A systematic review of the efficacy and safety of Rosa damascena Mill. with an overview on its phytopharmacological properties

Deciphering the antidepressant effects of Rosa damascena essential oil mediated through the serotonergic synapse signaling pathway

ETHNOPHARMACOLOGICAL RELEVANCE

Rosa damascena is an ancient plant with significance in both medicine and perfumery that have a variety of therapeutic properties, including antidepressant, anti-anxiety, and anti-stress effects. Rose damascena essential oil (REO) has been used to treat depression, anxiety and other neurological related disorders in Iranian traditional medicine. However, its precise mechanism of action remains elusive.

AIM OF THE STUDY

The aim of this study was to investigate the impact and mechanism underlying the influence of REO on chronic unpredictable mild stress (CUMS) rats.

MATERIALS AND METHODS

Gas chromatography-mass spectrometry (GC-MS) technique coupling was used to analyze of the components of REO. A CUMS rat model was replicated to assess the antidepressant effects of varying doses of REO. This assessment encompassed behavioral evaluations, biochemical index measurements, and hematoxylin-eosin staining. For a comprehensive analysis of hippocampal tissues, we employed transcriptomics and incorporated weighting coefficients by means of network pharmacology. These measures allowed us to explore differentially expressed genes and biofunctional pathways affected by REO in the context of depression treatment. Furthermore, GC-MS metabolomics was employed to assess metabolic profiles, while a joint analysis in Metscape facilitated the construction of a network elucidating the links between differentially expressed genes and metabolites, thereby elucidating potential relationships and clarifying key pathways regulated by REO. Finally, the expression of relevant proteins in the key pathways was determined through immunohistochemistry and Western blot analysis. Molecular docking was utilized to investigate the interactions between active components and key targets, thereby validating the experimental results.

RESULTS

REO alleviated depressive-like behavior, significantly elevated levels of the neurotransmitter 5-hydroxytryptamine (5-HT), and reduced hippocampal neuronal damage in CUMS rats. This therapeutic effect may be associated with the modulation of the serotonergic synapse signaling pathway. Furthermore, REO rectified metabolic disturbances, primarily through the regulation of amino acid metabolic pathways. Joint analysis revealed five differentially expressed genes (EEF1A1, LOC729197, ATP8A2, NDST4, and GAD2), suggesting their potential in alleviating depressive symptoms by modulating the serotonergic synapse signaling pathway and tryptophan metabolism. REO also modulated the 5-HT2A-mediated extracellular regulated protein kinases-cAMP-response element binding protein-brain-derived neurotrophic factor (ERK-CREB-BDNF) pathway. In addition, molecular docking results indicated that citronellol, geraniol and (E,E)-farnesol in REO may serve as key active ingredients responsible for its antidepressant effects.

CONCLUSIONS

This study is the first to report that REO can effectively alleviate CUMS-induced depression-like effects in rats. Additionally, the study offers a comprehensive understanding of its intricate antidepressant mechanism from a multi-omics and multi-level perspective. Our findings hold promise for the clinical application and further development of this essential oil.

Effects of a traditional herbal formula containing Melissa officinalis, Pimpinella anisum, and Rosa damascena on anxiety and depression in patients with constipation-predominant irritable bowel syndrome (IBS-C): A double-blind randomized clinical trial

INTRODUCTION

Irritable bowel syndrome (IBS) is associated with a high prevalence of anxiety and depression. This study aimed to evaluate the effects of a traditional Persian herbal formula containing Melissa officinalis, Pimpinella anisum, and Rosa damascena (MPR) on anxiety and depression in IBS patients with symptoms of constipation-predominant IBS (IBS-C).

METHODS

This double-blind randomized clinical trial was conducted in Afzalipour Hospital via block randomization method. A total of 96 IBS-C patients (based on Rome IV criteria), aged 18-60 years, were included in this study. Participants received capsules containing either 500 mg of herbal formula or placebo (cornstarch) twice a day for four weeks Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale.

RESULTS

Forty-three patients in the intervention group and 45 patients in the control group completed this study. Except for the education level, there were no significant differences in the demographic characteristics between the two groups (P > 0.05). The mean levels of anxiety and depression, and total IBS symptom severity score showed no significant differences between the two groups at baseline (P > 0.05). After four weeks of treatment, the anxiety score considerably improvement in the treatment group (Cohen's d = -1.19, 95 % confidence intervals [CIs] -4.49 to 2.13), as did the depression score (Cohen's d = -1.93, 95 % CIs -4.32 to 2.79).

CONCLUSION

MPR considerably improved anxiety and depression in patients with IBS-C compared to the placebo without serious side effects.

Effect of aromatherapy with rose essential oil on the nausea and vomiting in chemotherapy patients: a randomized controlled trial

Background

The present study aims to determine the effect of aromatherapy with rose essential oil on the rate of nausea and vomiting in chemotherapy patients.

Materials and methods

This randomized controlled trial included 66 cancer patients who were randomly divided: the rose essential oil aromatherapy group (n=33) and the control group (n=33). The sampling period ranged from November 2022 to March 2023. The state of nausea and vomiting was assessed using the Visual Analog Scale.

Results

The average scores of nausea and vomiting of both the second and third cycle in three time periods after chemotherapy (first, second, and third six hours) were significantly lower in the intervention group than the control group (P<0.001). Also, in the second cycle of chemotherapy, unlike the third cycle of chemotherapy, there was a significant interaction between group and time (ηp2=0.100, P=0.001, F (84.70, 1.37) = 6.91). In other words, the amount of difference between the mean scores of nausea and vomiting of the two control and intervention groups depended on the variable levels of time and vice versa.

Conclusion

The results indicate the reducing effect of aromatherapy with rose essential oil on the severity of nausea and vomiting after chemotherapy in cancer patients. Therefore, it is recommended to be used in chemotherapy to reduce the severity of nausea and vomiting according to the patient's condition.

Taif Rose Oil Ameliorates UVB-Induced Oxidative Damage and Skin Photoaging in Rats via Modulation of MAPK and MMP Signaling Pathways

Short-wave UVB (ultraviolet B) causes rapid oxidative damage to the skin. Rose water is obtained mainly from the petals of Rosa damascena Mill. (Rosaceae) and used traditionally to hydrate dry skin and reduce signs of aging. This work aimed at evaluating the possible protective potential of the prepared eco-friendly Taif rose oil nanoemulsion (ROSE-NANO) against UVB-induced photoaging in adult male Wistar rats. Taif rose oil (ROSE) was obtained from R. damascene by classical steam distillation and formulated in emulgel (100 mg/g). In addition, the oil was formulated in ROSE-NANO-loaded emulgel (50 and 100 mg/g) to enhance the effect of ROSE. All prepared formulas were tested topically for their potential protective effect in UV-induced skin photoaging. The obtained results demonstrated that application of ROSE-NANO-loaded emulgel resulted in superior antiaging potency over ROSE emulgel based on histological studies as well as biochemical evaluations via amendment in CAT and SOD activities, decreasing the concentration of the inflammatory markers and preventing collagen fragmentation through reduction of MMP-9 content in fibroblasts. Moreover, a significant decrease in mRNA expression of NF-KB, JNK, ERK1/2, and p38 MAPK genes was observed. In conclusion, the current study provides scientific evidence for the traditional use of rose oil in skin aging. Moreover, the NANO formula showed promising efficacy as a skin photoprotector against UV-induced oxidative damage and skin aging.

Comparative In Vitro and In Silico Enzyme Inhibitory Screening of Rosa x damascena and Pelargonium graveolens Essential Oils and Geraniol

The present work aims to evaluate Rosa x damascena Herrm. and Pelargonium graveolens L'Hér. essential oils, and the major constituent geraniol for their in vitro and in silico inhibitory activities against 5-lipoxygenase (5-LOX), cyclooxygenase (COX), acetyl cholinesterase (AChE), butyryl cholinesterase (BuChE), and angiotensin converting enzyme (ACE2) enzymes. Geraniol most potently inhibited the ACE2 relative to other enzymes. R. damascena essential oil moderately inhibited the cancer cell lines with no toxic effects on healthy HEK 293 cells. P. graveolens essential oil inhibited a number of cancer cell lines including A549, MCF7, PC3, and HEK 293 that are reported here for the first time. The molecular docking of geraniol with the target enzymes revealed that it binds to the active sites similar to that of known drugs. Geraniol carries the potential for further drug development due to its drug-like binding mode for the target enzymes. Our work confirms that these essential oils possess similar biological activities due to their similar phytochemistry in terms of the major constituents of the plants. The promising biological activities reported in this work further warrant the inclusion of in vivo studies to establish safe use of the target essential oils and their constituents.

The Effect of Precolonoscopy Lavender Inhalation on Patient Anxiety and Comfort: A Randomized, Controlled, Double-Blinded, Single-Center Study

The purpose of this study was to determine the effect of lavender oil inhalation on the anxiety and comfort levels of patients scheduled for colonoscopy. Seventy-three experimental group patients scheduled for colonoscopy at a training and research hospital in the west of Turkey in June to September 2022 and 72 control group patients were included in this randomized, controlled, prospective study. Minimal sedation (propofol 2-3 mg/kg) was applied in both groups. Lavender inhalation was applied to the experimental group, whereas the control group patients received nursing care (vital sign monitoring, prevention of complications, and rest). The State-Trait Anxiety Inventory and the Shortened General Comfort Questionnaire were used for pre- and postprocedural data collection. Median ages were 53.00 years (47.25-59.00) in the experimental group patients and 51.00 (44.00-59.5) in the control group. Although postprocedural state anxiety scores were lower in the experimental group compared with the control group, the difference was not statistically significant ( p = .069). The general postcolonoscopy comfort score was significantly higher in the experimental group compared with the control group ( p < .001). Trait anxiety scores also increased as the number of colonoscopies increased in both groups. We conclude that lavender oil inhalation, a simple and inexpensive intervention, increases patient comfort while exhibiting a positive, albeit statistically insignificant, effect on anxiety.

Characterization of volatiles in flowers from four Rosa chinensis cultivars by HS-SPME-GC × GC-QTOFMS

Rosa chinensis cultivars with volatile aromas are important resources in the perfume industry. The four rose cultivars introduced to Guizhou province are rich in volatile substances. In this study, volatiles from four Rosa chinensis cultivars were extracted using headspace-solid phase microextraction (HS-SPME), and analyzed with two-dimensional gas chromatography quadrupole time of flight mass spectrometry (GC × GC-QTOFMS). A total of 122 volatiles were identified; the main compounds in these samples were benzyl alcohol, phenylethyl alcohol, citronellol, beta-myrcene and limonene. A total of 68, 78, 71, and 56 volatile compounds were identified in Rosa 'Blue River' (RBR), Rosa 'Crimson Glory' (RCG), Rosa 'Pink Panther' (RPP), and Rosa 'Funkuhr' (RF) samples, respectively. The total volatile contents were in the following order: RBR > RCG > RPP > RF. Four cultivars exhibited similar volatility profiles, with alcohols, alkanes, and esters as the major chemical groups, followed by aldehydes, aromatic hydrocarbons, ketones, benzene, and other compounds. Alcohols and aldehydes were quantitatively the two most abundant chemical groups that included the highest number and highest content of compounds. Different cultivars have different aromas, and RCG had high contents of phenyl acetate, rose oxide, trans-rose oxide, phenylethyl alcohol and 1,3,5-trimethoxybenzene, characterized by floral and rose descriptors. RBR contained a high content of phenylethyl alcohol, and RF contained a high content of 3,5-dimethoxytoluene. Hierarchical cluster analysis (HCA) of all volatiles showed that the three cultivars (RCG, RPP, and RF) had similar volatile characteristics and were significantly different from RBR. Differential metabolites among cultivars were screened based on the OPLS-DA model, and there were six main enriched pathways of differential metabolites: biosynthesis of secondary metabolites, monoterpenoid biosynthesis, metabolic pathways, limonene and pinene degradation, sesquiterpenoid and triterpenoid biosynthesis, and alpha-linolenic acid metabolism. The biosynthesis of secondary metabolites is the most differential metabolic pathway.

Aqueous Rosa damascena extract: Antibacterial activity and its role of adhesion to human epithelial cells in vitro

The current study aimed to investigate the inhibitory activity of aqueous extracts of different plant parts of Rosa damascena, represented by the whole rose, petals, and calyces, against clinical isolates of Staphylococcus spp., Escherichia coli, and Klebsiella pneumoniae, and the inhibition of the bacterial cell. The isolates were obtained from the advanced microbiology laboratory for postgraduate studies in the Department of Biology, Faculty of Education for Girls. They were isolated from urinary tract infections, which were subsequently subjected to diagnosis by the Vitek-2 compact system to confirm the type of bacteria as well as their sensitivity to antibiotics. The results obtained included Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus lentus, Staphylococcus saprophyticus, E. coli, and K. pneumoniae. A test was conducted to investigate the microbiological inhibitory activity of aqueous plant extracts of the whole rose, petals, and calyces using the well diffusion method and three concentrations of each aqueous extract (25, 50, and 100 mg/ml). The results showed the inhibitory ability of all concentrations of the different extracts toward Staphylococcus spp., and E. coli and K. pneumoniae bacteria were not affected by the different concentrations of the plant extract. The concentration of (100 mg/ml) for the aqueous extract was the most efficient in inhibiting growth compared to the other concentrations. The synergistic effect of three antibiotics was examined (Amoxicillin-clavulanate 10/20 μg, Piperacillin 100 μg, Trimethoprim-sulfamethoxazole 23.75/1.25 μg) and for all concentrations of the aqueous plant extract was investigated in both E. coli and K. pneumoniae, as it found a synergistic action between some of the antibiotics and extracts towards inhibiting the growth of the two bacterial isolates Resistance to the plant extract alone. Bacterial isolates showed a significant decrease in the rate of adhesion to epithelial cells isolated from urine samples of healthy women in the presence of the aqueous extract of whole rose, petals, and calyces at their three concentrations compared with the control treatment.

Simple and complex coacervation methods for the nanoencapsulation of Rosa damascena mill L. anthocyanin in zein/potato starch: A new approach to enhance antioxidant and thermal properties

The structure and antioxidant properties of zein and potato starches as well as the stability of anthocyanins strongly depend on the pH. However, due to the stability of anthocyanins in at acidic medium, their encapsulation has been limited to low pHs. In the present work, an encapsulation of anthocyanins extracted from Rosa damascena mill L. (as a model) into zein, starch, and their binary mixtures by simple and complex coacervation methods over a wide range of pH (especially higher pHs), and different encapsulating agent doses and different initial volumes of anthocyanin were studied in order to obtain new conditions for the preservation of anthocyanins and to improve the antioxidant activities of zein and potato starches. High levels of antioxidant activity and encapsulation efficiency for zein/starch/anthocyanin nanocapsules and maximum antioxidant activity for zein/starch nanocapsules (without anthocyanin) were obtained at pHs 8 and 2, respectively. Fourier transform infrared spectroscopy, field emission scanning electron microscopy, X-ray powder diffraction, and thermal gravimetric analysis techniques were used to analyze simple and complex coacervates biopolymer interactions, morphology, and thermal stability. The size of zein nanocapsules (283-366 nm) decreased in the range of 50-175 nm after the encapsulation of anthocyanin (pH 8), which makes them suitable for drug delivery processes. The prepared nanocapsules showed a high scavenging ability.

Determination of Major, Minor and Chiral Components as Quality and Authenticity Markers of Rosa damascena Oil by GC-FID

Rose oil is traditionally produced by the water distillation of Rosa damascena and is of high economic value due to the low essential oil yield. It is therefore a common target for adulteration, which can cause harm to consumers. Current standards for authenticity control only consider the analysis of major components and overlook minor quality markers as well as the enantiomeric ratio of terpenes, which have proven useful in originality determination. The aim of this study was the development of two analytical GC-FID methods for the analysis of 21 and 29 rose oil analytes including major, minor and chiral components on a DB-wax and BGB 178 30% CD (chiral) capillary column, respectively. The total run time for both methods was within 60 min. For all target analytes, the % bias at the lower and upper calibration range varied from -7.8 to 13.2% and -13.1 to 5.2% analysed on the DB-wax column and 0.5 to 13.3% and -6.9 to 7.0% analysed on the chiral column. The chiral analysis successfully separated the enantiomers (+/-)-camphene, (+/-)-rose oxide, (+/-)-linalool, (+/-)-citronellol and (+/-)-citronellyl acetate, as well as the diastereomers of citral and β-damascenone. Both methods were applied to the analysis of 10 authentic rose oil samples and the enantiomeric/diastereomeric ratios, as well as the content of major and minor components, were determined. The identity of the analysed components in the authentic samples was further confirmed by GC-MS.

The effect of aromatherapy with rose essential oil on apparent anxiety in patients with myocardial infarction

OBJECTIVES

Acute myocardial infarction (MI) and hospitalization are one of the most stressful situations for many patients. Aromatherapy is a branch of the complementary medicine that is effective in anxiety. The present study aims to determine the effect of aromatherapy with rose essential oil (REO) on apparent anxiety in patients with acute MI.

METHODS

This randomized clinical trial was carried out on patients with acute MI admitted to the cardiac ward of Heshmatieh Hospital in Sabzevar. Eighty patients were randomly assigned to two aromas and placebo groups, who received three drops of REO or placebo by inhalation three times a day for 3 days. Before and after the intervention, patients' anxiety levels were measured by the Spielberger questionnaire. Data were analyzed by chi-square and the independent and paired and t-tests.

RESULTS

Before the intervention, the mean of apparent anxiety was not significantly different in the intervention and control groups (48.44 ± 3.81 and 51.38 ± 7.21, respectively, p=0.16) while this parameter was significant after the intervention in both experimental groups (47.27 ± 7.11 and 44.16 ± 4.63, respectively, p=0.000), with a reduction in the mean of apparent anxiety in the intervention group. Moreover, the results of paired t-test revealed that the anxiety scores decreased significantly in the test group before and after the intervention (51.38 ± 7.21 and 44.16 ± 4.63, p=0.000).

CONCLUSIONS

Considering the positive effects of REO used in this study to reduce anxiety in patients with acute MI, the use of REO is recommended as a complementary treatment to reduce anxiety in these patients.

Kaempferol: Antimicrobial Properties, Sources, Clinical, and Traditional Applications

Flavonoids are a category of plant-derived compounds which exhibit a large number of health-related effects. One of the most well-known and studied flavonoids is kaempferol, which can be found in a wide variety of herbs and plant families. Apart from their anticarcinogenic and anti-inflammatory effects, kaempferol and its associated compounds also exhibit antibacterial, antifungal, and antiprotozoal activities. The development of drugs and treatment schemes based on these compounds is becoming increasingly important in the face of emerging resistance of numerous pathogens as well as complex molecular interactions between various drug therapies. In addition, many of the kaempferol-containing plants are used in traditional systems all over the world for centuries to treat numerous conditions. Due to its variety of sources and associated compounds, some molecular mechanisms of kaempferol antimicrobial activity are well known while others are still under analysis. This paper thoroughly documents the vegetal and food sources of kaempferol as well as the most recent and significant studies regarding its antimicrobial applications.

Phytochemical, Physiochemical, Macroscopic, and Microscopic Analysis of Rosa damascena Flower Petals and Buds

Macroscopic and microscopic analysis of R. damascena buds and flower petals was used to find the main morphological and anatomical features of these types of medicinal plant material (MPM). The presence of polysaccharides, free and bound monosaccharides, tannins, flavonoids, saponins, and essential oils was confirmed by chemical and histochemical reactions. The quality indicator of R. damascena buds and flower petals was evaluated in this study; weight loss on drying gave the next result: 6.69 ± 0.20% for flower petals and 6.65 ± 0.13% for buds. The swelling index showed a high result for R. damascena flower petals and buds. R. damascena buds swelling index—5 ± 0.2 and R. damascenaflower petals swelling index—15 ± 0.6. The determination of volatile substances by GC/MS shows the presence of 18 volatile compounds in flower petals and buds, this number varies up to 17. Nonadecane, heneicosane, and octadecane are the main components in both medicinal plant materials. Both buds and flower petals contain approximately the same amount of citronellol. Phenylethyl alcohol is present in large amounts in buds but in small amounts in flower petals. R. damascena flower petals and buds are the sources of volatile compounds, phenols, and polysaccharides. The results of our investigation showed great differences and similarities between buds and flower petals of R. damascena. We have confirmed that not only buds but also flower petals could be a source of biologically active substances (BASs) such as essential oils, polysaccharides, and phenolic compounds. Flower petals could be an alternative MPM. We would also like to underline the importance of standard documentation for MPM: its macro and microscopic description, harvest time, control techniques of the qualitative composition, and the quantitative content of the main BAS. Because it will help in the production of various high-quality products that can be used in medicine, pharmacy, food, and the perfume industries.

Phenolic Composition, Antioxidant and Antibacterial Activities of Extract from Flowers of Rosa damascena from Morocco

Rosa damascena is referred to as the queen of roses due to its ornamental, flavoring, and perfuming uses, along with its recognized use in therapy. This study aimed to investigate the total phenols and flavonoids contents, the phenolic compounds, and study the antioxidant and antibacterial properties of the hydroethanolic extract from Rosa damascena flowers, collected from the Middle Atlas of Morocco (Khenifra). The total phenols and flavonoids were assessed using gallic acid and quercetin as standards, and the phenolic compounds were characterized using HPLC-PDA-ESI/MS. The antioxidant activity was evaluated by two methods, namely ferric reducing assay power and total antioxidant capacity. The broth microdilution method was employed to evaluate the antibacterial activity of extract against four bacteria (Escherichia coli, Salmonella typhimurium, Staphylococcus aureus, and Listeria monocytogenes). Up to 16 phenolic compounds belonging to tannins and flavonoids were positively identified in the Rosa damascena extract. The latter displayed high antioxidant activity and exhibited a bacteriostatic effect against Escherichia coli and a bactericidal effect against Salmonella typhimuriumn, Staphylococcus aureus, and Listeria monocytogenes. As a result, the flowers of Rosa damascena might be employed as natural agents in the pharmaceutical field.

A Systematic Review on the Effect of Nutraceuticals on Antidepressant-Induced Sexual Dysfunctions: From Basic Principles to Clinical Applications

Sexual dysfunctions are common side effects reported by patients during antidepressant treatment. When they occur, patients often discontinue psychopharmacological therapy, with a negative impact on the underlying psychiatric disease. Recently, great attention has been paid to the use of nutraceuticals in the management of psychiatric disorders, although a systematic review on their effects as a treatment option for antidepressant-induced sexual dysfunctions (AISD) is lacking. Here, we conducted a systematic search in the following databases: MEDLINE (through PubMed), EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and Web of Science. We searched eligible studies among parallel or crossover randomized controlled trials (RCTs) in adult populations. After this process, a total of 10 articles that evaluated the effect of six different nutraceuticals versus placebo were included: Maca Root, S-adenosyl-L-methionine (SAMe), Rosa Damascena, Ginkgo Biloba, Saffron, and Yohimbine. Overall, a high dose of Maca Root and the use of SAMe or Saffron may improve AISD. Additionally, the administration of Rosa Damascena seemed to be more effective in men than in women, whereas no evidence of effects emerged for Gingko Biloba and Yohimbine. Given the mixed results still available, future RCTs should consider larger samples and confounding factors, such as depressive status and individual vulnerability.

Aromas Influencing the GABAergic System

Aromas have a powerful influence in our everyday life and are known to exhibit an array of pharmacological properties, including anxiolytic, anti-stress, relaxing, and sedative effects. Numerous animal and human studies support the use of aromas and their constituents to reduce anxiety-related symptoms and/or behaviours. Although the exact mechanism of how these aromas exert their anxiolytic effects is not fully understood, the GABAergic system is thought to be primarily involved. The fragrance emitted from a number of plant essential oils has shown promise in recent studies in modulating GABAergic neurotransmission, with GABA_A receptors being the primary therapeutic target. This review will explore the anxiolytic and sedative properties of aromas found in common beverages, such as coffee, tea, and whisky as well aromas found in food, spices, volatile organic compounds, and popular botanicals and their constituents. In doing so, this review will focus on these aromas and their influence on the GABAergic system and provide greater insight into viable anxiety treatment options.

Evaluation of the Phytochemical and Pharmacological Potential of Taif’s Rose (Rosa damascena Mill var. trigintipetala) for Possible Recycling of Pruning Wastes

This study investigated the phytochemical contents of Taif’s rose pruning wastes and their potential application as phytomedicine, thereby practicing a waste-recycling perspective. In the Al-Shafa highland, four Taif rose farms of various ages were chosen for gathering the pruning wastes (leaves and stems) for phytochemical and pharmacological studies. The leaves and stems included significant amounts of carbohydrates, cardiac glycosides, alkaloids, flavonoids, and other phenolic compounds. The cardiac glycoside and flavonoid contents were higher in Taif rose stems, while the phenolic and alkaloid contents were higher in the plant leaves. Cardiovascular glycosides (2.98–5.69 mg g⁻¹), phenolics (3.14–12.41 mg GAE g⁻¹), flavonoids (5.09–9.33 mg RUE g ⁻¹), and alkaloids (3.22–10.96 mg AE g⁻¹) were among the phytoconstituents found in rose tissues. According to the HPLC analysis of the phenolic compounds, Taif’s rose contains flavonoid components such as luteolin, apigenin, quercetin, rutin, kaempferol, and chrysoeriol; phenolics such as ellagic acid, catechol, resorcinol, gallic acid, and phloroglucinol; alkaloids such as berbamine, jatrorrhizine, palmatine, reticuline, isocorydine, and boldine. Warm water extract was highly effective against Bacillus subtilis, Escherichia coli, and Proteus vulgaris, whereas methanol and cold water extracts were moderately effective against Aspergillus fumigatus and Candida albicans. The study’s findings suggested that Taif’s rose wastes could be used for varied medical purposes.

A Randomized Controlled Trial Examining the Effect of Aromatherapy Using the Damask Rose Essential Oil on Pre-operative Anxiety Levels

Background: Non-pharmacological care interventions like aromatherapy can be cost-effective and efficient ways to reduce anxiety and adverse results before surgery. Objectives: In this study, the efficacy of aromatherapy on pre-operative anxiety in patients undergoing Percutaneous Nephrolithotomy (PCNL) referring to Peymaniyeh Hospital in Jahrom-Iran was the main goal. Methods: This controlled-randomized trial was conducted on 38 patients that were randomly assigned to two groups: Control and Aromatherapy (Rosa damascena). The anxiety levels were recorded for all two groups the night before the surgery. On the day of surgery and after re-communication, patients were approached in a pre-operative holding area, and the intervention was performed. Data were collected over 11 months from June 2015 to May 2016. Results: The statistically significant difference after the intervention between the control and intervention groups indicated that Aromatherapy with Rosa damascene reduced the patient’s anxiety. Conclusions: This survey prepares evidence for the use of Damask rose as an anti-anxiety intervention. Using Damask rose as a nursing intervention helps nurses provide individualized care and helps patients control their anxiety.

Antibacterial and anti-Trichomonas Vaginalis effects of Rosa Damascena mill petal oil (a persian medicine product), aqueous and hydroalcoholic extracts

Background

Oils in traditional medicine are important products and used routinely for therapeutic purposes. Rose oil (Rosa damascene Mill), a product of Persian medicine, is advised for the treatment of Infectious diseases related to the female genitourinary tract. In the present study, R. damascena petal oil, aqueous, and hydroalcoholic extracts were evaluated for their in vitro antibacterial and anti-Trichomonas vaginalis effects.

Methods

Anti-trichomonas activity evaluation of extracts and oil were assayed by the Homocytometery method. Their antibacterial effects against Escherichia coli, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and clinically isolated Group B Streptococcus were assayed by broth microdilution in 96-well plates.

Results

The MIC of hydroalcoholic and aqueous extracts ranged from 25-50 and 25-100 mg/ml, respectively. Rose oil at all administered doses failed to show any antibacterial activity.

Conclusion

All extracts and oil concentrations showed some degree of growth inhibition activity on T. vaginalis; however, hydroalcoholic extract was more efficient.

Effect of Rosa damascena on improvement of adults' sleep quality: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Recent studies have reported inconclusive results regarding the potential effects of Rosa damascena on sleep quality. Therefore, this review aimed to summarize the findings of parallel-group and cross-over randomized controlled trials (RCTs) on the effects of aromatherapy and oral intake of Rosa damascena on adults' sleep quality.

METHODS

The electronic data sources of PubMed, Scopus, Web of Science Core Collection, Embase, CENTRAL, ProQuest, CINAHL, SID, and MagIran were searched from inception to June 30, 2021. Out of 1341 publications found in the initial search, 10 RCTs were considered eligible for this review. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. Sufficient data were statistically pooled by a random-effects model using Stata software (version 11.2); otherwise, a narrative summary was presented.

RESULTS

Based on the systematic review, the inhalation and oral intake of Rosa damascena could improve some sleep-related outcomes. The pooled analysis of seven effect sizes revealed that inhalation aromatherapy with Rosa damascena significantly improved sleep quality (standardized mean difference: 2.24; 95% confidence interval: 1.01-3.48; P < 0.001). Most RCTs had fair methodological quality, and two RCTs reported the adverse effects of treatment, including headache, nausea, vomiting, and frequent sneezing.

CONCLUSIONS

The administration of Rosa damascena seems to be a promising approach in complementary and alternative medicine for the improvement of adults' sleep quality. However, considering the fair methodological quality of most RCTs and reported adverse effects, it is required to perform further high-quality RCTs to draw an evidence-based conclusion on the use of Rosa damascena for the improvement of adults' sleep quality.

PROSPERO NO

CRD42020211778.

Rosa Damascena mill for treating adults' anxiety, depression, and stress: A systematic review and dose-response meta-analysis of randomized controlled trials

Recent studies have reported conflicting findings on the antianxiety, antidepressant, and anti-stress properties of Rosa Damascena Mill (RDM). Therefore, the present systematic review and meta-analysis were conducted on the effects of RDM for treating anxiety, depression, and stress amongst adults. The online data sources of Cochrane Central Register of Controlled Trials, PubMed, Scopus, Web of Science, Embase, ProQuest, and Scientific Information Database were searched from inception to June 30, 2021. The randomized controlled trials (RCTs), which examined the effects of RDM (in any form of administration) on adults' anxiety, depression, and stress, were included. A random-effects model was applied to pool the data, and a total of 32 publications were included. The results of the meta-analysis revealed that administration of RDM significantly reduced state anxiety (effect size [ES]: 24, standardized mean difference [SMD]: -1.74, 95% confidence interval [CI]: -2.29, -1.20; p < .001), depression (ES: 7, SMD: -0.87, 95% CI: -1.47, -0.28; p = .004), and stress (ES: 4, SMD: -1.33, 95% CI: -1.98, -0.69; p < .001). However, the treatment had no significant effect on trait anxiety (ES: 6, weighted mean difference: -0.75, 95% CI: -1.93, 0.43; p = .214). The association between the total administration dosage and/or duration of RDM and the changes in state anxiety and depression was not dose-dependent. Most RCTs had a fair methodological quality based on the Cochrane risk of bias assessment tool. Besides, the quality of evidence ranged from very low to moderate according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Hence, further high-quality RCTs are needed to draw reliable conclusions regarding the use of RDM for treating adults' anxiety, depression, and stress.

Effects of the hydroalcoholic extract of Rosa damascena on hippocampal long-term potentiation in rats fed high-fat diet

High-fat diets (HFDs) and obesity can cause serious health problems, such as neurodegenerative diseases and cognitive impairments. Consumption of HFD is associated with reduction in hippocampal synaptic plasticity. Rosa damascena (R. damascena) is traditionally used as a dietary supplement for many disorders. This study was carried out to determine the beneficial effect of hydroalcoholic extract of R. damascena on in vivo hippocampal synaptic plasticity (long-term potentiation, LTP) in the perforant pathway (PP)-dentate gyrus (DG) pathway in rats fed with an HFD. Male Wistar rats were randomly assigned to four groups: Control, R. damascena extract (1 g/kg bw daily for 30 days), HFD (for 90 days) and HFD + extract. The population spike (PS) amplitude and slope of excitatory post-synaptic potentials (EPSP) were measured in DG area in response to stimulation applied to the PP. Serum oxidative stress biomarkers [total thiol group (TTG) and superoxide dismutase (SOD)] were measured. The results showed the HFD impaired LTP induction in the PP-DG synapses. This conclusion is supported by decreased EPSP slope and PS amplitude of LTP. R. damascena supplementation in HFD animals enhanced EPSP slope and PS amplitude of LTP in the granular cell of DG. Consumption of HFD decreased TTG and SOD. R. damascena extract consumption in the HFD animals enhanced TTG and SOD. These data indicate that R. damascena dietary supplementation can ameliorate HFD-induced alteration of synaptic plasticity, probably through its significant antioxidant effects and activate signalling pathways, which are critical in controlling synaptic plasticity.

A Comparison Study on Traditional Mixtures of Herbal Teas Used in Eastern Mediterranean Area

Multipurpose herbal teas with numerous ingredients, in which flowers are the main component, are common in the traditional medicine and pharmacy of Greece and the Eastern Mediterranean countries. In this study, we combine ethnobotany and ethnopharmacology field work techniques and botany and pharmacognosy laboratory methods for the study of traditional herbal mixtures with flowers, we identify their botanical ingredients and record the local medicinal uses of these mixtures, in Greece, Lebanon, Syria, Iran and Turkey. These, and their industrial versions, are analyzed, using morphological and multivariate analysis techniques in order to determine marker species, relevant patterns of combination and local styles. The medicinal properties attributed to the different flowers are discussed in relation with their role in the mixtures. These blends are consumed for their relaxing, digestive, and anti-infective properties. These mixtures are not consumed as a treatment when one is sick but rather to avoid getting sick, as a preventive measure. The formulations can reach forty ingredients (sarantha in Greek, arbain in Arabic language of Palestine), usually entire or coarsely chopped in the more traditional formulations, leading to extreme variability of individual doses. We ask what biological signification this randomness can have. To give an answer requires new and more comprehensive pharmacological approaches. The flowers of Rosaceae, Asteraceae, Lamiaceae, Malvaceae and Fabaceae species characterize these mixtures in which other materials (roots, leaves, and fruits) and other species are present as well. Flowers of some species, particularly of Fabaceae, are exclusively used in mixtures, and their use in monospecific herbal teas is not yet recorded. We draw attention on the urgent need in exhaustively recording in Greece and the Near East, the formulation and use of traditional herbal mixtures and their numerous local variants. To consider these mixtures and the contribution of flowers (most mixtures receive the general name of tea of flowers) merits further extensive study.

Effect of rose oil on Gastroesophageal Reflux Disease in comparison with omeprazole: A double-blind controlled trial

BACKGROUND AND OBJECTIVE

Gastroesophageal reflux disease (GERD) as one of the most common ailments of gastrointestinal system diminishes quality of life and impairs physical functioning and work productivity. Proton-pump inhibitors (PPIs), such as omeprazole play a more dominant role in amelioration of GERD symptoms; nonetheless, there is a growing concern about their side effects. According to traditional Persian medicine (TPM), the use of rose oil is recommended to alleviate GERD symptoms.

MATERIALS AND METHODS

Therefore, a randomized double-blind controlled trial was performed on 70 subjects who were randomly enrolled in two groups and received either rose oil softgel or omeprazole capsule combined with the placebo. Data were collected within 3 sessions of visit using the Mayo-gastroesophageal reflux questionnaire (GERQ).

RESULTS

Although, our findings showed that reflux symptoms were decreased in both groups after receiving medicine and the decrement was significant in treatment group, before and after the intervention, this decrease was not significant between two groups.

CONCLUSION

Given that the rose oil used in this study was produced according to the Iranian method and effective ingredients of Rosa damascena were preserved in sesame oil in production process, it seems that effectiveness of this product can be due to its tonic and enlivening properties. Consumption of rose oil soft capsule alleviates cardinal GERD symptoms similar to omeprazole. It seems that rose oil can have the same effects as PPIs in treatment of GERD but with no side effects due to its different mechanisms of action.

An Evidence-Based Research on Botanical Sources for Oral Mucositis Treatment in Traditional Persian Medicine

BACKGROUND

Cancer is one of the most prevalent diseases associated with heavy complications in treatment. Mucotoxic cancer therapies such as head and neck radiotherapy and some of the chemotherapy agents may lead to oral mucositis. In addition to its economic consequences, mucositis also affects patients' quality of life. In Traditional Persian Medicine (TPM) manuscripts, several medicaments have been suggested for the treatment of mucositis.

OBJECTIVE

Considering the public welcome for herbal medicine, the current evidence-based review study is conducted to investigate the herbal remedies which have been proposed for oral mucositis in TPM.

METHODS

At first, a comprehensive survey was done on Qanon fi al-Teb, which is the most important textbook of TPM; then the scientific name of the herbs was authenticated according to the botanical textbooks. At last, data banks including Scopus, Pubmed, Web of science and Science direct were investigated for possible relevant properties of each medicinal plant in the literature.

RESULTS

In total, 30 herbs are introduced in this study. According to the registered documents, 18 herbs are reported to have antioxidant, anti-inflammatory, antimicrobial, anti-nociceptive and wound healing properties of which the therapeutic effect of only a few herbs including Glycyrrhiza glabra, Malva sylvestris, Morus nigra, Punica granatum, and Solanum nigrum were directly evaluated against oral mucositis on the literature.

CONCLUSION

Despite the lack of human studies on mucositis for the other discussed herbs, their related pharmacological properties can be considered for new natural drug discovery supported by medieval and traditional experiments.

An Evaluation of Traditional Persian Medicine for the Management of SARS-CoV-2

A new coronavirus causing severe acute respiratory syndrome (SARS-CoV-2) has emerged and with it, a global investigation of new antiviral treatments and supportive care for organ failure due to this life-threatening viral infection. Traditional Persian Medicine (TPM) is one of the most ancient medical doctrines mostly known with the manuscripts of Avicenna and Rhazes. In this paper, we first introduce a series of medicinal plants that would potentially be beneficial in treating SARS-CoV-2 infection according to TPM textbooks. Then, we review medicinal plants based on the pharmacological studies obtained from electronic databases and discuss their mechanism of action in SARS-CoV-2 infection. There are several medicinal plants in TPM with cardiotonic, kidney tonic, and pulmonary tonic activities, protecting the lung, heart, and kidney, the three main vulnerable organs in SARS-CoV-2 infection. Some medicinal plants can prevent "humor infection", a situation described in TPM which has similar features to SARS-CoV-2 infection. Pharmacological evaluations are in line with the therapeutic activities of several plants mentioned in TPM, mostly through antiviral, cytoprotective, anti-inflammatory, antioxidant, and anti-apoptotic mechanisms. Amongst the primarily-introduced medicinal plants from TPM, rhubarb, licorice, garlic, saffron, galangal, and clove are the most studied plants and represent candidates for clinical studies. The antiviral compounds isolated from these plants provide novel molecular structures to design new semisynthetic antiviral agents. Future clinical studies in healthy volunteers as well as patients suffering from pulmonary infections are necessary to confirm the safety and efficacy of these plants as complementary and integrative interventions in SARS-CoV-2 infection.

Effect of aromatherapy with Damask rose on alleviating adults' acute pain severity: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND PURPOSE

Although recent studies have investigated the analgesic activity of Damask rose using aromatherapy in different painful conditions, the results are inconclusive. Hence, this systematic review and meta-analysis aimed to clarify the effect of aromatherapy with Damask rose on adults' acute pain.

MATERIAL AND METHODS

The online databases of MEDLINE/PubMed, Scopus, ISI web of science, Embase, ProQuest, CENTRAL, CINAHL, SID, and MagIran were searched up to August 10, 2020. The aim of this study was to find randomized controlled trials on the effect of aromatherapy with Damask rose in any form of administration (inhalation, vapor diffusion, and massage) on different types of acute pain in adults. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. Moreover, the quality of the evidence was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects model was applied to pool data using Stata.

RESULTS

A total of 16 studies met the inclusion criteria, of which only one was not included in the meta-analysis. Pooled analysis revealed that aromatherapy with Damask rose reduced the pain severity significantly (WMD: -2.12; 95% CI [-2.85, -1.40]; P < 0.001). Inhalation aromatherapy (WMD: -2.39; 95% CI [-3.31, -1.48]; P < 0.001) and aromatherapy massage (WMD: -1.16; 95% CI [-1.57, -0.75]; P < 0.001) also had significant effects on pain reduction. The quality of evidence was low.

CONCLUSION

Aromatherapy with Damask rose had a favourable effect on reducing the severity of acute pain in adults. However, there is insufficient evidence for the clinical benefits of aromatherapy with Damask rose due to the low-quality evidence. Accordingly, more high quality randomized clinical trials are needed to make an evidence-based conclusion.

Evaluation of antioxidant and anti-collagenase activity of Rosa damascena L. flower petal and receptacle extract

Background: Rosa damascena L. is the most notable species of the Rosaceae family in the world, and has been used in food, cosmetics, and the pharmaceutical industry. Bioactive compounds in this flower are known to have several activities, such as antioxidant, antimicrobial, and anti-inflammatory. In this study, the antioxidant and collagenase inhibitory activities of R. damascena L. petal and receptacle extracts were evaluated.  Methods: Ethanolic extraction of R. damascena L. petals (EERP) and R. damascena L. receptacles (EERR) were obtained, and bioactive compounds (flavonoids, phenolics, alkaloids, steroids, tannins, terpenoids, and triterpenoids) were classified by phytochemical screening. Antioxidant activities were analyzed by Ferric Reducing Antioxidant Power (FRAP) assay, while anti-collagenase analysis was examined through the inhibition of collagenase. Results: Phytochemical test revealed the presence of flavonoids, phenolics, alkaloids, steroids, triterpenoids, triterpenes, and tannin. EERP showed higher FRAP activity (164.23 ± 1.34 μM Fe(II)) than EERR (12.85 ± 6.19 μM Fe(II)). EERP also had higher inhibitory activity of collagenase (IC50 = 115.48±1.78 µM/mL) compared to EERR (IC50 = 141.96±6.13 µM/mL). Conclusions: R. damascena L. petal and receptacle ethanol extracts contain several components, such as phenolics, flavonoids, alkaloids, tannins, terpenes, triterpenoids, and steroids. These extracts exhibit antioxidant activity and collagenase inhibition. R. damascena L. petal extract showed higher antioxidant activity through FRAP assay and inhibitory activity of collagenase than R. damascena L. receptacle extract.

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.

Herbal medications for anxiety, depression, pain, nausea and vomiting related to preoperative surgical patients: a systematic review and meta-analysis of randomised controlled trials

OBJECTIVE

To summarise the effects of herbal medications for the prevention of anxiety, depression, pain, and postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic, obstetrical/gynaecological or cardiovascular surgical procedures.

METHODS

Searches of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and LILACS up until January 2018 were performed to identify randomised controlled trials (RCTs). We included RCTs or quasi-RCTs evaluating any herbal medication among adults undergoing laparoscopic, obstetrical/gynaecological or cardiovascular surgeries. The primary outcomes were anxiety, depression, pain and PONV. We used the Grading of Recommendations Assessment, Development and Evaluation approach to rate overall certainty of the evidence for each outcome.

RESULTS

Eleven trials including 693 patients were eligible. Results from three RCTs suggested a statistically significant reduction in vomiting (relative risk/risk ratio (RR) 0.57; 95% CI 0.38 to 0.86) and nausea (RR 0.69; 95% CI 0.50 to 0.96) with the use of Zingiber officinale (ginger) compared with placebo in both laparoscopic and obstetrical/gynaecological surgeries. Results suggested a non-statistically significantly reduction in the need for rescue medication for pain (RR 0.52; 95% CI 0.13 to 2.13) with Rosa damascena (damask rose) and ginger compared with placebo in laparoscopic and obstetrical/gynaecological surgery. None of the included studies reported on adverse events (AEs).

CONCLUSIONS

There is very low-certainty evidence regarding the efficacy of both Zingiber officinale and Rosa damascena in reducing vomiting (200 fewer cases per 1000; 288 fewer to 205 fewer), nausea (207 fewer cases per 1000; 333 fewer to 27 fewer) and the need for rescue medication for pain (666 fewer cases per 1000; 580 fewer to 752 more) in patients undergoing either laparoscopic or obstetrical/gynaecological surgeries. Among our eligible studies, there was no reported evidence on AEs.

PROSPERO REGISTRATION NUMBER

CRD42016042838.