The Beneficial Effect of Korean Red Ginseng Extract on Atopic Dermatitis Patients: An 8 Weeks Open, Noncomparative Clinical Study

Anti-Allergic Effects of Fermented Red Ginseng Marc on 2,4-Dinitrochlorobenzene-Induced Atopic Dermatitis-like Mice Model

Atopic dermatitis (AD) is a chronic and allergic skin disease; however, there is no cure for the disease. Red ginseng is well known to have anti-AD potential, while red ginseng marc (RGM) remaining after ginseng extraction is regarded as useless and discarded. However, it has recently been reported that RGM, particularly fermented RGM (fRGM), still contains bioactive properties. Thus, the anti-allergic effects of fRGM were examined in a 2,4-dinitrochlorobenzene-induced AD-like mice model. The model was topically treated with distilled water (control), dexamethasone, or fRGM for six weeks. Treatments of fRGM alleviated skin lesions and reduced serum IgE levels, compared with the control. The fRGM also reduced skin levels of lipid peroxidation and superoxide anion; however, it increased glutathione contents, with downregulated gene expression for inflammatory mediators. Histopathological analyses demonstrated that fRGM suppressed epidermal thickening, collagen deposition, and inflammatory cell and mast cell infiltration, which involved anti-inflammatory, antioxidant, and anti-apoptotic effects. Further, fRGM suppressed hypertrophic changes and inflammatory responses in the spleen and lymph nodes. The beneficial effects were observed in the dexamethasone and fRGM groups; however, the antioxidant effects were evident only in the fRGM treatments. These results provide useful information for developing fRGM as a therapeutic source for AD.

Effect of a combination of Korean red ginseng extract and probiotics on the prevention of atopic dermatitis in a murine model

ETHNOPHARMACOLOGICAL RELEVANCE

Panax ginseng C.A.Mey. (Korea red ginseng) has been used in Asia to treat inflammatory skin diseases. Recently, Korea red ginseng (KRG) is emerging as a good candidate for treating atopic dermatitis (AD) because of its anti-allergic and anti-inflammatory effects.

AIM OF THE STUDY

Despite much effort, no systemic prevention strategy has been established for AD currently. Therefore, the aim of this study was to determine the preventive effect of a combination of KRG extract and probiotics on AD-like skin lesions of mice.

MATERIALS AND METHODS

Forty NC/Nga mice were randomly divided into eight groups: Sham, AD control, Cyclosporine, KRG, Duolac ATP® (ATP), BYO Plant Origin Skin Probiotics (BYO), KRG + ATP, and KRG + BYO. Mice were administered orally with KRG and/or other agents using a gastric tube for 5 days prior to challenge with 1-chloro-2,4-dinitrobenzene (DNCB). AD-like skin lesions were induced by percutaneous challenge with DNCB on ears and backs of NC/Nga mice. Effects of each treatment were evaluated based on the following: Clinical severity score, ear thickness, transepidermal water loss (TEWL), total serum Immunoglobulin E (IgE) level, mRNA expression levels and immunohistochemistry analysis of IFN-γ, IL-4, and TSLP in cutaneous lesions.

RESULTS

TEWL, serum IgE level, and expression of immunohistopathologic markers were more improved in the group using KRG combined with probiotics than in the group using KRG or probiotics alone. ATP, KRG + ATP, and KRG + BYO groups showed reduced TEWL increase (ΔTEWL) at 48 h (p < 0.005). KRG + ATP showed a preventive effect on the increase of serum IgE level (p = 0.009). In immunohistopathologic analysis, KRG, ATP, BYO, KRG + ATP, and KRG + BYO groups showed significantly reduced expression levels of IFN-γ at 1 h, 6 h, and 48 h (all p < 0.05). KRG, ATP, BYO, and KRG + BYO groups showed reduced expression levels of IL-4 compared to the AD control group at 6 h and 24 h. KRG, ATP, BYO, KRG + ATP, and KRG + BYP groups showed significantly lower expression levels of TSLP than the AD control group at 1 h and 24 h.

CONCLUSION

KRG can suppress increases of allergic and inflammatory cytokines and increase of TEWL. A combination of KRG and probiotics might have better effects than KRG or probiotics alone for preventing an AD flare-up.

Optimization of the extraction process of high levels of chlorogenic acid and ginsenosides from short-term hydroponic-cultured ginseng and evaluation of the extract for the prevention of atopic dermatitis

Background

Short-term hydroponic-cultured ginseng (sHCG), which is 1-year-old ginseng seedlings cultivated for 4 weeks in a hydroponic system, is a functional food item with several biological effects. However, the optimal extraction conditions for sHCG, and the bioactivity of its extracts, have not been evaluated.

Methods

Chlorogenic acid (CGA) and ginsenoside contents were evaluated in sHCG, white ginseng (WG), and red ginseng (RG) using high-performance liquid chromatography. Response surface methodology (RSM) was used to optimize the extraction conditions (temperature and ethanol concentration) to maximize the yield of dry matter, CGA, and four ginsenosides (Re, Rg₁, Rb₁, and Rd) from sHCG. The optimal extraction conditions were applied to pilot-scale production of sHCG extracts. The expression levels of tumor necrosis factor (TNF)-α/interferon (IFN)-γ-induced thymic and activation-regulated chemokines (TARC/CCL17) were measured after treatment with sHCG, WG, and RG extracts, and the effects of their bioactive compounds (CGA and four ginsenosides) on human skin keratinocytes (HaCaTs) were evaluated.

Results

CGA and four ginsenosides, which are bioactive compounds of sHCG, significantly inhibited TNF-α/IFN-γ-induced TARC/CCL17 expression. The optimal sHCG extraction conditions predicted by the RSM models were 80 °C and 60% ethanol (v/v). The sHCG extracts produced at the pilot scale under optimal conditions greatly alleviated TNF-α/IFN-γ-induced TARC/CCL17 production compared with WG and RG extracts.

Conclusions

Pesticide-free sHCG extracts, which contain high levels of CGA and the ginsenosides Re, Rg₁, Rb₁, and Rd as bioactive compounds, may have therapeutic potential for atopic diseases.

Therapeutic potential of ginsenoside Rg3 and Rf for Huntington's disease

Ginseng is a popular herbal medicine and known to have protective and therapeutic effects in various diseases. Ginsenosides are active gradients representing the diverse pharmacological efficacy of ginseng. Huntington's disease (HD) is incurable genetic disorder associated with mutant huntingtin (mHtt) aggregation in the central nervous system. This study was conducted to investigate the effects of ginsenoside Rg3 and Rf on mHtt aggregation, cell viability, mitochondrial function, and apoptotic molecules on HD model. To investigate the effect of ginsenosides on HD, neural stem cells were isolated from the R6/2 mouse brain and used as a cellular model of HD. Nuclear aggregation of mHtt was measured by immunocytochemistry, and expressions of mitochondrial biogenesis and apoptotic molecules were investigated by western blot. As a result, the number of mHtt aggregates positive cells has decreased by ginsenoside Rg3 and Rf treatment in cellular model of HD. Mitochondrial biogenesis-related molecules such as PGC-1α and phosphorylated CREB were increased or showed increased tendency by ginsenoside Rg3 and Rf. Apoptotic molecules, p53, Bax, and cleaved caspase-3, were down-regulated by treatment of ginsenoside Rg3 and Rf. In addition, Lysotracker staining result showed that cellular lysosomal content was reduced by ginsenoside Rg3 and Rf. Given that ginsenoside Rg3 and Rf have the potential to reduce mHtt aggregation and cellular apoptosis, these ginsenosides can be possible therapeutic candidates for treating HD phenotypes.

Importance of food in the control of inflammation in atopic dermatitis

Patients that suffer from inflammatory diseases need to pay special attention to nutrition. For this reason, it is very important to change the approach of both health professionals and food industry specialists. There must be a close collaboration, starting from research, the development phase of foods for special nutrition states. Our primary objective was to identify foods or potential dietary ingredients, which efficacy in the treatment of atopic dermatitis had been scientifically demonstrated in vitro, in vivo and clinically. Furthemore, our perspective is presented regarding the research and development of foods for special nutritional states in atopic dermatitis. The PubMed database was analyzed for the period 2018-2020, as well as the European Legislation regarding the appropriate requirements for the composition and knowledge applicable to foods destined for use in special medical purposes. The search criteria were 'chronic dermatitis', 'atopic dermatitis', 'psoriasis', 'alternative treatments', 'natural treatments', 'complementary treatments', 'treatments for chronic dermatitis'. We also looked for undesirable effects or side effects of the foods included in the research in order to treat atopic dermatitis. The results showed that prebiotics, probiotics and certain plant extracts had a high efficacy in controlling inflammation in atopic dermatitis. The food development research for special nutrition states (atopic dermatitis) involves a multidisciplinary team. We started with the establishment of the general objective and continued with the consultation of the PubMed, EMBASE and other databases, and with the in vitro, preclinical and/or clinical determination of the efficacy of new developed foods, that must be protected with patents. The development of foods for special nutrition states represents a solution for improving the quality of life of atopic dermatitis patients.

Effect of Intraoperative Dexmedetomidine Dose on Postoperative First Night Sleep Quality in Elderly Surgery Patients: A Retrospective Study With Propensity Score-Matched Analysis

Background: Postoperative sleep disorder is common in elderly surgery patients, and it often worsens their recovery after surgery. This study aimed to explore the effect of intraoperative dexmedetomidine dose on postoperative sleep quality.

Methods: Based on information regarding dexmedetomidine use during surgery from an electronic medical record system, 4,349 elderly surgery patients were divided into three groups: 1,374 without intraoperative use of dexmedetomidine (Non-DEX), 917 with dexmedetomidine 0.1–0.2 μg/kg/h (Low-DEX), and 2,058 with dexmedetomidine >0.2 μg/kg/h (High-DEX). The numerical rating scale (NRS) for sleep disturbance during the first night after surgery was recorded, and the incidence of NRS ≥ 6 was considered the primary outcome.

Results: NRS (P < 0.001) and incidence of severe sleep disturbance (P < 0.001) were lower in patients receiving intraoperative dexmedetomidine than in those without the intraoperative use of dexmedetomidine. Patients in the Low-DEX group had the lowest incidence, followed by those in the High-DEX and Non-DEX groups (6.7% vs. 13.7% vs. 19.5%). After propensity score matching, 906 pairs of elderly surgery patients were included in the Low-DEX and High-DEX groups, and the Low-DEX group had lower NRS (2.7 ± 2.1 vs. 3.1 ± 2.4, P < 0.001) than the High-DEX group. The incidence of severe sleep disturbance was lower in the Low-DEX group than in the High-DEX group (6.6% vs. 12.8%) with an odds rate of 0.48 (95% confidence interval, 0.35 to 0.67).

Conclusions: For elderly patients, intraoperative dexmedetomidine use can significantly improve the quality of the first night sleep after surgery. Low-dose (0.1–0.2 μg/kg/h) dexmedetomidine can have an improvement effect on sleep quality, and it is recommended to improve the quality of postoperative sleep.

Effects of Red and Fermented Ginseng and Ginsenosides on Allergic Disorders

Both white ginseng (WG, dried root of Panax sp.) and red ginseng (RG, steamed and dried root of Panax sp.) are reported to exhibit a variety of pharmacological effects such as anticancer, antidiabetic, and neuroprotective activities. These ginsengs contain hydrophilic sugar-conjugated ginsenosides and polysaccharides as the bioactive constituents. When taken orally, their hydrophilic constituents are metabolized into hydrophobic ginsenosides compound K, Rh1, and Rh2 that are absorbable into the blood. These metabolites exhibit the pharmacological effects more strongly than hydrophilic parental constituents. To enforce these metabolites, fermented WG and RG are developed. Moreover, natural products including ginseng are frequently used for the treatment of allergic disorders. Therefore, this review introduces the current knowledge related to the effectiveness of ginseng on allergic disorders including asthma, allergic rhinitis, atopic dermatitis, and pruritus. We discuss how ginseng, its constituents, and its metabolites regulate allergy-related immune responses. We also describe how ginseng controls allergic disorders.

Medicinal potential of Panax ginseng and its ginsenosides in atopic dermatitis treatment

Atopic dermatitis (AD) is a chronic and relapsing inflammatory disease that affects 1%-20% of people worldwide. Despite affecting many people, AD current treatments, such as corticosteroids and calcineurin inhibitors, have not only harmful secondary effects but are also often ineffective. Therefore, natural nontoxic compounds are on high demand for developing new effective AD treatments. Panax ginseng Meyer has been used traditionally for its promising healing and restorative properties to treat many diseases including skin disorders, reason why in this review we want to explore the research performed with AD and P. ginseng as well as determining its potential for new drug development. Previous researches have shown that P. ginseng has positive effects in AD patients such as lower eczema area and severity index, transepidermal water loss, and immunoglobulin E levels and better quality of sleep. In vivo animal models, as well, have shown positive results to P. ginseng and derived ginsenosides, such as the decrease of transepidermal water loss, immunoglobulin E levels in serum, allergy-related cytokines, and downregulation of NF-κB, MAPK, and Ikaros pathways. All of these previous data suggest that P. ginseng and its derived ginsenosides are undoubtedly a nontoxic effective option to treat AD.

Synthesis of eugenol derivatives and its anti-inflammatory activity against skin inflammation

Eugenol is a phytochemical present in aromatic plants has generated considerable interest in the pharmaceutical industries mainly in cosmetics. A series of eugenol esters (ST1-ST7) and chloro eugenol (ST8) have been synthesized. The structures of newly synthesized compounds were confirmed by ¹H and ¹³C NMR and mass spectrometry. In an effort to evaluate the pharmacological activity of eugenol derivatives, we explored its anti-inflammatory potential against skin inflammation using in-vitro and in-vivo bioassay. Synthesized derivatives significantly inhibited the production of pro-inflammatory cytokines against LPS-induced inflammation in macrophages. Among all derivatives, ST8 [Chloroeugenol (6-chloro, 2-methoxy-4-(prop-2-en-1-yl)-phenol)] exhibited most potent anti-inflammatory activity without any cytotoxic effect. We have further evaluated the efficacy and safety in in-vivo condition. ST8 exhibited significant anti-inflammatory activity against TPA-induced skin inflammation without any skin irritation effect on experimental animals. These findings suggested that ST8 may be a useful therapeutic candidate for the treatment of skin inflammation.