Combined lowering of low grade systemic inflammation and insulin resistance in metabolic syndrome patients treated with Ginkgo biloba

Prevalence of metabolic syndrome and its association with oral health: First results from the Kurdish cohort study

Aims

Investigate the association between oral and dental health (ODH) and metabolic syndrome (MetS) in adults aged 35-70 years.

Methods

The study utilized data from the enrollment phase of Dehgolan prospective cohort study in the west of Iran. A cross-sectional assessment was conducted on a total of 3996 participants, involving a comprehensive oral examination and the assessment of their oral hygiene behavior (ODH). MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III. Logistic regression used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic characteristics.

Results

MetS was more prevalent among those who not daily brushing and flossing. Participants with missing teeth (MT) show higher prevalent of MetS. Being female, lower age, illiteracy, family history of diabetes, low physical activity, and salt at table were independently associated with increase odds of MetS (p < 0.05). Odds of MetS were significantly decreased with use flossing (OR = 0.75; CI = 0.60-0.93), decayed (OR = 0.83; CI = 0.72-0.97), filled (OR = 0.84; CI = 0.71-0.99), and increased with MT (OR = 1.45; CI = 1.16-1.81) as long as adjusted for ODH factors. When other potential confounder such as sociodemographic, personal and nutritional habits were adjusted, daily flossing was the only factor that still statistically decreased (OR = 0.79; CI = 0.62-0.99) the odds of MetS.

Conclusion

Daily flossing was the only factor that independently associated with MetS. Relationship of other ODH factors with Mets were confounded by sociodemographic characteristics of the participants.

Pharmacokinetics of ginkgolide B-lyophilized nanoparticles after intravenous injection in rats using liquid chromatography-tandem mass spectrometry

RATIONALE

Ginkgolide B (GB) performs diverse pharmacological activities but has poor water solubility. The currently available GB injections have a short half-life and are lethal when injected rapidly. We prepared GB-lyophilized nanoparticles (GB-NPs) using a new nonsurfactant polysaccharide polymer, ZY-010, as its carrier to regulate the release of GB in vivo. Here, the pharmacokinetics (PK) of GB-NPs after intravenous injection in rats was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS).

METHODS

The samples were separated on an Agilent Eclipse XDB-C 18 column (2.1 × 50 mm, 1.85 μm) maintained at 30°C. The MS/MS transitions of GB and glibenclamide as the internal standard (IS) were set at m/z 423.1 → 367.1 and m/z 492.1 → 367.0, respectively. The standard curve of GB content was constructed, and the specificity, sensitivity, precision, and extraction recovery of LC-MS/MS analysis were assessed. The main PK parameters were analyzed using DAS (Drug And Statistics for Windows) software, version 2.0.

RESULTS

The retention time of GB and IS at elution was 2.77 and 4.75 min, respectively. An excellent linear response across the concentration range of 0.001-100 μg/ml was achieved (r = 0.9997). The relative standard deviation value of precision was less than 10%. The total extraction recovery was above 80.76 ± 2.08%. The main PK parameters for the GB-NPs were as follows: t_1/2  = 69.32 h, AUC_{(0 → ∞)}  = 188 312.97 ± 143 312.41 μg/L h, CL = 0.03 ± 0.02 L/h/kg, and V = 0.09 ± 0.05 L/kg. The t_1/2 of the GB-NPs was significantly longer than that of GB solution, and AUC_{(0 → ∞)} of GB-NPs was about 1.4 times that of GB solution. The PK data demonstrated that the blood concentration of GB in rats conformed to a three-compartment model in both GB solution and GB-NPs.

CONCLUSION

A rapid and accurate LC-MS/MS method was established for the determination of GB-NPs in rats. GB-NPs exhibited a sustained-release behavior in vivo compared with GB solution.

Cardiovascular Activity of Ginkgo biloba-An Insight from Healthy Subjects

Ginkgo biloba is the oldest living tree species in the world. Despite less than encouraging clinical results, extracts from its leaves are among the most used herbal preparations in the prevention and treatment of cardiovascular diseases. Most data on the efficacy of Ginkgo biloba on cardiovascular disease is from clinical studies, with few results from healthy subjects. This paper aims to provide a comprehensive review of the mechanisms underlying the known beneficial cardiovascular activities of Ginkgo biloba. It displays myocardial suppressant and vasorelaxant activities ex vivo, potentiating endothelial-dependent and -independent pathways. It improves perfusion in different vascular beds, namely ocular, cochlear, cutaneous, cerebral, and coronary. Although scarce, evidence suggests that Ginkgo biloba displays a heterogeneous effect on tissue perfusion which is dependent on the individual elimination pathways. It displays an acceptable safety profile, with most reported adverse reactions constituting rare occurrences. Collectively, Ginkgo biloba positively impacts cardiovascular physiology, improving hemodynamics and organ perfusion. In the future, better controlled clinical studies should be performed in order to identify the target populations who may benefit the most from pharmacotherapeutic interventions involving Ginkgo biloba.

Preparation of a new component group of Ginkgo biloba leaves and investigation of the antihypertensive effects in spontaneously hypertensive rats

Ginkgo (Ginkgo biloba L.) is a traditional economic tree species in China. Ginkgo biloba extract (GBE) is widely used in combination to treat hypertension and complications in clinical practice. However, the antihypertensive effect of GBE alone is weak and it is also difficult to study the mechanism because of its complex composition. This study was to prepare a new component group of Ginkgo biloba leaves (GBLCG) with clear chemical structures, and to investigate its effect on reducing blood pressure and improving myocardial hypertrophy in spontaneously hypertensive rats with GBE and amlodipine as positive controls. The results showed that total flavonoid aglycones (TFAs) of GBLCG was mainly composed of quercetin (QCT), kaempferol (KMF) and isorhamnetin (ISR); Total terpenoid lactones (TTLs) of GBLCG might be a novel cocrystal composed of Ginkgolide A (GA), Ginkgolide B (GB) Ginkgolide C (GC), Ginkgolide J (GJ) and bilobalide (BB). The hypotensive activity of GBLCG (4.4 mg/kg) group was better than that of GBE group (p < 0.05), and the effect of improving myocardial hypertrophy was better than that of amlodipine besylate group (p < 0.01). GBLCG might reduce blood pressure and improve myocardial hypertrophy by promoting the synthesis and release of NO in endothelial cells, reducing oxidative stress, inhibiting platelet aggregation and promoting lesion circulation. Eventually, we hope to introduce GBLCG as a new drug for hypertension.

Ginkgo biloba in the Aging Process: A Narrative Review

Neurodegenerative diseases, cardiovascular disease (CVD), hypertension, insulin resistance, cancer, and other degenerative processes commonly appear with aging. Ginkgo biloba (GB) is associated with several health benefits, including memory and cognitive improvement, in Alzheimer’s disease (AD), Parkinson’s disease (PD), and cancer. Its antiapoptotic, antioxidant, and anti-inflammatory actions have effects on cognition and other conditions associated with aging-related processes, such as insulin resistance, hypertension, and cardiovascular conditions. The aim of this study was to perform a narrative review of the effects of GB in some age-related conditions, such as neurodegenerative diseases, CVD, and cancer. PubMed, Cochrane, and Embase databases were searched, and the PRISMA guidelines were applied. Fourteen clinical trials were selected; the studies showed that GB can improve memory, cognition, memory scores, psychopathology, and the quality of life of patients. Moreover, it can improve cerebral blood flow supply, executive function, attention/concentration, non-verbal memory, and mood, and decrease stress, fasting serum glucose, glycated hemoglobin, insulin levels, body mass index, waist circumference, biomarkers of oxidative stress, the stability and progression of atherosclerotic plaques, and inflammation. Therefore, it is possible to conclude that the use of GB can provide benefits in the prevention and treatment of aging-related conditions.

Molecular Action of Herbal Medicine in Physiology of Erection and its Dysfunction

Erection is a physiological process that involves vascular, hormonal, and nervous factors. Erectile dysfunction is one of the male sexual problems that occur globally and is reported to affect men's quality of life. Herbal plants have been widely used for disease treatment, including the problem of erectile dysfunction. This paper aims to review the molecular potential of various plants in the physiology of erection and to treat erectile dysfunction. The literature search was carried out through the Pubmed and Google Scholar databases regarding the molecular mechanisms of herbal plants and their potential involvement in the physiology of erection and overcoming erectile dysfunction. This paper focuses on six herbal plants: Panax ginseng, Ginkgo biloba, Epimedium, Black pepper, Tribulus terrestris, and Eurycoma longifolia. The six herbal plants have involvement in the erection process and have molecular potential in the treatment of erectile problems

Worldwide flavor enhancer monosodium glutamate combined with high lipid diet provokes metabolic alterations and systemic anomalies: An overview

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Flavor enhancing high lipid diet acts as silent killer.

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Monosodium glutamate mixed with high lipid diet alters redox-status.

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Monosodium glutamate mixed with high lipid diet induces systemic anomalies.

In this fast-food era, people depend on ready-made foods and engage in minimal physical activities that ultimately change their food habits. Majorities of such foods have harmful effects on human health due to higher percentages of saturated fatty acids, trans-fatty acids, and hydrogenated fats in the form of high lipid diet (HLD). Moreover, food manufacturers add monosodium glutamate (MSG) to enhance the taste and palatability of the HLD. Both MSG and HLD induce the generation of reactive oxygen species (ROS) and thereby alter the redox-homeostasis to cause systemic damage. However, MSG mixed HLD (MH) consumption leads to dyslipidemia, silently develops non-alcoholic fatty liver disease followed by metabolic alterations and systemic anomalies, even malignancies, via modulating different signaling pathways. This comprehensive review formulates health care strategies to create global awareness about the harmful impact of MH on the human body and recommends the daily consumption of more natural foods rich in antioxidants instead of toxic ingredients to counterbalance the MH-induced systemic anomalies.

New Insight into the Mechanisms of Ginkgo Biloba Extract in Vascular Aging Prevention

BACKGROUND

Aging-associated vascular dysfunction promotes cardiovascular diseases. Recently, Ginkgo biloba extract (GBE) has attracted considerable attention in the prevention of aged vasculature.

METHODS

This review discusses the pathophysiological alterations in aged vasculature and the underlying mechanisms of GBE in vascular aging suppression.

RESULTS

Both arterial stiffening and endothelial dysfunction are critical aging-related vascular phenotypes that result in the progression of cardiovascular diseases in the general population. Consistent oxidative stress and inflammatory reaction lead to vascular dysfunction. GBE ameliorates aging-related vascular dysfunction, due to its antioxidant and anti-inflammatory properties. The main effects of GBE in aged vasculature might be associated with the longevity signaling pathways. GBE also attenuates the progression of vascular aging in diabetes mellitus via regulation of glucose and lipid metabolism.

CONCLUSION

GBE plays an important role in the prevention of vascular aging process. It is a promising therapeutic approach to ameliorate aging-related vascular dysfunction and cardiovascular diseases.

Effects of Ginkgo biloba intake on cardiometabolic parameters in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of clinical trials

Ginkgo biloba (GKB) may have a beneficial effect on cardiometabolic parameters in type 2 diabetes mellitus (T2DM), but the data is inconsistent. Therefore, the current systematic review and meta-analysis of clinical trials was conducted to assess the influence of GKB on cardiometabolic parameters in T2DM. Several online databases such as PubMed, Embase, Scopus, Web of Sciences, Google Scholar and Cochrane Library were systematically searched from inception up to September 2, 2019. Heterogeneity across included studies was assessed using the Cochran's Q statistic and I2 index. To pool weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs) as summary effect size, we selected fixed or random-effects model according to the result of heterogeneity. Seven studies comprising 768 subjects were included in the present meta-analysis which resulted in a significant effect of GKB on hemoglobin A1c (HbA1c) (WMD = 0.26, 95% CI = [0.02, 0.50], p = .034) and serum HDL-cholesterol levels (WMD = 1.99, 95% CI = [0.19, 3.79], p = .030) with no significant publication bias. GKB can significantly modulate HbA1c and HDL-cholesterol levels. However, due to uncertainties related to the limited number of studies, it is too early to conclude whether GKB has any potential effects on the cardiometabolic factors in patients with T2DM or not.

Efficacy and safety of Ginkgo biloba extract as an "add-on" treatment to metformin for patients with metabolic syndrome: a pilot clinical study

Background and aim

Ginkgo biloba (GKB) extract has shown to be beneficial in experimental models of metabolic and inflammatory disorders such as diabetes and metabolic syndrome (MTS). The objective of this pilot clinical study was to evaluate the effects of GKB extract as an “add-on” treatment with metformin (Met) in MTS patients.

Patients and methods

We performed a randomized, placebo-controlled, double-blinded clinical study in subjects with MTS. Forty patients completed the 90-day clinical trial and were randomly allocated to administer either GKB extract (120 mg capsule/day) or placebo (120 mg starch/day) as an add-on treatment with their currently used doses of Met for 90 days. During the study, body mass index (BMI), waist circumference (WC), serum leptin, glycated hemoglobin (HbA1c), fasting serum glucose (FSG), insulin, insulin resistance (IR), visceral adiposity index (VAI), lipid profile, and the inflammatory markers high sensitive C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were evaluated.

Results

GKB extract significantly decreases HbA1c, FSG and insulin levels, IR, BMI, WC, VAI, serum leptin, and the inflammatory markers compared to baseline values. Simultaneously, GKB did not negatively affect the functions of the liver, kidney, and hematopoietic system.

Conclusion

The use of GKB extract as an adjuvant with Met was effective in improving the outcome of patients with MTS.

Protective effect of the standardized leaf extract of Ginkgo biloba (EGb761) against hypertension-induced renal injury in rats

BACKGROUND

Ginkgo biloba leaves extract has been widely used worldwide to protect against oxidative stress-induced cell damage and improves blood circulation.

METHODS

The potential protective role of the standardized leaf extract of Ginkgo biloba (EGb761) on hypertension-induced renal injury was investigated in rats. Hypertension was induced in rats by L-NAME.

RESULT

Repeated treatment with EGb761 produced progressive reductions in the systolic, diastolic and mean arterial blood pressure. Also, EGb761 increased the progressive reductions in blood pressure induced by losartan. Hypertension-induced marked elevation of renal malondialdehyde (MDA) and nitrite levels and reduction of reduced glutathione (GSH) level were inhibited by EGb761. In addition, hypertension-induced increases in tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β)) levels in renal tissues were inhibited by EGb761. Also, treatment with EGb761 inhibited hypertension-induced decrease in endothelial nitric oxide synthase (eNOS) protein expression and increase in the protein expressions of inducible NO synthase (iNOS), TNF-α, IL-6 and IL-1B in the kidney tissues. EGb761 enhanced losartan effects on renal tissues oxidative stress, nitrite, and inflammatory markers levels and on protein expressions of eNOS, iNOS, TNF-α, IL-6 and IL-1B. effects.

CONCLUSIONS

These results indicate that EGb761 has the ability to protect against hypertension-induced renal injury.

Postprandial hyperglycemia and postprandial hypertriglyceridemia in type 2 diabetes

Postprandial glucose level is an independent risk factor for cardiovascular disease that exerts effects greater than glucose levels at fasting state, whereas increase in serum triglyceride level, under both fasting and postprandial conditions, contributes to the development of arteriosclerosis. Insulin resistance is a prevailing cause of abnormalities in postabsorptive excursion of blood glucose and postprandial lipid profile. Excess fat deposition renders a vicious cycle of hyperglycemia and hypertriglyceridemia in the postprandial state, and both of which are contributors to atherosclerotic change of vessels especially in patients with type 2 diabetes mellitus. Several therapeutic approaches for ameliorating each of these abnormalities have been attempted, including various antidiabetic agents or new compounds targeting lipid metabolism.

Protective effect of the standardized extract of ginkgo biloba (EGb761) against hypertension with hypercholesterolemia-induced renal injury in rats: Insights in the underlying mechanisms

The potential protective role of the standardized leaf extract of ginkgo biloba (EGb761) on hypertension with hypercholesterolemia-induced renal injury was investigated in rats. Hypertension was induced by L-N(G)-nitroarginine methyl ester (L-NAME) and hypercholesterolemia was induced by feeding rats with a diet containing 1% cholesterol. In these animals repeated treatment with EGb761 produced a progressive reduction in the systolic, diastolic and mean arterial blood pressure (BP). EGb761 increased the progressive reduction in the systolic, diastolic and mean arterial BP induced by repeated administration of losartan with simvastatin. EGb761 corrected the compromised serum lipid profile and enhanced the effect of losartan with simvastatin on lipid profile. EGb761 protected against hypertension with hypercholesterolemia-induced renal injury as assessed by measurement of serum renal function markers and by histopathological examination. EGb761 enhanced the renoprotective effect of losartan with simvastatin in these rats. Concomitantly, hypertension with hypercholesterolemia-induced elevation of renal tissue malondialdehyde (MDA) and nitrite levels and reduction of intracellular reduced glutathione (GSH) level were inhibited by repeated treatment with EGb761. In addition, hypertension with hypercholesterolemia-induced increases in tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) levels in renal tissues were inhibited by treatment with EGb761. Also, EGb761 inhibited hypertension with hypercholesterolemia-induced decrease in endothelial nitric oxide synthase (eNOS) protein expression and increase in the protein expressions of inducible NO synthase (iNOS), TNF-α, IL-6 and IL-1β in the kidney tissues. Losartan with simvastatin produced similar effects on renal tissues oxidative stress, nitrite and inflammatory markers levels and on protein expressions of eNOS, iNOS, TNF-α, IL-6 and IL-1β. EGb761 enhanced losartan with simvastatin effects. These results indicate that EGb761 has the ability to protect against hypertension with hypercholesterolemia-induced renal injury. The ability of EGb761 to provide this renoprotective effect may positively correlate, besides its antihypertensive and antihypercholesterolemic effects, to its ability to suppress renal oxidative stress, nitrosative stress and inflammation.

Relationship between dental caries and metabolic syndrome among 13 998 middle-aged urban Chinese

BACKGROUND

The association between dental caries and metabolic syndrome (MetS) is inconsistent. The aim of the present study was to assess the relationship between dental caries and MetS and its components in a middle-aged Chinese population.

METHODS

A cross-sectional analysis was performed of 13 998 participants aged 45-65 years undergoing a health check during 2013-14. An index variable of decayed, missing, and filled teeth (DMFT) was calculated. Logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) after adjustment for sex, age, education level, dietary habits, alcohol use, smoking, physical activity, and periodontitis.

RESULTS

Of the 13 998 participants, 6164 had dental caries and 7834 did not; 3571 had MetS, whereas 10 427 did not. Participants with severe caries showed a higher prevalence of MetS, abdominal obesity, elevated blood pressure, dyslipidemia, and hyperglycemia than those with mild or no caries (all P < 0.01). Adjusted ORs for MetS for those with two or more dental caries and those with two or more DMFT were 1.12 (95 % CI 1.14-1.74) and 1.09 (95 % CI, 0.89-1.21), respectively (P _trend  < 0.001). Stratified analysis by individual MetS components showed that caries were associated with MetS among subjects with hyperglycemia (OR 1.14 [95%CI, 0.98-1.34]; P < 0.001). However, there was no significant relationship between caries and abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, and elevated blood pressure (adjusted ORs [95 % CIs] 0.98 [0.82-1.16], 1.01 [0.85-1.19], 0.84 [0.70-1.00], and 0.96 [0.86-1.13], respectively; all P > 0.05).

CONCLUSIONS

Dental caries were associated with MetS among middle-aged Chinese in the present study.

Novel analysis of maturation of murine bone-marrow-derived dendritic cells induced by Ginkgo Seed Polysaccharides

Our understanding of the mechanisms of effect of Ginkgo Seed Polysaccharides (GSPs) on the immune system remains unclear. The aim of this work was to investigate the effect of GSPs on the maturation and function of bone-marrow-derived dendritic cells (BMDCs). The results demonstrate that GSP could exert positive immune modulation on the maturation and functions of BMDCs. This effect was evidenced by decreased changes of phagosome number inside BMDCs, decreased activity of acidic phosphatase (ACP), decreased phagocytosis of BMDCs, and increased changes of key membrane molecules on BMDCs. Upregulated production of cytokines IL-12 and TNF-α also was confirmed. Therefore, it can be concluded that GSPs can efficiently induce the maturation of BMDCs. Our exploration provides direct data and a rationale for potential application of GSPs as an immune enhancer in improving immunity and as a potent adjuvant in the design of DC-based vaccines.

Effect of oxymatrine on insulin resistance in patients with type 2 diabetes mellitus

AIM: To observe the influence of oxymatrine on insulin resistance in patients with type 2 diabetes mellitus and the mechanism involved.

METHODS: This was a prospective randomized controlled clinical study. Patients with type 2 diabetes mellitus were divided into either an oxymatrine treatment group or an untreated group. Glucose oxidase method was used to detect serum fasting blood glucose (FBG) and fasting insulin (FINS). The homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of insulin sensitivity index (HOMA-ISI) were also detected. ELISA was carried out to detect the serum levels of reactive oxygen species (ROS) and tumor necrosis factor-α (TNF-α). Western blot was used to detect the expression of protein kinase B (AKT), p-AKT, glycogen synthase kinase-3α/β (GSK3α/β), and p-GSK3α/β proteins.

RESULTS: FBG, FINS and HOMA-IR significantly decreased and HOMA-ISI increased in the oxymatrine treatment group compared with the untreated group (P < 0.05). Serum levels of ROS and TNF-α in the oxymatrine treatment group decreased significantly compared with the untreated group (P < 0.05). Western blot analysis showed that the total protein levels of AKT and GSK3α/β were unchanged (P > 0.05), but the expression of p-AKT and p-GSK3α/β significantly increased in the oxymatrine treatment group compared with the untreated group (P < 0.05).

CONCLUSION: Oxymatrine can reduce FBG and FINS, and improve insulin resistance by reducing the production of serum ROS and TNF-α and by influencing the photophosphorylation of key proteins (such as AKT and GSK3α/β) in the insulin resistance-related signaling pathways.