An overview of the genus Aloysia Paláu (Verbenaceae): Essential oil composition, ethnobotany and biological activities.

Aloysia Paláu is an important herbal genus from the Verbenaceae family and possesses numerous remedial properties in the folk medicine of Asian, European, and, in particular, South American countries. Only a few reports have discussed some phytochemical characteristics associated with Aloysia species. Right the lack of an exhaustive report prompted us to organize this review article. Accordingly, besides the ethnobotanical knowledge of Aloysia species, their essential oil profiles, phytochemistry of the polar isolated fractions, and the relevant biological activities are discussed in detail.[Formula: see text].

Redescription of Mastigias papua (Scyphozoa, Rhizostomeae) with designation of a neotype and recognition of two additional species.

Mastigias, the 'golden' or 'spotted' jellyfish, is distributed throughout the Indo-Pacific. Specimens are identified routinely as Mastigias papua, although eight species were described historically, and molecular analyses evince at least three phylogenetic species. Understanding species diversity in Mastigias has become a priority because of its growing relevance in studies of boom-bust dynamics related to environmental change, cryptic species, local adaptation, parallel evolution, and peripatric speciation. However, species delimitation and identification are inhibited by a dearth of type specimens for most species, including M. papua. We address these issues by resampling Mastigias from the type locality in Waigeo, West Papua, as well as in the Philippines, and by comparing cytochrome c oxidase subunit I and up to 34 morphological characters of 268 Mastigias specimens from surrounding regions in the Indo-Pacific. We also gathered data from the historical descriptions of the eight species of Mastigias to estimate the identity of the two other currently revealed clades. Using this integrative taxonomic approach, we re-describe Mastigias papua as endemic to the tropical western Pacific islands (including Papua, Palau, Enewetak) and designate a neotype for the species. Additionally, based on morphological similarity and geographic overlap, we identified a second clade most probably as M. albipunctatus (from Japan, Komodo, Berau and Philippines) and a third clade tentatively as either M. andersoni or M. ocellatus. This study highlights the benefits of combining molecular analyses, samples from type locations, traditional descriptions and statistical analyses of morphological variation in systematic studies, and the concomitant potential of such studies to increase understanding of evolutionary patterns and processes in Scyphozoa.

Effects of gamma radiation on the bioactivity of medicinal and aromatic plants: Mentha × piperita L., Thymus vulgaris L. and Aloysia citrodora Paláu as case studies.

Irradiation is a feasible and safe decontamination technique, being applied to several types of foods including edible and medicinal plants. The aim of this study was to evaluate the effects of different gamma radiation doses (1, 5 and 10 kGy) on the individual profile of phenolic compounds determined by HPLC-DAD-ESI/MS, and the bioactive potential (cytotoxic, virucidal, and antimicrobial activities) of Aloysia citrodora Paláu (lemon verbena), Mentha × piperita L. (peppermint) and Thymus vulgaris L. (thyme). The observed cytotoxic activity varied with the plant and with the applied dose, being higher in Thymus vulgaris irradiated with 10 kGy. The virucidal activity was also dependent on the radiation dose, but was preserved with irradiation treatment. Gamma rays had no effect on the antimicrobial activity of the studied plants. Otherwise, the effects of gamma radiation on the phenolic profile were heterogeneous, with an increase in some compounds and decrease in others, depending on the species and on the radiation dose.

"DAK", a traditional decoction in Palau, as adjuvant for patients with insufficient control of diabetes mellitus type II.

ETHNOPHARMACOLOGICAL RELEVANCE: Can a medicinal plant be useful when standard modern treatment is insufficient? After a population survey in the Republic of Palau (retrospective treatment-outcome study, following the reverse pharmacology approach) on local treatments and associated outcomes for diabetes, a traditional drink made with Phaleria nisidai Kaneh and several other plants called "Delal A Kar", (meaning "mother of medicine") appeared as a promising therapy. This is the first clinical study on a standardized version of "Delal A Kar" called DAK. AIMS/HYPOTHESIS: This is a study of the effect of DAK as adjuvant therapy when diabetes control is insufficient. METHODS: In this randomized, double blind, crossover study conducted in Koror, Palau, DAK or placebo was assigned to 68 patients with type II diabetes treated with oral hypoglycemic agents and with insufficient glycaemic control. All patients received instructions on how to improve their diet and a home glucometer for blood glucose follow-up. RESULTS: Fifty-five patients completed the study and significant improvements were observed in both groups over the 12 weeks follow-up period: weight decreased an average of 2 to -4.5 pounds (p<0,001) and HbA1C also decreased from 9.7% to 7.8% (p<0,001), with a consistent trend toward better outcomes after DAK, as compared to placebo. The average effect of Ongael was 0.5% (SD 2.5) decrease of HbA1C. Furthermore, seventy-five percent (41/55) of the patients reduced their HbA1C by at least 0.7% at 12 weeks. CONCLUSION: The observed trends in this trial suggest that poorly controlled diabetic patients improved their control of diabetes within 12 weeks when drinking DAK for at least 6 weeks. The drink DAK, in addition to the usual prevention activities of special diet and physical exercise, was followed by improvement of diabetes control (HbA1C) and decrease of blood pressure and weight. TRIAL REGISTRATION: The study protocol was approved by the Institutional Ethical Committee and registered by international Australia and New Zealand trial registry (Request Number: 369395) FUNDING: Pacific Academic Institute for Research office fund, Belau Medical Clinic, The Environment, Inc, Antenna Foundation, Grandjean and Michèle Berset funds and the Weil Foundation.

Imported Flood-Related Leptospirosis From Palau: Awareness of Risk Factors Leads to Early Treatment.

We describe two Japanese travelers with leptospirosis who visited Palau. Both travelers swam in Ngardmau Falls, which was flooded for two days after typhoon Phanfone. The diagnoses were confirmed by microscopic agglutination test or polymerase chain reaction. This is the first report of leptospirosis in travelers who returned from Palau. It should be noted that choosing the appropriate test to biologically confirm leptospirosis was highly time-dependent. Awareness of the risk factors for leptospirosis, mainly that of the exposure to contaminated fresh water after a flooding, would lead to an early and appropriate treatment before the confirmed diagnosis.

Traditional preparation of Phaleria nisidai, a Palauan tea, reduces exposure to toxic daphnane-type diterpene esters while maintaining immunomodulatory activity.

ETHNOPHARMACOLOGICAL RELEVANCE: The leaves of Phaleria nisidai Kaneh. (Thymelaeaceae) are brewed into a tea commonly used as a tonic, strengthening beverage and immune enhancer in Palau, Micronesia. Recently, the leaves of P. nisidai have been shown to contain toxic daphnane diterpene esters which may pose a public health threat to Palauans. AIMS OF THE STUDY: This project documents the use frequency, preparation and side effects of P. nisidai. The content of daphnane diterpene esters in aqueous and methanol extracts and infusions prepared by healers in Palau is compared to assess the risk of daphnane ingestion associated with traditional consumption. Quantitative results are correlated with an in vitro assessment of the immunomodulating activity of the extracts. MATERIALS AND METHODS: Research participants, comprising traditional healers and laypeople, were interviewed concerning use patterns and side effects of P. nisidai. Several traditional healers prepared and provided boiled tea samples for chemical analysis. Leaves were collected and methanolic and aqueous extractions were prepared in the laboratory. Peripheral blood mononuclear cells (PBMCs) were cultured with various concentrations of methanol and aqueous leaf extracts and their output of IFNγ was measured using ELISA. Cell proliferation was also assessed using the MTT assay. The concentration of selected daphnane diterpene esters in healer-prepared infusions, lab methanol and lab aqueous extracts was quantified using ultraperformance liquid chromatography-mass spectrometry-triple quadrupole detection (UPLC-MS-TQD). RESULTS: Through structured interviews it was determined that P. nisidai tea was used frequently, with many participants drinking it daily. The reported side effects were mild, and with the exception of diarrhea (n=2), no side effect was mentioned more than once. Methanol extracts contained 4.0µg simplexin, 17.6µg acetoxyhuratoxin and 2.3µg huratoxin per g dry leaf material. In traditional water infusions provided by healers and in standardized lab-prepared aqueous extracts all three compounds were below the limit of detection (16.3ng/mL) using our UPLC-MS-TQD method. Methanol and aqueous extracts increased the release of IFNγ by PBMCs (p<0.05); however, methanol extracts were significantly more active than aqueous extracts (p<0.05). Methanol and aqueous extracts significantly increased proliferation of PBMCs, causing at least 60% more cell proliferation than negative control (p<0.05). CONCLUSIONS: The presence of daphnane diterpene esters in a frequently consumed traditional beverage was initially viewed as a public health concern, though interview data reveal that Palauans do not observe toxicity or side effects associated with their use of P. nisidai tea. Concurrently, daphnanes are present in methanolic extracts but not detected in aqueous preparations indicating that the traditional method of preparation avoids the extraction of these potentially toxic compounds, while still maintaining immunostimulant activity.

Pharmacological and neuroprotective profile of an essential oil derived from leaves of Aloysia citrodora†Palau.

OBJECTIVES: The Jordanian 'Melissa', (Aloysia citrodora) has been poorly studied both pharmacologically and in the clinic. Essential oils (EO) derived from leaves of A. citrodora were obtained by hydrodistillation, analysed by gas chromatography-mass spectrometry (GC-MS) and were investigated for a range of neurobiological and pharmacological properties, as a basis for potential future use in drug discovery. METHODS: A selection of central nervous system (CNS) receptor-binding profiles was carried out. Antioxidant activity and ferrous iron-chelating assays were adopted, and the neuroprotective properties of A. citrodora EO assessed using hydrogen peroxide-induced and ß-amyloid-induced neurotoxicity with the CAD (Cath.-a-differentiated) neuroblastoma cell line. KEY FINDINGS: The major chemical components detected in the A. citrodora EOs, derived from dried and fresh leaves, included limonene, geranial, neral, 1, 8-cineole, curcumene, spathulenol and caryophyllene oxide, respectively. A. citrodora leaf EO inhibited [(3) H] nicotine binding to well washed rat forebrain membranes, and increased iron-chelation in vitro. A. citrodora EO displays effective antioxidant, radical-scavenging activities and significant protective properties vs both hydrogen peroxide- and ß-amyloid-induced neurotoxicity. CONCLUSIONS: A. citrodora EO displays a range of pharmacological properties worthy of further investigation to isolate the compounds responsible for the observed neuroactivities, to further analyse their mode of action and determine their clinical potential in neurodegenerative diseases.

Traditional local medicines in the republic of Palau and non-communicable diseases (NCD), signs of effectiveness.

ETHNOPHARMACOLOGICAL RELEVANCE: The aim of this survey was to describe which traditional medicines (TM) are most commonly used for non-communicable diseases (NCD - diabetes, hypertension related to excess weight and obesity) in Pacific islands and with what perceived effectiveness. NCD, especially prevalent in the Pacific, have been subject to many public health interventions, often with rather disappointing results. Innovative interventions are required; one hypothesis is that some local, traditional approaches may have been overlooked. MATERIALS AND METHODS: The method used was a retrospective treatment-outcome study in a nation-wide representative sample of the adult population (about 15,000 individuals) of the Republic of Palau, an archipelago of Micronesia. RESULTS: From 188 respondents (61% female, age 16-87, median 48,), 30 different plants were used, mostly self-prepared (69%), or from a traditional healer (18%). For excess weight, when comparing the two most frequent plants, Morinda citrifolia L. was associated with more adequate outcome than Phaleria nishidae Kaneh. (P=0.05). In case of diabetes, when comparing Phaleria nishidae (=Phaleria nisidai) and Morinda citrifolia, the former was statistically more often associated with the reported outcome "lower blood sugar" (P=0.01). CONCLUSIONS: Statistical association between a plant used and reported outcome is not a proof of effectiveness or safety, but it can help select plants of interest for further studies, e.g. through a reverse pharmacology process, in search of local products which may have a positive impact on population health.

The effects of an indigenous muscarinic drug, Betel nut (Areca catechu), on the symptoms of schizophrenia: a longitudinal study in Palau, Micronesia.

OBJECTIVE: This study tested the findings of a prior study indicating a therapeutic relationship between consumption of betel nut and symptoms of schizophrenia. METHOD: The subjects were 65 outpatients with diagnoses of schizophrenia or schizoaffective disorder. Symptoms rated with the Positive and Negative Syndrome Scale were compared between high- and low-consumption betel chewers in a repeated-measures design. Movement disorders were assessed with the Abnormal Involuntary Movement Scale and Simpson-Angus Rating Scale. Global health and social functioning were assessed with the Medical Outcomes Study 12-item and 36-item Short-Form Health Surveys, respectively. RESULTS: Male high-consumption betel chewers had significantly milder positive symptoms than low-consumption chewers over 1 year. Betel chewing was not associated with global health, social functioning, or movement disorders. Betel chewing was associated with tobacco use but not with cannabis or alcohol. CONCLUSIONS: These findings have clinical significance in betel-chewing regions and broader implications for theory of muscarinic neurophysiology in schizophrenia.

Cancer in the Republic of Palau (Belau).

This study, funded by the National Cancer Institute, assessed cancer awareness and service needs in the Republic of Belau (Belau) in April 2003. Cancer prevention and control is a concern for Belau, and this country maintains a cancer registry to track cases and outcomes. However, assistance is needed to strengthen and expand existing cancer-related services. Key informants requested help to develop a comprehensive cancer prevention and control program, increase the capacity of professional staff in diagnosing and treating cancer, and improve laboratory and pathology services.

The early childhood caries prevention program in Palau.

Early Childhood Caries is a significant public health problem in Palau. Data have shown that nearly 80% of children ages 3-5 years of age in Palau experience dental caries and a significant number of these children require general anesthesia to treat or remove painful or infected carious teeth. In response to this growing problem, the Division of Oral Health has systematically developed a prevention program in collaboration with the Maternal and Child Health Unit under the Ministry of Health. The core program involves integrating preventive oral health services into all regular prenatal and postnatal care programs and improving the capacities of health professionals to provide such services. The program promotes the idea that oral health is an important component to overall health and all efforts are made to integrate oral health into broader public health initiatives. Both health and process outcomes are being monitored by an oral health surveillance system, while preliminary data show improved oral health among young children. This paper takes a closer look at the development of the Palau program.