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Ma H, Li J. The ginger extract could improve diabetic retinopathy by inhibiting the expression of e/iNOS and G6PDH, apoptosis, inflammation, and angiogenesis. J Food Biochem 2022; 46:e14084. [PMID: 35060143 DOI: 10.1111/jfbc.14084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 12/26/2021] [Accepted: 01/04/2022] [Indexed: 12/24/2022]
Abstract
Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the retina. It is the result of damage to the small blood vessels and neurons of the retina. Ginger and its phytochemical compounds can improve oxidative damage and inflammation. However, the effects of this plant on ocular expression G6PDH and e/iNOS, eye cell apoptosis, and angiogenesis are not well known in this tissue. Therefore, the aim of this study was to evaluate the therapeutic potential of ginger extract on rats with type 2 diabetic retinopathy. Thirty-two Wistar rats were randomly divided into four controlled and treated groups. The serum level of metabolic factors such as lipid profiles, insulin and glucose, and the level of oxidative biomarkers along with the TNF-α level in eye tissue were measured. The expression of NF-κB, VEGF, BAX, Bcl-2, caspase-3, e/iNOS, and G6PDH in eye tissue was measured. Serum levels of lipid profiles, glucose, and insulin, oxidative and inflammatory markers were significantly increased in the diabetic group compared to control. While, treatment with ginger extract could significantly improve these factors in diabetic rats. Moreover, the ocular expression of e/iNOS, G6PDH, VEGF, NF-κB, and genes involved in apoptosis was changed in diabetic rats. However, treatment with ginger extract could ameliorate these changes in the diabetic-treated group. It can be concluded that ginger extract could improve diabetic retinopathy by inhibiting oxidative damage, inflammation, iNOS, VEGF, apoptosis, and improving eNOS and G6PDH. PRACTICAL APPLICATIONS: Microvascular complications of diabetes such as retinopathy can be one of the main causes of disability in people with diabetes. Chronic hyperglycemia, oxidative stress, inflammation, and apoptosis cause diabetic retinopathy through retinal damage. Ginger, on the other hand, is an available, inexpensive, and uncomplicated medicinal plant that contains more than 20 different phytochemicals, such as gingerol and shogaol, which have anti-inflammatory, antioxidant, antihypertensive, hypoglycemic, and hypolipidemic properties. The results of our study showed well that the ginger extract could improve diabetic retinopathy by inhibiting the expression of e/iNOS and G6PDH and oxidative damage, apoptosis, inflammation, and angiogenesis. Therefore, ginger and its compounds can be a good option to improve the complications of diabetes.
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Affiliation(s)
- Haiyan Ma
- Department of Ophthalmology, Shandong Feicheng People's Hospital, Taian, China
| | - Jinqi Li
- Department of Ophthalmology, Jinan Second People's Hospital, Jinan, China
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Yildizhan E, Aslan Sirakaya H, Korkmaz S. Therapeutic plasma exchange in non-immune hemolytic anemia associated with henna ingestion: A case report. Transfus Apher Sci 2021; 60:103204. [PMID: 34275735 DOI: 10.1016/j.transci.2021.103204] [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: 06/16/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 10/21/2022]
Abstract
Henna is a herb that is used in traditional medicine for medical purposes as well as in the field of cosmetic. It is one of the agents that can trigger hemolytic crisis in G6PD deficient patients but it is considered safe in patients with normal G6PD enzyme. Here we present a case of non-immune hemolytic anemia occurred after ingestion of a homemade solution containing henna powder. Therapeutic plasma exchange was performed daily for 3 subsequent days and the hemoglobin levels and hemolytic markers were improved dramatically. Laboratory test revealed a normal G6PD enzyme level six weeks after recovery. We would like to emphasize the possibility of unexpected adverse effects and undefined ingredients of herbal products. Therapeutic plasma exchange can be a promising treatment option in such cases.
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Affiliation(s)
- Esra Yildizhan
- Kayseri City Hospital, Hematology Department, Kayseri, Turkey.
| | | | - Serdal Korkmaz
- Kayseri City Hospital, Hematology Department, Kayseri, Turkey.
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3
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Gomez CR, Espinoza I, Faruque FS, Hasan MM, Rahman KM, Walker LA, Muhammad I. Therapeutic Intervention of COVID-19 by Natural Products: A Population-Specific Survey Directed Approach. Molecules 2021; 26:1191. [PMID: 33672163 PMCID: PMC7927139 DOI: 10.3390/molecules26041191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/13/2021] [Accepted: 02/20/2021] [Indexed: 12/15/2022] Open
Abstract
To date very few promising leads from natural products (NP) secondary metabolites with antiviral and immunomodulatory properties have been identified for promising/potential intervention for COVID-19. Using in-silico docking studies and genome based various molecular targets, and their in vitro anti-SARS CoV-2 activities against whole cell and/or selected protein targets, we select a few compounds of interest, which can be used as potential leads to counteract effects of uncontrolled innate immune responses, in particular those related to the cytokine storm. A critical factor for prevention and treatment of SARS-CoV-2 infection relates to factors independent of viral infection or host response. They include population-related variables such as concurrent comorbidities and genetic factors critically relevant to COVID-19 health disparities. We discuss population risk factors related to SARS-CoV-2. In addition, we focus on virulence related to glucose-6-phosphate dehydrogenase deficiency (G6PDd), the most common human enzymopathy. Review of data on the response of individuals and communities with high prevalence of G6PDd to NP, prompts us to propose the rationale for a population-specific management approach to rationalize design of therapeutic interventions of SARS-CoV-2 infection, based on use of NP. This strategy may lead to personalized approaches and improve disease-related outcomes.
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Affiliation(s)
- Christian R. Gomez
- Department of Pathology, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, USA
- Department of Radiation Oncology, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, USA
- Center for Clinical and Translational Science (CCTS), University of Mississippi School of Pharmacy (UMSOP) & University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, USA;
| | - Ingrid Espinoza
- Center for Clinical and Translational Science (CCTS), University of Mississippi School of Pharmacy (UMSOP) & University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, USA;
- Department of Preventive Medicine, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, USA;
| | - Fazlay S. Faruque
- Department of Preventive Medicine, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, USA;
| | - Md. Mahbub Hasan
- Institute of Pharmaceutical Science, School of Cancer and Pharmaceutical Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK; (M.M.H.); (K.M.R.)
| | - Khondaker Miraz Rahman
- Institute of Pharmaceutical Science, School of Cancer and Pharmaceutical Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK; (M.M.H.); (K.M.R.)
| | - Larry A. Walker
- National Center for Natural Product Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA;
| | - Ilias Muhammad
- National Center for Natural Product Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA;
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Du L, Ma X, Shen X, Bao Y, Chen L, Bhutani VK. Neonatal hyperbilirubinemia management: Clinical assessment of bilirubin production. Semin Perinatol 2021; 45:151351. [PMID: 33308896 DOI: 10.1016/j.semperi.2020.151351] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The predominant cause of elevated total/plasma bilirubin (TB) levels is from an increase in bilirubin production primarily because of ongoing hemolysis. If undiagnosed or untreated, the risk for developing extreme neonatal hyperbilirubinemia and possibly bilirubin-induced neurological dysfunction (BIND) is increased. Since carbon monoxide (CO) and bilirubin are produced in equimolar amounts during the heme catabolic process, measurements of end-tidal CO levels, corrected for ambient CO (ETCOc) can be used as a direct indicator of ongoing hemolysis. A newly developed point-of-care ETCOc device has been shown to be a useful for identifying hemolysis-associated hyperbilirubinemia in newborns. This review summarizes the biology of bilirubin production, the clinical utility of a novel device to identify neonates undergoing hemolysis, and a brief introduction on the use of ETCOc measurements in a cohort of neonates in China.
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Affiliation(s)
- Lizhong Du
- Department of Neonatology, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Center for Child Health, China.
| | - Xiaolu Ma
- Department of Neonatology, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Center for Child Health, China
| | - Xiaoxia Shen
- Department of Neonatology, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Center for Child Health, China
| | - Yinying Bao
- Women's Hospital, Zhejiang University School of Medicine, China
| | - Lihua Chen
- Department of Neonatology, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Center for Child Health, China
| | - Vinod K Bhutani
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Pallapothu B, Sankar J. Acalypha indica-Induced Hemolysis and Methemoglobinemia in a Child With G6PD Deficiency. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2113-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vitamin C and kidney transplantation: Nutritional status, potential efficacy, safety, and interactions. Clin Nutr ESPEN 2021; 41:1-9. [PMID: 33487249 DOI: 10.1016/j.clnesp.2020.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIM There are several observational and interventional studies regarding the advantages of sufficient serum levels of vitamin C and the evaluation of the effects of vitamin C supplementation post kidney transplantation. These studies have been put together to investigate the role of vitamin C post-kidney transplantation and make suggestions for designing future studies based on the use of vitamin C supplements or nutritional interventions among these patients. METHODS This narrative review was done by searching in the Embase, PubMed, and SCOPUS databases. RESULTS The results are presented in several sections as follows; nutritional status, potential protective effects, safety concerns, and medications/laboratory tests interactions of vitamin C. CONCLUSIONS Kidney transplant recipients are prone to vitamin C deficiency, which is related to higher mortality based on several long-term observational studies. Vitamin C supplementation improves endothelial function and creatinine clearance. Vitamin C is considered as a safe supplement, however, side effects such as kidney stones, pro-oxidant effect, hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency, impact on lymphocytic activity, acid-base disturbance, and increased sodium load following its administration have been reported. Interaction of vitamin C and cyclosporine is the most important interaction with post-renal transplant medications. Vitamin C also interferes with creatinine assay using Jaffe and enzymatic methods.
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Traditional African remedies induce hemolysis in a glucose-6-phopshate dehydrogenase deficient zebrafish model. Sci Rep 2020; 10:19172. [PMID: 33154437 PMCID: PMC7645625 DOI: 10.1038/s41598-020-75823-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022] Open
Abstract
Traditional remedies are widely used throughout Africa in routine care for infants. However, such remedies could have detrimental effects. Acute bilirubin encephalopathy (ABE) and kernicterus spectrum disorder (KSD) are common newborn health conditions in the developing world, contributing to substantial neonatal mortality and morbidity. They frequently occur in children with glucose-6-phopshate dehydrogenase (G6PD) deficiency. Using our established zebrafish model of G6PD deficiency, we tested the effects of three traditional compounds used in the care of the newborn umbilical cord: eucalyptus oil, methylated spirits, and Yoruba herbal tea. We found that eucalyptus oil induced a 13.4% increase in a hemolytic phenotype versus control, while methylated spirits showed a 39.7% increase in affected phenotype. Yoruba herbal tea exposure showed no effect. While methylated spirits are already a known pro-oxidant, these data indicate that eucalyptus oil may also be a hemolytic trigger in those with G6PD deficiency. Discovering which agents may contribute to the pathophysiology of G6PD deficiency is critical to eliminate ABE and KSD, especially in countries with a high prevalence of G6PD deficiency. The next step in elucidating the role of these agents is to determine the clinical correlation between the use of these agents and ABE/KSD.
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Li B, Wang X, Yu M, Yang P, Wang W. G6PD, bond by miR-24, regulates mitochondrial dysfunction and oxidative stress in phenylephrine-induced hypertrophic cardiomyocytes. Life Sci 2020; 260:118378. [PMID: 32898528 DOI: 10.1016/j.lfs.2020.118378] [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: 06/11/2020] [Revised: 08/18/2020] [Accepted: 08/29/2020] [Indexed: 02/06/2023]
Abstract
AIMS Pathological cardiac hypertrophy (CH) is one of the main risk factors for heart failure and cardiac death. Mitochondrial dysfunction and oxidative stress often occur in hypertrophic cardiomyocytes. It was recently proposed that deficiency or decreased activity of glucose-6-phosphate dehydrogenase (G6PD) may be related to the development of CH. This study aimed to investigate the expression of G6PD in CH and its regulatory role in mitochondrial dysfunction and oxidative stress of CH cells. MAIN METHODS Phenylephrine (PE) was used to create an in vitro model of CH. Using RT-qPCR and western blotting, the expression levels of target mRNAs and proteins were measured. ELISA assays and commercial kits based on spectrophotometry or colorimetry were used to measure mitochondrial function and oxidative stress. TargetScan and luciferase reporter gene assays were utilized for combination prediction and validation. CCK-8 and TUNEL kit were used to determine cell viability and apoptosis. KEY FINDINGS The results showed that G6PD overexpression attenuated the decreases of mitochondrial respiration, ATP, ATP synthetase and mitochondrial membrane potential induced by PE, as well as the increases of LDH release and apoptosis. Besides, PE elevated ROS activity, NO and MDA contents, and reduced SOD, CAT levels and cell viability. These effects were hindered by G6PD overexpression. MiR-24 was found to directly bind to G6PD at the motif of CUGAGCC and regulated its expression, furtherly, influenced the G6PD-mediated mitochondrial dysfunction and oxidative stress of CH cells. SIGNIFICANCE Generally, our study demonstrated that miR-24/G6PD regulates mitochondrial dysfunction and oxidative stress in CH cells, representing a new sight for CH therapy.
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Affiliation(s)
- Bing Li
- Department of Cardiology, The Third Hospital of Jilin University, Changchun 130033, China; Jilin Provincial Key Laboratory for Genetic Diagnosis of Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Cardiovascular Research Institute, Changchun 130033, China
| | - Xiaotong Wang
- Department of Cardiology, The Third Hospital of Jilin University, Changchun 130033, China; Jilin Provincial Key Laboratory for Genetic Diagnosis of Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Cardiovascular Research Institute, Changchun 130033, China
| | - Ming Yu
- Department of Cardiology, The Third Hospital of Jilin University, Changchun 130033, China; Jilin Provincial Key Laboratory for Genetic Diagnosis of Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Cardiovascular Research Institute, Changchun 130033, China
| | - Ping Yang
- Department of Cardiology, The Third Hospital of Jilin University, Changchun 130033, China; Jilin Provincial Key Laboratory for Genetic Diagnosis of Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Changchun 130033, China; Jilin Provincial Cardiovascular Research Institute, Changchun 130033, China
| | - Wei Wang
- Department of Cardiovascular Surgery, The Third Hospital of Jilin University, Changchun 130033, China.
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Mandal SK, Maji AK, Mishra SK, Ishfaq PM, Devkota HP, Silva AS, Das N. Goldenseal (Hydrastis canadensis L.) and its active constituents: A critical review of their efficacy and toxicological issues. Pharmacol Res 2020; 160:105085. [PMID: 32683037 DOI: 10.1016/j.phrs.2020.105085] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 12/19/2022]
Abstract
Goldenseal (Hydrastis canadensis L.) is a medicinal plant widely used in various traditional systems of medicine and as a food supplement. It has been traditionally used by Native Americans as a coloring agent and as medicinal remedy for common diseases and conditions like wounds, digestive disorders, ulcers, skin and eye ailments, and cancer. Over the years, goldenseal has become a popular food supplement in the USA and other regions. The rhizome of this plant has been used for the treatment of a variety of diseases including, gastrointestinal disorders, ulcers, muscular debility, nervous prostration, constipation, skin and eye infections, cancer, among others. Berberine is one of the most bioactive alkaloid that has been identified in different parts of goldenseal. The goldenseal extract containing berberine showed numerous therapeutic effects such as antimicrobial, anti-inflammatory, hypolipidemic, hypoglycemic, antioxidant, neuroprotective (anti-Alzheimer's disease), cardioprotective, and gastrointestinal protective. Various research finding suggest the health promoting effects of goldenseal components and their extracts. However, few studies have also suggested the possible neurotoxic, hepatotoxic and phototoxic activities of goldenseal extract and its alkaloids. Thus, large randomized, double-blind clinical studies need to be conducted on goldenseal supplements and their main alkaloids to provide more evidence on the mechanisms responsible for the pharmaceutical activity, clinical efficacy and safety of these products. Thus, it is very important to review the scientific information about goldenseal to understand about the current scenario.
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Affiliation(s)
- Sudip Kumar Mandal
- Dr. B. C. Roy College of Pharmacy and AHS, Durgapur, 713206, West Bengal, India
| | | | - Siddhartha Kumar Mishra
- Cancer Biology Laboratory, Department of Zoology, School of Biological Sciences, Dr. Harisingh Gour Central University, Sagar, 470003, Madhya Pradesh, India
| | - Pir Mohammad Ishfaq
- Cancer Biology Laboratory, Department of Zoology, School of Biological Sciences, Dr. Harisingh Gour Central University, Sagar, 470003, Madhya Pradesh, India
| | - Hari Prasad Devkota
- Department of Instrumental Analysis, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, 862-0973, Japan; Program for Leading Graduate Schools, Health Life Sciences: Interdisciplinary and Glocal Oriented (HIGO) Program, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, 862-0973, Japan
| | - Ana Sanches Silva
- National Institute for Agricultural and Veterinary Research (INIAV), I.P., Rua dos Lagidos, Lugar da Madalena, Vairão, Vila do Conde, 4485-655, Portugal; Center for Study in Animal Science (CECA), ICETA, University of Oporto, Oporto, 4051-401, Portugal
| | - Niranjan Das
- Department of Chemistry, Iswar Chandra Vidyasagar College, Belonia, 799155, Tripura, India.
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Borran M, Dashti-Khavidaki S, Alamdari A, Naderi N, Minoo F. Evaluation of the effect of high dose intravenous vitamin C on delayed allograft function in deceased donor kidney transplantation: a preliminary report. RENAL REPLACEMENT THERAPY 2020. [DOI: 10.1186/s41100-020-00279-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Delayed graft function (DGF) can affect short- and long-term allograft outcomes in kidney transplant recipients. One of the pathophysiological pathways in the occurrence of DGF is ischemia-reperfusion injury (IRI). High dose intravenous vitamin C has proven efficacy in decreasing IRI consequences. Accordingly, we designed this study to assess the effect of high dose intravenous vitamin C on the incidence and duration of DGF.
Methods
This is a pilot, single-center, double-blinded, randomized, placebo-controlled trial. In the treatment group, kidney transplant recipients received vitamin C infusion at the dose of 70 mg/kg diluted in 0.45% saline, and in another study arm, only the diluent solution was administered. Data regarding allograft function and other clinical information was recorded.
Results
This preliminary study on 19 patients (9 cases in the vitamin C and 10 cases in the placebo group) showed that after administration of single, high dose vitamin C the incidence of DGF was not significantly different between the groups, but the duration of DGF was substantially shorter in the vitamin C group than the placebo group (7.33 ± 5.68 versus 19.66 ± 0.57 days; P = 0.02). Acute rejection episodes were more seen in the vitamin C group than in the placebo group. Although this data was not statistically significant (P = 0.37), it led to the termination of the study.
Conclusion
A high dose of intravenous vitamin C before allograft implantation was effective in decreasing DGF duration but not DGF incidence.
Trial registration
The trial was registered in the Iranian registry of clinical trials encoded IRCT20100111003043N13 on June 24, 2019.
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Tan CSS, Lee SWH. Warfarin and food, herbal or dietary supplement interactions: A systematic review. Br J Clin Pharmacol 2020; 87:352-374. [PMID: 32478963 DOI: 10.1111/bcp.14404] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 12/12/2022] Open
Abstract
AIMS To present an updated overview on the safety of concurrent use of food, herbal or dietary supplement and warfarin. METHODS A systematic literature review was performed on 5 databases from inception up to 31 December 2019. These interactions were classified depending on the likelihood of interaction and supporting evidences. RESULTS A total of 149 articles describing 78 herbs, food or dietary supplements were reported to interact with warfarin. These reports described potentiation with 45 (57.7%) herbs, food or dietary supplements while 23 (29.5%) reported inhibition and 10 (12.8%) reported limited impact on warfarin pharmacokinetics and pharmacodynamics. Twenty unique herb and dietary supplements also reported to result in minor bleeding events, such as purpura and gum bleeding as well as major events such as intracranial bleeding that led to death. CONCLUSION While most food, herbs and supplements can be safely taken in moderation, healthcare professionals should be aware of the increased risk of bleeding when taking several food and herbs. These include Chinese wolfberry, chamomile tea, cannabis, cranberry, chitosan, green tea, Ginkgo biloba, ginger, spinach, St. John's Wort, sushi and smoking tobacco. Patients should be counselled to continue to seek advice from their healthcare professionals when starting any new herbs, food or supplement.
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Affiliation(s)
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia.,Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Selangor, Malaysia.,School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
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Chong PZ, Ng HY, Tai JT, Lee SWH. Efficacy and Safety of Ginkgo biloba in Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2020; 48:513-534. [PMID: 32349519 DOI: 10.1142/s0192415x20500263] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Ginkgo biloba and its extract have been suggested to have a neuroprotective role in patients with acute ischemic stroke. We aimed to examine the efficacy and safety of Ginkgo biloba use in patients with acute ischemic stroke. We searched seven databases for randomized controlled studies examining the use of Ginkgo biloba in patients with acute ischemic stroke. Relevant studies were retrieved, screened, and data were extracted independently by two reviewers. Random effects meta-analyses were performed to evaluate the efficacy and safety outcomes of Ginkgo biloba. We subsequently assessed the certainty of evidence using the GRADE (Grading of Recommendation Assessment, Development and Evaluation) methodology. We found 12 randomized controlled studies enrolling 1466 patients. Pooled results suggest that Ginkgo biloba use was associated with an improvement in neurological function among individuals with AIS with a reduction of 2.87 points on the National Institute of Health Stroke Scale score (95% CI: -4.01--1.74, p<0.001). Ginkgo biloba use was also associated with an improvement in activities of daily living and functional outcome (Mean Difference: 9.52; 4.66-14.33, p<0.001). Subgroup analysis suggest that the impact was larger when using an injectable formulation of Ginkgo biloba compared to the oral formulation. There was no apparent impact of Ginkgo biloba use on all-cause mortality (Risk ratio (RR): 1.21; 0.29-5.09, p=0.80) or cerebrovascular bleeding (RR: 0.82; 0.43-1.57, p=0.55). There was limited evidence on to support the use of gingko biloba in terms of improving quality of life and other stroke events. As such, more studies are needed before it can be recommended for routine use in improving neurological and cognitive function in patients with acute ischemic stroke.
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Affiliation(s)
- Phui Zee Chong
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Selangor, Malaysia
| | - Huey Ying Ng
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Selangor, Malaysia
| | - Jing Tong Tai
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Selangor, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Selangor, Malaysia.,School of Pharmacy, Taylor's University Lakeside Campus, Jalan Taylor's, 47500 Selangor, Malaysia
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Abstract
PURPOSE OF REVIEW Although vitamin C is essentially a nontoxic vitamin; however, it is important to be aware regarding the safety of high doses before the wide clinical use. RECENT FINDINGS Minor side effects of vitamin C have been reported, many being reported in earlier studies. High doses of vitamin C (up to 1.5 g/kg three times a week as intravenously) were safe in cancer patients with normal renal function and perfect glucose-6-phosphate dehydrogenase activity. As the dose and duration of administration of vitamin C in sepsis are lower and shorter than those used in cancer patients, it seems that it is relatively safe for this population. In ongoing trials, safety of high doses of vitamin C is considered. SUMMARY Data regarding the safety of high doses of vitamin C are scant. Until more data become available, caution should be applied in the use of high doses of vitamin C in patients with hemochromatosis, glucose-6-phosphate dehydrogenase deficiency, renal dysfunction, kidney stone, oxaluria, and pediatrics.
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Babu T, Panachiyil GM, Sebastian J, Ravi MD. Probable blueberry-induced haemolysis in a G6PD deficient child: A case report. Nutr Health 2019; 25:303-305. [PMID: 31707919 DOI: 10.1177/0260106019885290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Blueberry is a North American native fruit increasingly popular as a source of health-promoting bioactive compounds. However, there is evidence in the literature stating that blueberries should be avoided in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. CASE PRESENTATION We report the first case of a G6PD deficient child who developed haemolysis approximately after half a day following the intake of fresh blueberry. He presented with the complaints of the passage of orange coloured urine and hurried breathing. The child had haemoglobin of 7.9 g/dl on admission day and the laboratory results were indicative of haemolytic process. OUTCOMES AND IMPLICATIONS During the stay in the hospital, the child was managed conventionally, and he improved both clinically and symptomatically. The child was discharged after four days of treatment and diet counselling was provided to his parents. RECOMMENDATIONS Our report should encourage further research on this fruit regarding the mechanism behind the development of haemolytic anaemia. Also, it is important in the case of G6PD deficient patients to take lifelong precautions to avoid the foods that can trigger haemolysis.
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Affiliation(s)
- Tirin Babu
- Department of Clinical Pharmacy, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, India
| | - George Mathew Panachiyil
- Department of Clinical Pharmacy, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, India
| | - Juny Sebastian
- Department of Clinical Pharmacy, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, India
| | - Mandyam Dhati Ravi
- Department of Paediatrics, JSS Medical College and Hospital, JSS Academy of Higher Education & Research, Mysore, Karnataka, India
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Stone SN, Reisig KV, Saffel HL, Miles CM. Management of Athletes With G6PD Deficiency: Does Missing an Enzyme Mean Missing More Games? Sports Health 2019; 12:149-153. [PMID: 31603370 DOI: 10.1177/1941738119877177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
CONTEXT Glucose-6-phosphate dehydrogenase (G6PD) deficiency is likely the most prevalent enzyme deficiency on the planet, with an estimated 4.9% of people, or approximately 330 million individuals, across the globe affected by the disease. In the United States, 4% to 7% of the population is likely affected, but each year our nation's major sport leagues become more international. It is important for medical professionals who treat athletes to understand how this genetic condition can affect the athletes we are working with, especially because exercise in itself results in oxidative stress. EVIDENCE ACQUISITION PubMed was searched for relevant articles published from 1980 to 2018. The search terms G6PD, athletes, military, and sports were used. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS Though some case reports suggest a potential impact on athlete safety and performance, controlled studies demonstrate limited impact of exercise on oxidative stress in G6PD-deficient individuals. The care of athletes with G6PD deficiency does not drastically differ from the care of athletes without this condition. Most of the medications and supplements that are regularly given to athletes should not negatively affect their health. CONCLUSION Although the care of athletes with G6PD deficiency is for the most part no different from the care of other athletes, there are certain situations (visiting areas where malaria is endemic) and medications for which it is important to recognize how your management should change. G6PD deficiency is not regularly screened for but could be considered if an athlete has known sickle cell disease or when traveling to areas where malaria is prevalent. Expanding our knowledge of G6PD deficiency will allow for better care of athletes.
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Affiliation(s)
- Shane N Stone
- Primary Care Sports Medicine Fellowship, Department of Family & Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
| | - Karl V Reisig
- Bozeman Health Family Medicine at Belgrade Clinic, Belgrade, Montana
| | - Heather L Saffel
- Primary Care Sports Medicine Fellowship, Department of Family & Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
| | - Christopher M Miles
- Primary Care Sports Medicine Fellowship, Department of Family & Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
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16
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Suspected adverse reactions associated with herbal products used for weight loss: spontaneous reports from the Italian Phytovigilance System. Eur J Clin Pharmacol 2019; 75:1599-1615. [PMID: 31428816 DOI: 10.1007/s00228-019-02746-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Overweight and obesity represent worldwide a rising health problem. In this context, dietary supplements and herbal preparations are often used as self-medication for weight loss. The aim of this study was to describe the safety profile of dietary supplements for weight control by analyzing spontaneous reports of suspected adverse reactions (ARs) received by the Italian Phytovigilance System, from July 2010 to October 2017. METHODS The suspected ARs were collected using an ad hoc reporting form, registered in a database at the National Institute of Health and evaluated by a multidisciplinary group of experts. The causality assessment was performed using the WHO-UMC system or the CIOMS/RUCAM score. In case of serious adverse reactions, a feedback is provided to the reporter by e-mail. RESULTS Sixty-six spontaneous reports were collected. ARs involved cardiovascular system (26%), liver (14%), central nervous system (12%), skin (9%), gastrointestinal system (17%), thyroid (8%), kidney (4%), and other organs/systems (10%). In 64% of cases, the reaction was serious. Dechallenge was positive in 46 cases; three cases of positive rechallenge were reported. After the causality assessment, the association between the product intake and the adverse reaction was judged as possible in the majority of the cases (n = 43; 65%). CONCLUSIONS The data collected confirmed the existence of safety concerns on herbal dietary supplements used for body weight control, mainly related to quality of products and their use as self-medication. In this scenario, spontaneous reports represent the only tools available to monitor safety of these products.
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17
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Liew NY, Chong YY, Yeow SH, Kua KP, Saw PS, Lee SWH. Prevalence of potentially inappropriate medications among geriatric residents in nursing care homes in Malaysia: a cross-sectional study. Int J Clin Pharm 2019; 41:895-902. [PMID: 31073975 DOI: 10.1007/s11096-019-00843-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 05/03/2019] [Indexed: 12/27/2022]
Abstract
Background Polypharmacy has been associated with an increased risk of morbidity and mortality among older adults especially those living in nursing homes. Explicit criteria to evaluate the appropriateness of medications have recently been updated. Objective To estimate and compare the prevalence of potentially inappropriate medications (PIMs) among older adults in nursing homes using screening tool for older people's prescription (STOPP-2) and the 2015 Beers criteria. Setting Nursing care homes in the Klang Valley, Malaysia. Method A cross-sectional survey of medications used among residents living in nursing homes was performed. The 2015 Beers criteria and STOPP-2 criteria were used to evaluate the use of PIMs among this population. These PIMs were subsequently classified using the Pharmaceutical Network Europe classification (PCNE). Main outcome measure Number of PIMs among residents using both criteria. Results A total of 155 residents were recruited into the study. The prevalence of PIMs was 9.7% using the STOPP-2 criteria, 17.6% using the 2015 Beers criteria and 21.3% when both tools were used in combination. The PCNE criteria identified a total of 198 drug related issues, with an average of 1.27 issue per resident. Factors associated with higher risk of having PIM include multiple medication use and history of psychiatric disorder. Conclusion The 2015 Beers criteria was able to identify more PIM's compared to STOPP-2 criteria. The findings also support the expansion of pharmacists' services in nursing homes in Malaysia.
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Affiliation(s)
- Ngit Yi Liew
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Ying Yee Chong
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Shiau Huey Yeow
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Kok Pim Kua
- Department of Pharmacy, Klinik Kesihatan Puchong, Puchong, Selangor, Malaysia
| | - Pui San Saw
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
- Gerentology Laboratory, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
- School of Pharmacy, Taylor's University, Jalan Taylors, 47500, Subang Jaya, Selangor, Malaysia.
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Exercise in Glucose-6-Phosphate Dehydrogenase Deficiency: Harmful or Harmless? A Narrative Review. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:8060193. [PMID: 31089417 PMCID: PMC6476018 DOI: 10.1155/2019/8060193] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 02/12/2019] [Indexed: 11/17/2022]
Abstract
Objectives Glucose-6-phosphate dehydrogenase (G6PD) deficiency, theoretically, renders red blood cells (RBC) susceptible to oxidative stress. G6PD deficiency has also been found in other types of cells than RBC, such as leukocytes and myocytes, where an inefficient protection against oxidative stress may occur too. Glutathione (GSH), a significant antioxidant molecule, levels are lower in G6PD individuals, and theoretically, the probability of oxidative stress and haemolysis due to exercise in individuals with G6PD deficiency is increased, whereas dietary supplementation with antioxidants may have beneficial effects on various aspects of this enzymopathy. Methods A search of the available literature was conducted using the keywords glucose-6-phosphate dehydrogenase (G6PD), deficiency, disease, exercise, muscle, antioxidant, vitamin, supplement, and supplementation. The search was limited to publications in English, conducted on humans, and published until August 2018. After screening, only relevant articles were included. Results There is little evidence indicating that G6PD deficiency can cause perturbations in redox status, haemolysis, and clinical symptoms such as fatigability and myoglobinuria, especially after intense exercise, compared to individuals with normal enzyme levels. Conclusions Exercise could be used by G6PD-deficient individuals as a tool to improve their quality of life. However, there is a lack of training studies, and assessment of the effects of regular and systematic exercise in G6PD-deficient individuals is warranted. Finally, since GSH levels are lower in G6PD deficiency, it would be interesting to examine the effects of antioxidant or cysteine donor supplements on redox status after exercise in these individuals.
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19
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La Vieille S, Lefebvre DE, Khalid AF, Decan MR, Godefroy S. Dietary restrictions for people with glucose-6-phosphate dehydrogenase deficiency. Nutr Rev 2018; 77:96-106. [DOI: 10.1093/nutrit/nuy053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sébastien La Vieille
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, Ontario, Canada
- Department of Food Sciences, Faculty of Agriculture and Food Sciences, Université Laval, Québec City, Québec, Canada
| | - David E Lefebvre
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Ahmad Firas Khalid
- Health Policy PhD Program, McMaster University, Hamilton, Ontario, Canada
| | - Matthew R Decan
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Samuel Godefroy
- Department of Food Sciences, Faculty of Agriculture and Food Sciences, Université Laval, Québec City, Québec, Canada
- Institute of Nutrition and Functional Foods, Université Laval, Québec City, Québec, Canada
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20
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Emir DF, Ozturan IU, Yilmaz S. Alpha lipoic acid intoxicatıon: An adult. Am J Emerg Med 2018; 36:1125.e3-1125.e5. [PMID: 29559356 DOI: 10.1016/j.ajem.2018.03.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 03/10/2018] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Alpha lipoic acid (ALA) is a potent antioxidant used to treat a variety of disorders. Although ALA is considered a very safe supplement and intoxication is very rare, acute high-dose ingestions can cause mortality. In this report, we discuss a very rare case of ALA intoxication to increase awareness of this issue. CASE REPORT A 22-year-old female was referred to our emergency department with ALA intoxication after ingesting a total of 18g of ALA with a suicidal intention. The patient was found in an altered mental state and confused. During the physical examination, the patient's Glasgow Coma Scale was 13 (E4M6V3); however, she was neither alert nor oriented. Vital signs revealed a mildly decreased blood pressure, tachycardia, and an increased respiratory rate. Cranial nerve examination was normal except a horizontal gaze nystagmus. Laboratory testing showed a decompensated metabolic acidosis. T wave inversions were seen in the electrocardiography (EKG). The patient was treated with supportive treatment and discharged within three days of intensive care unit (ICU) admission. CONCLUSION ALA is a very common supplement that is easily accessible worldwide. Although ALA intoxication is very rare, it is sometimes seen after accidental or suicidal acute ingestion. Neurologic effects, metabolic acidosis, and t wave inversions in the EKG are observed when this acute poisoning occurs. Supportive treatment should be the main therapy.
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Affiliation(s)
- Duygu Ferek Emir
- Kocaeli University, Faculty of Medicine, Dept. of Emergency Medicine, Kocaeli, Turkey
| | - Ibrahim Ulas Ozturan
- Kocaeli University, Faculty of Medicine, Dept. of Emergency Medicine, Kocaeli, Turkey.
| | - Serkan Yilmaz
- Kocaeli University, Faculty of Medicine, Dept. of Emergency Medicine, Kocaeli, Turkey
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21
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Al-Abdi SY. Prolonged indirect hyperbilirubinemia in a moderately preterm boy with Mediterranean glucose-6-phosphate dehydrogenase and glutathione S-transferase Mu 1 null mutations. BMJ Case Rep 2017; 2017:bcr-2016-218404. [PMID: 28069791 DOI: 10.1136/bcr-2016-218404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 33-week gestation boy with Mediterranean glucose-6-phosphate dehydrogenase (G6PD) and a glutathione S-transferase Mu 1 null mutations (GSTM1*0/*0) developed prolonged indirect hyperbilirubinemia (PIH). He had no laboratory evidence of haemolysis or infection, and no exposure to oxidising agents. He has two full-term older brothers who have no history of neonatal hyperbilirubinemia. One brother, who was exclusively breast fed, has only Mediterranean G6PD and the other has only GSTM1*0/*0. The three boys have no mutation in the uridine diphosphate glucuronosyltransferase 1A1 gene. This suggests that a combination of all or any two of prematurity, G6PD deficiency and GSTM1*0/*0 is a possible risk factor for PIH. However, this remains to be confirmed.
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22
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Minuz P, Velo G, Violi F, Ferro A. Are nutraceuticals the modern panacea? From myth to science. Br J Clin Pharmacol 2017; 83:5-7. [PMID: 27933660 PMCID: PMC5338160 DOI: 10.1111/bcp.13142] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 09/26/2016] [Indexed: 12/15/2022] Open
Affiliation(s)
- Pietro Minuz
- Unit of Internal Medicine C, Department of MedicineUniversity of VeronaVeronaItaly
| | - Giampaolo Velo
- Pharmacology Unit, Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly
- International School of PharmacologyEttore Majorana Foundation and Centre for Scientific CultureEriceTrapaniItaly
| | - Francesco Violi
- Clinica Medica, Atherothrombosis Centre, Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeRomeItaly
| | - Albert Ferro
- Department of Clinical Pharmacology, Cardiovascular Division, British Heart Foundation Centre of Research ExcellenceKing's College LondonLondonUK
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23
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Vitamins, Amino Acids and Drugs and Formulations Used in Nutrition. SIDE EFFECTS OF DRUGS ANNUAL 2017. [DOI: 10.1016/bs.seda.2017.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Lee SWH, Chaiyakunapruk N, Lai NM. What G6PD-deficient individuals should really avoid. Br J Clin Pharmacol 2016; 83:211-212. [PMID: 27650490 DOI: 10.1111/bcp.13091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 08/07/2016] [Accepted: 08/10/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia.,School of Population Health, University of Queensland, Brisbane, QLD, Australia.,Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,School of Pharmacy, University of Wisconsin, Madison, WI, USA
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Subang Jaya, Malaysia
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25
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Lee SWH, Lai NM, Chaiyakunapruk N, Chong DWK. Adverse effects of herbal or dietary supplements in G6PD deficiency: a systematic review. Br J Clin Pharmacol 2016; 83:172-179. [PMID: 27081765 DOI: 10.1111/bcp.12976] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/29/2016] [Accepted: 04/13/2016] [Indexed: 01/10/2023] Open
Abstract
AIM Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common genetic disorder, affecting nearly 400 million individuals worldwide. Whilst it is known that a number of drugs, foods and chemicals can trigger haemolysis in G6PD deficient individuals, the association between herbal and dietary supplements and haemolysis is less clear. The objective of this study was to evaluate the association between herbal or dietary supplements and adverse events in G6PD deficient individuals. METHODS We searched 14 electronic databases from their inception until November 2015 for articles describing the use of herbal or dietary supplements in G6PD deficient individuals. Additional publications were identified from manually searching textbooks, conference abstracts and the grey literature. All study designs were included as long as they contained clinical information. These gathered findings were summarized narratively. RESULTS Thirty-two publications met inclusion criteria. These reported on 10 herbal and dietary supplements. Overall evidence linking haemolysis to a herbal/dietary supplement was only found for henna. No evidence of harm was observed for vitamin C, vitamin E, vitamin K, Gingko biloba and α-lipoic acid. CONCLUSIONS The review showed that there was insufficient evidence to contravene the use of most herbal or dietary products at therapeutic doses in G6PD deficient subjects.
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Affiliation(s)
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Malaysia
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Monash University Malaysia.,Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,School of Pharmacy, University of Wisconsin, Madison, USA.,School of Population Health, University of Queensland, Brisbane, Australia
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