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Tian X, Wei J, Zhuang Y, Lin X, Liu L, Xia J, Huai W, Xiong Y, Chen Y. Effectiveness and safety of Chinese herbal footbaths as an adjuvant therapy for dysmenorrhea: a systematic review and meta-analysis. Front Pharmacol 2024; 15:1397359. [PMID: 39161905 PMCID: PMC11331266 DOI: 10.3389/fphar.2024.1397359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/16/2024] [Indexed: 08/21/2024] Open
Abstract
Objectives To evaluate the effectiveness and safety of Chinese herbal footbaths (CHF) as an adjunctive therapy in managing dysmenorrhea. Methods Ten electronic databases were searched to identify eligible randomized clinical trials (RCTs) from inception until June 2023. Outcome measurements encompassed the total effective rate, visual analog scale (VAS) score of pain intensity, Cox menstrual symptom scale (CMSS) score, symptom score, Traditional Chinese Medicine (TCM) syndrome scale, and any reported adverse events. The methodological quality of the included studies was assessed with the Cochrane collaboration tool. Review Manager 5.3 software was employed for quantitative synthesis, and funnel plots were utilized to evaluate potential reporting bias. Results Eighteen RCTs with 1,484 dysmenorrhea patients were included. The aggregated results suggested that the adjunctive CHF could significantly ameliorate dysmenorrhea, as evident from the improved total effective rate [risk ratio (RR) 1.18, 95% confidence interval (CI): 1.12 to 1.23, P < 0.00001], VAS (MD 0.88, 95% CI: 0.68 to 1.09, P < 0.00001), CMSS (MD 3.61, 95% CI: 2.73 to 4.49, P < 0.00001), symptom score (SMD 1.09, 95% CI: 0.64 to 1.53, P < 0.00001), and TCM syndrome scale (MD 3.76, 95% CI: 2.53 to 4.99, P < 0.0001). In addition, CHF presented fewer adverse events with a better long-term effect (RR 1.34, 95% CI: 1.11 to 1.63, P < 0.01) and diminished recurrence rate (RR 0.19, 95% CI: 0.09 to 0.39, P < 0.0001). Conclusion Current evidence implies that CHF may be an effective and safe adjunctive therapy for patients with dysmenorrhea. However, the methodological quality of the studies included was undesirable, necessitating further verification with more well-designed and high-quality multicenter RCTs. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=188256, identifier registration number.
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Affiliation(s)
- Xiaoping Tian
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jingwen Wei
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Yijia Zhuang
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiaoding Lin
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liu Liu
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Xia
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenying Huai
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ying Xiong
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Yunhui Chen
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Wang F, Qian Q, Feng Y, Zhang D, Wang X, Niu L. Study on the enhanced efficacy mechanism of vinegar-processed Cyperus rotundus in the treatment of primary dysmenorrhea. Biomed Chromatogr 2024:e5942. [PMID: 39039792 DOI: 10.1002/bmc.5942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 07/24/2024]
Abstract
The enhanced efficacy of vinegar-processed Cyperus rotundus (VCR) in treating primary dysmenorrhea (PD) has been observed. However, the active components and potential mechanisms of synergy are still unclear. The objective of this study was to develop a method that combines bionic technology, plant metabolomics and network pharmacology to discover the active components and potential mechanisms underlying the enhanced therapeutic effects of VCR for PD. Vinegar processing alters the flavor of C. rotundus, leading to changes in its properties. The acidic nature of vinegar enhances the selectivity of the medicine toward the liver, thereby improving its ability to soothe the liver, regulate qi and provide pain relief. Through gas chromatography-mass spectrometry and multivariate statistical analysis, 30 key differential components between raw C. rotundus and VCR have been screened and identified. These differential components primarily exert their therapeutic effects in treating PD by modulating targets such as interleukin-6, TNF, TP53 and PTGS2, as well as pathways including the estrogen signaling pathway, ovarian steroidogenesis, the TNF signaling pathway and the HIF-1 signaling pathway. The findings of this study serve as a reference for the application of VCR in compound formulas and clinic practiceal. Furthermore, the methodology employed in this study provides research insights for the processing of other Chinese medicines.
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Affiliation(s)
- Fengxia Wang
- School of Integrated Traditional Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, P. R. China
- Jingfukang Pharmaceutical Group Co. Ltd, Chengde, China
| | - Qi Qian
- School of Integrated Traditional Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, P. R. China
- Hebei Traditional Chinese Medicine Formula Granule Engineering & Technology Innovate Center, Shijiazhuang, China
- Quality Evaluation & Standardization Hebei Province Engineering Research Center of Traditional Chinese Medicine, Shijiazhuang, China
| | - Yu Feng
- School of Integrated Traditional Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, P. R. China
| | - Dongge Zhang
- Jingfukang Pharmaceutical Group Co. Ltd, Chengde, China
| | - Xinguo Wang
- School of Integrated Traditional Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, P. R. China
- Hebei Traditional Chinese Medicine Formula Granule Engineering & Technology Innovate Center, Shijiazhuang, China
- Quality Evaluation & Standardization Hebei Province Engineering Research Center of Traditional Chinese Medicine, Shijiazhuang, China
| | - Liying Niu
- School of Integrated Traditional Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, P. R. China
- Hebei Traditional Chinese Medicine Formula Granule Engineering & Technology Innovate Center, Shijiazhuang, China
- Quality Evaluation & Standardization Hebei Province Engineering Research Center of Traditional Chinese Medicine, Shijiazhuang, China
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Fang X, Liu H, Wang M, Wang G. Scientific Knowledge Graph of Dysmenorrhea: A Bibliometric Analysis from 2001 to 2021. J Pain Res 2023; 16:2883-2897. [PMID: 37638206 PMCID: PMC10460176 DOI: 10.2147/jpr.s418602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/05/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose This study aims to help researchers master the most active hotspots and trends quickly through bibliometric analysis in the field of dysmenorrhea. Methods We retrieved literature on Web of Science from 2001 to 2021, and bibliometric analysis software CiteSpace was used in combination with VOSviewer. Results We finally acquired 944 papers and an upward trend in articles continued in this field overall. Through the map, China contributed the most, followed by the USA and Turkey. For institutions, Beijing University of Chinese Medicine in China contributed the most, followed by National Yang-Ming University in Taiwan, China. Hsieh JC and Hellman KM were both the most prolific authors with 14 articles. Five major research groups, respectively, with Hsieh JC, Hellman KM, Zhu J, Liang F and Dun W were the key group. Dawood MY was the most dominant author and most frequently cited author. The Cochrane Database of Systematic Reviews Journal was the most productive, and the Fertility and Sterility Journal was the most cited. Advances in pathogenesis and management for primary dysmenorrhea written by Dawood MY was most cited and influential. Pathophysiology, the potential central mechanism, syndrome, evaluation index, diagnosis of adenomyosis-associated dysmenorrhea, treatment, etc., were the main trends and hotspots. Conclusion Dysmenorrhea research has received a lot of attention from scholars. Strengthening international cooperation may promote the development of this field. The pathophysiology of dysmenorrhea, its impact on public health and its treatment are current research hotspots and are likely to be the focus of future study.
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Affiliation(s)
- Xiaoting Fang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Haijuan Liu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Mina Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Guohua Wang
- Gynecology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
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Alikamali M, Mohammad-Alizadeh-Charandabi S, Maghalian M, Mirghafourvand M. The effects of vitamin E on the intensity of primary dysmenorrhea: A systematic review and meta-analysis. Clin Nutr ESPEN 2022; 52:50-59. [PMID: 36513486 DOI: 10.1016/j.clnesp.2022.10.001] [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: 04/10/2022] [Revised: 09/17/2022] [Accepted: 10/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Primary dysmenorrhea (PD) refers to the presence of painful menstrual cramps due to increased synthesis of prostaglandins. Vitamin E inhibits the release of arachidonic acid and its conversion to prostaglandins through its antioxidant properties. This study sought to examine the effects of oral vitamin E supplementation on PD intensity (primary outcome) and its side effects (secondary outcomes). METHODS In this systematic review and meta-analysis, databases in English and Persian, including PubMed, Cochrane Library, Google Scholar, Scopus, Web of Science, SID, and Magiran, were systematically searched until August 30, 2021. The study included all randomized, controlled clinical trials comparing oral vitamin E to placebo in healthy women with PD and measuring PD severity as a primary or secondary outcome. The quality of the included articles was assessed using the Cochrane Handbook, and the meta-analysis was performed using RevMan software. Given the continuous nature of the data and the utilization of different tools in the extracted articles, the meta-analysis results were reported using standardized mean difference (SDM) and 95% confidence interval (95% CI). A subgroup analysis was performed in low-dose (100 units), moderate-dose (200 units), and high-dose (400 units) categories. The quality of evidence was examined according to the GRADE approach. RESULTS Eight articles with a sample size of 1002 people were entered into this systematic review. The results of meta-analysis revealed that vitamin E consumption significantly reduced PD mean intensity in the first month (n = 7 records; SDM = -1.16; 95%CI: -2.16 to -0.17; I2 = 31.9%; P = 0.02) and the second month (n = 8 records; SDM = -1.83; 95%CI: -2.90 to -0.77; I2 = 76.3.9%; P < 0.0001) compared with placebo. Serious side effects were not reported in vitamin E recipients. CONCLUSION Vitamin E could be an adjunctive treatment for women with PD. However, higher-quality clinical trials with larger sample sizes are recommended for a more definite conclusion. PROSPERO ID CRD42021276609.
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Affiliation(s)
| | | | - Mahsa Maghalian
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University y of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Silva GD, Canova NAH, Bortoletto P, Wutzke MLS, Dos Santos Soares F, Bertolini GRF. Cryotherapy Produces Pain Relief in Young People with Primary Dysmenorrhea. Ther Hypothermia Temp Manag 2021; 12:57-60. [PMID: 34129396 DOI: 10.1089/ther.2021.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Primary dysmenorrhea is characterized as painful menstruation without associated pelvic disease and has been considered common among young people of reproductive age. Cryotherapy is a technique aimed at analgesia and anti-inflammatory action. The objective of this study was to analyze the analgesic efficacy of cryotherapy in sedentary youth with primary dysmenorrhea. Methods were included sedentary, affected by primary dysmenorrhea. The analysis of pain intensity by visual analog scale (VAS) and the Brazilian Version of the Wisconsin Brief Pain Questionnaire were used for evaluation. The participants were randomly separated into a control group (CG, n = 10) and a cryotherapy group (CryoG, n = 10). The evaluations and treatment occurred during a menstrual cycle, with three interventions, in the initial 3 days of higher menstrual flow history report. CG showed a reduction in pain when comparing the 1st with the 4th day of assessment; CryoG showed a daily reduction in VAS; for the pain questionnaire, cryotherapy showed a reduction in interference with sleep dysmenorrhea; and for all other variables, although there was no significant difference, a large effect size was observed. Cryotherapy was effective in reducing pain in women with primary dysmenorrhea, with indication of clinical improvement in daily living activities.
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Affiliation(s)
- Graziele Diniz Silva
- Department of Physical Therapy, Universidade Estadual do Oeste do Paraná (UNIOESTE), Cascavel, Brazil
| | | | - Polyana Bortoletto
- Department of Physical Therapy, Universidade Estadual do Oeste do Paraná (UNIOESTE), Cascavel, Brazil
| | | | - Francyelle Dos Santos Soares
- Bioscience and Health Posgraduate Program, Universidade Estadual do Oeste do Paraná (UNIOESTE), Cascavel, Brazil
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Tsonis O, Gkrozou F, Barmpalia Z, Makopoulou A, Siafaka V. Integrating Lifestyle Focused Approaches into the Management of Primary Dysmenorrhea: Impact on Quality of Life. Int J Womens Health 2021; 13:327-336. [PMID: 33762855 PMCID: PMC7982556 DOI: 10.2147/ijwh.s264023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/04/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE This narrative review aims to identify alternative ways to improve the symptoms of primary dysmenorrhea (PD). BACKGROUND PD refers to endometrial painful cramps during the premenstrual period. This condition affects a lot of women worldwide and is accompanied with absenteeism and high economic costs, thus, risk-free, and effective therapeutic approaches are needed. Pharmacological agents such as non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptive pills (OCPs), which are widely prescribed for these women, demonstrate adequate efficacy in alleviating pain and discomfort. The long natural course of the disease dictates remedies that focus on lifestyle changes and on improvement of Quality-of-Life (QoL) for women suffering with PD. MATERIALS AND METHODS Five major search engines, namely MEDLINE, PubMed, EMBASE, and Cochrane Library were searched for articles published prior to October 2020 focused in PD. A total of 74 paper were included. DISCUSSION Physical activity, for instance yoga, aromatherapy massage, and other forms of relaxation, vitamins and dietary changes, acupressure and acupuncture,a and some psychological interventions are just few of the proposed health behavior targeted approaches in cases of PD. This review focuses on lifestyle changes and alternative methods that could potentially result in minimizing symptoms of PD and in improving overall QoL for these patients, by providing current scientific evidence on their efficacy. CONCLUSION Complementary and alternative medicine practices (CAM) are widely accepted by women. International literature provides controversial scientific evidence, thus further studies need to be conducted in order to prove or disregard their efficacy in cases of PD.
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Affiliation(s)
- Orestis Tsonis
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Ioannina, Greece
| | - Fani Gkrozou
- Department of Obstetrics and Gynaecology, University Hospitals of Birmingham, Birmingham, UK
| | - Zoi Barmpalia
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Ioannina, Greece
| | - Annamaria Makopoulou
- School of Psychology, College of Human Sciences, Bangor University, Bangor, Wales, UK
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Zhao S, Wu W, Kang R, Wang X. Significant Increase in Depression in Women With Primary Dysmenorrhea: A Systematic Review and Cumulative Analysis. Front Psychiatry 2021; 12:686514. [PMID: 34421672 PMCID: PMC8374105 DOI: 10.3389/fpsyt.2021.686514] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 07/09/2021] [Indexed: 12/30/2022] Open
Abstract
Women with primary dysmenorrhea are vulnerable to develop a depressive disorder, which is a common form of psycho-disturbance. However, clinical findings are inconsistent across studies, and the evidence has not been previously synthesized. This study aims to investigate whether primary dysmenorrhea is associated with a higher risk of depression via a cumulative analysis. Four electronic databases were systematically searched for the eligible studies. The combined effect was assessed by analyzing the relative risk (RR) and standard mean differences (SMD) with a 95% confidence interval (CI). This cumulative analysis was registered on the PROSPERO (ID: CRD42020169601). Of 972 publications, a total of 10 studies involving 4,691 participants were included. Pooled results from six included studies showed that primary dysmenorrhea was associated with a significant depressive disorder (RR = 1.72, 95%CI: 1.44 to 2.0, P < 0.001; heterogeneity: I 2 = 0%, P = 0.544). In addition, synthesis results from two studies provided the BDI scores suggested that dysmenorrhea had significantly higher scores when compared to non-dysmenorrhea (SMD = 0.47, 95% CI: 0.31-0.62, P < 0.001; heterogeneity: I 2 = 0%, P = 0.518). However, in the two studies providing the PROMIS T-Score, the pooled result showed that there was no significant difference between women with dysmenorrhea and those without dysmenorrhea (P = 0.466). The overall quality of the evidence in our study was judged to MODERATE. The present study has confirmed the positive relationship between primary dysmenorrhea and depression. Social supports and medical help from pain management physicians or psychologists are important interventions for women with dysmenorrhea-suffering depressive disorder.
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Affiliation(s)
- Shankun Zhao
- Department of Urology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
| | - Weizhou Wu
- Department of Urology, Maoming People's Hospital, Maoming, China
| | - Ran Kang
- Department of Urology, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Xiaolan Wang
- Reproductive Center of Medicine, The First Affiliated Hospital of University of South China, Hengyang, China
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Chai C, Hong F, Yan Y, Yang L, Zong H, Wang C, Liu Z, Yu B. Effect of traditional Chinese medicine formula GeGen decoction on primary dysmenorrhea: A randomized controlled trial study. JOURNAL OF ETHNOPHARMACOLOGY 2020; 261:113053. [PMID: 32534120 DOI: 10.1016/j.jep.2020.113053] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE GeGen Decoction, a well-known Chinese herbal formula, is widely used in China and other Asian countries to treat gynecological diseases, including primary dysmenorrhea. Pharmacological studies have confirmed that GeGen Decoction is able to inhibit spasmodic contractions of the uterus in vivo and in vitro. AIM OF THE STUDY The objective of this study is to examine the efficacy and safety of GeGen Decoction on primary dysmenorrheic patients. METHODS This was a randomized, double-blinded, placebo-controlled trial. GeGen Decoction or placebo was administered a week before the expected start of each cycle for three consecutive menstrual periods. Between-group differences in pain intensity were detected by visual analogue scale (VAS). In addition, serum levels of arginine vasopressin (AVP) and estrogen (E) were examined by enzyme-linked immunosorbent assay. Metabolomic analysis was further used to evaluate the influence of GeGen Decoction on the metabolomics of primary dysmenorrheic patients. RESULTS A total of 71 primary dysmenorrheic women were recruited and 30 participants met the criteria were randomized into GeGen Decoction or placebo group. After three consecutive menstrual cycles' treatments, the VAS score of the GeGen Decoction group was significantly lower than that of the placebo group. Both serum levels of AVP and E decreased after GeGen Decoction administration, while the placebo seemed to have little effect on either of the index. Moreover, after GeGen Decoction treatment, seven important metabolites were identified by metabolomic analysis compared to the placebo group. No abnormalities in blood biochemical and routine physical examination pre and post GeGen Decoction intervention were observed. CONCLUSIONS GeGen Decoction can remarkably relieve the severity of menstrual pain without obvious adverse effects. Its therapeutic effect on primary dysmenorrhea might be related to the regulation of pituitary hypothalamic ovarian hormones, and interfering with the metabolic change.
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Affiliation(s)
- Chengzhi Chai
- Jiangsu Provincial Key Laboratory for TCM Evaluation and Translational Development, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province, 211198, PR China
| | - Fang Hong
- Jiangsu Provincial Key Laboratory for TCM Evaluation and Translational Development, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province, 211198, PR China
| | - Yan Yan
- Shanxi University, Taiyuan, Shanxi Province, PR China
| | - Lu Yang
- Jiangsu Provincial Key Laboratory for TCM Evaluation and Translational Development, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province, 211198, PR China
| | - Hui Zong
- Hospital Affiliated to Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi Province, PR China
| | - Changsong Wang
- Department of Traditional Chinese Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, PR China
| | - Zhigang Liu
- Department of Traditional Chinese Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, PR China.
| | - Boyang Yu
- Jiangsu Provincial Key Laboratory for TCM Evaluation and Translational Development, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province, 211198, PR China.
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Xia MQ, Tian CL, Liu L, Hu RF, Gui SY, Chu XQ. Transdermal Administration of Ibuprofen-Loaded Gel: Preparation, Pharmacokinetic Profile, and Tissue Distribution. AAPS PharmSciTech 2020; 21:84. [PMID: 31989358 DOI: 10.1208/s12249-020-1627-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/15/2020] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to compare the pharmacokinetics and tissue distribution of ibuprofen (IBU) gel in female rats after transdermal administration through the skin of the abdomen and back. IBU was used as the model drug to prepare carbomer gel. After the abdominal and back administration, the concentration of IBU in rat plasma was detected by high-performance liquid chromatography (HPLC). Besides, the contents of IBU in the uterus, heart, liver, spleen, lung, and kidney were detected, respectively, to clarify the distribution characteristics in vivo. Through abdominal route, the AUC0- ∞ (area under the concentration-time curve from time zero to infinity) of uterus was 424.75 μg/g h, which is 3.60 times higher than that of plasma, and was significantly higher than that of other tissues (P < 0.0001). Tmax (peak time) of uterus and plasma was 4 h and 2 h, respectively. Upon transdermal application of IBU to the back, the AUC0-∞ of uterus was 75.47 μg/g h, which is 12.63 times lower than that of plasma, while Tmax of uterus and plasma was not lower than 20 h. These results indicated that IBU entered the blood circulation through abdominal administration in a small amount and mainly of the drug entered the uterus, while IBU entered the blood circulation and redistributed to tissues after absorption through the dorsal skin slowly. IBU could effectively reach the uterus and have a certain targeting through abdominal administration, which provides a prospect for clinical transdermal administration in the treatment of dysmenorrhea.
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Coelho AG, Dos Santos WRP, Dos Santos AA, da Silva MG, Cunha FVM, Mendes AN, Arcanjo DDR. Plant-Derived Butters as Lipid Nanocarriers: A Systematic and Prospective Review. RECENT PATENTS ON NANOTECHNOLOGY 2020; 14:262-275. [PMID: 32442090 DOI: 10.2174/1872210514666200522213144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 02/29/2020] [Accepted: 03/07/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Pharmaceutical nanotechnology represents an efficient alternative for the delivery of pharmacologically active plant-derived compounds, considering their protective capacity, oral bioavailability and drug vectorization capacity. In this context, butters obtained from plant seeds have emerged as promising products for the development of pharmacologically active nanostructures. They possess a complex lipid composition, allowing the formation of different emulsion systems with solid cores, since this mixture of different triglycerides is solid at room temperature and body temperature. Therefore, the systematic mapping around the technological development of nanostructures produced from plant-derived butters is potentially valuable for researchers interested in novel alternative formulations for pharmacological therapy, with potential industrial, economic, health and societal impacts. METHODS Systematic review was carried out by the search of scientific papers and patents deposited in official databases concerning the development of nanostructured pharmaceutical products using plantderived butters as starting material. The publications obtained were subjected to sorting and analysis by applying the following inclusion/exclusion criteria. RESULTS The Solid Lipid Nanoparticle (SLN) was the type of nanostructure produced in all the analyzed scientific papers, due to the physicochemical characteristics of the lipid constituents of plantderived butters. In this sense, 54% of the articles have reported the use of Cocoa Butter for the production of nanostructures; 28% for Shea Butter; 6% for Cupuacu Butter, 6% for Murumuru Butter and 6% for Bacuri Butter. DISCUSSION In the technological prospection, only two patents exhibited SLN as an invention based on cocoa butter and on shea butter, respectively. The production methods employed have included: phase inversion temperature, microemulsion, hot high pressure homogenization, high shear homogenization and ultrasonication. CONCLUSION In light of this prospective review, the encouragement of novel studies in lipids-based nanotechnology is evident, considering the small number of findings so far, in order to stimulate new research involving plant-derived butters from easily cultivated fruits in tropical regions, then stimulating the pharmaceutical development of new therapeutic alternatives using biocompatible and sustainable raw materials.
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Affiliation(s)
- Angélica G Coelho
- Department of Biophysics and Physiology, Laboratory of Functional and Molecular Studies in Physiopharmacology, Federal University of Piauí, Teresina, Brazil
| | - Webysten R P Dos Santos
- Department of Biophysics and Physiology, Laboratory of Functional and Molecular Studies in Physiopharmacology, Federal University of Piauí, Teresina, Brazil
| | - Andressa A Dos Santos
- Department of Biophysics and Physiology, Laboratory of Functional and Molecular Studies in Physiopharmacology, Federal University of Piauí, Teresina, Brazil
| | - Maisa G da Silva
- Department of Biophysics and Physiology, Laboratory of Functional and Molecular Studies in Physiopharmacology, Federal University of Piauí, Teresina, Brazil
| | - Francisco V Macedo Cunha
- Department of Biophysics and Physiology, Laboratory of Functional and Molecular Studies in Physiopharmacology, Federal University of Piauí, Teresina, Brazil
| | - Anderson N Mendes
- Laboratory of Innovation on Science and Technology, Department of Biophysics and Physiology, Federal University of Piauí, Teresina, Brazil
| | - Daniel D R Arcanjo
- Department of Biophysics and Physiology, Laboratory of Functional and Molecular Studies in Physiopharmacology, Federal University of Piauí, Teresina, Brazil
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