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Crichton M, Marshall S, Isenring E, Lohning A, McCarthy AL, Molassiotis A, Bird R, Shannon C, Koh A, McPherson I, Marx W. Effect of a Standardized Ginger Root Powder Regimen on Chemotherapy-Induced Nausea and Vomiting: A Multicenter, Double-Blind, Placebo-Controlled Randomized Trial. J Acad Nutr Diet 2024; 124:313-330.e6. [PMID: 37699474 DOI: 10.1016/j.jand.2023.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 08/02/2023] [Accepted: 09/06/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND There is substantial interest in the role of ginger as an adjuvant therapy for chemotherapy-induced nausea and vomiting (CINV). However, available evidence lacks robust methodology. OBJECTIVE To assess the effect of adjuvant ginger compared with placebo on chemotherapy-induced nausea-related quality of life (QoL) and CINV-related outcomes. DESIGN A parallel, double-blind, placebo-controlled randomized trial with 1:1 allocation was conducted. PARTICIPANTS/SETTING One hundred three chemotherapy-naïve adults scheduled to receive moderately to highly emetogenic chemotherapy at two hospitals in Australia were enrolled and analyzed. INTERVENTION Four standardized ginger capsules (totaling 84 mg/day active gingerols/shogaols), or placebo, were administered commencing the day of chemotherapy and continuing for 5 days for chemotherapy cycles 1 through 3. MAIN OUTCOME MEASURES The primary outcome was chemotherapy-induced nausea-related QoL. Secondary outcomes were vomiting- and CINV-related QoL; anticipatory, acute, and delayed nausea and vomiting; fatigue; nutritional status; depression and anxiety; health-related QoL; and adverse events. STATISTICAL ANALYSES PERFORMED Intention-to-treat analysis was performed. Mixed analysis of variance with repeated measures determined differences between groups. The null hypothesis was no difference between groups. After applying a Bonferroni multiple testing correction, evidence against the null hypothesis was considered at P= 0.003. RESULTS One hundred three participants (ginger: n = 52; placebo: n = 51) were enrolled and analyzed. There was clinically relevant evidence against the null hypothesis, favoring ginger, in change scores for nausea-related QoL (F[df] = 9.34[1,101]; P = 0.003; partial η2 = 0.09), overall CINV-related QoL (F[df] = 12.26[1,101]; P < 0.001; partial η2 = 0.11), delayed nausea severity (F[df] = 9.46[1,101]; P = 0.003; partial η2 = 0.09), and fatigue (F[df] = 10.11[1,101]; P = 0.002; partial η2 = 0.09). There was a clinically meaningful lower incidence of delayed nausea and vomiting in the ginger group at Cycle 2 (53% vs 75%; P = 0.020 and 4% vs 27%; P = 0.001, respectively) and Cycle 3 (49% vs 79%; P = 0.002 and 2% vs 23%; P = 0.001, respectively). There was a clinically meaningful lower incidence of malnutrition in the ginger group at Cycle 3 (18% vs. 41%; P = 0.032) and in change scores for Patient-Generated Subjective Global Assessment (F[df)] = 4.32[1,100]; P = 0.040; partial η2 = 0.04). Change scores between groups favored ginger for vomiting-related QoL and number of vomiting episodes; however, findings were not clinically meaningful. There was no effect of ginger on anticipatory or acute CINV, health-related QoL, anxiety, or depression. No serious adverse events were reported. CONCLUSIONS Ginger supplementation was a safe adjuvant to antiemetic medications for CINV that enhanced QoL during chemotherapy treatment. Future trials are needed to examine dose-dependent responses to verify optimal dosing regimens.
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Affiliation(s)
- Megan Crichton
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Skye Marshall
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia; Research Institute for Future Health, Gold Coast, Queensland, Australia
| | - Elizabeth Isenring
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia; Research Institute for Future Health, Gold Coast, Queensland, Australia
| | - Anna Lohning
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery, and Social Work, University of Queensland, and Mater Research Institute, Brisbane, Queensland, Australia
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong; College of Arts, Humanities and Education, Universtiy of Derby, Derby, UK
| | - Robert Bird
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Catherine Shannon
- Oncology Department, Mater Cancer Care Centre, South Brisbane, Queensland, Australia
| | - Andy Koh
- Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia; Department of Legal Medicine, Faculty of Medicine, KINDAI Univeristy, Osaka, Japan
| | - Ian McPherson
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Wolfgang Marx
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Deakin University Institute for Mental and Physical Health and Clinical Translation, Food and Mood Centre, Geelong, Victoria, Australia
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Crichton M, Marshall S, Marx W, Isenring E, Vázquez-Campos X, Dawson SL, Lohning A. Effect of Ginger Root Powder on Gastrointestinal Bacteria Composition, Gastrointestinal Symptoms, Mental Health, Fatigue, and Quality of Life: A Double-Blind Placebo-Controlled Trial. J Nutr 2023; 153:3193-3206. [PMID: 37690779 DOI: 10.1016/j.tjnut.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/02/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Despite compositional alterations in gastrointestinal microbiota being purported to underpin some of the therapeutic effects of ginger, the effect of a standardized ginger supplement on gut microbiota has not been tested in humans. OBJECTIVES To determine the effect of a standardized ginger (Zingiber officinale) root powder, compared to placebo, on gastrointestinal bacteria and associated outcomes in healthy adults. METHODS A randomized double-blind placebo-controlled trial allocated participants aged 18 to 30 y to ginger or microcrystalline cellulose (MCC) placebo. The intervention comprised 1.2 g/d of ginger (4 capsules per day totaling 84 mg/d of active gingerols/shogaols) for 14 d following a 1-wk run-in period. Primary outcomes were gastrointestinal community composition, alpha and beta diversity, and differential abundance, measured using 16S rRNA gene sequencing of fecal samples. Secondary outcomes were gastrointestinal symptoms, bowel function, depression, anxiety, stress, fatigue, quality of life, and adverse events. RESULTS Fifty-one participants were enrolled and analyzed (71% female; mean age 25 ± 3 y; ginger: n = 29, placebo: n = 22). There was a greater increase in relative abundance of phylum, Actinobacteria, observed following ginger supplementation compared to placebo (U: 145.0; z: -2.1; P = 0.033). Ginger was associated with a greater abundance of the genera Parabacteroides, Bacillus, Ruminococcaceae incertae sedis, unclassified Bacilli, families Defluviitaleaceae, Morganellaceae, and Bacillaceae as well as lower abundance of the genus Blautia and family Sphingomonadaceae (P < 0.05). An improvement in indigestion symptoms was observed with ginger supplementation (U: 196.0; z: -2.4; P = 0.015). No differences between ginger and placebo groups were found for alpha and beta diversity or other secondary outcomes. No moderate or severe adverse events were reported. CONCLUSIONS Supplementation with ginger root powder was safe and altered aspects of gastrointestinal bacteria composition; however, it did not change alpha- or beta diversity, bowel function, gastrointestinal symptoms, mood, or quality of life in healthy adults. These results provide further understanding regarding the mechanisms of action of ginger supplementation. This trial was registered in the Australia New Zealand Clinical Trials Registry as ACTRN12620000302954p and the Therapeutic Goods Administration as CT-2020-CTN-00380-1.
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Affiliation(s)
- Megan Crichton
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Faculty of Health, Kelvin Grove, Queensland, Australia.
| | - Skye Marshall
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Research Institute for Future Health, Gold Coast, Queensland, Australia
| | - Wolfgang Marx
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Deakin University, Food & Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Elizabeth Isenring
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Xabier Vázquez-Campos
- NSW Systems Biology Initiative, School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Kensington, New South Wales, Australia
| | - Samantha L Dawson
- Deakin University, Food & Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Anna Lohning
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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Crichton M, Marshall S, Marx W, Isenring E, Lohning A. Therapeutic health effects of ginger (Zingiber officinale): updated narrative review exploring the mechanisms of action. Nutr Rev 2023; 81:1213-1224. [PMID: 36688554 DOI: 10.1093/nutrit/nuac115] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Ginger (Zingiber officinale) has been investigated for its potentially therapeutic effect on a range of chronic conditions and symptoms in humans. However, a simplified and easily understandable examination of the mechanisms behind these effects is lacking and, in turn, hinders interpretation and translation to practice, and contributes to overall clinical heterogeneity confounding the results. Therefore, drawing on data from nonhuman trials, the objective for this narrative review was to comprehensively describe the current knowledge on the proposed mechanisms of action of ginger on conferring therapeutic health effects in humans. Mechanistic studies support the findings from human clinical trials that ginger may assist in improving symptoms and biomarkers of pain, metabolic chronic disease, and gastrointestinal conditions. Bioactive ginger compounds reduce inflammation, which contributes to pain; promote vasodilation, which lowers blood pressure; obstruct cholesterol production, which regulates blood lipid profile; translocate glucose transporter type 4 molecules to plasma membranes to assist in glycemic control; stimulate fatty acid breakdown to aid weight management; and inhibit serotonin, muscarinic, and histaminergic receptor activation to reduce nausea and vomiting. Additional human trials are required to confirm the antimicrobial, neuroprotective, antineoplastic, and liver- and kidney-protecting effects of ginger. Interpretation of the mechanisms of action will help clinicians and researchers better understand how and for whom ginger may render therapeutic effects and highlight priority areas for future research.
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Affiliation(s)
- Megan Crichton
- Faculty of Health Science & Medicine, Bond University Nutrition and Dietetics Research Group, Bond University, Robina, Queensland, Australia
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Faculty of Health, Kelvin Grove, Queensland, Australia
| | - Skye Marshall
- Faculty of Health Science & Medicine, Bond University Nutrition and Dietetics Research Group, Bond University, Robina, Queensland, Australia
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
| | - Wolfgang Marx
- Faculty of Health Science & Medicine, Bond University Nutrition and Dietetics Research Group, Bond University, Robina, Queensland, Australia
- Impact (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, Deakin University, Geelong, Australia
| | - Elizabeth Isenring
- Faculty of Health Science & Medicine, Bond University Nutrition and Dietetics Research Group, Bond University, Robina, Queensland, Australia
| | - Anna Lohning
- Faculty of Health Science & Medicine, Bond University Nutrition and Dietetics Research Group, Bond University, Robina, Queensland, Australia
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Crichton M, Davidson AR, Innerarity C, Marx W, Lohning A, Isenring E, Marshall S. Orally consumed ginger and human health: an umbrella review. Am J Clin Nutr 2022; 115:1511-1527. [PMID: 35147170 PMCID: PMC9170469 DOI: 10.1093/ajcn/nqac035] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/04/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Emerging evidence supports the health benefits of ginger for a range of conditions and symptoms; however, there is a lack of synthesis of literature to determine which health indications are supported by quality evidence. OBJECTIVES In this umbrella review of systematic reviews we aimed to determine the therapeutic effects and safety of any type of ginger from the Zingiber family administered in oral form compared with any comparator or baseline measures on any health and well-being outcome in humans. METHODS Five databases were searched from inception to April 2021. Review selection and quality were assessed in duplicate using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) checklist and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method, with results presented in narrative form. RESULTS Twenty-four systematic reviews were included with 3% overlap of primary studies. The strongest evidence was found for the antiemetic effects of ginger in pregnant women (effect size: large; GRADE: high), analgesic effects for osteoarthritis (effect size: small; GRADE: high), and glycemic control (effect size: none to very large; GRADE: very low to moderate). Ginger also had a statistically significant positive effect on blood pressure, weight management, dysmenorrhea, postoperative nausea, and chemotherapy-induced vomiting (effect size: moderate to large; GRADE: low to moderate) as well as blood lipid profile (effect size: small; GRADE: very low) and anti-inflammatory and antioxidant biomarkers (effect size: unclear; GRADE: very low to moderate). There was substantial heterogeneity and poor reporting of interventions; however, dosage of 0.5-3 g/d in capsule form administered for up to 3 mo was consistently reported as effective. CONCLUSIONS Dietary consumption of ginger appears safe and may exert beneficial effects on human health and well-being, with greatest confidence in antiemetic effects in pregnant women, analgesic effects in osteoarthritis, and glycemic control. Future randomized controlled and dose-dependent trials with adequate sample sizes and standardized ginger products are warranted to better inform and standardize routine clinical prescription.
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Affiliation(s)
- Megan Crichton
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Alexandra R Davidson
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Celia Innerarity
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Wolfgang Marx
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
- Deakin University, Impact (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, Geelong, Australia
| | - Anna Lohning
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Elizabeth Isenring
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Skye Marshall
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
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Pourmasoumi M, Hadi A, Marx W, Najafgholizadeh A, Kaur S, Sahebkar A. The Effect of Green Coffee Bean Extract on Cardiovascular Risk Factors: A Systematic Review and Meta-analysis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1328:323-345. [PMID: 34981487 DOI: 10.1007/978-3-030-73234-9_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND AIM Cardiovascular disease remains the primary cause of noncommunicable disease- related death. The present systematic review and meta-analysis was performed to assess the possible benefit of the green coffee bean extract on cardio-metabolic markers. METHODS PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched to identify clinical trials that examined the effect of green coffee bean extract on cardio-metabolic risk factors including serum lipid profiles, glycemic status-related markers, blood pressure, and anthropometric indices. Since the included RCTs were carried out in different settings, random effect models were used to conduct all meta-analyses. RESULTS Fifteen studies (19 arms) consisting of 637 participants were included. The results indicated that green coffee bean extract significantly reduced levels of total cholesterol (-5.93 mg/dl; 95% CI: -9.21, -2.65; I2: 0%), fasting plasma glucose (-2.21 mg/dl; 95% CI: -3.94, -0.48; I2: 32%), systolic blood pressure (-3.08 mmHg; 95% CI: -4.41, -1.75; I2: 26%), diastolic blood pressure (-2.27 mmHg; 95% CI: -3.82, -0.72; I2: 61%), body weight (-1.24 kg; 95% CI: -1.82, -0.66; I2: 15%), and BMI (-0.55 kg/m2; 95% CI: -0.88, -0.22; I2: 73%). Although the pooled effect size of LDL-C, fasting insulin, and waist circumstance were significant, the results were significantly influenced by individual studies. No significant effect was detected for triglycerides, HDL-C, HbA1C, and HOMA-IR. However, the nonsignificant pooled effect size for triglyceride levels was influenced by one individual study. CONCLUSION The present study suggests that green coffee been extract consumption can improve total cholesterol, triglycerides, body weight, blood pressure, and fasting plasma glucose.
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Affiliation(s)
- Makan Pourmasoumi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Wolfgang Marx
- School of Medicine, iMPACT, Food & Mood Centre, Deakin University, Geelong, Australia
| | | | - Sukhdeep Kaur
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana, Punjab, India
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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Wu M, Gani H, Viney S, Ho P, Orfila C. Effect of ginger‐enriched pasta on acceptability and satiety. Int J Food Sci Technol 2021. [DOI: 10.1111/ijfs.15264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Mengyao Wu
- School of Food Science and Nutrition University of Leeds Woodhouse Lane Leeds West Yorkshire LS2 9JT UK
| | - Hanis Gani
- School of Food Science and Nutrition University of Leeds Woodhouse Lane Leeds West Yorkshire LS2 9JT UK
- Faculty of Bioresources and Food Industry Universiti Sultan Zainal Abidin Besut 22000Terengganu Malaysia
| | - Sara Viney
- School of Food Science and Nutrition University of Leeds Woodhouse Lane Leeds West Yorkshire LS2 9JT UK
| | - Peter Ho
- School of Food Science and Nutrition University of Leeds Woodhouse Lane Leeds West Yorkshire LS2 9JT UK
| | - Caroline Orfila
- School of Food Science and Nutrition University of Leeds Woodhouse Lane Leeds West Yorkshire LS2 9JT UK
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Lv Y, Li Y, Liu X, Xu K. Identification of Ginger ( Zingiber officinale Roscoe) Reference Genes for Gene Expression Analysis. Front Genet 2020; 11:586098. [PMID: 33240331 PMCID: PMC7670040 DOI: 10.3389/fgene.2020.586098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/09/2020] [Indexed: 11/24/2022] Open
Abstract
Quantitative real-time PCR (qRT-PCR) is widely used in the detection of gene expression level. However, there is no suitable ginger reference gene for qPCR analysis. Therefore, it is the primary task to select and validate the appropriate ginger reference gene to normalize the expression of target genes. In this study, 14 candidate reference genes were selected and analyzed in different tissues (leaf, and rhizome), different development stages, different varieties, and abiotic stress (ABA and salt stress). Expression stability was calculated using geNorm and NormFinder, Bestkeeper, and RefFinder. For abiotic stress and total conditions, 28S and COX were identified as the most stable genes. In addition, RPII was the most stable in the different development stages and different varieties. TEF2 and RPL2 were the least stably expressed in the tissue and all the conditions. In order to verify the feasibility of these genes as reference genes, we used the most stable and least stable reference genes to normalize the expression levels of ZoSPS genes under different conditions. This work can provide theoretical support for future research on ginger gene expression.
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Affiliation(s)
- Yao Lv
- College of Horticulture Science and Engineering, Shandong Agricultural University, Tai'an, China.,Collaborative Innovation Center of Fruit & Vegetable Quality and Efficient Production in Shandong, Tai'an, China.,Key Laboratory of Biology of Horticultural Crops in Huanghuai Region, Ministry of Agriculture and Rural Affairs, Tai'an, China.,State Key Laboratory of Crop Biology, Tai'an, China
| | - Yanyan Li
- College of Horticulture Science and Engineering, Shandong Agricultural University, Tai'an, China
| | - Xiaohui Liu
- School of Environment, Tsinghua University, Qingdao, China
| | - Kun Xu
- College of Horticulture Science and Engineering, Shandong Agricultural University, Tai'an, China.,Collaborative Innovation Center of Fruit & Vegetable Quality and Efficient Production in Shandong, Tai'an, China.,Key Laboratory of Biology of Horticultural Crops in Huanghuai Region, Ministry of Agriculture and Rural Affairs, Tai'an, China.,State Key Laboratory of Crop Biology, Tai'an, China
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Marx W, McCarthy A, Marshall S, Crichton M, Molassiotis A, Ried K, Bird R, Lohning A, Isenring E. Supplemental prophylactic intervention for chemotherapy-induced nausea and emesis (SPICE) trial: Protocol for a multicentre double-blind placebo-controlled randomised trial. Nutr Diet 2020; 77:144-150. [PMID: 30033645 DOI: 10.1111/1747-0080.12446] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 05/19/2018] [Accepted: 05/27/2018] [Indexed: 02/02/2023]
Abstract
AIM There is significant recent interest in the role of ginger root (Zingiber officinale) as an adjuvant therapy for chemotherapy-induced nausea. The supplemental prophylactic intervention for chemotherapy-induced nausea and emesis (SPICE) trial aims to assess the efficacy by reduced incidence and severity of chemotherapy-induced nausea and vomiting, and enhanced quality of life, safety and cost effectiveness of a standardised adjuvant ginger root supplement in adults undergoing single-day moderate-to-highly emetogenic chemotherapy. METHODS Multisite, double-blind, placebo-controlled randomised trial with two parallel arms and 1:1 allocation. The target sample size is n = 300. The intervention comprises four capsules of ginger root (totalling 60 mg of active gingerols/day), commencing the day of chemotherapy and continuing for five days during chemotherapy cycles 1 to 3. The primary outcome is chemotherapy-induced nausea-related quality of life. Secondary outcomes include nutrition status; anticipatory, acute and delayed nausea and vomiting; fatigue; depression and anxiety; global quality of life; health service use and costs; adverse events; and adherence. RESULTS During the five-month recruitment period from October 2017 to April 2018 at site A only, a total of n = 33 participants (n = 18 female) have been enrolled in the SPICE trial. Recruitment is expected to commence at Site B in May 2018. CONCLUSIONS The trial is designed to meet research gaps and could provide evidence to recommend specific dosing regimens as an adjuvant for chemotherapy-induced nausea and vomiting prevention and management.
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Affiliation(s)
- Wolfgang Marx
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Alexandra McCarthy
- School of Nursing, University of Auckland, Auckland, New Zealand
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Skye Marshall
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Megan Crichton
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Bond Institute of Health and Sport, Gold Coast, Queensland, Australia
| | - Alex Molassiotis
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Karin Ried
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- National Institute of Integrative Medicine (NIIM), Melbourne, Victoria, Australia
| | - Robert Bird
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Medicine, Griffith University, Brisbane, Queensland, Australia
| | - Anna Lohning
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Elizabeth Isenring
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Department of Nutrition & Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Marx W, Hockey M, McGuinness AJ, Lane M, Christodoulou J, van der Mei I, Berk M, Dean OM, Taylor B, Broadley S, Lechner-Scott J, Jacka FN, Lucas RM, Ponsonby AL. The effect of emerging nutraceutical interventions for clinical and biological outcomes in multiple sclerosis: A systematic review. Mult Scler Relat Disord 2020; 37:101486. [PMID: 31707234 DOI: 10.1016/j.msard.2019.101486] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/11/2019] [Accepted: 10/28/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Due to the considerable burden of multiple sclerosis (MS)-related symptoms and the need to identify effective interventions to prevent disease progression, various nutraceutical interventions have been trialed as adjunctive treatments. The aim of this review was to investigate the efficacy and safety of nutraceutical interventions for clinical and biological outcomes in people with MS. METHODS In accordance with PRISMA reporting guidelines, a systematic literature search was conducted using three electronic literature databases. Risk of bias was assessed using the Jadad scale. RESULTS Thirty-seven randomized controlled trials, investigating fourteen nutraceuticals, were included in the review. Trials that investigated alpha lipoic acid (n = 4/6), ginkgo biloba (n = 3/5), vitamin A (n = 2/2), biotin (n = 1/2), carnitine (n = 1/2), green tea (n = 1/2), coenzyme Q10 (n = 1/1), probiotics (n = 1/1), curcumin (n = 1/1), Andrographis paniculata (n = 1/1), ginseng (n = 1/1), and lemon verbena (n = 1/1) were reported to improve biological (e.g. MRI brain volume change, antioxidant capacity) and/or clinical (e.g. fatigue, depression, Expanded Disability Status Scale) outcomes in multiple sclerosis compared to control. However, most trials were relatively small (average study sample size across included studies, n = 55) and there were few replicate studies per nutraceutical to validate the reported results. Furthermore, some nutraceuticals (e.g. green tea and inosine) should be used with caution due to reported adverse events. Risk of bias across most studies was low, with 31 studies receiving a score between 4 and 5 (out of 5) on the Jadad Scale. CONCLUSION The existing literature provides preliminary support for the use of a number of nutraceutical interventions in MS. However, sufficiently powered long-term trials are required to expand the currently limited literature and to investigate unexplored nutraceuticals that may target relevant pathways involved in MS such as the gut microbiome and mitochondrial dysfunction. Prospero ID: CRD42018111736.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Australia.
| | - Meghan Hockey
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Amelia J McGuinness
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Melissa Lane
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - John Christodoulou
- Murdoch Children's Research Institute, Royal Children's Hospital, Australia; Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Australia
| | - Ingrid van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Olivia M Dean
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, Australia
| | - Bruce Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Simon Broadley
- School of Medicine, Griffith University, Gold Coast, Queensland Australia
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Australia; Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - Felice N Jacka
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia; Centre for Ophthalmology and Visual Sciences, University of Western Australia, Perth, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Royal Children's Hospital, Australia; National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
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10
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You H, Ireland B, Moeszinger M, Zhang H, Snow L, Krepich S, Takagawa V. Determination of bioactive nonvolatile ginger constituents in dietary supplements by a rapid and economic HPLC method: Analytical method development and single-laboratory validation. Talanta 2019; 194:795-802. [PMID: 30609608 DOI: 10.1016/j.talanta.2018.10.075] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/22/2018] [Accepted: 10/22/2018] [Indexed: 11/16/2022]
Abstract
Most of the validated methods for ginger-containing dietary supplements have long run time and low sensitivity and only analyze gingerols and shogaols. 6-Paradol and zingerone become popular in modern dietary supplement industry as bioactive ginger constituents. Therefore, we developed an efficient HPLC-UV/Vis method to analyze all above major constituents. Compared to 282/280 nm used by the current compendial United States Pharmacopeia (USP) monograph method and International Organization for Standardization (ISO) 13685-1997 method, detection wavelength was optimized to 230 nm which showed a higher sensitivity (signal-to-noise ratio) and better peak resolution. For measuring the ginger constituents in AOAC required matrices, the method was demonstrated to be selective, linear (R2 > 0.999), specific, accurate (91.1-103.2% spike recovery rate) and precise (RSDr < 5%, RSDR < 8%). Among 10 commercial ginger-containing samples that we screened using this method, the results were 80-123% of the products' labeling value. The HPLC running time was successfully shortened from 29 min (USP method) and 40 min (ISO method) to 12 min without the need of using an expensive Mass Spectrometer for analyte separation. The method is the first method that meets all AOAC SMPR 2017.12 requirements and therefore has the potential to be adopted as a consensus industrial reference method for meeting FDA's cGMP Compliance for the manufacture and quality control of dietary supplements and ingredients.
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Affiliation(s)
- Hong You
- Eurofins Scientific, Inc., 1365 Redwood Way, Petaluma, CA 94954, United States.
| | - Bailey Ireland
- Eurofins Scientific, Inc., 1365 Redwood Way, Petaluma, CA 94954, United States.
| | - Michael Moeszinger
- Eurofins Scientific, Inc., 1365 Redwood Way, Petaluma, CA 94954, United States.
| | - Haoshu Zhang
- Eurofins Scientific, Inc., 1365 Redwood Way, Petaluma, CA 94954, United States.
| | - Laura Snow
- Phenomenex, Inc., 411 Madrid Avenue, Torrance, CA 90501, United States.
| | - Scott Krepich
- Phenomenex, Inc., 411 Madrid Avenue, Torrance, CA 90501, United States.
| | - Vivian Takagawa
- ChromaDex, Inc., 10005 Muirlands Blvd Suite #G, Irvine, CA 92618, United States.
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11
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SUMIDA Y, KIMURA M, YORIE T, SOESHIMA N, KAWABATA K, INAGAKI M, NISHI H. Simultaneous Separation of Active Ingredients Contained in Ginger (Shokyo), Processed Ginger (Kankyo) and Magnolia Bark (Koboku) by Reversed-Phase HPLC with Core-Shell Type Columns: Application to Kampo Products and Food Analysis. CHROMATOGRAPHY 2018. [DOI: 10.15583/jpchrom.2018.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | - Miho KIMURA
- Faculty of Pharmacy, Yasuda Women's University
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12
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Wang Q, Yang Q, Cao X, Wei Q, Firempong CK, Guo M, Shi F, Xu X, Deng W, Yu J. Enhanced oral bioavailability and anti-gout activity of [6]-shogaol-loaded solid lipid nanoparticles. Int J Pharm 2018; 550:24-34. [DOI: 10.1016/j.ijpharm.2018.08.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/29/2018] [Accepted: 08/14/2018] [Indexed: 10/28/2022]
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