Lemon balm: A promising herbal therapy for patients with borderline hyperlipidemia—A randomized double-blind placebo-controlled clinical trial

Do polyphenols affect body fat and/or glucose metabolism?

Background

Obesity is reaching epidemic proportions with 51% of the population expected to be obese by 2030. Recently, polyphenols have been highlighted as an effective approach to managing obesity and associated risks. Polyphenols are a large class of bioactive plant compounds classified into two major categories: flavonoids which are distinguished by the fundamental C6-C3-C6 skeleton and non-flavonoids.

Objective

This systematic review evaluated the effect of different polyphenol sources in overweight and obese people with and without type 2 diabetes. The primary outcome was lipid profile and the secondary outcomes were blood glucose, HbA1c (%), HOMA-IR, weight, and body mass index.

Method

A search was undertaken in PubMed, Web of Science, Medline, and Wiley for randomized control trials that assessed different sources of polyphenols in overweight and obese people with or without type 2 diabetes. The quality of the included studies was assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tool.

Result

The search yielded 935 studies, of which six randomized control trials met the inclusion criteria. Five studies found no significant difference in lipid profile between the control and intervention groups in triglycerides, total cholesterol, LDL cholesterol, and HDL cholesterol. However, one study showed significant differences in triglycerides (p = 0.04) and HDL cholesterol (p = 0.05) between the two groups with no significant difference in total cholesterol and LDL cholesterol. There were no significant changes in blood glucose observed in the included studies, with only two studies reporting a significant difference in A1c between the groups. Four studies found no difference in HOMA-IR, while one study showed a significant decrease in HOMA-IR in the intervention group compared to the control group. Three studies reported no difference in BMI or weight between the two groups.

Conclusion

The data associated with the specific health benefits of polyphenols and their sources in people with overweight, obese, and type 2 diabetes are still limited, so further research is required to support their use and prove their benefits.

Toxicological safety evaluation of an aqueous lemon balm (Melissa officinalis) extract

Melissa officinalis (lemon balm) has a long history of safe use as an aromatic herb, flavoring, tea, food supplement, and traditional medicine. An aqueous extract of the leaves of M. officinalis is intended for use as a food ingredient, however the existing safety database does not contain any high quality toxicological studies to support safe consumer exposure. Therefore, a standard tier 1 genotoxicity battery (bacterial reverse mutation and in vitro mammalian cell micronucleus tests) and a 90-day repeated dose oral toxicity study in rats were conducted in accordance with GLP and OECD guidelines. The genotoxicity studies confirmed that aqueous lemon balm extract is not genotoxic at up to the highest concentrations tested (5000 μg/plate or 5000 μg/mL). A non-GLP 14-day dose range finding study was conducted prior to the 90-day study to confirm dietary administration of aqueous lemon balm extract at concentrations of 0, 0.5, 1.6, or 5.0%. The 90-day study was conducted using the established dietary concentrations and no test substance-related adverse effects on clinical, hematological, biochemical, macroscopic, or histopathologic parameters were reported. Thus, the no-observed-adverse-effect-level was determined to be at least 3046.1 and 3720.9 mg/kg body weight/day (the highest doses tested) for male and female rats, respectively.

Effects of Melissa officinalis (lemon balm) consumption on serum lipid profile: a meta-analysis of randomized controlled trials

BACKGROUND

According to traditional medicine, Melissa officinalis L., (lemon balm) has been known to remove harmful substances from the blood and is considered a cardiac tonic. Therefore, its use as a cardiovascular remedy may explain the lipid-lowering effects of lemon balm. Dyslipidemia can be considered as a significant preventable risk factor for atherosclerosis, coronary heart disease and type 2 diabetes. The present study is the first meta-analysis to investigate the effects of M. officinalis administration on serum levels of high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglyceride (TG) and total cholesterol (TC).

METHODS

From inception to October 2023, a thorough search through literature was conducted using PubMed, Scopus, and Web of Science. The inclusion criteria of this study were randomized controlled trials, with or without blinding which provided adequate data for each group at the beginning and end of the follow-up period. Meta-analysis was performed on randomized controlled trials using Comprehensive Meta-Analysis (CMA) V4 software. Risk of bias in the selected studies was examined according to the revised Cochrane risk-of-bias tool for randomized trials. Begg's funnel plot symmetry status, Begg's rank correlation, and Egger's weighted regression tests were employed to evaluate potential publication bias.

RESULTS

The meta-analysis comprised of 5 randomized controlled trials with a total of 302 patients. The findings of the meta-analysis indicated that the consumption of lemon balm had a significant decrease in TG (SMD (95% CI): -0.396(-0.620, -0.173), p-value = 0.001), TC (SMD (95% CI): -0.416 (-0.641, -0.192), p-value < 0.001) and LDL (SMD (95% CI): -0.23(-0.45, -0.008), p < 0.05) levels compared to the placebo group. While it had no statistically significant effect on HDL level (SMD (95% CI): 0.336(-0.091, 0.767), p-value = 0.123). No significant and detectable publication bias was found in the meta-analysis. Additionally, all included clinical studies demonstrated a low risk of bias for missing outcome data and selection of the reported results. The robustness of the results was demonstrated by a sensitivity analysis using the one-study remove method.

CONCLUSIONS

The findings of this meta-analysis provide evidence that lemon balm may be administered as a safe and beneficial herbal medicine for reducing TC, TG and LDL levels. According to the pooled results of 5 studies with a total of 302 patients, lemon balm intake had no significant effect on HDL level. This study reinforces the notion that lemon balm may have a substantial impact on serum lipid profile as a potential remedy in cases of dyslipidemia. The main concern of our research is the limited number of eligible studies and the relatively small population size of each individual study. The patients of these studies had different types of diseases and metabolic syndromes. However, the meta-analysis was sufficiently powered to detect the considerable effects of lemon balm in the combined population regardless of type of diseases.

The effects of melissa officinalis on depression and anxiety in type 2 diabetes patients with depression: a randomized double-blinded placebo-controlled clinical trial

BACKGROUND

Depression is more common in diabetic patients, with a 1.5-fold increased risk of death.Melissa officinalis (M. officinalis) have anti-diabetic and anti-depression activities. The study aimed to determine the efficacy of M. officinalis extract on depression, anxiety, and sleep quality in patients with type 2 diabetes with depressive symptoms.

METHODS

In this double-blind clinical trial, 60 volunteer patients (age range 20-65 years) with type 2 diabetes mellitus with symptoms of depression were randomized into the intervention (received 700 mg/day hydroalcoholic extract; n = 30) or control group (received 700 mg/day toasted flour; n = 30). Dietary intake, physical activity, anthropometric indices, FBS (Fasting blood sugar), hs-CRP(High-sensitivity C-reactiveprotein), depression, anxiety, and sleep quality were determined at the beginning and end of the study. Depression and anxiety were assessed by Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI), respectively; sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI).

RESULTS

Sixty participants received M. officinalis extract or placebo, of which 44 patients completed the 12-week double-blind clinical trial. After 12-week the mean change of depression and anxiety scores were statistically significant between the two groups (p < 0.001 and p = 0.04, respectively), but no significant differences were observed in FBS, hs-CRP, anthropometric indices, sleep quality, and blood pressure.In the intervention group, there was a significant decrease in depression and anxiety severity(p < 0.001 and p = 0.01, respectively) at the end of the study compared to the baseline.

TRIAL REGISTRATION

All protocols in this study were followed in accordance with the Helsinki Declaration (1989 revision). Ethical approval for this study was obtained from the Iran University of Medical Sciences Ethics committee (IR.IUMS.FMD.REC 1396.9413468004; research.iums.ac.ir). The study was registered at the Iranian Registry of Clinical Trials (IRCT201709239472N16); Registration date: 09/10/2017.

The Potential of Lamiaceae Herbs for Mitigation of Overweight, Obesity, and Fatty Liver: Studies and Perspectives

Numerous plants, plant extracts, and plant-derived compounds are being explored for their beneficial effects against overweight and liver diseases. Obesity is associated with the increased prevalence of non-alcoholic fatty liver disease (NAFLD), becoming the most common liver disease in Western countries. Obesity and NAFLD are closely associated with many other metabolic alternations such as insulin resistance, diabetes mellitus, and cardiovascular diseases. Many herbs of the Lamiaceae family are widely employed as food and spices in the Mediterranean area, but also in folk medicine, and their use for the management of metabolic disorders is well documented. Hereby, we summarized the scientific results of the medicinal and nutraceutical potential of plants from the Lamiaceae family for prevention and mitigation of overweight and fatty liver. The evidence indicates that Lamiaceae plants may be a cost-effective source of nutraceuticals and/or phytochemicals to be used in the management of metabolic-related conditions such as obesity and NAFLD. PubMed, Google Scholar, Scopus, and SciFinder were accessed to collect data on traditional medicinal plants, compounds derived from plants, their reported anti-obesity mechanisms, and therapeutic targets.

Phytochemical Constituents, Biological Activities, and Health-Promoting Effects of the Melissa officinalis

Medicinal plants are being used worldwide for centuries for their beneficial properties. Some of the most popular medicinal plants belong to the Melissa genus, and different health beneficial effects have already been identified for this genus. Among these species, in particular, the Melissa officinalis L. has been reported as having many biological activities, such as antioxidant, antimicrobial, antitumour, antiviral, antiallergic, anti-inflammatory, and also flatulence inhibiting effects. The beneficial properties of the Melissa officinalis, also known as “lemon balm herb”, can be related to the bioactive compounds such as terpenoids, alcohols, rosmarinic acid, and phenolic antioxidants which are present in the plant. In this updated review, the botanical, geographical, nutritional, phytochemical, and traditional medical aspects of M. officinalis have been considered as well as in vitro and in vivo and clinically proven therapeutic properties have been reviewed with a special focus on health-promoting effects and possible perspective nutraceutical applications. To evidence the relevance of this plant in the research and completely assess the context, a literature quantitative research analysis has been performed indicating the great interest towards this plant for its beneficial properties.

In vivo antidiabetic potential of standardized Gymnocarpos decandrus Forssk. Extract

Background

Gymnocarpos decandrus (Caryophyllaceae) is a well-known wild plant used as a food for grazing animals. Recently it showed potent antidiabetic potential beside its established anti-inflammatory, analgesic and diuretic activities. G. decandrus antidiabetic potential was reported through in-vitro models and resulted in promising α-amylase, α-glucosidase and antiviral Coxsackie B4 inhibitory activities; however no in-vivo studies were conducted.

Purpose

This study aims to examine Gymnocarpos decandrus ethanol extract (GDEE) safety and to evaluate its in vivo antidiabetic potential.

Method

Adult albino rats were injected intraperitoneally with alloxan to induce diabetes mellitus and the glucose level was measured after two and four weeks against metformin as a standard drug. Additionally, GDEE characterization and standardization were carried out.

Results

GDEE LD₅₀ was up to 5.8 mg/kg and exhibited significant antidiabetic activity 77.17% comparable to the standard drug metformin. Its total phenolics, and flavonoids amounted 127.2 ± 0.23 and 85.5 ± 0.21 mg/g respectively. Vitexin was used as a marker compound for GDEE (140.70 mg/100 gm).

Conclusion

This study represents the sole in vivo scientific validation of G. decandrus recently documented in vitro antidiabetic potential.

Potential antidiabetic phytochemicals in plant roots: a review of in vivo studies

Background

Medicinal plants are used to treat various disorders, including diabetes, globally in a range of formulations. While attention has mainly been on the aerial plant parts, there are only a few review studies to date that are focused on the natural constituents present in the plant roots with health benefits. Thus, the present study was performed to review in vivo studies investigating the antidiabetic potential of the natural compounds in plant roots.

Methods

We sorted relevant data in 2001-2019 from scientific databases and search engines, including Web of Knowledge, PubMed, ScienceDirect, Medline, Reaxys, and Google Scholar. The class of phytochemicals, plant families, major compounds, active constituents, effective dosages, type of extracts, time of experiments, and type of diabetic induction were described.

Results

In our literature review, we found 104 plants with determined antidiabetic activity in their root extracts. The biosynthesis pathways and mechanism of actions of the most frequent class of compounds were also proposed. The results of this review indicated that flavonoids, phenolic compounds, alkaloids, and phytosteroids are the most abundant natural compounds in plant roots with antidiabetic activity. Phytochemicals in plant roots possess different mechanisms of action to control diabetes, including inhibition of α-amylase and α-glucosidase enzymes, oxidative stress reduction, secretion of insulin, improvement of diabetic retinopathy/nephropathy, slow the starch digestion, and contribution against hyperglycemia.

Conclusion

This review concludes that plant roots are a promising source of bioactive compounds which can be explored to develop against diabetes and diabetes-related complications.

Graphical abstract

Melissa officinalis tea favourably affects the frequency of premature ventricular beats and cardiometabolic profile among patients with premature ventricular contraction: A randomised open-label controlled trial

BACKGROUND AND AIMS

Premature ventricular contraction (PVC) as one of the most common arrhythmias could worsen the morbidity of cardiovascular events, particularly concurrent with other risk factors. Considering the probable side effects of antiarrhythmic drugs chronic use, prescribing herbal medicines for such conditions is on the rise. Melissa officinalis (MO) is widely identified as an antiarrhythmic and cardioprotective agent but there is limited evidence for its clinical use. This research, thus, aimed to investigate the effects of MO tea among patients with PVCs.

METHODS

The present 12-week randomised controlled trial enrolled 60 patients with confirmed diagnosis of moderate to low-grade PVCs. The patients in intervention group received MO teabags (containing 2-g dried leaves/250 mL in hot water) two times/day in addition to lifestyle modification recommendations, while control group only received lifestyle modification recommendations. After collecting the data, blood samples were gathered to explore serum concentrations of glucose and lipid markers. The number of premature ventricular beats and heart rates was determined by 24-hour rhythm Holter monitoring.

RESULTS

On average, the patients aged 47 years and approximately 67.8% (n = 40) were women. The ANCOVA adjusted for baseline values and confounders revealed that patients in the MO tea group had significantly lower concentrations of triglyceride (adjusted mean (AM) = 144.75 mg/dL), total cholesterol (AM = 155.35 mg/dL), and fasting blood sugar (AM = 90.85 mg/dL), compared with the controls (AM = 174.27, 171.99, 99.84 mg/dL, respectively (P-value ≤.042). However, the intervention failed to affect LDL-C and HDL-C levels significantly. Significantly reduced frequency of 24-hour premature ventricular beats in the MO tea group (AM = 2142.39) was also noted compared with the controls (AM = 3126.05); (P-value = .017). The 24-hour heartbeats showed only a significant decrease within the intervention group (P-value < .01).

CONCLUSION

Together, these results seem to support the higher cardioprotective effects of MO as a medicinal plant than lifestyle modifications alone. Nevertheless, further exploration of this hypothesis is warranted using large-scaled clinical trials.

Medicinal Plant Extracts Evaluated In Vitro and In Vivo for Antidiabetic Activities in Ethiopia: Bases for Future Clinical Trials and Related Investigations

Background

Diabetes mellitus (DM) is a metabolic disorder characterized by a persistent rise in the blood glucose level resulting from defects in cellular insulin function, secretion, or both, which affects millions of people every year. Several drawbacks have been stated with the use of marketed antidiabetic medicines such as drug resistance, adverse effects, toxicities, and even costs. Due to these several limitations, searching for novel antidiabetic medicines from medicinal plants (MPs) is becoming an active area of research. Therefore, MPs are exemplary sources of medicines with many accessible agents being obtained from them because numerous active constituents are isolated from them for direct use as pharmacological medicines or act as lead compounds. This paper was aimed to synthesize a concluding remark using in vitro and in vivo evaluations of extracts and fractions for antidiabetic potentials in Ethiopia, which can be used to direct future clinical trials and related investigations.

Method

So as to get data on the different investigations, publications related to experimental evaluations on animal diabetic models in Ethiopia were searched from databases, such as Google Scholar, Web of Science, Medline, PubMed, and Scopus using English key terms.

Results

In this paper, about 37 research findings based on data from various areas of Ethiopia published until the end of November 2020 were included. A total of 37 MP species extracts and fractions belonging to 19 families have been revealed in vitro or in vivo for potential antidiabetic activities. Crude extracts were carried out mostly by hydromethanolic whereas fractions were done mostly by chloroform. Leaves were the most commonly experimentally investigated plant part. Among the MP species experimentally studied, the most frequently used to treat DM in Ethiopia were Thymus schimperi Ronniger (Lamiaceae), Moringa stenopetala (Baker f.; Moringaceae), Ajuga remota Benth (Lamiaceae), and Datura stramonium Linn. (Solanaceae).

Conclusion

This paper gives aggregate evidences on the potential antidiabetic activities of MPs in Ethiopia. Antidiabetic MPs used in Ethiopia represent crucial input for the future development of novel antidiabetic drugs. To this end, more pharmacological and toxicological investigations need to be considered to prove the safety of constituents obtained from these MPs. Finally, we recommend upcoming research to ensure future success in the clinical study and development of novel medicines for DM treatment from these frequently evaluated MPs.

Effect of aromatherapy with Melissa essential oil on stress and hemodynamic parameters in acute coronary syndrome patients: A clinical trial in the emergency department

Stress and hemodynamic changes are among the most significant symptoms and signs that could be observed in patients with acute coronary syndrome (ACS) upon admission to the emergency department. The present study was conducted to determine the effect of the fragrance of lemon balm (Melissa Officinalis) essential oil on stress level and hemodynamic parameters in patients with ACS in the emergency department.

METHODS

In this double-blind clinical trial, 72 patients were allocated to two groups of Melissa and placebo based on stratified block random sampling. The Melissa group inhaled two drops of Melissa essential oil, whereas the placebo group inhaled two drops of sunflower oil in two aromatherapy phases for 10 min with 90-min intervals. Stress level was measured using the depression, anxiety and stress scale (DASS-21), and hemodynamic parameters were measured and recorded in six time points by a cardiac monitoring system. Data analysis was carried out using descriptive statistics and ANOVA statistical tests, Chi-square test, independent t-test, and post-hoc Tukey's test.

RESULTS

Interaction between the time and group indicated the significant decrease in the mean score of stress and heart rate in the time points 2 and 5 (5 min after every occasion of aromatherapy) (p < 0.001) and also the remarkable decrease in the mean arterial pressure (MAP) in the time point 2 in the Melissa group in comparison with the placebo group (p < 0.001). There were no significant differences between the mean changes in stress, heart rate and MAP in the two group (P > 0.05).

CONCLUSION

Aromatherapy via the inhalation of Melissa essential oil with temporary impacts on certain time points could relieve stress and regulate hemodynamic changes in patients with ACS in emergent and acute conditions.

Melissa officinalis L. as a Nutritional Strategy for Cardioprotection

This review aimed to provide a summary on the traditional uses, phytochemistry, and pharmacological activities in the cardiovascular system and cardiotoxicity of Melissa officinalis (MO), with the special emphasis on the protective mechanisms in different cardiovascular pathologies. MO is a perennial aromatic herb commonly known as lemon balm, honey balm, or bee balm, which belongs to Lamiaceae family. Active components are mainly located in the leaves or essential oil and include volatile compounds, terpenoid (monoterpenes, sesquiterpenes, triterpenes), and polyphenolic compounds [rosmarinic acid (RA), caffeic acid, protocatechuic acid, quercitrin, rhamnocitrin, luteolin]. For centuries, MO has been traditionally used as a remedy for memory, cognition, anxiety, depression, and heart palpitations. Up until now, several beneficial cardiovascular effects of MO, in the form of extracts (aqueous, alcoholic, and hydroalcoholic), essential oil, and isolated compounds, have been confirmed in preclinical animal studies, such as antiarrhythmogenic, negative chronotropic and dromotropic, hypotensive, vasorelaxant, and infarct size-reducing effects. Nonetheless, MO effects on heart palpitations are the only ones confirmed in human subjects. The main mechanisms proposed for the cardiovascular effects of this plant are antioxidant free radical-scavenging properties of MO polyphenols, amelioration of oxidative stress, anti-inflammatory effects, activation of M2 and antagonism of β1 receptors in the heart, blockage of voltage-dependent Ca²⁺ channels, stimulation of endothelial nitric oxide synthesis, prevention of fibrotic changes, etc. Additionally, the main active ingredient of MO-RA, per se, has shown substantial cardiovascular effects. Because of the vastness of encouraging data from animal studies, this plant, as well as the main ingredient RA, should be considered and investigated further as a tool for cardioprotection and adjuvant therapy in patients suffering from cardiovascular diseases.

Effects of artichoke on blood pressure: A systematic review and meta-analysis

PURPOSE

Clinical trials considering the effects of artichoke supplementation on blood pressure have yielded different and contradictory outcomes. Thus, a systematic review and meta-analysis were performed to assess effects of artichoke administration on blood pressure.

METHODS

Related studies were detected by searching the Cochrane Library, PubMed, Embase and Scopus databases up to 15 March 2020. Weighted Mean Differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analyses, and publication bias were evaluated using standard methods.

RESULTS

Pooled analysis of eight randomized controlled trials revealed that artichoke supplementation did not have an effect on systolic blood pressure (SBP), (WMD: -0.77 mmHg, 95 % CI: -2.76 to 1.22) or diastolic blood pressure (DBP) (WMD: -0.11 mmHg, 95 % CI: -1.72 to 1.50) when compared to the placebo group. However, subgroup analyses based on health status suggested that artichoke administration among hypertensive patients may significantly reduce SBP (WMD: -3.19 mmHg, 95 % CI: -3.32 to -3.06) and DBP (WMD: -2.33 mmHg, 95 % CI: -2.23 to -2.43), but no such reduction was found in NAFLD patients. Furthermore, our results indicated that artichoke supplementation for 12 weeks led to a significantly decreased DBP (WMD: -2.33 mmHg, 95 % CI: -2.43 to -2.23), but 8 weeks of intervention did not (WMD: 0.80 mmHg, 95 % CI: -1.06 to 2.66).

CONCLUSION

Artichoke supplementation may potentially lead to SBP and DBP reduction in hypertensive patients. In addition, artichoke supplementation for 12 weeks may significantly improve DBP.

Medicinal Plants in the Treatment of Peptic Ulcer Disease: A Review

Peptic Ulcer Disease (PUD) is the most common disorder of the stomach and duodenum, which is associated with Helicobacter pylori infection. PUD occurs due to an imbalance between offensive and defensive factors and Proton Pump Inhibitors (PPI), Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and antibiotics are frequently used for the treatment. Recently, medicinal plants have emerged as efficacious, safe and widely available alternative therapies for PUD. The aim of this review was to study the medicinal plants and phytochemicals, which have been used for PUD treatment to evaluate the potential role of natural compounds to develop herbal remedies for PUD. Information was obtained using a literature search of electronic databases, such as Web of Science, Google Scholar, PubMed, Sci Finder, Reaxys and Cochrane. Common and scientific names of the plants and keywords such as 'peptic ulcer', 'gastric ulcer', 'stomach ulcer' and 'duodenal ulcer' were used for search. Eventually, 279 plants from 89 families were identified and information on the plant families, part of the plant used, chemical constituents, extracts, ulcer model used and dosage were abstracted. The results indicated that most of the anti-PUD plants were from Asteraceae (7.1%) and Fabaceae (6.8%) families while flavonoids (49%), tannins (13%), saponins (10%) and alkaloids (9%) were the most common natural compounds in plants with anti-PUD activity.

Medicinal plants in the adjunctive treatment of patients with type-1 diabetes: a systematic review of randomized clinical trials

Propose

This study aims to systematically review the randomized controlled trials that address the effectiveness and safety of herbal medicine in patients with type 1 diabetes.

Methods

The Cochrane Library (latest issue); MEDLINE (until recent); EMBASE (until recent); AMED (Allied and Complementary Medicine Database) (until recent); and CINHAL (until recent) were searched electronically for the identification of trials until October 2019. Articles were initially screened based on title and abstract and then by full text by two independent authors. References of retrieved studies were hand-searched for further studies. Risk of bias was assessed according to the Cochrane handbook of systematic reviews of interventions. The results were summarized into GRADE (grading of recommendations, assessment, development and evaluation) tables. No meta-analysis was applicable as only one study was found for each intervention.

Results

Four RCTs were finally included in the systematic review with an overall moderate quality of conduct and low quality of reporting. The sample sizes were very small. The results of these RCTs show that cinnamon pills and Berberine/Silymarine compound capsules may decrease blood glucose indices from baseline, while fenugreek seeds and fig leaf decoction do not show any statistically significant effect.

Conclusions

The evidence is scarce and no recommendations can be made based on current evidence. Further trials with more rigorous methodology and stronger quality of reporting are needed to make conclusions.

Effects of Melissa officinalis (Lemon Balm) on cardio-metabolic outcomes: A systematic review and meta-analysis

Recent evidence indicates a beneficial effect of Melissa officinalis (MO) intake on several chronic diseases. However, the effects of MO intake have not yet been systematically reviewed. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of MO intake and focused on several cardiometabolic outcomes. MEDLINE, Scopus, EMBASE, Web of Science and the Cochrane Central Register of Controlled Trials were searched for MO-RCTs evaluating cardiometabolic outcomes. Random-effects meta-analyses estimated the pooled standardized mean differences (SMD) between intervention and control groups. Risk of bias was assessed with the Cochrane Collaboration's tool for assessing the risk of bias in RCTs. Seven RCTs were finally deemed eligible. MO intake was associated with a reduced total cholesterol (TC) (SMD: -0.26; 95% CI: -0.52, -0.01; I² = 13.7%; k = 6) and a reduced systolic blood pressure (SBP) (SMD: -0.56; 95% CI: -0.85, -0.27; I² = 00.0%; k = 3). MO intake was not associated with statistically significant changes in triglycerides, low-density lipoprotein, diastolic blood pressure, high sensitivity c-reactive protein levels, fasting blood sugar, HbA1c, insulin or high-density lipoprotein levels. No serious adverse events were reported. The risk of bias was high in a considerable amount of studies. Our study suggests that MO is a safe supplement with beneficial effects on TC and SBP. However, the findings of our study must be seen in the light of major limitations such as a low number of included studies and a serious risk of bias. High-quality RCTs are needed for firm conclusions concerning the effects of MO on cardiometabolic outcomes.

Effect of the consumption of natural products on some biochemical parameters of a type 2 diabetic population

PURPOSE

The use of phytotherapy is common worldwide and especially in Algeria. This practice was transmitted orally and ritually to treat chronic diseases. Safe extracts of edible plants can provide a resource of structurally diverse molecules that can effectively interfere with multifactorial diseases, such as diabetes mellitus. The objective of this work is to study the biochemical parameters of diabetic populations who consume medicinal plants.

METHODS

This study involved 100 T2D subjects, recruited over a five-month period via a questionnaire containing anthropometric information: sex, age, age of diabetes, type of diabetes, plants consumed. Recruited patients were recalled for further examination of the biochemical record (fasting glucose, glycated hemoglobin, total cholesterol, triglycerides, creatinine, ASL and ASP).

RESULTS

We found that diabetic patient associated with prescribed medical treatment uses the medicinal plants. This use is strongly predominant by women in both populations with 76% of them using herbal medicine. 58% of diabetics under herbal medicine had slightly unbalanced diabetes with HbA1c > 7. The difference between the total cholesterol, ASL and ASP parameters of the two populations was not significant. The study of correlation showed that the consumption of plant had an effect on the type of correlation between biochemical parameters of diabetic patients.

CONCLUSIONS

The consumption of medicinal plants did not affect the values of the measured biochemical parameters, while the correlation between these parameters can be modified.

The Effect of Cynara scolymus on Blood Pressure and BMI in Hypertensive Patients: A Randomized, Double-Blind, Placebo-Controlled, Clinical Trial

Background: Recent studies have suggested that artichoke (Cynara scolymus L.) may reduce certain biochemical blood factors but the efficacy of this plant on blood pressure (BP) has not yet been investigated. In this study, we determined the clinical efficacy of C. scolymuson BP and body mass index (BMI) in hypertensive patients as an adjunctive to captopril for the first time. Methods: The total phenolic content and gas chromatography-mass spectrometry metabolite profiling in leaves of C. scolymus have been evaluated. A clinical trial was subsequently carried out on 40 patients to determine the effect of C. scolymus on BP and BMI in hypertensive patients. The treatment group received capsules containing C. scolymus(500 mg twice daily) and the placebo group received starch powder for 8 weeks. Systolic blood pressure (SBP), diastolic blood pressure, and BMI were determined before and after the study. Results: A significant improvement of the BMI was seen in the C. scolymus group compared with the placebo group (p = 0.04). Conclusions: Our findings demonstrated that the consumption of C. scolymus powder as a rich source of phenolic and antioxidant compounds could potentially improve BMI and SBP in hypertensive patients. Therefore, more trials are needed to confirm or reject the antihypertensive impact of artichoke.

The effects of a Melissa officinalis L. based product on metabolic parameters in patients with type 2 diabetes mellitus: A randomized double-blinded controlled clinical trial

Background

Diabetic patients are at increased risk for coronary artery disease. Since phytotherapy has been greatly common, finding safe and effective treatments is of importance. This study aimed to evaluate the effects of a Melissa officinalis L. based product (MO) in patients with type 2 diabetes.

Methods

A randomized double-blinded controlled study was conducted with 37 dyslipidemic diabetic patients, assigned to either MO or placebo (P) groups receiving two 500 mg capsules daily for 3 months. Finally, 32 cases completed the study and were included in the analysis; MO (n=16) and P (n=16).

Results

Safe and significant effects in terms of decreasing the serum level of triglyceride (TG) in all patients after 2 months (p-value=0.02) and in patients with higher baseline serum levels of TG (TG≥200 mg/dl) after 3 months (p-value=0.04) were shown in the MO group. However, no metabolic significant changes were seen compared to the control group. Significant decrease in both systolic and diastolic blood pressure from baseline values were also found in patients with higher systolic blood pressure (SBP≥130 mmHg) (p-value=0.02) and those with higher diastolic blood pressure (DBP≥85 mmHg) (p-value=0.02) in the MO group.

Conclusion

This study showed that MO might be safe and beneficial in decreasing the serum TG level in dyslipidemic diabetic patients. Although, larger long-term studies are required.

Evaluation of in vivo antidiabetic, antidyslipidemic, and in vitro antioxidant activities of hydromethanolic root extract of Datura stramonium L. (Solanaceae)

BACKGROUND

The global morbidity and mortality rates of diabetes mellitus are persistently increasing. There is a demand for new antidiabetic drugs because the safety and efficacy of currently available medications are limited. The present study was therefore conducted to study the antidiabetic activities of the hydromethanolic root extract of Datura stramonium L. (Solanaceae) in mice.

METHODS

Blood glucose lowering activity of three doses (100, 200, and 400 mg/kg) of the hydromethanolic root extract of D. stramonium was tested on normoglycemic, oral glucose-loaded, and streptozotocin (STZ)-induced diabetic mice models. The effect of the extract on body weight and diabetic dyslipidemia was also studied on STZ-induced diabetic mice. Additionally, antioxidant activity of the plant extract was determined using 2,2-diphenyl-1-picrylhydrazine free radical scavenging assay. Data were analyzed using one way ANOVA followed by Tukey's post hoc multiple comparison test.

RESULTS

The hydromethanolic root extract did not show significant hypoglycemic activity in normoglycemic mice. The plant extract at doses of 100, 200, and 400 mg/kg significantly (P<0.05) reduced blood glucose levels of oral glucose-loaded and diabetic mice. All the three doses of the root extract significantly improved diabetic dyslipidemia and the body weight of diabetic mice. Free radical scavenging activity of the root extract was found to be comparable to ascorbic acid with an IC50 of 13.47 µg/mL.

CONCLUSION

This study demonstrated that the hydromethanolic root extract of D. stramonium possesses significant antidiabetic, antidyslipidemic, and antioxidant activities.

Efficacy of Melissa officinalis L. (lemon balm) extract on glycemic control and cardiovascular risk factors in individuals with type 2 diabetes: A randomized, double-blind, clinical trial

Melissa officinalis is a plenteous source of antioxidant flavonols and flavonoids that contain health-promoting and antidiabetic properties, so this study was undertaken to provide the first assessment of the antidiabetic properties of hydroalcoholic extract of M. officinalis in type 2 diabetic patients. We did a randomized, placebo-controlled trial which included 62 patients, receiving either M. officinalis capsules (700 mg/d; n = 31) or the placebo (n = 31) twice daily for 12 weeks. There were significant differences in serum FBS (P = 0.007), HbA_1c (P = 0.002), β-cell activity (P = 0.05), TG (P = 0.04), HDL-c (P = 0.05), hs-CRP (P = 0.001), and systolic blood pressure (P = 0.04) between the two groups at the end of the study; but total cholesterol, LDL-c, insulin, and HOMA-IR showed no significant changes between the groups. In M. officinalis group, there was a significant change in HDL-c (P = 0.009) and QUICKI (P = 0.005) compared with baseline values. No adverse effects were observed. It seems that M. officinalis is safe and effective in improvement of lipid profile, glycemic control, and reduction of inflammation.

The role of artichoke leaf tincture (Cynara scolymus) in the suppression of DNA damage and atherosclerosis in rats fed an atherogenic diet

CONTEXT

Polyphenols and flavonoids in artichoke leaf tincture (ALT) protect cells against oxidative damage.

OBJECTIVES

We examined ALT effects on deoxyribonucleic acid (DNA) damage and lipid profiles in rat plasma and gene expression in rat aorta [haemeoxygenase-1 (HO1), haemeoxygenase-2 (HO2), NADPH oxidase 4 (NOX-4), monocyte chemoattractant protein-1 (MCP-1) and nuclear factor (erythroid-derived 2)-like 2 (Nrf2)].

MATERIALS AND METHODS

Eighteen male Wistar albino rats were divided into three groups (n = 6/group): The control group (CG) was fed with standard pellet chow for 11 weeks; the AD group was fed for a similar period of time with pellet chow supplemented with 2% cholesterol, 3% sunflower oil and 1% sodium cholate. The ADA group was fed with pellet chow (for 1 week), the atherogenic diet (see above) for the following 4 weeks and then with ALT (0.1 mL/kg body weight) and atherogenic diet for 6 weeks. According to HPLC analysis, the isolated main compounds in ALT were chlorogenic acid, caffeic acid, isoquercitrin and rutin.

RESULTS

Normalized HO-1 [0.11 (0.04-0.24)] and MCP-1 [0.29 (0.21-0.47)] mRNA levels and DNA scores [12.50 (4.50-36.50)] were significantly lower in the ADA group than in the AD group [0.84 (0.35-2.51)], p = 0.021 for HO-1 [0.85 (0.61-3.45)], p = 0.047 for MCP-1 and [176.5 (66.50-221.25)], p = 0.020 for DNA scores. HO-1 mRNA was lower in the ADA group than in the CG group [0.30 (0.21-0.71), p = 0.049].

CONCLUSIONS

Supplementation with ALT limited the effects of the atherogenic diet through reduced MCP-1 expression, thereby preventing oxidative damage.

Active phytochemicals of Pueraria tuberosa for DPP-IV inhibition: in silico and experimental approach

Background

We had earlier reported that the extract of Pueraria tuberosa significantly inhibits DPP-IV enzyme, resulting in glucose tolerance response in rats. In this study, we have explored the active phytochemicals responsible for this potential. The results have been validated in both fasting and postprandial states in the plasma of normal rats and also in fasting blood and intestinal homogenates of diabetic models.

Methods

Pueraria tuberosa water extract (PTWE) was administered to normal Charles Foster rats for 35 days and to diabetic model (65 mg/kg bw) for 10 days. After treatments, oral glucose tolerance test (OGTT) and insulin was done for 90 min, and the changes in the levels of GLP-1, GIP, and DPP-IV activities were monitored in fasting and postprandial states. In the case of the diabetic model, DPP-IV activity was measured in intestinal homogenate and basal insulin in plasma. The components of PTWE were analyzed via HPLC-MS based on their chemical formula, molecular mass, and retention time. Using the molecular docking study, we have selected the top five components having strong binding energy with DPP-IV.

Results

The increase in secretion of GLP-1 and GIP was significantly higher in the postprandial state when compared to fasting condition. GLP-1 plasma concentration increased by 5.8 and 2.9 folds and GIP increased by 8.7 and 2.4 folds in PTWE and control rats, respectively. In contrast, the postprandial decrease in DPP-IV specific activities was recorded at 2.3 and 1.4 folds. The response in OGTT and insulin was also consistent with these changes. In comparison to diabetic controls, PTWE-administered rats showed decreased DPP-IV activity in the intestine, leading to enhanced basal insulin concentration. Through molecular docking, we found Puerarone and Robinin to be the most potential phytochemicals of PTWE for DPP-IV inhibition. Binding energy (kcal/mol) and dissociation constant (pM) of Robinin with DPP-IV protein were found to be 7.543 and 2,957,383.75, respectively. For Puerarone, it was 7.376 and 3,920,309, respectively.

Conclusions

Thus, this study provides the novel active components that contribute to the DPP-IV inhibitory property of PTWE.

Improved Lipid Profile Associated with Daily Consumption of Tri-Sura-Phon in Healthy Overweight Volunteers: An Open-Label, Randomized Controlled Trial

Tri-Sura-Phon (TSP), a traditional Thai polyherbal formula renowned for its rejuvenating properties, is commonly used as a blood tonic. It comprises Cinnamomum bejolghota, Cinnamomum parthenoxylon, and Aquilaria crassna. The aim of this study is to evaluate the beneficial properties of TSP tea consumption on blood glucose regulation and serum lipid profiles of healthy overweight volunteers. This open-label, randomized controlled trial was conducted in 70 healthy overweight adults. Two groups of 35 subjects took a TSP infusion or a placebo (cornstarch) twice daily for 8 weeks. The blood glucose regulation, serum lipid profiles, BMI, and liver function tests of the subjects were determined at the baseline, 4th week, and endpoint (8th week). Significant decreases in the average fasting levels of total cholesterol (p = 0.013), triglyceride (p = 0.001), and low-density lipoprotein (LDL, p = 0.017) were observed in the TSP group at the 8th week compared to those at the baseline. The average HDL level in the TSP group at the beginning of the study was 65.2 mg/dL, and it increased significantly (p = 0.005) to 72.4 mg/dL after 8 weeks of TSP intake. This study showed that the intake of TSP tea as an antioxidant-rich beverage might be safe and improve lipid profiles in overweight adults.