The protective effects of Ziziphus vulgaris L. fruits on biochemical and histological abnormalities induced by diabetes in rats

The effects of jujube (Ziziphus jujube) on metabolic and mental health outcomes in patients with metabolic syndrome: A randomized controlled trial

OBJECTIVES

The effects of jujube (Ziziphus jujube) consumption on metabolic and mental health outcomes in subjects diagnosed with metabolic syndrome (MetS) is unknown and remains to be examined. Hence, we carried out a parallel-group, randomized controlled trial to investigate this issue.

METHODS

Eligible participants were randomly assigned to the intervention (n = 30) or the control (n = 30) groups to receive either jujube or a placebo for eight weeks. Subjects were provided with 30 g dried jujube powder or placebo and were asked to consume half of the powder at 10 a.m. and the rest at 4 p.m. Lipid profile, fasting blood glucose (FBG), waist circumference (WC), and blood pressure were evaluated as primary outcomes. Secondary outcomes collected were mental health measures (e.g., depression, anxiety, and stress).

RESULTS

Jujube consumption failed to decrease FBG, total cholesterol, low-density lipoprotein cholesterol, and blood pressure, as well as depression and anxiety scores (P > 0.05). However, the between-group comparison revealed a significant improvement in WC (- 3.98 vs. - 0.51, P = 0.01), triglyceride (TG) (- 24.96 vs. - 0.73, P = 0.03), and high-density lipoprotein cholesterol (HDL-C) (2.83 vs. 0.40, P = 0.01) in the jujube group compared to the placebo. In addition, compared to the control group, jujube consumption led to a significant improvement in the score of stress (- 5.80 vs. - 2.86, P = 0.01).

CONCLUSION

Jujube consumption only had beneficial effects on WC, TG, and HDL-C in subjects with MetS. However, the current study has methodological weaknesses in blinding and herb purity/potency testing, which should be addressed in future studies.

In vitro anti-Trichomonas gallinae effects of Ziziphus vulgaris L. and Camellia sinensis (L.) Kuntze extracts

BACKGROUND

Trichomonas gallinae is a parasite that causes canker and severe loss and death, especially in young pigeons. Metronidazole (MTZ) is the recommended drug for treating avian trichomoniasis. Due to drug resistance, non-chemical alternatives, such as medicinal plant extracts, are also considered possible therapies for this disease.

OBJECTIVES

This study compares the antitrichomonal effects of MTZ with extracts of Camellia sinensis and Ziziphus vulgaris on T. gallinae in vitro.

METHODS

Samples of T. gallinae were taken from infected pigeons. Multi-well plates with different concentrations (5, 10, 25, 50 and 100 µg/mL) of plant extracts were used for the in vitro study.

RESULTS

The minimum inhibitory concentration (MIC) of C. sinensis extract was 25 µg/mL over 24 h, compared to 50 µg/mL for MTZ. The MIC value of the Z. vulgaris extracts was 50 µg/mL.

CONCLUSIONS

The results suggest that the extracts of Z. vulgaris and C. sinensis, as potential natural agents, could have anti-avian trichomoniasis properties. This study also shows that MTZ, C. sinensis and Z. vulgaris are equally effective in preventing the growth of T. gallinae trophozoites in the culture.

Effects of Fermented Camel Milk Supplemented with Sidr Fruit (Ziziphus spina-christi L.) Pulp on Hyperglycemia in Streptozotocin-Induced Diabetic Rats

Diabetes is one of the most common chronic metabolic diseases, and its occurrence rate has increased in recent decades. Sidr (Ziziphus spina-christi L.) is a traditional herbaceous medicinal plant. In addition to its good flavor, sidr has antidiabetic, anti-inflammatory, sedative, analgesic, and hypoglycemic activities. Camel milk has a high nutritional and health value, but its salty taste remains the main drawback in relation to its organoleptic properties. The production of flavored or fortified camel milk products to mask the salty taste can be very beneficial. This study aimed to investigate the effects of sidr fruit pulp (SFP) on the functional and nutritional properties of fermented camel milk. SFP was added to camel milk at rates of 5%, 10%, and 15%, followed by the selection of the best-fermented product in terms of functional and nutritional properties (camel milk supplemented with 15% SFP), and an evaluation of its hypoglycemic activity in streptozotocin (STZ)-induced diabetic rats. Thirty-two male adult albino rats (weighing 150–185 g) were divided into four groups: Group 1, nontreated nondiabetic rats (negative control); Group 2, diabetic rats given STZ (60 mg/kg body weight; positive control); Group 3, diabetic rats fed a basal diet with fermented camel milk (10 g/day); and Group 4, diabetic rats fed a basal diet with fermented camel milk supplemented with 15% SFP (10 g/day). The results revealed that supplementation of camel milk with SFP increased its total solids, protein, ash, fiber, viscosity, phenolic content, and antioxidant activity, which was proportional to the supplementation ratio. Fermented camel milk supplemented with 15% SFP had the highest scores for sensory properties compared to other treatments. Fermented camel milk supplemented with 15% SFP showed significantly decreased (p < 0.05) blood glucose, malondialdehyde, low-density lipoprotein-cholesterol, cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, creatinine, and urea, and a significantly increased (p < 0.05) high-density lipoprotein-cholesterol, total protein content, and albumin compared to diabetic rats. The administration of fermented camel milk supplemented with 15% SFP in diabetic rats restored a series of histopathological changes alonsgside an improvement in various enzyme and liver function tests compared to the untreated group, indicating that fermented camel milk supplemented with 15% SFP might play a preventive role in such patients.

The effect of dried Ziziphus vulgaris on glycemic control, lipid profile, Apo-proteins and hs-CRP in patients with type 2 diabetes mellitus: A randomized controlled clinical trial

We aimed to evaluate the effect of dried Ziziphus vulgaris [Z. vulgaris] consumption on liver enzymes, blood pressure, inflammatory status, glycemic control, and lipid concentrations in type 2 diabetes patients. Seventy-six diabetic participants (aged 20-65 years) randomly assigned to intervention (n = 38) and placebo (n = 38) groups. The intervention group received 30 g/day dried Z. vulgaris for 12 weeks. At the end of the study, there was a significant reduction in the percentage change of weight, body mass index [BMI], insulin, homeostasis model assessment-insulin resistance [HOMA-IR], Apoprotein B100 [ApoB100], and high-sensitive c-reactive protein [hs-CRP] in the intervention group compared to the controls. Also, increased values of quantitative insulin check index [QUICKI] and Apoprotein A-I [ApoA-I] in Z. vulgaris group compared to the controls were observed. In conclusion, consumption of dried Z. vulgaris fruit could have beneficial effects on improving the glycemic control and reducing the cardiovascular risk factors in the diabetic patients. PRACTICAL APPLICATIONS: In the present study we found that consumption of 30 g/day dried Z. vulgaris fruit in patients with type 2 diabetes for 12 weeks has beneficial anti-inflammatory, anti-hyperglycemic, and anti-hyperlipidemic effects on type 2 diabetes mellitus [T2DM] patients compared to the control group. Thus, it seems reasonable to design a large-scale clinical trial to determine the potential adverse effects of higher doses of this fruit and identify the therapeutic doses for the complementary treatment in T2DM medication. The medication with this popular fruit as an ingredient could be easily accepted by diabetic patients and may reduce the dependency and dosage of some of the routine diabetes medications which often have some adverse side effects.

Dietary chokeberry and dried jujube fruit attenuates high-fat and high-fructose diet-induced dyslipidemia and insulin resistance via activation of the IRS-1/PI3K/Akt pathway in C57BL/6 J mice

Background

The incidence of metabolic syndrome linked to dyslipidemia and insulin resistance has increased; thus, studies must be conducted to elucidate this phenomenon. The present study aimed to investigate the protective effects of chokeberry and dried jujube diet on high-fat and high-fructose diet-induced dyslipidemia in mice.

Methods

Male C57BL/6 J mice were divided into five groups: ND, mice fed normal diet and tap water; HFFD, mice fed 60% high-fat and 10% fructose diet (HFFD) in tap water; HFFD+C, mice fed HFFD with 1% chokeberry powder; HFFD+J, mice fed HFFD with 1% jujube fruit powder; and HFFD+M, mice fed HFFD with 0.5% chokeberry + 0.5% jujube fruit powder mixture.

Results

After 10 weeks of dietary treatment, chokeberry and dried jujube fruits reduced HFFD-induced weight gain and central obesity and decreased liver weight and abdominal and epididymal fat mass. Furthermore, such fruits attenuated HFFD-induced dyslipidemia; decreased triglyceride, total cholesterol, non-high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and very-low-density lipoprotein-cholesterol levels. Insulin resistance was improved via the consumption of dietary chokeberry and dried jujube fruits according to various indicators (serum insulin level, fasting blood glucose level, homeostatic model assessment-insulin resistance score, and oral glucose tolerance test value). These treatments were found to lower serum triglyceride levels. Moreover, the consumption of chokeberry and dried jujube changed the hepatic protein expression of insulin receptor, insulin receptor substrate 1, phosphoinositide 3-kinase, Akt, and catalase, which are associated with insulin resistance.

Conclusions

Chokeberry and dried jujube could be used in the management of dyslipidemia and insulin resistance associated with metabolic syndrome by reducing risk parameters in mice with HFFD.

A review of the molecular mechanisms of hyperglycemia-induced free radical generation leading to oxidative stress

The prevalence of diabetes is growing worldwide with an increasing morbidity and mortality associated with the development of diabetes complications. Free radical production is a normal biological process that is strictly controlled and has been shown to be important in normal cellular homeostasis, and in the bodies response to pathogens. However, there are several mechanisms leading to excessive free radical production that overcome the normal protective quenching mechanisms. Studies have shown that many of the diabetes complications result from excessive free radical generation and oxidative stress, and it has been shown that chronic hyperglycemia is a potent inducer for free radical production, generated through several pathways and triggering multiple molecular mechanisms. An understanding of these processes may help us to improving our preventive or therapeutic strategies. In this review, the major molecular pathways involved in free radical generation induced by hyperglycemia are described.

Ethnopharmacological Study of Medicinal Plants Used for Treating Dysuria: A Collection from Traditional Markets in Shiraz

Background: Data from the ethnopharmacological field on the treatment of dysuria are provided and analyzed with regard to traditional healers from Shiraz and in comparison to previous studies. Material and Methods: From April 21 to June 25, 2014, we visited traditional markets called Attari in Shiraz, and plants used in dysuria were collected. Questionnaires asking for general information on the traditional healers named Attars, local names of plant species, plant parts, preparation methods, etc. were prepared in order to gather data from Attars. Results: We visited 40 Attari, and 29 questionnaires were filled in by male Attars. Evaluation of our investigation revealed that Tribulus terrestris, Zea mays, and Cerasus avium were the most common plants suggested by Attars (24, 23, and 23, respectively). Infusion (37%) and decoction (34%) were the most common preparation methods for these plants. 50% of the main effects intended by the Attars were antimicrobial effects, while diuretic effects were reported at 35.7%. The temperament of the plants, as one aspect of the questionnaires, showed that more plants have a hot and dry temperament (47.9%). According to available studies about the plants, we found that flavonoids (78.3%), higher terpenoids (43.5%), and essential oils (39.1%) exist in higher amounts than other components in the plants. Conclusions: We analyzed the information gathered from the questionnaires and from previous studies and found that flavonoids are the most important constituents among the plants, especially those that exist in T. terrestris, Z. mays, and C. avium. Due to the useful effects of flavonoids in urological diseases, we suggest to evaluate and concentrate on the effects of flavonoids in dysuria treatments.

Acupuncture paired with herbal medicine for prediabetes: study protocol for a randomized controlled trial

Background

Type-2 diabetes has become a major disease and is known to seriously impair people’s health worldwide. Prediabetes includes impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and is the most critical period for preventing type-2 diabetes, as it can be identified and reversed. Studies in the past decade have indicated that acupuncture and Chinese herbal medicine may be beneficial for treating prediabetes. However, a randomized controlled trial (RCT) should be conducted to obtain more clinical evidence on this topic.

Methods/design

An RCT will be implemented in this study, using a72-week study period (24 weeks for the intervention and 48 weeks for follow-up). Participants will be recruited from the Fifth Affiliated Hospital of Guangzhou Medical University in China. Eighty participants will be randomized to the treatment group (acupuncture plus herbal medicine and health education) or the control group (health education only), 40 participants in each. People included in this study must have been diagnosed with prediabetes using Western medicine criteria. The endpoint indices include the incidence of diabetes mellitus and the reversion rate. The primary outcome is fasting plasma glucose (FPG) level, 2-h plasma glucose (2-hPG) level after a 75-g oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA_1c) level. Secondary outcomes include the following: Body Mass Index (BMI); hemorheology, including shear rates of whole-blood viscosity and plasma viscosity. Safety indices include hepatic (ALT, AST) and renal function (BUN, Cr) and records of adverse events, including diarrhoea, colds, pharyngitis, and sleep disorders. Quality control will be implemented, including quality control of the laboratory, researchers, participants, investigational drugs, data and documents, occurrence of bias, supervision, among others, according to uniform standard operating procedures (SOPs) which have been established by the Good Clinical Practice (GCP) office of the Fifth Affiliated Hospital of Guangzhou Medical University.

Discussion

The aim of this study is to evaluate the efficacy and safety of acupuncture paired with herbal medicine for the treatment of patients with prediabetes.

Trial registration

Chinese clinical trials register ChiCTR-INR-16008891. Registered on 23 July 2016.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-017-2014-4) contains supplementary material, which is available to authorized users.

Regulation of PCSK9 by nutraceuticals

PCSK9 (proprotein convertase subtilisin kexin type 9) is a liver secretory enzyme that regulates plasma low-density lipoprotein (LDL) cholesterol (LDL-C) levels through modulation of LDL receptor (LDLR) density on the surface of hepatocytes. Inhibition of PCSK9 using monoclonal antibodies can efficiently lower plasma LDL-C, non-high-density lipoprotein cholesterol and lipoprotein (a). PCSK9 inhibition is also an effective adjunct to statin therapy; however, the cost-effectiveness of currently available PCSK9 inhibitors is under question. Nutraceuticals offer a safe and cost-effective option for PCSK9 inhibition. Several nutraceuticals have been reported to modulate PCSK9 levels and exert LDL-lowering activity. Mechanistically, those nutraceuticals that inhibit PCSK9 through a SREBP (sterol-responsive element binding protein)-independent pathway can be more effective in lowering plasma LDL-C levels compared with those inhibiting PCSK9 through the SREBP pathway. The present review aims to collect available data on the nutraceuticals with PCSK9-inhibitory effect and the underlying mechanisms.

Emerging CAM Ziziphus nummularia with in vivo sedative-hypnotic, antipyretic and analgesic attributes

Ziziphus nummularia from Rhamnaceae family is traditionally used for sedative-hypnotic, antipyretic and analgesic purposes; however, scientific validations are lacking. This in vivo study was undertaken to verify the above ameliorative properties of Z. nummularia root methanolic extract. Various fractions of the extract were assayed on Balb/c mice by open field, Brewer’s yeast-induced hyperthermia and acetic acid-induced writhing experiments. The significance of the outcomes was analyzed with statistical tests. Various fractions of the extract exhibited marked dose-dependent (p < 0.05) sedative-hypnotic and antipyretic activities. The biological efficacies were most pronounced between 50 and 100 mg/kg. Further, the acetic acid-induced abdominal constrictions were significantly (p < 0.05) attenuated by the extract. Chloroform fraction of the extract was most dominant followed by ethyl acetate. The demonstrated therapeutic attributes of Z. nummularia extract can be exploited to isolate pharmaceutically relevant compounds.