A review of the antimicrobial potential of herbal drugs used in popular Italian medicine (1850s-1950s) to treat bacterial skin diseases

Antibiofilm Effects of Plant Extracts Against Staphylococcus aureus

The global rise in antimicrobial resistance poses a significant threat to public health, necessitating alternative therapeutic options. One critical challenge is treating infections caused by biofilm-forming bacteria, which are notably resistant to conventional antibiotics. Staphylococcus aureus, including methicillin-resistant strains (MRSA), is a major pathogen in biofilm-related infections, complicating treatment and leading to chronic cases. Plant extracts have emerged as promising alternatives, offering new avenues for effective treatment. This study evaluated the antibacterial and antibiofilm activities of commercial extracts of Vitis vinifera L. (grape), Camellia sinensis L. (green tea), Olea europaea L. (olive), Quercus robur (oak), and Coffea arabica L. (coffee) against S. aureus strains from ATCC collections and clinical isolates. Preliminary screening using the disk diffusion test assessed the zones of inhibition, which was followed by minimum inhibitory concentration (MIC) determination via broth microdilution, with Quercus robur L. showing the best overall MIC results. The results obtained demonstrate the strong antibacterial activity of the extracts, with the MIC values ranging from 0.2 to 12.4 mg/mL. Using the XTT reduction assay, the extracts inhibited biofilm growth by 80-85% after 24 h of incubation, with Coffea arabica L. achieving interesting antibiofilm activities. These findings suggest that the investigated plant extracts hold potential as antimicrobial agents and biofilm inhibitors, offering an alternative approach to tackling antimicrobial resistance. Further research is needed to explore their potential applications in developing novel adjuvant therapies.

Phytochemical and ethnomedicinal evidences of the use of Alternanthera brasiliana (L.) Kuntze against infectious diseases

ETHNOPHARMACOLOGICAL RELEVANCE

Popularly known as "penicilina" and "terramicina", Alternanthera brasiliana (L.) Kuntze belongs to the Amaranthaceae family and stands out for its ethnomedicinal uses in the treatment of infections caused by pathogenic microorganisms in some countries.

AIM OF THE STUDY

The present study aimed to carry out a literature review and analyze whether the scientific evidence really validates the numerous indications for the use of A. brasiliana in traditional medicine for the treatment of infectious diseases. Phytochemical and toxicological studies related to this species were also analyzed.

MATERIAL AND METHODS

Scientific documents were retrieved from Google Scholar, PubMed®, ScienceDirect®, SciELO, SpringerLink®, Scopus®, and Web of Science™ databases. The literature was reviewed from the first report on the antimicrobial activity of A. brasiliana in 1994 until April 2024.

RESULTS

According to the scientific documents analyzed, it was observed that A. brasiliana is widely used as a natural antibiotic for the treatment of infectious diseases in Brazil, mainly in the states of Rio Grande do Sul, Mato Grosso, and Minas Gerais. Its ethnomedicinal uses have also been reported in other countries such as Colombia and India. The leaves (78%) of A. brasiliana are the main parts used in the preparation of herbal medicines by traditional communities. Several A. brasiliana extracts showed low activity when evaluated against pathogens, including gram-positive bacteria, gram-negative bacteria, parasitic protozoa, and fungi. Only two studies reported that extracts from this plant showed high activity against the herpes simplex virus, Mycobacterium smegmatis, and Candida albicans. Phytochemicals belonging to the classes of phenolic compounds and flavonoid (52%), saturated and unsaturated fatty acids (33%), steroids and phytosterols (8%), terpenoids (5%), and fatty alcohol esters (2%) were identified in A. brasiliana. Toxicity (in vivo) and cytotoxicity (in vitro) studies of polar and non-polar extracts obtained from A. brasiliana leaves indicated that this plant is biologically safe.

CONCLUSION

Despite being widely used as a natural antibiotic by traditional communities, scientific investigations related to the antimicrobial potential of A. brasiliana extracts have indicated inactivity against several pathogens.

Plants in Menstrual Diseases: A Systematic Study from Italian Folk Medicine on Current Approaches

Background: Plant-based remedies have been used since antiquity to treat menstrual-related diseases (MD). From the late nineteenth to the early to mid-twentieth century, Italian folk remedies to treat "women's diseases" were documented in a vast corpus of literature sources. Aim: The purpose of this paper is to bring to light the plant-based treatments utilized by Italian folk medicine to heal clinical manifestations of premenstrual syndrome (PMS), dysmenorrhea, amenorrhea and menstrual disorders in an attempt to discuss these remedies from a modern pharmacological point of view. Moreover, we compare the medical applications described by Hippocrates with those utilized by Italian folk medicine to check if they result from a sort of continuity of use by over two thousand years. Results: Out of the 54 plants employed in Italian folk medicine, 25 (46.3%) were already documented in the pharmacopoeia of the Corpus Hippocraticum for treating MD. Subsequently, a detailed search of scientific data banks such as Medline and Scopus was undertaken to uncover recent results concerning bioactivities of the plant extracts to treat MD. About 26% of the plants used by Italian folk medicine, nowadays, have undergone human trials to assess their actual efficacy. At the same time, about 41% of these herbal remedies come back to in different countries. Conclusions: Active principles extracted from plants used by Italian folk healers could be a promising source of knowledge and represent strength candidates for future drug discovery for the management of MD.

Wound healing potential of extract from Sambucus nigra L. leaves and its fractions

ETHNOPHARMACOLOGICAL RELEVANCE

Sambucus nigra L. (Viburnaceae), commonly known as black elderberry, is a native species throughout Europe and Western Asia. Elderberry leaves have been used in traditional European medicine, mainly externally, to treat skin and mucosal diseases. They are usually used as decoctions for washing hemorrhoids, ulcers, insect bites, wounds, scrapes, and gingivitis.

AIM OF THE STUDY

Our work aimed to scientifically verify the traditional use of the plant material in treating wounds and skin inflammations accompanied by its phytochemical characterization.

MATERIALS AND METHODS

The effect of 70% (v/v) ethanolic extract and its fractions of different polarities on the inflammatory response of cells involved in wound healing (fibroblasts, keratinocytes, and neutrophils) was investigated. In addition, their effect on the migration of keratinocytes to the scratch site in an in vitro wound healing assay and their impact on the activity of the enzymes involved in skin inflammation, were assessed. The chemical composition was analyzed by UHPLC-DAD-MSn, and the structure of the isolated compounds was determined by NMR.

RESULTS

The supportive effect of the elderberry leaves extract towards wound healing and modulation of the inflammatory response was demonstrated by induction of the keratinocytes. Additionally, the extract was shown to affect the cellular secretion of TNF-α and interleukins -1β, -6, and -8. Examinations of fractionated extract have shown that active principles were mainly contained in dichloromethane fraction. Eleven chemical constituents belonging to flavonoids, cyanogenic glycosides, and lignans were isolated and characterized.

CONCLUSION

The beneficial effect of S. nigra leaves in treating skin diseases has been partially verified and supports its traditional use in skin ailments of different etiologies.

Identification and characterization of major bioactive compounds from Andrographis paniculata (Burm. f.) extracts showed multi-biomedical applications

The Andrographis paniculata recognized as most valuable medicinal plant in folk medicine. Hence, this research was designed to evaluate antibacterial potential of petroleum ether (PE) and methanol (ME) extracts of A. paniculata against skin infection causing bacterial pathogens such as Staphylococcus aureus, Streptococcus pyogenes, Klebsiella pneumoniae, Enterobacter aerogenes, Proteus vulgaris, and Propionibacterium acnes. Also assessed the antidiabetic (α-glucosidase and α-amylase inhibition assay), antioxidant, and photoprotective potential of PE and ME extract analyses. The major bioactive compounds were identified and characterized through UV, FTIR, 1H-NMR and 13C-NMR spectra analyses. The ME extract contain more number of phytochemicals (alkaloids, flavonoids, saponins, terpenoids, glycoside, protein, and phytosterol) than PE extract. The antibacterial activity result also revealed that the ME (as dose dependent) extract showed better activity at 250 mg mL-1 as in the following order: P. acnes (6-29 mm) > K. pneumoniae (3-28 mm) > S. aureus (3-27 mm) > P. vulgaris (3-26 mm) > S. pyogenes (2-25 mm) > E. aerogenes (1-23 mm). PE: E. aerogenes (3-20 mm) > P. vulgaris (2-19 mm) > P. acnes (3-18 mm) > K. pneumoniae (3-17 mm) > S. aureus (2-16 mm) > S. pyogenes (0-11 mm). The MIC value of ME extract was found as 100-150 mg mL-1 and it was better than PE extract. Similarly, the ME also possesses dose based α-glucosidase inhibition activity as up to 85% at 250 mg mL-1 concentration. The fluorescence spectra analysis method also stated that the ME extract possess photoprotective bioactive agent. The ME fractions (F01 and F02) obtained from TLC and column chromatogram were identified as 3-O-β-d-glucosyl-14- deoxyandrographiside and 14-deoxyandrographolide respectively through UV, FTIR, 1H-NMR and 13C-NMR spectra analyses. Such compounds may be responsible for significant antibacterial activity against pathogenic bacteria causing skin infections, excellent antidiabetic activity, as well as photoprotective potential.

Biological effects of bergamot and its potential therapeutic use as an anti-inflammatory, antioxidant, and anticancer agent

Context: Bergamot, mainly produced in the Ionian coastal areas of Southern Italy (Calabria), has been used since 1700 for its balsamic and medicinal properties. Phytochemical profiling has confirmed that bergamot juices are rich in flavonoids, including flavone and flavanone glycosides which are responsible for its beneficial effects.Objective: Recently, it was shown that the combination of natural compounds with conventional treatments improves the efficacy of anticancer therapies. Natural compounds with anticancer properties attack cancerous cells without being toxic to healthy cells. Bergamot can induce cytotoxic and apoptotic effects and prevent cell proliferation in various cancer cells.Methods: In this review, the antiproliferative, pro-apoptotic, anti-inflammatory, and antioxidant effects of bergamot are described. Information was compiled from databases such as PubMed, Web of Science, and Google Scholar using the key words 'bergamot' accompanied by 'inflammation' and, 'cancer' for data published from 2015-2021.Results: In vitro and in vivo studies provided evidence that different forms of bergamot (extract, juice, essential oil, and polyphenolic fraction) can affect several mechanisms that lead to anti-proliferative and pro-apoptotic effects that decrease cell growth, as well as anti-inflammatory and antioxidant effects.Conclusions: Considering the effects of bergamot and its new formulations, we affirm the importance of its rational use in humans and illustrate how bergamot can be utilized in clinical applications. Numerous studies evaluated the effect of new bergamot formulations that can affect the absorption and, therefore, the final effects by altering the therapeutic profile of bergamot and enhancing the scientific knowledge of bergamot.

Research Progress of Dihydroquercetin in the Treatment of Skin Diseases

Skin is a barrier to maintaining the stability of the human environment and preventing the invasion of pathogens. When skin tissue is exposed to the external environment, it will inevitably develop defects due to trauma, injury, burns, ulcers, surgery, and chronic diseases. Rapid skin repair is the key to reducing infection, relieving pain, and improving quality of life. Dihydroquercetin is a kind of flavonoid that has a wide range of pharmacological activities and can improve skin repair, skin inflammation, skin cancer, and so on. In this paper, the application of dihydroquercetin in medical dressings and the research progress in the treatment of skin-related diseases are reviewed, so as to provide reference for further developing dihydroquercetin as a drug for the treatment of skin diseases.

The rise and fall of mandrake in medicine

ETHNOPHARMACOLOGICAL RELEVANCE

Mandrake (Mandragora sp.) is one of the most famous medicinal plants. It has been in continuous medical use throughout written history and is still in use today in popular medicine.

AIM OF THE STUDY

Mandrake derived drugs once played an important role in medicine and in magical practices. Today, the role of mandrake in popular medicine is marginal. However, natural products present in mandrake such as atropine and scopolamine, as well as their semi synthetic derivatives continue to hold and important role in medicine. Here we aim to trace the development of historical rationales and scientific events that led to the abandonment of mandrake as a medicine.

MATERIALS AND METHODS

We review the medicinal uses of mandrake drugs since antiquity in an attempt to pinpoint use patterns that were popular in certain periods of time and others that are more general. We compare the uses from the native territories to those from regions where the plant got introduced and use literature reporting mandrake's chemistry and pharmacology in order to explain the diachronic changes of use patterns.

RESULTS AND CONCLUSION

We found information about 88 different medicinal uses for mandrake, grouped into 39 conditions. According to the number of different medicinal uses, the most versatile period was the medieval (37), followed by the Renaissance (31), the classical (27), and the modern period (21). Considering the higher number of textual sources and use-records collected for the Renaissance period, the decrease of versatility in comparison to the medieval period appears robust. This seems to indicate a more consolidated use pattern, that might be conditioned by the reproduction of classic textual sources as well as by a less experimental approach and reduced popularity of mandrake in medicine. The introduction of the volatile anaesthetics with more reliable narcotic effects set the seal on using mandrake in surgery but opened the way for atropine being used as a prophylactic and antidote during surgical interventions.

Study of Component Composition and Antimicrobial Activity of the Ophthalmic Emulsion Based on the Safflower Flowers (Carthamus tinctorius L.)

The use of medicinal plants has increased significantly in recent years. More than 80% of the world’s population uses medicinal plants to treat themselves. Many antibacterial and anti-inflammatory synthetic drugs are available in medical practice. However, recent tendency of increasing capability of resistance of bacteria to usage of antibacterial drugs of different groups is taking place. Considering the wide range of pharmacological and antimicrobial activity of safflower flower extracts and available vitamins in their composition, it was decided to create a preparation based on the CO2 extract of safflower (Carthamus tinctorius L.) in the form of an ophthalmic emulsion. The aim of this research is to study the composition and antimicrobial activity of the extract and ophthalmic emulsion drops against test strains of microorganisms. The subject of this study is the ophthalmic emulsions from flowers of Kazakhstan species of “Akmai” safflower, collected in the flowering stage in southern Kazakhstan in August 2021. The component composition was determined using gas chromatography with the Agilent 7890A/5975C mass spectrometry technique. A study of the antimicrobial activity of the ophthalmic emulsion drop extracts was performed with two strains of Gram-positive bacteria, one strain of Gram-negative bacteria, and one culture of fungi. The following biologically active substances were determined from the GC-MS results: tridecane 94%, tricosane 93%, hexacosane 93%, dodecanoic acid 92%, pentacosane 91%, and linoleic acid 63.7%. The investigated emulsion-type eye drop shows bactericidal activity against S. aureus ATCC 6538-P, where the zone of growth suppression under the ophthalmic emulsion action corresponded to 9.0 ± 0.0 mm. The tested ophthalmic emulsion drops show the presumed biological activity against conditionally pathogenic bacteria. The results of chromatographic analysis and antimicrobial activity of the tested samples indicate the prospects for their further study for use as anti-infectious (anti-inflammatory) agents in medicine.

Treating leishmaniasis in Amazonia, part 2: Multi-target evaluation of widely used plants to understand medicinal practices

ETHNOPHARMACOLOGICAL RELEVANCE

Leishmaniasis are widely distributed among tropical and subtropical countries, and remains a crucial health issue in Amazonia. Indigenous groups across Amazonia have developed abundant knowledge about medicinal plants related to this pathology.

AIM OF THE STUDY

We intent to explore the weight of different pharmacological activities driving taxa selection for medicinal use in Amazonian communities. Our hypothesis is that specific activity against Leishmania parasites is only one factor along other (anti-inflammatory, wound healing, immunomodulating, antimicrobial) activities.

MATERIALS AND METHODS

The twelve most widespread plant species used against leishmaniasis in Amazonia, according to their cultural and biogeographical importance determined through a wide bibliographical survey (475 use reports), were selected for this study. Plant extracts were prepared to mimic their traditional preparations. Antiparasitic activity was evaluated against promastigotes of reference and clinical New-World strains of Leishmania (L. guyanensis, L. braziliensis and L. amazonensis) and L. amazonensis intracellular amastigotes. We concurrently assessed the extracts immunomodulatory properties on PHA-stimulated human PBMCs and RAW264.7 cells, and on L. guyanensis antigens-stimulated PBMCs obtained from Leishmania-infected patients, as well as antifungal activity and wound healing properties (human keratinocyte migration assay) of the selected extracts. The cytotoxicity of the extracts against various cell lines (HFF1, THP-1, HepG2, PBMCs, RAW264.7 and HaCaT cells) was also considered. The biological activity pattern of the extracts was represented through PCA analysis, and a correlation matrix was calculated.

RESULTS

Spondias mombin L. bark and Anacardium occidentale L. stem and leaves extracts displayed high anti-promatigotes activity, with IC₅₀ ≤ 32 μg/mL against L. guyanensis promastigotes for S. mombin and IC₅₀ of 67 and 47 μg/mL against L. braziliensis and L. guyanensis promastigotes, respectively, for A. occidentale. In addition to the antiparasitic effect, antifungal activity measured against C. albicans and T. rubrum (MIC in the 16-64 μg/mL range) was observed. However, in the case of Leishmania amastigotes, the most active species were Bixa orellana L. (seeds), Chelonantus alatus (Aubl.) Pulle (leaves), Jacaranda copaia (Aubl.) D. Don. (leaves) and Plantago major L. (leaves) with IC₅₀ < 20 μg/mL and infection rates of 14-25% compared to the control. Concerning immunomodulatory activity, P. major and B. orellana were highlighted as the most potent species for the wider range of cytokines in all tested conditions despite overall contrasting results depending on the model. Most of the species led to moderate to low cytotoxic extracts except for C. alatus, which exhibited strong cytotoxic activity in almost all models. None of the tested extracts displayed wound healing properties.

CONCLUSIONS

We highlighted pharmacologically active extracts either on the parasite or on associated pathophysiological aspects, thus supporting the hypothesis that antiparasitic activities are not the only biological factor useful for antileishmanial evaluation. This result should however be supplemented by in vivo studies, and attracts once again the attention on the importance of the choice of biological models for an ethnophamacologically consistent study. Moreover, plant cultural importance, ecological status and availability were discussed in relation with biological results, thus contributing to link ethnobotany, medical anthropology and biology.

Biochemical Profile and Antimicrobial Activity of an Herbal-Based Formula and Its Potential Application in Cosmetic Industry

Microbial infections, and especially microbial resistance, are critical and actual problems that require targeted and efficient therapeutic intervention. Natural-based solutions are a viable alternative, at least for complementary therapy, due to few or no side effects and high safety and efficacy levels. The aim of this study was to demonstrate the potential use of a patented formula based on Achillea millefolium, Origanum vulgare, and Lychnis coronaria species as an antibacterial ingredient, mainly for skin and mucosal infections, in order to support its pharmaco-cosmetic application. The chemical composition of the formula was analyzed by HPLC and spectrophotometric methods. Furthermore, antioxidant and antimicrobial activity were evaluated. To determine the formula’s safety for topical application, it was used on a reconstructed human epidermal model. The formula showed inhibitory activity on both Gram-positive and Gram-negative bacteria, respectively, moderate inhibition on B. cereus, Kocuria kristinae, P. aeurginosa, S. enterica Typhimurium, methicillin-resistant and methicillin-sensible S. aureus, as well as high inhibition on S. epidermidis, Serratia marescens, and Streptococcus pyogenes. The developed product was biochemically characterized for its content in polyphenols, triterpenes, and polyphenol carboxylic acids. The formula was proven to have a nonirritant effect on the human epidermis and important antioxidant activity.

Natural medicine delivery from biomedical devices to treat bone disorders: A review

With an increasing life expectancy and aging population, orthopedic defects and bone graft surgeries are increasing in global prevalence. Research to date has advanced the understanding of bone biology and defect repair mechanism, leading to a marked success in the development of synthetic bone substitutes. Yet, the quest for functionalized bone grafts prompted the researchers to find a viable alternative that regulates cellular activity and supports bone regeneration and healing process without causing serious side-effects. Recently, researchers have introduced natural medicinal compounds (NMCs) in bone scaffold that enables them to release at a desirable rate, maintains a sustained release allowing sufficient time for tissue in-growth, and guides bone regeneration process with minimized risk of tissue toxicity. According to World Health Organization (WHO), NMCs are gaining popularity in western countries for the last two decades and are being used by 80% of the population worldwide. Compared to synthetic drugs, NMCs have a broader range of safety window and thus suitable for prolonged localized delivery for bone regeneration. There is limited literature focusing on the integration of bone grafts and natural medicines that provides detailed scientific evidences on NMCs, their toxic limits and particular application in bone tissue engineering, which could guide the researchers to develop functionalized implants for various bone disorders. This review will discuss the emerging trend of NMC delivery from bone grafts, including 3D-printed structures and surface-modified implants, highlighting the significance and potential of NMCs for bone health, guiding future paths toward the development of an ideal bone tissue engineering scaffold. STATEMENT OF SIGNIFICANCE: To date, additive manufacturing technology provids us with many advanced patient specific or defect specific bone constructs exhibiting three-dimensional, well-defined microstructure with interconnected porous networks for defect-repair applications. However, an ideal scaffold should also be able to supply biological signals that actively guide tissue regeneration while simultaneously preventing post-implantation complications. Natural biomolecules are gaining popularity in tissue engineering since they possess a safer, effective approach compared to synthetic drugs. The integration of bone scaffolds and natural biomolecules exploits the advantages of customized, multi-functional bone implants to provide localized delivery of biochemical signals in a controlled manner. This review presents an overview of bone scaffolds as delivery systems for natural biomolecules, which may provide prominent advancement in bone development and improve defect-healing caused by various musculoskeletal disorders.