Comparison of hypotensive, diuretic and renal effects between cladodes of Opuntia ficus-indica and furosemide

Safety classification of herbal medicine use among hypertensive patients: a systematic review and meta-analysis

Background

The use of herbal medicines (HMs) for the treatment of hypertension (HTN) is increasing globally, but research on the potential adverse effects and safety of HMs in HTN patients is limited. Therefore, this systematic review and meta-analysis aim to determine the global prevalence of HM usage among HTN patients and assess the safety of identified herbs based on current scientific evidence.

Methods

The PubMed/MEDLINE, EMBASE (Ovid), and Cumulated Index to Nursing and Allied Health Literature (CINAHL) databases were searched for cross-sectional studies on the use of HM among HTN patients. Our review includes studies published in English up to the year 2023. After extracting and appraising the data from the studies, a meta-analysis was conducted using the Stata version 16.0 to estimate the pooled prevalence of HM use in patients with HTN (PROSPERO: CRD42023405537). The safety classification of the identified HM was done based on the existing scientific literature.

Results

This study analyzed 37 cross-sectional studies from 21 countries and found that 37.8% of HTN patients used HM to manage their health. The prevalence of HM use varied significantly based on publication year and geographical region. Among the 71 identified herbs, Allium sativum L., Hibiscus sabdariffa L., and Olea europaea L. were the most commonly used. However, four herbs were identified as contraindicated, 50 herbs required caution, and only 11 herbs were considered safe for use.

Conclusion

The study highlights the potential risks of toxicities and adverse effects associated with HM use in the treatment of HTN. Ensuring patient safety involves using safe HMs in appropriate doses and avoiding contraindicated HMs. Future research should focus on identifying commonly used herbs, especially in resource-limited countries with poor HTN management, and additional clinical research is required to assess the toxicity and safety of commonly used HMs.

An overview and update on the chemical composition and potential health benefits of Opuntia ficus-indica (L.) Miller

Opuntia ficus-indica (OFI), widely recognized as prickly pear, is native to Mexico and it is distributed in many areas of the world because of its socioeconomic, agronomic, and ecological benefits, besides its large amounts of functional, nutraceutical, and biological activities. Various parts of this plant including the fruit pulp and peel, cladode, and seeds are scientifically proven to have therapeutic potentials and are safe for human use. The contents of phytochemical compounds in each part of the OFI are different. Each pharmacological activity depends on the phytochemical compounds, the components used, and the extraction type. In this review, we summarize the active constituents from different parts of OFI and their pharmacological effects including the antioxidant, wound healing, skin protective, hepatoprotective, anticancer, antidiabetic, antihypercholesterolemic, and anti-obesity activities. Besides its effects on the bone health, cardiovascular system, kidneys, and gastrointestinal tract, its gastroprotective, anti-ulcer, anti-inflammatory, antiviral, neuroprotective, sedative, analgesic, anxiolytic and antimicrobial effects and effects on cognitive and memory function are also mentioned. PRACTICAL APPLICATIONS: Over the past few decades, the health benefits of Opuntia ficus-indica (OFI) have received much attention. All parts of the plant, including the fruit pulp and peel, cladode, and seeds have found use in the treatment of many diseases. The chemical composition of OFI provides both a high nutritional value and various health benefits. Therefore, the aim of this review is to present the up-to-date research carried out on OFI phytochemicals, showing the most important biological activities reported.

Ethnobotanical, pharmacological, phytochemical, and clinical investigations on Moroccan medicinal plants traditionally used for the management of renal dysfunctions

ETHNOPHARMACOLOGICAL RELEVANCE

Renal disease is a significant public health concern that affects people all over the world. The main limitations of conventional therapy are the adverse reaction on human health and the expensive cost of drugs. Indeed, it is necessary to develop new therapeutic strategies that are less expensive and have fewer side effects. As a consequence of their natural compounds, medicinal plants can be used as an alternative therapy to cure various ailments including kidney diseases.

OBJECTIVE

of the study: This review paper has two principal goals: (1) to inventory and describe the plants and their ancestral use by Moroccan society to cure renal problems, (2) to link traditional use with scientific confirmations (preclinical and clinical).

METHODS

To analyze pharmacological effects, phytochemical, and clinical trials of plants, selected for renal therapy, a bibliographical search was undertaken by examining ethnobotanical investigations conducted in Morocco between 1991 and 2019 and consulting peer-reviewed papers from all over the world.

RESULTS

Approximately 290 plant species, spanning 81 families and 218 genera have been reported as being utilized by Moroccans to manage renal illness. The most frequently mentioned species in Morocco were Herniaria hirsuta subsp. cinerea (DC.), Petroselinum crispum (Mill.) Fuss and Rosmarinus officinalis L. The leaves were the most frequently used plant parts, followed by the whole plant. Decoction and infusion were the most popular methods of preparation. A record of 71 plant species was studied in vitro and/or in vivo for their therapeutic efficacy against kidney disorders, including 10 plants attempting to make it to the clinical stage. Twenty compounds obtained from 15 plants have been studied for the treatment of kidney diseases.

CONCLUSION

Medicinal herbs could be a credible alternative therapy for renal illness. However, additional controlled trials are required to confirm their efficiency in patients with kidney failure. Overall, this work could be used as a database for future exploration.

Inventory of Medicinal Plants Used Traditionally to Manage Kidney Diseases in North-Eastern Morocco: Ethnobotanical Fieldwork and Pharmacological Evidence

Kidney disease is one of the most common health problems and kidney failure can be fatal. It is one of the health disorders associated with extreme pain and discomfort in patients. In developing countries, such as Morocco where socioeconomic and sanitary conditions are precarious, medicinal plants are considered the primary source of medication. In the present work an ethnobotanical survey was conducted in a remote area of North-Eastern Morocco and we focused on (1) establishing a record of medicinal plants used traditionally by local people to treat kidney diseases and (2) correlate the obtained ethnomedical use with well-studied pharmacological evidence. From February 2018 to January2020, information was gathered from 488 informants using semi-structured questionnaires. The data were analyzed using three quantitative indices: The use value (UV), family use value (FUV), and informant consensus factor (ICF). A total of 121 plant species belonging to 57 botanical families were identified to treat kidney diseases. The families most represented were Asteraceae (14 species), followed by Lamiaceae (12 species) and Apiaceae (10 species). The most commonly used plant parts were leaves, followed by the whole plant and they were most commonly prepared by decoction and infusion. The highest value of the (UV) index was attributed to Herniaria hirsuta L. (UV = 0.16), and the highest family use value (FUV) was assigned to Caryophyllaceae with (FUV = 0.163). Regarding the informant consensus factor (ICF), this index's highest values were recorded for kidney stones (ICF = 0.72). The use of 45% of the selected plants were validated based on literature review. This study helped document and preserve crucial traditional plant knowledge of 121 plant species used to treat kidney problems that can be used in the search for new biologically active compounds through more upcoming pharmacological studies.

Opuntia ficus indica Fruits Ameliorate Cisplatin-Induced Nephrotoxicity in Mice

This study aims to determine the potential renal protective effects of Opuntia ficus-indica (L.) Miller (OFI) fruits against cisplatin-induced nephrotoxicity in mice. The antioxidant activity of OFI methanol extract was calculated by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulfonic acid (ABTS) free radical scavenging assays. Furthermore, the LC-mass spectroscopy (MS) analysis of the OFI fruit extract was carried out. Mice were treated with OFI extract (250 mg/kg) for 10 d and injected with a single dose of cisplatin (20 mg/kg) on the 7th day. The blood samples were collected to measure blood urea nitrogen (BUN) and serum creatinine level on the 10th day. Their kidneys were removed for histopathological examination. The renal morphological alterations were assessed through the mesangial matrix index and transmission electron microscopy (TEM). The OFI fruit extract showed significant in vitro antioxidant activity. In further, it was revealed that the cisplatin-induced nephrotoxicity in mice was ameliorated; this outcome was supported by both histological examination results and the depicted reduced levels of BUN and serum creatinine. The potent antioxidant compounds which were detected in the extract of OFI fruits such as myricetin, quercetin, luteolin might be responsible for the observed renoprotective effect. The results clarified that the OFI fruit extract could ameliorate cisplatin-induced renal toxicity in mice via including antioxidant and renoprotective compounds.

The Beekeeping State and Inventory of Mellifero-Medicinal Plants in the North-Central of Morocco

This study aims to determine the diversity of melliferous plants and to recognize the state of beekeeping in the Fez-Meknes region in Morocco. We conducted a questionnaire for beekeepers that set up their hives in the prefectures and provinces of the region, and we have studied the pharmacological evidence of the most preferred plants by beekeepers to assess its medicinal values. The results indicate that honey, bee pollen, bee bread, royal jelly, propolis, bee wax, bee venom, and bee queens are produced in this region with different percentages, and 102 plants belonging to 32 families were obtained in the inventory of melliferous plants; the most represented families were Asteraceae and Lamiaceae (13.73% each) followed by Rosaceae (8.82%). Among these 102 plants identified, 79 plants provide nectar and pollen for bees, 16 plants provide only pollen, 3 plants provide only nectar, 35 plants are resinous, and 6 plants provide honeydew for bees. The outcome of this study will contribute to the valuation of melliferous plants and help to establish a practical guide for the development of the beekeeping sector as an agricultural economic approach.

The effects of betalain-rich cacti (dragon fruit and cactus pear) on endothelial and vascular function: a systematic review of animal and human studies

Dragon fruit (Hylocereus) and cactus pear (Opuntia) are cacti species that have been widely used globally as a reliable source of food as well as traditional folk remedies. They have become of scientific interest recently due to their high levels of bioactive phytochemical compounds, in particular betalains. Earlier systematic reviews have explored the impact of supplementation of these cactus species on obesity, type-2 diabetes mellitus and cardiovascular risk factors: body weight and composition, serum triglycerides, cholesterol, blood glucose and blood pressure. However, effects on vascular health and endothelial function have yet to be reviewed. In order to address this gap in the literature, a systematic review has been conducted to evaluate the physiological effects of Hylocereus and Opuntia cacti on endothelial and vascular function in in vivo animal models and human studies. An electronic search was performed in the following databases: PubMed (MEDLINE), EMBASE (via Ovid), CINAHL, Scopus, Web of Science®, and The Cochrane Library (CENTRAL). All journals were searched since inceptions up to January 2020 without language restriction. Outcomes of interest were blood pressure, arterial stiffness, vascular reactivity and biochemical markers of endothelial dysfunction. Two investigators independently performed the study selection and data extraction. From 394 references, only 16 studies (9 animal and 7 human) fulfilled the eligibility criteria. Animal studies suggested a potential increase in vasodilation and serum nitric oxide and a reduction in vascular stiffness and blood pressure. The small number of human studies showed a reduction in heart rate as well as an increase in heart rate variability. Although these findings appear to indicate improvement in vascular health, there is a severe lack of robust, randomised human intervention studies to identify underlying mechanisms, optimal dose and long-term effects of cacti consumption.

Consumer perception and use of nopal (Opuntia ficus-indica): A cross-cultural study between Mexico and Brazil

The objective of the present study was, in a first moment, to observe the consumers' perception, qualitatively and quantitatively, with respect to nopal through a cross-cultural study among participants from Mexico (n = 200) and Brazil (n = 200), traditional and potential consumers, respectively. And, secondly, to use a Brazilian nopal cookie to complement the perception of the Brazilians regarding the nopal, evaluating their sensory acceptance and possible commercial potential in this country through the Check All That Apply (CATA) test. The cross-cultural study using the word association task has shown that although nopal is not part of the Brazilian food culture, people are willing to accept it as food because of its functional properties. This result, coupled with the positive acceptance of Mexican nopal cookies, confirmed the primary objective of working with products made from this unfamiliar vegetable in Brazil. In this context, the use of Brazilian nopal cladodes resulted in cookies with satisfactory sensory acceptance. This acceptance was similar to the one obtained by the Mexican commercial cookies. The affective and the CATA tests constitute a potential tool to evaluate and develop innovative products made with nopal, thus increasing their commercial potential. The results obtained provide support for a better utilization of this food, mainly in the arid and semi-arid regions, where this cactus is generally abundant, considering the social and cultural context to which the nopal is inserted in each country.