Zataria multiflora extract influenced asthmatic patients by improving respiratory symptoms, pulmonary function tests and lung inflammation

Zatariamultiflora hydroalcoholic extract: A triple-blind randomized controlled trial on immune genes, inflammation, and ulcerative colitis symptoms

ETHNOPHARMACOLOGICAL RELEVANCE

Zataria multiflora Boiss. (Shirazi thyme) is traditionally used for digestive disorders and inflammatory conditions. Despite its known anti-inflammatory, immunomodulatory, and antioxidant properties, there is limited clinical evidence on its efficacy for ulcerative colitis (UC).

AIM OF THE STUDY

To evaluate the effectiveness of Zataria multiflora Boiss. (Z. multiflora) extract in alleviating UC symptoms, reducing inflammatory markers, and modulating immune-related gene expression.

MATERIALS AND METHODS

In a multicenter, randomized, placebo-controlled, triple-blind trial in Iran, 92 participants received Z. multiflora extract (6 mg/kg/day) or a placebo for two months. Inflammatory markers and gene expression were analyzed from blood samples. Disease activity was assessed using the Partial Mayo Score (p-Mayo) and the Gastrointestinal Symptom Rating Scale (GSRS). Data were analyzed with SPSS software.

RESULTS

The Z. multiflora group showed significant reductions in C-reactive protein (CRP) (p < 0.001), Interleukin-17 (IL-17) (p = 0.001), Interferon-gamma (IFN-γ) (p = 0.002), Nuclear Factor kappa B (NF-κB) (p = 0.002), T-box Transcription Factor T-bet (T-bet) (p = 0.006), and Retinoic Acid-Related Orphan Receptor gamma t (ROR-γt) (p < 0.001). No significant changes were observed in Erythrocyte Sedimentation Rate (ESR) (p = 0.25), GATA Binding Protein 3 (GATA3) (p = 0.09), and Forkhead Box P3 (FOXP3) (p = 0.17). Symptoms such as heartburn, acid reflux, bloating, diarrhea, and fecal urgency improved (p < 0.05). The GSRS score improved (p < 0.001), while the p-Mayo score did not show a significant change (p = 0.24).

CONCLUSION

Z. multiflora extract significantly alleviated UC symptoms and reduced inflammatory markers, indicating its potential as a complementary treatment for UC. However, the study was limited by its short intervention period and the absence of biopsy analysis to assess local tissue effects. Further longitudinal studies are required to validate these findings and determine long-term efficacy.

Effect of Zataria multiflora supplementation on pro- or anti-inflammatory markers: a systematic review and meta-analysis of randomized placebo-controlled trials

The aim of this study was to investigate the effectiveness of Zataria multiflora and carvacrol supplementation on inflammatory markers (IL-2, IL-4, IL-5, IL-6, TNF-α, IL-8, IL-10, interferon gamma (IFN-γ), C-reactive protein (CRP), monocyte chemotactic protein 1 (MCP-1), epidermal growth factor (EGF), and vascular endothelial growth factor (VEGF)) by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs).The exploration of literature was conducted until August 2024 on databases like PubMed/Medline, Web of Science, Scopus, Cochrane CENTRAL, and Google Scholar. The current study incorporated trial studies examining how oral supplements of Zataria multiflora and carvacrol impact concentrations of inflammatory markers. By utilizing a random effects model, the mean differences (SMD) and 95% confidence intervals (CI) were pooled for analysis of the results. The Cochrane Q and I2 values were used to evaluate heterogeneity. The meta-analysis included ten cases, with 562 participants in the Zataria multiflora group and 700 in the control group. A significant decrease in the levels of various cytokines including IL-2, IL-4, IL-5, IL-6, IL-8, CRP, EGF, VEGF, and MCP-1 was observed with the consumption of Zataria multiflora along with a noteworthy increase in both IFN-γ and IL-10. However, TNF-α levels remained unaffected by the intervention involving Zataria multiflora and carvacrol. It should be noted that limitations of this study include the fact that it draws from research in Iran, encompasses a range of different diseases, and overlooks potential confounders like smoking, physical activity, and diet. In summary, the results suggested that Zataria multiflora and carvacrol can be beneficial for reducing inflammation.

The effect of Zataria multiflora on respiratory symptoms, pulmonary functions, and oxidative stress parameters: a systematic review and meta-analysis

BACKGROUND

Zataria multiflora (Z. multiflora), also known as Shirazi thyme, is recognized for its medicinal properties, including antioxidant, anti-inflammatory, and immunomodulatory effects. Its longstanding use in traditional medicine for respiratory ailments underscores its significance. Given the widespread prevalence of respiratory disorders and inconclusive outcomes from previous trials, this research aims to conduct a systematic review and meta-analysis to evaluate Z. multiflora's impact on respiratory symptoms, pulmonary function, and oxidative stress markers using available randomized controlled trials (RCTs).

METHODS

In this systematic review and meta-analysis, a comprehensive search of published literature was conducted up to January 2024, encompassing databases such as PubMed, Scopus, Web of Science, and the Cochrane Central for Randomized Clinical Trials. The assessment of the quality of each eligible study was conducted using the Cochrane risk-of-bias tool. The random-effects model was used in the meta-analysis to determine the weighted mean difference (WMD) with 95% confidence intervals (CIs). All statistical analyses were conducted using STATA (version 15).

RESULTS

A total of 9 studies involving 394 participants were included. The administration of Z. multiflora showed significant effects on cough (WMD: -0.99; 95% CI: -1.66, -0.33; P = 0.003), day wheezing (WMD: -1.18; 95% CI: -1.44, -0.92; P < 0.001), night wheezing (WMD: -0.74; 95% CI: -1.09, -0.37; P < 0.001), chest wheezing (WMD: -1.15; 95% CI: -1.65, -0.64; P < 0.001), forced expiratory volume (WMD: 11.38; 95% CI: 7.40, 15.35; P < 0.001), forced vital capacity (WMD: 16.01; 95% CI: 12.26, 19.75; P < 0.001), and peak expiratory flow (WMD: 8.78; 95% CI: 4.13, 13.43; P < 0.001) compared to the control group. Additionally, Z. multiflora significantly reduced malondialdehyde levels (SMD: -1.54; 95% CI: -2.17, -0.90; P < 0.001) and increased catalase levels (SMD: 0.97; 95% CI: 0.46, 1.46; P < 0.001).

CONCLUSION

Z. multiflora shows potential as a complementary treatment for respiratory diseases by improving symptoms, pulmonary functions, and reducing oxidative stress. However, due to the limited number of trials, findings should be interpreted cautiously, and further research is needed.

The interplay of plant-based antioxidants, inflammation, and clinical outcomes in asthma: A systematic review

BACKGROUND

Asthma is a chronic inflammatory disease and a leading cause of disability, posing a huge economic and social burden. Plant-based antioxidants have the potential to block proinflammatory pathways and protect against oxidative damage, which could improve asthma management.

OBJECTIVE

This review examines the role of plant-based antioxidants as adjuvant therapy on inflammatory markers and clinical outcomes of adults with asthma.

METHODS

Digital databases, including Scopus, MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Airway Group's Specialized Register of Trials, were searched. Two independent authors performed initial and full-text screening of identified papers. The criteria for study inclusion and exclusion were predefined. Two authors independently performed data extraction and risk of bias as per the PRISMA checklist.

RESULTS

After full-text screening, nine randomized controlled trials were included in the final review. Seven of the included studies highlighted the efficacy of plant-based antioxidants in modulating the inflammatory cytokines in asthmatics. The benefits of antioxidants were also observed for improving oxidative status, lung functioning, and airway inflammatory markers. Furthermore, the overall quality of asthmatic patients' lives was improved with fewer exacerbations such as night coughs and wheezing. Despite having some limitations, the overall risk of bias was low in this review.

CONCLUSION

The review indicated that plant-based antioxidants could have adjuvant beneficial effects in the management of asthma inflammatory markers, which may help improve asthma-related clinical outcomes. However, due to the small number of study subjects, further research is required on the effect of plant-based antioxidants on asthma-inflammatory markers and clinical outcomes.

The molecular basis of the immunomodulatory effects of natural products: A comprehensive review

BACKGROUND

Natural products (NPs) have long been recognized for their potential to modulate the immune system, offering a natural and holistic approach to enhancing immune function. In recent years, the immunomodulation effects of various natural products have attained significant attention.

PURPOSE

This article provides an overview of the role of natural products in immunomodulation, exploring their mechanisms of action, common types of NPs with immunomodulation properties, clinical applications, as well as considerations for their safety and efficacy.

METHODS

Extensive research has been conducted to compile important discoveries on the immunomodulatory properties of NPs through thorough searches of multiple databases such as PubMed, Science Direct, and Scopus up until January 2024.

RESULTS

By decreasing the levels of Th2 cytokines and pro-inflammatory cytokines, the results suggested that NPs have the ability to modulate the immune system. Therefore, NPs alleviate inflammation in various disorders such as asthma and cancer. Furthermore, the observed increase in CD4 cells and IFN-ɣ/IL4 levels, along with an increased IFN-c/IL4 ratio, indicates a stimulatory effect of NPs on Th1 activity in various inflammatory conditions. Therefore, NPs regulate the immune system by inhibiting T-cells and decreasing the growth of young B-cell lymphoma cells.

CONCLUSION

Reviewing studies indicated that NPs have the potential to serve as immunomodulatory candidates for treating disorders characterized by immune dysregulation. However, additional experimental and clinical studies are necessary before these agents can be implemented in clinical settings.

The effects of aromatherapy with thyme oil on disease symptoms, vital findings, and hemodynamic parameters in COVID-19 patients

OBJECTIVE

To determine the effect of aromatherapy with thyme oil on disease symptoms, vital signs, and hemodynamic parameters in COVID-19 patients.

METHODS

We conducted the randomized controlled trial with 140 (experimental group=70, control group=70) COVID-19 patients. Patients admitted to the COVID-19 service of the Batman Training and Research Hospital were included in the sample between 31.01 - 31.08 2022. Patients in the experimental group inhaled thyme oil 3 times a day during 5 days. At the end of day 5, symptoms and hemodynamic parameters were measured as posttest. Vital signs were measured 3 times a day during 5 days. The control group only received routine treatment.

RESULTS

Thyme oil was found to be effective in relieving symptoms of shortness of breath, dizziness, secretion, diarrhea, weakness, loss of appetite, cough, headache and muscle joint pain. Although there was improvement in the symptoms of nausea-vomiting, runny nose and loss of taste-smell, the effect was not statistically significant. Thyme oil significantly decreased body temperature, pulse rate and respiratory rate (p<0.05), increased SPO 2 (p<0.05), and did not affect systolic and diastolic blood pressure (p>0.05). It had a significant effect on the regulation of pH, decreased CO2 and increased O2 significantly (p<0.05).

CONCLUSION

Thyme oil aromatherapy was effective in reducing symptoms, regulating vital signs and hemodynamic parameters. Accordingly, thyme oil is recommended as non-pharmacological treatment method in COVID-19 patients.

Effects of Lamiaceae family plants and their bioactive ingredients on coronavirus-induced lung inflammation

Coronaviruses (CoVs) are a family of viruses that cause infection in respiratory and intestinal systems. Different types of CoVs, those responsible for the SARS-CoV and the new global pandemic of coronavirus disease 2019 in people, have been found. Some plants were used as food additives: spices and dietary and/or medicinal purposes in folk medicine. We aimed to provide evidence about possible effects of two Lamiaceae family plants on control or treatment of CoVs-induced inflammation. The keywords including coronaviruses, Thymus vulgaris, Zataria multiflora, thymol, carvacrol, antivirus, and anti-inflammatory and antioxidant effects were searched in various databases such as PubMed, Web of Sciences (ISI), and Google Scholar until September 2022. The medicinal herbs and their main ingredients, thymol and carvacrol, showed antiviral properties and reduced inflammatory mediators, including IL-1β; IL-6, and TNF-α, at both gene and protein levels but increased the levels of IFN-γ in the serum as anti-inflammatory cytokine. These medicinal herbs and their constituents also reduce oxidative stress and enhance antioxidant capacity. The results of molecular docking analyses also indicated that polyphenol components such as thymol, carvone, and carvacrol could inhibit the entry of the viruses into the host cells in molecular docking analyses. The antiviral, anti-inflammatory, and antioxidant effects of these plants may be due to actions of their phenolic compounds that modulate immune response and may be useful in the control and treatment of CoV-induced lung disorder.

Effect of dietary interventions on markers of type 2 inflammation in asthma: A systematic review

INTRODUCTION

Type 2 (T2) inflammation is a key mechanism in the pathophysiology of asthma. Diet may have immunomodulatory effects, and a role for diet in T2 inflammation has been suggested in the literature. Indeed, diet and food allergies play a role in children with atopic asthma, but less is known about diet in relation to adult asthma, which is often non-atopic.

OBJECTIVE

To review the effect of dietary interventions on markers of T2 inflammation in adults with asthma.

METHODS

The databases PubMed, Embase, Cochrane Library, and CINAHL were searched for eligible studies until December 2022. We included studies of all types of foods, nutrients, diets or supplements, either as an exposure or as an intervention, in adults and adolescents with asthma. Outcomes of interest included the T2 biomarkers FeNO, eosinophils, IL-4, IL-5, IL-13, eosinophil cationic protein and eosinophil peroxidase. The methodological quality of eligible studies was systematically evaluated, and the results were summarised according to dietary clusters.

RESULTS

The systematic search identified studies on the dietary clusters antioxidants (n = 14), fatty acids, (n = 14), Mediterranean-style diets (n = 5), phytotherapy (n = 7), prebiotics & probiotics (n = 8), vitamin D (n = 7), and other dietary factors (n = 5). Studies within the phytotherapy and omega-3 poly-unsaturated fatty acids (PUFA) clusters showed possible improvements in T2 inflammation. Furthermore, we found little evidence for an effect of antioxidants, prebiotics & probiotics, and Mediterranean-style diets on T2 inflammation. However, heterogeneity in study protocols, methodological shortcomings and limited power of almost all studies make it difficult to fully determine the impact of different dietary approaches on T2 inflammation in asthma.

CONCLUSIONS

Overall, the current evidence does not support a specific dietary intervention to improve T2 inflammation in asthma. Interventions involving phytotherapy and omega-3 PUFA currently have the best evidence and warrant further evaluation in well-designed and adequately powered studies, while taking into account T2-high phenotypes of asthma.

Promising treatment biomarkers in asthma

Asthma is a highly heterogenous disease which researchers over time have attempted to classify into different phenotypes and endotypes to improve diagnosis, prognosis and treatment. Earlier classifications based on reaction to environmental allergens, age, sex and lung function have evolved, and today, the use of precision medicine guided by biomarkers offers new perspectives on asthma management. Identifying biomarkers that may reveal the underlying pathophysiology of the disease will help to select the patients who will benefit most from specific treatments. This review explores the classification of asthma phenotypes and focuses on the most recent advances in using biomarkers to guide treatment.

Therapeutic effects of medicinal plants and their constituents on lung cancer, in vitro, in vivo and clinical evidence

The most common type of cancer in the world is lung cancer. Traditional treatments have an important role in cancer therapy. In the present review, the most recent findings on the effects of medicinal plants and their constituents or natural products (NP) in treating lung cancer are discussed. Empirical studies until the end of March 2022 were searched using the appropriate keywords through the databases PubMed, Science Direct and Scopus. The extracts and essential oils tested were all shown to effect lung cancer by several mechanisms including decreased tumour weight and volume, cell viability and modulation of cytokine. Some plant constituents increased expression of apoptotic proteins, the proportion of cells in the G2/M phase and subG0/G1 phase, and Cyt c levels. Also, natural products (NP) activate apoptotic pathways in lung cancer cell including p-JNK, Akt/mTOR, PI3/ AKT\ and Bax, Bcl2, but suppressed AXL phosphorylation. Plant-derived substances altered the cell morphology, reduced cell migration and metastasis, oxidative marker production, p-eIF2α and GRP78, IgG, IgM levels and reduced leukocyte counts, LDH, GGT, 5'NT and carcinoembryonic antigen (CEA). Therefore, medicinal plant extracts and their constituents could have promising therapeutic value for lung cancer, especially if used in combination with ordinary anti-cancer drugs.

Experimental and clinical evidence on the effect of carvacrol on respiratory, allergic, and immunologic disorders: A comprehensive review

Carvacrol (CAR) showed various pharmacological and therapeutic effects in different disorders. In the current article, the experimental and clinical effects of CAR on respiratory, allergic, and immunologic disorders are described. Various databases, including PubMed, Science Direct, and Scopus, were searched regarding the effects of CAR on respiratory and allergic disorders until the end of October 2021. CAR showed the relaxant effect, with various possible mechanisms suggesting the bronchodilatory effect in obstructive pulmonary diseases. The preventive effects of CAR on experimental animal models of respiratory diseases were shown through mechanisms such as antioxidant, immunomodulatory, and anti-inflammatory. CAR also showed therapeutic potential on lung cancer, lung infections, and allergic and immunologic disorders. Clinical studies also revealed therapeutic effects of CAR on asthma, sulfur-mustard-induced lug disorders, and some other allergic and immunologic diseases. Pharmacological and therapeutic effects of CAR indicate possible remedy effects of this agent in the treatment of respiratory, allergic, and immunologic diseases.

The effect of Zataria multiflora on respiratory allergic and immunologic disorders, experimental and clinical evidence: A comprehensive review

Zataria multiflora (Z. multiflora) is used in traditional and modern medicine for therapeutic objectives especially in respiratory disorders. Therefore, updated experimental and clinical studies on the effects of Z. multiflora on respiratory, allergic, and immunologic disorders are reviewed. Various electronic search engines including PubMed, Science Direct, Scopus, and Google Scholar were searched using appropriate keywords until the end of November 2021. Books, thesis-hard copies of some articles were also included. The effects of Z. multiflora on respiratory disorders including asthma, chronic obstructive pulmonary disease (COPD), lung infection, and lung cancer were shown. Extracts of Z. multiflora showed the relaxant effect with various mechanisms. The preventive effects of Z. multiflora were also demonstrated by mechanisms such as antioxidant, immunomodulatory, and antiinflammatory properties in the experimental animal models of different respiratory diseases. Carvacrol and thymol are probably responsible for the therapeutic effect of plant among 56 constituents of Z. multiflora. In addition, bronchodilatory and preventive effects of the plant and its constituents on asthma, COPD, lung disorders due to noxious agents and allergic and immunologic disorders were shown in the clinical studies. Therefore Z. multiflora and its constituents may be considered as a preventive and/or relieving therapy in various respiratory diseases.