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Farasati Far B, Gouranmohit G, Naimi-Jamal MR, Neysani E, El-Nashar HAS, El-Shazly M, Khoshnevisan K. The potential role of Hypericum perforatum in wound healing: A literature review on the phytochemicals, pharmacological approaches, and mechanistic perspectives. Phytother Res 2024; 38:3271-3295. [PMID: 38600756 DOI: 10.1002/ptr.8204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024]
Abstract
St. John's Wort, commonly known as Hypericum perforatum L., is a flowering plant in the Clusiaceae family that traditionally been employed for treating anxiety, depression, wounds, burns, sunburn, irritation, and stomach ailments. This review provides a synopsis of H. perforatum L. phytoconstituents and their biological effects, highlighting its beneficial therapeutic properties for dermatological indications, as well as its antioxidant, antimicrobial, anti-inflammatory, and anti-angiogenic activity in various applications including wound healing and skin conditions such as eczema, sun burn and minor burns also spastic paralysis, stiff neck and mood disorders as anti-depressant and nerve pains such as neuralgia. The data were collected from several databases as Web of Science PubMed, ScienceDirect, Scopus and Google Scholar using the terms: "H. perforatum L.", "H. perforatum L. /phytochemistry," and "H. perforatum extracts/wound healing" collected from 1994 to 2023. The findings suggest H. perforatum L. acts through various mechanisms and plays a role in each phase of the wound healing process, including re-epithelialization, angiogenesis, wound contraction, and connective tissue regeneration. H. perforatum L. enhances collagen deposition, decreases inflammation, inhibits fibroblast migration, and promotes epithelialization by increasing the number of fibroblasts with polygonal shape and the number of collagen fibers within fibroblasts. H. Perforatum L. extracts modulate the immune response and reduce inflammation were found to accelerate the wound healing process via inhibition of inflammatory mediators' production like interleukin-6, tumor necrosis factor-α, cyclooxygenase-2 gene expression, and inducible nitric oxide synthase. Thus, H. perforatum L. represents a potential remedy for a wide range of dermatological problems, owing to its constituents with beneficial therapeutic properties. H. perforatum L. could be utilized in the development of novel wound healing therapies.
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Affiliation(s)
- Bahareh Farasati Far
- Research Laboratory of Green Organic Synthesis and Polymers, Department of Chemistry, Iran University of Science and Technology, Tehran, Iran
| | - Ghazaleh Gouranmohit
- Faculty of Pharmaceutical Chemistry, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad Reza Naimi-Jamal
- Research Laboratory of Green Organic Synthesis and Polymers, Department of Chemistry, Iran University of Science and Technology, Tehran, Iran
| | - Erfan Neysani
- Pharmaceutical Sciences Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Heba A S El-Nashar
- Department of Pharmacognosy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Mohamed El-Shazly
- Department of Pharmacognosy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Kamyar Khoshnevisan
- Medical Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Vilhelmova-Ilieva N, Petrova Z, Georgieva A, Tzvetanova E, Trepechova M, Mileva M. Anti-Coronavirus Efficiency and Redox-Modulating Capacity of Polyphenol-Rich Extracts from Traditional Bulgarian Medicinal Plants. LIFE (BASEL, SWITZERLAND) 2022; 12:life12071088. [PMID: 35888176 PMCID: PMC9319587 DOI: 10.3390/life12071088] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 01/01/2023]
Abstract
Background: The use of various herbal therapists as part of traditional medicine in different parts of the world, including Bulgaria, is due to the knowledge accumulated over the centuries by people about their valuable biological activities. In this study, we investigate extracts from widely used Bulgarian medicinal plants for their ability to prevent the coronavirus infection of cells by testing different mechanisms of antiviral protection, their polyphenol content, and redox-modulating capacity. Methods: The influence on the stage of viral adsorption, the inhibition of extracellular virions, and the protective effect on uninfected cells of the plant’s extracts were reported by the end-point dilution method, and virus titer (in Δ lgs) was determined as compared to the untreated controls. The total content of polyphenols and flavonoids was also determined. We tested the antioxidant power of the extracts by their ability to inhibit the generation of superoxide anionic radicals and to scavenge DPPH radicals. We determined their iron-reducing, copper-reducing, and metal-chelating antioxidant powers. Results: Most of the extracts tested suppress the extracellular virions of HCov. They also inhibit the stage of viral adsorption to the host cell to varying degrees and have a protective effect on healthy cells before being subjected to viral invasion. The examined extracts contained significant levels of polyphenols and quercetin-like flavonoids and showed remarkable antioxidant, radical, and redox-modulating effects. Conclusions: All of these 13 extracts from Bulgarian medicinal plants tested can act as antioxidants and antiviral and symptomatic drugs for the management of coronavirus infection.
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Affiliation(s)
- Neli Vilhelmova-Ilieva
- The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, 26 Georgi Bonchev, 1113 Sofia, Bulgaria; (N.V.-I.); (Z.P.); (A.G.); (E.T.); (M.T.)
| | - Zdravka Petrova
- The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, 26 Georgi Bonchev, 1113 Sofia, Bulgaria; (N.V.-I.); (Z.P.); (A.G.); (E.T.); (M.T.)
- Institute of Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, 25 Georgi Bonchev, 1113 Sofia, Bulgaria
| | - Almira Georgieva
- The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, 26 Georgi Bonchev, 1113 Sofia, Bulgaria; (N.V.-I.); (Z.P.); (A.G.); (E.T.); (M.T.)
- Institute of Neurobiology, Bulgarian Academy of Sciences, 23 Acad. G. Bontchev St., 1113 Sofia, Bulgaria
| | - Elina Tzvetanova
- The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, 26 Georgi Bonchev, 1113 Sofia, Bulgaria; (N.V.-I.); (Z.P.); (A.G.); (E.T.); (M.T.)
- Institute of Neurobiology, Bulgarian Academy of Sciences, 23 Acad. G. Bontchev St., 1113 Sofia, Bulgaria
| | - Madlena Trepechova
- The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, 26 Georgi Bonchev, 1113 Sofia, Bulgaria; (N.V.-I.); (Z.P.); (A.G.); (E.T.); (M.T.)
| | - Milka Mileva
- The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, 26 Georgi Bonchev, 1113 Sofia, Bulgaria; (N.V.-I.); (Z.P.); (A.G.); (E.T.); (M.T.)
- Correspondence: ; Tel.: +359-899-151-169
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Raak CK, Ostermann T, Schönenberg-Tu AL, Fricke O, Martin DD, Robens S, Scharbrodt W. No Gender Differences in Pain Perception and Medication after Lumbar Spine Sequestrectomy—A Reanalysis of a Randomized Controlled Clinical Trial. J Clin Med 2022; 11:jcm11092333. [PMID: 35566458 PMCID: PMC9105259 DOI: 10.3390/jcm11092333] [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: 03/03/2022] [Revised: 04/11/2022] [Accepted: 04/18/2022] [Indexed: 01/20/2023] Open
Abstract
Background: Gender issues have received increasing attention in clinical research of the past years, and biological sex has been introduced as a moderating variable in experimental pain perception. However, in clinical studies of acute pain and gender, there are conflicting results. In particular, there are limited data on the impact of gender differences after spinal sequestrectomy. The aim of this work is to examine gender differences in postoperative pain and pain medication consumption in an inpatient clinical setting. Methods: Data of a completed double-blind RCT was subdivided by gender and reanalyzed by means of an analysis of variance in repeated measures. Outcomes included pain severity measured on a VAS, affective (SES-A) and sensory pain perception (SES-S) and morphine equivalent doses (MED) of analgesics after spinal sequestrectomy. Results: In total, 42 female (47.73%) and 46 male (52.27%) patients were analyzed. No differences in pain severity (VAS: Gender × Time F = 0.35; (df = 2, 86); p = 0.708), affective and sensory pain perception (SES-A: Gender × Time F = 0.08; (df = 2, 86); p = 0.919; SES-S: Gender × Time F = 0.06; (df = 2, 86); p = 0.939) or post-operative opioid use between men and women (MEDs: Gender × Time F = 1.44; (df = 2, 86); p = 0.227) could be observed. Conclusions: This reanalysis of an RCT with respect to gender differences is to our knowledge the first attempt to investigate the role of gender in pain perception and medication after lumbar spine sequestrectomy. In contrast to other studies, we were not able to show significant differences between male and female patients in all pain-related outcomes. Apart from well-established pain management, psychological reasons such as gender-specific response biases or the observer effect might explain our results. Trial registration: The study was registered as a regulatory phase IV study at the German Clinical Trials Register (DRKS), an open-access online register for clinical trials conducted in Germany (Reg-No: DRKS00007913).
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Affiliation(s)
- Christa K. Raak
- Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany; (O.F.); (D.D.M.); (W.S.)
- Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, 58313 Herdecke, Germany;
- Correspondence:
| | - Thomas Ostermann
- Department of Psychology and Psychotherapy, Witten/Herdecke University, 58448 Witten, Germany; (T.O.); (S.R.)
| | - Anna-Li Schönenberg-Tu
- Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, 58313 Herdecke, Germany;
| | - Oliver Fricke
- Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany; (O.F.); (D.D.M.); (W.S.)
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Witten/Herdecke University, 58313 Herdecke, Germany
| | - David D. Martin
- Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany; (O.F.); (D.D.M.); (W.S.)
| | - Sibylle Robens
- Department of Psychology and Psychotherapy, Witten/Herdecke University, 58448 Witten, Germany; (T.O.); (S.R.)
| | - Wolfram Scharbrodt
- Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany; (O.F.); (D.D.M.); (W.S.)
- Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, 58313 Herdecke, Germany;
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Raak CK, Scharbrodt W, Berger B, Büssing A, Schönenberg-Tu A, Martin DD, Robens S, Ostermann T. Hypericum perforatum to Improve Postoperative Pain Outcome After Monosegmental Spinal Sequestrectomy (HYPOS): Results of a Randomized, Double-Blind, Placebo-Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:407-417. [PMID: 35171041 DOI: 10.1089/jicm.2021.0389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: Patients undergoing lumbar spine surgery often suffer from severe radicular postoperative pain leading to the prescription of high-dose opioids. In Integrative Medicine, Hypericum perforatum is known as a remedy to relieve pain caused by nerve damage. Objectives: This trial investigated whether homeopathic Hypericum leads to a reduction in postoperative pain and a decrease in pain medication compared with placebo. Design: Randomized double blind, monocentric, placebo controlled clinical trial. Settings/Location: Department of Neurosurgery, Community Hospital Herdecke. Subjects: Inpatients undergoing lumbar sequestrectomy surgery. Interventions: Homeopathic treatment versus placebo in addition to usual pain management. Outcomes Measures: Primary endpoint was pain relief measured with a visual analog scale. Secondary endpoints were the reduction of inpatient postoperative analgesic medication and change in sensory and affective pain perception. Results: Baseline characteristics were comparable between the groups. Pain perception between baseline and day 3 did not significantly differ between the study arms. With respect to pain medication, total morphine equivalent doses did not differ significantly. However, a statistical trend and a moderate effect (d = 0.432) in the decrease of pain medication consumption in favor of the Hypericum group was observed. Conclusion: This is the first trial of homeopathy that evaluated the efficacy of Hypericum C200 after lumbar monosegmental spinal sequestrectomy. Although no significant differences between the groups could be shown, we found that patients who took potentiated Hypericum in addition to usual pain management showed lower consumption of analgesics. Further investigations, especially with regard to pain medication, should follow to better classify the described analgesic reduction. Clinical Trial Registration Number: German Clinical Trials Register No: DRKS00007913.
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Affiliation(s)
- Christa K Raak
- Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany.,Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, Herdecke, Germany
| | - Wolfram Scharbrodt
- Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, Herdecke, Germany
| | - Bettina Berger
- Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany
| | - Arndt Büssing
- Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany
| | - Anna Schönenberg-Tu
- Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, Herdecke, Germany
| | - David D Martin
- Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany
| | - Sibylle Robens
- Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Witten, Germany
| | - Thomas Ostermann
- Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Witten, Germany
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Abstract
Dietary supplements are frequently used in surgical patients. Surgeons should be up to date with regard to the efficacies and potential complications related to these supplements. This article provides the most updated practices and evidence of commonly used supplements.
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