Hepatoprotective effect of Commiphora myrrha against d-GalN/LPS-induced hepatic injury in a rat model through attenuation of pro inflammatory cytokines and related genes

Therapeutic effects of myrrh extract and myrrh-based silver nanoparticles on Trichinella spiralis-infected mice: parasitological, histopathological, and immunological (IFN-γ, IL-10, and MMP-9) investigations

Introduction

Trichinellosis, caused by Trichinella spiralis (T. spiralis), remains a prevalent parasitic zoonosis. Developing new drugs targeting and understanding the immune response against the infection is imperative. Previous research has inadequately explored the efficacy of crude myrrh extract and myrrh-based silver nanoparticles (AgNPs) against trichinellosis, as well as their impact on histopathological, and immunological factors.

Methods

This study evaluated the effects of silver nanoparticles biosynthesized using myrrh, crude myrrh extracts, and albendazole on the intestinal phase of T. spiralis. It also examined the associated histopathological changes and alterations in key immunological markers, including Interferon-gamma (IFN-γ), Interleukin-10 (IL-10), and Matrix Metalloproteinase-9 (MMP-9). Five groups of 12 mice were allocated as follows: group 1: non-infected, non-treated (negative control), group 2: infected, non-treated (positive control), group 3: infected and treated with biosynthesized silver nanoparticles (40 μg/mL), group 4: infected and treated with myrrh crude extract (800 mg/kg), and group 5: infected and treated with albendazole (50 mg/kg). Treatment was orally administered starting on the 2nd day post-infection and continued for three successive days. Mice of all groups were euthanized on the 6th day post-infection, and the intestine of each was isolated for parasitological, histopathological, and immunohistochemistry evaluation of MMP-9, as well as assessment of cytokines level (IFN-γ and IL-10 gene expressions) via Real-time PCR technique.

Results

The present study showed a considerable reduction in adult worm count among the treated groups. The mortality rates of adult worms were 88.64% in the silver nanoparticles treated group, 85.17% in the myrrh crude extract group, and 94.07% in the albendazole-treated group. Histopathological examination revealed prominent alterations in the intestine of the infected non-treated mice, which were markedly restored by treatment. Immunohistochemical examination accompanied by significant reduction in MMP-9 expression in the infected mice treated with AgNPs compared to the infected non-treated group, reflecting the role of AgNPs in downgrading the inflammatory reaction in the intestine of infected mice.

Conclusion

Collectively, this study demonstrates the novel antiparasitic potential of silver nanoparticles biosynthesized with myrrh against T. spiralis in infected mice. The treatment was associated with moderate rise in IFN-γ gene expression and IL-10 expression, highlighting its therapeutic efficacy against T. spiralis.

A retrospective study on the effect of Chinese patent medicine combined with conventional treatment on the survival outcomes of 313 patients with stage II-III NSCLC

PURPOSE

We aim to explore the effect of Chinese Patent Medicine (CPM), including Huisheng oral solution (HSOS) on the 4-year survival rate of patients with stage II and III non-small cell lung cancer, and assess the association between blood coagulation indicators and survival outcomes.

MATERIALS AND METHODS

313 patients diagnosed with stage II and III NSCLC were collected during 2015-2016. Kaplan-Meier method and Cox proportional hazard model were applied to analyze the factors affecting the 4-year survival rate of patients.

RESULTS

According to the effect of CPM, the medicine prescribed in this study could be classified into two types. The proportion of patients who received "Fuzheng Quyu" CPM for more than three months was higher than the proportion of patients who received other two types of CPM for more than three months. Medical records of 313 patients with NSCLC were analyzed. 4-year survival rate for patients received CPM more than 6 months and 3 months were higher than those received CPM less than 3 months (P = 0.028 and P = 0.021 respectively. In addition, 4-year survival rate for patients who received HSOS for more than 3 months was higher than those who received HSOS for less than 3 months (P = 0.041). Patients with elevated preoperative fibrinogen (FIB) level and those without surgery had an increased mortality risk (HR = 1.98, P < 0.01, and HR = 2.76, P < 0.01 respectively).

CONCLUSION

The medium and long-term use of CPM/HSOS was positively associated with higher survival rate in NSCLC patients. Patients with high-level preoperative FIB level and those without surgery might have a poor prognosis in the following years.

Cytotoxic activity, selectivity, and clonogenicity of fruits and resins of Saudi medicinal plants against human liver adenocarcinoma

Background

Edible fruits and resins provide various benefits to mankind including potential medicinal applications. This study aimed to determine the cytotoxicity, selectivity, and clonogenicity of fruits and exudates of certain Saudi medicinal plants (Anethum graveolens (BEP-09), Opuntia ficus-indica (L.) Miller (BEP-10), Boswellia serrata Roxb. ex Colebr. (BEP-11), and Commiphora myrrha (BEP-12)) against human liver adenocarcinoma (HepG2).

Methods

Initial cytotoxicity and cell line selectivity against different cell lines were screened using MTT assay. The most promising extract was subjected to gas chromatography-mass spectrometry (GC-MS) analysis to determine the main phytoconstituents. Clonogenicity was checked for the most active extract.

Results

The selected plants' fruits and resins possess a significant cytotoxic activity estimated as IC50. The fruit of BEP-10 was found to be the most active extract against liver cancer cells (IC50 = 2.82) comparable to both doxorubicin (IC50 = 1.40) and camptothecin (IC50 = 1.11). It showed a selectivity index of 4.47 compared to the normal human foetal lung fibroblast (MRC5) cells. BEP-10 showed a dose-dependent clonogenic effect against HepG2 cells comparable to the effect of doxorubicin. The GC-MS chromatogram of BEP-10 extract revealed the presence of eight small polar molecules, representing 73% of the total identified compounds and the rest three molecules (27%) were non-polar constituents. The furan derivatives represent the chief components in BEP-10 (16.3%), while the aldehyde 5-(hydroxymethyl)-2-furancarboxaldehyde was found to be the main molecule (13.2%).

Conclusion

The fruits of BEP-10 have a potential cytotoxic effect particularly against HepG2. The identified phytoconstituents in the tested plant extract might contribute to the investigated cytotoxic activity.

Myrrh Essential Oil Mitigates Renal Ischemia/Reperfusion-Induced Injury

BACKGROUND

Ischemia/reperfusion (I/R)-induced renal injury is a common reason for kidney injury in clinical settings; therefore, continuous investigation of novel nephroprotective agents is crucial. Myrrh, the oleoresin exudates generated by the genus Commiphora, display numerous pharmacological actions. This study tried to assess the preventive effects of myrrh essential oil against I/R-induced renal damage.

METHODS

Rats were randomized into five groups. In the sham group, the animals were subjected to bilateral renal artery separation with no occlusion. In the sham + myrrh group; the rats were administered myrrh essential oil and then treated similarly to the sham group. Renal I/R group: the animals were challenged with renal I/R. In the myrrh + renal I/R groups, rats were administered 50 or 100 mg/kg of myrrh essential oil orally for three weeks before being confronted with I/R.

RESULTS

Serum levels of renal function tests and renal injury biomarkers, including NGAL, KIM-1, and CysC, were amplified in the renal I/R group. Animals that experienced renal I/R exhibited elevated lipid peroxidation (MDA); declined SOD, CAT, and GPx activity; declined GSH content; augmented TLR4/NFκB gene expression; and subsequent enhancement of inflammatory mediators (TNF-α, IFN-γ, IL-1β, and IL-6). Myrrh reduced renal function tests and injury biomarkers and amended renal histological alterations. Pretreatment with myrrh reduced MDA, elevated the antioxidant enzymes' activities and GSH content, and reduced the TLR4 and NFκB gene expression, leading to subsequent inflammation and apoptosis alleviation.

CONCLUSIONS

The outcomes of the present investigation established the protective effect of myrrh essential oil against renal I/R via pointing out the antioxidant, anti-inflammatory, and anti-apoptotic effects of myrrh.

Propitious maneuvering for delivery of the phytopharmaceutical "apocynin" to induced fulminant hepatitis in BALB/c mice: In vitro and in vivo assessments

Apocynin (APO), a specific nicotinamide adenine dinucleotide phosphate-oxidase (NADPH-oxidase, NOX) inhibitor, has recently emerged as a bioactive phytochemical with eminent anti-inflammatory and anti-oxidant activities. To our knowledge, no research has been conducted to fabricate a mucoadhesive nanostructured delivery system of APO that targets the liver. Accordingly, chitosan (CS) surface decorated polymeric nanoparticulate delivery system (PNDS) was victoriously fabricated by double emulsion-solvent evaporation method. Herein, a randomized full 33 factorial design was employed to assess the impact of the independently processing parameters (IPPs) namely; (poly(d,l-lactide-co-glycolide) (PLGA) amount (A)), (polyvinyl alcohol (PVA) concentration (B)), and (CS concentration (C)), on different dependently measured attributes (DMAs). The optimal APO-loaded chitosan-coated poly(d,l-lactide-co-glycolide) nanoparticles (APO-loaded CS-coated PLGA NPs) formula (F19) would be extensively appraised through meticulous in vitro-in vivo studies. Crucially, the results revealed that oral pre-treatment with the optimal formula evoked a prodigious in vivo hepatoprotective efficacy against lipopolysaccharide (LPS)/D-(+)-galactosamine (D-GalN) induced fulminant hepatitis (FH) in BALB/c mice when compared with pure APO, uncoated F19, and plain NPs (P NPs) pretreated groups. In conclusion, APO-loaded CS-coated PLGA NPs could be considered as a promising oral mucoadhesive phytopharmaceutical PNDS to open new prospects for therapeutic intervention in inflammatory based liver diseases.

GC-MS Method for Quantification and Pharmacokinetic Study of Four Volatile Compounds in Rat Plasma after Oral Administration of Commiphora myrrh (Nees) Engl. Resin and In Vitro Cytotoxic Evaluation

A rapid, simple, and sensitive gas chromatography–tandem mass spectrometry (GC–MS) method was established and validated for simultaneous determination of four volatile compounds, namely curzerene, methoxyfuranodiene, β-elemene, and α-pinene in rat plasma samples after oral administration of the resin extract of Commiphora myrrh using limonene as an internal standard (IS). Liquid-liquid extraction using hexane and ethyl acetate (1:1) mixture as an extracting agent was used for the samples extraction procedure. The GC–MS system was operated under selective ion monitoring (SIM) mode using Perkin Elmer Elite 5MS column (30 m × 0.25 mm × 0.25 µm film thickness). Specificity, linearity, precision, accuracy, extraction recovery, and stability were used to validate the developed method. The assay showed good linearity (r2 ≥ 0.998), and the lowest limits of quantification (LLOQ) were 3.97–21.38 ng/mL for the four analytes. This assay was successfully applied to pharmacokinetic studies of the four volatile compounds in rat plasma. The antiproliferative activity of these volatile compounds was evaluated against lung carcinoma (A549) and colon (LoVo) cell lines, were each compound caused variable inhibition on cells proliferation and methoxyfuranodiene exerted the strong antiproliferative activity against both cell line according to IC50 values.

Investigating the effect of ethanolic extract of Commiphora myrrha (Nees) Engl. gum-resin against hepatorenal injury in diabetic rats

PURPOSE

Management of hepatorenal complications in diabetic patients is still a challenge for clinicians. The study aimed to investigate the impacts of ethanolic extract of Commiphora myrrha (Nees) Engl.oleo-gum-resin (EEM) against hepatorenal injury in diabetic rats.

METHODS

Diabetes was induced by an intraperitoneal (i.p.) injection of streptozotocin (55 mg/kg) in adult male Wistar rats (n = 40); whereas, normal control rats (NC, n = 8) were treated with vehicle solution (citrate buffer, i.p.). Diabetic animals were gavaged with 500 mg/kg of metformin (MET500) and different doses of EEM (100, 300, and 500 mg/kg) once daily for 28 days. Diabetic model (DM) and NC groups were treated with normal saline. Various parameters like fasting blood glucose (FBG), plasma insulin, aspartate transaminase (AST), alanine transaminase (ALT), creatinine (Cr), urea, 24-h urine total protein (UTP), urine volume, and hepatorenal histopathology were assessed at the end of the study.

RESULTS

Compared to the NC group, diabetic rats showed marked elevations in FBG, AST, ALT, urea, Cr, UTP, urine volume, and a significant reduction in insulin. Diabetic animals also exhibited severe histopathological alterations in liver and kidney tissues. The EEM treatment could not influence the biochemical and pathological alterations. Treatment with EEM at the dose of 300 mg/kg could slightly ameliorate some pathological alterations (fatty changes and tubular congestion) in hepatic and renal tissues.

CONCLUSIONS

These findings demonstrated that EEM treatment at doses up to 500 mg/kg could not effectively slow down the pathological process of hepatorenal damage in diabetic rats.

Chinese Herbal Medicine Decreases Incidence of Cirrhosis in Patients with Non-Alcoholic Fatty Liver Disease in Taiwan: A Propensity Score-Matched Cohort Study

Objective: Chinese herbal medicine (CHM) is quite popular in Asia. The purpose of this study is to investigate the benefits of decreasing the risk of cirrhosis in patients with non-alcoholic fatty liver disease (NAFLD) by using CHM. Design: We performed a 1:3 propensity score-matched cohort study to analyze patients with NAFLD diagnosed between January 1, 1997 and December 31, 2011 through the Taiwanese National Health Insurance Research Database. Patients who received CHM therapy from the initial date of diagnosis of NAFLD to December 31, 2011 were included in the CHM group. Patients who were not treated with CHM during the same interval were categorized in the non-CHM group. Cox regression model was used to adjust for sex, age, comorbidities, and drug use. Hazard ratios were also compared between the two groups. Results: A total of 13,072 patients were identified after 1:3 propensity score matching. The patients had similar basic characteristics. A lower cumulative incidence of cirrhosis was found in the CHM cohort (log-rank test, p < 0.0001). Finally, 176 patients in the CHM cohort (4.66 per 1000 person-years) and 582 patients in the non-CHM cohort (7.92 per 1000 person-years) developed cirrhosis (adjusted hazard ratios 0.63, 95% confidence interval 0.53-0.75). The effect of CHM to lower cirrhosis incidence was independent of sex, drug use, and comorbidities, including diabetes mellitus, hypertension, and cardiovascular diseases. Patients older than 40 years of age and without comorbidities such as chronic obstructive pulmonary disease, hyperlipidemia, alcoholism, tobacco use, or obesity also benefited from CHM. Conclusions: Our study is the first large-scale investigation in Taiwan that shows the association between patients with NAFLD and cirrhosis prevention after CHM intervention. The results may be useful for treatment and for decision making for patients and clinical doctors. Further restricted trials are needed to support our findings.

Protective effects of myrrh essential oil on isoproterenol-induced myocardial infarction in rats through antioxidant, anti-inflammatory, Nrf2/HO-1 and apoptotic pathways

ETHNOPHARMACOLOGICAL RELEVANCE

Myrrh, a traditional remedy, is the stem resinous exudate of Commiphora molmol Engler (Burseraceae). The aromatic yellowish-brown oleoresin has a long history in folk and traditional medicine, in Saudi Arabia and the Arab world. Severe universal concern attributable to the high mortality is Myocardial Infarction (MI). Acute administration of Isoproterenol (ISO) is an established animal model to induce myocardial injury.

OBJECTIVE

The existing animal study was outlined to inspect the actions of Myrrh essential oil on cardiac functional, antioxidant status, apoptotic and inflammatory deviations in isoproterenol induced MI.

MATERIALS AND METHODS

Normal and Myrrh control animals were administered normal saline and Myrrh essential oil for thirty days orally, respectively. On the 29th and 30th day, the animals were injected by saline (s.c.). In the ISO control, the animals were administered saline orally for 30 days and then confronted with ISO (85 mg/kg s.c.) on 29th and 30th days. In the Myrrh Groups (IV and V), the animals were treated with Myrrh essential oil (50 and 100 mg/k) respectively for 30 days and injected with ISO (85 mg/kg, s.c.) on 29th and 30th days.

RESULTS

Animals experienced MI displayed functional blood pressure deviations, intensification in the heart to body weight ratio, myocytes indicative markers (CK-MB, CPK, LDH, cTnT, cTnI), lipid peroxidation (MDA), protein expression of Nrf2 and HO-1, apoptotic markers (Caspase 3,9), and inflammatory indicators. Conversely, animals pre-treated with Myrrh revealed obliteration of those elevations triggered by ISO induction, diminished elevated biochemical values and improved heart function.

CONCLUSION

Myrrh abstain effective cardio-protective action in MI model through improving the oxidative condition with myocytes and abolishing apoptotic as well as inflammatory responses.

Understanding Humma-e-Wabai (epidemic fever) and Amraz-e-Wabai (epidemic disease) in the light of Unani medicine

The pathogenesis and clinical characteristics of Humma-e-Wabai were described several years ago in the Unani System of Medicine close to the clinical manifestation associated with epidemic or pandemic situations. In the Unani System of Medicine, Humma-e-Wabai described under the legend of epidemic disease (Amraz-e-Wabai). Amraz-e-Wabai is an umbrella term which is applied for all types of epidemic or pandemic situation. Renowned Unani Scientists like; Zakariya Rhazi (865-925 AD), Ali Ibn Abbas Majusi (930-994 AD), Ibn Sina (980-1037 AD), Ismail Jorjani (1,042-1,137 AD), Ibn Rushd etc., explained that Humma-e-Waba is an extremely rigorous, lethal fever, that is caused due to morbid air (fasid hawa) and it frequently spreads among the larger population in the society. There are four etiological factors responsible for Amraz-e-Wabai viz; change in the quality of air, water, earth, and celestial bodies, which was described by Ibn Sina in Canon of Medicine. He also advised that movements should be limited during epidemic situations. Shelters should be fumigated with loban (Styrax benzoin W. G. Craib ex Hartwich.), Kafoor (Cinnamomum camphora L.), Oodkham (Aquilaria agallocha Roxb.), Hing (Ferula foetida L.), myrtle (Myrtus communis L.), and sandalwood (Santalum album L.), etc. The use of vinegar (sirka) and rose water (arque gulab) has been advocated to prevent the infection by spray. Avoid consumption of flesh, oil, milk, sweets, alcohol. Food prepared with vinegar. Specific antidotes (e.g. Tiryaq-e-Wabai, Tiryaq-e-Farooque), should be used as prophylaxis. This review attempts to explain the concept, prevention, and management of epidemic or pandemic situations.

Herbal approach for the management of C0VID-19: an overview

COVID-19 is the most recently discovered coronavirus infectious disease and leads to pandemic all over the world. The clinical continuum of COVID-19 varies from mild illness with non-specific signs and symptoms of acute respiratory disease to extreme respiratory pneumonia and septic shock. It can transmit from animal to human in the form of touch, through the air, water, utensils, fomite and feco-oral route blood. The pathogenesis and clinical features of COVID-19 be the same as the clinical manifestation associated epidemic Fever. In Unani medicine, various herbal drugs are described under the caption of epidemic disease. Great Unani scholar also Avicenna (980-1037 AD) recommended that during epidemic condition movement should be restricted, self-isolation, fumigation around the habitant with perfumed herbs (Ood, Kafoor, Sumbuluttib, Saad Kofi, Loban, etc.), and use of appropriate antidotes (Tiryaqe Wabai) and vinegar (Sirka) as prophylaxis. Herbal approach is based on single (Unnab-Ziziphus jujuba, Sapistan-Cordia myxa, Bahidana-Cydonia oblonga, Khatmi-Althea officinalis, Khubazi-Malva sylvestris, Zafran-Crocus sativus, Sibr-Aloe barbedensis, Murmuki-Commiphora myrrha, Darchini-Cinnamomum zeylanicum, Qaranfal-Syzygium aromaticum, Rihan-Oscimum sanctum, Habtus Sauda-Nigella sativa, Aslus Sus-Glycyrrhiza glabra, Maghze Amaltas-Cassia fistula and Adusa-Adhatoda vasica) and compound drugs (Habbe Bukhar, Sharbat Khaksi, Sharbat Zanjabeel, Naqu Nazla, Majoon Chobchini, Jawrish Jalinus and Khamira Marvareed) most of them are claimed for anti-viral, anti-pyretic, blood purifier, cardioprotective and expectorant activities. Traditionally most of the herbal practitioners are using it.

Understanding COVID-19 in the light of epidemic disease described in Unani medicine

Unani system of medicine is based on the humoral theory postulated by Hippocrates, according to him the state of body health and disease are regulated by qualitative and quantitative equilibrium of four humours. Amraz-e-Waba is an umbrella term which is used in Unani medicine for all types of epidemics (smallpox, measles, plague, Hameer Saifi, influenza, Nipaha, Ebola, Zika, and 2019 novel coronavirus, etc.) mostly fatal in nature. The coronavirus disease 2019 (COVID-19) is a severe acute respiratory infection, and the pathogenesis and clinical features resemble with those of Nazla-e-Wabaiya (influenza) and Zatul Riya (pneumonia) which were well described many years ago in Unani text such as high-grade fever, headache, nausea and vomiting, running nose, dry cough, respiratory distress, alternate and small pulse, asthenia, foul smell from breath, insomnia, frothy stool, syncope, coldness in both upper and lower extremities, etc. The World Health Organization declared COVID-19 as a global emergency pandemic. Unani scholars like Hippocrates (370-460 BC), Galen (130-200 AD), Rhazes (865-925 AD), and Avicenna (980-1037 AD) had described four etiological factors for Amraz-e-Waba viz., change in quality of air, water, Earth, and celestial bodies, accordingly mentioned various preventive measures to be adopted during epidemics such as restriction of movement, isolation or "quarantena", and fumigation with loban (Styrax benzoin W. G. Craib ex Hartwich.), sandalwood (Santalum album L.), Zafran (Crocus sativus L.), myrtle (Myrtus communis L.), and roses (Rosa damascena Mill.) and use of vinegar (sirka) and antidotes (Tiryaq) as prophylaxis, and avoiding consumption of milk, oil, sweet, meat, and alcohol. This review focuses and elaborates on the concept, prevention, and probable management of COVID-19 in the light of Amraz-e-Waba.

Understanding COVID-19 in the light of epidemic disease described in Unani medicine

Unani system of medicine is based on the humoral theory postulated by Hippocrates, according to him the state of body health and disease are regulated by qualitative and quantitative equilibrium of four humours. Amraz-e-Waba is an umbrella term which is used in Unani medicine for all types of epidemics (smallpox, measles, plague, Hameer Saifi, influenza, Nipaha, Ebola, Zika, and 2019 novel coronavirus, etc.) mostly fatal in nature. The coronavirus disease 2019 (COVID-19) is a severe acute respiratory infection, and the pathogenesis and clinical features resemble with those of Nazla-e-Wabaiya (influenza) and Zatul Riya (pneumonia) which were well described many years ago in Unani text such as high-grade fever, headache, nausea and vomiting, running nose, dry cough, respiratory distress, alternate and small pulse, asthenia, foul smell from breath, insomnia, frothy stool, syncope, coldness in both upper and lower extremities, etc. The World Health Organization declared COVID-19 as a global emergency pandemic. Unani scholars like Hippocrates (370-460 BC), Galen (130-200 AD), Rhazes (865-925 AD), and Avicenna (980-1037 AD) had described four etiological factors for Amraz-e-Waba viz., change in quality of air, water, Earth, and celestial bodies, accordingly mentioned various preventive measures to be adopted during epidemics such as restriction of movement, isolation or "quarantena", and fumigation with loban (Styrax benzoin W. G. Craib ex Hartwich.), sandalwood (Santalum album L.), Zafran (Crocus sativus L.), myrtle (Myrtus communis L.), and roses (Rosa damascena Mill.) and use of vinegar (sirka) and antidotes (Tiryaq) as prophylaxis, and avoiding consumption of milk, oil, sweet, meat, and alcohol. This review focuses and elaborates on the concept, prevention, and probable management of COVID-19 in the light of Amraz-e-Waba.

Commiphora myrrha Resin Alcoholic Extract Ameliorates High Fat Diet Induced Obesity via Regulation of UCP1 and Adiponectin Proteins Expression in Rats

This study was performed to evaluate anti-obesity potential of Commiphora myrrha resin ethanolic extract (CME) with the respect to expression of leptin, adiponectin and uncoupling protein 1 (UCP1) in rats. Control rats fed basal diet. Second group fed basal diet and administered CME (500 mg/kg bw) orally for 14 weeks. Third group fed high fat diet (HFD) for 14 weeks. Fourth group fed HFD and administered CME as second group. Fifth group fed HFD for 8 weeks then fed basal diet and administered CME as third group for another 6 weeks. Phytochemical analysis of CME identified the presence of germacrene B, 1,4-benzoquinone, benzofuran, hexadecanoic acid, 9,12-octadecnoic acid methyl ester, reynosin, 11, 14-eicosadienoic acid, isochiapin B, bisabolene epixod, elemene and 1-heptatriacotanol. High fat diet significantly increased food intake, body weight, hyperglycemia, serum levels of total cholesterol, triacylglycerol, low density lipoprotein and ketone bodies, AST and AST activities, concentration of malondialdehyde and histopathological changes in hepatic tissues. However, it significantly reduced serum levels of high density lipoprotein, leptin and adiponectin, activity of hepatic glutathione reductase (GR) and brown adipose tissue UCP1 protein expression. In contrast, CME ameliorated HFD increased body weight, hyperglycemia, dyslipidemia, ketonemia, hepatic tissues lipid peroxidation, restored hepatic tissue architecture and enhanced protein expression of leptin, adiponectin and UCP1 and activity of hepatic GR. This study indicated that CME ameliorated HFD induced hyperglycemia and dyslipidemia through normalization of HFD reduced leptin, adiponectin and UCP1 proteins production and antioxidant activity.

An Evidence-based Review of Medicinal Plants used in Traditional Persian Medicine for Treatment of Osteoarthritis

Osteoarthritis (OA) is known to be the leading cause of pain and disability in the elderly. The prevalence of this disease in adults over 60 years was 9.6% in men and 18% in women. The therapeutic goals of this disease generally include pain relief with the least side effects, improvement of articular function and improvement of life, in which pharmacological and nonpharmacological treatments are performed in different protocols. Due to the common side effects of pain relievers and complaints after invasive joint surgeries, there is a growing interest in the use of Traditional and Complementary protocols in OA treatment. In this paper, different sources of Traditional Persian Medicine (TPM) were searched to obtain any evidence evaluating any medicinal plants in the management of OA. Over 250 effective medicinal plants for the treatment of OA have been introduced in these sources, and by searching electronic databases including PubMed and Scopus, we have found that of these plants, 39 have direct or indirect evidence in the treatment of this complication by different mechanism of actions such as effect on Body mass index (BMI), obesity and dyslipidemia, anti-inflammatory, anti-nociceptive and antioxidant activity. The most important medicinal plants with direct evidence in the management of OA are Allium sativum, Commiphora mukul, Linum usitatissimum, Matricaria chamomilla, Nigella sativa, Zingiber officinale, and Piper nigrum. Medicinal plants seem to be a valuable source for discovering and identifying new drugs for treatment of OA; however, since most of the studies are preclinical, further clinical trials are required to achieve more conclusive results.

Lophenol and lathosterol from resin of Commiphora kua possess hepatoprotective effects in vivo

ETHNOPHARMACOLOGICAL RELEVANCE

Drug induced liver damage remains a prevalent concern in healthcare and may reduce the effectiveness of therapy by compromising therapeutic regimens. Many Commiphora species are known for their medicinal properties, and some of them are used traditionally for hepatoprotective effect. In the course of our drugs discovery from natural sources, phytosterols (lophenol (Lop) and lathosterol (Lat)), isolated from Commiphora kua were studied to evaluate their hepatoprotective effects in acetaminophen (APAP) induced hepatotoxicity in mice.

AIMS AND OBJECTIVE

To evaluate the hepatoprotective effects of phytosterols isolated from C. kua using in vivo experimental model.

MATERIALS AND METHODS

Mice of either sex were divided into 7 groups: Vehicle, silymarin (SLY), acetaminophen (APAP), Lop 25, Lop 50, Lat 25, Lat 50 (n = 5). Vehicle group received only vehicle (0.1% DMSO solution) for 7 days, APAP group received single dose of acetaminophen on day 7 and SLY group received silymarin for 7 days. Lop 25 and Lop 50 received low and high doses of Lop (25 μg/kg BW and 50 μg/kg BW), respectively, for 7 days, while Lat 25 and Lat 50 received low and high doses of Lat (25 μg/kg BW and 50 μg/kg BW) for 7 days. On day 7, all animals except Vehicle group kept fasted for 18 h and received APAP i. p. 400 mg/kg BW. After 20 h of APAP administration, the animals anesthetized with light chloroform and scarified by cervical decapitation. The blood serum and liver tissue samples were collected for biochemical and histopathological analysis. Liver function tests (LFTs) including lactate deydrogenase (LDH), alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST) and direct bilirubin) were used as biochemical parameters. While catalase (CAT), superoxide dismutase (SOD) and reduced glutathione (GSH) were taken as anti-oxidant enzymes.

RESULTS

Significant increase in levels of ALT, AST, ALP, LDH and direct bilirubin, and significant decrease in concentration of anti-oxidant enzymes (SOD, CAT and GSH) was observed in APAP-treated group. Similarly, histological slides showed obvious signs of damage to liver cells, reflecting acetaminophen induced hepatotoxicity. Treatment of test animals with phytosterols resulted in significant recovery of LFTs profile and concentration of anti-oxidant enzymes. Similarly, significant improvement of liver tissues was noted in histological analysis.

CONCLUSIONS

Both phytosterols possessed hepatoprotective potential and should be further evaluated for acute toxicity studies and pharmacokinetics/pharmacodynamics profile.

Propofol attenuates inflammatory response and apoptosis to protect d-galactosamine/lipopolysaccharide induced acute liver injury via regulating TLR4/NF-κB/NLRP3 pathway

OBJECTIVE

Propofol has been reported to be protective against liver injury due to its anti-inflammatory, anti-oxidative and anti-apoptotic activities. The purpose of this study was to examine the protective effects of propofol on d-galactosamine/lipopolysaccharide (d-GalN/LPS) induced acute liver injury.

METHODS

Mice were given an intraperitoneal injection of propofol before d-GalN/LPS treatment. Liver injury was confirmed by serum biochemical analysis and liver histopathological analysis. Relevant molecular events were determined by ELISA, western blot, and test kits. Cell apoptosis were evaluated by TUNEL assay.

RESULTS

The results showed that propofol significantly prevented d-GalN/LPS-induced liver damage by preventing associated increases of serum alanine transaminase (ALT) and aspartate transaminase (AST) and restoring liver histopathological changes. Propofol markedly inhibited the production of inflammatory cytokines and oxidative stress-related factors. Propofol markedly reduced hepatocyte apoptosis, decreased Bax, Bad, cleaved caspase-3 and increased Bcl-2 expression. Besides, NLRP3 inflammasome and TLR4/NF-κB pathway were inactivated under the treatment of propofol according to the expression of pathways-related proteins.

CONCLUSION

Taken together, propofol contributed to liver protection against d-GalN/LPS-induced liver injury in mice by inhibiting inflammation, oxidative stress and hepatocyte apoptosis through regulating TLR4/NF-κB/NLRP3 pathway.

Bone marrow mesenchymal stem cell-derived exosomes attenuate D-GaIN/LPS-induced hepatocyte apoptosis by activating autophagy in vitro

Background

Acute liver failure is an inflammation-mediated hepatocyte injury. Mesenchymal stem cell (MSC) transplantation is currently considered to be an effective treatment strategy for acute liver failure. Exosomes are an important paracrine factor that can be used as a direct therapeutic agent. However, the use of bone marrow mesenchymal stem cell-derived exosomes (BMSC-Exos) in the treatment of acute liver failure has not been reported.

Purpose

Here, we established a model of hepatocyte injury and apoptosis induced by D-galactosamine and lipopolysaccharide (D-GalN/LPS) to study the protective effect of BMSC-Exos on hepatocyte apoptosis, and further explored its protective mechanism.

Methods

BMSC-Exos was identified by transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA) and Western blot. Laser confocal microscopy was used to observe the uptake of Dil-Exos by hepatocytes. D-GalN/LPS-induced primary hepatocytes were pretreated with BMSC-Exos in vitro, and then the cells were harvested. The apoptosis of hepatocytes was observed by TUNEL staining, flow cytometry and Western blot. Electron microscopy and mRFP-GFP-LC3 and Western blot was used to observe autophagy.

Results

BMSC-Exos increased the expression of autophagy marker proteins LC3 and Beclin-1 and promoted the formation of autophagosomes. After BMSC-Exos treatment, the expression levels of the proapoptotic proteins Bax and cleaved caspase-3 were significantly decreased, while the expression level of the anti-apoptotic protein Bcl-2 was upregulated. However, when the autophagy inhibitor 3MA was present, the effect of BMSC-Exos on inhibiting apoptosis was significantly reversed.

Conclusions

Our results showed for the first time that BMSC-Exos had the potential to reduce hepatocyte apoptosis after acute liver failure. In particular, we found that BMSC-Exos attenuated hepatocyte apoptosis by promoting autophagy. 

The hepatoprotective effects of Radix Bupleuri extracts against D-galactosamine/lipopolysaccharide induced liver injury in hybrid grouper (Epinephelus lanceolatus♂ × Epinephelus fuscoguttatus♀)

The present study is aiming at evaluating the hepatoprotective of Radix Bupleuri extracts (RBE) on the d-galactosamine/lipopolysaccharide (D-GalN/LPS) induced liver injury of hybrid grouper in vitro and in vivo. In vitro, RBE (0, 200, 400 and 800 μg/ml) was added to the hybrid grouper primary hepatocytes before (pretreatment) the incubation of the hepatocytes with D-GalN (20 mM) plus LPS (1 μg/ml) in the culture medium. RBE at concentrations of 200, 400 and 800 μg/ml significantly improved cell viability and inhibited the elevation of TNF-α, IL-1β and IL-6 and significantly down-regulated the caspase-3, caspase-9 and P53 mRNA levels. In vivo administration of RBE at the doses of 0, 200, 400, 800 and 1600 mg/kg in the diet for 8 weeks prior to D-GalN (500 mg/kg) and LPS (20 μg/kg) intoxication. The study indicated that the RBE not only ameliorated liver injury, as evidenced by well-preserved liver architecture, but also significantly increased hepatic antioxidant enzymes activities in the D-GalN/LPS-induced liver injury animal model. Further demonstrating the protective effects of the RBE, we found that pretreatment with the RBE up-regulated the expression of antioxidant genes (GPx and MnSOD), while down-regulated apoptosis-related genes (caspase-3, caspase-9 and P53), immune related genes (MHC2 and TLR3) and pro-inflammatory cytokines (TOR and IKKα) mRNA expression in the liver of hybrid grouper. In brief, the present study showed that RBE can protect hepatocyte injury induced by D-GalN/LPS through elevating antioxidant enzyme activity and suppressing apoptosis and immune inflammatory responses. The results support the use of RBE as a hepatoprotective in fish.

Commiphora molmol Modulates Glutamate-Nitric Oxide-cGMP and Nrf2/ARE/HO-1 Pathways and Attenuates Oxidative Stress and Hematological Alterations in Hyperammonemic Rats

Hyperammonemia is a serious complication of liver disease and may lead to encephalopathy and death. This study investigated the effects of Commiphora molmol resin on oxidative stress, inflammation, and hematological alterations in ammonium chloride- (NH₄Cl-) induced hyperammonemic rats, with an emphasis on the glutamate-NO-cGMP and Nrf2/ARE/HO-1 signaling pathways. Rats received NH₄Cl and C. molmol for 8 weeks. NH₄Cl-induced rats showed significant increase in blood ammonia, liver function markers, and tumor necrosis factor-alpha (TNF-α). Concurrent supplementation of C. molmol significantly decreased circulating ammonia, liver function markers, and TNF-α in hyperammonemic rats. C. molmol suppressed lipid peroxidation and nitric oxide and enhanced the antioxidant defenses in the liver, kidney, and cerebrum of hyperammonemic rats. C. molmol significantly upregulated Nrf2 and HO-1 and decreased glutamine and nitric oxide synthase, soluble guanylate cyclase, and Na⁺/K⁺-ATPase expression in the cerebrum of NH₄Cl-induced hyperammonemic rats. Hyperammonemia was also associated with hematological and coagulation system alterations. These alterations were reversed by C. molmol. Our findings demonstrated that C. molmol attenuates ammonia-induced liver injury, oxidative stress, inflammation, and hematological alterations. This study points to the modulatory effect of C. molmol on glutamate-NO-cGMP and Nrf2/ARE/HO-1 pathways in hyperammonemia. Therefore, C. molmol might be a promising protective agent against hyperammonemia.

Hepatoprotective activity of Lepidium sativum seeds against D-galactosamine/lipopolysaccharide induced hepatotoxicity in animal model

BACKGROUND

Fulminant hepatic failure (FHF) is clinical syndrome with very poor prognosis and high mortality there is urgent need for the development of safe and non-toxic hepatoprotective agents for the adequate management of hepatitis. Hepatoprotective effect of the Lepidium sativum ethanolic extract (LSEE) was assessed by D-galactosamine-induced/lipopolysaccharide (400 mg/kg and 30 μg/kg) liver damage model in rats.

METHODS

Hepatoprotective activity of LSEE (150 and 300 mg/kg) and silymarin on D-GalN/LPS induced FHF in rat was assessed using several liver function enzyme parameters. Antioxidant properties as antioxidant stress enzymes were assessed in hepatic Liver as well as mRNA expression of cytokines genes such as TNF-α, IL-6, and IL-10 and stress related genes iNOS and HO-1 were determined by RT-PCR. Protein expression of apoptotic genes were evaluated through western blot. MPO and NF-κB DNA-binding activity was analyzed by ELISA. The magnitude of hepatic impairment was investigated through histopathological evaluation.

RESULTS

Marked amelioration of hepatic injuries by attenuation of serum and lipid peroxidation has been observed as comparable with silymarin (25 mg/kg p.o). D-GalN/LPS induced significant decrease in oxidative stress markers protein level, and albumin. LSEE significantly down-regulated the D-GalN/LPS induced pro-inflammatory cytokines TNFα and IL-6 mRNA expression in dose dependent fashion about 0.47 and 0.26 fold and up-regulates the IL-10 by 1.9 and 2.8 fold, respectively. While encourages hepatoprotective activity by down-regulating mRNA expression of iNOS and HO-1. MPO activity and NF-κB DNA-binding effect significantly increased and was mitigated by LSEE in a dose-dependent style as paralleled with silymarin.

CONCLUSION

Our data suggests that pretreatment of LSEE down regulates the caspase 3 and up-regulates the BCl₂ protein expression. The above findings revealed that Lepidium sativum has significant hepatoprotective activity.