Traditionally Used Natural Products in Preventing Ionizing Radiation-Induced Dermatitis: First Review on the Clinical Studies

Screening model in Caenorhabditis elegans for radioprotective natural products

PURPOSE

Ionizing radiation (IR) could induce damage such as DNA damage and oxidative stress. Natural products, like tea, have been demonstrated potential in mitigating these damages. However, the lack of efficient and rapid screening methods for natural products hinders their widespread application. To address this challenge, this study utilized Caenorhabditis elegans (C. elegans) as an in vivo model to investigate radioprotective natural products.

METHODS

L1 stage C. elegans were exposed to X-rays or 60Co γ-rays at varying dosages (20, 50, and 100 Gy), then the growth, reproduction, and lifespan of the nematodes were observed. Different culture and sample-administered modes were tested. Known radioprotective agents, including Amifostine (WR2721), Lycium barbarum extract (LBE), and Trillium tschonoskii fraction (TTF), served as positive controls to validate the reliability of the model. The radioprotective activity of teas with different fermentation degrees was compared based on this screening model.

RESULTS

A screening model in C. elegans was established by X-rays at 20 Gy. An appropriate sample-administrated approach was investigated, which involves adding the sample to the nematode growth medium (NGM) agar covered with inactivated Escherichia coli 2 h before irradiation. The known radioprotective agents (WR2721, LBE, and TTF) validated that the model is stable. Our results of the model application revealed that teas with lower fermentation levels, such as green tea and oolong tea, particularly the n-butanol and ethyl acetate fractions from oolong tea, exhibited significant radioprotective activity.

CONCLUSIONS

This study presents an effective in vivo approach for the initial screening of radioprotective natural products.

Effectiveness of the Traditional Japanese Herbal Medicine, Yokuinin (Kampo), in the Treatment of Cervical Precancerous Lesions

Background Human papillomavirus (HPV) infection precedes cervical dysplasia, culminating in cervical cancer. Yokuinin extract, used for treating verruca vulgaris caused by HPV, exhibits potential antitumor activity against cervical cancer and mild cervical dysplasia. We examined the usefulness of Yokuinin in the treatment of cervical precancerous lesions. Methods This retrospective study included 73 female patients with verrucous skin lesions and mildly abnormal cervical cytology diagnosed between April 2019 and August 2021. Of the 73 patients, 34 received Yokuinin treatment whereas 39 did not. The Yokuinin-treated patients received 1.0 g Yokuinin orally divided into three doses daily. Evaluation criteria included retested cervical cytology, time to negative cervical cytology (negative for intraepithelial lesions or malignancies), and side effects. Statistical analyses employed the Mann-Whitney U test and chi-square test, indicating a statistically significant difference (p<0.05). Results Yokuinin-treated patients were significantly more likely to achieve normal cytology (NILM) status (p= 0.0441). Median time to NILM was three months for Yokuinin-treated versus five months for non-Yokuinin-treated group, indicating that the Yokuinin-treated group achieved NILM significantly earlier (p= 0.0011). Additionally, high-risk HPV-positive patients were more likely to develop NILM in a short period after Yokuinin administration, and premenopausal patients also developed NILM in a short period. No adverse effects were associated with Yokuinin administration. Conclusion Yokuinin administration effectively normalized precancerous cervical lesions, with expedited normalization observed in HPV-positive and premenopausal cases. Yokuinin emerges as a promising treatment for cervical precancerous lesions.

Evaluation of the effect of herbal agents as management of radiodermatitis in breast cancer patients: A systematic review and meta-analysis

OBJECTIVE

To evaluate the effectiveness of herbal agents in the prevention and therapy of radiodermatitis in breast cancer patients.

METHODS

Randomized controlled trials were searched from databases such as PubMed, Web of Science, Embase, Cochrane Library, and Chinese National Knowledge Infrastructure (CNKI) to assess the effectiveness of herbal agents compared to a standard medication or placebo in prevention or treatment of radiodermatitis in breast cancer.

RESULTS

Data from 16 studies involving 1994 patients were included. This meta-analysis included 10 clinical trials of 562 breast cancer patients treated with calendula, silymarin, or aloe vera for the prevention of radiodermatitis. Silymarin showed positive effects in ameliorating the damage of radiodermatitis, whereas the efficacy of calendula and aloe vera in the treatment of radiodermatitis lacks sufficient evidence.

CONCLUSIONS

Herbal medicine may show therapeutic effects on radiodermatitis in breast cancer, but more comprehensive investigations and clinical trials are required in the future.

Ethosomes and their monotonous effects on Skin cancer disruption

Skin cancer is one of the most prominent diseases, affecting all continents worldwide, and has shown a significant rise in mortality and prevalence. Conventional therapy, including chemotherapy and surgery, has a few drawbacks. The ethosomal systems would be thoroughly reviewed in this compilation, and they would be classified based on constituents: classical ethosomes, binary ethosomes, and transethosomes. Ethosomes systems are model lipid vesicular carriers with a substantial portion of ethanol. The impacts of ethosomal system components, preparation techniques, and their major roles in selecting the final characteristics of these nanocarriers are comprehensively reviewed in this chapter. The special techniques for ethosomes, including the cold approach, hot approach, injection method, mechanical dispersion method, and conventional method, are explained in this chapter. Various evaluation parameters of ethosomes were also explained. Furthermore, ethosomal gels, patches, and creams can be emphasised as innovative pharmaceutical drug formulations. Some hybrid ethosomal vesicles possessing combinatorial cancer therapy using nanomedicine could overcome the current drug resistance of specific cancer cells. Through the use of repurpose therapy, phytoconstituents may be delivered more effectively. A wide range of in vivo models are employed to assess their effectiveness. Ethosomes have provided numerous potential skin cancer therapeutic approaches in the future.

Plant and Herbal Extracts as Ingredients of Topical Agents in the Prevention and Treatment Radiodermatitis: A Systematic Literature Review

Background: The use of herbal extracts as the source of antioxidant substances capable of neutralizing free radicals and providing protection from ionizing radiation appears to be an alternative therapy for radiodermatitis. As concerns the prevention and treatment of side effects, a lot of recommendations are based on proper experience of radiotherapy centers. We summarize recent research aiming at reducing radiation-induced skin injuries by use of proper skin care, using topical preparations with herbal extracts including onco-cosmetics. Methods: This article is limited to a critical analysis of scientific and professional literature. It concerns preparations in different physicochemical forms, e.g., gels, emulsions, ointments. We stress the connection between the type of applied skin care (type of preparation, its composition, the dose), the properties of the herbal extract and the evaluation of its efficiency in preventing and treating radiation reaction on skin. Conclusions: Herbal extracts can be added to recipes because they are part of a category of cosmeceutical supplements and can be introduced into preparations without prescription. The effectiveness evaluation for herbal extracts in radiotherapy is not an easy task since there are no strict guidelines. Studies should be preceded by the analysis of herbal extracts and recipe in terms of physicochemical, dermatological and performance characteristics.

Ethnobotanical Survey on Skin Whitening Prescriptions of Traditional Chinese Medicine in Taiwan

The increasing interest and demand for skin whitening products globally, particularly in Asia, have necessitated rapid advances in research on skin whitening products used in traditional Chinese medicine (TCM). Herein, we investigated 74 skin whitening prescriptions sold in TCM pharmacies in Taiwan. Commonly used medicinal materials were defined as those with a relative frequency of citation (RFC) > 0.2 and their characteristics were evaluated. Correlation analysis of commonly used medicinal materials was carried out to identify the core component of the medicinal materials. Of the purchased 74 skin whitening prescriptions, 36 were oral prescriptions, 37 were external prescriptions, and one prescription could be used as an oral or external prescription. After analysis, 90 traditional Chinese medicinal materials were obtained. The Apiaceae (10%; 13%) and Leguminosae (9%; 11%) were the main sources of oral and external medicinal materials, respectively. Oral skin whitening prescriptions were found to be mostly warm (46%) and sweet (53%), while external skin whitening prescriptions included cold (43%) and bitter (29%) medicinal materials. Additionally, mainly tonifying and replenishing effects of the materials were noted. Pharmacological analysis indicated that these medicinal materials may promote wound healing, treat inflammatory skin diseases, or anti-hyperpigmentation. According to the Spearman correlation analysis on interactions among medicinal materials with an RFC > 0.2 in the oral skin whitening prescriptions, Paeonia lactiflora Pall. (white) and Atractylodes macrocephala Koidz. showed the highest correlation (confidence score = 0.93), followed by Ziziphus jujuba Mill. (red) and Astragalus propinquus Schischkin (confidence score = 0.91). Seven medicinal materials in external skin whitening prescriptions with an RFC > 0.2, were classified as Taiwan qī bái sàn (an herbal preparation), including Angelica dahurica (Hoffm.) Benth. & Hook. f. ex Franch. & Sav., Wolfiporia extensa (Peck) Ginns, Bletilla striata (Thunb.) Rchb. f., Atractylodes macrocephala Koidz., Ampelopsis japonica (Thunb.) Makino, Paeonia lactiflora Pall. (white), and Bombyx mori Linnaeus. Skin whitening prescriptions included multiple traditional Chinese medicinal materials. Despite the long history of use, there is a lack of studies concerning skin whitening products, possibly due to the complex composition of traditional Chinese medicine. Further studies are required to assess the efficacy and safety of these traditional Chinese medicinal materials for inclusion in effective, safe, and functional pharmacological products.