1
|
Mohapatra S, Kumar PA, Aggarwal A, Iqubal A, Mirza MA, Iqbal Z. Phytotherapeutic approach for conquering menopausal syndrome and osteoporosis. Phytother Res 2024; 38:2728-2763. [PMID: 38522005 DOI: 10.1002/ptr.8172] [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: 03/26/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 03/25/2024]
Abstract
Women face a significant change in their reproductive health as menopause sets in. It is marred with numerous physiological changes that negatively impact their quality of life. This universal, transition phase is associated with menopausal and postmenopausal syndrome, which may spread over 2-10 years. This creates a depletion of female hormones causing physical, mental, sexual and social problems and may, later on, manifest as postmenopausal osteoporosis leading to weak bones, causing fractures and ultimately morbidity and mortality. Menopausal hormone therapy generally encompasses the correction of hormone balance through various pharmacological agents, but the associated side effects often lead to cessation of therapy with poor clinical outcomes. However, it has been noticed that phytotherapeutics is trusted by women for the amelioration of symptoms related to menopause and for improving bone health. This could primarily be due to their reduced side effects and lesser costs. This review attempts to bring forth the suitability of phytotherapeutics/herbals for the management of menopausal, postmenopausal syndrome, and menopausal osteoporosis through several published research. It tries to enlist the available botanicals with their key constituents and mechanism of action for mitigating symptoms associated with menopause as well as osteoporosis. It also includes a list of a few herbal commercial products available for these complications. The article also intends to collate the findings of various clinical trials and patents available in this field and provide a window for newer research avenues in this highly important yet ignored health segment.
Collapse
Affiliation(s)
- Sradhanjali Mohapatra
- Nanotechnology Lab, School of Pharmaceutical Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - P Ayash Kumar
- Sun Pharmaceutical Industries Limited, R&D Centre, Gurugram, India
| | - Akshay Aggarwal
- Sun Pharmaceutical Industries Limited, R&D Centre, Gurugram, India
| | - Ashif Iqubal
- Department of Pharmacology, School of Pharmaceutical Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - Mohd Aamir Mirza
- Nanotechnology Lab, School of Pharmaceutical Education and Research (SPER), Jamia Hamdard, New Delhi, India
| | - Zeenat Iqbal
- Nanotechnology Lab, School of Pharmaceutical Education and Research (SPER), Jamia Hamdard, New Delhi, India
| |
Collapse
|
2
|
Dernbach MR, Carpenter JE, Shah N, Carter GB. Black Cohosh Interactions with Prescription Medications Associated with Serotonin Toxicity and Rhabdomyolysis: A Case Report. J Emerg Med 2024; 66:e592-e596. [PMID: 38556373 DOI: 10.1016/j.jemermed.2024.01.003] [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: 03/26/2023] [Revised: 12/26/2023] [Accepted: 01/06/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Serotonin toxicity is a well-described phenomenon that is commonly attributed to a variety of drug-drug combinations. Some unregulated herbal supplements have been implicated in the onset of serotonin toxicity, however, there is currently minimal literature available on the potential for black cohosh to contribute to rhabdomyolysis and serotonin toxicity, in spite of its known serotonergic properties. CASE REPORT A middle-aged woman presented to the emergency department with serotonin toxicity and rhabdomyolysis shortly after taking black cohosh supplements in the setting of long-term dual antidepressant use. The serotonin toxicity and rhabdomyolysis resolved with IV fluids, benzodiazepines, and discontinuation of the offending drugs. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Patients are sometimes not aware of how over-the-counter supplements might interact with their prescription medications. Female patients taking black cohosh to manage hot flashes and menopausal symptoms could be at risk for developing rhabdomyolysis and serotonin toxicity if they are also taking other serotonergic agents.
Collapse
Affiliation(s)
- Matthew Robert Dernbach
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Joseph E Carpenter
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Nihar Shah
- Division of Pulmonary and Critical Care, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - George Benjamin Carter
- Division of Pulmonary and Critical Care, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
3
|
Fatima S, Verma M, Ansari IA. Phytochemistry and ethnopharmacological studies of genus Cimicifuga: A systematic and comprehensive review. Fitoterapia 2024; 172:105767. [PMID: 38052334 DOI: 10.1016/j.fitote.2023.105767] [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: 09/09/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/07/2023]
Abstract
ETHNOPHARMACOLOGICAL USES Black cohosh, also known as Cimicifuga sp., is one of the most widely used ethnomedicine for the treatment of major health issues in women. Some reports show that Cimicifuga sp. exhibit anti-cancer, anti-viral, anti-microbial, anti-pyretic, and anti-inflammatory properties. PURPOSE OF THIS REVIEW The objective of this comprehensive review is to furnish current and exhaustive knowledge pertaining to the pharmacological, phytochemical, and therapeutic properties of Cimicifuga sp. MATERIALS AND METHODS In this review, all the available information was collected on Cimicifugasp. via computerized search using Google Scholar, PubMed, Research Gate, Sci-Hub, supplementary resources (books, government reports, and Ph.D. theses). RESULT The phytochemical investigation on Cimicifuga sp. has shown phytoconstituents such as triterpenoid glycosides, phenylpropanoid, flavonoids, saponin, lignan, nitrogenous compounds, alkaloids, 4α-Methyl steroids and some other component like monoterpene lactones cimicifugolides A-C etc. Cimicifuga conveys a wide scope of research on in-vitro and in-vivo pharmacological potential, like anti-cancer, anti-microbial, anti-viral, anti-inflammatory, estrogenic, anti-oxidant, anti-neoplastic, anti-depressant, anti-Alzheimer, and anti-climacteric properties. CONCLUSION This article discusses the medicinal and traditional histories of various Cimicifuga species. Because quality control and safety assessments of Cimicifuga species are currently lacking, only a limited portion of the plant may be used as medication. The majority of current research focuses on triterpene glycosides. Although there are a variety of additional molecules that may have novel biological functions, systematic investigations of these compounds are lacking. The Cimicifuga plant has to go through a lot of studies before it can be completely used in clinics as a viable medicinal contender.
Collapse
Affiliation(s)
- Shireen Fatima
- Department of Biosciences, Integral University, Lucknow 226026, India
| | - Mahima Verma
- Department of Biosciences, Integral University, Lucknow 226026, India
| | | |
Collapse
|
4
|
Płoska A, Wozniak M, Hedhli J, Konopka CJ, Skondras A, Matatov S, Stawarz A, Schuh S, Czerwinski A, Dobrucki LW, Kalinowski L, Dobrucki IT. In Vitro and In Vivo Imaging-Based Evaluation of Doxorubicin Anticancer Treatment in Combination with the Herbal Medicine Black Cohosh. Int J Mol Sci 2023; 24:17506. [PMID: 38139334 PMCID: PMC10743623 DOI: 10.3390/ijms242417506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
As a substitution for hormone replacement therapy, many breast cancer patients use black cohosh (BC) extracts in combination with doxorubicin (DOX)-based chemotherapy. In this study, we evaluated the viability and survival of BC- and DOX-treated MCF-7 cells. A preclinical model of MCF-7 xenografts was used to determine the influence of BC and DOX administration on tumor growth and metabolism. The number of apoptotic cells after incubation with both DOX and BC was significantly increased (~100%) compared to the control. Treatment with DOX altered the potential of MCF-7 cells to form colonies; however, coincubation with BC did not affect this process. In vivo, PET-CT imaging showed that combined treatment of DOX and BC induced a significant reduction in both metabolic activity (29%) and angiogenesis (32%). Both DOX and BC treatments inhibited tumor growth by 20% and 12%, respectively, and combined by 57%, vs. control. We successfully demonstrated that BC increases cytotoxic effects of DOX, resulting in a significant reduction in tumor size. Further studies regarding drug transport and tumor growth biomarkers are necessary to establish the underlying mechanism and potential clinical use of BC in breast cancer patients.
Collapse
Affiliation(s)
- Agata Płoska
- Department of Medical Laboratory Diagnostics-Fahrenheit Biobank BBMRI.Pl, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.P.); (M.W.); (L.W.D.)
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
| | - Marcin Wozniak
- Department of Medical Laboratory Diagnostics-Fahrenheit Biobank BBMRI.Pl, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.P.); (M.W.); (L.W.D.)
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
| | - Jamila Hedhli
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
- Carle-Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Christian J. Konopka
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Antonios Skondras
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
| | - Sarah Matatov
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
| | - Andrew Stawarz
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Sarah Schuh
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Andrzej Czerwinski
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
| | - Lawrence W. Dobrucki
- Department of Medical Laboratory Diagnostics-Fahrenheit Biobank BBMRI.Pl, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.P.); (M.W.); (L.W.D.)
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
- Carle-Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Leszek Kalinowski
- Department of Medical Laboratory Diagnostics-Fahrenheit Biobank BBMRI.Pl, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.P.); (M.W.); (L.W.D.)
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
- BioTechMed Centre, Department of Mechanics of Materials and Structures, Gdansk University of Technology, 80-233 Gdansk, Poland
| | - Iwona T. Dobrucki
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA; (J.H.); (C.J.K.)
- Carle-Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Academy of Medical and Social Applied Sciences, 82-300 Elblag, Poland
| |
Collapse
|
5
|
Alanazi HH, Elasbali AM, Alanazi MK, El Azab EF. Medicinal Herbs: Promising Immunomodulators for the Treatment of Infectious Diseases. Molecules 2023; 28:8045. [PMID: 38138535 PMCID: PMC10745476 DOI: 10.3390/molecules28248045] [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: 10/02/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023] Open
Abstract
Humans are constantly at high risk of emerging pandemics caused by viral and bacterial infections. The emergence of new pandemics is mainly caused by evolved viruses and bacteria that are highly resistant to existing medications. The rapid evolution of infectious agents demands the urgent investigation of new therapeutic strategies to prevent and treat these infections at an early stage. One of these therapeutic strategies includes the use of medicinal herbs for their antibacterial and antiviral properties. The use of herbal medicines as remedies is very ancient and has been employed for centuries. Many studies have confirmed the antimicrobial activities of herbs against various pathogens in vitro and in vivo. The therapeutic effect of medicinal herbs is mainly attributed to the natural bioactive molecules present in these plants such as alkaloids, flavonoids, and terpenoids. Different mechanisms have been proposed for how medicinal herbs enhance the immune system and combat pathogens. Such mechanisms include the disruption of bacterial cell membranes, suppression of protein synthesis, and limitation of pathogen replication through the inhibition of nucleic acid synthesis. Medicinal herbs have been shown to treat a number of infectious diseases by modulating the immune system's components. For instance, many medicinal herbs alleviate inflammation by reducing pro-inflammatory cytokines (e.g., tumor necrosis factor-alpha (TNF-α), interleukin-1, IL-6) while promoting the production of anti-inflammatory cytokines (e.g., IL-10). Medicinal herbs also play a role in defense against viral and intracellular infections by enhancing the proliferation and functions of natural killer cells, T-helper-1 cells, and macrophages. In this review, we will explore the use of the most common herbs in preventing and treating infectious and non-infectious diseases. Using current and recently published studies, we focus on the immunomodulatory and therapeutic effects induced by medicinal herbs to enhance immune responses during diseases.
Collapse
Affiliation(s)
- Hamad H. Alanazi
- Department of Clinical Laboratory Science, College of Applied Medical Sciences-Qurayyat, Jouf University, Al-Qurayyat 77455, Saudi Arabia; (A.M.E.); (E.F.E.A.)
| | | | | | | |
Collapse
|
6
|
Crișan S, Pop AL, Lacatusu I, Badea N, Mustaciosu C, Radu M, Varlas VN, Peneş ON, Ciobanu AM, Ghica M, Voicu SN, Udeanu DI. Safety of Innovative Nanotechnology Oral Formulations Loaded with Bioactive Menopause Molecules: Influence of Genotoxicity and Biochemical Parameters on a Menopausal Rat Model. Nutrients 2023; 15:4951. [PMID: 38068809 PMCID: PMC10708031 DOI: 10.3390/nu15234951] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
In recent years, nanoparticles have gained significant importance due to their unique properties, such as pharmacological, electrical, optical, and magnetic abilities, contributing to the growth of the science and technology sector. Particular naturally derived biomolecules with beneficial effects on menopause disorder have been the subject of studies of pharmaceutical formulation to obtain alternative pharmaceutical forms with increased bioavailability and without side effects, as in nanostructured lipid carriers (NLCs) loaded with such active ingredients. In the present study, one stage of a broader project, we have performed pharmacotoxicology studies for six combinatory innovative nanocapsule pharmaceutical forms containing active natural biomolecules before considering them as oral formulas for (1) in vitro toxicity studies on culture cells and (2) in vivo preclinical studies on a surgically induced menopause model of Wistar female rats, and the influence of the NLCs on key biochemical parameters: lipid profile (TG, Chol, HDL), glycemic markers (Gli), bone markers (Pac, Palc, Ca, phosphorus), renal markers (Crea, urea, URAC), inflammation (TNF), oxidative stress (GSH, MDA), and estrogen-progesterone hormonal profile. The micronucleus test did not reveal the genotoxicity of the tested compounds; the menopause model showed no significant safety concerns for the six tested formulas evaluated using the blood biochemical parameters; and the results showed the potential hypoglycemic, hypolipidemic, hypouricemic, and antioxidant potential of one of the tested formulas containing nano diosgenin and glycyrrhizic acid.
Collapse
Affiliation(s)
- Simona Crișan
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 6 Traian Vuia Street, 020945 Bucharest, Romania; (S.C.); (A.L.P.); (A.M.C.); (M.G.); (D.I.U.)
- R&D Center, AC HELCOR, Victor Babes St., 430082 Baia Mare, Romania
| | - Anca Lucia Pop
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 6 Traian Vuia Street, 020945 Bucharest, Romania; (S.C.); (A.L.P.); (A.M.C.); (M.G.); (D.I.U.)
| | - Ioana Lacatusu
- Faculty of Applied Chemistry and Materials Science, The Polytechnic University of Bucharest, Polizu No 1, 011061 Bucharest, Romania; (I.L.); (N.B.)
| | - Nicoleta Badea
- Faculty of Applied Chemistry and Materials Science, The Polytechnic University of Bucharest, Polizu No 1, 011061 Bucharest, Romania; (I.L.); (N.B.)
| | - Cosmin Mustaciosu
- Horia Hulubei National Institute for Physics and Nuclear Engineering IFIN-HH, 077125 Bucharest, Romania; (C.M.); (M.R.)
| | - Mihai Radu
- Horia Hulubei National Institute for Physics and Nuclear Engineering IFIN-HH, 077125 Bucharest, Romania; (C.M.); (M.R.)
| | - Valentin Nicolae Varlas
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Ovidiu Nicolae Peneş
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Anne Marie Ciobanu
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 6 Traian Vuia Street, 020945 Bucharest, Romania; (S.C.); (A.L.P.); (A.M.C.); (M.G.); (D.I.U.)
| | - Manuela Ghica
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 6 Traian Vuia Street, 020945 Bucharest, Romania; (S.C.); (A.L.P.); (A.M.C.); (M.G.); (D.I.U.)
| | - Sorina Nicoleta Voicu
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 030018 Bucharest, Romania;
| | - Denisa Ioana Udeanu
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 6 Traian Vuia Street, 020945 Bucharest, Romania; (S.C.); (A.L.P.); (A.M.C.); (M.G.); (D.I.U.)
| |
Collapse
|
7
|
Kumari S, Singh M, Nupur, Jain S, Verma N, Malik S, Rustagi S, Priya K. A review on therapeutic mechanism of medicinal plants against osteoporosis: effects of phytoconstituents. Mol Biol Rep 2023; 50:9453-9468. [PMID: 37676432 DOI: 10.1007/s11033-023-08751-4] [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: 05/05/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023]
Abstract
Osteoporosis is a metabolic bone disorder that over time results in bone loss and raises the risk of fracture. The condition is frequently silent and only becomes apparent when fractures develop. Osteoporosis is treated with pharmacotherapy as well as non-pharmacological therapies such as mineral supplements, lifestyle changes, and exercise routines. Herbal medicine is frequently used in clinical procedures because of its low risk of adverse effects and cost-effective therapeutic results. In the current review, we have used a thorough strategy to identify some known medicinal plants with anti-osteoporosis capabilities, their origin, active ingredients, and pharmacological information. Furthermore, several signaling pathways, such as the apoptotic pathway, transcription factors, the Wnt/-catenin signaling pathway, and others, are regulated by bioactive components and help to improve bone homeostasis. This review will provide a better understanding of the anti-osteoporotic effects of bioactive components and the concomitant modulations of signaling pathways.
Collapse
Affiliation(s)
- Shilpa Kumari
- Department of Life Sciences, School of Basic Sciences and Research, Sharda University, Knowledge parkIII, Greater Noida, 201310, U.P., India
| | - Mohini Singh
- Department of Life Sciences, School of Basic Sciences and Research, Sharda University, Knowledge parkIII, Greater Noida, 201310, U.P., India
| | - Nupur
- Department of Life Sciences, School of Basic Sciences and Research, Sharda University, Knowledge parkIII, Greater Noida, 201310, U.P., India
| | - Smita Jain
- Department of Life Sciences, School of Basic Sciences and Research, Sharda University, Knowledge parkIII, Greater Noida, 201310, U.P., India
| | - Neha Verma
- Department of Life Sciences, School of Basic Sciences and Research, Sharda University, Knowledge parkIII, Greater Noida, 201310, U.P., India
| | - Sumira Malik
- Amity Institute of Biotechnology, Amity University, Ranchi, 834002, Jharkhand, India
| | - Sarvesh Rustagi
- Department of Food Technology, Uttaranchal University, Dehradun, 248007, Uttarakhand, India
| | - Kanu Priya
- Department of Life Sciences, School of Basic Sciences and Research, Sharda University, Knowledge parkIII, Greater Noida, 201310, U.P., India.
| |
Collapse
|
8
|
Undeberg MR, Barash A, McKeirnan KC. Role of the pharmacist in the management of postmenopausal breast cancer treatment with vasomotor symptoms: A case report. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 11:100324. [PMID: 37694166 PMCID: PMC10485165 DOI: 10.1016/j.rcsop.2023.100324] [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: 06/15/2023] [Revised: 08/23/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023] Open
Abstract
This case report describes the pharmacist intervention with a 62-year-old woman who had postmenopausal breast cancer. The patient was experiencing severe vasomotor symptoms from her cancer therapy and wanted to discontinue her treatment despite her risk of cancer returning. Using guidelines for treatment of postmenopausal breast cancer and medication options to mitigate vasomotor symptoms, the pharmacist developed a treatment plan that was acceptable to the patient and approved by the oncologist. Following implementation, the patient was satisfied to experience minimal hot flashes and relayed full compliance with her breast cancer treatment regimen. Pharmacists can play an important role in the management of postmenopausal breast cancer and vasomotor symptoms by providing patient education and recommending medications based on treatment guidelines with consideration to side effects and drug interactions.
Collapse
Affiliation(s)
- Megan R. Undeberg
- Washington State University College of Pharmacy and Pharmaceutical Sciences, 412 E. Spokane Falls Blvd, Spokane, WA 99202-2131, USA
| | - Alanda Barash
- Washington State University College of Pharmacy and Pharmaceutical Sciences, 412 E. Spokane Falls Blvd, Spokane, WA 99202-2131, USA
| | - Kimberly C. McKeirnan
- Washington State University College of Pharmacy and Pharmaceutical Sciences, 412 E. Spokane Falls Blvd, Spokane, WA 99202-2131, USA
| |
Collapse
|
9
|
Tjeerdsma AM, van Hunsel FPAM, van de Koppel S, Ekhart C, Vitalone A, Woerdenbag HJ. Analysis of Safety Concerns on Herbal Products with Assumed Phytoestrogenic Activity. Pharmaceuticals (Basel) 2023; 16:1137. [PMID: 37631050 PMCID: PMC10459077 DOI: 10.3390/ph16081137] [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: 06/22/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Phytoestrogens (PEs) are plant-based compounds that can interact with estrogen receptors and are mainly used to treat menopausal complaints. However, the safety of products with assumed phytoestrogenic activity is not fully understood. This study aimed to identify plant species with assumed phytoestrogenic activity, review existing literature on their use and safety, and critically evaluate adverse reaction (AR) reports of single-herb, multi-herb, and mixed-multiple products, as submitted to the Netherlands Pharmacovigilance Centre Lareb and to VigiBase of the World Health Organization (WHO). In the Lareb database, the most commonly reported plant species to cause ARs (total of 67 reports) were Actaea racemosa L. (black cohosh) (47.8%), Humulus lupulus L. (hops) (32.8%), and Glycine max (L.) Merr. (soybean) (22.4%). In the VigiBase database (total of 21,944 reports), the top three consisted of Glycine max (L.) Merr. (71.4%), Actaea racemosa L. (11.6%), and Vitex agnus-castus L. (chaste tree) (6.4%). In the scoping review (total of 73 articles), Actaea racemosa L. (30.1%), Glycine max (L.) Merr. (28.8%), and Trifolium pratense L. (13.7%) were the most frequently mentioned plant species. ARs were most frequently reported in the system organ classes "gastrointestinal disorders", "skin and subcutaneous tissue disorders", "reproductive system and breast disorders", and "general disorders and administration site conditions". Furthermore, from the scoping review, it appeared that the use of products with assumed phytoestrogenic activity was associated with postmenopausal bleeding. It was concluded that, while the potential benefits of products with assumed phytoestrogenic activity have been extensively pursued, the potential occurrence of ARs after using these products is less well understood. This study highlights the need for further investigation and careful monitoring of these products to better understand their effects and ensure the safety and well-being of individuals using them.
Collapse
Affiliation(s)
- A. Marije Tjeerdsma
- Department of Pharmaceutical Technology and Biopharmacy, Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH ’s-Hertogenbosch, The Netherlands; (F.P.A.M.v.H.); (S.v.d.K.); (C.E.)
| | - Florence P. A. M. van Hunsel
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH ’s-Hertogenbosch, The Netherlands; (F.P.A.M.v.H.); (S.v.d.K.); (C.E.)
- Department of PharmacoTherapy, -Epidemiology & -Economics, Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Sonja van de Koppel
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH ’s-Hertogenbosch, The Netherlands; (F.P.A.M.v.H.); (S.v.d.K.); (C.E.)
| | - Corine Ekhart
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH ’s-Hertogenbosch, The Netherlands; (F.P.A.M.v.H.); (S.v.d.K.); (C.E.)
| | - Annabella Vitalone
- Department of Physiology and Pharmacology ‘Vittorio Erspamer’, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Herman J. Woerdenbag
- Department of Pharmaceutical Technology and Biopharmacy, Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
| |
Collapse
|
10
|
Cui L, Wu J, Wang X, Yang X, Ye Z, Mayo KH, Sun L, Zhou Y. Purification and identification of oligosaccharides from Cimicifuga heracleifolia Kom. rhizomes. Food Chem X 2023; 18:100706. [PMID: 37215199 PMCID: PMC10196342 DOI: 10.1016/j.fochx.2023.100706] [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: 02/10/2023] [Revised: 04/14/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023] Open
Abstract
Even though Cimicifuga sp. is widely used in functional foods around the world, the content and structure of its oligosaccharides remain unclear. Here, we isolated a mixture of oligosaccharides from Cimicifuga heracleifolia Kom. rhizomes with a yield of 9.5% w/w. Twenty-six oligosaccharide monomers from the mixture were purified using optimized SEC and HILIC techniques. The oligosaccharides were identified as belonging to two groups by using HPAEC-PAD, MALDI-TOF-MS, NMR and GC-MS methylation analyses. One group belongs to sucrose and inulin type fructo-oligosaccharides (FOS) {β-d-Fruf-(2 → 1)-[β-d-Fruf-(2 ↔ 1)]n=1-12-α-d-Glcp} with a 3-14 degree of polymerization (DP). Oligosaccharides in the other group belong to the inulo-n-ose type FOS {β-d-Fruf-(2 → 1)-[β-d-Fruf-(2 → 1)]m=0-12-β-d-Frup} with a DP of 2-14. This appears to be the first time that these oligosaccharides have been purified from Cimicifuga heracleifolia Kom., thus providing useful information concerning the utilization of Cimicifuga heracleifolia Kom. in functional foods.
Collapse
Affiliation(s)
- Liangnan Cui
- Engineering Research Center of Glycoconjugates, Ministry of Education, Jilin Provincial Key Laboratory on Chemistry and Biology of Changbai Mountain Natural Drugs, School of Life Sciences, Northeast Normal University, Changchun 130024, China
| | - Jing Wu
- Engineering Research Center of Glycoconjugates, Ministry of Education, Jilin Provincial Key Laboratory on Chemistry and Biology of Changbai Mountain Natural Drugs, School of Life Sciences, Northeast Normal University, Changchun 130024, China
| | - Xiang Wang
- Engineering Research Center of Glycoconjugates, Ministry of Education, Jilin Provincial Key Laboratory on Chemistry and Biology of Changbai Mountain Natural Drugs, School of Life Sciences, Northeast Normal University, Changchun 130024, China
| | - Xiaotong Yang
- Engineering Research Center of Glycoconjugates, Ministry of Education, Jilin Provincial Key Laboratory on Chemistry and Biology of Changbai Mountain Natural Drugs, School of Life Sciences, Northeast Normal University, Changchun 130024, China
| | - Zixin Ye
- Engineering Research Center of Glycoconjugates, Ministry of Education, Jilin Provincial Key Laboratory on Chemistry and Biology of Changbai Mountain Natural Drugs, School of Life Sciences, Northeast Normal University, Changchun 130024, China
| | - Kevin H. Mayo
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, 6-155 Jackson Hall, Minneapolis, MN 55455, USA
| | - Lin Sun
- Engineering Research Center of Glycoconjugates, Ministry of Education, Jilin Provincial Key Laboratory on Chemistry and Biology of Changbai Mountain Natural Drugs, School of Life Sciences, Northeast Normal University, Changchun 130024, China
| | - Yifa Zhou
- Engineering Research Center of Glycoconjugates, Ministry of Education, Jilin Provincial Key Laboratory on Chemistry and Biology of Changbai Mountain Natural Drugs, School of Life Sciences, Northeast Normal University, Changchun 130024, China
| |
Collapse
|
11
|
Dong JJ, Ma JY, Yang WY, Cai W, Wu WH. Characterization of the volatile profile and its estrogenic activity in Kadsura coccinea fruit. JOURNAL OF ETHNOPHARMACOLOGY 2023; 309:116341. [PMID: 36889418 DOI: 10.1016/j.jep.2023.116341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/18/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The fruit of Kadsura coccinea (Lem.) A. C. Smith is an ethnomedicine used to treat abnormal menstruation, menopausal syndrome, and female infertility among the Dong Nationality in China. AIM OF THE STUDY Our study aimed to identify the volatile oil profiles of the K. coccinea fruit and elucidate their estrogenic activity. MATERIALS AND METHODS The peel volatile oil (PeO), pulp volatile oil (PuO), and seed volatile oil (SeO) of K. coccinea were extracted using hydrodistillation and qualitatively analyzed using gas chromatography-mass spectrometry (GC-MS). Estrogenic activity was evaluated in vitro using cell assay and in vivo using immature female rats. Serum 17β-Estradiol (E2) and follicle-stimulating hormone (FSH) levels were detected using ELISA. RESULTS In total, 46 PeO, 27 PuO, and 42 SeO components representing 89.96%, 90.19%, and 97% of the total composition, respectively, were identified. The compounds with the highest content in PeO, PuO, and SeO were β-caryophyllene, γ-amorphene, and n-hexadecanoic acid, respectively. PeO induced proliferation of MCF-7 cells with an EC50 of 7.40 μg/mL. Subcutaneous administration of 10 mg/kg PeO significantly increased the weight of the uteri in immature female rats, with no effect on serum E2 and FSH levels. PeO acted as an agonist of ERα and ERβ. PuO and SeO showed no estrogenic activity. CONCLUSION The chemical compositions of PeO, PuO, and SeO of K. coccinea are different. PeO is the main effective fraction for estrogenic activities, providing a new source of phytoestrogen for the treatment of menopausal symptoms.
Collapse
Affiliation(s)
- Jin-Jin Dong
- School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jie-Yao Ma
- Hunan Provincial Key Laboratory for Synthetic Biology of Traditional Chinese Medicine, School of Pharmaceutical Sciences, Hunan University of Medicine, Huaihua, Hunan, China
| | - Wei-Ye Yang
- School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Cai
- Hunan Provincial Key Laboratory for Synthetic Biology of Traditional Chinese Medicine, School of Pharmaceutical Sciences, Hunan University of Medicine, Huaihua, Hunan, China.
| | - Wei-Hua Wu
- School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, China; Hunan Provincial Key Laboratory for Synthetic Biology of Traditional Chinese Medicine, School of Pharmaceutical Sciences, Hunan University of Medicine, Huaihua, Hunan, China.
| |
Collapse
|
12
|
Quality by Design Assisted Optimization and Risk Assessment of Black Cohosh Loaded Ethosomal Gel for Menopause: Investigating Different Formulation and Process Variables. Pharmaceutics 2023; 15:pharmaceutics15020465. [PMID: 36839787 PMCID: PMC9966456 DOI: 10.3390/pharmaceutics15020465] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023] Open
Abstract
Black cohosh (Cimicifuga racemosa) (CR) is a popular herb and is medically lauded for ameliorating myriad symptoms associated with menopause. However, its pharmaceutical limitations and non-availability of a patient-compliant drug delivery approach have precluded its prevalent use. Henceforth, the current research premise is aimed at developing an ethosomal gel incorporating triterpene enriched fraction (TEF) obtained from CR and evaluating its effectiveness through the transdermal application. TEF-loaded ethosomes were formulated using solvent injection, optimized and characterised. The optimized ethosomes were then dispersed into a polymeric gel base to form ethosomal gel which was further compared with the conventional gel by in-vitro and ex-vivo experiments. Here, the quality by design (QbD) approach was exploited for the optimization and development of ethosomal gel. The elements of QbD comprising initial risk assessment, design of experimentation (DoE), and model validation for the development of formulation have all been described in detail. The optimized ethosomes (F03) showed a nanometric size range, negative zeta potential and good entrapment. The in vitro release profile of gel revealed a burst release pattern following the Korsmeyer Peppas model having Fickian diffusion. The transdermal flux of ethosomal gel was observed to be more than that of conventional gel. Texture analysis and rheological characterization of the gel, revealed good strength showing shear thinning and pseudoplastic behaviour. The confocal microscope investigation revealed the deeper skin permeation of ethosomal gel than conventional gel. This result was further strengthened by DSC, IR and histological assessment of the animal skin (Wistar rat), treated with the optimized formulation. Conclusively, the implementation of QbD in the formulation resulted in a better understanding of the process and the product. It aids in the reduction of product variability and defects, hence improving product development efficiencies. Additionally, the ethosomal gel was found to be a more effective and successful carrier for TEF than the conventional gel through the transdermal route. Moreover, this demands an appropriate animal study, which is underway, for a stronger outcome.
Collapse
|
13
|
Actaea racemosa L. Rhizome Protect against MPTP-Induced Neurotoxicity in Mice by Modulating Oxidative Stress and Neuroinflammation. Antioxidants (Basel) 2022; 12:antiox12010040. [PMID: 36670902 PMCID: PMC9854773 DOI: 10.3390/antiox12010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/09/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Parkinson's disease (PD) is a dopaminergic neuron-related neurodegenerative illness. Treatments exist that alleviate symptoms but have a variety of negative effects. Recent research has revealed that oxidative stress, along with neuroinflammation, is a major factor in the course of this disease. Therefore, the aim of our study was to observe for the first time the effects of a natural compound such as Actaea racemosa L. rhizome in an in vivo model of PD induced by neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). For the study, mice received four injections of MPTP (20 mg/kg) for the induction of PD. Starting 24 h after the first administration of MPTP we treated mice with Actaea racemosa L. rhizome (100 mg/kg) daily for seven days. Our findings clearly demonstrated that Actaea racemosa L. rhizome treatment decreases oxidative stress by activating redox balance enzymes such as Nrf2/HO-1. We also demonstrated that Actaea racemosa L. rhizome is capable of modulating inflammatory indicators involved in PD, such as IκB-α, NF-κB, GFAP and Iba1, thus reducing the degeneration of dopaminergic neurons and motor and non-motor alterations. To summarize, Actaea racemosa L. rhizome, which is subject to fewer regulations than traditional medications, could be used as a dietary supplement to improve patients' brain health and could be a promising nutraceutical choice to slow the course and symptoms of PD.
Collapse
|
14
|
Trant AA, Chagpar A, Wei W, Neumeister V, Rimm D, Stavris K, Lurie B, Frederick C, Andrejeva L, Raghu M, Killelea B, Horowitz N, Lannin D, Knill-Selby E, Sturrock T, Hofstatter E. The Effect of Black Cohosh on Ki67 expression and Tumor Volume: A Pilot Study of Ductal Carcinoma in Situ Patients. Integr Cancer Ther 2022; 21:15347354221137290. [PMID: 36444764 PMCID: PMC9716631 DOI: 10.1177/15347354221137290] [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] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Black cohosh (BC) (Cimicifuga racemosa) may prevent and treat breast cancer through anti-proliferative, pro-apoptotic, anti-estrogenic, and anti-inflammatory effects. This study sought to evaluate the effect of BC on tumor cellular proliferation, measured by Ki67 expression, in a pre-operative window trial of ductal carcinoma in situ (DCIS) patients. METHODS Patients were treated pre-operatively for 2 to 6 weeks with BC extract. Eligible subjects were those who had DCIS on core biopsy. Ki67 was measured using automated quantitative immunofluorescence (AQUA) pre/post-operatively. Ki67, tumor volume, and hormone changes were assessed with 2-sided Wilcoxon signed-rank tests, α = .05. RESULTS Thirty-one patients were treated for an average of 24.5 days (median 25; range 15-36). Ki67 decreased non-significantly (n = 26; P = .20; median pre-treatment 1280, post-treatment 859; range pre-treatment 175-7438, post-treatment 162-3370). Tumor volume, estradiol, and FSH did not change significantly. No grade 3 or 4 adverse events were reported. CONCLUSIONS BC use showed no significant impact on cellular proliferation, tumor volume, or invasive disease upgrade rates in DCIS patients. It was well-tolerated, with no observed significant toxicities. Further study is needed to elucidate BC's role in breast cancer treatment and prevention.ClinicalTrials.gov Identifier: NCT01628536https://clinicaltrials.gov/ct2/show/NCT01628536.
Collapse
Affiliation(s)
| | | | - Wei Wei
- Yale School of Medicine, New Haven, CT, USA
| | | | - David Rimm
- Yale School of Medicine, New Haven, CT, USA
| | | | | | | | | | | | | | | | | | | | | | - Erin Hofstatter
- Yale School of Medicine, New Haven, CT, USA,Erin Hofstatter, Yale School of Medicine, 333 Cedar St., PO Box 208032 New Haven, CT 05620, USA.
| |
Collapse
|
15
|
Xie Y, Duan H, Wang D, Li H, Jia J, Zhang J, Li L. Gonadotropin-releasing hormone agonist protects ovarian function in young patients with ovarian malignancy undergoing platinum-based chemotherapy: A prospective study. Front Oncol 2022; 12:986208. [DOI: 10.3389/fonc.2022.986208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeWe aimed to ascertain the effectiveness of gonadotropin-releasing hormone (GnRH) agonist co-therapy for the preservation of ovarian function in patients with ovarian malignancy who underwent unilateral salpingo-oophorectomy and platinum-based chemotherapy.MethodsWe enrolled 158 patients with ovarian malignancy who underwent fertility preservation surgery and postoperative platinum-based chemotherapy between January 2018 and December 2020. Patients were divided into two groups based on the use of GnRH agonist (GnRHa) during chemotherapy. Two patients withdrew from the study. Laboratory tests (serum follicle-stimulating hormone [FSH], serum luteinizing hormone [LH], and serum anti-Müllerian hormone [AMH]) were performed pre-chemotherapy and one year post-chemotherapy. Data on menstruation resumption, perimenopausal symptoms (modified Kupperman Menopausal Index [KMI]), health-related quality of life (Medical Outcomes Study Short Form-36 [MOS SF-36]), and obstetric outcomes were collected.ResultsOne year post-chemotherapy, the serum AMH level in the GnRHa group was higher than that in the control group (P<0.001), while the serum FSH and FSH/LH levels in the GnRHa group were lower than those in the control group (P<0.001). The mean period from last chemotherapy to menstrual resumption was 3.86 and 5.78 months in the GnRHa and control groups (P<0.001), respectively. The rate of menstrual resumption post-chemotherapy was 93.5% and 82.3% in the GnRHa and control groups (P<0.05), respectively. GnRHa co-administration during chemotherapy reduced the likelihood of low AMH levels post-chemotherapy and was significant in the multivariate analysis (P<0.05). The modified KMI scores and MOS SF-36 scores were better in the GnRHa group than in the control group (both P<0.001).ConclusionGnRHa protects ovarian function during platinum-based adjuvant chemotherapy in young patients with ovarian malignancy. This study provides a therapeutic reference for gynecologists, especially for those in economically and medically underdeveloped areas.Trial registrationChinese Clinical Trial Registry (chiCTR1800019114; October 26, 2018; http://www.chictr.org.cn/index.aspx)
Collapse
|
16
|
Efficacy and Mechanisms of Oleuropein in Postmenopausal Osteoporosis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9767113. [PMID: 36060661 PMCID: PMC9436544 DOI: 10.1155/2022/9767113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022]
Abstract
Background Postmenopausal osteoporosis (PMOP) has a supernal morbidity rate in elderly females. Objective To appraise the effects of oleuropein on bone densitometry, bone metabolic index, oxidative stress, and inflammatory index in PMOP. In addition, the mechanism of olive bittersweet preventing bone loss was explored. Methods We grouped 80 salubrious female Sprague-Dawley rats into four teams: (1) sham operation team (sham, N = 20), (2) ovariectomy (OVX, N = 20), (3) castrated mice fed with oleuropein (OVX+ole, N = 20), and (4) castrated mice fed with estrogen (OVX+E2, N = 20). The ovariectomized SD rats were continuously raised with 200 μg/kg/dose of oleuropein. Bone mineral density and bone metabolism indexes were recorded. In order to assess the effectiveness of oleuropein on osteopenia, an enzyme-linked immunosorbent assay (ELISA) was devoted to examining the bone marrow indexes. The bone metabolism standards of PMOP rats were appraised by assessing serum levels of calcium, alkaline phosphatase (ALP), phosphorus, malondialdehyde (MDA), and nitrate content by experimental detection methods and levels of osteoclastogenesis inhibitory factor (OPG) and receptor activator for nuclear factor-κB ligand (RANKL) by ELISA. The OPG-RANK-RANKL signal passage was examined by Western blot (WB). We measured bone mineral density using dual-energy X-rays. Results Our animal experimental results indicated that oleuropein could significantly improve the bone mineral density of ovariectomized SD rats. In the meantime, it could reduce ending interleukin-6 (IL-6), malondialdehyde (MDA), nitrate, alkaline phosphatase (ALP), and phosphorus (P) serum concentration and would not affect Ca2+ concentration. In cell experiments, oleuropein also can promote the proliferation of osteoblasts. Furthermore, it can promote the expression of OPG protein and mRNA. In reverse, it inhibits the expression of RANKL protein and mRNA. Conclusion Oleuropein can not only improve the inflammatory and oxidative indexes of castrated rats but also prevent osteoporosis. Oleuropein avoids bone resorption by regulating OPG/RANKL expression.
Collapse
|
17
|
Mohapatra S, Ayash Kumar P, Farooq U, Jain P, khan R, Hasan N, Shamim A, Javed Ansari M, Alalaiwe AS, Aldawsari MF, Aamir Mirza M, Iqbal Z. COVID 19 pandemic challenges and their management: A review of medicines, vaccines, patents and clinical trials with emphasis on psychological health issues. Saudi Pharm J 2022; 30:879-905. [PMID: 35645588 PMCID: PMC9128298 DOI: 10.1016/j.jsps.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/20/2022] [Indexed: 12/15/2022] Open
Abstract
The SARS‐CoV‐2 (COVID 19) paroxysm is a dominant health exigency that caused significant distress, affecting physical and mental health. Increased mortality, a stressed healthcare system, financial crisis, isolation, and new living and working styles enhanced societal commiseration leading to poor health outcomes. Though people try to maintain good physical health but unfortunately the mental affliction is still ignored. Poor psychological health has emerged as a burgeoning social issue and demands attention. Henceforth, the fundamental objective of this review article is to collate information about COVID-linked physical and psychological agony in diverse population groups with related symptoms and accessible diagnosis techniques. Recent studies have unraveled the fragile mental states of people who have either contracted COVID 19 or had near and dear ones falling prey to it. The impact of the epidemic on the human mind both in short and long-term, with possible risk and preventive factors together with suggested solutions for maintaining good health have also been discussed here. It also enlists the available medications, vaccines and investigational research in the form of patents and clinical trials. This article can be taken as an updated information sheet for COVID 19, accompanied by its management techniques with special emphasis on coping strategies for mental health. Further, it may also assist the policymakers to devise approaches that could enable the public to overcome the pandemic-driven adversity not only in the given situation but also futuristically.
Collapse
|