Herbal Medicine for Idiopathic Central Precocious Puberty: A Systematic Review and Meta-Analysis

Comparative effectiveness of Korean medicine treatment for idiopathic central precocious puberty: A Bayesian network meta-analysis

BACKGROUND

The purpose of this study is to analyze the comparative effect of the Korean medicine treatment for idiopathic central precocious puberty (ICPP) using Bayesian network meta-analysis (NMA).

METHODS

Seventeen electronic databases were used to search for randomized controlled trials (RCTs) that evaluated various Korean medicine treatments for ICPP. R software (version 4.2.3) was used to perform NMA. The risk of bias was assessed using the Risk of Bias 2 tool proposed by the Cochrane Collaboration. The results of NMA were expressed as network map, SUCRA, and Rank plot.

RESULTS

A total of 81 RCTs were included in the NMA. The gonadotropin-releasing hormone agonist (GnRHa) was the most effective for growth rate, followed by herbal medicine (HM) combined with GnRHa. The combination of HM and auricular plaster therapy was the most effective in improving the bone age index and ovarian volume, and megestrol was the most effective in improving uterine volume. The combination of HM, auricular plaster therapy and GnRHa was the most effective in improving follicle-stimulating hormone, and the combination of HM and GnRHa was the most effective in improving luteinizing hormone and estradiol.

CONCLUSION

The combination of HM and GnRHa generally showed greater effectiveness compared to GnRHa monotherapy or HM monotherapy. Although there have been few reports of adverse events related to HM, additional research and practical experience are needed. Further diverse studies should be conducted to support the decision-making process of patients and clinicians during the diagnosis and treatment of ICPP.

Perceptions and use of complementary and alternative medicine in patients with precocious puberty

OBJECTIVES

Use of complementary and alternative medicine (CAM) is widespread. This study aimed to investigate the use of CAM in children with central precocious puberty (PP) who used gonadotropin-releasing hormone analog (GnRHa) treatment.

METHODS

Parents of 108 patients who were diagnosed as having PP were involved in the study. A questionnaire was administered to the parents during follow-ups. The patients were divided into two groups according to the use of CAM.

RESULTS

Forty (37%) patients had used CAM. Parents who graduated from primary school tended not to use CAM (χ ² =10.463; p=0.015). There was no other statistically significant difference between the sociodemographic features (p>0.05). The most common information source was physicians (40%). Seventy-five percentage of CAM users and 44.1% of non-CAM users knew/heard about herbal medicine (χ ² =8.517; p=0.004) and herbal medicine was the most common type of CAM used. 80% of parents in the CAM group and 54.4% of parents in the non-CAM group knew at least one biologically based therapy that had estrogenic activity (χ ² =6.082; p=0.014). Seventy-one percentage of parents in the CAM group and 29% of parents in the non-CAM group stated that they would consider using CAM in the future (χ ² =16.979; p<0.001).

CONCLUSIONS

The use of CAM among patients with PP is high. Although most CAM therapies are harmless, there may be adverse effects or drug interactions with current conventional treatment in children. Health professionals should be aware and inquire about the use and type of CAM, considering the medical history at every patient encounter.

Bioactive phytoconstituents as potent inhibitors of casein kinase-2: dual implications in cancer and COVID-19 therapeutics

Casein kinase 2 (CK2) is a conserved serine/threonine-protein kinase involved in hematopoietic cell survival, cell cycle control, DNA repair, and other cellular processes. It plays a significant role in cancer progression and viral infection. CK2 is considered a potential drug target in cancers and COVID-19 therapy. In this study, we have performed a virtual screening of phytoconstituents from the IMPPAT database to identify some potential inhibitors of CK2. The initial filter was the physicochemical properties of the molecules following the Lipinski rule of five. Then binding affinity calculation, PAINS filter, ADMET, and PASS analyses followed by interaction analysis were carried out to discover nontoxic and better hits. Finally, two compounds, stylopine and dehydroevodiamines with appreciable affinity and specific interaction towards CK2, were identified. Their time-evolution analyses were carried out using all-atom molecular dynamics simulation, principal component analysis and free energy landscape. Altogether, we propose that stylopine and dehydroevodiamines can be further explored in in vitro and in vivo settings to develop anticancer and antiviral therapeutics.

Showing protein–ligands interactions, electrostatic potential of CK2 bound to selected compounds, free energy landscapes of CK2-stylopine, and CK2-dehydroevodiamines complexes.