Traditional Herbal Medicine in Mesoamerica: Toward Its Evidence Base for Improving Universal Health Coverage

Evaluation of the Effects of Extracts Containing Valeriana officinalis and Piper methysticum on the Activities of Cytochrome P450 3A and P-Glycoprotein

This work investigated interactions ascribed to the administration of phytomedicines containing Valeriana officinalis and Piper methysticum with conventional drugs. The phytomedicines were characterized by HPLC and administered per os to male Wistar rats, either concomitantly or not with the CYP3A substrate midazolam. To distinguish between the presystemic or systemic effect, midazolam was given orally and intravenously. The effects on the P-gp substrate fexofenadine uptake by Caco-2 cells were examined. The valerenic acid content was 1.6 ± 0.1 mg per tablet, whereas kavain was 13.7 ± 0.3 mg/capsule. Valerian and kava-kava extracts increased the maximum plasma concentration (Cmax) of midazolam 2- and 4-fold compared to the control, respectively. The area under the plasma concentrations versus time curve (AUC(0-∞)) was enhanced from 994.3 ± 152.3 ng.h/mL (control) to 3041 ± 398 ng.h/mL (valerian) and 4139 ± 373 ng.h/mL (kava-kava). The half-life of midazolam was not affected. These changes were attributed to the inhibition of midazolam metabolism by the enteric CYP3A since the i. v. pharmacokinetic of midazolam remained unchanged. The kava-kava extract augmented the uptake of fexofenadine by 3.5-fold compared to the control. Although Valeriana increased the uptake of fexofenadine, it was not statistically significant to that of the control (12.5 ± 3.7 ng/mg protein vs. 5.4 ± 0.3 ng/mg protein, respectively). Therefore, phytomedicines containing V. officinalis or P. methysticum inhibited the intestinal metabolism of midazolam in rats. Conversely, the P-gp-mediated transport of fexofenadine was preferably affected by kava-kava.

Investigating the anti-growth, anti-resistance, and anti-virulence activities of Schoepfia schreberi J.F.Gmel. against the superbug Acinetobacter baumannii

Schoepfia schreberi has been used in Mayan folk medicine to treat diarrhea and cough. This study aimed to determine the anti-growth, anti-resistance, and/or anti-virulence activities of S. schreberi extracts against Acinetobacter baumannii, a pathogen leader that causes healthcare-associated infections with high rates of drug-resistant including carbapenems, the last line of antibiotics known as superbugs, and analyze their composition using HPLC-DAD. Ethyl acetate (SSB-3) and methanol (SSB-4) bark extracts exhibit antimicrobial and biocidal effects against drug-susceptible and drug-resistant A. baumannii. Chemical analysis revealed that SSB-3 and SSB-4 contained of gallic and ellagic acids derivatives. The anti-resistance activity of the extracts revealed that SSB-3 or SSB-4, combined with imipenem, exhibited potent antibiotic reversal activity against A. baumannii by acting as pump efflux modulators. The extracts also displayed activity against surface motility of A. baumannii and its capacity to survive reactive oxygen species. This study suggests that S. schreberi can be considered a source of antibiotics, even adjuvanted compounds, as anti-resistant or anti-virulence agents against A. baumannii, contributing to ethnopharmacological knowledge and reappraisal of Mayan medicinal flora, and supporting the traditional use of the bark of the medicinal plant S. schreberi for the treatment of infectious diseases.

Technology Readiness Level Roadmap for Developing Innovative Herbal Medicinal Products

Despite the vast global botanical diversity, the pharmaceutical development of herbal medicinal products (HMPs) remains underexploited. Of over 370,000 described plant species, only a few hundred are utilized in HMPs. Most of these have originated from traditional use, and only a minority come from megadiverse countries. Exploiting the pharmacological synergies of the hundreds of compounds found in poorly studied plant species may unlock new therapeutic possibilities, enhance megadiverse countries' scientific and socio-economic development, and help conserve biodiversity. However, extensive constraints in the development process of HMPs pose significant barriers to transforming this unsatisfactory socio-economic landscape. This paper proposes a roadmap to overcome these challenges, based on the technology readiness levels (TRLs) introduced by NASA to assess the maturity of technologies. It aims to assist research entities, manufacturers, and funding agencies from megadiverse countries in the discovery, development, and global market authorization of innovative HMPs that comply with regulatory standards from ANVISA, EMA, and FDA, as well as WHO and ICH guidelines.

Are we romanticizing traditional knowledge? A plea for more experimental studies in ethnobiology

In answer to the debate question "Is ethnobiology romanticizing traditional practices, posing an urgent need for more experimental studies evaluating local knowledge systems?" I suggest to follow-up on field study results adopting an inclusive research agenda, and challenge descriptive data, theories, and hypotheses by means of experiments. Traditional and local knowledge are generally associated with positive societal values by ethnobiologists and, increasingly also by stakeholders. They are seen as a way for improving local livelihoods, biocultural diversity conservation and for promoting sustainable development. Therefore, it is argued that such knowledge needs to be documented, protected, conserved in situ, and investigated by hypothesis testing. Here I argue that a critical mindset is needed when assessing any kind of knowledge, whether it is modern, local, indigenous, or traditional.

Use of complementary and alternative medicine by cancer patients in Colombia

BACKGROUND

The use of complementary and alternative medicines (CAM) among cancer patients varies greatly. The available data suggest an increasing use of CAM over time and a higher prevalence in low- and middle-income countries. However, no reliable data are available from Latin America. Accordingly, we examined the prevalence of CAM use among cancer patients from six Colombian regions.

METHODS

We conducted a survey on cancer patients attending comprehensive cancer centres in six capital cities from different regions. The survey was designed based on a literature review and information gathered through focus groups on CAM terminology in Colombia. Independent random samples of patients from two comprehensive cancer centres in every city were obtained. Patients 18 years and older with a histopathological diagnosis of cancer undergoing active treatment were eligible. The prevalence of CAM use is reported as a percentage with the corresponding confidence interval. CAM types are reported by region. The sociodemographic and clinical characteristics of CAM users and non-users were compared using Chi square and t tests.

RESULTS

In total, 3117 patients were recruited. The average age 59.6 years old, and 62.8% were female. The prevalence of CAM use was 51.7%, and compared to non-users, CAM users were younger, more frequently women, affiliated with the health insurance plan for low-income populations and non-Catholic. We found no differences regarding the clinical stage or treatment modality, but CAM users reported more treatment-related side effects. The most frequent types of CAM were herbal products, specific foods and vitamins, and individually, soursop was the most frequently used product. Relevant variability between regions was observed regarding the prevalence and type of CAM used (range: 36.6% to 66.7%). The most frequent reason for using CAM was symptom management (30.5%), followed by curative purposes (19.5%).

CONCLUSIONS

The prevalence of CAM use among cancer patients in Colombia is high in general, and variations between regions might be related to differences in cultural backgrounds and access to comprehensive cancer care. The most frequently used CAM products and practices have little scientific support, suggesting the need to enhance integrative oncology research in the country.

A Perspective on Missing Aspects in Ongoing Purification Research towards Melissa officinalis

Melissa officinalis L. is a medicinal plant used worldwide for ethno-medical purposes. Today, it is grown everywhere; while it is known to originate from Southern Europe, it is now found around the world, from North America to New Zealand. The biological properties of this medicinal plant are mainly related to its high content of phytochemical (bioactive) compounds, such as flavonoids, polyphenolic compounds, aldehydes, glycosides and terpenes, among many other groups of substances. Among the main biological activities associated with this plant are antimicrobial activity (against fungi and bacteria), and antispasmodic, antioxidant and insomnia properties. Today, this plant is still used by society (as a natural medicine) to alleviate many other illnesses and symptoms. Therefore, in this perspective, we provide an update on the phytochemical profiling analysis of this plant, as well as the relationships of specific biological and pharmacological effects of specific phytochemicals. Currently, among the organic solvents, ethanol reveals the highest effectiveness for the solvent extraction of precious components (mainly rosmarinic acid). Additionally, our attention is devoted to current developments in the extraction and fractionation of the phytochemicals of M. officinalis, highlighting the ongoing progress of the main strategies that the research community has employed. Finally, after analyzing the literature, we suggest potential perspectives in the field of sustainable extraction and purification of the phytochemical present in the plant. For instance, some research gaps concern the application of cavitation-assisted extraction processes, which can effectively enhance mass transfer while reducing the particle size of the extracted material in situ. Meanwhile, membrane-assisted processes could be useful in the fractionation and purification of obtained extracts. On the other hand, further studies should include the application of ionic liquids and deep eutectic solvents (DES), including DESs of natural origin (NADES) and hydrophobic DESs (hDES), as extraction or fractionating solvents, along with new possibilities for effective extraction related to DESs formed in situ, assisted by mechanical mixing (mechanochemistry-based approach).

Mexican traditional medicines for women's reproductive health

Like China, Mexico has a traditional system of medicine dating back almost 5000 years that incorporates the healing practices of pre-Columbian civilizations, including the Maya and Aztec. Mexican Traditional Medicine (MTM) women depend on MTM practices and herbal medicines for their primary healthcare needs as limited access and high costs of Western medicine is a significant problem. The aims of this work were to determine the medicinal plants more commonly used in MTM for women's reproductive health issues and assess the clinical data supporting their use. Data from multiple sources was compiled and information on plants commonly used by women in Mexico MTM for the treatment of fertility and menstruation issues, pregnancy, and menopause was analyzed. Analysis of the data show that 185 species of plants representing > 60 families were used for a wide range of reproductive health issues. Some of these plants have been used in MTM for fertility regulation in women of which 35 species were used as emmenagogues and abortifacients. Approximate 40 species were used for the symptoms of premenstrual syndrome, heavy menstrual bleeding, and dysmenorrhea. In terms of pregnancy, 35 species were used for postpartum care and to facilitate breastfeeding, 16 species were used as oxytocic agents to induce labor and speed birth, and six plant species were used to prevent miscarriage. Fourteen plant species were reported to treat infertility or promote fertility, and seven species were used to treat uterine prolapse. Three plants species were reported to treat menopause and two plants were used for osteoporosis. Analysis of the clinical data for commonly used medicinal plants showed some clinical support for the use of these plants in MTM. In Mexico, women use medicinal plants for almost every aspect of reproductive health. While some plants have clinical data, most medicinal plants used in MTM have no safety or efficacy data available and could serve as the basis of future investigations.

Nephroprotective plant species used in traditional Mayan Medicine for renal-associated diseases

ETHNOPHARMACOLOGICAL RELEVANCE

The prevalence of kidney disease has increased rapidly in recent years and has emerged as one of the leading causes of mortality worldwide. Natural products have been suggested as valuable nephroprotective agents due to their multi-target and synergistic effects on modulating important proteins involved in kidney injury. There is a large number of plant species that have been used traditionally for kidney-related conditions in Mesoamerican medicine by different cultural groups that could provide a valuable source of nephroprotective therapeutic candidates and could lead to potential drug discovery.

AIM OF REVIEW

This review aims to provide an overview of the currently known efficacy of plant species used traditionally in Mesoamerica by Mayan groups to treat kidney-related conditions and to analyze the phytochemical, pharmacological, molecular, toxicological, and clinical evidence to contribute to public health efforts and for directing future research.

METHODS

Primary sources of plant use reports for traditional kidney-related disorders in Mesoamerica were searched systematically from library catalogs, theses, and scientific databases (PubMed, Google Scholar; and Science Direct), and were filtered according to usage frequency in Mayan groups and plant endemism. The database of traditional plants was further analyzed based on associations with published reports of the phytochemical, pharmacological, molecular, toxicological, and clinical evidence.

RESULTS

The most reported kidney-related conditions used traditionally in Mayan medicine involve reducing renal damage (a cultural interpretation that considers an inflammatory or infectious condition), cleaning or purifying the blood and kidney, reducing kidney pain, and eliminating kidney stones. A total of 208 plants used for kidney-related problems by 10 Mayan groups were found, representing 143 native species, where only 42 have reported pharmacological activity against kidney damage, mainly approached by in vitro and in vivo models of chemical- or drug-induced nephrotoxicity, diabetes nephropathy, and renal injury produced by hypertension. Nephroprotective effects are mainly mediated by reducing oxidative stress, inflammatory response, fibrosis mechanisms, and apoptosis in the kidney. The most common nephroprotective compounds associated with traditional Mayan medicine were flavonoids, terpenoids, and phenolic acids. The most widely studied traditional plants in terms of pharmacological evidence, bioactive compounds, and mechanisms of action, are Annona muricata L., Carica papaya L., Ipomoea batatas (L.) Lam., Lantana camara L., Sechium edule (Jacq.) Sw., Tagetes erecta L., and Zea mays L. Most of the plant species with reported pharmacological activity against kidney damage were considered safe in toxicological studies.

CONCLUSION

Available pharmacological reports suggest that several herbs used in traditional Mayan medicine for renal-associated diseases may have nephroprotective effects and consistent pharmacological evidence, nephroprotective compounds, and mechanisms of action in different models of kidney injury. However, more research is required to fully understand the potential of traditional Mayan medicine in drug discovery given the limited ethnobotanical studies and data available for most species with regards to identification on bioactive components, pharmacological mechanisms, and the scarce number of clinical studies.

Historical Aspects of Herbal Use and Comparison of Current Regulations of Herbal Products between Mexico, Canada and the United States of America

Increased life expectancy and high costs of medicines and medical care have led to the use of herbal products. However, these items may contain toxic compounds that have an impact on public health. We will focus on the regulatory aspects and differences of these products marketed in the North American region (USA-Mexico-Canada) from government websites and selected literature. Mexico has an ancestral tradition of using plants for the treatment, improvement, and maintenance of human health as compared with Canada and the USA Currently, the use of herbal products in this region has a regulatory framework. The legal framework in these three countries is related to their history, idiosyncrasies, socio-economic and cultural aspects. Therefore, there are different public policies for herbal products consumed in the region. Mexico has a more specific classification of these products. In Canada, all herbal products are classified as natural health products and the safety and efficacy must be scientifically proven. In the USA, the development of botanical drugs is very recent. In particular, both herbal products classified as food supplements in Mexico and dietary supplements in the USA may have risks in both safety and efficacy.

Development and Validation of a Tool to Improve Community Pharmacists’ Surveillance Role in the Safe Dispensing of Herbal Supplements

Background: There has been an appreciable increase in the use of herbal supplements, including immune boosters, during the current COVID-19 pandemic. However, there are concerns with falsified herbal supplements.

Objectives: Developed a new questionnaire that can potentially help community pharmacists identify the extent of falsified herbal supplements.

Methods: A 9-month cross sectional study was conducted among 500 community pharmacies across United Arab Emirates. A new 5-factor, 24-itmes scale was developed based on current labelling requirements across countries and piloted. This included seven items on identified uses and contraindication, seven items on hazard identification, four items on product identity, three items on packaging and product insert and three items on product handling and storage. The face and content validity of the scale was assessed via the content validity index (CVI). Its construct validity was tested using an exploratory factor analysis (EFA) via principally component analysis (PCA). The model was subsequently confirmed through partial confirmatory factor analysis (PCFA). Its reliability was assessed via test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs).

Results: The CVI of the finalized questionnaire was 0.843. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.891, and Bartlett’s test of sphericity indicated significance (p-value < 0.001). Confirmation of the subsequent 5-domains was achieved through PCFA using maximum likelihood analysis with oblimin rotation. The PCFA obtained values was 0.962 for NFI, 0.977 for CFI, and 0.987 for the Tucker Lewis Index. All values were greater than 0.95, and the RMSEA value was 0.03 (i.e., less than 0.06). Consequently, the model had a good fit. All domains demonstrated Cronbach’s alpha coefficients above 0.70, with 0.940 for the full instrument. Meanwhile, all items met the IIC correlation standard of ≥0.40. The instrument presented good ICC statistics of 0.940 (0.928–0.950) as well as statistical significance (p < 0.001). Community pharmacists with more than 10 experience years were more likely to identify falsified herbal supplements compared to those with 1–10 years experience (p < 0.001).

Conclusion: This study developed and validated a new instrument to identify safe herbal supplements, which should enhance the role of the community pharmacists in the safe and effective treatment of suitable patients with herbal supplements.

Beyond the Exploration of Muicle (Justicia spicigera): Reviewing Its Biological Properties, Bioactive Molecules and Materials Chemistry

In recent years, the research community is tremendously investigating unexplored plants and herbals as they represent a potential source of various biomolecules, which not only contribute to nutrition but also to human health. In fact, Muicle (Justicia spicigera) has attracted the attention of scientists thanks to its multiple biological activities associated with the phytochemicals and specific biomolecules present in this plant. In this review, an evidence on current development works assaying the potential biological properties of Muicle is given. Here, we introduce the key biologically active molecules ascribed to such properties, along with the mechanism of action and interaction. Although the utilization of this plant has been majorly focused on traditional medicine, specific applications in terms of production of new feedstocks and nanomaterials, and developments of functional foods and formulations, are also a current direction towards the exploitation of this natural source. Therefore, this review reports the main outcomes of current research towards the utilization of biomolecules and other elements of the plant in new fields of research such as materials chemistry.

Promotive effects of four herbal medicine ARCC on wound healing in mice and human

Background

Traditional Chinese medicine (TCM) had been extensively used in China for wound management and had shown great potential in wound treatment while its mechanism is still needed to be addressed.

Objective

The present study sought to investigate the therapuetic effect of the TCM ARCC on acute and chronic wounds.

Methods

Here, using the ultra‐low temperature preparation method, the mixed ultramicro powder prepared with Angelica (A), Angelica (R), Calcined Gypsum (C) and Caleramide (C) named as ARCC. The effects of ARCC on wound healing in adult and aged mice were comparatively evaluated through a full‐thickness skin defect model. In addition, we randomly selected 10 patients aged 55 to 70 years from a cohort of 500 patients with diabetic feet to assess their prognosis.

Results

As the results showed that the healing rate had delayed in aged mice compared to adult mice, while ARCC prominently augmented the healing process in aged mice. Moreover, ARCC treatment wounds in aged mice showed accelerated re‐epithelization, enhanced granulation tissue formation, and increased vascularization, which was similar to that of adult mice. Furthermore, ARCC also achieved therapeutic effects in diabetic foot patients, accelerating wound healing. The results found that foot ulcers improved significantly 7 days after the ARCC administration, and 80% of patients were healed within 1 month.

Discussion

In the present study, ARCC was found to have therapeutic effects on both acute and chronic wounds in animal models. ARCC also demonstrated therapeutic effects in diabetic feet, which promoted wound healing, prevented wound infection, and avoided the risk of further surgery or amputation. All these evidences suggested ARCC was a promising approach for wound treatment.

Conclusions

ARCC might be recommended as a promising therapeutic medication in diabetic and chronic refractory wounds.

Phytochemistry in the Ethnopharmacology of North and Central America

Traditionally the role of phytochemistry in the ethnopharmacology of North and Central America has been to characterize plant materials so that they can be produced reproducibly for commercial use or to identify active principles in unstudied traditional medicines for drug discovery. With new decolonial objectives coming from Indigenous communities, emphasis has shifted to evaluating the safety and efficacy of traditional medicines and preparations for community use. With new techniques and technologies available, scientific focus has shifted from individual bioactives to more rapid and comprehensive chemical characterizations and polypharmacy of traditional medicines. Untargeted metabolomics and associated statistical treatments have greatly expanded identification of components, improved species and cultivar identification and provided means for identifying multiple activity biomarkers, via chemometric and biochemometric analysis. New integrated techniques are available for identifying multiple active principles and synergists. The recent explosion of information is not without problems that need to be addressed including many unconfirmed tentative identifications of phytochemicals, lack of quantitative testing, superficial chemical activity testing and continuing need for dereplication.

Medicinal plants used in traditional Mayan medicine for the treatment of central nervous system disorders: An overview

ETHNOPHARMACOLOGICAL RELEVANCE

For thousands of years, different cultural groups have used and transformed natural resources for medicinal purposes focused on psychological or neurological conditions. Some of these are recognized as central nervous system (CNS) disorders and diseases, whereas other ethnopsychiatric interpretations are explained in culture-specific terms. In traditional Mayan medicine, several herbs have been part of treatments and rituals focused on cultural and ethnomedical concepts.

AIM OF REVIEW

This study aims to provide a comprehensive overview of the medicinal plants used in Mesoamerica by traditional healers and Mayan groups to CNS disorders and associate the traditional use with demonstrated pharmacological evidence to establish a solid foundation for directing future research.

METHODS

A systematic search for primary sources of plant use reports for traditional CNS-related remedies of Mesoamerica were obtained from library catalogs, thesis and scientific databases (PubMed, Scopus, Google Scholar; and Science Direct), and entered in a database with data analyzed in terms of the usage frequency, use by ethnic groups, plant endemism, and pharmacological investigation.

RESULTS

A total of 155 plants used for ethnopsychiatric conditions in Mesoamerica by Mayan groups were found, encompassing 127 native species. Of these, only 49 native species have reported in vitro or in vivo pharmacological analyses. The most commonly reported ethnopsychiatric conditions are related to anxiety, depression, memory loss, epilepsy, and insomnia. The extent of the scientific evidence available to understand the pharmacological application for their use against CNS disorders varied between different plant species, with the most prominent evidence shown by Annona cherimola, Justicia pectoralis, J. spicigera, Mimosa pudica, Persea americana, Petiveria alliacea, Piper amalago, Psidium guajava, Tagetes erecta and T. lucida.

CONCLUSION

Available pharmacological data suggest that different plant species used in traditional Mayan medicine may target the CNS, mainly related to GABA, serotonin, acetylcholine, or neuroprotective pathways. However, more research is required, given the limited data regarding mechanism of action at the preclinical in vivo level, identification of active compounds, scarce number of clinical studies, and the dearth of peer-reviewed studies.

Pharmacological screening of Eryngium foetidum Linn – A Review

Eryngium foetidum L. (Family Apiaceae) is a biennial herb, and it is used as a culinary herb and spice across the different countries of the world, including Sri Lanka, India, Bangladesh, Malaysia, Singapore, etc. due to its high aroma quality. Also, it is used to treat several ailments, such as respiratory diseases, gastrointestinal ailments, and skin diseases among different indigenous populations for its medicinal properties. Based on ethnomedical evidence, many studies have been conducted to identify the phytoconstituents, underlying mechanisms, and related pharmacological effects of different parts of this plant. This study reviewed the current state of findings related to the Pharmacological activities of E. foetidum. Based on this review, this plant is widely used for ethnomedical and culinary purposes. Pharmacological screening of the plant revealed that it had different activities such as anti-inflammatory, antioxidant, antimicrobial, anthelminthic, anticonvulsant, anticancer, antidiabetic, antimalarial, larvicidal, and hepatoprotective activities. This review further promised that potential new chemical entities could be elicited from the phytoconstituents of E. foetidum.

Mesoamerican nephropathy: A not so unknown chronic kidney disease

From 2000, Mesoamerican region has reached an important rate of chronic kidney disease of unknown etiology. Under the name of Meroamerican Nephropathy (MeN) several hypotheses (including dehydration, heat stress, environmental or toxic exposure or even infections) have tried to explain the etiology this new disease. MeN affects young men, agricultural workers exposed to high temperatures. MeN courses with unspecific symptoms as low-grade fever and dysuria and progressive kidney disease with impaired renal function and hydroelectrolyte disturbances. The diagnosis requires kidney biopsy showing tubule-interstitial nephritis (usually at chronic stage). Although MeN conditions a high morbi-mortality in endemic regions, there is a lack of specific treatment and only preventive measures have demonstrated some effect of prognosis (avoid heat stress, constant hydration). In this review we aim to summarize the available information of MeN, illustrating the information in a case report.

Ethnomedicine and neuropsychopharmacology in Mesoamerica

ETHNOPHARMACOLOGICAL RELEVANCE

The burden of disease caused by mental and neurological disorders is increasing globally, to a disproportionate degree in Latin America. In contrast to the many psychoactive plants with a use history in Mesoamerican cultures, the translation to the wider population of knowledge around numerous botanicals used contemporarily by indigenous Mesoamerican societies to treat psychological and neurological disorders did not receive the same attention.

MATERIAL AND METHODS

We used the previously published Mesoamerican Medicinal Plant Database to extract species and associated botanical drugs used as treatments for illnesses associated with the nervous system by Mesoamerican cultures in Belize, Guatemala, and Mexico. With the critical use of published pharmacological literature, the cross-culturally most salient genera are systematically reviewed.

RESULTS

From 2188 plant taxa contained in the database 1324 are used as treatments for illnesses associated with the nervous system. The ethnomedical data was critically confronted with the available biomedical literature for the 58 cross-culturally most salient genera. For a considerable proportion of the frequently used taxa, preclinical data are available, mostly validating ethnomedicinal uses.

CONCLUSION

This quantitative approach facilitates the prioritization of taxa for future pre-clinical, clinical and treatment outcome studies and gives patients, practitioners, and legislators a fundamental framework of evidence, on which to base decisions regarding phytomedicines.

Phytochemicals and In Vitro Bioactivities of Aqueous Ethanolic Extracts from Common Vegetables in Thai Food

Non-communicable diseases (NCDs) are the leading global cause of death. The World Health Organization (WHO) has endorsed the consumption of fruits and vegetables because they are rich in phytochemicals that sustainably ameliorate the occurrence of NCDs. Thai food contains many spices and vegetables with recognized health benefits. Quality control of plant samples encountered a bottleneck in the field and comparative studies of plant control origins including species or cultivar identification, growing area and appropriate harvesting time are limited. To address this issue, all plant samples used in this study were cultivated and controlled by the Department of Agriculture, Ministry of Agriculture and Cooperatives, Thailand. The samples were phytochemically screened and determined their health-promoting bioactivities via antioxidant activities and inhibition of NCD-related enzymes including lipase (obesity), α-amylase and α-glucosidase (diabetes), angiotensin-converting enzyme (hypertension), as well as acetylcholinesterase, butyrylcholinesterase and β-secretase (Alzheimer’s disease). The non-enzymatic reaction toward glycation was also evaluated. The results showed that Senegalia pennata subsp. insuavis (Lace) Maslin, Seigler & Ebinger, Citrus hystrix DC. and Solanum melongena ‘Kermit’ extracts exhibited high antioxidant activities. Moreover, Citrus hystrix DC. extract was a potent inhibitor against lipase, angiotensin-converting enzyme and butyrylcholinesterase, while Coriandrum sativum L. and Psophocarpus tetragonolobus (L.) DC. were potent anti-diabetic agents and Senegalia pennata subsp. insuavis (Lace) Maslin, and Seigler & Ebinger was a potent anti-glycation agent. Our data provide a comparative analysis of ten vegetables to encourage healthy food consumption and development to control NCDs in Thailand in the future.

Mesoamerican nephropathy: A not so unknown chronic kidney disease

From 2000, Mesoamerican region has reached an important rate of chronic kidney disease of unknown etiology. Under the name of Meroamerican Nephropathy (MeN) several hypotheses (including dehydration, heat stress, environmental or toxic exposure or even infections) have tried to explain the etiology this new disease. MeN affects young men, agricultural workers exposed to high temperatures. MeN courses with unspecific symptoms as low-grade fever and dysuria and progressive kidney disease with impaired renal function and hydroelectrolyte disturbances. The diagnosis requires kidney biopsy showing tubule-interstitial nephritis (usually at chronic stage). Although MeN conditions a high morbi-mortality in endemic regions, there is a lack of specific treatment and only preventive measures have demonstrated some effect of prognosis (avoid heat stress, constant hydration). In this review we aim to summarize the available information of MeN, illustrating the information in a case report.

Self-treatment and adverse reactions with herbal products for treating symptoms associated with anxiety and depression in adults from the central-western region of Mexico during the Covid-19 pandemic

ETHNOPHARMACOLOGICAL RELEVANCE

There are plant species used in the Mexican traditional medicine for the empirical treatment of anxiety and depression.

AIM OF THE STUDY

This work assessed the prevalence of self-medication with medicinal plants and the prevalence of the concomitant use of prescribed psychiatric drugs and medicinal plants for treating symptoms associated with anxiety and depression during the Covid-19 lockdown in Mexico.

MATERIALS AND METHODS

The suspected adverse reactions associated with drug-herb interactions were assessed. The factors associated with self-medication, the concomitant use of herb-drug combinations, and the presence of adverse reactions due their combined use is also reported. The study was descriptive and cross-sectional using an online questionnaire conducted among population with symptoms associated with anxiety and depression (n = 2100) from seven states of central-western Mexico.

RESULTS

The prevalence of the use of herbs (61.9%) and the concomitant use of drug-herb combinations (25.3%) were associated with being diagnosed with mental illness [OR:2.195 (1.655-2.912)] and the use of psychiatric medications [OR:307.994 (178.609-531.107)], respectively. The presence of adverse reactions (n = 104) by the concomitant use of drug-herb combinations was associated with being unemployed [p = 0.004, OR: 3.017 (1.404-6.486)].

CONCLUSION

Health professionals should be aware if their patients concomitantly use medicinal plants and psychiatric drugs. Public health campaigns should promote the possible adverse reactions that might produce the concomitant use of drug-herb combinations for mental illnesses.

Climate and categories: Two key elements for understanding the Mesoamerican hot-cold classification of illnesses and medicinal plants

ETHNOPHARMACOLOGICAL RELEVANCE

The concepts of health and illness, and their causes, are fundamental for understanding medicinal plant choice and use by traditional people. The hot-cold system is widespread in Mesoamerican traditional medicine and guides many therapeutic decisions.

AIM OF THE STUDY

This study explores a hypothesis that climate influences the hot-cold classification of illnesses and medicinal plants, and the perception of hazard of illnesses. In addition, we examine the classification categories within the system used in different regions of Mexico.

MATERIALS AND METHODS

Studies from Mexico with quantitative and qualitative data on the hot-cold properties of medicinal plants and ailments were reviewed. The information was organized and then related to the climate type of the study areas.

RESULTS

In temperate climates, most diseases were considered cold, and hot medicinal plants were dominant. Conversely, in warm-tropical climates, hot diseases dominated, and the majority of medicinal plants were cold; however, this evidence was weaker. The perception of hazard was congruent with the number of illnesses for temperate climates. There were additional classification categories within the hot-cold system for diseases and medicinal plants, and they were expressed in different terms in Spanish, English, and indigenous languages. Although similar terms and categories were used in the classification of diseases and medicinal plants, they can differ conceptually and vary between places and cultures. Publications are sometimes unclear if the terms used are emic or etic. The basic principle of using plants with the opposite property of the disease does not always apply strictly.

CONCLUSIONS

Climate appears to influence the hot-cold classification of diseases and medicinal plants in Mexico, and the system is not strictly dual. Improved knowledge of the hot-cold system is necessary to understand Mesoamerican medicinal plant use and culture.

Actualized inventory of medicinal plants used in traditional medicine in Oaxaca, Mexico

BACKGROUND

Oaxaca is one of the most diverse states in Mexico from biological and cultural points of view. Different ethnic groups living there maintain deep and ancestral traditional knowledge of medicinal plants as well as traditional practices and beliefs about diseases/illnesses and cures. Previous ethnobotanical research in this state has helped document this knowledge, but with the addition of more studies, more records appear. We updated the inventory of medicinal knowledge between the different ethnic groups that inhabit the Oaxacan territory.

METHODS

A database was constructed from two sources: (1) original data from a 3-year project in 84 municipalities of Oaxaca inhabited by eight ethnic groups and (2) different electronic databases.

RESULTS

Records of 1032 medicinal plants were obtained; 164 families were registered, with Asteraceae, Fabaceae, and Rubiaceae being the most commonly used. A total of 770 species were reported in 14 vegetation types; the most important species came from temperate forests. Only 144 species corresponded to introduced species, and 272 were listed in a risk category. Illnesses of the digestive and genitourinary systems as well as culture-bound syndromes were treated with high numbers of medicinal plants. The Mestizo, Mixe, Mixtec, and Zapotec ethnic groups exhibited the greatest number of recorded medicinal plants. The 17 species that were used among almost all ethnic groups in Oaxaca were also used to cure the highest number of diseases.

DISCUSSION

Inventories of medicinal plants confirm the persistence of traditional knowledge and reflect the need to recognize and respect this cosmovision. Many species are gathered in wild environments. The most important illnesses or diseases recorded in the present inventory are also mentioned in different studies, suggesting that they are common health problems in the rural communities of Mexico.

CONCLUSIONS

Medicinal plants are essential for ethnic groups in Oaxaca. It is necessary to recognize and understand the complex ancestral processes involved in the human-nature interaction and the role of these processes in the conservation of biodiversity and in the survivorship of ethnic groups that have persisted for centuries. Finally, this study serves as a wake-up call to respect those worldviews.