Antihyperlipidemic effects of Salvia officinalis L. leaf extract in patients with hyperlipidemia: a randomized double-blind placebo-controlled clinical trial

Effects of Free Linoleic Acid and Oleic Acid in Sesame Meal Extract as Pancreatic Lipase Inhibitors on Postprandial Triglyceridemia: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Volunteers

A great number of chemically diverse pancreatic lipase (PL) inhibitors have been identified to tackle obesity; however, very few of them have entered clinical studies. The ethanolic extract of sesame meal is a potent PL inhibitor, and its activity hinges exclusively on two free fatty acids: linoleic acid and oleic acid, which were proven to reduce postprandial triglyceride excursion in rats. Herein, to investigate the clinical efficacy of the sesame meal extract, in a crossover trial, 30 healthy volunteers were randomized to receive the sesame meal extract containing experimental food or placebo along with a high-fat meal. Treatment with the sesame meal extract significantly lowered the incremental postprandial serum triglyceride concentration and reduced the incremental area under the curve (iAUC) by 16.8% (p-value = 0.03) compared to placebo. Significant decreases in postprandial remnant-like lipoprotein particle cholesterol and low-density lipoprotein particles were also observed, whereas high-density lipoprotein cholesterol was increased. These results suggest that treatment with the sesame meal extract significantly reduced the postprandial excursion of triglycerides and improved the lipidemic profile after high dietary fat intake in healthy individuals, indicating the substantial potential of free linoleic acid and oleic acid and natural products rich in these compounds for the management of obesity and related conditions.

Polyphenol Extracts from Sage (Salvia lavandulifolia Vahl) By-Products as Natural Antioxidants for Pasteurised Chilled Yoghurt Sauce

Sage by-product extracts (SE) are a valuable source of phenolic acids and flavonoids for food applications. The objective was to test two SE as antioxidants in pasteurised chilled yoghurt sauces against oxidation. Two SE of different polyphenol total content and profile were selected: SE38 (37.6 mg/g) and SE70 (69.8 mg/g), with salvianic and rosmarinic acid as the main polyphenols, respectively. Four experimental low-fat yoghurt sauces were formulated: untreated; SE70/2 (0.16 g/kg); SE38 (0.3 g/kg); and SE70 (0.3 g/kg). The stability of phenolic acids, microbiological quality (mesophilic bacteria, moulds and yeasts, and L. monocytogenes), and oxidative stability (lipids, colour, and pH) were studied in the sauces after pasteurisation at 70 °C for 30 min (day 0) and stored by refrigeration (day 42). Pasteurisation and further chilling ensured the microbiological quality and inhibition of microbial growth could not be evidenced, although SE70 showed some antimicrobial potential. Both SE showed good properties as antioxidants for yoghurt sauces. This finding was based on two results: (i) their main polyphenols, salvianic and rosmarinic acids, resisted to mild pasteurisation and remained quite stable during shelf life; and (ii) SE improved radical scavenging capacity, delayed primary and secondary lipid oxidation, and increased colour stability, contributing to sauce stabilisation. SE38 had a better antioxidant profile than SE70; therefore, the selection criteria for SE should be based on both quantity and type of polyphenols. Due to their stability and antioxidant properties, sage polyphenols can be used as natural antioxidants for clean-label yoghurt sauces.

Therapeutic effects of Salvia balansae on metabolic disorders and testicular dysfunction mediated by a high-fat diet in Wistar rats

Medicinal plants offer an important therapeutic resource in treatment of male infertility. We aim to evaluate the possible therapeutic effects of Salvia balansae on metabolic disorders and testicular dysfunction resulting from a high-fat diet (HFD). Antioxidant activity of aqueous extract of S. balansae leaves was evaluated using 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, 2,2’-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) assay and total antioxidant capacity (TAC) assay. Antidiabetic activity was determined by α-amylase inhibition. In vivo, HFD was administered in Wistar rats for 18 weeks and aqueous extract of S. balansae for the last 6 weeks (200 mg/Kg of body weight/day). At the term of experimentation, testosterone and some plasma parameters were analyzed and removed testes were subjected to a histomorphometric study. Our results show high levels of phenolic components in aqueous extract of S. balansae and significant antioxidant and antidiabetic activity. HFD increases body weight, causes type 2 diabetes, dyslipidemia, liver failure and inflammation. Also, HFD decreases testosterone and alters testis histological structure (seminiferous tubular degeneration, impaired spermatogenesis and interstitial fibrosis). Treatment of HFD rats with extract of S. balansae normalizes body weight and plasma parameters, increases testosterone and regenerates testicular structure and function. In summary, S. balansae could reduce metabolic complications induced by HFD and serve the basis for developing a new therapy for testicular dysfunction.

Therapeutic roles of plants for 15 hypothesised causal bases of Alzheimer's disease

Alzheimer's disease (AD) is progressive and ultimately fatal, with current drugs failing to reverse and cure it. This study aimed to find plant species which may provide therapeutic bioactivities targeted to causal agents proposed to be driving AD. A novel toolkit methodology was employed, whereby clinical symptoms were translated into categories recognized in ethnomedicine. These categories were applied to find plant species with therapeutic effects, mined from ethnomedical surveys. Survey locations were mapped to assess how this data is at risk. Bioactivities were found of therapeutic relevance to 15 hypothesised causal bases for AD. 107 species with an ethnological report of memory improvement demonstrated therapeutic activity for all these 15 causal bases. The majority of the surveys were found to reside within biodiversity hotspots (centres of high biodiversity under threat), with loss of traditional knowledge the most common threat. Our findings suggest that the documented plants provide a large resource of AD therapeutic potential. In demonstrating bioactivities targeted to these causal bases, such plants may have the capacity to reduce or reverse AD, with promise as drug leads to target multiple AD hallmarks. However, there is a need to preserve ethnomedical knowledge, and the habitats on which this knowledge depends.

Adverse effects associated with use of specific dietary supplements: The US Military Dietary Supplement Use Study

Dietary supplements (DSs) are used by 50% of Americans and 70% of United States military service members (SMs); some have adverse effects (AEs). This cross-sectional investigation examined AEs associated with specific DSs. A stratified random sample of SMs from the Air Force, Army, Marine Corps, and Navy was obtained. Volunteers completed a questionnaire reporting AEs for 96 generic and 62 specific DSs. The highest prevalence (≥1 AE) in specific DS categories was 35% prohormones, 33% weight loss supplements, 26% pre/post workout supplements, 14% herbal products, 12% multivitamin/multiminerals, 11% protein/amino acids, 9% muscle building supplements, 7% other DSs, 6% joint health products, and 5% individual vitamins/minerals. Specific DSs of concern (with proportion reporting AEs) included: Libido Max® (35%), Hydroxycut Hardcore® (33%), OxyElite® (33%), Roxylean® (31%), Growth Factor 9® (30%), Super HD® (29%), Hydroxycut Advanced® (29%), Lipo 6® (28%), The Ripper® (27%), Test Booster® (27%), Xenadrine Xtreme Thermogenic® (27%), C4 Extreme® (26%), and C4 Origional® (25%). Products marketed for weight loss, use before/after workout, and prohormones had the highest AE prevalence. DSs can contain substances with independent/additive AEs and/or interact with other ingredients or prescribed medications. Methods described here could provide a continuous surveillance system detecting dangerous DSs entering the market.

Salvia Species as Nutraceuticals: Focus on Antioxidant, Antidiabetic and Anti-Obesity Properties

Salvia plants belong to the Lamiaceae family and are recognized as being strongly aromatic, being widely used for different purposes in culinary or traditional medicine. These plants are well recognized as being rich in phenolic acids, flavonoids and terpenic compounds, which exhibit health-beneficial activities, protecting against oxidative and inflammatory-related diseases, such as diabetes and obesity. Because of these properties, phytochemicals from Salvia species have been investigated as health promoting agents, for application in distinct fields. However, the growing demand for natural products with possible uses and applications in industry requires scientific validation studies. This review consists of a compilation of relevant studies with an emphasis on the antioxidant, antidiabetic and anti-obesity properties of phenolic-rich extracts from Salvia plants.

Targeting interleukin-β by plant-derived natural products: Implications for the treatment of atherosclerotic cardiovascular disease

Inflammation is the main contributing factor to atheroma formation in atherosclerosis. Interleukin-1 beta (IL-1β) is an inflammatory mediator found in endothelial cells and resident leukocytes. Canakinumab is a selective monoclonal antibody against IL-1β which attenuates inflammation and concurrently precipitates fatal infections and sepsis. Natural products derived from medicinal plants, herbal remedy and functional foods are widely used nowadays. Experimental and clinical trial evidence supports that some natural products such as curcumin, resveratrol, and quercetin have potential effects on IL-1β suppression. In this review, we tried to document findings that used medicinal plants and plant-based natural products for treating atherosclerosis and its related diseases through the suppression of IL-1β.

The effect of herbs and spices on risk factors for cardiometabolic diseases: a review of human clinical trials

Herbs and spices are recommended to increase flavor and displace salt in the diet. Accumulating evidence suggests herbs and spices may improve risk factors for cardiometabolic diseases. In this narrative review, an overview of evidence from human clinical trials examining the effect of herbs and spices on risk factors for cardiometabolic diseases is provided. Human clinical trials examining supplemental doses of individual spices and herbs, or the active compounds, have yielded some evidence showing improvements to lipid and lipoprotein levels, glycemic control, blood pressure, adiposity, inflammation, and oxidative stress. However, cautious interpretation is warranted because of methodological limitations and substantial between-trial heterogeneity in the findings. Evidence from acute studies suggests intake of mixed herbs and spices as part of a high-saturated fat, high-carbohydrate meal reduces postprandial metabolic impairments, including lipemia, oxidative stress, and endothelial dysfunction. Limited studies have examined the postprandial metabolic effects of incorporating mixed herbs and spices into healthy meals, and, to our knowledge, no trials have assessed the effect of longer-term intake of mixed herbs and spices on risk factors for cardiometabolic diseases. To inform evidence-based guidelines for intake of herbs and spices for general health and cardiometabolic disease risk reduction, rigorously conducted randomized controlled trials are needed, particularly trials examining herb and spice doses that can be incorporated into healthy dietary patterns.

Bioactive Components of Salvia and Their Potential Antidiabetic Properties: A Review

The utilization of therapeutic plants is expanding around the globe, coupled with the tremendous expansion of alternative medicine and growing demand in health treatment. Plants are applied in pharmaceuticals to preserve and expand health—physically, mentally and as well as to treat particular health conditions and afflictions. There are more than 600 families of plants identified so far. Among the plants that are often studied for their health benefit include the genus of Salvia in the mint family, Lamiaceae. This review aims to determine the bioactive components of Salvia and their potential as antidiabetic agents. The search was conducted using three databases (PubMed, EMBASE and Scopus), and all relevant articles that are freely available in the English language were extracted within 10 years (2011–2021). Salvia spp. comprises many biologically active components that can be divided into monoterpenes, diterpenes, triterpenes, and phenolic components, but only a few of these have been studied in-depth for their health benefit claims. The most commonly studied bioactive component was salvianolic acids. Interestingly, S. miltiorrhiza is undoubtedly the most widely studied Salvia species in terms of its effectiveness as an antidiabetic agent. In conclusion, we hope that this review stimulates more studies on bioactive components from medicinal plants, not only on their potential as antidiabetic agents but also for other possible health benefits.

Anti-oxidant and hepatoprotective effects of Salvia officinalis essential oil against vanadium-induced oxidative stress and histological changes in the rat liver

The present study was designed to evaluate the protective effects of Salvia officinalis essential oil (SOEO) against vanadium-induced hepatotoxicity in Wistar rats. Animals were divided into three groups: the first group served as the control (C), where rats received daily 0.5 mL of saline solution (0.9%) given by intraperitoneal (i.p.) way. Rats in the second group (V) received daily by i.p. way 5 mg/kg BW of NH₄VO₃ (V). Rats in the third group (SV) received daily V (5 mg/kg BW) by i.p. way and SOEO (15 mg/kg BW) by gavage. Animals were sacrificed after 4 or 10 days of treatment. Administration of V increased plasma ALT, AST, ALP, and LDH activities, and cholesterol, bilirubin, triglyceride, and NO levels in rats and reduced anti-oxidant enzyme activities in the liver. Treatment with SOEO significantly attenuated these changes. Moreover, the histopathological changes and the overexpression of Hsp72/73 proteins induced by V were significantly improved by SOEO. Therefore, our results suggested that SOEO could protect against V-induced oxidative damage in rat livers. The hepatoprotective effect of SOEO might be attributed to its modulation of detoxification enzymes and/or to its anti-oxidant and free radical scavenging effects.

Flavone Hispidulin Stimulates Glucagon-Like Peptide-1 Secretion and Ameliorates Hyperglycemia in Streptozotocin-Induced Diabetic Mice

SCOPE

Loss of functional β-cell mass is central for the deterioration of glycemic control in diabetes. The incretin hormone glucagon-like peptide-1 (GLP-1) plays a critical role in maintaining glycemic homeostasis via potentiating glucose-stimulated insulin secretion and promoting β-cell mass. Agents that can directly promote GLP-1 secretion, thereby increasing insulin secretion and preserving β-cell mass, hold great potential for the treatment of T2D.

METHODS AND RESULTS

GluTag L-cells, INS832/13 cells, and mouse ileum crypts and islets are cultured for examining the effects of flavone hispidulin on GLP-1 and insulin secretion. Mouse livers and isolated hepatocytes are used for gluconeogenesis. Streptozotocin-induced diabetic mice are treated with hispidulin (20 mg kg^-1 day^-1 , oral gavage) for 6 weeks to evaluate its anti-diabetic potential. Hispidulin stimulates GLP-1 secretion from the L-cell line, ileum crypts, and in vivo. This hispidulin action is mediated via activation of cyclic adenosine monophosphate/protein kinase A signaling. Hispidulin significantly improves glycemic control in diabetic mice, concomitant with improved insulin release, and β-cell survival. Additionally, hispidulin decreases hepatic pyruvate carboxylase expression in diabetic mice and suppresses gluconeogenesis in hepatocytes. Furthermore, hispidulin stimulates insulin secretion from β-cells.

CONCLUSION

These findings suggest that Hispidulin may be a novel dual-action anti-diabetic compound via stimulating GLP-1 secretion and suppressing hepatic glucose production.

Hypolipidemic effects of protein hydrolysates from Trachinotus ovatus and identification of peptides implied in bile acid-binding activity using LC-ESI-Q-TOF-MS/MS

In the present work, analysis of the hypolipidemic properties of Trachinotus ovatus protein hydrolysates (TOPHs) and identification of peptides with bile acid-binding activity were performed. Hydrolysates prepared by trypsin digestion exhibited the highest in vitro bile acid-binding capacities compared with hydrolysates prepared with the other four proteases and were mainly composed of small peptides and amino acids with molecular weights <3 kDa, accounting for 77.30%. Among the five ultra-filtration fractions of TOPHs, TOPHs-5 (<3 kDa) exhibited the highest in vitro bile acid-binding capacity, which was equivalent to 77.97% of cholestyramine at the same concentration. A total of 68 peptides were identified from TOPHs-5 by LC-ESI-Q-TOF-MS/MS and 9 of them had hydrophobicity of more than 60%. These highly hydrophobic peptides might be associated with the bile acid-binding activity of TOPHs-5. In vivo experiments indicated that the TOPHs could effectively reduce total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and the atherogenic index (AI), while they could evidently increase the high-density lipoprotein cholesterol (HDL-C) content. Furthermore, TOPHs exerted a marked protective effect on hepatorenal function, as evidenced by decreased levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatinine (CREA). Histopathological studies confirmed that TOPHs evidently protected the liver from histological alterations. In summary, for the first time, hypolipidemic effects and subsequential identification were obtained from TOPHs, which are promising natural ingredients that could potentially be employed in the management of hyperlipidemia.

For the first time, the hypolipidemic effect of Trachinotus ovatus protein hydrolysates was obtained and its active peptides were identified.

Natural Products from Mediterranean Diet: From Anti-hyperlipidemic Agents to Dietary Epigenetic Modulators

Background:

Cardiovascular Diseases (CVD) are, currently, the major contributor to global mortality and will continue to dominate mortality rates in the future. Hyperlipidemia refers to the elevated levels of lipids and cholesterol in the blood, and is also identified as dyslipidemia, manifesting in the form of different disorders of lipoprotein metabolism. These abnormalities may lead to the development of atherosclerosis, which can lead to coronary artery disease and stroke. In recent years, there is a growing interest in the quest for alternative therapeutic treatments based on natural products, offering better recovery and the avoidance of side effects. Recent technological advances have further improved our understanding of the role of epigenetic mechanisms in hyperlipidemic disorders and dietary prevention strategies.

Objective:

This is a comprehensive overview of the anti-hyperlipidemic effects of plant extracts, vegetables, fruits and isolated compounds thereof, with a focus on natural products from the Mediterranean region as well as the possible epigenetic changes in gene expression or cardiometabolic signaling pathways.

Methods:

For the purpose of this study, we searched the PubMed, Scopus and Google Scholar databases for eligible articles and publications over the last five years. The keywords included: “hyperlipidemia”, “plant extract”, “herbs”, “natural products”, “vegetables”, “cholesterol” and others. We initially included all relevant articles referring to in vitro studies, animal studies, Randomized Controlled Trials (RCTs) and previous reviews.

Conclusion:

Many natural products found in the Mediterranean diet have been studied for the treatment of hyperlipidemia. The antihyperlipidemic effect seems to be dose and/or consumption frequency related, which highlights the fact that a healthy diet can only be effective in reversing disease markers if it is consistent and within the framework of a healthy lifestyle. Finally, epigenetic biomarkers are increasingly recognized as new lifestyle management tools to monitor a healthy dietary lifestyle for the prevention of hyperlipidaemic disorders and comorbidities to promote a healthy life.

Induction of EpRE-mediated gene expression by a series of mediterranean botanicals and their constituents

ETHNOPHARMACOLOGICAL RELEVANCE

A variety of Mediterranean plant species, traditionally used for the prevention and treatment of several health conditions, contain ingredients with potential biological activity of which many remain unexplored. Among the beneficial health effects of bioactive phytochemicals is the activation of cellular defense mechanisms involving the activation of EpRE (electrophile responsive element) - mediated changes in gene expression.

AIM OF THE STUDY

The present study aimed to identify botanicals and their active constituents able to activate the EpRE mediated gene expression within a series of Mediterranean plant species known for their hepatoprotective and/or cardioprotective properties.

MATERIALS AND METHODS

Methanolic extracts of 18 botanicals were prepared and tested for their ability to induce gene expression in EpRE-LUX reporter cells. Subsequently, LC-MS (Liquid Chromatography Mass Spectrometry) analysis combined with MAGMa (MS Annotation based on in silico Generated Metabolites) software for automated compound annotation was used to facilitate tentative identification of the active constituents within two of the active extracts. Selected annotated compounds were tested in the EpRE-LUX reporter gene assay followed by definite identification of the most active ones.

RESULTS

It appeared that 9 of the 18 extracts were able to activate EpRE-mediated gene expression. Many active ingredients of the methanolic extracts from Juglans regia and Rhamnus frangula were revealed. Among them, chrysophanol and aloe-emodin were confirmed to be active EpRE inducing ingredients and were definitely identified in the Rhamnus Frangula extract.

CONCLUSIONS

The protective effect of half of the tested botanical varieties via the activation of EpRE-mediated gene expression was confirmed. The study also provided an example of how in vitro bioassays can be combined with LC-MS and the automated chemical annotation software MAGMa, to identify biologically active constituents in complex botanical extracts.

Salvia officinalis, Rosmarinic and Caffeic Acids Attenuate Neuropathic Pain and Improve Function Recovery after Sciatic Nerve Chronic Constriction in Mice

The leaves of Salvia officinalis L. have a traditional reputation for the management of pain in Morocco. This study was conducted to investigate the curative effects of Salvia officinalis (SO) and its major constituents Rosmarinic (ROS) and Caffeic acids (CAF) on peripheral neuropathic pain in mice. Chronic constriction injury (CCI) was induced in mice, and neuropathic pain behaviors tests were evaluated by mechanical, chemical, thermal sensation tests and functional recovery of the sciatic nerve at different time intervals, i.e., (day 0, 1, 7, 14, and 21). Ethanolic extract of SO (100 and 200 mg/kg, p.o.), ROS (10 and 20 mg/kg, i.p.), CAF (30 and 40 mg/kg, i.p.), and CLOM (5 mg/kg, i.p., a positive control) was given for 21 days after surgery. Hematological and biochemical parameters were also measured as well as histopathological analysis. CCI produced significant development in mechanical and thermal hyperalgesia, cold allodynia, and rise in the sciatic functional index in mice. Chronic treatments with SO extract, ROS, CAF, and CLOM for 3 weeks significantly increased mechanical sensibility, cold, and thermal withdrawal latency and enhanced functional recovery of the injured nerve. The same treatments remarkably ameliorated hematological parameters and did not alter biochemical levels. The histopathological findings had revealed the protective effect of SO, ROS, and CAF against the CCI-induced damage. Our data support the use of SO in folk medicine to alleviate pain. Their main phenolic constituents could be promising antineuropathic compounds, which may be attributed to their biological activities including anti-inflammatory, antioxidant, and neuroprotective effects. SO leaves may be a good candidate to treat neuropathic pain.

Integrative herbal treatments of diabetes in Beni Mellal region of Morocco

OBJECTIVES

Diabetes is one of the most life-threatening chronic metabolic disorders and is considered a global health problem due to its prevalence and incidence. In Morocco, several herbal preparations are utilized to treat this disease. For this reason, the current study aimed to identify and to collect data about the medicinal plants utilized in folk medicine for the treatment of diabetes in the Beni Mellal region of Morocco.

METHODS

An ethnobotanical survey was carried out among 400 herbalists, competent villagers and traditional healers from the Beni Mellal region through direct interviews using a semistructured questionnaire.

RESULTS

Forty-five medicinal plants belonging to 25 families were identified for their use in diabetes treatment. Interview results showed that the most frequently used plants were Olea europaea, Salvia officinalis, Allium sativum and Trigonella foenum-graecum, with a relative frequency of citation values of 24.3%, 23.0%, 22.5% and 20.5%, respectively. Moreover, in this study, the Fabaceae family was the most commonly reported plant family, and the leaves and roots were the most commonly used parts, for the treatment of diabetes.

CONCLUSION

The Beni Mellal region of Morocco has an important floristic biodiversity of plants used to treat diabetes in traditional medicinal practice. This result provides a good database for pharmacological screenings in the search for plant-based antidiabetic medications.

Salvia (Sage): A Review of its Potential Cognitive-Enhancing and Protective Effects

Genus Salvia, commonly known as sage, is the largest genus in the Lamiaceae family. It comprises many species traditionally used as brain-enhancing tonics. In vitro and animal studies have confirmed that several Salvia species contain a large array of active compounds that may enhance cognitive activity and protect against neurodegenerative disease. In this review, the active constituents in plants belonging to the genus Salvia are summarised, and their influence on pharmacodynamics pertinent to cognitive activity are detailed. In particular, the effects of plants belonging to the genus Salvia and their constituents on cognitive skills including memory, attention and learning are detailed. Their potential effects in dementia, including Alzheimer’s disease, are also examined. Completed human trials are summarised, and factors influencing the potency of Salvia plants are covered. Finally, directions for future research are proposed to enhance our understanding of the potential health benefits of Salvia plants.

The Health Benefits of Selected Culinary Herbs and Spices Found in the Traditional Mediterranean Diet

The Mediterranean diet is considered one of the healthiest diets in the world. This is often attributed to low saturated fat consumption, moderate wine consumption, and high vegetable consumption. However, herbs and spices associated with these diets may also play an important role in the quality of this diet. This review summarizes the most recent research regarding the anti-diabetic, anti-inflammatory, anti-hyperlipidemic and anti-hypertensive properties of this collection of culinary species. Additionally, this review briefly summarizes studies performed on lesser known herbs from around the world, with the goal of identifying new culinary species that may be useful in the treatment or prevention of diseases.

Pharmacological properties of Salvia officinalis and its components

Salvia officinalis (Sage) is a plant in the family of Labiatae/Lamiaceae. It is native to Middle East and Mediterranean areas, but today has been naturalized throughout the world. In folk medicine, S. officinalis has been used for the treatment of different kinds of disorders including seizure, ulcers, gout, rheumatism, inflammation, dizziness, tremor, paralysis, diarrhea, and hyperglycemia. In recent years, this plant has been a subject of intensive studies to document its traditional use and to find new biological effects. These studies have revealed a wide range of pharmacological activities for S. officinalis. Present review highlights the up-to-date information on the pharmacological findings that have been frequently reported for S. officinalis. These findings include anticancer, anti-inflammatory, antinociceptive, antioxidant, antimicrobial, antimutagenic, antidementia, hypoglycemic, and hypolipidemic effects. Also, chemical constituents responsible for pharmacological effects of S. officinalis and the clinical studies on this plant are presented and discussed.

Evaluation of the Effects of Pinus koraiensis Needle Extracts on Serum Lipid and Oxidative Stress in Adults with Borderline Dyslipidemia: A Randomized, Double-Blind, and Placebo-Controlled Clinical Trial

Background. Dyslipidemia has been well-known as a common metabolic disorder contributing to cardiovascular disease. The aim of this study was to evaluate the effect of the Pinus koraiensis needle extracts (PKE) on the blood cholesterol and oxidative stress. Method. We conducted a 12-week randomized, double-blinded controlled trial to examine the effect of PKE on blood lipid profiles in adults with borderline dyslipidemia. Thirty-three eligible persons were recruited and randomly assigned into PKE (n = 20) and placebo groups (n = 13). Serum lipids including total cholesterol, low-density lipoprotein- (LDL-) cholesterol, high-density lipoprotein- (HDL-) cholesterol, very low-density lipoprotein- (VLDL-) cholesterol, and triglyceride were measured before and after trial. Serum insulin, glucose, and antioxidant indicators were also analyzed before and after trial and anthropometry and blood pressure were measured every 4 weeks. Results. After 12 weeks, PKE statically significant decreases in systolic blood pressure (p < 0.05) and waist circumference (p < 0.05) were observed. Also, VLDL-cholesterol significantly decreased (from 24.4 ± 10.0 mg/dL at baseline to 18.4 ± 4.1 mg/dL after 12 weeks) (p < 0.05) and superoxide dismutase (SOD) increased (6.12 ± 0.41 U/mL to 9.06 ± 0.62 U/mL) (p < 0.01) in PKE group. However, after adjustment with WC, VLDL-cholesterol was not significant between groups (p = 0.095) and while SOD remained significant between groups (p = 0.013). Conclusion. The results show that PKE was effective in improving the superoxide dismutase in the individuals with borderline dyslipidemia.

Diabetes mellitus and its management with medicinal plants: A perspective based on Iranian research

ETHNOPHARMACOLOGICAL RELEVANCE

Complementary and alternative medicine has been increasingly used to treat chronic illnesses, such as diabetes mellitus. However, various limitations in terms of their application and efficacies exist. Furthermore, there is still much to be done to discover the right herbal medicine for diabetes.

AIM OF THE STUDY

This paper aims to evaluate previous herbal studies on the management of diabetes mellitus, to address their strengths and weaknesses and propose a general framework for future studies.

APPROACH AND METHODS

Data sources such as PubMed, ScienceDirect, Scopus, SpringerLink, and Wiley were searched, limited to Iran, using 36 search terms such as herbal, traditional, medicine, and phytopharmacy in combination with diabetes and related complications. Reviewed articles were evaluated regarding the use of botanical nomenclature and included information on (1) identity of plants and plant parts used, (2) the processing procedure, and (3) the extraction process. The main outcomes were extracted and then surveyed in terms of the efficacies of herbs in the management of diabetes mellitus. Then a comparative study was performed between Iranian and non-Iranian studies with respect to herbs best studied in Iran.

RESULTS

Of the 82 herbs studied in Iran, only six herbs were endemic and 19 were studied in detail. Although most of the reviewed herbs were found to decrease the level of blood glucose (BG) and/or glycated hemoglobin (HbA1C) in both Iranian and non-Iranian studies, information on their pharmacological mechanisms is scarce. However, the level of HbA1C was measured in a limited number of clinical trials or animal studies. Available information on both short- and long-term use of studied herbs on diabetes related complications and functions of involved organs as well as comorbid depression and/or simultaneous changes in lifestyle is also insufficient. Furthermore, little or no information on their phytochemical, toxicological, and herb-drug interaction properties is available. It is worth noting that the efficacy of the reviewed herbs has been studied scarcely in both humans and animals regarding both Iranian and non-Iranian studies. A significant number of reviewed articles failed to cite the scientific name of herbs and include information on the processing procedure and the extraction process.

CONCLUSIONS

Treatment of diabetes mellitus as a multifactorial disease using herbal medicines requires a comprehensive approach. In order to discover the right herbal medicine for the management of diabetes many other important factors than the levels of BG, HbA1C and insulin should be considered. According to our criteria, all the reviewed herbs suffered from inadequate investigation in human, animal and in vitro models in this respect, whereas they are worth investigating further. However, more research on endemic plants and the traditional history of herbal medicine is warranted. In our opinion, the pharmacological, toxicological, and phytochemical information should be obtained before clinical trials. Furthermore, information such as botanical scientific nomenclature, side effects, and toxicity will improve the quality and validity of publications in herbal research. In particular, designing a database covering all valid information about herbs and/or diseases will decrease unnecessary costs and increase the efficiency of research.

Salvia libanotica improves glycemia and serum lipid profile in rats fed a high fat diet

BACKGROUND

Salvia libanotica (S. Libanotica) is a commonly used herb in folk medicine in Lebanon and the Middle East. The present study aimed to assess the scientific basis for the therapeutic use of S. libanotica in glycemia and to evaluate its effects on lipemia and abdominal fat.

METHODS

Animals were fed a high-fat diet and allocated into a control and three experimental groups (GI, GII and GIII) receiving incremental doses of the plant water extract in drinking water (50, 150 and 450 mg/Kg body weight respectively) for six weeks.

RESULTS

The intake of S. libanotica extract was associated with a significant decrease in fasting serum glucose (102.9 ± 10.8 in GII and 87.5 ± 6.4 in GIII vs. 152.1 ± 7.9 mg/dl in controls) and a two fold increase in fasting serum insulin (GIII) and liver glycogen content (GII and GIII). Group III also had better glucose tolerance following intraperitoneal glucose challenges. Additionally, the plant extract intake produced a significant improvement in serum HDL (34.4 ± 2.4 in GIII vs. 27.2 ± 1.9 mg/dl in controls) and HDL/LDL cholesterol ratio (2.79 ± 0.32 in GII and 3.02 ± 0.31 in GIII vs. 1.74 ± 0.18 in controls), as well as a decrease in abdominal fat.

CONCLUSION

The current study is the first to demonstrate that the chronic intake of S. libanotica infusion helps in the prevention of high fat-induced hyperglycemia and dyslipidemia. This supports the plant use as a remedy for the prevention of type 2 diabetes and cardiovascular diseases.

Bridging cross-cultural gaps: monitoring herbal use during chemotherapy in patients referred to integrative medicine consultation in Israel

INTRODUCTION

The high prevalence of the use of traditional herbs among patients with cancer is a cause for concern with regard to potentially adverse interactions with conventional oncology treatments. In this study, we explore herbal use among patients with cancer in northern Israel who are referred by their health care providers to complementary and traditional medicine (CTM) consultations provided to them within the conventional oncology department. The study's objectives were to identify which herbs patients use and to examine the scope of current research on the efficacy and safety regarding the identified herbs.

PATIENTS AND METHODS

Herbal use by patients receiving oncology care was assessed prospectively from July 2009 to July 2012 by integrative physicians (IPs) trained in herbal medicine. Historical, ethnobotanical, basic research, and clinical data regarding the identified herbs were explored by using a keyword search in PubMed and Middle Eastern ethnohistorical literature.

RESULTS

Disclosure of herbal use was reported by 154 of the 305 patients (50.5 %) interviewed by IPs. The use of 85 single herbs and 30 different herbal formulas was documented during the initial or follow-up IP assessments. Patients reported 14 quality of life-associated indications for herbal use. The ten most prevalent herbs displaying in vitro/in vivo anticancer activity and nine other herbs were preliminarily assessed concerning potential risks, safety, and interaction with chemotherapy.

CONCLUSIONS

Herbal use by patients with cancer in northern Israel is widespread and calls for further study in order to address issues of safety and effectiveness. We recommend constructing a multinational and multidisciplinary team of researchers with ethnopharmacological and clinical expertise that will explore the use of herbs among patients with cancer in a cross-cultural perspective attuned with patients' affinity to traditional herbal medicine.

Trends in publication of evidence-based Traditional Iranian medicine in endocrinology and metabolic disorders

Traditional Iranian medicine (TIM) is a main part of complementary and alternative medicine (CAM). The popularity and use of alternative therapies are increasing due to adverse effects and ineffectiveness of pharmacologic treatments in some cases. Herbal medicine is one of the methods of traditional therapy that plays a key role in the treatment of various diseases specifically in diabetes mellitus, hyperlipidemia and obesity that are growing rapidly in the world. In this article, trends of scientific publications of Iranian medicine in endocrinology and metabolic disorders have been investigated. Our data show that the numbers of related researches have uptrend from 2000 till now. These data are valuable to pharmaceutical companies to get the idea to invest and produce effective drugs.

Improved glycemic control and lipid profile in hyperlipidemic type 2 diabetic patients consuming Salvia officinalis L. leaf extract: a randomized placebo. Controlled clinical trial

OBJECTIVES

Evaluation of the efficacy and safety of Salvia officinalis L. (S. officinalis) leaf extract in the treatment of hyperlipidemic type 2 diabetic patients.

DESIGN

Randomized placebo-controlled parallel group study.

SETTING

Diabetes Clinic (Karaj City, Alborz Province of Iran).

INTERVENTIONS

The efficacy and safety of taking S. officinalis leaf extract (one 500 mg capsule t.i.d. for 3 months) in treatment of 40 hyperlipidemic (hypercholesterolemic and/or hypertriglyceridemic) type 2 diabetic patients were evaluated and compared with the placebo group (n=40).

MAIN OUTCOME MEASURES

Fasting blood levels of glucose, glycosylated hemoglobin (HbA1c), total cholesterol, triglyceride, LDL-C (low density lipoprotein cholesterol), HDL-C (high density lipoprotein cholesterol), SGOT (serum glutamic-oxaloacetic transaminase), SGPT (serum glutamic-pyruvic transaminase) and creatinine.

RESULTS

The extract lowered fasting glucose, HbA1c, total cholesterol, triglyceride and LDL-C but increased HDL-C compared to baseline at endpoint. Percent difference mean (95% confidence interval) between the extract and placebo groups in terms of effects on fasting glucose, HbA1c, total cholesterol, triglyceride, LDL-C and HDL-C at endpoint were 32.2 (26.5, 37.9), 22.7 (16.8, 28.6), 16.9 (9.7, 24.1), 56.4 (36.1, 76.7), 35.6 (29.9, 41.3) and 27.6 (15.8, 39.4) (P=0.001, P=0.01, P=0.01, P=0.009, P<0.001 and P=0.008), respectively. Moreover, the extract did not have any significant effects on the other parameters compared to the placebo group at endpoint (P>0.05). No adverse effects were reported.

CONCLUSIONS

S. officinalis leaves may be safe and have anti-hyperglycemic and lipid profile improving effects in hyperlipidemic type 2 diabetic patients.

Hypolipidemic activity of okra is mediated through inhibition of lipogenesis and upregulation of cholesterol degradation

Little is known about the hypolipidemic activity of okra; therefore, we investigated the hypolipidemic activity of okra and its interaction with gene expression of several key components involved in lipid homeostasis. Male C57BL/6 mice were randomly divided into three groups and fed with hyperlipidemic diet or two hyperlipidemic diets supplemented with 1% or 2% okra powder for eight weeks. Results demonstrated that okra dose-dependently decreased serum and hepatic total cholesterol and triglyceride, and enhanced fecal excretion of bile acids. Gene expression analysis revealed that okra upregulated cholesterol 7α-hydroxylase (CYP7A1) expression, downregulated expression of sterol regulatory element-binding protein 1c (SREBP1c) and fatty acid synthase (FAS), with no effect on sterol regulatory element-binding protein 2 (SREBP2), 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR), low-density lipoprotein receptor (LDLR) and carnitine palmitoyltransferase-1A (CPT1A). It was suggested that hypolipidemic activity of okra was mediated most likely by upregulation of cholesterol degradation through CYP7A1 and by inhibition of lipogenesis through SREBP1c and FAS. Okra raw and fractionated polysaccharide showed strong bile acid binding capacity in vitro, which may contribute to the hypolipidemic activity observed. In conclusion, okra has potential application in the management of hyperlipidemia and its associated metabolic disorders.

Purslane Effect on GLP-1 and GLP-1 receptor in type 2 diabetes

BACKGROUND

The aim of this study was to examine the effect of purslane seeds in glucagon-like peptide-1 concentration and glucagon-like peptide-1 receptor in women with diabetes.

METHODS

This was a quasi-experimental study. The population was consisted of the city of Sari where diabetic women with diabetes II who had no history of using purslane seeds. All individuals used the same dose of metformin under the specialist supervision. Among these individuals, 16 were assigned at random to Purslane group and control group. The purslane group consumed 2.5 grams Purslane with lunch and along with 5 grams of purslane (Portulaca oleracea seeds 7.5 g daily) with dinner meals twice daily for 8 weeks. Blood sample was taken before and after 8 weeks, after 12 hours of fasting to 5 ml of the left brachial vein.

RESULTS

After 8 weeks using purslane seeds in the experimental group, a significant increase was seen in glucagon-like peptide-1 concentrations (p<0.007), but there was no significant difference in the concentration of glucagon-like peptide-1 receptor (p <0.455). No significant relationship was found between changes in glucagon-like peptide-1 and its receptor.

CONCLUSION

The use of purslane seeds improved Type II diabetes; therefore it can be effective in improving the health of women with diabetes.