Vetiver aerial parts and roots ameliorate rheumatoid arthritis in complete Freund's adjuvant rat model, a phytochemical profiling and mechanistic study.

ETHNOPHARMACOLOGICAL RELEVANCE: Vetiver (Chrysopogon zizanioides) is indigenous to India where it is traditionally used to relief rheumatisms, lumbagos and sprains. Vetiver anti-inflammatory activity has not been previously investigated, and its specific interactions with body inflammation cascade remain largely unknown. AIM OF THE STUDY: The present work was performed to validate the ethnobotanical use of the plant and compare the anti-inflammatory activities of the ethanolic extracts of the most traditionally used part (aerial part) to that of the root. Furthermore, we attempt to reveal the molecular mechanism of this anti-inflammatory activity in correlation to the chemical composition of C. zizanioides aerial (CA) and root parts (CR). MATERIALS AND METHODS: Ultraperformance liquid chromatography coupled to high resolution mass spectrometry (UHPLC/HRMS) was used for comprehensive analysis of both CA and CR. The anti-inflammatory effect of both extracts was evaluated in complete Freund's adjuvant (CFA)-induced RA model in Wistar rats. RESULTS: Phenolic metabolites were predominant in CA and 42 were identified for the first time, while only 13 were identified in CR. Meanwhile, triterpenes and sesquiterpenes were confined to the root extract. In CFA arthritis model, CA showed better anti-inflammatory activity than CR marked by an increase in serum level of IL-10 with simultaneous decrease in pro-inflammatory markers; IL-6, ACPA and TNF-α and was evident in histopathological examination. This anti-inflammatory effect was accompanied by down-regulation of JAK2/STAT3/SOCs3, ERK1/ERK2, TRAF6/c-FOS/NFATC1, TRAF6/NF-κB/NFATC1 and RANKL pathways which were all upregulated after CFA injection. These pathways were modulated to larger extent by CA, except for ERK1/ERK2 which was downregulated more effectively by CR. This differential effect between CA and CR can be explained by the variability in their phytoconstituents profile. CONCLUSION: In agreement with the ethnobotanical preference, CA extract was more effective than CR extract in reducing the symptoms of RA probably due to its enrichment with flavonoids, lignans, and flavolignans. Both CA and CR reduced the production of inflammatory cytokines through modulating various biological signaling pathways. These findings support the traditional use of vetiver leaves as a remedy for RA and suggest that the use of the whole plant may offer advantage by synergistically affecting more inflammatory pathways.

Rapid and Effective Inactivation of SARS-CoV-2 with a Cationic Conjugated Oligomer with Visible Light: Studies of Antiviral Activity in Solutions and on Supports.

This paper presents results of a study of a new cationic oligomer that contains end groups and a chromophore affording inactivation of SARS-CoV-2 by visible light irradiation in solution or as a solid coating on paper wipes and glass fiber filtration substrates. A key finding of this study is that the cationic oligomer with a central thiophene ring and imidazolium charged groups gives outstanding performance in both the killing of E. coli bacterial cells and inactivation of the virus at very short times. Our introduction of cationic N-methyl imidazolium groups enhances the light activation process for both E. coli and SARS-CoV-2 but dampens the killing of the bacteria and eliminates the inactivation of the virus in the dark. For the studies with this oligomer in solution at a concentration of 1 µg/mL and E. coli, we obtain 3 log killing of the bacteria with 10 min of irradiation with LuzChem cool white lights (mimicking indoor illumination). With the oligomer in solution at a concentration of 10 µg/mL, we observe 4 log inactivation (99.99%) in 5 min of irradiation and total inactivation after 10 min. The oligomer is quite active against E. coli on oligomer-coated paper wipes and glass fiber filter supports. The SARS-CoV-2 is also inactivated by oligomer-coated glass fiber filter papers. This study indicates that these oligomer-coated materials may be very useful as wipes and filtration materials.

Sesquiterpene lactones; Damsin and neoambrosin suppress cytokine-mediated inflammation in complete Freund's adjuvant rat model via shutting Akt/ERK1/2/STAT3 signaling.

ETHNOPHARMACOLOGIAL RELEVANCE: Although Damsissa (Ambrosia maritima) is traditionally used as anti-inflammatory and diuretic, the biological activity and mechanism of action of its major constituents are to be elucidated. AIM: to decipher the anti-arthritic potential of damsin (DMS) and neoambrosin (NMS) and to unfold their molecular signaling in complete Freund's adjuvant (CFA)-induced arthritis model. MATERIALS AND METHODS: the right hind paw was inoculated with CFA (0.1 ml) at day 0 and 7 while treatments were started from the 14th day and continued for 2 weeks. Rats were randomly assigned into 4 groups; normal group (NRML), CFA-induced arthritis group, CFA-induced arthritis treated with DMS and NMS (10 mg/kg/day) as 3rd and 4th group; respectively. RESULTS: Throughout experimental period, treatments ameliorated the increase of paw volume, knee joint diameter and nociception tests as reflected in open field arena. Also, DSM and NMS suppressed phosphorylation of Akt, STAT-3, ERK1/2 which was further mirrored by inactivation of GSK3ß and downregulation of MCP-1 together with CCN1 and NF-kß in hind paw tissue. Concomitantly, inflammation markers; TNF-α, IL-6, -12 were lowered as confirmed microscopically during examination of hind paw tissue. CONCLUSION: DSM and NMS-induced suppression of NF-kß subdues clinical features of RA most probably through repression of Akt/ERK1/2/STAT3 pathway. Therefore, DMS and NMS can serve as safe and effective treatment for rheumatoid arthritis, one of the most disabling chronic, inflammatory and painful autoimmune disease.

Therapeutic effect of bone marrow mesenchymal stem cells in a rat model of carbon tetrachloride induced liver fibrosis.

BACKGROUND: Liver fibrosis is a major medical problem with high mortality and morbidity rates where the formation of regenerative nodules and cirrhosis leads to loss of liver function and may result in the development of hepatocellular carcinoma. bone marrow mesenchymal stem cells (BM-MSCs) have drawn attention as a novel approach for treatment of liver fibrosis. This study aimed to evaluate the therapeutic effect of BM-MSCs on the liver structure in carbon tetrachloride (CCl4) induced liver fibrosis in male rats relative to resveratrol and Silybum marianum as standard drugs derived from herbal plants. METHODS: Fifty adult male albino rats (Sprague Dawley strain; 180-220 g mean body weight) were purchased from the Laboratory Animal Unit in the Nile Center of Experimental Research, Mansoura, Egypt. Liver function were determined, isolation and preparation of BM- MSCs and detection of cell-surface markers by flow cytometry. RESULTS: Animals exposed to CCl4 developed liver injury characterized by significant increase of liver enzymes, malondialdehyde (MDA), tumor necrosis factor alpha (TNFα), and CYP450, inhibition of antioxidant enzymes, and decreased albumin. Treatment with stem cells enhanced liver state more effectively than resveratrol and S. marianum. It significantly decreased AST, ALT, ALP, MDA, TNF-α, and CYP450 and increased albumin, SOD, GSH, GST, and CAT. Histopathological study and atomic force microscope results confirmed the therapeutic effects of MSCs. CONCLUSIONS: BM-MSCs could restore liver structure and function in CCL4 induced liver fibrosis rat model, ameliorating the toxicity of CCl4 and improving liver function tests.

New calogenin pregnane glycoside derivative from Huernia saudi- arabica and its Lipase and α-Glucosidase Inhibitory Activities.

As ongoing investigation of Huernia saudi-arabica D.V.Field (Asclepiadaceae), a new steroidal pregnane glycoside (Huernioside A) was isolated from dichloromethane fraction (DCM); it was identified as 3ß, 11, 14ß, 20(R)-tetrahydroxy-pregna-5,9(11)-diene-3-O-ß-D-thevetopyranosyl-(1-4)-ß-D-cymaropyranoside(HCP) through analysis of 1D, 2D NMR besides ESI-MS data. The alcoholic extract of the aerial part (ALE), DCM and HCP showed inhibitory potential against pancreatic lipase compared to orilstat. Among the tested samples, the ALE and HCP exhibited a promising pancreatic lipase inhibitory commotion through IC50 values of 0.61 ±â€¯0.15, 1.23 ±â€¯0.07 mg/ml (equivalent to 88.8 µM), respectively. HCP was prevailed to have a mixed mode of inhibition as exposed by enzyme kinetic studies. Hydrophobic interactions were the major forces involved in ligand enzyme interactions. In contrast, moderate α-glucosidase inhibitory activities were evidenced for ALE and HCP (% inhibition: 24.8 ±â€¯1.8 and 26.6 ±â€¯2.5, respectively) compared to acarbose. This investigation is the first to report on the possible in vitro anti-obesity and anti-diabetic impact of H. saudi-arabica.

Ambrosin, a potent NF-κß inhibitor, ameliorates lipopolysaccharide induced memory impairment, comparison to curcumin.

Despite its poor bioavailability, curcumin is a promising natural polyphenol targeting NF-κß. NF-κß is a target for new therapeutics because it plays a pivotal role in the pathophysiology of Alzheimer disease (AD). In contrast, ambrsoin, a sesquiterpene lactone which is a potent NF-κß inhibitor, is scarcely studied in AD models. The current work aims to assess the efficacy of ambrosin as a possible remedy for AD. In silico studies showed that bioavailability and BBB permeability could be favorable for ambrosin over curcumin. Memory impairment was induced in mice by single intraperitoneal injection of LPS (0.4 mg/kg). Treated groups received curcumin (100 mg/kg) or ambrosin at doses (5 or 10 mg/kg) for 7 days. Mice in treated groups showed a significant improvement in memory functions during Morris water maze and object recognition tests. Curcumin and ambrosin (10 mg/kg) inhibited the upsurge of NF-κßp65 transcript and protein levels. Consequently, downstream pro-inflammatory and nitrosative mediators were inhibited, namely, TNF-α, IL-1ß, COX-2 and iNOS. BACE1 was inhibited, thereby reducing amyloid plaques (Aß) deposition and eventually reducing inflammation and apoptosis of neurons as revealed by immunohistopathological examination. In conclusion, ambrosin can be repurposed as AD remedy after further pharmacokinetic/pharamacodynamic assessments. It could serve as an additional lead drug for AD therapeutics.

A Descriptive Review of the Prevalence and Usage of Traditional and Complementary Medicine among Saudi Diabetic Patients.

Diabetes mellitus represents a major burden in Saudi Arabia where seven million (20% of population) are living with diabetes. This article reviews the literature on usage of traditional and complementary medicine (T&CM) therapies among Saudi diabetic patients, focusing in particular on identifying the prevalence as well as discussing their safety and efficacy. Three databases (PubMed, Cochrane, and ScienceDirect) were searched prior to December 10, 2017, for articles published in peer-reviewed journals that reported primary data on the use of traditional and complementary medicine therapies among diabetic patients in Saudi Arabia. Six studies were selected according to the inclusion/exclusion criteria. In conclusion, the prevalence of use of T&CM therapies among diabetics in Saudi Arabia was 32.18%. This review identified that the most used T&CM therapy among diabetics was herbal treatment. The most used herbs were fenugreek, black seeds, neem, myrrh, helteet, harmel, and aloes. There is insufficient or little evidence to support the efficacy of the most identified herbs and therapies. This review is raising the safety concerns about the used herbs and complementary therapies which were commonly used without any medical consultation.

Protective action of Crateva nurvala Buch. Ham extracts against renal ischaemia reperfusion injury in rats via antioxidant and anti-inflammatory activities.

ETHNOPHARMACOLOGICAL RELEVANCE: Crateva nurvala stem bark is commonly used in Ayruveda in treatment of many renal injuries, e.g., urinary lithiasis, diuretic and nephroprotective. However, its protective effect against renal ischaemia/reperfusion, the major cause of acute kidney injury, has never been studied. Moreover, no comprehensive chemical profiling of its extracts was recorded. AIM OF THE STUDY: Assessment of the protective effect of the plant extracts against renal ischaemia/reperfusion and elucidation of the possible mechanism of action. Then, to determine its bioactive constituents using modern UPLC-HRMS technique. MATERIAL AND METHODS: Unilateral ischaemia was induced by clamping the left renal artery for 1h then reperfusion for 24h. Rats were divided in 4 groups: i) sham-operated group, ii) ischaemia/reperfusion, I/R group, iii) I/R protected by previous administration of Crateva leaves extract, CLE group and iv) I/R protected by previous administration of Crateva bark extract, CBE group. At the end of reperfusion, blood samples were analyzed for renal function biomarkers. Kidneys were examined histopathologically and their homogenates were used in determining the intracellular levels of oxidative stress, inflammatory, and apoptosis markers. RESULTS: Leaves and bark extracts attenuated the deleterious effects of I/R apparent in reducing LDH, creatinine and blood urea nitrogen levels. The extracts reduced the oxidative stress by replenishing the glutathione levels and Nrf2 factor levels. Moreover, extracts decreased levels of pro-inflammatory TNF-α, NF-κß and IL-6; which ultimately resulted in reducing the pro-apoptotic caspase-3. Bark and leave extracts have quite similar chemical profile where 42 compounds of various chemical classes were identified. Flavonoids are the major class of the bioactive phytochemicals CONCLUSION: C. nurvala extracts had effectively ameliorated the deleterious effects of renal I/R by mainly counteracting oxidative stress and presumably inflammation. Consequently, it can be used as a complementary treatment with other agents. In this aspect, leaves stand as a sustainable alternative to bark. The presented chemical profiling can be used in future standardization and quality control of the drug.

Management outcome(s) in eyes with retinoblastoma previously inadequately treated with systemic chemotherapy alone without focal therapy.

OBJECTIVE: The objective of this study was to evaluate the outcome of management in eyes with intraocular retinoblastoma (RB) that had received inadequate initial therapy (chemotherapy without focal therapy) before eventually receiving necessary consolidation therapy at a tertiary referral center. METHODS: A retrospective observational case series of 30 eyes from 26 RB patients who had initially received systemic chemotherapy as a sole therapy. The main outcome measures were demographics, laterality, International Classification of RB (ICRB), treatments, tumor control, and survival. RESULTS: The median age at diagnosis was 24 months and the median delay between time at diagnosis and time at referral to a tertiary center that has adequate focal therapy for RB was 9.5 months (range 5-20 months). Sixteen (62%) patients were monocular from enucleation of the contralateral eye. Features of ICRB Group A tumors were seen in 3 (10%) eyes, Group B in 7 (23%) eyes, Group C in 2 (7%) eyes, Group D in 16 (53%) eyes, and Group E in 2 (7%) eyes. Eighteen (69%) patients required more systemic chemotherapy (median, 4.4 cycles; range, 2-8 cycles), and 8 (26%) eyes received local chemotherapy (subtenon, intravitreal, or intra-arterial). All treated eyes received consolidation therapy as transpupillary thermotherapy and/or cryotherapy. Radioactive plaque therapy was used in 1 (3%) eye and external beam radiation therapy in 3 (10%) eyes. At a mean follow-up of 13 months (median, 11.5 months; range, 9-27 months), enucleation was avoided in 25 (83%) eyes. Two (7%) eyes were enucleated initially, and 3 (10%) were enucleated after failure of additional therapy. Twenty-three (77%) eyes did not show any viable tumor after a median of 11.5 months of follow-up after the last treatment, and 2 (7%) eyes still have residual tumor recurrences that need more consolidation focal therapy. CONCLUSION: Chemotherapy alone cannot eradicate RB cells in effected eyes without combination with consolidation therapy by a multidisciplinary team to salvage the affected eye as well as its vision. Nonetheless, chemotherapy can be initiated (to keep the tumor at a less invasive stage) for patients from centers or countries where combination therapy is not available until they gain access to adequate management of RB.

Knowledge and attitude of health professionals in the Riyadh region, Saudi Arabia, toward complementary and alternative medicine.

BACKGROUND: Complementary and alternative medicine (CAM) is a popular treatment option for many populations. The present work is aimed at studying the knowledge and attitude of health professionals in the Riyadh region, Saudi Arabia, toward CAM. MATERIAL AND METHODS: In this cross-sectional survey, a multistage random sample was taken from health professionals working in hospitals in Riyadh city and surrounding governorates. Data were collected through a self-administered questionnaire, from 306 health professionals working in 19 hospitals, on socio-demographic data, knowledge about CAM and their sources, and attitudes toward CAM practices. RESULTS: Of the participants, 88.9% had some knowledge about CAM. Respondents with a doctorate degree (94.74%) and 92.53% of those with a bachelor's degree had significantly higher knowledge of CAM than subjects with a diploma, a fellowship, or a master's degree (68.75%, 76.67%, and 85.41%, respectively, P = 0.004). Mass media represented 60.1% of sources of the knowledge of CAM followed by family, relatives, and friends (29.08%) and health educational organizations (14.71%). Participants estimated that prophetic medicine including prayer, honey and bee products, medical herbs, Hijama, nutrition and nutritional supplements, cauterization, and camel milk and urine were the most commonly used CAM practices (90.5%, 85%, 76.9%, 70.6%, 61.4%, 55.9%, and 52.5%, respectively) in addition to medical massage (61.8%) and acupuncture (55%). One hundred and fifteen (80%) physicians were ready to talk with their patients on CAM. CONCLUSION: The willingness to improve knowledge and create a positive attitude in health professionals toward CAM has increased. Religious practices, especially those related to prophetic medicine, are more common in the region. Health educational organizations have to play a greater role by being the source of evidence-based knowledge of CAM. Talking on CAM with patients should be improved by rooting them on evidence-based practices.