Inhibition of Bone Loss by Cissus quadrangularis in Mice: A Preliminary Report

Self Emulsifying Delivery System of Cissus quadrangularis: Evidence of Enhanced Efficacy and Promising Pharmacokinetic Profile in the Management of Osteoporosis

Treatment therapies used to manage osteoporosis are associated with severe side effects. So worldwide herbs are widely studied to develop alternative safe & effective treatments. Cissus quadrangularis (CQ) has a significant role in bone health and fracture healing. It is documented that its extracts increase osteoblastic differentiation & mineralization. Currently, Cissus quadrangularis is available in the form of tablets in the market for oral delivery. But these conventional forms are associated with poor bioavailability. There is a need for a novel drug delivery system with improving oral bioavailability. Therefore, a Cissus quadrangularis-loaded self-emulsifying drug delivery system (CQ-SEDDS) was developed which disperses rapidly in the gastrointestinal fluids, yielding nano-emulsions containing a solubilized drug. This solubilized form of the drug can be easily absorbed through lymphatic pathways and bypass the hepatic first-pass effect. The emulsification efficiency, zeta potential, globule size, in-vitro dissolution, ex-vivo, in-vivo and bone marker studies were performed to assess the absorption and permeation potential of CQ incorporated in SEDDS. CQ-SEDDS with excipients Tween 80, Cremophor RH40, Transcutol HP & α-Tocopherol acetate had shown about 76% enhancement in the bioavailability of active constituents of CQ. This study provided the pre-clinical data of CQ-SEDDS using osteoporotic rat model studies.

Potential use of barks of woody vascular plants in bone mending: A review

The use of synthetic drugs to overcome bone ailments causes severe side effects, but the application of herbals is helpful in maintaining bone health and accelerating bone mending. Currently, there is no oral allopathic medicine to hasten bone healing, though folk and traditional practices have adopted herbal to fasten the recovery from bone ailments. Earliest recovery is a universally desired phenomenon, especially for elderly people where many more cases of traumatic injuries are common along the compromised body immunity. The computerized database search engines, such as Google Scholar, PubMed, ScienceDirect, Springer Link, etc., and textbooks were used to collect all relevant information about barks for bone mending activity published from 1990 onwards using certain keywords such as bark, folklore/ traditional bone healing practices, and phytopharmacology. The results obtained were compiled to make this review and related information is tabulated herewith. Traditional herbal bone healing exists in every society in the world. The plant barks of a few species (e.g., Ficus religiosa, Prunus cerasoides, Terminalia arjuna, etc.) have outstanding significance for bone healing because of their special chemical composition and novel properties to reduce swelling, pain, soreness, and speedy recovery of functions. Mostly bark extracts are rich in polyphenols, and minerals, represented with antioxidant, immunostimulatory, antibacterial properties, etc. There is a diversity of bark utilization for bone healing from different plant species, globally, of which only a few have been phytopharmacologically deciphered. Validated bark ingredients as medicine or food supplements are more useful due to the least side effects. Entrepreneurs have a scope to use bioactive obtained from plant barks that have not been scientifically screened till now. The research focused on the commercial application of plant barks as green medicine needs fingerprints of bioactive and clinically validated data including the concentration of biomarkers in the blood (IC50) for reducing the healing period. Phytopharmacological screening of barks used in folk medicine and synthesizing the therapeutics at mega quantities in industries is an array of hopes for sustainable utilization of natural resources. The bio-stimulating knowledge of certain herbal ingredients will be helpful in the development of synergistic formulations for rapid bone mending.

Fine-tuning osteoclastogenesis: An insight into the cellular and molecular regulation of osteoclastogenesis

Osteoclasts, the bone-resorbing cells, are essential for the bone remodeling process and are involved in the pathophysiology of several bone-related diseases. The extensive corpus of in vitro research and crucial mouse model studies in the 1990s demonstrated the key roles of monocyte/macrophage colony-stimulating factor, receptor activator of nuclear factor kappa B ligand (RANKL) and integrin αvβ3 in osteoclast biology. Our knowledge of the molecular mechanisms by which these variables control osteoclast differentiation and function has significantly advanced in the first decade of this century. Recent developments have revealed a number of novel insights into the fundamental mechanisms governing the differentiation and functional activity of osteoclasts; however, these mechanisms have not yet been adequately documented. Thus, in the present review, we discuss various regulatory factors including local and hormonal factors, innate as well as adaptive immune cells, noncoding RNAs (ncRNAs), etc., in the molecular regulation of the intricate and tightly regulated process of osteoclastogenesis. ncRNAs have a critical role as epigenetic controllers of osteoclast physiologic activities, including differentiation and bone resorption. The primary ncRNAs, which include micro-RNAs, circular RNAs, and long noncoding RNAs, form a complex network that affects gene transcription activities associated with osteoclast biological activity. Greater knowledge of the involvement of ncRNAs in osteoclast biological activities will contribute to the treatment and management of several skeletal diseases such as osteoporosis, osteoarthritis, rheumatoid arthritis, etc. Moreover, we further outline potential therapies targeting these regulatory pathways of osteoclastogenesis in distinct bone pathologies.

Understanding the mechanistic potential of plant based phytochemicals in management of postmenopausal osteoporosis

Postmenopausal osteoporosis, an epidemic disorder is defined as a loss in bone mineral density and a greater possibility of fractures in older women. It is a multifactorial disease under the control of various genetic, hormonal, and environmental factors. Insufficiency of estrogen hormone, leads to postmenopausal osteoporosis. Hormone replacement therapy (HRT), despite being the most effective treatment, it is associated with the risk of breast cancer and cardiovascular disorders. This review seeks to compile the most recent information on medicinal plants and natural compounds used to treat and prevent postmenopausal osteoporosis. Furthermore, the origin, chemical constituents and the molecular mechanisms responsible for this therapeutic and preventive effect are also discussed. Literature research was conducted using PubMed, Science direct, Scopus, Web of Science, and Google Scholar. Different plant extracts and pure compounds exerts their antiosteoporotic activity by inhibition of RANKL and upregulation of OPG. RANKL signaling regulates osteoclast formation, characterized by increased bone turnover and osteoprotegrin is a decoy receptor for RANKL thereby preventing bone loss from excessive resorption. In addition, this review also includes the chemical structure of bioactive compounds acting on NFκB, TNF α, RUNX2. In conclusion, we propose that postmenopausal osteoporosis could be prevented or treated with herbal products.

Depletion of β-sitosterol and enrichment of quercetin and rutin in Cissus quadrangularis Linn fraction enhanced osteogenic but reduced osteoclastogenic marker expression

Background

Cissus quadrangularis Linn. (CQ) has been used in Indian and Thai traditional medicine for healing bone fractures because of numerous active ingredients in CQ. It is still unclear which compounds are the active ingredients for bone formation.

Methods

The molecular docking technique, the ethanolic extraction along with hexane fractionation, and an in vitro experiment with a human osteoblast cell line (MG-63) were used to narrow down the active compounds, to prepare the CQ extract, and to test biological activities, respectively.

Results

The molecular docking technique revealed that quercetin and β-sitosterol had highest and lowest potential to bind to estrogen receptors, respectively. Compared to the crude ethanol extract (P1), the ethanolic fraction (P2) was enriched with rutin and quercetin at 65.36 ± 0.75 and 1.06 ± 0.12 mg/g, respectively. Alkaline phosphatase (ALP) activity was significantly enhanced in osteoblasts exposed to the P2 in both tested concentrations. The amount of hydroxyproline was slightly increased in the P1 treatment, while osteocalcin was inhibited. Moreover, the P2 significantly activated osteoprotegerin (OPG) and inhibited receptor activator of nuclear factor κ ligand (RANKL) expression.

Conclusions

Taken together, the enriched rutin and quercetin fraction of CQ triggered the molecules involved in bone formation and the molecules inhibiting bone resorption.

Modulation of bone turnover by Cissus quadrangularis after ovariectomy in rats

In women, age-related bone loss is associated with increased risk of bone fracture. Existing therapies are associated with severe side effects; thus, there is a need to find alternative medicines with less or optimal side effects. Cissus quadrangularis (CQ), an Ayurvedic medicine used to enhance fracture healing, was tested for its bone protective properties and studied to discern the mechanism by which it is beneficial to bone. Female Sprague Dawley rats were either sham operated or ovariectomized and were fed CQ for 3 months. Several biochemical markers, cytokines and hormones were assayed. Femur, tibia and lumbar vertebrae were subjected to pQCT and µCT densitometry. MC3T3 cells were cultured, treated with CQ and used to analyze miRNA content and subjected to qPCR for gene expression analysis related to bone metabolism. CQO rats showed protected bone mass and microarchitecture of trabecular bone in the distal femoral metaphysis and the proximal tibial metaphysis. The lumbar vertebrae, however, showed no significant changes. Serum protein expression levels of P1NP increased and Trap5b and CTX levels decreased with in vivo CQ treatment. Some influence on the anti- and pro-inflammatory markers was also observed. Significantly high level of estradiol in the CQO rats was observed. In vitro expression of a few genes related to bone metabolism showed that osteocalcin increased significantly. The other genes-collagen I expression, SPP1, BMP2, DCAT1-decreased significantly. Certain miRNA that regulate bone turnover using the BMP pathway and Wnt signaling pathways were upregulated by CQ. qPCR after acute treatment with CQ showed significantly increased levels of osteocalcin and decreased levels of Wnt/β catenin antagonist DCAT1. Overall, CQ protected the microarchitecture of the long bones from ovariectomy-induced bone loss. This may be because of decreased inflammation and modulation through the BMP and Wnt signaling pathways. We conclude that CQ is a potential therapeutic agent to treat postmenopausal osteoporosis with no side effects.

Ethyl acetate and n-butanol fraction of Cissus quadrangularis promotes the mineralization potential of murine pre-osteoblast cell line MC3T3-E1 (sub-clone 4)

In a sequel to investigate osteogenic potential of ethanolic extract of Cissus quadrangularis (CQ), the present study reports the osteoblast differentiation and mineralization potential of ethyl acetate (CQ-EA) and butanol (CQ-B) extracts of CQ on mouse pre-osteoblast cell line MC3T3-E1 (sub-clone 4) with an objective to isolate an antiosteoporotic compound. Growth curve, proliferation, and viability assays showed that both the extracts were nontoxic to the cells even at high concentration (100 µg/ml). The cell proliferation was enhanced at low concentrations (0.1 µg/ml and 1 µg/ml) of both the extracts. They also upregulated the osteoblast differentiation and mineralization processes in MC3T3-E1 cells as reflected by expression profile of osteoblast marker genes such as RUNX2, Osterix, Collagen (COL1A1), Alkaline Phosphatase (ALP), Integrin-related Bone Sialoprotein (IBSP), Osteopontin (OPN), and Osteocalcin (OCN). CQ-EA treatment resulted in early differentiation and mineralization as compared with the CQ-B treatment. These findings suggest that low concentrations of CQ-EA and CQ-B have proliferative and osteogenic properties. CQ-EA, however, is more potent osteogenic than CQ-B.

Novel phytochemical Cissus quadrangularis extract–loaded chitosan/Na-carboxymethyl cellulose–based scaffolds for bone regeneration

Medicinal plants are attracting considerable interest as a potential therapeutic agent for bone tissue regeneration. Cissus quadrangularis L. is also a medicinal plant known with its osteogenic activity. In this study, a phytochemical scaffold was produced by incorporating Cissus quadrangularis with chitosan/Na-carboxymethyl cellulose blend by lyophilization technique. The effect of Cissus quadrangularis loading on the mechanical, morphological, chemical, and degradation properties as well as in vitro cytotoxicity, cell proliferation, and differentiation of the composites was investigated. Scanning electron microscopy images showed that porous Cissus quadrangularis–loaded scaffolds were obtained with an average pore size of 148–209 µm which is appropriate for bone regeneration. Cissus quadrangularis incorporation enhanced the compression modulus of scaffolds from 76 to 654 kPa. In vitro cell culture results indicated that Cissus quadrangularis/chitosan/Na-carboxymethyl cellulose scaffolds provided a favorable substrate for the osteoblast adhesion, proliferation, and mineralization. Results supported the osteoinductive property of the Cissus quadrangularis extract–incorporated scaffolds even without osteogenic media supplement. Cissus quadrangularis extract increased the alkaline phosphatase activity of the SaOS-2 cells on scaffolds on 7th and 14th days of incubation. The investigation of characterization and cell culture studies suggest that Cissus quadrangularis–loaded osteoinductive Cissus quadrangularis/chitosan/Na-carboxymethyl cellulose scaffold can serve as a potential biomaterial for bone tissue engineering applications.

Cinnamomum burmanini Blume increases bone turnover marker and induces tibia's granule formation in ovariectomized rats

Background

Bone fragility and an increase in susceptibility to fracture osteoporosis is characterized by a reduction in bone mass and the micro-architectural deterioration of bone tissue. There is no previous study regarding the effect of Cinnamomum burmanini Blume on osteoporosis.

Objective

This study was aimed to investigate the effect of C. burmanini Blume on bone turnover marker, mineral elements, and mesostructure of ovariectomized rats.

Materials and methods

Thirty female Wistar rats were randomly divided into five groups, which included a control group (sham surgery), ovariectomy group (OVX), and ovariectomy groups in the presence of ethanolic extract of C. burmanini Blume (EECB) at doses of 12.5; 25; 50 mg/kg body weight (BW). Analysis of serum C-telopeptide collagen type I (CTX) and osteocalcin (OC) were done by enzyme-linked immunosorbent assay (ELISA). Tibia mineral elements and mesostructure were analyzed by X-ray Fluorescence and Scanning Electron Microscopy, respectively. In silico study was performed by modeling protein structure using SWISS-MODEL server and Ramachandran plot analysis.

Results

The increase in OC and CTX were significantly attenuated by treatments of EECB. Ovariectomy significantly decreased Cu/Zn ratio compared to sham-operated rats (p < 0.05). Mesostructure of ovariectomized rats was significantly different compared with the control group.

Conclusion

Cinnamon was able to normalize bone turnover markers, but, the mesostructure of hydroxyapatite crystal growth was achieved at the highest dose extract. In silico study showed that the active compound of EECB could not only support osteoclastogenesis process by decreasing the binding energy between RANKL and RANK, but also by inhibiting the interaction between OPG and RANK.

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Administration EECB significantly increased OC and CTX level compared to OVX group.

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The ratio of Cu/Zn was lower significantly in OVX rats compared to sham-operated rats.

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Hydroxyapatite crystal growth can reach at the highest dose of Cinnamon.

The inhibitory activity of herbal medicines on the keys enzymes and steps related to carbohydrate and lipid digestion

BACKGROUND

Obesity and overweight are consistently associated with metabolic disorders including hyperglycemia and hyperlipidemia. Herbal medicines have been currently suggested as an alternative source of potentially useful antihyperglycemic, antihyperlipidemic, antioxidant activities. The objective of this study was to assess the in vitro inhibitory effects of eleven herbal medicines on carbohydrate and lipid digestive enzymes and the key steps of lipid digestion including the inhibition of micelle formation and the ability to bind bile acid. In addition, antioxidant activity of herbal medicines was also investigated.

METHODS

α-Glucosidase, pancreatic α-amylase, pancreatic lipase, and pancreatic cholesterol esterase inhibitory activities of aqueous extract of herbal medicines were measured using the enzymatic colorimetric assay. The formation of cholesterol micelles was determined using the cholesterol assay kit. The bile acid binding was measured using the colorimetric assay. Antioxidant activities were assessed by using four methods including Trolox equivalent antioxidant capacity (TEAC), oxygen radical absorbance capacity ORAC), superoxide radical scavenging activity (SRSA), and hydroxyl radical scavenging activity (HRSA).

RESULTS

The extracts (1 mg/mL) markedly inhibited intestinal maltase (5.16 - 44.33 %), sucrase (1.25-45.86 %), pancreatic α-amylase (1.75-12.53 %), pancreatic lipase (21.42-85.93 %), and pancreatic cholesterol esterase (2.92-53.35 %). The results showed that all extracts exhibited the inhibitory activity against pancreatic lipase with the IC₅₀ values ranging from 0.015 to 4.259 mg/mL. In addition, the incorporation of cholesterol into micelles was inhibited by the extracts (6.64-33.74 %). The extracts also bound glycodeoxycholic acid (9.9-15.08 %), taurodeoxycholic acid (12.55-18.18 %), and taurocholic acid (11.91 - 18.4 %). Furthermore, the extracts possessed various antioxidant activities including the TEAC values (0.50 - 4.70 μmol trolox/mg dried extract), the ORAC values (9.14-44.41 μmol trolox/mg dried extract), the SRSA (0.31 - 18.82 mg trolox/mg dried extract), and the HRSA (0.05-2.29 mg trolox/mg dried extract). The findings indicated that Syzygium aromaticum, Phyllanthus amarus, Thunbergia laurifolia were the effective promising antihyperglycemic and antihyperlipidemic agents. Statistical analysis demonstrated strong positive significant correlations between the contents of phenolic compounds and % inhibition of pancreatic lipase (r = 0.885, p < 0.001), % inhibition of pancreatic cholesterol esterase (r = 0.761, p < 0.001), and the TEAC value (r = 0.840, p < 0.001). Furthermore, there was a strongly positive correlation between the TEAC value and % inhibition of pancreatic cholesterol esterase (r = 0.851, p < 0.001) and % inhibition of pancreatic lipase (r = 0.755, p < 0.001).

CONCLUSIONS

Three herbal medicines including Syzygium aromaticum, Thunbergia laurifolia, and Phyllanthus amarus markedly inhibited the intestinal α-glucosidase, pancreatic α-amylase, pancreatic lipase, and pancreatic cholesterol esterase. They also reduced formation of cholesterol micelle and bound bile acid. The findings indicate that these herbal medicines might be a promising agent for antihyperglycemic, antihyperlipidemic, and antioxidant activities.

Beneficial Effect of Cissus quadrangularis Linn. on Osteopenia Associated with Streptozotocin-Induced Type 1 Diabetes Mellitus in Male Wistar Rats

Petroleum ether fraction of Cissus quadrangularis (PECQ) impact on the development of osteopenia in type 1 diabetic rat model has been evaluated. Diabetic rats were treated orally with two doses of PECQ. Another group of diabetic rats were treated with subcutaneous injection of synthetic human insulin. The cortical and trabecular bone thickness and bone strength were significantly decreased in diabetic rats. Treatment with two doses of PECQ significantly prevented these changes in diabetic rats. However, PECQ treatment (two doses) did not alter the glycemic levels in these diabetic rats. Increased levels of serum alkaline phosphatase (ALP), tartrate-resistant acid phosphatase (TRAP), and hydroxyproline were noted in diabetic rats when compared to normal control rats. The two doses of PECQ treatment further improved the serum ALP levels and significantly decreased the serum levels of TRAP and hydroxyproline. The effects of PECQ treatment on histological, biomechanical, and biochemical parameters are comparable to those of insulin. Since PECQ improves the bone health in hyperglycemic conditions by enhancing the cortical and trabecular bone growth and altering the circulating bone markers, it could be used as an effective therapy against diabetes-associated bone disorders.

Pomegranate seed oil prevents bone loss in a mice model of osteoporosis, through osteoblastic stimulation, osteoclastic inhibition and decreased inflammatory status

In the current context of longer life expectancy, the prevalence of osteoporosis is increasingly important. This is why development of new strategies of prevention is highly suitable. Pomegranate seed oil (PSO) and its major component, punicic acid (a conjugated linolenic acid), have potent anti-inflammatory and anti-oxidative properties both in vitro and in vivo, two processes strongly involved in osteoporosis establishment. In this study, we demonstrated that PSO consumption (5% of the diet) improved significantly bone mineral density (240.24±11.85 vs. 203.04±34.19 mg/cm(3)) and prevented trabecular microarchitecture impairment in ovariectomized (OVX) mice C57BL/6J, compared to OVX control animals. Those findings are associated with transcriptional changes in bone tissue, suggesting involvement of both osteoclastogenesis inhibition and osteoblastogenesis improvement. In addition, thanks to an ex vivo experiment, we provided evidence that serum from mice fed PSO (5% by gavage) had the ability to significantly down-regulate the expression of specific osteoclast differentiation markers and RANK-RANKL downstream signaling targets in osteoclast-like cells (RAW264.7) (RANK: negative 0.49-fold vs. control conditions). Moreover, in osteoblast-like cells (MC3T3-E1), it elicited significant increase in alkaline phosphatase activity (+159% at day 7), matrix mineralization (+271% on day 21) and transcriptional levels of major osteoblast lineage markers involving the Wnt/β-catenin signaling pathways. Our data also reveal that PSO inhibited pro-inflammatory factors expression while stimulating anti-inflammatory ones. These results demonstrate that PSO is highly relevant regarding osteoporosis. Indeed, it offers promising alternatives in the design of new strategies in nutritional management of age-related bone complications.

Dietary coral calcium and zeolite protects bone in a mouse model for postmenopausal bone loss

In patients diagnosed with osteoporosis, calcium is lost from bones making them weaker and easily susceptible to fractures. Supplementation of calcium is highly recommended for such conditions. However, the source of calcium plays an important role in the amount of calcium that is assimilated into bone. We hypothesize that naturally occurring coral calcium and zeolite may prevent ovariectomy-induced bone loss. We have measured bone loss in ovariectomized mice supplemented with coral calcium and Zeolite. Female C57BL/6 mice were either sham-operated or ovariectomized and fed diets containing coral calcium or zeolite for 6 months. Serum was analyzed for bone biochemical markers and cytokines. Bones were analyzed using dual x-ray absorbtiometry, peripheral quantitative computed tomography, and micro-computed tomography densitometry. In the distal femoral metaphysis, total bone and cortical bone mass was restored and the endocortical surface was significantly decreased in coral calcium and zeolite fed ovariectomized (OVX) mice. Trabecular number and the ratio of bone volume to total volume was higher in OVX mice after coral calcium and zeolite feeding, while trabecular separation decreased in the different treatment OVX groups. Coral calcium protected bone to a lesser extent in the proximal tibia and lumbar vertebrae. Overall, coral calcium and zeolite may protect postmenopausal bone loss.