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Roshanravan B, Yousefizadeh S, Apaydin Yildirim B, Farkhondeh T, Amirabadizadeh A, Ashrafizadeh M, Talebi M, Samarghandian S. The effects of Berberis vulgaris L. and Berberis aristata L. in metabolic syndrome patients: a systematic and meta-analysis study. Arch Physiol Biochem 2023; 129:393-404. [PMID: 33040642 DOI: 10.1080/13813455.2020.1828482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION This meta-analysis study assessed the effects of Berberis vulgaris L. and Berberis aristata L. in patients with metabolic syndrome. METHODS Data were analysed through "random-effects meta-regression" performance. RESULTS The findings indicated that LDL was 0.68 and 2.92 lower in the B. vulgaris L. and B. aristata L.-treated groups versus the controls. The HDL was 0.71-fold higher in the B. aristata L.-treated group versus the controls. The total-cholesterol levels were 1.02 and 2.25 folds lower in the B. vulgaris L. and B. aristata L.-treated groups versus the matched control groups. The triglyceride levels were 1.35 and 1.16-fold lower in the B. vulgaris L. and B. aristata L.-treated groups versus the controls. Glucose was 0.96 and 0.54 folds lower in the B. vulgaris L. and B. aristata L.-treated groups versus the control groups, respectively. CONCLUSION B. vulgaris L. and B. aristata L. have beneficial effects in patients with metabolic syndrome.
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Affiliation(s)
- Babak Roshanravan
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Shahnaz Yousefizadeh
- Department of Laboratory and Clinical Sciences, Faculty of Para-Veterinary, Ilam University, Ilam, Iran
| | - Betul Apaydin Yildirim
- Department of Biochemistry, Faculty of Veterinary Medicine, Ataturk University, Erzurum, Turkey
| | - Tahereh Farkhondeh
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran
- Faculty of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
| | - Alireza Amirabadizadeh
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Marjan Talebi
- Department of Pharmacognosy and Pharmaceutical Biotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Samarghandian
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Chattopadhyay K, Wang H, Kaur J, Nalbant G, Almaqhawi A, Kundakci B, Panniyammakal J, Heinrich M, Lewis SA, Greenfield SM, Tandon N, Biswas TK, Kinra S, Leonardi-Bee J. Effectiveness and Safety of Ayurvedic Medicines in Type 2 Diabetes Mellitus Management: A Systematic Review and Meta-Analysis. Front Pharmacol 2022; 13:821810. [PMID: 35754481 PMCID: PMC9213670 DOI: 10.3389/fphar.2022.821810] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/07/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction: Many Ayurvedic medicines have the potential for managing type 2 diabetes mellitus (T2DM), with previous systematic reviews demonstrating effectiveness and safety for specific Ayurvedic medicines. However, many of the reviews need updating and none provide a comprehensive summary of all the Ayurvedic medicines evaluated for managing T2DM. Objective: The objective of this systematic review was to evaluate and synthesize evidence on the effectiveness and safety of Ayurvedic medicines for managing T2DM. Inclusion criteria: Published and unpublished RCTs assessing the effectiveness and safety of Ayurvedic medicines for managing T2DM in adults. Methods: The JBI systematic review methodology was followed. A comprehensive search of sources (including 18 electronic databases) from inception to 16 January 2021 was made. No language restrictions were applied. Data synthesis was conducted using narrative synthesis and random effects meta-analyses, where appropriate. Pooled results are reported as mean differences (MD) with 95% confidence intervals (CI). Results: Out of 32,519 records identified from the searches, 219 articles were included in the systematic review representing 199 RCTs (21,191 participants) of 98 Ayurvedic medicines. Overall, in the studies reviewed the methodology was not adequately reported, resulting in poorer methodological quality scoring. Glycated hemoglobin (HbA1c) was reduced using Aegle marmelos (L.) Corrêa (MD -1.6%; 95% CI −3 to −0.3), Boswellia serrata Roxb. (−0.5; −0.7 to −0.4), Gynostemma pentaphyllum (Thunb.) Makino (−1; −1.5 to −0.6), Momordica charantia L. (−0.3; −0.4 to −0.1), Nigella sativa L. (−0.4; −0.6 to −0.1), Plantago ovata Forssk. (−0.9; −1.4 to −0.3), Tinospora cordifolia (Willd.) Hook.f. and Thomson (−0.5; −0.6 to −0.5), Trigonella foenum-graecum L. (−0.6; −0.9 to −0.4), and Urtica dioica L. (−1.3; −2.4 to −0.2) compared to control. Similarly, fasting blood glucose (FBG) was reduced by 4–56 mg/dl for a range of Ayurvedic medicines. Very few studies assessed health-related quality of life (HRQoL). Adverse events were not reported in many studies, and if reported, these were mostly none to mild and predominately related to the gastrointestinal tract. Conclusion: The current evidence suggests the benefit of a range of Ayurvedic medicines in improving glycemic control in T2DM patients. Given the limitations of the available evidence and to strengthen the evidence base, high-quality RCTs should be conducted and reported.
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Affiliation(s)
- Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom
| | - Haiquan Wang
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jaspreet Kaur
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Gamze Nalbant
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Abdullah Almaqhawi
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia
| | - Burak Kundakci
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jeemon Panniyammakal
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Michael Heinrich
- Centre for Pharmacognosy and Phytotherapy, School of Pharmacy, University College London, London, United Kingdom
| | - Sarah Anne Lewis
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | | | - Nikhil Tandon
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India
| | - Tuhin Kanti Biswas
- Department of Kayachikitsa, J B Roy State Ayurvedic Medical College and Hospital, Kolkata, India
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom
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3
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Taheri Y, Herrera-Bravo J, Huala L, Salazar LA, Sharifi-Rad J, Akram M, Shahzad K, Melgar-Lalanne G, Baghalpour N, Tamimi K, Mahroo-Bakhtiyari J, Kregiel D, Dey A, Kumar M, Suleria HAR, Cruz-Martins N, Cho WC. Cyperus spp.: A Review on Phytochemical Composition, Biological Activity, and Health-Promoting Effects. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:4014867. [PMID: 34539969 PMCID: PMC8443348 DOI: 10.1155/2021/4014867] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/02/2021] [Indexed: 11/24/2022]
Abstract
Cyperaceae are a plant family of grass-like monocots, comprising 5600 species with a cosmopolitan distribution in temperate and tropical regions. Phytochemically, Cyperus is one of the most promising health supplementing genera of the Cyperaceae family, housing ≈950 species, with Cyperus rotundus L. being the most reported species in pharmacological studies. The traditional uses of Cyperus spp. have been reported against various diseases, viz., gastrointestinal and respiratory affections, blood disorders, menstrual irregularities, and inflammatory diseases. Cyperus spp. are known to contain a plethora of bioactive compounds such as α-cyperone, α-corymbolol, α-pinene, caryophyllene oxide, cyperotundone, germacrene D, mustakone, and zierone, which impart pharmacological properties to its extract. Therefore, Cyperus sp. extracts were preclinically studied and reported to possess antioxidant, anti-inflammatory, antimicrobial, anticancer, neuroprotective, antidepressive, antiarthritic, antiobesity, vasodilator, spasmolytic, bronchodilator, and estrogenic biofunctionalities. Nonetheless, conclusive evidence is still sparse regarding its clinical applications on human diseases. Further studies focused on toxicity data and risk assessment are needed to elucidate its safe and effective application. Moreover, detailed structure-activity studies also need time to explore the candidature of Cyperus-derived phytochemicals as upcoming drugs in pharmaceuticals.
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Affiliation(s)
- Yasaman Taheri
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jesús Herrera-Bravo
- Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomas, Chile
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile
| | - Luis Huala
- Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomas, Chile
| | - Luis A. Salazar
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Khuram Shahzad
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Guiomar Melgar-Lalanne
- Instituto de Ciencias Básicas, Universidad Veracruzana, Av. Dr. Luis Castelazo Ayala s/n. Col Industrial Ánimas, 91192 Xalapa, Veracruz, Mexico
| | - Navid Baghalpour
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Katayoun Tamimi
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Javad Mahroo-Bakhtiyari
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Dorota Kregiel
- Department of Environmental Biotechnology, Lodz University of Technology, Wolczanska 171/173, 90-924 Lodz, Poland
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, 86/1 College Street, Kolkata 700073, India
| | - Manoj Kumar
- Chemical and Biochemical Processing Division, ICAR–Central Institute for Research on Cotton Technology, Mumbai 400019, India
| | | | - Natália Cruz-Martins
- Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
- Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal
- Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Rua Central de Gandra, 1317, 4585-116, Gandra, PRD, Portugal
| | - William C. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong
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Reverse pharmacology of phytoconstituents of food and plant in the management of diabetes: Current status and perspectives. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2020.10.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Chávez-Castillo M, Nuñez V, Rojas M, Ortega Á, Durán P, Pirela D, Marquina M, Cano C, Chacín M, Velasco M, Rojas-Quintero J, Bermúdez V. Exploring Phytotherapeutic Alternatives for Obesity, Insulin Resistance and Diabetes Mellitus. Curr Pharm Des 2021; 26:4430-4443. [PMID: 32611293 DOI: 10.2174/1381612826666200701205132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/29/2020] [Indexed: 11/22/2022]
Abstract
At present, the pathologic spectrum of obesity-insulin resistance (IR)-diabetes mellitus (DM) represents not only a pressing matter in public health but also a paramount object of study in biomedical research, as they constitute major risk factors for cardiovascular disease (CVD), and other chronic non-communicable diseases (NCD). Phytotherapy, the use of medicinal herbs (MH) with treatment purposes, offers a wide array of opportunities for innovation in the management of these disorders; mainly as pharmacological research on small molecules accumulates. Several MH has displayed varied mechanisms of action relevant to the pathogenesis of obesity, IR and DM, including immunological and endocrine modulation, reduction of inflammation and oxidative stress (OS), regulation of appetite, thermogenesis and energy homeostasis, sensitisation to insulin function and potentiation of insulin release, among many others. However, the clinical correlates of these molecular phenomena remain relatively uncertain, with only a handful of MH boasting convincing clinical evidence in this regard. This review comprises an exploration of currently available preclinical and clinical research on the role of MH in the management of obesity, IR, and DM.
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Affiliation(s)
- Mervin Chávez-Castillo
- Psychiatric Hospital of Maracaibo, Maracaibo, Venezuela,Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Victoria Nuñez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Milagros Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Ángel Ortega
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Pablo Durán
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Daniela Pirela
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - María Marquina
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Clímaco Cano
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Maricarmen Chacín
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
| | - Manuel Velasco
- Clinical Pharmacology Unit, José María Vargas School of Medicine, Central University of Venezuela, Caracas-Venezuela
| | - Joselyn Rojas-Quintero
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Valmore Bermúdez
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
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6
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Suvarna R, Shenoy RP, Hadapad BS, Nayak AV. Effectiveness of polyherbal formulations for the treatment of type 2 Diabetes mellitus - A systematic review and meta-analysis. J Ayurveda Integr Med 2021; 12:213-222. [PMID: 33551339 PMCID: PMC8039362 DOI: 10.1016/j.jaim.2020.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 11/13/2020] [Accepted: 11/18/2020] [Indexed: 01/06/2023] Open
Abstract
Background The mortality and morbidity rate of diabetes patients is increasing worldwide which requires an ideal treatment to prevent the disease worsening. Traditional medicine is gaining more attention in diabetes due to its efficacy and safety. We, therefore performed a systematic review study of clinical trials to assess the comparative effect of polyherbal formulations in type 2 Diabetes mellitus. Objectives To find the effectiveness of polyherbal formulations in blood sugar and lipid level for type 2 Diabetes mellitus. Material and methods PubMed, Scopus and CINAHL databases for clinical trials investigating the effect of polyherbal formulations in Type 2 Diabetes mellitus patients were searched. Meta-analysis of eligible trials was conducted employing Revman 5.2 software. Results Fourteen randomized controlled trials were found eligible for meta-analysis. Meta-analysis of findings showed a significant effect of polyherbal formulations on blood sugar level compared to control group. The estimated standard mean changes at 95% confidence interval, following polyherbal formulations treatment were −0.59, (−0.91 to – 0.27) mg/dL; for fasting blood sugar(p < 0.001), −0.69, (−1.18 to −0.21) mg/dL; for postprandial blood sugar (p = 0.005) and −0.46, (−0.88 to −0.04) gm%; for glycated haemoglobin (p = 0.03). The reduction in postprandial sugar and glycated haemoglobin was statistically significant with polyherbal formulations compared to metformin treatment but not for fasting sugar. Similarly in lipid profile the reduction for total cholesterol and triglycerides was statistically significant with polyherbal formulations compared to control group but was not significant for HDL and LDL whereas in other group of polyherbal formulations and metformin only HDL was favouring polyherbal formulations. Conclusion Polyherbal formulations occurred to be effective in lowering blood sugar level in Type 2 diabetes but their further efficacy in managing diabetes needs to be validated. Therefore, a qualitative, long term, randomized placebo-controlled trials of adequate sample size are necessary to determine the efficacy of polyherbal formulation in managing diabetes.
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Affiliation(s)
- Renuka Suvarna
- Division of Ayurveda, Centre for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Revathi P Shenoy
- Department of Biochemistry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Basavaraj S Hadapad
- Division of Ayurveda, Centre for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
| | - Anupama V Nayak
- Division of Ayurveda, Centre for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
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Huang HZ, Qiu M, Lin JZ, Li MQ, Ma XT, Ran F, Luo CH, Wei XC, Xu RC, Tan P, Fan SH, Yang M, Han L, Zhang DK. Potential effect of tropical fruits Phyllanthus emblica L. for the prevention and management of type 2 diabetic complications: a systematic review of recent advances. Eur J Nutr 2021; 60:3525-3542. [PMID: 33439332 DOI: 10.1007/s00394-020-02471-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023]
Abstract
Phyllanthus emblica is a fruit widely consumed in subtropical areas, which is rich in polyphenols and other nutrients. There are increasing evidences that as a daily and nutritious fruit, it may have a positive role in controlling diabetic complications. According to the new study, its mechanisms include enhancing the functioning of insulin, reducing insulin resistance, activating the insulin-signaling pathway, protecting β-cells, scavenging free radicals, alleviating inflammatory reactions, and reducing the accumulation of advanced glycation end products. Owing to its few side effects, and low price, it should be easily accepted by patients and has potential for preventing diabetes. Taken together, Phyllanthus emblica may be an ideal fruit for controlling diabetic complications. This review highlights the latest findings of the role of Phyllanthus emblica in anti-diabetes and its complications, especially clarifies the molecular mechanism of the chemical components related to this effect, and prospects some existing problems and future research directions.
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Affiliation(s)
- Hao-Zhou Huang
- Pharmacy College, State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, Chengdu University of TCM, Chengdu, 611137, China
| | - Min Qiu
- Pharmacy College, State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, Chengdu University of TCM, Chengdu, 611137, China
| | - Jun-Zhi Lin
- Teaching Hospital of Chengdu University of TCM, Chengdu, 610072, China
| | - Meng-Qi Li
- Sichuan Nursing Vocational College, Chengdu, 610100, China
| | - Xi-Tao Ma
- Teaching Hospital of Chengdu University of TCM, Chengdu, 610072, China
| | - Fei Ran
- Pharmacy College, State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, Chengdu University of TCM, Chengdu, 611137, China
| | - Chuan-Hong Luo
- Pharmacy College, State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, Chengdu University of TCM, Chengdu, 611137, China
| | - Xi-Chuan Wei
- Pharmacy College, State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, Chengdu University of TCM, Chengdu, 611137, China
| | - Run-Chun Xu
- Pharmacy College, State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, Chengdu University of TCM, Chengdu, 611137, China
| | - Peng Tan
- State Key Laboratory of Biological Evaluation of Traditional Chinese Medicine Quality, National Administration of TCM, Sichuan Academy of Chinese Medicine Sciences, Chengdu, 610041, China
| | - San-Hu Fan
- Sanajon Pharmaceutical Group, Chengdu, 610000, China
| | - Ming Yang
- Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, People's Republic of China
| | - Li Han
- Pharmacy College, State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, Chengdu University of TCM, Chengdu, 611137, China.
| | - Ding-Kun Zhang
- Pharmacy College, State Key Laboratory of Characteristic Chinese Medicine Resources in Southwest China, Chengdu University of TCM, Chengdu, 611137, China.
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8
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Pingali U, Sukumaran D, Nutalapati C. Effect of an aqueous extract of Terminalia chebula on endothelial dysfunction, systemic inflammation, and lipid profile in type 2 diabetes mellitus: A randomized double-blind, placebo-controlled clinical study. Phytother Res 2020; 34:3226-3235. [PMID: 32618037 DOI: 10.1002/ptr.6771] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/02/2020] [Accepted: 05/20/2020] [Indexed: 01/10/2023]
Abstract
Endothelial dysfunction is a crucial complication in type 2 diabetic patients, related to cardiovascular risk. Terminalia chebula (TC), a traditional ayurvedic herb, is known for its antioxidant and antihyperlipidemic activity. A prospective, randomized, double-blind, placebo-controlled clinical study was undertaken to evaluate the effects of an aqueous extract of T. chebula 250 and 500 mg versus placebo on endothelial dysfunction and biomarkers of oxidative stress in type 2 diabetic patients. A total of 60 eligible patients were randomized to receive either T. chebula 250 mg, T. chebula 500 mg, or placebo twice daily for 12 weeks. The subjects were assessed based on the endothelial function, the levels of nitric oxide, malondialdehyde, glutathione, high sensitivity C-reactive protein, glycosylated hemoglobin, and lipid profile at baseline and after 12 weeks of treatment. Treatment with T. chebula 250 mg and T. chebula 500 mg for 12 weeks significantly improved the endothelial function (reflection index) compared to placebo (absolute changes: - T. chebula 250: -2.55 ± 1.82% vs. T. chebula 500: -5.21 ± 2.41% vs. placebo: 1.40 ± 2.11%). Other cardiovascular risk indicators were also significantly ameliorated in the treatment groups compared to placebo. In conclusion, T. chebula (especially, 500 mg BID dose) significantly minimized the cardiovascular risk factors in patients with type 2 diabetes compared to placebo.
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Affiliation(s)
- Usharani Pingali
- Department of Clinical Pharmacology & Therapeutics, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Deepasree Sukumaran
- Department of Clinical Pharmacology & Therapeutics, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Chandrasekhar Nutalapati
- Department of Clinical Pharmacology & Therapeutics, Nizam's Institute of Medical Sciences, Hyderabad, India
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9
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Belwal T, Bisht A, Devkota HP, Ullah H, Khan H, Pandey A, Bhatt ID, Echeverría J. Phytopharmacology and Clinical Updates of Berberis Species Against Diabetes and Other Metabolic Diseases. Front Pharmacol 2020; 11:41. [PMID: 32132921 PMCID: PMC7040237 DOI: 10.3389/fphar.2020.00041] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/14/2020] [Indexed: 02/05/2023] Open
Abstract
The incidences of diabetic mellitus and other metabolic diseases such as hypertension and hyperlipidemia are increasing worldwide; however, the current treatment is not able to control the rapidly increasing trend in diabetes mortality and morbidity. Studies related to the effectiveness of extracts and pure compounds obtained from plants have shown promising responses in preclinical and clinical studies related to these metabolic diseases. Plants belonging to the genus Berberis (Family: Berberidaceae) are widely distributed with nearly 550 species worldwide. Extracts and compounds obtained from Berberis species, especially Berberine alkaloid, showed effectiveness in the management of diabetes and other metabolic diseases. Various pharmacological experiments have been performed to evaluate the effects of Berberis extracts, berberine, and its natural and chemically synthesized derivatives against various cell and animal disease models with promising results. Various clinical trials conducted so far also showed preventive effects of Berberis extracts and berberine against metabolic diseases. The present review focuses on i) research updates on traditional uses, ii) phytopharmacology and clinical studies on Berberis species, and iii) active metabolites in the prevention and treatment of diabetes and other metabolic diseases with a detailed mechanism of action. Furthermore, the review critically analyzes current research gaps in the therapeutic use of Berberis species and berberine and provides future recommendations.
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Affiliation(s)
- Tarun Belwal
- Centre for Biodiversity Conservation and Management, G. B. Pant National Institute of Himalayan Environment and Sustainable Development (GBPNIHESD), Kosi-Katarmal, Almora, India
| | - Aarti Bisht
- Centre for Biodiversity Conservation and Management, G. B. Pant National Institute of Himalayan Environment and Sustainable Development (GBPNIHESD), Kosi-Katarmal, Almora, India
| | - Hari Prasad Devkota
- Department of Instrumental Analysis, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.,Program for Leading Graduate Schools, Health Life Science: Interdisciplinary and Glocal Oriented (HIGO) Program, Kumamoto University, Kumamoto, Japan
| | - Hammad Ullah
- Department of Pharmacy, Abdul Wali Khan University, Mardan, Pakistan
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University, Mardan, Pakistan
| | - Aseesh Pandey
- Centre for Biodiversity Conservation and Management, G.B. Pant National Institute of Himalayan Environment and Sustainable Development, Sikkim Regional Centre, Pangthang, Gangtok, India
| | - Indra Dutt Bhatt
- Centre for Biodiversity Conservation and Management, G. B. Pant National Institute of Himalayan Environment and Sustainable Development (GBPNIHESD), Kosi-Katarmal, Almora, India
| | - Javier Echeverría
- Department of Environmental Sciences, Faculty of Chemistry and Biology, Universidad de Santiago de Chile, Santiago, Chile
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10
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Imenshahidi M, Hosseinzadeh H. Berberine and barberry (Berberis vulgaris): A clinical review. Phytother Res 2019; 33:504-523. [DOI: 10.1002/ptr.6252] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 10/20/2018] [Accepted: 11/03/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Mohsen Imenshahidi
- Department of Pharmacodynamics and Toxicology, School of Pharmacy; Mashhad University of Medical Sciences; Mashhad Iran
- Pharmaceutical Research Center, Pharmaceutical Technology Institute; Mashhad University of Medical Sciences; Mashhad Iran
| | - Hossein Hosseinzadeh
- Department of Pharmacodynamics and Toxicology, School of Pharmacy; Mashhad University of Medical Sciences; Mashhad Iran
- Pharmaceutical Research Center, Pharmaceutical Technology Institute; Mashhad University of Medical Sciences; Mashhad Iran
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Choudhury H, Pandey M, Hua CK, Mun CS, Jing JK, Kong L, Ern LY, Ashraf NA, Kit SW, Yee TS, Pichika MR, Gorain B, Kesharwani P. An update on natural compounds in the remedy of diabetes mellitus: A systematic review. J Tradit Complement Med 2018; 8:361-376. [PMID: 29992107 PMCID: PMC6035310 DOI: 10.1016/j.jtcme.2017.08.012] [Citation(s) in RCA: 187] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 12/21/2022] Open
Abstract
Herbal medicine, phytomedicine or botanical medicine are synonymous, utilizes plants intended for medicinal purposes. Medicinal use of herbal medicine in the treatment and prevention of diseases including diabetes has a long history compared to conventional medicine. Diabetes is one of the major public health concerns over the world. Diabetes or hyperglycemia is considered to be one of the common public health hazard; optimal control of which is still not possible. Persistent hyperglycemia or uncontrolled diabetes has the potential to cause serious complications such as kidney disease, vision loss, cardiovascular disease, and lower-limb amputations which contributed towards morbidity and mortality in diabetes. There are various approaches to treat and prevent diabetes as well as its secondary complications, one of it is herbal medicines. However, the selection of herbs might depends on several factors, which include the stage of progression of diabetes, types of comorbidities that the patients are having, availability, affordability as well as the safety profile of the herbs. This review focuses on the herbal and natural remedies that play the role in the treatment or prevention of this morbid disorder - diabetes, including their underlying mechanisms for the blood glucose-lowering property and the herbal products already been marketed for the remedial action of diabetes.
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Affiliation(s)
- Hira Choudhury
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Manisha Pandey
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Chua Kui Hua
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Cheah Shi Mun
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Jessmie Koh Jing
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Lillian Kong
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Liang Yee Ern
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Nik Ahmad Ashraf
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Soohg Wai Kit
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Tan Sin Yee
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Mallikarjuna Rao Pichika
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
| | - Bapi Gorain
- Faculty of Pharmacy, Lincoln University College, Petalling Jaya, Kuala Lumpur, Selangor, 47301, Malaysia
| | - Prashant Kesharwani
- International Medical University, School of Pharmacy, Department of Pharmaceutical Technology, 57000, Kuala Lumpur, Malaysia
- Pharmaceutics Division, CSIR-Central Drug Research Institute, Lucknow, UP, 226031, India
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An antidiabetic polyherbal phytomedicine confers stress resistance and extends lifespan in Caenorhabditis elegans. Biogerontology 2016; 18:131-147. [PMID: 27853905 DOI: 10.1007/s10522-016-9668-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/06/2016] [Indexed: 01/15/2023]
Abstract
An Ayurvedic polyherbal extract (PHE) comprising six herbs viz. Berberis aristata, Cyperus rotundus, Cedrus deodara, Emblica officinalis, Terminalia chebula and Terminalia bellirica is mentioned as an effective anti-hyperglycemic agent in 'Charaka Samhita', the classical text of Ayurveda. Previously, antidiabetic drug metformin was found to elicit antiaging effects and PHE was also found to exhibit antidiabetic effects in humans. Therefore, we screened it for its in vivo antioxidant antiaging effect on stress and lifespan using human homologous Caenorhabditis elegans model system. The effect on aging is evaluated by studying effect of PHE on mean survival in worms. The stress modulatory potential was assessed by quantification of intracellular ROS level, autofluorescent age pigment lipofuscin, oxidative and thermal stress assays. Additionally, stress response was quantified using gene reporter assays. The 0.01 µg/ml dose of PHE was able to enhance mean lifespan by 16.09% (P < 0.0001) in C. elegans. Furthermore, PHE treated worms demonstrated oxidative stress resistance in both wild type and stress hypersensitive mev-1 mutant along with upregulation of stress response genes sod-3 and gst-4. The delayed aging under stress can be attributed to its direct reactive oxygen species-scavenging activity and regulation of some age associated genes like daf-2, daf-16, skn-1, sod-3 and gst-4 in wild-type worms. Additonally, PHE delayed age related paralysis phenotype in CL4176 transgenic worms. Altogether, our results suggest PHE significantly improves the oxidative stress and life span in C. elegans. Overall the present study suggests this polyherbal formulation might play important role in regultaing aging and related complications like diabetes.
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