use of MemoVigor 2 improved recent-onset tinnitus, as proved by a set of tests performed for its evaluation, including audiometric measures, specific measures of tinnitus perception and tinnitus questionnaires. Tinnitus in the placebo group improved too, but to a lesser degree. Clinical Trial Registration: isrctn.com, Identifier ISRCTN16025480.
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Affiliation(s)
| | - Isidora Papitsi
- Department of Otorhinolaryngology, Tzaneio General Hospital, Piraeus, Greece
| | - George Koukoutsis
- Department of Otorhinolaryngology, Tzaneio General Hospital, Piraeus, Greece
| | - Michael Katotomichelakis
- Department of Otorhinolaryngology, Medical School, Democritus University of Thrace, Komotini, Greece
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Chhaya V, Patel D, Shethia F, Manchaiah V, Khambholja K. Current Therapeutic Trends for Tinnitus Cure and Control: A Scoping Review. Indian J Otolaryngol Head Neck Surg 2023:1-9. [PMID: 37362110 PMCID: PMC10237063 DOI: 10.1007/s12070-023-03910-2] [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: 03/20/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
The present scoping review assessed knowledge updates in tinnitus management. We included randomized trials, non-randomized studies, systematic reviews, meta-analyses, and observational studies in last 5 years on patients with tinnitus using Population, Concept, and Context mnemonic. We excluded studies on tinnitus epidemiology, technique-specific comparative studies for tinnitus assessment, review articles, or case reports. We used an artificial intelligence-powered tool MaiA for overall workflow management. Data charting elements included study identifiers, study design, population, interventions used, their outcomes on tinnitus scales, and treatment recommendations if any. Charted data from selected sources of evidence was presented using tables and a concept map. We also identified five evidence-based clinical practice guidelines (CPGs) [from the United States, Europe, and Japan regions] in our review of total 506 results, 205 underwent screening based on eligibility criteria and 38 were included for the final charting. We found three major categories of interventions in our review: Medical technology therapies; Behavioural/habituation therapies; and Pharmacological, herbal/complementary, and alternative medicine therapies. Although evidence-based guidelines on tinnitus therapy did not recommend stimulation therapies, majority of the tinnitus research to date is focused on stimulation. It is highly recommended that clinicians consider CPGs when making treatment recommendations and make the distinction between established management approaches with good evidence and emerging treatment approaches for tinnitus management. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03910-2.
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Affiliation(s)
| | - Divya Patel
- Genpro Research Pvt Ltd, Baroda, Gujarat India
| | | | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado Hospital, Aurora, CO USA
| | - Kapil Khambholja
- Genpro Research Pvt Ltd, Baroda, Gujarat India
- Genpro Research Inc, Boston, USA
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Liu D, Hu Y, Wang D, Han H, Wang Y, Wang X, Zhou Z, Ma X, Dong Y. Herbal medicines in the treatment of tinnitus: An updated review. Front Pharmacol 2023; 13:1037528. [PMID: 36686691 PMCID: PMC9847569 DOI: 10.3389/fphar.2022.1037528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023] Open
Abstract
Tinnitus is perception of sound in the absence of an apparent external acoustic stimulus. The condition is prevalent in adults, especially the elderly (≥65 years), and may be associated with cognitive function decline and significantly impacts on the quality of life, heralding difficulties in managing this challenging disorder. Interventions for tinnitus have been varied. However, drugs have not yet been approved for the treatment of tinnitus and there is no pharmacotherapy recommended by existing guidelines. Still, herbal medicines are used for the treatment of tinnitus in many countries, especially Gingko (G.) biloba. In the current updated literature review, we evaluated the efficacy of herbal medicines in the treatment of tinnitus by reviewing the evidence of relevant randomized controlled trials. The authors also highlight some of the issues in clinical trials of herbal medicines given that currently available evidence on herbal medicines for tinnitus is overall of insufficient quality and the conclusions from existing trials are conflicting. Nevertheless, there is a clear and urgent need for safe and effective pharmacotherapy of tinnitus.
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Affiliation(s)
| | | | | | | | | | | | | | - Xiulan Ma
- *Correspondence: Yaodong Dong, ; Xiulan Ma,
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Chauhan B, Arya S, Chauhan K. Ginkgo biloba Administered Singly and Combined With Antioxidants in Tinnitus Patients. J Audiol Otol 2023; 27:37-44. [PMID: 36710418 PMCID: PMC9884989 DOI: 10.7874/jao.2022.00395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 11/24/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Tinnitus, or ear ringing, involves impulsive and spontaneous activity in the auditory neurons. Its prevalence is high in the elderly, but 10%-15% of adults suffer from tinnitus, affecting their quality of life. Therefore, this study aimed to evaluate the efficacy of Ginkgo biloba administered singly and in combination with antioxidants in tinnitus patients. Subjects and. METHODS Patients were randomly allocated to Placebo (T0, n=22), Treatment 1 (T1, n=24), and Treatment 2 (T2, n=23) groups. The patients were educated on the study's methodology and were instructed to visit at 0, 4, 8, 12, and 14 weeks. The placebo group received starch capsule supplements. Conversely, the treatment groups received Ginkgo biloba (60 mg twice a day) singly and in combination with antioxidants. We enrolled 69 patients aged 40-70 years (41 men, 28 women). The Tinnitus Handicap Index (THI), Visual Analogue Score (VAS), and Short Form 36 (SF-36) Health Scores were determined pre- and post-treatment at each visit. RESULTS Supplementation of Ginkgo biloba, along with antioxidants, provided marked improvement (p<0.05) in post-treatment THI and VAS scores in the T2 group compared to those in the T1 and T0 groups. The greatest (p<0.05) percent difference was observed in the pre- and post-treatment THI (-36%) and VAS scores (-22.6%) of T2 patients. Likewise, the SF-36 scores improved significantly (p<0.05) in the T2 group in varied parameters. CONCLUSIONS Ginkgo biloba, along with antioxidants, can be a promising therapy for tinnitus patients, providing marked improvement in THI, VAS, and SF-36 scores.
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Affiliation(s)
- Bhushan Chauhan
- Department of ENT, M. M. Institute of Medical Sciences and Research, MMDU, Mullana, Ambala, Haryana, India,Address for correspondence Bhushan Chauhan, MS Department of ENT, M. M. Institute of Medical Sciences & Research, MMDU, Mullana, Ambala, Haryana, India Tel +91-9357097074 E-mail
| | - Shantanu Arya
- Department of ENT, M. M. Institute of Medical Sciences and Research, MMDU, Mullana, Ambala, Haryana, India
| | - Komal Chauhan
- National Institute of Food Technology Entrepreneurship and Management, Kundli, Sonipat, Haryana, India
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Lorca C, Mulet M, Arévalo-Caro C, Sanchez MÁ, Perez A, Perrino M, Bach-Faig A, Aguilar-Martínez A, Vilella E, Gallart-Palau X, Serra A. Plant-derived nootropics and human cognition: A systematic review. Crit Rev Food Sci Nutr 2022; 63:5521-5545. [PMID: 34978226 DOI: 10.1080/10408398.2021.2021137] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Substances with modulatory capabilities on certain aspects of human cognition have been revered as nootropics from the dawn of time. The plant kingdom provides most of the currently available nootropics of natural origin. Here, in this systematic review, we aim to provide state-of-the-art information regarding proven and unproven effects of plant-derived nootropics (PDNs) on human cognition in conditions of health and disease. Six independent searches, one for each neurocognitive domain (NCD), were performed in parallel using three independent scientific library databases: PubMed, Cochrane and Scopus. Only scientific studies and systematic reviews with humans published between January 2000 and November 2021 were reviewed, and 256 papers were included. Ginkgo biloba was the most relevant nootropic regarding perceptual and motor functions. Bacopa monnieri improves language, learning and memory. Withania somnifera (Ashwagandha) modulates anxiety and social-related cognitions. Caffeine enhances attention and executive functions. Together, the results from the compiled studies highlight the nootropic effects and the inconsistencies regarding PDNs that require further research.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2021137.
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Affiliation(s)
- Cristina Lorca
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
- Proteored - Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - María Mulet
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
| | - Catalina Arévalo-Caro
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
| | - M Ángeles Sanchez
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
| | - Ainhoa Perez
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
| | - María Perrino
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
| | - Anna Bach-Faig
- FoodLab Research Group (2017SGR 83), Faculty of Health Sciences, Open University of Catalonia (UOC), Barcelona, Spain
- Food and Nutrition Area, Barcelona Official College of Pharmacists, Barcelona, Spain
| | - Alicia Aguilar-Martínez
- FoodLab Research Group (2017SGR 83), Faculty of Health Sciences, Open University of Catalonia (UOC), Barcelona, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata (HUIPM), Institut Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
- Centro de investigación Biomédica en Salud Mental CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Xavier Gallart-Palau
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
- Proteored - Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Hospital Universitari Institut Pere Mata (HUIPM), Institut Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de investigación Biomédica en Salud Mental CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Aida Serra
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
- Proteored - Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Sahib S, Sharma A, Muresanu DF, Zhang Z, Li C, Tian ZR, Buzoianu AD, Lafuente JV, Castellani RJ, Nozari A, Patnaik R, Menon PK, Wiklund L, Sharma HS. Nanodelivery of traditional Chinese Gingko Biloba extract EGb-761 and bilobalide BN-52021 induces superior neuroprotective effects on pathophysiology of heat stroke. PROGRESS IN BRAIN RESEARCH 2021; 265:249-315. [PMID: 34560923 DOI: 10.1016/bs.pbr.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Military personnel often exposed to high summer heat are vulnerable to heat stroke (HS) resulting in abnormal brain function and mental anomalies. There are reasons to believe that leakage of the blood-brain barrier (BBB) due to hyperthermia and development of brain edema could result in brain pathology. Thus, exploration of suitable therapeutic strategies is needed to induce neuroprotection in HS. Extracts of Gingko Biloba (EGb-761) is traditionally used in a variety of mental disorders in Chinese traditional medicine since ages. In this chapter, effects of TiO2 nanowired EGb-761 and BN-52021 delivery to treat brain pathologies in HS is discussed based on our own investigations. We observed that TiO2 nanowired delivery of EGb-761 or TiO2 BN-52021 is able to attenuate more that 80% reduction in the brain pathology in HS as compared to conventional drug delivery. The functional outcome after HS is also significantly improved by nanowired delivery of EGb-761 and BN-52021. These observations are the first to suggest that nanowired delivery of EGb-761 and BN-52021 has superior therapeutic effects in HS not reported earlier. The clinical significance in relation to the military medicine is discussed.
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Affiliation(s)
- Seaab Sahib
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
| | - Dafin F Muresanu
- Department of Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania; "RoNeuro" Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Zhiqiang Zhang
- Department of Neurosurgery, Chinese Medicine Hospital of Guangdong Province, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Yuexiu, Guangzhou, China
| | - Cong Li
- Department of Neurosurgery, Chinese Medicine Hospital of Guangdong Province, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Yuexiu, Guangzhou, China
| | - Z Ryan Tian
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - Anca D Buzoianu
- Department of Clinical Pharmacology and Toxicology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - José Vicente Lafuente
- LaNCE, Department of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Rudy J Castellani
- Department of Pathology, University of Maryland, Baltimore, MD, United States
| | - Ala Nozari
- Anesthesiology & Intensive Care, Massachusetts General Hospital, Boston, MA, United States
| | - Ranjana Patnaik
- Department of Biomaterials, School of Biomedical Engineering, Indian Institute of Technology, Banaras Hindu University, Varanasi, India
| | - Preeti K Menon
- Department of Biochemistry and Biophysics, Stockholm University, Stockholm, Sweden
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
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The Influence of Depression, Anxiety and Cognition on the Treatment Effects of Ginkgo biloba Extract EGb 761 ® in Patients with Tinnitus and Dementia: A Mediation Analysis. J Clin Med 2021; 10:jcm10143151. [PMID: 34300317 PMCID: PMC8307082 DOI: 10.3390/jcm10143151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Comorbid occurrence of tinnitus and emotional symptoms of anxiety and depression is highly prevalent. The Ginkgo biloba extract EGb 761® has been shown to be effective in reducing neuropsychiatric symptoms in patients with dementia and tinnitus. Methods: We performed a mediation analysis to evaluate direct effects of EGb 761® on tinnitus severity, as well as indirect effects mediated by symptoms of depression and anxiety and by changed cognition. We pooled data from subsets of patients suffering from tinnitus that were enrolled in three double-blind, randomized, placebo-controlled clinical trials, which investigated the efficacy of EGb 761® (240 mg/day for 22–24 weeks) in dementia with concomitant neuropsychiatric symptoms. Results: In total, 594 patients suffered from tinnitus (EGb 761®, 289; placebo, 305). Direct effects of EGb 761® on tinnitus severity (p < 0.001) in patients with mild to moderate dementia were found to represent about 60% of the total effect, whereas the indirect effects (p < 0.001) mediated by improvement of anxiety, depression and cognition represented about 40% of the total effect. Conclusions: EGb 761® could be considered as a supporting treatment for tinnitus in elderly patients suffering from dementia, with added benefit in those with symptoms of depression or anxiety.
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Kikidis D, Vassou E, Schlee W, Iliadou E, Markatos N, Triantafyllou A, Langguth B. Methodological Aspects of Randomized Controlled Trials for Tinnitus: A Systematic Review and How a Decision Support System Could Overcome Barriers. J Clin Med 2021; 10:1737. [PMID: 33923778 PMCID: PMC8074073 DOI: 10.3390/jcm10081737] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 12/05/2022] Open
Abstract
Although a wide range of tinnitus management interventions is currently under research and a variety of therapeutic interventions have already been applied in clinical practice, no optimal and universal tinnitus treatment has been reached yet. This fact is to some extent a consequence of the high heterogeneity of the methodologies used in tinnitus related clinical studies. In this manuscript, we have identified, summarized, and critically appraised tinnitus-related randomized clinical trials since 2010, aiming at systematically mapping the research conducted in this area. The results of our analysis of the 73 included randomized clinical trials provide important insight on the identification of limitations of previous works, methodological pitfalls or gaps in current knowledge, a prerequisite for the adequate interpretation of current literature and execution of future studies.
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Affiliation(s)
- Dimitrios Kikidis
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Evgenia Vassou
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, Universität Regensburg, 93053 Regensburg, Germany; (W.S.); (B.L.)
| | - Eleftheria Iliadou
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Nikolaos Markatos
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Aikaterini Triantafyllou
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, Universität Regensburg, 93053 Regensburg, Germany; (W.S.); (B.L.)
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13
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Talap J, Shen Z, Nie J, Pan J, Xu M, Zeng K, He K, Ou F, He H, Yao J, Wang R, Yu L, Zeng S. The characterisation of the in vitro metabolism and transport of 6-hydroxykynurenic acid, an important constituent of Ginkgo biloba extracts. Xenobiotica 2021; 51:513-521. [PMID: 33512253 DOI: 10.1080/00498254.2021.1881654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
6-Hydroxykynurenic acid (6-HKA) is a nitrogen-containing phenolic acid compound in Ginkgo biloba leaves. The pharmacological activities of 6-HKA have been reported and shown that 6-HKA has the potential to become a therapeutic drug and may play an important role in the treatment of nervous system diseases. However, there are few studies on the drug metabolism and transport of 6-HKA. The aim of this study is to investigate the in vitro metabolism of 6-HKA and its interaction with multiple important drug transporters.The in vitro metabolism experiments in the present study demonstrate that 6-HKA might not undergo phase-I or phase-II metabolism in hepatic microsomes/S9 of rats. In addition, some drug transporters, including OAT1/3, OCT2, MDR1, OATP1B1, MATE1/2K and OCTN2, were investigated. The cellular uptake assays indicate that 6-HKA exhibits inhibition to the transport of classical substrates mediated by OAT3, OCT2, MATE2K and OCTN2 but has no significant effect on the transport of substrates mediated by MDR1, OAT1, OATP1B1 or MATE1. Further investigation of cellular accumulation assays shows that 6-HKA might be the substrate of OAT3, but not OCT2 or OCTN2. The bidirectional transport study suggests that 6-HKA is not a substrate of MDR1.The information about the in vitro metabolism of 6-HKA and the interaction between 6-HKA and some transporters will help us to better understand the pharmacokinetic properties of 6-HKA and provide reference for its pharmacodynamics, DDIs and drug-food interactions studies.
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Affiliation(s)
- Jadera Talap
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Cancer Center of Zhejiang University, College of Pharmaceutical Sciences, Hangzhou, PR China
| | - Zhuowei Shen
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Cancer Center of Zhejiang University, College of Pharmaceutical Sciences, Hangzhou, PR China
| | - Jing Nie
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Cancer Center of Zhejiang University, College of Pharmaceutical Sciences, Hangzhou, PR China
| | - Jie Pan
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Cancer Center of Zhejiang University, College of Pharmaceutical Sciences, Hangzhou, PR China
| | - Mingcheng Xu
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Cancer Center of Zhejiang University, College of Pharmaceutical Sciences, Hangzhou, PR China
| | - Kui Zeng
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Cancer Center of Zhejiang University, College of Pharmaceutical Sciences, Hangzhou, PR China
| | - Kaifeng He
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Cancer Center of Zhejiang University, College of Pharmaceutical Sciences, Hangzhou, PR China
| | - Fengting Ou
- Zhejiang Conba Pharmaceutical Co., Ltd, Zhejiang Provincial Key Laboratory of TCM Pharmaceutical Technology, Hangzhou, PR China
| | - Houhong He
- Zhejiang Conba Pharmaceutical Co., Ltd, Zhejiang Provincial Key Laboratory of TCM Pharmaceutical Technology, Hangzhou, PR China
| | - Jianbiao Yao
- Zhejiang Conba Pharmaceutical Co., Ltd, Zhejiang Provincial Key Laboratory of TCM Pharmaceutical Technology, Hangzhou, PR China
| | - Ruwei Wang
- Zhejiang Conba Pharmaceutical Co., Ltd, Zhejiang Provincial Key Laboratory of TCM Pharmaceutical Technology, Hangzhou, PR China
| | - Lushan Yu
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Cancer Center of Zhejiang University, College of Pharmaceutical Sciences, Hangzhou, PR China
| | - Su Zeng
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Cancer Center of Zhejiang University, College of Pharmaceutical Sciences, Hangzhou, PR China
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14
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Clinical randomized trial study of hearing aids effectiveness in association with Ginkgo biloba extract (EGb 761) on tinnitus improvement. Braz J Otorhinolaryngol 2020; 86:734-742. [PMID: 31300303 PMCID: PMC9422696 DOI: 10.1016/j.bjorl.2019.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 05/04/2019] [Accepted: 05/15/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction Tinnitus is defined as the perception of sound without its actual presence in the environment. It has been the subject of a great number of studies, especially considering its consequences on patient's quality of life. Objective This study aimed to investigate the effect of hearing aids and/or Ginkgo biloba extract EGb 761 on tinnitus in patients with hearing loss. Methods This is a trial randomized-controlled treatment, parallel, double-blind, with three-arm. Thirty-three adults subjects were divided into three groups: group 1 — subjects undergoing drug therapy with Ginkgo biloba extract EGb 761; group 2 — individuals fitted with digital hearing aids; group 3 — individuals submitted to drug therapy with Ginkgo biloba extract EGb 761 and using hearing aids. The tinnitus handicap inventory and visual analogue scale were used to evaluate self-perception of tinnitus loudness and severity before treatment and 90 days after treatment. Results This study demonstrated a significant correlation between tinnitus handicap inventory and visual analogue scale, before and after treatment. We observed a significant improvement in self-perception of tinnitus loudness and severity after 90 days of treatment with Ginkgo biloba extract EGb 761 and/or hearing aids. No correlation was found between tinnitus onset time and self-perception of tinnitus loudness and severity. Hearing aids were more effective in patients with a shorter tinnitus onset time and Ginkgo biloba extract was effective regardless of tinnitus duration. Conclusions It was possible to prove the effectiveness of the hearing aids and/or Ginkgo biloba extract EGb 761 treatment, which shows success in the control of tinnitus contributing to the improvement of this symptom.
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Wang K, Tang D, Ma J, Sun S. Auditory Neural Plasticity in Tinnitus Mechanisms and Management. Neural Plast 2020; 2020:7438461. [PMID: 32684922 PMCID: PMC7349625 DOI: 10.1155/2020/7438461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/15/2020] [Accepted: 06/20/2020] [Indexed: 11/24/2022] Open
Abstract
Tinnitus, which is the perception of sound in the absence of a corresponding external acoustic stimulus, including change of hearing and neural plasticity, has become an increasingly important ailment affecting the daily life of a considerable proportion of the population and causing significant burdens for both the affected individuals and society as a whole. Here, we briefly review the epidemiology and classification of tinnitus, and the currently available treatments are discussed in terms of the available evidence for their mechanisms and efficacy. The conclusion drawn from the available evidence is that there is no specific medication for tinnitus treatment at present, and tinnitus management might provide better solutions. Therapeutic interventions for tinnitus should be based on a comprehensive understanding of the etiology and features of individual cases of tinnitus, and more high quality and large-scale research studies are urgently needed to develop more efficacious medications.
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Affiliation(s)
- Kunkun Wang
- ENT institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Dongmei Tang
- ENT institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Jiaoyao Ma
- ENT institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Shan Sun
- ENT institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
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16
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Petridou AI, Zagora ET, Petridis P, Korres GS, Gazouli M, Xenelis I, Kyrodimos E, Kontothanasi G, Kaliora AC. The Effect of Antioxidant Supplementation in Patients with Tinnitus and Normal Hearing or Hearing Loss: A Randomized, Double-Blind, Placebo Controlled Trial. Nutrients 2019; 11:E3037. [PMID: 31842394 PMCID: PMC6950042 DOI: 10.3390/nu11123037] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/27/2019] [Accepted: 12/03/2019] [Indexed: 01/08/2023] Open
Abstract
Tinnitus is the perception of sound in the absence of any external stimulus. Oxidative stress is possibly involved in its pathogenesis and a variety of antioxidant compounds have been studied as potential treatment approaches. The objective of the present study was to assess the effects of antioxidant supplementation in tinnitus patients. This is a randomized, double-blind, placebo-controlled clinical trial. Patients (N = 70) were randomly allocated to antioxidant supplementation (N = 35) or to placebo (N = 35) for a total of 3 months. Demographic, anthropometric, clinical, and nutritional data were collected. Serum total antioxidant capacity (TAC), oxidized LDL (oxLDL), and superoxide dismutase (SOD), tinnitus loudness, frequency, and minimum masking level (MML), and scores in Tinnitus Handicap Inventory questionnaire (THI), Tinnitus Functional Index (TFI), and Visual Analogue Scale (VAS) were evaluated at baseline and follow-up. Tinnitus loudness and MML significantly decreased from baseline to post measure (p < 0.001) only in the antioxidant group, the overall change being significantly different between the two groups post-intervention (p < 0.001). THI and VAS decreased only in the antioxidant group. Differences in changes in serum TAC, SOD, and oxLDL post-intervention were insignificant. In conclusion, antioxidant therapy seems to reduce the subjective discomfort and tinnitus intensity in tinnitus patients.
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Affiliation(s)
- Anna I. Petridou
- 1st ENT Department, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (A.I.P.); (I.X.); (E.K.)
| | - Eleftheria T. Zagora
- ENT Department, General Hospital of Nikaia “Agios Panteleimon”, Nikaia, 18454 Athens, Greece; (E.T.Z.); (G.K.)
| | - Petros Petridis
- ENT Department, St. Johannes Hospital, 44137 Dortmund, Germany;
| | - George S. Korres
- 2nd ENT Department, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, 12462 Chaidari, Greece;
| | - Maria Gazouli
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Ioannis Xenelis
- 1st ENT Department, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (A.I.P.); (I.X.); (E.K.)
| | - Efthymios Kyrodimos
- 1st ENT Department, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (A.I.P.); (I.X.); (E.K.)
| | - Georgia Kontothanasi
- ENT Department, General Hospital of Nikaia “Agios Panteleimon”, Nikaia, 18454 Athens, Greece; (E.T.Z.); (G.K.)
| | - Andriana C. Kaliora
- Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
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Shen Z, He K, Xu M, Zeng K, Pan J, Ou F, Yao J, Wang R, Zeng S. Development and validation of a sensitive LC-MS/MS method for the determination of 6-hydroxykynurenic acid in rat plasma and its application to pharmacokinetics study. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1116:44-50. [PMID: 30981181 DOI: 10.1016/j.jchromb.2019.03.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/19/2019] [Accepted: 03/26/2019] [Indexed: 10/27/2022]
Abstract
A sensitive and specific bioanalytical method of liquid chromatography-tandem mass spectrometry (LC-MS/MS) for the quantification of 6-hydroxykynurenic acid (6-HKA) in a small quantity of rat plasma has been developed and comprehensively validated. Tolbutamide (Tol) was used as the internal standard (IS). An aliquot of 50 μL rat plasma sample was deproteinized by 150 μL methanol, and then 100 μL of its supernatant was mixed with 100 μL water after centrifugation. Chromatographic separation was performed on a ZORBAX Eclipse Plus C18 Rapid Resolution HD column (2.1 mm × 100 mm, 1.8 μm) with a gradient mobile phase consisting of water containing 2 mM ammonium formate and methanol at a flow rate of 0.2 mL/min over a total run time of 5.0 min. The mass spectrometer was operated under multiple reactions monitoring (MRM) mode with the transitions m/z 206.1 → 160.0 for 6-HKA and m/z 269.0 → 170.0 for Tol. The linear range was 2.5-250 ng/mL with the square regression coefficient (r2) of 0.997. The lower limit of quantification (LLOQ) was 2.5 ng/mL (Relative Error, RE +1.6% and RSD 4.8%, n = 5). The intra- and inter-day precision and accuracy was <13.3%. The mean recovery of 6-HKA in rat plasma was between the range of 99.3-103.4%. This method was successfully applied to study the pharmacokinetics of 6-HKA in rats after oral administration at a single dose of 20.0 mg/kg and after tail intravenous injection at a single dose of 2.0 mg/kg. Pharmacokinetic parameters bioavailability, Cmax, oral, Tmax, oral, AUC0-24h, oral, AUC0-∞, oral, AUC0-24h, iv and AUC0-∞, iv were 3.96%, 152.0 ± 85.5 ng/mL, 0.4 ± 0.1 h, 340.0 ± 136.3 ng/mL ∗ h, 369.5 ± 135.0 ng/mL ∗ h, 906.6 ± 324.1 ng/mL*h and 932.9 ± 336.5 ng/mL ∗ h, respectively.
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Affiliation(s)
- Zhuowei Shen
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Kaifeng He
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Mingcheng Xu
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Kui Zeng
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Jie Pan
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Fengting Ou
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Jianbiao Yao
- Zhejiang Conba Pharmaceutical Co.,Ltd., PR China
| | - Ruwei Wang
- Zhejiang Conba Pharmaceutical Co.,Ltd., PR China
| | - Su Zeng
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China.
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