Myrtus communis L. and its application in treatment of Recurrent Aphthous Stomatitis

The therapeutic value of Myrtus communis L.: an updated review

Myrtus communis L. (Family: Myrtaceae) is naturally found in the western part of Asia, Southern Europe, and North Africa. It has been reportedly applied in pharmaceutical industry, traditional medicine, cosmetics, spices, and food. Pubmed, Google scholar, Web of Science, and Scopus were utilized to seek out relevant content concerning the therapeutic potential of M. communis. Subsequently, we conducted a review to identity noteworthy updates pertaining to M. communis. Myrtle berries, leaves, seeds, and essential oils are natural sources of several nutrients and bioactive compounds with marked health effects. The chemical analysis showed that M. communis contained oils, alkaloids, flavonoids, phenolics, coumarins, saponosides, tannins, quinines, and anthraquinones. A pharmacological investigation revealed that M. communis possessed anti-inflammatory, analgesic, antimicrobial, antiparasitic, antioxidant, antidiabetic, anticancer, antimutagenic, immunomodulatory, dermatological, cardiovascular, central nervous system, and gastrointestinal protective effects, among numerous other biological effects. This current review focused on the biochemical, pharmacological, therapeutic effects, and various biological activities of different parts of M. communis. It signifies that M. communis is a therapeutic plant with numerous applications in medicine and could be used as a drug isolate based on its safety and effectiveness.

Effect of Honey-Lime Spray as Add-On Therapy on Chemotherapy-Induced Xerostomia in Breast Cancer Patients: A Pilot Randomized Double-Blinded Controlled Trial

INTRODUCTION

Xerostomia (dry mouth) is a common side effect among patients with cancer undergoing chemotherapy. There is no standard treatment for this symptom yet, although Persian medicine textbooks suggested some products to relieve xerostomia. We aimed to assess the efficacy of honey-lime spray in treating chemotherapy-induced xerostomia in breast cancer patients through a controlled study.

METHODS

In this pilot, randomized, double-blinded clinical trial conducted in Shohadaye Tajrish Hospital, Iran, the intervention group received honey-lime spray and nystatin, while the control group used distilled water plus nystatin for 2 weeks. The six-item dry mouth form and visual analog score (VAS) were used to evaluate xerostomia extent and pain, respectively.

RESULTS

The standardized value of the difference between the mean scores before and after the study was -10.21 (p < 0.001), and the effect size was estimated at 55%. Also, VAS showed a significant decrease in pain for the intervention group compared with the control group (p < 0.001). There were no serious side effects.

CONCLUSION

Honey-lime spray may be a good treatment choice for xerostomia in chemotherapy-induced breast cancer patients, but robust trials with larger samples and prolonged follow-ups are highly recommended.

Einleitung

Mundtrockenheit (Xerostomie) ist eine häufige Nebenwirkung bei Krebspatienten, die sich einer Chemotherapie unterziehen. Es gibt bisher keine Standardtherapie für dieses Symptom, doch Lehrbücher der persischen Medizin schlagen einige Mittel zur Linderung von Mundtrockenheit vor. Unser Ziel war es, die Wirksamkeit von Honig-Limetten-Spray zur Behandlung von chemotherapiebedingter Mundtrockenheit bei Patientinnen mit Brustkrebs im Rahmen einer kontrollierten Studie zu untersuchen.

Methoden

In dieser randomisierten, doppelt verblindeten klinischen Pilotstudie, die im Shohadaye Tajrish Hospital im Iran durchgeführt wurde, erhielt die Interventionsgruppe zwei Wochen lang Honig-Limetten-Spray und Nystatin und die Kontrollgruppe destilliertes Wasser plus Nystatin. Ein Mundtrockenheits-Fragebogen mit sechs Items wurde zur Beurteilung der Schwere der Mundtrockenheit verwendet und eine visuelle Analogskala zur Beurteilung der Schmerzen.

Ergebnisse

Der standardisierte Wert der Differenz zwischen den mittleren Scores vor und nach der Studie betrug −10,21 (p < 0,01), und die geschätzte Effektstärke betrug 55%. Zudem zeigte die VAS eine signifikante Abnahme der Schmerzen in der Interventionsgruppe im Vergleich zur Kontrollgruppe (p < 0,01). Es traten keine schwerwiegenden Nebenwirkungen auf.

Schlussfolgerung

Honig-Limetten-Spray könnte eine gute Wahl für die Behandlung von Mundtrockenheit bei Brustkrebspatientinnen unter Chemotherapie sein, doch hierzu werden belastbare Studien mit größerem Probenumfang und längerer Nachbeobachtung nachdrücklich empfohlen.

Effect of myrtle (Myrtus communis L.) essential oil on oxidant-antioxidant balance in rats with propylthiouracil-induced hypothyroidism

Among today's health problems, metabolic diseases are at the forefront. Hypothyroidism (HT) is a disease characterized by increased TSH, decreased T3&T4 concentrations in serum, with overall metabolic slowdown. Although there are many studies in the literature about oxidative status in HT, statements in these studies are contradictory. In our study, the effect of essential oils obtained from the leaves, flowers, and roots of Myrtus communis L. on oxidative metabolism in an HT model induced by propylthiouracil (PTU) in rats was investigated. A total of 36 Wistar albino rats were randomly divided into six groups as follows: (1) Control, (2) PTU, (3) M. communis L. oil 200 (MO 200), (4) M. communis L. oil 400 (MO 400), (5) PTU + MO 200, and (6) PTU + MO 400. In our study, while oxidative status deteriorates in groups given PTU, antioxidant activity increases in groups given M. communis L. oil. PRACTICAL APPLICATIONS: Essential oils are aromatic oily liquids derived from different parts of plants. M. communis L. is one of the best-known herbs in the class of aromatic and medicinal plants. This paper emphasizes the effect of M. communis L. oil on the negative oxidative state that occurs in HT conditions. The present study provides a positive effect of essential oils obtained from the M. communis L. on the oxidative state seen in HT. In light of this information, it may be beneficial to use M. communis L. oil due to its antioxidative effect in HT conditions.

The Effect of Myrtus communis Aqueous Extract-Containing Gel on Wound Healing in Streptozotocin-Induced Diabetic Rats

BACKGROUND

The medicinal plant Myrtus communis L. (Myrtle) has properties, including anti-inflammatory and wound healing in Persian Medicine.

OBJECTIVE

The objective of this study was to explore the wound healing potential of the local application of a gel containing aqueous extract of the plant berry in streptozotocin (STZ)-induced diabetic rats.

METHODS

Seven days after diabetes establishment, full-thickness excision skin wounds were made in normal and diabetic rats where treated groups received topical application of a gel containing 6% aqueous extract of myrtle berries for 3 weeks. The rate of wound healing and the level of epidermal and dermal maturation in the wound tissue were determined.

RESULTS

The results showed that after 3 and 7 days of wound injury, the gel significantly improved wound healing by accelerating epidermal and dermal maturation in diabetic rats with no significant effect in the control group. However, the wounds of all groups almost completely healed after 3 weeks.

CONCLUSION

These results demonstrate that aqueous extract of myrtle possesses a definite wound healing potential in diabetic conditions. The present findings may suggest the use of topical myrtle berries aqueous extract gel 6% to treat and manage intractable diabetic wounds.

Hemostatic activity of aqueous extract of Myrtus communis L. leaf in topical formulation: In vivo and in vitro evaluations

ETHNOPHARMACOLOGICAL RELEVANCE

Myrtus communis L. (MC) is a well-known medicinal plant in traditional Persian medicine, which contains a large amount of phenolic compounds (mainly hydrolyzable tannins). As mentioned in ancient literature, MC was widely used to control bleeding in every part of the body. Nevertheless, there is no pharmacological study on the anti-hemorrhagic activity of this plant till now.

AIM OF THE STUDY

The current in vivo and in vitro study aimed at evaluating the hemostatic activity of M. communis aqueous leaf extract (MCE) in topical formulation.

MATERIALS AND METHODS

Two parameters of bleeding time and amount in tail bleeding model were measured in vivo in rats treated with MCE (1%, 2.5%, 5%, 7.5%, 10%, 15%, and 20% w/v), 5% M. communis aqueous leaf extract gel (G), tannic acid (TA) (1%, 2.5%, 5%, 7.5%, and 10%), normal saline (NS), and the Monsel's solution (MS), a commercial hemostatic agent. Also, the effect of 5% MCE and 5% TA on PT (prothrombin time) and aPTT (activated partial thromboplastin time) as well as protein precipitation and platelet aggregation were assessed in vitro.

RESULTS

In the rat-tail bleeding model, bleeding time and amount significantly (P < 0.001) reduced by the application of 5% MCE solution on the cut tail compared with the NS group. The bleeding time and amount in the MS group were not significantly different from those of the 5% MCE group. Platelet microaggregates were detected by fluorescent microscope. PT and aPTT values increased >120 s and >180 s by 5% MCE, respectively. Also, protein precipitation and significant reduction in serum proteins were observed in the 5% MCE group.

CONCLUSION

The current study provided new insights into the hemostatic effect of MCE, which may be partially mediated by platelet aggregation activity. Hence, it could be evaluated as the resource of new plant origin hemostatic agent.

Herb medicine for relieving radiation induced oral mucositis: A systematic review and meta-analysis protocol

BACKGROUND

Oral mucositis (OM) is a common and unavoidable side effect in patients suffering from head and neck cancer who are undergoing radiotherapy. It is characterized by unbearable pain, as well as eating and speech disorders. This has serious negative effects on the patients' quality of life and can even reduce radiotherapy tolerance, ultimately resulting in a poor prognosis. At present, many prevention and treatment methods are still in the experimental stage, and the efficacies are controversial.

METHODS

Four English databases: Medline via pubmed, EMBASE, the Cochrane Library, Web of Science and another 4 Chinese databases: China National Knowledge Infrastructure (CNKI), China Science and Technology Journal database (VIP), Wanfang Database and CBM, will be searched from inception to August 2019. All randomized controlled trials in Chinese and English language will be included. Literature selection, data extraction and quality assessment will be completed by 2 independent authors. The primary outcomes will include the incidence of OM (1-4 grade) and the pain degree. The onset time of OM, the improvement rate for quality of life, and any adverse effects will be evaluated as the secondary outcomes. The data will be synthesized by Review Manager and Stata software.

RESULTS

This study provides a high-quality synthesis from existing evidence for Chinese herbal medicine in radiotherapy induced OM treatment, according to the criteria: incidence of OM, onset time of OM, status changes in quality of life and adverse events.

CONCLUSION

This study will provide evidence to help determine whether Chinese herbal medicine is effective and safe for use in the prevention and/or treatment of radiotherapy induced OM.

ETHICS AND DISSEMINATION

No additional formal ethical recognition or informed consent is required since no primary data collection is involved. The study result will be published in peer-reviewed journals or at related conferences.PROSPERO registration number: PROSPERO CRD42019141900.

In vitro evaluation on the scolicidal effect of Myrtus communis L. and Tripleurospermum disciforme L. methanolic extracts

Hydatid disease, a zoonotic disease, is still endemic in many developing countries that is caused by the metacestode of Echinococcus (E.) granulosus. Surgical management is one of the best choices for the treatment of the hydatidosis and using effective scolicidal agents during hydatid surgery is essential to prevent the secondary infection. The aim of the present in vitro study was to evaluate the scolicidal effect of the methanolic extract of Myrtus communis and Tripleurospermum disciforme against protoscoleces of hydatid cyst. Protoscoleces of E. granulosus were aspirated aseptically from infected livers. Various concentrations of M. communis and T. disciforme extracts at different exposure times were examined for their scolicidal activity. Normal saline and silver nitrate were used as negative and positive groups, correspondingly. The viability of protoscoleces was evaluated by 0.1% eosin. The result of the current study indicated that the highest scolicidal effect (100%) of M. communis was obtained at 100 and 50 mg/ml concentrations and LC50 in 10, 20 and 30 min were 11.64 mg/ml, 7.62 mg/ml, and 6.47 mg/ml respectively. The scolicidal activity of T. disciforme was negligible even at high concentration. The findings have shown that the scolicidal activity of M. communis against echinococcosis protoscoleces was strong, while the T. disciforme extract showed fewer effects. However, further studies are required for identification of the active ingredients in the extract and its safety on cells in effective concentrations.

Evaluation of the protective effect of Myrtus communis in scopolamine-induced Alzheimer model through cholinergic receptors

Alzheimer's disease is a progressive neurodegenerative disorder causing common health problem with increasing age. Evidences show that the key symptoms of AD are mainly caused by cholinergic system dysfunction which has a role in cognitive disorders. Cholinergic pathways especially muscarinic receptors like M₁ subtype also have a major role in learning, memory, cognitive functions and emotional state. There is no available permanent treatment currently to cure AD or to change its progression. This study was designed to investigate the factors that play important role in pathogenesis of AD and to compare the effects of Galantamine treatment with effects of Myrtus communis treatment. The expression level of M₁, ACh, BDNF; AChE activity, GSH level, MDA and MPO activity and AChE gene expression were investigated in scopolamine-induced rat model. Results showed that, administration of MC significantly improves the SCOP-induced reduction of latency and object recognition time; increasing BDNF, M₁ and ACh receptor expression levels in the different brain regions. Additionally, MC showed an increased in AChE by enhancing GSH activity and reducing MDA level and MPO activity. In conclusion MC considered as a possible novel therapeutic approach that can be a valuable alternative way in the prevention and treatment of AD.

Effectiveness of Myrtus communis in the treatment of hemorrhoids

Myrtus communis is an important plant in the treatment of many different diseases. The aim of this review was to determine the importance of M. communis essential oil in the treatment of hemorrhoids. For preparing this manuscript, the information was extracted from different resources. The results of clinical studies showed that M. communis essential oil (lotion or ointment) can significantly improve bleeding, permanent pain, pain during defecation, anal irritation, anal itching and anal heaviness in patients with hemorrhoids types I and II. M. communis was also effective in treating patients who did not respond to current chemical treatments (anti-hemorrhoids ointment). Further clinical studies should look into designing a suppository form of M. communis essential oil and compare its effect with the lotion and ointment forms.