The Role of Saponins in the Treatment of Neuropathic Pain

Treatment of neuropathic pain by traditional Chinese medicine: An updated review on their effect and putative mechanisms of action

Neuropathic pain (NP) is a common chronic pain with heterogeneous clinical features, and consequent lowering of quality of life. Currently, although conventional chemical drugs can effectively manage NP symptoms in the short term, their long-term efficacy is limited, and they come with significant side effects. In this regard, traditional Chinese medicine (TCM) provides a promising avenue for treating NP. Numerous pharmacological and clinical studies have substantiated the effectiveness of TCM with multiple targets and mechanisms. We aimed to outline the characteristics of TCM, including compound prescriptions, single Chinese herbs, active ingredients, and TCM physical therapy, for NP treatment and discussed their efficacy by analyzing the pathogenesis of NP. Various databases, such as PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang database, were searched. We focused on recent research progress in NP treatment by TCM. Finally, we proposed the future challenges and emerging trends in the treatment of NP. TCM demonstrates significant clinical efficacy in NP treatment, employing multi-mechanisms. Drawing from the theory of syndrome differentiation, four types of dialectical treatments for NP by compound TCM prescriptions were introduced: promoting blood circulation and removing blood stasis; promoting blood circulation and promote Qi flow; warming Yang and benefiting Qi; soothing the liver and regulating Qi. Meanwhile, 33 single Chinese herbs and 25 active ingredients were included. In addition, TCM physical therapy (e.g., acupuncture, massage, acupoint injection, and fumigation) also showed good efficacy in NP treatment. TCM, particularly through the use of compound prescriptions and acupuncture, holds bright prospects in treating NP owing to its diverse holistic effects. Nonetheless, the multi-targets of TCM may result in possible disadvantages to NP treatment, and the pharmacological mechanisms of TCM need further evaluation. Here, we provide an overview of NP treatment via TCM, based on the pathogenesis and the potential therapeutic mechanisms, thus providing a reference for further studies.

Critical review on anti-inflammation effects of saponins and their molecular mechanisms

This review highlights the increasing interest in one of the natural compounds called saponins, for their potential therapeutic applications in addressing inflammation which is a key factor in various chronic diseases. It delves into the molecular mechanisms responsible for the anti-inflammatory effects of these amphiphilic compounds, prevalent in plant-based foods and marine organisms. Their structures vary with soap-like properties influencing historical uses in traditional medicine and sparking renewed scientific interest. Recent research focuses on their potential in chronic inflammatory diseases, unveiling molecular actions such as NF-κB and MAPK pathway regulation and COX/LOX enzyme inhibition. Saponin-containing sources like Panax ginseng and soybeans suggest novel anti-inflammatory therapies. The review explores their emerging role in shaping the gut microbiome, influencing composition and activity, and contributing to anti-inflammatory effects. Specific examples, such as Panax notoginseng and Gynostemma pentaphyllum, illustrate the intricate relationship between saponins, the gut microbiome, and their collective impact on immune regulation and metabolic health. Despite promising findings, the review emphasizes the need for further research to comprehend the mechanisms behind anti-inflammatory effects and their interactions with the gut microbiome, underscoring the crucial role of a balanced gut microbiome for optimal health and positioning saponins as potential dietary interventions for managing chronic inflammatory conditions.

The potential of herbal drugs to treat heart failure: The roles of Sirt1/AMPK

Heart failure (HF) is a highly morbid syndrome that seriously affects the physical and mental health of patients and generates an enormous socio-economic burden. In addition to cardiac myocyte oxidative stress and apoptosis, which are considered mechanisms for the development of HF, alterations in cardiac energy metabolism and pathological autophagy also contribute to cardiac abnormalities and ultimately HF. Silent information regulator 1 (Sirt1) and adenosine monophosphate-activated protein kinase (AMPK) are nicotinamide adenine dinucleotide (NAD+)-dependent deacetylases and phosphorylated kinases, respectively. They play similar roles in regulating some pathological processes of the heart through regulating targets such as peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), protein 38 mitogen-activated protein kinase (p38 MAPK), peroxisome proliferator-activated receptors (PPARs), and mammalian target of rapamycin (mTOR). We summarized the synergistic effects of Sirt1 and AMPK in the heart, and listed the traditional Chinese medicine (TCM) that exhibit cardioprotective properties by modulating the Sirt1/AMPK pathway, to provide a basis for the development of Sirt1/AMPK activators or inhibitors for the treatment of HF and other cardiovascular diseases (CVDs).

Antinociceptive and antiinflammatory activities of crude leave extract and solvent fractions of Commelina latifolia Hochst. ex C.B.Clarke (Commelinaceae) leaves in murine model

Ethnopharmacological relevance: In the past, Ethiopian traditional medicine employed the leaves of the native Commelina latifolia Hochst. ex C.B. Clarke plant to treat wounds, pain, and malaria. Aim of the study: The crude extract and solvent fractions of C. latifolia Hochst. ex C.B. Clarke leaves were examined in the present investigation to determine their ability to have an antiinflammatory effect and provide an antinociceptive effect in animal models. Materials and methods: The leaves of C. latifolia were extracted with 80% methanol, and the CL crude extract was further fractionated with chloroform, pure methanol, and distilled water. The carrageenan-induced paw edema model was used to test the extracts' ability to reduce inflammation. The hotplate model and the acetic acid-induced writhing test on rodents were used to test the extracts' potential antinociceptive effect to reduce pain. Results: Inflammation was decreased by 64.59% with CL crude extract (400 mg/kg); 56.34% (400 mg/kg) of methanol fraction, 64.59% of aqueous fraction (400 mg/kg), and 38.27% of chloroform fraction in the carrageenan-induced inflammatory model. All extracts demonstrated a considerable lengthening of the nociception reaction time in the hot plate test, with a maximum antinociceptive effect of 78.98% (crude extract) and 71.65% (solvent fractions). At a dosage of 400 mg/kg, the natural C. latifolia crude extract and aqueous fraction demonstrated considerable antinociceptive effects against acetylsalicylic acid (ASA) during the writhing test (48.83% and 45.37than%, respectively). The current findings support Ethiopia's traditional user's assertions that the herb can alleviate inflammation and pain.

The effect of a topical formulation from Lawsonia inermis L. (henna) on pain intensity in patients with chronic sciatica: A randomized double-blind clinical trial

ETHNOPHARMACOLOGICAL RELEVANCE

Chronic sciatica (CS) is a common condition of disability and pain. Lawsonia inermis L. (henna) is a medicinal plant that is commonly recommended in traditional Persian medicine textbooks for pain relief in patients with sciatica, particularly in the form of oil.

AIM OF THE STUDY

This research was designed to investigate the efficacy of a topical formulation from henna on pain intensity in patients with CS.

METHODS AND MATERIALS

In a randomized, double-blind clinical study, 81 patients were randomly allocated to three groups to receive the topical henna formulation (aqueous extract of henna in sesame oil), sesame oil, or placebo, three times daily, for four weeks. The patients were assessed by visual analog scale (VAS), 36-item short form health survey (SF-36), and Oswestry disability index (ODI).

RESULTS

There was a significant decrease in mean VAS in henna oil compared to sesame oil (p = 0.004) and placebo (p = 0.004). Significant improvements in total SF-36 scores were observed in henna oil and sesame oil compared to placebo (p = 0.011 and p = 0.025, respectively). Furthermore, ODI significantly decreased in henna oil compared to sesame oil (p < 0.001) and placebo (p = 0.005).

CONCLUSION

Henna oil seems to be an effective treatment to reduce pain intensity in patients with CS. Moreover, it improves quality of life and functional ability. Further randomized controlled trials with longer intervention periods are recommended to confirm this efficacy.

Glutamatergic and GABAergic neurons in the vLGN mediate the nociceptive effects of green and red light on neuropathic pain

Phototherapy is an emerging non-pharmacological treatment for depression, circadian rhythm disruptions, and neurodegeneration, as well as pain conditions including migraine and fibromyalgia. However, the mechanism of phototherapy-induced antinociception is not well understood. Here, using fiber photometry recordings of population-level neural activity combined with chemogenetics, we found that phototherapy elicits antinociception via regulation of the ventral lateral geniculate body (vLGN) located in the visual system. Specifically, both green and red lights caused an increase of c-fos in vLGN, with red light increased more. In vLGN, green light causes a large increase in glutamatergic neurons, whereas red light causes a large increase in GABAergic neurons. Green light preconditioning increases the sensitivity of glutamatergic neurons to noxious stimuli in vLGN of PSL mice. Green light produces antinociception by activating glutamatergic neurons in vLGN, and red light promotes nociception by activating GABAergic neurons in vLGN. Together, these results demonstrate that different colors of light exert different pain modulation effects by regulating glutamatergic and GABAergic subpopulations in the vLGN. This may provide potential new therapeutic strategies and new therapeutic targets for the precise clinical treatment of neuropathic pain.