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McBenedict B, Orfao AL, Goh KS, Yau RCC, Alphonse B, Machado Lima J, Ahmed HA, Ienaco GP, Cristina de Souza E, Lima Pessôa B, Hauwanga WN, Valentim G, de Souza Chagas M, Abrahão A. The Role of Alternative Medicine in Managing Type 2 Diabetes: A Comprehensive Review. Cureus 2024; 16:e61965. [PMID: 38978922 PMCID: PMC11229830 DOI: 10.7759/cureus.61965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 06/08/2024] [Indexed: 07/10/2024] Open
Abstract
Diabetes, a chronic metabolic disorder marked by elevated blood glucose levels, is increasingly prevalent globally, significantly impacting health-related quality of life. Type 2 diabetes (T2DM), characterized by insulin resistance and inadequate insulin production, presents a substantial public health challenge, necessitating comprehensive management strategies. Conventional treatments, including lifestyle modifications and pharmacotherapy, are essential for glycemic control and preventing complications. However, adherence to these treatments is often limited, highlighting the need for alternative strategies. Complementary and alternative medicine (CAM) offers potential cost-effective and accessible approaches for managing T2DM. Key herbal remedies like cinnamon, fenugreek, and bitter melon, along with dietary supplements like chromium, magnesium, and vanadium, have shown promise in glycemic control. Mind-body therapies, including yoga, tai chi, and meditation, contribute to improved hemoglobin A1c and fasting blood glucose levels. Research supports the integration of CAM with conventional therapies, demonstrating enhanced clinical efficacy and reduced economic burden. However, challenges such as standardization, quality control, and potential risks of herbal medicines need careful consideration. Regulatory frameworks and ethical considerations are essential to ensure patient safety and informed decision-making. Patient education and effective communication between healthcare providers and patients are crucial for integrating CAM into diabetes management. Empowerment-based interventions and collaborative approaches can enhance self-management skills and clinical outcomes. Overall, integrating CAM with conventional treatments offers a holistic approach to managing T2DM, potentially improving patient outcomes and reducing healthcare costs.
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Affiliation(s)
| | - Andréa L Orfao
- Public Health, Federal Fluminense University, Niterói, BRA
| | - Kang S Goh
- Internal Medicine, Monash University Malaysia, Johor Bahru, MYS
| | - Ryan Chun C Yau
- Internal Medicine, Monash University Malaysia, Johor Bahru, MYS
| | | | | | - Hassan A Ahmed
- Neurosurgery, Fluminense Federal University, Niterói, BRA
| | | | | | | | - Wilhelmina N Hauwanga
- Family Medicine, Federal University of the State of Rio de Janeiro, Rio de Janeiro, BRA
| | | | | | - Ana Abrahão
- Public Health, Federal Fluminense University, Niterói, BRA
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2
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Zhang X, Zhao Y, Song Y, Miao M. Effects of Momordica charantia L. supplementation on glycemic control and lipid profile in type 2 diabetes mellitus patients: A systematic review and meta-analysis of randomized controlled trials. Heliyon 2024; 10:e31126. [PMID: 38784554 PMCID: PMC11112315 DOI: 10.1016/j.heliyon.2024.e31126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 04/08/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Background and aims Momordica charantia L. (M. charantia) has been traditionally utilized as a medicinal intervention for managing type 2 diabetes mellitus (T2DM). The current study was designed to offer a GRADE-assessed systematic review and meta-analysis of randomized controlled trials (RCTs) examining the impact of M. Charantia intake on glycemic indexes and the lipid profile of patients with T2DM. Methods A comprehensive search was conducted across several databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, from the inception of each database until April 22, 2023. The Hartung-Knapp adjustment was applied to ensure conservative summary estimates with broad confidence intervals. Results A total of eight trials involving 423 patients with T2DM were included in this study. Compared to the control group, the intake of M. charantia supplementation resulted in significant reductions in fasting blood glucose (FBG) (WMD: -0.85 mmol/L; 95%CI: -1.44, -0.26; p = 0.005; I2 = 73.4 %), postprandial glucose (PPG) (WMD: -2.28 mmol/L; 95%CI: -3.35, -1.21; p = 0.000; I2 = 66.9 %), glycosylated hemoglobin A1c (HbA1c) (WMD: -0.38 %; 95%CI: -0.53, -0.23; p = 0.000; I2 = 37.6 %), and total cholesterol (TC) (WMD: -0.38 mmol/L; 95%CI: -0.70, -0.07; p = 0.017; I2 = 63.6 %). These results remained statistically significant even after applying the Hartung-Knapp adjustment. However, no significant differences were observed in terms of triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Conclusions The findings of this study suggest that M. charantia could serve as a potential alternative for individuals with T2DM, particularly those with elevated total cholesterol levels. However, further high-quality studies are necessary to validate these results.
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Affiliation(s)
- Xiaolei Zhang
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Yinan Zhao
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Yagang Song
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Mingsan Miao
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, 450046, China
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Jiang Y, Liang B, Wu Q, Wang JR, Liu B. One new triterpenoids from Momordica charantia L. Nat Prod Res 2024; 38:1375-1380. [PMID: 36377715 DOI: 10.1080/14786419.2022.2144302] [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: 09/14/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022]
Abstract
Momordica charantia L. (M. charantia) is an annual climbing herb in Cucurbitaceae. It is not only a food, but also a drug with a long history of application. This study aims to isolate and identify the chemical constituents form M. charantia and evaluate their inhibiting effect on Hcy-induced proliferation of VSMCs. Silica column chromatography, ODS silica column chromatography, Sephadex LH-20 column chromatography and semi-preparative HPLC were used to obtain one new compound (1). The inhibition on Hcy-induced proliferation of VSMCs 1 was tested through MTT method. As a result, 1 could partially rescue Hcy-induced proliferation of VSMCs at both 5 and 25 μM.
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Affiliation(s)
- Yue Jiang
- Department of Cardiology, The fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Bing Liang
- Department of Critical Care Medcine, The fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Qiong Wu
- Department of Critical Care Medcine, The fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing-Ru Wang
- Department of Cardiology, The fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Bing Liu
- College of Pharmacy, Harbin University of Commerce, Harbin, P.R. China
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Koopmans SJ, Binnendijk G, Ledoux A, Choi YH, Mes JJ, Guan X, Molist F, Thị Minh TP, van der Wielen N. Momordica charantia fruit reduces plasma fructosamine whereas stems and leaves increase plasma insulin in adult mildly diabetic obese Göttingen Minipigs. PLoS One 2024; 19:e0298163. [PMID: 38498469 PMCID: PMC10947704 DOI: 10.1371/journal.pone.0298163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 01/16/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Traditionally Momordica charantia (Bitter gourd) is known for its blood glucose lowering potential. This has been validated by many previous studies based on rodent models but human trials are less convincing and the physiological mechanisms underlying the bioactivity of Bitter gourd are still unclear. The present study compared the effects of whole fruit or stems-leaves from five different Bitter gourd cultivars on metabolic control in adult diabetic obese Göttingen Minipigs. METHODS Twenty streptozotocin-induced diabetic (D) obese Minipigs (body weight ~85 kg) were subdivided in mildly and overtly D pigs and fed 500 g of obesogenic diet per day for a period of three weeks, supplemented with 20 g dried powdered Bitter gourd or 20 g dried powdered grass as isoenergetic control in a cross-over, within-subject design. RESULTS Bitter gourd fruit from the cultivars "Palee" and "Good healthy" reduced plasma fructosamine concentrations in all pigs combined (from 450±48 to 423±53 and 490±50 to 404±48 μmol/L, both p<0.03, respectively) indicating improved glycemic control by 6% and 17%. These effects were statistically confirmed in mildly D pigs but not in overtly D pigs. In mildly D pigs, the other three cultivars of fruit showed consistent numerical but no significant improvements in glycemic control. The composition of Bitter gourd fruit was studied by metabolomics profiling and analysis identified three metabolites from the class of triterpenoids (Xuedanoside H, Acutoside A, Karaviloside IX) that were increased in the cultivars "Palee" (>3.9-fold) and "Good healthy" (>8.9-fold) compared to the mean of the other three cultivars. Bitter gourd stems and leaves from the cultivar "Bilai" increased plasma insulin concentrations in all pigs combined by 28% (from 53±6 to 67±9 pmol/L, p<0.03). The other two cultivars of stems and leaves showed consistent numerical but no significant increases in plasma insulin concentrations. The effects on plasma insulin concentrations were confirmed in mildly D pigs but not in overtly D pigs. CONCLUSIONS Fruits of Bitter gourd improve glycemic control and stems-leaves of Bitter gourd increase plasma insulin concentrations in an obese pig model for mild diabetes. The effects of Bitter gourd fruit on glycemic control seem consistent but relatively small and cultivar specific which may explain the varying results of human trials reported in the literature.
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Affiliation(s)
- Sietse Jan Koopmans
- Wageningen Livestock Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Gisabeth Binnendijk
- Wageningen Livestock Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Allison Ledoux
- Natural Products Laboratory, Institute of Biology, Leiden University, Leiden, The Netherlands
| | - Young Hae Choi
- Natural Products Laboratory, Institute of Biology, Leiden University, Leiden, The Netherlands
- College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea
| | - Jurriaan J. Mes
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Xiaonan Guan
- Schothorst Feed Research, Lelystad, The Netherlands
| | | | - Tâm Phạm Thị Minh
- Department of Food crops and Horticulture, Nong Lam University, Ho Chi Minh City, Vietnam
| | - Nikkie van der Wielen
- Department of Animal Nutrition and Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands
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Ferreira Almeida N, Dos Santos Niculau E, Cordeiro Toledo Lima P, Ferreira da Silva W. Determination of the volatile chemical profile of Momordica charantia (bitter melon) leaf and fruit by GC-MS. Nat Prod Res 2024:1-8. [PMID: 38440938 DOI: 10.1080/14786419.2024.2325595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/24/2024] [Indexed: 03/06/2024]
Abstract
The plant Momordica charantia (Cucurbitaceae), popularly known as bitter melon, snake fruit, Saint Vincent's herb, or little melon, is an African species that has developed in tropical and subtropical biomes in various parts of Brazil. The fruit is used in various traditional medicinal applications. The study aimed to identify the compounds of the essential oil of the leaves obtained by hydrodistillation and in the fruit through Solid-Phase Microextraction by headspace mode (HS-SPME) coupled to gas chromatography-mass spectrometry (GC-MS). The analysis of mature fruits led to the identification of 18 compounds, compared to the hydrodistillation, in which 21 compounds were identified. Benzaldehyde, linalool, and β-cyclocitral were identified in both methods. Linalool was the major compound in both processes. These findings highlight the importance of knowing the chemical composition of organic volatile compounds (VOCs), given the potential for medicinal applications and popular use of plants.
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Affiliation(s)
- Natália Ferreira Almeida
- Center for Integrated Sciences, University Campus of Araguaína, Federal University of Northern Tocantins, Araguaína, Brazil
| | - Edenilson Dos Santos Niculau
- Center for Integrated Sciences, University Campus of Araguaína, Federal University of Northern Tocantins, Araguaína, Brazil
| | - Pedro Cordeiro Toledo Lima
- Center for Integrated Sciences, University Campus of Araguaína, Federal University of Northern Tocantins, Araguaína, Brazil
| | - Wanderson Ferreira da Silva
- Center for Integrated Sciences, University Campus of Araguaína, Federal University of Northern Tocantins, Araguaína, Brazil
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Laczkó Zöld E, Toth LM, Farczadi L, Ştefănescu R. Polyphenolic profile and antioxidant properties of Momordica charantia L. 'Enaja' cultivar grown in Romania. Nat Prod Res 2024; 38:1060-1066. [PMID: 37211778 DOI: 10.1080/14786419.2023.2213805] [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: 01/19/2023] [Revised: 04/24/2023] [Accepted: 05/04/2023] [Indexed: 05/23/2023]
Abstract
This is the first study describing phenolics of Momordica charantia L. 'Enaja' cultivar (bitter melon) produced in Romania. Total polyphenol content, total tannin content, total flavonoid content, and antioxidant activity of bitter melon stems and leaves, young fruits, and ripe fruits grown in Romania were analysed, along with fruits imported from India. The UPLC-DAD analysis led to the identification of (+)-catechin, (-)-epicatechin, luteolin-3',7-di-O-glucoside, luteolin-7-O-glucoside and vanillic acid. (-)-Epicatechin (859 µg/g) and (+)-catechin (1677 µg/g) were the most abundant compounds in stems and leaves, while in the ripe fruits, luteolin-7-O-glucoside (310 µg/g) was the main phenolic. Stems and leaves were the most active for capturing free DPPH radicals (IC50 = 216.9 ± 11.91 µg/ml); the scavenging activity strongly correlated with the flavonoid content (r = 0.8806, r2 = 0.7754). Momordica charantia fruits from Romania, both young and ripe, are a source of polyphenols as valuable as those imported from India.
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Affiliation(s)
- Eszter Laczkó Zöld
- Department of Pharmacognosy and Phytotherapy, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, Mureș, Romania
| | - Larisa Melinda Toth
- Faculty of Pharmacy, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, Mureș, Romania
| | - Lenard Farczadi
- Chromatography and Mass Spectrometry Laboratory, Center for Advanced Medical and Pharmaceutical Research, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, Mureș, Romania
| | - Ruxandra Ştefănescu
- Department of Pharmacognosy and Phytotherapy, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, Mureș, Romania
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7
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Smirnova IE, Galimova ZI, Sapozhnikova TA, Khisamutdinova RY, Thi THN, Kazakova OB. New Dipterocarpol-Based Molecules with α-Glucosidase Inhibitory and Hypoglycemic Activity. Chembiochem 2024; 25:e202300716. [PMID: 37990648 DOI: 10.1002/cbic.202300716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/07/2023] [Accepted: 11/21/2023] [Indexed: 11/23/2023]
Abstract
Dammarane triterpenoids are affordable and bioactive natural metabolites with great structural potential, which makes them attractive sources for drug development. The aim of the study was to investigate the potency of new dipterocarpol derivatives for the treatment of diabetes. Two dammaranes (dipterocarpol and its 20(24)-diene derivative) were modified by a Claisen-Schmidt aldol condensation to afford C2(E)-arylidenes in good yields. The majority of the synthesized compounds exhibited an excellent-to-moderate inhibitory effect toward α-glucosidase (from S. saccharomyces), among them eight compounds showed IC50 values less than 10 μM. 3-Oxo-dammarane-2(E)-benzylidenes (holding p-hydroxy- 3 l and p-carbonyl- 3 m substituents) demonstrated the most potent α-glucosidase inhibition with IC50 0.753 and 0.204 μM, being 232- and 857-times more active than acarbose (IC50 174.90 μM), and a high level of NO inhibition in Raw 264.7 cells with IC50 of 1.75 and 4.57 μM, respectively. An in vivo testing of compound 3 m (in a dose of 20 mg/kg) on a model of streptozotocin-induced T1DM in rats showed a pronounced hypoglycemic activity, the ability to reduce effectively the processes of lipid peroxidation in liver tissue and decrease the excretion of glucose and pyruvic acid in the urine. Compound 3 m reduced the death of diabetic rats and preserved their motor activity.
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Affiliation(s)
- Irina E Smirnova
- Ufa Institute of Chemistry, UFRC RAS, 71, pr. Oktyabrya, Ufa, 450054, Russian Federation
| | - Zarema I Galimova
- Ufa Institute of Chemistry, UFRC RAS, 71, pr. Oktyabrya, Ufa, 450054, Russian Federation
| | - Tatyana A Sapozhnikova
- Ufa Institute of Chemistry, UFRC RAS, 71, pr. Oktyabrya, Ufa, 450054, Russian Federation
| | | | - Thu Ha Nguyen Thi
- Institute of Chemistry, Vietnamese Academy of Science and Technology, 18 Hoang Quoc Viet Str., Cau Giay Dist., Hanoi, Vietnam
| | - Oxana B Kazakova
- Ufa Institute of Chemistry, UFRC RAS, 71, pr. Oktyabrya, Ufa, 450054, Russian Federation
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Parasher M, Pandey DK, Manhas RK. Traditionally used anti-diabetic plants in Kathua district of Union Territory of Jammu and Kashmir, India. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117087. [PMID: 37683931 DOI: 10.1016/j.jep.2023.117087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/27/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023]
Affiliation(s)
- Madhvi Parasher
- School of Bioengineering & Biosciences, Lovely Professional University, Phagwara, 144411, Punjab, India; Department of Botany, Govt. Degree College, Marh, 181206, Jammu, JKUT, India.
| | - Devendra Kumar Pandey
- School of Bioengineering & Biosciences, Lovely Professional University, Phagwara, 144411, Punjab, India.
| | - R K Manhas
- Department of Botany, Govt. Degree College, Basohli, 184201, JKUT, India.
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Laczkó-Zöld E, Csupor-Löffler B, Kolcsár EB, Ferenci T, Nan M, Tóth B, Csupor D. The metabolic effect of Momordica charantia cannot be determined based on the available clinical evidence: a systematic review and meta-analysis of randomized clinical trials. Front Nutr 2024; 10:1200801. [PMID: 38274207 PMCID: PMC10808600 DOI: 10.3389/fnut.2023.1200801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Several studies have shown that Momordica charantia L. (Cucurbitaceae, bitter melon) has beneficial effects on metabolic syndrome (MetS) parameters and exerts antidiabetic, anti-hyperlipidemic, and anti-obesity activities. Since the findings of these studies are contradictory, the goal of this systematic review and meta-analysis was to assess the efficacy of bitter melon in the treatment of metabolic syndrome, with special emphasis on the anti-diabetic effect. Embase, Cochrane, PubMed, and Web of Science databases were searched for randomized controlled human trials (RCTs). The meta-analysis was reported according to the PRISMA statement. The primary outcomes of the review are body weight, BMI, fasting blood glucose, glycated hemoglobin A1c, systolic blood pressure, diastolic blood pressure, serum triglyceride, HDL, LDL, and total cholesterol levels. Nine studies were included in the meta-analysis with 414 patients in total and 4-16 weeks of follow-up. In case of the meta-analysis of change scores, no significant effect could be observed for bitter melon treatment over placebo on fasting blood glucose level (MD = -0.03; 95% CI: -0.38 to 0.31; I2 = 34%), HbA1c level (MD = -0.12; 95% CI: -0.35 to 0.11; I2 = 56%), HDL (MD = -0.04; 95% CI: -0.17 to 0.09; I2 = 66%), LDL (MD = -0.10; 95% CI: -0.28 to 0.08; I2 = 37%), total cholesterol (MD = -0.04; 95% CI: -0.17 to 0.09; I2 = 66%,), body weight (MD = -1.00; 95% CI: -2.59-0.59; I2 = 97%), BMI (MD = -0.42; 95% CI: -0.99-0.14; I2 = 95%), systolic blood pressure (MD = 1.01; 95% CI: -1.07-3.09; I2 = 0%) and diastolic blood pressure levels (MD = 0.24; 95% CI: -1.04-1.53; I2 = 0%). Momordica treatment was not associated with a notable change in ALT, AST, and creatinine levels compared to the placebo, which supports the safety of this plant. However, the power was overall low and the meta-analyzed studies were also too short to reliably detect long-term metabolic effects. This highlights the need for additional research into this plant in carefully planned clinical trials of longer duration.
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Affiliation(s)
- Eszter Laczkó-Zöld
- Department of Pharmacognosy and Phytotherapy, "George Emil Palade" University of Medicine, Pharmacy, Sciences, and Technology of Târgu Mureş, Târgu Mureş, Romania
| | - Boglárka Csupor-Löffler
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Edina-Blanka Kolcsár
- Department of Pharmacognosy and Phytotherapy, "George Emil Palade" University of Medicine, Pharmacy, Sciences, and Technology of Târgu Mureş, Târgu Mureş, Romania
| | - Tamás Ferenci
- Physiological Controls Research Center, Óbuda University, Budapest, Hungary
- Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
| | - Monica Nan
- Pharmacy Department, Encompass Health Rehabilitation Hospital of Round Rock, Round Rock, TX, United States
| | - Barbara Tóth
- Institute of Clinical Pharmacy, University of Szeged, Szeged, Hungary
| | - Dezső Csupor
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Institute of Clinical Pharmacy, University of Szeged, Szeged, Hungary
- Institute of Pharmacognosy, University of Szeged, Szeged, Hungary
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Sukhikh S, Babich O, Prosekov A, Kalashnikova O, Noskova S, Bakhtiyarova A, Krol O, Tsvetkova E, Ivanova S. Antidiabetic Properties of Plant Secondary Metabolites. Metabolites 2023; 13:metabo13040513. [PMID: 37110171 PMCID: PMC10144365 DOI: 10.3390/metabo13040513] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 04/05/2023] Open
Abstract
The prevalence of diabetes mellitus is one of the major medical problems that the modern world is currently facing. Type 1 and Type 2 diabetes mellitus both result in early disability and death, as well as serious social and financial problems. In some cases, synthetic drugs can be quite effective in the treatment of diabetes, though they have side effects. Plant-derived pharmacological substances are of particular interest. This review aims to study the antidiabetic properties of secondary plant metabolites. Existing review and research articles on the investigation of the antidiabetic properties of secondary plant metabolites, the methods of their isolation, and their use in diabetes mellitus, as well as separate articles that confirm the relevance of the topic and expand the understanding of the properties and mechanisms of action of plant metabolites, were analyzed for this review. The structure and properties of plants used for the treatment of diabetes mellitus, including plant antioxidants, polysaccharides, alkaloids, and insulin-like plant substances, as well as their antidiabetic properties and mechanisms for lowering blood sugar, are presented. The main advantages and disadvantages of using phytocomponents to treat diabetes are outlined. The types of complications of diabetes mellitus and the effects of medicinal plants and their phytocomponents on them are described. The effects of phytopreparations used to treat diabetes mellitus on the human gut microbiota are discussed. Plants with a general tonic effect, plants containing insulin-like substances, plants-purifiers, and plants rich in vitamins, organic acids, etc. have been shown to play an important role in the treatment of type 2 diabetes mellitus and the prevention of its complications.
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Affiliation(s)
- Stanislav Sukhikh
- Institute of Living Systems, Immanuel Kant Baltic Federal University, A. Nevskogo Street 14, 236016 Kaliningrad, Russia
| | - Olga Babich
- Institute of Living Systems, Immanuel Kant Baltic Federal University, A. Nevskogo Street 14, 236016 Kaliningrad, Russia
| | - Alexander Prosekov
- Laboratory of Biocatalysis, Kemerovo State University, Krasnaya Street 6, 650043 Kemerovo, Russia
| | - Olga Kalashnikova
- Institute of Living Systems, Immanuel Kant Baltic Federal University, A. Nevskogo Street 14, 236016 Kaliningrad, Russia
| | - Svetlana Noskova
- Institute of Living Systems, Immanuel Kant Baltic Federal University, A. Nevskogo Street 14, 236016 Kaliningrad, Russia
| | - Alina Bakhtiyarova
- Institute of Living Systems, Immanuel Kant Baltic Federal University, A. Nevskogo Street 14, 236016 Kaliningrad, Russia
| | - Olesia Krol
- Institute of Living Systems, Immanuel Kant Baltic Federal University, A. Nevskogo Street 14, 236016 Kaliningrad, Russia
| | - Elena Tsvetkova
- Department of Biochemistry, St. Petersburg State University, 199034 Saint-Petersburg, Russia
- Department of General Pathology and Pathological Physiology, Institute of Experimental Medicine, 197022 Saint-Petersburg, Russia
| | - Svetlana Ivanova
- Natural Nutraceutical Biotesting Laboratory, Kemerovo State University, Krasnaya Street 6, 650043 Kemerovo, Russia
- Department of TNSMD Theory and Methods, Kemerovo State University, Krasnaya Street 6, 650043 Kemerovo, Russia
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Yu X, Su T, Liu B. Two new triterpenoids preventing the hydrocortisone-induced injury in HMEC-1 cells from Momordica charantia L. Nat Prod Res 2023; 37:663-668. [PMID: 35546104 DOI: 10.1080/14786419.2022.2075863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Momordica charantia L. (M. charantia) is an annual climbing herb in Cucurbitaceae. As a medicinal and edible homologous plant, it has a long history of application. This study aims to isolate and identify the chemical constituents from M. charantia and evaluate their prevention effect on hydrocortisone-induced injury in HMEC-1 cells. 10 kg of M. charantia was extracted with 95% ethanol for three times and partitioned with petroleum ether, dichloromethane and n-butanol. The dichloromethane part was performed by silica, ODS silica, Sephadex LH-20 column chromatography and semi-preparative HPLC to obtain two new compounds. The prevention effect on hydrocortisone-induced injury in HMEC-1 cells of these two compounds was determined by the method of CCK-8. The cell viability of HMEC-1 cells treated with 2 (25 μM) was 85.85% ± 4.39%. The results indicated that 2 exhibited significantly prevention effect on hydrocortisone-induced injury in HMEC-1 cells but 1 exhibited no this activity in vitro.
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Affiliation(s)
- Xiaoling Yu
- Department of Respiratory, The Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Tongchun Su
- Department of Cadre Diagnosis and Treatment, The Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Bing Liu
- College of Pharmacy, Harbin University of Commerce, Harbin, P.R. China
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12
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Combinatory Effect and Modes of Action of Chrysin and Bone Marrow-Derived Mesenchymal Stem Cells on Streptozotocin/Nicotinamide-Induced Diabetic Rats. Pharmaceuticals (Basel) 2022; 16:ph16010034. [PMID: 36678531 PMCID: PMC9863970 DOI: 10.3390/ph16010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/25/2022] [Accepted: 12/18/2022] [Indexed: 12/28/2022] Open
Abstract
The purpose of this study was to see how chrysin and/or bone marrow-derived mesenchymal stem cells (BM-MSCs) affected streptozotocin (STZ)/nicotinamide (NA)-induced diabetic rats as an animal model of type 2 diabetes mellitus (T2DM). Male Wistar rats were given a single intraperitoneal (i.p.) injection of 60 mg STZ/kg bodyweight (bw) 15 min after an i.p. injection of NA (120 mg/kg bw) to induce T2DM. The diabetic rats were given chrysin orally at a dose of 100 mg/kg bw every other day, BM-MSCs intravenously at a dose of 1 × 106 cells/rat/week, and their combination for 30 days after diabetes induction. The rats in the diabetic group displayed impaired oral glucose tolerance and a decrease in liver glycogen content and in serum insulin, C-peptide, and IL-13 levels. They also had significantly upregulated activities in terms of liver glucose-6-phosphatase and glycogen phosphorylase and elevated levels of serum free fatty acids, IL-1β, and TNF-α. In addition, the diabetic rats exhibited a significant elevation in the adipose tissue resistin protein expression level and a significant decrease in the expression of adiponectin, insulin receptor-beta subunit, insulin receptor substrate-1, and insulin receptor substrate-2, which were associated with a decrease in the size of the pancreatic islets and in the number of β-cells and insulin granules in the islets. The treatment of diabetic rats with chrysin and/or BM-MSCs significantly improved the previously deteriorated alterations, with chrysin combined with BM-MSCs being the most effective. Based on these findings, it can be concluded that combining chrysin with BM-MSCs produced greater additive therapeutic value than using them separately in NA/STZ-induced T2DM rats.
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13
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Usai R, Majoni S, Rwere F. Natural products for the treatment and management of diabetes mellitus in Zimbabwe-a review. Front Pharmacol 2022; 13:980819. [PMID: 36091798 PMCID: PMC9449367 DOI: 10.3389/fphar.2022.980819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/02/2022] [Indexed: 12/19/2022] Open
Abstract
Use of medicinal plants and herbs in the treatment and management of diseases, including diabetes mellitus and its complications remains an integral part of African tradition. In Zimbabwe, nearly one million people are living with diabetes mellitus. The prevalence of diabetes mellitus in Zimbabwe is increasing every year due to lifestyle changes, and has accelerated the use of traditional medicines for its treatment and management in urban areas. In addition, the high cost of modern medicine has led many people in rural parts of Zimbabwe to rely on herbal plant medicine for the treatment of diabetes mellitus and its complications. This review highlights a number of studies carried out to evaluate the antidiabetic properties of indigenous plants found in Zimbabwe with the goal of treating diabetes mellitus. Further, we discuss the mechanism of action of various plant extracts in the treatment and management of diabetes mellitus. Together, this review article can open pathways leading to discovery of new plant derived medicines and regularization of use of crude plant remedies to treat diabetes mellitus by the Zimbabwean government and others across Africa.
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Affiliation(s)
- Remigio Usai
- Department of Chemistry, Marquette University, Milwaukee, WI, United States
| | - Stephen Majoni
- Department of Chemical and Forensic Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Freeborn Rwere
- Department Anesthesiology, Perioperative, and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, United States
- Department of Chemistry, School of Natural Sciences and Mathematics, Chinhoyi University of Technology, Chinhoyi, Zimbabwe
- *Correspondence: Freeborn Rwere,
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Chattopadhyay K, Wang H, Kaur J, Nalbant G, Almaqhawi A, Kundakci B, Panniyammakal J, Heinrich M, Lewis SA, Greenfield SM, Tandon N, Biswas TK, Kinra S, Leonardi-Bee J. Effectiveness and Safety of Ayurvedic Medicines in Type 2 Diabetes Mellitus Management: A Systematic Review and Meta-Analysis. Front Pharmacol 2022; 13:821810. [PMID: 35754481 PMCID: PMC9213670 DOI: 10.3389/fphar.2022.821810] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/07/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction: Many Ayurvedic medicines have the potential for managing type 2 diabetes mellitus (T2DM), with previous systematic reviews demonstrating effectiveness and safety for specific Ayurvedic medicines. However, many of the reviews need updating and none provide a comprehensive summary of all the Ayurvedic medicines evaluated for managing T2DM. Objective: The objective of this systematic review was to evaluate and synthesize evidence on the effectiveness and safety of Ayurvedic medicines for managing T2DM. Inclusion criteria: Published and unpublished RCTs assessing the effectiveness and safety of Ayurvedic medicines for managing T2DM in adults. Methods: The JBI systematic review methodology was followed. A comprehensive search of sources (including 18 electronic databases) from inception to 16 January 2021 was made. No language restrictions were applied. Data synthesis was conducted using narrative synthesis and random effects meta-analyses, where appropriate. Pooled results are reported as mean differences (MD) with 95% confidence intervals (CI). Results: Out of 32,519 records identified from the searches, 219 articles were included in the systematic review representing 199 RCTs (21,191 participants) of 98 Ayurvedic medicines. Overall, in the studies reviewed the methodology was not adequately reported, resulting in poorer methodological quality scoring. Glycated hemoglobin (HbA1c) was reduced using Aegle marmelos (L.) Corrêa (MD -1.6%; 95% CI −3 to −0.3), Boswellia serrata Roxb. (−0.5; −0.7 to −0.4), Gynostemma pentaphyllum (Thunb.) Makino (−1; −1.5 to −0.6), Momordica charantia L. (−0.3; −0.4 to −0.1), Nigella sativa L. (−0.4; −0.6 to −0.1), Plantago ovata Forssk. (−0.9; −1.4 to −0.3), Tinospora cordifolia (Willd.) Hook.f. and Thomson (−0.5; −0.6 to −0.5), Trigonella foenum-graecum L. (−0.6; −0.9 to −0.4), and Urtica dioica L. (−1.3; −2.4 to −0.2) compared to control. Similarly, fasting blood glucose (FBG) was reduced by 4–56 mg/dl for a range of Ayurvedic medicines. Very few studies assessed health-related quality of life (HRQoL). Adverse events were not reported in many studies, and if reported, these were mostly none to mild and predominately related to the gastrointestinal tract. Conclusion: The current evidence suggests the benefit of a range of Ayurvedic medicines in improving glycemic control in T2DM patients. Given the limitations of the available evidence and to strengthen the evidence base, high-quality RCTs should be conducted and reported.
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Affiliation(s)
- Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom
| | - Haiquan Wang
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jaspreet Kaur
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Gamze Nalbant
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Abdullah Almaqhawi
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia
| | - Burak Kundakci
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jeemon Panniyammakal
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Michael Heinrich
- Centre for Pharmacognosy and Phytotherapy, School of Pharmacy, University College London, London, United Kingdom
| | - Sarah Anne Lewis
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | | | - Nikhil Tandon
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India
| | - Tuhin Kanti Biswas
- Department of Kayachikitsa, J B Roy State Ayurvedic Medical College and Hospital, Kolkata, India
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom
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15
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Peter EL, Sesaazi CD. D-optimal mixture design optimized solid formulation containing fruits extracts of Momordica charantia and Abelmoschus esculentus. PLoS One 2022; 17:e0270547. [PMID: 35749521 PMCID: PMC9232165 DOI: 10.1371/journal.pone.0270547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
Fruit extracts of Momordica charantia L. (Cucurbitaceae) and Abelmoschus esculentus (L.) Moench (Malvaceae) have shown promising antidiabetic activities in clinical trials. However, they remain underutilized due to insufficient standardization and lack of formulation containing their mixture. This study’s overall purpose was to develop and optimize a capsule dosage form containing dried fruit extracts of M. charantia and A. esculentus. The design of the experiment involved two steps; first, response surface methodology (RSM) with a five-level two-factor central composite rotatable design (CCRD) was employed to determine the optimal dose of a mixture of extracts for adequate glycemic control. The extract of M. charantia and A. esculentus were the independent variables while fasting plasma glucose (FPG) was the dependent factor. In the second step, a D-optimal mixture design was applied to study the interaction effect of the optimal dose and selected excipients on granules flowability and capsules’ disintegration time. Moreover, a second-order quadratic model determined the interrelationship of excipients and the desired capsules’ quality attributes. The validity of the predicted models was confirmed. The findings indicated that a combined dose of 175 A. esculentus and 281 M. charantia (mg/kg) significantly reduced the FPG level compared to vehicle at day 14 (mean difference -2.7 ± 0.21, p < 0.001). This dose was used to make a 600 mg capsule (DM083) with 76% drug loading. The DM083 had 40.4 ± 0.62 mg GAE/gDW total polyphenols, 12 peaks HPLC fingerprint, and 26.6 ± 4.75 min average disintegration time. Together, these findings showed that a mixture of M. charantia and A. esculentus fruit extracts could be formulated in a stable capsule dosage form with acceptable quality standards. Further biological studies such as toxicity assays and long-term efficacy studies of the developed capsules could be carried out before large-scale commercial production.
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Affiliation(s)
- Emanuel L. Peter
- Department of Innovation, Technology Transfer and Commercialization, National Institute for Medical Research, Dar Es Salaam, Tanzania
- * E-mail: ,
| | - Crispin D. Sesaazi
- Department of Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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16
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Çiçek SS. Momordica charantia L.-Diabetes-Related Bioactivities, Quality Control, and Safety Considerations. Front Pharmacol 2022; 13:904643. [PMID: 35656300 PMCID: PMC9152207 DOI: 10.3389/fphar.2022.904643] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 04/28/2022] [Indexed: 11/21/2022] Open
Abstract
Momordica charantia L. (Cucurbitaceae), commonly known as bitter gourd or bitter melon, is widely cultivated in many tropical and subtropical regions of the world, where its unripe fruits are eaten as a vegetable. Apart from its culinary use, M. charantia has a long history in traditional medicine, serving as stomachic, laxative or anthelmintic, and, most notably, for the treatment of diabetes and its complications. Its antidiabetic properties and its beneficial effects on blood glucose and lipid concentrations have been reported in numerous in vitro and in vivo studies, but the compounds responsible for the observed effects have not yet been adequately described. Early reports were made for charantin, a mixture of two sterol glucosides, and the polypeptide p-insulin, but their low concentrations in the fruits or their limited bioavailability cannot explain the observed therapeutic effects. Still, for many decades the search for more reasonable active principles was omitted. However, in the last years, research more and more focused on the particular cucurbitane-type triterpenoids abundant in the fruits and other parts of the plant. This mini review deals with compounds isolated from the bitter gourd and discusses their bioactivities in conjunction with eventual antidiabetic or adverse effects. Furthermore, methods for the quality control of bitter gourd fruits and preparations will be evaluated for their meaningfulness and their potential use in the standardization of commercial preparations.
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Affiliation(s)
- Serhat S Çiçek
- Department of Pharmaceutical Biology, Institute of Pharmacy, Kiel University, Kiel, Germany
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17
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Xu B, Li Z, Zeng T, Zhan J, Wang S, Ho CT, Li S. Bioactives of Momordica charantia as Potential Anti-Diabetic/Hypoglycemic Agents. Molecules 2022; 27:2175. [PMID: 35408574 PMCID: PMC9000558 DOI: 10.3390/molecules27072175] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 11/17/2022] Open
Abstract
Momordica charantia L., a member of the Curcubitaceae family, has traditionally been used as herbal medicine and as a vegetable. Functional ingredients of M. charantia play important roles in body health and human nutrition, which can be used directly or indirectly in treating or preventing hyperglycemia-related chronic diseases in humans. The hypoglycemic effects of M. charantia have been known for years. In this paper, the research progress of M. charantia phytobioactives and their hypoglycemic effects and related mechanisms, especially relating to diabetes mellitus, has been reviewed. Moreover, the clinical application of M. charantia in treating diabetes mellitus is also discussed, hoping to broaden the application of M. charantia as functional food.
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Affiliation(s)
- Bilin Xu
- College of Biology and Agricultural Resources, Huanggang Normal University, Huanggang 438000, China; (B.X.); (Z.L.); (J.Z.); (S.W.)
| | - Zhiliang Li
- College of Biology and Agricultural Resources, Huanggang Normal University, Huanggang 438000, China; (B.X.); (Z.L.); (J.Z.); (S.W.)
| | - Ting Zeng
- College of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China;
| | - Jianfeng Zhan
- College of Biology and Agricultural Resources, Huanggang Normal University, Huanggang 438000, China; (B.X.); (Z.L.); (J.Z.); (S.W.)
| | - Shuzhen Wang
- College of Biology and Agricultural Resources, Huanggang Normal University, Huanggang 438000, China; (B.X.); (Z.L.); (J.Z.); (S.W.)
| | - Chi-Tang Ho
- Department of Food Science, Rutgers University, New Brunswick, NJ 08901, USA;
| | - Shiming Li
- College of Biology and Agricultural Resources, Huanggang Normal University, Huanggang 438000, China; (B.X.); (Z.L.); (J.Z.); (S.W.)
- Department of Food Science, Rutgers University, New Brunswick, NJ 08901, USA;
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18
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Alam S, Sarker MMR, Sultana TN, Chowdhury MNR, Rashid MA, Chaity NI, Zhao C, Xiao J, Hafez EE, Khan SA, Mohamed IN. Antidiabetic Phytochemicals From Medicinal Plants: Prospective Candidates for New Drug Discovery and Development. Front Endocrinol (Lausanne) 2022; 13:800714. [PMID: 35282429 PMCID: PMC8907382 DOI: 10.3389/fendo.2022.800714] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/04/2022] [Indexed: 02/05/2023] Open
Abstract
Diabetes, a chronic physiological dysfunction affecting people of different age groups and severely impairs the harmony of peoples' normal life worldwide. Despite the availability of insulin preparations and several synthetic oral antidiabetic drugs, there is a crucial need for the discovery and development of novel antidiabetic drugs because of the development of resistance and side effects of those drugs in long-term use. On the contrary, plants or herbal sources are getting popular day by day to the scientists, researchers, and pharmaceutical companies all over the world to search for potential bioactive compound(s) for the discovery and development of targeted novel antidiabetic drugs that may control diabetes with the least unwanted effects of conventional antidiabetic drugs. In this review, we have presented the prospective candidates comprised of either isolated phytochemical(s) and/or extract(s) containing bioactive phytoconstituents which have been reported in several in vitro, in vivo, and clinical studies possessing noteworthy antidiabetic potential. The mode of actions, attributed to antidiabetic activities of the reported phytochemicals and/or plant extracts have also been described to focus on the prospective phytochemicals and phytosources for further studies in the discovery and development of novel antidiabetic therapeutics.
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Affiliation(s)
- Safaet Alam
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
| | - Md. Moklesur Rahman Sarker
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
- Pharmacology and Toxicology Research Division, Health Med Science Research Limited, Dhaka, Bangladesh
- *Correspondence: Md. Moklesur Rahman Sarker, ; ; orcid.org/0000-0001-9795-0608; Isa Naina Mohamed, ; orcid.org/0000-0001-8891-2423
| | | | | | - Mohammad A. Rashid
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | | | - Chao Zhao
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Jianbo Xiao
- Department of Analytical Chemistry and Food Science, Faculty of Food Science and Technology, University of Vigo, Vigo, Spain
| | - Elsayed E. Hafez
- Plant Protection and Biomolecular Diagnosis Department, ALCRI (Arid Lands Cultivation Research Institute), City of Scientific Research and Technological Applications, Alexandria, Egypt
| | - Shah Alam Khan
- College of Pharmacy, National University of Science & Technology, Muscat, Oman
| | - Isa Naina Mohamed
- Pharmacology Department, Medicine Faculty, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
- *Correspondence: Md. Moklesur Rahman Sarker, ; ; orcid.org/0000-0001-9795-0608; Isa Naina Mohamed, ; orcid.org/0000-0001-8891-2423
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19
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Liao PY, Lo HY, Liu IC, Lo LC, Hsiang CY, Ho TY. The novel anti-inflammatory activity of mcIRBP from Momordica charantia is associated with the improvement of diabetic nephropathy. Food Funct 2022; 13:1268-1279. [DOI: 10.1039/d1fo03620c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Diabetic nephropathy is an inflammatory immune disorder accompanying diabetes.
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Affiliation(s)
- Pei-Yung Liao
- Graduate Institute of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Hsin-Yi Lo
- Graduate Institute of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - I-Chen Liu
- Graduate Institute of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Lun-Chien Lo
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Chien-Yun Hsiang
- Department of Microbiology and Immunology, China Medical University, Taichung 40402, Taiwan
| | - Tin-Yun Ho
- Graduate Institute of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Department of Health and Nutrition Biotechnology, Asia University, Taichung 41354, Taiwan
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20
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Willcox ML, Elugbaju C, Al-Anbaki M, Lown M, Graz B. Effectiveness of Medicinal Plants for Glycaemic Control in Type 2 Diabetes: An Overview of Meta-Analyses of Clinical Trials. Front Pharmacol 2021; 12:777561. [PMID: 34899340 PMCID: PMC8662558 DOI: 10.3389/fphar.2021.777561] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/09/2021] [Indexed: 01/08/2023] Open
Abstract
Aims: To rank the effectiveness of medicinal plants for glycaemic control in Type 2 Diabetes (T2DM). Methods: MEDLINE, EMBASE, CINAHL and Cochrane Central were searched in October 2020. We included meta-analyses of randomised controlled clinical trials measuring the effectiveness of medicinal plants on HbA1c and/or Fasting Plasma Glucose (FPG) in patients with T2DM. Results: Twenty five meta-analyses reported the effects of 18 plant-based remedies. Aloe vera leaf gel, Psyllium fibre and Fenugreek seeds had the largest effects on HbA1c: mean difference –0.99% [95% CI−1.75, −0.23], −0.97% [95% CI −1.94, −0.01] and −0.85% [95% CI −1.49, −0.22] respectively. Four other remedies reduced HbA1c by at least 0.5%: Nigellasativa, Astragalus membranaceus, and the traditional Chinese formulae Jinqi Jiangtang and Gegen Qinlian. No serious adverse effects were reported. Several other herbal medicines significantly reduced FPG. Tea and tea extracts (Camellia sinensis) were ineffective. However, in some trials duration of follow-up was insufficient to measure the full effect on HbA1c (<8 weeks). Many herbal remedies had not been evaluated in a meta-analysis. Conclusion: Several medicinal plants appear to be as effective as conventional antidiabetic treatments for reducing HbA1c. Rigorous trials with at least 3 months’ follow-up are needed to ascertain the effects of promising plant-based preparations on diabetes.
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Affiliation(s)
- Merlin L Willcox
- Primary Care Research Centre, Aldermoor Health Centre, University of Southampton, Southampton, United Kingdom
| | - Christina Elugbaju
- Primary Care Research Centre, Aldermoor Health Centre, University of Southampton, Southampton, United Kingdom
| | | | - Mark Lown
- Primary Care Research Centre, Aldermoor Health Centre, University of Southampton, Southampton, United Kingdom
| | - Bertrand Graz
- Medicines Unit, Antenna Foundation, Geneva, Switzerland
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21
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Development and validation of a RP-HPLC-DAD method for quantification of charantin in Momordica charantia products. J Food Compost Anal 2021. [DOI: 10.1016/j.jfca.2021.104161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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22
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Gao Y, Li X, Huang Y, Chen J, Qiu M. Bitter Melon and Diabetes Mellitus. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1923733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ya Gao
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, PR China
- University of the Chinese Academy of Sciences, Beijing, PR China
- Yunnan Key Laboratory of Natural Medicinal Chemistry, Chinese Academy of Sciences, Kunming, PR China
| | - Xian Li
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, PR China
- University of the Chinese Academy of Sciences, Beijing, PR China
- Yunnan Key Laboratory of Natural Medicinal Chemistry, Chinese Academy of Sciences, Kunming, PR China
| | - Yanjie Huang
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, PR China
- University of the Chinese Academy of Sciences, Beijing, PR China
- Yunnan Key Laboratory of Natural Medicinal Chemistry, Chinese Academy of Sciences, Kunming, PR China
| | - Jianchao Chen
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, PR China
| | - Minghua Qiu
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, PR China
- University of the Chinese Academy of Sciences, Beijing, PR China
- Yunnan Key Laboratory of Natural Medicinal Chemistry, Chinese Academy of Sciences, Kunming, PR China
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23
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Arif R, Ahmad S, Mustafa G, Mahrosh HS, Ali M, Tahir ul Qamar M, Dar HR. Molecular Docking and Simulation Studies of Antidiabetic Agents Devised from Hypoglycemic Polypeptide-P of Momordica charantia. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5561129. [PMID: 34589547 PMCID: PMC8476269 DOI: 10.1155/2021/5561129] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/30/2021] [Accepted: 09/04/2021] [Indexed: 12/15/2022]
Abstract
Diabetes mellitus termed as metabolic disorder is a collection of interlinked diseases and mainly body's inability to manage glucose level which leads to cardiovascular diseases, renal failure, neurological disorders, and many others. The drugs contemporarily used for diabetes have many inevitable side effects, and many of them have become less responsive to this multifactorial disorder. Momordica charantia commonly known as bitter gourd has many bioactive compounds with antidiabetic properties. The current study was designed to use computational methods to discover the best antidiabetic peptides devised from hypoglycemic polypeptide-P of M. charantia. The binding affinity and interaction patterns of peptides were evaluated against four receptor proteins (i.e., as agonists of insulin receptor and inhibitors of sodium-glucose cotransporter 1, dipeptidyl peptidase-IV, and glucose transporter 2) using molecular docking approach. A total of thirty-seven peptides were docked against these receptors. Out of which, top five peptides against each receptor were shortlisted based on their S-scores and binding affinities. Finally, the eight best ligands (i.e., LIVA, TSEP, EKAI, LKHA, EALF, VAEK, DFGAS, and EPGGGG) were selected as these ligands strictly followed Lipinski's rule of five and exhibited good ADMET profiling. One peptide EPGGGG showed activity towards insulin and SGLT1 receptor proteins. The top complex for both these targets was subjected to 50 ns of molecular dynamics simulations and MM-GBSA binding energy test that concluded both complexes as highly stable, and the intermolecular interactions were dominated by van der Waals and electrostatic energies. Overall, the selected ligands strongly fulfilled the drug-like evaluation criterion and proved to have good antidiabetic properties.
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Affiliation(s)
- Rawaba Arif
- Department of Biochemistry, Government College University, Faisalabad 38000, Pakistan
| | - Sajjad Ahmad
- Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan
| | - Ghulam Mustafa
- Department of Biochemistry, Government College University, Faisalabad 38000, Pakistan
| | - Hafiza Salaha Mahrosh
- Department of Biochemistry, Government College University, Faisalabad 38000, Pakistan
| | - Muhammad Ali
- Department of Biotechnology, Akhuwat Faisalabad Institute of Research Science and Technology, Faisalabad 38000, Pakistan
| | | | - Hafiza Rabia Dar
- Department of Biochemistry, University of Agriculture, Faisalabad 38040, Pakistan
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Bae W, Kim S, Choi J, Lee TW, Bae E, Jang HN, Jung S, Lee S, Chang SH, Park DJ. Acute interstitial nephritis associated with ingesting a Momordica charantia extract: A case report. Medicine (Baltimore) 2021; 100:e26606. [PMID: 34232214 PMCID: PMC8270600 DOI: 10.1097/md.0000000000026606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/22/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Momordica charantia is often used to treat type 2 diabetes mellitus in Korea. Drug-induced acute interstitial nephritis (AIN) accounts for 60% to 70% of AIN cases. However, only 1 case of AIN associated with ingesting M charantia has been reported in the English literature. We report an extremely rare case of AIN that occurred after a patient ingested a pure M charantia extract over 7 months. PATIENT CONCERNS A 60-year-old Korean woman was admitted to our hospital for a renal biopsy. Her renal function had decreased gradually over the last 9 months without symptoms or signs. DIAGNOSIS Her blood urea nitrogen and serum creatinine levels were 29.7 mg/dL (range: 8.0-20.0 mg/dL) and 1.45 mg/dL (range: 0.51-0.95 mg/dL) on admission. Renal histology indicated AIN; there was immune cell infiltration into the interstitium, tubulitis, and epithelial casts, although the glomeruli were largely intact. INTERVENTIONS M charantia was discontinued and prednisolone was prescribed. OUTCOMES The value of serum creatinine has almost been restored to the baseline level after 3 months. CONCLUSION s: This is the first case report of AIN associated with the ingestion of a pure M charantia extract. Recognition of the possible adverse effects of these agents by physicians is very important for early diagnosis and appropriate management.
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Affiliation(s)
- Wooram Bae
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Seongmin Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jungyoon Choi
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Tae Won Lee
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Eunjin Bae
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
- Department of Internal Medicine, Gyeongsang National University College of Medicine, South Korea
- Institute of Health Science, Gyeongsang National University, Jinju, South Korea
| | - Ha Nee Jang
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Sehyun Jung
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Seunghye Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Se-Ho Chang
- Department of Internal Medicine, Gyeongsang National University College of Medicine, South Korea
- Institute of Health Science, Gyeongsang National University, Jinju, South Korea
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Dong Jun Park
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
- Department of Internal Medicine, Gyeongsang National University College of Medicine, South Korea
- Institute of Health Science, Gyeongsang National University, Jinju, South Korea
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Therapeutic potential of targeting intestinal bitter taste receptors in diabetes associated with dyslipidemia. Pharmacol Res 2021; 170:105693. [PMID: 34048925 DOI: 10.1016/j.phrs.2021.105693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/23/2021] [Accepted: 05/23/2021] [Indexed: 12/19/2022]
Abstract
Intestinal release of incretin hormones after food intake promotes glucose-dependent insulin secretion and regulates glucose homeostasis. The impaired incretin effects observed in the pathophysiologic abnormality of type 2 diabetes have triggered the pharmacological development of incretin-based therapy through the activation of glucagon-like peptide-1 (GLP-1) receptor, including GLP-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase 4 (DPP4) inhibitors. In the light of the mechanisms involved in the stimulation of GLP-1 secretion, it is a fundamental question to explore whether glucose and lipid homeostasis can be manipulated by the digestive system in response to nutrient ingestion and taste perception along the gastrointestinal tract. While glucose is a potent stimulant of GLP-1 secretion, emerging evidence highlights the importance of bitter tastants in the enteroendocrine secretion of gut hormones through activation of bitter taste receptors. This review summarizes bitter chemosensation in the intestines for GLP-1 secretion and metabolic regulation based on recent advances in biological research of bitter taste receptors and preclinical and clinical investigation of bitter medicinal plants, including bitter melon, hops strobile, and berberine-containing herbs (e.g. coptis rhizome and barberry root). Multiple mechanisms of action of relevant bitter phytochemicals are discussed with the consideration of pharmacokinetic studies. Current evidence suggests that specific agonists targeting bitter taste receptors, such as human TAS2R1 and TAS2R38, may provide both metabolic benefits and anti-inflammatory effects with the modulation of the enteroendocrine hormone secretion and bile acid turnover in metabolic syndrome individuals or diabetic patients with dyslipidemia-related comorbidities.
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Bitter Melon ( Momordica charantia L.) Fruit Bioactives Charantin and Vicine Potential for Diabetes Prophylaxis and Treatment. PLANTS 2021; 10:plants10040730. [PMID: 33918062 PMCID: PMC8070166 DOI: 10.3390/plants10040730] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 12/25/2022]
Abstract
Natural products are gaining clinical significance in modern day health care systems to prevent diseases. Bitter melon, a health promoting vegetable, is traditionally used for medical nutrition therapy to cure diabetes but to reap maximum health claims, vigilant control of its substances in diet is crucial as part of curative action for effective diabetes management. In the present research, first phase focused on detection of key bioactive components, i.e., charantin and vicine in different parts of its fruit. In the second phase, normal and hyperglycemic Sprague Dawley rats were fed on skin, flesh and whole fruit of bitter melon at 150 and 300 mg/kg body weight and assessed for diabetes prophylaxis and treatment. The highest amount of charantin (0.16 ± 0.02 mg/g) was recorded in flesh while vicine was present in abundance in whole fruit (0.21 ± 0.01 μg/100 g). In normal rats, bitter melon supplementation was helpful in managing the onset of diabetes. Hyperglycemic rats showed diabetic complications including polydipsia, polyuria, glycosuria, renal hypertrophy and increased glomerular filtration rate. However, bitter melon consumption showed significant improvements in these parameters. The most potent dose was 300 mg/kg whole fruit that resulted in 31.64% lowering of blood glucose level and 27.35% increase in insulin level in hyperglycemic rats.
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Peter EL, Nagendrappa PB, Hilonga S, Tuyiringire N, Ashuro E, Kaligirwa A, Sesaazi CD. Pharmacological reflection of plants traditionally used to manage diabetes mellitus in Tanzania. JOURNAL OF ETHNOPHARMACOLOGY 2021; 269:113715. [PMID: 33358853 DOI: 10.1016/j.jep.2020.113715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/01/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The increasing national prevalence of diabetes mellitus (DM) and its complications have overstretched the health care system in Tanzania and influenced patients to use herbal medicines as alternative therapeutic strategies. Therefore, an urgent need exists to validate the safety and efficacy of plants used locally. AIM OF THE STUDY To identify plants used for the management of DM in Tanzania and analyses their pharmacological, phytochemistry, and safety evidence with a special focus on the mechanism of action. METHODS Researchers searched Medline, web of science, and Scopus for published articles. Also, specialized herbarium documents of Muhimbili Institute of traditional medicine were reviewed. Articles were assessed for relevance, quality, and taxonomical accuracy before being critically reviewed. RESULTS We identified 62 plant species used locally for DM management. Moringa oleifera Lam. and Cymbopogon citratus (D.C) stapf were the most mentioned. Fifty-four phytochemicals from 13 species had DM activities. These were mainly; polyphenolics, phytosterols, and triterpenoids. Extracts, fractions, and pure compounds from 18 species had in vitro antidiabetic activities of which 14 had α-glucosidase and α-amylase inhibition effects. The most studied -Momordica charantia L. increased; glucose uptake and adiponectin release in 3T3-L1 adipocytes, insulin secretion, insulin receptor substrate-1 (IRS-1), GLUT-4 translocation, and GLP-1 secretion; and inhibited protein tyrosine phosphatase 1 B (PTP1B). Preclinical studies reported 30 species that lower plasma glucose with molecular targets in the liver, skeletal muscles, adipose tissues, pancreases, and stomach. While three species; Aspilia mossambiscensis (Oliv.) Willd, Caesalpinia bonduc (L.) Roxb, and Phyllanthus amarus Schumach. & Thonn. had mild toxicity in animals, 33 had no report of their efficacy in DM management or toxicity. CONCLUSION Local communities in Tanzania use herbal medicine for the management of DM. However, only a fraction of such species has scientific evidence. A. mossambiscensis, C. bonduc., and P. amarus had mild toxicity in animals. Together, our findings call for future researches to focus on in vitro, in vivo, and phytochemical investigation of plant species for which their use in DM among the local communities in Tanzania have not been validated.
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Affiliation(s)
- Emanuel L Peter
- Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Prakash B Nagendrappa
- Centre for Local Health Traditions & Policy, The University of Trans-disciplinary Health Sciences and Technology, Bengaluru, India.
| | - Samson Hilonga
- Institute of Traditional Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Naasson Tuyiringire
- Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Efrata Ashuro
- Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Anita Kaligirwa
- Department of Pharmacology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Crispin Duncan Sesaazi
- Department of Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
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Liu Z, Gong J, Huang W, Lu F, Dong H. The Effect of Momordica charantia in the Treatment of Diabetes Mellitus: A Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:3796265. [PMID: 33510802 PMCID: PMC7826218 DOI: 10.1155/2021/3796265] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/02/2020] [Accepted: 12/18/2020] [Indexed: 12/29/2022]
Abstract
In recent years, many studies of Momordica charantia (MC) in the treatment of diabetes mellitus (DM) and its complications have been reported. This article reviewed the effect and mechanism of MC against diabetes, including the results from in vitro and in vivo experiments and clinical trials. The common side effects of MC were also summarized. We hope that it might open up new ideas for further mechanism exploration and clinical application as well as provide a scientific theoretical basis for the development of drugs or foods derived from MC.
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Affiliation(s)
- Zhuo Liu
- Grade 2016 of Integrated Traditional Chinese and Western Clinical Medicine, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Gong
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenya Huang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fuer Lu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Dong
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Rainkie DC, Abedini ZS, Abdelkader NN. Reporting and methodological quality of systematic reviews and meta-analysis with protocols in Diabetes Mellitus Type II: A systematic review. PLoS One 2020; 15:e0243091. [PMID: 33326429 PMCID: PMC7743973 DOI: 10.1371/journal.pone.0243091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/15/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Systematic reviews with or without meta-analyses (SR/MAs) are strongly encouraged to work from a protocol to facilitate high quality, transparent methodology. The completeness of reporting of a protocol (PRISMA-P) and manuscript (PRISMA) is essential to the quality appraisal (AMSTAR-2) and appropriate use of SR/MAs in making treatment decisions. OBJECTIVES The objectives of this study were to describe the completeness of reporting and quality of SR/MAs, assess the correlations between PRISMA-P, PRISMA, and AMSTAR-2, and to identify reporting characteristics between similar items of PRISMA-P and PRISMA. METHODS We performed a systematic review of Type 2 Diabetes Mellitus SR/MAs of hypoglycemic agents with publicly available protocols. Cochrane reviews, guidelines, and specific types of MA were excluded. Two reviewers independently, (i) searched PubMed and Embase between 1/1/2015 to 20/3/2019; (ii) identified protocols of included studies by searching the manuscript bibliography, supplementary material, PROSPERO, and Google; (iii) completed PRISMA-P, PRISMA, and AMSTAR-2 tools. Data analysis included descriptive statistics, Pearson correlation, and multivariable linear regression. RESULTS Of 357 relevant SR/MAs, 51 had available protocols and were included. The average score for PRISMA-P was 15.8±3.3 (66%; maximum 24) and 25.2±1.1 (93%; maximum 27) for PRISMA. The quality of SR/MAs assessed using the AMSTAR-2 tool identified an overall poor quality (63% critically low, 18% low, 8% moderate, 12% high). The correlation between the PRISMA-P and PRISMA was not significant (r = 0.264; p = 0.06). Correlation was significant between PRISMA-P and AMSTAR-2 (r = 0.333; p = 0.02) and PRISMA and AMSTAR-2 (r = 0.555; p<0.01). Discrepancies in reporting were common between similar PRISMA-P and PRISMA items. CONCLUSION Adherence to protocol reporting guidance was poor while manuscript reporting was comprehensive. Protocol completeness is not associated with a completely reported manuscript. Independently, PRISMA-P and PRISMA scores were weakly associated with higher quality assessments but insufficient as a surrogate for quality. Critical areas for quality improvement include protocol description, investigating causes of heterogeneity, and the impact of risk of bias on the evidence synthesis.
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Lu K, Chen S, Lin Y, Wu H, Chao P. An antidiabetic nutraceutical combination of red yeast rice ( Monascus purpureus), bitter gourd ( Momordica charantia), and chromium alleviates dedifferentiation of pancreatic β cells in db/db mice. Food Sci Nutr 2020; 8:6718-6726. [PMID: 33312555 PMCID: PMC7723183 DOI: 10.1002/fsn3.1966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/10/2020] [Accepted: 10/10/2020] [Indexed: 11/13/2022] Open
Abstract
Antidiabetic properties of red yeast rice, bitter gourd, and chromium have gained scientific support. This study aimed to test whether a nutraceutical combination of these 3 materials prevented dedifferentiation of pancreatic β cells. Male db/db mice (8 weeks of age) were allocated into four groups (DB, DB/L, DB/M, and DB/H; n = 8-10) and fed a high-fat diet containing 0%, 0.2%, 0.4%, or 1% nutraceutical, respectively, whereas wild-type mice receiving a standard diet served as a healthy control (C; n = 10). The nutraceutical contained 10 mg/g monacolin K, 165 µg/g chromium, and 300 mg/g bitter gourd. After 8-weeks dietary treatment, diabetic syndromes (including hyperglycemia, hyperphagia, excessive drinking, polyuria, glucosuria, albuminuria, and glucose intolerance), were improved by the nutraceutical in a dose-dependent fashion. Decreased insulin and increased glucagon in serum and pancreatic islets in db/db mice were abolished in the DB/H group. Furthermore, supplementation curtailed dedifferentiation of β cells, as evidenced by decreasing the dedifferentiation marker (Aldh1a3) and increasing β-cell-enriched genes and transcription factors (Ins1, Ins2, FOXO1, and NKX6.1), as well as nuclear localization of NKX6.1 in pancreatic islets when compared to the DB group. We concluded that this nutraceutical, a combination of Monascus purpureus, Momordica charantia, and chromium, could be used as an adjunct for type 2 diabetes treatment and delay disease progression by sustaining β-cell function.
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Affiliation(s)
- Ke‐Ying Lu
- Department of NutritionChina Medical UniversityTaichungTaiwan
- Lishui Municipal Central HospitalLishuiChina
| | - Szu‐Han Chen
- Department of NutritionChina Medical UniversityTaichungTaiwan
| | - Yu‐Shun Lin
- Department of NutritionChina Medical UniversityTaichungTaiwan
| | - Hai‐Ping Wu
- Department of NutritionChina Medical UniversityTaichungTaiwan
| | - Pei‐Min Chao
- Department of NutritionChina Medical UniversityTaichungTaiwan
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Zhou J, Pan J, Xiang Z, Wang Q, Tong Q, Fang J, Wan L, Chen J. Xiaokeyinshui extract combination, a berberine-containing agent, exerts anti-diabetic and renal protective effects on rats in multi-target mechanisms. JOURNAL OF ETHNOPHARMACOLOGY 2020; 262:113098. [PMID: 32726678 DOI: 10.1016/j.jep.2020.113098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/19/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Xiaokeyinshui (XKYS) formula, an anti-diabetic formula, was recorded in many ancient Chinese medical books. Xiaokeyinshui extract combination (XEC) originated from this ancient formula, consisting extracts of four herbal drugs, namely, Coptidis Rhizoma, Liriopes Radix, bitter melon, and Cassiae Semen. OBJECTIVE Therapeutic effects of Xiaokeyinshui extract combination (XEC) were assessed on diabetic rats. MATERIALS AND METHODS Herb extracts were prepared and mixed, yielding XEC. XEC were intragastrically given at doses of 260, 380 and 500 mg/kg/d to diabetic rats for 60 days. Anti-diabetic effects of XEC were studied, with measurement of body weight, and assessment of both glycemic control and lipid management. Measurement of oxidative stress and inflammatory cytokines were conducted in accordance to protocols of commercial kits. Parameters related to renal functions were also measured. Western blot (WB) analysis was performed to explore the anti-diabetic and renal protective mechanisms of XEC. RESULTS Compared to diabetic control, XEC exhibited significant effects in both glucose-lowering and lipid management (p < 0.01). Both oxidative stress and inflammatory cytokines were reduced after treatment of XEC for two months. In addition, XEC exhibited renal protective effects. WB analysis of liver tissue demonstrated that XEC achieved anti-diabetic effects through up-regulation of InsRα/IRS-1/PI3K/Akt/GLUT4 signaling pathway and phosphorylation of AMPK. In addition, renal protective effects were also achieved with down-regulation of RAGE and VEGF expressions in kidney. CONCLUSIONS XEC exerts promising anti-diabetic and renal protective effects on diabetic rats in multi-target mechanisms. XEC could be a satisfying alternative treating T2DM and preventing diabetic nephropathy.
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Affiliation(s)
- Jiewen Zhou
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, College of Pharmacy, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei Province, China
| | - Jun Pan
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, College of Pharmacy, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei Province, China
| | - Zhinan Xiang
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, College of Pharmacy, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei Province, China
| | - Qiuyan Wang
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, College of Pharmacy, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei Province, China
| | - Qilin Tong
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, College of Pharmacy, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei Province, China
| | - Jinbo Fang
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, College of Pharmacy, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei Province, China
| | - Luosheng Wan
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, College of Pharmacy, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei Province, China.
| | - Jiachun Chen
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, College of Pharmacy, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei Province, China.
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Soliman GA, Abdel-Rahman RF, Ogaly HA, Althurwi HN, Abd-Elsalam RM, Albaqami FF, Abdel-Kader MS. Momordica charantia Extract Protects against Diabetes-Related Spermatogenic Dysfunction in Male Rats: Molecular and Biochemical Study. Molecules 2020; 25:molecules25225255. [PMID: 33187275 PMCID: PMC7698202 DOI: 10.3390/molecules25225255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 01/18/2023] Open
Abstract
More than 90% of diabetic patients suffer from sexual dysfunction, including diminished sperm count, sperm motility, and sperm viability, and low testosterone levels. The effects of Momordica charantia (MC) were studied by estimating the blood levels of insulin, glucose, glycosylated hemoglobin (HbA1c), testosterone (TST), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) in diabetic rats treated with 250 and 500 mg/kg b.w. of the total extract. Testicular antioxidants, epididymal sperm characteristics, testicular histopathology, and lesion scoring were also investigated. Testicular mRNA expression of apoptosis-related markers such as antiapoptotic B-cell lymphoma-2 (Bcl-2) and proapoptotic Bcl-2-associated X protein (Bax) were evaluated by real-time PCR. Furthermore, caspase-3 protein expression was evaluated by immunohistochemistry. MC administration resulted in a significant reduction in blood glucose and HbA1c and marked elevation of serum levels of insulin, TST, and gonadotropins in diabetic rats. It induced a significant recovery of testicular antioxidant enzymes, improved histopathological changes of the testes, and decreased spermatogenic and Sertoli cell apoptosis. MC effectively inhibited testicular apoptosis, as evidenced by upregulation of Bcl-2 and downregulation of Bax and caspase-3. Moreover, reduction in apoptotic potential in MC-treated groups was confirmed by reduction in the Bax/Bcl-2 mRNA expression ratio.
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Affiliation(s)
- Gamal A. Soliman
- Department of Pharmacology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (G.A.S.); (H.N.A.); (F.F.A.)
- Department of Pharmacology, College of Veterinary Medicine, Cairo University, Giza 12211, Egypt
| | | | - Hanan A. Ogaly
- Department of Chemistry, College of Science, King Khalid University, Abha 61421, Saudi Arabia;
- Department of Biochemistry, College of Veterinary Medicine, Cairo University, Giza 12211, Egypt
| | - Hassan N. Althurwi
- Department of Pharmacology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (G.A.S.); (H.N.A.); (F.F.A.)
| | - Reham M. Abd-Elsalam
- Department of Pathology, College of Veterinary Medicine, Cairo University, Giza 12211, Egypt;
| | - Faisal F. Albaqami
- Department of Pharmacology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (G.A.S.); (H.N.A.); (F.F.A.)
| | - Maged S. Abdel-Kader
- Department of Pharmacognosy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
- Department of Pharmacognosy, College of Pharmacy, Alexandria University, Alexandria 21215, Egypt
- Correspondence: ; Tel.: +966-545539145
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Geck MS, Cristians S, Berger-González M, Casu L, Heinrich M, Leonti M. Traditional Herbal Medicine in Mesoamerica: Toward Its Evidence Base for Improving Universal Health Coverage. Front Pharmacol 2020; 11:1160. [PMID: 32848768 PMCID: PMC7411306 DOI: 10.3389/fphar.2020.01160] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 07/16/2020] [Indexed: 01/28/2023] Open
Abstract
The quality of health care in Mesoamerica is influenced by its rich cultural diversity and characterized by social inequalities. Especially indigenous and rural communities confront diverse barriers to accessing formal health services, leading to often conflicting plurimedical systems. Fostering integrative medicine is a fundamental pillar for achieving universal health coverage (UHC) for marginalized populations. Recent developments toward health sovereignty in the region are concerned with assessing the role of traditional medicines, and particularly herbal medicines, to foster accessible and culturally pertinent healthcare provision models. In Mesoamerica, as in most regions of the world, a wealth of information on traditional and complementary medicine has been recorded. Yet these data are often scattered, making it difficult for policy makers to regulate and integrate traditionally used botanical products into primary health care. This critical review is based on a quantitative analysis of 28 survey papers focusing on the traditional use of botanical drugs in Mesoamerica used for the compilation of the "Mesoamerican Medicinal Plant Database" (MAMPDB), which includes a total of 12,537 use-records for 2188 plant taxa. Our approach presents a fundamental step toward UHC by presenting a pharmacological and toxicological review of the cross-culturally salient plant taxa and associated botanical drugs used in traditional medicine in Mesoamerica. Especially for native herbal drugs, data about safety and effectiveness are limited. Commonly used cross-culturally salient botanical drugs, which are considered safe but for which data on effectiveness is lacking constitute ideal candidates for treatment outcome studies.
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Affiliation(s)
- Matthias S. Geck
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- Biovision – Foundation for Ecological Development, Zurich, Switzerland
| | - Sol Cristians
- Botanical Garden, Institute of Biology, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Mónica Berger-González
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala, Guatemala
- Department of Epidemiology and Public Heath, Swiss TPH, University of Basel, Basel, Switzerland
| | - Laura Casu
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Michael Heinrich
- Pharmacognosy and Phytotherapy, UCL School of Pharmacy, London, United Kingdom
| | - Marco Leonti
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
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Characterization of α-glucosidase inhibitory activity of Tetracera scandens leaves by Fourier transform infrared spectroscopy-based metabolomics. ADVANCES IN TRADITIONAL MEDICINE 2020. [DOI: 10.1007/s13596-019-00417-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Gao Y, Chen JC, Peng XR, Li ZR, Su HG, Qiu MH. Cucurbitane-Type Triterpene Glycosides from Momordica charantia and Their α-Glucosidase Inhibitory Activities. NATURAL PRODUCTS AND BIOPROSPECTING 2020; 10:153-161. [PMID: 32378043 PMCID: PMC7253571 DOI: 10.1007/s13659-020-00241-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/17/2020] [Indexed: 06/11/2023]
Abstract
Ten cucurbitane-type triterpene glycosides, including five new compounds named charantosides H (1), J (2), K (3), momorcharacoside A (4), goyaglycoside-L (5), and five known compounds (6-10), were isolated from the EtOAc extract of Momordica charantia fruits. The chemical structures of these compounds were identified by 1D and 2D NMR and HRESIMS spectroscopic analyses. Configurations of new compounds were determined by ROESY correlations and comparison of their 13C NMR data with literature reported values. All compounds were evaluated for their inhibition against α-glucosidase, in which compounds 2, 5, 7, 8, 9 showed moderate inhibitory activities with IC50 values ranging from 28.40 to 63.26 μM comparing with the positive control (acarbose, IC50 87.65 ± 6.51 μM).
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Affiliation(s)
- Ya Gao
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China
- University of the Chinese Academy of Sciences, Beijing, 100049, People's Republic of China
| | - Jian-Chao Chen
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China
| | - Xing-Rong Peng
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China
| | - Zhong-Rong Li
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China
| | - Hai-Guo Su
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China
- University of the Chinese Academy of Sciences, Beijing, 100049, People's Republic of China
| | - Ming-Hua Qiu
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China.
- University of the Chinese Academy of Sciences, Beijing, 100049, People's Republic of China.
- Yunnan Key Laboratory of Natural Medicinal Chemistry, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China.
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36
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Peter EL, Mtewa AG, Nagendrappa PB, Kaligirwa A, Sesaazi CD. Systematic review and meta-analysis protocol for efficacy and safety of Momordica charantia L. on animal models of type 2 diabetes mellitus. Syst Rev 2020; 9:7. [PMID: 31915054 PMCID: PMC6950794 DOI: 10.1186/s13643-019-1265-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 12/23/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Studies on several preclinical models of type 2 diabetes mellitus have been conducted to establish the hypoglycemic activity of Momordica charantia L. Concerned with appropriateness of these models, we designed a systematic review to establish the efficacy and safety of M. charantia L. in preclinical models of type 2 diabetes mellitus. METHODS Review authors will search without language restriction in MEDLINE/PubMed, Web of Science, Embase, Scopus, and CINAHL databases through April 2019. Search filters will be applied to enhance search efficiency. The authors will search for gray literature in Google and Google Scholar, OpenGrey, and ProQuest Dissertations & Theses. Two authors will evaluate full texts, extract data, and asses risk of bias independently. The review will include randomized or non-randomized studies that assessed the efficacy or safety of M. charantia L. with vehicle control group. The primary endpoint will be fasting blood glucose level. We will use Egger's test to assess publication biases. Chi-square test and I2 will be used to assess heterogeneity in effect size of the primary outcome. Using RevMan software version 5.3, the authors will perform a meta-analysis of quantitative data. DISCUSSION The strength of evidence will be rated as high, moderate, low, or very low using GRADE framework for animal studies. This systematic review will potentially improve research practice by identifying risks of bias and design features that compromise translatability and contribute to evidence-based clinical trial design. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019119181.
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Affiliation(s)
- Emanuel L. Peter
- Pharm-Biotechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
- Department of Innovation, Technology transfer & Commercialization, National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Andrew G. Mtewa
- Pharm-Biotechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
- Chemistry Section, Department of Applied Sciences, Malawi Institute of Technology, Malawi University of Science & Technology, Limbe, Malawi
| | - Prakash B. Nagendrappa
- Centre for Local Health Traditions & Policy, Trans-disciplinary University (TDU), Bengaluru, India
| | - Anita Kaligirwa
- Department of Pharmacology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Crispin Duncan Sesaazi
- Pharm-Biotechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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Banerjee M, Khursheed R, Yadav AK, Singh SK, Gulati M, Pandey DK, Prabhakar PK, Kumar R, Porwal O, Awasthi A, Kumari Y, Kaur G, Ayinkamiye C, Prashar R, Mankotia D, Pandey NK. A Systematic Review on Synthetic Drugs and Phytopharmaceuticals Used to Manage Diabetes. Curr Diabetes Rev 2020; 16:340-356. [PMID: 31438829 DOI: 10.2174/1573399815666190822165141] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/15/2019] [Accepted: 08/04/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Diabetes is a multifactorial disease and a major cause for many microvascular and macrovascular complications. The disease will ultimately lead to high rate mortality if it is not managed properly. Treatment of diabetes without any side effects has always remained a major challenge for health care practitioners. INTRODUCTION The current review discusses the various conventional drugs, herbal drugs, combination therapy and the use of nutraceuticals for the effective management of diabetes mellitus. The biotechnological aspects of various antidiabetic drugs are also discussed. METHODS Structured search of bibliographic databases for previously published peer-reviewed research papers was explored and data was sorted in terms of various approaches that are used for the treatment of diabetes. RESULTS More than 170 papers including both research and review articles, were included in this review in order to produce a comprehensive and easily understandable article. A series of herbal and synthetic drugs have been discussed along with their current status of treatment in terms of dose, mechanism of action and possible side effects. The article also focuses on combination therapies containing synthetic as well as herbal drugs to treat the disease. The role of pre and probiotics in the management of diabetes is also highlighted. CONCLUSION Oral antihyperglycemics which are used to treat diabetes can cause many adverse effects and if given in combination, can lead to drug-drug interactions. The combination of various phytochemicals with synthetic drugs can overcome the challenge faced by the synthetic drug treatment. Herbal and nutraceuticals therapy and the use of probiotics and prebiotics are a more holistic therapy due to their natural origin and traditional use.
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Affiliation(s)
- Mayukh Banerjee
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Rubiya Khursheed
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Ankit Kumar Yadav
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Monica Gulati
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Devendra Kumar Pandey
- Department of Biotechnology, Lovely Faculty of Technology and Sciences, Lovely Professional University, Phagwara 144402, Punjab, India
| | - Pranav Kumar Prabhakar
- Department of Medical Laboratory Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Rajesh Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Omji Porwal
- Faculty of Pharmacy, Ishik University, Erbil, Iraq
| | - Ankit Awasthi
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Yogita Kumari
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Gurmandeep Kaur
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Clarisse Ayinkamiye
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Rahul Prashar
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Diksha Mankotia
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
| | - Narendra Kumar Pandey
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara - 144411, Punjab, India
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38
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Vieira R, Souto SB, Sánchez-López E, Machado AL, Severino P, Jose S, Santini A, Fortuna A, García ML, Silva AM, Souto EB. Sugar-Lowering Drugs for Type 2 Diabetes Mellitus and Metabolic Syndrome-Review of Classical and New Compounds: Part-I. Pharmaceuticals (Basel) 2019; 12:ph12040152. [PMID: 31658729 PMCID: PMC6958392 DOI: 10.3390/ph12040152] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/06/2019] [Accepted: 10/08/2019] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia together with disturbances in the metabolism of carbohydrates, proteins and fat, which in general results from an insulin availability and need imbalance. In a great number of patients, marketed anti-glycemic agents have shown poor effectiveness in maintaining a long-term glycemic control, thus being associated with severe adverse effects and leading to an emerging interest in natural compounds (e.g., essential oils and other secondary plant metabolites, namely, flavonoid-rich compounds) as a novel approach for prevention, management and/or treatment of either non-insulin-dependent diabetes mellitus (T2DM, type 2 DM) and/or Metabolic Syndrome (MS). In this review, some of these promising glucose-lowering agents will be comprehensively discussed.
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Affiliation(s)
- Raquel Vieira
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, 3000-548 Coimbra, Portugal.
| | - Selma B Souto
- Department of Endocrinology, Hospital São João, Prof. Alameda Hernâni Monteiro, 4200 - 319 Porto, Portugal.
| | - Elena Sánchez-López
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Institute of Nanoscience and Nanotechnology (IN2UB), 08028 Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, 08028 Barcelona, Spain.
| | - Ana López Machado
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, 08028 Barcelona, Spain.
| | - Patricia Severino
- Laboratory of Nanotechnology and Nanomedicine (LNMED), Institute of Technology and Research (ITP), Av. Murilo Dantas, 300, Aracaju 49010-390, Brazil.
- University of Tiradentes (UNIT), Industrial Biotechnology Program, Av. Murilo Dantas 300, Aracaju 49032-490, Brazil.
| | - Sajan Jose
- Department of Pharmaceutical Sciences, Mahatma Gandhi University, Cheruvandoor Campus, Ettumanoor, Kerala 686631, India.
| | - Antonello Santini
- Department of Pharmacy, University of Naples Federico II, Via Domenico Montesano, 49-80131 Naples, Italy.
| | - Ana Fortuna
- Department of Pharmacology, Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, 3000-548 Coimbra, Portugal.
- CIBIT-Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, 3 000-548 Coimbra, Portugal.
| | - Maria Luisa García
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Institute of Nanoscience and Nanotechnology (IN2UB), 08028 Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, 08028 Barcelona, Spain.
| | - Amelia M Silva
- Department of Biology and Environment, University of Trás-os Montes e Alto Douro (UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal.
- Centre for Research and Technology of Agro-Environmental and Biological Sciences (CITAB-UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal.
| | - Eliana B Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, 3000-548 Coimbra, Portugal.
- CEB-Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
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Pahlavani N, Roudi F, Zakerian M, Ferns GA, Navashenaq JG, Mashkouri A, Ghayour-Mobarhan M, Rahimi H. Possible molecular mechanisms of glucose-lowering activities of Momordica charantia (karela) in diabetes. J Cell Biochem 2019; 120:10921-10929. [PMID: 30790347 DOI: 10.1002/jcb.28483] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 12/09/2018] [Accepted: 12/13/2018] [Indexed: 01/24/2023]
Abstract
Diabetes mellitus is a highly prevalent metabolic disorder which is characterized by impaired glucose tolerance, with a relative or absolute insulin deficiency and profound changes in the metabolism of macronutrients. Traditional and complementary medicine is therapeutic strategies that have both been applied to improving glycemic control. Momordica charantia is one of the plant-based, folk medicines that used for improving glycemic control. We aimed to review, the effects of M. charantia on blood glucose with a clarification of the molecular pathways involved. Of the compounds derived from the plants, the insulin-like peptide, charantin, and the alkaloid vicine, have been reported to have hypoglycemic effects. Different mechanisms contribute to the antidiabetic activities of M. charantia, these include increasing pancreatic insulin secretion, decreasing insulin resistance and increasing peripheral and skeletal muscle cell glucose utilization, inhibition of intestinal glucose absorption and suppressing of key enzymes in the gluconeogenic pathways.
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Affiliation(s)
- Naseh Pahlavani
- Students Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Roudi
- Students Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Zakerian
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Brighton, Sussex, UK
| | | | - Amir Mashkouri
- Students Research Committee, Imam Reza International University, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Rahimi
- Department of Modern Sciences and Technology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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40
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Bortolotti M, Mercatelli D, Polito L. Momordica charantia, a Nutraceutical Approach for Inflammatory Related Diseases. Front Pharmacol 2019; 10:486. [PMID: 31139079 PMCID: PMC6517695 DOI: 10.3389/fphar.2019.00486] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/17/2019] [Indexed: 01/24/2023] Open
Abstract
Momordica charantia, commonly called bitter melon, is a plant belonging to Cucurbitaceae family known for centuries for its pharmacological activities, and nutritional properties. Due to the presence of many bioactive compounds, some of which possess potent biological actions, this plant is used in folk medicine all over the world for the treatment of different pathologies, mainly diabetes, but also cancer, and other inflammation-associated diseases. It is widely demonstrated that M. charantia extracts contribute in lowering glycaemia in patients affected by type 2 diabetes. However, the majority of existing studies on M. charantia bioactive compounds were performed only on cell lines and in animal models. Therefore, because the real impact of bitter melon on human health has not been thoroughly demonstrated, systematic clinical studies are needed to establish its efficacy and safety in patients. Besides, both in vitro and in vivo studies have demonstrated that bitter melon may also elicit toxic or adverse effects under different conditions. The aim of this review is to provide an overview of anti-inflammatory and anti-neoplastic properties of bitter melon, discussing its pharmacological activity as well as the potential adverse effects. Even if a lot of literature is available about bitter melon as antidiabetic drug, few papers discuss the anti-inflammatory and anti-cancer properties of this plant.
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Affiliation(s)
- Massimo Bortolotti
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Daniele Mercatelli
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Department of Pharmacy and Biotechnology, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Letizia Polito
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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