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Flores Jiménez NG, Zamorano MM, Reséndiz-González G, Mercado-Márquez C, Morales-Álvarez JF, Cuéllar-Ordaz JA, de-la-Cruz Cruz HA, Adams-Vázquez O, López-Arellano ME, Díaz-Torres R, Noguera PR, Higuera-Piedrahita RI. Biochemical parameters, oxidative stress biomarkers, and anatomopathological changes in Wistar rats treated with 3'-demethoxy-6-O-demethylisoguaiacin and norisoguaiacin. Sci Rep 2024; 14:11568. [PMID: 38773157 PMCID: PMC11109246 DOI: 10.1038/s41598-024-61903-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/10/2024] [Indexed: 05/23/2024] Open
Abstract
Artemisia cina (Ac) is a plant with anthelmintic compounds such as 3'-demethoxy-6-O-demethylisoguaiacin (D) and norisoguaiacin (N). Three major objectives were proposed: (1) To evaluate biochemical parameters in blood (2) to determine the tissue oxidative stress by biomarkers as TBARS and glutathione peroxidase activity, and (3) to evaluate anatomopathological changes in organs such as the brain, liver, kidney, and lung after oral administration of n-hexane extract of Ac and D and N. D and N were administrated following the OECD guides for acute oral toxicity evaluation (Guide 420). Fifty Wistar rats were distributed into ten groups as follows: Group 1 (G1): 4 mg/Kg; G2: 40 mg/Kg; G3: 240 mg/Kg; G4: 1600 mg/Kg of n-hexane extract of Ac. G5: 2 mg/Kg; G6: 20 mg/Kg; G7: 120 mg/Kg; G8: 800 mg/Kg of D and N, G9: water and G10: polyvinylpyrrolidone at 2000 mg/Kg. At 14 days, the rats were euthanized, and the blood, liver, brain, kidney, and lung were taken for biochemical analysis, anatomopathological changes, and TBARS and GSH evaluation. Glucose, cholesterol, and phosphorus were altered. Histopathological analysis showed multifocal neuronal degeneration in the brain (G2). The kidney and lungs had changes in G7. The GSH and TBARS increased in G6 and G7. The TBARS activity was higher in G1 and G2. In conclusion, extract and D and N of Ac did not have damage at therapeutic doses. D, N, and n-hexane extract of A. cina do not cause histopathological damage at pharmaceutical doses. Still, the brain, kidney, and liver are related to biochemical parameters at higher doses. However, compounds are proposed as antioxidant agents.
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Affiliation(s)
- Nancy Guadalupe Flores Jiménez
- Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, Instituto Nacional de Investigaciones Forestales, Agrícolas y Pecuarias, Palo Alto, Mexico, Mexico
| | - Martha Manzano Zamorano
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Mexico, Estado de México, Mexico
| | - Guillermo Reséndiz-González
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Mexico, Estado de México, Mexico
| | - Crisóforo Mercado-Márquez
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Mexico, Estado de México, Mexico
| | - José Francisco Morales-Álvarez
- Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, Instituto Nacional de Investigaciones Forestales, Agrícolas y Pecuarias, Palo Alto, Mexico, Mexico
| | - Jorge Alfredo Cuéllar-Ordaz
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Mexico, Estado de México, Mexico
| | | | - Olivia Adams-Vázquez
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Mexico, Estado de México, Mexico
| | - María Eugenia López-Arellano
- Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, Instituto Nacional de Investigaciones Forestales, Agrícolas y Pecuarias, Jiutepec, Morelos, Mexico
| | - Roberto Díaz-Torres
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Mexico, Estado de México, Mexico
| | - Patricia Ramírez Noguera
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Mexico, Estado de México, Mexico
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Ekiert H, Klimek-Szczykutowicz M, Rzepiela A, Klin P, Szopa A. Artemisia Species with High Biological Values as a Potential Source of Medicinal and Cosmetic Raw Materials. Molecules 2022; 27:6427. [PMID: 36234965 PMCID: PMC9571683 DOI: 10.3390/molecules27196427] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 01/19/2023] Open
Abstract
Artemisia species play a vital role in traditional and contemporary medicine. Among them, Artemisia abrotanum, Artemisia absinthium, Artemisia annua, Artemisia dracunculus, and Artemisia vulgaris are the most popular. The chemical composition and bioactivity of these species have been extensively studied. Studies on these species have confirmed their traditional applications and documented new pharmacological directions and their valuable and potential applications in cosmetology. Artemisia ssp. primarily contain sesquiterpenoid lactones, coumarins, flavonoids, and phenolic acids. Essential oils obtained from these species are of great biological importance. Extracts from Artemisia ssp. have been scientifically proven to exhibit, among others, hepatoprotective, neuroprotective, antidepressant, cytotoxic, and digestion-stimulating activities. In addition, their application in cosmetic products is currently the subject of several studies. Essential oils or extracts from different parts of Artemisia ssp. have been characterized by antibacterial, antifungal, and antioxidant activities. Products with Artemisia extracts, essential oils, or individual compounds can be used on skin, hair, and nails. Artemisia products are also used as ingredients in skincare cosmetics, such as creams, shampoos, essences, serums, masks, lotions, and tonics. This review focuses especially on elucidating the importance of the most popular/important species of the Artemisia genus in the cosmetic industry.
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Affiliation(s)
- Halina Ekiert
- Chair and Department of Pharmaceutical Botany, Faculty of Pharmacy, Medical College, Jagiellonian University, Medyczna 9, 30-688 Kraków, Poland
| | - Marta Klimek-Szczykutowicz
- Department of Dermatology, Cosmetology and Aesthetic Surgery, The Institute of Medical Sciences, Medical College, Jan Kochanowski University, IX Wieków Kielc 19a, 25-516 Kielce, Poland
| | - Agnieszka Rzepiela
- Museum of Pharmacy, Medical College, Jagiellonian University, Floriańska 25, 31-019 Kraków, Poland
| | - Paweł Klin
- US Army Health Clinic, Urlas Kaserne, Building 8156, 91522 Ansbach, Germany
| | - Agnieszka Szopa
- Chair and Department of Pharmaceutical Botany, Faculty of Pharmacy, Medical College, Jagiellonian University, Medyczna 9, 30-688 Kraków, Poland
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Amrouche TA, Yang X, Güven EÇ, Huang W, Chen Q, Wu L, Zhu Y, Liu Y, Wang Y, Lu B. Contribution of edible flowers to the Mediterranean diet: Phytonutrients, bioactivity evaluation and applications. FOOD FRONTIERS 2022. [DOI: 10.1002/fft2.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Thanina Amel Amrouche
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Xuan Yang
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Esra Çapanoğlu Güven
- Faculty of Chemical and Metallurgical Engineering Food Engineering Department Istanbul Technical University Maslak Istanbul Turkey
| | - Weisu Huang
- Zhejiang Economic & Trade Polytechnic Department of Applied Technology Hangzhou China
| | - Qi Chen
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Lipeng Wu
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Yuhang Zhu
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Yuqi Liu
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Yixuan Wang
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Baiyi Lu
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
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Ekiert H, Knut E, Świątkowska J, Klin P, Rzepiela A, Tomczyk M, Szopa A. Artemisia abrotanum L. (Southern Wormwood)-History, Current Knowledge on the Chemistry, Biological Activity, Traditional Use and Possible New Pharmaceutical and Cosmetological Applications. Molecules 2021; 26:2503. [PMID: 33923002 PMCID: PMC8123286 DOI: 10.3390/molecules26092503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Artemisia abrotanum L. (southern wormwood) is a plant species with an important position in the history of European and Asian medicine. It is a species famous as a medicinal plant in Central Asia, Asia Minor, and in South-East and Central Europe. The raw materials obtained from this species are Abrotani herba and Abrotani folium. In the traditional European medicine, they have been used successfully most of all in liver and biliary tract diseases, in parasitic diseases in children and as antipyretic medication. In the official European medicine, this plant species is recommended by the French Pharmacopoeia for use in homeopathy. In many European countries, it is used traditionally in allopathy. The latest studies on the biological activity of extracts from the aboveground parts of the plant and/or the leaves, and/or the essential oil have provided evidence of other possible applications related to their antibacterial, antifungal, antioxidant, anticancer, and antiallergic properties. The latest studies have also focused on the repellent activity of the essential oil of this species and the possibility to use it in the prevention of diseases in which insects are the vectors. The main substances obtained from the plant that are responsible for this activity are: the essential oil, coumarins, phenolic acids, and flavonoids. Some of the latest investigations emphasize the large differences in the composition of the essential oil, determined by the geographical (climatic) origin of the plant. A. abrotanum is recommended by the European Cosmetic Ingredients Database (CosIng) as a source of valuable cosmetic ingredients. Additionally, the leaves of this species possess a well-established position in the food industry. This plant species is also the object of biotechnological studies.
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Affiliation(s)
- Halina Ekiert
- Chair and Department of Pharmaceutical Botany, Medical College, Jagiellonian University, ul. Medyczna 9, 30-688 Kraków, Poland; (E.K.); (J.Ś.)
| | - Ewa Knut
- Chair and Department of Pharmaceutical Botany, Medical College, Jagiellonian University, ul. Medyczna 9, 30-688 Kraków, Poland; (E.K.); (J.Ś.)
| | - Joanna Świątkowska
- Chair and Department of Pharmaceutical Botany, Medical College, Jagiellonian University, ul. Medyczna 9, 30-688 Kraków, Poland; (E.K.); (J.Ś.)
| | - Paweł Klin
- Family Medicine Clinic, Medizinisches Versorgungszentrum (MVZ) Burgbernheim GmbH, Gruene Baumgasse 2, 91593 Burgbernheim, Germany;
| | - Agnieszka Rzepiela
- Museum of Pharmacy, Medical College, Jagiellonian University, ul. Floriańska 25, 31-019 Kraków, Poland;
| | - Michał Tomczyk
- Department of Pharmacognosy, Faculty of Pharmacy, Medical University of Białystok, ul. Mickiewicza 2a, 15-230 Białystok, Poland;
| | - Agnieszka Szopa
- Chair and Department of Pharmaceutical Botany, Medical College, Jagiellonian University, ul. Medyczna 9, 30-688 Kraków, Poland; (E.K.); (J.Ś.)
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Evaluation of a Web-Based, 'Purchase Event' Intensive Monitoring Method for Pharmacovigilance of Natural Health Products: Lessons and Insights from Development Work in New Zealand. Drug Saf 2020; 43:981-998. [PMID: 32596765 DOI: 10.1007/s40264-020-00963-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Intensive monitoring methods are used in pharmacovigilance for prescription medicines but have not yet been implemented for natural health products (NHPs). OBJECTIVES Our objective was to assess feasibility issues with a new 'purchase event' intensive monitoring method for pharmacovigilance of NHPs, including pharmacy and NHP purchaser recruitment rates, collection of NHP purchaser key patient identifier information for data linkage and quality and completeness of data. METHODS For the Ginkgo study, 213 community pharmacies in the Auckland (Aotearoa New Zealand) District Health Board area were invited to participate. Staff in participating pharmacies (n = 3 [1.4%]) recorded ginkgo product sales and gave purchasers a study invitation card (October 2015-January 2016). Ginkgo purchaser participants were emailed links to web-based baseline and follow-up questionnaires about adverse events occurring during/after taking ginkgo. Participating pharmacists and consumers were invited to provide qualitative feedback about the study. For the NHP-Lite study, all NHPs were included for monitoring. Community pharmacies in the Green Cross Health network were invited to participate. Participating pharmacy staff gave all NHP purchasers a study invitation card over a 2-week period (May 2016). NHP purchaser participants were emailed links to web-based baseline, follow-up and feedback questionnaires. RESULTS Few community pharmacists (Ginkgo study, n = 3; NHP-Lite study, n = 18) and NHP purchasers (Ginkgo study, n = 0; NHP-Lite study, n = 4) participated. Pharmacists (Ginkgo study, 3/3; NHP-Lite study, 11/18) described several reasons for participating and suggested ways to increase consumer recruitment, including simplifying study procedures. CONCLUSIONS These web-based, purchase event, intensive monitoring studies, with cohorts built through NHP purchases in pharmacies, identified substantial issues with recruiting pharmacists/pharmacies and NHP purchasers that, at present, render such studies unfeasible. Future studies need to consider other methods of recruiting NHP purchasers and develop a simple method for recording NHP purchases.
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Anthroposophic Medicine: A multimodal medical system integrating complementary therapies into mainstream medicine. Complement Ther Med 2019; 47:102151. [DOI: 10.1016/j.ctim.2019.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Chitrakar B, Zhang M, Bhandari B. Edible flowers with the common name “marigold”: Their therapeutic values and processing. Trends Food Sci Technol 2019. [DOI: 10.1016/j.tifs.2019.05.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Matricaria genus as a source of antimicrobial agents: From farm to pharmacy and food applications. Microbiol Res 2018; 215:76-88. [PMID: 30172312 DOI: 10.1016/j.micres.2018.06.010] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 06/05/2018] [Accepted: 06/23/2018] [Indexed: 01/10/2023]
Abstract
Matricaria is a widespread genus of flowering plants of the family Asteraceae that grow in temperate regions of Europe, Asia, America and Africa. Some of the species are also naturalized in Australia. Some species of this genus such as Chamomiles are recognized medicinal plants and cultivated in several countries for commercial purposes: to obtain its blue essence, as herbal tea, and for pharmaceutical or cosmeceutical uses. The phytochemical composition of Matricaria spp. includes volatile terpenoids (e.g., α-bisabolol, bisabolol oxide A and B, β-trans-farnesene and chamazulene), sesquiterpene lactones such as matricin, and phenolic compounds (flavonoids, coumarins and phenolic acids). Their essential oil is obtained from the fresh or dried inflorescences by steam distillation, and additionally cohobation of the remaining water. The volatile composition of the essential oil, especially the content of the valuable components α-bisabolol and chamazulene, depends on the plant part, origin and quality of the source, genetic, and environmental factors. Moreover, other parameters, such as season of harvest and methods of extraction, can affect the extraction yield of the essential oils/extracts, their composition and, therefore, their bioactivity. Due to the importance of this genus and particularly M. recutita (M. chamomilla), this review focus on its cultivation, factor affecting essential oils' composition and their role in traditional medicine, as antibacterial agents and finally as food preservatives.
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Sharifi-Rad M, Mnayer D, Morais-Braga MFB, Carneiro JNP, Bezerra CF, Coutinho HDM, Salehi B, Martorell M, Del Mar Contreras M, Soltani-Nejad A, Uribe YAH, Yousaf Z, Iriti M, Sharifi-Rad J. Echinacea plants as antioxidant and antibacterial agents: From traditional medicine to biotechnological applications. Phytother Res 2018; 32:1653-1663. [PMID: 29749084 DOI: 10.1002/ptr.6101] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 04/01/2018] [Accepted: 04/05/2018] [Indexed: 12/11/2022]
Abstract
The genus Echinacea consists of 11 taxa of herbaceous and perennial flowering plants. In particular, Echinacea purpurea (L.) Moench is widely cultivated all over the United States, Canada, and in Europe, exclusively in Germany, for its beauty and reported medicinal properties. Echinacea extracts have been used traditionally as wound healing to improve the immune system and to treat respiratory symptoms caused by bacterial infections. Echinacea extracts have demonstrated antioxidant and antimicrobial activities, and to be safe. This survey aims at reviewing the medicinal properties of Echinacea species, their cultivation, chemical composition, and the potential uses of these plants as antioxidant and antibacterial agents in foods and in a clinical context. Moreover, the factors affecting the chemical composition of Echinacea spp. are also covered.
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Affiliation(s)
- Mehdi Sharifi-Rad
- Department of Medical Parasitology, Zabol University of Medical Sciences, Zabol, Iran
| | - Dima Mnayer
- Department of Agricultural Engineering and Veterinary Medicine, Lebanese University, Beirut, Lebanon
| | - Maria Flaviana Bezerra Morais-Braga
- Laboratório de Microbiologia e Biologia Molecular - LMBM, Departamento de Química Biológica - DQB, Universidade Regional do Cariri - URCA, Av. Cel. Antonio Luiz, 1161. Pimenta, Crato, CE, Brazil
| | - Joara Nályda Pereira Carneiro
- Laboratório de Microbiologia e Biologia Molecular - LMBM, Departamento de Química Biológica - DQB, Universidade Regional do Cariri - URCA, Av. Cel. Antonio Luiz, 1161. Pimenta, Crato, CE, Brazil
| | - Camila Fonseca Bezerra
- Laboratório de Microbiologia e Biologia Molecular - LMBM, Departamento de Química Biológica - DQB, Universidade Regional do Cariri - URCA, Av. Cel. Antonio Luiz, 1161. Pimenta, Crato, CE, Brazil
| | - Henrique Douglas Melo Coutinho
- Laboratório de Microbiologia e Biologia Molecular - LMBM, Departamento de Química Biológica - DQB, Universidade Regional do Cariri - URCA, Av. Cel. Antonio Luiz, 1161. Pimenta, Crato, CE, Brazil
| | - Bahare Salehi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Miquel Martorell
- Department of Nutrition and Dietetics, School of Pharmacy, University of Concepcion, Concepcion, Chile
| | - María Del Mar Contreras
- Departamento de Química Analítica, Instituto Universitario de Investigación en Química Fina y Nanoquímica IUIQFN, Universidad de Córdoba, Campus de Rabanales, Edificio Marie Curie, Córdoba, E-14071, Spain
| | - Azam Soltani-Nejad
- Department of Genetics and Biotechnology, Osmania University, Hyderabad, India
| | | | - Zubaida Yousaf
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Marcello Iriti
- Department of Agricultural and Environmental Sciences, Milan State University, Milan, Italy
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Chemistry, Richardson College for the Environmental Science Complex, The University of Winnipeg, Winnipeg, MB, Canada
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Risk of anaphylaxis in complementary and alternative medicine. Curr Opin Allergy Clin Immunol 2018; 17:332-337. [PMID: 28731887 DOI: 10.1097/aci.0000000000000384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Complementary and alternative medicine (CAM) use is widespread across the world. Patients with asthma and allergy regularly use CAM therapies. Allergic and anaphylactic reactions to CAM have been reported. RECENT FINDINGS Recent attempts to regulate and monitor adverse reaction to these therapies have given us further insight into potential causes of severe allergic reactions. Several culprits identified including Andrographis paniculata, Echinacea species, bee products, Ginkgo biloba and Ginseng are discussed here. SUMMARY Knowing the factors that increase the risk of anaphylaxis allows reactions to be recognized, reported and further investigated. Research to identify key causative allergens is necessary in the future. Collaboration between the allergy community and CAM practitioners can allow better understanding of allergy to these therapies.
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Use and Safety of Anthroposophic Medicinal Products: An Analysis of 44,662 Patients from the EvaMed Pharmacovigilance Network. Drugs Real World Outcomes 2017; 4:199-213. [PMID: 28965336 PMCID: PMC5684047 DOI: 10.1007/s40801-017-0118-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background There is a need for data on the clinical safety of anthroposophic medicinal products (AMPs). Objectives The main objective of this analysis was to determine the frequency of adverse drug reactions (ADRs) to AMPs, relative to the number of AMP prescriptions. Methods EvaMed (Evaluation of Anthroposophic Medicine) was a prospective pharmacovigilance study with the patients of 38 physicians in outpatient care in Germany. Diagnoses and prescriptions were extracted from the electronic medical records. All physicians documented ADRs of Grades III–IV and serious ADRs, seven ‘prescriber physicians’ also documented non-serious ADRs of any intensity. Patients were eligible for this analysis if they had one or more AMP prescription in the years 2001–2010, followed by one or more physician visit. Results A total of 44,662 patients with 311,731 AMP prescriptions, comprising 1722 different AMPs, were included. One hundred ADRs to AMPs occurred, caused by 83 different AMPs. ADR intensity was mild, moderate, and severe in 50% (n = 50/100), 43%, and 7% of cases, respectively; one ADR was serious. Among patients of prescriber physicians, ADRs of any intensity occurred in 0.071% (n = 67/94,734) of AMP prescriptions and in 0.502% (n = 65/12,956) of patients prescribed AMPs. In subgroup analyses according to age, specific AMPs or AMP groups, dosage forms, and concentrations (altogether 11 groups), the highest ADR frequency was 0.290% of prescriptions (for one specific AMP). Among all patients, serious ADRs occurred in 0.0003% (n = 1/311,731) of prescriptions and 0.0022% (n = 1/44,662) of patients. Conclusion In this analysis from a large sample, ADRs to AMP therapy in outpatient care were rare; ADRs of high intensity as well as serious ADRs were very rare. Electronic supplementary material The online version of this article (doi:10.1007/s40801-017-0118-5) contains supplementary material, which is available to authorized users.
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Sharma A, Flores-Vallejo RDC, Cardoso-Taketa A, Villarreal ML. Antibacterial activities of medicinal plants used in Mexican traditional medicine. JOURNAL OF ETHNOPHARMACOLOGY 2017; 208:264-329. [PMID: 27155134 DOI: 10.1016/j.jep.2016.04.045] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 04/24/2016] [Accepted: 04/25/2016] [Indexed: 05/17/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE We provide an extensive summary of the in vitro antibacterial properties of medicinal plants popularly used in Mexico to treat infections, and we discuss the ethnomedical information that has been published for these species. MATERIALS AND METHODS We carried out a bibliographic investigation by analyzing local and international peer-reviewed papers selected by consulting internationally accepted scientific databases from 1995 to 2014. We provide specific information about the evaluated plant parts, the type of extracts, the tested bacterial strains, and the inhibitory concentrations for each one of the species. We recorded the ethnomedical information for the active species, as well as their popular names and local distribution. Information about the plant compounds that has been identified is included in the manuscript. This review also incorporates an extensive summary of the available toxicological reports on the recorded species, as well as the worldwide registries of plant patents used for treating bacterial infections. In addition, we provide a list with the top plant species with antibacterial activities in this review RESULTS: We documented the in vitro antibacterial activities of 343 plant species pertaining to 92 botanical families against 72 bacterial species, focusing particularly on Staphylococcus aureus, Mycobacterium tuberculosis, Escherichia coli and Pseudomonas aeruginosa. The plant families Asteraceae, Fabaceae, Lamiaceae and Euphorbiaceae included the largest number of active species. Information related to popular uses reveals that the majority of the plants, in addition to treating infections, are used to treat other conditions. The distribution of Mexican plants extended from those that were reported to grow in just one state to those that grow in all 32 Mexican states. From 75 plant species, 225 compounds were identified. Out of the total plant species, only 140 (40.57%) had at least one report about their toxic effects. From 1994 to July 2014 a total of 11,836 worldwide antibacterial patents prepared from different sources were recorded; only 36 antibacterial patents from plants were registered over the same time period. We offered some insights on the most important findings regarding the antibacterial effects, current state of the art, and research perspectives of top plant species with antibacterial activities in vitro. CONCLUSIONS Studies of the antibacterial in vitro activity of medicinal plants popularly used in Mexico to treat infections indicate that both the selection of plant material and the investigation methodologies vary. Standardized experimental procedures as well as in vivo pharmacokinetic studies to document the effectiveness of plant extracts and compounds are necessary. This review presents extensive information about the medicinal plants possessing antibacterial activity that has been scientifically studied and are popularly used in Mexico. We anticipate that this review will be of use for future studies because it constitutes a valuable information tool for selecting the most significant plants and their potential antibacterial properties.
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Affiliation(s)
- Ashutosh Sharma
- Escuela de Ingeniería en Alimentos, Biotecnología y Agronomía (ESIABA), Tecnológico de Monterrey, Campus Querétaro, México
| | - Rosario Del Carmen Flores-Vallejo
- Centro de Investigación en Biotecnología, Universidad Autónoma del Estado de Morelos, Avenida Universidad 1001, Col. Chamilpa, Cuernavaca Morelos 62209, México
| | - Alexandre Cardoso-Taketa
- Centro de Investigación en Biotecnología, Universidad Autónoma del Estado de Morelos, Avenida Universidad 1001, Col. Chamilpa, Cuernavaca Morelos 62209, México
| | - María Luisa Villarreal
- Centro de Investigación en Biotecnología, Universidad Autónoma del Estado de Morelos, Avenida Universidad 1001, Col. Chamilpa, Cuernavaca Morelos 62209, México
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Olioso D, Marzotto M, Bonafini C, Brizzi M, Bellavite P. Arnica montana effects on gene expression in a human macrophage cell line. Evaluation by quantitative Real-Time PCR. HOMEOPATHY 2016; 105:131-47. [PMID: 27211321 DOI: 10.1016/j.homp.2016.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/01/2016] [Accepted: 02/01/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Arnica montana is a popular traditional remedy widely used in complementary medicine, also for its wound healing properties. Despite its acknowledged action in clinical settings at various doses, the molecular aspects relating to how A. montana promotes wound healing remain to be elucidated. To fill this gap, we evaluated the whole plant extract, in a wide range of dilutions, in THP-1 human cells, differentiated into mature macrophages and into an alternative IL-4-activated phenotype involved in tissue remodelling and healing. METHODS Real-time quantitative Reverse Transcription Polymerase Chain Reaction (PCR) analysis was used to study the changes in the expression of a customized panel of key genes, mainly cytokines, receptors and transcription factors. RESULTS On macrophages differentiated towards the wound healing phenotype, A. montana affected the expression of several genes. In particular CXC chemokine ligand 1 (CXCL1), coding for an chief chemokine, exhibited the most consistent increase of expression, while also CXC chemokine ligand 2 (CXCL2), Interleukin8 (IL8) and bone morphogenetic protein (BMP2) were slightly up-regulated, suggesting a positive influence of A. montana on neutrophil recruitment and on angiogenesis. MMP1, coding for a metalloproteinase capable of cleaving extracellular matrix substrates, was down-regulated. Most results showed non-linearity of the dose-effect relationship. CONCLUSIONS This exploratory study provides new insights into the cellular and molecular mechanisms of action of A. montana as a promoter of healing, since some of the genes it modifies are key regulators of tissue remodelling, inflammation and chemotaxis.
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Affiliation(s)
- Debora Olioso
- Department of Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
| | - Marta Marzotto
- Department of Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
| | - Clara Bonafini
- Department of Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
| | - Maurizio Brizzi
- Department of Statistical Sciences, University of Bologna, Via delle Belle Arti 41, 40126 Bologna, Italy
| | - Paolo Bellavite
- Department of Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy.
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Effectiveness and Safety of Arnica montana in Post-Surgical Setting, Pain and Inflammation. Am J Ther 2016; 23:e184-97. [DOI: 10.1097/mjt.0000000000000036] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Heckenbach K, Ostermann T, Schad F, Kröz M, Matthes H. Medication and falls in elderly outpatients: an epidemiological study from a German Pharmacovigilance Network. SPRINGERPLUS 2014; 3:483. [PMID: 25207204 PMCID: PMC4158008 DOI: 10.1186/2193-1801-3-483] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/12/2014] [Indexed: 01/07/2023]
Abstract
The aim of this study was to investigate the relationship between fall risk increasing drugs (FRIDS) and the risk of falls in regard to fall-related chronic diseases. In total, 39 primary care physicians in Germany participated in the EvaMed Pharmacovigilance Network. Antihypertensives, non-steroidal anti-inflammatory drugs, hypnotics and sedatives, antidepressants and psycholeptics were labelled as FRIDS. A fall was defined according to a diagnosis in the chapter Injury or poisoning (S00-T14 in International Statistical Classification of Diseases 10th Revision (ICD-10)). Patients older than or equal to 65 years with at least two doctor’s visits were included. FRIDS were prescribed for 1768 patients from a total of 5124 patients included in the analysis. FRIDS and seven chronic diseases were statistically significant associated with a higher risk of experiencing a fall. The risk was highest for patients with a diagnosis abnormalities of gait and mobility, vertigo, visual -impairment and weight loss, and increased by 50-90% with arthritis, diseases of arteries, arterioles and capillaries and heart failure. From patients (N = 425) with at least one diagnosis of fall, 219 patients were prescribed FRIDS. In 100 (45.7%) of cases the diagnoses for fall were made before and in 105 (47.9%) of cases at least a month after the prescription of FRIDS. 14 (6.4%) patients had a prescription of FRIDS and a diagnosis of fall within one month. Perceptual disorders, low walking speed and pain are prominent predictors for falls in the elderly. A prescription of FRIDS selects more vulnerable patients having a higher risk of falls. However, experiencing a fall is mainly due to the disease followed by treatment. Thus, not prescribing FRIDS will avoid only a small number of falls.
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Affiliation(s)
| | - Thomas Ostermann
- Institute of Integrated medicine, University of Witten/Herdecke, Gerhard-Kienle-Weg 4, D-58313 Herdecke, Germany
| | - Friedemann Schad
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
| | - Matthias Kröz
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
| | - Harald Matthes
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
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Schveitzer MC, Zoboli ELCP. Role of complementary therapies in the understanding of primary healthcare professionals: a systematic review. Rev Esc Enferm USP 2014; 48 Spec No:184-91. [PMID: 25517853 DOI: 10.1590/s0080-623420140000500026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 07/06/2014] [Indexed: 11/21/2022] Open
Abstract
Objective To identify the understanding of the healthcare professionals in relation to the role of complementary therapies in primary health care. Method Systematic review by way of the following information sources: PubMed, CINAHL, PeriEnf, AMED, EMBASE, Web of Science, Psicoinfo and Psicodoc, using the keyword Primary Health Care alone, and associated with the following keywords: Medicinal Plants, Herbal Medicine, Homeopathy, Traditional Chinese Medicine, Acupuncture, Anthroposophical Medicine. Results Twenty-two studies from 1986 to 2011 were included. We identified three styles of practice: conventional medicine, complementary therapies and integrative medicine. Positioning professional practices within these three styles may facilitate discussion of concepts of health care, enhancing the health care provided as a result. Conclusion The work process in primary care presents difficulties for conducting integrative and holistic health care, but this practice has been introduced over time by professionals who integrate conventional medicine and complementary therapies, concerned with the care and well-being of patients.
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Tanvir R, Sajid I, Hasnain S. Biotechnological potential of endophytic actinomycetes associated with Asteraceae plants: isolation, biodiversity and bioactivities. Biotechnol Lett 2013; 36:767-73. [DOI: 10.1007/s10529-013-1430-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 11/22/2013] [Indexed: 11/30/2022]
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Kim JH, Kwong EMS, Chung VCH, Lee JCO, Wong T, Goggins WB. Acute adverse events from over-the-counter Chinese herbal medicines: a population-based survey of Hong Kong Chinese. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 13:336. [PMID: 24279604 PMCID: PMC4222756 DOI: 10.1186/1472-6882-13-336] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 10/30/2013] [Indexed: 12/02/2022]
Abstract
Background Although over-the-counter traditional Chinese herbal medicine (COTC) is commonly used to treat everyday illness in many parts of the world, no population-based study has been done to examine the prevalence and factors associated with COTC-related adverse events. Methods A cross-sectional telephone survey was conducted among Hong Kong Chinese adults in 2011 (n = 1100) with informed verbal consent. Stepwise logistic regression of demographic, attitudinal and behavioral variables was used to determine factors associated with past-year adverse events. Results Of study respondents, 71.7% (789/1100) reported past-year COTC use and 2.3% (25/1100) reported at least one COTC-related adverse event in the past year. Of the 27 adverse events cases reported among COTC users, the most common were allergic reactions (n = 11) dizziness (n = 5), and gastro-intestinal problems (n = 4). Pills/capsules were the dosage form that caused the highest proportion of adverse events (n = 10), followed by plasters (n = 7), creams/ointments (n = 5), and ingestible powders (n = 2). Although COTC users reporting adverse events were more likely to report greater practices to avoid adverse events (OR = 6.47; 95% CI: 1.38-30.3); they were also more likely to possess lower education levels (OR = 9.64, 95% CI: 2.20-42.3) and to have received COTC information from non-reliable, mass-media information sources such as magazines (OR = 3.32; 95% CI: 1.01-8.50) or television (OR = 2.93; 95% CI: 1.03-10.7). Package labels were also felt to be unclear by 42.9% of COTC users. A large proportion of COTC users demonstrated low levels of COTC-related knowledge, while the main impediment to greater information-seeking was the belief that reliable COTC information is not obtainable from Western health professionals. Conclusions Despite global movements toward more stringent complementary medicine regulation, the limited accessibility of reliable information and widespread misperceptions among consumers present major challenges for the safe use of complementary medicine.
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Kienle GS, Albonico HU, Baars E, Hamre HJ, Zimmermann P, Kiene H. Anthroposophic medicine: an integrative medical system originating in europe. Glob Adv Health Med 2013; 2:20-31. [PMID: 24416705 PMCID: PMC3865373 DOI: 10.7453/gahmj.2012.087] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Anthroposophic medicine is an integrative multimodal treatment system based on a holistic understanding of man and nature and of disease and treatment. It builds on a concept of four levels of formative forces and on the model of a three-fold human constitution. Anthroposophic medicine is integrated with conventional medicine in large hospitals and medical practices. It applies medicines derived from plants, minerals, and animals; art therapy, eurythmy therapy, and rhythmical massage; counseling; psychotherapy; and specific nursing techniques such as external embrocation. Anthroposophic healthcare is provided by medical doctors, therapists, and nurses. A Health-Technology Assessment Report and its recent update identified 265 clinical studies on the efficacy and effectiveness of anthroposophic medicine. The outcomes were described as predominantly positive. These studies as well as a variety of specific safety studies found no major risk but good tolerability. Economic analyses found a favorable cost structure. Patients report high satisfaction with anthroposophic healthcare.
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Affiliation(s)
- Gunver S Kienle
- Institute for Applied Epistemology and Medical Methodology at the University of Witten/Herdecke, Germany
| | | | - Erik Baars
- European Scientific Cooperative on Anthroposophic Medicinal Products (ESCAMP), Freiburg, Germany
| | - Harald J Hamre
- Institute for Applied Epistemology and Medical Methodology at the University of Witten/Herdecke, Germany, Norway
| | - Peter Zimmermann
- Department of Gynecology, Plusterveys, Nastola Medical Center, Finland
| | - Helmut Kiene
- Institute for Applied Epistemology and Medical Methodology at the University of Witten/Herdecke, Germany
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Hamre HJ, Kiene H, Glockmann A, Ziegler R, Kienle GS. Long-term outcomes of anthroposophic treatment for chronic disease: a four-year follow-up analysis of 1510 patients from a prospective observational study in routine outpatient settings. BMC Res Notes 2013; 6:269. [PMID: 23849335 PMCID: PMC3711832 DOI: 10.1186/1756-0500-6-269] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 06/25/2013] [Indexed: 11/23/2022] Open
Abstract
Background Anthroposophic treatment includes special artistic and physical therapies and special medications. We here report an update to a previously published study of anthroposophic treatment for chronic diseases, including more patients and a longer follow up. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational cohort study of anthroposophic treatment for chronic indications in routine outpatient settings in Germany. Anthroposophic treatment was associated with improvements of symptoms and quality of life. Previous follow-up-analyses have been performed after 24 months or, in subgroups of patients enrolled in the period 1999-2001, after 48 months. We conducted a 48-month follow-up analysis of all patients enrolled in AMOS in the period 1999-2005. Methods 1,510 outpatients aged 1-75 years, starting anthroposophic treatment for chronic conditions in routine German outpatient settings, participated in a prospective cohort study. Main outcomes were Symptom Score (primary outcome, mean symptom severity on numerical rating scales), SF-36 Physical and Mental Component scores in adults, and disease-specific outcomes in the six most common diagnosis groups: asthma, anxiety disorders and migraine (numerical rating scales), depression (Center for Epidemiological Studies Depression Scale), attention deficit hyperactivity symptoms (FBB-HKS Total score), and low back pain (Hanover Functional Ability Questionnaire, Low Back Pain Rating Scale). Results Median disease duration at baseline was 3.5 years. From baseline to 48-month follow-up all ten outcomes improved significantly (p < 0.001 for all pre-post comparisons). Standardised Response Mean effect sizes were large (range 0.84-1.24 standard deviations) for seven comparisons, medium for two comparisons (SF-36 Mental Component: 0.60, Low Back Pain Rating Scale: 0.55), and small for one comparison (SF-36 Physical Component: 0.39). Symptom Score improved significantly with large effect sizes in adults and children, and in the four main anthroposophic therapy modality groups (art therapy, eurythmy therapy, rhythmical massage therapy, medical therapy). Conclusions This 48-month follow-up analysis confirmed previous analyses from the AMOS study. Outpatients receiving anthroposophic treatment for chronic indications had sustained, clinically relevant improvements of symptoms and quality of life.
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Adverse drug reactions in a complementary medicine hospital: a prospective, intensified surveillance study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:320760. [PMID: 22315630 PMCID: PMC3270557 DOI: 10.1155/2012/320760] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 11/06/2011] [Accepted: 11/23/2011] [Indexed: 01/22/2023]
Abstract
Background. Anthroposophic medicine is one of the widely used approaches of complementary and alternative medicine. However, few prospective studies have generated safety data on its use. Objectives. We aimed to assess adverse drug reactions (ADRs) caused by anthroposophical medicines (AMEDs) in the anthroposophical Community Hospital Havelhoehe, GERMANY. Study Design and Methods. Between May and November 2007, patients of six medical wards were prospectively assessed for ADRs. Suspected ADRs occurring during hospitalization were documented and classified in terms of organ manifestation (WHO SOC-code), causality (according to the Uppsala Monitoring Centre WHO criteria), and severity. Only those ADRs with a severity of grade 2 and higher according to the CTCAE classification system are described here. Results. Of the 3,813 patients hospitalized, 174 patients (4.6%) experienced 211 ADRs (CTCAE grade 2/3 n = 191, 90.5%, CTCAE grade 4/5 n = 20, 9.5%) of which 57 ADRs (27.0%) were serious. The median age of patients with ADRs (62.1% females) was 72.0 (IQR: 61.0; 80.0). Six patients (0.2%) experienced six ADRs (2.8% of ADRs) caused by eight suspected AMEDs, all of which were mild reactions (grade 2). Conclusion. Our data show that ADRs caused by AMEDs occur rarely and are limited to mild symptoms.
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Simões-Wüst AP, Jeschke E, Mennet M, Schnelle M, Matthes H, von Mandach U. Prescribing Pattern of Bryophyllum Preparations among a Network of Anthroposophic Physicians. ACTA ACUST UNITED AC 2012; 19:293-301. [DOI: 10.1159/000345841] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
Drugs based on herbs have become a common form of therapy as well as for prophylaxis because they are often perceived as being natural and therefore harmless. Today they are one of the hottest trends and most sought after in the field of nutrition or herbal therapeutics. As the use of complementary medicine grows, so does the knowledge that many compounds in common use not only have a significant effect on the body but may also interact with pharmaceuticals and also with other alternative products. Concurrent use of herbs with drugs may mimic, magnify, or oppose the effect of drugs leading to herb-drug interactions. Currently, there is very little information published on herb-herb or herb-drug interactions as compared to the use of herbs which is progressively growing across the world. Many reports of herb-drug interactions are sketchy and lack laboratory analysis of suspect preparations. Health-care practitioners should caution patients against mixing herbs and pharmaceutical drugs. The article reviews the recent literature on the adverse effects of herbal remedies including the most widely sold herbal medicinal products, like liquorice, garlic, ginger, green tea, and turmeric, etc., and reinforce the safety aspect of herbal products, which are considered to be relatively safe by common people.
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Affiliation(s)
- Divya Singh
- Faculty of Pharmacy, Babu Banarasi Das National Institute of Technology and Management, Dr. Akhilesh Das Nagar, Lucknow, India
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Kienle GS, Glockmann A, Grugel R, Hamre HJ, Kiene H. [Clinical research on anthroposophic medicine:update of a health technology assessment report and status quo]. Complement Med Res 2011; 18:269-82. [PMID: 22105040 DOI: 10.1159/000331812] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE In 2005 a Health Technology Assessment (HTA) report analyzed efficacy, effectiveness, safety, utilization and costs of Anthroposophic Medicine (AM). After a recent referendum of the ‘Swiss Population pro Complementary Medicine’ (May 2009) this HTA report was updated. DESIGN Update of the HTA report by a systematic review. METHODS Methods corresponded to the existing HTA report and the guidelines of the Swiss Federal Office of Public Health. For clinical studies four databases and a specialized journal were searched, and extensive expert consultations were used. Studies were selected according to predefined inclusion criteria, data were extracted, and methodological quality was assessed individually. RESULTS 70 new clinical studies were found. Altogether, 265 clinical studies investigated efficacy and effectiveness of AM: 38 randomized controlled trials, 36 prospective and 49 retrospective non-randomized controlled trials as well as 90 prospective and 52 retrospective trials without control groups. They investigated a wide spectrum of AM treatments in a multitude of diseases; the whole AM system in 38 trials, non-pharmacological therapies in 10 trials, AM mistletoe products in cancer therapy in 133 trials, and other AM medication treatments in 84 trials. Most studies showed a positive result for AM. Methodological quality differed substantially; some studies showed major limitations, others were reasonably well conducted. Trials with better quality still showed a positive result. External validity was usually high. Side effects or other risks were rare and usually described to be mild or moderate. Studies regarding safety showed a good tolerability altogether. CONCLUSION Trials of varying design and quality in a variety of diseases predominantly describe good clinical outcomes for AM, only marginal side effects, high satisfaction of patients with regard to results and safety and presumably slightly less costs. Further high-quality evaluations are desirable.
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Affiliation(s)
- Gunver Sophia Kienle
- Institut für angewandte Erkenntnistheorie und medizinische Methodologie e.V. (IFAEMM), Freiburg i.Br., Deutschland
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Jeschke E, Ostermann T, Vollmar HC, Tabali M, Schad F, Matthes H. Prescribing patterns in dementia: a multicentre observational study in a German network of CAM physicians. BMC Neurol 2011; 11:99. [PMID: 21824429 PMCID: PMC3178479 DOI: 10.1186/1471-2377-11-99] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 08/08/2011] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Dementia is a major and increasing health problem worldwide. This study aims to investigate dementia treatment strategies among physicians specialised in complementary and alternative medicine (CAM) by analysing prescribing patterns and comparing them to current treatment guidelines in Germany. METHODS Twenty-two primary care physicians in Germany participated in this prospective, multicentre observational study. Prescriptions and diagnoses were reported for each consecutive patient. Data were included if patients had at least one diagnosis of dementia according to the 10th revision of the International Classification of Diseases during the study period. Multiple logistic regression was used to determine factors associated with a prescription of any anti-dementia drug including Ginkgo biloba. RESULTS During the 5-year study period (2004-2008), 577 patients with dementia were included (median age: 81 years (IQR: 74-87); 69% female). Dementia was classified as unspecified dementia (57.2%), vascular dementia (25.1%), dementia in Alzheimer's disease (10.4%), and dementia in Parkinson's disease (7.3%). The prevalence of anti-dementia drugs was 25.6%. The phytopharmaceutical Ginkgo biloba was the most frequently prescribed anti-dementia drug overall (67.6% of all) followed by cholinesterase inhibitors (17.6%). The adjusted odds ratio (AOR) for receiving any anti-dementia drug was greater than 1 for neurologists (AOR = 2.34; CI: 1.59-3.47), the diagnosis of Alzheimer's disease (AOR = 3.28; CI: 1.96-5.50), neuroleptic therapy (AOR = 1.87; CI: 1.22-2.88), co-morbidities hypertension (AOR = 2.03; CI: 1.41-2.90), and heart failure (AOR = 4.85; CI: 3.42-6.88). The chance for a prescription of any anti-dementia drug decreased with the diagnosis of vascular dementia (AOR = 0.64; CI: 0.43-0.95) and diabetes mellitus (AOR = 0.55; CI: 0.36-0.86). The prescription of Ginkgo biloba was associated with sex (female: AOR = 0.41; CI: 0.19-0.89), patient age (AOR = 1.06; CI: 1.02-1.10), treatment by a neurologist (AOR = 0.09; CI: 0.03-0.23), and the diagnosis of Alzheimer's disease (AOR = 0.07; CI: 0.04-0.16). CONCLUSIONS This study provides a comprehensive analysis of everyday practice for treatment of dementia in primary care in physicians with a focus on CAM. The prescribing frequency for anti-dementia drugs is equivalent to those found in other German studies, while the administration of Ginkgo biloba is significantly higher.
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Affiliation(s)
- Elke Jeschke
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
| | - Thomas Ostermann
- Center for Integrative Medicine, University of Witten/Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
| | - Horst C Vollmar
- German Center for Neurodegenerative Diseases (DZNE), Stockumer Str. 12, 58453 Witten, Germany
- Institute for General Practice and Family Medicine, University of Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany
| | - Manuela Tabali
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
| | - Friedemann Schad
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
| | - Harald Matthes
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
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Cochrane ZR, Gregory P, Wilson A. Quality of Natural Product Clinical Trials: A Comparison of Those Published in Alternative Medicine Versus Conventional Medicine Journals. J Diet Suppl 2011; 8:135-43. [DOI: 10.3109/19390211.2011.561823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jeschke E. Adverse drug reactions of remedies containing Asteraceae extracts. Drug Saf 2010; 33:705-6; author reply 706-7. [PMID: 20662152 DOI: 10.2165/11537970-000000000-00000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Jeschke E, Ostermann T, Tabali M, Vollmar HC, Kröz M, Bockelbrink A, Witt CM, Willich SN, Matthes H. Pharmacotherapy of elderly patients in everyday anthroposophic medical practice: a prospective, multicenter observational study. BMC Geriatr 2010; 10:48. [PMID: 20663129 PMCID: PMC2916899 DOI: 10.1186/1471-2318-10-48] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Accepted: 07/21/2010] [Indexed: 01/12/2023] Open
Abstract
Background Pharmacotherapy in the older adult is a complex field involving several different medical professionals. The evidence base for pharmacotherapy in elderly patients in primary care relies on only a few clinical trials, thus documentation must be improved, particularly in the field of complementary and alternative medicine (CAM) like phytotherapy, homoeopathy, and anthroposophic medicine. This study describes diagnoses and therapies observed in elderly patients treated with anthroposophic medicine in usual care. Methods Twenty-nine primary care physicians in Germany participated in this prospective, multicenter observational study on prescribing patterns. Prescriptions and diagnoses were reported for each consecutive patient. Data were included if patients were at least 60 years of age. Multiple logistic regression analysis was used to determine factors associated with anthroposophic prescriptions. Results In 2005, a total of 12 314 prescriptions for 3076 patients (68.1% female) were included. The most frequent diagnoses were hypertension (11.1%), breast cancer (3.5%), and heart failure (3.0%). In total, 30.5% of the prescriptions were classified as CAM remedies alone, 54.4% as conventional pharmaceuticals alone, and 15.1% as a combination of both. CAM remedies accounted for 41.7% of all medications prescribed (35.5% anthroposophic). The adjusted odds ratio (AOR) for receiving an anthroposophic remedy was significantly higher for the first consultation (AOR = 1.65; CI: 1.52-1.79), treatment by an internist (AOR = 1.49; CI: 1.40-1.58), female patients (AOR = 1.35; CI: 1.27-1.43), cancer (AOR = 4.54; CI: 4.12-4.99), arthropathies (AOR = 1.36; CI: 1.19-1.55), or dorsopathies (AOR = 1.34; CI: 1.16-1.55) and it decreased with patient age (AOR = 0.97; CI: 0.97-0.98). The likelihood of being prescribed an anthroposophic remedy was especially low for patients with hypertensive diseases (AOR = 0.36; CI: 0.32-0.39), diabetes mellitus (AOR = 0.17; CI: 0.14-0.22), or metabolic disorders (AOR = 0.17; CI: 0.13-0.22). Conclusion The present study is the first to provide a systematic overview of everyday anthroposophic medical practice in primary care for elderly patients. Practitioners of anthroposophic medicine prescribe both conventional and complementary treatments. Our study may facilitate further CAM-research on indications of, for example, dementia or adverse drug reactions in the elderly.
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2010. [DOI: 10.1002/pds.1849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Jeschke E, Ostermann T, Vollmar HC, Kröz M, Bockelbrink A, Witt CM, Willich SN, Matthes H. Evaluation of prescribing patterns in a German network of CAM physicians for the treatment of patients with hypertension: a prospective observational study. BMC FAMILY PRACTICE 2009; 10:78. [PMID: 20003298 PMCID: PMC2804584 DOI: 10.1186/1471-2296-10-78] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 12/10/2009] [Indexed: 01/14/2023]
Abstract
BACKGROUND The management of hypertension is a key challenge in modern health systems. This study aimed to investigate hypertension treatment strategies among physicians specialized in complementary and alternative medicine (CAM) in Germany by analysing prescribing patterns and comparing these to the current treatment guidelines issued by the German Hypertension Society. METHODS In this prospective, multicentre observational study, which included 25 primary care physicians specialized in CAM treatment, prescriptions and diagnoses were analysed for each consecutive hypertensive patient using routine electronic data. Data analysis was performed using univariate statistical tests (Chi square test, Cochran-Armitage trend test). Multiple logistic regression was used to determine factors associated with antihypertensive medication. RESULTS In the year 2005, 1320 patients with 3278 prescriptions were included (mean age = 64.2 years (SD = 14.5), 63.5% women). Most patients were treated with conventional antihypertensive monotherapies (n = 838, 63.5%). Beta-blockers were the most commonly prescribed monotherapy (30.7%), followed by ACE inhibitors (24.0%). Combination treatment usually consisted of two antihypertensive drugs administered either as separate agents or as a coformulation. The most common combination was a diuretic plus an ACE inhibitor (31.2% of dual therapies). Patient gender, age, and comorbidities significantly influenced which treatment was prescribed. 187 patients (14.2%) received one or more CAM remedies, most of which were administered in addition to classic monotherapies (n = 104). Men (OR = 0.66; 95% CI: 0.54-0.80) and patients with diabetes (OR = 0.55; 95% CI: 0.42-0.0.73), hypercholesterolaemia (OR = 0.59; 95% CI: 0.47-0.75), obesity (OR = 0.74; 95% CI: 0.57-0.97), stroke (OR = 0.54; 95% CI: 0.40-0.74), or prior myocardial infarction (OR = 0.37; 95% CI: 0.17-0.81) were less likely to receive CAM treatment. CONCLUSIONS The large majority of antihypertensive treatments prescribed by CAM physicians in the present study complied with the current German Hypertension Society treatment guidelines. Deviations from the guidelines were observed in one of every seven patients receiving some form of CAM treatment.
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Affiliation(s)
- Elke Jeschke
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
| | - Thomas Ostermann
- Chair for Theory of Medicine, Integrative and Anthroposophic Medicine, University of Witten/Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
| | - Horst C Vollmar
- Institute for General Practice and Family Medicine, University of Witten/Herdecke, Alfred-Herrhausen-Str 50, 58448 Witten, Germany
- Fraunhofer Institute for Systems and Innovation Transfer (ISI), Breslauer Str 48, 76139 Karlsruhe, Germany
| | - Matthias Kröz
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
| | - Angelina Bockelbrink
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre, 10117 Berlin, Germany
| | - Claudia M Witt
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre, 10117 Berlin, Germany
| | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre, 10117 Berlin, Germany
| | - Harald Matthes
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
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