Opium tincture versus methadone for opioid agonist treatment: a randomized controlled trial.

AIM: To test if opium tincture (OT) was non-inferior to methadone in retaining participants in opioid agonist treatment (OAT). DESIGN: A Phase III, multi-centre, parallel-group, non-inferiority, double-blind randomized controlled trial with an allocation ratio of 1:1. Participants were provided treatment and followed for a period of 85 days. SETTING: Four OAT clinics in Iran. PARTICIPANTS: Two hundred and four participants with opioid use disorder [mean age (standard deviation) = 37.4 (9.3); female 11.3%] recruited between July 2017 and January 2018. INTERVENTIONS: Participants were assigned to either OT (102) or methadone (102) using a patient-centred flexible dosing strategy. MEASUREMENTS: Treatment retention over 85 days was the primary outcome. Self-reported opioid use outside treatment and occurrence of adverse events (AEs) were the secondary outcomes. FINDINGS: Remaining in treatment at the end of the follow-up were 68.6% in the methadone arm and 59.8% in the OT arm. The relative retention rate of methadone to OT was 1.15 (0.97, 1.36) in both intent-to-treat and per-protocol analyses; non-inferiority was not supported statistically, as the upper bound of the confidence interval exceeded our pre-specified non-inferiority margin (1.25). Opioid use outside treatment was reported by 30.3% of OT (n = 152) and 49.4% of methadone (n = 168) patients, a difference in proportions of -19%: 90% confidence interval (-28%, -10%). The total count of AEs in the OT arm (22 among nine individuals) was significantly higher (P = 0.04) than that in the methadone arm (three among two individuals). Nausea was the most common side effect. CONCLUSION: While this study could not conclude the non-inferiority of opium tincture (OT) to methadone for retaining patients in opioid agonist treatment, OT retained 60% of participants to end of follow-up (85 days) and was superior to methadone in reducing self-reported opioid use outside treatment.

Imperatorin Attenuates the Proliferation of MCF-7 Cells in Combination with Radiotherapy or Hyperthermia.

BACKGROUND: Breast cancer is one of the most common types of malignancies in the world. Cancer resistance is an unavoidable consequence of therapy with radiation or other modalities. Ongoing research aims to improve cancer response to therapy. AIM: The aim of this study was to evaluate the possible sensitization effect of imperatorin (IMP) in combination with external radiotherapy (ERT) or HT. METHODS: After treatment of MCF-7 breast cancer cells with IMP, cells were exposed to 4 Gy X-rays or HT (42 °C for 1 hour). The viability of MCF-7 cells was measured using an MTT assay. Furthermore, the expression of pro-apoptotic genes, including Bax, Bcl-2, caspase-3, caspase-8, and caspase- 9, was investigated using real-time PCR. The sensitizing effect of IMP in combination with ERT or HT was calculated and compared to ERT or HT alone. RESULTS: Results showed an increase in the expression of pro-apoptotic genes and downregulation of anti-apoptotic Bcl-2 following ERT and HT. Furthermore, cell viability was reduced following these treatments. IMP was able to augment these effects of ERT and HT. CONCLUSION: IMP could increase the efficiency of HT and ERT. This effect of IMP may suggest it as an adjuvant for increasing the therapeutic efficiency of ERT.

Trigonella teheranica: a valuable source of phytochemicals with antibacterial, antioxidant and cytotoxic properties.

Trigonella genus is a member of Fabaceae family, which is used as medicinal plant. The aim of this study was investigation of phytochemicals and some biological activities of Trigonella teheranica for the first time. The essential oils (EOs) of different parts (leaves, fruits and roots) were obtained and analyzed by GC-MS. Also, their chloroform and methanol extracts were prepared, too. The antimicrobial effects, antioxidant activities and cytotoxic effects against cancer (MDA-MB-231, MRC5 and HT-29) cell lines were investigated. N-hexadecanoic acid was the major compound of leaves and fruits EOs, and hexanal was abundant component of roots EO. The extracts showed stronger antibacterial effects than volatile oils against Gram-positive bacteria such as Staphylococcus aureus and Bacillus subtilis. All methanol extracts showed strong antioxidant effects, while the volatile oils, especially of leaves was the most effective in cytotoxic assay. Also, three derivatives of coumaric acid were isolated and identified from T. teheranica.

Suberosin Attenuates the Proliferation of MCF-7 Breast Cancer Cells in Combination with Radiotherapy or Hyperthermia.

AIM: The aim of this study was to determine the proliferation of MCF-7 following irradiation or hyperthermia as alone or pre-treatment with suberosin. BACKGROUND: Radiotherapy is a major therapeutic modality for the control of breast cancer. However, hyperthermia can be prescribed for relief of pain or enhancing cancer cell death. Some studies have attempted its use as an adjuvant to improve therapeutic efficiency. Suberosin is a cumarin- derived natural agent that has shown anti-inflammatory properties. OBJECTIVE: In this in vitro study, possible sensitization effect of suberosin in combination with radiation or hyperthermia was evaluated. METHODS: MCF-7 breast cancer cells were irradiated or received hyperthermia with or without treatment with suberosin. The incidence of apoptosis as well as viability of MCF-7 cells were observed. Furthermore, the expressions of pro-apoptotic genes such as Bax, Bcl-2, and some caspases were evaluated using real-time PCR. RESULTS: Both radiotherapy or hyperthermia reduced the proliferation of MCF-7 cells. Suberosin amplified the effects of radiotherapy or hyperthermia for induction of pro-apoptotic genes and reducing cell viability. CONCLUSION: Suberosin has a potent anti-cancer effect when combined with radiotherapy or hyperthermia. It could be a potential candidate for killing breast cancer cells as well as increasing the therapeutic efficiency of radiotherapy or hyperthermia.

Cuminum cyminum fruits as source of luteolin- 7-O-glucoside, potent cytotoxic flavonoid against breast cancer cell lines.

Cuminum cyminum is famous for its spicy fruits used for culinary and therapeutic properties worldwide. Brine shrimp test was performed for detecting cytotoxic fractions and subfractions. Ethyl acetate (EA) and hexane (HE) fractions demonstrated LC50 of 52.40 and 60.77 µg/ml against Artemia salina while other fractions showed no toxicity (LC50> 500 µg/ml). Bioguided elucidation of EA and HE fractions were carried out and cytotoxicity of pure compounds were investigated against breast cancer cell lines (MCF-7 and MDA-MB-231) and normal cell line (NIH/3T3) by MTT assay. Four flavone structures as luteolin, apigenin, luteolin-7-O-glucoside and apigenin-7-O-glucoside from EA and cuminoid A from HE were purified and identified. Luteolin-7-O-glucoside demonstrated potent anticancer activities against MCF-7 cell line (IC50 of 3.98 µg/ml) with selectivity index of 8.0. In conclusion, flavonoids especially luteolin-7-O-glucoside play a significant role in cytotoxic effect of C. cyminum fruits and can be introduced as candidate for chemopreventive and chemotherapeutic drugs.

Comparing opium tincture and methadone for medication-assisted treatment of patients with opioid use disorder: Protocol for a multicenter parallel group noninferiority double-blind randomized controlled trial.

OBJECTIVES: This is the first study to compare the safety and efficacy of opium tincture (OT) with methadone for treatment of opioid use disorder. METHODS: In this multicenter, double-blind, noninferiority controlled trial, a stratified sample of 204 participants with opioid use disorder were recruited from community outreach, drop-in centers, and triangular clinics. Participants were excluded in case of active participation in another treatment program for opioid use disorder, hypersensitivity to trial medications, pregnancy, and certain serious medical conditions. They were randomized to receive either OT or methadone with an allocation ratio of 1:1 using a patient-centered flexible dosing strategy. Eligible participants were followed for a period of 12 weeks. Primary outcome is the difference in percentage of patients retained in the treatment. Secondary outcomes are craving, withdrawal symptoms, physical health, mental health, quality of life, and severity of substance use problems, cognitive function, safety profile, cost-effectiveness, and participants' satisfaction. Both intention-to-treat and per-protocol analyses will be conducted. The Ethics Board of the University of British Columbia and Tehran University of Medical Sciences approved the study. (clinicaltrials.gov; NCT02502175). RESULTS: To be reported after final analysis. CONCLUSIONS: If shown to be effective, OT will diversify the options for medication-assisted treatment of opioid use disorder.

Strong insecticidal potential of methanol extract of Ferulago trifida fruits against Anopheles stephensi as malaria vector.

Many researchers have focused on controlling pest insects and vectors by natural products because of their low environmental pollution. The present study was conducted to evaluate the antioxidant and larvicidal activities of chloroform and methanol extracts of the leaves, fruits, roots, and isolated coumarin compounds (prantschimgin, oxypeucedanin, and 6-hydroxymethylherniarin) of Ferulago trifida from the Apiaceae family against Anopheles stephensi as one of the main malaria vectors. For insecticidal evaluation, A. stephensi larvae were exposed to different concentrations of the extracts and pure compounds (0.625-1280 ppm) according to the WHO protocol. The mortality percentages were measured 24 h after treatment and lethal concentration values were calculated. In addition, radical scavenging activities of the mentioned extracts and compounds were measured by the DPPH method. The methanol extract of fruits showed potent insecticidal properties with LC50 and LC90 values of 2.94 and 18.12 ppm, respectively. The chloroform extracts of the fruits and leaves were the second and third extracts with larvicidal effects. Among pure compounds, only oxypeucedanin showed moderate toxicity against A. stephensi with LC50 and LC90 values of 116.54 and 346.41 ppm, respectively. The antioxidant activities of the methanol extracts of leaves and fruits were stronger than other extracts with IC50 values of 155.83 and 159.32 ppm, respectively. In conclusion, the methanol extract of F. trifida fruits can be used as a potent bio-insecticide in green control programs of mosquitoes, especially A. stephensi.

Bioactive coumarins from the roots and fruits of Ferulago trifida Boiss., an endemic species to Iran.

Phytochemical analysis of the Ferulago trifida Boiss. from Apiaceae family led to the isolation and identification of suberosin (1), isoimperatorin (2), prantschimgin (3), oxypeucedanin (4), oxypeucedanin methanolate (5), suberenol (6), 6-hydroxymethylherniarin (7), oxypeucedanin hydrate (8), ulopterol (9), bergapten (10), xanthotoxin (11), imperatorin (12) and grandivittin (13) from chloroform extracts of the roots (1-9) and fruits (1, 2, 8, 10-13) of this species. Oxypeucedanin methanolate and suberenol demonstrated a potent antioxidant power with 268.2 ± 5.4 and 251.2 ± 6.2 mmol FSE/100 g, respectively, compared by BHT (267.2 ± 4.2 mmol FSE/100 g) in FRAP method. The potent antibacterial effects were found for oxypeucedanin methanolate on S. epidermidis (IZ; 26 mm, MIC; 250 µg mL-1) an oxypeucedanin hydrate on K. pneumoniae (IZ: 21 mm, MIC: 250 µg mL-1). Moreover, suberosin showed higher preferential toxicity against MDA-MB-23 cells (IC50: 0.21 mM, SI: 5.0), in comparison with tamoxifen (IC50: 0.012 mM, SI: 2.45) in MTT assay.

A Survey on Phytochemical Composition and Biological Activity of Zygophyllum fabago from Iran.

Purpose: Zygophyllum fabago L. (Z. fabago) is a widespread perennial herb which is used as a medicinal plant in traditional medicine of Iran, Turkey and China. The present study was a survey on phytochemical constituents and biological activities of this plant. Methods: Methanolic extract of the roots was fractionated over a C-18 pre-packed cartridge (Sep-pak) and chromatographic separation was performed on a reversed-phase preparative HPLC. Structural elucidation of the isolated compounds was carried out using UV, 1H-NMR and 13C-NMR spectral analyses. Furthermore, the chemical compositions of the essential oil of the aerial parts were identified by GC-MS analysis. Antiproliferative and antioxidant activities of all extracts from aerials were determined by MTT and DPPH assays, respectively. Results: Phytochemical investigation on the plant roots led to the isolation and identification of two the 60% methanol-water Sep-pak fraction, a prenylated flavone glycoside, 6-C-prenyl-7-O-[ ß -D-4'''-O-acetyl-glucopyranosyl-(1'''→2'')-ß-D-glucopyranosyl] apigenin, which was named as a Zygocaperoside and also, other flavonoid, was named as the Isorhamnetin -3-O glucoside. None of the extracts showed antiproliferative effect against cancerous cells. However, among the extracts, methanolic extract indicated antioxidant activity. Moreover, essential oils of flowers and leaves of plant have high amounts of sesquiterpene hydrocarbons and diterpenoides. Conclusion: The results of present study introduce Z. fabago roots as a new source of flavonoid glycosides and suggest it as an appropriate candidate for further pharmacological studies.

Purification of Cucurbitacins D, E, and I from Ecballium Elaterium (L.) A. Rich Fruits and Study of Their Cytotoxic Effects on the AGS Cell Line

Background: The plant Ecballium elaterium (L.) A. Rich, belongs to the Cucurbitaceae family which occupies an important position in traditional medicine prescriptions. It has been reported that a freeze-dried aqueous extract of E. elaterium fruits has cytotoxic effects on the AGS human stomach adenocarcinoma cell line. We here focused on anticancer effects of the main chemicals purified from E. elaterium fruits. Materials and Methods: We isolated cucurbitacins D, E, and I from chloroform, and ethyl acetate fractions of a methanolic extract of E. elaterium fruits and assessed their cytotoxic effects on the AGS cell line by MTT assay. The methanolic extract was fractionated to petroleum ether, chloroform, and ethyl acetate fractions. The compounds isolated by column chromatography were identified by NMR spectroscopy. Results: After 24 h of incubation with AGS cells, the IC50 values were 0.3, 0.1, and 0.5 µg/ml for cucurbitacins D, E, and I respectively. Conclusions: This finding suggests that because of its cucurbitacins, E. elaterium fruit may have some cytotoxic effects on gastric cancer cells. Also, compared with D and I, cucurbitacin E showed greater potency in this regard.

Phytochemical and Antioxidant Investigation of the Aerial Parts of Dorema glabrum Fisch. & C.A. Mey.

Dorema glabrum Fisch. & C.A. Mey. (Apiaceae) is a monocarpic perennial plant distributed in southern Caucasus. In Azerbaijan Republic folk medicine, the gum-resin of this species is used as a diuretic and anti-diarrheal agent. It is also traditionally used for the treatment of bronchitis and catarrh. In the present study, chemical constituents of the essential oil and extract of D. glabrum aerial parts were investigated and their free radical scavenging potentials were assessed. GC-MS and GC-FID analyses of the plant essential oil resulted in identifying twenty compounds, out of which elemicin (38.6%) and myristicin (14.3%) were main compounds. Seven compounds including daucosterol (1), chlorogenic acid (2), a mixture of cynarin (3) and 3,5-di-O-caffeoylquinic acid (4), isorhamnetin-3-O-ß-D-glucopyranoside (5), isoquercetin (6) and astragalin (7) were also isolated from the ethyl acetate and methanol fractions of D. glabrum aerial parts using different chromatographic methods on silica gel (normal and reversed-phase) and sephadex LH20. Structures of the isolated compounds were elucidated using UV and (1)H, (13)C-NMR spectrain comparison with those reported in respective published data. Antioxidant activities of the crude extract, fractions and isolated compounds were evaluated using DPPH free radical scavenging assay method. Among the fractions, methanol fraction (IC50=53.3 ±4.7µg mL(-1)) and among the isolated compounds, caffeoylquinic acid derivatives exhibited the highest free radical scavenging activity (IC50= 2.2-2.6 µg mL(-1)).