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Individualized herbal prescriptions for delayed union: A case series. Explore (NY) 2023; 19:260-266. [PMID: 35304090 DOI: 10.1016/j.explore.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/05/2022] [Indexed: 11/23/2022]
Abstract
Background Bone fractures are important clinical events for both patients and professionals. Active treatment options are limited for delayed unions and for nonunions; surgery is common but not entirely risk-free. This report describes three cases of delayed union successfully treated with herbal decoction. Participants Three patients had trapezoid and 3rd metacarpal bone fractures, 2nd, and 5th metatarsal bone fractures, respectively. All three patients were diagnosed with delayed union by an independent orthopedic surgeon based on computed tomography (CT) scan/radiographic imaging and fracture duration without a healing process. Patients took herbal decoction, Jeopgol-tang, with individually added herbs based on symptom manifestations, twice daily for 56, 85 and 91 days with no additional interventions except for a splint that they had been wearing since fracture diagnosis. Outcomes Improvement of delayed union was evaluated using radiographic imaging or CT during treatment with Jeopgol-tang. Results After taking herbal medicine, callus and bony bridging were confirmed on follow-up imagings and the patients described their experience with pain reduction at an interview after recovery. Conclusions This case series suggests that the herbal decoction Jeopgol-tang warrants further investigation to establish its role as a complementary and integrative medicine treatment option for delayed unions.
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Nakae H, Takayama S, Namiki T. Editorial: Potentials of Kampo Medicine in Modern Society. Front Nutr 2022; 9:912874. [PMID: 35774542 PMCID: PMC9239303 DOI: 10.3389/fnut.2022.912874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hajime Nakae
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan
- *Correspondence: Hajime Nakae
| | - Shin Takayama
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Takao Namiki
- Department of Japanese-Oriental (Kampo) Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
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Nakae H, Irie Y, Kitamura T, Okuyama M. Application of Traditional Japanese Drug Jidabokuippo in a Modern Society. Front Pharmacol 2022; 13:853012. [PMID: 35677432 PMCID: PMC9168538 DOI: 10.3389/fphar.2022.853012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/11/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Jidabokuippo (JDI) (治打撲一方) has been used in Japan to alleviate contusion-induced swelling and pain since medieval times. Method: This review investigated the effects of JDI on various symptoms in patients with trauma or static blood[TM1]. The PubMed and Igaku Chuo Zasshi databases were searched until 24 December 2021. We summarize the benefits of applying JDI to inflammatory conditions, including bruises. Results: JDI has been used to resolve blood [TM1] stasis, regulate qi in trauma patients, and treat inflammatory swelling and pain caused by rheumatoid arthritis and cellulitis. As the adverse event rate associated with JDI is low (1.3%), JDI is considered a safe drug. Conclusion: JDI can be used to resolve blood[TM1] stasis in trauma patients without adverse events associated with nonsteroidal anti-inflammatory drugs.
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Affiliation(s)
- Hajime Nakae
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Yasuhito Irie
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Toshiharu Kitamura
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Manabu Okuyama
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan
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Kimura K, Kubo Y, Dobashi K, Katakura Y, Chida K, Kobayashi M, Yoshida K, Fujiwara S, Terasaki K, Kawamura T, Ogasawara K. Angiographic, Cerebral Hemodynamic, and Cognitive Outcomes of Indirect Revascularization Surgery Alone for Adult Patients With Misery Perfusion due to Ischemic Moyamoya Disease. Neurosurgery 2022; 90:676-683. [PMID: 35311740 DOI: 10.1227/neu.0000000000001907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/05/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Revascularization surgery for adult patients with ischemic moyamoya disease (MMD) may improve both cognitive function and cerebral perfusion. OBJECTIVE To determine angiographic, cerebral hemodynamic, and cognitive outcomes of indirect revascularization surgery alone for adult patients with misery perfusion due to ischemic MMD (IDR group) and to test the superiority of indirect revascularization surgery for cognitive improvement by conducting comparisons with historical control patients who had undergone direct revascularization surgery (DR group) through prospective cohort study with historical controls. METHODS Twenty adult patients with cerebral misery perfusion underwent encephalo-duro-myo-arterio-pericranial-synangiosis alone. Cerebral angiography through arterial catheterization, brain perfusion single-photon emission computed tomography, and neuropsychological testing were performed preoperatively and at 6 months postoperatively. RESULTS In 17 patients of the IDR group, collateral flows that were newly formed after surgery on angiograms fed more than one-third of the middle cerebral artery (MCA) cortical territory. In the IDR group, perfusion in the MCA territory was significantly increased after surgery (P < .0001), and the difference in MCA perfusion between before and after surgery was significantly greater (P = .0493) compared with the DR group. Improved cognition was significantly more frequent in the IDR group (65%) than in the DR group (31%, P = .0233). CONCLUSION Indirect revascularization surgery alone forms sufficient collateral circulation, improves cerebral hemodynamics, and recovers cognitive function in adult patients with misery perfusion due to ischemic MMD. The latter 2 beneficial effects may be higher when compared with patients undergoing direct revascularization surgery.
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Affiliation(s)
- Kazuto Kimura
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Japan
| | - Yoshitaka Kubo
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Japan
| | - Kazumasa Dobashi
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Japan
| | - Yasukazu Katakura
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Japan
| | - Kohei Chida
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Japan
- Institute for Biomedical Sciences, School of Medicine, Iwate Medical University, Japan
| | - Masakazu Kobayashi
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Japan
- Institute for Biomedical Sciences, School of Medicine, Iwate Medical University, Japan
| | - Kenji Yoshida
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Japan
| | - Shunrou Fujiwara
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Japan
| | - Kazunori Terasaki
- Institute for Biomedical Sciences, School of Medicine, Iwate Medical University, Japan
| | | | - Kuniaki Ogasawara
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Japan
- Institute for Biomedical Sciences, School of Medicine, Iwate Medical University, Japan
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Cytotoxicity of Thioalkaloid-Enriched Nuphar lutea Extract and Purified 6,6′-Dihydroxythiobinupharidine in Acute Myeloid Leukemia Cells: The Role of Oxidative Stress and Intracellular Calcium. Pharmaceuticals (Basel) 2022; 15:ph15040410. [PMID: 35455407 PMCID: PMC9032197 DOI: 10.3390/ph15040410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/20/2022] [Accepted: 03/23/2022] [Indexed: 11/17/2022] Open
Abstract
Acute myeloid leukemia (AML) is an aggressive hematological malignancy characterized by uncontrolled proliferation of immature myeloid progenitors. Here, we report the in vitro antileukemic effects of the sesquiterpene thioalkaloid-enriched fraction of the Nuphar lutea leaf extract (NUP) and a purified thioalkaloid 6,6′-dihydroxythiobinupharidine (DTBN). Treatment with 0.3–10 µg/mL NUP caused a dose- and time-dependent reduction in proliferation and viability of human AML cells (KG-1a, HL60 and U937). This was associated with apoptosis induction manifested by annexin-V/propidium iodide binding as well as cleavage of caspases 8, 9, and 3 as well as poly (ADP-ribose) polymerase. Caspase-dependence of the apoptotic effect was confirmed using the pan-caspase inhibitor Q-VD-OPH. NUP induced significant biphasic changes in the cytosolic levels of reactive oxygen species (ROS) compared to untreated cells—a decrease at early time points (2–4 h) and an increase after a longer incubation (24 h). ROS accumulation was accompanied by lowering the cellular glutathione (GSH) levels. In addition, NUP treatment resulted in elevation of the cytosolic Ca2+ (Ca2+cyt) levels. The thiol antioxidant and glutathione precursor N-acetyl cysteine prevented NUP-induced ROS accumulation and markedly inhibited apoptosis. A similar antiapoptotic effect was obtained by Ca2+cyt chelating using BAPTA. These data indicate that NUP-induced cell death is mediated, at least in part, by the induction of oxidative stress and Ca2+cyt accumulation. However, a substantial apoptotic activity of pure DTBN (0.05–0.25 µg/mL), was found to be independent of cytosolic ROS or Ca2+, suggesting that alternative mechanisms are involved in DTBN-induced cytotoxicity. Notably, neither NUP nor DTBN treatment significantly induced cell death of normal human peripheral blood mononuclear cells. Our results provide the basis for further investigation of the antileukemic potential of NUP and its active constituents.
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Granados Santiago M, Valenza MC, Prados Román E, López López L, Muñoz Vigueras N, Cabrera Martos I, Cebrià I Iranzo MÀ. Impacts of tailored, rehabilitation nursing care on functional ability and quality of life in hospitalized elderly patients after rib fractures. Clin Rehabil 2021; 35:1544-1554. [PMID: 34092117 DOI: 10.1177/02692155211022734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We aimed to analyze the effects of a tailored rehabilitation nursing care program on functional ability and quality of life in patients with conservative treatment for rib fractures. DESIGN Randomized controlled trial. SETTING Inpatient rehabilitation hospital. SUBJECTS Rib fracture patients treated conservatively were randomized into two groups (experimental and control group). INTERVENTIONS Patients in control group received Treatment as Usual (TAU) and patients included in experimental group received TAU and an added tailored rehabilitation nursing care program (RNT). MAIN MEASURES At baseline, and end of hospitalization treatment, the functional ability was assessed with the Barthel Index, and the quality of life was evaluated with the EuroQol-5D. Additionally, the outcomes were assessed at six-month follow-up. RESULTS A total of 80 patients were included in the study, whose mean age was 77.19 SD 7.71 in the RNT group and 75.55 SD 9.46 in the TAU group. Our data showed a significant difference in the post-treatment gains in overall quality of life (74.25 SD 20.62 vs 60.28 SD 20.54), and functional ability (71.79 SD 23.85 vs 69.41 SD 24.30) between the RNT group and the TAU group (P < 0.05). Compared to the TAU group, the RNT group also showed a significant improvement in functional ability and quality of life at six-month follow-up. CONCLUSIONS A tailored rehabilitation nursing care program added to the conservative treatment during hospitalization can improve the functional ability and quality of life of patients after rib fractures at discharge and at six-month follow-up. TRIAL REGISTRATION ClinicalTrial.gov Identifier: NCT04168996.
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Affiliation(s)
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Esther Prados Román
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López López
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Natalia Muñoz Vigueras
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Cabrera Martos
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Yoshinaga R, Nakayasu K, Tahara E. An ankle sprain with long-term swelling and pain successfully treated with the traditional Japanese herbal medicine Jidabokuippo: A case report. J Gen Fam Med 2020; 21:261-263. [PMID: 33304722 PMCID: PMC7689226 DOI: 10.1002/jgf2.354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/27/2020] [Accepted: 06/03/2020] [Indexed: 11/17/2022] Open
Abstract
In this report, we present a case in which long-term swelling and pain because of an ankle sprain were successfully treated with the traditional Japanese herbal (Kampo) medicine Jidabokuippo. Jidabokuippo was created in Japan and has been used to treat swelling and pain associated with trauma. A 44-year-old woman sprained her right ankle and received the standard treatments including icing and immobilization for three weeks. However, the swelling, redness, and pain of her ankle continued for two months after the treatments. After initiating Jidabokuippo, her pain and swelling were promptly improved. This suggests that Jidabokuippo is a potentially promising pharmacotherapy for patients with ankle sprain which has not recovered smoothly. It is said that Jidabokuippo can be prescribed simply referring to pain and swelling of the affected areas; therefore, it should be considered as a treatment for trauma patients with long-term swelling and pain.
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Affiliation(s)
- Ryo Yoshinaga
- Department of Japanese Oriental MedicineIizuka HospitalIizukaJapan
| | - Kazuo Nakayasu
- Department of General Internal MedicineIizuka HospitalIizukaJapan
- Kaita HospitalIizukaJapan
| | - Eiichi Tahara
- Department of Japanese Oriental MedicineIizuka HospitalIizukaJapan
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8
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Takayama S, Tomita N, Arita R, Ono R, Kikuchi A, Ishii T. Kampo Medicine for Various Aging-Related Symptoms: A Review of Geriatric Syndrome. Front Nutr 2020; 7:86. [PMID: 32766269 PMCID: PMC7381143 DOI: 10.3389/fnut.2020.00086] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 05/12/2020] [Indexed: 12/12/2022] Open
Abstract
With the continued growth of the aging population in Japan, geriatric syndrome (GS), which is associated with aging-related symptoms, has become a social problem. GS is caused by physiological and pathological aging and may manifest various symptoms. Physicians use multidisciplinary approaches to provide treatment for individual GS symptoms. Kampo medicine, a Japanese traditional medicine that uses multiple pharmacologically active substances, is useful for many syndromes, conditions, disorders, and diseases associated with GS. Evidence of the effectiveness of Kampo medicine for GS has accumulated in recent years. The effects of Kampo treatment for symptoms related to functional decline of the cardiovascular, respiratory, and digestive systems, cognitive impairment and related disorders, pain and other sensory issues, among others, support the use of Kampo medicine for the management of GS. The role of Kampo medicine for GS is summarized in this review.
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Affiliation(s)
- Shin Takayama
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Naoki Tomita
- Department of Geriatrics and Gerontology, Institue of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryutaro Arita
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Rie Ono
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Akiko Kikuchi
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Tadashi Ishii
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
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9
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Nuphar lutea Extracts Exhibit Anti-Viral Activity against the Measles Virus. Molecules 2020; 25:molecules25071657. [PMID: 32260270 PMCID: PMC7180909 DOI: 10.3390/molecules25071657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/22/2020] [Accepted: 04/02/2020] [Indexed: 02/06/2023] Open
Abstract
Different parts of Nuphar lutea L. (yellow water lily) have been used to treat several inflammatory and pathogen-related diseases. It has shown that Nuphar lutea extracts (NUP) are active against various pathogens including bacteria, fungi, and leishmanial parasites. In an effort to detect novel therapeutic agents against negative-stranded RNA (- RNA) viruses, we have tested the effect of a partially-purified alkaloid mixture of Nuphar lutea leaves on the measles virus (MV). The MV vaccine’s Edmonston strain was used to acutely or persistently infect cells. The levels of several MV proteins were detected by a Western blot and immunocytochemistry. Viral RNAs were quantitated by qRT-PCR. Virus infectivity was monitored by infecting African green monkey kidney VERO cells’ monolayers. We showed that NUP protected cells from acute infection. Decreases in the MV P-, N-, and V-proteins were observed in persistently infected cells and the amount of infective virus released was reduced as compared to untreated cells. By examining viral RNAs, we suggest that NUP acts at the post-transcriptional level. We conclude, as a proof of concept, that NUP has anti-viral therapeutic activity against the MV. Future studies will determine the mechanism of action and the effect of NUP on other related viruses.
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10
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Craxford S, Deacon C, Myint Y, Ollivere B. Assessing outcome measures used after rib fracture: A COSMIN systematic review. Injury 2019; 50:1816-1825. [PMID: 31353094 DOI: 10.1016/j.injury.2019.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE The incidence of invasive treatment of rib fracture has increased significantly over the last decade however the evidence of improved patient outcomes to support this is lacking. A systematic review was performed to identify patient reported outcome measures (PROMs) used in the assessment of outcomes following chest wall injury. The quality of evidence for the psychometric properties of the identified PROMs was graded using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. METHODS Rib fracture studies measuring patient reported outcomes were identified using PubMed/Medline, EMBASE, AMED and PsycINFO. Methodological quality of measurement properties was evaluated with the COnsensus-based Standards for selection of health status Measurement INstruments (COSMIN) checklist. RESULTS A total of 64 studies were identified including 19 different PROM instruments. Domains included in the reported PROMs included pain, breathlessness, general health quality of life, physical function and physiological health. No rib fracture specific PROM was identified. The most frequently reported instrument was the SF-36 reporting overall quality of life (HRQoL) although there was very low quality evidence for its content validity. There was low quality evidence to support good content validity for the Medical Research Council (MRC) dyspnoea scale, Brief Pain Index (BPI) and McGill Pain Questionnaire (MPQ). No PROM had undergone validation in a rib fracture population. The overall quality of the PROM development studies was poor. While we were unable to identify a clear "gold standard", based on the limited current evidence, we recommend that the EQ-5D-5L is used in combination with the MRC and BPI or MPQ for future rib fracture studies. CONCLUSION The lack of validated outcome measures for rib fracture patients is a significant limitation of the current literature. Further studies are needed to provide validated outcome measures to ensure accuracy of the reported results and conclusions. As interventions for rib fractures have become more common in both research and clinical practice this has become an urgent priority.
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Affiliation(s)
| | - Christopher Deacon
- Department of Trauma and Orthopaedics, Queens Medical Centre, Nottingham, UK
| | - Yulanda Myint
- Department of Trauma and Orthopaedics, Queens Medical Centre, Nottingham, UK
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Dalvie ED, Gopas J, Golan-Goldhirsh A, Osheroff N. 6,6'-Dihydroxythiobinupharidine as a poison of human type II topoisomerases. Bioorg Med Chem Lett 2019; 29:1881-1885. [PMID: 31182315 DOI: 10.1016/j.bmcl.2019.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/28/2019] [Accepted: 06/01/2019] [Indexed: 12/31/2022]
Abstract
A number of natural products with medicinal properties increase DNA cleavage mediated by type II topoisomerases. In an effort to identify additional natural compounds that affect the activity of human type II topoisomerases, a blind screen of a library of 341 Mediterranean plant extracts was conducted. Extracts from Nuphar lutea, the yellow water lily, were identified in this screen. N. lutea has been used in traditional medicine by a variety of indigenous populations. The active compound in N. lutea, 6,6'-dihydroxythiobinupharidine, was found to enhance DNA cleavage mediated by human topoisomerase IIα and IIβ ∼8-fold and ∼3-fold, respectively. Mechanistic studies with topoisomerase IIα indicate that 6,6'-dihydroxythiobinupharidine is a "covalent poison" that acts by adducting the enzyme outside of the DNA cleavage-ligation active site and requires the N-terminal domain of the protein for its activity. Results suggest that some of the medicinal properties of N. lutea may result from the interactions between 6,6'-dihydroxythiobinupharidine and the human type II enzymes.
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Affiliation(s)
- Esha D Dalvie
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, TN 37232-0146, USA
| | - Jacob Gopas
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Department of Oncology, Soroka University Medical Center, Beer Sheva 84105, Israel
| | - Avi Golan-Goldhirsh
- The Jacob Blaustein Institutes for Desert Research, French Associates Institute for Agriculture and Biotechnology of Drylands, Ben-Gurion University of the Negev, Sede Boqer Campus, Beer Sheva 84990, Israel
| | - Neil Osheroff
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, TN 37232-0146, USA; Department of Medicine (Hematology/Oncology), Vanderbilt University School of Medicine, Nashville, TN 37232-6307, USA; VA Tennessee Valley Healthcare System, Nashville, TN 37212, USA.
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12
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Komasawa N, Yamamoto K, Ito Y, Omori M, Ueno T, Minami T. Preoperative Administration of Jidabokuippo, a Kampo Medicine, Alleviates Postoperative Pain after Tooth Extraction with Mandible Bone Removal under General Anesthesia: A Prospective, Single-Blind, Randomized Controlled Trial. J Altern Complement Med 2018; 24:1214-1218. [PMID: 29993259 DOI: 10.1089/acm.2018.0244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to determine the efficacy of preoperative administration of Jidabokuippo (JDI), a Kampo medicine, in treating postoperative pain after tooth extraction with mandible bone removal. DESIGN This single-blind, randomized controlled study was conducted among two groups of adult patients who were scheduled to undergo tooth extraction with mandible bone removal under general anesthesia. Patients were randomly assigned to either the JDI or control group. INTERVENTION Before surgery, the JDI group received JDI (7.5 g), whereas the control group did not receive any treatment. Patients and the evaluator were blinded to the treatment status. At 0, 1, 3, and 24 h after anesthesia recovery, an investigator recorded the severity of postoperative pain and nausea using a numeric rating scale (0, no pain or nausea; 10, worst imaginable pain or nausea). The number of patients who requested nonsteroidal anti-inflammatory drug (NSAID) and that of additional NSAID administration within 24 h from anesthesia recovery, and the time to the first NSAID request from anesthesia recovery was also measured. RESULTS The severity of postoperative pain was significantly lower in the JDI group compared with the control group at 3 and 24 h after anesthesia recovery (p < 0.001 each). Both the number of patients requesting NSAID and additional NSAID administration after anesthesia recovery were significantly smaller in the JDI group than in the control group (p = 0.006, p < 0.001). The time to first NSAID request from anesthesia recovery was significantly longer in the JDI group compared with control group (p < 0.001). The severity of nausea did not differ significantly between the groups. No significant side effects related to JDI were noted during the trial. CONCLUSIONS JDI administration before general anesthesia effectively decreased the severity of postoperative pain after anesthesia recovery in patients who underwent tooth extraction with mandible bone removal.
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Affiliation(s)
| | - Kayoko Yamamoto
- 2 Department of Oral and Maxillofacial Reconstructive Surgery, Osaka Medical College, Osaka, Japan
| | - Yuichi Ito
- 2 Department of Oral and Maxillofacial Reconstructive Surgery, Osaka Medical College, Osaka, Japan
| | - Michi Omori
- 2 Department of Oral and Maxillofacial Reconstructive Surgery, Osaka Medical College, Osaka, Japan
| | - Takaaki Ueno
- 2 Department of Oral and Maxillofacial Reconstructive Surgery, Osaka Medical College, Osaka, Japan
| | - Toshiaki Minami
- 1 Department of Anesthesiology, Osaka Medical College, Osaka, Japan
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13
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Development of a blunt chest injury care bundle: An integrative review. Injury 2018; 49:1008-1023. [PMID: 29655592 DOI: 10.1016/j.injury.2018.03.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/28/2018] [Accepted: 03/30/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Blunt chest injuries (BCI) are associated with high rates of morbidity and mortality. There are many interventions for BCI which may be able to be combined as a care bundle for improved and more consistent outcomes. OBJECTIVE To review and integrate the BCI management interventions to inform the development of a BCI care bundle. METHODS A structured search of the literature was conducted to identify studies evaluating interventions for patients with BCI. Databases MEDLINE, CINAHL, PubMed and Scopus were searched from 1990-April 2017. A two-step data extraction process was conducted using pre-defined data fields, including research quality indicators. Each study was appraised using a quality assessment tool, scored for level of evidence, then data collated into categories. Interventions were also assessed using the APEASE criteria then integrated to develop a BCI care bundle. RESULTS Eighty-one articles were included in the final analysis. Interventions that improved BCI outcomes were grouped into three categories; respiratory intervention, analgesia and surgical intervention. Respiratory interventions included continuous positive airway pressure and high flow nasal oxygen. Analgesia interventions included regular multi-modal analgesia and paravertebral or epidural analgesia. Surgical fixation was supported for use in moderate to severe rib fractures/BCI. Interventions supported by evidence and that met APEASE criteria were combined into a BCI care bundle with four components: respiratory adjuncts, analgesia, complication prevention, and surgical fixation. CONCLUSIONS The key components of a BCI care bundle are respiratory support, analgesia, complication prevention including chest physiotherapy and surgical fixation.
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14
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Lee Y, Lee SH, Kim C, Choi HJ. Comparison of the effectiveness in pain reduction and pulmonary function between a rib splint constructed in the ER and a manufactured rib splint. Medicine (Baltimore) 2018; 97:e10779. [PMID: 29794759 PMCID: PMC6393019 DOI: 10.1097/md.0000000000010779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In the treatment of patients with rib fractures (RFs), pain reduction is the most important consideration. Various studies have examined the effectiveness of treatments administered to RF patients, such as lidocaine patches, IV drugs, nerve blockers, and surgery. In this study, we evaluated the difference in the effectiveness in pain reduction between 2 groups of RF patients: 1 group who received a rib splint constructed in the ER (ER splint) and another group who received a Chrisofix Chest Orthosis (CCO) manufactured rib splint. METHODS A pilot study for a prospective randomized clinical trial was conducted to compare subjects using the CCO (Group A) with those using the ER splint (Group B) before and after the intervention. The primary outcome was difference in the level of pain based on the visual analogue scale (VAS) and the pulmonary function (PF) variables between before and after intervention in each group during forceful and resting respiration. RESULTS A total of 24 subjects were enrolled in this study. The VAS results showed that the intervention was significantly effective in each group (before vs after: Group A resting: 8.50 ± 1.05 vs 4.17 ± 1.33, P < .001; Group A forceful: 9.83 ± 0.41 vs 7.17 ± 0.75, P < .001; Group B resting: 8.83 ± 1.60 vs 4.50 ± 1.38, P < .001; and Group B forceful: 9.67 ± 0.82 vs 7.33 ± 1.51, P = .003). The PF variables showed that the intervention was significantly effective in each group (before vs after: Group A, FVC: 2.74 ± 0.92 vs 3.35 ± 0.99, P < .001; FEV1: 2.16 ± 0.74 vs 2.57 ± 0.78, P = .001; PEF: 235.30 ± 43.06 vs 319.00 ± 51.58, P = .004; and Group B, FVC: 2.02 ± 0.49 vs 2.72 ± 0.62, P < .001; FEV1: 1.27 ± 0.25 vs 1.91 ± 0.37, P < .001; PEF: 216.67 ± 67.49 vs 300.33 ± 87.79, P = .003). CONCLUSION Applying either the CCO or the ER splint to RF patients effectively reduced pain, and no significant differences in pain level were observed between these 2 techniques.
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Affiliation(s)
- Yoonje Lee
- Department of Emergency Medicine, Seoul Hospital, Hanyang University, Gyeonggi-do
| | - Sang-Hyun Lee
- Department of Emergency Medicine, Hangang Sacred Heart Hospital, Hallym University, Gangwon-do
| | - Changsun Kim
- Department of Emergency Medicine, Guri Hospital, Hanyang University, Gyeonggi-do, Korea
| | - Hyuk Joong Choi
- Department of Emergency Medicine, Guri Hospital, Hanyang University, Gyeonggi-do, Korea
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15
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Nakae H, Hiroshima Y, Hebiguchi M. Kampo Medicines for Frailty in Locomotor Disease. Front Nutr 2018; 5:31. [PMID: 29755984 PMCID: PMC5933258 DOI: 10.3389/fnut.2018.00031] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 04/12/2018] [Indexed: 12/23/2022] Open
Abstract
Frailty is a syndrome that includes broad problems of senility and consists of three domains: physical, psychological, and social. Kampo medicine is used for intervention in cases of hypofunction in a mental or physical state. Kampo treatment, using Hojin formulations such as Hachimijiogan and Gosyajinkigan, is useful in patients with “jinkyo,” or kidney hypofunction. Ketsu includes both blood and its metabolic products that circulate throughout the body. Oketsu is a disturbance of ketsu and is considered to be a microcirculation disorder. Anti-oketsu formulations, such as Keishibukuryogan and Jidabokuippo, are useful in the treatment of trauma patients who are experiencing swelling and pain. “Ki” is the universal energy that exists in the world. Hoki formulations, such as Rikkunshito and Hochuekkito, are useful in patients with poor appetites for reinforcing vital energy. Juzentaihoto and Ninjinyoeito are useful in patients with hypofunction of ki and ketsu, which are accompanying symptoms of coldness or cutaneous dryness. Thus, Kampo medicines can be used as a superior approach for the management of frailty.
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Affiliation(s)
- Hajime Nakae
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan.,Department of Traditional Japanese Medicine, Akita University Hospital, Akita, Japan
| | - Yuko Hiroshima
- Department of Traditional Japanese Medicine, Akita University Hospital, Akita, Japan
| | - Miwa Hebiguchi
- Department of Traditional Japanese Medicine, Akita University Hospital, Akita, Japan
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16
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Peek J, Smeeing DPJ, Hietbrink F, Houwert RM, Marsman M, de Jong MB. Comparison of analgesic interventions for traumatic rib fractures: a systematic review and meta-analysis. Eur J Trauma Emerg Surg 2018; 45:597-622. [PMID: 29411048 PMCID: PMC6689037 DOI: 10.1007/s00068-018-0918-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/31/2018] [Indexed: 02/04/2023]
Abstract
Purpose Many studies report on outcomes of analgesic therapy for (suspected) traumatic rib fractures. However, the literature is inconclusive and diverse regarding the management of pain and its effect on pain relief and associated complications. This systematic review and meta-analysis summarizes and compares reduction of pain for the different treatment modalities and as secondary outcome mortality during hospitalization, length of mechanical ventilation, length of hospital stay, length of intensive care unit stay (ICU) and complications such as respiratory, cardiovascular, and/or analgesia-related complications, for four different types of analgesic therapy: epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks. Methods PubMed, EMBASE and CENTRAL databases were searched to identify comparative studies investigating epidural, intravenous, paravertebral and intercostal interventions for traumatic rib fractures, without restriction for study type. The search strategy included keywords and MeSH or Emtree terms relating blunt chest trauma (including rib fractures), analgesic interventions, pain management and complications. Results A total of 19 papers met our inclusion criteria and were finally included in this systematic review. Significant differences were found in favor of epidural analgesia for the reduction of pain. No significant differences were observed between epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks, for the secondary outcomes. Conclusions Results of this study show that epidural analgesia provides better pain relief than the other modalities. No differences were observed for secondary endpoints like length of ICU stay, length of mechanical ventilation or pulmonary complications. However, the quality of the available evidence is low, and therefore, preclude strong recommendations.
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Affiliation(s)
- Jesse Peek
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Diederik P J Smeeing
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.,Utrecht Traumacenter, Utrecht, The Netherlands
| | - Falco Hietbrink
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roderick M Houwert
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.,Utrecht Traumacenter, Utrecht, The Netherlands
| | - Marije Marsman
- Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mirjam B de Jong
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
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Wada K, Uchida HA, Wada Y. Effectiveness case of Jidabokuippo (traditional Japanese Kampo medicine) on pain, venous thrombosis, and subcutaneous hematoma after percutaneous femoral catheterization in a hemodialysis patient. RENAL REPLACEMENT THERAPY 2017. [DOI: 10.1186/s41100-016-0086-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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18
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Takayama S, Kaneko S, Numata T, Kamiya T, Arita R, Saito N, Kikuchi A, Ohsawa M, Kohayagawa Y, Ishii T. Literature Review: Herbal Medicine Treatment after Large-Scale Disasters. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2017; 45:1345-1364. [DOI: 10.1142/s0192415x17500744] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Large-scale natural disasters, such as earthquakes, tsunamis, volcanic eruptions, and typhoons, occur worldwide. After the Great East Japan earthquake and tsunami, our medical support operation’s experiences suggested that traditional medicine might be useful for treating the various symptoms of the survivors. However, little information is available regarding herbal medicine treatment in such situations. Considering that further disasters will occur, we performed a literature review and summarized the traditional medicine approaches for treatment after large-scale disasters. We searched PubMed and Cochrane Library for articles written in English, and Ichushi for those written in Japanese. Articles published before 31 March 2016 were included. Keywords “disaster” and “herbal medicine” were used in our search. Among studies involving herbal medicine after a disaster, we found two randomized controlled trials investigating post-traumatic stress disorder (PTSD), three retrospective investigations of trauma or common diseases, and seven case series or case reports of dizziness, pain, and psychosomatic symptoms. In conclusion, herbal medicine has been used to treat trauma, PTSD, and other symptoms after disasters. However, few articles have been published, likely due to the difficulty in designing high quality studies in such situations. Further study will be needed to clarify the usefulness of herbal medicine after disasters.
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Affiliation(s)
- Shin Takayama
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Aobaku, Sendai City, Miyagi Prefecture 980-8574, Japan
| | - Soichiro Kaneko
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Aobaku, Sendai City, Miyagi Prefecture 980-8574, Japan
| | - Takehiro Numata
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Aobaku, Sendai City, Miyagi Prefecture 980-8574, Japan
| | - Tetsuharu Kamiya
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Aobaku, Sendai City, Miyagi Prefecture 980-8574, Japan
| | - Ryutaro Arita
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Aobaku, Sendai City, Miyagi Prefecture 980-8574, Japan
| | - Natsumi Saito
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Aobaku, Sendai City, Miyagi Prefecture 980-8574, Japan
| | - Akiko Kikuchi
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Aobaku, Sendai City, Miyagi Prefecture 980-8574, Japan
| | - Minoru Ohsawa
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Aobaku, Sendai City, Miyagi Prefecture 980-8574, Japan
| | - Yoshitaka Kohayagawa
- National Disaster Medical Center, 8-15 Oota-machi, Fukushima Prefecture 960-8068, Japan
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Aobaku, Sendai City, Miyagi Prefecture 980-8574, Japan
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Comparison of the Spasmolytic Effects of Jakyak-Gamcho Decoctions Derived via Different Extractants. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:270380. [PMID: 26539219 PMCID: PMC4619897 DOI: 10.1155/2015/270380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/22/2015] [Accepted: 09/02/2015] [Indexed: 01/04/2023]
Abstract
Aim. To investigate whether differences in the amounts of effective index components in Jakyak-Gamcho decoctions derived via extraction with either water or ethanol were associated with differential spasmolytic effectiveness. Methods. The amounts of effective index components (paeoniflorin, benzoic acid, glycyrrhizin, and isoliquiritin) contained in water-extracted Jakyak-Gamcho decoction and 70% ethanol-extracted Jakyak-Gamcho decoction were compared by high-performance liquid chromatography. Muscle cramp reduction rates were compared between the two decoctions by comparing the degrees of muscle contraction, measured as the tension developed during electrical stimulation, before and 1 and 2 h after injection in rats. Results. The relative amounts of effective index components were, on average, about 43% higher in the 70% ethanol-extracted decoction than in the water-extracted decoction. Two hours after injection, 0.25 g/kg of 70% ethanol-extracted decoction produced a significantly greater spasmolytic effect than 0.25 g/kg of water-extracted Jakyak-Gamcho decoction or distilled water (both p < 0.05). Conclusion. Differences in the amounts of effective index components resulting from the use of different extractants were associated with differences in spasmolytic effectiveness. Hence, it may be worthwhile to investigate alternative extraction methods in terms of extraction efficiency and in vivo effectiveness for various herbal medicines in the future.
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Ozer J, Levi T, Golan-Goldhirsh A, Gopas J. Anti-inflammatory effect of a Nuphar lutea partially purified leaf extract in murine models of septic shock. JOURNAL OF ETHNOPHARMACOLOGY 2015; 161:86-91. [PMID: 25490314 DOI: 10.1016/j.jep.2014.11.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/11/2014] [Accepted: 11/29/2014] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Various plant organs of Nuphar lutea (L.) SM. (Nymphaeaceae) are used in traditional medicine for the treatment of arthritis, fever, aches, pains and inflammation. The main purpose of this study was to determine the anti-inflammatory effect of Nuphar lutea leaf extract (NUP) in two septic shock models: (1) Survival of mice challenged with a lethal dose of LPS, determination of pro-inflammatory and anti-inflammatory cytokines in serum, as well as in peritoneal macrophages in cell culture. (2) The effect of NUP in a murine model of fecal-induced peritonitis. MATERIALS AND METHODS NUP pre-treatment partially protected mice in two models of acute septic shock. We concluded that NUP is anti-inflammatory by inhibiting the NF-κB pathway, modulating cytokine production and ERK phosphorylation. RESULTS A significant average survival rate (60%) of LPS lethally-challenged mice was achieved by pre-treatment with NUP. In addition, NUP pre-treatment reduced nuclear NF-κB translocation in peritoneal macrophages. The production of pro-inflammatory cytokines, TNF-α, IL-6 and IL-12, in the sera of LPS-treated mice or in the supernatants of peritoneal macrophages stimulated with LPS for 2-6 h was also decreased by NUP. Pre-treatment with NUP caused a significant increase in the anti-inflammatory cytokine IL-10. The NUP pre-treatment reduced and delayed mortality in mice with fecal-induced peritonitis. Our studies also revealed that NUP pre-treatment induced a dose-dependent phosphorylation of ERK in peritoneal macrophages. Since most of the reports about the anti-inflammatory effect of Nuphar lutea refer to rhizome and root powder and extracts, it is important to clarify the effectiveness of leaf extract as a source for such activity. CONCLUSION NUP pre-treatment partially protected mice in two models of acute septic shock. We concluded that NUP is anti-inflammatory by inhibiting the NF-κB pathway, modulating cytokine production and ERK phosphorylation.
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Affiliation(s)
- J Ozer
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | - T Levi
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - A Golan-Goldhirsh
- The Jacob Blaustein Institutes for Desert Research (BIDR), French Associates Institute for Agriculture and Biotechnology of Drylands, Sede Boqer Campus, 84990, Israel
| | - J Gopas
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences Ben-Gurion University of the Negev, Beer Sheva, Israel; Department of Oncology, Soroka University Medical Center, Beer Sheva, Israel
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Nakae H, Takahashi G, Sato R, Shibata S, Endo S. Determination of β-d-glucan and endotoxin levels in Kampo extracts. Acute Med Surg 2014; 2:77-81. [PMID: 29123698 DOI: 10.1002/ams2.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 06/15/2014] [Indexed: 11/10/2022] Open
Abstract
Aims Kampo medicine is based on the use of established formulations combining natural extracts with no "brand-name" products or corresponding "generic" formulation. Due to differences in manufacturing practices, products of different pharmaceutical companies may contain different concentrations of β-d-glucan and endotoxins. The aim of this study was to compare the concentrations of β-d-glucan and endotoxins in five Kampo extracts from four pharmaceutical companies. Methods Packages of Kampo extracts were dissolved in distilled water. β-d-Glucan and endotoxin concentrations were measured using high-sensitivity kinetic turbidimetric Limulus assay. Results All Kampo extracts examined in this study were found to contain detectable concentrations of β-d-glucan and endotoxins. Significant differences in the concentration of β-d-glucan and endotoxins (P = 0.0024 and P = 0.0013, respectively) were observed between products of different pharmaceutical companies. Conclusions High β-d-glucan and endotoxin contents were detected in Kampo extracts, with a large variability in the concentrations of both β-d-glucan and endotoxins among extracts from different pharmaceutical companies.
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Affiliation(s)
- Hajime Nakae
- Department of Emergency and Critical Care Medicine Akita University Graduate School of Medicine Akita Japan
| | - Gaku Takahashi
- Department of Critical Care Medicine School of Medicine, Iwate Medical University Morioka Japan
| | - Ryo Sato
- Department of Critical Care Medicine School of Medicine, Iwate Medical University Morioka Japan
| | - Shigehiro Shibata
- Department of Critical Care Medicine School of Medicine, Iwate Medical University Morioka Japan
| | - Shigeatsu Endo
- Department of Critical Care Medicine School of Medicine, Iwate Medical University Morioka Japan
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