Traditional uses of medicinal plants to prevent and treat diabetes; an updated review of ethnobotanical studies in Iran

Economic burden of diabetic foot ulcer: a case of Iran

BACKGROUND

Diabetic foot ulcer (DFU) is known as a serious complication of diabetes mellitus in patients with diabetes, imposing heavy medical costs on healthcare systems due to its chronic nature. patients with severe diabetic foot ulcer are often disabled to work, and some of them may even die, leading to associated productivity losses. Since no previous study has investigated the economic burden of DFU in Iran, this study is to estimate the economic burden of diabetic foot disease in Iran.

METHODS

In this descriptive cross-sectional study, randomly selected samples consisted of 542 patients with DFU, hospitalized in the hospitals of Shahid Beheshti University of Medical Sciences. The demographic profile and cost data used in this analysis were derived from a researcher-designed checklist. Lost productivity was calculated based on Human Capital Approach, and the total economic cost of DFU was determined using patient-level data on costs and prevalence data from the global burden of diseases reports. All analyses were performed using SPSS software (Version 23), and Microsoft Excel (Version 19).

RESULTS

The economic burden of DFU in Iran in two scenarios of discounting future costs and not discounting them was about $8.7 billion and $35 billion, respectively (about 0.59 and 2.41% of GDP). 79.25% of the estimated costs in this study were indirect costs and productivity losses, of which 99.34% (7,918.4 million Dollars) were productivity losses due to premature death. 20.75% (2,064.4 million dollars) of the estimated costs in this study were direct costs. The average length of stay (LOS) was 8.10 days (SD = 9.32), and 73.3% of patients recovered and were discharged after hospitalization and 7.6% died. The majority of the costs are imposed on the age group of 60-69 year (53.42% of the productivity lost due to hospital length of stay, 58.91% of the productivity lost due to premature death & 40.41% of direct costs).

CONCLUSIONS

DFU represents a heavy burden to patients, Iran's health system, and the economy. Early prevention strategies need to be prioritized in making public health policies. These policies and decisions can be in the area of changing lifestyle, health education, changing people's behavior, and encouraging physical activity that targeted high-risk populations in order to reduce the prevalence of diabetic foot and resulting substantial economic burden.

The effect of cinnamon supplementation on glycemic control in patients with type 2 diabetes mellitus: An updated systematic review and dose-response meta-analysis of randomized controlled trials

Although many randomized controlled trials (RCTs) have revealed the benefits of cinnamon on type 2 diabetes mellitus (T2DM), the effects of cinnamon supplementation on glycemic control in patients with T2DM are inconclusive. Therefore, the aim of this meta-analysis of RCTs was to assess the effects of cinnamon supplementation in managing glycemic control in patients with T2DM. Scientific international databases including Scopus, Web of Sciences, PubMed, Embase, and the Cochrane Library were searched till December 2022. For net changes in glycemic control, standard mean differences (SMDs) were calculated using random-effects models. Findings from 24 RCTs revealed that cinnamon supplementation had a statistically significant reduction in fasting blood sugar (SMD: -1.32; 95% CI: -1.77, -0.87, p < 0.001), Homeostatic Model Assessment for Insulin Resistance (SMD: -1.32; 95% CI: -1.77, -0.87, p < 0.001), and hemoglobin A1C (SMD: -0.67; 95% CI: -1.18, -0.15, p = 0.011) compared with the control group in patients with T2DM. Additionally, cinnamon did not change the serum levels of insulin (SMD: -0.17; 95% CI: -0.34, 0.01, p = 0.058) significantly. Our analysis indicated that glycemic control indicators are significantly decreased by cinnamon supplementation. Together, these findings support the notion that cinnamon supplementation might have clinical potential as an adjunct therapy for managing T2DM.

Citrullus colocynthis (L.) Schrad.: A Promising Pharmaceutical Resource for Multiple Diseases

Citrullus colocynthis (L.) Schrad. (Cucurbitaceae) is widely distributed in the desert areas of the world. The fruit bodies of C. colocynthis are recognized for their wide range of nutraceutical potential, as well as medicinal and pharmaceutical uses. The plant has been reported for various uses, such as asthma, bronchitis, cancer, colic, common cold, cough, diabetes, dysentery, and jaundice. The fruit has been extensively studied for its biological activities, which include insecticide, antitumor, and antidiabetic effects. Numerous bioactive compounds have been reported in its fruit bodies, such as essential oils, fatty acids, glycosides, alkaloids, and flavonoids. Of these, flavonoids or caffeic acid derivatives are the constituents associated with the inhibition of fungal or bacterial growth, whereas eudesmane sesquiterpenes or sesquiterpene lactones are most active against insects, mites, and nematodes. In this review, the scientific evidence for the biological activity of C. colocynthis against insecticide, cytotoxic, and antidiabetic effects is summarized.

The effect of cinnamon supplementation on glycemic control in patients with type 2 diabetes or with polycystic ovary syndrome: an umbrella meta-analysis on interventional meta-analyses

BACKGROUND

Several meta-analyses reported glycemic-lowering effects of cinnamon, while others reported conflicting findings. In the present study, we aimed to perform an umbrella meta-analysis of previous interventional meta-analyses on the effects of cinnamon on glycemic control in patients with type 2 diabetes (T2D) or with polycystic ovary syndrome (PCOS).

METHODS

Relevant studies were searched in PubMed, Scopus, EMBASE, Web of Science, and Google Scholar up to June 2022. Meta-analyses of randomized clinical trials (RCTs) investigating the effects of cinnamon on glycemic indices including fasting plasma glucose (FPG), homeostatic model assessment for insulin resistance (HOMA-IR), insulin, and hemoglobin A1C (HbA1c) were included. Random-effects models were used to perform the umbrella meta-analysis and pool the weighted mean difference (WMD) or standardized mean difference (SMD) and their 95% confidence intervals (CI).

RESULTS

Overall, 11 meta-analyses of RCTs were included. Cinnamon supplementation was effective in reducing serum FPG (WMD: -10.93 mg/dL; 95%CI: -16.22, -5.65; SMD: -0.86; 95%CI: -1.19, -0.52), insulin (WMD: -2.01 IU/mL; 95%CI: -3.96, -0.07; SMD: -0.61; 95%CI: -0.93, -0.30), HOMA-IR levels (WMD: -0.61; 95%CI: -0.91, -0.31; SMD: -0.78; 95%CI: -1.26, -0.30), and HbA1c (WMD: -0.10%; 95%CI: -0.17, -0.03).

CONCLUSION

Cinnamon can be used as an anti-diabetic agent and an add-on treatment to control glycemic indices among patients with T2D or PCOS.

Novel zinc oxide nanoparticles of Teucrium polium suppress the malignant progression of gastric cancer cells through modulating apoptotic signaling pathways and epithelial to mesenchymal transition

Management of gastric cancer is still challenging due to resistance to current chemotherapeutics and recurrent disease. Moreover, green- synthesized zinc oxide nanoparticles (ZnO-NPs) using natural resources are one of the most promising therapeutic agents for anticancer therapy. Here we report the facile green synthesis and characterization of ZnO-NPs from Teucrium polium (TP-ZnO-NP) herb extract and the anticancer activities of these nanoparticles on gastric cancer cells. Facile green synthesis of TP-ZnO-NP was achieved using zinc acetate dihydrate. For the characterization of TP-ZnO-NP, UV-vis spectroscopy, FTIR, SEM, XRD and EDX analyses were performed. Antiproliferative and anticancer activities of TP-ZnO-NP were explored using the HGC-27 gastric cancer cell line model. MTT cell viability and colony formation assays were used for the analysis of cell proliferation and migration. Wound healing assay was used to analyze the migration capacities of cells. Annexin V/PI double staining, DNA ladder assay, and Acridine orange/Ethidium bromide staining were performed to analyze the induction of apoptosis. qPCR was used to determine gene expression levels of apoptotic and epithelial to mesenchymal transition marker genes. The aqueous extract of TP served as both a reducing and capping agent for the successful biosynthesis of zinc oxide nanoparticles. Remarkably, synthesized TP-ZnO-NPs were found to have significant antiproliferative and anticancer activities on HGC-27 gastric cancer cells. Collectively, current data suggest that TP-ZnO-NP is a novel and promising anticancer agent for future therapeutic interventions in gastric cancer.

Traditional uses, phytochemistry, pharmacology and toxicology of garlic (Allium sativum), a storehouse of diverse phytochemicals: A review of research from the last decade focusing on health and nutritional implications

Allium sativum L. (Garlic) is a fragrant herb and tuber-derived spice that is one of the most sought-after botanicals, used as a culinary and ethnomedicine for a variety of diseases around the world. An array of pharmacological attributes such as antioxidant, hypoglycemic, anti-inflammatory, antihyperlipidemic, anticancer, antimicrobial, and hepatoprotective activities of this species have been established by previous studies. A. sativum houses many sulfur-containing phytochemical compounds such as allicin, diallyl disulfide (DADS), vinyldithiins, ajoenes (E-ajoene, Z-ajoene), diallyl trisulfide (DATS), micronutrient selenium (Se) etc. Organosulfur compounds are correlated with modulations in its antioxidant properties. The garlic compounds have also been recorded as promising immune-boosters or act as potent immunostimulants. A. sativum helps to treat cardiovascular ailments, neoplastic growth, rheumatism, diabetes, intestinal worms, flatulence, colic, dysentery, liver diseases, facial paralysis, tuberculosis, bronchitis, high blood pressure, and several other diseases. The present review aims to comprehensively enumerate the ethnobotanical and pharmacological aspects of A. sativum with notes on its phytochemistry, ethnopharmacology, toxicological aspects, and clinical studies from the retrieved literature from the last decade with notes on recent breakthroughs and bottlenecks. Future directions related to garlic research is also discussed.

Investigation of the Chemical Composition, Antihyperglycemic and Antilipidemic Effects of Bassia eriophora and Its Derived Constituent, Umbelliferone on High-Fat Diet and Streptozotocin-Induced Diabetic Rats

This study was designed to investigate the chemical profile, antihyperglycemic and antilipidemic effect of total methanolic extract (TME) of Bassia eriophora and isolated pure compound umbelliferone (UFN) in high-fat diet (HFD)- and streptozotocin (STZ)- induced diabetic rats. TME was subjected to various techniques of chromatography to yield UFN. Diabetes was induced after eight weeks of HFD by administration of STZ (40 mg/kg) intraperitoneally, and experimental subjects were divided into five groups. The diabetic control showed an increase in levels of blood glucose throughout the experiment. Treatments were initiated in the other four groups with glibenclamide (GLB) (6 mg/kg), TME (200 mg/kg and 400 mg/kg) and isolated UFN (50 mg/kg) orally. The effect on blood glucose, lipid profile and histology of the pancreatic and adipose tissues was assessed. Both 200 and 400 mg/kg of TME produced a comparably significant decrease in blood glucose levels and an increase in insulin levels with GLB. UFN began to show a better blood sugar-lowering effect after 14 days of treatment, comparatively. However, both 400 mg/kg TME and UFN significantly returned blood glucose levels in diabetic rats compared to normal rats. Analysis of the lipid profile showed that while HFD + STZ increased all lipid profile parameters, TME administration produced a significant decrease in their levels. Histopathological examinations showed that treatment with TME and UFN revealed an improved cellular architecture, with the healthy islets of Langerhans and compact glandular cells for pancreatic cells distinct from damaged cells in non-treated groups. Conversely, the adipose tissue displayed apparently normal polygonal fat cells. Therefore, these results suggest that TME has the potential to ameliorate hyperglycemia conditions and control lipid profiles in HFD + STZ-induced diabetic rats.

A Study on the Safety and Effects of Amorpha fruticosa Fruit Extract on Spontaneously Hypertensive Rats with Induced Type 2 Diabetes

Metabolic syndrome is characterized by a variety of diagnostic criteria: obesity, dyslipidemia, type 2 diabetes, and arterial hypertension. They contribute to the elevated risk of cardiovascular morbidity and mortality. The potential for Amorpha fruticosa L. (Fabaceae) to improve diabetes and metabolic disease is promising, based on in vitro tests. This is why a further investigation of the species is needed. Additionally, a toxicity review in relation to safety revealed that to date, there are no published data regarding the toxicity of A. fruticosa towards humans. This species could provide abundant and cheap resources because it is an aggressive invasive plant that grows almost unrestrictedly. The objective of this study was to evaluate the acute toxicity of a purified extract of A. fruticosa (EAF), and to assess its antioxidant, antihypertensive, and antihyperglycemic activity in streptozotocin-induced diabetic spontaneously hypertensive rats (SHRs). The EAF was slightly toxic (LD50 = 2121 mg/kg, b.w.) when administered orally, and moderately toxic (LD50 = 316 mg/kg, b.w.) at intraperitoneal administration, both in mice. The oral administration of EAF (100 mg/kg) for 35 days to SHRs caused significant decreases in the systolic pressure, blood glucose levels, and MDA quantity. It also increased the hepatic level of the endogenous antioxidant GSH, not only in diabetic SHRs, but also in the control group. An additional potential benefit to human health might be conferred through the environmental management of A. fruticosa based on its large-scale use for medicinal purposes, as this aggressive invasive species brings problems to natural habitats in many European countries.

Bioprospecting the Metabolome of Plant Urtica dioica L.: A Fast Dereplication and Annotation Workflow in Plant Metabolomics

Plants have a pivotal role in ethnopharmacology, and their preparations are in use globally. However, getting down to the structure requires an effective workflow and mostly requires a time-consuming isolation process. Although bioassay-guided approaches are widely popular, they face a massive problem of rediscovery in recent times, especially in plant metabolomics. Mass spectrometry (MS)-based approach incorporated molecular networking via Global Natural Product Social Molecular Networking (GNPS) is considered here for the benefit of the fast screening of secondary metabolites. This study uses direct crude extracts obtained from various parts of the Urtica dioica plant for the characterization of secondary metabolites. The crude extract of the plant initially displayed promising antioxidant and anti-diabetic activities. Then, we employed mass spectrometry-based dereplication to identify the phytochemical components in the extracts. This led to the discovery of 7 unknown and 17 known secondary metabolites, which were further verified with the SIRIUS 4 platform, a computational tool for the annotation of compounds using tandem MS data. On the other hand, chasing the antioxidant activity of methanolic extract of U. dioica leaves, we employed a bioassay-guided isolation approach. With this method, we isolated and characterized compound 13, a known molecule, which possessed strong antioxidant activity without showing much toxicity in the brine shrimp lethality test at the test concentration of 1 mg/mL. With our results, we advocate the MS-based approach as a good starting point for the dereplication of compounds from the complex crude extracts of plants.

A review of the effects of Urtica dioica (nettle) in metabolic syndrome

Metabolic syndrome is a serious health condition, yet a common worldwide disorder. It includes several risk factors such as hypertension, dyslipidemia, and high glucose levels which lead the patients to higher risks of cardiovascular diseases, diabetes, and stroke. Phytotherapy plays an important role in treating components of metabolic syndrome. Nettle (Urtica dioica) is considered a valuable plant due to bioactive compounds such as formic acid and rich sources of flavonoids. To acknowledge the role of nettle in metabolic syndrome, several mechanisms have been suggested such as alterations in potassium and calcium channels which improve hypertension. Antihyperlipidemic properties of nettle are mediated by inhibition of HMGCoA reductase and amelioration of lipid peroxidation via antioxidant effects. Also, one of the flavonoids in nettle, quercetin, is responsible for decreasing total cholesterol. Moreover, nettle is responsible for anti-diabetic effects through processes such as increasing insulin secretion and proliferation of pancreatic β-cells. This review aims to gather different studies to confirm the potential efficacy of nettle in metabolic syndrome.

Urtica dioica-Derived Phytochemicals for Pharmacological and Therapeutic Applications

Urtica dioica belongs to the Urticaceae family and is found in many countries around the world. This plant contains a broad range of phytochemicals, such as phenolic compounds, sterols, fatty acids, alkaloids, terpenoids, flavonoids, and lignans, that have been widely reported for their excellent pharmacological activities, including antiviral, antimicrobial, antihelmintic, anticancer, nephroprotective, hepatoprotective, cardioprotective, antiarthritis, antidiabetic, antiendometriosis, antioxidant, anti-inflammatory, and antiaging effects. In this regard, this review highlights fresh insight into the medicinal use, chemical composition, pharmacological properties, and safety profile of U. dioica to guide future works to thoroughly estimate their clinical value.

Novel Perceptions on Chemical Profile and Biopharmaceutical Properties of Mentha spicata Extracts: Adding Missing Pieces to the Scientific Puzzle

Mentha spicata is one of the most popular species in the genus, and it is of great interest as a gastrointestinal and sedative agent in the folk medicine system. In this study, different M. spicata extracts, obtained by the use of four solvents (hexane, chloroform, acetone and acetone/water) were chemically characterized using HPLC-ESI-MS n, which allowed for identification of 27 phenolic compounds. The extracts' antioxidant and enzyme inhibitory properties were investigated. In addition, neuroprotective effects were evaluated in hypothalamic HypoE22 cells, and the ability of the extracts to prevent the hydrogen peroxide-induced degradation of dopamine and serotonin was observed. The best antioxidant effect was achieved for all the extraction methods using acetone/water as a solvent. These extracts were the richest in acacetin, eriodictyol, hesperidin, sagerinic acid, naringenin, luteolin, chlorogenic acid, chrysoeriol and apigenin. The intrinsic antioxidant and enzyme inhibition properties of the acetone/water extract could also explain, albeit partially, its efficacy in preventing prostaglandin E2 overproduction and dopamine depletion (82.9% turnover reduction) in HypoE22 cells exposed to hydrogen peroxide. Thus, our observations can provide a scientific confirmation of the neuromodulatory and neuroprotective effects of M. spicata.

The traditional uses, phytochemistry and pharmacology of spearmint (Mentha spicata L.): A review

ETHNOPHARMACOLOGY RELEVANCE

Mentha spicata L. (Lamiaceae), commonly called Spearmint, is wildly cultivated worldwide for its remarkable aroma and commercial value. In addition to traditional foods flavouring agent, M. spicata is well known for its traditional medicinal uses, particularly for the treatment of cold, cough, asthma, fever, obesity, jaundice and digestive problems.

AIM OF THE REVIEW

This review aims to critically appraise scientific literature regarding the traditional uses, bioactive chemical constituents and pharmacological activities of M. spicata.

MATERIALS AND METHODS

A review of the literature information on M. spicata was searched from scientific electronic search databases (Google Scholar, PubMed, Web of Science, ACS, Science Direct, Taylor and Francis, Wiley, Springer and SCOPUS. Structures for secondary metabolites were confirmed using PubChem and ChemSpider.

RESULTS

The studies conducted on either crude extracts, essential oil or isolated pure compounds from M. spicata had reported a varied range of biological effects including antibacterial, antifungal, antioxidant, hepatoprotective, antidiabetic, cytotoxic, anti-inflammatory, larvicidal activity, antigenotoxic potential and antiandrogenic activities. Phytochemical analysis of various parts of M. spicata revealed 35 chemical constituents, belonging to phenolic acids, flavonoids and lignans.

CONCLUSION

The review finding indicates that the pharmacological properties of M. spicata supported its traditional uses. The essential oils and extracts showed remarkable antimicrobial, antioxidant, anticancer, anti-inflammatory and hepatoprotective activities. However, more studies, especially in vivo experiments and clinical trials of the human to evaluate cellular and molecular mechanisms based pharmacological, bioactive effectiveness and safety investigation, should be undertaken in the future to provide stronger scientific proof for their traditional medicinal properties.

A Review of the Phytochemistry, Traditional Uses and Biological Activities of the Essential Oils of Genus Teucrium

The genus Teucrium is a large and polymorphic genus of the Lamiaceae family distributed in mild climate zones, particularly in the Mediterranean basin and Central Asia. Studies of nonvolatile constituents of Teucrium species showed that they are a rich source of neo-clerodane diterpenoids, considered as chemotaxonomic markers of the genus. In addition to the nonvolatile metabolites, there has been a large interest in the essential oils of this genus. In this review, a complete survey of the chemical composition and biological properties of the essential oils isolated from Teucrium taxa is provided. In traditional medicine, since ancient times, species of this genus have been widely implemented for their biological properties, including antimicrobial, anti-inflammatory, antispasmodic, insecticidal, anti-malaria, etc. Therefore, a complete review of all of the traditional uses of Teucrium taxa are also reported.

Quantitative ethnomedicinal study of plants used to cure different ailments in Rajaji tiger reserve, Uttarakhand, India

Introduction: India has a rich diversity of ethnomedicinal plants where the preparations from plants are used in treatment of various infection and ailments.

Objectives: The detailed survey was done to gather the information about potential preparation of ethno-medicinal plants by the local communities of the study area.

Methods: Data on 54 ethnomedicinal plants were recorded with the help of 19 men and 18 women aged between 45 and 60. Direct observation, group discussion and semi structured interview were used to collect the ethnobotanical information of the study area.

Results: Prevalent ethnomedicinal uses of the plants were used for treating diarrhoea, asthma, dysentery, and other human ailments. The most commonly plant parts gathered were leaves (28.78 %) followed by bark (19.69 %), root (12.12 %), flower (10.60 %), fruit (9.09 %), seed and whole plant (7.57 % each), stem (4.54 %). It was observed from the investigation that the ethnomedicinal plants used most frequently in the treatment of diarrhoea and dysentery (29 taxa) followed by other liver problems (7 taxa), healing cut and wounds, tooth problems, blood dysentery, piles, asthma, fractured bones, scorpion/insects bite (2 taxa), skin diseases, urinary disorder and headache, menstrual disorder, infertility, stone problems, cold and cough, muscle pain and swelling, memory enhancer, killing of liver worms in children, insects repellent, bronchial catarrh (1 taxa each).

Conclusion: The folk knowledge and ethnomedicinal preparation recorded in the present study area can be implemented in future for pharmacological and biological assay which could be further lead to new drug development.

Evaluation of clinical trials for natural products used in diabetes: An evidence-based systemic literature review

BACKGROUND RELEVANCE

A plethora of literature is available regarding the clinical trials for natural products however; no information is available for critical assessments of the quality of these clinical trials.

AIM OF STUDY

This is a first time report to critically evaluate the efficacy, safety and large scale applications of up-to-date clinical trials for diabetes, based on the three scales of Jadad, Delphi, and Cochrane.

METHODOLOGY

An in-depth and extensive literature review was performed using various databases, journals, and books. The keywords searched included, "clinical trials," "clinical trial in diabetes," "diabetes," "natural products in diabetes," "ethnopharmacological relevance of natural products in diabetes," etc.

RESULTS

Based on eligibility criteria, 16 plants with 74 clinical trials were found and evaluated. Major drawbacks observed were; "non-randomization and blindness of the studies," "non-blindness of patients/healthcare/outcome assessors," "lack of patient compliance and co-intervention reports," "missing information regarding drop-out/withdrawal procedures," and "inappropriate baseline characteristics." Principal component analysis and Pearson correlation revealed four components with %variability; PC1: 23.12, PC2: 15.83, PC3: 13.11, and PC4: 11.38 (P ≤ .000). According to descriptive statistics, "non-blinding of outcome assessors" was the major drawback (82%) whereas, "not mentioning the timing of outcome assessment" was observed lowest (6.8%). An in-house quality grading (scale 0-24) classified these clinical trials as; poor (67.6%), acceptable (19.9%), and good quality trials (13.5%).

CONCLUSION

Proper measures in terms of more strict regulations with pharmacovigilance of plants are utmost needed in order to achieve quality compliance of clinical trials.

Middle East Medicinal Plants in the Treatment of Diabetes: A Review

Diabetes is a global health problem, and the number of diabetic patients is in continuous rise. Conventional antidiabetic therapies are associated with high costs and limited efficiency. The use of traditional medicine and plant extracts to treat diabetes is gaining high popularity in many countries. Countries in the Middle East region have a long history of using herbal medicine to treat different diseases, including diabetes. In this review, we compiled and summarized all the in vivo and in vitro studies conducted for plants with potential antidiabetic activity in the Middle East region. Plants of the Asteraceae and Lamiaceae families are the most investigated. It is hoped that this review will contribute scientifically to evidence the ethnobotanical use of medicinal plants as antidiabetic agents. Work has to be done to define tagetes, mechanism of action and the compound responsible for activity. In addition, safety and pharmacokinetic parameters should be investigated.

Neuroprotective Effects of Medicinal Plants in Cerebral Hypoxia and Anoxia: A Systematic Review

Background:

Hypoxia and anoxia are dangerous and sometimes irreversible complications in the central nervous system (CNS), which in some cases lead to death.

Objective:

The aim of this review was to investigate the neuroprotective effects of medicinal plants in cerebral hypoxia and anoxia.

Methods:

The word hypox*, in combination with some herbal terms such as medicinal plant, phyto* and herb*, was used to search for relevant publications indexed in the Institute for Scientific Information (ISI) and PubMed from 2000-2019.

Results:

Certain medicinal plants and herbal derivatives can exert their protective effects in several ways. The most important mechanisms are the inhibition of inducible nitric oxide synthase (iNOS), production of NO, inhibition of both hypoxia-inducible factor 1α and tumor necrosis factor-alpha activation, and reduction of extracellular glutamate, N-Methyl-D-aspartic and intracellular Ca (2+). In addition, they have an antioxidant activity and can adjust the expression of genes related to oxidant generation or antioxidant capacity. These plants can also inhibit lipid peroxidation, up-regulate superoxide dismutase activity and inhibit the content of malondialdehyde and lactate dehydrogenase. Moreover, they also have protective effects against cytotoxicity through down-regulation of the proteins that causes apoptosis, anti-excitatory activity, inhibition of apoptosis signaling pathway, reduction of pro-apoptotic proteins, and endoplasmic reticulum stress that causes apoptosis during hypoxia, increasing anti-apoptotic protein, inhibition of protein tyrosine kinase activation, decreasing proteases activity and DNA fragmentation, and upregulation of mitochondrial cytochrome oxidase.

Conclusion:

The results indicated that medicinal plants and their compounds mainly exert their neuroprotective effects in hypoxia via regulating proteins that are related to antioxidant, anti-apoptosis and anti-inflammatory activities.

The Influence of Nasturtium officinale R. Br. Agar and Agitated Microshoot Culture Media on Glucosinolate and Phenolic Acid Production, and Antioxidant Activity

This paper presents an optimization of conditions for microshoot cultures of Nasturtium officinale R. Br. (watercress). Variants of the Murashige and Skoog (MS) medium containing different plant growth regulators (PGRs): cytokinins—BA (6-benzyladenine), 2iP (6-γ,γ-dimethylallylaminopurine), KIN (kinetin), Zea (zeatin), and auxins—IAA (3-indoleacetic acid), IBA (indole-3-butyric acid), 2,4-d (2,4-dichlorophenoxyacetic acid), IPA (indole-3-pyruvic acid), NAA (naphthalene-1-acetic acid), total 27 MS variants, were tested in agar and agitated cultures. Growth cycles were tested for 10, 20, or 30 days in the agar cultures, and 10 or 20 days in the agitated cultures. Glucosinolate and phenolic acid production, total phenolic content and antioxidant potential were evaluated. The total amounts of glucosinolates ranged from 100.23 to 194.77 mg/100 g dry weight of biomass (DW) in agar cultures, and from 78.09 to 182.80 mg/100 g DW in agitated cultures. The total phenolic acid content varied from 15.89 to 237.52 mg/100 g DW for the agar cultures, and from 70.80 to 236.74 mg/100 g DW for the agitated cultures. Extracts of the cultured biomass contained higher total amounts of phenolic acids, lower total amounts of glucosinolates, a higher total phenolic content and similar antioxidant potentials compared to plant material. The analyses performed confirmed for the first time the explicit influence on secondary metabolite production and on the antioxidant potential. The significance was statistically estimated in a complex manner.

Effects of Cynara scolymus L. on glycemic indices:A systematic review and meta-analysis of randomized clinical trials

OBJECTIVES

Cynara scolymus L. (common artichoke) and its products have been considered as potential phytotherapeutic agents for various conditions, such as cardiovascular, hepatic and gastric diseases, among others. Until now, the effects of artichoke and artichoke products administration on glycemic indices have not been sufficiently appraised. The present study evaluated the effects of artichoke and artichoke products administration on the glycemic indices.

METHODS

Clinical trials were identified in the Cochrane Library, PubMed, Embase and Scopus databases; to infinity until 15 March 2020. Weighted mean differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods.

RESULTS

Pooled analysis of nine Randomized controlled trials (RCTs), demonstrated that the administration of artichoke and artichoke products led to a significant reduced fasting blood sugar (FBS) (WMD: -5.28 mg/dl, 95 % CI: -8.95, -1.61; p = 0.005). However, other glycemic indeces including fasting insulin (WMD: -0.45 μIU/dL, 95 % CI: -1.14, 0.25; p = 0.20), HOMA-IR (MD: -0.25, 95 % CI: -0.57, 0.07; p = 0.12) or Hemoglobin A1c (HbA1c) (WMD: -0.09, 95 % CI: -0.20, 0.02; p = 0.09) did not alter after the administration of artichoke and artichoke products. A subgroup analysis comparing the kind of intervention, revealed that just the supplementation of artichoke and artichoke products, in a noco-supplementation form, was efficacy for the reduction of Homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: -0.52, 95 % CI: -0.85, -0.19; p = 0.002).

CONCLUSIONS

The supplementation of artichoke and artichoke products can significantly reduce the FBS concentrations in humans. Moreover, these outcomes suggested that just the supplementation of artichoke and artichoke products is more effective in the reduction of HOMA-IR levels than the co-supplementation form. However, additional clinical trials with longer study periods are necessitated to obtain a robust conclusion for producing new guidelines as part of a healthy diet.

Anil Kumar N, Sharopov F, Ramírez-Alarcón K, Ruiz-Ortega A, Abdulmajid Ayatollahi S, Valere Tsouh Fokou P, Kobarfard F, Amiruddin Zakaria Z, Iriti M, Taheri Y, Martorell M, Sureda A, N. Setzer W, Durazzo A, Lucarini M, Santini A, Capasso R, Adrian Ostrander E, -ur-Rahman A, Iqbal Choudhary M, C. Cho W, Sharifi-Rad J. Antidiabetic Potential of Medicinal Plants and Their Active Components

Diabetes mellitus is one of the major health problems in the world, the incidence and associated mortality are increasing. Inadequate regulation of the blood sugar imposes serious consequences for health. Conventional antidiabetic drugs are effective, however, also with unavoidable side effects. On the other hand, medicinal plants may act as an alternative source of antidiabetic agents. Examples of medicinal plants with antidiabetic potential are described, with focuses on preclinical and clinical studies. The beneficial potential of each plant matrix is given by the combined and concerted action of their profile of biologically active compounds.

An ethnobotanical study of medicinal plants used to treat skin diseases in northern Pakistan

Background

Skin diseases are a major health concern especially in association with human immune deficiency syndrome and acquired an immune deficiency. The aim of this study was to document the ethnomedicinal information of plants used to treat skin diseases in Northern Pakistan. This is the first quantitative ethnobotanical study of therapeutic herbs utilized by the indigenous people of Northern Pakistan for skin diseases.

Methods

Interviews were taken to obtain information from 180 participants. Quantitative methods including fidelity level (FL), Frequency of citation (FC), Use-value (UV), Jaccard indices (JI), Family importance value (FIV), Relative frequency of citation (RFC) and Chi-square test were applied. Medicinal plants uses are also compared with 50 national and international publications.

Results

In this study, we recorded 106 plant species belonged to 56 floral families for treatment of skin ailments. The dominant life form reported was herb while the preferred method of utilization was powder, along with leaf as the most used plant part. RFC ranges from 0.07 to 0.25% whereas the highest FIV was recorded for family Pteridaceae. FL values range from 36.8 to 100%. The study reported 88% of new plant reports for the treatment of skin diseases.

Conclusion

The present study revealed the importance of several plants used to treat skin diseases by the local communities of Northern Pakistan. The available literature supported the evidence of plant dermatological properties. Plants having high UV and RFC can be considered for further scientific analysis. There is dire need to create awareness among local, government and scientific communities for the preservation of medicinal species and ethnomedicinal knowledge in Northern Pakistan.

Electronic supplementary material

The online version of this article (10.1186/s12906-019-2605-6) contains supplementary material, which is available to authorized users.

A systematic literature review and classification of knowledge discovery in traditional medicine

INTRODUCTION AND OBJECTIVE

Despite the importance of machine learning methods application in traditional medicine there is a no systematic literature review and a classification for this field. This is the first comprehensive literature review of the application of data mining methods in traditional medicine.

METHOD

We reviewed 5 database between 2000 to 2017 based on the Kitchenham systematic review methodology. 502 articles were identified and reviewed for their relevance to application of machine learning methods in traditional medicine, 42 selected papers were classified and categorized on four dimension; 1) application domain of data mining techniques in traditional medicine; 2) the data mining methods most frequently used in traditional medicine; 3) main strength and limitation of data mining techniques in traditional medicine; 4) the performance evaluation methods in data mining methods in traditional medicine.

RESULT

The result obtained showed that main application domain of data mining techniques in traditional medicine was related to syndrome differentiation. Bayesian Networks (BNs), Artificial Neural Networks (ANNs) and Support Vector Machines (SVMs) were recognized as being the methods most frequently applied in traditional medicine. Furthermore, each data mining techniques has its own strength and limitations when applied in traditional medicine. Single scaler methods were frequently used for performance evaluation of data mining methods.

CONCLUSION

Machine learning methods have become an important research field in traditional medicine. Our research provides information about this methods by examining the related articles.

Medicinal Plants with Multiple Effects on Diabetes Mellitus and Its Complications: a Systematic Review

PURPOSE OF REVIEW

This systematic review describes evidence concerning medicinal plants that, in addition to exerting hypoglycemic effects, decrease accompanying complications such as nephropathy, neuropathy, retinopathy, hypertension, and/or hyperlipidemia among individuals with diabetes mellitus (DM).

RECENT FINDINGS

Studies on the antidiabetic mechanisms of medicinal plants have shown that most of them produce hypoglycemic activity by stimulating insulin secretion, augmenting peroxisome proliferator-activated receptors (PPARs), inhibiting α-amylase or α-glucosidase, glucagon-like peptide-1 (GLP-1) secretion, advanced glycation end product (AGE) formation, free radical scavenging plus antioxidant activity (against reactive oxygen or nitrogen species (ROS/RNS)), up-regulating or elevating translocation of glucose transporter type 4 (GLUT-4), and preventing development of insulin resistance. Not only are medicinal plants effective in DM, but many of them also possess a variety of effects on other disease states, including the complications of DM. Such plants may be appropriate alternatives or adjuncts to available antidiabetic medications.

Chemical composition, traditional and professional use in medicine, application in environmental protection, position in food and cosmetics industries, and biotechnological studies of Nasturtium officinale (watercress) - a review

The herb of Nasturtium officinale is a raw material that has long been used in the traditional medicine of Iran, Azerbaijan, Morocco and Mauritius. Nowadays, this raw material is the object of numerous professional pharmacological studies that have demonstrated its antioxidant, anticancer, antibacterial, anti-inflammatory and cardioprotective properties. These therapeutic effects are caused by glucosinolates present in the plant, isothiocyanates, polyphenols (flavonoids, phenolic acids, proanthocyanidins), terpenes (including carotenoids), vitamins (B₁, B₂, B₃, B₆, E, C) and bioelements. The article presents the current state of phytochemical research on the generative and vegetative organs of the plant. A special spotlight is put on the main N. officinale secondary metabolites - glucosinolates. Attention is drawn to the important position of N. officinale in the production of healthy foods and in the production of cosmetics. A large part of the article is devoted to the importance of this species in phytoremediation processes used in the protection of soil environments and water reservoirs. The biotechnological research on this species has also been reviewed. Those studies are of particular importance not only due to the attractiveness of this species in phytotherapy and cosmetology, but also due to the deteriorating natural state of this species and the threat of extinction. The aim of this review is to promote N. officinale as a very valuable species, not yet fully discovered by global medicine.