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Moradnia M, Mohammadkhani N, Azizi B, Mohammadi M, Ebrahimpour S, Tabatabaei-Malazy O, Mirsadeghi S, Ale-Ebrahim M. The power of Punica granatum: A natural remedy for oxidative stress and inflammation; a narrative review. JOURNAL OF ETHNOPHARMACOLOGY 2024; 330:118243. [PMID: 38677577 DOI: 10.1016/j.jep.2024.118243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 12/18/2023] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Pomegranate 'Punica granatum' offers multiple health benefits, including managing hypertension, dyslipidemia, hyperglycemia, insulin resistance, and enhancing wound healing and infection resistance, thanks to its potent antioxidant and anti-inflammatory properties. It has been symbolized by life, health, femininity, fecundity, and spirituality. AIM OF THE STUDY Although laboratory and animal studies have been conducted on the healing effects of pomegranate, there needs to be a comprehensive review on its anti-oxidative and anti-inflammatory effects in chronic disorders. We aim to provide a comprehensive review of these effects based on in-vitro, in-vivo, and clinical studies conducted in managing various disorders. MATERIALS AND METHODS A comprehensive search of in-vitro, in-vivo, and clinical findings of pomegranate and its derivatives focusing on the highly qualified original studies and systematic reviews are carried out in valid international web databases, including Web of Science, PubMed, Scopus, and Cochrane Library. RESULTS Relevant studies have demonstrated that pomegranate and its derivatives can modulate the expression and activity of several genes, enzymes, and receptors through influencing oxidative stress and inflammation pathways. Different parts of pomegranate; roots, bark, blossoms, fruits, and leaves contain various bioactive compounds, such as polyphenols, flavonoids, anthocyanins, and ellagitannins, that have preventive and therapeutic effects against many disorders such as cardiovascular diseases, diabetes, neurological diseases, and cancers without any serious adverse effects. CONCLUSIONS Most recent scientific evidence indicates that all parts of the pomegranate can be helpful in treating a wide range of chronic disorders due to its anti-oxidative and anti-inflammatory activities. Since the safety of pomegranate fruit, juice, and extracts is established, further investigations can be designed by targeting its active antioxidant and anti-inflammatory constituents to discover new drugs.
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Affiliation(s)
- Mahdis Moradnia
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Niyoosha Mohammadkhani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Bayan Azizi
- Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohammadi
- Department of Clinical Pharmacy, School of Pharmacy, Alborz University of Medical Sciences, Karaj, Iran
| | - Sholeh Ebrahimpour
- Department of Clinical Pharmacy, School of Pharmacy, Alborz University of Medical Sciences, Karaj, Iran
| | - Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Somayeh Mirsadeghi
- KonadHerbs Co., Sharif Innovation Area, Sharif University of Technology, Tehran, Iran.
| | - Mahsa Ale-Ebrahim
- Department of Physiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
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Al-Habib OAM, Adam LN. Exploring the therapeutic potential of pomegranate juice for uterine relaxation. Expert Rev Endocrinol Metab 2024; 19:377-384. [PMID: 38525817 DOI: 10.1080/17446651.2024.2334218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/26/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND The effects of pomegranate juice (PJ) and its components on uterine smooth muscle are unknown. Hence, this study unequivocally demonstrates that pomegranate juice (PJ) significantly impacts myometrial function, providing crucial insights into its relaxant properties and their potential therapeutic applications for uterine-related disorders. RESEARCH DESIGN AND METHODS Rat uterine smooth muscle horn strips were suspended in Krebs solution organ baths. Contractions were measured isometrically using a transducer (AD instrument Australia). The effects of PJ were evaluated on contractile activity elicited by potassium chloride (KCl 60 Mm) depolarization. Inhibitors of nitric oxide (L-NAME 3 X 10-4), guanylate cyclase (methylene blue 1 X 10-5), and Prostaglandin I2 (indomethacin 3 X 10-5), as well as Potassium Channels blockers, were determined. RESULTS The juice at concentrations from 1.5-5 mg/ml significantly decreased the rat uterine horn contraction induced by KCl. The NO, cGMP, and PGI2 inhibitors did not block the relaxation response. Furthermore, the PGI2 inhibitor significantly enhanced the relaxation effects; K+ channel blockers had no inhibitory effects on the relaxation responses. Contrarily, GLIB improved considerably relaxation. CONCLUSION Research suggests pomegranate juice's active ingredient may reduce uterine contractions and treat uterotonic disorders, potentially preventing preterm birth and dysmenorrhea. Further research is needed to determine its mechanism of action. TRIAL REGISTRATION Code: AEC-013.
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Affiliation(s)
- Omar A M Al-Habib
- Department of Biology, College of Science, University of Nawroz, Duhok, Kurdistan Region, Iraq
| | - Lina N Adam
- Department of Biology, College of Science, University of Zakho, Duhok, Kurdistan Region, Iraq
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Wahid S, Ramli MDC, Fazleen NE, Naim RM, Mokhtar MH. Exploring the Therapeutic Potential of Natural Products in Polycystic Ovarian Syndrome (PCOS): A Mini-Review of Lipid Profile, Blood Glucose, and Ovarian Histological Improvements. Life (Basel) 2024; 14:150. [PMID: 38276279 PMCID: PMC10817691 DOI: 10.3390/life14010150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 01/27/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women that is characterized by fluid-filled sacs in the ovaries and various symptoms, including high androgen levels, endometrial irregularities, and cysts. Although the main cause of PCOS remains unknown, it has been linked to genetic, endocrine, and metabolic factors, and there are several treatment options, including lifestyle modifications, medications, and surgery. Natural products such as medicinal plants and fruits are being explored as potential treatments for PCOS because of their bioactive compounds with pharmacological effects related to antioxidant, antimicrobial, anticancer, and antidiabetic properties. Some of these compounds improve insulin sensitivity, reduce inflammation, and enhance glucose metabolism, thereby benefiting patients with PCOS. This mini-review examined the effects of natural products on PCOS, including their effects on ovarian histological changes, blood glucose, sex hormones, and lipid profiles, based on animal and human studies. This study suggests that the use of natural products as complementary medicines can be a promising resource for the development of effective therapeutics for PCOS; however, further research is needed to fully understand their benefits.
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Affiliation(s)
- Syawany Wahid
- School of Graduate Studies, Management and Science University, Shah Alam 40100, Malaysia; (S.W.)
| | | | - Nur Ezza Fazleen
- International Medical School, Management and Science University, Shah Alam 40100, Malaysia
| | - Rosli Muhammad Naim
- School of Graduate Studies, Management and Science University, Shah Alam 40100, Malaysia; (S.W.)
| | - Mohd Helmy Mokhtar
- Department of Physiology, Faculty of Medicine, University Kebangsaan Malaysia, Bangi 43600, Malaysia
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Ulug E, Pinar AA. A New Approach to Polycystic Ovary Syndrome and Related Cardio-metabolic Risk Factors: Dietary Polyphenols. Curr Nutr Rep 2023; 12:508-526. [PMID: 37530952 DOI: 10.1007/s13668-023-00488-7] [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] [Accepted: 07/14/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE OF REVIEW Polycystic ovarian syndrome (PCOS) is a common endocrine disease characterized by ovulatory dysfunction, hyperandrogenism, and polycystic ovarian morphology and causing various reproductive, metabolic, cardiovascular, oncological, and psychological complications. Recent meta-analyses and systemic reviews showed that PCOS increases the risk factor for various cardio-metabolic complications like insulin resistance, type II diabetes mellitus, dyslipidemia, metabolic syndrome, hypertension, and endothelial dysfunction. In addition to these, it was suggested that chronic low-grade inflammation and oxidative stress are the underlying mechanisms of PCOS-mediated metabolic consequences and might trigger cardio-metabolic risk in women with PCOS. At this point, there is substantial evidence to suggest that various non-nutrient food components modulate cardio-metabolic health together with inflammation and oxidative stress. RECENT FINDINGS Increasing the intake of dietary polyphenols might reduce oxidative stress and inflammation and thus alleviate the risk of metabolic, endothelial, and cardiovascular disorders. Nowadays, there are an increasing number of studies related to the effects of dietary polyphenols on PCOS and its accompanying cardio-metabolic disturbances. Currently, there is a cumulative number of studies connected to the effects of dietary polyphenols on PCOS and accompanying cardio-metabolic disturbances. However, there is a lack of knowledge in combining the probable mechanisms of dietary polyphenols on PCOS and related cardio-metabolic consequences. Thus, the effects of dietary polyphenols on PCOS and accompanying cardio-metabolic disturbances need to be discussed and evaluated with underlying mechanisms. Consequently, this review was written to reveal the potential effects of dietary polyphenols on PCOS and related metabolic and cardiovascular risk factors in all their aspects.
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Affiliation(s)
- Elif Ulug
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Ankara, Turkey
| | - Aylin Acikgoz Pinar
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Ankara, Turkey.
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Chavez GN, Jaworsky K, Basu A. The Effects of Plant-Derived Phytochemical Compounds and Phytochemical-Rich Diets on Females with Polycystic Ovarian Syndrome: A Scoping Review of Clinical Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6534. [PMID: 37569074 PMCID: PMC10418663 DOI: 10.3390/ijerph20156534] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is an endocrine condition that impacts nutritional status, metabolic, and hormonal function in females of reproductive age. This condition is associated with increased androgen production (hyperandrogenism) and decreased insulin sensitivity, which often leads to insulin resistance and hyperinsulinemia. This increase in androgen production and insulin resistance is strongly associated with a high incidence of obesity, type-2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and certain types of gonad-related cancers among females who suffer from this condition. As research continues to grow, it has been demonstrated that PCOS is a complex condition, and some of its characteristics vary among the females that have this disorder. However, it has been suggested that oxidative stress and low-grade chronic inflammation could play an important role in the development of PCOS. Current evidence suggest that phytochemicals could potentially help with weight-loss by reducing oxidative stress and low-grade inflammation, as well as aid in metabolic and hormonal regulation due to their antioxidant properties. Some of the bioactive compounds found in plants that have shown positive effects in the attenuation of PCOS include flavonoids, polyphenols, phytoestrogen, and polyunsaturated fatty acids (PUFAs). Thus, a review of the current literature published on PCOS and phytochemicals was conducted in PubMed, Google Scholar, and the Academy of Nutrition and Dietetics databases for articles published between 2013 and 2023 with a study duration of 1 to 3 months and adequate sample sizes. The main purpose of this review of literature was to investigate the metabolic effects of phytochemical compounds and phytochemical-rich diets on females with PCOS by comparing the results of several randomized clinical trials.
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Affiliation(s)
- Guadalupe Nayeli Chavez
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (G.N.C.); (K.J.)
| | - Kataryna Jaworsky
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (G.N.C.); (K.J.)
- Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89106, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (G.N.C.); (K.J.)
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Zhai Y, Pang Y. Systemic and Ovarian Inflammation in Women with Polycystic Ovary Syndrome. J Reprod Immunol 2022; 151:103628. [DOI: 10.1016/j.jri.2022.103628] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/01/2022] [Accepted: 04/13/2022] [Indexed: 02/08/2023]
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Bahmani M, Shokri S, Akhtar ZN, Abbaszadeh S, Manouchehri A. The effect of pomegranate seed oil on human health, especially epidemiology of polycystic ovary syndrome; a systematic review. JBRA Assist Reprod 2022; 26:631-636. [PMID: 35257560 PMCID: PMC9635601 DOI: 10.5935/1518-0557.20210121] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Polycystic ovary syndrome is the most common endocrine disorder in women. Today, medicinal plants have been considered by women, especially in the reproductive and pregnancy ages. Multiple drug treatments and the length of the treatment period often lead to incomplete treatment by patients. Therefore, due to the side effects of chemical drugs, this study was conducted to assess investigate the effect of pomegranate seed oil on polycystic ovary syndrome. The prevalence of polycystic ovary syndrome is increasing by 15 to 20% and clinically includes oligomenorrhea or amenorrhea, hirsutism, and often infertility. Databases such as Cochran library, Medline, PubMed, SID, and Science Direct were used to access the related articles. To collect the required information, first, the articles that had one of the keywords of medicinal plants, polycystic ovary syndrome, plant, pomegranate extract, and menstrual irregularities in their text were searched in databases. All studies from 1985 to 2021 are included in the study. Conjugated linolenic acid (CLN) is a group of geometric and positional isomers of linolenic acid in which double bonds are conjugated. CLN has been reported to have a very strong cytotoxic effect on tissue tumor cells in the body, preventing cancer, reducing the accumulation of triacylglycerol in the liver, polycystic ovary syndrome, and LDL cholesterol in the blood. So far, seven CLN isomers have been identified, including ponic acid in pomegranate seed oil. Conjugated linoleic acid (CLA) is a group of situational and geometric isomers of linoleic acid in which double bonds are conjugated. The positive effects of the two main CLA isomers (cis-9, trans-11, and trans-10, cis-12) include inhibiting the growth of cancer, reducing the risk of atherosclerosis, and reducing body fat.
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Affiliation(s)
- Mahmoud Bahmani
- Biotechnology and Medicinal Plants Research Center, Ilam
University of Medical Sciences, Ilam, Iran
| | - Samira Shokri
- Department of Environmental Health Engineering, Division
of Food Safety & Hygiene, School of Public Health, Tehran University of Medical
Sciences, Tehran, Iran
| | | | - Saber Abbaszadeh
- Department of Biochemistry and Genetics, School of
Medicine, Lorestan University of Medical Sciences, Khor-ramabad, Iran
| | - Aliasghar Manouchehri
- Department of Internal Medicine, Shahid Beheshti
Hospital, Babol University of Medical Sciences, Babol, Iran,Corresponding author: Aliasghar Manouchehri, Babol
University of Medical Sciences, Babol, Iran, E-mail:
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Kuşçu GC, Gürel Ç, Buhur A, Oltulu F, Akman L, Köse T, Yavaşoğlu NÜK, Yavaşoğlu A. The regulatory effects of clomiphene and tamoxifen on mTOR and LC3-II expressions in relation to autophagy in experimental polycystic ovary syndrome (PCOS). Mol Biol Rep 2021; 49:1721-1729. [PMID: 34813001 DOI: 10.1007/s11033-021-06981-y] [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: 04/25/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a metabolic disease that causes infertility due to anovulation in women in reproductive age. It is known that clomiphene citrate (CC) and tamoxifen citrate (TMX) induce ovulation in women with PCOS. In this study, we aimed to investigate the effects of CC and TMX on the autophagy pathway in PCOS. METHODS AND RESULTS Experimental PCOS model was induced by letrozole (1 mg/kg) in rats by gavage for 21 days. After the last letrozole administration, rats were treated TMX (1 mg/kg) or CC (1 mg/kg) for 5 days. At the end of the experimental procedures, rats in all groups were sacrificed and ovarian tissues were removed. It was observed that mRNA and protein expressions of LC3-II were significantly higher in TMX and CC groups than control and PCOS groups (p < 0.05), while mRNA and protein expressions of mTOR in TMX and CC groups were found significantly lower than control and PCOS groups (p < 0.05). CONCLUSIONS In conclusion, present study suggests that TMX and CC induce autophagy in ovaries with PCOS. Autophagy is a promising target for understanding pathophysiology of this disease and for developing more effective and safe new protocols for the treatment of PCOS-related anovulation.
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Affiliation(s)
- Gökçe Ceren Kuşçu
- Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Çevik Gürel
- Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey
- Department of Histology and Embryology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Aylin Buhur
- Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Fatih Oltulu
- Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Levent Akman
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Timur Köse
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Izmir, Turkey
| | | | - Altuğ Yavaşoğlu
- Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey
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