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

The effects of resistance training on cardiovascular factors and anti-inflammation in diabetic rats

Diabetes induces a range of macrovascular and microvascular changes, which lead to significant clinical complications. Although many studies have tried to solve the diabetic problem using drugs, it remains unclear. In this study, we investigated whether resistance exercise affects cardiovascular factors and inflammatory markers in diabetes. The study subjected Otsuka Long-Evans Tokushima Fatty (OLETF) rats, which have genetically induced diabetes mellitus, to a resistance exercise program for 12 weeks and assessed the levels of cardiovascular factors and inflammatory markers using western blotting analysis, ELISA, and immunohistochemistry. During the training period, OLETF + exercise (EX) group exhibited lower body weight and reduced glucose levels when compared with OLETF group. Western blotting analysis, ELISA, and immunohistochemistry revealed that the levels of PAI-1, VACM-1, ICAM-1, E-selectin, TGF-β, CRP, IL-6, and TNF-α were decreased in OLETF + EX group when compared with the OLETF group. Moreover, the anti-inflammatory markers, IL-4 and IL-10, were highly expressed after exercise. Therefore, these results indicate that exercise may influence the regulation of cardiovascular factors and inflammatory markers, as well as help patients with metabolic syndromes regulate inflammation and cardiovascular function.

Production and purification of fucoxanthins and β-carotenes from Halopteris scoparia and their effects on digestive enzymes and harmful bacteria

ABSTRACTAlgae constitute a significant part of marine biodiversity. They represent a renewable source of bioactive metabolites from drug development and therapeutic fields. Fucoxanthin and β-carotene from the brown macroalgae Halopteris scoparia, were extracted using conventional organic solvent extraction, then purified, to homogeneity, based on various chromatographic principles. Their effects on digestive enzymes and harmful bacteria were investigated. The capacities of both purified pigments to inhibit α-amylase and trypsin enzymes were evaluated. Purified fucoxanthin and β-carotene exhibited interesting α-amylase inhibition activities, with IC50 of 300 and 500 µg/mL, respectively. Moreover, trypsin inhibition activities were detected using purified these two pigments. The antibacterial potential of the purified pigments was evaluated. β-carotene showed to be a great antibacterial natural compound against gram-positive and gram-negative bacteria such as Listeria monocytogenes, Staphylococcus aureus and Salmonella enterica with Minimal Inhibitory Concentration (MIC) of about 0.225, 0.1125, 0.225 µg/mL, respectively. Those findings are in favor of the exploitation of H. scoparia pigments in therapeutic fields as an antidiabetic source directly by the inhibition of α-amylase and trypsin as well as antibacterial agents against gastrointestinal infections.

Evaluation of the biological efficiency of Terminalia chebula fruit extract against neurochemical changes induced in brain of diabetic rats: an epigenetic study

Diabetes mellitus (DM) is a chronic and progressive metabolic disorder that can stimulate neuroinflammation and increase oxidative stress in the brain. Therefore, the present study was aimed to assess the efficacy of ethanolic Terminalia chebula extract against the neurochemical and histopathological changes induced in the brains of diabetic rats. The study clarified the reduction in oxidative stress induced in the brains of diabetic rats by the significant (P ≤ 0.05) increase in levels of the antioxidants with decreasing the peroxidation products via ethanolic T. chebula extract at both doses (400 and 600 mg/kg). Moreover, T. chebula extract improved the brain integrity by lowering levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), β-amyloid (Aβ) content, monocyte chemoattractant protein-1 (MCP-1) and acetylcholine esterase (ACHE) significantly (P ≤ 0.05) in a dose dependent manner compared to brain of diabetic rats. Severe nuclear pyknosis and degeneration were noticed in neurons of the cerebral cortex, hippocampus and striatum in brains of diabetic rats. The severity of these alterations decreased with T. chebula extract at a dose of 600 mg/kg compared to the other treated groups. The different electrophoretic protein and isoenzyme assays revealed that the lowest similarity index (SI%) values exist in the brains of diabetic rats compared to the control group. The quantity of the most native proteins and isoenzyme types increased significantly (P ≤ 0.05) in the brains of diabetic rats, and these electrophoretic variations were completely diminished by T. chebula extract. The study concluded that T. chebula extract ameliorated the biochemical, histopathological and electrophoretic abnormalities induced in the brains of diabetic rats when administered at a dose of 600 mg/kg.

Anti-inflammatory potential of some eudesmanolide and guaianolide sesquiterpenes

Ten sesquiterpene lactones isolated from Anvillea garcinii (Burm.f.) DC ethanolic extract were assessed for their anti-inflammatory potential by myeloperoxidase (MPO) activity assignment, and mice paw swelling model. 3α,4α-10β-trihydroxy-8α-acetyloxyguaian-12,6α-olide (1), epi-vulgarin (3), 9a-hydroxyparthenolide (4), garcinamine C (7), garcinamine D (8), garcinamine E (9), and 4, 9-dihydroxyguaian-10(14)-en-12-olide (10) showed explicit anti-inflammatory activity in rodent paw edema and MPO assignment. The findings of this study showed that the α-methylene γ-lactone moiety does not always guarantee an anti-inflammatory effect, but the presence of proline at the C3 of the lactone ring improves the binding of sesquiterpene lactones with MPO isoenzymes, resulting in a more potent inhibition.

Urtica pilulifera L. seed extract promotes folliculogenesis and alleviates the diminished ovarian reserve in the Balb/c mice model: An experimental study

Background

Urtica pilulifera L. seed (UPS) is a Persian traditional medicine prescription that positively affects female infertility.

Objective

This study aimed to evaluate the beneficial effects of UPS on a diminished ovarian reserve (DOR) model induced by cyclophosphamide in Balb/c mice.

Materials and Methods

A single intraperitoneal (75 mg/kg) of cyclophosphamide was administered to establish a DOR model. 25 female Balb/c mice (6-8 wk, 25 ± 2 gr) were randomly divided into 5 groups (n = 5/each), including control (normal saline), model (DOR), DOR+50, DOR+100, and DOR+200 (mg/kg UPS, gavage) groups for 14 days. The levels of follicle-stimulating hormone, luteinizing hormone, estradiol, malondialdehyde, superoxide dismutases, apoptosis, and histopathological alterations were analyzed. Gas chromatography-mass spectrometry analysis was performed to identify the phytochemicals of the UPS.

Results

It was observed that the UPS extract reduced malondialdehyde concentration and apoptosis in the DOR model as well as enhanced superoxide dismutases activity in the ovaries in a dose-dependent manner. Moreover, it exerted a modulatory effect on steroidal hormones such as follicle-stimulating hormone, luteinizing hormone, and estradiol. The histopathological analysis revealed the therapeutic potential of the UPS extract. The main chemical components of UPS were linoleic acid (59.25%), n-hexadecanoic acid (10.36%), and oleic acid (8.29%).

Conclusion

The results indicated that the UPS extract has therapeutic potential in the DOR model. This potential is attributed to the reduction of oxidative stress, modulation of apoptosis, and regulation of steroidal hormones that may be associated with the observed beneficial effects of fatty acids on fertility improvement.

Antioxidant properties of date seeds extract (Phoenix dactylifera L.) in alloxan induced damage in rats

The study was conducted to examine the antioxidant activity and evaluate the protective effects of the date seeds powder kentichi against alloxan-induced damage in the liver, kidney, and pancreas in diabetic's rats. Group 1: control group, that did not receive any treatment, Group 2: alloxan was injected intraperitoneally (120 mg/kg body weight) for two days (Diab), Group 3: treated only by date seeds powder added in the diet (300 g/kg) for 6 weeks (DSPK), Group 4: alloxan-diabetic rats treated with date seeds powder (300 g/kg) (DSPK + Diab). Estimations of biochemical parameters in blood were determined. TBARS, SOD, CAT, and GPx activities were determined. A histopathological study was done by immersing pieces of both organs in a fixative solution followed by paraffin hematoxylin-eosin staining. In addition, the antioxidant activities of DSPK were evaluated by DPPH radical scavenging activity, reducing power, and ABTS free radical scavenging. The results revealed that date seeds significantly decreased serum levels of glucose, cholesterol, triglycerides, urea, creatinine, T-protein, ALP, D-bili and T-bili levels. In addition, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) activities that had been reduced in liver, kidney, and pancreas of the treated group were restored by DSPK treatments and, therefore, the lipid peroxidation level was reduced in the liver, kidney and pancreas tissue compared to the control group. Additionally, the histological structure in these organs was restored after treatment with date seeds powder.

Medicinal plants of Jordan: Scoping review

Jordan is rich in the flora of ethnobotanical importance. This scoping review aims to highlight the ethnopharmacological value of Jordanian medicinal plants using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of one hundred twenty-four articles published between 2000 and 2022 obtained from PubMed, EBSCO, and Google Scholar databases were included in this review. These plants own several classes of secondary bioactive metabolites, including alkaloids, flavonoids, phenolics, and terpenes. Jordanian plants exhibited potential therapeutic activity against various tumors, bacterial infections, elevated blood glucose levels, hyperlipidemia, platelets aggregation disorders, and gastrointestinal disorders. Phytochemicals' biological activities depend on their structures, parts used, methods of extraction, and evaluation model. In conclusion, this review highlights the need of researching Jordan's abundant naturally occurring medicinal plants and their phytochemicals as novel lead molecules in drug discovery and development. Studying active phytochemicals for disease treatment will help develop drugs for safe treatment and cure in the future.

Ethnobotanical and Ethnopharmacological Study in the Bulgarian Mountain Rhodopes: Part II—Contemporary Use of Medicinal Plants

Rhodopes Mountain is ethnobotanically poorly studied, but our preliminary observation in a number of settlements revealed that even nowadays, the local population relies solely on previously collected medicinal plants. We aimed to assess the contemporary use of medicinal plants in the Central and East Rhodopes and the health conditions that local communities address with them. The ethnobotanical field data were collected through an in-depth method in combination with semi-structured face-to-face interviews, adapted with modifications to the objectives of this study. The following quantitative ethnobotanical indices were used in this study: informant consensus factor (ICF), fidelity level (FL), and Jaccard similarity coefficient or Jaccard index (JI). Data analyses from our field research showed that 92 informants mentioned the utilization of a total of 114 plant species. The results of this study reveal that in both regions of the Rhodopes, medicinal plants are mentioned most often in relation to diseases affecting nervous, respiratory, digestive, and cardiovascular systems, followed by reproductive, urinary, immune, and musculoskeletal. The risk of disruption or loss of traditional knowledge of medicinal plants is expected in the condition of cultural globalization. However, there is no metrified data about the use of medicinal plants in the Rhodopes from the past. The application of statistical indices in this research will make such assessment and monitoring possible in the future.

Relevance of Indian traditional tisanes in the management of type 2 diabetes mellitus: a review

Background

Tisanes are a potential source of phytochemicals to reduce disease risk conditions and are used to protect from non-communicable diseases, globally. A few tisanes have gained more popularity than others depending on their chemical composition based on the geographical origin of the used herb. Several Indian tisanes have been claimed to have traits beneficial to people with or at a high risk of type 2 diabetes mellitus. Under the concept, the literature was reviewed and compiled into a document to highlight the chemical uniqueness of popular Indian traditional tisanes to be more informative and potent as per modern medicine to overcome type 2 diabetes mellitus.

Methods

An extensive literature survey was conducted using computerized database search engines, such as Google Scholar, PubMed, ScienceDirect, and EMBASE (Excerpta Medica database) for herbs that have been described for hyperglycemia, and involved reaction mechanism, in-vivo studies as well as clinical efficacies published since 2001 onwards using certain keywords. Compiled survey data used to make this review and all findings on Indian traditional antidiabetic tisanes are tabulated here.

Results

Tisanes render oxidative stress, counter the damage by overexposure of free radicals to the body, affect enzymatic activities, enhance insulin secretion, etc. The active molecules of tisanes also act as anti-allergic, antibacterial, anti-inflammatory, antioxidant, antithrombotic, antiviral, antimutagenicity, anti-carcinogenicity, antiaging effects, etc. WHO also has a strategy to capitalize on the use of herbals to keep populations healthy through effective and affordable alternative means with robust quality assurance and strict adherence to the product specification.

Ameliorative effects of propolis upon reproductive toxicity in males

Propolis is a sticky natural product produced by honeybees. Research studies have discussed the effectiveness of propolis, directly or indirectly, for ameliorating reproductive toxicity in males; however, this research has not yet been reviewed. The current paper presents an integrative summary of all research studies in Scopus and PubMed that investigated the effects of propolis on semen quality, and hence on male fertility, in conditions of reproductive toxicity. The consensus indicates that propolis ameliorates reproductive toxicity and enhances semen quality in vivo in test animals. These effects may be attributable to the ability of propolis to reduce testicular oxidative damage, enhance testicular antioxidant defense mechanisms, increase nitric oxide production, reduce testicular apoptotic injury, and boost testosterone production. However, to generalize these effects in humans would require further research.

Naturally-occurring carboxylic acids from traditional antidiabetic plants as potential pancreatic islet FABP3 inhibitors. A molecular docking-aided study

The antidiabetic action of traditional plants is mostly attributed to their antioxidant and anti-inflammatory properties. These plants are still having some secrets, making them an attractive source that allows for investigating new drugs or uncovering precise pharmacologic antidiabetic functions of their constituents. In diabetes, which is a lipid disease, long-term exposure of pancreatic islet beta cells to fatty acids (FAs) increases basal insulin release, reduces glucose-stimulated insulin secretion, causes islet beta cell inflammation, failure and apoptosis. Pancreatic islet beta cells express fatty acid binding protein 3 (FABP3) that receives long-chain FAs and traffics them throughout different cellular compartments to be metabolized and render their effects. Inhibition of this FABP3 may retard FA metabolism and protect islet beta cells. Since FAs interact with FABPs by their carboxylic group, some traditionally-known antidiabetic plants were reviewed in the present study, searching for their components that have common features of FABP ligands, namely carboxylic group and hydrophobic tail. Many of these carboxylic acids were computationally introduced into the ligand-binding pocket of FABP3 and some of them exhibited FABP3 ligand possibilities. Among others, the naturally occurring ferulic, cleomaldeic, caffeic, sinapic, hydroxycinnamic, 4-p-coumaroylquinic, quinoline-2-carboxylic, chlorogenic, 6-hydroxykynurenic, and rosmarinic acids in many plants are promising candidates for being FABP3-specific inhibitors. The study shed light on repurposing these phyto-carboxylic acids to function as FABP inhibitors. However, more in-depth biological and pharmacological studies to broaden the understanding of this function are needed.

Alpha-glucosidase inhibitory activities of astilbin contained in Bauhinia strychnifolia Craib. stems: an investigation by in silico and in vitro studies

INTRODUCTION

Bioactive compounds from traditional medicines are good alternatives to standard diabetes therapies and may lead to new therapeutic discoveries. The stems of Bauhinia strychnifolia Craib. (BC) have a possible antihyperglycemic effect; However, the extraction of astilbin from BC has never been recorded in alpha-glucosidase inhibitory activities.

METHODS

Using liquid chromatography-mass spectrometry (LC-MS/MS), 32 compounds were detected in the BC extract. The screening was based on peak area. Seven compounds found. PASS recognized all seven compounds as potential alpha-glucosidase (AG) inhibitors. Astilbin and quercetin 3-rhamnoside were the most likely inhibitors of AG. Arguslab, AutoDock, and AutoDock Vina investigated the binding of the two compounds and AG. The binding stability was confirmed by molecular dynamics (MD). In addition, the optimum solvent extraction was studied via CosmoQuick, and extracts were examined with ¹H-NMR prior to testing with AG.

RESULTS

All three software programs demonstrated that both compounds inhibit AG more effectively than acarbose. According to the sigma profile, THF is recommended for astilbin extraction. The BC extract with THF showed outstanding AG inhibitory action with an IC₅₀ of 158 ± 1.30 µg mL-1, which was much lower than that of the positive control acarbose (IC₅₀ = 190 ± 6.97 µg mL-1). In addition, astilbin from BC was found to inhibit AG strongly, IC50 = 22.51 ± 0.70 µg mL-1 through the extraction method of large-scale astilbin with THF has the best extraction capacity compared to other solvents, hence the initial stage of extraction employs THF to extract and precipitate them with ethyl acetate and water.

CONCLUSION

In silico and in vitro studies reveal that astilbin inhibits AG and is superior to acarbose, validating its promise as an AG inhibitor. Overall, astilbin was the most bioactive component of BC for antidiabetic action.

Antidiabetic activity of Solanum torvum fruit extract in streptozotocin-induced diabetic rats

Background

Solanum torvum Swartz, a medicinal plant belonging to the family Solanaceae, is an important medicinal plant widely distributed throughout the world and used as medicine to treat diabetes, hypertension, tooth decay, and reproductive problems in traditional systems of medicine around the world including Malaysia. The objective of this study was to investigate hypoglycemic, antilipidemic, and hepatoprotective activities, histopathology of the pancreas, and specific glucose regulating gene expression of the ethanolic extract of S. torvum fruit in streptozotocin-induced diabetic Sprague–Dawley rats.

Materials and methods

Acute toxicity study was done according to OECD-423 guidelines. Diabetes was induced by intraperitoneal (i.p.) injection of streptozotocin (55 mg/kg) in male Sprague–Dawley rats. Experimental diabetic rats were divided into six different groups; normal, diabetic control, and glibenclamide at 6 mg/kg body weight, and the other three groups of animals were treated with oral administration of ethanolic extract of S. torvum fruit at 120, 160, and 200 mg/kg for 28 days. The effect of ethanolic extract of S. torvum fruit on body weight, blood glucose, lipid profile, liver enzymes, histopathology of pancreas, and gene expression of glucose transporter 2 (slc2a2), and phosphoenolpyruvate carboxykinase (PCK1) was determined by RT-PCR.

Results

Acute toxicity studies showed LD₅₀ of ethanolic extract of S. torvum fruit to be at the dose of 1600 mg/kg body weight. Blood glucose, total cholesterol, triglycerides, low-density lipoproteins, very low-density lipoproteins, serum alanine aminotransferase, and aspartate aminotransferase were significantly reduced, whereas high-density lipoproteins were significantly increased in S. torvum fruit (200 mg/kg)-treated rats. Histopathological study of the pancreas showed an increase in number, size, and regeneration of β-cell of islets of Langerhans. Gene expression studies revealed the lower expression of slc2a2 and PCK1 in treated animals when compared to diabetic control.

Conclusion

Ethanolic extract of S. torvum fruits showed hypoglycemic, hypolipidemic, and hepatoprotective activity in streptozocin-induced diabetic rats. Histopathological studies revealed regeneration of β cells of islets of Langerhans. Gene expression studies indicated lower expression of slc2a2 and PCK1 in treated animals when compared to diabetic control, indicating that the treated animals prefer the gluconeogenesis pathway.

Antidiabetic effects of Brugmansia aurea leaf extract by modulating the glucose levels, insulin resistance, and oxidative stress mechanism

Background

Ethnopharmacological relevance: Brugmansia, a genus of the Solanaceae family, has historically been utilized in many different parts of the world as an anti-inflammatory for treating skin infections, wounds, and bodily aches and pains. The current study aimed to investigate the potential benefits of a methanolic extract of Brugmansia aurea in the management of diabetes and underlying complications in alloxanized-induced diabetic rats.

Materials and methods

Animals were divided into nine groups (n = 6). Four groups received different standard oral hypoglycemic agents; three groups received 100, 200, and 400 mg/kg of B. aurea leaf extract for six consecutive weeks, and the remaining two were normal and disease control groups. All groups received alloxan (150 mg/kg) except for the normal control. Only those animals whose glucose levels were raised to 200 mg/dl were selected for the study. After a 6-week dosage period, various biochemical parameters, as well as HbA1c, antioxidant profile, oral glucose tolerance test (OGTT), insulin sensitivity, histopathology, and insulin resistance, were measured and compared with the untreated diabetic group.

Results

Brugmansia aurea leaf extract at a dose of 400 mg/kg showed potent antidiabetic activity by reducing blood glucose levels (p < 0.001) after 6 weeks of treatment. OGTT data showed that B. aurea exhibited significant (p < 0.001) glucose tolerance by significantly reducing blood glucose levels in just 2 h post-treatment. Other tests showed that plant extract significantly increased (p < 0.001) insulin sensitivity and decreased (p < 0.001) insulin resistance. The biochemical profile showed reduced triglyceride and cholesterol, while the antioxidant profile showed restoration of antioxidant enzymes in the pancreas, kidney, and liver tissues of treated rats.

Conclusion

The present study indicated that crude extracts of B. aurea increase insulin sensitivity and reduce hyperlipidemia in diabetic rats, which rationalizes the traditional medicinal use of this plant as an antidiabetic agent.

Antioxidant, Antibacterial, and Antifungal Activities of the Ethanolic Extract Obtained from Berberis vulgaris Roots and Leaves

This work assessed the phenolic and flavonoid components and their antioxidant, antifungal, and antibacterial effects in the ethanolic extract of barberry leaf and roots. The antibactericidal activity of root and leaf extracts against pathogenic bacteria was tested using agar diffusion and microdilution broth production for the lowest inhibitory concentration (MIC). Berberis vulgaris root and leaf extracts inhibited Staphylococcus aureus ATCC9973, Escherichia coli HB101, Staphylococcus enteritis, and Escherichia coli Cip812. The disc assay technique was used to assess the bactericidal activity of the extracts versus both pathogenic Gram-positive and Gram-negative strains. Hydro alcoholic extract was more effective against bacterial than fungal strains. The results showed that Berberis vulgaris leaf and roots extract had similar antifungal activities. Berberis vulgaris root extract inhibited the mycelial growth of Penicillium verrucosum, Fusarium proliferatum, Aspergillus ochraceous, Aspergillus niger, and Aspergillus flavus. Berberis vulgaris root extract has excellent antioxidant, antibacterial, and antifungal effects. Berberis vulgaris exhibited antimicrobial activity in vitro, and MIC showed that Berberis vulgaris parts efficiently affected pathogens in vitro. In conclusion, both Berberis vulgaris roots and leaves have considerable antibacterial activity and can be used as a source of antibacterial, antioxidant, and bioactive compounds to benefit human health.

Cinnamon as a Complementary Therapeutic Approach for Dysglycemia and Dyslipidemia Control in Type 2 Diabetes Mellitus and Its Molecular Mechanism of Action: A Review

The scientific evidence that cinnamon may exert beneficial effects on type 2 diabetes mellitus due to the biological activity of its bioactive compounds has been increasing in recent years. This review provides an overview of the effects of cinnamon on clinical parameters of diabetes and summarizes the molecular mechanisms of action of cinnamon on glucose and lipid metabolism. Search criteria include an electronic search using PubMed, Medline, and Cochrane Library databases. English literature references from 2000 up to 2022 were included. Following title and abstract review, full articles that met the inclusion criteria were included. The results from the available evidence revealed that cinnamon improved glycemic and lipidemic indicators. Clinical trials clarified that cinnamon also possesses an anti-inflammatory effect, which may act beneficially in diabetes. Based on in vitro and in vivo studies, cinnamon seems to elicit the regulation of glucose metabolism in tissues by insulin-mimetic effect and enzyme activity improvement. Furthermore, cinnamon seems to decrease cholesterol and fatty acid absorption in the gut. The current literature search showed a considerable number of studies on diabetic subjects. Some limitations in comparing published data should be highlighted, including variability in doses, extracts and species of cinnamon, administration forms, and antidiabetic therapy.

Exploring the Mangrove Fruit: From the Phytochemicals to Functional Food Development and the Current Progress in the Middle East

Nowadays, the logarithmic production of existing well-known food materials is unable to keep up with the demand caused by the exponential growth of the human population in terms of the equality of access to food materials. Famous local food materials with treasury properties such as mangrove fruits are an excellent source to be listed as emerging food candidates with ethnomedicinal properties. Thus, this study reviews the nutrition content of several edible mangrove fruits and the innovation to improve the fruit into a highly economic food product. Within the mangrove fruit, the levels of primary metabolites such as carbohydrates, protein, and fat are acceptable for daily intake. The mangrove fruits, seeds, and endophytic fungi are rich in phenolic compounds, limonoids, and their derivatives as the compounds present a multitude of bioactivities such as antimicrobial, anticancer, and antioxidant. In the intermediary process, the flour of mangrove fruit stands as a supplementation for the existing flour with antidiabetic or antioxidant properties. The mangrove fruit is successfully transformed into many processed food products. However, limited fruits from species such as Bruguiera gymnorrhiza, Rhizophora mucronata, Sonneratia caseolaris, and Avicennia marina are commonly upgraded into traditional food, though many more species demonstrate ethnomedicinal properties. In the Middle East, A. marina is the dominant species, and the study of the phytochemicals and fruit development is limited. Therefore, studies on the development of mangrove fruits to functional for other mangrove species are demanding. The locally accepted mangrove fruit is coveted as an alternate food material to support the sustainable development goal of eliminating world hunger in sustainable ways.

Garlic: A systematic review of the effects on cardiovascular diseases

Allium sativum (garlic) certainly is one of the oldest horticultural crops in the world and presents bioactive compounds that are related to the garlic's effects on human health. Several authors have shown beneficial effects on diabetes, hypertension, dyslipidemia, obesity, and cardiovascular diseases (CVD), which are among the most relevant causes of mortality in the world. The aim of this systematic review was to evaluate the effects of garlic in the risk factors of CVD and evaluate its economic importance. MEDLINE-PubMed, COCHRANE, EMBASE, and Google Scholar databases were searched. The included studies showed that the use of garlic can reduce blood pressure, waist circumference, body mass index, LDL-c, non-HDL-c, total cholesterol, triglycerides, and inflammatory markers. It also can increase the levels of HDL-c and can improve cardiovascular parameters such as coronary artery calcium, microcirculation, epicardial and periaortic adipose tissue, post occlusive reactive hyperemia, low attenuation plaque, carotid intima-media thickness; and carotid intima-media thickness. Due to these reasons, garlic can be considered in the prevention and treatment of CVD risk factors.

Formulation, Evaluation of Physical Properties, and In Vitro Antioxidant Activity Test of Moringa Leaf (Moringa oleifera L.) Ethanolic Extract Capsules

BACKGROUND: Supplements that contain antioxidants may enhance prevention and treatment effects of a wide range of diseases including COVID-19. Quercetin, a flavonoid compound, is a natural antioxidant that can neutralize free radicals. The current study was conducted to formulate Moringa leaf (Moringa oleifera L) ethanol extract capsules and to determine the quercetin antioxidant activity levels of Moringa ethanol extract capsule formulations.  MATERIALS AND METHODS: We tested the total flavonoid levels in solutions with concentrations of 20, 50, 60, 70 and 100 ppm using Thin Layer Chromatography Densitometric method. Evaluation of physical properties of 96% Moringa leaf ethanol extract capsules included moisture content test, granule angle of repose test, granule flow property test, capsule weight uniformity test and capsule disintegration time test. Antioxidant activity test using the DPPH method with two samples, namely 96% Moringa leaf ethanol extract capsules with formulas I, II, III, quercetin as a comparison.  RESULT: The results of the evaluation of 96% Moringa leaf ethanol extract capsules showed that formula II (PVP 50 mg) had good physical properties. Testing the antioxidant activity of capsules of ethanol extract of Moringa leaves formulas I, II, III, quercetin obtained IC50 values of 44.0 ppm, 40.2 ppm, 46.4 ppm, and 4.80 ppm, respectively.  CONCLUSION: The evaluation of the ethanol extract capsules of Moringa leaf formula II, met the parameters of a good capsule evaluation test requirement and had very strong antioxidant activity seen from the acquisition of the IC50 value. The antioxidant properties of Moringa leaf extract capsules may be able to improve the immune system and clinical trials need to be carried out on patients to become candidates for prevention and therapeutic supplement fora range of diseases including COVID-19. 

The Role of Natural Products on Diabetes Mellitus Treatment: A Systematic Review of Randomized Controlled Trials

The present study was carried out to relate the role of natural products in the metabolism of an increasingly prevalent disease, type 2 diabetes mellitus. At present, in addition to the pharmacological resources, an attempt is being made to treat diabetes mellitus with natural products. We carried out a systematic review of studies focusing on the role of natural products on diabetes mellitus treatment. The bibliographic search was done through Medline (Pubmed) and Web of Science. From 193 records, the title and summary of each were examined according to the criteria and whether they met the selection criteria. A total of 15 articles were included; after reviewing the literature, it is apparent that the concept of natural products is ambiguous as no clear boundary has been established between what is natural and what is synthetic, therefore we feel that a more explicit definition of the concept of "natural product" is needed. Gut microbiota is a promising therapeutic target in the treatment of diabetes. Therefore, it would be necessary to work on the relationship between the microbiome and the benefits in the treatment of diabetes mellitus. Treatment based solely on these natural products is not currently recommended as more studies are needed.

Momordica balsamina: phytochemistry and pharmacological potential of a gifted species

Momordica balsamina L. (Cucurbitaceae), frequently named balsam apple, southern balsam pear or African pumpkin, is a vegetable with high nutritional value, being mostly used as food in sub-Saharan Africa. It has also been largely used in traditional medicine to treat several diseases, such as malaria fevers and diabetes. As a member of the Cucurbitaceae family, the main constituents are cucurbitane-type triterpenoids, with different oxidation patterns, named cucurbitacins. This review aims at summarizing our contribution to the phytochemical study of M. balsamina and the evaluation of the isolated cucurbitacins and derivatives as multidrug resistance reversers in cancer cells and bacteria. In this way, the selective antiproliferative activity against multidrug resistant cancer cells of cucurbitacins obtained from M. balsamina, their ability as P-glycoprotein inhibitors in cancer cells overexpressing this ABC transporter, as well as efflux pump inhibitors in resistant bacteria strains are reviewed. Moreover, the in vitro antimalarial activity of cucurbitacins and acyl derivatives against the blood and liver-stages of Plasmodium strains, and the in vivo activity of selected compounds is also reviewed. Besides our work, edible and medicinal uses, and other studies mainly reporting the biological activities of M. balsamina extracts, such as antidiabetic, antibacterial, anti-inflammatory, and antioxidant properties are also addressed.

Differential expression of gluconeogenic enzymes in early- and late-stage diabetes: the effect of Citrullus colocynthis (L.) Schrad. Seed extract on hyperglycemia and hyperlipidemia in Wistar-Albino rats model

Background

The medicinal plant Citrullus colocynthis (L.) Schrad. (C. colocynthis) may benefit patients at different phases of diabetes by attuning to contrasting situations. Our primary objective was to find the mechanism(s) behind the antidiabetic/anti-hyperlipidemic effects of C.colocynthis seed aqueous extract (CCAE) in two different stages of type 2 diabetes (T2D) in rats.

Methods

Fasting blood sugar (FBS) levels, body weights, and the degree of impaired glucose tolerance (IGT) were measured in healthy nondiabetic control rats (Con), as well as rats with early and late stages of T2D, denoted as ET2D and LT2D, respectively. CCAE was intraperitoneally (IP) injected for 28 days. In the end, the hepatic mRNA expression levels of the following genes were determined by RT-PCR: glucose-6-phosphatase (G6Pase), phosphoenolpyruvate carboxykinase (PEPCK), insulin-dependent sterol regulatory element-binding protein-1c (SREBP-1c), acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), peroxisome proliferator-activated receptor alpha (PPARα), and carnitine palmitoyltransferase I (CPT1). The liver was examined by hematoxylin and eosin (H&E) and Oil-Red O staining. CCAE was partially analyzed by HPLC-DAD.

Results

ET2D and LT2D were characterized by differentially elevated FBS, deteriorated bodyweight, and significant IGT compared to Con. Hepatosteatoses of varying morphologies and higher hepatic expression of G6Pase than PRPCK in ET2D versus the opposite in LT2D further confirmed the divergent nature of metabolic aberrations. At the end of 28 days, the high levels of FBS, alkaline phosphatase (ALP), triglyceride (TG), urea, hepatic protein carbonyl content (PCC), and alanine and aspartate aminotransferases (AST and ALT, respectively) persisted in untreated LT2D. CCAE ameliorated oxidative stress and upregulated PPARα expression in diabetic groups and Con; it downregulated CPT1 expression in the LT2D group. CCAE’s ability to lower FBS and serum and hepatic TG in both ET2D and LT2D indicated its ability to act via different mechanisms. Ferulic acid (Fer A) and rutin hydrate (RH) were detected in CCAE.

Conclusion

CCAE lowered the FBS in ET2D via inhibiting the hepatic G6Pase expression (glycogenolysis). In LT2D, CCAE abated sugar levels by diverting PEPCK activity, preferably towards glyceroneogenesis than gluconeogenesis. The preserved triglyceride/fatty acid (TG/FA) cycle, the upregulated PPARα, and the downregulated CPT1 gene expressions reduced serum and hepatic TG.

Effect of Salvia officinalis and S. sclarea on rats with a high-fat hypercaloric diet

Phytotherapy for the correction of excess body weight is widely used. However, a comprehensive study of herbal preparations on the organism of model animals has been carried out only for a few plant species. Supplementing the diet of rats with closely related sage species (Salvia officinalis L. and S. sclarea L.) against the background of high-fat hypercaloric diet triggered multidirectional changes in their metabolism. The addition of crushed dry shoots of S. officinalis to the diet of animals led to a sharp increase in their body weight (up to 130.8% of the initial one in 30 days of the experiment). The body weight of the rats treated with S. sclarea for 30 days increased only up to 103.8% of their initial weight and was lower than in the control group. Addition of S. officinalis caused an increase in daily weight gain up to 253.1% of the control group, and S. sclarea – its decrease to 27.8% of the daily weight gain in the control group. In the S. officinalis group, the relative weight of the brain, spleen, and thymus decreased, while in the S. sclarea group, the relative weight of the thymus decreased and that of the colon increased. Under the influence of S. officinalis, the concentration of urea, total bilirubin, and triglycerides in the blood plasma of male rats decreased and the concentration of total protein and the activity of alkaline phosphatase increased. While consuming S. sclarea shoots, there was an increase of alkaline phosphatase activity in the rats’ blood, but atherogenic index (23.1% of the level of the control group) sharply dropped due to an increase in the concentration of high-density lipoprotein cholesterol (286.9% of the control) and a decrease in the concentration of low-density lipoprotein cholesterol (67.7% of control). In rats feeding on S. sclarea shoots, we observed a decrease in the concentration of triglycerides in the blood (39.9% of the control), a decrease in the activity of gamma-glutamyl transferase (62.8%), and an increase in the Ca/P ratio (132.5% of the control group). No significant changes were observed in CBC and WBC differential of male rats when eating S. officinalis and S. sclarea shoots. According to the results of the open field test, the physical and orientational activity of male rats under the influence of S. officinalis significantly decreased by the end of the experiment. Emotional status of rats, on the contrary, decreased when they ate dry crushed shoots of S. sclarea in the composition of the food. Thus, excess body weight of rats in the conditions of hypercaloric diet led to more pronounced deviations from the norm while consuming dry crushed shoots of S. officinalis. The addition of S. sclarea dry crushed shoots to the animals’ diet normalized the body weight in comparison with the control group, reduced the negative manifestations of obesity at the biochemical and organismal levels. In this regard, the substances that contains S. sclarea should be carefully studied for anti-atherosclerotic activity, and tea supplemented with S. sclarea shoots can be recommended as a corrective supplement in the diet of overweight people.

A Review on Antidiabetic Activity of Centaurea spp.: A New Approach for Developing Herbal Remedies

Objective

Diabetes mellitus (DM) is a long-life metabolic disorder, characterized by high blood glucose levels. The hyperglycemic condition generally leads to irreversible nerve injury and vascular damage. Among different types of diabetes, type 2 is more common and has spread all over the world. Although various therapeutic approaches have been developed to control type 2 DM, regulating blood glucose levels has still remained a controversial challenge for patients. Also, most prescription drugs cause different side effects, such as gastrointestinal disorders. Thus, developing novel and efficient antidiabetic agents possessing fewer adverse effects is in high demand.

Method

The literature was comprehensively surveyed via search engines such as Google Scholar, PubMed, and Scopus using appropriate keywords.

Results

Medicinal plants, both extracts and isolated active components, have played a significant role in controlling the blood glucose levels. Good-to-excellent results documented in the literature have made them a precious origin for developing and designing drugs and supplements against DM. Centaurea spp. have been traditionally used for controlling high blood glucose levels. Also, the antidiabetic properties of different species of Centaurea have been confirmed in recent studies through in vitro assays as well as in vivo experiments.

Conclusion

Potent results encouraged us to review their efficacy to open a new horizon for development of herbal antidiabetic agents.