Art of Prevention: Essential Oils - Natural Products Not Necessarily Safe

Effect of inhaled aromatherapy on sleep quality in critically ill patients: A systematic review and network meta-analysis

AIM

This study aimed to compare the effect of inhaled aromatherapy using various essential oils on the sleep quality of critically ill patients.

BACKGROUND

Inhalation of essential oils significantly promotes the physiological and psychological health of patients in intensive care units (ICUs). However, research identifying and ranking the effects of different essential oils on the sleep quality of critically ill patients is lacking.

DESIGN

This study followed the PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-Analyses of Health Care Interventions (PRISMA-NMA) guidelines.

METHODS

A comprehensive search of five databases (Embase, MEDLINE, the Cochrane Library, CINAHL and PsycINFO) was conducted from their inception to March 15, 2023 (with an additional eligible study included dated August 14, 2023). Google Scholar was used as a supplementary method. Frequentist NMA was used to determine the effects of various essential oils. Certainty of evidence (CoE) was assessed using Confidence in Network Meta-Analysis (CINeMA).

RESULTS

A total of 11 trials involving 690 critically ill patients were included in the analysis. The NMA of inhaled aromatherapy revealed that the combination of lavender, Matricaria recutita, and neroli essential oils (ratio 6:2:0.5) resulted in the most significant improvement in sleep quality compared to usual care, followed by Rosa damascene, peppermint, Citrus aurantium, pure sunflower oil and lavender oil alone. The overall CoE for the results was rated as low.

CONCLUSIONS

The results of this study indicate that a combination of lavender, Matricaria recutita and neroli essential oils significantly positively affected sleep quality among critically ill patients. Despite the low quality of evidence, inhaled aromatherapy is non-invasive and easy to use.

RELEVANCE TO CLINICAL PRACTICE

Inhaled aromatherapy can effectively improve sleep quality among critically ill patients.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution applies to this work.

STUDY REGISTRATION

The study protocol was registered to the PROSPERO International Prospective Register of Systematic Reviews (protocol number CRD42023433194).

LVI and DI-SPME Combined with GC/MS and GC/MS for Volatile Chemical Profile Investigation and Cytotoxic Power Evaluation of Essential Oil and Hydrolate from Cannabis sativa L. cv. Carmagnola

Cannabis sativa L. is a plant that has been cultivated since ancient times thanks to its various uses. Even its extraction products, such as essential oil and hydrolate, having a varied chemical composition and rich in bioactive components, find wide use in different sectors, gathering ever-increasing interest over time. In this work, the essential oil of Cannabis sativa L. cv. Carmagnola was characterized by using Gas Chromatography/Mass Spectrometry (GC/MS) and, for the first time, the chemical profile of the hydrolate was also described through different analytical techniques such as Large-Volume Injection Gas Chromatography/Mass Spectrometry (LVI-GC/MS) and Direct Immersion-Solid Phase Microextraction-Gas Chromatography/Mass spectrometry (DI-SPME-GC/MS), in order to provide a more complete compositional profile. The results of the analyses conducted on the hydrolate highlighted a high content of α-terpineol; on the other side, in the essential oil, a prevalence of monoterpenes, with α-pinene and limonene as the characterizing components, was detected. Both matrices were also investigated to evaluate their cytotoxic activity by using a panel of cancer cell lines derived from different histotypes such as melanoma (A375, LOX IMVI), non-small cell lung cancer (H1299, A549), colon (HT29) and pancreatic (L3.6) cancer cell lines. The obtained data demonstrated that essential oil was more effective than hydrolate in terms of reduction in cell viability.

Intrinsic properties and extrinsic factors of food matrix system affecting the effectiveness of essential oils in foods: a comprehensive review

Essential oils (EOs) have been proved as natural food preservatives because of their effective and wide-spectrum antimicrobial activity. They have been extensively explored for potential applications in food industry, and substantial progresses have been achieved. However well EOs perform in antibacterial tests in vitro, it has generally been found that a higher level of EOs is needed to achieve the same effect in foods. Nevertheless, this unsimilar effect has not been clearly quantified and elaborated, as well as the underlying mechanisms. This review highlights the influence of intrinsic properties (e.g., oils and fats, carbohydrates, proteins, pH, physical structure, water, and salt) and extrinsic factors (e.g., temperature, bacteria characteristics, and packaging in vacuum/gas/air) of food matrix systems on EOs action. Controversy findings and possible mechanism hypotheses are also systematically discussed. Furthermore, the organoleptic aspects of EOs in foods and promising strategies to address this hurdle are reviewed. Finally, some considerations about the EOs safety are presented, as well as the future trends and research prospects of EOs applications in foods. The present review aims to fill the evidenced gap, providing a comprehensive overview about the influence of the intrinsic and extrinsic factors of food matrix systems to efficiently orientate EOs applications.

Flower Power: An Overview on Chemistry and Biological Impact of Selected Essential Oils from Blossoms

Natural raw materials such as essential oils have received more and more attention in recent decades, whether in the food industry, as flavorings and preservatives, or as insecticides and insect repellents. They are, furthermore, very popular as fragrances in perfumes, cosmetics, and household products. In addition, aromatherapy is widely used to complement conventional medicine. This review summarizes investigations on the chemical composition and the most important biological impacts of essential oils and volatile compounds extracted from selected aromatic blossoms, including Lavandula angustifolia, Matricaria recutita, Rosa x damascena, Jasminum grandiflorum, Citrus x aurantium, Cananga odorata, and Michelia alba. The literature was collected from PubMed, Google Scholar, and Science Direct. Blossom essential oils discussed in this work are used in a wide variety of clinical issues. The application is consistently described as safe in studies and meta-analyses, although there are notes that using essential oils can also have side effects, especially dermatologically. However, it can be considered as confirmed that essential oils have positive influences on humans and can improve quality of life in patients with psychiatric disorders, critically ill patients, and patients in other exceptional situations. Although the positive effect of essential oils from blossoms has repeatedly been reported, evidence-based clinical investigations are still underrepresented, and the need for research is demanded.

Non-Pharmacological Pain Management in Labor: A Systematic Review

Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women's individual requirements, to strengthen obstetricians' knowledge in guiding decision-making for women in childbirth.

Quality-by-Design-Assisted Optimization of Carvacrol Oil-Loaded Niosomal Gel for Anti-Inflammatory Efficacy by Topical Route

Niosomes are multilamellar vesicles that effectively transfer active ingredients into the skin's layers. To improve the active substance's penetration across the skin, these carriers are frequently utilized as topical drug delivery systems. Essential oils (EOs) have garnered significant interest in the field of research and development owing to their various pharmacological activities, cost-effectiveness, and simple manufacturing techniques. However, these ingredients undergo degradation and oxidation over time, leading to a loss of functionality. Niosome formulations have been developed to deal with these challenges. The main goal of this work was to create a niosomal gel of carvacrol oil (CVC) to improve its penetration into the skin for anti-inflammatory actions and stability. By changing the ratio of drug, cholesterol and surfactant, various formulations of CVC niosomes were formulated using Box Behnken Design (BBD). A thin-film hydration technique using a rotary evaporator was employed for the development of niosomes. Following optimization, the CVC-loaded niosomes had shown: 180.23 nm, 0.265, -31.70 mV, and 90.61% of vesicle size, PDI, zeta potential, and EE%. An in vitro study on drug release discovered the rates of drug release for CVC-Ns and CVC suspension, which were found to be 70.24 ± 1.21 and 32.87 ± 1.03, respectively. The release of CVC from niosomes best fit the Higuchi model, and the Korsmeyer-Peppas model suggests that the release of the drug followed the non-Fickian diffusion. In a dermatokinetic investigation, niosome gel significantly increased CVC transport in the skin layers when compared to CVC-conventional formulation gel (CVC-CFG). Confocal laser scanning microscopy (CLSM) of rat skin exposed to the rhodamine B-loaded niosome formulation showed a deeper penetration of 25.0 µm compared to the hydroalcoholic rhodamine B solution (5.0 µm). Additionally, the CVC-N gel antioxidant activity was higher than that of free CVC. The formulation coded F4 was selected as the optimized formulation and then gelled with carbopol to improve its topical application. Niosomal gel underwent tests for pH determination, spreadability, texture analysis, and CLSM. Our findings imply that the niosomal gel formulations could represent a potential strategy for the topical delivery of CVC in the treatment of inflammatory disease.

Riluzole-Loaded Nanostructured Lipid Carriers for Hyperproliferative Skin Diseases

Nanocarriers, and especially nanostructured lipid carriers (NLC), represent one of the most effective systems for topical drug administration. NLCs are biodegradable, biocompatible and provide a prolonged drug release. The glutamate release inhibitor Riluzole (RLZ) is a drug currently used for amyotrophic lateral sclerosis (ALS), with anti-proliferative effects potentially beneficial for diseases with excessive cell turnover. However, RLZ possesses low water solubility and high light-sensibility. We present here optimized NLCs loaded with RLZ (RLZ-NLCs) as a potential topical treatment. RLZ-NLCs were prepared by the hot-pressure homogenization method using active essential oils as liquid lipids, and optimized using the design of experiments approach. RLZ-NLCs were developed obtaining optimal properties for dermal application (mean size below 200 nm, negative surface charge and high RLZ entrapment efficacy). In vitro release study demonstrates that RLZ-NLCs allow the successful delivery of RLZ in a sustained manner. Moreover, RLZ-NLCs are not angiogenic and are able to inhibit keratinocyte cell proliferation. Hence, a NLCs delivery system loading RLZ in combination with natural essential oils constitutes a promising strategy against keratinocyte hyperproliferative conditions.

Anti-inflammatory activity of essential oils from Tunisian aromatic and medicinal plants and their major constituents in THP-1 macrophages

In this study, the capacity of eight essential oils (EOs), sage (Salvia officinalis), coriander (Coriandrum sativum), rosemary (Rosmarinus officinalis), black cumin (Nigella sativa), prickly juniper (Juniperus oxycedrus), geranium (Pelargonium graveolens), oregano (Origanum vulgare) and wormwood (Artemisia herba-alba), on the inhibition of NF-κB activation was screened at concentrations up to 0.25 µL/mL using THP-1 human macrophages bearing a NF-κB reporter. This screening selected coriander, geranium, and wormwood EOs as the most active, which later evidenced the ability to decrease over 50 % IL-6, IL-1β, TNF-α and COX-2 mRNA expression in LPS-stimulated THP-1 macrophages. The chemical composition of selected EOs was performed by gas chromatography-mass spectrometry (GC-MS). The two major constituents (>50 % of each EO) were tested at the same concentrations presented in each EO. It was demonstrated that the major compound or the binary mixtures of the two major compounds could explain the anti-inflammatory effects reported for the crude EOs. Additionally, the selected EOs also inhibit>50 % caspase-1 activity. However, this effect could not be attributed to the major components (except for β-citronellol/geranium oil, 40 %/65 % caspase-1 inhibition), suggesting, in addition to potential synergistic effects, the presence of minor compounds with caspase-1 inhibitory activity. These results demonstrated the potential use of the EOs obtained from Tunisian flora as valuable sources of anti-inflammatory agents providing beneficial health effects by reducing the levels of inflammatory mediators involved in the genesis of several diseases.

Complementary Intervention in Postoperative Care: Aromatherapy's Role in Decreasing Postoperative Nausea and Vomiting

Purpose: This study analyzed the efficacy of Post-Ease, a custom essential oil aromatherapy blend, in decreasing postoperative nausea and vomiting (PONV) and the need for antiemetic drugs in an orthopaedic surgical population. Study Design: This is retrospective cohort study, utilizing electronic health record data pre- and post-implementation of a nurse-driven quality improvement intervention. Methods: The study examined the impact of an inhaled custom blend of essential oils containing lavender, peppermint, ginger and lemon to assist in decreasing PONV and reduce the use of antiemetic medications. Data on the use of antiemetic drugs in pre- and post-intervention periods were analyzed. Findings: Nurses provided the Post-Ease blend 384 times in 2020 to patients as an option before proceeding, if necessary, to antiemetic drugs. The intervention group demonstrated a statistically significant reduction in the number of unique surgical patients' need for antiemetics as treatment (22%; p = .05). Similarly, the total doses of antiemetics administered was significantly reduced (21%; p ≤ .05) during the study period. Conclusion: This study supports the use of aromatherapy to reduce PONV and minimize antiemetic use in an orthopaedic population.

Application of direct peptide reactivity assay for assessing the skin sensitization potential of essential oils

Plant-derived products are frequently found as ingredients in cosmetics. However, the current data show non-neglectable skin sensitizing potential of these preparations suggesting an urgent need for data regarding their health safety profile. The aim of this study was to assess the skin sensitization potential of commercial essential oils by selected Lamiaceae species (Lavandula angustifolia, Melissa officinalis, Mentha longifolia, Thymus vulgaris, Salvia officinalis, and Rosmarinus officinalis) using a chemistry-based Direct Peptide Reactivity Assay (DPRA) in order to predict their potential allergic properties. In the DPRA assay, nucleophile-containing synthetic peptides (cysteine peptide and lysine peptide) were incubated with the test substance for 24 h. Depletion of the peptide in the reaction mixture was measured by high-pressure liquid chromatography (HPLC) using UV detection and the average peptide depletion data for cysteine and lysine was then calculated. Menthae longifoliae aetheroleum showed no or minimal reactivity with 4.48% cysteine depletion, Rosmarini aetheroleum and Salviae aetheroleum showed low reactivity with the 12.79% and 15.34% of cysteine depletion, respectively, while the other analyzed essential oils showed moderate reactivity with the cysteine depletion between 23.21 and 48.43%. According to DPRA predictive analysis, only Menthae longifoliae aetheroleum can be classified as negative, while all other essential oils may be classified as positive, thus having the potential to cause skin sensitization.

Developing Eco-Friendly Skin Care Formulations with Microemulsions of Essential Oil

With the rising public awareness of environmental issues, consumers are increasingly demanding skin care products that create less environmental impact but still provide the same or even greater efficacy. In the skin care arena, microemulsions have been receiving increased attention as the promising delivery technology of skin care actives. Essential oils such as peppermint oil, lavender oil and eucalyptus oil are purported to have excellent antioxidant and antimicrobial properties that could be used as the eco-friendly alternatives for synthetic antioxidants and preservatives in the skin care formulations. This work therefore seeks to develop eco-friendly skin care formulations based on microemulsions of essential oil. Peppermint oil, lavender oil and eucalyptus oil were used as the oil phase to formulate naringin-loaded microemulsions, which demonstrated similar or better antioxidant and antimicrobial properties compared to the synthetic ones. When formulated into gel form, naringin-loaded microemulsion-gel formulations showed enhanced stability and release profile over their unformulated counterpart. Hence, microemulsions of essential oil developed in this work conferred a 4-fold benefits to the skin care formulations: (1) improved release (membrane permeation) of skin care active, (2) improved stability of skin care active, (3) as an eco-friendly alternative to synthetic antioxidant, and (4) a self-preserving system.

Review of air disinfection approaches and proposal for thermal inactivation of airborne viruses as a life-style and an instrument to fight pandemics

COVID-19 (Coronavirus Disease 2019) pandemic highlighted the importance of air biosecurity because SARS-CoV-2 is mainly transmitted from person to person via airborne droplets. Preventing infectious droplets from entering the body is one of the best ways to protect against infection. This paper reviews the transmission patterns of airborne pathogens and air disinfection methods. A particular emphasis is put on studies devoted to the thermal inactivation of viruses. These reviews reveal that air heat treatment has not been seriously considered as a possible air disinfection approach. Simple calculations show that the energy input required for thermal disinfection of human's air daily consumption is almost the same as for daily water consumption (by heat treatment from room temperature to 100 °C). Moreover, it is possible to organize a continuous heat recovery from the air already heated during disinfection to the inlet air, thus significantly increasing the energy efficiency. Therefore, I propose a solution for the thermal inactivation of airborne pathogens based on air heating and its subsequent cooling in a heat exchanger with heat recovery. Such a solution could be used to create mobile personal and stationary indoor air disinfectors, as well as heating, ventilation, and air conditioning systems. Thermal disinfection of air to breathe might one day be part of people's daily life like thermal disinfection of drinking water. Aside from limiting infectious disease transmission, thermal inactivation might be the basis for developing inhaled vaccines using thermally inactivated whole pathogens.

Antibacterial Activities of Homemade Matrices Miming Essential Oils Compared to Commercial Ones

The increasing bacterial resistance to antibiotics is a worldwide concern. Essential oils are known to possess remarkable antibacterial properties, but their high chemical variability complicates their development into new antibacterial agents. Therefore, the main purpose of this study was to standardize their chemical composition. Several commercial essential oils of ajowan (Trachyspermum ammi L.) and thyme (chemotype thymol) (Thymus vulgaris L.) were bought on the market. GC-MS analysis revealed that thyme essential oils have a chemical composition far more consistent than ajowan essential oils. Sometimes thymol was not even the major compound. The most abundant compounds and the homemade mixtures were tested against two Staphylococcus aureus strains. The antibacterial property of β-caryophyllene presented no direct activity against S. aureus LMG 15975, but in association with thymol or carvacrol at equal percentages an MIC of 125 μg/mL was observed. The mixture of those three compounds at equivalent percentages also decreased by 16-fold the MIC of the penicillin V. Against S. aureus LMG 21674, β-caryophyllene presented an MIC of 31.3 μg/mL and decreased by 267-fold the MIC of the penicillin V. These observations led us to question the benefits of using a complex chemical mixture instead of one active compound to fight bacterial resistance.