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Buccato DG, Ullah H, De Lellis LF, Morone MV, Larsen DS, Di Minno A, Cordara M, Piccinocchi R, Baldi A, Greco A, Santonastaso S, Sacchi R, Daglia M. Efficacy and Tolerability of a Food Supplement Based on Zea mays L., Gymnema sylvestre (Retz.) R.br.ex Sm, Zinc and Chromium for the Maintenance of Normal Carbohydrate Metabolism: A Monocentric, Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Nutrients 2024; 16:2459. [PMID: 39125340 PMCID: PMC11314272 DOI: 10.3390/nu16152459] [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: 06/25/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
A study on 81 individuals (18-75 years old) with mildly impaired fasting blood glucose (FBG) concentrations (98-125 mg/dL) was undertaken to investigate the tolerability of a food supplement (FS) based on Zea mays and Gymnema sylvestre extracts, zinc, and chromium and its efficacy on glucose and lipid metabolism. The subjects were randomized into three groups (27 in each group) and supplemented with one or two tablet(s)/day of FS (groups 1 and 2, respectively), or two tablets/day of placebo (group 3). Blood sampling was carried out at baseline (t0) and after a 3-month treatment (t1), and biochemical parameters associated with glucose and lipid metabolism and kidney and liver toxicity were evaluated. Compared to the placebo, FBG and glycated haemoglobin (HbA1c) were significantly (p < 0.001) reduced in group 1 subjects. In contrast, at the doses of one and two tablet(s)/day, the FS exerted no effect on the other parameters examined. We conclude that in subjects with slightly impaired FBG, ingestion of a FS based on Z. mays and G. sylvestre extracts, zinc, and chromium over 3 months lowers FBG and modulates glucose homeostasis by improving glucose metabolism. These beneficial effects occur in the absence of biochemical evidence of kidney and liver toxicity.
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Affiliation(s)
- Daniele Giuseppe Buccato
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Naples, Italy; (D.G.B.); (H.U.); (L.F.D.L.); (A.B.); (M.D.)
| | - Hammad Ullah
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Naples, Italy; (D.G.B.); (H.U.); (L.F.D.L.); (A.B.); (M.D.)
| | - Lorenza Francesca De Lellis
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Naples, Italy; (D.G.B.); (H.U.); (L.F.D.L.); (A.B.); (M.D.)
| | - Maria Vittoria Morone
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania “L. Vanvitelli”, 80138 Naples, Italy;
| | - Danaé S. Larsen
- School of Chemical Sciences, The University of Auckland, Auckland 1010, New Zealand;
| | - Alessandro Di Minno
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Naples, Italy; (D.G.B.); (H.U.); (L.F.D.L.); (A.B.); (M.D.)
- CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy
| | - Marcello Cordara
- School of Medicine, University of Milano-Bicocca, 20126 Milan, Italy;
| | - Roberto Piccinocchi
- Level 1 Medical Director Anaesthesia and Resuscitation A. U. O. Luigi Vanvitelli, Via Santa Maria di Costantinopoli, 80138 Naples, Italy;
| | - Alessandra Baldi
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Naples, Italy; (D.G.B.); (H.U.); (L.F.D.L.); (A.B.); (M.D.)
| | - Agostino Greco
- A.S.L. Caserta, Via P. Harris, 81100 Caserta, Italy; (A.G.); (S.S.)
| | | | - Roberto Sacchi
- Applied Statistic Unit, Department of Earth and Environmental Sciences, University of Pavia, Viale Taramelli 24, 27100 Pavia, Italy;
| | - Maria Daglia
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Naples, Italy; (D.G.B.); (H.U.); (L.F.D.L.); (A.B.); (M.D.)
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China
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Bandala C, Carro-Rodríguez J, Cárdenas-Rodríguez N, Peña-Montero I, Gómez-López M, Hernández-Roldán AP, Huerta-Cruz JC, Muñoz-González F, Ignacio-Mejía I, Domínguez B, Lara-Padilla E. Comparative Effects of Gymnema sylvestre and Berberine on Adipokines, Body Composition, and Metabolic Parameters in Obese Patients: A Randomized Study. Nutrients 2024; 16:2284. [PMID: 39064727 PMCID: PMC11280467 DOI: 10.3390/nu16142284] [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: 06/16/2024] [Revised: 07/09/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Gymnema sylvestre (GS) and berberine (BBR) are natural products that have demonstrated therapeutic potential for the management of obesity and its comorbidities, as effective and safe alternatives to synthetic drugs. Although their anti-obesogenic and antidiabetic properties have been widely studied, comparative research on their impact on the gene expression of adipokines, such as resistin (Res), omentin (Ome), visfatin (Vis) and apelin (Ap), has not been reported. METHODOLOGY We performed a comparative study in 50 adult Mexican patients with obesity treated with GS or BBR for 3 months. The baseline and final biochemical parameters, body composition, blood pressure, gene expression of Res, Ome, Vis, and Ap, and safety parameters were evaluated. RESULTS BBR significantly decreased (p < 0.05) body weight, blood pressure and Vis and Ap gene expression and increased Ome, while GS decreased fasting glucose and Res gene expression (p < 0.05). A comparative analysis of the final measurements revealed a lower gene expression of Ap and Vis (p < 0.05) in patients treated with BBR than in those treated with GS. The most frequent adverse effects in both groups were gastrointestinal symptoms, which attenuated during the first month of treatment. CONCLUSION In patients with obesity, BBR has a better effect on body composition, blood pressure, and the gene expression of adipokines related to metabolic risk, while GS has a better effect on fasting glucose and adipokines related to insulin resistance, with minimal side effects.
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Affiliation(s)
- Cindy Bandala
- Laboratorio de Neurociencia Traslacional Aplicada a Enfermedades Crónicas y Emergentes, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (C.B.); (J.C.-R.); (A.P.H.-R.); (F.M.-G.); (B.D.)
| | - Jazmín Carro-Rodríguez
- Laboratorio de Neurociencia Traslacional Aplicada a Enfermedades Crónicas y Emergentes, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (C.B.); (J.C.-R.); (A.P.H.-R.); (F.M.-G.); (B.D.)
| | | | - Itzel Peña-Montero
- Laboratorio de Obesidad, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (I.P.-M.); (M.G.-L.)
| | - Modesto Gómez-López
- Laboratorio de Obesidad, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (I.P.-M.); (M.G.-L.)
| | - Ana Paola Hernández-Roldán
- Laboratorio de Neurociencia Traslacional Aplicada a Enfermedades Crónicas y Emergentes, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (C.B.); (J.C.-R.); (A.P.H.-R.); (F.M.-G.); (B.D.)
| | - Juan Carlos Huerta-Cruz
- Unidad de Investigación en Farmacología, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosio Villegas, Secretaria de Salud, Mexico City 14080, Mexico;
| | - Felipe Muñoz-González
- Laboratorio de Neurociencia Traslacional Aplicada a Enfermedades Crónicas y Emergentes, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (C.B.); (J.C.-R.); (A.P.H.-R.); (F.M.-G.); (B.D.)
- Laboratorio de Diseño y Desarrollo de Nuevos Fármacos e Innovación Biotecnológica, Mexico City 11340, Mexico
| | - Iván Ignacio-Mejía
- Laboratorio de Medicina Traslacional, Escuela Militar de Graduados en Sanidad, Universidad del Ejército y Fuerza Aérea, Mexico City 11200, Mexico;
| | - Brayan Domínguez
- Laboratorio de Neurociencia Traslacional Aplicada a Enfermedades Crónicas y Emergentes, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (C.B.); (J.C.-R.); (A.P.H.-R.); (F.M.-G.); (B.D.)
| | - Eleazar Lara-Padilla
- Laboratorio de Obesidad, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (I.P.-M.); (M.G.-L.)
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Gauttam VK, Munjal K, Chopra H, Ahmad A, Rana MK, Kamal MA. A Mechanistic Review on Therapeutic Potential of Medicinal Plants and their Pharmacologically Active Molecules for Targeting Metabolic Syndrome. Curr Pharm Des 2024; 30:10-30. [PMID: 38155468 DOI: 10.2174/0113816128274446231220113957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/06/2023] [Indexed: 12/30/2023]
Abstract
Metabolic syndrome (MetS) therapy with phytochemicals is an emerging field of study with therapeutic potential. Obesity, insulin resistance, high blood pressure, and abnormal lipid profiles are all components of metabolic syndrome, which is a major public health concern across the world. New research highlights the promise of phytochemicals found in foods, including fruits, vegetables, herbs, and spices, as a sustainable and innovative method of treating this illness. Anti-inflammatory, antioxidant, and insulin-sensitizing qualities are just a few of the many positive impacts shown by bioactive substances. Collectively, they alleviate the hallmark symptoms of metabolic syndrome by modulating critical metabolic pathways, boosting insulin sensitivity, decreasing oxidative stress, and calming chronic low-grade inflammation. In addition, phytochemicals provide a multimodal strategy by targeting not only adipose tissue but also the liver, skeletal muscle, and vascular endothelium, all of which have a role in the pathogenesis of MetS. Increasing evidence suggests that these natural chemicals may be useful in controlling metabolic syndrome as a complementary treatment to standard medication or lifestyle changes. This review article emphasizes the therapeutic potential of phytochemicals, illuminating their varied modes of action and their ability to alleviate the interconnected causes of metabolic syndrome. Phytochemical-based interventions show promise as a novel and sustainable approach to combating the rising global burden of metabolic syndrome, with the ultimate goal of bettering public health and quality of life.
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Affiliation(s)
- Vinod Kumar Gauttam
- Department of Pharmacognosy, Shiva Institute of Pharmacy, Bilaspur, Hmachal Pradesh, India
| | - Kavita Munjal
- Department of Pharmacognosy, Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh, India
| | - Hitesh Chopra
- Department of Biosciences, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, India
| | - Aftab Ahmad
- Department of Pharmacology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mahesh Kumar Rana
- Department of Agriculture, M.M. (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Mohammad Amjad Kamal
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, China
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh
- Enzymoics, 7 Peterlee Place, Hebersham, NSW 2770, Australia
- Novel Global Community Educational Foundation, Hebersham, NSW 2770, Australia
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Nani A, Bertuzzi F, Meneghini E, Mion E, Pintaudi B. Combined Inositols, α-Lactalbumin, Gymnema Sylvestre and Zinc Improve the Lipid Metabolic Profile of Patients with Type 2 Diabetes Mellitus: A Randomized Clinical Trial. J Clin Med 2023; 12:7650. [PMID: 38137721 PMCID: PMC10743679 DOI: 10.3390/jcm12247650] [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: 10/30/2023] [Revised: 11/27/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is characterized by high blood glucose levels and lipid alterations. Besides pharmacological treatment, lifestyle modifications and nutraceuticals can be used to manage glucose and lipid profiles, which is crucial for preventing, or avoiding, serious consequences associated with the condition. This randomized controlled clinical trial on 75 patients with T2DM evaluated the effects of a combination of myo-inositol and d-chiro-inositol (40:1), α-lactalbumin, Gymnema sylvestre, and zinc on glucose and lipid profile. The intention-to-treat analysis displayed no significant differences in glucose parameters between the groups; however, the study group displayed reduced levels of total cholesterol (p = 0.01) and LDL (p = 0.03) after 3 months of supplementation. A subgroup analysis involving patients who did not modify their antidiabetic therapy, after 6 months displayed improved levels of total cholesterol (p = 0.03) and LDL (p = 0.04) in the study group versus placebo, along with a greater body weight reduction (p = 0.03) after 3 months. Furthermore, within the study group, levels of HDL (p = 0.03) and triglycerides (p = 0.04) improved after 3 months. These findings support supplementation with myo-inositol and d-chiro-inositol (40:1), α-lactalbumin, Gymnema sylvestre, and zinc as an adjuvant and safe strategy to manage the lipid profiles of patients with T2DM.
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Affiliation(s)
- Alessandro Nani
- Department of Medical Biotechnology and Translational Medicine, University of Milan, 20133 Milan, Italy
| | | | - Elena Meneghini
- Department of Diabetology, Niguarda Hospital, 20162 Milan, Italy
| | - Elena Mion
- Department of Diabetology, Niguarda Hospital, 20162 Milan, Italy
| | - Basilio Pintaudi
- Department of Diabetology, Niguarda Hospital, 20162 Milan, Italy
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
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Basciani S, Nordio M, Dinicola S, Unfer V, Gnessi L. Diet Plus Inositols, α-Lactalbumin and Gymnema sylvestre: The Successful Combo to Restore Body Weight and Metabolic Profile in Obese and Dysmetabolic Patients. Nutrients 2023; 15:3142. [PMID: 37513560 PMCID: PMC10385591 DOI: 10.3390/nu15143142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The primary control of dysmetabolic patients is extremely challenging worldwide, with inadequate dietary habits and sporadic physical activity among the key risk factors for metabolic syndrome onset. Nowadays, there is no exclusive treatment for this condition, and considering that preventive measures usually fail, new therapeutic approaches need to be proposed and investigated. This present pilot study compared the effects of diet alone and in association with a combination of myo-inositol and d-chiro-inositol in their 40:1 ratio, α-lactalbumin, and Gymnema sylvestre on different metabolic parameters in obese dysmetabolic patients. To this purpose, 37 patients with BMI between 30 and 40 and fasting blood glucose between 100 and 125 mg/dL were divided into two groups: (i) the control group followed a hypocaloric Mediterranean diet, (ii) while the study group was also supplemented with a daily dosage of two sachets, each one containing 1950 mg myo-inositol, 50 mg d-chiro-inositol, 50 mg α-lactalbumin, and 250 mg Gymnema Sylvestre. After a 6-month treatment, all parameters improved in both groups. Nevertheless, the treated group experienced a greater improvement, especially concerning the variation from the baseline of HOMA index, triglycerides, BMI, body weight, and waist circumference. These findings support the supplementation with myo-inositol and d-chiro-inositol in the 40:1 ratio, α-lactalbumin, and Gymnema sylvestre as a therapeutical strategy to potentiate the beneficial effects induced via dietary programs in dysmetabolic patients.
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Affiliation(s)
- Sabrina Basciani
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Maurizio Nordio
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
| | - Simona Dinicola
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
- R&D Department, Lo.Li. Pharma, 00156 Rome, Italy
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy
| | - Lucio Gnessi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
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Boix-Castejón M, Roche E, Olivares-Vicente M, Álvarez-Martínez FJ, Herranz-López M, Micol V. Plant compounds for obesity treatment through neuroendocrine regulation of hunger: A systematic review. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 113:154735. [PMID: 36921427 DOI: 10.1016/j.phymed.2023.154735] [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: 11/07/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Food intake behavior is influenced by both physiological and psychological complex processes, such as appetite, satiety, and hunger. The neuroendocrine regulation of food intake integrates short- and long-term acting signals that modulate the moment of intake and energy storage/expenditure, respectively. These signals are classified as orexigenic, those that activate anabolic pathways and the desire of eating, and anorexigenic, those that activate the catabolic pathways and a sensation of satiety. Appetite control by natural vegetal compounds is an intense area of research and new pharmacological interventions have been emerging based on an understanding of appetite regulation pathways. Several validated psychometric tools are used to assess the efficacy of these plant ingredients. However, these data are not conclusive if they are not complemented with physiological parameters, such as anthropometric evaluations (body weight and composition) and the analysis of hormones related to adipose tissue and appetite in blood. PURPOSE The purpose of this manuscript is the critical analysis of the plant compounds studied to date in the literature with potential for the neuroendocrine regulation of hunger in order to determine if the use of phytochemicals for the treatment of obesity constitutes an effective and/or promising therapeutic tool. METHODS Relevant information on neuroendocrine regulation of hunger and satiety for the treatment of obesity by plant compounds up to 2022 in English and/or Spanish were derived from online databases using the PubMed search engine and Google Scholar with relevant keywords and operators. RESULTS Accordingly, the comparison performed in this review between previous studies showed a high degree of experimental heterogeneity. Among the studies reviewed here, only a few of them establish comprehensively a potential correlation between the effect of the ingredient on hunger or satiety, body changes and a physiological response. CONCLUSIONS More systematic clinical studies are required in future research. The first approach should be to decode the pattern of circulating hormones regulating hunger, satiety, and appetite in overweight/obese subjects. Thereafter, studies should correlate brain connectivity at the level of the hypothalamus, gut and adipose tissue with the hormone patterns modulating appetite and satiety. Extracts whose mode of action have been well characterized and that are safe, can be used clinically to perform a moderate, but continuous, caloric restriction in overweight patients to lose weight excess into a controlled protocol.
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Affiliation(s)
- M Boix-Castejón
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain
| | - E Roche
- Institute of Bioengineering, Applied Biology Department-Nutrition, University Miguel-Hernández, 03202, Elche, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010, Alicante, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - M Olivares-Vicente
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain
| | - F J Álvarez-Martínez
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain
| | - M Herranz-López
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain.
| | - V Micol
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
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Zamani M, Ashtary-Larky D, Nosratabadi S, Bagheri R, Wong A, Rafiei MM, Asiabar MM, Khalili P, Asbaghi O, Davoodi SH. The effects of Gymnema Sylvestre supplementation on lipid profile, glycemic control, blood pressure, and anthropometric indices in adults: A systematic review and meta-analysis. Phytother Res 2023; 37:949-964. [PMID: 36580574 DOI: 10.1002/ptr.7585] [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: 02/01/2022] [Revised: 06/07/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
There is a growing interest in the considerable health benefits of Gymnema Sylvestre (GS) supplementation, as some studies have reported that it may improve cardiometabolic risk factors. However, the widespread impact of GS supplementation on the parameters mentioned above is not fully resolved. Consequently, this study aimed to examine the effects of GS supplementation on lipid profile, glycemic control, blood pressure, and anthropometric indices in adults. Eligible randomized controlled trials (RCT), published up to November 2021, were identified through PubMed, Scopus, and ISI Web of Science databases. Six studies were included and analyzed using a random-effects model to calculate weighted mean differences (WMDs) with 95% confidence intervals (CI). All studies were conducted in adults that used a GC supplement (>1 week) and assessed our selected cardiovascular risk factors. Outcomes revealed that GS supplementation significantly decreased triglyceride (p < .001), total cholesterol (p < .001), low-density lipoprotein (p < .001), fasting blood sugar (p < .001), and diastolic blood pressure (p = .003). Some limitations, including notable heterogeneity, low quality of studies, and lack of diversity among research participants, should be considered when interpreting our results. Our outcomes suggest that GS supplementation may improve cardiovascular risk factors. Future large-high-quality RCTs with longer duration and various populations are needed to firmly establish the clinical efficacy of the plant.
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Affiliation(s)
- Mohammad Zamani
- Department of Clinical Nutrition, School of Nutritional sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Damoon Ashtary-Larky
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Nosratabadi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, USA
| | - Mohammad Mahdi Rafiei
- Centre de Recherche du Centre Hospitalier de l'Universit ́e de Montr ́eal (CRCHUM), Montréal, Canada.,School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, Canada
| | - Mojtaba Mahdavi Asiabar
- Department of Physical Education and Sport Science, Sanandaj Branch, Islamice Azad University, Sanandaj, Iran
| | - Pardis Khalili
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayed Hosein Davoodi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wen ZG, Zhang QQ, Zhang LL, Shen MF, Huang YS, Zhao LH. Efficacy and safety of traditional chinese medicine treatment for overweight and obese individuals: A systematic review and meta-analysis. Front Pharmacol 2022; 13:964495. [PMID: 36278196 PMCID: PMC9581128 DOI: 10.3389/fphar.2022.964495] [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: 06/08/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The prevalence of obesity is increasing worldwide, causing a global health issue. Traditional Chinese medicine (TCM) used in treating overweight/obesity has been widely implemented in clinical practice, but its overall efficacy and safety remain unclear. This review aims to evaluate the effectiveness and safety of TCM based on randomized controlled trials (RCTs). Methods: A systematic review was conducted by searching PubMed, Cochrane Library, Web of Science, Embase, and Clinical Trails from their inception to March 2021. Two reviewers screened studies, extracted the data, and assessed the risk of bias independently. The data were pooled for meta-analysis or presented narratively. Results: Twenty-five RCTs involving 1,947 participants were included. Compared with placebo or blank control, TCM preparations reduced Body Mass Index (BMI) [MD = -1.16; 95% confidence interval (CI) = -1.44, -0.89; I2 = 34%], reduced weight (MD = -2.53; 95% CI = -3.08, -1.99; I2 = 34%), reduced waist circumference (MD = -2.64; 95% CI = -3.42, -1.87; I2 = 0%), reduced hip circumference (MD = -3.48; 95% CI = -4.13, -2.83; I2 = 0%), reduced total cholesterol (TCHO) (MD = -10.45; 95% CI = -18.92, -1.98; I2 = 63%), reduced triglycerides (TG) (MD = -4.19; 95% CI = -6.35, -2.03; I2 = 25%), increased high-density lipoprotein (HDL) (MD = -3.60; 95% CI = -6.73, -0.47; I2 = 81%), reduced fasting blood glucose (FBG) (MD = -0.77; 95% CI = -1.24, -0.29; I2 = 91%). Glycated hemoglobin (HbA1c)、body fat rate、low-density lipoprotein (LDL) were not statistically significant. For people with hypertension, decreased systolic blood pressure (SBP) (MD = -5.27; 95% CI = -8.35, -2.19; I2 = 58%), decreased diastolic blood pressure (DBP) (MD = -4.30; 95% CI = -5.90, -2.69; I2 = 0%). For people with normal blood pressure, there was no significant change. There was no significant difference in liver function. Conclusion: It has been demonstrated that TCM preparations have good clinical efficacy and safety for overweight/obesity. TCM may be suitable for overweight/obesity in adult populations for its efficacy and safety of long-term treatment.
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Affiliation(s)
- Zhi Ge Wen
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qi Qi Zhang
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Li Li Zhang
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Meng Fei Shen
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yi Shan Huang
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lin Hua Zhao
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Petrillo T, Semprini E, Tomatis V, Arnesano M, Ambrosetti F, Battipaglia C, Sponzilli A, Ricciardiello F, Genazzani AR, Genazzani AD. Putative Complementary Compounds to Counteract Insulin-Resistance in PCOS Patients. Biomedicines 2022; 10:biomedicines10081924. [PMID: 36009471 PMCID: PMC9406066 DOI: 10.3390/biomedicines10081924] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/25/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most frequent endocrine-metabolic disorder among women at reproductive age. The diagnosis is based on the presence of at least two out of three criteria of the Rotterdam criteria (2003). In the last decades, the dysmetabolic aspect of insulin resistance and compensatory hyperinsulinemia have been taken into account as the additional key features in the etiopathology of PCOS, and they have been widely studied. Since PCOS is a complex and multifactorial syndrome with different clinical manifestations, it is difficult to find the gold standard treatment. Therefore, a great variety of integrative treatments have been reported to counteract insulin resistance. PCOS patients need a tailored therapeutic strategy, according to the patient’s BMI, the presence or absence of familiar predisposition to diabetes, and the patient’s desire to achieve pregnancy or not. The present review analyzes and discloses the main clinical insight of such complementary substances.
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Affiliation(s)
- Tabatha Petrillo
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Elisa Semprini
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Veronica Tomatis
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Melania Arnesano
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Fedora Ambrosetti
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Christian Battipaglia
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Alessandra Sponzilli
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Francesco Ricciardiello
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Andrea R. Genazzani
- Department of Obstetrics and Gynecology, University of Pisa, 56126 Pisa, Italy
| | - Alessandro D. Genazzani
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Correspondence:
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Udrea AM, Gradisteanu Pircalabioru G, Boboc AA, Mares C, Dinache A, Mernea M, Avram S. Advanced Bioinformatics Tools in the Pharmacokinetic Profiles of Natural and Synthetic Compounds with Anti-Diabetic Activity. Biomolecules 2021; 11:1692. [PMID: 34827690 PMCID: PMC8615418 DOI: 10.3390/biom11111692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022] Open
Abstract
Diabetes represents a major health problem, involving a severe imbalance of blood sugar levels, which can disturb the nerves, eyes, kidneys, and other organs. Diabes management involves several synthetic drugs focused on improving insulin sensitivity, increasing insulin production, and decreasing blood glucose levels, but with unclear molecular mechanisms and severe side effects. Natural chemicals extracted from several plants such as Gymnema sylvestre, Momordica charantia or Ophiopogon planiscapus Niger have aroused great interest for their anti-diabetes activity, but also their hypolipidemic and anti-obesity activity. Here, we focused on the anti-diabetic activity of a few natural and synthetic compounds, in correlation with their pharmacokinetic/pharmacodynamic profiles, especially with their blood-brain barrier (BBB) permeability. We reviewed studies that used bioinformatics methods such as predicted BBB, molecular docking, molecular dynamics and quantitative structure-activity relationship (QSAR) to elucidate the proper action mechanisms of antidiabetic compounds. Currently, it is evident that BBB damage plays a significant role in diabetes disorders, but the molecular mechanisms are not clear. Here, we presented the efficacy of natural (gymnemic acids, quercetin, resveratrol) and synthetic (TAK-242, propofol, or APX3330) compounds in reducing diabetes symptoms and improving BBB dysfunctions. Bioinformatics tools can be helpful in the quest for chemical compounds with effective anti-diabetic activity that can enhance the druggability of molecular targets and provide a deeper understanding of diabetes mechanisms.
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Affiliation(s)
- Ana Maria Udrea
- Laser Department, National Institute for Laser, Plasma and Radiation Physics, 077125 Maurele, Romania; (A.M.U.); (A.D.)
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 1 B. P. Hașdeu St., 50567 Bucharest, Romania;
| | - Gratiela Gradisteanu Pircalabioru
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 1 B. P. Hașdeu St., 50567 Bucharest, Romania;
| | - Anca Andreea Boboc
- “Maria Sklodowska Curie” Emergency Children’s Hospital, 20, Constantin Brancoveanu Bd., 077120 Bucharest, Romania;
- Department of Pediatrics 8, “Carol Davila” University of Medicine and Pharmacy, Eroii Sanitari Bd., 020021 Bucharest, Romania
| | - Catalina Mares
- Department of Anatomy, Animal Physiology and Biophysics, Faculty of Biology, University of Bucharest, 91–95 Splaiul Independentei, 050095 Bucharest, Romania; (C.M.); (S.A.)
| | - Andra Dinache
- Laser Department, National Institute for Laser, Plasma and Radiation Physics, 077125 Maurele, Romania; (A.M.U.); (A.D.)
| | - Maria Mernea
- Department of Anatomy, Animal Physiology and Biophysics, Faculty of Biology, University of Bucharest, 91–95 Splaiul Independentei, 050095 Bucharest, Romania; (C.M.); (S.A.)
| | - Speranta Avram
- Department of Anatomy, Animal Physiology and Biophysics, Faculty of Biology, University of Bucharest, 91–95 Splaiul Independentei, 050095 Bucharest, Romania; (C.M.); (S.A.)
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11
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Devangan S, Varghese B, Johny E, Gurram S, Adela R. The effect of Gymnema sylvestre supplementation on glycemic control in type 2 diabetes patients: A systematic review and meta-analysis. Phytother Res 2021; 35:6802-6812. [PMID: 34467577 DOI: 10.1002/ptr.7265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/15/2021] [Accepted: 08/14/2021] [Indexed: 12/22/2022]
Abstract
This systematic review and meta-analysis aims to find the effect of Gymnema sylvestre (GS) supplementation on glycemic control in type-2 diabetes mellitus (T2DM). PubMed, Cochrane library, Google Scholar, and Science Direct were searched from inception to June 2020 to identify the studies that reported GS supplementation on glycemic parameters. Standardized mean difference (SMD) was calculated by comparing the post-intervention data with baseline data. SMDs with 95% confidence intervals (CIs) were pooled using a random-effects model. Our meta-analysis consisting of 10 studies with a total of 419 participants showed that GS supplementation significantly reduces fasting blood glucose (FBG) (SMD 1.57 mg/dl, 95% CI 2.22 to -0.93, p < .0001, I2 90%), postprandial blood glucose (PPBG) (SMD 1.04 mg/dl, 95% CI 1.53 to -0.54, p < .0001, I2 80%), and glycated haemoglobin (HbA1c) (SMD 3.91, 95% CI 7.35 to -0.16%, p < .0001, I2 99%) compared to baseline. Further, our study also found that GS significantly reduces triglycerides (SMD 1.81 mg/dl, 95% CI 2.95 to -0.66, p < .0001, I2 : 96%), and total cholesterol (SMD 4.10 mg/dl, 95% CI 7.21 to -0.99, p < .0001, I2 : 98%) compared to baseline. Our study shows that GS supplementation is effective in improving glycemic control and reducing lipid levels in T2DM patients and suggests that such supplementation might be used as an effective therapy for the management of T2DM and its associated complications to an extent.
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Affiliation(s)
- Suneel Devangan
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research-Guwahati, Guwahati, Assam, India.,Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research-Hajipur, Hajipur, Bihar, India
| | - Bincy Varghese
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research-Guwahati, Guwahati, Assam, India
| | - Ebin Johny
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research-Guwahati, Guwahati, Assam, India
| | - Surender Gurram
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research-Guwahati, Guwahati, Assam, India
| | - Ramu Adela
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research-Guwahati, Guwahati, Assam, India
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12
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Shekhawat RS, Mandal CC. Anti-obesity Medications in Cancer Therapy: A Comprehensive Insight. Curr Cancer Drug Targets 2021; 21:476-494. [PMID: 34225630 DOI: 10.2174/1568009621666210322122829] [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: 08/15/2020] [Revised: 11/29/2020] [Accepted: 12/10/2020] [Indexed: 11/22/2022]
Abstract
The interplay between cancer and obesity is multifactorial and complex with the increased risk of cancer development in obese individuals posing a significant threat. Obesity leads to the upregulation or hyperactivation of several oncogenic pathways in cancer cells, which drives them towards a deleterious phenotype. The cross-talk between cancer and obesity is considered a large contributing factor in the development of chemotherapeutic drug resistance and the resistance to radiotherapy. The link between obesity and the development of cancer is so strong that a medication that demonstrates effectiveness against both conditions would serve as an essential step. In this context, anti-obesity medications provide a worthy list of candidates based on their chemo-preventive potential and chemotherapeutic properties. The current study focuses on exploring the potential of anti-obesity medicines as dual anticancer drugs. These medications target several key signaling pathways (e.g., AMPK, PI3K/Akt/mTOR, MAPK, NF-κB, JNK/ERK), which prove to be crucial for both cancer growth and metastases. Some of these drugs also play an important role in attenuating the signaling and cellular events which incite cancer-obesity cross-talk and demonstrate efficient counteraction of neoplastic transformation. Thus, this review highlights a comprehensive view of the potential use of anti-obesity medicines to treat both cancer and obesity for patients exhibiting both comorbities.
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Affiliation(s)
| | - Chandi C Mandal
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, India
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13
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Chávez-Castillo M, Nuñez V, Rojas M, Ortega Á, Durán P, Pirela D, Marquina M, Cano C, Chacín M, Velasco M, Rojas-Quintero J, Bermúdez V. Exploring Phytotherapeutic Alternatives for Obesity, Insulin Resistance and Diabetes Mellitus. Curr Pharm Des 2021; 26:4430-4443. [PMID: 32611293 DOI: 10.2174/1381612826666200701205132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/29/2020] [Indexed: 11/22/2022]
Abstract
At present, the pathologic spectrum of obesity-insulin resistance (IR)-diabetes mellitus (DM) represents not only a pressing matter in public health but also a paramount object of study in biomedical research, as they constitute major risk factors for cardiovascular disease (CVD), and other chronic non-communicable diseases (NCD). Phytotherapy, the use of medicinal herbs (MH) with treatment purposes, offers a wide array of opportunities for innovation in the management of these disorders; mainly as pharmacological research on small molecules accumulates. Several MH has displayed varied mechanisms of action relevant to the pathogenesis of obesity, IR and DM, including immunological and endocrine modulation, reduction of inflammation and oxidative stress (OS), regulation of appetite, thermogenesis and energy homeostasis, sensitisation to insulin function and potentiation of insulin release, among many others. However, the clinical correlates of these molecular phenomena remain relatively uncertain, with only a handful of MH boasting convincing clinical evidence in this regard. This review comprises an exploration of currently available preclinical and clinical research on the role of MH in the management of obesity, IR, and DM.
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Affiliation(s)
- Mervin Chávez-Castillo
- Psychiatric Hospital of Maracaibo, Maracaibo, Venezuela,Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Victoria Nuñez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Milagros Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Ángel Ortega
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Pablo Durán
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Daniela Pirela
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - María Marquina
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Clímaco Cano
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Maricarmen Chacín
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
| | - Manuel Velasco
- Clinical Pharmacology Unit, José María Vargas School of Medicine, Central University of Venezuela, Caracas-Venezuela
| | - Joselyn Rojas-Quintero
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Valmore Bermúdez
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
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14
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Jugran AK, Rawat S, Devkota HP, Bhatt ID, Rawal RS. Diabetes and plant-derived natural products: From ethnopharmacological approaches to their potential for modern drug discovery and development. Phytother Res 2020; 35:223-245. [PMID: 32909364 DOI: 10.1002/ptr.6821] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 06/08/2020] [Accepted: 07/02/2020] [Indexed: 02/06/2023]
Abstract
Diabetes is a disease of serious concern faced by the health care industry today. Primary diabetes mellitus and its complications are still costly to manage with modern drugs. Extensive research on the screening of anti-diabetic agents in past decades established natural products as one of the major potential sources of drug discovery. However, only a few drugs of plant origin have been scientifically validated. Therefore, the development of new anti-diabetic drugs is of great demand. Hence, natural products could be explored as potential anti-diabetic drugs. Natural plants derived extracts and molecules like berberine, ginsenosides, curcumin, stevioside, gingerols, capsaicin, catechins, simple phenolic compounds, anthocyanins, resveratrol, genistein and hesperidin obtained from different species are used for curing diabetes and found to possess different action mechanisms. In this review, the importance of medicinal plants and their active constituents for anti-diabetic agents are described. The present study also emphasized the importance of diabetes control, reduction in its complications and use of the anti-diabetic agents. The detailed action mechanism of these extracts/compounds for their activities are also described. However, the anti-diabetic drugs from plant origin require scientific validation through animal and clinical studies to exploit in terms of modern commercial medicines.
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Affiliation(s)
- Arun K Jugran
- Garhwal Regional Centre, G. B. Pant National Institute of Himalayan Environment (NIHE), Srinagar, Uttarakhand, India
| | - Sandeep Rawat
- Sikkim Regional Centre, G. B. Pant National Institute of Himalayan Environment (NIHE), Gangtok, Sikkim, India
| | - Hari P Devkota
- Department of Instrumental Analysis, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Indra D Bhatt
- Center for Biodiversity Conservation and Management (CBCM), G. B. Pant National Institute of Himalayan Environment (NIHE), Kosi-Katarmal, Almora, Uttarakhand, India
| | - Ranbeer S Rawal
- Center for Biodiversity Conservation and Management (CBCM), G. B. Pant National Institute of Himalayan Environment (NIHE), Kosi-Katarmal, Almora, Uttarakhand, India
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15
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Gaytán Martínez LA, Sánchez-Ruiz LA, Zuñiga LY, González-Ortiz M, Martínez-Abundis E. Effect of Gymnema sylvestre Administration on Glycemic Control, Insulin Secretion, and Insulin Sensitivity in Patients with Impaired Glucose Tolerance. J Med Food 2020; 24:28-32. [PMID: 32460589 DOI: 10.1089/jmf.2020.0024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Gymnema sylvestre, a plant typical of India, has long been known for its hypoglycemic effects. The objective of this study was to evaluate the effect of G. sylvestre administration on glycemic control, insulin secretion, and insulin sensitivity in patients with impaired glucose tolerance (IGT). A randomized, double-blind, placebo-controlled clinical trial was conducted in 30 patients with IGT. Fifteen patients randomly received G. sylvestre in doses of 300 mg b.i.d. and the other 15 received placebo in the same way. Before and after the intervention, anthropometric and metabolic measurements were taken, including 2-h oral glucose tolerance test (2-h OGTT), fasting plasma glucose, glycated hemoglobin A1c (A1C), and the lipid profile panel. Areas under the curve of glucose and insulin were calculated, as well as the insulinogenic, Stumvoll, and Matsuda indices. Wilcoxon, Mann-Whitney U, and chi-square or Fisher's exact tests were performed, and a P-value ≤.05 was considered statistically significant. There was a significant reduction in 2-h OGTT (9.1 ± 1.2 vs. 7.8 ± 1.7 mmol/L, P = .003), A1C (5.8 ± 0.3% vs. 5.4 ± 0.4%, P = .025), body weight, body mass index, and low-density lipoprotein cholesterol levels in the G. sylvestre group, with an increment in the Matsuda index (1.8 ± 0.8 vs. 2.4 ± 1.2, P = .008). At the end of the intervention, 46.7% of the patients obtained normal values in A1C. In conclusion, G. sylvestre administration in patients with IGT decreased 2-h OGTT and A1C, increasing insulin sensitivity. There were also improvements in anthropometric measures and the lipid profile.
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Affiliation(s)
- Luis A Gaytán Martínez
- Department of Physiology, Institute of Experimental and Clinical Therapeutics, Health Science University Center, University of Guadalajara, Guadalajara, Mexico
| | - Luis A Sánchez-Ruiz
- Department of Physiology, Institute of Experimental and Clinical Therapeutics, Health Science University Center, University of Guadalajara, Guadalajara, Mexico
| | - Laura Y Zuñiga
- Department of Physiology, Institute of Experimental and Clinical Therapeutics, Health Science University Center, University of Guadalajara, Guadalajara, Mexico
| | - Manuel González-Ortiz
- Department of Physiology, Institute of Experimental and Clinical Therapeutics, Health Science University Center, University of Guadalajara, Guadalajara, Mexico
| | - Esperanza Martínez-Abundis
- Department of Physiology, Institute of Experimental and Clinical Therapeutics, Health Science University Center, University of Guadalajara, Guadalajara, Mexico
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Furman BL, Candasamy M, Bhattamisra SK, Veettil SK. Reduction of blood glucose by plant extracts and their use in the treatment of diabetes mellitus; discrepancies in effectiveness between animal and human studies. JOURNAL OF ETHNOPHARMACOLOGY 2020; 247:112264. [PMID: 31600561 DOI: 10.1016/j.jep.2019.112264] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/03/2019] [Accepted: 09/29/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The global problem of diabetes, together with the limited access of large numbers of patients to conventional antidiabetic medicines, continues to drive the search for new agents. Ancient Asian systems such as traditional Chinese medicine, Japanese Kampo medicine, and Indian Ayurvedic medicine, as well as African traditional medicine and many others have identified numerous plants reported anecdotally to treat diabetes; there are probably more than 800 such plants for which there is scientific evidence for their activity, mostly from studies using various models of diabetes in experimental animals. AIM OF THE REVIEW Rather than a comprehensive coverage of the literature, this article aims to identify discrepancies between findings in animal and human studies, and to highlight some of the problems in developing plant extract-based medicines that lower blood glucose in patients with diabetes, as well as to suggest potential ways forward. METHODS In addition to searching the 2018 PubMed literature using the terms 'extract AND blood glucose, a search of the whole literature was conducted using the terms 'plant extracts' AND 'blood glucose' AND 'diabetes' AND 'double blind' with 'clinical trials' as a filter. A third search using PubMed and Medline was undertaken for systematic reviews and meta-analyses investigating the effects of plant extracts on blood glucose/glycosylated haemoglobin in patients with relevant metabolic pathologies. FINDINGS Despite numerous animal studies demonstrating the effects of plant extracts on blood glucose, few randomised, double-blind, placebo-controlled trials have been conducted to confirm efficacy in treating humans with diabetes; there have been only a small number of systematic reviews with meta-analyses of clinical studies. Qualitative and quantitative discrepancies between animal and human clinical studies in some cases were marked; the factors contributing to this included variations in the products among different studies, the doses used, differences between animal models and the human disease, and the impact of concomitant therapy in patients, as well as differences in the duration of treatment, and the fact that treatment in animals may begin before or very soon after the induction of diabetes. CONCLUSION The potential afforded by natural products has not yet been realised in the context of treating diabetes mellitus. A systematic, coordinated, international effort is required to achieve the goal of providing anti-diabetic treatments derived from medicinal plants.
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Affiliation(s)
- Brian L Furman
- Strathclyde Institute of Pharmacy & Biomedical Sciences, 161, Cathedral Street Glasgow, G4 ORE, Scotland, UK.
| | - Mayuren Candasamy
- School of Pharmacy, International Medical University, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Subrat Kumar Bhattamisra
- School of Pharmacy, International Medical University, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Sajesh K Veettil
- School of Pharmacy, International Medical University, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
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Khan F, Sarker MMR, Ming LC, Mohamed IN, Zhao C, Sheikh BY, Tsong HF, Rashid MA. Comprehensive Review on Phytochemicals, Pharmacological and Clinical Potentials of Gymnema sylvestre. Front Pharmacol 2019; 10:1223. [PMID: 31736747 PMCID: PMC6830388 DOI: 10.3389/fphar.2019.01223] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/23/2019] [Indexed: 12/30/2022] Open
Abstract
Gymnema sylvestre is a plant included in Apocynaceae family and is located in many regions of Asia, Africa and Australia. This plant is widely used as a traditional therapy for different purposes. Even now it is being used as a dietary supplement due to its numerous therapeutic uses. It is known to have blood glucose lowering potential and, thus, is widely used in traditional and Ayurvedic systems of medicine. It renders glucose lowering activity due to the presence of phytochemicals, such as gurmarin, gymnemic acid as well as gymnemasaponins. Gymnema sylvestre is also known to have anti-oxidant, antibiotic, anti-inflammatory, antiviral, gastro and hepatoprotective, anticancer and lipid-lowering activities. This review discusses in details on different pharmacological and clinical potentials of Gymnema sylvestre and its chemical constituents associated with its therapeutic potentials.
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Affiliation(s)
- Farzana Khan
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
- Pharmacology and Toxicology Research Division, Health Med Science Research Ltd., Dhaka, Bangladesh
| | - Md. Moklesur Rahman Sarker
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
- Pharmacology and Toxicology Research Division, Health Med Science Research Ltd., Dhaka, Bangladesh
| | - Long Chiau Ming
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
- Division of Pharmacy, School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Isa Naina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia (The National University of Malaysia), Cheras, Malaysia
| | - Chao Zhao
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Bassem Y. Sheikh
- Faculty of Medicine, Taibah University, Almadinah Almunawwarah, Saudi Arabia
| | | | - Mohammad A. Rashid
- Phytochemical Research Laboratory, Department of Pharmaceutical Chemistry, University of Dhaka, Dhaka, Bangladesh
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Veerapandian R, Vediyappan G. Gymnemic Acids Inhibit Adhesive Nanofibrillar Mediated Streptococcus gordonii-Candida albicans Mono-Species and Dual-Species Biofilms. Front Microbiol 2019; 10:2328. [PMID: 31681200 PMCID: PMC6797559 DOI: 10.3389/fmicb.2019.02328] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/24/2019] [Indexed: 12/17/2022] Open
Abstract
Dental caries and periodontitis are the most common oral disease of all age groups, affecting billions of people worldwide. These oral diseases are mostly associated with microbial biofilms in the oral cavity. Streptococcus gordonii, an early tooth colonizing bacterium and Candida albicans, an opportunistic pathogenic fungus, are the two abundant oral microbes that form mixed biofilms with augmented virulence, affecting oral health negatively. Understanding the molecular mechanisms of the pathogen interactions and identifying non-toxic compounds that block the growth of biofilms are important steps in the development of effective therapeutic approaches. In this in vitro study we report the inhibition of mono-species or dual-species biofilms of S. gordonii and C. albicans, and decreased levels of biofilm extracellular DNA (eDNA), when biofilms were grown in the presence of gymnemic acids (GAs), a non-toxic small molecule inhibitor of fungal hyphae. Scanning electron microscopic images of biofilms on saliva-coated hydroxyapatite (sHA) surfaces revealed attachment of S. gordonii cells to C. albicans hyphae and to sHA surfaces via nanofibrils only in the untreated control, but not in the GAs-treated biofilms. Interestingly, C. albicans produced fibrillar adhesive structures from hyphae when grown with S. gordonii as a mixed biofilm; addition of GAs abrogated the nanofibrils and reduced the growth of both hyphae and the biofilm. To our knowledge, this is the first report that C. albicans produces adhesive fibrils from hyphae in response to S. gordonii mixed biofilm growth. Semi-quantitative PCR of selected genes related to biofilms from both microbes showed differential expression in control vs. treated biofilms. Further, GAs inhibited the activity of recombinant S. gordonii glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Taken together, our results suggest that S. gordonii stimulates the expression of adhesive materials in C. albicans by direct interaction and/or signaling, and the adhesive material expression can be inhibited by GAs.
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Affiliation(s)
- Raja Veerapandian
- Division of Biology, Kansas State University, Manhattan, KS, United States
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Li J, Bai L, Wei F, Zhao J, Wang D, Xiao Y, Yan W, Wei J. Therapeutic Mechanisms of Herbal Medicines Against Insulin Resistance: A Review. Front Pharmacol 2019; 10:661. [PMID: 31258478 PMCID: PMC6587894 DOI: 10.3389/fphar.2019.00661] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/23/2019] [Indexed: 12/16/2022] Open
Abstract
Insulin resistance is a condition in which insulin sensitivity is reduced and the insulin signaling pathway is impaired. Although often expressed as an increase in insulin concentration, the disease is characterized by a decrease in insulin action. This increased workload of the pancreas and the consequent decompensation are not only the main mechanisms for the development of type 2 diabetes (T2D), but also exacerbate the damage of metabolic diseases, including obesity, nonalcoholic fatty liver disease, polycystic ovary syndrome, metabolic syndrome, and others. Many clinical trials have suggested the potential role of herbs in the treatment of insulin resistance, although most of the clinical trials included in this review have certain flaws and bias risks in their methodological design, including the generation of randomization, the concealment of allocation, blinding, and inadequate reporting of sample size estimates. These studies involve not only the single-flavored herbs, but also herbal formulas, extracts, and active ingredients. Numerous of in vitro and in vivo studies have pointed out that the role of herbal medicine in improving insulin resistance is related to interventions in various aspects of the insulin signaling pathway. The targets involved in these studies include insulin receptor substrate, phosphatidylinositol 3-kinase, glucose transporter, AMP-activated protein kinase, glycogen synthase kinase 3, mitogen-activated protein kinases, c-Jun-N-terminal kinase, nuclear factor-kappaB, protein tyrosine phosphatase 1B, nuclear factor-E2-related factor 2, and peroxisome proliferator-activated receptors. Improved insulin sensitivity upon treatment with herbal medicine provides considerable prospects for treating insulin resistance. This article reviews studies of the target mechanisms of herbal treatments for insulin resistance.
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Affiliation(s)
- Jun Li
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Litao Bai
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fan Wei
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Zhao
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Danwei Wang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yao Xiao
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weitian Yan
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Junping Wei
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Marakis G, Ziegenhagen R, Lampen A, Hirsch-Ernst KI. Risk assessment of substances used in food supplements: the example of the botanical Gymnema sylvestre. EFSA J 2018; 16:e16083. [PMID: 32626054 PMCID: PMC7015520 DOI: 10.2903/j.efsa.2018.e16083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Botanicals and preparations derived from these are among the substances frequently added to foods and food supplements, yet the safety of many botanicals has not been systematically assessed. In the context of the EU‐FORA fellowship programme, the fellow performed an assessment on the safety of the botanical Gymnema sylvestre, in accordance with EFSA's guidance on the assessment of safety of botanicals. Although preparations of G. sylvestre are marketed as food supplements, they may appeal to people who are suffering from metabolic syndrome and/or diabetes mellitus. A scientific literature search was carried out using PubMed/MEDLINE and EMBASE electronic databases. Experience was gained by the fellow in systematic data extraction from scientific publications, structuring of the data and evaluating toxicological key parameters, outcomes of clinical significance, pharmacokinetic and pharmacodynamic interactions, uncertainties and methodological shortcomings of studies. Limited evidence from toxicological in vivo studies and human clinical studies suggested lack of relevant adverse effects of this botanical. However, human studies provided some indications that certain Gymnema extracts may enhance the glucose‐lowering effects of certain antidiabetic drugs. Considering the uncertainties for the composition of different Gymnema preparations, potential herb–drug interactions and the indications of glucose lowering or hypoglycaemic effects, the use of Gymnema‐based food supplements in combination with authorised antidiabetic drugs may be associated with risks. The procedures learned for the safety evaluation of Gymnema may be similarly applied by the fellow for the risk assessment of other substances with nutritional or physiological effect added to foods and food supplements. Furthermore, apart from learning by conducting exercises in risk assessment, the fellow was able to develop other skills (e.g. communication skills), diversify his competencies and expand his network of scientific connections for future collaborations in the field of nutritional risk assessment.
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