Effects of Chinese medicinal herbs on expression of brain-derived Neurotrophic factor (BDNF) and its interaction with human breast cancer MDA-MB-231 cells and endothelial HUVECs

BACKGROUND

Our previous study demonstrated that an up-regulation of the Brain-Derived Neurotrophic Factor (BDNF) signaling pathway is involved the mechanism causing the recurrence of triple negative breast cancer. The aim of this study is to investigate the effects of commonly used Chinese medicinal herbs on MDA-MB-231 and HUVEC cells and how they interact with BDNF.

METHODS

Human TNBC MDA-MB-231 cells and human endothelial HUVEC cells were used to explore the effect of commonly used Chinese herbal medicines on cancer cells alone, on endothelial cells alone and on cancer cell/endothelial cell interactions; this was done via functional studies, including migration and invasion assays. Furthermore, Western blot analysis and real-time PCR investigations were also used to investigate migration signal transduction, invasion signal transduction, and angiogenic signal transduction in these systems. Finally, the effect of the Chinese medicinal herbs on cancer cell/endothelial cell interactions was assessed using co-culture and ELISA.

RESULTS

In terms of autoregulation, BDNF up-regulated TrkB gene expression in both MDA-MB-231 and HUVEC cells. Furthermore, BDNF enhanced migration by MDA-MB-231 cells via Rac, Cdc42 and MMP, while also increasing the migration of HUVEC cells via MMP and COX-2 expression. As measured by ELISA, the Chinese herbal medicinal herbs A. membranaceus, P. lactiflora, L. chuanxiong, P. suffruticosa and L. lucidum increased BDNF secretion by MDA-MB-231 cells. Similarly, using a co-culture system with MDA-MB-231 cells, A. membranaceus and L. lucidum modulated BDNF-TrkB signaling by HUVEC cells.

CONCLUSION

We conclude that BDNF plays an important role in the metastatic interaction between MDA-MB-231 and HUVEC cells. Some Chinese medicinal herbs are able to enhance the BDNF-related metastatic potential of the interaction between cancer cells and endothelial cells. These findings provide important information that should help with the development of integrated medical therapies for breast cancer patients.

Occupational rhinoconjunctivitis caused by the common indoor plant, Hoya compacta

BACKGROUND

Allergic reactions to the common house plant Hoya compacta (HC) have not previously been described.

AIMS

To confirm HC as the cause of rhinoconjunctivitis in three horticultural workers.

METHODS

Greenhouse working conditions were reproduced in our challenge chamber.

RESULTS

All three cases developed rhinoconjunctivitis when working with HC plants. A control challenge was performed in two cases with iceberg lettuce causing no symptoms. Nasal volume measured by acoustic rhinometry (AR) fell after all three active challenges, but also after one of the control challenges.

CONCLUSIONS

Our study confirms that HC may cause occupational rhinoconjunctivitis and asthma through a Type I hypersensitivity reaction. Specific inhalation challenges, nasal nitric oxide measurement and AR may be useful additional tools in supporting such diagnoses for occupational physicians to consider.

The rise of traditional Chinese medicine and its materia medica: a comparison of the frequency and safety of materials and species used in Europe and China

ETHNOBOTANICAL RELEVANCE

Due to the global rise in the use of traditional Chinese medicine (TCM), Chinese materia medica (medicinal materials, or CMM) are giving cause for concern over their evidence base, safety/possible toxicity, questionable quality and use of endangered species of both animals and plants. However, little if anything is actually known about the range of species used to produce CMM used in Europe and even in China. This study represents the first attempt to identify and compare the most important CMM used in both regions, to begin the process of assessing the risks to public health and possible future benefits.

MATERIALS AND METHODS

Data were collected from a convenience sample of TCM practitioners in the EU and mainland China, using a paper/online survey. Among other questions, respondents were asked (1) which conditions they most commonly treated using CMM and the likelihood of them using herbal manufactured products and decoctions in addition to raw herbs; (2) the perceived frequency with which they observed adverse events to CMM; (3) the frequency and reasons for use of 1 herbal formula and 6 specific individual herbs; (4) an open question about other CMM they used, including materials of non-plant origin. Data were entered into PASW statistics package and analysed using frequency tables, cross-tabulations and chi-squared tests to compare EU and Chinese results.

RESULTS

From a total of 747 useable questionnaires (420 from China, 327 from the EU) of those responding from the EU, TCM was generally more commonly used for obstetric/gynaecological and dermatological conditions, compared to neurological and gastrointestinal diseases in China. Disorders treated by Chinese practitioners were more varied, and often more serious, than those treated by their European counterparts, and the range of materials used in China was wider. The potential for toxicity was not high in either region, but although greater in China due to the use of more potent CMM, the incidence of side effects was perceived to be higher by EU practitioners.

CONCLUSIONS

Very few of the species used to prepare CMM in the EU in this study give rise to safety concerns from what is known from the scientific and other literature, and in China only a few toxic CMM appear to be commonly used, some of them only after processing and mainly for serious disorders. The main cause for concern is likely to be interaction with prescribed medication, especially in central nervous system and cardiovascular conditions where drug interactions have previously been reported most frequently and which would currently be more applicable in China than Europe.

Acute and subchronic toxicity study of tud-rak-ka-sai-puu recipe in rats

Acute and subchronic toxicities of Tud-Rak-Ka-Sai-Puu (TR) recipe were studied in male and female rats. After 14 days of a single oral administration of test substance (5,000 mg/kg body weight), measurement of the body and organs weights, necropsy and health monitoring were performed. No signs and differences in the weights and behavior were observed relative to the control rats, suggesting that TR recipe in the dose of 5,000 mg/kg body weight does not produce acute toxicity. The subchronic toxicity was determined by oral feeding in male and female rats daily with the test substance at 2, 20, 200 and 2,000 mg/kg body weight for 90 days. No defects of animal behavior were observed in the test groups. Both test and control groups (on the 90(th) day) as well as the satellite group (on the 118(th) day) were analyzed by measuring their final body and organ weights, taking necropsy, and examining hematology, blood clinical chemistry, and microanatomy. These results together with the information of signs, behavior and health monitoring can lead to a conclusion that an oral administration of TR recipe at 2, 20, 200 and 2,000 mg/kg body weight for 90 days did not cause subchronic toxicity.

[Clinical characteristics and long-term follow-up analysis of three cases with newborn aristolochic acid nephropathy]

OBJECTIVE

To summarize the clinical characteristics and prognosis of newborn aristolochic acid nephropathy induced by akebia.

METHOD

Retrospective analysis of clinical manifestations, therapy and prognosis was made upon data of 3 newborn infants with renal function lesion induced by akebia.

RESULT

Three infants who were fed with Chinese herbal medicines containing akebia trifoliate suffered from acute renal failure, renal glomerular and tubular injury, with symptoms of vomiting, diarrhea, and oliguria. Laboratory tests manifested hyperpotassemia, hyponatremia, elevation of serum creatinine and urea nitrogen, and metabolic acidosis. Renal glomerular lesion was mild, presented with proteinuria and increased serum β(2) microglobin. Renal dysfunction was manifested with alkaline urine, glucosuria, positiveness of urine glucose, ketone and aminoaciduria, and increased urine β(2) microglobin excretion. After symptomatic treatment for 3 to 4 weeks, the renal function of these infants recovered. Proteinuria, aminoaciduria and glucosuria turned negative within 5 to 8 months, 3 months to 1 year, and 9 months to 3 years, respectively. Urine pH decreased to 7.0 after 5.0 - 5.5 years. All cases took citric acid mixtures for 5.5 to 6 years. A 12-years follow-up demonstrated that serum creatinine of 3 cases were within normal range during the first 11 years of life, however recent follow-up showed increased serum creatinine of case 1 and case 2, except for serum creatinine of case 3 remained normal. The estimated glomerular filtration rate (eGFR) of all the 3 cases decreased. Among which, eGFR of case 1 and case 2 were lower than 90 [ml/(min·1.73 m(2))], and decreased 1.1 [ml/(min·1.73 m(2))] and 0.6 [ml/(min·1.73 m(2))] per year during recent six years, respectively. No obvious decrease of eGFR was observed in case 3. Blood gas analysis and urine routine were normal, yet blood and urine β(2) microglobin excretion were still high. Urinary N-acetyl-β-D-glucosaminidase increased again after having returned to normal.

CONCLUSION

Newborn aristolochic acid nephropathy induced by akebia might induce acute renal failure and renal tubules injury. Renal function could recover after symptomatic treatment in short-term. Nevertheless, glomerular filtration rate presents a slow descending tendency and renal tubules lesion lasted for many years, which requires a long-term follow-up.

The effect of use of dates on serum potassium in nondiabetic hemodialysis patients

Hyperkalemia is common in patients with ESRD and may contribute to mortality. Dates have been reported to be high in potassium content. One of the concerns on hemodialysis (HD) is convincing patients to give up ingestion of dates as a part of their diet. To determine the effect of dates on serum potassium on patients, we studied 9 (M: F, 6:3, mean age 47.6) non diabetic patients on chronic hemodialysis, without evidence of hyperkalemia on monthly labs. Nearly all the patients had been on dialysis for an average of four years. The average monthly potassium was 4.6 mmol/L. The patients ingested 100 gm of dates (Rothana and Sukari) on two separate dialysis sessions. Serum potassium was measured at two and four hours post ingestion along with ECG monitoring. The patients underwent their regular dialysis as scheduled. The patients acted as their own controls and underwent the same protocol with 20meq of KCl on a separate session. The potassium levels did not change significantly over the four hours with either variety of dates or with potassium solution. Combining the two types of dates resulted in a trend towards higher potassium levels than with KCl, but it did not reach statistical significance. We conclude that in selected HD patients without hyperkalemia, ingestion of a few dates does not cause significant hyperkalemia and could be allowed on days of dialysis prior to their dialysis sessions.

Herbal medicine in the treatment of liver diseases

Herbal drugs have become increasingly popular and their use is widespread. Licensing regulations and pharmacovigilance regarding herbal products are still incomplete and clearcut proof of their efficacy in liver diseases is sparse. Nevertheless, a number of herbals show promising activity including silymarin for antifibrotic treatment, phyllantus amarus in chronic hepatitis B, glycyrrhizin to treat chronic viral hepatitis, and a number of herbal combinations from China and Japan that deserve testing in appropriate studies. Apart from therapeutic properties, reports are accumulating about liver injury after the intake of herbals, including those advertised for liver diseases. Acute and/or chronic liver damage occurred after ingestion of some Chinese herbs, herbals that contain pyrrolizidine alkaloids, germander, greater celandine, kava, atractylis gummifera, callilepsis laureola, senna alkaloids, chaparral and many others. Since the evidence supporting the use of botanicals to treat chronic liver diseases is insufficient and only few of them are well standardised and free of potential serious side effects, most of these medications are not recommended outside clinical trials. Particularly with regard to the latter, adequately powered randomised-controlled clinical trials with well-selected end points are needed to assess the role of herbal therapy for liver diseases.

Incidence of pollinosis in the city of A Coruña: correlation with aerobiological data

An atmospheric pollen count was carried out in the city of A Coruña during 1999 using two pollen traps located at two different points in the city. A total number of 6979 and 3536 pollen grains, respectively, were identified, the majority during the Spring and Summer. Further, patients living near the pollen traps were selected from among those diagnosed as suffering from respiratory allergies by the Allergy Department of A Coruña's Juan Canalejo Hospital. The patients had at least one positive skin test for some pollen type, had not received immunotherapy in the last year, and were willing to fill in a symptoms booklet during the study period. The results obtained reveal the pollen types that produce the greatest number of skin sensitization cases (Poaceae, Plantago, Chenopodium and Parietaria), with a positive correlation between the atmospheric pollen concentration of such taxa and the frequency of allergy symptoms. This has enabled the setting of pollen values, above which A Coruña's inhabitants are considered to be at risk.

Accumulation of sapogenin conjugates and histological changes in the liver and kidneys of lambs suffering from alveld, a hepatogenous photosensitization disease of sheep grazing Narthecium ossifragum

Sixteen lambs exhibiting hepatogenous photosensitization (alveld) after grazing pasture containing Narthecium ossifragum and seven nonphotosensitized lambs grazing the same pastures were studied. All the alveld-affected lambs revealed liver damage dominated by single cell necrosis, portal fibroplasia and bile duct proliferation. Crystalloid clefts were demonstrated in the bile ducts of two and in the hepatocytes and Kupffer cells of nine photosensitized lambs. Plasma bilirubin concentration was severely increased in ten of the cases of alveld whereas the activity of aspartate aminotransferase was moderately to severely increased in seven cases. The activity of glutamate dehydrogenase was moderately elevated in one of the photosensitized lambs. The main histopathological findings in the kidneys from the alveld-affected lambs were dilated tubules, often with eosinophilic material in the tubular lumina. Regenerative changes were seen in a large proportion of the renal sections. Elevated plasma concentrations of urea and creatinine, and the renal histopathological changes, suggested that the photosensitized lambs had been through a phase of renal injury. Analysis of the free and conjugated sapogenin content in liver tissue and bile was performed by gas chromatography-mass spectrometry. There were significantly higher concentrations of conjugated episapogenins in both the liver and bile in the alveld-affected lambs than in the nonphotosensitized lambs.

Hypersensitivity to common tree pollens in New York City patients

Testing for tree pollen hypersensitivity typically requires the use of several tree pollens. Identifying patterns of cross-sensitivity to tree pollens could reduce the number of trees used for testing. The goal of this study was to relate reported tree pollen levels to hypersensitivity patterns. Three hundred seventy-one allergy patients were tested serologically for hypersensitivity toward prevalent tree pollens in the surrounding New York area over the years 1993-2000. Specific tree pollens that were examined included oak (Quercus alba), birch (Betula verrucosa), beech (Fagus grandifolia), poplar (Populus deltoides), maple (Acer negundo), ash (Fraxinus americana), hickory (Carya pecan), and elm (Ulmus americana). Statistical analysis of the levels of hypersensitivity was performed to identify correlations and grouping factors. Pollen levels, obtained from published annual pollen and spore reports, were characterized and related to the prevalence of hypersensitivity for the various trees. The highest prevalence of hypersensitivity (score > or = class 1) was for oak (34.3%), birch (32.9%), and maple (32.8%) tree pollens. Lower prevalences were observed for beech (29.6%), hickory (27.1%), ash (26%), elm (24.6%), and poplar (20.6%) trees. Significant correlations were observed between oak, birch, and beech radioallergosorbent test scores. Factor analysis identified two independent pollen groups with oak, birch, and beech consisting of one group and the other five tree pollens constituting the other group. Peak pollen counts clearly were highest for oak, birch, and maple trees. The peak pollen counts corresponded roughly to seropositivity prevalences for the tree pollens. When elm, poplar, and beech test scores were not used to identify patients who were allergic to tree pollens, only 1 of 106 patients with any positive tree radioallergosorbent test score was missed. It is concluded that in the New York City area, hypersensitivity to tree pollens most often is manifested with allergy to oak, birch, and maple tree pollens. Identifying beech, poplar, and elm hypersensitivity adds little toward identifying patients who are allergic to tree pollens. This may relate in part to cross-reactive epitopes. These data suggest that these three trees can be eliminated from testing with only a < 1% loss of sensitivity.

[Nil nocere! Phytotherapy causing nephropathy]

The summary draws attention to the nephropathy caused by "Chinese tea", with all its attendant risks that lead to organ damage. Available data from the literature describe more than 100 women who, at various times, underwent long-term slimming courses by taking two types of Chinese tea containing tablets, namely, Stefania tetranda and Magnolia officinalis. The nephropathy is characterized by severe anemia, tubular proteinuria, histologically chronic ischaemic, interstitial nephritis, accelerated decline in kidney function, and epithelial cell dysplasia of the urinary tract, with consequent inclination towards malignant transformation. The clinical and histological picture resembles that of the Balkan nephropathy. Apart from all these a proportion of the patients may develop aorta insufficiency. The author emphasises the hazards in one of the branches of alternative medicine, fitotherapy, and their prevention.

Herbs and the perioperative patient

Herbs are claimed to cure or correct many ills, and in the United States, they are classified as dietary supplements. The Federal Trade Commission, rather than the US Food and Drug Administration, has primary responsibility for dietary supplements, so companies may make claims about herbs that are unsubstantiated by research. Perioperative nurses should be aware of herb usage, interactions with other traditional medications, and herbs effects on perioperative patients.

[Dermatitis from contact with Agave americana]

Various plants induce dermatitis in man. There have been only a few published cases of contact dermatitis caused by Agave americana (AA). We report intentional exposure to AA in a soldier seeking sick leave, and review our previously reported cases. Treatment with oral antihistamines and topical saline compresses resulted in subsidence of the systemic symptoms within 24 h and regression of cutaneous manifestations in 7-10 days. Physicians should be alert to the possibility of self-inflicted contact dermatitis induced by exposure to plants, especially to A. americana. Systemic signs may accompany the cutaneous lesions.

Adult syncytial giant cell chronic hepatitis due to herbal remedy

Syncytial giant cell hepatitis is an uncommon form of chronic hepatitis in adults, although it has been reported in association with viral infection (including HCV and HIV infection), drug reactions and autoimmune disorders. We here report a very unusual case of giant cell chronic hepatitis in a 26-old-woman, who had been taking a herbal remedy (ISABGOL) for chronic constipation. The presence of viral and metabolic diseases has been excluded; an autoimmune etiology was very unlikely as the autoimmunity test remained negative during the year of follow-up and the total disease score normalized (from 13 to 8) without corticosteroid treatment. The causative role of the herbal remedy was further supported by the spontaneous and dramatic clinical, biochemical and histologic improvement observed following its withdrawal, despite the absence of any treatment.

Potential interactions between alternative therapies and warfarin

Potential and documented interactions between alternative therapy agents and warfarin are discussed. An estimated one third of adults in the United States use alternative therapies, including herbs. A major safety concern is potential interactions of alternative medicine products with prescription medications. This issue is especially important with respect to drugs with narrow therapeutic indexes, such as warfarin. Herbal products that may potentially increase the risk of bleeding or potentiate the effects of warfarin therapy include angelica root, arnica flower, anise, asafoetida, bogbean, borage seed oil, bromelain, capsicum, celery, chamomile, clove, fenugreek, feverfew, garlic, ginger ginkgo, horse chestnut, licorice root, lovage root, meadowsweet, onion, parsley, passionflower herb, poplar, quassia, red clover, rue, sweet clover, turmeric, and willow bark. Products that have been associated with documented reports of potential interactions with warfarin include coenzyme Q10, danshen, devil's claw, dong quai, ginseng, green tea, papain, and vitamin E. Interpretation of the available information on herb-warfarin interactions is difficult because nearly all of it is based on in vitro data, animal studies, or individual case reports. More study is needed to confirm and assess the clinical significance of these potential interactions. There is evidence that a wide range of alternative therapy products have the potential to interact with warfarin. Pharmacists and other health care professionals should question all patients about use of alternative therapies and report documented interactions to FDA's MedWatch program.

[High temperature "matè" infusion drinking in a population at risk for squamous cell carcinoma of the esophagus]

"Matè", a popular hot infusion of a herb (Ilex paraguayensis) drunk in large volumes, is a known risk factor for squamous cell carcinoma of the esophagus and there is a suspicion that high temperature of boiled water used for the infusion may contribute for carcinogenesis.

METHODS

We measured the temperature of "matè" infusion drunk by a sample of the population at risk for this carcinoma in Taquara, southern Brazil. We interviewed inhabitants for drinking habits and the temperature of the infusion was measured with high precision thermometers. Temperature of the infusion was asked to consumers and their estimate compared to our measurements. We considered 60 degrees C or higher as "hot".

RESULTS

In 36 residencies, 107 individuals were drinking "matè". Most individuals drank it daily (97.2%), and the medium daily volume was 1,265 ml (SD +/- 1,132 mL) ranging from 250 to 6,000 mL. The measured temperature was 60 degrees C or higher in 72% of residencies with medium of 63.4 degrees C (51-78 degrees C) and median 64.4 degrees C.

CONCLUSION

In this study, "matè" was consumed in large volumes at high temperature and individuals did not estimate correctly the temperature of infusion. High temperatures of "matè" may contribute to carcinogenesis in this population.

Safety issues with herbal products

OBJECTIVE

To review safety issues associated with the use of herbal products.

DATA SOURCES

Literature accessed through MEDLINE and other Internet search engines. Key search terms included herbs, dietary supplements, and safety.

DATA SYNTHESIS

A misconception exists among consumers that herbal remedies are safe because they are natural. In an effort to provide healthcare practitioners with information necessary for a patient discussion, a review of safety concerns with herbal products was conducted.

CONCLUSIONS

Several safety concerns exist with herbal products including lack of safety data, absence of quality-control requirements for potency and purity, and lenient labeling standards.

Natural remedies recommended for the management of oral health

This paper discusses various practices recommended by homeopaths, herbalists, spiritual and natural healers for the management and maintenance of oral health. It is intended as a partial guide to educate the dental professional on self-administered, over-the-counter remedies that are easily available to the general population. Since few if any clinical studies exist assessing the efficacy or side effects of these ingested products, little is known about the beneficial or potentially harmful course these remedies may take on the human body.

Allergic alveolitis due to herb dust exposure

We report an episode of allergic alveolitis in a female farmer due to massive exposure to organic dust contaminated with microorganisms during threshing of herbs (thyme). The patient's medical history, the results of exposure test, inhalation challenge, and bronchoalveolar lavage suggested the diagnosis of allergic alveolitis

Herbs as medicines

Herbs and related products are commonly used by patients who also seek conventional health care. All physicians, regardless of specialty or interest, care for patients who use products that are neither prescribed nor recommended. Some herbs have been extensively studied, but little is known about others. When a patient asks for advice regarding the use of a particular herb, how should a physician respond? Similarly, how does a physician determine if a patient's symptoms are caused by a "remedy"? This review attempts to answer these questions by investigating pertinent definitions, the history of herbs in medicine, epidemiology and prevalence of herbal use, and relevant psychosocial issues.

Harmless herbs? A review of the recent literature

Herbal medicines have become a popular form of therapy. They are often perceived as being natural and therefore harmless. This article reviews the recent literature on the adverse effects of herbal remedies. Examples of allergic reactions, toxic reactions, adverse effects related to an herb's desired pharmacological actions, possible mutagenic effects, drug interactions, drug contamination, and mistaken plant identities are provided. Because of underreporting, our present knowledge may well be just the "tip of the iceberg." Little is known about the relative safety of herbal remedies compared to synthetic drug treatments, although for some herbal remedies, the risks may be less than for conventional drugs.

A review of some herbal and related products commonly used in cancer patients

In light of the research in progress on the benefits of various phytochemicals in foods, it appears feasible that the chemical compounds from herbs also could be helpful in prevention or treatment of cancer and other diseases. Prior to 1994, the burden of proving that a product was not harmful was the manufacturer's responsibility. Now the FDA has to prove beyond a doubt that the product is unsafe to remove it from the market. Product standardization is optional at this point, and substitution with less expensive herbs presents a risk. The FDA soon will publish a proposal for good manufacturing practices that was developed by a coalition of supplement organizations to assist in establishing quality control. Dietetics professionals can contribute value in this area by talking with patients, keeping interested physicians informed, and maintaining information on alternative therapies.

Occupational asthma caused by aromatic herbs

We describe a subject with occupational asthma caused by several aromatic herbs: thyme, rosemary, bay leaf, and garlic. The diagnosis was confirmed by several inhalation challenges in the laboratory. Although immediate skin reactivity was demonstrated to the herbs the subject reacted to by inhalation, RAST showed that garlic was the most potent allergen by weight, the other herbs showing less reactivity. These aromatic herbs, bay leaf, thyme, and rosemary, should be included among agents causing occupational asthma in the food industry.

Mate drinking and risk of lung cancer in males: a case-control study from Uruguay

During the period from January 1988 to December 1994, a case-control study that included 497 cases of lung cancer and 497 controls was carried out at the Instituto de Oncologia, Montevideo, Uruguay, to evaluate the relationship between the drinking of mate (a local tea prepared with infusions of the herb Ilex paraguariensis) and the risk of lung cancer in men. Mate drinking has been associated with risk of most upper-aerodigestive tract cancers. After adjusting for major covariates, including pack-years of cigarette smoking, the amount of mate was associated with a 1.6-fold increase in risk for heavy drinkers, compared with light drinkers, with a significant dose-response pattern. When the analysis was performed by cell type, small cell lung cancer showed a significant increase in relative risk for mate amount (odds ratio, 2.9; 95% confidence interval, 1.3-6.2) and mate duration (odds ratio, 3.6; 95% confidence interval, 1.3-9.9). On the other hand, pulmonary adenocarcinoma was not associated with mate drinking. Possible reasons for these results are discussed, and areas for future research are suggested.

Labiatae allergy: systemic reactions due to ingestion of oregano and thyme

BACKGROUND

There are no cases described in the medical literature of systemic allergic reactions due to oregano (Origanum vulgare) or thyme (Thymus vulgaris). These herbs belong to the Lamiaceae (Labiatae) family which comprises other plants such as hyssop (Hyssopus officinalis), basil (Ocimum basilicum), marjoram (Origanum majorana), mint (Mentha piperita), sage (Salvia officinalis) and lavender (Lavandula officinalis).

OBJECTIVE

We describe three systemic allergic reactions caused by oregano and thyme in the same patient.

METHODS

Skin tests with inhalant allergens and plants of the Labiatae family were done. We used the prick by prick technique with dried commercial plants and prick tests with extracts prepared with the Frugoni method in our patient and in ten control patients. Total serum IgE was determined by Phadezym IgE PRIST (Pharmacia). Specific IgE was measured by two methods: CAP system (Pharmacia) and Phadezym RAST (Pharmacia Diagnostics, Uppsala, Sweden) with activated discs of the allergenic extracts that were prepared in our laboratory.

RESULTS

Skin tests with inhalants were positive to grasses. Skin tests with plants of the Labiatae family were positive in all cases when the skin prick technique was used; tests were negative with basil and lavender, and positive with all the others when we used the prick by prick technique. We did not detect any positive skin tests nor specific IgE to plants of the Labiatae family in control patients. Total serum IgE was 406 U/mL. Specific IgE was detected to all herbs tested; higher levels were obtained with the CAP system.

CONCLUSIONS

Plants belonging to the Labiatae family seem to show cross-sensitivity on the basis of clinical history and in vitro and in vivo test results.

The acidogenic potential of herbal baby drinks

The acidogenic potential of a range of commonly available herbal baby drinks was assessed on the basis of their ability to depress plaque pH in vivo in 10 adult volunteers using the plaque harvesting technique. In addition the pH and inherent acidity of each drink was also analysed in vitro. Solutions of 10% sucrose was used as a positive control and full fat milk served as a negative control as it has traditionally been recommended as a safe drink. Three of the six test drinks had a low pH though most had a low titratable acidity. All drinks, except herbal tea, on rising led to a significant drop in the plaque pH to near critical pH value of 5.5. Most drinks were also more acidogenic than milk and some behaved essentially similar to a 10% sucrose solution. The area under the curve below the resting pH was highest for apple and raspberry herbal drink (20.51 +/- 3.66) and was the least for herbal tea (0.00) compared with the 10% sucrose control (22.01 +/- 2.87) and milk (0.07 +/- 0.14). It was concluded that most herbal drinks tested, especially those with added fruit, can lead to a significant acid production in the plaque and therefore have a potential to cause demineralisation of the enamel.

Hot and cold mate drinking and esophageal cancer in Paraguay

A hospital-based case-control study, including 131 cases of esophageal cancer and 381 controls, was carried out in Paraguay to investigate the role of hot and cold mate drinking in esophageal cancer risk. Detailed information on mate drinking and on tobacco smoking, alcohol consumption, and dietary habits was obtained by interview. Amount and duration of cold or hot mate drinking were not associated with esophageal cancer risk. However, temperature at which mate was drunk was significantly associated with risk. As compared to drinkers of warm or hot mate, drinkers of very hot mate had an increased risk for esophageal cancer even after adjusting for the strong effects of alcohol and tobacco consumption (adjusted odds ratio = 2.4; 95% confidence interval = 1.3-4.3). This effect seemed to be mainly due to the temperature at which mate cocido (one of the two ways in which hot mate is prepared) was drunk (odds ratio = 6.5; 95% confidence interval = 3.2-12.2). As expected, very strong dose-response associations were found for alcohol consumption and cigarette smoking. After correcting for these and the consumption of other food groups, diets rich in fats and red meats, especially beef, were associated with esophageal cancer risk. In conclusion, the findings from this study suggest that cold mate drinking does not increase the risk of esophageal cancer. This study identifies the very hot temperature at which mate is drunk, and not the amount or the duration, as an important risk factor for esophageal cancer in this population. Alcohol drinking and tobacco smoking remain, nevertheless, the main risk factors for esophageal cancer in Paraguay.

Maté, coffee, and tea consumption and risk of cancers of the upper aerodigestive tract in southern Brazil

Consumption of maté, a tea-like infusion of the herb Ilex paraguariensis, is common in South America. Drinkers have high risks of upper aerodigestive tract cancers, but it is conceivable that this high risk may be attributable to confounding by smoking alcohol, and other exposures. To test this hypothesis, we analyzed the data from a case-control study of upper aerodigestive tract cancers conducted in Southern Brazil. We matched noncancer controls (N = 756) to cases (N = 378) on the basis of age, sex, and period of admission. We estimated the effect of mateé consumption by conditional logistic regression with adjustment for smoking, alcohol, sociodemographics, and several dietary items, considered as confounders. The unadjusted relative risk (RR) for all upper aerodigestive tract cancers was 2.1 [95% confidence interval (CI) = 1.6-2.7]. Some excess risk persisted after adjustment for potential confounders (RR = 1.6; 95% CI = 1.2-2.2). Most of the excess risk for maté drinkers was for oral (RR = 1.9; 95% CI = 1.1-3.3) and laryngeal (RR = 2.2; 95% CI = 2.2; 95% CI = 1.1-4.5) cancers. There was no evidence of associations with coffee and tea drinking. We conclude that the association of maté consumption with upper aerodigestive tract cancer risk is unlikely to result from insufficient control of confounding by critical exposures. Owing to its high prevalence in Southern South America, maté drinking may be linked to as many as 20% of all cases occurring in this region.