Automédication par Annona muricata L. (corossol) à visée anticancéreuse à la Réunion

Patterns of complementary and alternative medicine use among Tunisian cancer patients

INTRODUCTION

The use of complementary and alternative medicine (CAM) among cancer patients is prevalent worldwide as cancer patient are perpetually seeking for a way to improve their quality of life and to cure their disease. Unfortunately, the majority ignore the danger that can resort when they use CAM currently with conventional therapies. The purpose of this study is to assess prevalence and predictors of CAM use in cancer patients.

METHODS

Cross-sectional study using a questionnaire administered to cancer patients, who were attending Salah Azaiz institute, Tunis, Tunisia. The study took place from September to December 2018.

RESULTS

In 222 cancer patients, the overall prevalence of CAM use was 40.54%. On univariate analysis, patients who had university education level were less likely to use CAM (p = 0.05). Based on multivariate analysis, CAM users had more likely metastatic tumor (p = 0.047; OR = 1.913).It is reported that the majority of the population used herbal medicine. The most common herbal products consuming by patients, included Ephedra foeminea (51.8%), Annona muricata (12%) and Curcuma longa L. (10.84%).The main source of information was entourage (family, friends, hospital entourage) (74.44%).The majority of CAM users (61.11%) reported to consume CAM currently with conventional therapies.

CONCLUSION

This survey revealed a high prevalence of CAM use. The most common type of CAM use is herbal products. Some of the used herbal products are known to interact with conventional anticancer medication. This emphasizes the importance of patients disclosure of CAM use to health professionals in order to avoid herb-medications interactions.

Optimization of pectinase-assisted extraction of Annona muricata L. juice and the effect of liquefaction on its pectin structure

BACKGROUND

Soursop (Annona muricata L.) is an underutilized tropical and subtropical fruit with high nutritional and therapeutic benefits. This fruit is faced with enormous post-harvest losses due to its high perishability. This work was aimed to optimize the pectinase-assisted extraction conditions of soursop juice using Doehlert design and to study the effect of pectinase on its pectin structure.

RESULTS

The predicted models were validated for all the responses studied and the regression coefficients ranged from 0.905 to 0.987 (P ≤ 0.05). An incubation time of 172 min, enzyme concentration of 0.04% (w/w) and incubation temperature at 42.9 °C were found to be the optimal conditions for soursop juice extraction, which resulted in 75.20%, 3.74, 7.35 °Brix, 87.06%T, and 0.44% MAE for soursop juice yield (%), pH, total soluble solids (TSS) (°Brix), clarity (%T) and titratable acidity (% malic acid equivalent, MAE), respectively. Morphologically, untreated soursop pulp presented a non-uniform spherical surface; enzyme hydrolyzed soursop exhibited ruptured and wrinkled surface; meanwhile for the different pectin obtained, untreated soursop pectin depicted porous surface and enzyme hydrolyzed soursop pectin showed whirling rough surface. Fourier-transform infrared (FTIR) confirmed the presence of similar chemical group stretching and vibrations in commercial pectin and soursop pectin.

CONCLUSION

Under the optimum conditions, the numerical predictions were similar to the experimental data obtained, thus confirming the validity of the models. Application of enzyme treatment caused the breakdown of pectin structure as illustrated by scanning electron microscopy (SEM) and FTIR analyses.

Food toxins and the Caribbean Parkinson plus types

In the 90's, clinico pathological studies have considerably improved the diagnosis of specific and rare neurodegenerative diseases. After a training in Parkinsons' disease in Paris, the author moved to French West Indies (Guadeloupe) and observed a high incidence of atypical parkinsonism with dementia, unresponsive to levodopa. Similar features were observed in Martinique. An environmental origin has been suspected with the exposure to toxins of annonaceae leaves and seeds. The candidate toxins are acetogenins acting as mitochondrial poison. This was demonstrated in neuronal cell cultures, and in animals. However, the agency for food security did not conclude that Annonaceae should not be used for herbal (medicinal) tea, even if the population is now aware about the possible risk of parkinsonism after exposure to annonaceae acetogenins.

Ameliorative effects of Annona muricata Linn. (Annonaceae) against potassium dichromate-induced hypertension in vivo: involvement of Kim-1/p38 MAPK/Nrf2 signaling

Background Recently, the incidences of hypertension and environmental pollution have increased significantly. This study investigates the antihypertensive effect of Annona muricata extract against K2Cr2O7-induced hypertension. Methods Fifty rats were used for this study, which were divided into five groups of 10 rats each. Rats in Group A received normal saline, and those in Groups B, C, D, and E were treated with A. muricata extract alone at 250 mg/kg, K2Cr2O7 at 30 mg/kg, pretreated with the extract at 250 mg/kg, and pretreated with gallic acid at 60 mg/kg for 14 days, respectively, and thereafter administered with a single intraperitoneal injection of K2Cr2O7 at 30 mg/kg. Results Administration of K2Cr2O7 significantly increased systolic, diastolic, and mean arterial pressure and caused prolonged QT and QTc intervals. Further, pretreatment with the extract at 250 mg/kg and gallic acid at 60 mg/kg significantly reduced high blood pressure to near-normal values. K2Cr2O7 intoxication led to significant increases in serum advanced oxidative protein products, myeloperoxidase, and xanthine oxidase, while serum nitric oxide (NO) also reduced significantly. Immunohistochemistry of the renal kidney injury molecule (Kim-1) and p38 MAPK showed increased expressions following the administration of K2Cr2O7 together with the downregulation of nuclear factor erythroid 2-related factor 2 (Nrf2). Pretreatment with the extract at 250 mg/kg and gallic acid at 60 mg/kg also increased the expressions of Nrf2 and downregulated Kim-1 and p38. Conclusion Together, we found that pretreatment with the extract at 250 mg/kg and gallic acid at 60 mg/kg normalized the blood pressure, reduced the markers of oxidative stress, and improved the antioxidant defense system and serum NO bioavailability.