Narrative Review: The FDA's Perfunctory Approach of Dietary Supplement Regulations Giving Rise to Copious Reports of Adverse Events.

Background: The Food and Drug Administration (FDA) originated from the passage of the 1906 Pure Food and Drugs act aimed to rein in the long-standing abuse in the consumer product marketplace. The act was passed to prohibit interstate commerce of misbranded and adulterated foods, drinks, drugs. Thus, promoting the FDA's mission to protect the public health by regulating human and veterinary drugs, biological products, medical devices, food supply, cosmetics, and tobacco to ensure safety, efficacy, and security. Progressing further in 1994, the Dietary Supplement Health and Education Act (DSHEA) was established designating specific label requirements, providing regulatory framework, and authorizing the FDA to promulgate good manufacturing practices for dietary supplements. This act defined and classified "dietary supplements" and "dietary ingredients" as food requiring all over the counter products (OTC) products to consist of labeling that is easy to understand and meets the FDA quality, effectiveness, and safety standards. However, under the umbrella of OTC products, the FDA fell short in its regulation of the expansive dietary supplement market. The objective of this study is to discern how the lack of efficacy in the FDA's regulations of OTC dietary supplements inevitably inspired more harm than benefit. Methods: This review comprised of case studies including young adolescents and adult consumers who experienced adverse events from the use of dietary supplements. Products which showed highest prevalence in adverse event reports through the Food and Drug Administration CFSAN Adverse Event Reporting System (CAERS) included but not limited to; Vitamin E (vitamin derivative), Beta-sitosterol (plant sterol) Yohimbine, Kava Kava Kratom, Garcinia Cambogia, (herbal products) and OxyElite Pro (marketed weight loss product). The primary endpoint was evaluating the FDA's regulations on dietary supplement safety protocols. The secondary endpoint was assessing the actions of the FDA in response to these case events. Results: Overall, between 2004 to 2021, a total of 79,071 adverse events related to the use of dietary supplements were reported to the Center for Food Safety and Applied Nutrition. Vitamin E products for example, marketed for decades for their antioxidant benefits in turn have shown significant evidence of toxicity and an increased risk of bleeding outweighing its potential benefit. The FDA's response was simply implementing a label guideline update, yet this update had evidence of minimal effect as the number of cases gradually continued to increase. Likewise, herbal products such as Kava Kava, Yohimbine, Kratom, and Garcinia Cambogia, in addition to weight regulating products, such as OxyElite Pro and HydroxyCut, have been linked to organ failure, hepatic, renal, cardiac toxicity, and death respectively. The FDA merely responded through instating public consumer warnings of their effects with consumption and limited recalls of certain products. Conclusion: With the easy accessibility of these products, the general public is more inclined to its use without proper guidance and monitoring from their healthcare team, posing as a major concern for possible interactions, contraindications and unfavorable outcomes. With proper implementation of stringent regulations post findings from increased studies on efficacy and safety, cases of adverse events could have been reduced significantly or averted completely. The FDA's minimalistic efforts consisting of only post-marketing monitoring and retrospective actions of label modifying have time and time again shown flaws as seen in the growing series of reports. By emending the over-the-counter supplement review process to reflect that of prescription medication, the magnitude of adverse events can be diminished. The process should include preclinical research in addition to clinical research, FDA thorough examination of data prior approval and post marketing surveillance.

Clonal Propagation and Assessment of Biomass Production and Saponin Content of Elite Accessions of Wild Paris polyphylla var. yunnanensis.

Paris polyphylla var. yunnanensis is an endangered medicinal plant endemic to China with great economic importance for the pharmaceutical industry. Two significant barriers to its commercial development are the long duration of its seed germination and the frequency of interspecific hybridization. We developed a method for clonal propagation of Paris polyphylla var. yunnanensis and successfully applied it to selected elite wild plants, which could become cultivar candidates based on their biomass production and saponin content. In comparison to the traditional method, somatic embryogenesis produced an average of 63 somatic embryos per gram of callus in just six weeks, saving 12 to 15 months in plantlet production. The produced in vitro plantlets were strong and healthy and 94% survived transplanting to soil. Using this method, four candidate cultivars with diverse morphologies and geographic origins were clonally reproduced from selected elite wild accessions. In comparison to those obtained with the traditional P. polyphylla propagation technique, they accumulated higher biomass and polyphyllin levels in rhizomes plus adventitious roots during a five-year period. In conclusion, somatic embryogenesis-based methods offer an alternate approach for the rapid and scaled-up production of P. polyphylla, as well as opening up species conservation options.

Abnormal Micronutrient Intake Is Associated with the Risk of Periodontitis: A Dose-response Association Study Based on NHANES 2009-2014.

The association between micronutrient intake and the risk of periodontitis has received much attention in recent years. However, most studies focused on the linear relationship between them. This study aimed to explore the dose-response association between micronutrient intake and periodontitis. A total of 8959 participants who underwent a periodontal examination, and reported their micronutrient intake levels were derived from the US National Health and Nutrition Examination Survey (NHANES, 2009-2014) database. Logistic regression was performed to evaluate associations between micronutrient intake and periodontitis after propensity score matching (PSM), and restricted cubic splines (RCS) analysis was conducted to explore the dose-response associations. Following PSM, 5530 participants were included in the RCS analysis. The risk of periodontitis was reduced with sufficient intake of the following micronutrients: vitamin A, vitamin B1, vitamin B2, and vitamin E. In addition, the risk of periodontitis was increased with excessive intake of the following micronutrients: vitamin B1 (1.8 mg/day, males; 1.3 mg/day, females), vitamin C (90 mg/day, males), and copper (1.1 mg/day, combined). In conclusion, a linear association was found between vitamin A, vitamin B2, vitamin C, and copper and periodontitis-namely, a sufficient intake of vitamin A and vitamin B2 might help reduce the prevalence of periodontitis; by contrast, a high intake of vitamin C and copper increased the risk. In addition, a nonlinear dose-response association was found for the incidence of periodontitis with vitamin B1 and vitamin E. When within reasonable limits, supplemental intake helped reduce the prevalence of periodontitis, while excessive intake did not help significantly and might even increase the risk. However, confounding factors, such as health awareness, should still be considered.

Matrine ameliorates cognitive deficits via inhibition of microglia mediated neuroinflammation in an Alzheimer's disease mouse model.

Amyloid ß (Aß) induced microglial activation and attendant neuroinflammation play pivotal roles in Alzheimer's disease (AD) pathogenesis. Matrine is a natural anti-inflammation compound from the Chinese herbal medicine Sophora flavescens Ait. (Kushen). This study aimed to investigate the effects of matrine on memory deficit and neuroinflammation in an oligomeric Aß (oAß)-induced AD mice model. Whether microglial activation and NADPH oxidase were involved in these effects were further studied. Different doses of matrine (10, 20, or 40 mg/kg) were intragastrically administered once a day after intracerebroventricular oAß injection (2.5 µg/µl, 4 µl). 15 days after the oAß injection, behavioral experiments including novel object recognition (NOR) test and Morris water maze (MWM) test were performed. 21 days after the oAß injection, concentration of ROS, TNF-α, IL-1ß and IL-6 as well as expression of NADPH oxidase subunits gp91phox and p47phox in mice hippocampal tissues were assessed, and microglial activation were evaluated by Iba-1 immunohistochemical staining. Results of NOR test and MWM test revealed that oAß injection could remarkably impair learning and memory function in AD mice, and matrine administration could significantly ameliorate the impairment. ROS, TNF-α, IL-1ß and IL-6 levels increased after oAß injection, while matrine could significantly reduce the concentrations of these inflammatory factors. OAß induced protein expression of NADPH oxidase subunits gp91phox and p47phox were also significantly reduced by matrine. Iba-1 immunohistochemistry results showed less activated microglia in matrine-treated mice brain. These results indicate that matrine could ameliorate learning and memory impairment and neuroinflammation induced by oAß injection. These effects were found to be mediated through inhibition of microglial activation and NADPH oxidase expression in hippocampal tissue. The results suggest that matrine may be a valuable natural compound with therapeutic potential against AD.

Analysis of changes in the Panax notoginseng glycerolipidome in response to long-term chilling and heat.

Long-term moderately high or low temperatures can damage economically important plants. In the present study, we treated Panax notoginseng, an important traditional Chinese medicine, with temperatures of 10, 20, and 30 °C for 30 days. We then investigated P. notoginseng glycerolipidome responses to these moderate temperature stresses using an ESI/MS-MS-based lipidomic approach. Both long-term chilling (LTC, 10 °C) and long-term heat (LTH, 30 °C) decreased photo pigment levels and photosynthetic rate. LTH-induced degradation of photo pigments and glycerolipids may further cause the decline of photosynthesis and thereafter the senescence of leaves. LTC-induced photosynthesis decline is attributed to the degradation of photosynthetic pigments rather than the degradation of chloroplastidic lipids. P. notoginseng has an especially high level of lysophosphatidylglycerol, which may indicate that either P. notoginseng phospholipase A acts in a special manner on phosphatidylglycerol (PG), or that phospholipase B acts. The ratio of sulfoquinovosyldiacylglycerol (SQDG) to PG increased significantly after LTC treatment, which may indicate that SQDG partially substitutes for PG. After LTC treatment, the increase in the degree of unsaturation of plastidic lipids was less than that of extraplastidic lipids, and the increase in the unsaturation of PG was the largest among the ten lipid classes tested. These results indicate that increasing the level of unsaturated PG may play a special role in maintaining the function and stability of P. notoginseng photosystems after LTC treatment.

Ramosissimin, a new flavonol from Tararix ramosissima, induces apoptosis in rheumatoid arthritis fibroblast-like synoviocytes.

Tamarix ramosissima is a traditional Chinese herbal medicine used for rheumatoid arthritis (RA) treatment in Northwest China. Chemical investigation of EtOH/H2O extracts of T. ramosissima led to the discovery of a new flavonol, ramosissimin (1), together with the known flavonoids compounds quercetin (2), quercetin-3'4'-dimethylether (3) and kaempferol (4). By means of high resolution electrospray ionization mass spectroscopy (HRESIMS) and 1D and 2D-NMR experiments, and after comparison with literature data, the structures of the compounds were determined. The effect of compound 1 on the viability of RA fibroblast-like synoviocytes (RA-FLS) was evaluated by MTT assay. Apoptosis-inducing effect of compound 1 in RA-FLS was further investigated by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay and activated caspase-3/7 level assessment using luminescent assay. The results revealed that ramosissimin displayed remarkable proliferation inhibitory effect in RA-FLS. Furthermore, compound 1 could significantly induce cellular apoptosis of RA-FLS and increase activated caspase-3/7 levels. It is suggested that ramosissimin may inhibit the proliferation of RA-FLS by inducing apoptosis.

Structure characterization and biological activities of a pectic polysaccharide from cupule of Castanea henryi.

A pectic polysaccharide (CHIP3) was fractionated from the natural cupule of Castanea henryi. It contained mannose (10.70%), rhamnose (8.70%), galacturonic acid (38.21%), galactose (13.75%) and arabinose (28.63%) with a molecular weight of 2.44 × 104 g/mol by multi-laser light scattering. The structure was elucidated by using FT-IR spectroscopy, methylation analysis and NMR analysis. Results showed that the backbone of CHIP3 consisted of 1, 4-α-linked d-GalpA residues containing the non-methyl-esterified carboxyl groups, interspersed with a few 1,2-α-l-Rhap units. Its side chains were attached by two branches to O-4 of Rhap with 1,4-ß-linked d-Galp units and 1,5-α-l-linked Araf units bearing 3,5-substituted α-l-linked Araf residues as branching points. AFM data revealed it existed as a flexible chain in 0.1 M NaNO3 aqueous solution. Furthermore, CHIP3 was demonstrated to have notable antioxidant activity of FRAP, ABTS+ radical scavenging and reducing power. Cytotoxicity assay showed it displayed inhibitory activity against HepG2 cells with IC50 values of 242.6 µg/mL.

Tamaractam, a New Bioactive Lactam from Tamarix ramosissima, Induces Apoptosis in Rheumatoid Arthritis Fibroblast-Like Synoviocytes.

Chemical investigation of Tamarix ramosissima Ledeb, a traditional herbal medicine used for rheumatoid arthritis (RA) treatment in northwest China, led to the discovery of a new phenolic aromatic rings substituted lactam, tamaractam (1), together with the previously reported compounds cis-N-feruloyl-3-O-methyldopamine (2) and trans-N-feruloyl-3-O-methyldopamine (3). The structures of the compounds were determined by high resolution electrospray ionization mass spectroscopy (HRESIMS) and 1D and 2D-NMR experiments, as well as comparison with the literature data. The effects of the three compounds on the viability of RA fibroblast-like synoviocytes (RA-FLS) were assessed by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. Pro-apoptosis effect of compound 1 in RA-FLS was further investigated by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay, activated caspase-3/7 level assessment using luminescence assay, and sub-G1 fraction measurement using flow cytometry. It was found that these three compounds displayed variable proliferation inhibitory activity in RA-FLS, and compound 1 exhibited the strongest effect. Compound 1 could remarkably induce cellular apoptosis of RA-FLS, increase activated caspase-3/7 levels, and significantly increase sub-G1 fraction in the cell cycle. The results suggested that compound 1 may inhibit the proliferation of RA-FLS through apoptosis-inducing effect, and these compounds may contribute to the anti-RA effect of T. ramosissima.

[Phenolic compounds in branches of Tamarix rasissima].

To study the chemical constituents of the branches of Tamarix rasissima, repeated silica gel column chromatography, Sephadex LH-20 chromatography and recrystallization were applied for chemical constituents isolation and purification. Ten phenolic compounds were isolated from the n-BuOH fraction and their structures were elucidated by physical properties and spectra analysis such as UV, ESI-MS and NMR as monodecarboxyellagic acid (1), ellagic acid (2), 3, 3'-di-O-methylellagic acid (3), 3, 3'-di-O-methylellagic acid-4-O-beta-D-glucopyranoside (4), 3, 3'-di-O-methylellagic acid-4'-O-alpha-D-arabinfuranoside (5), ferulic acid (6), isoferulic acid (7), caffeic acid (8), 4-O-acetyl-caffeic acid (9), and 4-methyl-1, 2-benzenediol (10). All compounds except for isoferulic acid were isolated firstly from this plant except for isoferulic acid, and compounds 5, 9 and 10 were obtained from Tamarix genus for the first time.

Post desiccation germination of mature seeds of tea (Camellia sinensis L.) can be enhanced by pro-oxidant treatment, but partial desiccation tolerance does not ensure survival at -20°C.

The maximal potential desiccation tolerance (MPDT) of tea (Camellia sinensis) seeds has been a matter of debate for decades. Here we assessed the ability of tea seeds from three sites in China to germinate after desiccation. Desiccation tolerance was greatest in Kunming, followed by Puer and Lincang, with Kunming seeds tolerating drying to 8% moisture content (MC), or ∼0.5 water activity (a(w)). Such tolerance was observed in Lincang seeds only when hydrogen peroxide (H2O2) at 0.5 or 1M was applied to seeds, indicating a stimulatory role for H2O2 in post-desiccation germination. Puer seeds exhibited MPDT of 16% MC (∼0.7 a(w)). Therefore, seeds from all three sites were not recalcitrant. The length of the dry season after dispersal and the high ratio of seed coat to seed mass (>0.3) support the observation of non-recalcitrant behaviour. The seeds were not immature, as the lipid signal in embryonic axes mirrored that of the cotyledons (30% oil). Even after high survival [>60% total germination (TG)] on drying to 10-13% MC, no Kunming seeds tolerated 1 month storage at -20 °C coinciding with lipid transitional changes at this temperature. The results indicate that tea seeds from China are neither recalcitrant nor storable at -20 °C.

Monoterpenoid indole alkaloids from the bark of Alstonia scholaris.

Six new monoterpenoid indole alkaloids, scholarisines B-G (1- 6), together with 15 known analogues (7- 21), were isolated from the bark of Alstonia scholaris. Their structures were determined by 1D and 2D NMR spectra and MS analyses. The structure of 1 was further supported by the single-crystal X-ray.

Terpenes from Eupatorium adenophorum and their allelopathic effects on Arabidopsis seeds germination (dagger).

The invasive plant Eupatorium adenophorum Spreng. (or Ageratina adenophora (Spreng.) King and Robinson) (Compositae) has caused great economic loss in China, especially the southwestern region, and is gravely threatening the native biodiversity. The aerial part of this plant was phytochemically investigated for its allelochemicals. Eleven terpenes (2 monoterpenes and 9 sesquiterpenes) were isolated and identified, which include a new monoterpene, (-)-(1R*,2S,*4R*,5S*)-3,3-dimethyl-5-hydroxybicyclo[2,2,1]hept-2-ylmethanol (1), two new cadinane sesquiterpenes, (-)-(5S*,6S*,7S*,9R*,10S*)-7-hydroxy-5,7-epidioxycadinan-3-ene-2-one (2) and (+)-(5S*,6R*,9R*,10S*)-5,6-dihydroxycadinan-3-ene-2,7-dione (3), and eight known terpene compounds (4, 6-12). The new structures were established by spectroscopic studies such as 1D- and 2D-NMR and MS analyses. Meanwhile, the potential allelopathic effects of these compounds on the Arabidopsis seeds germination were tested. Compounds 3 and 7 retarded the Arabidopsis seeds germination at 0.5 mM and 1.0 mM concentrations, respectively, while other compounds showed no obvious inhibitory effects.

A cage-monoterpene indole alkaloid from Alstonia scholaris.

An unprecedented cage-like alkaloid, scholarisine A was isolated from the leaves of Alstonia scholaris and its structure determined on the basis of 1D and 2D NMR, FTIR, UV, and high-resolution mass spectroscopic data. This alkaloid might be derived from picrinine via oxygenation, rearrangement, and lactonization.

[Studies on chemical constituents in herb of Lamium maculatum L. var Kansuense].

OBJECTIVE: To study the chemical constituents from Lamium maculatum L. var Kansuense. METHOD: The chemical constituents were isolated and repeatedly purified by silica gel column chromatography and the structures were elucidated by the NMR spectra and physico-chemical properties. RESULT: Ten compounds were obtained and they were identified as D-mannitol, beta-sitosterol, stigmasterol, rutin, 3'-methylquercetin-3-O-rutinoside, n-butyl-beta-D-fructopyranoside, daucosterol, acteoside, 20-hydroxyecdysone, allantoin. CONCLUSION: All the compounds were obtained from L. maculatum L. var Kansuense for the first time.