Neuroendocrine and cellular mechanisms in stress resilience: From hormonal influence in the CNS to mitochondrial dysfunction and oxidative stress

Recent advancements in neuroendocrinology challenge the long-held belief that hormonal effects are confined to perivascular tissues and do not extend to the central nervous system (CNS). This paradigm shift, propelled by groundbreaking research, reveals that synthetic hormones, notably in anti-inflammatory medications, significantly influence steroid psychosis, behavioural, and cognitive impairments, as well as neuropeptide functions. A seminal development in this field occurred in 1968 with McEven's proposal that rodent brains are responsive to glucocorticoids, fundamentally altering the understanding of how anxiety impacts CNS functionality and leading to the identification of glucocorticosteroids and mineralocorticoids as distinct corticotropic receptors. This paper focuses on the intricate roles of the neuroendocrine, immunological, and CNS in fostering stress resilience, underscored by recent animal model studies. These studies highlight active, compensatory, and passive strategies for resilience, supporting the concept that anxiety and depression are systemic disorders involving dysregulation across both peripheral and central systems. Resilience is conceptualized as a multifaceted process that enhances psychological adaptability to stress through adaptive mechanisms within the immunological system, brain, hypothalamo-pituitary-adrenal axis, and ANS Axis. Furthermore, the paper explores oxidative stress, particularly its origin from the production of reactive oxygen species (ROS) in mitochondria. The mitochondria's role extends beyond ATP production, encompassing lipid, heme, purine, and steroidogenesis synthesis. ROS-induced damage to biomolecules can lead to significant mitochondrial dysfunction and cell apoptosis, emphasizing the critical nature of mitochondrial health in overall cellular function and stress resilience. This comprehensive synthesis of neuroendocrinological and cellular biological research offers new insights into the systemic complexity of stress-related disorders and the imperative for multidisciplinary approaches in their study and treatment.

In silico anti-alzheimer study of phytochemicals from Lamiaceae family through GSK3-β inhibition

Glycogen synthase kinase 3-beta (GSK3-β) is a serine-threonine protease expressed in the brain, and its hyperactivity is considered the underlying cause of Alzheimer's disease. This enzyme requires an ATP molecule in its N-terminal lobe to phosphorylate its substrates, with the most important substrate being the Tau protein. This study focuses on the inhibitory mechanism of four naturally occurring compounds-apigenin, luteolin, rosmarinic acid, and salvianolic acid-from the Laminaceae family against GSK3-β. The orientation of the ligands within the ATP-binding pocket of GSK3-β and their binding energy were determined through molecular docking. Additionally, molecular dynamics simulations was conducted to study the conformational changes induced by the ligands in the protein structure. The results showed that apigenin and salvianolic acid achieved deeper parts of the cavity compared to luteolin and rosmarinic acid and formed stable complexes with the enzyme. In the rosmarinic acid complex, the enzyme exhibited the most exposed conformation. On the other hand, luteolin binding caused a small closure of the opening, suggesting a potentially ATP-competitive role. Our results suggest these compounds as lead candidates for the design of GSK3-β inhibitors.

Medicinal Plants in the Treatment of Depression. II: Evidence from Clinical Trials

Depression is a syndrome characterized by deep sadness and the inhibition of psychic functions, sometimes accompanied by neurovegetative disorders, with symptoms of anxiety almost always present. The disease produces alterations in a variety of neural networks and neurotransmission systems, along with a dysfunction of the hypothalamic-pituitary-adrenal axis, which leads to concomitant alterations in the immunological response. Generally, there is a parallel increase in proinflammatory mediators as well as oxidative and nitrosative damage caused by a reduction of antioxidant defenses. In a previous review, we compiled and examined studies of medicinal plants that had been evaluated in preclinical assays, including existing data on 155 species studied and reported as antidepressants or as sources of active principles for treating this condition. This review will thus limit its focus to the 95 clinical trials found in PubMed among the 670 articles on antidepressant-like medicinal plants. To this end, we have reviewed the publications cited in the Cochrane Database of Systematic Reviews, PubMed, and the Science Citation Index from 2000 to 2020. Our review emphasizes those species that have demonstrated the greatest pharmacological potential when studied for their antidepressant properties in humans through clinical trials. Saffron, turmeric, St. John's wort, ginkgo, kava, and golden root are the most relevant plants that have provided important evidence for the treatment of depression in clinical trials.

Powerful Stress Relieving Medicinal Plants for Anger, Anxiety, Depression, and Stress During Global Pandemic

Consideration and improvement for anxiety and depression are important during a global pandemic. Appropriate healthcare can be obtained by paying more attention to traditional medicinal sciences. The adverse effects of stress with various symptoms can be managed by introducing plants that boost mental health. The most relevant psychological reactions in the general population related to the global pandemic are pervasive anxiety, frustration and boredom, specific and uncontrolled fear, disabling loneliness, significant lifestyle changes, and psychiatric conditions. Ginseng, chamomile, passionflower, herbal tea, lavender, saffron, kava, rose, cardamom, Chinese date, and some chief formula like yokukansan, Dan-zhi-xiao-yao-san, so-ochim-tang-gamiband, and saikokaryukotsuboreito are notable herbal treatments for mental health problems. The most common medicinal plants that have been used in Iran for the cure of stress and anxiety are Viper's-buglosses, Dracocephalum, valerian, chamomile, common hop, hawthorns, and lavender. Medicinal plants and herbs can be used for the treatment and alleviation of the negative effects of stress, anger, and depression during the global pandemic.

Traditional herbal medicines to overcome stress, anxiety and improve mental health in outbreaks of human coronaviruses

Mental health condition is including depression and anxiety, and they may impact wellbeing, personal relationships and productivity of both genders. Herbal medicines have been used to treatment of anxiety and depression symptoms for centuries. SARS, MERS and COVID-19 are related to coronavirus types. SARS (sever acute respiratory syndrome, China, 2002), MERS (Middle East respiratory syndrome, Saudi Arabia, 2012), and SARS-CoV-2 (2019-2020) are the main coronavirus outbreaks. Both anxiety and depression are more serious to be considered and improved for all general public during fight with these diseases. In this mini-review article, we have mentioned the key role some of the most important plants and herbs for treatment of stress and anxiety and improve mental health against SARS and SARS-CoV-2 on the basis of traditional Asian medicine, especially traditional Chinese and Persian medicine.

Proconvulsant effects of Nepeta menthoides hydro alcoholic extract in different seizure tests: behavioral and biochemical studies

In Iran, both Nepeta menthoides - the endemic species of Nepeta genus - and Lavandula officinalis are known as Ustukhuddoos and used widely as medicinal herbs. In Iranian traditional medicine, Ustukhuddoos has been recommended for several neuronal diseases including depression and epilepsy. While the antiepileptic effects of Lavandula officinalis have been investigated in a number of studies, no reports are available taking into account the effect of Nepeta menthoides on epilepsy. Since convulsion is an important side effect of some medicinal plants, a thorough study of the effects of Nepeta menthoides on epilepsy seems necessary.

This study was designed to investigate the potential anti- or pro-convulsant activity of Nepeta menthoides and its effects on oxidative stress markers. Since an herbal medicine showed opposite effects in two animal models of epilepsy in our laboratory, authers decided to study Nepeta effects through several seizure tests including the intravenous pentylenetetrazol (i.v. PTZ) infusion, the maximal electroshock (MES), acute PTZ and PTZ-kindling tests. These seizure models are generally used for screening pro- or anti-epileptic drugs. Nepeta menthoides (400 mg/kg) significantly reduced the dose of PTZ necessary for clonus seizure induction. Combining either phenytoin (Phen) or Valproate (Val) with Nepeta decreased their antiepileptic effects. Therefore, Nepeta menthoides not only failed to prevent the seizures but also increased sensitivity to them. Nepeta raised brain NO levels in different seizure tests. It seems there is a relation between NO elevation by Nepeta and increased sensitivity to seizures that should be investigated later.

Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial

BACKGROUND

Major depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders.

OBJECTIVE

This study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTION

This six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h.

MAIN OUTCOME MEASURES

Primary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups.

RESULTS

Fifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007).

CONCLUSION

The herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress.

TRIAL REGISTRATION NUMBER

IRCT2016102430459N1 on Iranian Registry of Clinical Trials.

The genus Cuscuta (Convolvolaceac): An updated review on indigenous uses, phytochemistry, and pharmacology

Cuscuta, commonly known as dodder, is a genus of family convolvolaceace. Approximately 170 species of Cuscuta are extensively distributed in temperate and subtropical areas of the world. Species of this genus are widely used as essential constituents in functional foods and traditional medicinal systems. Various parts of many members of Cuscuta have been found efficacious against a variety of diseases. Phytochemical investigations have confirmed presence of biologically active moieties such as flavonoids, alkaloids, lignans, saponines, phenolics, tannins, and fatty acids. Pharmacological studies and traditional uses of these plants have proved that they are effective antibacterial, antioxidant, antiostioporotic, hepatoprotective, anti-inflammatory, antitumor, antipyretic, antihypertensive, analgesic, anti hair fall, and antisteriogenic agents.

Nepeta menthoides Boiss. & Buhse, an endemic species in Iran: A review of traditional uses, phytochemistry and pharmacology

Nepeta menthoides Boiss & Buhse is one of the endemic species in Iran. Named Ostokhodus, it is almost used as substitute of the Lavandula stoechas –the original Ostokhodus- in traditional Persian medicine (TPM) over the time and widely used for the management of some ailments such as anxiety, depression, dementia and chronic pain. The aim of this study is to review the pharmacological and phytochemical evidence on Nepeta menthoides for the assessment of the recommended traditional indications of this herb. In this review, all the relevant articles that met our inclusion criteria [English or Persian articles, having full text, evaluating therapeutic effects of N. menthoides and dated mainly from the year 1980 to 2018] were included by searching studies in PubMed, Scopus, Google Scholar, Web of Science, and SID. The search terms were "Nepeta menthoides, "Ostokhodus". Triterpenes and monoterpenes were the most chemicals reported from essential oil of N. menthoides. Several pharmacological properties via in vitro, in vivo and clinical studies have been reported including antioxidant, anti-inflammatory, anti-nociceptive, antidepressant and anxiolytic, anticholinesterase, neuroprotective, memory enhancing, anti-Alzheimer’s disease, anticancer and effect on opioid dependence. Some proposed traditional indications of this herb in TPM books are in accordance with pharmacological evidence like anti-nociceptive, anti-seizure, anti-Alzheimer’s disease, memory enhancing, neuroprotective, antidepressant, anxiolytic activity and anti-infective properties. Although some properties in TPM, such as anti-tussive and gastrotonic effects are not supported by scientific evidence, they need more investigations.

Effects of Herbal combination (Melissa officinalis L. and Nepeta menthoides Boiss. & Buhse) on insomnia severity, anxiety and depression in insomniacs: Randomized placebo controlled trial

BACKGROUND

Insomnia is a prevalent disorder leading to psychological problems such as anxiety and depression.

METHODS

This study investigates the effect of a combination of herbs (Melissa officinalis L. and Nepeta menthoides Boiss. & Buhse) on anxiety and depression for insomniacs and on insomnia severity. This study is a double-blind randomized placebo-controlled clinical trial. A total number of 67 participants met the inclusion criteria who were diagnosed as cases of insomnia. The patients were randomized into the herbal treatment or placebo groups. The herbal treatment group received a combination of Melissa officinalis and Nepeta menthoides Boiss. & Buhse. The primary outcomes were insomnia, depression and anxiety. We used per-protocol analysis.

RESULTS

The all outcomes of herbal treatment were significantly improved compared with placebo in the ISI, BAI and BDI scores after four weeks' treatment (p value: 0.008, 0.005 and <0.001 respectively).

CONCLUSION

A combination of Melissa officinalis L. and Nepeta menthoides Boiss. & Buhse may improve insomnia and its comorbid depression and anxiety.

Prevention of morphine dependence and tolerance by Nepeta menthoides was accompanied by attenuation of Nitric oxide overproduction in male mice

ETHNOPHARMACOLOGICAL RELEVANCE

Repeated administration of morphine for chronic pain leads to dependence and tolerance that limits clinical usage. Nepeta menthoides is commonly known as Iranian Ustukhuddoos and are administered in traditional medicine for gastrodynia, bone pain, blood depurative and restlessness.

AIMS OF STUDY

To investigate the effects of Nepeta menthoides on expression and acquisition of morphine dependence and tolerance in mice with regard to oxidative stress.

MATERIALS AND METHODS

Morphine dependence in mice was developed by administration of gradually increasing doses of morphine twice daily for 7 consecutive days. In experimental groups, administration of Nepeta menthoides (200 and 400mg/kg), methadone and their combination were performed 60min prior to each morphine injection (for acquisition) or the last injection of morphine on test day (for expression). Morphine tolerance was measured by the tail-immersion test before and after the administration of a single dose of morphine (100mg/kg; i.p.) on the test day (8th day). Morphine dependence was also evaluated by counting the number of jumps after the injection of naloxone (5mg/kg; i.p.).

RESULTS

Nepeta menthoides, similar to methadone, significantly prevented the development (but not the expression) of morphine dependence, tolerance, and potentiated morphine antinociception and also reduced (23.23±1.15) Nitric oxide (NO) overproduction (35.23±3.36) (in compared with naloxone group (6.3±0.52)). However, single and repeated application of the extract could not change high single-dose morphine analgesia.

CONCLUSION

It appears that Nepeta menthoides and methadone prevented morphine dependence and tolerance, partly through inhibition of the NO overproduction.

Effectiveness of Anise Oil for Treatment of Mild to Moderate Depression in Patients With Irritable Bowel Syndrome: A Randomized Active and Placebo-Controlled Clinical Trial

Depression is a prevalent disorder among patients suffering from irritable bowel syndrome. The current study was performed to evaluate the effect of a traditional Persian medicine product, anise oil, in removing the symptoms of mild to moderate depression in patients with irritable bowel syndrome. In a randomized double-blinded active and placebo controlled clinical trial, 120 participants with mild to moderate depression according to the Beck Depression Inventory-II total scores were categorized into 3 equal groups and received anise oil, Colpermin, and placebo. The results at the end of trial (week 4) and follow-up (week 6) demonstrated significant priority against active and placebo groups. Although the mechanism is unknown yet, anise oil could be a promising choice of treatment for depressed patients with irritable bowel syndrome.