From plant to patient: an ethnomedical approach to the identification of new drugs for the treatment of NIDDM

Effect of crocin and treadmill exercise on oxidative stress and heart damage in diabetic rats

Diabetes increases the production of free radicals and inflammatory agents in the heart tissue and alters the expression of genes associated with the induction of apoptosis. Considering the importance of common cardiovascular disorders in diabetes, this study investigated the effect of eight weeks of aerobic exercise and crocin use, as well as tissue damage and oxidative stress caused by diabetes in the hearts of adult rats. Streptozotocin 50 mg/kg was injected as a single dose intraperitoneally to cause the diabetes. After 72 hours, a glucometer monitored blood glucose levels, and blood glucose above 250 mg/dl was considered diabetes. Continuous treadmill exercise was performed for eight weeks by placing the animal on the treadmill. Next, the animals were anesthetized, and samples were taken from the hearts and frozen in liquid nitrogen. Then, superoxide dismutase (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA) were measured in the cardiac tissue. Finally, the hearts of half of the animals were immediately immersed in a formalin solution for histological changes. According to our findings, diabetes increased lipid peroxidation, characterized by increased MDA levels in the control diabetes group and decreased SOD and GPx levels (P <0.05). It also changes the balance of expression of genes associated with apoptosis control, increased Bcl-2-associated X (Bax) expression, and decreased Bcl-2 expression (P <0.05). Also, we observed the induction of apoptosis in cardiac tissue. Using eight weeks of continuous exercise and administration of crocin significantly reduced blood sugar levels and lipid peroxidation and increased the activity of antioxidant enzymes and Bcl-2 gene expression compared to the diabetes control group. In addition, continuous exercise and crocin improved the oxidative stress parameters in the control group. This study showed that diabetes could cause oxidative stress and heart dysfunction. Moreover, simultaneously and separately, aerobic exercise with a treadmill and crocin administration can reduce these disorders and prevent apoptosis in the heart tissue.

A Pragmatic Historical Assessment Tool: A New Systematic Framework for the Collation and Evaluation of Documented Empirical Effectiveness and Safety of Traditional Plant Medicines in the European Materia Medica

INTRODUCTION

Traditional plant medicines (TPMs) are plant-derived therapeutic products prepared and applied according to longstanding medical customs. Around the world they are widely used in primary and preventative health care. The World Health Organization (WHO) calls in its Traditional Medicine Strategy 2014-2023 for Member States to provide a regulatory framework so that the formal contribution of traditional therapeutics can be advanced in national systems of health care. Evidence of effectiveness and safety is paramount for the regulatory integration of TPMs; however, a presumed lack of such "evidence" is one obstacle for full integration. The consequential health policy question is how to systematically evaluate therapeutic claims relating to herbal remedies when the extant evidence is predominantly based on historical and contemporary clinical usage, i.e., is empiricist in nature. This paper introduces a new method along with several illustrative examples.

METHOD

Our research design employs a longitudinal, comparative textual analysis of standard textbooks of the professional European medical literature from the early modern period (1588/1664) onwards to today. It then triangulated these intergenerationally documented clinical observations on two exemplars (Arnica and St. John's Wort) with corresponding listings in multiple qualitative and quantitative sources. A Pragmatic Historical Assessment (PHA) tool was developed and tested as a method to systematically collate the large amount of pharmacological data recorded in these judiciously selected sources. The evidential validity of longstanding professional clinical knowledge could thus be compared with therapeutic indications approved in official and authoritative sources (pharmacopoeias, monographs) and with those supported by contemporary scientific research (randomised-controlled trials [RCTs], experimental research).

RESULTS

There was high congruency between therapeutic indications that are based on repeated empirical observations from professional patient care (empirical evidence), those approved in pharmacopoeias and monographs, and modern scientific evidence based on RCTs. The extensive herbal triangulation confirmed parallel records of all main therapeutic indications of the exemplars across all qualitative and quantitative sources over the past 400 years.

CONCLUSIONS

Historical clinical medical textbooks and contemporary phytotherapeutic equivalents are the key repository of repeatedly evaluated therapeutic plant knowledge. The professional clinical literature proved to be a reliable and verifiable body of empirical evidence that harmonised with contemporary scientific assessments. The newly developed PHA tool provides a coding framework for the systematic collation and evaluation of empirical data on the effectiveness and safety of TPMs. It is suggested as a feasible and efficient tool to extend evidence typologies that substantiate therapeutic claims for TPMs as part of an evidence-based regulatory framework that formally integrates these medically and culturally important therapeutics.

Einleitung

Traditionelle pflanzliche Arzneimittel sind aus Pflanzen gewonnene Heilmittel, die gemäß langjähriger medizinischer Praxis zubereitet und angewendet werden. Weltweit sind sie in der primären und präventiven Gesundheitsversorgung weit verbreitet. Die Weltgesundheitsorganisation (WHO) ruft in ihrer Traditional Medicine Strategy 2014–2023 die Mitgliedstaaten dazu auf, regulatorische Rahmenbedingungen zu schaffen, welche den formellen Beitrag traditioneller Therapeutika in den nationalen Gesundheitssystemen fördern. Der Nachweis von Wirksamkeit und Sicherheit ist von zentraler Bedeutung für die regulatorische Integration traditioneller pflanzlicher Arzneimittel, doch das angebliche Fehlen solcher “Nachweise“ ist eine der Hürden für die vollständige Integration. Daraus ergibt sich die gesundheitspolitische Frage, wie man therapeutische Anwendungsgebiete pflanzlicher Heilmittel systematisch evaluieren kann, wenn die vorliegende Evidenz überwiegend auf deren historischer und aktueller klinischen Verwendung beruht, also empirischer Natur ist. In dieser Arbeit wird eine neue Methode mitsamt veranschaulichenden Beispielen vorgestellt.

Methoden

Unser Forschungsansatz beruhte auf einer longitudinalen, vergleichenden Textanalyse von Standard-Lehrwerken der europäischen medizinischen Fachliteratur ausgehend von der frühen Neuzeit (1588/1664) bis heute. Die über Generationen dokumentierten klinischen Beobachtungen wurden anhand von zwei Beispielen (Arnika and Johanniskraut) mit den diesbezüglichen Angaben in unterschiedlichen qualitativen und quantitativen Quellen trianguliert. Ein Pragmatisch‐Historisches Auswertungstool (PHA) wurde als Methode entwickelt und getestet, um die großen Mengen der in diesen kritisch ausgewählten Quellen enthaltenen pharmakologischen Daten systematisch zu erfassen. Die Evidenzvalidität des langjährigen klinischen Fachwissens konnte so mit den therapeutischen Anwendungsgebieten verglichen werden, die in offiziellen und autoritativen Quellen (Pharmakopöen, Monografien) zugelassen sind, sowie mit denjenigen, die durch zeitgenössische wissenschaftliche Forschung gestützt werden (randomisierte kontrollierte Studien [RCTs], experimentelle Forschung).

Ergebnisse

Es bestand ein hohes Maß an Kongruenz zwischen den therapeutischen Anwendungsgebieten, welche auf wiederholte empirische Beobachtung aus der professionellen Patientenversorgung beruhen (empirische Evidenz), den zugelassenen Indikationen in Pharmakopöen und Monographien sowie der aktuellen wissenschaftlichen Evidenz basierend auf klinischen Studien. Die umfassende pflanzenbezogene Triangulation bestätigte parallele Aufzeichnungen aller wesentlichen Anwendungsgebiete der untersuchten Beispiele in allen qualitativen und quantitativen Quellen über die letzten 400 Jahre hinweg.

Schlussfolgerungen

Historische Lehrbücher für klinische Medizin und zeitgenössische phytotherapeutische Äquivalente sind die wichtigsten Quellen von wiederholt evaluiertem therapeutischem Wissen zu Heilpflanzen. Die klinische Fachliteratur erwies sich als zuverlässiger und verifizierbarer Korpus empirischer Evidenz, der mit aktuellen wissenschaftlichen Untersuchungen übereinstimmte. Das neu entwickelte PHA-Verfahren bietet ein Kodierungs‐Instrument für das systematische Erfassen und Auswerten empirischer Daten zur Wirksamkeit und Sicherheit von traditionellen pflanzlichen Arzneimitteln. Das PHA‐Verfahren wird als praktikables und effizientes Instrument zur Erweiterung der Evidenz‐Typologien empfohlen, indem es therapeutische Indikationen für traditionelle pflanzliche Arzneimittel untermauern kann, so dass diese medizinisch und kulturell wichtigen Therapeutika in einen evidenz-basierten regulatorischen Rahmen integriert werden können.

Investigating the effects of Ceylon cinnamon water extract on HepG2 cells for Type 2 diabetes therapy

Cinnamon and its extracts have been used as herbal remedies for many ailments, including for reducing insulin resistance and diabetes complications. Type 2 diabetes mellitus (T2DM) is a rapidly growing health concern around the world. Although many drugs are available for T2DM treatment, side effects and costs can be considerable, and there is increasing interest in natural products for managing chronic health conditions. Cinnamon may decrease the expression of genes associated with T2DM risk. The purpose of this study was to evaluate the effects of cinnamon water extract (CWE) compared with metformin on T2DM-related gene expression. HepG2 human hepatoma cells, widely used in drug metabolism and hepatotoxicity studies, were treated with different concentrations of metformin or CWE for 24 or 48 h. Cell viability was assessed by MTT (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) assay and glucose uptake was compared in untreated and CWE- or metformin-treated cells under high-glucose conditions. Finally, total RNA was extracted and analyzed by RNA sequencing (RNA-seq), and bioinformatics analyses were performed to compare the transcriptional effects of CWE and metformin. We found cell viability was better in cells treated with CWE than in metformin-treated cells, demonstrating that CWE was not toxic at tested doses. CWE significantly increased glucose uptake in HepG2 cells, to the same degree as metformin (1.4-fold). RNA-seq data revealed CWE and metformin both induced significantly increased (1.3- to 1.4-fold) glucose uptake gene expression compared with untreated controls. Transcriptional differences between CWE and metformin were not significant. The effects of 0.125 mg mL^-1 CWE on gene expression were comparable to 1.5 mg mL^-1 (9.5 mM) metformin. In addition, gene expression at 0.125 mg mL^-1 CWE was comparable to 1.5 mg mL^-1 (9.5 mM) metformin. Our results reveal that CWE's effects on cell viability, glucose uptake, and gene expression in HepG2 cells are comparable to those of metformin, suggesting CWE may be an effective dietary supplement for mitigating T2DM-related metabolic dysfunction.

Pinus roxburghii and Nauplius graveolens Extracts Elevate Apoptotic Gene Markers in C26 Colon Carcinoma Cells Induced in a BALB/c Mouse Model

The present study aimed to evaluate the chemopreventive potential of Pinus roxburghii branch (P. roxburghii) and Nauplius graveolens (N. graveolens) extracts against human colorectal cancer (CRC) induced by C26 murine cells in a BALB/c mouse model. Real-time qRT-PCR was used to evaluate the apoptotic pathway by measuring the relative mRNA expression levels of the Bcl-2, Bax, Cas3, NF-κB, and PI3k genes. At the termination of the 30-day period, blood samples were collected to assay the biomarkers. The results showed a significant increase (p < 0.05) in the levels of TGF-β, CEA, CA19-9, malondialdehyde, ALT, AST, ALP, urea, and creatinine in the positive control compared to the negative control group. In addition, the glutathione reductase activity and total antioxidant activity were reduced in the positive control compared to the negative control. The biomarkers mentioned above were restored to almost normal levels after administering a safe dose (1/10) of a lethal dose of P. roxburghii and N. graveolens extracts. Administration of one-tenth of the LD50 of P. roxburghii and N. graveolens extracts caused a significant upregulation of the expression of Bax and Cas-3 and downregulation of the Bcl-2, NF-ĸB, and PI3k genes vs. the GAPDH gene as a housekeeping gene compared to the control group. Furthermore, the Bax/Bcl-2 ratio increased upon treatment. After administration of P. roxburghii and N. graveolens at a safe dose (1/10) of a lethal dose, the results showed improvement in both body weight gain and a significant decrease (p < 0.05) in tumor volume. Histopathological changes supported these improvements. Conclusively, the research outputs show that P. roxburghii and N. graveolens extracts can be utilized as potential chemopreventive agents for CRC treatment by stimulating cancer cell apoptosis and suppressing CRC survival and proliferation.

Pharmacological evaluation of medicinal plants with antidiabetic activities in Ethiopia: A review

Diabetes mellitus is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin, or when the body can't effectively use insulin. Herbal medicines have been commonly used by diabetic patients for the treatment of diabetes mellitus. To include findings from different studies, publications related to in vivo and invitro antidiabetic activities of medicinal plants in Ethiopia were searched from different databases, such as Web of Science, Google Scholar, Medline, Scopus, and PubMed, using English key terms. Different medicinal plant parts were used experimentally for antidiabetic effects in Ethiopia. Among these, leaves (69%) were the most commonly investigated medicinal plant parts followed by roots (14%) and seeds (7%). Most of the investigations were completed with hydro-methanolic extracts to obtain a higher percentage of yield. Medicinal plants such as Thymus schemperi R, Thymus vulgaris L, Hagenia abyssinica, Aloe megalacantha baker, Aloe moticola Reyonolds, Aloe pulecherrima Gilbert & sebseb, Bersama abyssinica fresen, and Rubus Erlangeri Engl have shown in vitro α-amylase inhibitory activity. However, only Hagenia abyssinica, Thymus schemperi R, and Thymus vulgaris L have exhibited α-glucosidase inhibitory activity. Likewise, only the extract of Aloe pulecherrima Gilbert & sebseb posses’ maltase and sucrose inhibitory activity. In vivo antidiabetic activity were conducted for the extract of medicinal plants such as A. remota, S. rebaudiani, T. schemperi, T. vulgaris, H. abyssinica, C. aurea, D. stramonium, A. megalacantha, A. moticola, A.integrifolia, A. pulecherrima, B. grandiflorum, B. abyssinica, P. schimperiana, M. stenopetala, C. aure, J. schimperiana, T. brownie, C. macrostachys, I. spicata, O. integrifolia, C. abyssinica, R. Erlangeri, L. culinaris, A. camperi, A. polystachyus, A. ilicifalius, C. tomentosa, and C. Edulis. This review gives collective evidence on the potential antidiabetic activities of medicinal plants in Ethiopia. Moreover, further studies are recommended to substantiate the use of these medicinal plants as an antidiabetic agent.

Bioactive Secondary Metabolites from Plant Sources: Types, Synthesis, and Their Therapeutic Uses

Plants are the source of various photochemicals; metabolites are used in medicinal and environmental sectors as well as being widely used in commercial and pharmaceutical products. Although they produce a number of medicinal products, either already on the market or under trial, the amounts obtained from plant sources are very minute or difficult to synthesize at an industrial level due to the complex chemical composition and chirality exhibited by these compounds. However, plant cell cultures offer a good alternative for the consistent production of desired secondary metabolites under the influence of precursors and elicitors. In this review, we discuss the various aspects of secondary metabolites, production synthesis, and sources of medical products from plant sources.

A review on network pharmacology based phytotherapy in treating diabetes- An environmental perspective

Diabetes has become common lifestyle disorder associated with obesity and cardiovascular diseases. Environmental factors like physical inactivity, polluted surroundings and unhealthy dieting also plays a vital role in diabetes pathogenesis. As the current anti-diabetic drugs possess unprecedented side effects, traditional herbal medicine can be used an alternative therapy. The paramount challenge with the herbal formulation usage is the lack of standardized procedure, entangled with little knowledge on drug safety and mechanism of drug action. Heavy metal contamination is a major environmental hazard where plants tend to accumulate toxic metals like nickel, chromium and lead through industrial and agricultural activities. It becomes inappropriate to use these plants for phytotherapy as it may affect the human health on long term consumption. This review discuss about the environmental risk factors related to diabetes and better implication of medicinal plants in anti-diabetic therapy using network pharmacology. It is an in silico analytical tool that helps to unravel the multi-targeted action of herbal formulations rich in secondary metabolites. Also, a special focus is attempted to pool the databases regarding the medicinal plants for diabetes and associated diseases, their bioactive compounds, possible diabetic targets, drug-target interaction and toxicology reports that may open an aisle in safer, effective and toxicity-free drug discovery.

Prevalence and associated factors of herbal medicine use among adult diabetes mellitus patients at government hospital, Ethiopia: An institutional-based cross-sectional study

BACKGROUND

Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Thus, this study aimed to assess the prevalence and factors associated with HM use among DM patients.

METHODS

A hospital-based cross-sectional study was conducted on 395 diabetic patients visiting the diabetes care service of Debre Tabor General Hospitalfrom August 1 to September 28, 2020. Interview guided self-administered questionnaire was used for data collection.

RESULTS

Out of 395 diabetic patients, 231(58.5%) participants were used herbal medicine. The most dominant herbal products used were M.stenoptela (53.2%), N. sativa (42.0%), Z. officinale (32.5%), A. sativum (20.8%), A. vera (13.4%), P.gracilis(10.4%), T.schimperi(7.5%), V. amygdalina (5.2%), T. foenumgraecum(3.5%),and D.penninervum(2.2%).The odds of HM use in female participants were 1.98 times (AOR=1.98, 95% CI=1.72, 3.25) higher compared to male participants. The odds of HM use among participants who develop DM complications were 1.77 times (AOR=1.77, 95% CI=1.03, 2.83) higher than in participants without DM complications. The odds of HM use among participants with a family history of DM were 2.89 times (AOR=2.89, 95% CI=1.42, 3.19) higher than in participants without a family history of DM.

CONCLUSION

The prevalence of herbal medicine use among diabetic patients was high. Educational level, gender, residence, educational level, duration of DM, presence of DM complication, and family history of DMwere the independent predictors' of HM use.

Ethnomedicinal Value of Antidiabetic Plants in Bangladesh: A Comprehensive Review

The use of conventional drugs to treat metabolic disorders and the pathological consequences of diabetes further increases the complications because of the side effects, and is sometimes burdensome due to relatively higher costs and occasionally painful route of administration of these drugs. Therefore, shifting to herbal medicine may be more effective, economical, have fewer side effects and might have minimal toxicity. The present review amasses a list of ethnomedicinal plants of 143 species belonging to 61 families, from distinctive domestic survey literature, reported to have been used to treat diabetes by the ethnic and local people of Bangladesh. Leaves of the medicinal plants were found leading in terms of their use, followed by fruits, whole plants, roots, seeds, bark, stems, flowers, and rhizomes. This review provides starting information leading to the search for and use of indigenous botanical resources to discover bioactive compounds for novel hypoglycemic drug development.

The complete chloroplast genome of Galega officinalis L

Galega officinalis L. is a perennial herb of the Fabaceae family. The flowers of G. officinalis L. are colorful and suitable for ornamental purposes. It can be used as a food complement for animals and humans, and it could promote lactation in animals and humans. In this study, we obtained the complete chloroplast genome of G. officinalis L. and found it is 125,086 bp in length. The GC content of this genome is 34.18%. Among the 112 unique genes in the chloroplast genome of G. officinalis L., 30 tRNA, 4 rRNA and 78 protein-coding genes were successfully annotated. We constructed the maximum likelihood (ML) tree with 26 species, and concluded that G. officinalis is phylogenetically closely related to the genus of Cicer, Glycine and Desmodium.

Survey about do-it-yourself closed loop systems in the treatment of diabetes in Germany

Continuous glucose monitoring (CGM) improves treatment with lower blood glucose levels and less patient effort. In combination with continuous insulin application, glycemic control improves and hypoglycemic episodes should decrease. Direct feedback of CGM to continuous subcutaneous insulin application, using an algorithm is called a closed-loop (CL) artificial pancreas system. Commercial devices stop insulin application by predicting hypoglycemic blood glucose levels through direct interaction between the sensor and pump. The prediction is usually made for about 30 minutes and insulin delivery is restarted at the previous level if a rise in blood glucose is predicted within the next 30 minutes (hybrid closed loop system, HCL this is known as a predictive low glucose suspend system (PLGS)). In a fully CL system, sensor and pump communicate permanently with each other. Hybrid closed-loop (HCL) systems, which require the user to estimate the meal size and provide a meal insulin basis, are commercially available in Germany at the moment. These systems result in fewer hyperglycemic and hypoglycemic episodes with improved glucose control. Open source initiatives have provided support by building do-it-yourself CL (DIYCL) devices for automated insulin application since 2014, and are used by a tech-savvy subgroup of patients. The first commercial hybrid CL system has been available in Germany since September 2019. We surveyed 1054 patients to determine which devices are currently used, which features would be in demand by potential users, and the benefits of DIYCL systems. 9.7% of these used a DIYCL system, while 50% would most likely trust these systems but more than 85% of the patients would use a commercial closed loop system, if available. The DIYCL users had a better glucose control regarding their time in range (TIR) and glycated hemoglobin (HbA1c).

Hypoglycemic, Anti-Hyperglycemic and Anti-Hyperlipidemic Effects of Bersama abyssinica Fresen (Melianthaceae) Leaves' Solvent Fractions in Normoglycemic and Streptozotocin-Induced Diabetic Mice

Background

The leaves of Bersama abyssinica are used by traditional healers and the community for the treatment of diabetes mellitus. Thus, the current study intended to evaluate the hypoglycemic, anti-diabetic, and anti-hyperlipidemic effects of Bersama abyssinica.

Methods

The solvent fractions of Bersama abyssinica leaves were prepared. A total of 132 healthy, male Swiss albino mice weighing 20-28 grams (age of 6-10 weeks) were used. The antidiabetic activity of all the doses (100, 200, and 400 mg/kg) of Bersama abyssinica solvent fractions was evaluated by animal models: normoglycemic mice, oral glucose loaded mice, and diabetic mice. Diabetes was induced by a single intraperitoneal injection of streptozotocin (150mg/kg body weight). The effect of the plant extract on body weight and serum lipid levels were measured in diabetic mice. Statistical analysis was performed by using statistical package for social sciences version 24. The analyses were carried out using one-way ANOVA, followed by Tukey's multiple comparison tests. The result was considered significant when p <0.05.

Results

The solvent fractions of B. abyssinica at all tested doses (100, 200, and 400 mg/kg) exhibited significant (P<0.05-0.001) BGL reduction in all animal models. In hypoglycemic activity, the percentage reduction of baseline BGL was 25.90%, 26.36%, 38.43%, 30.96% and 49.42% for EAF200mg/kg, AQF200mg/kg, EAF400mg/kg, AQF400mg/kg, and GLC 5mg/kg, respectively. B. abyssinica at the dose of AQF 200 mg/kg (p<0.05), AQF 400mg/kg (p<0.001), EAF 200mg/kg (p<0.01), and GLC 5mg/kg (p<0.001) significantly reduced the BGL following 1-hour post-treatment as compared to the negative control. Likewise, the higher doses of the solvent fractions (400mg/kg) significantly (p<0.001) reduced the BGL following 2- and 3-hours post-treatment as compared to the negative control. Daily administration of aqueous fraction of B. abyssinica caused a maximum reduction in fasting BGL at the fourteenth day of administration by 33.29%, 38.59%, 52.71%, and 59.66%, respectively, for AQF100, AQF200, AQF400, and GLC 5mg/kg. The aqueous fraction of B. abyssinica and the glibenclamide significantly (p<0.05) prevent loss of body weight and showed improvement in serum lipid levels.

Conclusion

The solvent fractions of Bersama abyssinica exhibit noticeable antidiabetic activity in all animal models (normoglycemic mice, oral glucose loaded mice, and diabetic mice) and showed improvement in body weight and serum lipid profile levels, which rationalizes the claimed use of the B. abyssinica in the treatment of diabetes mellitus.

Antidiabetic and Anti-hyperlipidemic Effects of the Crude Hydromethanol Extract of Hagenia abyssinica (Rosaceae) Leaves in Streptozotocin-Induced Diabetic Mice

BACKGROUND

The leaves of Hagenia abyssinica (Rosaceae) have been used traditionally for the management of diabetes mellitus. Thus, this study aimed to evaluate the antidiabetic and anti-hyperlipidemic activity of Hagenia abyssinica leaves crude extract in streptozotocin-induced diabetic mice.

METHODS

Antidiabetic and anti-hyperlipidemic activity of the crude extract of Hagenia abyssinica was studied in streptozotocin-induced diabetic mice. The effects of the extract on fasting blood glucose level, body weight, and serum lipid profiles were analyzed. One-way ANOVA followed by Tukey's post hoc test was used for data analysis and p<0.05 was considered as statistically significant.

RESULTS

Hagenia abyssinica leaves crude extract showed significant (p<0.05-p<0.001) blood-glucose-lowering activity. Moreover, the crude extract of H. abyssinica reduced the fasting blood glucose level by 23.21%, 38.20%, 43.53%, and 58.99%, respectively, for CE100, CE 200, CE 400, and GLC 5 mg/kg on the 14th day of treatment. After diabetic mice were treated with H. abyssinica (100, 200 and 400 mg/kg) for 14 days, there was a significant decrease in serum total cholesterol, very-low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and serum triglyceride and a significant increase in body weight, and HDL-cholesterol level as compared to diabetic control.

CONCLUSION

The present findings revealed that H. abyssinica leaves could be useful for the management of diabetes mellitus and other abnormalities related to this metabolic disorder. Thus, the present study may support the traditional use of H. abyssinica for diabetes mellitus treatment.

Hypoglycemic activity of Phaseolus vulgaris (L.) aqueous extract in type 1 diabetic rats

The aim of the present study was to evaluate the hypoglycemic activity of the aqueous extract from the fruit walls of Phaseolus vulgaris pods and to examine the potential mechanism underlying the improvement of the glycemic level. In the course of the study, diabetes mellitus was induced in rats with a single intraperitoneal injection of streptozotocin (45 mg·kg−1 b.w.). Diabetic and control rats were then orally administered with a single-dose or repeated-dose (28 day) of P. vulgaris extract (200 mg·kg−1). Results show that the extract was found to possess significant hypoglycemic activity, and the study of glucose utilization by isolated rat hemidiaphragm suggests that the aqueous extract may enhance the peripheral utilization of glucose. The subsequent experiments have revealed that the P. vulgaris extract could increase glucose transporter 4 (GLUT-4) content in skeletal muscle cells of control and diabetic rats. Our data also indicate that the P. vulgaris extract did not affect the content of the insulin receptor, but significantly reduced the total tyrosine kinase activity in skeletal muscle cells of both experimental groups of rats. The present results clearly indicated that P. vulgaris extract may be beneficial for reducing hyperglycemia through its potency in regulation of glucose utilization via GLUT-4, but the current mechanism remains to be unidentified.

Efficacy of Ginger (Zingiber officinale) in Ameliorating Streptozotocin-Induced Diabetic Liver Injury in Rats: Histological and Biochemical Studies

Ginger (Zingiber officinale) was reported to have an antioxidant, antidiabetic effect. This study was done to investigate its therapeutic effect against functional and structural alteration in liver of diabetic rat (intraperitoneal streptozotocin (STZ) in a dose of 60 mg/kg/bw). Thirty adult male rats (three-months-old and 250 g weight) were sorted into five groups (N=6). G1 used as control, G2 was diabetic rats without any treatment, G3 was diabetic rats given oral ginger in a dose of 500 mg/kg/bw, G4 was diabetic rats treated with metformin (500 mg/kg/bw) while G5 received ginger orally. The experiment lasts for six weeks, animals were anesthetized by ether, body weight was recorded for all animals. Blood was collected for further analysis of lipid profile, liver enzymes and total antioxidant. Liver was dissected, weighted and samples were processed for histopathological study. The results showed significant decrease of glaucous level and liver enzymes in ginger treated rats. Total antioxidant was preserved. Ginger lowered blood glucose, level, regained body weight and liver index to near normal values. Diabetes induced degenerative changes and micro-vesicular lipid deposition in hepatocytes with moderate portal area fibrosis. Ultrastructure study confirmed such changes beside demonstrating increased lipid deposition in fat storing cells. Ginger was found to ameliorate those changes in treated animals. Results were matching metformin effects. In conclusion, Ginger as a natural safe Herbal medication can be used to support liver functions in diabetic status.

In vitro protein tyrosine phosphatase 1B inhibition and antioxidant property of different onion peel cultivars: A comparative study

The aim of the present study was a comparative investigation of water and 70% ethanol extracts derived from yellow and red onion (Allium cepa L.) peels against diabetes and diabetic complications. The total phenolic contents (TPCs) and total flavonoid contents (TFCs) of each cultivar, measured to assess phytochemical characteristics, showed a direct correlation with the in vitro antioxidant effects. Among the two captives, the yellow onion peel extract showed higher antioxidant activity than red one. However, all extracts exhibited significant protein tyrosine phosphatase 1B (PTP1B) inhibitory activity (IC50; 0.30-0.86 μg/ml), showing water extracts more potent (IC50; approximately 0.3 μg/mL), than the 70% ethanol extracts (IC50; approximately 0.8 μg/ml). Similarly, in insulin-resistant HepG2 cells, all extracts enhanced the glucose uptake and reduced the expression of PTP1B in a concentration-dependent manner, water extract displaying better activity. Our results overall suggest that in vitro antioxidant and antidiabetic potentials vary among red and yellow cultivars and extracting solvents, which could therefore be a promising strategy to prevent diabetes and associated complications.

In vitro antiprotozoal activity of some medicinal plants against sleeping sickness, Chagas disease and leishmaniasis

AIM

Antiprotozoal activity of 36 medicinal plants was evaluated.

MATERIALS & METHODS

In vitro potency against Trypanosoma brucei brucei, T. b. rhodesiense, T. cruzi and Leishmania infantum beside cytotoxicity on MRC-5 fibroblasts were determined.

RESULTS & CONCLUSION

Maytenus parviflora showed the highest activity against T. b. brucei (IC₅₀ of 0.6 μg/ml) and T. b. rhodesiense (IC₅₀ of 0.5 μg/ml) with low cytotoxicity (CC₅₀ of 30 μg/ml). Saussurea costus and Commiphora wightii, showed pronounced potency against T. cruzi with an IC₅₀ of 3.6 and 2.5 μg/ml, respectively. Jatropha pelargonifolia and Solanum villosum exhibited pronounced activity toward L. infantum with an IC₅₀ of 3.2 and 2.0 μg/ml, respectively. M. parviflora, S. costus, C. wightii, J. pelargonifolia and S. villosum showed relevant selectivity.

The Discovery of Insulin: An Important Milestone in the History of Medicine

The discovery of insulin represents an authentic breakthrough, characterized, at the same time, by contrasts, controversies and disputes among scholars, as well as by great disappointments, failures and hopes. It is the story of famous, almost famous and little known people, of serendipities, discoveries and re-discoveries. The discovery of insulin has been a milestone and has truly revolutionized both the therapy and the prognosis of the diabetes, one of the diseases most studied in the history of medicine, whose first mentions trace back to a collection of ancient Egyptian, Indian and Chinese textbooks. As stated by Colwell, the introduction of insulin has heralded the end of the so-called "pre-insulin era" or "frustration era", paving the way for a new era and clinical advancements. The current review offers a broad, comprehensive overview of main steps culminating into insulin discovery, including recent advancements such as personalized and individualized insulin therapy.

The therapeutics effects and toxic risk of Heracleum persicum Desf. extract on streptozotocin-induced diabetic rats

There is an increasing interest against to fight of diabetes by using hypoglycemic plants in the world. The public thinks that Heracleum persicum (HP) has antidiabetic effect local consumer in Turkey. As far as our literature survey, no studies have been reported so far on antidiabetic effects and toxic risk potential of the HP lyophilized extract supplementation used in this study. The aim of this study, for the first time, was to investigate the therapeutic effects of diabetic complications, antioxidant properties and toxic risk potential of HP against experimentaly streptozotocin (STZ) induced diabetes in rats, which were evaluated by measuring the level of serum biomarker releated diabetes complications changes such glucose, insülin, c-peptide, lipid profile (LP), hepatic and renal damage biomarkers (HRDB), glucosylated hemoglobin (HbA1c), antioxidant defense system constituents (ADSCs), malondialdehyde (MDA) content measured in erythrocyte, brain, kidney and liver tissues, and α-glucosidase activitiy of small intestine. The plant aqueous extract was allowed to freeze-dried under a vacuum at -54 °C to obtain a fine lyophilized extract. The study was performed on STZ-induced diabetic rats (45 mg/kg, body weight (bw), intraperitonally) designed as normal control (NC), diabetic control (DC), diabetes + acarbose (DAC) (20 mg/kg, bw), diabetes + HP (100 mg/kg, bw) (DH1), diabetes + HP (200 mg/kg, bw) (DH2) and diabetes + HP (400 mg/kg, bw) (DH3)] groups. The experimental process lasted 21 days. According to results; the levels of blood glucose (BG), glucosylated hemoglobin (HbA1c) and malondialdehyde (MDA) of DC group increased significantly (p<0.05) compared to NC group, whereas these parameters of the groups treated with oral administrations of HP plant lyophilized extract were observed significant (p<0.05) declines compared to DC. The biochemical analyses showed a considerable decrease in insulin and c-peptide levels and the fluctuated ADSCs in the DC group as compared to control group, whereas the extract supplementations diet restored the diabetic complications parameters towards to the NC. On the other hands, liver damage serum enzymes as serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were incressed significantly (p<0.05) in the plant extract supplementations groups as compared to NC and DC groups. It was concluded that while the extracts of HP have had therapeutic effects on some complications caused by diabetes, but might be caused hepatocyte damage changes as the transport functions and membrane permeability of these cells, thus causing enzymes to leak.

Cocos nucifera and metformin combination for modulation of diabetic symptoms in streptozotocin induced diabetic rats

Background

Cocos nucifera, belonging to Arecaceae family, holds quite an importance in the Indian traditional medicinal system. C.nucifera inflorescence (CnI) has been reported in the literature to be useful in the treatment of diarrhoea, dysentery, diabetes, and dyspepsia. In this study, we aimed to evaluate the efficacy of CnI as an adjuvant with metformin in ameliorating Type-2 diabetes mellitus (T2-DM).

Objectives

To evaluate antidiabetic activity of CnI in combination with metformin in Streptozotocin (STZ) induced diabetic rats.

Materials and methods

Diabetes was induced in male Wistar rats using streptozotocin (45 mg/kg; i.p.). Plasma glucose level (PGL) was estimated after 72 h of STZ injection. Ethanolic extract of CnI (250 mg/kg and 500 mg/kg) per se and in combination with metformin (22.5 mg/kg) was administered orally once daily to rats for a period of 28 days. PGL level was estimated on 7^th, 14^th and 21^st day followed by Oral Glucose Tolerance Test (OGTT) and PGL both on the 28^th day of treatment. DPPH assay was performed to evaluate antioxidant activity of CnI extract.

Results

Extract of CnI (250 mg/kg and 500 mg/kg alone and the combination of extract (250 mg/kg) along with metformin (22.5 mg/kg) significantly decreased PGL (p < 0.0001) on 7^th, 14^th, 21^st and 28^th days. Histopathological analysis of pancreatic tissue showed that treatment with CnI extract per se and in combination with metformin improved the damaged architecture of pancreas.

Conclusion

The combination therapy of CnI and metformin produced a significant antidiabetic effect than that of the extract alone and provides a scientific rationale for their use in antidiabetic therapy as an adjuvant.

Gastro-Resistant Insulin Receptor-Binding Peptide from Momordica charantia Improved the Glucose Tolerance in Streptozotocin-Induced Diabetic Mice via Insulin Receptor Signaling Pathway

Momordica charantia is a commonly used food and has been used for the management of diabetes. Our previous study has identified an insulin receptor (IR)-binding protein (mcIRBP) from Momordica charantia. Here we identified the gastro-resistant hypoglycemic bioactive peptides from protease-digested mcIRBP. By in vitro digestion and IR kinase activity assay, we found that a 9-amino-acid-residue peptide, mcIRBP-9, was a gastro-resistant peptide that enhanced IR kinase activities. mcIRBP-9 activated IR signaling transduction pathway, which resulted in the phosphorylation of IR, the translocation of glucose transporter 4, and the uptake of glucose in cells. Intraperitoneal and oral administration of mcIRBP-9 stimulated the glucose clearance by 30.91 ± 0.39% and 32.09 ± 0.38%, respectively, in streptozotocin-induced diabetic mice. Moreover, a pilot study showed that daily ingestion of mcIRBP-9 for 30 days decreased the fasting blood glucose levels and glycated hemoglobin (HbA1c) levels by 23.62 ± 6.14% and 24.06 ± 1.53%, respectively. In conclusion, mcIRBP-9 is a unique gastro-resistant bioactive peptide generated after the digestion of mcIRBP. Furthermore, oral administration of mcIRBP-9 improves both the glucose tolerance and the HbA1c levels in diabetic mice via targeting IR signaling transduction pathway.

Antidiabetic activity and phytochemical screening of extracts of the leaves of Ajuga remota Benth on alloxan-induced diabetic mice

Background

Ajuga remota Benth is traditionally used in Ethiopia for the management of diabetes mellitus. Since this claim has not been investigated scientifically, the aim of this study was to evaluate the antidiabetic effect and phytochemical screening of the aqueous and 70% ethanol extracts on alloxan-induced diabetic mice.

Methods

After acute toxicity test, the Swiss albino mice were induced with alloxan to get experimental diabetes animals. The fasting mean blood glucose level before and after treatment for two weeks in normal, diabetic untreated and diabetic mice treated with aqueous and 70% ethanol extracts were performed. Data were statistically evaluated by using Statistical Package for the Social Sciences software version 20. P-value <0.05 was considered statistically significant.

Results

The medium lethal doses (LD₅₀) of both extracts were higher than 5000 mg/kg, indicating the extracts are not toxic under the observable condition. Aqueous extracts of A.remota (300 mg/kg and 500 mg/kg body weight) reduced elevated blood glucose levels by 27.83 ± 2.96% and 38.98 ± 0.67% (P < 0.0001), respectively while the 70% ethanol extract caused a reduction of 27.94 ± 1.92% (300 mg/kg) & 28.26 ± 1.82% (500 mg/kg). Treatment with the antidiabetic drug, Glibenclamide (10 mg/kg body weight) lowered blood glucose level by 51.06% (p < 0.05). Phytochemical screening of both extracts indicated the presence of phenolic compounds, flavonoids, saponins, tannins, and steroids, which might contribute to the antidiabetic activity. The extracts, however, did not contain alkaloids and anthraquinones.

Conclusion

The aqueous extract (500 mg/kg) showed the highest percentage reduction in blood glucose levels and the ability of A. remota extracts in reducing blood glucose levels presumably due to the presence of antioxidant constituents such as flavonoids. The effect of the extract supported the traditional claim of the plant.

Antidiabetic and gastric emptying inhibitory effect of herbal Melia azedarach leaf extract in rodent models of diabetes type 2 mellitus

Diabetes type 2 is associated with impaired insulin production and increased insulin resistance. Treatment with antidiabetic drugs and insulin strives for normalizing glucose homeostasis. In Ethiopian traditional medicine, plant extracts of Melia azedarach are used to control diabetes mellitus and various gastrointestinal disorders. The objective of this study was to clarify the antidiabetic effects of M. azedarach leaf extracts in diabetic type 2 experimental animals. In this study, mice were injected with Melia extract intraperitoneally. Plasma glucose was studied by using tail vein sampling in acute experiments over 4 h and chronic experiments over 21 days with concurrent insulin and body weight assessments. Glucose tolerance was studied by using intraperitoneal glucose (2 mg/g) tolerance test over 120 min. Gastric emptying of a metabolically inert meal was studied by the gastric retention of a radioactive marker over 20 min. Melia extracts displayed acute, dose-dependent antidiabetic effects in ob/ob mice similar to glibenclamide (p<0.05–0.001). Long-term administration of Melia extract reduced plasma glucose (p<0.001) and insulin (p<0.01–0.001) levels over 21 days, concurrent with body weight loss. Glucose tolerance test showed reduced basal glucose levels (p<0.05–0.01), but no difference was found in glucose disposal after long-term treatment with Melia extract. In addition, the Melia extract at 400 mg/kg slowed gastric emptying rate of normal Sprague-Dawley (p<0.001) and diabetic Goto-Kakizaki rats (p<0.001) compared with controls. It is concluded that the M. azedarach leaf extract elicits diabetic activity through a multitargeted action. Primarily an increased insulin-sensitizing effect is at hand, resulting in blood glucose reduction and improved peripheral glucose disposal, but also through reduced gastric emptying and decreased insulin demand.

Unproven Therapies for Diabetes and Their Implications

Diabetes is a chronic disease and is one of the leading causes of morbidity and mortality worldwide. Being an ancient disease, many individuals follow complementary and alternative medicinal (CAM) therapies for either the cure or prevention of the disease. The popularity of these practices among the general public is in no way a testimony to their safety and efficacy. Due to the possibility of undesirable interactions with conventional medicines, it is imperative that patients are asked about CAM use during patient assessment. Patient- and physician-targeted awareness programs on various aspects of CAM use must be initiated to create a better understanding of evidence-based use of these practices. In addition, there should be guidelines in place based on clinical trial outcomes, and stricter regulations need to be enforced on CAM practices to ensure their safety and effectiveness.

In vitro and in vivo inhibition of aldose reductase and advanced glycation end products by phloretin, epigallocatechin 3-gallate and [6]-gingerol

Hyperglycemic stress activates polyol pathway and aldose reductase (AR) key enzyme responsible for generating secondary complications during diabetes. In this study the therapeutic potential of phloretin, epigallocatechin 3-gallate (EGCG) and [6]-gingerol were evaluated for anti-glycating and AR inhibitory activity in vitro and in vivo systems. Human retinal pigment epithelial (HRPE) cells were induced with high glucose supplemented with the phloretin, EGCG and [6]-gingerol. Aldose reductase activity, total advanced glycation end products (AGEs) and enzyme inhibitor kinetics were assessed. Male C57BL/6J mice were randomly assigned to one of the different treatments (bioactive compounds at 2 concentrations each) with either a low fat diet or high fat diet (HFD). After sixteen weeks, AGE accumulation and AR activity was determined in heart, eyes and kidney. High glucose induced toxicity decreased cell viability compared to the untreated cells and AR activity increased to 2-5 folds from 24 to 96h. Pre-treatment of cells with phloretin, EGCG and [6]-gingerol improved cell viability and inhibited AR activity. The enzyme inhibition kinetics followed a non-competitive mode of inhibition for phloretin and EGCG whereas [6]-gingerol indicated uncompetitive type of inhibition against AR. Data from the animal studies showed high plasma glucose levels in HFD group over time, compared to the low fat diet. HFD group developed cataract and AR activity increased to 4 folds compared to the group with low fat diet. Administration of EGCG, phloretin and [6]-gingerol significantly reduced blood sugar levels, AGEs accumulation, and AR activity. These findings could provide a basis to consider using the selected dietary components alone or in combination with other therapeutic approaches to prevent diabetes-related complications in humans.

Ethnobotany and herbal medicine in modern complementary and alternative medicine: An overview of publications in the field of I&C medicine 2001-2013

ETHNOPHARMACOLOGICAL RELEVANCE

Ethnobotanical knowledge and traditional medicinal practices from different parts of the world are of global importance and documentation of ethnobotanical, and ethnopharmacological data is a key prerequisite for further research in the area of herbal medicine and its implementation in clinical practice.

AIMS

An attempt was made to evaluate the scientific output of research related to ethnobotany and herbal medicine in journals indexed in the subject area "Integrative and Complementary Medicine" in the period 2001-2013, in order to ascertain research trends in both subdisciplines.

MATERIALS AND METHODS

All articles related to ethnobotany and herbal medicine, extracted from journals included in the field of I&C Medicine and published in the period 2001-2013, have been analyzed for general bibliometric data, and specific data: ethnobotanical data (geographic, floristic, pharmacological, sociological and other relevant data) and phytotherapeutic data (type of applied herbal medicine, plant species studied, pharmacological activity of studied plant species and disease and disorder type studied on a particular model).

RESULTS

In the studied period, the number of articles dealing with ethnobotany and herbal medicine increased 6.3-fold. Articles related to ethnobotanical studies documented medicinal flora from 81 countries, either giving an overview of overall medicinal flora, or presenting the ethnomedicinal aspect of the use of plants for the treatment of ailments typical to the studied area. Additionally, the authors provided significant information on the methods of use and herbal preparations. In herbal medicine studies, plants, traditional plant remedies, herbal medicinal products and active herbal compounds were tested for many of pharmacological activities (146), with the curative activity emerging as most frequently tested. Out of 39 model systems, most of the studies were carried out under controlled in vitro conditions (4589 articles), followed by rat in vivo (2320), human in vivo (1285), mouse in vivo (955), and on agents of pathogenic diseases (887); more than 800 medical disorders were treated.

CONCLUSIONS

The study revealed the regions most studied for new records of floristic and ethnomedicinal diversity, the most frequently studied plant species, and the most promising therapeutic indications for the integration of herbal remedies in the curative process, as ascertained from the selected bibliographic databases.

Uromastyx acanthinura as a natural treatment in a mouse model of type 2 diabetes

AIMS

Oral testimonies from North Africa attribute anti-diabetic effects to medicinal preparations of the lizard Uromastyx acanthinura (UA). No scientific evidence of such effects is currently available. The acute effects of oral administration of UA to C57Bl/6J mice with diet-induced diabetes were tested and, if effectiveness was shown, the effect of subchronic UA administration was assessed in the same model.

METHODS

Mice were fed a diet containing 60% fat for at least 12 weeks. To assess acute effects, different doses of UA or saline were orally administered with 2g of glucose/kg during an oral glucose tolerance test (OGTT) on different days in a randomised crossover design. The most effective dose was then fed together with the high-fat diet for 90 days and compared to high-fat diet alone in a parallel design. Body weight (BW), food consumption, welfare, and external appearance were assessed weekly. HbA1c, OGTT, and intraperitoneal insulin tolerance tests (IPITT) were performed at baseline and after treatment. Severity of neuropathy was evaluated by cold allodynia response in the acetone test.

RESULTS

UA significantly decreased glucose levels as compared to saline 15min after administration. After 90 days of treatment, no differences were seen in OGTT or HbA1c between the groups, while IPITT showed higher glucose levels in UA-treated animals. Although weight increase was similar in both groups, weight tended to be higher in the treated group, which had a significantly higher daily food consumption. Cold allodynia response improved in frequency and intensity in the UA group.

CONCLUSIONS

Orally administered UA acutely decreased blood glucose in diabetic mice. Paradoxically, long-term administration of UA increased food consumption, weight, and insulin resistance. Improved nociceptive response suggested an effect on pain and/or neuropathy. Although additional studies are needed to elucidate the properties and potential applications of UA, our results highlight the value of ethnomedical approaches to African traditional medicine as starting point to evaluate new bioactive components.

In vitro evaluation of anti-diabetic activity and cytotoxicity of chemically analysed Ocimum basilicum extracts

The aim of this study was to evaluate the role of glucose transporter-4 (GLUT4) in the anti-diabetic effects of methanol, hexane and dichloromethane extracts of the aerial parts of Ocimum basilicum (OB) and to analyze their phytochemical composition. Phytochemical analysis of the three extracts by GC/MS using the silylation derivatization technique revealed 53 compounds, 17 of them were found for the first time in OB. Cytotoxic and anti-diabetic properties of the extracts were evaluated using L6-GLUT4myc muscle cells stably expressing myc epitope at the exofacial loop (GLUT4). No cytotoxic effects were observed in treated cells up to 0.25 mg/ml extract as measured with MTT and LDH-leakage assays. GLUT4 translocation to the plasma membrane was elevated by 3.5 and 7 folds (-/+ insulin) after treatment with OB extracts for 20 h. Our findings suggest that the observed anti-diabetic properties of OB extracts are possibly mediated in part through one or more of the 17 new identified compound.

The use of complementary and alternative medicines (CAMs) in the treatment of diabetes mellitus: is continued use safe and effective?

INTRODUCTION

Diabetes mellitus is a major cause of morbidity and mortality worldwide, with a prevalence of 347 million in 2013. Complementary and Alternative Medicines (CAM) are a group of remedies that is fast gaining acceptance among individuals. Cinnamon, Bitter gourd (Momordica charantia) and Fenugreek (Trigonella foenum-graecum) are 3 widely used CAMs used worldwide for the treatment of diabetes. Data on safety and efficacy is limited, but the consumption is wide. Crepe ginger (Costus speciosus) and Ivy gourd (Coccinia grandis) are 2 plants used widely in the Asian region for their presumed hypoglycaemic properties.

OBJECTIVE

In this review, we analyzed the available evidence for the 5 CAMs mentioned above in terms of in-vitro studies, animal studies sand clinical trials. We also describe the mechanisms of hypoglycaemia and safety concerns where there is available evidence.

RESULTS AND CONCLUSIONS

Clinical trials that studied the hypoglycaemic effects of Cinnamon, bitter gourd, fenugreek and ivy gourd showed conflicting results. Direct comparison between studies remains a challenge in view of the baseline heterogeneity of subjects, differences in substrate preparation, variable end points and poor trial design. Short durations of study and small number of subjects studied is universal. Crepe ginger has not been studied adequately in humans to draw conclusions.In view of the high prevalence of use and safety and efficacy issues, there is an urgent need to study their hypoglycaemic and adverse effects in well-designed long-term clinical trials.

Use of Complementary and Alternative Medicines (CAMs) among type 2 diabetes patients in Sri Lanka: a cross sectional survey

BACKGROUND

The incidence of chronic illnesses has increased worldwide. Diabetes is one such illness and 80% of the diabetic population lives in the developing world. There is a rapidly growing trend towards the use of Complementary and Alternative Medical practices in Diabetes. Sri Lanka is a developing Asian nation with a rich culture of Ayurvedic and native medical culture. The objective of this study was to find the prevalence of use of CAMs in a diabetic population attending a large multiethnic diabetes facility in a University unit and to assess whether there is an increase in the incidence of hypoglycaemic episodes among users of CAMs.

METHODS

A cross sectional study was performed at Teaching Hospital Peradeniya between April and August 2012. Following verbal consent, 254 type 2 adult diabetic patients attending the diabetes facility were interviewed regarding the use of CAM and hypoglycaemia using an interviewer-administered questionnaire.

RESULTS

Of the 252 valid results, 192 patients (76%) admitted to the use of a CAM to reduce blood glucose. Bitter gourd, ivy gourd and crepe ginger were used by 128, 113 and 92 individuals. While 19% used a single agent, 34%, 21% and 2.4% used 2,3 and more than 3 agents. The incidence of hypoglycaemia in CAM users was 21% and 16.6% in non-users. The difference was statistically not significant. (p = 0.57) Ingestion of Costus speciosus (Crepe ginger) was associated with higher incidence of hypoglycaemia (P = 0.01).Female gender was significantly associated with CAM use (p = 0.01), while the age, duration of diabetes, presence of co-morbidities and complications of diabetes failed to show a significant association.

CONCLUSION

Sri Lanka has a very high use of herbal supplementation in type 2 diabetes patients. Although the overall incidence of hypoglycaemia is not increased among CAM users, crepe ginger is associated with significant hypoglycaemia and warrants further research.

Diosgenin from Dioscorea bulbifera: novel hit for treatment of type II diabetes mellitus with inhibitory activity against α-amylase and α-glucosidase

Diabetes mellitus is a multifactorial metabolic disease characterized by post-prandial hyperglycemia (PPHG). α-amylase and α-glucosidase inhibitors aim to explore novel therapeutic agents. Herein we report the promises of Dioscorea bulbifera and its bioactive principle, diosgenin as novel α-amylase and α-glucosidase inhibitor. Among petroleum ether, ethyl acetate, methanol and 70% ethanol (v/v) extracts of bulbs of D. bulbifera, ethyl acetate extract showed highest inhibition upto 72.06 ± 0.51% and 82.64 ± 2.32% against α-amylase and α-glucosidase respectively. GC-TOF-MS analysis of ethyl acetate extract indicated presence of high diosgenin content. Diosgenin was isolated and identified by FTIR, 1H NMR and 13C NMR and confirmed by HPLC which showed an α-amylase and α-glucosidase inhibition upto 70.94 ± 1.24% and 81.71 ± 3.39%, respectively. Kinetic studies confirmed the uncompetitive mode of binding of diosgenin to α-amylase indicated by lowering of both Km and Vm. Interaction studies revealed the quenching of intrinsic fluorescence of α-amylase in presence of diosgenin. Similarly, circular dichroism spectrometry showed diminished negative humped peaks at 208 nm and 222 nm. Molecular docking indicated hydrogen bonding between carboxyl group of Asp300, while hydrophobic interactions between Tyr62, Trp58, Trp59, Val163, His305 and Gln63 residues of α-amylase. Diosgenin interacted with two catalytic residues (Asp352 and Glu411) from α-glucosidase. This is the first report of its kind that provides an intense scientific rationale for use of diosgenin as novel drug candidate for type II diabetes mellitus.

Cytotoxic effects of alcoholic extract of dorema glabrum seed on cancerous cells viability

PURPOSE

In the present study cytotoxic effects of the alcoholic extract of Dorema Glabrum seed on viability of WEHI-164 cells, mouse Fibrosarcoma cell line and L929 normal cells were compared with the cytotoxic effects of Taxol (anticancer and apoptosis inducer drug).

METHODS

To find out the plant extract cytotoxic effects, MTT test and DNA fragmentation assay, the biochemical hallmark of apoptosis were performed on cultured and treated cells.

RESULTS

According to the findings the alcoholic extract of Dorema Glabrum seed can alter cells morphology and because of chromatin condensation and other changes they shrink and take a spherical shape, and lose their attachment too. So the plant extract inhibits cell growth albeit in a time and dose dependent manner and results in degradation of chromosomal DNA.

CONCLUSION

Our data well established the anti-proliferative effect of methanolic extract of Dorema Glabrum seed and clearly showed that the plant extract can induce apoptosis and not necrosis in vitro, but the mechanism of its activities remained unknown. These results demonstrated that Dorema Glabrum seed might be a novel and attractive therapeutic candidate for tumor treatment in clinical practices.

Effect of samh seeds supplementation (Mesembryanthemum forsskalei Hochst) on liver enzymes and lipid profiles of streptozotocin (STZ)-induced diabetic Wistar rats

Thirty streptozotocin (STZ)-induced diabetic of Wistar Albino rats were divided into five groups. The rat groups received different food (natural diet or high fat content diet) supplemented with 10% or 15% of samh seeds for 6 weeks. At the end of the study, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phophatase (ALP) and lactate dehydrogenase (LDH) enzymes have been measured in diabetic rats liver. In addition, liver lipid profile (total cholesterol (TC), triglyceride (TAG), lipid peroxide production malondialdehyde (MDA)) and reduced glutathione (GSH) in have been measured in diabetic rats liver, and the levels of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX) were also determined. The samh seeds diet supplemented with cholesterol significantly increase (P < 0.05) the levels of liver peroxide production MDA, TC and TG in diabetic rats comparing to the samh diet not supplemented with the cholesterol. However, the samh seeds significantly decrease (P < 0.05) the level of GSH. These data suggest that the samh seeds diet not supplemented with the cholesterol regulated C and TG metabolism and decrease the lipid peroxidation in the diabetic rats.

Herbal therapies for type 2 diabetes mellitus: chemistry, biology, and potential application of selected plants and compounds

Diabetes mellitus has been recognized since antiquity. It currently affects as many as 285 million people worldwide and results in heavy personal and national economic burdens. Considerable progress has been made in orthodox antidiabetic drugs. However, new remedies are still in great demand because of the limited efficacy and undesirable side effects of current orthodox drugs. Nature is an extraordinary source of antidiabetic medicines. To date, more than 1200 flowering plants have been claimed to have antidiabetic properties. Among them, one-third have been scientifically studied and documented in around 460 publications. In this review, we select and discuss blood glucose-lowering medicinal herbs that have the ability to modulate one or more of the pathways that regulate insulin resistance, β-cell function, GLP-1 homeostasis, and glucose (re)absorption. Emphasis is placed on phytochemistry, anti-diabetic bioactivities, and likely mechanism(s). Recent progress in the understanding of the biological actions, mechanisms, and therapeutic potential of compounds and extracts of plant origin in type 2 diabetes is summarized. This review provides a source of up-to-date information for further basic and clinical research into herbal therapy for type 2 diabetes. Emerging views on therapeutic strategies for type 2 diabetes are also discussed.

Herbal therapies for type 2 diabetes mellitus: chemistry, biology, and potential application of selected plants and compounds

Background:

Diabetes mellitus, becoming the third killer of mankind after cancer and cardiovascular diseases, is one of the most challenging diseases facing health care professionals today. That is why; there has been a growing interest in the therapeutic use of natural products for diabetes, especially those derived from plants.

Aim:

To evaluate the anti-diabetic activity together with the accompanying biological effects of the fractions and the new natural compounds of Hyphaene thebaica (HT) epicarp.

Materials and Methods:

500 g of coarsely powdered of (HT) fruits epicarp were extracted by acetone. The acetone crude extract was fractionated with methanol and ethyl acetate leaving a residual water-soluble fraction WF. The anti-diabetic effects of the WF and one of its compounds of the acetone extract of the (HT) epicarp were investigated in this study using 40 adult male rats.

Results:

Phytochemical investigation of active WF revealed the presence of ten different flavonoids, among which two new natural compounds luteolin 7-O-[6”-O-α-Lrhamnopyranosyl]-β-D-galactopyranoside 3 and chrysoeriol 7-O-β-D-galactopyranosyl(1→2)-α-L-arabinofuranoside 5 were isolated. Supplementation of the WF improved glucose and insulin tolerance and significantly lowered blood glycosylated hemoglobin levels. On the other hand, compound 5 significantly reduced AST and ALT levels of liver, respectively. Likewise, the kidney functions were improved for both WF and compound 5, whereby both urea and creatinine levels in serum were highly significant

Conclusion:

The results justify the use of WF and compound 5 of the (HT) epicarp as anti-diabetic agent, taking into consideration that the contents of WF were mainly flavonoids

Antidiabetic effect and mode of action of cytopiloyne

Cytopiloyne was identified as a novel polyacetylenic compound. However, its antidiabetic properties are poorly understood. The aim of the present study was to investigate the anti-diabetic effect and mode of action of cytopiloyne on type 2 diabetes (T2D). We first evaluated the therapeutic effect of cytopiloyne on T2D in db/db mice. We found that one dose of cytopiloyne reduced postprandial glucose levels while increasing blood insulin levels. Accordingly, long-term treatment with cytopiloyne reduced postprandial blood glucose levels, increased blood insulin, improved glucose tolerance, suppressed the level of glycosylated hemoglobin A_1c (HbA_1c), and protected pancreatic islets in db/db mice. Next, we studied the anti-diabetic mechanism of action of cytopiloyne. We showed that cytopiloyne failed to decrease blood glucose in streptozocin- (STZ-)treated mice whose β cells were already destroyed. Additionally, cytopiloyne dose dependently increased insulin secretion and expression in β cells. The increase of insulin secretion/expression of cytopiloyne was regulated by protein kinase Cα (PKCα) and its activators, calcium, and diacylglycerol (DAG). Overall, our data suggest that cytopiloyne treats T2D via regulation of insulin production involving the calcium/DAG/PKCα cascade in β cells. These data thus identify the molecular mechanism of action of cytopiloyne and prove its therapeutic potential in T2D.

Antihyperglycemic, antilipid peroxidation, and insulin secretory activities of Otostegia persica shoot extract in streptozotocin-induced diabetic rats and in vitro C187 pancreatic β-cells

CONTEXT

Otostegia persica Boiss (Lamiaceae) contains antioxidant agents and is used in traditional medicine for treatment of diabetes mellitus complications.

OBJECTIVES

The acute antihyperglycemic, antilipid peroxidation, and insulin secretory activities of methanol extract of O. persica aerial parts were investigated.

MATERIALS AND METHODS

The extract [200, 300, 400 mg/kg body weight (b.w.)] was given orally to rats and glucose (2 g/kg b.w. orally) was administered 30 min later. Glucose and insulin serum levels were measured before and 30, 60, 120, and 240 min after administration of the test samples in normal and diabetic rats. The in vitro insulin secretory activity of extract was evaluated in C187 pancreatic β-cells and its antilipid peroxidation effect was determined by measuring malondialdehyde (MDA) and glutathione (GSH) levels in rat livers after 240 min. The identification of the major phytoconstituents of the extract was carried out using gas chromatography-mass spectrometry.

RESULTS

The extract (300 mg/kg b.w.) significantly decreased the serum glucose level in diabetic rats at 1 h (494 ± 13.4 vs. 426 ± 12.9), 2 h (472.8 ± 17.8 vs. 396 ± 22), and 4 h (438.8 ± 25 vs. 346 ± 19) after treatment. Accordingly, the serum insulin level increased at the same times. The extract significantly increased glucose-induced insulin secretion in C187 β-cells. Moreover, the extract significantly decreased MDA and increased GSH levels in the liver of diabetic rats. Phytochemical analysis revealed thymol as the major phytoconstituent in the extract.

DISCUSSION AND CONCLUSION

O. persica shoot extract has antihyperglycemic, antilipid peroxidation, and insulin secretory properties.

Investigating Apoptotic Effects of Methanolic Extract of Dorema glabrum Seed on WEHI-164 Cells

We aimed to investigate the apoptotic effects of the methanolic extract of Dorema glabrum seed on WEHI-164, cancerous cells in comparison with L929, normal cells and compared them with the cytotoxic effects of Taxol. So, MTT test and DNA fragmentation assay were performed on cultured and treated cells. Also electrophoresis which was followed by immunoblotting was done to survey the production of Caspase-3 and Bcl2 proteins, and to inquire into their relative genes expression, RT-PCR was used. According to our findings, the methanolic extract of Dorema glabrum seed can alter cells morphology as they shrink and take a spherical shape and lose their attachment too. So, the plant extract inhibits cell growth albeit in a time- and dose-dependent manner and results in degradation of chromosomal DNA. Induction of apoptosis by the plant extract was proved by the reduction of pro-Caspase-3 and Bcl2 proteins and increase in Caspase-3 gene expression and decrease in that of bcl2 too. Our data well established the antiproliferative effect of methanolic extract of Dorema glabrum seed and clearly showed that the plant extract can induce apoptosis and not necrosis in vitro. These results demonstrated that Dorema glabrum seed might be a novel and attractive therapeutic candidate for tumor treatment.

Ethnobotanical survey of medicinal plants used by Bangladeshi traditional health practitioners in the management of diabetes mellitus

ETHNOPHARMACOLOGICAL RELEVANCE

There is very limited information regarding plants used by traditional healers for treating diabetes in Bangladesh, let alone compilation on the use of those. This study aimed at collecting and documenting information on antidiabetic plants traditionally used in the treatment of diabetes.

MATERIALS AND METHODS

The survey was carried out in a period of almost 2 years. Fieldwork was undertaken in total of 15 districts of Bangladesh. Open-ended and semi structured questionnaire were used to interview a total of 1060 people including traditional healers, Ayurvedic/Unani drug manufacturers and local people.

RESULTS

A total of 83 plant species of 38 families were listed. Leaves were the most cited plant part used against diabetes. Most of the reported species were tree in nature and decoction is the mode of preparation of major portions of the plant species. Most of the plant species were very common and were cultivated or planted in homestead or roadsides.

CONCLUSION

Conventional use of many antidiabetic plants of Bangladesh can be rationalized by the presence of active compounds found in those plants. The documentation could be important for the conservation of these plants and represent the preliminary information required for future phytochemical investigation.