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Rashid M, Rashid R, Saroya S, Deverapalli M, Brim H, Ashktorab H. Saffron as a Promising Therapy for Inflammatory Bowel Disease. Nutrients 2024; 16:2353. [PMID: 39064796 PMCID: PMC11280066 DOI: 10.3390/nu16142353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic inflammatory illness of the gastrointestinal tract (GI), characterized by recurrent episodes of inflammation and tissue destruction. It affects an increasing number of individuals worldwide who suffer from Crohn's disease (CD) or ulcerative colitis (UC). Despite substantial advances in understanding the underlying causes of IBD, the available treatments remain restricted and are sometimes accompanied by severe consequences. Consequently, there is an urgent need to study alternate therapeutic options. This review assesses the present drugs, identifies their limitations, and proposes the use of saffron, a natural plant with great therapeutic potential based on preclinical and clinical investigations. Saffron has gained attention for its potential therapeutic benefits in treating various ailments due to its established bioactive compounds possessing antioxidant and anti-inflammatory properties. This review covers how saffron impacts the levels of calprotectin, an inflammatory marker, for various inflammatory responses in multiple diseases including IBD. Data from clinical trials were assessed to determine the efficacy and safety of using saffron to counter inflammation in multiple diseases. Studies have shown that saffron may protect against inflammatory bowel disease (IBD) through several mechanisms by inhibiting pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6), reducing oxidative stress through antioxidant effects, enhancing mucosal barrier function by upregulating tight junction proteins, and modulating the gut microbiota composition to promote beneficial bacteria while suppressing pathogenic ones; these combined actions contribute to its therapeutic potential in managing and alleviating the symptoms of IBD. This will enable future research endeavors and expedite the translation of saffron-based interventions into clinical practice as a valuable adjunctive therapy or a potential alternative to conventional treatments, thereby enhancing the quality of life for individuals suffering from inflammatory diseases including IBD.
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Affiliation(s)
| | | | | | | | | | - Hassan Ashktorab
- Department of Medicine and Cancer Center, Howard University College of Medicine, Washington, DC 20059, USA; (M.R.); (R.R.); (S.S.); (M.D.); (H.B.)
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Goyal A, Raza FA, Sulaiman SA, Shahzad A, Aaqil SI, Iqbal M, Javed B, Pokhrel P. Saffron extract as an emerging novel therapeutic option in reproduction and sexual health: recent advances and future prospectives. Ann Med Surg (Lond) 2024; 86:2856-2865. [PMID: 38694315 PMCID: PMC11060205 DOI: 10.1097/ms9.0000000000002013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/19/2024] [Indexed: 05/04/2024] Open
Abstract
Saffron, derived from Crocus sativus, is gaining research attention for potential therapeutic applications. Its diverse clinical applications extend to cardiovascular health, diabetes management, sleep quality, psychiatric illnesses, and rheumatoid arthritis. Saffron's positive effects on blood pressure, glucose levels, cognitive function, and inflammatory markers contribute to its versatility. Additionally, carotenoids like crocin and crocetin suggest anti-cancer potential. In terms of reproductive health, saffron's impact on male reproductive health shows conflicting findings on semen parameters. However, in female reproductive health, saffron appears promising for managing dysmenorrhoea, reducing menstrual pain, regulating hormonal fluctuations, and improving overall menstrual health. Safety considerations highlight the importance of adhering to specified dosages, as excessive intake may lead to toxicity. Yet, within the therapeutic range, saffron is considered safe, relieving symptoms without serious side effects, according to clinical research. Future trials in 2023 will explore saffron's potential in cancer therapy, diabetes management, mental health, stress response, cardiovascular health, postmenopausal women's well-being, and chronic obstructive pulmonary disease (COPD). This ongoing research underscores saffron's adaptability and promise as a natural treatment across various medical applications, emphasizing its efficacy. The current review, therefore, aims to provide up-to-date insights on saffron's role particularly in the realm of reproductive health, contributing to a growing body of evidence supporting its diverse therapeutic benefits.
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Affiliation(s)
- Aman Goyal
- Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai
| | - Fatima Ali Raza
- Department of Internal Medicine, Karachi Medical and Dental College
| | - Samia Aziz Sulaiman
- Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Abeer Shahzad
- Department of Internal Medicine, Dow Medical College
| | - Syeda Ilsa Aaqil
- Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Mahrukh Iqbal
- Department of Internal Medicine, Karachi Medical and Dental College
| | - Binish Javed
- Department of Internal Medicine, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar LohiaHospital, New Delhi,India
| | - Prakriti Pokhrel
- Department of Internal Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu Nepal
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Xu D, Zhang Y, Bai J, Yuan H, Wang T, Liu J, Song W, Ma D. Botanical drugs for treating erectile dysfunction: clinical evidence. Front Pharmacol 2023; 14:1232774. [PMID: 37654605 PMCID: PMC10467024 DOI: 10.3389/fphar.2023.1232774] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/03/2023] [Indexed: 09/02/2023] Open
Abstract
Phosphodiesterase-5 inhibitors (PDE5-i) have been widely used in clinical practice for the treatment of erectile dysfunction (ED). However, due to its suboptimal therapeutic effects and side effects, it is necessary to develop new medicines for ED treatment. Botanical drugs have been widely investigated as potential ED treatment drugs and have shown promising therapeutic effects. This review summarized 34 studies, including five botanical drugs with PDE5 inhibitory activity, seven botanical drugs without PDE5 inhibitory activity, and six mixed botanical drugs. The results of clinical studies regarding the aforementioned botanical drugs and relevant mechanisms are summarized in this study. It is necessary to conduct high-quality clinical trials to verify the dosage, targeted patients and therapeutic effects, and further pharmacology experiments are also needed to identify the active compounds.
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Affiliation(s)
- Dengjianyi Xu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yucong Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Institute of Gerontology, Huazhong University of Science and Technology, Wuhan, China
| | - Jian Bai
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huixing Yuan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wen Song
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Delin Ma
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Langarizadeh MA, Salary A, Tavakoli MR, Nejad BG, Fadaei S, Jahani Z, Forootanfar H. An overview of the history, current strategies, and potential future treatment approaches in erectile dysfunction: a comprehensive review. Sex Med Rev 2023:7131122. [PMID: 37076171 DOI: 10.1093/sxmrev/qead014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/10/2023] [Accepted: 03/21/2023] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) is one of the most common urologic problems in men worldwide, with an approximately high incidence rate, significantly affecting patients' quality of life and their sexual partners. OBJECTIVES Due to the association of this disorder with essential diseases such as cardiovascular disease and diabetes, its prevention and treatment are vital for overall human physiologic and psychological health. Along with reviewing the history of treatment and current methods, we seek new approaches to curb this issue in the future. METHODS In this review, investigations were based on the focus of each section's content or conducted on an ad hoc basis. Searches were performed in Scopus and PubMed. RESULTS In recent years, many treatments for ED have been reported besides oral administration of phosphodiesterase 5 inhibitors such as sildenafil and tadalafil (approved by the Food and Drug Administration). Common oral medications, intracavernous injections, herbal therapies (eg, herbal phosphodiesterase 5 inhibitors), and topical/transdermal medications are routine ED treatment approaches. Moreover, some novel medications are innovative candidates for completing ED's treatment protocols: stem cell injection, low-intensity extracorporeal shock wave therapy, platelet-rich plasma injection, gene therapy, amniotic fluid matrices, rho-kinase inhibitors, melanocortin receptor antagonists, maxi-K channel activators (ie, large-conductance calcium-activated potassium channels), guanylate cyclase activators, and nitric oxide donors. CONCLUSION Due to the importance of this complicated problem in men's society, a faster course of treatment trends toward new methods is needed to increase efficiency. Combining the mentioned treatments and attentively examining their efficacy through programmed clinical trials can be a big step toward solving this global problem.
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Affiliation(s)
- Mohammad Amin Langarizadeh
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman 7616913555, Iran
| | - Amirhossein Salary
- Student Research Committee, Kerman University of Medical Sciences, Kerman 7616913555, Iran
| | | | - Behnam Ghorbani Nejad
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Kerman Medical University, Kerman 7616913555, Iran
| | - Shirin Fadaei
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman 7616913555, Iran
| | - Zahra Jahani
- Student Research Committee, Kerman University of Medical Sciences, Kerman 7616913555, Iran
| | - Hamid Forootanfar
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman 7616913555, Iran
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The pathophysiology of Post SSRI Sexual Dysfunction - Lessons from a case study. Biomed Pharmacother 2023; 161:114166. [PMID: 36898260 DOI: 10.1016/j.biopha.2022.114166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Although Post-SSRI Sexual Dysfunction (PSSD) has finally been recognized by the European Medicines Agency as a medical condition that can outlast discontinuation of SSRI and SNRI antidepressants, this condition is still largely unknown by patients, doctors, and researchers, and hence, poorly understood, underdiagnosed, and undertreated. OBJECTIVE Becoming familiar with the symptomatology of PSSD and understanding the underlying mechanisms and treatment options. METHOD We applied a design thinking approach to innovation to 1) provide insights into the medical condition as well as the personal needs and pains of a targeted patient; and 2) generate ideas for new solutions from the perspective of this particular patient. These insights and ideas informed a literature search on the potential pathophysiological mechanisms that could underlie the patient's symptoms. RESULTS The 55-year-old male patient developed symptoms of low libido, delayed ejaculation, erectile dysfunction, 'brain zaps', overactive bladder and urinary inconsistency after discontinuation of the SNRI venlafaxine. In many of these symptoms a dysregulation in serotonergic activity has been implicated, with an important role of 5-HT1A receptor downregulation and possible downstream effects on neurosteroid and oxytocin systems. CONCLUSIONS The clinical presentation and development of symptoms are suggestive of PSSD but need further clinical elaboration. Further knowledge of post-treatment changes in serotonergic - and possibly noradrenergic - mechanisms is required to improve our understanding of the clinical complaints and to inform appropriate treatment regimes.
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Possible effects of Saffron (Crocus sativus) in the treatment of erectile dysfunction: a randomized, double-blind, placebo-controlled trial. J Herb Med 2022. [DOI: 10.1016/j.hermed.2022.100551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Roshanravan N, Ghaffari S. The therapeutic potential of Crocus sativus Linn.: A comprehensive narrative review of clinical trials. Phytother Res 2021; 36:98-111. [PMID: 34532906 DOI: 10.1002/ptr.7286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 08/28/2021] [Accepted: 09/02/2021] [Indexed: 12/26/2022]
Abstract
Crocus sativus Linn. (Saffron) is valued worldwide for its potential use in the management of various degenerative disorders, including cardiovascular diseases (CVDs), diabetes, cancer, metabolic syndrome (MetS), neurodegenerative diseases, immune disorders, and sexual dysfunction. Previous reports, based on clinical trials, suggest that crocetin, crocin, picrocrocin, and safranal are the main bioactive components of saffron with antioxidant, anti-inflammatory, and anti-apoptotic effects. In this comprehensive narrative review, we studied the recent clinical trials, investigating the medicinal applications of saffron and/or its components. The present results can provide important insights into the potential of saffron in preventing and treating different disorders, with a special focus on the underlying cellular and molecular mechanisms. However, further high-quality studies are needed to firmly establish the clinical efficacy of saffron in treating some degenerative diseases.
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Affiliation(s)
- Neda Roshanravan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Leisegang K, Finelli R. Alternative medicine and herbal remedies in the treatment of erectile dysfunction: A systematic review. Arab J Urol 2021; 19:323-339. [PMID: 34552783 PMCID: PMC8451697 DOI: 10.1080/2090598x.2021.1926753] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/02/2021] [Indexed: 12/17/2022] Open
Abstract
Objectives: To systematically review and discuss the current evidence from placebo-controlled clinical trials that investigated the use of alternative medicines and herbal remedies in the management of erectile dysfunction (ED). Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-based systematic review using specific keyword combinations was conducted on the PubMed and Scopus databases. Randomised controlled trials investigating herbal medicine in at least one group and using the International Index of Erectile Function (IIEF) as an outcome in patients primarily diagnosed with ED were included for review. Results: Following the literature search, screening and eligibility analysis, a total of 42 articles were included. The 42 articles were categorised as single herb extractions (n = 14), combination herbal formula (n = 5), combination of herbal formula and non-herbal nutraceuticals (n = 7), non-herbal nutraceuticals (n = 5), acupuncture and moxibustion (n = 2), diet and nutrition (n = 3), exercise (n = 5), and topical treatments (n = 1). Based on the results, Korean ginseng, Pygnogenol and Prelox, Tribulus terrestris, Lepidium meyenii, L-arginine, acupuncture and lifestyle interventions were the more predominantly investigated treatments interventions for ED. Conclusions: Panax ginseng, Pygnogenol, Prelox and Tribulus terrestris have promising evidence as herbal products, alongside L-arginine as a nutritional supplement, for ED based on IIEF outcomes, and warrant further clinical investigation. The mechanisms of action remain unclear, but each of these appears to in part increase nitric oxide synthesis. Importantly, improved diet and exercise should be considered, particularly in patients with obesity or diabetes mellitus.
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Affiliation(s)
- Kristian Leisegang
- School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Renata Finelli
- American Center for Reproductive Medicine, Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
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Sin VJE, Anand GS, Koh HL. Botanical Medicine and Natural Products Used for Erectile Dysfunction. Sex Med Rev 2020; 9:568-592. [PMID: 33277212 DOI: 10.1016/j.sxmr.2020.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/16/2020] [Accepted: 10/25/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Erectile dysfunction is the persistent or recurrent inability to achieve or maintain an erection sufficient for intercourse. Despite various treatment options, not all patients respond adequately and their usefulness is limited by adverse effects and cost. Botanical medicine and natural products have been and continue to be invaluable and untapped sources of new drugs, including potentially those to treat erectile dysfunction. OBJECTIVES To review the current literature on botanical medicine traditionally used as aphrodisiacs and treatment of erectile dysfunction, in particular, scientific and clinical investigations that have been performed, possible active phytoconstituents, and mechanisms of action and to identify gaps in current knowledge to better guide future research efforts. METHODS A comprehensive literature search was conducted via PubMed, Scopus, Science Direct, and Web of Science on English publications, using various keywords, for example, "herb", "natural product", combined with "erectile dysfunction", "aphrodisiac", and "sexual performance". RESULTS 369 relevant articles studying medicinal plants used for erectile dysfunction were analyzed. A total of 718 plants from 145 families and 499 genera were reported to be used traditionally as aphrodisiacs and treatment of erectile dysfunction. Top plants used include Pausinystalia johimbe, Lepidium meyenii, and Panax ginseng. Different plant parts are used, with roots being the most common. Less than half of these plants have been evaluated scientifically, using various research methodologies. Clinical trials conducted were collated. Current scientific investigation shows mixed results about their usefulness in enhancing sexual performance. A limited number of studies have attempted to elucidate the mechanisms of action of these medicinal plants. CONCLUSION A comprehensive literature review on botanical medicine and natural products used for treatment of erectile dysfunction was successfully conducted. Although medicinal plants serve as a potential source of lead compounds for erectile dysfunction drugs, further studies are warranted to further evaluate their efficacy and safety. SinVJ-E, Anand GS, Koh H-L. Botanical Medicine and Natural Products Used for Erectile Dysfunction. Sex Med Rev 2020;XX:XXX-XXX.
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Affiliation(s)
- Valerie Jia-En Sin
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Ganesh Srinivasan Anand
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Hwee-Ling Koh
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore.
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Khan A, Muhamad NA, Ismail H, Nasir A, Khalil AAK, Anwar Y, Khan Z, Ali A, Taha RM, Al-Shara B, Latif S, Mirza B, Fadladdin YAJ, Zeid IMA, Al-Thobaiti SA. Potential Nutraceutical Benefits of In Vivo Grown Saffron (Crocus sativus L.) As Analgesic, Anti-inflammatory, Anticoagulant, and Antidepressant in Mice. PLANTS 2020; 9:plants9111414. [PMID: 33105854 PMCID: PMC7690613 DOI: 10.3390/plants9111414] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/15/2020] [Accepted: 10/20/2020] [Indexed: 02/01/2023]
Abstract
Crocus sativus, a medicinally important herbaceous plant, has been traditionally used to cure coughs, colds, insomnia, cramps, asthma, and pain. Moreover, the therapeutic applications of saffron include its immunomodulatory and anticancer properties. The current experimental analysis was performed to explore the potential nutraceutical efficacy of corm, leaf, petal, and stigma of saffron ethanolic extracts as analgesic, anti-inflammatory, anticoagulant, and antidepressant using hot plate, carrageenan-induced paw edema, capillary tube and forced swim test, respectively in mice. The results indicated that among all the extracts, stigma ethanolic extract (SEE) represented maximum latency activity (72.85%) and edema inhibition (77.33%) followed by petal ethanolic extract (PEE) with latency activity and edema inhibition of 64.06 and 70.50%, respectively. Corm ethanolic extract (CEE) and leaf ethanolic extract (LEE) displayed mild analgesic activity of 22.40% and 29.07%, respectively. Additionally, LEE (53.29%) and CEE (47.47%) exhibited mild to moderate response against inflammation. The coagulation time of SEE (101.66 s) was almost equivalent to the standard drug, aspirin (101.66 s), suggesting a strong anticoagulant effect followed by PEE (86.5 s). LEE (66.83 s) represented moderate inhibitory effect on coagulation activity while CEE (42.83 s) showed neutral effect. Additionally, PEE and SEE also expressed itself as potential antidepressants with immobility time ≤76.66 s, while CEE (96.50 s) and LEE (106.83 s) indicated moderate to mild antidepressant efficacy. Based on the in vivo activities, saffron extract, particularly SEE and PEE, can be used as a potential nutraceutical and therapeutic agent due to its significant pharmacological activities.
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Affiliation(s)
- Asif Khan
- Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia; (A.K.); (R.M.T.); (B.A.-S.)
| | - Nur Airina Muhamad
- Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia; (A.K.); (R.M.T.); (B.A.-S.)
- Correspondence:
| | - Hammad Ismail
- Department of Biochemistry and Biotechnology, University of Gujrat, Gujrat 50700, Pakistan;
| | - Abdul Nasir
- Department of Molecular Science and Technology, Ajou University, Suwan 16499, Korea;
| | - Atif Ali Khan Khalil
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi 46000, Pakistan;
| | - Yasir Anwar
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, P.O. Box 54229, Jeddah, Saudi Arabia; (Y.A.); (Y.A.J.F.); (I.M.A.Z.)
| | - Zahid Khan
- Department of Pharmacognosy, Faculty of Pharmacy, Federal Urdu University of Arts Science and Technology, Karachi 75300, Pakistan;
| | - Amjad Ali
- Department of Botany, University of Malakand, Khyber Pakhtunkhwa 18800, Pakistan;
| | - Rosna Mat Taha
- Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia; (A.K.); (R.M.T.); (B.A.-S.)
| | - Baker Al-Shara
- Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia; (A.K.); (R.M.T.); (B.A.-S.)
| | - Sara Latif
- Department of Biochemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan; (S.L.); (B.M.)
| | - Bushra Mirza
- Department of Biochemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan; (S.L.); (B.M.)
- Lahore College for Women University, Lahore 54000, Pakistan
| | - Yousef Abdal Jalil Fadladdin
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, P.O. Box 54229, Jeddah, Saudi Arabia; (Y.A.); (Y.A.J.F.); (I.M.A.Z.)
| | - Isam Mohamed Abu Zeid
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, P.O. Box 54229, Jeddah, Saudi Arabia; (Y.A.); (Y.A.J.F.); (I.M.A.Z.)
| | - Saed Ayidh Al-Thobaiti
- Department of Biology, University College Turabah, Taif University, Taif 21995, Saudi Arabia;
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Masuku NP, Unuofin JO, Lebelo SL. Promising role of medicinal plants in the regulation and management of male erectile dysfunction. Biomed Pharmacother 2020; 130:110555. [PMID: 32795922 DOI: 10.1016/j.biopha.2020.110555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/03/2020] [Accepted: 07/25/2020] [Indexed: 12/31/2022] Open
Abstract
Male erectile dysfunction (ED) refers to incompetency to reaching and retaining adequate penile tumescence for sexual intercourse. Over 152 million men globally suffer from ED and by 2025, the number of affected individuals is anticipated to be around 322 million. Pharmacological and nonpharmacological therapies such as phosphodiesterase (PDE) inhibitors, alprostadil, penile prosthesis surgery, and hormonal replacement are available for management and recuperation of ED. Nevertheless, such therapies are reported to have adverse effects as well as life-threatening. Accordingly, diversity of medicinal plant species and bioactive active compounds are preferred as therapeutic options because they are natural, abundant, available, low-cost and cause fewer or no side effects. This current review will emphasise the aetiology, risk factors, mechanisms underlying the pathophysiology of ED, treatments of ED as well as their side effects. It also provides medicinal plants that are proven effective in vivo and in vitro for the mitigation and treatment of male ED. This knowledge could be used in the future in drug discovery for the development of more natural drugs with no side effects.
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Affiliation(s)
- Nelisiwe Prenate Masuku
- Department of Life and Consumer Sciences, University of South Africa, Cnr Christiaan de Wet and Pioneer Ave, Private Bag X6, Florida, 1710, South Africa
| | - Jeremiah Oshiomame Unuofin
- Department of Life and Consumer Sciences, University of South Africa, Cnr Christiaan de Wet and Pioneer Ave, Private Bag X6, Florida, 1710, South Africa.
| | - Sogolo Lucky Lebelo
- Department of Life and Consumer Sciences, University of South Africa, Cnr Christiaan de Wet and Pioneer Ave, Private Bag X6, Florida, 1710, South Africa
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Borrelli F, Colalto C, Delfino DV, Iriti M, Izzo AA. Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis. Drugs 2019; 78:643-673. [PMID: 29633089 DOI: 10.1007/s40265-018-0897-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Erectile dysfunction (ED) is a common condition that significantly affects quality of life and interpersonal relationships. OBJECTIVE Our objective was to perform a systematic review and meta-analysis to evaluate the efficacy of herbal dietary supplements in the treatment of ED. MATERIALS AND METHODS We searched five databases to identify randomized controlled trials (RCTs) that evaluated the clinical efficacy of herbal medicines in ED. Quality was assessed and risk of bias was estimated using the Jadad score and the Cochrane risk-of-bias tool. RESULTS In total, 24 RCTs, including 2080 patients with ED, were identified. Among these, 12 evaluated monopreparations (five ginseng [n = 399], three saffron [n = 397], two Tribulus terrestris [n = 202], and one each Pinus pinaster [n = 21] and Lepidium meyenii [n = 50]), seven evaluated formulations (n = 544), and five investigated dietary supplements in combination with pure compounds (n = 410). Ginseng significantly improved erectile function (International Index of Erectile Function [IIEF]-5 score: 140 ginseng, 96 placebo; standardized mean difference [SMD] 0.43; 95% confidence interval [CI] 0.15-0.70; P < 0.01; I2 = 0), P. pinaster and L. meyenii showed very preliminary positive results, and saffron and T. terrestris treatment produced mixed results. Several herbal formulations were associated with a decrease of IIEF-5 or IIEF-15, although the results were preliminary. The quality of the included studies varied, with only seven having a prevalent low risk of bias. The median methodological quality Jadad score was three out of a maximum of five. Adverse events were recorded in 19 of 24 trials, with no significant differences between placebo and verum in placebo-controlled studies. CONCLUSIONS Encouraging evidence suggests that ginseng may be an effective herbal treatment for ED. However, further, larger, and high-quality studies are required before firm conclusions can be drawn. Promising (although very preliminary) results have also been generated for some herbal formulations. Overall, more research in the field, adhering to the CONSORT statement extension for reporting trials, is justified before the use of herbal products in ED can be recommended.
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Affiliation(s)
- Francesca Borrelli
- Department of Pharmacy, School of Medicine and Surgery, University of Napes Federico II, Via D. Montesano 49, 80131, Naples, Italy. .,Working Group "Pharmacognosy and Phytotherapy" of the Italian Pharmacological Society, Viale Abruzzi 32, 20131, Milan, Italy.
| | - Cristiano Colalto
- Farmacia San Paolo dr Colalto, Piazza Dè l'Osto 37, 37035, San Giovanni Ilarione, Verona, Italy.,Working Group "Pharmacognosy and Phytotherapy" of the Italian Pharmacological Society, Viale Abruzzi 32, 20131, Milan, Italy
| | - Domenico V Delfino
- Section of Pharmacology, Department of Medicine, University of Perugia, Piazzale Severi, 06132, S. Andrea delle Fratte, Perugia, Italy.,Working Group "Pharmacognosy and Phytotherapy" of the Italian Pharmacological Society, Viale Abruzzi 32, 20131, Milan, Italy
| | - Marcello Iriti
- Department of Agricultural and Environmental Sciences, Milan State University, Via Celoria 2, 20133, Milan, Italy.,Working Group "Pharmacognosy and Phytotherapy" of the Italian Pharmacological Society, Viale Abruzzi 32, 20131, Milan, Italy
| | - Angelo A Izzo
- Department of Pharmacy, School of Medicine and Surgery, University of Napes Federico II, Via D. Montesano 49, 80131, Naples, Italy. .,Working Group "Pharmacognosy and Phytotherapy" of the Italian Pharmacological Society, Viale Abruzzi 32, 20131, Milan, Italy.
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13
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Khalatbari-Mohseni A, Banafshe HR, Mirhosseini N, Asemi Z, Ghaderi A, Omidi A. The effects of crocin on psychological parameters in patients under methadone maintenance treatment: a randomized clinical trial. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2019; 14:9. [PMID: 30795785 PMCID: PMC6387551 DOI: 10.1186/s13011-019-0198-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/11/2019] [Indexed: 12/31/2022]
Abstract
Background Methadone maintenance treatment (MMT) might be associated with the symptoms of depression and anxiety, sleep disturbances and sexual dysfunctions. This study was designed to determine the effects of crocin on psychological parameters in patients under MMT. Methods Patients under MMT were randomly allocated into two groups to receive either 30 mg/day crocin (2 plus crocin tablet, 15 mg BID) (n = 25) or placebo (2 tablets per day, 15 mg BID) (n = 25), one hour after taking food, for 8 weeks. Psychological parameters were evaluated at baseline and end of the trial to determine related associations between crocin and patients’ mental health status. Results After 8-week intervention, crocin significantly decreased Beck Depression Inventory (b − 6.66; 95% CI, − 9.88, − 3.45; P < 0.0001), Beck Anxiety Inventory (b − 4.35; 95% CI, − 5.94, − 2.75; P < 0.0001), general health questionnaire (b − 4.45; 95% CI, − 7.68, − 1.22; P = 0.008) and Pittsburgh Sleep Quality Index (b − 2.73; 95% CI, − 3.74, − 1.73; P < 0.0001) in patients under MMT, compared with the placebo. Crocin also significantly improved International Index of Erectile Functions (b 4.98; 95% CI, 2.08, 7.88; P = 0.001) rather than placebo. Conclusion Our findings indicated that taking crocin for 8 weeks by patients under MMT had beneficial effects on their mental health status. Crocin can be recommended as an adjunct to methadone in opioid withdrawal protocols because of the ability to improve the quality of life and decrease opioids side effects in these patients. This trial was registered in the Iranian website for clinical trials registry as http://www.irct.ir: IRCT2017110537243N1. Clinical trial registration number www.irct.ir: http://www.irct.ir: IRCT2017110537243N1.
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Affiliation(s)
| | - Hamid Reza Banafshe
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran.,Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.,Physiology Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R., Iran
| | - Amir Ghaderi
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
| | - Abdollah Omidi
- Department of clinical psychology, School of Medicine, Kashan University of Medical Science, Kashan, Iran.
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