Toxicological Effects of Glycyrrhiza glabra (Licorice): A Review

Fermented milk containing Lactobacillus paracasei and Glycyrrhiza glabra has a beneficial effect in patients with Helicobacter pylori infection: A randomized, double-blind, placebo-controlled study

BACKGROUND

Lactobacillus paracasei and Glycyrrhiza glabra have been reported as having beneficial effects on Helicobacter pylori infection. We aimed to assess the efficacy and safety of fermented milk containing L paracasei HP7 and G glabra in patients with H pylori infection.

METHODS

This multicenter, prospective, randomized, double-blind, placebo-controlled clinical trial was conducted in 2 hospitals from April to December 2017. Patients with H pylori infection were randomized into either the treatment group (fermented milk with L paracasei HP7 and G glabra) or placebo group (fermented milk only) once daily for 8 weeks. The primary endpoint was the gastric load of H pylori measured by C-urea breath test (UBT). Secondary endpoints were histologic and clinical improvement.

RESULTS

A total of 142 patients were randomly allocated to the treatment (n = 71) or placebo groups (n = 71). Compared to baseline data, the quantitative value of C-UBT at 8 weeks was significantly reduced in the treatment group (from 20.8 ± 13.2% to 16.9 ± 10.8%, P = .035), but not in the placebo group (P = .130). Chronic inflammation improved significantly only in the treatment group (P = .013), whereas the neutrophil activity deteriorated significantly only in the placebo group (P = .003). Moreover, the treatment group had significant improvement in gastrointestinal symptoms (P = .049) and quality of life (P = .029). No serious adverse events were observed.

CONCLUSION

The combination of fermented milk containing L paracasei and G glabra reduced H pylori density and improved histologic inflammation. However, their mechanisms of action should be elucidated in further studies.

The Sex-Gender Effects in the Road to Tailored Botanicals

Phenols are a wide family of phytochemicals that are characterized by large chemical diversity and are considered to bioactive molecules of foods, beverages, and botanicals. Although they have a multitude of biological actions, their beneficial effects are rarely evidenced in clinical research with high scientific rigor. This may occur due to the presence of numerous confounders, such as the modulation of phenol bioavailability, which can be regulated by microbiota, age, sex-gender. Sex-gender is an important determinant of health and well-being, and has an impact on environmental and occupational risks, access to health care, disease prevalence, and treatment outcomes. In addition, xenobiotic responses may be strongly influenced by sex-gender. This review describes how sex–gender differentially influences the activities of phenols also in some critical periods of women life such as pregnancy and lactation, considering also the sex of fetuses and infants. Thus, sex–gender is a variable that must be carefully considered and should be used to propose directions for future research on the road to tailored medicine and nutrition.

Medications and Vocal Function

Medications can have innumerable direct and indirect effects on laryngeal hydration, vocal fold mucosal integrity, laryngeal muscle function, and laryngeal sensation. Effects, therefore, can be subtle and slowly progressive over time. This article delineates the general classes of medications that are known to cause alterations of vocal function, highlights medical history symptoms that may help raise suspicion for medication-related vocal changes, and presents recommendations for approaches to treatment of these issues.

Natural products in licorice for the therapy of liver diseases: Progress and future opportunities

Liver diseases related complications represent a significant source of morbidity and mortality worldwide, creating a substantial economic burden. Oxidative stress, excessive inflammation, and dysregulated energy metabolism significantly contributed to liver diseases. Therefore, discovery of novel therapeutic drugs for the treatment of liver diseases are urgently required. Licorice is one of the most commonly used herbal drugs in Traditional Chinese Medicine for the treatment of liver diseases and drug-induced liver injury (DILI). Various bioactive components have been isolated and identified from the licorice, including glycyrrhizin, glycyrrhetinic acid, liquiritigenin, Isoliquiritigenin, licochalcone A, and glycycoumarin. Emerging evidence suggested that these natural products relieved liver diseases and prevented DILI through multi-targeting therapeutic mechanisms, including anti-steatosis, anti-oxidative stress, anti-inflammation, immunoregulation, anti-fibrosis, anti-cancer, and drug-drug interactions. In the current review, we summarized the recent progress in the research of hepatoprotective and toxic effects of different licorice-derived bioactive ingredients and also highlighted the potency of these compounds as promising therapeutic options for the treatment of liver diseases and DILI. We also outlined the networks of underlying molecular signaling pathways. Further pharmacology and toxicology research will contribute to the development of natural products in licorice and their derivatives as medicines with alluring prospect in the clinical application.

An ethnobotanical survey of medicinal plants used for diabetes treatment in Rabat, Morocco

Diabetes mellitus is a major public health problem in Morocco. The value of ethnobotanical information is now increasingly acknowledged. To inventory and to provide ethnobotanical information on some of the medicinal plants used in traditional medicine to treat diabetes in Rabat (Morocco), a survey was undertaken from March 1^st to April 30^th 2018. This survey was conducted using a semi-structured questionnaire targeting diabetic patients from the SOS Diabetes Center. 334 diabetic patients were interviewed. Of this group, 53.6% (34 men and 145 women) use medicinal plants to control their diabetes. 47.2% have type 2 diabetes and 52.5% have type 1diabetes. Thirty plant species belonging to 18 botanical families were recorded for the treatment of diabetes. The most represented families were Lamiaceae with 8 species followed by Fabaceae with 3 species. Based on the highest number of users, the most important species were Trigonella foenum-graecum L. (15.4%), Salvia officinalis L. (13.3%) and Olea europaea L. (10.8%). Leaves (47.5%), seeds (20.2%) and stem (17.6%) were the parts predominantly used to prepare the formulations, which were mainly infusions (50.9%), administrated by the oral route (98.9%). Some plants were used only by type 1 diabetics while others were used by type 2 diabetics. The observed adverse events related to the use of medicinal plants were represented by occasional heartburn in 2.2% of diabetic patients. This study is the first to collect and document information on medicinal plants and how they are used by diabetic patients. Calamintha alpina L. is reported for the first time at the international level as used in traditional treatment of diabetes and seven others were reported as new medicinal plants used to treat diabetes in Morocco. This will extend the list of plants already mentioned as used for diabetes. Further research should be carried out to validate the antidiabetic uses of most of these plant species.

An experimental in-vitro study to evaluate the anti-helicobacter activity of Glycyrrhetinic acid

Aim: The aim of this study was to investigate the in-vitro efficacy of Glycyrrhetinic acid against Helicobacter pylori (H. pylori) strains, as compared with conventional antibacterial agents.

Methods: A total of 41 H. pylori isolates were used, 6 of which were of standard strains (NCTC 1637), 8 of which were drug-sensitive, and 27 were resistant to drugs isolates. Clarithromycin and metronidazole resistance in all strains of H. pylori were determined by the Epsilometer test (E-test) method. MIC study was performed by using microdilution broth method.

Results: Glycyrrhetinic acid was found to be effective against H. pylori NCTC 1637 in doses of 12.0±4.38 µg/mL, while the MIC value of clinical H. pylori isolates susceptible to antimicrobials was 20.8±10.11 µg/ml. It was found that the MIC values for antimicrobial-sensitive clinical H. pylori isolates was higher when compared with H. pylori NCTC 1637 strains. The MIC values of the standard antimicrobial agents against drug-resistant H. pylori strains were higher than H. pylori NCTC 1637 strains and drug-sensitive H. pylori strains. The MIC value was found to be 14.22±7.77 µg/ml for metronidazole, 3.89±1.90 µg/ml for clarithromycin, 2.33±1.0 µg/ml for amoxicillin, 2.44±0.88 µg/ml for levofloxacin and 4.89±2.47 µg/ml for tetracycline, whereas the MIC value of Glycyrrhetinic acid was 26.67±8.0 µg/ml in metronidazole-resistant H. pylori isolates. Besides, MIC values of the antimicrobials and 18ß-Glycyrrhetinic acid among the strains resistant to clarithromycin were as follows: 3.25±2.12 µg/ml for metronidazole, 9.71±4.54 µg/ml for clarithromycin, 2.06±1.32 µg/ml for amoxicillin, 3.88±4.22 µg/ml for levofloaxacin and 3.25±1.04 µg/mL for tetracycline and 22.0±11.11 µg/ml for Glycyrrhetinic acid.

Conclusion: Glycyrrhetinic acid had significant antimicrobial activity against H. pylori strains. Although further in-vivo studies are needed on antimicrobial activity of Glycyrrhetinic acid, increased resistance to drugs currently used in treatment suggests that Glycyrrhetinic acid may be a potential agent for the treatment of H. pylori.

Use of alternative medicine, ginger and licorice among Danish pregnant women - a prospective cohort study

BACKGROUND

The use of alternative medicines and dietary supplements is constantly changing, as are dietary habits. One example of this phenomenon is the current popularity of ginger products as an everyday health boost. Ginger and licorice has also been shown to ameliorate nausea a common complaint in early pregnancy. Alternative medicines are often regarded as safe. However, they might affect fetal development, such as through alterations of hormone metabolism and cytochrome P450 function. Health care professionals may be unaware of the supplementation habits of pregnant women, which may allow adverse exposures to go unnoticed, especially if the rates of use in pregnancy are not known. We therefore investigated the use of alternative medicines and licorice among pregnant Danish women.

METHODS

A total of 225 pregnant women were included in a prospective cohort when attending the national prenatal screening program at gestational weeks 10-16. Participants were asked to complete a questionnaire regarding their socio-economic status and lifestyle habits, including their intake of alternative medicine and licorice.

RESULTS

We found that 22.7% of women reported taking alternative medicines, with 14.7% reporting daily consumption. Ginger supplements were consumed by 11.1%, mainly as health boost and 87.1% reported consumption of licorice. Regular or daily licorice consumption was reported by 38.2 and 7.1%, respectively. Notably, the use of licorice was reflected by an increase in blood pressure of the pregnant women.

CONCLUSIONS

The use of licorice and alternative medicines appears to be common in pregnant Danish women, supporting the need for further investigations into the safety of alternative medicine use during pregnancy and the importance of up-to-date personalized counseling regarding popular health trends and lifestyle habits.

Therapeutic potential of Panax ginseng and its constituents, ginsenosides and gintonin, in neurological and neurodegenerative disorders: a patent review

INTRODUCTION

Ginseng, Panax ginseng, has been used for various diseases and proven its great efficacy in managing central nervous system diseases.

AREAS COVERED

This article covers the therapeutic potential of patents on ginseng and its active constituents to develop therapies for neurodegenerative and neurological disorders, since 2010. The literature review was provided using multiple search engines including Google Patent, Espacenet and US Patent in the field of neurodegenerative diseases, Alzheimer's disease, Parkinson's disease, cognitive, and neurological disorders.

EXPERT OPINION

The gathered data represented outstanding merits of ginseng in treatment of neurodegenerative and neurological disorders. These effects have been mediated by neurogenesis, anti-apoptotic and antioxidant properties, inhibition of mitochondrial dysfunction, receptor-operated Ca²⁺ channels, amyloid beta aggregation, and microglial activation as well as neurotransmitters modulation. However, these compounds have limited clinical application of for the prevention or treatment of neurodegenerative and neurological disorders. This might be due to incomplete data on their clinical pharmacokinetic and toxicity properties, and limited economic investments. There is an increasing trend in use of herbal medicines instead of chemical drugs, so it is time to make more attention to the application of ginseng, the grandfather of medicinal plants, from basic sciences to patients' bed.

Toxicological effects of Camellia sinensis (green tea): A review

Many scientific articles proved that green tea (GT), Camellia sinensis, has a great potential to manage central nervous system, cardiovascular, and metabolic diseases and treat cancer and inflammatory disorders. However, it is important to consider that "natural" is not always "safe." Some relevant articles reported side effects of GT, detrimental effects on health. The aim of this study is to provide a classified report about the toxicity of GT and its main constituents in acute, subacute, subchronic, and chronic states. Furthermore, it discusses on the cytotoxicity, genotoxicity, mutagenicity, carcinogenicity, and developmental toxicity of GT and its main constituents. The most important side effects have been reported hepatotoxicity and gastrointestinal disorders specially while consumed on an empty stomach. GT and its main components are not major teratogen, mutagen, or carcinogen substances. However, there is limited data in using them during pregnancy, and they should be used with caution in pregnancy, breast-feeding, and susceptible people. Because GT and its main components have a wide variety of drug interactions, consideration should be taken in coadministration of them with narrow therapeutic indexed drugs. Furthermore, they evoke selective cytotoxicity on cancerous cells that could engage them as an adjuvant substance in cancer therapy.

Changes of Insulin Resistance and Adipokines Following Supplementation with Glycyrrhiza Glabra L. Extract in Combination with a Low-Calorie Diet in Overweight and Obese Subjects: a Randomized Double Blind Clinical Trial

Purpose: Adipose tissue is a highly active endocrine organ which plays a key role in energy homeostasis. The aim of this study was to determine the effects of dried licorice extract along with a calorie restricted diet on body composition, insulin resistance and adipokines in overweight and obese subjects.

Methods: Sixty-four overweight and obese volunteers (27 men, 37 women) were recruited into this double-blind, placebo-controlled, randomized, clinical trial. Participants were randomly allocated to the Licorice (n=32) or the placebo group (n=32), and each group received a low-calorie diet with either 1.5 g/day of Licorice extract or placebo for 8 weeks. Biochemical parameters, anthropometric indices, body composition and dietary intake were measured at baseline and at the end of the study.

Results: A total of 58 subjects completed the trial. No side effects were observed following licorice supplementation. At the end of the study, waist circumference, fat mass, serum levels of vaspin, zinc-α2 glycoprotein, insulin and HOMA-IR were significantly decreased in the intervention group, but only the reduction in serum vaspin levels in the licorice group was significant when compared to the placebo group (p<0.01).

Conclusion: Supplementation with dried licorice extract plus a low-calorie diet can increase vaspin levels in obese subjects. However, the anti-obesity effects of the intervention were not stronger than a low-calorie diet alone in the management of obesity.

Herbal Bioenhancers in Veterinary Phytomedicine

Herbal bioenhancers are active phytomolecules that increase the bioavailability, bioefficacy and biological activity of various drugs when coadministered at low concentrations. These valuable compounds reduce the dose, increase the treatment rate, decrease the treatment duration, drug resistance or related adverse reactions which have economical implications in livestock and pet medicine. Eventhough the concept of herbal bioenhancers are known for years through Ayurvedic medicine, the underlying mechanisms remains unclear. The main mechanisms involved are related to drug absorption (effect on solubility, drug efflux and transport proteins, increased permeability in gastrointestinal system) and drug metabolism (inhibition/induction of drug metabolysing enzymes, thermogenic effect). Due to species specific differences in these mechanisms, corresponding data on human and laboratory animal could not be attributed. As multidrug resistance is a major treat to both human and animal health, within "One Health" concept, efficient therapeutical strategies are encouraged by authorities, where focus on herbal supplements as a vast unexploited field remains to be researched within "Bioenhancement Concept." This review brings insight to mechanims involved in bioenhancing effect, examples of herbal extracts and phytoactive compounds and their potential in the veterinary medicine including different classes of drugs such as antibiotics, anticancerous, antiviral, and antituberculosis.