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Kadioglu O, Saeed MEM, Greten HJ, Mayr K, Schrama D, Roos WP, Efferth T. Identification of potential inhibitors targeting BRAF-V600E mutant melanoma cells. J Am Acad Dermatol 2020; 84:1086-1089. [PMID: 32707252 DOI: 10.1016/j.jaad.2020.07.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Onat Kadioglu
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany
| | - Mohamed E M Saeed
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany
| | - Henry J Greten
- Heidelberg Clinics for Integrative Diagnostics, Heidelberg, Germany
| | - Katharina Mayr
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany
| | - David Schrama
- Department of Dermatology, Julius-Maximilian University, Würzburg, Germany
| | - Wynand P Roos
- Institute of Toxicology, Medical University Center, Mainz, Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany.
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Abdelfatah S, Berg A, Huang Q, Yang LJ, Hamdoun S, Klinger A, Greten HJ, Fleischer E, Berg T, Wong VK, Efferth T. MCC1019, a selective inhibitor of the Polo-box domain of Polo-like kinase 1 as novel, potent anticancer candidate. Acta Pharm Sin B 2019; 9:1021-1034. [PMID: 31649851 PMCID: PMC6804483 DOI: 10.1016/j.apsb.2019.02.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/20/2018] [Accepted: 12/22/2018] [Indexed: 01/01/2023] Open
Abstract
Polo-like kinase (PLK1) has been identified as a potential target for cancer treatment. Although a number of small molecules have been investigated as PLK1 inhibitors, many of which showed limited selectivity. PLK1 harbors a regulatory domain, the Polo box domain (PBD), which has a key regulatory function for kinase activity and substrate recognition. We report on 3-bromomethyl-benzofuran-2-carboxylic acid ethyl ester (designated: MCC1019) as selective PLK1 inhibitor targeting PLK1 PBD. Cytotoxicity and fluorescence polarization-based screening were applied to a library of 1162 drug-like compounds to identify potential inhibitors of PLK1 PBD. The activity of compound MC1019 against the PLK1 PBD was confirmed using fluorescence polarization and microscale thermophoresis. This compound exerted specificity towards PLK1 over PLK2 and PLK3. MCC1019 showed cytotoxic activity in a panel of different cancer cell lines. Mechanistic investigations in A549 lung adenocarcinoma cells revealed that MCC1019 induced cell growth inhibition through inactivation of AKT signaling pathway, it also induced prolonged mitotic arrest—a phenomenon known as mitotic catastrophe, which is followed by immediate cell death via apoptosis and necroptosis. MCC1019 significantly inhibited tumor growth in vivo in a murine lung cancer model without affecting body weight or vital organ size, and reduced the growth of metastatic lesions in the lung. We propose MCC1019 as promising anti-cancer drug candidate.
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Key Words
- 3-MA, 3-methyladenine
- ABC, avidin-biotin complex
- APC/C, anaphase-promoting complex/cyclosome
- BUBR1, budding uninhibited by benzimidazole-related 1
- CDC2, cell division cycle protein 2 homolog
- CDC25, cell division cycle 25
- CDK, cyclin-dependent kinase
- Cell cycle
- DAPI, 4′,6-diamidino-2-phenylindole
- DAPKs, death-associated protein kinase
- FBS, fetal bovine serum
- FOXO, forkhead box O
- HIF-1α, hypoxia-inducible factor 1 α
- IC50, 50% inhibition concentration
- IHC, immunohistochemistry
- Kd, the dissociation constant
- LC3, light chain 3
- MFP, M phase promoting factor
- MST, microscale thermophoresis
- MTD, maximal tolerance dose
- Mono-targeted therapy
- Nec-1, necrostatin 1
- Necroptosis
- PARP-1, poly(ADP-ribose) polymerase-1
- PBD, Polo box domain
- PDB, Protein Data Bank
- PI, propidium iodide
- PLK1
- PLK1, Polo-like kinase
- Polo box domain
- Polo-like kinase
- SAC, spindle assembly checkpoint
- Spindle damage
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Affiliation(s)
- Sara Abdelfatah
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz 55128, Germany
| | - Angela Berg
- Leipzig University, Institute of Organic Chemistry, Leipzig 04103, Germany
| | - Qi Huang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Li Jun Yang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Sami Hamdoun
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz 55128, Germany
| | | | - Henry J. Greten
- Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto 4099-003, Portugal
| | | | - Thorsten Berg
- Leipzig University, Institute of Organic Chemistry, Leipzig 04103, Germany
| | - Vincent K.W. Wong
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz 55128, Germany
- Corresponding author. Tel.: +49 6131 3925751; fax: +49 6131 23752.
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Efferth T, Banerjee M, Abu-Darwish MS, Abdelfatah S, Böckers M, Bhakta-Guha D, Bolzani V, Daak S, Demirezer ÖL, Dawood M, Efferth M, El-Seedi HR, Fischer N, Greten HJ, Hamdoun S, Hong C, Horneber M, Kadioglu O, Khalid HE, Khalid SA, Kuete V, Mahmoud N, Marin J, Mbaveng A, Midiwo J, Nakagawa H, Naß J, Ngassapa O, Ochwang'i D, Omosa LK, Ooko EA, Özenver N, Poornima P, Romero MR, Saeed MEM, Salgueiro L, Seo EJ, Yan G, Yasin Z, Saeed EM, Paul NW. Biopiracy versus One-World Medicine-From colonial relicts to global collaborative concepts. Phytomedicine 2019; 53:319-331. [PMID: 30190231 DOI: 10.1016/j.phymed.2018.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 05/10/2018] [Accepted: 06/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Practices of biopiracy to use genetic resources and indigenous knowledge by Western companies without benefit-sharing of those, who generated the traditional knowledge, can be understood as form of neocolonialism. HYPOTHESIS The One-World Medicine concept attempts to merge the best of traditional medicine from developing countries and conventional Western medicine for the sake of patients around the globe. STUDY DESIGN Based on literature searches in several databases, a concept paper has been written. Legislative initiatives of the United Nations culminated in the Nagoya protocol aim to protect traditional knowledge and regulate benefit-sharing with indigenous communities. The European community adopted the Nagoya protocol, and the corresponding regulations will be implemented into national legislation among the member states. Despite pleasing progress, infrastructural problems of the health care systems in developing countries still remain. Current approaches to secure primary health care offer only fragmentary solutions at best. Conventional medicine from industrialized countries cannot be afforded by the impoverished population in the Third World. Confronted with exploding costs, even health systems in Western countries are endangered to burst. Complementary and alternative medicine (CAM) is popular among the general public in industrialized countries, although the efficacy is not sufficiently proven according to the standards of evidence-based medicine. CAM is often available without prescription as over-the-counter products with non-calculated risks concerning erroneous self-medication and safety/toxicity issues. The concept of integrative medicine attempts to combine holistic CAM approaches with evidence-based principles of conventional medicine. CONCLUSION To realize the concept of One-World Medicine, a number of standards have to be set to assure safety, efficacy and applicability of traditional medicine, e.g. sustainable production and quality control of herbal products, performance of placebo-controlled, double-blind, randomized clinical trials, phytovigilance, as well as education of health professionals and patients.
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Affiliation(s)
- Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany.
| | - Mita Banerjee
- Department of English and Linguistics, American Studies, Center for Comparative Native and Indigenous Studies, Johannes Gutenberg University, Mainz, Germany
| | - Mohammad Sanad Abu-Darwish
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany; Shoubak University College, Al-Balqa Applied University, Jordan
| | - Sara Abdelfatah
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Madeleine Böckers
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Dipita Bhakta-Guha
- School of Chemical and Biotechnology, SASTRA University, Thanjavur 613401, TN, India
| | - Vanderlan Bolzani
- Department of Organic Chemistry, Institute of Chemistry, São Paulo State University, Araraquara, Brazil
| | - Salah Daak
- Dr. Salah Wanesi Foundation for Cancer Research and Control, Khartoum, Sudan
| | | | - Mona Dawood
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Monika Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Hesham R El-Seedi
- Chemistry Department, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia; Division of Pharmacognosy, Department of Medicinal Chemistry, Uppsala University, Biomedical Center, Uppsala, Sweden
| | - Nicolas Fischer
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Henry J Greten
- Biomedical Sciences Institute Abel Salazar, University of Porto, Porto, Portugal; Heidelberg School of Chinese Medicine, Heidelberg, Germany
| | - Sami Hamdoun
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Chunlan Hong
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Markus Horneber
- Department of Internal Medicine, Division of Oncology and Hematology, Paracelsus Medical University, Klinikum Nürnberg, Germany
| | - Onat Kadioglu
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Hassan E Khalid
- Department of Pharmacognosy, University of Khartoum, Khartoum, Sudan
| | - Sami A Khalid
- Faculty of Pharmacy, University of Science and Technology, Omdurman, Sudan; Faculty of Pharmacy, University of Khartoum, Karthoum, Sudan
| | - Victor Kuete
- Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Nuha Mahmoud
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - José Marin
- Department of Biochemistry and Molecular Biology, Experimental Hepatology and Drug Targeting (HEVEFARM), CIBERehd, IBSAL, University of Salamanca Campus Miguel de Unamuno, 37007 Salamanca, Spain
| | - Armelle Mbaveng
- Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Jacob Midiwo
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
| | - Hiroshi Nakagawa
- Department of Applied Biological Chemistry, Graduate School of Bioscience and Biotechnology, Chubu University, Kasugai, Aichi, Japan
| | - Janine Naß
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Olipa Ngassapa
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Dominic Ochwang'i
- Department of Veterinary Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Leonida K Omosa
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
| | - Edna A Ooko
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Nadire Özenver
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany; Hacettepe University, Faculty of Pharmacy, Department of Pharmacognosy, Ankara, Turkey
| | - Paramasivan Poornima
- Molecular and Cellular Pharmacology Laboratory, School of Science, Engineering and Technology, University of Abertay, Dundee, Scotland, United Kingdom
| | - Marta Rodriguez Romero
- Department of Biochemistry and Molecular Biology, Experimental Hepatology and Drug Targeting (HEVEFARM), CIBERehd, IBSAL, University of Salamanca Campus Miguel de Unamuno, 37007 Salamanca, Spain
| | - Mohamed E M Saeed
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Ligia Salgueiro
- Center of Neurosciences and Cell Biology and Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Ean-Jeong Seo
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Ge Yan
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | | | | | - Norbert W Paul
- Institute for the History, Philosophy, and Ethics of Medicine, Johannes Gutenberg University Medical Center, Mainz, Germany
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Seca S, Patrício M, Kirch S, Franconi G, Cabrita AS, Greten HJ. Effectiveness of Acupuncture on Pain, Functional Disability, and Quality of Life in Rheumatoid Arthritis of the Hand: Results of a Double-Blind Randomized Clinical Trial. J Altern Complement Med 2019; 25:86-97. [DOI: 10.1089/acm.2018.0297] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Susana Seca
- Heidelberg School of Chinese Medicine, Heidelberg, Germany
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Miguel Patrício
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sebastian Kirch
- Heidelberg School of Chinese Medicine, Heidelberg, Germany
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Giovanna Franconi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Henry J. Greten
- Heidelberg School of Chinese Medicine, Heidelberg, Germany
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
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Seca S, Patrício M, Kirch S, Franconi G, Cabrita AS, Greten HJ. Chinese medicine functional diagnosis: An integrative insight to understand rheumatoid arthritis of the hand. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Kadioglu O, Saeed M, Kuete V, Greten HJ, Efferth T. Oridonin Targets Multiple Drug-Resistant Tumor Cells as Determined by in Silico and in Vitro Analyses. Front Pharmacol 2018; 9:355. [PMID: 29713280 PMCID: PMC5911471 DOI: 10.3389/fphar.2018.00355] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/27/2018] [Indexed: 01/08/2023] Open
Abstract
Drug resistance is one of the main reasons of chemotherapy failure. Therefore, overcoming drug resistance is an invaluable approach to identify novel anticancer drugs that have the potential to bypass or overcome resistance to established drugs and to substantially increase life span of cancer patients for effective chemotherapy. Oridonin is a cytotoxic diterpenoid isolated from Rabdosia rubescens with in vivo anticancer activity. In the present study, we evaluated the cytotoxicity of oridonin toward a panel of drug-resistant cancer cells overexpressing ABCB1, ABCG2, or ΔEGFR or with a knockout deletion of TP53. Interestingly, oridonin revealed lower degree of resistance than the control drug, doxorubicin. Molecular docking analyses pointed out that oridonin can interact with Akt/EGFR pathway proteins with comparable binding energies and similar docking poses as the known inhibitors. Molecular dynamics results validated the stable conformation of oridonin docking pose on Akt kinase domain. Western blot experiments clearly revealed dose-dependent downregulation of Akt and STAT3. Pharmacogenomics analyses pointed to a mRNA signature that predicted sensitivity and resistance to oridonin. In conclusion, oridonin bypasses major drug resistance mechanisms and targets Akt pathway and might be effective toward drug refractory tumors. The identification of oridonin-specific gene expressions may be useful for the development of personalized treatment approaches.
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Affiliation(s)
- Onat Kadioglu
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mohamed Saeed
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Victor Kuete
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Henry J Greten
- Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal.,Heidelberg School of Chinese Medicine, Heidelberg, Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University Mainz, Mainz, Germany
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Ooko E, Kadioglu O, Greten HJ, Efferth T. Pharmacogenomic Characterization and Isobologram Analysis of the Combination of Ascorbic Acid and Curcumin-Two Main Metabolites of Curcuma longa-in Cancer Cells. Front Pharmacol 2017; 8:38. [PMID: 28210221 PMCID: PMC5288649 DOI: 10.3389/fphar.2017.00038] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/18/2017] [Indexed: 12/11/2022] Open
Abstract
Curcuma longa has long been used in China and India as anti-inflammatory agent to treat a wide variety of conditions and also as a spice for varied curry preparations. The chemoprofile of the Curcuma species exhibits the presence of varied phytochemicals with curcumin being present in all three species but AA only being shown in C. longa. This study explored the effect of a curcumin/AA combination on human cancer cell lines. The curcumin/AA combination was assessed by isobologram analysis using the Loewe additivity drug interaction model. The drug combination showed additive cytotoxicity toward CCRF-CEM and CEM/ADR5000 leukemia cell lines and HCT116p53+/+ and HCT116p53−/− colon cancer cell line, while the glioblastoma cell lines U87MG and U87MG.ΔEGFR showed additive to supra-additive cytotoxicity. Gene expression profiles predicting sensitivity and resistance of tumor cells to induction by curcumin and AA were determined by microarray-based mRNA expressions, COMPARE, and hierarchical cluster analyses. Numerous genes involved in transcription (TFAM, TCERG1, RGS13, C11orf31), apoptosis-regulation (CRADD, CDK7, CDK19, CD81, TOM1) signal transduction (NR1D2, HMGN1, ABCA1, DE4ND4B, TRIM27) DNA repair (TOPBP1, RPA2), mRNA metabolism (RBBP4, HNRNPR, SRSF4, NR2F2, PDK1, TGM2), and transporter genes (ABCA1) correlated with cellular responsiveness to curcumin and ascorbic acid. In conclusion, this study shows the effect of the curcumin/AA combination and identifies several candidate genes that may regulate the response of varied cancer cells to curcumin and AA.
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Affiliation(s)
- Edna Ooko
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University Mainz, Germany
| | - Onat Kadioglu
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University Mainz, Germany
| | - Henry J Greten
- Heidelberg School of Chinese MedicineHeidelberg, Germany; Abel Salazar Biomedical Sciences Institute, University of PortoPorto, Portugal
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University Mainz, Germany
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Seca S, Kirch S, Cabrita AS, Greten HJ. Evaluation of the effect of acupuncture on hand pain, functional deficits and health-related quality of life in patients with rheumatoid arthritis—A study protocol for a multicenter, double-blind, randomized clinical trial. Journal of Integrative Medicine 2016; 14:219-27. [DOI: 10.1016/s2095-4964(16)60254-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Efferth T, Banerjee M, Paul NW, Abdelfatah S, Arend J, Elhassan G, Hamdoun S, Hamm R, Hong C, Kadioglu O, Naß J, Ochwangi D, Ooko E, Ozenver N, Saeed MEM, Schneider M, Seo EJ, Wu CF, Yan G, Zeino M, Zhao Q, Abu-Darwish MS, Andersch K, Alexie G, Bessarab D, Bhakta-Guha D, Bolzani V, Dapat E, Donenko FV, Efferth M, Greten HJ, Gunatilaka L, Hussein AA, Karadeniz A, Khalid HE, Kuete V, Lee IS, Liu L, Midiwo J, Mora R, Nakagawa H, Ngassapa O, Noysang C, Omosa LK, Roland FH, Shahat AA, Saab A, Saeed EM, Shan L, Titinchi SJJ. Biopiracy of natural products and good bioprospecting practice. Phytomedicine 2016; 23:166-173. [PMID: 26926178 DOI: 10.1016/j.phymed.2015.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 11/30/2015] [Accepted: 12/04/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Biopiracy mainly focuses on the use of biological resources and/or knowledge of indigenous tribes or communities without allowing them to share the revenues generated out of economic exploitation or other non-monetary incentives associated with the resource/knowledge. METHODS Based on collaborations of scientists from five continents, we have created a communication platform to discuss not only scientific topics, but also more general issues with social relevance. This platform was termed 'PhytCancer -Phytotherapy to Fight Cancer' (www.phyt-cancer.uni-mainz.de). As a starting point, we have chosen the topic "biopiracy", since we feel this is of pragmatic significance for scientists working with medicinal plants. RESULTS It was argued that the patenting of herbs or natural products by pharmaceutical corporations disregarded the ownership of the knowledge possessed by the indigenous communities on how these substances worked. Despite numerous court decisions in U.S.A. and Europe, several international treaties, (e.g. from United Nations, World Health Organization, World Trade Organization, the African Unity and others), sharing of a rational set of benefits amongst producers (mainly pharmaceutical companies) and indigenous communities is yet a distant reality. In this paper, we present an overview of the legal frameworks, discuss some exemplary cases of biopiracy and bioprospecting as excellent forms of utilization of natural resources. CONCLUSIONS We suggest certain perspectives, by which we as scientists, may contribute towards prevention of biopiracy and also to foster the fair utilization of natural resources. We discuss ways, in which the interests of indigenous people especially from developing countries can be secured.
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Affiliation(s)
- Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany.
| | - Mita Banerjee
- Department of English and Linguistics, Johannes Gutenberg University, Mainz, Germany
| | - Norbert W Paul
- Institute for History, Theory and Ethics of Medicine, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Sara Abdelfatah
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Joachim Arend
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Gihan Elhassan
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany; Department of Botany, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | - Sami Hamdoun
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Rebecca Hamm
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Chunlan Hong
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Onat Kadioglu
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Janine Naß
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Dominic Ochwangi
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany; Department of Veterinary Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Edna Ooko
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Nadire Ozenver
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Mohamed E M Saeed
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Mathias Schneider
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Ean-Jeong Seo
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Ching-Fen Wu
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Ge Yan
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Maen Zeino
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Qiaoli Zhao
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | | | - Kai Andersch
- Wilderness International, Dresden (Germany) and Stony Plain, Alberta, Canada
| | | | - Dawn Bessarab
- Center for Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Dipita Bhakta-Guha
- School of Chemical and Biotechnology, SASTRA University, Thanjavur 613401, T.N., India
| | - Vanderlan Bolzani
- Department of Organic Chemistry, Institute of Chemistry, São Paulo State University, Araraquara, Brazil
| | - Else Dapat
- Department of Biology, University of the Philippines, Manila City, and Institute of Biology, University of the Philippines, Dilman, Quezon City, Philippines
| | | | - Monika Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Henry J Greten
- Biomedical Sciences Institute Abel Salazar, University of Porto, Porto, Portugal and Heidelberg School of Chinese Medicine, Heidelberg, Germany
| | - Leslie Gunatilaka
- Southwest Center for Natural Products Research and Commercialization, School of Natural Resources and the Environment, Tucson, Arizona, United States
| | - Ahmed A Hussein
- Chemistry Department, University of Western Cape, Belleville, South Africa
| | - Asuman Karadeniz
- Mehmet Akif Ersoy University, Biology Department, Burdur, Turkey
| | - Hassan E Khalid
- Department of Pharmacognosy, University of Khartoum, Khartoum, Sudan
| | - Victor Kuete
- Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Ik-Soo Lee
- College of Pharmacy, Chonnam National University, Gwangju, Republic of Korea
| | - Liang Liu
- Macao University of Science and Technology, Macao, China
| | - Jacob Midiwo
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
| | - Rodrigo Mora
- Faculty of Microbiology, Rodrigo Facio University, San José, Costa Rica
| | - Hiroshi Nakagawa
- Department of Applied Biological Chemistry, College of Bioscience and Biotechnology, Chubu University, Kasugai, and Department of Biomolecular Engineering, Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Yokohama, Japan
| | - Olipa Ngassapa
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Chanai Noysang
- Department of Pharmacognosy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand and Traditional Medicine College, Rajamangala University of Technology Thayaburi, Phathumthani, Thailand
| | - Leonida K Omosa
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
| | | | - Abdelaaty A Shahat
- Pharmacognosy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia ; Phytochemistry Department, National Research Center, Cairo, Egypt
| | - Antoine Saab
- Faculty of Sciences II, Lebanese University, Chemistry Department, Beirut, Lebanon
| | | | - Letian Shan
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Salam J J Titinchi
- Chemistry Department, University of Western Cape, Belleville, South Africa
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10
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Sousa CM, Coimbra D, Machado J, Greten HJ. Effects of self-administered exercises based on Tuina techniques on musculoskeletal disorders of professional orchestra musicians: a randomized controlled trial. J Integr Med 2015; 13:314-8. [PMID: 26343102 DOI: 10.1016/s2095-4964(15)60194-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Musicians are frequently affected by playing-related musculoskeletal disorders (PRMD). Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, but their results are sometimes disappointing. OBJECTIVE To study the effects of self-administered exercises based on Tuina techniques on the pain intensity caused by PRMD of professional orchestra musicians, using numeric visual scale (NVS). DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS We performed a prospective, controlled, single-blinded, randomized study with musicians suffering from PRMD. Participating musicians were randomly distributed into the experimental (n=39) and the control (n=30) groups. After an individual diagnostic assessment, specific Tuina self-administered exercises were developed and taught to the participants. Musicians were instructed to repeat the exercises every day for 3 weeks. MAIN OUTCOME MEASURES Pain intensity was measured by NVS before the intervention and after 1, 3, 5, 10, 15 and 20 d of treatment. The procedure was the same for the control group, however the Tuina exercises were executed in points away from the commonly-used acupuncture points. RESULTS In the treatment group, but not the control group, pain intensity was significantly reduced on days 1, 3, 5, 10, 15 and 20. CONCLUSION The results obtained are consistent with the hypothesis that self-administered exercises based on Tuina techniques could help professional musicians controlling the pain caused by PRMD. Although our results are very promising, further studies are needed employing a larger sample size and double blinding designs.
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Affiliation(s)
- Cláudia Maria Sousa
- Institute of Biomedical Sciences Abel Salazar, University of Porto, 4099-030 Porto, Portugal; E-mail:
| | - Daniela Coimbra
- Porto Polytechnic Institute, Superior School of Music and PerformingArts, 4000-035 Porto, Portugal
| | - Jorge Machado
- Institute of Biomedical Sciences Abel Salazar, University of Porto, 4099-030 Porto, Portugal
| | - Henry J Greten
- Institute of Biomedical Sciences Abel Salazar, University of Porto, 4099-030 Porto, Portugal.,German Society of Traditional Chinese Medicine, 69126 Heidelberg, Germany.,Heidelberg School of Chinese Medicine, 69126 Heidelberg, Germany
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11
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Ooko E, Saeed MEM, Kadioglu O, Sarvi S, Colak M, Elmasaoudi K, Janah R, Greten HJ, Efferth T. Artemisinin derivatives induce iron-dependent cell death (ferroptosis) in tumor cells. Phytomedicine 2015; 22:1045-54. [PMID: 26407947 DOI: 10.1016/j.phymed.2015.08.002] [Citation(s) in RCA: 254] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/03/2015] [Accepted: 08/05/2015] [Indexed: 05/21/2023]
Abstract
BACKGROUND Apoptosis and other forms of cell death have been intensively investigated in the past years to explain the mode of action of synthetic anticancer drugs and natural products. Recently, a new form of cell death emerged, which was termed ferroptosis, because it depends on intracellular iron. Here, the role of genes involved in iron metabolism and homeostasis for the cytotoxicity of ten artemisinin derivatives have been systematically investigated. MATERIAL AND METHODS Log10IC50 values of 10 artemisinin derivatives (artesunate, artemether, arteether, artenimol, artemisitene, arteanuin B, another monomeric artemisinin derivative and three artemisinin dimer molecules) were correlated to the microarray-based mRNA expression of 30 iron-related genes in 60 cell lines of the National Cancer Institute (NCI, USA) as determined in 218 different microarray hybridization experiments. The effect of desferoxamine and ferrostatin-1 on the cytotoxicity of artenimol of CCRF-CEM cells was determined by resazurin assays. The mRNA expression of TFRC was exemplarily validated by immunohistochemical detection of transferrin receptor protein expression. RESULTS The mRNA expression of 20 genes represented by 59 different cDNA clones significantly correlated to the log10IC50 values for the artemisinins, including genes encoding transferrin (TF), transferrin receptors 1 and 2 (TFRC, TFR2), cerulopasmin (CP), lactoferrin (LTF) and others. The ferroptosis inhibitor ferrostatin-1 and the iron chelator deferoxamine led to a significantly reduced cytotoxicity of artenimol, indicating ferroptosis as cell death mode. CONCLUSION The numerous iron-related genes, whose expression correlated with the response to artemisinin derivatives speak in factor for the relevance of iron for the cytotoxic activity of these compounds. Treatment with ferroptosis-inducing agents such as artemisinin derivatives represents an attractive strategy for cancer therapy. Pre-therapeutic determination of iron-related genes may indicate tumor sensitivity to artemisinins. Ferroptosis induced by artemisinin-type drugs deserve further investigation for individualized tumor therapy.
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Affiliation(s)
- Edna Ooko
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Mohamed E M Saeed
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Onat Kadioglu
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Shabnam Sarvi
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Merve Colak
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Kaoutar Elmasaoudi
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Rabab Janah
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Henry J Greten
- Biomedical Sciences Institute Abel Salazar, University of Porto, Portugal, and Heidelberg School of Chinese Medicine, Heidelberg, Germany
| | - Thomas Efferth
- Biomedical Sciences Institute Abel Salazar, University of Porto, Portugal, and Heidelberg School of Chinese Medicine, Heidelberg, Germany.
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12
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Sousa CM, Moreira L, Coimbra D, Machado J, Greten HJ. Immediate effects of Tuina techniques on working-related musculoskeletal disorder of professional orchestra musicians. J Integr Med 2015; 13:257-61. [PMID: 26165370 DOI: 10.1016/s2095-4964(15)60181-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Musicians are a prone group to suffer from working-related musculoskeletal disorder (WRMD). Conventional solutions to control musculoskeletal pain include pharmacological treatment and rehabilitation programs but their efficiency is sometimes disappointing. OBJECTIVE The aim of this research is to study the immediate effects of Tuina techniques on WRMD of professional orchestra musicians from the north of Portugal. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS We performed a prospective, controlled, single-blinded, randomized study. Professional orchestra musicians with a diagnosis of WRMD were randomly distributed into the experimental group (n=39) and the control group (n=30). During an individual interview, Chinese diagnosis took place and treatment points were chosen. Real acupoints were treated by Tuina techniques into the experimental group and non-specific skin points were treated into the control group. Pain was measured by verbal numerical scale before and immediately after intervention. RESULTS After one treatment session, pain was reduced in 91.8% of the cases for the experimental group and 7.9% for the control group. CONCLUSION Although results showed that Tuina techniques are effectively reducing WRMD in professional orchestra musicians of the north of Portugal, further investigations with stronger measurements, double-blinding designs and bigger simple sizes are needed.
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Affiliation(s)
- Cláudia Maria Sousa
- University of Porto, Institute of Biomedical Sciences Abel Salazar, 4099-030 Porto, Portugal
| | - Luis Moreira
- Jean Piaget Health Superior School, 4405-708 Gaia, Portugal
- Research in Education and Community Intervention - RECI, 3515-776 Viseu, Portugal
| | - Daniela Coimbra
- Porto Polytechnic Institute, Superior School of Music and PerformingArts, i2ads, 4000-035 Porto, Portugal
| | - Jorge Machado
- University of Porto, Institute of Biomedical Sciences Abel Salazar, 4099-030 Porto, Portugal
| | - Henry J Greten
- University of Porto, Institute of Biomedical Sciences Abel Salazar, 4099-030 Porto, Portugal
- German Society of Traditional Chinese Medicine, 69126 Heidelberg, Germany
- Heidelberg School of Chinese Medicine, 69126 Heidelberg, Germany
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13
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Schlotterer A, Greten HJ, Remppis BA, Kukudov G, Machado J, Efferth T, Humpert P, Hammes HP, Morcos M. Neuroprotektive und antioxidative Wirkungen von Sijunzi-Tang-Dekokt in C. elegans. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Allard T, Wenner T, Greten HJ, Efferth T. Mechanisms of herb-induced nephrotoxicity. Curr Med Chem 2014; 20:2812-9. [PMID: 23597204 DOI: 10.2174/0929867311320220006] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 02/19/2013] [Accepted: 04/11/2013] [Indexed: 11/22/2022]
Abstract
Herbal therapies gained much popularity among the general public, but compared to therapies approved by official authorities, toxicological studies are frequently not available for them. Hence, there may be inherent risks and the kidneys may be especially vulnerable to toxic effects. Herbs may induce nephrotoxicity by induction of apoptosis. High oxalate contents in Star fruit (Averrhoa carambola L.) may induce acute nephropathy. Triptolide from Thunder God Vine (Triperygium wilfordii Hook) is a diterpenoid epoxide with induces reactive oxygen species and nephrotubular apoptosis. Cranberry juice is discussed as promoter of kidney stone formation (nephrolithiasis). Abuse of guaifenesin from Roughbark (Guaicum officinale L.) increases stone formation. Aristolochia acids from Aristolochia fangchi Y.C.Wu ex L.D. Chow & S.M. Hwang causes the well-known aristolochic acid nephropathy and carcinogenesis by DNA adduct formation. Carboxyatractyloside from Impila (Callilepsis laureola DC.) inhibits mitochondrial ATP synthesis. Acute allergic interstitial nephritis was diagnosed after intake of Peruvian Cat's claw (Uncaria tomentosa Willd. DC.). Whether or not Willow Bark (Salix alba L.) induces analgesic nephropathwy is a matter of discussion. Other herbal therapies are considered to affect the rennin-angiotensisn-aldosterone (RAA) system Ephedra sinica Stapf with its ingredient ephedrine. Devil's Claw (Harpagophytum procumbens DC. Ex Meisn.) and licorice (Glycyrrhiza glabra L.) may inhibit major renal transport processes needed for filtration, secretion, and absorption. Strategies to minimize nephrotoxicity include (1) quality control and standardization of herbal products, (2) research on the molecular modes of action to better understand pathophysiological mechanisms of herbal products as well as (3) clinical trials to demonstrate efficacy and safety.
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Affiliation(s)
- T Allard
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
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15
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Saganha JP, Doenitz C, Greten T, Efferth T, Greten HJ. Qigong therapy for physiotherapists suffering from burnout: a preliminary study. ACTA ACUST UNITED AC 2013; 10:1233-9. [PMID: 23158941 DOI: 10.3736/jcim20121106] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The study was carried out in order to evaluate the prevalence of burnout in physiotherapists, and to assess whether "White Ball" Qigong exercises may be effective in burnout. This was aimed to provide preliminary data for the preparation and development of a larger study. METHODS Physiotherapists completed a demographic questionnaire and the Maslach Burnout Inventory (MBI) questionnaire. For the intervention and the control groups, the authors selected those physiotherapists with the highest levels of burnout on the most important subscale. The intervention group (eight physiotherapists) performed a specific qigong intervention as developed by the Heidelberg School of Chinese Medicine; the control group consisted of eight physiotherapists on a waiting list. At the end of a three-week period of treatment or waiting list, both groups repeated the MBI for the comparison of results. RESULTS Of 106 physiotherapists (36 males and 70 females) assessed by the MBI, Emotional Exhaustion subscale was seen in 52 (49.1%), Depersonalization subscale in 36 (33.9%), and Burnout in the Personal Accomplishment subscale in 33 (31.2%), of whom 4 (3.8%) suffered to a severe degree and 29 (27.4%) moderately. Within the study group qigong lowered the mean values of Emotional Exhaustion subscale from 38.0 to 31.4, whereas in the control group the values rose from 33.9 to 37.9. The differences between the two groups were statistically significant (P=0.023). Qigong lowered the mean value of Depersonalization subscale from 10.8 to 6.8. In controls the value rose from 7.3 to 10.6. The difference between the two groups was statistically significant (P=0.013). The mean values of Personal Accomplishment subscale decreased in both groups: from 35.4 to 33.9 in the intervention group, and from 37.5 to 37.1 in the control group. The difference between the two groups was not statistically significant. CONCLUSION The effects of "White Ball" Qigong on burnout symptoms are measurable by the MBI. The results are compatible with the thesis that this type of qigong is an effective tool for the self-management of burnout. It is easy to integrate into a daily routine as it takes only 2×5 min per day. On the basis of this evaluation, a study design can now be developed on a larger scale with appropriate blinding, follow-up testing and adequate controls.
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