Exploring the efficacy of herbal medicinal products as oral therapy for inflammatory bowel disease

Curcumin for the clinical treatment of inflammatory bowel diseases: a systematic review and meta-analysis of placebo-controlled randomized clinical trials

Introduction

Inflammatory Bowel Disease (IBD), encompassing Crohn disease (CD) and ulcerative colitis (UC), presents complex challenges in management due to dysregulated immune responses and genetic predispositions. This study explored the potential of curcumin as an adjunctive therapy in IBD, assessing its efficacy and safety through a systematic review of clinical trials to enhance treatment strategies and outcomes.

Methods

To identify placebo-controlled randomized clinical trials on curcumin treatment in IBD, databases such as Medline/PubMed, Scopus, Embase, Web of Knowledge, and Google Scholar were searched till May 2024. Inclusion criteria focused on RCTs comparing curcumin with placebo in IBD patients, with data extraction and analysis conducted using established methodologies and tools for comprehensive synthesis and assessment of study findings.

Results

In this meta-analysis, 13 placebo-controlled RCTs on curcumin treatment in IBD were included after screening 362 records and conducting a full-text review. Most trials focused on UC patients and were published post-2010, utilizing oral curcumin with varying dosages and durations. The analysis showed curcumin's significant efficacy in achieving clinical remission and response in UC patients, with heterogeneity observed. Adverse events and withdrawal rates did not significantly differ between curcumin and placebo groups. In CD patients, curcumin did not show superiority over placebo for clinical and endoscopic remission.

Conclusion

The findings highlight curcumin's potential as a treatment for UC but indicate inconclusive results for CD, emphasizing the need for further research. The multifaceted mechanisms of curcumin's efficacy in IBD involve anti-inflammatory, antioxidant, microbiota modulatory, and immune-regulating properties. Further research is warranted to enhance understanding and treatment efficacy.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024567247.

Jasonia glutinosa (L.) DC.: Back in Our Pantries? A Review of Its Pharmacological Activity and Mechanisms of Action

Jasonia glutinosa (L.) DC., commonly known in Spain as "Rock Tea", is a medicinal plant native to the Iberian Peninsula, southern France, and Morocco. It has traditionally been used as a digestive, analgesic, antimicrobial, antidepressant, or for respiratory diseases. This narrative review aims to scientifically validate the ethnopharmacological uses of J. glutinosa as a medicinal plant, emphasizing the relationship between its traditional applications, pharmacological activities, and mechanisms of action based on experimental evidence. A comprehensive search was conducted in various electronic databases to gather information on its traditional uses, phytochemical composition, and in vitro, ex vivo, and in vivo studies related to pharmacological properties. The literature review uncovered significant findings regarding the pharmacological and molecular mechanisms of this medicinal plant in various experimental models, particularly highlighting its spasmolytic, anti-inflammatory, and antioxidant properties.

Potential Chondroprotective Effect of Artemisia annua L. Water Extract on SW1353 Cell

Inflammation plays a critical role in the pathogenesis of osteoarthritis (OA). The objective of this study was to investigate the anti-inflammatory and chondroprotective properties of Artemisia annua L. water extract (AWE) following the induction of inflammation in cartilage cells (SW1353 cell) through the administration of interleukin-1 beta (IL-1β). We demonstrated significant antioxidant activity, as evidenced by elevated total phenolic and flavonoid content, in addition to robust free radical scavenging capacity, as assessed through DPPH (2,2-diphenyl-1-picrylhydrazyl) and ABTS (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) assays. Its cytotoxic effects were assessed at a concentration of 200 μg/mL, where no cytotoxic signs were observed in SW1353 cells treated with IL-1β; the levels of reactive oxygen species (ROS) were notably reduced in a dose-dependent manner. The principal inflammatory markers, cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS), were significantly diminished by AWE treatment. AWE administration led to a dose-dependent reduction in the expression of key proteins involved in the mitogen-activated protein kinase (MAPK) and nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB) signaling pathways, ultimately resulting in a decrease in the release of matrix metalloproteinases (MMPs), specifically MMP-1 and MMP-13, which are known to contribute to cartilage degradation. Additionally, the levels of degraded collagen type II in the cartilage cells were restored. These findings suggest that reducing oxidative stress and inflammation, along with inhibiting activated MAPK and NF-κB signaling pathways, may ameliorate the progression of IL-1β-induced OA. Furthermore, a molecular docking analysis revealed a strong binding affinity of MMP-13, a critical mediator in the pathogenesis of OA. Six compounds were identified in AWE, corroborating its potential antioxidant and anti-inflammatory effects. Therefore, AWE may serve as a potentially useful therapeutic agent against OA by modulating inflammation-related mechanisms.

An Overview of the Current Scientific Evidence on the Biological Properties of Abelmoschus esculentus (L.) Moench (Okra)

Abelmoschus esculentus (L.) Moench, commonly known as okra or lady's finger, is an annual flowering plant belonging to the Malvaceae family. Okra is a native plant in Africa as well as a traditional medicine in Africa and India for treating different diseases and conditions. Today, okra is widely consumed as a vegetable and is increasingly recognized as a superfood due to its rich nutritional profile and potential pharmacological benefits. Research indicates that okra exhibits a range of biological activities, including antidiabetic, antihyperlipidemic, antifatigue, vasoprotective, hepatoprotective, antitumor, anti-inflammatory, and antimicrobial effects. Despite its promising therapeutic potential, research on the active compounds in okra and evaluating efficacy in clinical settings remains limited. This review aims to consolidate existing scientific knowledge on the biological and pharmacological properties of okra, thereby encouraging further investigation into its health benefits. Ultimately, this could pave the way for the development of functional foods or health supplements that leverage okra as a key ingredient to prevent chronic diseases and enhance overall health outcomes.

Inhibition of intestinal inflammation and fibrosis by Scutellaria Baicalensis georgi and Boswellia serrata in human epithelial cells and fibroblasts

OBJECTIVE AND RATIONALE

Inflammatory bowel disease, including Crohn's disease and ulcerative colitis, manifests with chronic intestinal inflammation and frequent sequential fibrosis. Current pharmacological therapies may show harmful side effects and are not useful for prevention or resolution of fibrosis. Thus, the use of alternative therapies is emerging as a novel useful approach. Previous results suggest that Scutellaria baicalensis Georgi (SBG) and Boswellia serrata (BS) display anti-inflammatory properties. The aim of this study was to investigate in intestinal epithelial cells and fibroblasts the anti-inflammatory and anti-fibrotic potential of SBG and BS, alone or in combination.

METHODS

Human colorectal adenocarcinoma cells (HT29), human intestinal epithelial cells (HIEC6) and human colon fibroblasts (CCD-18Co) were used. Cells were pretreated with SBG and BS and then exposed to pro-inflammatory and pro-fibrotic cytokines.

RESULTS

SBG and BS extracts significantly decreased pro-inflammatory cytokine expression and improved epithelial restitution in HT29 and HIEC6 cells. Besides, fibrotic marker expression, including SNAIL, ACTA2, ZNF281, was strongly reduced. Colon myofibroblasts treated with SBG and BS showed a significant decrease of fibrotic markers as well.

CONCLUSIONS

SBG and BS extracts significantly reduce inflammation and impair fibrosis in intestinal epithelial cells and colon myofibroblasts. No cooperative effect is observed.

Aloe vera-An Extensive Review Focused on Recent Studies

Since ancient times, Aloe vera L. (AV) has attracted scientific interest because of its multiple cosmetic and medicinal properties, attributable to compounds present in leaves and other parts of the plant. The collected literature data show that AV and its products have a beneficial influence on human health, both by topical and oral use, as juice or an extract. Several scientific studies demonstrated the numerous biological activities of AV, including, for instance, antiviral, antimicrobial, antitumor, and antifungal. Moreover, its important antidepressant activity in relation to several diseases, including skin disorders (psoriasis, acne, and so on) and prediabetes, is a growing field of research. This comprehensive review intends to present the most significant and recent studies regarding the plethora of AV's biological activities and an in-depth analysis exploring the component/s responsible for them. Moreover, its morphology and chemical composition are described, along with some studies regarding the single components of AV available in commerce. Finally, valorization studies and a discussion about the metabolism and toxicological aspects of this "Wonder Plant" are reported.

Orally ingestible medication utilizing layered double hydroxide nanoparticles strengthened alginate and hyaluronic acid-based hydrogel bead for bowel disease management

In the treatment of bowel diseases such as ulcerative colitis through oral administration, an effective drug delivery system targeting the colon is crucial for enhancing efficacy and minimizing side effects of therapeutic agents. This study focuses on the development of a novel nanocomposite hydrogel bead comprising a synergistic blend of biological macromolecules, namely sodium alginate (ALG) and hyaluronic acid (HA), reinforced with layered double hydroxide nanoparticles (LDHs) for the oral delivery of dual therapeutics. The synthesized hydrogel bead exhibits significantly enhanced gel strength and controllable release of methylprednisolone (MP) and curcumin (CUR), serving as an anti-inflammatory drug and a mucosal healing agent, compared to native ALG or ALG/HA hydrogel beads without LDHs. The physicochemical properties of the synthesized LDHs and hydrogel beads were characterized using various techniques, including scanning electron microscopy, zeta potential measurement, transmission electron microscopy, X-ray diffraction, and energy-dispersive X-ray spectroscopy. In vitro release studies of MP and CUR under simulated gastrointestinal tract (GIT) conditions demonstrate the superior controlled release property of the nanocomposite hydrogel bead, particularly in minimizing premature drug release in the upper GIT environment while sustaining release of over 82 % of drugs in the colonic environment. Thus, the modularly engineered carrier designed for oral colon targeting holds promise as a potential candidate for the treatment of ulcerative colitis.

Polyphenolic Characterization and Anti-Inflammatory Effect of In Vitro Digested Extracts of Echinacea purpurea L. Plant Parts in an Inflammatory Model of Human Colon Cells

Echinacea purpurea L. (EP) preparations are globally popular herbal supplements known for their medicinal benefits, including anti-inflammatory activities, partly related to their phenolic composition. However, regarding their use for the management of inflammation-related intestinal diseases, the knowledge about the fate of orally ingested constituents throughout the human gastrointestinal tract and the exposition of in vitro digested extracts in relevant inflammatory models are unknown. This study investigated for the first time the impact of in vitro gastrointestinal digestion (INFOGEST) on the phenolic composition and anti-inflammatory properties of EP extracts from flowers (EF), leaves (EL), and roots (ER) on IL-1β-treated human colon-derived CCD-18Co cells. Among the seven hydroxycinnamic acids identified using HPLC-UV-MS/MS, chicoric and caftaric acids showed the highest concentrations in EL, followed by EF and ER, and all extracts exerted significant reductions in IL-6, IL-8, and PGE2 levels. After digestion, despite reducing the bioaccessibility of their phenolics, the anti-inflammatory effects were preserved for digested EL and, to a lesser extent, for EF, but not for digested ER. The lower phenolic content in digested EF and ER could explain these findings. Overall, this study emphasizes the potential of EP in alleviating intestinal inflammatory conditions and related disorders.