Oral administration of the purple passion fruit peel extract reduces wheeze and cough and improves shortness of breath in adults with asthma

Association of dietary flavonoid intakes with prevalence of chronic respiratory diseases in adults

BACKGROUND AND AIMS

Flavonoids are a class of secondary plant metabolites that have been shown to have multiple health benefits, including antioxidant and anti-inflammatory. This study was to explore the association between dietary flavonoid consumption and the prevalence of chronic respiratory diseases (CRDs) in adults.

METHODS AND RESULTS

The six main types of flavonoids, including isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols, were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007-2010 and 2017-2018 by the two 24-h recall interviews. The prevalence of CRDs, including asthma, emphysema, and chronic bronchitis, was determined through a self-administered questionnaire. The analysis included 15,753 participants aged 18 years or older who had completed a diet history interview. After adjustment for potential confounders, the inverse link was found with total flavonoids, anthocyanidins, flavanones, and flavones, with an OR (95%CI) of 0.86 (0.75-0.98), 0.84 (0.72-0.97), 0.80(0.69-0.92), and 0.85(0.73-0.98) for the highest group compared to the lowest group. WQS regression revealed that the mixture of flavonoids was negatively linked with the prevalence of CRDs (OR = 0.88 [0.82-0.95], P < 0.01), and the largest effect was mainly from flavanones (weight = 0.41). In addition, we found that flavonoid intake was negatively linked with inflammatory markers, and systemic inflammation significantly mediated the associations of flavonoids with CRDs, with a mediation rate of 12.64% for CRP (P < 0.01).

CONCLUSION

Higher flavonoid intake was related with a lower prevalence of CRDs in adults, and this relationship may be mediated through systemic inflammation.

Extracts and Scirpusin B from Recycled Seeds and Rinds of Passion Fruits (Passiflora edulis var. Tainung No. 1) Exhibit Improved Functions in Scopolamine-Induced Impaired-Memory ICR Mice

In this paper, the seeds and rinds of passion fruit, which are the agricultural waste of juice processing, were recycled to investigate their biological activities for sustainable use. De-oiled seed powders (S) were successively extracted by refluxing 95% ethanol (95E), 50E, and hot water (HW), respectively, to obtain S-95EE, S-50EE, and S-HWE. Dried rind powders were successively extracted by refluxing HW and 95E to obtain rind-HWE and rind-95EE, respectively. S-50EE and S-95EE showed the most potent extracts, such as anti-amyloid-β1-42 aggregations and anti-acetylcholinesterase inhibitors, and they exhibited neuroprotective activities against amyloid-β25-35-treated or H2O2-treated SH-SY5Y cells. Scirpusin B and piceatannol were identified in S-95EE, S-50EE, and rind-HWE, and they showed anti-acetylcholinesterase activity at 50% inhibitory concentrations of 62.9 and 258.9 μM, respectively. Daily pretreatments of de-oiled seed powders and rind-HWE (600 mg/kg), S-95EE, and S-50EE (250 mg/kg) or scirpusin B (40 mg/kg) for 7 days resulted in improved learning behavior in passive avoidance tests and had significant differences (p < 0.05) compared with those of the control in scopolamine-induced ICR mice. The seeds and rinds of passion fruit will be recycled as materials for the development of functional foods, promoting neuroprotection and delaying the onset of cognitive dysfunctions.

Efficacy of Herbal Medicines on Lung Function in Asthma: a systematic review and meta-analysis of randomized controlled trials

Objectives

The present study was designed to conduct a comprehensive systematic review and meta-analysis to assess the efficacy of herbal medicines as add-on therapy on lung function in asthmatic patients.

Methods

A comprehensive search of online databases was performed up to December 2021 to identify randomized controlled trials that used orally herbal preparations for asthma as add-on therapy. Studies were assessed for methodological quality using the Cochrane Collaboration's Risk of Bias tool. The main outcome was percent predicted value of forced expiratory volume (% predicted FEV1). Pooled weighted mean difference (WMD) estimate with corresponding 95% confidence interval (CI) was calculated using inverse-variance weights method while random effects meta-analysis was used, taking into account clinical and conceptual heterogeneity.

Results

As a result, 1,525 studies were identified. 169 studies were reviewed in-depth and 23 studies met our systematic review inclusion criteria. Finally, nine randomized controlled trials were included in the meta-analysis. Findings indicated that use of herbal medicines in patients with asthma significantly improved % predicted FEV1 (WMD 3.73, 95% CI 1.76-5.70), with no evidence for significant heterogeneity (p = 0.56 [Q statistic], I² = 0.0%). In subgroup analysis by age, improvement in % predicted FEV1 was higher and significant in adults (WMD 5.16; 95% CI 2.68-7.63) compared to children (WMD = 1.27; 95% CI -1.98-4.51). Sensitivity analysis showed the significant effect of herbal medicine consumption on improving FEV1 was consistently (range of summary WMDs 3.27-4.59), indicating that the meta-analysis model was robust. There was no evidence of publication bias both visually and statistically.

Conclusion

Findings support, the complementary use of herbal medicines resulted in significant improvement in the lung function compared to standard treatment in asthmatic patients with no considerable adverse events. This improvement is more likely to be observed amongst adults.

Enhancement of γ-aminobutyric acid content in shells of passion fruit (Passiflora edulis) under anoxic vacuum conditions

Passiflora edulis, commonly known as passion fruit, is a popular all-weather fruit eaten fresh or processed. Its shells, which currently are mostly discarded as waste and hurt the environment, account for more than half of the passion fruit. The shells contain gamma-aminobutyric acid (GABA) which is the main inhibitory neurotransmitter and has many proven medical values such as antidepressant, anti-anxiety, etc. Many studies have shown that GABA production in plants can be significantly increased by reverse stress. Taking Tainong 1 as a typical passion fruit cultivar, this study explored the optimal anoxic vacuum treatment for increasing the GABA content of passion fruit shells. The content increased to 2139.25 ± 26.69 mg/100 g on day 4 of chill storage after vacuum packing (63.68% higher than the control). The activities of glutamate decarboxylase (GAD) and diamine oxidase (DAO) were significantly higher in the vacuum-treated group than in the control group after 4 days of vacuum-chill storage. On day 5 of vacuum-chill storage, the activities of all measured enzymes decreased except for the increase of GABA transaminase (GABA-T), which was accompanied by a decrease in GABA content. Vacuum treatment and subsequent chill storage increased the content of GABA, thereby increasing functional value of passion fruit shells.

A review on the gastrointestinal protective effects of tropical fruit polyphenols

Tropical fruits are popular because of their unique, delicious flavors and good nutritional value. Polyphenols are considered to be the main bioactive ingredients in tropical fruits, and these exert a series of beneficial effects on the human gastrointestinal tract that can enhance intestinal health and prevent intestinal diseases. Moreover, they are distinct from the polyphenols in fruits grown in other geographical zones. Thus, the comprehensive effects of polyphenols in tropical fruits on gut health warrant in-depth review. This article reviews, first, the biological characteristics of several representative tropical fruits, including mango, avocado, noni, cashew apple, passion fruit and lychee; second, the types and content of the main polyphenols in these tropical fruits; third, the effects of each of these fruit polyphenols on gastrointestinal health; and, fourth, the protective mechanism of polyphenols. Polyphenols and their metabolites play a crucial role in the regulation of the gut microbiota, increasing intestinal barrier function, reducing oxidative stress, inhibiting the secretion of inflammatory factors and regulating immune function. Thus, review highlights the value of tropical fruits, highlighting their significance for future research on their applications as functional foods that are oriented to gastrointestinal protection.

Therapeutic Efficacy of Flavonoids in Allergies: A Systematic Review of Randomized Controlled Trials

Objective. To assess the clinical efficacy of flavonoid supplements on allergic diseases. Design. Systematic review. Data Sources. MEDLINE/PubMed, Scopus, Web of Science, and Embase databases were searched from inception to September 2021. Eligibility Criteria for Selecting Studies. Eligible study designs were randomized controlled trials that investigated the effect of flavonoids applied to allergic diseases. Results. This review included 15 randomized controlled trials, including allergic rhinitis/cedar pollinosis ( $n=10$ ), asthma ( $n=3$ ), and atopic dermatitis ( $n=2$ ). A total of 990 participants aged 6 to 69 years were included in these studies. Globally, 12 studies (80%) revealed some benefits of flavonoids (isolate or combined with other compounds) in allergic patients, while three studies (20%) reported no statistically significant impact on symptom scores and/or lung function. No severe adverse events related to treatment were reported. According to the GRADE system, the outcomes evaluated were of low to moderate quality of evidence. Conclusions. Overall, this review suggests that the administration of flavonoids may provide a viable strategy for mitigating allergic symptoms. Future trials with high methodological quality are needed to establish definitive conclusions. This trial is registered with PROSPERO registration no. CRD42021237403.

Phytowaste as nutraceuticals in boosting public health

The utilization of bioactive constituent of peels and seeds provide an effective, environment friendly and inexpensive therapy for different forms of human disease, and the production, improvement and documentation of novel nutraceuticals. This review systematically presents findings and further understanding of the reported benefits and therapeutic applications of peel and seed extracts on innovative cell culture and animal studies, as well as phased clinical human trial research. The extracts of seed and peels were reported to possess high quantities of bioactive substances with antioxidative, antidiabetic, hepatorenal protective, antithyroidal, anti-inflammatory, antibacterial, cardiovascular protective, neuro-protective effects, anticancer and wound healing activities. Therapeutic activities of the bioactive substances of peel and seed extracts include elevation of Superoxide dismutase (SOD), GSH-Px, t-GPx, Catalase and GST activities, with the suppression of MDA levels, hydroperoxide generation and lipid peroxidized products, the extracts also regulate inflammatory mediators and cytokines as they are reported to suppress the secretion of inflammatory cytokines, which include; IL-1β, PGE2, TGF-β and TNF-α and induces apoptosis and cell differentiation. This review revealed the therapeutic importance and best utilization of peels and seed extracts of fruits and vegetables.

Passiflora edulis: An Insight Into Current Researches on Phytochemistry and Pharmacology

Passiflora edulis, also known as passion fruit, is widely distributed in tropical and subtropical areas of the world and becomes popular because of balanced nutrition and health benefits. Currently, more than 110 phytochemical constituents have been found and identified from the different plant parts of P. edulis in which flavonoids and triterpenoids held the biggest share. Various extracts, fruit juice and isolated compounds showed a wide range of health effects and biological activities such as antioxidant, anti-hypertensive, anti-tumor, antidiabetic, hypolipidemic activities, and so forth. Daily consumption of passion fruit at common doses is non-toxic and safe. P. edulis has great potential development and the vast future application for this economically important crop worldwide, and it is in great demand as a fresh product or a formula for food, health care products or medicines. This mini-review aims to provide systematically reorganized information on physiochemical features, nutritional benefits, biological activities, toxicity, and potential applications of leaves, stems, fruits, and peels of P. edulis.

Anthocyanin Profile and Antioxidant Property of Anti-asthma Flowers of Cordyline terminalis (L.) Kunth (Agavaceae)

Cordyline terminalis flower is traditionally used to treat asthma and the purple color of the flower is suggestive of anthocyanins. The purpose of this study was to characterize and determine the antioxidant property of anthocyanins from C. terminalis purple flowers. Five anthocyanins, cyanidin 3,5-di- O-β-glucopyranoside (2.6 ± 0.2 mg/g fr. wt) (1), peonidin 3,5-di- O-β-glucopyranoside (2.8 ± 0.3 mg/g fr. wt) (2), cyanidin 3- O-β-(6″- O- E- p-caffeoylglucopyranoside)-5- O-β-glucopyranoside (3.2 ± 0.2 mg/g fr. wt) (3), cyanidin 3- O-β-(6″- O- E- p-coumaroylglucopyranoside)-5- O-β-glucopyranoside (6.2 ± 0.4 mg/g fr. wt) (4), and peonidin 3- O-β-(6″- O- E- p-coumaroylglucopyranoside)-5- O-β-glucopyranoside (9.8 ± 0.2 mg/g fr. wt) (5), were isolated from the flowers of C. terminalis by a combination of chromatographic techniques. Their structures were established by UV-visible, NMR, and ESI-MS. The extract exhibited appreciable antioxidant activity (IC50 ± SD = 13.1 ± 0.8 μg/mL) against quercetin (IC50 ± SD = 4.5 ± 0.4 μg/mL) compared to the individual anthocyanins (IC50 ± SD = 13.8 ± 0.5 to 16.4 ± 0.7 μg/mL) when measured using the 2,2-diphenyl-1-picryl-hydrazyl method. Cordyline terminalis flowers extract may be justified for use and standardization as herbal remedy for asthma.

Physcion-Matured Dendritic Cells Induce the Differentiation of Th1 Cells

In addition to their use as colorants, anthraquinone derivatives have numerous medical applications, for example, as antibacterial and antiinflammatory agents. We confirmed that physcion (an anthraquinone derivative) induces TNF-alpha production by macrophages and increased the expressions of surface molecules (CD40, CD80, and CD86) and major histocompatibility complex (MHC) II. Based on these results, we hypothesized that physcion might induce the maturation of dendritic cells (DCs) to antigen-presenting cells (APCs), and decided to conduct in vitro experiments using bone-marrow-derived DCs (BMDCs). Physcion was not toxic to DCs and increased the expression of surface molecules (e.g., CD40, CD80, CD86, and MHC II) and the production of cytokines (e.g., IL-12p70, IL-1beta, IL-6, and TNF-alpha), but not of IL-10. To confirm that DCs matured by physcion induce T-cell-immune responses, naive CD4⁺ T cells were treated with physcion-treated DCs or their supernatants. Physcion induced the maturation of DCs, which promoted the polarization of Th1 cells. Our results show physcion-induced DC maturation via TLR4, and that mature DCs promote the differentiation of Th1 cells without affecting the differentiation of Th2 cells. These findings show that physcion has potential use as a treatment for inflammatory diseases associated with Th1/Th2 cell imbalance.

Dietary flavonoids and respiratory diseases: a population-based multi-case-control study in Italian adults

OBJECTIVE

To analyse the associations between chronic respiratory diseases and intakes of total flavonoids and their major subclasses (flavanones, anthocyanins, flavan-3-ols, flavonols, flavones, polymers and proanthocyanidins).

DESIGN

Multi-case-control study.

SETTING

The analysis was conducted in the frame of the Genes Environment Interaction in Respiratory Diseases (GEIRD) study. The European Prospective Investigation into Cancer and Nutrition FFQ was used to ascertain dietary intake. Multinomial regression models adjusting for age, sex, centre, BMI, smoking habit, alcohol intake, education, total energy intake, vitamin C intake and total fruit intake were used to examine the associations between dietary exposures and the relative risk ratio (RRR) of being a case.

PARTICIPANTS

Individuals (n 990) hierarchically defined as follows: cases with asthma (current, n 159; past, n 78), chronic bronchitis (n 47), rhinitis (allergic rhinitis, n 167; non-allergic rhinitis, n 142) and controls (n 97).

RESULTS

An increase of 1 sd in flavanones was associated with a reduced risk of non-allergic rhinitis (adjusted RRR = 0·68, 95 % CI 0·47, 0·97); a similar result was found comparing the highest v. lowest quartile of flavanones intake (adjusted RRR = 0·24, 95 % CI 0·10, 0·59).

CONCLUSIONS

Flavonoids contained in fruits and vegetables, especially flavanones, might reduce the risk of non-allergic rhinitis. No associations were found between other flavonoids and the considered outcomes.

Berberine Inhibits Pro-inflammatory Cytokine-induced IL-6 and CCL11 Production via Modulation of STAT6 Pathway in Human Bronchial Epithelial Cells

Berberine is an isoquinoline alkaloid isolated from various Chinese herbs that has potential of anti-inflammatory, anti-lipidemic, anti-neoplastic, and anti-diabetic activity. In this study, we evaluated the anti-inflammatory efficacy of berberine on allergic airway inflammation by targeting epithelial cells. Allergic airway inflammation driven by T helper 2 (Th2)-type immunity is characterized by airway hyperresponsiveness, elevated IgE production, and eosinophilic infiltration. For eosinophil recruitment, major chemoattractant CCL11 (eotaxin-1) was secreted by lung epithelial cells. BEAS-2B cells, a human bronchial epithelial cell line, were pre-treated with berberine and then activated by IL-4 plus TNF-α. The viability of BEAS-2B cells was assessed. Expression levels of IL-6 and CCL11 were determined using ELISA and real-time PCR. The signaling pathways of MAP kinases, NF-κB, and STAT6 were analyzed by western blot. Berberine treatment (≤1 μM) didn't significantly affect the viability of BEAS-2B cells with or without IL-4 plus TNF-stimulation. Berberine significantly inhibited the secretion of IL-6 and CCL11 from pro-inflammatory cytokine-activated BEAS-2B cells. NF-κB and MAP kinase pathways were seemingly unaffected in BEAS-2B cells with berberine treatment. Significant reduction of nuclear STAT6 protein expression in activated BEAS-2B cells with berberine treatment was observed. Current study reveals that berberine has inhibitory effect in pro-inflammatory cytokine-activated BEAS-2B cells through reducing IL-6 and CCL11 production, which is possibly modulated by suppressing STAT6 signaling pathway.

Analgesic Herbal Medicines in the Treatment of Knee Osteoarthritis: A Systematic Review

Background:

Osteoarthritis (OA) is a type of progressive rheumatoid disease, which leads to the degeneration of the articular cartilage, synovium, subchondral bone, tendons, and the surrounding ligaments.There are various treatments for knee OA, including pharmaceutical, nonpharmaceutical, and surgical treatments. Considering the chronic nature of the disease as well as the necessity for the long-term use of chemical medications, various side effects could occur that include gastrointestinal bleeding, hypertension, congestive heart failure, hyperkalemia, and kidney failure. Therefore, suitable treatments with fewer side effects should be recommended. Recent investigations suggest increased tendency in people to use Complementary and Alternative Medicine (CAM) for knee OA treatment.

Objective:

This systematic review aimed to assess the effectiveness and safety of herbal preparations for the treatment of OA.

Methods:

The searched databases were Cochrane, Scopus, and PubMed. All the selected papers pertained to randomized controlled trials until August 8, 2017 in English in which one or several specific herbs had been used in knee OA treatment.

Results:

We included 24 randomized trials (involving 2399 women and men). There were several different herbal medicines used within the included trials.

Conclusion:

The results show that the methods used in these trials may reduce symptoms and the extent of NSAID consumption and enhance the quality of life. Additional trials are suggested to investigate the safety and efficacy of herbs for the treatment of patients with OA.

Associations of Herbs and Nonvitamin Dietary Supplements Use with Clinical Outcomes Among Adult and Pediatric Patients with Asthma in the United States

BACKGROUND

Herbs and nonvitamin dietary supplements (NVDS) have been commonly used among patients with asthma, yet evidence of their impact on patients' clinical outcomes is limited.

OBJECTIVE

This study examined the associations of herbs and NVDS use with asthma episodes and asthma-related emergency department (ED) visits among US adults and pediatric patients with asthma.

METHODS

A cross-sectional analysis of the 2012 National Health Interview Survey data included 2,930 US adults and 1923 children with self-reported asthma. We estimated the prevalence and type of herbs and/or NVDS use and identified factors associated with their use. We then used multivariable logistic regression models to examine the associations between these supplemental medications use and asthma outcomes, controlling for patient-related covariates. All results were weighted to represent national estimates.

RESULTS

Approximately 7.20% of American children and 21.17% of adults with asthma used herbs and/or NVDS in 2012. Herb and/or NVDS users were more likely to be female, non-Hispanic white, living in the West region, having higher family income, and having comorbidities compared with nonusers. Herbs and/or NVDS use was associated with lower likelihood of having asthma-related ED visit (adjusted odds ratio = 0.48; 95% confidence interval: 0.31, 0.75) among adult patients with asthma, but not for pediatric patients with asthma. No association between herbs and/or NVDS use and having an asthma episode was observed in either adults or children.

CONCLUSIONS

This study found high prevalence of herbs and/or NVDS use among US patients with asthma. Potential benefit of these supplemental medications use on asthma-related ED visits might exist for adult patients with asthma.

Acute Effects of Passion Fruit Juice Supplementation on Cardiac Autonomic Function and Blood Glucose in Healthy Subjects

Ascorbic acid supplementation provides beneficial effects on enhancing cardiac autonomic function in patients with heart failure. Ascorbic acid also reduces blood sugar levels and enhances insulin activity, and encourages cardiac autonomic function. Passion fruit is rich in ascorbic acid and potential antioxidants. This study aimed to evaluate the acute effects of passion fruit juice (PFJ) supplementation primarily on cardiac autonomic function and secondary on blood glucose in healthy subjects. A randomized cross-over trial was conducted in 14 healthy subjects aged 21.29±0.73 years. Subjects were supplemented with either 50% PFJ, or glucose and fructose solution as a placebo (PLA) at 3.5 mL/kg body mass with a 1-week washout between treatments in a single-dose design. Short-term heart rate variability and blood glucose levels were evaluated prior to supplementation (T0) and following supplementation for 30, 60, 90, and 120 min (T30, T60, T90, and T120, respectively). Indexes of cardiac autonomic function at T30, including high frequency power (P=0.03) and total power (P=0.01), were significantly higher and the ratio of low frequency/high frequency power was significantly lower (P=0.01) in the PFJ group compared to the PLA group. Blood glucose levels significantly increased at T30 in both PLA (P=0.00) and PFJ (P=0.00) groups. However, there were no significant differences between groups. A single administration of PFJ enhanced cardiac autonomic function through augmentation of parasympathetic activity, although it did not attenuate postprandial hyperglycemia. PFJ may be potentially recognized as beverage able to prevent cardiovascular disease.

Inhibitions of HMGB1 and TLR4 alleviate DINP-induced asthma in mice

We studied the effects of high mobility group box chromosomal protein 1 (HMGB1) and toll-like receptor (TLR4) in diisonoyl phthalate (DINP)-induced asthma. Mice with DINP-induced asthma were treated with a TLR4-signaling inhibitor or anti-HMGB1 antibody, and various markers of asthma were measured 24 h later. DINP increased airway hyperresponsiveness, numbers of cells in BALF, numbers of inflammatory cells (leukocytes, lymphocytes, monocytes, eosinophils, neutrophils, basophils) in blood, mucus production, pulmonary fibrosis, Th2 type cytokine levels in BALF, and lung cell apoptosis. On the other hand, administrations of TLR4-signaling inhibitors (TAK-242) or anti-HMGB1 antibodies to a mouse model of DINP-induced asthma reduced biological markers of asthma. These results show TLR4 and HMGB1 both contribute to DINP-induced asthma, and that the inhibitions of TLR4 or HMGB1 offer potential means of treating asthma induced by phthalates like DINP.

RCT of the effect of berryfruit polyphenolic cultivar extract in mild steroid-naive asthma: a cross-over, placebo-controlled study

OBJECTIVE

There is preclinical evidence that consumption of berryfruit extract may reduce chronic airways inflammation and modify airway remodelling in allergen-induced models of lung inflammation. We investigated the effect of berryfruit extract on the fractional expired nitric oxide (FeNO), a biomarker of eosinophilic airways inflammation, in adults with steroid-naïve asthma.

DESIGN

Randomised placebo-controlled cross-over double-blind trial.

SETTING

Single-centre community-based trial.

PARTICIPANTS

28 steroid-naïve mild asthmatics with Feno >40 ppb, of whom 25 completed both study interventions.

INTERVENTIONS

Participants were randomised to receive, according to the cross-over design, 100 mg berryfruit polyphenolic extract (BFPE) or placebo for 4 weeks, with a 4-week washout period between the interventions.

PRIMARY OUTCOME MEASURE

The primary outcome variable was FeNO at 4 weeks, analysed by a mixed linear model, with a random effect for participant and baseline FeNo as a covariate.

RESULTS

The mean (SD) natural logarithm transformed (ln) FeNO after 4 weeks of treatment for the BFPE and placebo groups was 4.28 (0.47) and 4.22 (0.47), respectively. The paired change from baseline mean (SD) BFPE minus placebo ln FeNO was -0.03 (0.39), N=25. The mixed linear model estimate, with baseline covariate adjustment, difference in ln FeNO, was -0.002 (95% CI -0.15 to 0.14), p=0.98. This is equivalent to a ratio of geometric mean FeNO of 1.0 (95% CI 0.86 to 1.15).

CONCLUSIONS

In steroid-naïve participants with mild asthma and elevated FeNO, there was no effect of BFPE on FeNO, a biomarker of eosinophilic airways inflammation. Caution is required in the extrapolation of apparent benefit in murine models of lung eosinophilia to clinical efficacy in patients with asthma.

TRIAL REGISTRATION NUMBER

ANZCTR: 12613000451707; Results.

Evidences of Herbal Medicine-Derived Natural Products Effects in Inflammatory Lung Diseases

Pulmonary inflammation is a hallmark of many respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), and acute respiratory syndrome distress (ARDS). Most of these diseases are treated with anti-inflammatory therapy in order to prevent or to reduce the pulmonary inflammation. Herbal medicine-derived natural products have been used in folk medicine and scientific studies to evaluate the value of these compounds have grown in recent years. Many substances derived from plants have the biological effects in vitro and in vivo, such as flavonoids, alkaloids, and terpenoids. Among the biological activities of natural products derived from plants can be pointed out the anti-inflammatory, antiviral, antiplatelet, antitumor anti-allergic activities, and antioxidant. Although many reports have evaluated the effects of these compounds in experimental models, studies evaluating clinical trials are scarce in the literature. This review aims to emphasize the effects of these different natural products in pulmonary diseases in experimental models and in humans and pointing out some possible mechanisms of action.

Medical Plant Extracts for Treating Knee Osteoarthritis: a Snapshot of Recent Clinical Trials and Their Biological Background

In light of the growing global health problem associated with osteoarthritis, herbal remedies have become an important research focus in the scientific and medical community, and numerous studies have been published to identify their biological effects and mechanisms in vitro and in vivo. This review is a snapshot of the most recent clinical trials on the efficacy of medical plant extracts in knee osteoarthritis patients, and provides relevant background information on the biological mechanisms that may underlie the clinical observations. Therefore, we performed a PubMed literature survey and discussed a selection of clinical trials in the field, with special attention being drawn to the design and outcome measures of the studies. We further spotlighted on issues relating to the efficacy and safety of the plant extracts and discussed major challenges for upcoming studies in the field, which include the need for rigorously designed in vivo and in vitro studies, as well as the elucidation of potential additive effects and structure-modifying activities beyond symptom relief.

Passion fruit peel extract attenuates bleomycin-induced pulmonary fibrosis in mice

Idiopathic pulmonary fibrosis is a progressive fatal lung disease characterized by excessive collagen deposition, with no effective treatments. We investigated the efficacy of natural products with high anti-inflammatory activity, such as passion fruit peel extract (PFPE), in a mouse model of bleomycin-induced pulmonary fibrosis (PF). C57BL/6J mice were subjected to a single intratracheal instillation of bleomycin to induce PF. Daily PFPE treatment significantly reduced loss of body mass and mortality rate in mice compared with those treated with bleomycin. While bleomycin-induced PF resulted in elevated total numbers of inflammatory cells, macrophages, lymphocytes, and neutrophils in bronchoalveolar lavage fluid on both days 7 and 21, PFPE administration significantly attenuated these phenomena compared with bleomycin group. On day 7, the decreased superoxide dismutase and myeloperoxidase activities observed in the bleomycin group were significantly restored with PFPE treatment. On day 21, enhanced hydroxyproline deposition in the bleomycin group was also suppressed by PFPE administration. PFPE treatment significantly attenuated extensive inflammatory cell infiltration and accumulation of collagen in lung tissue sections of bleomycin-induced mice on days 7 and 21, respectively. Our results indicate that administration of PFPE decreased bleomycin-induced PF because of anti-inflammatory and antioxidant activities.

Fruit and vegetable intake and risk of wheezing and asthma: a systematic review and meta-analysis

Major bibliographic databases were searched for studies examining the relationship between fruit and vegetable consumption and the risk of wheezing and asthma. Random-effects models were used to pool study results. Subgroup analyses were conducted by fruit and vegetable categories, study design, and age group. Twelve cohorts, 4 population-based case-control studies, and 26 cross-sectional studies published between January 1990 and July 2013 were identified. For the meta-analysis of adults and children, the relative risk (RR) and confidence intervals (CI) when comparing the highest intake group with the lowest intake group were 0.78 (95%CI, 0.70-0.87) for fruit and 0.86 (95%CI, 0.75-0.98) for vegetables. High intake of fruit and vegetables (RR = 0.76; 95%CI, 0.68-0.86 and RR = 0.83; 95%CI, 0.72-0.96) reduced the risk of childhood wheezing. Total intake of fruit and vegetables had a negative association with risk of asthma in adults and children (RR = 0.54; 95%CI, 0.41-0.69). Consuming fruit and vegetables during pregnancy had no association with the risk of asthma in offspring. High intake of fruit and vegetables may reduce the risk of asthma and wheezing in adults and children.

Efficacy of Purple Passion Fruit Peel Extract in Lowering Cardiovascular Risk Factors in Type 2 Diabetic Subjects

The clinical efficacy of purple passion fruit peel extract (a flavonoid-rich dietary supplement) in reducing cardiovascular risk factors in adult type 2 diabetic subjects was investigated in a randomized, double-blind, placebo-controlled trial. Forty-one subjects were randomly assigned to receive a daily dose of purple passion fruit (220 mg) or a matched placebo for 16 weeks. Body mass index, blood pressure, fasting and postprandial blood glucose, glycated hemoglobin, and lipid profile were determined at baseline and at monthly intervals. A significant reduction in systolic blood pressure and fasting blood glucose was observed following administration of purple passion fruit ( P < .05). Purple passion fruit was well tolerated, and no adverse events were reported. These data suggest that purple passion fruit supplementation for 16 weeks in type 2 diabetics results in a significant reduction in systolic blood pressure and fasting blood glucose, indicating that purple passion fruit is safe and well tolerated by diabetics.

Reduced medication use and improved pulmonary function with supplements containing vegetable and fruit concentrate, fish oil and probiotics in asthmatic school children: a randomised controlled trial

Dietary pattern changes may be one of the key factors associated with increasing asthma prevalence. Observational studies have found negative associations between fruit, vegetable and fish consumption and risk of asthma. Experimental studies have also shown that probiotics can modulate the immune system. However, each dietary component exhibits a modest effect. The objective of the present study was to investigate the joint effect of multiple beneficial dietary components on asthma. We designed a 16-week school-based double-blind placebo-controlled randomised trial. The supplement group received fruit plus vegetable concentrate, fish oil and probiotics (FVFP supplement), while the control group received placebos. A total of 192 asthmatic children aged 10-12 years were recruited from elementary schools in metropolitan Taipei. Pulmonary function, medication usage, Paediatric Asthma Quality of Life Questionnaire (PAQLQ) score and the Childhood Asthma Control Test score were evaluated at baseline, and at weeks 8 and 16. Compared with the placebo group, the supplement group showed significant improvement in pulmonary function parameters (91 v. 178 ml for forced vital capacity (FVC), 40 v. 107 ml for forced expiratory volume in 1 s (FEV1) and 1·6 v. 4·8 % for FEV1:FVC ratio; all P values < 0·01) and had a significantly reduced proportion of those using short-acting inhaled bronchodilators and inhaled corticosteroids. However, the PAQLQ score and the Childhood Asthma Control Test score were not significantly different between the two groups, possibly because the majority of the children were treated routinely. FVFP supplements reduced medication use and improved pulmonary function in asthmatic children. The present study supports an adjuvant intervention with a combination of fruit, vegetable, fish and probiotic foods.

Phytomedicine in otorhinolaryngology and pulmonology: clinical trials with herbal remedies

Phytomedicine has become an important alternative treatment option for patients in the Western world, as they seek to be treated in a holistic and natural way after an unsatisfactory response to conventional drugs. Ever since herbal remedies have been introduced in the Western world, clinicians have raised concerns over their efficacy and possible side-effects. A PubMed (Medline) search was performed covering the last five years (01/07-04/12) and including 55 prospective clinical randomized control trials in the medical specialities Otorhinolaryngology and Pulmonology. In this review, we present evidence-based clinical data with herbal remedies and try to enlighten the question of efficacy and reliability of phytomedicine.

Fruit polyphenols, immunity and inflammation

Flavonoids are a large class of naturally occurring compounds widely present in fruits, vegetables and beverages derived from plants. These molecules have been reported to possess a wide range of activities in the prevention of common diseases, including CHD, cancer, neurodegenerative diseases, gastrointestinal disorders and others. The effects appear to be related to the various biological/pharmacological activities of flavonoids. A large number of publications suggest immunomodulatory and anti-inflammatory properties of these compounds. However, almost all studies are in vitro studies with limited research on animal models and scarce data from human studies. The majority of in vitro research has been carried out with single flavonoids, generally aglycones, at rather supraphysiological concentrations. Few studies have investigated the anti-inflammatory effects of physiologically attainable flavonoid concentrations in healthy subjects, and more epidemiological studies and prospective randomised trials are still required. This review summarises evidence for the effects of fruit and tea flavonoids and their metabolites in inflammation and immunity. Mechanisms of effect are discussed, including those on enzyme function and regulation of gene and protein expression. Animal work is included, and evidence from epidemiological studies and human intervention trials is reviewed. Biological relevance and functional benefits of the reported effects, such as resistance to infection or exercise performance, are also discussed.

Common respiratory diseases

The self-medication phenomenon in upper respiratory tract infections, rhinosinusitis, asthma, and chronic obstructive pulmonary disease are significant and will continue to increase. Current level of evidence is poor because of the small number of good quality studies, small sample size, short duration, and variation in the composition of the herbal interventions or therapies. The current review points to several potential therapies that could be effective either alone, or as adjuncts to conventional therapies.