Effects of rooibos (Aspalathus linearis) on oxidative stress and biochemical parameters in adults at risk for cardiovascular disease

ETHNOPHARMACOLOGICAL RELEVANCE

In South Africa, the plant Aspalathus linearis (Brum.f) Dahlg. (Fabaceae) is traditionally used as a "tea" referred to as rooibos or redbush. This plant has been listed as a medicinal plant based mostly on anecdotal evidence.

AIMS OF THE STUDY

Despite a long history of traditional use in South Africa, very little scientific data are available from controlled clinical trials confirming its popular use. The aim of the present study was to investigate the effect of rooibos on biochemical and oxidative stress parameters in adults at risk for cardiovascular disease.

MATERIALS AND METHODS

After a washout period of 2 weeks, 40 volunteers consumed six cups of fermented/traditional rooibos daily for 6 weeks, followed by a control period. Blood biochemical parameters indicative of antioxidant activity and content (total polyphenols), lipid peroxidation (conjugated dienes - CDs, thiobarbituric acid reactive substances - TBARS), redox status (total glutathione - tGSH, ratio of reduced to oxidized glutathione - GSH:GSSG), lipid profile (total cholesterol, low density lipoprotein - LDL and high density lipoprotein - HDL cholesterol and triacylglycerol levels) and liver and kidney function were measured at the end of each study period.

RESULTS

Plasma antioxidant capacity was not altered, but plasma total polyphenol levels increased significantly after rooibos consumption compared with the control levels (from 79.8±16.9 mg/L to 89.8±14.1 mg/L). Significant decreases in plasma markers of lipid peroxidation were found after rooibos consumption, as reported by levels of CDs (167.3±29.5 nmol/mL vs. 108.8±20.1 nmol/mL) and TBARS (1.9±0.6 μmol/L vs. 0.9±0.3 μmol/L). Reduced glutathione (797±238 μmol/L vs. 1082±140 μmol/L) and the GSH:GSSG ratio (41±14 vs. 76±17) were both significantly increased after consumption of rooibos. The lipid profiles showed that rooibos consumption, compared with the control values, significantly decreased serum LDL-cholesterol (4.6±1.3 mmol/L vs. 3.9±0.7 mmol/L) and triacylglycerols (1.7±0.8 mmol/L vs. 1.2±0.7 mmol/L), while HDL-cholesterol (0.9±0.1 mmol/L vs. 1.2±0.2 mmol/L) was significantly increased.

CONCLUSION

Confirming its popular use, consumption of fermented, traditional rooibos significantly improved the lipid profile as well as redox status, both relevant to heart disease, in adults at risk for developing cardiovascular disease.

Docetaxel in advanced breast cancer (BC) in the community setting: Analysis of treatment and prognostic factors in 129 South African patients

10715

Background: Docetaxel has become a standard of care in BC, initially as salvage therapy, then as front line therapy for advanced disease and now in the adjuvant setting. Patients and Methods: A survey of the use of docetaxel in advanced BC in the community setting included 129 patients (128 females; 1 male) treated by 29 oncologists from 27 centers in South Africa from August 2002 until October 2003. Median age was 51 years (range 25–82 years). Median time between initial diagnosis and treatment was 27 months (range 6 days - 22 years). Although the survey was planned for advanced disease, 10 patients received adjuvant therapy; 59 received 1st line docetaxel and the rest 2nd line or more; major metastatic sites were bone (n = 57), liver (n = 45) and lung (n = 37); 47% patients were ER+, 30% ER- and 23% ER unknown; most had good PS (63 ECOG PS 0, 53 PS 1); 19 patients had no prior chemotherapy, 58 prior adjuvant therapy and 52 prior non-taxane chemotherapy for advanced disease. 62% patients received single agent docetaxel including 75–100mg/m2 3–4 weekly (38%) and 20–50mg/m2 weekly (19%) with 38% receiving docetaxel plus another drug. Results: At 1 year, 88 patients (68.8%) were alive. Log rank analysis showed age >40 years (p = 0.025) and PS 0 (p = 0.0000) were prognostic factors for survival, while post docetaxel chemotherapy (p = 0.062), 1st line vs more advanced disease (p = 0.3557), weekly vs 3–4 weekly docetaxel (p = 1.00), ER status (p = 0.1527) and menopausal status (p = 0.997) were not. Of 59 1st line patients, 40 (67.8%) were alive at 1 year. Age >40 years (p = 0.0015) and PS 0 (p = 0.031) as well as ER status (p = 0.011) and post docetaxel chemotherapy (p = 0.0436) were prognostic factors for survival, while menopausal status (p = 0.0609) and weekly vs 3–4 weekly docetaxel (p = 0.248) were not. 115 patients had 655 adverse events (AEs) including 111 serious AEs (SAEs) in 55 patients. 470 AEs were drug related with 54 SAEs including neutropenia (8), diarrhea (6) febrile neutropenia (5), emesis (5), cellulitis (3) and pneumonia (3). There were no treatment related deaths. Conclusions: Docetaxel alone or in combination is effective and well tolerated therapy in advanced BC especially in patients over 40 years of age with good PS (ECOG 0). Sponsored by Aventis Pharma (South Africa).

No significant financial relationships to disclose.