The efficacy of medicinal plant preparations in the alleviation of radiodermatitis in patients with breast cancer: A systematic review of clinical trials.

Radiodermatitis in breast cancer patients varies from mild irritation to life-threatening lesions. Several studies suggest a role for topical corticosteroid ointments in the treatment of radiodermatitis. Yet, to avoid the adverse effects of corticosteroids, many authors recommend the use of topical herbal products instead. The therapeutic role of herbal treatments has yet to be fully understood. This systematic review evaluates the role of topical or oral herbal medicines in radiodermatitis prevention and treatment. A systematic search of four databases (Embase, PubMed, Web of Science, and Scopus) was performed without language and time restrictions from their inception until April 2023. The bibliographies of potential articles were also searched manually. Studies evaluated and compared the effects of herbal preparations with the control group, on dermatitis induced by radiotherapy for breast cancer. The Cochrane risk of bias tool was used to assess the included studies. Thirty-five studies were included in the systematic review. Studies which used herbal drugs including topical and oral formulations were evaluated. Herbal monotherapy and combination therapy were reported, and their effects on radiodermatitis were explained in the systematic review. In conclusion, henna ointments, silymarin gel, and Juango cream were reported to reduce the severity of radiodermatitis. These agents should be considered for radiodermatitis prophylaxis and treatment. The data on aloe gel and calendula ointment were conflicting. Further randomized controlled trials of herbal medications and new herbal formulations are required to determine their effects on breast cancer radiodermatitis.

Rupestrines A-D, alkaloids from the aerial parts of Corydalis rupestris.

Phytochemical investigation of the dichloromethane extract of the dried aerial parts of Corydalis rupestris (Papaveraceae) resulted in the identification of four new isoquinoline alkaloids rupestrines A-D and one known isoquinoline alkaloid, namely, stylopine. The structures of these compounds were characterized by extensive spectroscopic methods including 1D- (1H and 13C) and 2D NMR experiments (COSY, HSQC, HMBC, and NOESY) as well as HRESIMS analyses. In addition, the absolute configurations of rupestrines A-D were determined using modified Mosher's method. Cytotoxic effects of alkaloids and their interaction with albumin were also investigated in this study.

Sesquiterpene lactone fraction from Artemisia khorassanica inhibits inducible nitric oxide synthase and cyclooxygenase-2 expression through the inactivation of NF-κB.

OBJECTIVE: Members of the Artemisia genus (Astraceae) are important medicinal plants throughout the world. Here, we prepared a sesquiterpene lactone fraction from Artemisia khorassanica (SLAK) and evaluated its effect on inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) expression, and nuclear factor-κB (NF-κB) activity. METHODS: The effects of SLAK on lipopolysaccharide (LPS)-induced NO, prostaglandin E(2) (PGE(2)), tumor necrosis factor-α (TNF-α) and interleukin-1ß (IL-1ß) production was evaluated in mouse macrophage J774A.1 cells. Moreover, we evaluated SLAK modulation of iNOS and COX-2 enzyme expression by western blot analysis. RESULTS: Our data revealed that SLAK (10-100 µg/mL), in a dose-dependent manner, inhibits NO, PGE(2), TNF-α, and IL-1ß production induced by LPS in the J774A.1 cells. These data were consistent with the modulation of iNOS and COX-2 expressions. It was also showed that SLAK suppresses the iNOS and COX-2 enzyme expression through the inhibition of NF-κB activity. CONCLUSION: In this study, we demonstrated that SLAK inhibits the production of NO, PGE2, TNF-α, and IL-1ß in LPS-stimulated macrophages. This anti-inflammatory effect possibly occurs by inhibiting iNOS and COX-2 expression via the inactivation of NF-κB pathway.

Sesquiterpene fractions of Artemisia plants as potent inhibitors of inducible nitric oxide synthase and cyclooxygenase-2 expression.

OBJECTIVES: Artemisia species are important medicinal plants throughout the world. Some species are traditionally used for their anti-inflammatory effect. The present study was designed to isolate sesquiterpene fractions from several Artemisia species and evaluate their anti-inflammatory activities on key mediators and signaling molecules involved in regulation of inflammation. MATERIALS AND METHODS: Sesquiterpene fractions were prepared from several Artemisia species using the Herz-Högenauer technique. Lipopolysaccharide (LPS)-stimulated J774A.1 macrophages were exposed to isolated fractions. Their possible cytotoxic effect was examined using MTT assay. In addition, nitric oxide (NO) release was measured using Griess method and prostaglandin E2 (PGE2) level was determined by enzyme-linked immunosorbent assay (ELISA). Moreover, protein expression of pro-inflammatory enzymes, inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) were investigated using Western blot analysis. RESULTS: Nitric oxide level produced by LPS-primed macrophages was significantly decreased with all prepared fractions in a dose-dependent manner. Saturated sesquiterpene lactones-rich species (Artemisia kopetdaghensis, Artemisia santolina, Artemisia sieberi) showed the highest suppressive activity on NO and PGE2 production via suppression of iNOS and COX-2 expression. Fractions bearing unusual (Artemisia fragrans and Artemisia absinthium) and unsaturated sesquiterpene lactones (Artemisia ciniformis) possess less modulatory effect on PGE2 production and COX-2 expression. CONCLUSION: It can be concluded that some of the medicinally beneficial effects attributed to Artemisia plants may be associated with the inhibition of pro-inflammatory signaling pathways. However, these effects could be dependent on the type of their sesquiterpene content. These findings also introduce new Artemis species cultivated in Iran as a useful anti-inflammatory agents.

Effects of mastic oleoresin on wound healing and episiotomy pain: A mixed methods study.

INTRODUCTION: Mastic (Pistacia lentiscus) oleoresin (MO is used by traditional Baluch healers to precipitate wound healing and relieve episiotomy pain. OBJECTIVE(S): To investigate the effects of MO on wound healing and episiotomy pain intensity in nulliparous Baluch women. MATERIALS AND METHODS: This study had a mixed methods design. In the qualitative phase, we interviewed 9 traditional healers and 13 women to understand how the indigenous people use MO for wound healing. In the quantitative phase, a randomized controlled trial was performed on primiparous women during July 23-November 22 in 2016. One hundred and forty-seven women were randomly assigned to intervention (n=73) and control (n=74) groups. At 48h postpartum, 15g of MO was provided to the women to be administered for three days (through smoking the episiotomy wound). Pain and wound healing were measured at 3, 7, and 10 days postpartum using the visual analogue scale and REEDA scale, respectively. RESULTS: MO had no significant effect on episiotomy pain intensity at 3, 7, and 10 days postpartum (p=0.61, p=0.76, and p=0.45, respectively). In addition, healing rates of the episiotomy wounds treated by MO (mean: 0.11±0.45, 0.15±0.51, and 0.15±0.57, respectively) were higher than those in the control group (mean: 0.21±0.70, 0.16±0.63, and 0.49±0.28, respectively) at 3, 7, and 10 days postpartum; however, the difference between the two groups was not significant (p=0.27, p=0.76, and p=0.23, respectively). CONCLUSION: In the current study, healing rates in the MO group were higher than those in the control group; however, further studies should be undertaken to identify the effects of MO.

Compare the effect of flaxseed, evening primrose oil and Vitamin E on duration of periodic breast pain.

BACKGROUND: Breast periodic pain is the most common disorder of the breast which leads to consultation with knowledgeable people like a midwife. The aim of this study was to compare the therapeutic effect of flaxseed, evening primrose oil, and Vitamin E on the duration of the period of breast pain. MATERIALS AND METHODS: This study is a quasi-randomized clinical trial conducted in 2015 on ninety patients complaining of breast periodic pain referring to Gynecologic Clinics of Ghaem Hospital or residents living in dormitories of Mashhad University of Medical Sciences. Randomization was conducted based on the study environment. The first group received 30 g of powdered flaxseed, the second group received two 1000 mg capsules of evening primrose, and the third group received 1 capsule of 400 IU Vitamin E, daily and for two menstrual cycles. Cyclical breast pain was measured at the beginning and end of both intervention periods by daily subscription form of pain duration. Data analysis was performed by SPSS 16 software and Kolmogorov-Smirnov, Chi-square, Friedman, Fisher's, and one-sided ANOVA tests. The level of significance was set at P < 0.05. RESULTS: The mean duration of breast pain in flaxseed group within 2 months of intervention decreased significantly (confidence interval [CI] =95%, P = 0.006), but despite reducing the duration of pain in evening primrose oil group (CI = 95%, P = 0.058) and Vitamin E (CI = 95%, P = 0.306), this reduction was not significant. In overall, the average duration of breast pain in all three flaxseed, evening primrose oil, and Vitamin E groups was not significantly different before the intervention (CI = 95%, P = 0.286), 1 month after the intervention (CI = 95%, P = 0.195), and 2 months after the intervention (CI = 95%, P = 0.667). CONCLUSION: The use of flaxseed, evening primrose oil, or Vitamin E may reduce breast pain, and this is a significant reduction in flaxseed.

Razi's Al-Hawi and saffron (Crocus sativus): a review.

Traditional knowledge can be used as a source for development of new medicines. In the present study, we compare the data on saffron in Razi's Al-Hawi book with modern scientific studies. A computerized search of published articles was performed using MEDLINE, Scopus as well as native references. The search terms used were saffron, Crocus sativus, crocetin, crocin, safranal, Razi, and Al-Hawi. A variety of properties of saffron including diuretic, analgesic, anti-inflammatory, hepatoprotective, appetite suppressant, hypnotic, antidepressant, and bronchodilator effects were mentioned in Al-Hawi. Modern studies also confirmed most of these characteristics. This review indicates that the pharmacological data on saffron and its constituents are similar to those found in Razi's Al-Hawi monograph and it can be concluded that ethnobotanical information and ancient sources have precious data about medicinal plants that lead to finding new compounds for treatment of several diseases.

The Effect of Cinnamon on Glucose of Type II Diabetes Patients.

The incidence of type II diabetes is increasing across the world. Dietary modifications help the patients to control blood glucose. Traditional herbs and spices are commonly used for control of glucose among which cinnamon (Ròu Guì; Cinnamomum cassia) has the greatest effect. Research has shown that adding cinnamon to diet can help to lower the glucose level. The aim of this study was to determine the effect of cinnamon on the glucose level in blood. This was a Randomized clinical trial in which 70 Patients with type II diabetes were assigned randomly two groups (35 in cinnamon and 35 in placebo group). The groups were matched in terms of body mass index (BMI), HbAlc and fasting blood sugar (FBS). Patients were treated with cinnamon and the placebo group was treated with placebo in addition to their routine treatment for 60 days. FBG levels and glycosylated hemoglobin of patients on the first day, and 1 and 2 months after treatment were measured. Data were analyzed using t-test and paired t-test in Statistical Package for the Social Sciences (SPSS).16 software. The mean levels of FBS before, and 1 and 2 months after the intervention were 174 ± 59, 169 ± 43 and 177 ± 45; respectively. The levels of HbAlc before and after the intervention in the cinnamon group were (8.9 ± 1.7 and 8.9 ± 1.6). There was no significant difference in FBS and glycosylated hemoglobin levels between the two groups (P = 0.738 and P = 0.87, respectively). Results showed that using certain amount of cinnamon for 60 days did not change the glucose level of diabetic patients. So, using cinnamon to type II diabetes patients cannot be recommended and more studies are needed in future.