1
|
Wu P, Luo D, Wang Y, Shang X, Wang B, Deng X, Yuan J. Biosynthesis of Diverse Ephedra-Type Alkaloids via a Newly Identified Enzymatic Cascade. BIODESIGN RESEARCH 2024; 6:0048. [PMID: 39228751 PMCID: PMC11371322 DOI: 10.34133/bdr.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Accepted: 08/11/2024] [Indexed: 09/05/2024] Open
Abstract
Ephedra-type alkaloids represent a large class of natural and synthetic phenylpropanolamine molecules with great pharmaceutical values. However, the existing methods typically rely on chemical approaches to diversify the N-group modification of Ephedra-type alkaloids. Herein, we report a 2-step enzymatic assembly line for creating structurally diverse Ephedra-type alkaloids to replace the conventional chemical modification steps. We first identified a new carboligase from Bacillus subtilis (BsAlsS, acetolactate synthase) as a robust catalyst to yield different phenylacetylcarbinol (PAC) analogs from diverse aromatic aldehydes with near 100% conversions. Subsequently, we screened imine reductases (IREDs) for the reductive amination of PAC analogs. It was found that IRG02 from Streptomyces albidoflavus had good activities with conversions ranging from 37% to 84% for the reductive alkylamination with diverse amine partners such as allylamine, propargylamine, and cyclopropylamine. Overall, 3 new bio-modifications at the N-group of Ephedra-type alkaloids were established. Taken together, our work lays a foundation for the future implementation of biocatalysis for synthesizing structurally diverse Ephedra-type alkaloids with potential new pharmaceutical applications.
Collapse
Affiliation(s)
- Peiling Wu
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences,
Faculty of Medicine and Life Sciences, Xiamen University, Fujian 361102, China
| | - Ding Luo
- College of Chemistry and Chemical Engineering,
Xiamen University, Fujian 361105, China
| | - Yuezhou Wang
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences,
Faculty of Medicine and Life Sciences, Xiamen University, Fujian 361102, China
| | - Xiaoxu Shang
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences,
Faculty of Medicine and Life Sciences, Xiamen University, Fujian 361102, China
| | - Binju Wang
- College of Chemistry and Chemical Engineering,
Xiamen University, Fujian 361105, China
| | - Xianming Deng
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences,
Faculty of Medicine and Life Sciences, Xiamen University, Fujian 361102, China
| | - Jifeng Yuan
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences,
Faculty of Medicine and Life Sciences, Xiamen University, Fujian 361102, China
- Shenzhen Research Institute of Xiamen University, Shenzhen 518057, China
| |
Collapse
|
2
|
Li YC, Wu CH, Le TH, Yuan Q, Huang L, Chen GF, Yang ML, Lam SH, Hung HY, Sun H, Wu YH, Kuo PC, Wu TS. A Modified 1H-NMR Quantification Method of Ephedrine Alkaloids in Ephedrae Herba Samples. Int J Mol Sci 2023; 24:11272. [PMID: 37511036 PMCID: PMC10378770 DOI: 10.3390/ijms241411272] [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: 06/29/2023] [Revised: 07/07/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023] Open
Abstract
A previous 1H-NMR method allowed the quantification of ephedrine alkaloids; however, there were some disadvantages. The cyclized derivatives resulted from the impurities of diethyl ether were identified and benzene was selected as the better extraction solvent. The locations of ephedrine alkaloids were confirmed with 2D NMR. Therefore, a specific 1H-NMR method has been modified for the quantification of ephedrine alkaloids. Accordingly, twenty Ephedrae Herba samples could be classified into three classes: (I) E. sinica-like species; (II) E. intermedia-like species; (III) others (lower alkaloid contents). The results indicated that ephedrine and pseudoephedrine are the major alkaloids in Ephedra plants, but the concentrations vary greatly determined by the plant species and the collection locations.
Collapse
Affiliation(s)
- Yue-Chiun Li
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-C.L.); (T.H.L.); (M.-L.Y.); (S.-H.L.); (H.-Y.H.)
| | - Chia-Hung Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 404, Taiwan;
| | - Thi Ha Le
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-C.L.); (T.H.L.); (M.-L.Y.); (S.-H.L.); (H.-Y.H.)
| | - Qingjun Yuan
- State Key Laboratory Breeding Base of Dao-di Herbs, National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100010, China; (Q.Y.); (L.H.)
| | - Luqi Huang
- State Key Laboratory Breeding Base of Dao-di Herbs, National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100010, China; (Q.Y.); (L.H.)
| | - Guo-Fen Chen
- Department of Chemistry, National Chung-Hsing University, Taichung 402, Taiwan;
| | - Mei-Lin Yang
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-C.L.); (T.H.L.); (M.-L.Y.); (S.-H.L.); (H.-Y.H.)
| | - Sio-Hong Lam
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-C.L.); (T.H.L.); (M.-L.Y.); (S.-H.L.); (H.-Y.H.)
| | - Hsin-Yi Hung
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-C.L.); (T.H.L.); (M.-L.Y.); (S.-H.L.); (H.-Y.H.)
| | - Handong Sun
- Kunming Institute of Botany, Chinese Academy of Sciences, Kunming 650201, China;
| | - Yi-Hung Wu
- Hsinhua Forest Station, The Experimental Forest Management Office, National Chung-Hsing University, Taichung 402, Taiwan;
| | - Ping-Chung Kuo
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-C.L.); (T.H.L.); (M.-L.Y.); (S.-H.L.); (H.-Y.H.)
| | - Tian-Shung Wu
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-C.L.); (T.H.L.); (M.-L.Y.); (S.-H.L.); (H.-Y.H.)
| |
Collapse
|
3
|
Efficacy Evaluation of the Mahuang-Fuzi-Xixin Decoction in Combination with Shenmai Injection for Bradyarrhythmia Treatment: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2023; 2023:7280627. [PMID: 36785750 PMCID: PMC9922179 DOI: 10.1155/2023/7280627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/03/2022] [Accepted: 11/24/2022] [Indexed: 02/07/2023]
Abstract
Background Bradyarrhythmia treatment is often not timely enough, posing a potential threat to health. It is necessary to find a strategy with stable curative effects and high safety. Mahuang-Fuzi-Xixin (MFX) decoction and Shenmai injection (SMI) are compound Chinese Patent Medicines. Recent evidence has shown that the combined use of these two drugs can effectively treat bradyarrhythmia. Purpose To evaluate the effect of MFX decoction combined with SMI on bradyarrhythmia. Methods PRISMA was followed as the guideline for this systematic review. RevMan 5.4 software was applied for meta-analysis. Results Eight studies were included in the analysis, with a total of 340 patients in the intervention and control groups. The results of the meta-analysis showed that the effective rate of MFX combined with SMI treatment was higher than that of SMI alone (OR = 3.27, 95% CI (2.18, 4.89), P < 0.01); after treatment, MFX combined with SMI treatment and SMI alone had no significant difference in heart rate. In the subgroup of patients with an age less than 60, the effect of MFX combined with SMI treatment on the 24-hour mean heart rate was better than that of SMI alone (MD = 3.68, 95% CI (3.14, 4.22), P < 0.01), as did the 24-hour minimal heart rate (MD = 3.48, 95% CI (3.03, 3.93), P < 0.01). In addition, the effect of MFX combined with SMI treatment on the Traditional Chinese Medicine syndrome score (TCMSS) was significantly better than that of SMI alone (MD = -2.69, 95% CI (-3.10, -2.28), P < 0.01). In terms of safety, two adverse events were reported in the SMI combined with MFX group compared to 12 in the SMI alone group. Conclusions MFX combined with SMI treatment is effective in treating bradyarrhythmia. However, the results were heterogeneous. The safety of MFX combined with SMI treatment should be verified and treated with caution.
Collapse
|
4
|
Ephedrae Herba: A Review of Its Phytochemistry, Pharmacology, Clinical Application, and Alkaloid Toxicity. MOLECULES (BASEL, SWITZERLAND) 2023; 28:molecules28020663. [PMID: 36677722 PMCID: PMC9863261 DOI: 10.3390/molecules28020663] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
Ephedrae Herba (Ephedra), known as "MaHuang" in China, is the dried straw stem that is associated with the lung and urinary bladder meridians. At present, more than 60 species of Ephedra plants have been identified, which contain more than 100 compounds, including alkaloids, flavonoids, tannins, sugars, and organic phenolic acids. This herb has long been used to treat asthma, liver disease, skin disease, and other diseases, and has shown unique efficacy in the treatment of COVID-19 infection. Because alkaloids are the main components causing toxicity, the safety of Ephedra must be considered. However, the nonalkaloid components of Ephedra can be effectively used to replace ephedrine extracts to treat some diseases, and reasonable use can ensure the safety of Ephedra. We reviewed the phytochemistry, pharmacology, clinical application, and alkaloid toxicity of Ephedra, and describe prospects for its future development to facilitate the development of Ephedra.
Collapse
|
5
|
Are South African Wild Foods the Answer to Rising Rates of Cardiovascular Disease? DIVERSITY 2022. [DOI: 10.3390/d14121014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The rising burden of cardiovascular disease in South Africa gives impetus to managerial changes, particularly to the available foods in the market. Since there are many economically disadvantaged groups in urban societies who are at the forefront of the CVD burden, initiatives to make healthier foods available should focus on affordability in conjunction with improved phytochemical diversity to incentivize change. The modern obesogenic diet is deficient in phytochemicals that are protective against the metabolic products of sugar metabolism, i.e., inflammation, reactive oxygen species and mitochondrial fatigue, whereas traditional southern African food species have high phytochemical diversity and are also higher in soluble dietary fibres that modulate the release of sugars from starches, nurture the microbiome and produce digestive artefacts that are prophylactic against cardiovascular disease. The examples of indigenous southern African food species with high horticultural potential that can be harvested sustainably to feed a large market of consumers include: Aloe marlothii, Acanthosicyos horridus, Adansonia digitata, Aloe ferox, Amaranthus hybridus, Annesorhiza nuda, Aponogeton distachyos, Bulbine frutescens, Carpobrotus edulis, Citrullus lanatus, Dioscorea bulbifera, Dovyalis caffra, Eleusine coracana, Lagenaria siceraria, Mentha longifolia, Momordica balsamina, Pelargonium crispum, Pelargonium sidoides, Pennisetum glaucum, Plectranthus esculentus, Schinziophyton rautanenii, Sclerocarya birrea, Solenostemon rotundifolius, Talinum caffrum, Tylosema esculentum, Vigna unguiculata and Vigna subterranea. The current review explains the importance of phytochemical diversity in the human diet, it gives a lucid explanation of phytochemical groups and links the phytochemical profiles of these indigenous southern African foods to their protective effects against cardiovascular disease.
Collapse
|
6
|
Yang J, Sun Q, Ma Q, Yu Q, Liu X, Liu Y, Han Y, Yang Y, Rong R. Mahuang Xixin Fuzi decoction ameliorates apoptosis via the mitochondrial-mediated signaling pathway in MCM cells. JOURNAL OF ETHNOPHARMACOLOGY 2022; 297:115538. [PMID: 35843410 DOI: 10.1016/j.jep.2022.115538] [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: 05/12/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Mahuang Xixin Fuzi Decoction (MXF), as a classical prescription of traditional Chinese medicine (TCM), has been used to treat the symptoms of fever, nasal congestion and headache in elderly people for almost a thousand years. AIM OF THE STUDY The purpose of this study was to evaluate the effects and possible mechanisms of MXF on thermal stimulation-induced mouse cardiac myocytes (MCM) cell apoptosis. MATERIALS AND METHODS The apoptosis of the MCM cell model was induced by a PCR-calculated temperature control system with a gradual heating pattern at 43 °C for 1 h. The cytotoxic effects were determined using real-time cell analyzer (RTCA) technology. Annexin V-FITC/7-AAD staining, and JC-1 fluorescence were used to assess apoptosis. Specific substrates, enzyme-linked immunosorbent assays (ELISAs), and Western blotting were used to identify proteins in the mitochondrial-mediated pathway. The identification of chemical components in the mouse heart was performed by ultra-performance liquid chromatography-electrospray ionization tandem mass spectrometry analysis. RESULTS MXF inhibited apoptosis through the mitochondrial-mediated signaling pathway, including ameliorating ∆Ψm reduction, blocking mitochondrial Cyt C release, reducing Bax levels and increasing Bcl-2 levels, suppressing caspase-9 and caspase-3 activation in cytoplasmic fractions. Moreover, the components of MXF that act on the heart are mainly ephedra alkaloids and aconitine alkaloids. CONCLUSIONS The findings demonstrated that MXF treatment markedly reduced MCM cell apoptosis induced by thermal stimulation, which may be ascribed to the mitochondrial-mediated signaling pathway.
Collapse
Affiliation(s)
- Jia Yang
- Shandong University of Traditional Chinese Medicine, PR China
| | - Qihui Sun
- Shandong University of Traditional Chinese Medicine, PR China
| | - Qingyun Ma
- Shandong University of Traditional Chinese Medicine, PR China
| | - Qinhui Yu
- Shandong University of Traditional Chinese Medicine, PR China
| | - Xiaoyun Liu
- Shandong University of Traditional Chinese Medicine, PR China; Shandong Provincial Collaborative Innovation Center for Antiviral Traditional Chinese Medicine, Jinan, Shandong, 250355, PR China
| | - Yanliang Liu
- Shandong University of Traditional Chinese Medicine, PR China
| | - Yuxiu Han
- Shandong University of Traditional Chinese Medicine, PR China
| | - Yong Yang
- Shandong University of Traditional Chinese Medicine, PR China; Shandong Provincial Collaborative Innovation Center for Antiviral Traditional Chinese Medicine, Jinan, Shandong, 250355, PR China.
| | - Rong Rong
- Shandong University of Traditional Chinese Medicine, PR China; Shandong Provincial Collaborative Innovation Center for Antiviral Traditional Chinese Medicine, Jinan, Shandong, 250355, PR China.
| |
Collapse
|
7
|
Bachheti RK, Worku LA, Gonfa YH, Zebeaman M, Deepti, Pandey DP, Bachheti A. Prevention and Treatment of Cardiovascular Diseases with Plant Phytochemicals: A Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:5741198. [PMID: 35832515 PMCID: PMC9273387 DOI: 10.1155/2022/5741198] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/27/2022] [Accepted: 06/02/2022] [Indexed: 12/19/2022]
Abstract
Cardiovascular diseases (CVDs) are the world's leading killers, accounting for 30% deaths. According to the WHO report, CVDs kill 17.9 million people per year, and there will be 22.2 million deaths from CVD in 2030. The death rates rise as people get older. Regarding gender, the death rate of women by CVD (51%) is higher than that of men (42%). To decrease and prevent CVD, most people rely on traditional medicine originating from the plant (phytochemicals) in addition to or in preference to commercially available drugs to recover from their illness. The CVD therapy efficacy of 92 plants, including 15 terrestrial plants, is examined. Some medicinal plants well known to treat CVD are, Daucus carota, Nerium oleander, Amaranthus Viridis, Ginkgo biloba, Terminalia arjuna, Picrorhiza kurroa, Salvia miltiorrhiza, Tinospora cordifolia, Mucuna pruriens, Hydrocotyle asiatica, Bombax ceiba, and Andrographis paniculate. The active phytochemicals found in these plants are flavonoids, polyphenols, plant sterol, plant sulphur compounds, and terpenoids. A general flavonoid mechanism of action is to prevent low-density lipoprotein oxidation, which promotes vasodilatation. Plant sterols prevent CVD by decreasing cholesterol absorption in the blood. Plant sulphur compound also prevent CVD by activation of nuclear factor-erythroid factor 2-related factor 2 (Nrf2) and inhibition of cholesterol synthesis. Quinone decreases the risk of CVD by increasing ATP production in mitochondria while terpenoids by decreasing atherosclerotic lesion in the aortic valve. Although several physiologically active compounds with recognized biological effects have been found in various plants because of the increased prevalence of CVD, appropriate CVD prevention and treatment measures are required. More research is needed to understand the mechanism and specific plants' phytochemicals responsible for treating CVD.
Collapse
Affiliation(s)
- Rakesh Kumar Bachheti
- Bioprocess and Biotechnology Center of Excellence, Addis Ababa Sciences and Technology University, P.O. Box 16417, Addis Ababa, Ethiopia
- Department of Industrial Chemistry, College of Applied Sciences, Addis Ababa Sciences and Technology University, P.O. Box 16417, Addis Ababa, Ethiopia
| | - Limenew Abate Worku
- Bioprocess and Biotechnology Center of Excellence, Addis Ababa Sciences and Technology University, P.O. Box 16417, Addis Ababa, Ethiopia
- Department of Industrial Chemistry, College of Applied Sciences, Addis Ababa Sciences and Technology University, P.O. Box 16417, Addis Ababa, Ethiopia
| | - Yilma Hunde Gonfa
- Bioprocess and Biotechnology Center of Excellence, Addis Ababa Sciences and Technology University, P.O. Box 16417, Addis Ababa, Ethiopia
- Department of Chemistry, Faculty of Natural and Computational Science, Ambo University, Ambo, Ethiopia
| | - Meseret Zebeaman
- Bioprocess and Biotechnology Center of Excellence, Addis Ababa Sciences and Technology University, P.O. Box 16417, Addis Ababa, Ethiopia
- Department of Industrial Chemistry, College of Applied Sciences, Addis Ababa Sciences and Technology University, P.O. Box 16417, Addis Ababa, Ethiopia
| | - Deepti
- Department of Environment Science, Graphic Era University, Dehradun-248002, Uttarakhand, India
| | - D. P. Pandey
- Department of Chemistry, Government P. G. College, Uttarkashi, India
| | - Archana Bachheti
- Department of Environment Science, Graphic Era University, Dehradun-248002, Uttarakhand, India
| |
Collapse
|
8
|
Sharma T, Sharma P, Chandel P, Singh S, Sharma N, Naved T, Bhatia S, Al-Harrasi A, Bungau S, Behl T. Circumstantial Insights into the Potential of Traditional Chinese Medicinal Plants as a Therapeutic Approach in Rheumatoid Arthritis. Curr Pharm Des 2022; 28:2140-2149. [PMID: 35331092 DOI: 10.2174/1381612828666220324124720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/25/2022] [Indexed: 11/22/2022]
Abstract
The advanced era has invited a plethora of chronic and autoimmune infirmities unmistakably dominated by rheumatoid arthritis, occurring because of the equivocal causes, including ecological factors, genetic variations, etc. Unfortunately, it is winning pretty much in every stratum of the society in undefined age group of the population. Engineered drugs are accessible for the treatment; however, they do experience adverse effects as the treatment requires a prolonged duration worsened by noncompliance. To overwhelm it, certain pharmacological and molecular pathways are explored in the wake of Chinese herbs that prompted the prevention of this deteriorating autoimmune disease. The alcoholic extracts and decoctions are procured from Chinese herbs, such as Paeonia lactiflora, Glycyrrhiza uralensis, Tripterygium wilfordii, etc., which have been proved to manifest constructive pharmacological actions. The activities that were exhibited by extracts are significantly innocuous, non- toxic and potent to fix the affliction in contrast with the chemosynthetic drugs. Therefore, these Chinese herbs bring forth the potent anti-inflammatory, immune suppressing, anti-nociceptive, anti-neovascularizing, free radical scavenging activities and various other benefits to withstand several pathological events that usually endure the infirmity. It can be abridged that Chinese herbs possess assorted and selective therapeutic properties with profound safety and viability to treat this rheumatic disorder. Thus, this review aims to shed a light naturally originated treatment that is pertinent to provide invulnerable therapy exonerating from adverse effects, by restraining the occurrences of joint deformities, production of auto-antibodies, and inflammation.
Collapse
Affiliation(s)
- Twinkle Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Parth Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Parteek Chandel
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Sukhbir Singh
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Neelam Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Tanveer Naved
- Amity Institute of Pharmacy, Amity University, Noida, India
| | - Saurabh Bhatia
- School of Health Science, University of Petroleum and Energy Studies, Dehradun, Uttarakhand, India
- Natural & Medical Sciences Research Centre, University of Nizwa, Nizwa, Oman
| | - Ahmed Al-Harrasi
- Natural & Medical Sciences Research Centre, University of Nizwa, Nizwa, Oman
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| |
Collapse
|
9
|
Chu H, Kang B, Youn BY, Kim KI, Park J, Leem J. Comprehensive traditional East Asian medicine treatment strategy for obesity considering the therapeutic effects and adverse events: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2022; 101:e28673. [PMID: 35147089 PMCID: PMC8830816 DOI: 10.1097/md.0000000000028673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Obesity has become a serious global health problem due to its increasing prevalence. Because of several limitations or adverse events associated with conventional western medicine therapies, there has been an increase in demand for alternative therapies such as traditional East Asian medicine (TEAM). This study aims to provide comprehensive evidence-based information assessing the clinical efficacy and safety of TEAM treatment for obesity as the basis for reliable clinical strategies for patients with obesity. METHODS Electronic searches of the PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, OASIS, and Korea Citation Index will be performed. Methodological quality will be assessed using the "risk of bias" tool. The primary outcome for efficacy will be weight loss. The secondary outcomes will be response rate, body mass index, waist circumference, and blood pressure. We will also evaluate the rates of adverse events and mortality for safety assessment. First, we will conduct a conventional pairwise meta-analysis. Next, we will conduct network meta-analysis using the frequentist approach. We shall verify the assumption of network meta-analysis and provide network geometry, P-score, net league table, and intervention-based forest plot. A subgroup analysis will be conducted to ascertain the factors that affect treatment, such as dosage, treatment duration, and severity of obesity. RESULTS The results of this study will provide high-quality systematic reviews that can assist decision making in obesity management. Our network meta-analysis results can provide direct and indirect comparison evidence on comparative efficacy and safety. CONCLUSION This study will provide fundamental data for prospective research on the application of TEAM in patients with obesity. PROTOCOL REGISTRY NUMBER OF ONLINE REGISTRY This study protocol was registered in open Science framework (OSF) (Registration DOI: 10.17605/OSF.IO/ETWDS). URL OF THE ONLINE REGISTRY https://osf.io/etwds.
Collapse
Affiliation(s)
- Hongmin Chu
- Daecheong Public Health Subcenter, 3, Daecheong-ro, Daecheong-myeon, Ongjin-gun, Incheon, Republic of Korea
| | - Byungsoo Kang
- College of Korean Medicine, Dongshin University, 67, Dongsindae-gil, Naju-si, Jeollanamdo, Republic of Korea
| | - Bo-Young Youn
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Seoul, Republic of Korea
| | - Kwan-il Kim
- Division of Allergy, Immune Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jinbong Park
- Department of Pharmacology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jungtae Leem
- Research Center of Traditional Korean Medicine, Wonkwang University, 460, Iksan-daero, Sin-dong, Iksan, Jeollabuk-do, Republic of Korea
| |
Collapse
|
10
|
Cheng E, Hsiao R, Feliciano Z, Betancourt J, Han JK. Taken to heart—arrhythmic potential of heart-leaf sida, a banned ephedrine alkaloid: a case report. Eur Heart J Case Rep 2022; 6:ytac023. [PMID: 35106447 PMCID: PMC8801050 DOI: 10.1093/ehjcr/ytac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/21/2021] [Accepted: 12/31/2021] [Indexed: 11/14/2022]
Abstract
Background Ephedra and ephedrine alkaloids were commonly used in herbal supplements before being prohibited by the European Commission and US Food and Drug Administration. However, ongoing, unknowing use by consumers can lead to potential adverse cardiovascular effects, such as arrhythmias. Case summary A 65-year-old-man with a history of idiopathic pulmonary fibrosis status post-right single lung transplant was admitted for dizziness and resting tachycardia. Electrocardiogram showed a narrow complex, long R-P tachycardia with upright P-waves in lead V1. An initial workup suggested an arrhythmia associated with the consumption of an herbal supplement containing heart-leaf sida, a banned botanical ephedrine alkaloid. After the supplement was discontinued, the patient’s heart rate abruptly decreased without other intervention. Electrocardiogram showed a change in P-wave morphology in lead V1 from upright to biphasic (+/−) after conversion to normal sinus rhythm. Thus, a diagnosis of atrial tachycardia originating at or near the donor right superior pulmonary vein was favoured. Discussion Atrial tachycardia can be precipitated by the proarrhythmic effects of ephedrine alkaloids, especially in patients with underlying risk factors and susceptible atrial anatomical substrate post-lung transplantation. Despite being banned by the European Union and the USA, ephedrine alkaloids continue to be used in over-the-counter herbal supplements and may go undetected by consumers. Ongoing vigilance for ephedrine alkaloids, more rigorous regulation, and active patient education can help reduce potential cardiovascular adverse events.
Collapse
Affiliation(s)
- Evaline Cheng
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ruth Hsiao
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Zenaida Feliciano
- Department of Medicine, Cardiac Arrhythmia Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine, Cardiac Arrhythmia Center, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd 111E, Los Angeles, CA 90073, USA
| | - Jaime Betancourt
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Janet K Han
- Department of Medicine, Cardiac Arrhythmia Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine, Cardiac Arrhythmia Center, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd 111E, Los Angeles, CA 90073, USA
| |
Collapse
|
11
|
Nasar MQ, Zohra T, Khalil AT, Ovais M, Ullah I, Ayaz M, Zahoor M, Shinwari ZK. Extraction optimization, Total Phenolic-Flavonoids content, HPLC-DAD finger printing, antimicrobial, antioxidant and cytotoxic potentials of Chinese folklore Ephedra intermedia Schrenk & C. A. Mey. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | - Zabta Khan Shinwari
- Quaid-i-Azam University, Pakistan; Lady Reading Hospital (MTI), Pakistan; Pakistan Academy of Sciences, Pakistan
| |
Collapse
|
12
|
Huang L, Zhao B, Li Q, Wu J, Jiang H, Li Q. Ephedrine alleviates middle cerebral artery occlusion-induced neurological deficits and hippocampal neuronal damage in rats by activating PI3K/AKT signaling pathway. Bioengineered 2021; 12:4136-4149. [PMID: 34288825 PMCID: PMC8806764 DOI: 10.1080/21655979.2021.1953218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/02/2021] [Indexed: 10/31/2022] Open
Abstract
Inflammation and oxidative stress are crucial in ischemic stroke. Ephedrine (EPH) has been proven to have anti-inflammatory and anti-oxidative stress effects. The present study analyzes whether EPH possessed neuroprotective effects and explored the underlying mechanisms of EPH based on an experimental model of middle cerebral artery occlusion (MCAO). We found that intraperitoneal injection with EPH attenuated the neurological deficit, cerebral infarction, and cerebral edema induced by MCAO in rats. Besides, EPH treatment alleviated MCAO-induced brain tissue damage and morphological abnormality, as well as neuronal loss. Moreover, EPH treatment upregulated GPx and CAT activity and downregulated MDA and NO content. EPH also evidently decreased the levels of IL-6 and TNF-α but increased IL-4 and IL-10 levels. Of note, EPH treatment promoted the phosphorylation of PI3K and AKT proteins in MCAO rats. Furthermore, administration of PI3K/AKT pathway inhibitor LY294002 abolished the beneficial effects of EPH. These results confirmed that EPH alleviated brain injury induced by MCAO via activating PI3K/AKT signaling pathway.
Collapse
Affiliation(s)
- Lixian Huang
- Encephalopathy, Beijing University of Traditional Chinese Medicine, Dong Zhi Men Hospital, Tongzhou Hospital Area, Beijing, China
| | - Bo Zhao
- Encephalopathy, Beijing University of Traditional Chinese Medicine, Dong Zhi Men Hospital, Tongzhou Hospital Area, Beijing, China
| | - Qunxian Li
- Encephalopathy, Beijing University of Traditional Chinese Medicine, Dong Zhi Men Hospital, Tongzhou Hospital Area, Beijing, China
| | - Jing Wu
- Encephalopathy, Beijing University of Traditional Chinese Medicine, Dong Zhi Men Hospital, Tongzhou Hospital Area, Beijing, China
- ENT Department, Dong Fang Hospital of Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Hui Jiang
- ENT Department, Dong Fang Hospital of Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Qingbin Li
- Encephalopathy, Beijing University of Traditional Chinese Medicine, Dong Zhi Men Hospital, Tongzhou Hospital Area, Beijing, China
| |
Collapse
|
13
|
Capristo E, Maione A, Lucisano G, Russo MF, Mingrone G, Nicolucci A. Effects of weight loss medications on mortality and cardiovascular events: A systematic review of randomized controlled trials in adults with overweight and obesity. Nutr Metab Cardiovasc Dis 2021; 31:2587-2595. [PMID: 34154892 DOI: 10.1016/j.numecd.2021.05.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022]
Abstract
AIMS Adults affected by obesity are at higher risk of premature mortality. Medications can help to lose weight and to maintain weight loss. Aim of this meta-analysis was to assess whether anti-obesity medications affect all-cause mortality, mortality due to cardiovascular events, cardiovascular risk factors and body weight. DATA SYNTHESIS A Medline search was performed to identify randomized controlled trials (RCTs) of anti-obesity medications in adults with overweight or obesity reporting data on all-cause mortality, cardiovascular mortality or non-fatal cardiovascular events, with a follow-up of at least 6 months. We identified 28 RCTs with 50,106 participants. The median follow-up was 52 weeks. Evidence did not show superiority of anti-obesity medications over placebo in reducing all-cause mortality (risk ratio 1.03, 95%Confidence Interval [CI] 0.87 to 1.21) or cardiovascular mortality (risk ratio 0.92, 95%CI 0.72 to 1.18). All-cause mortality rate was positively associated with weight loss (β = 0.0007; p = 0.045); hence, for each kg of body weight lost there was a 0.07% decrease of all-cause mortality. The pharmacological treatment reduced total-cholesterol (7.15 mg/dl; 95%CI 1.46-12.85), LDL-cholesterol (5.06 mg/dl; 95%CI 1.12-9.00), and triglycerides levels (9.88 mg/dl; 95%CI 5.02-14.75), while it increased HDL-cholesterol (1.37 mg/dl; 95%CI 0.17-2.57). Systolic blood pressure decreased (0.90 mmHg; 95%CI 0.15-1.64). CONCLUSIONS Although we were unable to demonstrate a superiority of anti-obesity medications over placebo on mortality, metaregression showed that even a small weight reduction tends to reduce all-cause mortality in obesity. Our data support public health measures to reduce the obesity burden by including the use of anti-obesity medications. REGISTRATION NUMBER (PROSPERO) CRD42020210329.
Collapse
Affiliation(s)
- Esmeralda Capristo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy and Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Ausilia Maione
- Center for Outcomes Research and Clinical Epidemiology - CORESEARCH, Pescara, Italy
| | - Giuseppe Lucisano
- Center for Outcomes Research and Clinical Epidemiology - CORESEARCH, Pescara, Italy
| | - Maria F Russo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy and Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Geltrude Mingrone
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy and Università Cattolica Del Sacro Cuore, Rome, Italy; Department of Diabetes, School of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology - CORESEARCH, Pescara, Italy.
| |
Collapse
|
14
|
Ahsan H, Irfan HM, Alamgeer, Shahzad M, Asim MH, Akram M, Zafar MS. Anti-rheumatic activity of pseudoephedrine (a substituted phenethylamine) in complete Freund's adjuvant-induced arthritic rats by down regulating IL-1β, IL-6 and TNF-α as well as upregulating IL-4 and IL-10. Inflammopharmacology 2021; 29:673-682. [PMID: 33772383 DOI: 10.1007/s10787-021-00804-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
Pseudoephedrine (substituted phenethylamine) is well known as psychotic and bronchodilator. Numerous studies on phenethylamine derivatives indicated that these agents have the potential to abolish inflammatory responses in the non-biological and biological systems. These facts provided the basis to conduct a study on pseudoephedrine to explore its therapeutics in Complete Freund's Adjuvant (CFA)-induced arthritis. Furthermore, existing treatment approaches for RA associated with limited effect on chronic immunological models. Real-time polymerase chain reaction (q-PCR) was performed to execute the expression of pro and anti-inflammatory cytokines in treated and non-treated arthritic rats. These findings were further co investigate by histological observations. The paw volume, paw diameter, weight variations and arthritic score were determined at specific days throughout the experiment of 28 days. Pseudoephedrine at all doses significantly (p < 0.001) suppressed the expression of PGE2, TNF-α, IL-1β and IL-6. Moreover, pseudoephedrine (20 and 40 mg/kg) caused significant augmentation of IL-4 and IL-10. Similarly, the drug expressed a significant anti-arthritic effect by reducing the paw volume, paw diameter and arthritic score. Similarly, it also reverts the reduction in body weight of arthritic rats at all above-mentioned doses. These findings supported the anti-arthritic potential of pseudoephedrine and recommended it for clinical trials.
Collapse
Affiliation(s)
- Haseeb Ahsan
- College of Pharmacy, University of Sargodha, Sargodha, 40100, Pakistan
| | | | - Alamgeer
- Department of Pharmacology, University College of Pharmacy, University of the Punjab, Lahore, 54000, Pakistan
| | - Muhammad Shahzad
- Department of Pharmacology, University of Health Sciences, Lahore, 54000, Pakistan
| | | | - Muhammad Akram
- College of Pharmacy, University of Sargodha, Sargodha, 40100, Pakistan
| | | |
Collapse
|
15
|
Shi C, Li J, Li J. Ephedrine attenuates cerebral ischemia/reperfusion injury in rats through NF-κB signaling pathway. Hum Exp Toxicol 2020; 40:994-1002. [PMID: 33307823 DOI: 10.1177/0960327120975456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The inflammation and immune responses are critical in ischemic stroke and contribute to aggravated brain damage. Ephedrine was reported to play an important role in the control of inflammatory responses. This study was to investigate the repairing effects and potential mechanisms of ephedrine on cerebral ischemic injury in a rat model of focal cerebral ischemia. The rat model of cerebral ischemia/reperfusion injury was established using the middle cerebral artery occlusion (MCAO) method and then rats were treated with ephedrine (5 and 10 mg/kg) for 7 days. The neurobehavioral progression was assessed using the neurological scoring method. The pathology of brain tissue was evaluated by hematoxylin and eosin (H&E) staining. The infarct volume was examined by triphenyltetrazolium chloride (TTC) staining. The apoptosis in ischemic brain tissues was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. Inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). Gene quantification and protein expression were detected by real-time PCR and western blot, respectively. Ephedrine treatment significantly alleviated the cerebral ischemia/reperfusion injury, evidenced by decreased neurological deficit score, infarct volume and water content. Ephedrine also decreased autophagy and apoptosis in brain tissues. Moreover, ephedrine treatment significantly reduced inflammatory responses, associating with decreasing the protein expression of p-NF-κB. These results demonstrated neuroprotective properties of ephedrine and highlighted it as a new potential anti-inflammatory agent against injury of cerebral ischemia/reperfusion.
Collapse
Affiliation(s)
- Chanhong Shi
- Department of Neurology, Yiwu Central Hospital, Yiwu, China
| | - Jianhong Li
- Department of Ophthalmology, Yiwu Central Hospital, Yiwu, China
| | - Jianwei Li
- Department of Neurosurgery, Yiwu Central Hospital, Yiwu, China
| |
Collapse
|
16
|
Zhang H, Guo C, Lv J, Hou S, Zhang Y, Gao J, Xu J. Aqueous chlorination of ephedrine: Kinetic, reaction mechanism and toxicity assessment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 740:140146. [PMID: 32563881 DOI: 10.1016/j.scitotenv.2020.140146] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/04/2020] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
Ephedrine (EPH) is widely detected in the water environment, because it is the major ingredient in drugs treating influenza, asthma or hypotension, and is also a highly sought-after chemical precursor in the illicit manufacture of methamphetamine. In this study, transformation of EPH during the chlorination process was investigated for the first time, and the impact of water parameters including pH, different cations and anions on EPH transformation was evaluated as well. The degradation of EPH in the presence of NaClO fit the second order reaction kinetics, with a rate constant of 7.43 × 102 ((mol·L-1)-1·min-1). Increasing the dosage of NaClO increased the observed pseudo first order rate constant for EPH degradation (kobs). Degradation rate of EPH decreased with the increasing pH from 2.0 to 10.0, due to the formation of a chlorammonium intermediate that reacted with NaClO. Low concentration of Br- and I- did not exert significant influence on the degradation of EPH, while at high concentrations a promotive effect was observed. Other ions including Fe3+, Cu2+, NO3-, SO42-, Mg2+ and Ca2+ exerted negative effects even at relatively low concentrations. Based on the degradation products/intermediates identified by UPLC-MS/MS, the EPH degradation pathways were proposed. The reaction mechanism involved in the EPH degradation included dehydration, hydroxylation, deamination and demethylation. Toxicity assays by V. qinghaiensis sp. nov proved that the EPH transformation products were much more toxic than the parent compound. Results indicated that chlorination is an effective approach for the elimination of EPH in the aquatic environment, however, attention should be paid to its toxicity involvement during the chlorination process.
Collapse
Affiliation(s)
- Heng Zhang
- State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Department of Chemistry, College of Science, North University of China, Taiyuan 030051, China
| | - Changsheng Guo
- State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Jiapei Lv
- State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Song Hou
- State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Yan Zhang
- State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Jianfeng Gao
- Department of Chemistry, College of Science, North University of China, Taiyuan 030051, China
| | - Jian Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China.
| |
Collapse
|
17
|
A Review on Worldwide Ephedra History and Story: From Fossils to Natural Products Mass Spectroscopy Characterization and Biopharmacotherapy Potential. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:1540638. [PMID: 32419789 PMCID: PMC7210547 DOI: 10.1155/2020/1540638] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/08/2020] [Accepted: 04/16/2020] [Indexed: 02/07/2023]
Abstract
Growing worldwide, the genus Ephedra (family Ephedraceae) had a medicinal, ecological, and economic value. The extraordinary morphological diversity suggests that Ephedra was survivor of an ancient group, and its antiquity is also supported by fossil data. It has recently been suggested that Ephedra appeared 8–32 million years ago, and a few megafossils document its presence in the Early Cretaceous. Recently, the high analytical power provided by the new mass spectrometry (MS) instruments is making the characterization of Ephedra metabolites more feasible, such as ephedrine series. In this regard, the chemical compounds isolated from crude extracts, fractions, and few isolated compounds of Ephedra species were characterized by MS-based techniques (LC-MS, LC-ESI-MS, HPLC-PDA-ESI/MS, LC-DAD-ESI/MSn, LC/Orbitrap MS, etc.). Moreover, we carry out an exhaustive review of the scientific literature on biomedicine and pharmacotherapy (anticancer, antiproliferative, anti-inflammatory, antidiabetic, antihyperlipidemic, antiarthritic, and anti-influenza activities; proapoptotic and cytotoxic potential; and so on). Equally, antimicrobial and antioxidant activities were discussed. This review is focused on all these topics, along with current studies published in the last 5 years (2015–2019) providing in-depth information for readers.
Collapse
|
18
|
Stohs SJ, Shara M, Ray SD. p-Synephrine, ephedrine, p-octopamine and m-synephrine: Comparative mechanistic, physiological and pharmacological properties. Phytother Res 2020; 34:1838-1846. [PMID: 32101364 PMCID: PMC7496387 DOI: 10.1002/ptr.6649] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 01/23/2023]
Abstract
Confusion and misunderstanding exist regarding the lack of cardiovascular and other adverse health effects of p-synephrine and p-octopamine relative to ephedrine and m-synephrine (phenylephrine) which are known for their effects on the cardiovascular system. These four molecules have some structural similarities. However, the structural and stereochemical differences of p-synephrine and p-octopamine as related to ephedrine and m-synephrine result in markedly different adrenergic receptor binding characteristics as well as other mechanistic differences which are reviewed. p-Synephrine and p-octopamine exhibit little binding to α-1, α-2, β-1 and β-2 adrenergic receptors, nor are they known to exhibit indirect actions leading to an increase in available levels of endogenous norepinephrine and epinephrine at commonly used doses. The relative absence of these mechanistic actions provides an explanation for their lack of production of cardiovascular effects at commonly used oral doses as compared to ephedrine and m-synephrine. As a consequence, the effects of ephedrine and m-synephrine cannot be directly extrapolated to p-synephrine and p-octopamine which exhibit significantly different pharmacokinetic, and physiological/pharmacological properties. These conclusions are supported by human, animal and in vitro studies that are discussed.
Collapse
Affiliation(s)
- Sidney J Stohs
- School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, Nebraska.,Department of Pharmaceutical & Biomedical Sciences, Kitsto Consulting LLC, Frisco, Texas
| | - Mohd Shara
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | | |
Collapse
|
19
|
Ephedrannin B exerts anti-viral and anti-inflammatory properties in BEAS-2B cells infected with respiratory syncytial virus. J Biosci 2020. [DOI: 10.1007/s12038-020-0016-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
20
|
Li P, Zhang J, Liang X. Characterization of the complete chloroplast genome of Ephedra sinica Stapf (Ephedraceae), a traditional Chinese medicine. MITOCHONDRIAL DNA PART B-RESOURCES 2019; 4:3301-3302. [PMID: 33365965 PMCID: PMC7707388 DOI: 10.1080/23802359.2019.1673233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Ephedra sinica Stapf is a traditional Chinese medicine of Ephedraceae in China, which contains many chemicals, such as ephedrine and pseudoephedrine, flavonoids, polysaccharides, phenolic compounds, and proanthocyanidins. It shows significant activity in asthma, fever, rheumatoid arthritis, and also promotes diuresis and sweat.
Collapse
Affiliation(s)
- Peng Li
- Department of Pharmacy, Xi'an International University, Xi'an, Shaanxi, China
| | - Jinyang Zhang
- Department of Pharmacy, Xi'an International University, Xi'an, Shaanxi, China
| | - Xiaoqing Liang
- Department of Pharmacy, Xi'an International University, Xi'an, Shaanxi, China
| |
Collapse
|
21
|
Ma X, Fan L, Mao F, Zhao Y, Yan Y, Tian H, Xu R, Peng Y, Sui H. Discrimination of three Ephedra species and their geographical origins based on multi-element fingerprinting by inductively coupled plasma mass spectrometry. Sci Rep 2018; 8:10271. [PMID: 29980710 PMCID: PMC6035214 DOI: 10.1038/s41598-018-28558-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 06/22/2018] [Indexed: 11/29/2022] Open
Abstract
Discrimination of species and geographical origins of traditional Chinese medicine (TCM) is essential to prevent adulteration and inferior problems. We studied Ephedra sinica Stapf, Ephedra intermedia Schrenk et C.A.Mey. and Ephedra przewalskii Bge. to investigate the relationship between inorganic element content and these three species and their geographical origins. 38 elemental fingerprints from six major Ephedra-producing regions, namely, Inner Mongolia, Ningxia, Gansu, Shanxi, Shaanxi, and Sinkiang, were determined to evaluate the importance of inorganic elements to three species and their geographical origins. The contents of 15 elements, namely, N, P, K, S, Ca, Mg, Fe, Mn, Na, Cl, Sr, Cu, Zn, B, and Mo, of Ephedra samples were measured using inductively coupled plasma mass spectroscopy. Elemental contents were used as chemical indicators to classify species and origins of Ephedra samples using a radar plot and multivariate data analysis, including hierarchical cluster analysis (HCA), principal component analysis (PCA), and discriminant analysis (DA). Ephedra samples from different species and geographical origins could be differentiated. This study showed that inorganic elemental fingerprint combined with multivariate statistical analysis is a promising tool for distinguishing three Ephedra species and their geographical origins, and this strategy might be an effective method for authenticity discrimination of TCM.
Collapse
Affiliation(s)
- Xiaofang Ma
- Ningxia Medical University Pharmacy College, Yinchuan, 750004, Ningxia, China
| | - Lingling Fan
- Ningxia Medical University Pharmacy College, Yinchuan, 750004, Ningxia, China
| | - Fuying Mao
- Ningxia Medical University Pharmacy College, Yinchuan, 750004, Ningxia, China.,Ningxia Research Center of Modern Hui Medicine Engineering and Technology, Yinchuan, 750004, Ningxia, China
| | - Yunsheng Zhao
- Ningxia Medical University Pharmacy College, Yinchuan, 750004, Ningxia, China. .,Ningxia Research Center of Modern Hui Medicine Engineering and Technology, Yinchuan, 750004, Ningxia, China. .,Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Yinchuan, 750004, Ningxia, China.
| | - Yonggang Yan
- Shaanxi University of Chinese Medicine, Pharmacy College, Xianyang, 712046, Shaanxi, China
| | - Hongling Tian
- Institute of Industrial Crop Research, Shanxi Academy of Agricultural Sciences, Fenyang, 032200, Shanxi, China
| | - Rui Xu
- Ningxia Medical University Pharmacy College, Yinchuan, 750004, Ningxia, China
| | - Yanqun Peng
- Ningxia Medical University Pharmacy College, Yinchuan, 750004, Ningxia, China
| | - Hong Sui
- Ningxia Medical University Pharmacy College, Yinchuan, 750004, Ningxia, China.,Ningxia Research Center of Modern Hui Medicine Engineering and Technology, Yinchuan, 750004, Ningxia, China
| |
Collapse
|
22
|
Mladěnka P, Applová L, Patočka J, Costa VM, Remiao F, Pourová J, Mladěnka A, Karlíčková J, Jahodář L, Vopršalová M, Varner KJ, Štěrba M. Comprehensive review of cardiovascular toxicity of drugs and related agents. Med Res Rev 2018; 38:1332-1403. [PMID: 29315692 PMCID: PMC6033155 DOI: 10.1002/med.21476] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/20/2017] [Accepted: 11/16/2017] [Indexed: 12/12/2022]
Abstract
Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases. Due to the large number of clinically relevant compounds discussed, this article could be of interest to a broad audience including pharmacologists and toxicologists, pharmacists, physicians, and medicinal chemists. Particular emphasis is given to clinically relevant topics including the cardiovascular toxicity of illicit sympathomimetic drugs (e.g., cocaine, amphetamines, cathinones), drugs that prolong the QT interval, antidysrhythmic drugs, digoxin and other cardioactive steroids, beta-blockers, calcium channel blockers, female hormones, nonsteroidal anti-inflammatory, and anticancer compounds encompassing anthracyclines and novel targeted therapy interfering with the HER2 or the vascular endothelial growth factor pathway.
Collapse
Affiliation(s)
- Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Lenka Applová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Jiří Patočka
- Department of Radiology and Toxicology, Faculty of Health and Social StudiesUniversity of South BohemiaČeské BudějoviceCzech Republic
- Biomedical Research CentreUniversity HospitalHradec KraloveCzech Republic
| | - Vera Marisa Costa
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of PharmacyUniversity of PortoPortoPortugal
| | - Fernando Remiao
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of PharmacyUniversity of PortoPortoPortugal
| | - Jana Pourová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Aleš Mladěnka
- Oncogynaecologic Center, Department of Gynecology and ObstetricsUniversity HospitalOstravaCzech Republic
| | - Jana Karlíčková
- Department of Pharmaceutical Botany and Ecology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Luděk Jahodář
- Department of Pharmaceutical Botany and Ecology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Marie Vopršalová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Kurt J. Varner
- Department of PharmacologyLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Martin Štěrba
- Department of Pharmacology, Faculty of Medicine in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | | |
Collapse
|
23
|
Abstract
By the turn of the twenty-first century, the use of nutraceuticals became increasingly popular in both humans and animals due to their easy access, cost-effectiveness, and tolerability with a wide margin of safety. While some nutraceuticals are safe, others have a toxic potential. For a large number of nutraceuticals, no toxicity/safety data are available due to a lack of pharmacological/toxicological studies. The safety of some nutraceuticals can be compromised via contamination with toxic plants, metals, mycotoxins, pesticides, fertilizers, drugs of abuse, etc. Knowledge of pharmacokinetic/toxicokinetic studies appears to play a pivotal role in safety and toxicity assessment of nutraceuticals. Interaction studies are essential to determine efficacy, safety, and toxicity when nutraceuticals and therapeutic drugs are used concomitantly. This chapter describes various aspects of nutraceuticals, particularly their toxic potential, and the factors influencing their safety.
Collapse
|
24
|
Brown AC. Heart Toxicity Related to Herbs and Dietary Supplements: Online Table of Case Reports. Part 4 of 5. J Diet Suppl 2017; 15:516-555. [PMID: 28981338 DOI: 10.1080/19390211.2017.1356418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The purpose of this review was to create an online research summary table of heart toxicity case reports related to dietary supplements (DS; includes herbs). METHODS Documented PubMed case reports of DS appearing to contribute to heart-related problems were used to create a "Toxic Table" that summarized the research (1966 to April, 2016, and cross-referencing). Keywords included "herb," "dietary supplement," and cardiac terms. Case reports were excluded if they were herb combinations (some exceptions), Chinese herb mixtures, teas of mixed herb contents, mushrooms, poisonous plants, self-harm (e.g. suicide), excess dose (except vitamins/minerals), drugs or illegal drugs, drug-herbal interactions, and confounders of drugs or diseases. The spectrum of heart toxicities included hypertension, hypotension, hypokalemia, bradycardia, tachycardia, arrhythmia, ventricular fibrillation, heart attack, cardiac arrest, heart failure, and death. RESULTS Heart related problems were associated with approximately seven herbs: Four traditional Chinese medicine herbs - Don quai (Angelica sinensis), Jin bu huan (Lycopodium serratum), Thundergod vine or lei gong teng (Tripterygium wilfordii Hook F), and Ting kung teng (Erycibe henryi prain); one an Ayruvedic herb - Aswagandha, (Withania somnifera); and two North American herbs - blue cohosh (Caulophyllum thalictroides), and Yohimbe (Pausinystalia johimbe). Aconitum and Ephedra species are no longer sold in the United States. The DS included, but are not limited to five DS - bitter orange, caffeine, certain energy drinks, nitric oxide products, and a calming product. Six additional DS are no longer sold. Licorice was the food related to heart problems. CONCLUSION The online "Toxic Table" forewarns clinicians, consumers and the DS industry by listing DS with case reports related to heart toxicity. It may also contribute to Phase IV post marketing surveillance to diminish adverse events that Government officials use to regulate DS.
Collapse
Affiliation(s)
- Amy C Brown
- a Complementary and Alternative Medicine, John A. Burns School of Medicine , University of Hawaii at Manoa , Honolulu , HI , USA
| |
Collapse
|
25
|
Gentil P, de Lira CAB, Paoli A, Dos Santos JAB, da Silva RDT, Junior JRP, da Silva EP, Magosso RF. Nutrition, Pharmacological and Training Strategies Adopted by Six Bodybuilders: Case Report and Critical Review. Eur J Transl Myol 2017; 27:6247. [PMID: 28458804 PMCID: PMC5391526 DOI: 10.4081/ejtm.2017.6247] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The purpose of this study was to report and analyze the practices adopted by bodybuilders in light of scientific evidence and to propose evidence-based alternatives. Six (four male and two female) bodybuilders and their coaches were directly interviewed. According to the reports, the quantity of anabolic steroids used by the men was 500–750 mg/week during the bulking phase and 720–1160 mg during the cutting phase. The values for women were 400 and 740 mg, respectively. The participants also used ephedrine and hydrochlorothiazide during the cutting phase. Resistance training was designed to train each muscle once per week and all participants performed aerobic exercise in the fasted state in order to reduce body fat. During the bulking phase, bodybuilders ingested ~2.5 g of protein/kg of body weight. During the cutting phase, protein ingestion increased to ~3 g/kg and carbohydrate ingestion decreased by 10–20%. During all phases, fat ingestion corresponded to ~15% of the calories ingested. The supplements used were whey protein, chromium picolinate, omega 3 fatty acids, branched chain amino acids, poly-vitamins, glutamine and caffeine. The men also used creatine in the bulking phase. In general, the participants gained large amounts of fat-free mass during the bulking phase; however, much of that fat-free mass was lost during the cutting phase along with fat mass. Based on our analysis, we recommend an evidence-based approach by people involved in bodybuilding, with the adoption of a more balanced and less artificial diet. One important alert should be given for the combined use of anabolic steroids and stimulants, since both are independently associated with serious cardiovascular events. A special focus should be given to revisiting resistance training and avoiding fasted cardio in order to decrease the reliance on drugs and thus preserve bodybuilders’ health and integrity.
Collapse
Affiliation(s)
- Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | | | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | | | | | | | | | - Rodrigo Ferro Magosso
- Post Graduation Program in Movement Sciences, UNESP - Universidade Estadual Paulista, Rio Claro, Brazil
| |
Collapse
|
26
|
Barkaoui T, Kacem R, Guesmi F, Blell A, Landoulsi A. Evaluation of Antibacterial and Antioxidant Properties of Urtica urens Extract Tested by Experimental Animals. INT J PHARMACOL 2017. [DOI: 10.3923/ijp.2017.332.339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
27
|
Zarshenas MM, Jamshidi S, Zargaran A. Cardiovascular aspects of geriatric medicines in traditional Persian medicine; a review of phytochemistry and pharmacology. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:1182-1189. [PMID: 26964479 DOI: 10.1016/j.phymed.2016.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/01/2016] [Accepted: 01/12/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Geriatrics are a group of patients over 65 years and with multiple comorbidities and different functional impairments. Apart from decline in body mass, presence of exhaustion and general fatigue, an aged person may also suffer from various disorders. Approximately, around 30% of geriatric subjects have significant cardiovascular ailments. Apart from the intensive management of cardiovascular aspects in elderly, monitoring of the complementary cardiac medicine in those people should be received more attention. PURPOSE There are many management lines for a cardio-geriatric condition in Traditional Persian Medicine (TPM). Accordingly, this paper aimed to deal with those medicaments as well as evidence-based clinical aspects and phytochemistry. METHODS By searching through main pharmaceutical manuscripts of Persian medicine during 10th-18th centuries (A.D.), concurrently, natural medicines for geriatrics and remedies for cardiovascular ailments were derived. On the other side, related phytochemical and pharmacological aspects of those remedies were highlighted. RESULTS In all, 38 cardiovascular and 34 geriatric medicaments were found in those manuscripts. Antihyperlipidemic and cholesterol lowering activities of those medicines were the most reported activities in current medicine. However, other pharmacological reports were related to hypotensive, coagulant, cardio-protective and cardiotonic activities. In regard of the chemical composition, medicaments were mainly of polyphenols and flavonoids and also most of the employed extracts and fractions were yielded from polar or semi-polar solvents. CONCLUSION With reference to these findings, flavonoid-rich medicaments from Persian medicine may be selected as considerable herbs for geriatrics with cardiovascular ailments.
Collapse
MESH Headings
- Aged
- Aged, 80 and over
- Cardiovascular Diseases/drug therapy
- Flavonoids/pharmacology
- Flavonoids/therapeutic use
- Geriatrics/methods
- History, 15th Century
- History, 16th Century
- History, 17th Century
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, 21st Century
- History, Medieval
- Humans
- Iran
- Medicine, Traditional/history
- Phytochemicals/pharmacology
- Phytochemicals/therapeutic use
- Phytotherapy/history
- Plant Extracts/pharmacology
- Plant Extracts/therapeutic use
- Plants, Medicinal/chemistry
Collapse
Affiliation(s)
- Mohammad M Zarshenas
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sahar Jamshidi
- Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arman Zargaran
- Department of Traditional Pharmacy, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran; Research Office for the History of Persian Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
28
|
Tang Y, Zheng M, Chen YL, Chen J, He Y. Pharmacokinetic Effects of Cinnamic Acid, Amygdalin, Glycyrrhizic Acid and Liquiritin on Ephedra Alkaloids in Rats. Eur J Drug Metab Pharmacokinet 2016; 42:527-535. [DOI: 10.1007/s13318-016-0368-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
29
|
Stohs SJ, Badmaev V. A Review of Natural Stimulant and Non-stimulant Thermogenic Agents. Phytother Res 2016; 30:732-40. [PMID: 26856274 PMCID: PMC5067548 DOI: 10.1002/ptr.5583] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 01/11/2016] [Accepted: 01/14/2016] [Indexed: 01/19/2023]
Abstract
Obesity and overweight are major health issues. Exercise and calorie intake control are recognized as the primary mechanisms for addressing excess body weight. Naturally occurring thermogenic plant constituents offer adjunct means for assisting in weight management. The controlling mechanisms for thermogenesis offer many intervention points. Thermogenic agents can act through stimulation of the central nervous system with associated adverse cardiovascular effects and through metabolic mechanisms that are non-stimulatory or a combination thereof. Examples of stimulatory thermogenic agents that will be discussed include ephedrine and caffeine. Examples of non-stimulatory thermogenic agents include p-synephrine (bitter orange extract), capsaicin, forskolin (Coleus root extract), and chlorogenic acid (green coffee bean extract). Green tea is an example of a thermogenic with the potential to produce mild but clinically insignificant undesirable stimulatory effects. The use of the aforementioned thermogenic agents in combination with other extracts such as those derived from Salacia reticulata, Sesamum indicum, Lagerstroemia speciosa, Cissus quadrangularis, and Moringa olifera, as well as the use of the carotenoids as lutein and fucoxanthin, and flavonoids as naringin and hesperidin can further facilitate energy metabolism and weight management as well as sports performance without adverse side effects. © 2016 The Authors Phytotherapy Research published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- Sidney J. Stohs
- School of Pharmacy and Health ProfessionsCreighton UniversityOmahaNE68178USA
| | | |
Collapse
|
30
|
Abstract
Since the 1980s, the prevalence of obesity has almost doubled worldwide. Treatments for obesity include lifestyle modification, medications and surgery. Newer anti-obesity medications have been shown to be effective at inducing initial weight management in addition to successful long-term weight maintenance. Historically, weight management medications have been associated with public safety concerns that have resulted in the majority being withdrawn from the market or never receiving medicinal authorization. Recently, several countries have approved some newer generation weight management medications which may be beneficial to combat obesity. These medications have varying effects on cardiometabolic parameters, both positive and potentially negative. This review will outline the mechanisms of action of these medications and their implications for both diabetes and cardiovascular risks.
Collapse
Affiliation(s)
- S Wharton
- Weight Management and Diabetes Management, The Wharton Medical Clinic, 414 Victoria Ave N Suite 14, Hamilton, ON, L8L 5G8, Canada,
| | | |
Collapse
|
31
|
Tang F, Tang Q, Tian Y, Fan Q, Huang Y, Tan X. Network pharmacology-based prediction of the active ingredients and potential targets of Mahuang Fuzi Xixin decoction for application to allergic rhinitis. JOURNAL OF ETHNOPHARMACOLOGY 2015; 176:402-412. [PMID: 26545458 DOI: 10.1016/j.jep.2015.10.040] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 10/25/2015] [Accepted: 10/26/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Certain herbal formulae from Traditional Chinese Medicine (TCM) are effective for treating and preventing diseases in clinical practice. Mahuang fuzi Xixin Decoction (MFXD) is a TCM that is used to treat allergic rhinitis (AR); however, the active ingredients and potential targets of its action against AR remain unclear. Therefore, further investigation is required. METHODS A network pharmacology approach comprising drug-likeness evaluation, oral bioavailability prediction, multiple drug target prediction, and network analysis has been used in this study. RESULTS The comprehensive systematic approach was successfully to indentify 41 bioactive ingredients in MFXD, while 37 potential targets hit by these ingredients related to AR. Moreover, wherein four predicted ingredients possess anti-inflammatory effects were found by this technique. CONCLUSIONS Our works successfully predict the active ingredients and potential targets of MFXD for application to allergic rhinitis and helps to illustrate mechanism of action on a systematic level. This study not only provides new insights into the chemical basis and pharmacology of MFXD but also demonstrates a feasible method for discovering potential drugs from herbal medicine.
Collapse
Affiliation(s)
- Feng Tang
- School of Traditional Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China; Guangdong Province Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, 510515 Guangzhou, PR China
| | - Qingfa Tang
- School of Traditional Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China; Guangdong Province Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, 510515 Guangzhou, PR China
| | - Yuanxin Tian
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, PR China
| | - Qin Fan
- School of Traditional Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China
| | - Yao Huang
- School of Traditional Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China; Guangdong Province Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, 510515 Guangzhou, PR China
| | - Xiaomei Tan
- School of Traditional Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China; Guangdong Province Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, 510515 Guangzhou, PR China.
| |
Collapse
|
32
|
Alkaloids in Erythrina by UPLC-ESI-MS and In Vivo Hypotensive Potential of Extractive Preparations. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:959081. [PMID: 26356581 PMCID: PMC4556073 DOI: 10.1155/2015/959081] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/19/2015] [Accepted: 07/28/2015] [Indexed: 11/17/2022]
Abstract
Erythrina species are used in popular medicine as sedative, anxiolytic, anti-inflammatory, and antihypertensive. In this work, we investigated the chemical composition of extracts obtained from leaves of E. falcata and E. crista-galli. The hypotensive potential of E. falcata and the mechanism of action were also studied. The extracts were obtained by maceration and infusion. The total content of phenolic compounds and flavonoids was estimated by spectrophotometric methods. The chemical constituents were studied performing a chromatographic analysis by UPLC-ESI-MS. For in vivo protocols, blood pressure and heart rate were measured by the invasive hemodynamic monitoring method. Different concentrations of extracts and drugs such as L-NAME, losartan, hexamethonium, and propranolol were administrated i.v. The results of total phenolic contents for E. falcata and E. crista-galli were 1.3193-1.4989 mgGAE/mL for maceration and 0.8771-0.9506 mgGAE/mL for infusion. In total flavonoids, the content was 7.7829-8.1976 mg RE/g for maceration and 9.3471-10.4765 RE mg/g for infusion. The chemical composition was based on alkaloids, suggesting the presence of erythristemine, 11β-methoxyglucoerysodine, erysothiopine, 11β-hydroxyerysodine-glucose, and 11-hydroxyerysotinone-rhamnoside. A potent dose-dependent hypotensive effect was observed for E. falcata, which may be related to the route of β-adrenergic receptors.
Collapse
|
33
|
Oberholzer HM, Van Der Schoor C, Taute H, Bester MJ. A descriptive study to provide evidence of the teratogenic and cellular effects of sibutramine and ephedrine on cardiac- and liver-tissue of chick embryos. Microsc Res Tech 2015; 78:737-46. [PMID: 26138360 DOI: 10.1002/jemt.22539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/29/2015] [Accepted: 06/14/2015] [Indexed: 11/07/2022]
Abstract
Exposure to drugs during pregnancy is a major concern, as some teratogenic compounds can influence normal foetal development. Although the use of drugs during pregnancy should generally be avoided, exposure of the developing foetus to teratogens may occur unknowingly since these compounds may be hidden in products that are being marketed as "all natural." The aim of the current study was to investigate the possible teratogenic and cellular effects of sibutramine-a serotonin-norepinephrine reuptake inhibitor used in the treatment of obesity-on the heart and liver tissue of chick embryos. Ephedrine was used as a positive control. The chick embryo model was chosen because it has been used in studying developmental and experimental biology and teratology with great success. The embryos were exposed to three different concentrations of sibutramine and ephedrine respectively. The results obtained revealed that both compounds exhibited embryotoxicity when compared to the control groups. Liver and heart tissue of the exposed embryos was severely affected by these compounds in a dose-related manner. Morphology similar to that of muscle dystrophy was observed in the heart, where the muscle tissue was infiltrated by adipose and connective tissue. Severe liver steatosis was also noted. A more in-depth investigation into the molecular pathways involved might provide more information on the exact mechanism of toxicity of these products influencing embryonic development.
Collapse
Affiliation(s)
| | - Ciska Van Der Schoor
- Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
| | - Helena Taute
- Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
| | - Megan Jean Bester
- Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
| |
Collapse
|
34
|
Kim IS, Yoon SJ, Park YJ, Lee HB. Inhibitory effect of ephedrannins A and B from roots of Ephedra sinica STAPF on melanogenesis. Biochim Biophys Acta Gen Subj 2015; 1850:1389-96. [DOI: 10.1016/j.bbagen.2015.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 03/30/2015] [Accepted: 04/01/2015] [Indexed: 10/23/2022]
|
35
|
Zheng M, Zhou H, Wan H, Chen YL, He Y. Effects of herbal drugs in Mahuang decoction and their main components on intestinal transport characteristics of Ephedra alkaloids evaluated by a Caco-2 cell monolayer model. JOURNAL OF ETHNOPHARMACOLOGY 2015; 164:22-29. [PMID: 25660335 DOI: 10.1016/j.jep.2015.01.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 01/02/2015] [Accepted: 01/15/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Mahuang decoction, Ephedra combined with Cassia twig, Bitter apricot kernel and Prepared licorice, has been widely used as a multi-herb prescription in traditional Chinese medicine (TCM). Many modern pharmacological studies have shown that the compatibility application of these four herbs has promising therapeutic effects on respiratory infection, acute glomerulonephritis and chronic renal failure. However, the underlying principles for governing the formulation of Mahuang decoction remain unknown. In this study, we used a Caco-2 cell monolayer model to explicate the possible compatibility mechanism of Mahuang decoction from the perspective of intestinal absorption. MATERIAL AND METHODS Firstly, the apical-to-basolateral and basolarteral-to-apical transport of the main characteristic active alkaloids in Ephedra, l-ephedrine (LEP), d-pseudoephedrine (DPEP) and l-methylephedrine (LMEP), as a single compound, was investigated. Secondly, the influence of main components in Cassia twig, Bitter apricot kernel and Prepared licorice on the transport of LEP, DPEP and LMEP was investigated. Finally, the bidirectional transport of these three alkaloids in single Ephedra extract, in Mahuang decoction and in drug pair extracts, such as Ephedra-Cassia twig, Ephedra-Bitter apricot kernel, Ephedra-Prepared licorice, was assessed. RESULTS The investigated LEP, DPEP and LMEP could transport through the Caco-2 cell monolayer at a high level, with the efflux ratio (ER) of 1.41, 1.33 and 1.30, respectively, when the cells were treated with each single compound solution. In the presence of verapamil, the permeability from apical side to basolateral side (PAB) of the three alkaloids increased significantly (P<0.05), and their ERs decreased. The treatment of cells with Mahuang decoction and the drug pair extracts from Ephedra-Cassia twig, Ephedra-Bitter apricot kernel and Ephedra-Prepared licorice appreciably decreased PAB of LEP, DPEP and LMEP with increased ERs, compared to the treatment with single Ephedra extract. When concomitant administration with herbal drugs and their main ingredients (including cinnamaldehyde-cinnamyl alcohol-cinnamic acid group, volatile oil from Cassia twig, liquiritin-glycyrrhizic acid group from Prepared licorice, Cassia twig extract, Bitter apricot kernel extract and Prepared licorice extract), was adopted, PAB of LEP, DPEP and LMEP were reduced significantly and the ERs of the corresponding compounds were promoted appreciably. Only amygdalin (from Bitter apricot kernel) had little influence on the transport of Ephedra alkaloids. CONCLUSION The findings indicate that LEP, DPEP and LMEP in Ephedra extract have similar absorption as in the pure solution of each compound. The intestinal absorption of LEP, DPEP and LMEP is through passive diffusion and these compounds may be P-gp substrates. The compatibility application of Cassia twig, Bitter apricot kernel and Prepared licorice, and their main components except amygdalin can suppress the absorption of the three main Ephedra alkaloids across the Caco-2 cell monolayer. On the basis of our results, Cassia twig, Bitter apricot kernel and Prepared licorice in Mahuang decoction decrease the absorption of Ephedra alkaloids, which may alleviate the drastic diaphoretic function and toxicity of Ephedra.
Collapse
Affiliation(s)
- Mengkai Zheng
- Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Huifen Zhou
- Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Haitong Wan
- Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yu-Lin Chen
- Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yu He
- Zhejiang Chinese Medical University, Hangzhou 310053, China.
| |
Collapse
|
36
|
Mugabo P, Philander A, Raji I, Dietrich D, Green I. Effects of hippadine on the blood pressure and heart rate in male spontaneously hypertensive Wistar rats. JOURNAL OF ETHNOPHARMACOLOGY 2014; 158 Pt A:123-131. [PMID: 25456427 DOI: 10.1016/j.jep.2014.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 10/01/2014] [Accepted: 10/11/2014] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Hippadine is an alkaloid isolated from Crinum macowanii. Crinum macowanii is used in South Africa to treat oedema, 'heart disease', rheumatic fever, cancer and skin diseases, and belongs to the plant family Amaryllidaceae, assumed to have originated in the South African region. The aim of this study was to evaluate the effect of hippadine, an alkaloid extracted from Crinum macowanii, on the blood pressure (BP) and heart rate (HR) in anaesthetized male spontaneously hypertensive Wistar rats (SHR); and to find out if α1 and⧸or β1 adrenoceptors contribute to its effects. MATERIALS AND METHODS Hippadine (2.5-12.5mg/kg), adrenaline (0.05-0.20mg/kg), atenolol (0.5-40mg/kg) and prazosin hydrochloride (100-500µg/kg) were infused intravenously, and the BP and HR measured via a pressure transducer connecting the femoral artery and the PowerLab. Adrenaline increased the systolic, diastolic and mean arterial BP, while hippadine, atenolol and prazosin respectively decreased the systolic, diastolic and mean arterial BP. Increases in HR were observed with both adrenaline and prazosin, while reductions in HR were observed with atenolol and hippadine. Infusion of adrenaline in rats pre-treated with atenolol (30mg/kg), prazosin (400µg/kg), and hippadine (10mg/kg) led to similar increases in BP and HR in all groups. All changes in HR or BP were significant (p<0.05) and dose dependent. CONCLUSION Hippadine decreases the BP and HR in SHR, and these effects may be due to α1 and β1 adrenoceptor inhibition.
Collapse
Affiliation(s)
- Pierre Mugabo
- School of Pharmacy, University of the Western Cape, South Africa.
| | | | - Ismaila Raji
- Faculty of Medicine, National University of Science and Technology, Zimbabwe
| | - Daneel Dietrich
- Department of Medical Biosciences, University of the Western Cape, South Africa
| | - Ivan Green
- Department of Chemistry, University of the Western Cape, South Africa
| |
Collapse
|
37
|
Yao Y, Zhang X, Wang Z, Zheng C, Li P, Huang C, Tao W, Xiao W, Wang Y, Huang L, Yang L. Deciphering the combination principles of Traditional Chinese Medicine from a systems pharmacology perspective based on Ma-huang Decoction. JOURNAL OF ETHNOPHARMACOLOGY 2013; 150:619-638. [PMID: 24064232 DOI: 10.1016/j.jep.2013.09.018] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 09/12/2013] [Accepted: 09/16/2013] [Indexed: 06/02/2023]
Abstract
ETHNOPHARMACOLOGY RELEVANCE The main therapeutic concept in Traditional Chinese Medicine (TCM) is herb formula, which treats various diseases via potential herb interactions to maximize the efficacy and minimize the adverse effects. However, the combination principle of herb formula still remains a mystery due to the lack of appropriate methods. METHODS A systems pharmacology method integrating the pharmacokinetic analysis, drug targeting, and drug-target-disease network is developed to dissect this rule embedded in the herbal formula. All these are exemplified by a representative TCM formula, Ma-huang decoction, made up of four botanic herbs. RESULTS Based on the deep investigation of the function and compatibility of each herb, in a molecular/systems level, we demonstrate the different pharmacological roles that each herb might play in the prescription. By the way of enhancing the bioavailability and/or making the pharmacological synergy among different herbs, the four herbs effectively combine together to be suitable for treating diseases. CONCLUSIONS The present work lays foundations for a more comprehensive understanding of the combination rule of TCM, which might also be beneficial to drug development and applications.
Collapse
Affiliation(s)
- Yao Yao
- Center of Bioinformatics, Northwest A & F University, Yangling, Shaanxi 712100, China; College of Life Sciences, Northwest A & F University, Yangling, Shaanxi 712100, China
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Rosenbloom AL. Sudden death of a young woman attributed to diabetic ketoacidosis. J Forensic Leg Med 2013; 20:1063-5. [PMID: 24237820 DOI: 10.1016/j.jflm.2013.09.028] [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: 05/10/2013] [Revised: 08/23/2013] [Accepted: 09/29/2013] [Indexed: 10/26/2022]
Abstract
A young woman's death at home was attributed to new onset diabetic ketoacidosis with subsequent litigation supported by several expert consultants, despite a history and postmortem findings inconsistent with this diagnosis. More thorough tissue study of the heart and analysis of the circumstances led to a credible explanation of the entire scenario.
Collapse
Affiliation(s)
- Arlan L Rosenbloom
- Division of Endocrinology, Department of Pediatrics, University of Florida College of Medicine, United States.
| |
Collapse
|
39
|
Pharmacological effects of active compounds on neurodegenerative disease with gastrodia and uncaria decoction, a commonly used poststroke decoction. ScientificWorldJournal 2013; 2013:896873. [PMID: 24348193 PMCID: PMC3851952 DOI: 10.1155/2013/896873] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 09/17/2013] [Indexed: 01/14/2023] Open
Abstract
Neurodegenerative diseases refer to the selective loss of neuronal systems in patients. The diseases cause high morbidity and mortality to approximately 22 million people worldwide and the number is expected to be tripled by 2050. Up to now, there is no effective prevention and treatment for the neurodegenerative diseases. Although some of the clinical therapies target at slowing down the progression of symptoms of the diseases, the general effectiveness of the drugs has been far from satisfactory. Traditional Chinese medicine becomes popular alternative remedies as it has been practiced clinically for more than thousands of years in China. As neurodegenerative diseases are mediated through different pathways, herbal decoction with multiple herbs is used as an effective therapeutic approach to work on multiple targets. Gastrodia and Uncaria Decoction, a popular TCM decoction, has been used to treat stroke in China. The decoction contains compounds including alkaloids, flavonoids, iridoids, carotenoids, and natural phenols, which have been found to possess anti-inflammatory, antioxidative, and antiapoptotic effects. In this review, we will summarize the recent publications of the pharmacological effects of these five groups of compounds. Understanding the mechanisms of action of these compounds may provide new treatment opportunities for the patients with neurodegenerative diseases.
Collapse
|
40
|
Pressor mechanism evaluation for phytochemical compounds using in silico compound–protein interaction prediction. Regul Toxicol Pharmacol 2013; 67:115-24. [DOI: 10.1016/j.yrtph.2013.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 07/20/2013] [Accepted: 07/22/2013] [Indexed: 01/30/2023]
|
41
|
Verpeut JL, Walters AL, Bello NT. Citrus aurantium and Rhodiola rosea in combination reduce visceral white adipose tissue and increase hypothalamic norepinephrine in a rat model of diet-induced obesity. Nutr Res 2013; 33:503-12. [PMID: 23746567 DOI: 10.1016/j.nutres.2013.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 03/29/2013] [Accepted: 04/02/2013] [Indexed: 01/02/2023]
Abstract
Extracts from the immature fruit of Citrus aurantium are often used for weight loss but are reported to produce adverse cardiovascular effects. Root extracts of Rhodiola rosea have notable antistress properties. The hypothesis of these studies was that C aurantium (6% synephrine) and R rosea (3% rosavins, 1% salidroside) in combination would improve diet-induced obesity alterations in adult male Sprague-Dawley rats. In normal-weight animals fed standard chow, acute administration of C aurantium (1-10 mg/kg) or R rosea (2-20 mg/kg) alone did not reduce deprivation-induced food intake, but C aurantium (5.6 mg/kg) + R rosea (20 mg/kg) produced a 10.5% feeding suppression. Animals maintained (13 weeks) on a high-fat diet (60% fat) were exposed to 10-day treatments of C aurantium (5.6 mg/kg) or R rosea (20 mg/kg) alone or in combination. Additional groups received vehicle (2% ethanol) or were pair fed to the C aurantium + R rosea group. Although high-fat diet intake and weight loss were not influenced, C aurantium + R rosea had a 30% decrease in visceral fat weight compared with the other treatments. Only the C aurantium group had an increased heart rate (+7%) compared with vehicle. In addition, C aurantium + R rosea administration resulted in an elevation (+15%) in hypothalamic norepinephrine and an elevation (+150%) in frontal cortex dopamine compared with the pair-fed group. These initial findings suggest that treatments of C aurantium + R rosea have actions on central monoamine pathways and have the potential to be beneficial for the treatment of obesity.
Collapse
Affiliation(s)
- Jessica L Verpeut
- Department of Animal Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | | | | |
Collapse
|
42
|
Zheng Y, Yang Y, Li Y, Xu L, Wang Y, Guo Z, Song H, Yang M, Luo B, Zheng A, Li P, Zhang Y, Ji G, Yu Y. Ephedrine hydrochloride inhibits PGN-induced inflammatory responses by promoting IL-10 production and decreasing proinflammatory cytokine secretion via the PI3K/Akt/GSK3β pathway. Cell Mol Immunol 2013; 10:330-7. [PMID: 23604046 DOI: 10.1038/cmi.2013.3] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 12/15/2012] [Accepted: 12/16/2012] [Indexed: 02/06/2023] Open
Abstract
Approaches for controlling inflammatory responses and reducing the mortality rate of septic patients remain clinically ineffective; new drugs need to be identified that can induce anti-inflammatory responses. Ephedrine hydrochloride (EH) is a compound that is widely used in cardiovascular diseases, especially to treat hypotension caused by either anesthesia or overdose of antihypertensive drugs. In this study, we reported that EH also plays an important role in the control of the inflammatory response. EH increased IL-10 and decreased proinflammatory cytokine (IL-6, tumor-necrosis factor (TNF)-α, IL-12 and IL-1β) expression in primary peritoneal macrophages and Raw264.7 cells treated with peptidoglycan (PGN), a Gram-positive cell wall component. The anti-inflammatory role of EH was also demonstrated in an experimental mouse model of peritonitis induced by intraperitoneal PGN injection. The phosphatidylinositol 3-kinase (PI3K)/Akt pathway was found to be responsible for the EH-mediated increase in IL-10 production and decrease in IL-6 expression. Therefore, our results illustrated that EH can help maintain immune equilibrium and diminish host damage by balancing the production of pro- and anti-inflammatory cytokines after PGN challenge. EH may be a new potential anti-inflammatory drug that can be useful for treating severe invasive Gram-positive bacterial infection.
Collapse
Affiliation(s)
- Yuejuan Zheng
- Department of Immunology and Microbiology, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Norton R, Lehnhard R, Kearns C, McKeever K. Ephedra increases VO 2, impairs thermoregulation and cardiovascular function, but does not enhance exercise performance. COMPARATIVE EXERCISE PHYSIOLOGY 2013. [DOI: 10.3920/cep12021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The dietary supplement ephedra is a potent sympathomimetic that was banned by the US Food and Drug Administration in 2003 because of its deleterious effects on cardiovascular function and thermoregulation during exercise. Unfortunately, extracts of ephedra can still be obtained via the internet and are in use worldwide. The horse is the only athletic species other than humans that sweats to thermoregulate and it controls cardiovascular function in a similar fashion. The purpose of this study was to use the horse to examine the acute effects of ephedra (Ma Huang) to investigate on markers of performance as well as effects on cardiovascular function and thermoregulation during acute exercise. Six Standardbred mares (~450 kg; 6-12 years of age) were used in a crossover design consisting of a ephedra (Ma Huang containing 8% ephedra alkaloid) and control (applesauce) group. All horses performed an incremental graded exercise test (GXT) at a 6% fixed grade to measure oxygen uptake (VO2), run time, velocity at VO2max, maximal velocity, recovery time, haematocrit, total plasma protein concentration, heart rate, right ventricular pressure (RVP), pulmonary arterial pressure (PAP), rectal temperature and recovery. Measurements were recorded at rest, during exercise and post 2 and 5 min recovery. There was a difference (P<0.05) in pre-exercise haematocrit but not in any other haematocrit or plasma protein sampling intervals. VO2 was greater (P<0.05) for the ephedra group before exercise, at each step of the GXT, at VO2max, and during recovery compared to the control group. Recovery time was significantly different, but run time was not (P≯0.05). Heart rate was elevated (P<0.05) at 2 and 5 min recovery in horses administered ephedra. Significant differences were observed for RVP and PAP and rectal temperature during recovery. Recovery score (sweating response, respiration rate, behaviour) was altered (P<0.05) by ephedra administration. These data suggests an increase in energy expenditure and thermogenesis when horses consume ephedra. However, markers of performance (run time, velocity at VO2max, and maximal velocity completed) were not altered by ephedra administration.
Collapse
Affiliation(s)
- R.P. Norton
- Equine Science Center, Department of Animal Science, Rutgers, State University of New Jersey, New Brunswick, 84 Lipman Drive, New Brunswick, NJ 08901-8525, USA
| | - R.A. Lehnhard
- Department of Kinesiology, University of Maine, 112 Lengyel Hall, Orono, ME 04469, USA
| | - C.F. Kearns
- Equine Science Center, Department of Animal Science, Rutgers, State University of New Jersey, New Brunswick, 84 Lipman Drive, New Brunswick, NJ 08901-8525, USA
| | - K.H. McKeever
- Equine Science Center, Department of Animal Science, Rutgers, State University of New Jersey, New Brunswick, 84 Lipman Drive, New Brunswick, NJ 08901-8525, USA
| |
Collapse
|
44
|
Multiple Dosing of Ephedra-Free Dietary Supplements: Hemodynamic, Electrocardiographic, and Bacterial Contamination Effects. Clin Pharmacol Ther 2012; 93:267-74. [DOI: 10.1038/clpt.2012.241] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
45
|
Song MY, Bose S, Kim HJ, Lee MJ, Lim CY. The impact of Ephedra and green tea combination mesotherapy on localized fat: A randomized-controlled clinical trial. Eur J Integr Med 2012. [DOI: 10.1016/j.eujim.2012.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
46
|
Zheng Y, Guo Z, He W, Yang Y, Li Y, Zheng A, Li P, Zhang Y, Ma J, Wen M, Yang M, An H, Ji G, Yu Y. Ephedrine hydrochloride protects mice from LPS challenge by promoting IL-10 secretion and inhibiting proinflammatory cytokines. Int Immunopharmacol 2012; 13:46-53. [PMID: 22446503 DOI: 10.1016/j.intimp.2012.03.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 02/05/2012] [Accepted: 03/08/2012] [Indexed: 02/06/2023]
Abstract
Sepsis and its derivative endotoxic shock are still serious conditions with high mortality in the intensive care unit. The mechanisms that ensure the balance of proinflammatory cytokines and anti-inflammatory cytokine production are of particular importance. As an active α- and β-adrenergic agonist, ephedrine hydrochloride (EH) is a widely used agent for cardiovascular diseases, especially boosting blood pressure. Here we demonstrate that EH increased Toll-like receptor 4 (TLR4)-mediated production of interleukin 10 (IL-10) through p38 MAPK activation. Simultaneously, EH negatively regulated the production of proinflammatory cytokines. Consistently, EH increased lipopolysaccharide (LPS)-induced serum IL-10 and inhibited tumor necrotic factor-α (TNFα) production in vivo. As a result, EH treatment protected mice from endotoxic shock by lethal LPS challenge. In brief, our data demonstrated that EH could contribute to immune homeostasis by balancing the production of proinflammatory cytokines and anti-inflammatory cytokine in TLR4 signaling. This study provides a potential usage of EH in autoimmunologic diseases or other severe inflammations.
Collapse
Affiliation(s)
- Yuejuan Zheng
- Department of Immunology and Microbiology, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Poddar K, Kolge S, Bezman L, Mullin GE, Cheskin LJ. Nutraceutical Supplements for Weight Loss. Nutr Clin Pract 2011; 26:539-52. [DOI: 10.1177/0884533611419859] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Kavita Poddar
- Johns Hopkins Weight Management Center, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sanjivani Kolge
- Johns Hopkins Weight Management Center, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lena Bezman
- Kennedy Krieger Institute, Baltimore, Maryland
| | - Gerard E. Mullin
- Department of Medicine, Division of Gastroenterology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Lawrence J. Cheskin
- Johns Hopkins Weight Management Center, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Medicine, Division of Gastroenterology, Johns Hopkins School of Medicine, Baltimore, Maryland
| |
Collapse
|
48
|
Kim BY, Cao LH, Kim JY. Common responses in gene expression by Ephedra herba in brain and heart of mouse. Phytother Res 2011; 25:1440-6. [PMID: 21953708 DOI: 10.1002/ptr.3434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 07/26/2010] [Accepted: 01/08/2011] [Indexed: 01/04/2023]
Abstract
The physiological activities of Ephedra herba have been investigated extensively, particularly in the cardiovascular and cerebrovascular systems. However, the molecular mechanisms underlying the effects of Ephedra herba on the brain and heart have yet to be thoroughly elucidated at the whole genome level. Therefore, the present study focused on the identification of the regulatory pattern of gene expression occurring in response to Ephedra herba, using microarray assays in three mouse organs - namely, the brain, heart and liver. Interestingly, the brain and heart exhibited a similar reciprocal pattern of gene expression during the early stages after the administration of Ephedra herba, whereas the liver evidenced a different gene expression profile. Moreover, pathways analysis showed that genes regulated reciprocally by Ephedra herba were associated with neural disease-related functions, such as the Parkinson's disease pathway, in both the brain and the heart. Promoter sequence analysis demonstrated that reciprocally regulated genes could be classified into subgroups on the basis of the similarity of their transcription factor binding sequences, in which temporally up-regulated genes were clustered as distinctive subgroups. In conclusion, the brain and heart responded commonly to Ephedra herba with a temporally reciprocal pattern of gene expression.
Collapse
Affiliation(s)
- Bu-Yeo Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Republic of Korea.
| | | | | |
Collapse
|
49
|
Kim IS, Park YJ, Yoon SJ, Lee HB. Ephedrannin A and B from roots of Ephedra sinica inhibit lipopolysaccharide-induced inflammatory mediators by suppressing nuclear factor-κB activation in RAW 264.7 macrophages. Int Immunopharmacol 2010; 10:1616-25. [PMID: 20939997 DOI: 10.1016/j.intimp.2010.09.019] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 09/15/2010] [Accepted: 09/26/2010] [Indexed: 12/19/2022]
Abstract
Ephedra sinica is a traditional Chinese medicinal herb and has pharmacological functions including anti-inflammatory effects. However, the active ingredients from Ephedra roots have not been characterized. Here, two active constituents were isolated and their structures and mechanisms of action were defined. Active constituents from Ephedra roots were isolated by continuous solvent-extractions and column chromatography. Their structures were determined by use of multiple types of spectrometry. The mechanisms of action were examined using lipopolysaccharide (LPS)-stimulated RAW 264.7 cells through PCR, ELISA, electrophoretic mobility shift assays, and immunocytochemistry. Two active constituents, ephedrannin A and B, belonging to the A-type proanthocyanidin family were identified. Both ephedrannin A and B effectively suppressed the transcription of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). These compounds exerted their anti-inflammatory actions on LPS-stimulated macrophages by suppressing the translocation of nuclear factor-kappa B (NF-κB) and the phosphorylation of p38 mitogen-activated protein (MAP) kinase. Ephedrannin A and B both exhibited strong anti-inflammatory effects, however, the optimal dose of ephedrannin B was 10 times lower than that of ephedrannin A. This is the first report describing effective anti-inflammatory activity for ephedrannin A and B isolated from Ephedra roots. Ephedrannin B may be a good candidate for delaying the progression of human inflammatory diseases and warrants further studies.
Collapse
Affiliation(s)
- Ik-Soo Kim
- Department of Biochemistry, College of Natural Sciences, Kangwon National University, Chuncheon 200-701, Republic of Korea
| | | | | | | |
Collapse
|
50
|
Chen WL, Tsai TH, Yang CCH, Kuo TBJ. Effects of ephedra on autonomic nervous modulation in healthy young adults. JOURNAL OF ETHNOPHARMACOLOGY 2010; 130:563-568. [PMID: 20573567 DOI: 10.1016/j.jep.2010.05.056] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2010] [Revised: 05/18/2010] [Accepted: 05/25/2010] [Indexed: 05/29/2023]
Abstract
AIM OF THE STUDY Given the popularity of the use of ephedra in traditional Chinese medicine around the world, a greater understanding of its actions is required. This study aims to assess the effects of ephedra on autonomic nervous modulation using power spectral analysis of heart rate variability (HRV). METHODS This was a randomized, double-blind, placebo-controlled, crossover study. Twenty healthy subjects were given 1g of ephedra dry extract or placebo once per day for 14 days in a crossover fashion with a 7-day washout period between treatments. Sequential HRV measures at baseline and at 30, 60, 120, and 180 min after taking ephedra or the placebo on days 1 and 14 were obtained and compared. In addition, the baseline HRV measurements on days 1, 3, 7, 10, and 14 were also obtained and compared. RESULTS The normalized low-frequency component (LF%) and the low/high-frequency component ratio (LF/HF) of the HRV were significantly increased, whereas the high-frequency component (HF) and normalized HF (HF%) were significantly decreased at 120 and 180 min after taking ephedra on days 1 and 14. In addition, the baseline LF% and LF/HF were significantly increased, whereas the baseline HF% was significantly decreased on days 10 and 14, as compared to day 1. CONCLUSIONS By power spectral analysis of the HRV of healthy young adults, it is suggested that ingestion of ephedra dry extract acutely and chronically affects autonomic nervous activity by tilting the sympathovagal balance toward increased sympathetic activity, whereas parasympathetic activity was impaired.
Collapse
Affiliation(s)
- Wei-Lung Chen
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
| | | | | | | |
Collapse
|