Medicinal Plants used for Postnatal Care in Malay Traditional Medicine in the Peninsular Malaysia

Green extraction of Quercus infectoria gall with supercritical CO2 and methanol co-solvent

Green extraction of supercritical liquid CO2 (SCFE-CO2) using co-solvent methanol can produce a more complete phenolic acid composition and a higher quantity when compared to those without using co-solvent. The extract was devoid of toxicity. SCFE-CO2 is carried out by putting 100 g of Quercus infectoria gall of size 0.3 mm into extraction tube at temperature of 60 °C and the pressure of 20 MPa with a CO2 flow rate of 25 ml/min using co-solvent methanol with variation of flow speed 0.05, 0.5, 1.5, 3, and 6 for 60 min. The extract is analyzed using LC-MS/MS, the total phenolic content is determined using the Folin-Ceocateu method, and the toxicity value is determined using the Vero cell. According to the results, the green method of extracting SCFE-CO2 with methanol co-solvent can produce a peak and identify about 27 phenolic compounds, and increasing the rate of flow of methane co-solvent will greatly affect the outcome of the extraction to a flow rate of 0.5 ml/min, while adding a co-solvent with a flow speed above 0.5 does not affect the result. Repeated extraction of some of the largest phenolic peaks provide phenol content with minimal extract variability (div. sd. 0.1%), and the addition of soluble methanol will also increase the TPC concentration but does not increase the IC50 toxicity value above 1000.

Immunomodulatory effects and mechanisms of the extracts and secondary compounds of Zingiber and Alpinia species: a review

Zingiber and Alpinia species (family: Zingiberaceae) are popularly used in food as spices and flavoring agents and in ethnomedicine to heal numerous diseases, including immune-related disorders. However, their ethnomedicinal uses have not been sufficiently supported by scientific investigations. Numerous studies on the modulating effects of plants and their bioactive compounds on the different steps of the immune system have been documented. This review aimed to highlight up-to-date research findings and critically analyze the modulatory effects and mechanisms of the extracts and secondary compounds of several Zingiber and Alpinia species, namely, Zingiber officinale Roscoe, Z. cassumunar Roxb., Z. zerumbet (L.) Roscoe ex Sm., Alpinia galanga Linn., A. conchigera Griff, A. katsumadai Hayata, A. oxyphylla Miq., A. officinarum Hance, A. zerumbet (Pers.) Burtt. et Smith, and A. purpurata (Viell.) K. Schum. on the immune system, particularly via the inflammation-related signaling pathways. The immunomodulating activities of the crude extracts of the plants have been reported, but the constituents contributing to the activities have mostly not been identified. Among the extracts, Z. officinale extracts were the most investigated for their in vitro, in vivo, and clinical effects on the immune system. Among the bioactive metabolites, 6-, 8-, and 10-gingerols, 6-shogaol, and zerumbone from Zingiber species and cardamomin, 1'-acetoxychavicol acetate, yakuchinone, rutin, 1,8-cineole, and lectin from Alpinia species have demonstrated strong immunomodulating effects. More experimental studies using cell and animal models of immune-related disorders are necessary to further understand the underlying mechanisms, together with elaborate preclinical pharmacokinetics, pharmacodynamics, bioavailability, and toxicity studies. Many of these extracts and secondary metabolites are potential candidates for clinical development in immunomodulating agents or functional foods to prevent and treat chronic inflammatory disorders.

Use of Herbal Medicines Among Breastfeeding Mothers in Tanzania: A Cross-Sectional Study

Background: There are limited data on the use of herbal medicines (HM) among breastfeeding mothers, despite the fact that knowledge of the possible benefits or harms of HM use has a direct relationship with the health of infants, especially in resource-limited countries. The study aims to determine the prevalence and factors associated with HM use among breastfeeding mothers in Tanzania. Methods: The study followed a cross-sectional design using a structured survey questionnaire. Survey participants were recruited from the reproductive and child health clinic at Uhuru health center in Morogoro, Tanzania. The survey instrument comprised of 34 questions, including demographic information, the pattern of HM use during breastfeeding, and women's perceptions of HM. Chi-square test and logistic regression were used for data analysis using SPSS ver. 24.0. Results: The majority of the respondents (53.8%) used HM during breastfeeding. The most commonly used HM was black pepper (Piper nigrum L.; 80.0%), followed by pumpkin seeds (Cucurbita pepo L.; 18.0%). About one-third (27.5%) of HM users discussed their use with their healthcare providers. In addition, higher education levels and low breastmilk supply were identified as potential predictors of HM use. Conclusion: The practice of HM use among breastfeeding mothers in Tanzania is popular to ease breastfeeding difficulties. However, the issue of the safety or effectiveness of HM is still an unknown agenda. This awakens the need to evaluate HM's safety, efficacy, and quality through pharmacological studies for scientific evidence. Lastly, a clinical guideline should be developed in healthcare settings to promote open dialogues between the healthcare providers and mothers to ensure the safe use of HM.

Clinical Study on Plant Galactagogue Worldwide in Promoting Women's Lactation: a Scoping Review

Human milk is recommended by the World Health Organization (WHO) for the general well-being of infants. However, many mothers face an insufficient milk supply to breastfeed their children. Galactagogue, in particular, plant galactagogue, serves as a method to promote lactation. This in-depth review examines the evidence supporting different plants' galactagogic activity through clinical studies around the globe. A scoping review approach was adopted to establish the research questions, and define the findings, selection and analysis of the study. This scoping review highlights and compiles the clinical research performed globally involving plant galactagogue to better inform the medical practitioners, lactation consultants, nursing mothers, communities and relevant personnel on practicing, guidelines, policymaking and research. In general, a total of 1041 research publications were retrieved from different global bibliographic databases, of which only 13 articles were retained for analysis after applying the exclusion criteria. A total of 14 types of plants have undergone clinical studies in the past decade to verify their galactagogic activity. All but two showed a positive effect on promoting milk production. There were 42 articles categorised as excluded studies. The category includes review articles, surveys, case reports, introductory articles of regional plant galactagogue and preclinical studies, which involves animal testing and the studies exploring other issues related to plant galactagogue. The findings demonstrate that there is a significant research gap on the plant galactagogue using clinical studies. More clinical research is necessary to identify and verify the efficacy of various types of plant galactagogue for the benefit of humankind.

Genus Parkia: Phytochemical, Medicinal Uses, and Pharmacological Properties

The genus Parkia (Fabaceae, Subfamily, Mimosoideae) comprises about 34 species of mostly evergreen trees widely distributed across neotropics, Asia, and Africa. This review aims to provide an overview of the current status of the species from the genus Parkia in terms of its relationship between its phytochemistry and medical uses. Comprehensive information on Parkia species was retrieved from electronic databases, which were Web of Science, ScienceDirect, PubMed, and Google Scholar. This review identified nine species from genus Parkia with properties of medicinal use. They are used traditionally to treat several ailments, such as diabetes, diarrhea, wounds, hypertension, cough, chronic piles, conjunctivitis, and measles. The most common species studied are P. biglobosa, P. speciosa, P. javanica, P. bicolor, P. biglandulosa, P. filicoidea, and P. clappertoniana. A considerable number of secondary metabolites, such as terpenoids, phenolic acids, flavonoids (aglycone and glycosides), and numerous volatile compounds have been identified in this genus, which are responsible for their diverse pharmacological activities. Their extracts, pure compounds and seed lectins have been reported for their anticancer, antimicrobial, antihypertensive, antiulcer, antidiabetic, anti-inflammatory, antioxidant, antimalarial, hepatoprotective, and antidiarrheal activities. The information gathered in this review might be of help for future studies in terms of the current knowledge on the link between the phytochemical components and medicinal uses. This could facilitate more discoveries on its potentials particularly in the pharmacological characteristics and potential to be developed into modern medicines.

Connaraceae: An updated overview of research and the pharmacological potential of 39 species

ETHNOPHARMACOLOGICAL RELEVANCE

An interdisciplinary scientific investigation of biologically active agents is fundamental to search for natural substances with therapeutic action. This review collected the most relevant information on traditional knowledge related to the use of plants of the Connaraceae family. This work is the first to compile all the published ethnobotanical, chemical, pharmacological, and toxicological information about this important plant family.

AIM OF THE STUDY

Our objective was to provide the scientific community with an up-to-date overview of the pharmacological potential of Connaraceae species.

MATERIAL AND METHODS

We searched NCBI Pubmed Central, Google Scholar, Scientific Electronic Library Online (SciELO), ScienceDirect, SciFinder, and Scopus databases to review the research on ethnobotanical, chemical, pharmacognostical, pharmacological, and toxicological studies with Connaraceaes. Books that address the theme were also included.

DISCUSSION AND CONCLUSION

The literature review indicated that 39 species of Connaraceaes have pharmacological potentiality. Ethnobotany reports listed 36 of the 39 species discussed. Pharmacognostical studies have been conducted with 23 species and isolates, and chemical compounds have been identified for only 15 species. At least one study has been published concerning the pharmacological activities for 20 of the 39 species analyzed. For Agelaea pentagyna, Cnestis ferruginea, Connars suberosus, and Rourea minor, pharmacological activity experiments were performed using isolated compounds, which have the highest current pharmacological potential. Studies employing a toxicological approach cover only 10 of the 39 Connaraceaes species. Thus, scientific community should conduct much more research for a broader understanding of this plant family.

Pharmacokinetics and Biodistribution of Thymoquinone-loaded Nanostructured Lipid Carrier After Oral and Intravenous Administration into Rats

Background

Thymoquinone (TQ), an active compound isolated from Nigella sativa, has been proven to exhibit various biological properties such as antioxidant. Although oral delivery of TQ is valuable, it is limited by poor oral bioavailability and low solubility. Recently, TQ-loaded nanostructured lipid carrier (TQ-NLC) was formulated with the aim of overcoming the limitations. TQ-NLC was successfully synthesized by the high-pressure homogenization method with remarkable physiochemical properties whereby the particle size is less than 100 nm, improved encapsulation efficiency and is stable up to 24 months of storage. Nevertheless, the pharmacokinetics and biodistribution of TQ-NLC have not been studied. This study determined the bioavailability of oral and intravenous administration of thymoquinone-loaded nanostructured lipid carrier (TQ-NLC) in rats and its distribution to organs.

Materials and Methods

TQ-NLC was radiolabeled with technetium-99m before the administration to the rats. The biodistribution and pharmacokinetics parameters were then evaluated at various time points. The rats were imaged at time intervals and the percentage of the injected dose/gram (%ID/g) in blood and each organ was analyzed.

Results

Oral administration of TQ-NLC exhibited greater relative bioavailability compared to intravenous administration. It is postulated that the movement of TQ-NLC through the intestinal lymphatic system bypasses the first metabolism and therefore enhances the relative bioavailability. However, oral administration has a slower absorption rate compared to intravenous administration where the AUC_0-∞ was 4.539 times lower than the latter.

Conclusion

TQ-NLC had better absorption when administered intravenously compared to oral administration. However, oral administration showed greater bioavailability compared to the intravenous route. This study provides the pharmacokinetics and biodistribution profile of TQ-NLC in vivo which is useful to assist researchers in clinical use.

Phytochemistry, pharmacological activities and uses of traditional medicinal plant Kaempferia galanga L. - An overview

ETHNOPHARMACOLOGICAL RELEVANCE

Kaempferia galanga L. is a stemless, rhizomatous, aromatic, perennial and indigenous herb. It is native to India and distributed in China, Bangladesh, Myanmar, Sri Lanka, Japan, Thailand, Indonesia, Malaysia, Vietnam, Laos, Sudan, Nigeria and South Africa. It is an important Indian medicinal herb that has a long history of use in the treatment of several kinds of human ailments including vata ailments like cough and cold, fever, headache, pains disorders, skin diseases, rheumatic diseases, arthritis, joint fractures, vertigo, wounds, gastritis, antidote for snake venoms, inflammation, blood vomiting, mouth sores and tongue blisters in infants. Moreover, the rhizomes of this plant are highly aromatic and have been used widely as spices, in food flavoring, pickles, cosmetics and in perfumery products.

AIM OF THE REVIEW

This paper aimed to provide a critical review of current scenario on K. galanga. This review provides a current data on diversity, phytochemistry, pharmacological activities and traditional uses of K. galanga.

MATERIALS AND METHODS

The information and data on K. galanga were collated from various resources like ethnobotanical textbooks and literature databases such as PubMed, Science Direct, Wiley, Springer, Tailor and Francis, Scopus, Inflibnet, Google and Google Scholar.

RESULTS

The forty-nine phytochemicals including esters, terpenoids, flavonoids, thiourea derivatives, polysaccharides, diarylheptanoids, phenolic acids, phenolic glycoside and cyclic lipodepsipeptide have been hitherto isolated and characterized. The major bioactive compounds extracted from the rhizome of K. galanga were ethyl p-methoxycinnamate, ethyl cinnamate, kaempferol, kaempferide, kaempsulfonic acids, kaemgalangol A, xylose, cystargamide B and 3-caren-5-one. Various studies demonstrated that the K. galanga and its constituents possess several pharmacological activities like antimicrobial, antioxidant, amebicidal, analgesic, anti-inflammatory, anti-tuberculosis, anti-dengue, anti-nociceptive, anti-angiogenic, anticancer, hyperlipidemic, hypopigmentary, osteolysis, larvicidal, insecticidal and mosquito repellent, nematocidal, sedative, sniffing, vasorelaxant and wound healing.

CONCLUSION

Kaempferia galanga L. is a valuable medicinal plant which is used traditionally in India to treat a wide variety of ailments. A number of bioactive phytochemicals like esters, terpenoids, flavonoids, polysaccharides, diarylheptanoids, cyclic lipodepsipeptide, phenolic acids and glucoside have been isolated from the rhizomes of K. galanga by several researchers. These phytochemicals are highly bioactive and exhibit various pharmacological activities.

Asian Medicinal Plants’ Production and Utilization Potentials: A Review

Medicinal plants research in Asia continues to receive significant national and international attention, particularly concerning its multiple roles in poverty alleviation and health care support. However, scientific information on the institutional arrangements, the potentials of different medicinal plants production systems, and the utilization methods, remain highly fragmented. This incomprehensive information base shades the development of a comprehensive research agenda to improve the current body of knowledge, at least in the context of Asia. To address this impasse and propose future research perspectives, we systematically reviewed 247 journal articles, 15 institutional reports, and 28 book chapters. From the reviews, five key lessons are drawn: (i) Asian medicinal plant production systems demonstrate some dynamics, characterized by a gradual but continuous shift from wild gathering to cultivation, (ii) sub-regional variations exist with regards to the appreciation of medicinal plants potentials for traditional healing, modern healthcare and livelihoods support, (iii) knowledge on the effect of multi-scale institutional arrangements (formal and informal) on medicinal plant management practices is fragmented, (iv) very few studies dwell on the challenges of medicinal plants commercialization, particularly with regards to the role of middlemen, boom–bust cycle, raw material readiness, and product quality, and (v) law enforcement, benefit and knowledge sharing, and research and development should be prioritized to serve the interest of medicinal plants production actors. To further extend the body of knowledge on medicinal plants in Asia, we advance the need for empirical investigations on the performance of medicinal plants production systems and their contribution to livelihoods in diverse institutional contexts.

Predictors of SLE relapse in pregnancy and post-partum among multi-ethnic patients in Malaysia

Flare of Systemic Lupus Erythematosus (SLE) may occur during pregnancy and puerperium. We studied the prevalence and factors associated with SLE relapse during pregnancy and post-partum period in a multi-ethnic SLE cohort. Consecutive SLE patients who attended the outpatient clinic were reviewed for previous history of pregnancies in our institution. Patients who had a complete antenatal, delivery, and post-partum follow up were included. Their medical records were retrospectively analysed to assess the disease activity at pre-pregnancy/conception, during antenatal, and post-partum period. Presence of flare episodes during pregnancy and puerperium were recorded. The pregnancy outcomes recorded include live birth, foetal loss, prematurity and intra-uterine growth restrictions (IUGR). Univariate and multivariable logistic regression with generalized estimating equations (GEE) analyses were performed to determine the factors associated with disease relapse and the pregnancy outcomes. A total of 120 patients with 196 pregnancies were included, with a live birth rate of 78.6%. Four (2.0%) were diagnosed to have SLE during pregnancy. The flare rate in pregnancy was 40.1% while post-partum 17.4%. Majority of the relapse in pregnancy occurred in haematological system (62.3%) followed by renal (53.2%), musculoskeletal (22.1%), and mucocutaneous (14.3%). In GEE analyses, active disease at conception was the independent predictor of SLE relapse during and after pregnancy, whereas older maternal age and Malay ethnicity were associated with higher flare during post-partum. HCQ use was significantly associated with reduced risk of flare in univariate analysis but it was no longer significant in the GEE analyses. Presence of disease flare in pregnancy was significantly associated with prematurity. In conclusion, pregnancy in SLE need to be planned during quiescent state as pre-pregnant active disease was associated with disease relapse in both during and after pregnancy. Malay patients had an increased risk of post-partum flare but further larger prospective studies are needed to confirm the association between pregnancies in the different ancestral background.

Women's perspectives towards traditional and complementary medicine used to conceive, during pregnancy and the postpartum period

OBJECTIVES

This study aims to explore pregnant and postpartum women's understanding of the meaning of traditional and complementary medicine (T&CM) and how that may affect their T&CM use.

METHODS

A cross-sectional study was conducted using self-administered questionnaires. Data collected from 374 women were analysed and represented via descriptive statistics.

RESULTS

Out of the 374 participants, 285 (76.2%) reported using at least one type of T&CM to conceive, during pregnancy or in the postpartum period. The majority of the participants identified that T&CM is all about plants or natural products without chemicals or drugs (n = 267, 71.4%, p < .001). The category of T&CM with the highest usage was biological based therapies (n = 272, 95.4%), while the lowest was energy therapies (n = 8, 2.8%). The most commonly used T&CM was the traditional Malay massage (n = 170, 59.6%). The main sources of information and recommendations for using T&CM came from their family members or friends (n = 199, 69.8%). Almost half of the participants incurred minimum expenditures of MYR100 and below on the T&CM used (n = 137, 48.1%) and there was no significant difference between pregnant and postpartum women (p = .056).

CONCLUSION

This study reveals that many women are practising T&CM when trying to conceive and during pregnancy and the postpartum period even though they are aware that there is insufficient evidence on its safety and efficacy. Therefore, further studies are needed in order to gain sufficient clinical evidence that could be used to structure better guidelines for T&CM practices and services in Malaysia.

Artonin E Induces Apoptosis via Mitochondrial Dysregulation in SKOV-3 Ovarian Cancer Cells

Artonin E is a prenylated flavonoid isolated from the stem bark of Artocarpus elasticus Reinw.(Moraceae). This study aimed to investigate the apoptotic mechanisms induced by artonin E in a metastatic human ovarian cancer cell line SKOV-3 in vitro. MTT assay, clonogenic assay, acridine orange and propidium iodide double staining, cell cycle and annexin V analyses were performed to explore the mode of artonin E-induced cell death at different time points. DNA laddering, activation of caspases-3, -8, and -9, multi-parametric cytotoxicity-3 analysis by high-content screening, measurement of reactive oxygen species generation, and Western blot were employed to study the pathways involved in the apoptosis. MTT results showed that artonin E inhibited the growth of SKOV-3 cells, with IC50 values of 6.5±0.5 μg/mL after 72 h treatment, and showed less toxicity toward a normal human ovarian cell line T1074, with IC50 value of 32.5±0.5 μg/mL. Results showed that artonin E induced apoptosis and cell cycle arrest at the S phase. This compound also promoted the activation of caspases-3, -8, and -9. Further investigation into the depletion of mitochondrial membrane potential and release of cytochrome c revealed that artonin E treatment induced apoptosis via regulation of the expression of pro-survival and pro-apoptotic Bcl-2 family members. The expression levels of survivin and HSP70 proteins were also down regulated in SKOV-3 cells treated with artonin E. We propose that artonin E induced an antiproliferative effect that led to S phase cell cycle arrest and apoptosis through dysregulation of mitochondrial pathways, particularly the pro- and anti-apoptosis signaling pathways.