Human placental extract: a potential therapeutic in treating osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease marked by cartilage degradation and loss of function. Recently, there have been increased efforts to attenuate and reverse OA by stimulating cartilage regeneration and preventing cartilage degradation. Human placental extract (HPE) may be an option due to its anti-inflammatory, antioxidant, and growth stimulatory properties. These properties are useful in preventing cell death and senescence, which may optimize in-situ cartilage regeneration. In this review, we discuss the anatomy and physiology of the placenta, as well as explore in vivo and in vitro studies assessing its effects on tissue regeneration. Finally, we assess the potential role of HPE in cartilage regenerative medicine and OA. The Medline database was utilized for all studies that involved the use of HPE or human placenta hydrolysate. Exclusion criteria included articles not written in English, conference reviews, editorials, letters to the editor, surveys, case reports, and case series. HPE had significant anti-inflammatory and regenerative properties in vitro and in vivo. Furthermore, HPE had a role in attenuating cellular senescence and cell apoptosis via reduction of reactive oxidative species both in vitro and in vivo. One study explored the effects of HPE in OA and demonstrated reduction in cartilage catabolic gene expression, indicating HPE's effect in attenuating OA. HPE houses favorable properties that can attenuate and reverse tissue damage. This may be a beneficial therapeutic in OA as it creates a more favorable environment for in-situ cartilage regeneration. More well designed in-vitro and in-vivo studies are needed to define the role of HPE in treating OA.

Camel (Camelus spp.) Urine Bioactivity and Metabolome: A Systematic Review of Knowledge Gaps, Advances, and Directions for Future Research

Up to the present day, studies on the therapeutic properties of camel (Camelus spp.) urine and the detailed characterization of its metabolomic profile are scarce and often unrelated. Information on inter individual variability is noticeably limited, and there is a wide divergence across studies regarding the methods for sample storage, pre-processing, and extract derivatization for metabolomic analysis. Additionally, medium osmolarity is not experimentally adjusted prior to bioactivity assays. In this scenario, the methodological standardization and interdisciplinary approach of such processes will strengthen the interpretation, repeatability, and replicability of the empirical results on the compounds with bioactive properties present in camel urine. Furthermore, sample enlargement would also permit the evaluation of camel urine's intra- and interindividual variability in terms of chemical composition, bioactive effects, and efficacy, while it may also permit researchers to discriminate potential animal-intrinsic and extrinsic conditioning factors. Altogether, the results would help to evaluate the role of camel urine as a natural source for the identification and extraction of specific novel bioactive substances that may deserve isolated chemical and pharmacognostic investigations through preclinical tests to determine their biological activity and the suitability of their safety profile for their potential inclusion in therapeutic formulas for improving human and animal health.

No. 378-Placentophagy

Consumption of human placenta has recently been highlighted; however, there is no evidence of benefit from its consumption. In addition, there is potential for harm. Therefore the SOGC does not recommend the practice of placentophagy.

Birth, attitudes and placentophagy: a thematic discourse analysis of discussions on UK parenting forums

BACKGROUND

The post-partum consumption of the placenta by the mother (placentophagy) has been practiced since the 1970s in the global North and is seemingly increasing in popularity. Maternal placentophagy is not known to have been practiced in any other time period or culture, despite being near-ubiquitous in other placental mammals. An in-depth qualitative exploration as to the reasons for the practice, its increasing popularity and how it is narratively incorporated into discourses surrounding "ideal" natural and medical births are given in this paper.

METHODS

1752 posts from 956 users across 85 threads from the parenting forums Mumsnet and Netmums were identified for inclusion. A thematic discourse analysis was performed using NVivo.

RESULTS

Three main themes were identified: women recounted predominantly positive attitudes towards their own experiences of placentophagy, and they were respectful of others' views and experiences; some had negative views, particularly around the concept of disgust, but again, they were respectful of others' experiences. By far the most common method of consumption of the placenta was encapsulation.

CONCLUSIONS

This paper identifies the motivation for placentophagy to almost universally be for medical benefits, most commonly the prevention or treatment of post-natal depression (PND). Whilst disgust is a common reaction, discussion of risks is rare, and positive experiences outweigh negative ones. The increasing popularity of the practice is ascribed in part to the comparative palatability of encapsulation and the use of the internet to share resources and remove barriers. Parenting forums are important spaces to negotiate normative birth practices, including placentophagy, and act to build communities of women who value personal experience over medical evidence and highly value personal choice and bodily autonomy. Placentophagy is discussed in terms of its relation to natural and medical births with arguments being made using both discourses for and against the practice. This paper argues that placentophagy is practiced as a resistance to medicalisation as an assertion of control by the mother, whilst simultaneously being a medicalised phenomenon itself.

Perspectives from Patients and Healthcare Providers on the Practice of Maternal Placentophagy

PURPOSE

Placentophagy (maternal consumption of the placenta) has become increasingly prevalent in the past decade among women seeking to promote health and healing during the postpartum period. The purpose of this study was to assess patient and provider familiarity with and attitudes toward placentophagy, as well as patients' willingness to try placentophagy.

METHODS

Two cross-sectional surveys with questions regarding placentophagy practice were distributed to healthcare providers and patients. The provider survey was distributed via email listservers to international perinatal professional organizations and to obstetrics and gynecology, nurse midwifery, family medicine, and psychiatry departments at three urban hospitals. Patient surveys were administered in person at an urban hospital in Chicago, Illinois.

RESULTS

Approximately two thirds (66%; n = 100) of patients and most (89%; n = 161) of providers were familiar with placentophagy. Patients with a history of a self-reported mental health disorder were more likely to be willing to consider placentophagy and to believe that healthcare providers should discuss it with their patients.

CONCLUSIONS

Most providers and patients have heard of placentophagy but are unsure of its benefits and/or risks. Further research examining the potential therapeutic efficacy and/or risks of placentophagy is needed.

A Literature Review on the Practice of Placentophagia

Placentophagia (consuming the placenta) has historically not been a common practice among humans. Over the past few decades the practice has gained attention as more women, particularly educated, middle-class, White American women, choose to partake in this practice. Purported benefits of placentophagia include pain relief, increased breast milk production, and decreased risk of postpartum depression; however, there is a lack of evidence to support these claims. The placenta can be consumed raw, cooked, or encapsulated; it can be used for keepsakes; or it can be used to make topical applications such as dermatologic creams and hair-growth products. Placentophagia has typically been viewed as a personal choice, resulting in little rigorous scientific research on the topic. More research is necessary to determine if the purported health benefits of placentophagia are proven.

Review of practice: Facilitating normality at caesarean section

Expectant women often write detailed birth plans outlining their preferences for the birth of their baby. These plans are pushed aside when a caesarean is deemed necessary, being replaced with medical decisions in a clinical setting. In the busiest maternity unit in the South West, our team are trying to change this attitude, encompassing many of the key points of 'normal' birth choices that are important to mothers during caesarean section, without compromising clinical care.

Placentophagy: therapeutic miracle or myth?

Postpartum women are consuming their placentas encapsulated, cooked, and raw for the prevention of postpartum depression (PPD), pain relief, and other health benefits. Placentophagy is supported by health advocates who assert that the placenta retains hormones and nutrients that are beneficial to the mother. A computerized search was conducted using PubMed, Medline Ovid, and PsychINFO between January 1950 and January 2014. Keywords included placentophagy, placentophagia, maternal placentophagia, maternal placentophagy, human placentophagia, and human placentophagy. A total of 49 articles were identified. Empirical studies of human or animal consumption of human placentas were included. Editorial commentaries were excluded. Animal placentophagy studies were chosen based on their relevance to human practice. Ten articles (four human, six animal) were selected for inclusion. A minority of women in developed countries perceive placentophagy to reduce PPD risk and enhance recovery. Experimental animal research in support of pain reduction has not been applied in humans. Studies investigating placenta consumption for facilitating uterine contraction, resumption of normal cyclic estrogen cycle, and milk production are inconclusive. The health benefits and risks of placentophagy require further investigation of the retained contents of raw, cooked, and encapsulated placenta and its effects on the postpartum woman.