Evaluation of safety and efficacy profile of Nigella sativa oil as an add-on therapy, in addition to alpha-keto analogue of essential amino acids in patients with chronic kidney disease

Antidiabetic activity of the aqueous extract of Erigeron floribundus leaves in streptozotocin-induced type 1 diabetes model in Wistar rats

Backgroud

Erigeron floribundus is a herbaceous plant used in traditional Cameroonian medicine to treat diabetes mellitus. The aim of this study was to evaluate the antidiabetic properties of the aqueous extract of E. floribundus leaves (AEEF) in diabetic rats.

Methods

Diabetes was induced by a single intraperitoneal injection of streptozotocin (60 mg/kg) in normal rats fasted for 16 h. Subsequently, 30 diabetic male rats were divided into groups and treated orally for 21 days with distilled water (10 mL/kg), glibenclamide (3 mg/kg) and AEEF (300, 400, and 500 mg/kg). Body weight, food and water intake, blood glucose, insulin levels, lipid and oxidative profiles, as well as some markers of liver and kidney function were assessed. Histological sections of the rats' pancreas were taken.

Results

AEEF and glibenclamide significantly increased (p < 0.001) body weight and decreased food and water intake in rats. A decrease in blood glucose (p < 0.001) and an increase in insulin levels (p < 0.001) were observed in the AEEF and glibenclamide groups. AEEF caused a significant (p < 0.001) decrease in the levels of total cholesterol, LDL-c, triglycérides and coronary risk index (CRI), accompanied by a significant (p < 0.001) increase in HDL levels and HOMA-β in rats. AEEF showed an improvement (p < 0.001) in CAT and SOD activity and GSH levels accompanied by a significant decrease (p < 0.001) in malondialdehyde levels. In addition, ALAT and ASAT activity, urea and creatinine levels were significantly reduced (p < 0.001) after treatment with AEEF and glibenclamide. The extract also improved the size of Langerhans Islets in the pancreas of diabetic rats.

Conclusion

AEEF contains several bioactive compounds conferring antidiabetic, anti-dyslipidemic and antioxidant properties, thus justifying its therapeutic use in the treatment of diabetes mellitus.

Role of Alternative Medical Systems in Adult Chronic Kidney Disease Patients: A Systematic Review of Literature

There is a growing interest in the use of alternative medical systems (AMS), such as traditional Chinese medicine (TCM), ayurveda, homeopathy, and naturopathy, among chronic kidney disease patients. This review summarizes the efficacy and safety of AMS interventions in chronic kidney disease (CKD) patients. A systematic review was conducted in MEDLINE, Embase, Scopus, CINAHL, CENTRAL, and PsycINFO in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Synthesis without meta-analysis (SWiM) guidelines. Randomized controlled trials (RCTs) which evaluated the use of AMS among adult CKD patients were included. The efficacy of each AMS was assessed based on improvement in biochemical markers or reduction in symptom severity scores. All adverse reactions were recorded. Of the 14,583 articles retrieved, 33 RCTs were included. TCM (n=20) and ayurveda (n=6) were the most well-studied. Majority of studies (66.7%) had a sample size <100. Common indications evaluated included improvement in renal function (n=12), proteinuria (n=5), and uremic pruritus (n=5). Among TCM, acupuncture and syndromes-based TCM granules formulation were shown to improve estimated glomerular filtration rate (eGFR) by 5.1-15.5% and 7.07-8.12% respectively. Acupuncture reduced uremic pruritus symptoms by 54.7-60.2% while Huangkui, Shenqi granules, and Tripterygium wilfordii Hook F reduced proteinuria by 18.6-50.7%, 61.8%, and 32.1% respectively. For Ayurveda, camel milk and Nigella sativa oil improved eGFR by 16.9% and 86.8%, respectively, while capsaicin reduced pruritus scores by 84.3%. Homeopathic verum medication reduced pruritus scores by 29.2-41.5%. Nausea was the most common adverse effect reported with alpha-keto amino acids (0.07%), Nigella sativa oil (7.04%), and silymarin (10%). TCM and ayurveda were more well-studied AMS therapies that demonstrated efficacy in CKD patients. RCTs with larger sample sizes are needed to ascertain the efficacy and safety of promising AMS.

The Potential Role of Nigella sativa Seed Oil as Epigenetic Therapy of Cancer

Nigella sativa oil, commonly known as black seed oil (BSO), is a well-known Mediterranean food, and its consumption is associated with beneficial effects on human health. A large number of BSO's therapeutic properties is attributed to its pharmacologically active compound, thymoquinone (TQ), which inhibits cell proliferation and induces apoptosis by targeting several epigenetic players, including the ubiquitin-like, containing plant homeodomain (PHD) and an interesting new gene, RING finger domains 1 (UHRF1), and its partners, DNA methyltransferase 1 (DNMT1) and histone deacetylase 1 (HDAC1). This study was designed to compare the effects of locally sourced BSO with those of pure TQ on the expression of the epigenetic complex UHRF1/DNMT1/HDAC1 and the related events in several cancer cells. The gas chromatographs obtained from GC-MS analyses of extracted BSO showed that TQ was the major volatile compound. BSO significantly inhibited the proliferation of MCF-7, HeLa and Jurkat cells in a dose-dependent manner, and it induced apoptosis in these cell lines. BSO-induced inhibitory effects were associated with a significant decrease in mRNA expression of UHRF1, DNMT1 and HDAC1. Molecular docking and MD simulation showed that TQ had good binding affinity to UHRF1 and HDAC1. Of note, TQ formed a stable metal coordinate bond with zinc tom, found in the active site of the HDAC1 protein. These findings suggest that the use of TQ-rich BSO represents a promising strategy for epigenetic therapy for both solid and blood tumors through direct targeting of the trimeric epigenetic complex UHRF1/DNMT1/ HDAC1.

Protective Effects of Black Cumin (Nigella sativa) and Its Bioactive Constituent, Thymoquinone against Kidney Injury: An Aspect on Pharmacological Insights

The prevalence of chronic kidney disease (CKD) is increasing worldwide, and a close association between acute kidney injury (AKI) and CKD has recently been identified. Black cumin (Nigella sativa) has been shown to be effective in treating various kidney diseases. Accumulating evidence shows that black cumin and its vital compound, thymoquinone (TQ), can protect against kidney injury caused by various xenobiotics, namely chemotherapeutic agents, heavy metals, pesticides, and other environmental chemicals. Black cumin can also protect the kidneys from ischemic shock. The mechanisms underlying the kidney protective potential of black cumin and TQ include antioxidation, anti-inflammation, anti-apoptosis, and antifibrosis which are manifested in their regulatory role in the antioxidant defense system, NF-κB signaling, caspase pathways, and TGF-β signaling. In clinical trials, black seed oil was shown to normalize blood and urine parameters and improve disease outcomes in advanced CKD patients. While black cumin and its products have shown promising kidney protective effects, information on nanoparticle-guided targeted delivery into kidney is still lacking. Moreover, the clinical evidence on this natural product is not sufficient to recommend it to CKD patients. This review provides insightful information on the pharmacological benefits of black cumin and TQ against kidney damage.

Black Cumin (Nigella sativa L.): A Comprehensive Review on Phytochemistry, Health Benefits, Molecular Pharmacology, and Safety

Mounting evidence support the potential benefits of functional foods or nutraceuticals for human health and diseases. Black cumin (Nigella sativa L.), a highly valued nutraceutical herb with a wide array of health benefits, has attracted growing interest from health-conscious individuals, the scientific community, and pharmaceutical industries. The pleiotropic pharmacological effects of black cumin, and its main bioactive component thymoquinone (TQ), have been manifested by their ability to attenuate oxidative stress and inflammation, and to promote immunity, cell survival, and energy metabolism, which underlie diverse health benefits, including protection against metabolic, cardiovascular, digestive, hepatic, renal, respiratory, reproductive, and neurological disorders, cancer, and so on. Furthermore, black cumin acts as an antidote, mitigating various toxicities and drug-induced side effects. Despite significant advances in pharmacological benefits, this miracle herb and its active components are still far from their clinical application. This review begins with highlighting the research trends in black cumin and revisiting phytochemical profiles. Subsequently, pharmacological attributes and health benefits of black cumin and TQ are critically reviewed. We overview molecular pharmacology to gain insight into the underlying mechanism of health benefits. Issues related to pharmacokinetic herb-drug interactions, drug delivery, and safety are also addressed. Identifying knowledge gaps, our current effort will direct future research to advance potential applications of black cumin and TQ in health and diseases.

Discontinuation of Hemodialysis After 8 Years in Favor of Toprak's Kidney Care in a Patient with End-Stage Kidney Disease

Patient: Male, 77-year-old

Final Diagnosis: End-stage renal failure

Symptoms: No symptoms

Medication:—

Clinical Procedure: —

Specialty: Nephrology

Effect of Nigella sativa in the treatment of nonalcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials

The effectiveness of Nigella sativa (NS) treatment for nonalcoholic fatty liver disease (NAFLD) remains controversial. This systematic review, and meta-analysis, was conducted to evaluate potential benefits of NS for NAFLD. Up to June 11, 2020, randomized controlled trials (RCTs) evaluating NS for the treatment of NAFLD were searched and included from PubMed, Embase, Cochrane Library, and Web of science. Mean differences (MD) or risk ratio (RR) and 95% confidence intervals (CI) were calculated. Six articles from five trails with a total of 358 participants were included. Although NS has no beneficial effect on the levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL), triglyceride (TG), insulin, and tumor necrosis factor α (TNF-α), its supplementation did improve the levels of alanine transaminase (ALT), aspartate transaminase (AST), fasting blood sugar (FBS), high-density lipoprotein cholesterol (HDL), high-sensitivity C reactive protein (hs-CRP), and grade of fatty liver compared with placebo. In summary, this study showed that NS supplementation was effective in the treatment of NAFLD and could improve the levels of ALT, AST, FBS, HDL, and hs-CRP in patients with NAFLD, as well as the severity of NAFLD. High-quality large sample RCTs are necessary to confirm the benefit of NS supplementation for NAFLD.