Action Mechanism of Rosella (Hibiscus sabdariffa L.) Used to Treat Metabolic Syndrome in Elderly Women

Hibiscus sabdariffa Extract Protects HaCaT Cells against Phenanthrene-Induced Toxicity through the Regulation of Constitutive Androstane Receptor/Pregnane X Receptor Pathway

Phenanthrene (Phe) exposure is associated with skin ageing, cardiotoxicity and developmental defects. Here, we investigated the mode of Phe toxicity in human keratinocytes (HaCaT cells) and the attenuation of toxicity on pre-treatment (6 h) with ethanol extract of Hibiscus sabdariffa calyxes (HS). Cell viability, reactive oxygen species (ROS) generation, mitochondrial membrane potential (ΔΨm) alteration, changes in the transcriptional activity of selected genes involved in phase I and II metabolism, antioxidant response and gluconeogenesis, western blot and docking studies were performed to determine the protective effect of HS against Phe. Phe (250 μM) induced cytotoxicity in HaCaT cells through AhR-independent, CAR/PXR/RXR-mediated activation of CYP1A1 and the subsequent alterations in phase I and II metabolism genes. Further, CYP1A1 activation by Phe induced ROS generation, reduced ΔΨm and modulated antioxidant response, phase II metabolism and gluconeogenesis-related gene expression. However, pre-treatment with HS extract restored the pathological changes observed upon Phe exposure through CYP1A1 inhibition. Docking studies showed the site-specific activation of PXR and CAR by Phe and inhibition of CYP1A1 and CYP3A4 by the bioactive compounds of HS similar to that of the positive controls tested. Our results conclude that HS extract can attenuate Phe-induced toxicity in HaCaT cells through CAR/PXR/RXR mediated inhibition of CYP1A1.

Hibiscus sabdariffa in Diabetes Prevention and Treatment—Does It Work? An Evidence-Based Review

Diabetes is currently a global health problem that is already reported as an epidemic. This metabolic disease, characterized by a disturbance in the carbohydrate, protein, and lipid metabolism, is often accompanied by disorders of several organs. Its treatment is expensive and often difficult to control. Therefore, it seems necessary to search for new drugs and solutions to facilitate therapy and reduce treatment costs. Herbal medicines are becoming more and more popular. Hibiscus sabdariffa (roselle) is a plant that grows wild in a tropical climate. It has been used in folk medicine for thousands of years. Thanks to the numerous active compounds, including polyphenols, polysaccharides, organic acids, or pectins, it is reported to exhibit hypoglycemic, antioxidant, hypotensive, and anti-lipidemic activities and numerous indirect effects that are related to them. The aim of this review was to update the knowledge about the therapeutic effects of roselle in diabetes and its comorbidities based on in vitro, animal, and human studies. After a careful analysis of the scientific literature, it can be stated that roselle is a promising product that can be used either on its own or as an addition to the conventional treatment regimens to prevent or treat diabetes and its accompanying diseases.

The Effectiveness of Vegetable Starfruit Juice (Averrhoa bilimbi) and Rosella Tea (Hibiscus sabdariffa L) Against the Inhibition of Dental Plaque Formation

BACKGROUND: Dental disease is a significant public health problem. Various efforts have been made to maintain oral health by utilizing natural ingredients from plants. One of the natural ingredients often used among the community is Vegetable Starfruit Juice (Averrhoa bilimbi) and Rosella Tea. AIM: The purpose of this study was to analyze the effectiveness of Starfruit and rosella tea (Hibiscus sabdariffa L) on the Inhibition of Dental Plaque Formation. METHODS: Design this research is an experimental study with a post-test design only. The research was conducted in Gampong Batoh, Lueng Bata District, Banda Aceh City, from June 26 to October 04, 2021. The study population was the community of Gampong Batoh, Banda Aceh City. The sample in this study used a purposive sampling technique. The sample in this study met the criteria and was willing to assist in implementing the research by signing the informed consent. The number of research samples was 40 people. RESULTS: The results showed a significant difference in the effectiveness of Starfruit juice and rosella tea on the inhibition of plaque formation based on time duration (p < 0.05). The group that rinsed with rosella tea solution had more effective inhibition than the group that rinsed with vegetable Starfruit juice solution (p < 0.05). Vegetable Starfruit (A. bilimbi) and Rosella Tea contain bioactive compounds such as alkaloids, flavonoids, saponins, and tannins that can act as antibacterial agents in inhibiting the growth of Staphylococcus aureus. CONCLUSION: Vegetable Starfruit Juice (A. bilimbi) and Rosella Tea (H. sabdariffa L) effectively inhibit the formation of dental plaque.

Physiological Effects and Human Health Benefits of Hibiscus sabdariffa: A Review of Clinical Trials

Hibiscus sabdariffa Linn. Malvaceae (HS) is characterized by its edible calyxes. The HS calyxes are widely used for cosmetic, food, and medicinal applications. According to ethnobotanical evidence, decoction, infusion, or maceration extracts from HS calyxes have been used in folk medicine to treat many ailments. Moreover, several in vitro and in vivo studies have demonstrated the pharmacological properties and potential human health benefits of HS consumption. On the other hand, the evaluation of the physiological effects and health benefits of HS in clinical studies is most challenging. Therefore, this narrative review summarizes and discusses the physiological effects and health benefits of HS calyxes reported in clinical trials. Preparations obtained from HS calyxes (extracts, infusions, decoction, teas, beverages, capsules, and pills) are used as non-pharmacological therapies to prevent/control diverse chronic non-communicable diseases. The most-reported HS health benefits are its antihypertensive, antidyslipidemic, hypoglycemic, body fat mass reduction, nephroprotective, antianemic, antioxidant, anti-inflammatory, and anti-xerostomic activities; these effects are associated with the phytochemicals found in HS. Moreover, no adverse effects were reported during the clinical trials. However, clinical studies exhibited some limitations; thus, further studies are required to validate the clinical efficacy of HS in large-scale studies with higher doses and a good experimental design

Roselle for hypertension in adults

BACKGROUND

Hypertension is considered to be a serious health problem worldwide. Controlling and lowering blood pressure are of significant benefit to people with hypertension because hypertension is a risk factor for stroke, heart disease, and cardiovascular disease. Roselle, the tropical plant Hibiscus sabdariffa, also commonly called sour tea or red tea, has been used as both a thirst-quenching drink and for medicinal purposes.

OBJECTIVES

To assess the effect of Roselle on blood pressure in people with primary hypertension.

SEARCH METHODS

For this update, the Cochrane Hypertension Information Specialist searched the following databases and trials registers for randomised controlled trials (RCTs): the Cochrane Hypertension Specialised Register (to 6 August 2021), Cochrane Central Register of Controlled Trials (CENTRAL; 2021, Issue 7), MEDLINE Ovid (1946 to 5 August 2021), Embase Ovid (1974 to 5 August 2021), ProQuest Dissertations & Theses (to 6 August 2021), Web of Science Clarivate (to 7 August 2021), Food Science and Technology Abstracts Clarivate (to 7 August 2021), the WHO International Clinical Trials Registry Platform (to 6 August 2021), and the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (to 6 August 2021). We searched Google Scholar and OpenSIGLE. We also handsearched local and regional Chinese databases: CBM, CMCC, TCMLARS, CNKI, CMAC, and the Index to Chinese Periodical Literature (to 14 September 2020), as well as Thai databases (ThaiJO, CUIR, TDC, CMU e-Theses, TCTR) (to 3 October 2020). There were no language or publication date restrictions.

SELECTION CRITERIA

We sought RCTs evaluating the use of any forms of Roselle with placebo or no treatment in adults with hypertension. Our primary outcome was change in trough and/or peak systolic and diastolic blood pressure (SBP, DBP). Secondary outcomes were withdrawals due to adverse effects, change in pulse pressure, and change in heart rate.

DATA COLLECTION AND ANALYSIS

All search results were managed using Covidence and re-checked for the number of records, inclusion and exclusion of studies with Mendeley reference management software. We used standard methodological procedures expected by Cochrane. Two review authors worked independently in parallel for screening (titles and abstracts, and full reports), data extraction, risk of bias assessment, and assessment of the certainty of the evidence using the GRADE approach. Any disagreements were resolved by discussion or by consultation with the third review author if necessary. We presented mean difference (MD) of change in SBP and DBP with their corresponding 95% confidence interval (CI).

MAIN RESULTS

For this update, only one RCT with a parallel-group design involving 60 participants with type 2 diabetes mellitus fulfilled the inclusion criteria. This study investigated the effect of Roselle extract capsules (total dose of 5600 mg) compared with placebo (lactose) at eight weeks. The study was at low risk of selection bias, performance bias, and detection bias. Conversely, it was at high risk of attrition bias, reporting bias, and other bias (baseline imbalance). We have very little confidence in the effect estimate of Roselle on change-from-baseline in both SBP and DBP between the two groups. The MD of change in SBP was 1.65, 95% CI -7.89 to 11.19 mmHg, 52 participants, very low-certainty evidence. The MD of change in DBP was 4.60, 95% CI -1.38 to 10.58 mmHg, 52 participants, very low-certainty evidence. Our secondary outcomes of withdrawals due to adverse effects, change in pulse pressure, and change in heart rate were not reported. Due to the limited available data, no secondary analyses were performed (subgroup and sensitivity analysis).

AUTHORS' CONCLUSIONS

The evidence is currently insufficient to determine the effectiveness of Roselle compared to placebo for controlling or lowering blood pressure in people with hypertension. The certainty of evidence was very low due to methodological limitations, imprecision, and indirectness. There is a need for rigorous RCTs that address the review question.

Nutritional and lifestyle intervention strategies for metabolic syndrome in Southeast Asia: A scoping review of recent evidence

Metabolic syndrome (MetS) is frequently associated with various health issues and is a major contributor to morbidity and mortality worldwide, particularly with its recent relevance to coronavirus disease 2019 (COVID-19). To combat its increasing prevalence in Southeast Asia, numerous intervention programs have been implemented. We conducted a scoping review on recent interventions to manage MetS among Southeast Asians using standard methodologies. Cochrane, Embase, Ovid MEDLINE, PubMed, and Scopus databases were systematically searched to yield peer-reviewed articles published between 2010-2020. We included 13 articles describing 11 unique interventions in four Southeast Asian countries: Malaysia, Thailand, Indonesia, and Vietnam. These interventions were broadly categorized into four groups: (i) nutrition (n = 4); (ii) physical activity (n = 2); (iii) nutrition and physical activity (n = 2); and (iv) multi-intervention (n = 3). Most studies investigated the effects of an intervention on components of MetS, which are anthropometry, blood pressure, glucose-related parameters, and lipid profile. Significant improvements ranged from 50% of studies reporting serum triglyceride and HDL-cholesterol levels to 100% for waist circumference. Evidence on interventions for individuals with MetS remains limited in Southeast Asia. More studies from other countries in this region are needed, especially on the effects of dietary interventions, to effectively address gaps in knowledge and provide sufficient data to design the ideal intervention for Southeast Asian populations.

Modulation of the hypothalamic-pituitary-adrenal (HPA) axis by plants and phytonutrients: a systematic review of human trials

INTRODUCTION

The hypothalamic-pituitary-adrenal (HPA) axis plays a central role in the stress response. Plants, herbs, spices, and plant-based nutrients may influence HPA-axis activity.

OBJECTIVE

To evaluate randomised controlled, human trials assessing the effects of single plants or phytonutrients on HPA-axis related hormones.

METHODS

A systematic review of PubMed, Cochrane library, and the Cumulative Index to Nursing and Allied Health Literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria comprised of human, randomised controlled studies with a control intervention examining the effects of a single herb, spice, plant, or extract on pre- and post-changes in blood, saliva, urine, or hair concentrations of cortisol, cortisone, corticotrophin-releasing hormone, or adrenocorticotropic hormone. Databases were searched from inception until October 2020.

RESULTS

Fifty-two studies were identified examining the effects of ashwagandha, Korean ginseng, St John's Wort, cannabidiol, Rhodiola rosea, curcumin, cherry juice, asparagus, Jiaogulan, Black cohosh, Siberian ginseng, Bacopa monnieri, blueberries, green tea, Caralluma fimbriata, cashew apple juice, melon, American ginseng, Ginkgo biloba, grape juice, grapefruit juice, rosella, hops, mangosteen, holy basil, and pomegranate juice. Due to significant variability in study designs, the effect of phytonutrients on HPA-axis activity in humans was unclear. The most consistent finding was a morning, cortisol-lowering effect from ashwagandha supplementation.

CONCLUSION

For most phytonutrients, the effects of supplementation on HPA-axis activity in humans is unclear. Before more definitive conclusions about the effects of phytonutrients on the HPA-axis can be made, further research is required.

Mechanisms of Action of Nutritionally Rich Hibiscus sabdariffa's Therapeutic Uses in Major Common Chronic Diseases: A Literature Review

Hibiscus sabdariffa, this beverage has been used for millennia as both a delicious cultural beverage and an ancient medicinal therapy. In recent years, many studies have investigated the uses and mechanisms of action of Hibiscus sabdariffa to treat common chronic diseases. In this literature review, we place the spotlight on Hibiscus sabdariffa's medical effect on common chronic diseases, the flower commonly used to make hibiscus tea. The databases PubMed, MEDLINE, Clinical Key, and CINAHL were searched for studies related to Hibiscus sabdariffa's compounds, antioxidative and anti-inflammatory features, mechanism of action on common chronic diseases including hypertension, hyperlipidemia, obesity, diabetes, and Alzheimer's disease. Hibiscus sabdariffa antihypertensive potentials originate from the vasodilator activity, diuretic efficacy, functionality as an ACE inhibitor, adipocyte differentiation inhibitor, heart rate reduction ability, and anti-inflammatory mechanistic. The antihyperlipidemic effect is dose-dependent and stems from the antioxidative effect and the activation of AMPK through phosphorylation and the inhibition of regulatory adipogenic transcription factors PPAR-γ, C/EBP-α, and SREBP-1c, which altogether results in lipid-lowering effect. As an antihyperglycemic, Hibiscus sabdariffa serves as anti-insulin resistance by inhibition of the phosphorylation of IRS-1 beside a similar effect to gliptins. Finally, Hibiscus sabdariffa was proven to protect against neuroinflammation in microglial cell culture exposed to LPS by decreasing IL-1, IL-6, TNF-α expression, and the protective effect against glucotoxicity, improve memory function by inhibiting the formation of hyperphosphorylated tau proteins in the mouse brain. Regular consumption of hibiscus tea or extract is beneficial for a reduction in chronic disease risk and diagnosis. Key teaching pointsHibiscus sabdariffa, or hibiscus, has been used for millennia as both a delicious cultural beverage and an ancient medicinal therapy. Recent studies have investigated the uses of Hibiscus sabdariffa to treat common chronic diseases.Its antihypertensive potential originates from the vasodilator activity, diuretic efficacy, functionality as an ACE inhibitor, adipocyte differentiation inhibitor, heart rate reduction ability, and anti-inflammatory mechanistics.The antihyperlipidemic effect is dose-dependent and stems from the antioxidative effect and the activation of AMPK through phosphorylation and also the inhibition of regulatory adipogenic transcription factors PPAR-γ, C/EBP-α and SREBP-1c which all together results in lipid-lowering effect.As an antihyperglycemic, Hibiscus sabdariffa serves as anti-insulin resistance by inhibition of the phosphorylation of IRS-1 beside the similar effect to gliptins.Hibiscus sabdariffa was proven to protect against neuroinflammation in microglial cell culture exposed to LPS by decreasing IL-1, IL-6, TNF-α expression, and the protective effect against glucotoxicity, improve memory function by inhibiting the formation of hyperphosphorylated tau proteins in the mouse brain.

Roselle for hypertension in adults

BACKGROUND

Hypertension is considered a serious health problem worldwide. Controlling and lowering blood pressure have a significant benefit to the hypertensive patients because hypertension is a risk factor for stroke, heart disease and cardiovascular disease. A tropical plant called Roselle, or Red Sorrel in English-speaking countries, has been used both as a thirst-quenching drink and for medical purposes.

OBJECTIVES

To explore the effect of Roselle on blood pressure in hypertensive adult patients.

SEARCH STRATEGY

The following databases were searched (Date of most recent search was September 2009): - Cochrane Database of Systematic Reviews (2nd Quarter 2009) - DARE (2nd Quarter 2009) - Ovid MEDLINE (1950 to Present with Daily Update) - EMBASE (1980 to 2009 Week 22) - AMED (1985 to May 2009) - EBSCO CINAHL - BIOSIS (1969 to 2008) - AGRICOLA (1970 to May 2009) - Food Science and Technology Abstract (1969 to 2009 June Week 1) - International Pharmaceutical Abstracts - International Bibliographic Information on Dietary Supplements - Clinical Trials.gov and Current Controlled Trials - OpenSIGLE - Hand searching of journals - ISI Web of Knowledge

SELECTION CRITERIA

We sought randomised control trials (RCTs) evaluating use of any forms of Roselle with placebo or no treatment in hypertensive patients. Change in trough and/or peak systolic and diastolic blood pressure were primary outcomes. Secondary outcomes were withdrawals due to adverse effects, change of pulse pressure and change of heart rate.

DATA COLLECTION AND ANALYSIS

Two review authors (C Ngamjarus, CN and P Pattanittum, PP) independently scanned titles and abstracts, as well as independently screened the full reports of the potentially relevant studies. At each stage, the results were compared and disagreements were solved by discussion.

MAIN RESULTS

No studies were identified that met the inclusion criteria. However, one abstract of an ongoing study is likely to meet the inclusion criteria, when completed.

AUTHORS' CONCLUSIONS

There is insufficient evidence to support the benefit of Roselle for either controlling or lowering blood pressure in patients with hypertension. Based on the information of this review, there is a clear need to develop well-designed studies to assess the efficacy of Roselle on hypertensive patients.