Efficacy and safety of 'true' cinnamon (Cinnamomum zeylanicum) as a pharmaceutical agent in diabetes: a systematic review and meta-analysis

Network pharmacology analysis revealed the mechanism and active compounds of jiao tai wan in the treatment of type 2 diabetes mellitus via SRC/PI3K/AKT signaling

ETHNOPHARMACOLOGICAL RELEVANCE

Jiao-tai-wan (JTW) is a traditional Chinese herbal prescription, exerts its therapeutic effects on type 2 diabetes mellitus (T2DM). However, its mechanisms and active components remain unclear.

AIM OF THE STUDY

To investigate the therapeutic mechanisms of JTW in treating type 2 diabetes mellitus (T2DM), focusing on identifying active components, their targets, and validating efficacy through SRC/PI3K/AKT signaling pathway modulation in vitro and in vivo.

MATERIALS AND METHODS

Active ingredients were retrieved from the Traditional Chinese Medicine System Pharmacology (TCMSP) and Comprehensive Traditional Chinese Medicine Database (TCMID). Targets for these components were identified using the ChemMapper database based on 3D structural similarity. T2DM-related genes were sourced from the DisGeNET and Gene Expression Omnibus (GEO) databases. Protein-protein interaction (PPI) analysis and functional enrichment analysis were conducted to construct a pathway network of "herbs-active ingredients-candidate targets", identifying core molecular mechanisms and key active ingredients. SwissDock was used for molecular docking to predict ligands for candidate targets. The diabetic models were established using C57BL/6 mice and human liver HepG2 cell lines. Their Effectiveness and key molecules were verified through biochemical detection and immunoblotting.

RESULTS

Total 30 active compounds, 597 active ingredient targets, 9631 T2DM-related genes, and 521 overlapping candidate targets were found for JTW on T2DM. Go enrichment indicated the core pathways enriched on insulin and glucose metabolism. The auto-docking demonstrated SRC has potential binds to ingredients of JTW. In vivo, JTW can reduce blood glucose, and blood lipid levels, and HOMA-IR, and increase HOMA-ISI levels in T2DM mice with reduced ALT, AST, MDA levels and increased SOD levels. Meanwhile, decreased phosphorylation of SRC, along with increased levels of phosphorylated PI3K, PI3K, and phosphorylated AKT, were observed. HE staining of liver tissues further confirmed that JTW administration improved liver morphology, reducing inflammation and necrosis. In vitro, JTW significantly ameliorates upstream dysregulation by reducing SRC phosphorylation while enhancing phosphorylated PI3K, PI3K, and AKT phosphorylation levels.

CONCLUSION

JTW may alleviate glucose, insulin resistance, and lipid metabolism disorders by the SRC/PI3K/AKT signaling pathway, that provide a novel view of potential active compounds and essential targets in treating T2DM.

Effect of cinnamon supplementation on blood pressure, oxidative stress, and inflammatory biomarkers in adults: An umbrella review of the meta-analyses of randomized controlled trials

AIMS

Cinnamon has positive effects on markers of cardiometabolic health, including blood pressure (BP), oxidative stress, and inflammation. Despite the evidence accumulated from meta-analysis studies on the effects of cinnamon on these markers, the reported findings are still controversial. This umbrella review was conducted to evaluate the evidence and provide a definitive clarification.

DATA SYNTHESIS

We conducted a systematic search in four scientific databases, including PubMed, Scopus, Web of Science, and Embase electronic databases, up to March 2024 to identify systematic reviews and meta-analyses of randomized clinical trials investigating the impact of cinnamon on blood pressure, oxidative stress, and inflammation. The findings revealed that cinnamon might exert favorable effects on systolic blood pressure (SBP) (ES = -2.36 mmHg; 95% CI: 3.86, -1.40), diastolic blood pressure (DBP) (ES = -1.65 mmHg; 95% CI: 2.41, -0.90), total antioxidant capacity (TAC) (WMD = 0.34; 95% CI: 0.04, 0.64), and interleukin-6 (IL-6) (WMD = -1.48; 95% CI: 2.96, -0.01). However, the results did not show any significant effect of cinnamon on malondialdehyde (MDA) (WMD = -0.47; 95% CI: 0.99, 0.05), C-reactive protein (CRP) (WMD = -1.33; 95% CI: 2.66, 0.00), and intercellular adhesion molecule 1 (ICAM-1) (WMD= 1.53, 95% CI: 12.03, 15.10).

CONCLUSIONS

The results of the studies included in this umbrella review support the usefulness of cinnamon consumption in modulating BP as well as improving TAC and IL-6 in metabolic disorders. Due to the limited number of studies, clinical diversity, and other limitations, more high-quality studies must be conducted to provide more precise and comprehensive recommendations.

REGISTRATION NUMBER

PROSPERO, CRD42023487350.

Effect of cinnamon spice on continuously monitored glycemic response in adults with prediabetes: a 4-week randomized controlled crossover trial

BACKGROUND

Previous clinical studies showing that cinnamon spice lowers blood glucose concentrations had inconsistent results.

OBJECTIVES

To determine the effect of daily cinnamon spice supplementation in an amount commonly used for seasoning on glucose concentrations in adults with obesity and prediabetes.

METHODS

Following a 2-wk run-in period of maintaining a low polyphenol/fiber diet, 18 participants with obesity and prediabetes underwent a 10-wk randomized, controlled, double-blind, crossover trial (mean age 51.1 y; mean fasting plasma glucose 102.9 mg/dL). The participants were randomly assigned to take cinnamon (4 g/d) or placebo for 4-wk, followed by a 2-wk washout period, and then crossed over to the other intervention for an additional 4-wk. Glucose changes were measured with continuous glucose monitoring. Oral glucose tolerance testing immediately following ingestion of cinnamon or placebo was performed at 4-time points to assess their acute effects both at the baseline and end of each intervention phase. Digestive symptom logs were obtained daily.

RESULTS

There were 694 follow-up days with 66,624 glucose observations. When compared with placebo, 24-h glucose concentrations were significantly lower when cinnamon was administered [mixed-models; effect size (ES) = 0.96; 95 % confidence interval (CI): -2.9, -1.5; P < 0.001]. Similarly, the mean net-area-under-the-curve (netAUC) for glucose was significantly lower than for placebo when cinnamon was given (over 24 h; ES = -0.66; 95 % CI: 2501.7, 5412.1, P = 0.01). Cinnamon supplementation resulted in lower glucose peaks compared with placebo (Δpeak 9.56 ± 9.1 mg/dL compared with 11.73 ± 8.0 mg/dL; ES = -0.57; 95 % CI: 0.8, 3.7, P = 0.027). Glucose-dependent-insulinotropic-polypeptide concentrations increased during oral glucose tolerance testing + cinnamon testing (mixed-models; ES = 0.51; 95 % CI: 1.56, 100.1, P = 0.04), whereas triglyceride concentrations decreased (mixed-models; ES = 0.55; 95 % CI: -16.0, -1.6, P = 0.02). Treatment adherence was excellent in both groups (cinnamon: 97.6 ± 3.4 % compared with placebo: 97.9 ± 3.7 %; ES = -0.15; 95 % CI: -1.8, 0.2, P = 0.5). No differences were found in digestive symptoms (abdominal pain, borborygmi, bloating, excess flatus, and stools/day) between cinnamon and placebo groups.

CONCLUSIONS

Cinnamon, a widely available and low-cost supplement, may contribute to better glucose control when added to the diet in people who have obesity-related prediabetes. This trial was registered at clinicaltrials.gov as NCT04342624.

Chinese herb couple against diabetes: integrating network pharmacology and mechanism study

Cassia twig is a dry twig of Cinnamomum cassia Presl, a Lauraceae plant. Astragalus L is one of the largest genuses of flowering plants in the Leguminosae family. Roots of A. membranaceus Bge. var. mongholicus (Bge.) Hsiao, A. membranaceus (Fisch.) Bge. Chinese herb couple refers to the matching of two herbs in pairs, mostly with synergistic effects or toxicity reduction. This Chinese herb couple (Cassia twig-Astragalus) come from the classic famous book "Zhang Xichun's book on Chinese herb couple", which is widely used to treat diabetes. Moreover, both Cassia twig and Astragalus belong to the homology of medicine and food. However, its mechanism is still unclear. The study identified the effective components of Cassia twig-Astragalus by UPLC-Q-TOF-MS/MS and investigated the mechanism of Cassia twig-Astragalus in treating diabetes by virtue of network pharmacology, molecular docking and experimental verification. Firstly, based on UPLC-Q-TOF-MS/MS and network pharmacology, a total of 10 active ingredients of Astragalus and 6 active ingredients of Cassia twig were screened, and a total of 13 key targets were obtained. There were 64 targets at the intersection of Cassia twig-Astragalus with diabetes, mainly including IL-17, TNF, NF-κβ, AGE-RAGE signaling pathway, etc. It mainly involves the response of cells to insulin stimulation, the response to insulin and the positive regulation of cell adhesion. Secondly, molecular docking results showed that quercetin has good binding activities with AKT1 and TNF. Calycosin has good binding activities with AKT1, TNF and CAV1. Formononetin has good binding activities with TNF and IL-6. Isorhamnetin has good binding activities with AKT1, TNF and IL-6. Finally, the animal experiments showed that Cassia twig-Astragalus could improve the body weight, blood glucose and glucose tolerance in diabetic rats. After the intervention with Cassia twig-Astragalus, the inflammatory factors (IL-10, TNF-α, IL-6) were significantly improved in diabetic rats, which also effectively reduced TG and TC.Communicated by Ramaswamy H. Sarma.

A Scoping Review of the Clinical Evidence for the Health Benefits of Culinary Doses of Herbs and Spices for the Prevention and Treatment of Metabolic Syndrome

Metabolic syndrome (MetS) is a growing global health problem. Evidence suggests that diets rich in phytochemical-containing herbs and spices can contribute to reducing the risk of chronic diseases. This review assesses the scope of evidence supporting the use of herbs and spices in the diet for the prevention or treatment of MetS and its associated health conditions. A search of the PubMed, Scopus and Google Scholar databases was carried out to assess the available clinical evidence for culinary doses of commonly used herbs and spices. Trials that were measuring health factors related to metabolic disorders in healthy individuals, or the health of individuals with MetS or associated diseases, were included. Out of a total of 1738 papers identified, there were 142 relevant studies on black pepper, chilli, cardamom, cinnamon, coriander, cumin, fennel, fenugreek, garlic, ginger, nigella seed, rosemary, sage and turmeric. No relevant research was found for cloves, mint, oregano, parsley or thyme. Cinnamon, fenugreek and ginger were the herbs/spices with the most published trials on them and that showed promise for glycaemic control. Cardamom appears to have potential to reduce inflammatory markers, and cinnamon, ginger and turmeric to reduce blood lipids. Patients with type 2 diabetes were the population most likely to be included in studies, but the preventative benefits of herbs/spices in healthy populations were also investigated, particularly for chilli, ginger and cinnamon. There is evidence for the beneficial effect of culinary doses of many common herbs/spices in the prevention and treatment of MetS and associated disorders.

Efficacy of Habb-e-Asab in diabetic peripheral neuropathy: a randomized placebo control study

OBJECTIVES

Diabetic peripheral neuropathy (DPN) is a common diabetes complication. The prevalence of neuropathy is 55% for type 1 and 66% for type 2 diabetes. In Unani medicine neuropathy is known as Khidr (numbness). It is treated with drugs possessing hypoglycemic and analgesic properties, etc. Habb-e-Asab, a polyherbal Unani formulation used for the treatment of Waja-ul-Asab (neuralgia) is routinely used for its indications in neurological pain in Unani medicine. The aim of this study to investigate the efficacy of Habb-e-Asab in diabetic peripheral neuropathy.

METHODS

Thirty patients with DPN were randomly assigned to test (n=20) and control (n=10) groups in a randomized single-blind placebo control study. For 45 days, the test group was given 250 mg Habb-e-Asab twice a day and the control group 250 mg placebo twice a day. The subjective parameters Pain in feet, burning in feet, and tingling in feet was assessed by the arbitrary scale and VAS fortnightly and objective parameters MNSI, and VPT was assessed in pre-post-treatment.

RESULTS

The research drug revealed highly statistically significant with p<0.001 on VAS score and MNSI whereas VPT is significant with p<0.01 on few points. But control group exhibits no significant effect in any of the parameters. No adverse effects had been reported in either group.

CONCLUSIONS

Our finding indicated that the Habb-e-Asab for 45 days improved and reduced the severity of DPN in a patient with diabetes (CTRI/2018/02/011725).

Cinnamaldehyde Inhibits Postharvest Gray Mold on Pepper Fruits via Inhibiting Fungal Growth and Triggering Fruit Defense

Gray mold infected with Botrytis cinerea frequently appears on fruits and vegetables throughout the supply chain after harvest, leading to economic losses. Biological control of postharvest disease with phytochemicals is a promising approach. CA (cinnamaldehyde) is a natural phytochemical with medicinal and antimicrobial activity. This study evaluated the effect of CA in controlling B. cinerea on fresh pepper fruit. CA inhibited B. cinerea growth in vitro significantly in a dose- (0.1-0.8 mM) and time-dependent (6-48 h) manner, with an EC50 (median effective concentration) of 0.5 mM. CA induced the collapse and breakdown of the mycelia. CA induced lipid peroxidation resulting from ROS (reactive oxygen species) accumulation in mycelia, further leading to cell leakage, evidenced by increased conductivity in mycelia. CA induced mycelial glycerol accumulation, resulting in osmotic stress possibly. CA inhibited sporulation and spore germination resulting from ROS accumulation and cell death observed in spores. Spraying CA at 0.5 mM induced a defense response in fresh pepper fruits, such as the accumulation of defense metabolites (flavonoid and total phenols) and an increase in the activity of defense enzymes (PAL, phenylalanine ammonia lyase; PPO, polyphenol oxidase; POD, peroxidase). As CA is a type of environmentally friendly compound, this study provides significant data on the activity of CA in the biocontrol of postharvest gray mold in peppers.

Comparative Chemical Composition and Acetylcholinesterase (AChE) Inhibitory Potential of Cinnamomum camphora and Cinnamomum tamala

Cinnamomum species have applications in the pharmaceutical and fragrance industry for wide biological and pharmaceutical activities. The present study investigates the chemical composition of the essential oils extracted from two species of Cinnamomum namely C. tamala and C. camphora. Chemical analysis showed E-cinnamyl acetate (56.14 %), E-cinnamaldehyde (20.15 %), and linalool (11.77 %) contributed as the major compounds of the 95.22 % of C. tamala leaves essential oil found rich in phenylpropanoids (76.96 %). C. camphora essential oil accounting for 93.57 % of the total oil composition was rich in 1,8-cineole (55.84 %), sabinene (14.37 %), and α-terpineol (10.49 %) making the oil abundant in oxygenated monoterpenes (70.63 %). Furthermore, the acetylcholinesterase inhibitory activity for both the essential oils was carried out using Ellman's colorimetric method. The acetylcholinesterase inhibitory potential at highest studied concentration of 1 mg/mL was observed to be 46.12±1.52 % for C. tamala and 53.61±2.66 % for C. camphora compared to the standard drug physostigmine (97.53±0.63 %) at 100 ng/ml. These multiple natural aromatic and fragrant characteristics with distinct chemical compositions offered by Cinnamon species provide varied benefits in the development of formulations that could be advantageous for the flavor and fragrance industry.

The Effect of Cinnamon on Glycolipid Metabolism: A Dose-Response Meta-Analysis of Randomized Controlled Trials

(1) Background: The effect of cinnamon on the regulation of glycolipid levels in type 2 diabetic patients is still controversial, and there is a lack of research on the dose-response relationship between cinnamon and glycolipid indicators in type 2 diabetic patients. (2) Methods: This dose-response meta-analysis was performed to explore the effect of the cinnamon intervention on glycolipid metabolism. We conducted a comprehensive database search for literature published before November 2022. Nonlinear models were used for dose-response relationship analysis. (3) Results: We identified that a cinnamon intervention was effective in controlling triglyceride (TG) levels (mean difference = -7.31; 95%CI: -12.37, -2.25, p = 0.005) and low-density lipoprotein cholesterol (LDL-C) levels (mean difference = -6.78; 95%CI: -11.35, -2.22, p = 0.004) in type 2 diabetic patients; however, it also was able to increase high-density lipoprotein cholesterol (HDL-C) levels in patients with type 2 diabetes (mean difference = 1.53; 95%CI: 1.01, 2.05, p < 0.001). However, the cinnamon intervention had no significant effect on the level of fasting blood glucose, glycated hemoglobin (HbA1c), or total cholesterol (TC) levels. We found a significant effect of the cinnamon intervention dose on the TG level (p-nonlinearity = 0.016) and LDL-C (p-nonlinearity = 0.019) in the nonlinear dose-response analysis. In the subgroup analysis, we found a hypoglycemic effect with the cinnamon dose ≤1200 mg (mean difference = -11.1, 95%CI: -14.64, -7.58, p < 0.001). (4) Conclusion: Cinnamon intervention may be beneficial in lowering TG and LDL-C levels while enhancing HDL-C levels, and the dosage of the intervention was an important factor in influencing the TG and LDL-C levels.

The effect of cinnamon supplementation on glycemic control in patients with type 2 diabetes or with polycystic ovary syndrome: an umbrella meta-analysis on interventional meta-analyses

BACKGROUND

Several meta-analyses reported glycemic-lowering effects of cinnamon, while others reported conflicting findings. In the present study, we aimed to perform an umbrella meta-analysis of previous interventional meta-analyses on the effects of cinnamon on glycemic control in patients with type 2 diabetes (T2D) or with polycystic ovary syndrome (PCOS).

METHODS

Relevant studies were searched in PubMed, Scopus, EMBASE, Web of Science, and Google Scholar up to June 2022. Meta-analyses of randomized clinical trials (RCTs) investigating the effects of cinnamon on glycemic indices including fasting plasma glucose (FPG), homeostatic model assessment for insulin resistance (HOMA-IR), insulin, and hemoglobin A1C (HbA1c) were included. Random-effects models were used to perform the umbrella meta-analysis and pool the weighted mean difference (WMD) or standardized mean difference (SMD) and their 95% confidence intervals (CI).

RESULTS

Overall, 11 meta-analyses of RCTs were included. Cinnamon supplementation was effective in reducing serum FPG (WMD: -10.93 mg/dL; 95%CI: -16.22, -5.65; SMD: -0.86; 95%CI: -1.19, -0.52), insulin (WMD: -2.01 IU/mL; 95%CI: -3.96, -0.07; SMD: -0.61; 95%CI: -0.93, -0.30), HOMA-IR levels (WMD: -0.61; 95%CI: -0.91, -0.31; SMD: -0.78; 95%CI: -1.26, -0.30), and HbA1c (WMD: -0.10%; 95%CI: -0.17, -0.03).

CONCLUSION

Cinnamon can be used as an anti-diabetic agent and an add-on treatment to control glycemic indices among patients with T2D or PCOS.

The Anti-Cancer Effect of Cinnamon Aqueous Extract: A Focus on Hematological Malignancies

Cinnamon is an evergreen and tropical plant of the family Lauraceae, growing particularly in Sri Lanka, whose aqueous extract has been tested in different studies to evaluate its possible use as an anti-cancer compound. Both in vitro and in vivo experiments seem to confirm that it acts on various cellular pathways, contributing to down-regulating the activity of molecules that stimulate the proliferation and survival of cells such as the transcription factors NF-KB and AP-1, COX-2, dihydrofolate reductase and pro-angiogenic substances such as VEGF, while up-regulating the function of immune cells against tumors, such as cytotoxic CD8+ T cells. In hematological malignancies, aqueous cinnamon extract has been studied in order to understand if it is possible to count on its help, alone or in combination with traditional drugs such as doxorubicin, to treat patients. The aim of our work is to investigate results from in vitro and in vivo studies about the possible anti-cancer effect of aqueous cinnamon extract in hematological malignancies and the different pathways involved in its action. The possibility of using cinnamon extract in clinical practice is discussed; even if its use could appear very interesting, more studies are necessary to clear the real potentiality of this substance in cancer.

Role of Fenugreek, Cinnamon, Curcuma longa, Berberine and Momordica charantia in Type 2 Diabetes Mellitus Treatment: A Review

Type 2 diabetes mellitus (T2DM) is a complex disease that has become a major global health concern. Given the efficacy of antidiabetic drugs, pharmacological therapy is considered the first-line treatment of T2DM; however, due to their potential side effects and high costs, new and cost-effective treatments with minimal side effects are needed. Medicinal plants have been used for centuries as part of traditional medicine to treat T2DM. Among these, fenugreek, cinnamon, Curcuma longa, berberine, and Momordica charantia have demonstrated different degrees of hypoglycemic activity in clinical studies and animal models. Therefore, the aim of this review is to synthesize the mechanisms of action of five medicinal plants, as well as the experimental and clinical evidence of their hypoglycemic activity from the published literature.

Current Understanding of the Molecular Basis of Spices for the Development of Potential Antimicrobial Medicine

Antimicrobial resistance increases day by day around the world. To overcome this situation new antimicrobial agents are needed. Spices such as clove, ginger, coriander, garlic, and turmeric have the potential to fight resistant microbes. Due to their therapeutic properties, medicinal herbs and spices have been utilized as herbal medicines since antiquity. They are important sources of organic antibacterial substances that are employed in treating infectious disorders caused by pathogens such as bacteria. The main focus of the study is the bioactivity of the active ingredients present in different kinds of naturally available spices. We conducted a thorough search of PubMed, Google Scholar, and Research Gate for this review. We have read many kinds of available literature, and in this paper, we conclude that many different kinds of naturally available spices perform some form of bioactivity. After reading several papers, we found that some spices have good antimicrobial and antifungal properties, which may help in controlling the emerging antimicrobial resistance and improving human health. Spices have many phytochemicals, which show good antimicrobial and antifungal effects. This review of the literature concludes that the natural bioactivate compounds present in spices can be used as a drug to overcome antimicrobial resistance in human beings.

Sweetly Improving Sugars? Reviewing Cinnamon's Effects on Blood Glucose

Cinnamon is a spice that has been used in various cultures for centuries for its potential health benefits. While there are health claims for a variety of health conditions, it has continuously been explored for its ability to improve glucose handling in diabetes. Cinnamon is a very popular supplement used by patients with diabetes to help normalize blood glucose levels. A systematic review of the literature was conducted to assess the available evidence evaluating effects on diabetes and glucose handling with the use of various species of cinnamon. The intention was to summarize the existing evidence for cinnamon's effects on blood glucose, both for safety and efficacy, to help guide providers and consumers alike. Reviewing the available literature for the different types of cinnamon and their effects on the diabetes disease process, there are multiple proposed mechanisms for how cinnamon could improve diabetes, including increasing insulin sensitivity by multiple receptor signaling pathways, reducing inflammation, enhancing glucose uptake by effects on glucose transporter proteins, and effects on gastric emptying, and blocking glucose absorption. There appears to be conflicting evidence on whether cinnamon produces any significant effect on glucose parameters, and the extent of these effects. There are several variables that could explain these conflicting data, such as patient sample size, doses and formulations of cinnamon used, baseline patient characteristics, and study duration. A more in-depth evaluation and rating of the available evidence could help clarify this, but data suggest that in some circumstances, cinnamon may have modest effects on improving glucose handling in adults. The safety profile also has been demonstrated to be extremely favorable, with very few adverse events reported in the active treatment groups across all studies. Based upon these data, clinicians should consider cinnamon to be a potential adjunctive therapy to traditional diabetes treatments, and should be open to discussing this with patients expressing interest in the supplement.

Effect of Colloidal Cu NPs/Cinnamon Extract on the Antibacterial Activity

This study explores a new facile method of obtaining plant extract using a plasma jet and a way of producing Cu nanoparticles (Cu NPs) using pulsed laser ablation in liquid. A 532 nm Nd:YAG laser at varying energies (500, 700, and 900 mJ) was used to prepare Cu NPs. Cinnamon bark extract was prepared quickly by DC plasma discharge (plasma jet) exposure at 5 and 15 min. The study showed the effects of a mixture (Cu NPs with cinnamon extract) on Escherichia coli bacteria. The colloids inhibited E. coli; the inhibition increased with duration and laser energy. The characterization of the Cu NPs was performed using ultraviolet-visible spectrophotometry, and field emission-scanning electron microscopy (FE-SEM).

Characterization of the Biological Activities of a New Polyphenol-Rich Extract from Cinnamon Bark on a Probiotic Consortium and Its Action after Enzymatic and Microbial Fermentation on Colorectal Cell Lines

Cinnamon polyphenols are known as health-promoting agents. However, their positive impact depends on the extraction method and their bioaccessibility after digestion. In this work, cinnamon bark polyphenols were extracted in hot water and subjected to an in vitro enzymatic digestion. After a preliminary characterization of total polyphenols and flavonoids (respectively 520.05 ± 17.43 µgGAeq/mg and 294.77 ± 19.83 µgCATeq/mg powder extract), the extract antimicrobial activity was evidenced only against Staphylococcus aureus and Bacillus subtilis displaying a minimum inhibition growth concentration value of 2 and 1.3 mg/mL, respectively, although it was lost after in vitro extract digestion. The prebiotic potential was evaluated on probiotic Lactobacillus and Bifidobacterium strains highlighting a high growth on the in vitro digested cinnamon bark extract (up to 4 × 10⁸ CFU/mL). Thus, the produced SCFAs and other secondary metabolites were extracted from the broth cultures and determined via GC-MSD analyses. The viability of healthy and tumor colorectal cell lines (CCD841 and SW480) was assayed after the exposition at two different concentrations (23 and 46 µgGAeq/mL) of the cinnamon extract, its digested, and the secondary metabolites produced in presence of cinnamon extract or its digested, showing positive protective effects against a tumorigenic condition.

Traditional Medicine Use among Type 2 Diabetes Patients in KZN

Background. Traditional medicine (TM) is widely used in both developing and developed countries to assist in the attempt to curtail the prevalence and increase in diabetes mellitus. Approximately 53% of South Africans use TM to prevent and treat their diseases. There is no conclusive evidence regarding the safety and effectiveness of TM versus prescribed medicine. The most common therapies used by diabetics in Africa include herbal treatments, nutritional products, spiritual healing, and relaxation techniques. Therefore, this study aimed to evaluate the use of TM in patients with T2DM who are on chronic therapy and living in KwaZulu-Natal. Method. This cross-sectional study was conducted at a district hospital, in which purposive sampling was used to recruit participants and data were collected using a structured questionnaire. Information collected included demographic data, information pertaining to home remedies/TM, and self-care practices employed by participants while using TM. Data were analyzed using Pearson’s chi-squared test, t-test, and multivariate logistic regressions to determine predictors of TM usage. Results. Only 92 (27%) of 340 participants reported using TM, with Indians being the most frequent users (58.24%). Approximately, 83.72% (n = 72) used TM in conjunction with prescribed medication. Most participants (56.32%) acquired TM knowledge from family. The most frequently used TM was lemon and honey, Aloe vera, bitter gourd, green tea, and cinnamon. Traditional medicine use among African participants was 0.56 times (OR = 0.56, 95% CI = 0.34, 0.93) lower than Indian participants. There were no significant predictors for TM usage among the variables tested. Conclusion. A low prevalence rate of TM usage in T2DM patients was found. A significant correlation was noted between ethnicity and TM use. Large-scale studies are required to determine the additive and synergistic effects of TM in health care. Consideration should also be given to integrating TM into mainstream health care.

Cinnamon as a Complementary Therapeutic Approach for Dysglycemia and Dyslipidemia Control in Type 2 Diabetes Mellitus and Its Molecular Mechanism of Action: A Review

The scientific evidence that cinnamon may exert beneficial effects on type 2 diabetes mellitus due to the biological activity of its bioactive compounds has been increasing in recent years. This review provides an overview of the effects of cinnamon on clinical parameters of diabetes and summarizes the molecular mechanisms of action of cinnamon on glucose and lipid metabolism. Search criteria include an electronic search using PubMed, Medline, and Cochrane Library databases. English literature references from 2000 up to 2022 were included. Following title and abstract review, full articles that met the inclusion criteria were included. The results from the available evidence revealed that cinnamon improved glycemic and lipidemic indicators. Clinical trials clarified that cinnamon also possesses an anti-inflammatory effect, which may act beneficially in diabetes. Based on in vitro and in vivo studies, cinnamon seems to elicit the regulation of glucose metabolism in tissues by insulin-mimetic effect and enzyme activity improvement. Furthermore, cinnamon seems to decrease cholesterol and fatty acid absorption in the gut. The current literature search showed a considerable number of studies on diabetic subjects. Some limitations in comparing published data should be highlighted, including variability in doses, extracts and species of cinnamon, administration forms, and antidiabetic therapy.

Assessing the Ameliorative Effect of Selenium Cinnamomum verum, Origanum majorana, and Origanum vulgare Nanoparticles in Diabetic Zebrafish (Danio rerio)

Cinnamomum verum, Origanum majorana, and Origanum vulgare have been used in traditional medicine for a long time to treat diabetes because of their promising therapeutic effects. The combination of these plants (COO) was tested to improve their efficacy using selenium nanoparticles (Se-COO-NPs) and gum Arabic (GA) as stabilizers for sustained release. Phenolic compounds of plants were identified using liquid chromatography–mass spectrometry (LC–MS/MS). GA-Se-COO-NPs were characterized by spectroscopic and microscopic methods and evaluated in diabetic zebrafish. The ultraviolet spectrum was assessed to confirm the formation of plasmon resonance at 267 nm. The obtained particle size of selenium nanospheres was 65.76 nm. They were maintained in a stable form for 5 months at 4 °C. Transmission electron microscopy (TEM) images demonstrated the presence of individual spherical nanoparticles. Fourier transform infrared spectroscopy (FT-IR) showed the interaction between COO extract and selenium, exhibiting good entrapment efficiency (87%). The elemental analysis of COO extract and GA-COO-SeNPs confirmed that NPs were obtained. The zebrafish were exposed to a high glucose concentration for two weeks, and type 2 diabetes and oxidative stress responses were induced. In diabetic zebrafish, treatment with NPs showed antilipidemic and hypoglycemic effects, high survivability, and reduced levels of glucose, reactive oxygen species (ROS), and lipids in the blood. This group this had a higher survivorship rate than the diabetic control. The results demonstrated that GA-Se-COO-NPs have high antidiabetic potential, most likely because of the synergic effects of phenolic compounds and Se nanoparticles.

Cinnamon could improve hepatic steatosis caused by a high-fat diet via enhancing hepatic beta-oxidation and inhibiting hepatic lipogenesis, oxidative damage, and inflammation in male rats

Obesity is a health and medical problem and is known as the accumulation of fat that increases the risk of cardiovascular, type 2 diabetes mellitus, and infertility. Cinnamon is a spice that is used mainly as a flavoring additive and folk remedies to treat diabetes. Molecular mechanisms of its effects on hepatic lipogenesis and beta-oxidation, inflammation, and oxidative damage are not fully understood. Therefore, the aim of this study was to evaluate the protective and therapeutic effect of different doses of cinnamon in obese male rats. Forty-eight adult male Wister rats were randomly assigned into eight controlled and treated groups. Serum levels of lipid, glucose, and insulin profiles were measured along with liver levels of antioxidant enzymes, MDA and TNF-α. Hepatic expression of genes involved in beta-oxidation, lipogenesis, oxidative stress, and inflammation was also evaluated. Hepatic levels of oxidative and inflammatory biomarkers and serum levels of glucose, liver enzymes, insulin, and lipid profiles increased significantly in obese rats. Moreover, hepatic expression of SREBP-1c and NF-κB increased, and PPAR-alpha, CD36, FAS, CPT-1, and Nrf-2 decreased in obese rats. However, pretreatment and treatment with different doses of cinnamon in obese rats could significantly ameliorate them in obese rats. It can be concluded that cinnamon could improve hepatic steatosis caused by a high-fat diet via enhancing hepatic beta-oxidation and inhibiting hepatic lipogenesis, oxidative damage, and inflammation in male rats. PRACTICAL APPLICATIONS: Obesity as a medical and psychiatric problem is seen in more than a third of the world's population. Obesity leads to cardiovascular disease, diabetes, and in some cases even death. Cinnamon as a spice and folk remedy has long been used as a treatment for obesity and liver disease. Cinnamon has received a great of attention from the past to the present due to its pharmacological properties and in addition to its availability, cheapness and low side effects. Cinnamon can prevent dyslipidemia, hyperglycemia, oxidative damage, and inflammation by modulating multiple signaling pathways. Our results showed that cinnamon could improve hepatic steatosis caused by HFD via enhancing hepatic beta-oxidation and inhibiting hepatic lipogenesis, oxidative damage, and inflammation. Therefore, it can be recommended that cinnamon and its products can be used as a very suitable option for the production of pharmaceutical supplements for the prevention and treatment of metabolic diseases.

Beneficial effects of cinnamon and its extracts in the management of cardiovascular diseases and diabetes

Cardiovascular diseases (CVDs) and diabetes are the leading causes of death worldwide, which underlines the urgent necessity to develop new pharmacotherapies. Cinnamon has been an eminent component of spice and traditional Chinese medicine for thousands of years. Numerous lines of findings have elucidated that cinnamon has beneficial effects against CVDs in various ways, including endothelium protection, regulation of immune response, lowering blood lipids, antioxidative properties, anti-inflammatory properties, suppression of vascular smooth muscle cell (VSMC) growth and mobilization, repression of platelet activity and thrombosis and inhibition of angiogenesis. Furthermore, emerging evidence has established that cinnamon improves diabetes, a crucial risk factor for CVDs, by enhancing insulin sensitivity and insulin secretion; regulating the enzyme activity involved in glucose; regulating glucose metabolism in the liver, adipose tissue and muscle; ameliorating oxidative stress and inflammation to protect islet cells; and improving diabetes complications. In this review, we summarized the mechanisms by which cinnamon regulates CVDs and diabetes in order to provide a theoretical basis for the further clinical application of cinnamon.

Abdominal obesity and metabolic syndrome in South Asians: prevention and management

INTRODUCTION

The prevalence of metabolic syndrome (MetS) and abdominal obesity are escalating in South Asian countries. It is well established that MetS is associated with increased risk for both Type 2 diabetes mellitus and cardiovascular diseases. South Asians have an increased risk of MetS due to a variety of factors including unhealthy lifestyle and their unique body composition.

AREAS COVERED

In this review, we discuss the prevalence, associated risk factors, and evidence-based preventive and curative strategies for MetS and abdominal obesity in South Asians. A literature search through PubMed®, Web of Science®, and Scopus® was performed for studies published before 31^st April 2021. A combination of the following keywords was used with the names of the individual South Asian countries: 'metabolic syndrome,' 'syndrome X,' 'abdominal obesity,' 'central obesity,' 'visceral obesity,' 'prevention,' and 'management.'

EXPERT OPINION

According to current evidence, MetS and abdominal obesity are highly prevalent among South Asians. Several risk factors, such as lifestyle, socio-demography, cultural, and body composition, are associated with MetS. Limited research shows culturally tailored lifestyle interventions are effective in preventing and managing MetS and abdominal obesity among South Asians.

What is the influence of cinnamon supplementation on liver enzymes? A systematic review and meta-analysis of randomized controlled trials

Existing evidence has uncovered the potential health benefits of cinnamon intake; however, its effect on liver function is unclear. Thus, the aim of this systematic review and meta-analysis was to examine the effect of cinnamon supplementation on liver enzymes. Relevant articles were identified through a systematic search in PubMed/Medline, Scopus, Web of Science, Cochrane Library, and Embase up to September 2020. All trials assessing the effect of oral cinnamon supplementation on serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) in adults were included. The pooled effect sizes were obtained using the random-effects model and expressed as mean difference (MD) and 95% confidence intervals (CI). A total of seven original trials (nine treatment arms) involving a total of 256 subjects were included in the final analysis. The pooled analysis indicated that cinnamon supplementation had no significant effect on serum levels of ALT, AST, and ALP. However, there was a significant reduction in ALT levels in patients with type 2 diabetes (MD: -4.01 U/L; 95% CI: -6.86, -1.15) and in trials with low-dose supplementation (<1,500 mg/d), follow-up duration longer than 12 weeks, and in the elderly patients (aged>50 years). The beneficial effects of cinnamon intake were also shown in AST levels in patients with type 2 diabetes and trials with long-term follow-up (>12 weeks). Longer-term, oral cinnamon supplementation may improve serum levels of liver enzymes in patients with type 2 diabetes. Further high-quality studies are needed, especially in populations with abnormal liver enzyme levels, to firmly establish the clinical efficacy of cinnamon on liver function.

Cinnamomum Species: Bridging Phytochemistry Knowledge, Pharmacological Properties and Toxicological Safety for Health Benefits

The genus Cinnamomum includes a number of plant species largely used as food, food additives and spices for a long time. Different traditional healing systems have used these plants as herbal remedies to cure diverse ailments. The aim of this comprehensive and updated review is to summarize the biodiversity of the genus Cinnamomum, its bioactive compounds, the mechanisms that underlie the pharmacological activities and molecular targets and toxicological safety. All the data in this review have been collected from databases and recent scientific literature including Web of Science, PubMed, ScienceDirect etc. The results showed that the bioactive compounds of Cinnamomum species possess antimicrobial, antidiabetic, antioxidant, anti-inflammatory, anticancer and neuroprotective effects. The preclinical (in vitro/in vivo) studies provided the possible molecular mechanisms of these action. As a novelty, recent clinical studies and toxicological data described in this paper support and confirm the pharmacological importance of the genus Cinnamomum. In conclusion, the obtained results from preclinical studies and clinical trials, as well as reduced side effects provide insights into future research of new drugs based on extracts and bioactive compounds from Cinnamomum plants.

Medicinal Plants and Bioactive Compounds for Diabetes Management: Important Advances in Drug Discovery

BACKGROUND

Diabetes is a major public health problem in the world. It affects each and every part of the human body and also leads to organ failure. Hence, great progress is made in the field of herbal medicine and diabetic research.

OBJECTIVES

Our review will focus on the effect of bioactive compounds of medicinal plants which are used to treat diabetes in India and other countries.

METHODS

Information regarding diabetes, oxidative stress, medicinal plants and bioactive compounds was collected from different search engines like Science direct, Springer, Wiley online library, Taylor and francis, Bentham Science, Pubmed and Google scholar. Data was analyzed and summarized in the review.

RESULTS

Anti-diabetic drugs that are in use have many side effects on vital organs like heart, liver, kidney and brain. There is an urgent need for alternative medicine to treat diabetes and their disorders. In India and other countries, herbal medicine was used to treat diabetes. Many herbal plants have antidiabetic effects. The plants like ginger, phyllanthus, gymnea, aswagandha, aloe, hibiscus and curcuma showed significant anti-hyperglycemic activities in experimental models and humans. The bioactive compounds like Allicin, azadirachtin, cajanin, curcumin, querceitin, gingerol possess anti-diabetic, antioxidant and other pharmacological properties. This review focuses on the role of bioactive compounds of medicinal plants in the prevention and management of diabetes.

CONCLUSION

Moreover, our review suggests that bioactive compounds have the therapeutic potential against diabetes. However, further in vitro and in vivo studies are needed to validate these findings.

The beneficial effects of cinnamon among patients with metabolic diseases: A systematic review and dose-response meta-analysis of randomized-controlled trials

This systematic review and meta-analysis aims to summarize and conclude the clinical evidence regarding the use of cinnamon among patients with metabolic diseases. A comprehensive literature search without any limitation on language was conducted using the following bibliographical databases: ISI Web of Science, Embase, Scopus, PubMed, and Google Scholar. Search was conducted up to 23 January 2020. A total of 35 clinical trials were included for final analysis. Pooling of results showed a significant reducing effect of cinnamon on total cholesterol (TC) (weighted mean difference (WMD) = -11.67 mg/dL; P = 0.010), triglyceride (TG) (WMD = -16.27 mg/dL; P < 0.001), low density lipoprotein-cholesterol (LDL-C) (WMD = -6.36 mg/dL; P < 0.001), serum glucose (WMD = -11.39 mg/dL; P < 0.001), serum insulin (WMD = -1.27 μIU/mL; P = 0.028), and waist circumstance (WC) (WMD = -1.68 cm; P = 0.016). These lowering effects on TG, TC, LDL-C, and serum glucose levels were robust in studies that used cinnamon supplementation dose ≤1.5 g. Also, our findings of the present meta-analysis showed that cinnamon supplementation could have favorable effects on high density lipoprotein-cholesterol (HDL-C, WMD = 1.35; P = 0.038) as well as systolic (WMD = -3.95 mmHg; P = 0.018) and diastolic (WMD = -3.36; P = 0.001) blood pressure among patients with metabolic diseases. The present meta-analysis suggests that cinnamon might exert beneficial effects on various cardiometabolic risk factors among patients with metabolic diseases.

Acute Effects of Cinnamon Spice on Post-prandial Glucose and Insulin in Normal Weight and Overweight/Obese Subjects: A Pilot Study

Clinical studies and meta-analyses have supported the notion that consuming cinnamon spice long term can have beneficial effects in individuals with normal glucose homeostasis and varying degrees of glucose intolerance including type 2 diabetes. The objective of this study was to evaluate the acute effect of cinnamon on the post-prandial responses to a typical American breakfast in normal and overweight/obese participants (ClinicalTrials.gov registration No. NCT04686552). The consumption of a single dose of 6 g of cinnamon added to oatmeal prepared with milk resulted in a significant reduction of one of our primary outcomes post-prandial insulin response (niAUC_0−180min) in overweight/obese participants compared to control consuming breakfast without cinnamon. We also performed exploratory analysis of secondary outcomes. In normal weight participants, we observed a decrease of post-prandial glucagon response (niAUC_0−180min and glucagon levels at 60–120 min) and C-peptide response (30 min) comparing breakfast with to without cinnamon. Cinnamon consumption did not change post-prandial glycemic response in normal weight participants, but increased 60 min post-prandial glucose in overweight/obese participants compared to control. In summary, cinnamon consumption differentially affected post-prandial hormonal responses in normal and overweight/obese participants.

The effect of cinnamon supplementation on glycemic control in women with polycystic ovary syndrome: A systematic review and meta-analysis

Several clinical trials have identified glycemic-lowering effects of cinnamon, while other studies have reported conflicting findings. A comprehensive systematic search on Embase, PubMed, Scopus, Web of Science, and Cochrane Library was conducted using defined keywords in any language through June 2020. Studies that compared the effect of cinnamon with placebo on insulin resistance (IR) indices, as the primary outcome, in women with polycystic ovary syndrome (PCOS) were considered eligible. Standard Mean difference (SMD) (with 95% confidence intervals) for endpoints were calculated using the random-effects model. Finally, five RCTs which met the criteria were included in the meta-analysis. After pooling data, cinnamon supplementation significantly reduced homeostatic model assessment for insulin resistance (HOMA-IR) scores in women with PCOS (SMD: -0.84, 95% CI: -1.52, -0.16, p = .010). Cinnamon supplementation likely improves certain IR markers in patients with PCOS. PRACTICAL APPLICATIONS: There are controversies reports for cinnamon intake, which animal models have suggested that it decreases IR via promotion of insulin action, stimulating insulin signaling pathways, and enhancing insulin sensitivity. This study provides comprehensive information about the effect of cinnamon on insulin resistance (IR) indices in women with PCOS. In this regard, our results indicated that cinnamon supplementation significantly reduced homeostatic model assessment for insulin resistance (HOMA-IR) scores in women with PCOS. Therefore, consumption of cinnamon can be safe and this can be a useful recommendation for improving IR and promotion of healthy life which indeed are the potential or actual uses of this research.

Modulation of the antioxidant defense system in liver, kidney, and pancreas tissues of alloxan-induced diabetic rats by camphor

Excess production of reactive oxygen species and the loss of antioxidant efficiency systems play an important role in the development of diabetes. Thus, using antioxidant compounds is an important strategy to reduce these complications. This study aimed to investigate the possible effect of camphor on the serum biochemical parameters and oxidative parameters in the pancreas, liver, and kidney tissues of alloxan-induced diabetic rats. In this study, 40 male Wistar rats were divided into five groups, including normal group, diabetic group, the diabetic group treated with glibenclamide, the diabetic group treated with 30 mg/kg camphor, and the diabetic group receiving the camphor solvent. Intragastric administration of camphor and glibenclamide, as the control drug, to diabetic rats for 21 days lowered their blood glucose, total cholesterol, triglyceride, and LDL-cholesterol, while the blood high-density lipoprotein -cholesterol level was increased. In addition, our results indicated that treatment of diabetic rats with camphor increased the activity of glutathione peroxidase, catalase, and superoxide dismutase enzymes as well as reduced glutathione content in the liver, pancreas, and kidney tissues as compared to the diabetic rats. Based on our data, it can be concluded that camphor has a hypoglycemic activity, and this effect may be attributed, in part, to its antioxidant ability. PRACTICAL APPLICATIONS: Camphor is a terpenoid natural compound derived from the wood present in the camphor laurel's stem and roots (Cinnamomum camphora L.) trees. The synthetic form of camphor is currently being produced for medical, health, and industrial applications. In addition, this compound is present in Rosmarinus officinalis, Cinnamomum zeylanicum, Salvia officinalis, Artemisia Annua, and Ocimum basilicum. Numerous researches have shown its beneficial effects on various diseases. In this study, it has been shown that camphor possesses antidiabetic effects in alloxan-induced diabetic rats. Treatment of diabetic rats with camphor increased the antioxidant capacity and reduces the oxidative stress markers in the liver, pancreas, and kidney tissues as compared to the diabetic rats. Given the favorable effect of camphor on some oxidative parameters in diabetic rats in our study, its antihyperglycemic property is probably due to its antioxidant effects.

Effects of Cinnamon (Cinnamomum spp.) in Dentistry: A Review

Dental medicine is one of the fields of medicine where the most common pathologies are of bacterial and fungal origins. This review is mainly focused on the antimicrobial effects of cinnamon essential oil (EO), cinnamon extracts, and pure compounds against different oral pathogens and the oral biofilm and the possible effects on soft mouth tissue. Basic information is provided about cinnamon, as is a review of its antimicrobial properties against the most common microorganisms causing dental caries, endodontic and periodontal lesions, and candidiasis. Cinnamon EO, cinnamon extracts, and pure compounds show significant antimicrobial activities against oral pathogens and could be beneficial in caries and periodontal disease prevention, endodontics, and candidiasis treatment.

Analysis of the Efficacy of Cinnamon for Patients with Diabetes Mellitus Type II Based on Traditional Persian Medicine Syndrome Differentiation: A Randomized Controlled Trial

Background: Conflicting results have been obtained from the studies on the hypoglycemic effect of cinnamon in patients with diabetes mellitus type II (T2DM). Objectives: This research aimed at assessing the effect of applying the syndrome differentiation model based on traditional Persian medicine (TPM) to identify the patients who benefit more from cinnamon supplementation. Methods: This study was a randomized, triple-blind, placebo-controlled trial based on a parallel design. One hundred and forty eligible patients referring to the Diabetes Clinic of Yazd University of Medical Sciences, who were diagnosed with T2DM, were randomly divided into the cinnamon and placebo groups. Then, 500-mg capsules of cinnamon bark powder or placebo were administered to them twice a day for three months. All the participants completed a standard questionnaire for syndrome diagnosis in traditional Persian medicine (TPM). Fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), fasting insulin (FI), and insulin resistance (IR), calorie intake, and physical activity were measured before and after the interventions. The glycemic outcomes were analyzed according to the TPM syndrome. Results: There was no statistically significant difference between the patients’ demographic and clinical features in the two groups. Glycemic indices were improved in patients receiving cinnamon supplementation compared to placebo group (-13.1 ± 1.7, -1.7 ± 1.9, P < 0.001 for change in FPG and -0.27 ± 0.039 vs. 0.001 ± 0.019, P < 0.001 for change in HbA1C respectively). All the outcomes were more improved in the patients with wet syndrome compared to dry ones, which was compatible with Persian syndrome differentiation (P < 0.05). Conclusions: Diabetic patients with wet syndrome based on TPM benefit more form cinnamon supplementation.

Selected Indonesian Medicinal Plants for the Management of Metabolic Syndrome: Molecular Basis and Recent Studies

Increased prevalence of metabolic syndrome (MetS) in the world influences quality of health in all respective countries, including Indonesia. Data from Indonesian Family Life Survey reported in 2019 showed that the prevalence of MetS in Indonesia currently is 21.66%, estimated with the provincial incidence ranging up to 50%; additionally, the most common components of MetS discovered in Indonesia were poor high-density lipoprotein (HDL) cholesterol and hypertension. Management treatment of MetS involves a combination of lifestyle changes and pharmacological interventions to decrease cerebrovascular disease. Various natural substances have been shown to govern any cardiovascular or metabolic disorders through different mechanisms, such as triggering anti-inflammation, lipid profile correction, sensitization of insulin reception, or blood glucose control. In Indonesia, the utilization of natural compounds is part of the nation's culture. The community widely uses them; even though in general, their effectiveness and safety have not been thoroughly assessed by rigorous clinical trials. Scientific evidence suggested that cinnamon, mangosteen, and curcumin, as well as their derived components possess a broad spectrum of pharmacological activity. In this review, an enormous potential of cinnamon, mangosteen, and curcumin, which originated and are commonly used in Indonesia, could be treated against MetS, such as diabetes, hyperlipidemia, hypertension, and obesity. The findings suggested that cinnamon, mangosteen, curcumin and their derivatives may reflect areas of promise in the management of MetS.

Comparison of drug efficacy in two animal models of type 2 diabetes: A systematic review and meta-analysis

Previous qualitative research has suggested there are only minor differences between the db/db mouse and the Zucker Diabetic Fatty (ZDF) rat, both animal models of type 2 diabetes. However, it is not known whether these models are also comparable regarding drug response in quantitative terms (effect size). To investigate the extent of these differences, we conducted a systematic review and meta-analysis of approved drugs in these models. We searched on PubMed and Embase on July 3, 2019 for studies including either model, a monotherapy arm with an EMA/FDA approved drug for the treatment of type 2 diabetes, HbA1c assessment and a control group. Studies aimed at diabetes prevention or with surgical interventions were excluded. We calculated the Standardised Mean Difference (SMD) to compare effect sizes (HbA1c reduction) per drug and drug class across models. We included a risk of bias assessment for all included publications. A total of 121 publications met our inclusion criteria. For drugs with more than two comparisons, both models predicted the direction of the effect regarding HbA1c levels. There were no differences between the db/db mouse and ZDF rat, except for exenatide (P = 0.02) and GLP-1 agonists (P = 0.03) in which a larger effect size was calculated in the ZDF rat. Our results indicate the differences between the db/db mouse and ZDF rat are not relevant for preliminary efficacy testing. This methodology can be used to further differentiate between animal models used for the same indication, facilitating the selection of models more likely to predict human response.

Evaluation of relaxant responses properties of cinnamon essential oil and its major component, cinnamaldehyde on human and rat corpus cavernosum

Cinnamomum cassia (Cinnamon) is a well-known traditional medicine with therapeutic benefits for centuries. We evaluated the effects of cinnamon essential oil (CEO) and its main component cinnamaldehyde (CA) on human corpus cavernosum (HCC) and rat CC. The essential oil of cinnamon was analyzed for the confirmation of the oil profile. HCC specimens from patients undergoing penile prosthesis surgery (age 48-69 years) were utilized for functional studies. In addition, erectile responses in anesthetized control and diabetic rats were evaluated in vivo after intracavernosal injection of CEO and CA, and rat CC strips were placed in organ baths. After precontraction with phenylephrine (10μM), relaxant responses to CEO and CA were investigated. CA (96.9%) was found as the major component. The maximum relaxation responses to CEO and CA were 96.4±3.5% and 96.0±5.0% in HCC and 97.5±5.5% and 96.8±4.8% in rat CC, respectively. There was no difference between control and diabetic rats in relaxation responses to CEO and CA. The relaxant responses obtained with essential oil and CA were not attenuated in the presence of nitric oxide synthase (NOS) inhibitor, and soluble guanylate cyclase inhibitor (sGS) in CC. In vivo, erectile responses in diabetic rats were lower than in control rats, which was restored after intracavernosal injection of CEO and CA. CEO and CA improved erectile function and relaxation of isolated strips of rat CC and HCC by a NO/cGMP-independent mechanism. Further investigations are warranted to fully elucidate the restorative effects of CEO and CA on diabetic erectile dysfunction.

In vitro assessment of synergistic combinations of essential oils against Rhipicephalus (Boophilus) microplus (Acari: Ixodidae)

Rhipicephalus (Boophilus) microplus (Acari: Ixodidae), is one of the most important ectoparasite of cattle, responsible for causing severe economic losses in the tropical and subtropical regions of the world. The development of resistance to most of the commonly used chemical acaricides has stimulated the search for new herbal products as an eco-friendly tick control alternative. The aim of the present study was to evaluate the in vitro acaricidal activity of essential oils (EOs) of cloves (Syzygium aromaticum), bark of cinnamon (Cinnamomum zeylanicum) and leaves of lemon grass (Cymbopogon citratus) against unfed larvae of R. (B.)microplus by larval packet test. Also, various combinations were prepared by mixing of equal concentrations of any two and all three EOs and used to study the effects of interactions of mixtures against larvae of R. (B.) microplus. The lethal concentrations at 50% (LC₅₀), 90% (LC₉₀) and 99% (LC₉₉) with 95% confidence limits (CL) were estimated by Probit analysis using PoloPlus. The computer software, CompuSyn, was used for determining the effects of interactions (synergistic, additive or antagonistic) of EO mixtures by calculation of Combination index (CI) and Dose-reduction index (DRI). Among the individual and mixture of two EOs, cinnamon EO and cinnamon EO + lemon grass EO combination showed highest acaricidal activity against R. (B.) microplus larvae. Further, the combination of cinnamon EO + lemon grass EO showed high synergism with CI value of 0.381, followed by cinnamon EO + clove EO showing moderate synergism whereas, clove EO + lemon grass EO showed only additive effect, with favorable dose reduction for each constituent drug in all three combinations. The combination of all three EOs (1:1:1) showed high synergism (CI value of 0.376) and favorable dose reduction (DRI index of 8.19, 25.64 and 4.64 for clove, cinnamon and lemon grass EOs, respectively) against R. (B.) microplus larvae.

Maternal cinnamon intake during lactation led to visceral obesity and hepatic metabolic dysfunction in the adult male offspring

PURPOSE

Studies with foods, known to promote health benefits in addition to the nutritive value, show that their consumption by pregnant and/or lactating females could induce negative outcomes to the offspring. It is well characterized that cinnamon intake promotes benefits to energy homeostasis. The present study aimed to analyze the effects of the consumption of an aqueous extract of cinnamon by lactating female rats on the endocrine-metabolic outcomes in the adult offspring.

METHODS

Lactating dams (Wistar rats) were supplemented with cinnamon aqueous extract (400 mg/kg body weight/day) for the entire lactating period. The male adult offspring were evaluated at 180 days old (CinLac).

RESULTS

The offspring presented visceral obesity (P = 0.001), hyperleptinemia (P = 0.002), and hyperinsulinemia (P = 0.016). In the liver, CinLac exhibited reduced p-IRβ (P = 0.018) suggesting insulin resistance. However, phosphorylation of IRS1 (P = 0.041) and AKT (P = 0.050) were increased. JAK2 (P = 0.030) and p-STAT3 (P = 0.015) expressions were higher, suggesting that the activation of IRS1/AKT in the CinLac group could have resulted from the increased activation of leptin signaling. Although we observed no changes in the gluconeogenic pathway, the CinLac group exhibited lower hepatic glycogen content (P = 0.005) accompanied by increased p-GSK3β (P = 0.011). In addition, the CinLac group showed increased hepatic triacylglycerol content (P = 0.049) and a mild steatosis (P = 0.001), accompanied by reduced PPARα mRNA expression (P = 0.005).

CONCLUSION

We conclude that maternal intake of aqueous extract of cinnamon induces long-term molecular, metabolic, and hormonal changes in the adult progeny, including visceral obesity, higher lipid accumulation, and lower glycogen content in the liver.

Cinnamon supplementation positively affects obesity: A systematic review and dose-response meta-analysis of randomized controlled trials

BACKGROUND & AIMS

Data about the effects of cinnamon supplementation on obesity measures are conflicting. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effects of cinnamon intake on body weight (BW), Body Mass Index (BMI), Waist Circumference (WC), and fat mass (FM) in adults.

METHODS

Online electronic search engines including PubMed, SCOPUS, Cochrane Library, and Google Scholar were searched to find pertinent articles until September 2018. Data were pooled using the random-effects method and were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). The non-linear association was assessed using fractional polynomial modeling.

RESULTS

Out of 679 records, 12 trials that enrolled 786 subjects were included. The pooled results showed that cinnamon administration significantly decreased BW (WMD: -1.02 kg, 95% CI: -1.66 to -0.38, P = 0.002), BMI (WMD: -0.51 kg/m², 95% CI: -0.74, -0.28, P < 0.001), WC (WMD: -2.40 cm, 95% CI: -4.48, -0.33, P = 0.02), and FM (WMD: -1.02%, 95% CI: -1.80, -0.24, P = 0.01). Greater effects on BW were observed in subjects aged <50 years old and those with a baseline BMI of ≥30 kg/m². The cinnamon administrations significantly reduced FM at the dosages of ≥2 g/d, when administered for ≥12 weeks. Cinnamon administration resulted in BW and WC reduction in non-linear fashion (P = 0.04).

CONCLUSIONS

Cinnamon supplementation significantly affects obesity measures. It could be recommended as a weight-reducing supplement in obesity management.

Antibacterial Activities of Herbal Toothpastes Combined with Essential Oils against Streptococcus mutans

In recent years, people have become more conscious about the side-effects of fluoride toothpastes and herbal products have drawn attention as alternatives in the struggle against caries. Studies have focused on the benefits of essential oils obtained from herbs because of their antibacterial effects. The aim of this study was to evaluate and compare the antibacterial activity of Origanum dubium and Cinnamomum cassia oils combined with herbal toothpastes against Streptococcus mutans. The antibacterial activity of the test materials was determined using the agar well diffusion method before and after the addition of essential oils. We tested the efficacy of Splat Organic and Splat Biocalcium against S. mutans (12 mm and 11 mm, respectively) doubled in combination with Origanum dubium (23 mm for both toothpastes) and tripled with Cinnamomum cassia (38 mm and 36 mm, respectively). Jack N’ Jill toothpaste, which did not initially show any antibacterial effect, exhibited the largest inhibition zones after the addition of the essential oils (38 mm for Origanum dubium and 39 mm for Cinnamomum cassia). The results of this study pointed out that herbal toothpastes exhibit statistically higher antibacterial activity against Streptococcus mutans (p < 0.05) than their initial forms after the addition of essential oils.

Protective effects of Cinnamomum zeylanicum L. (Darchini) in acetaminophen-induced oxidative stress, hepatotoxicity and nephrotoxicity in mouse model

Cinnamomum zeylanicum, a widely used spice and flavor, is used in the treatment and prevention of many diseases. In the current study, Balb/c mice were pretreated with cinnamon bark aqueous extract (200 mg/kg/day i.g.) 14 days prior to intragastrically administer single toxic dose of acetaminophen (200 mg/kg). Blood samples were collected for analysis of biochemical and oxidative stress parameters and liver and kidney samples were collected for histopathological analysis. The results indicate that cinnamon aqueous extract exhibit a highly significant preventive potential by ameliorating APAP-induced elevated levels of serum alanine aminotransferase, aspartate aminotransferase, creatinine, urea and macroscopic and histological alterations in liver and kidney. Moreover, significant increase in total oxidant status and decrease in total antioxidant capacity accompanied by APAP exposure, were restored by cinnamon pretreatment. We found that prior administration of cinnamon prevented the toxic changes induced by acetaminophen as confirmed by histopathological examination, more possibly owing to its antioxidant potential. In conclusion, the pretreatment with cinnamon provide potential therapeutic applications in acute liver and kidney injury induced by APAP in experimental animal model and it could have therapeutic potential in oxidative stress associated diseases.