Aplicações terapêuticas do Cymbopogon citratus (capim-limão) na odontologia: uma revisão de literatura integrativa / Therapeutic applications of Cymbopogon citratus (lemon grass) in dentistry: an integrative literature review

Introdução: O Cymbopogon citratus (capim-limão) é uma espécie herbácea pertencente à família Poaceae, que engloba aproximadamente 500 gêneros e 8.000 espécies. Objetivos: Analisar as evidências científicas disponíveis sobre as aplicações terapêuticas de Cymbopogon citratus (capim-limão) na Odontologia durante os últimos dez anos. Métodos: Trata-se de uma revisão integrativa da literatura, que envolveu as seguintes etapas: elaboração da pergunta norteadora, estabelecimento das palavras-chave e dos critérios de inclusão e exclusão de artigos, seleção e análise crítica dos artigos, resultados, discussão e conclusão. Resultados: 8% dos artigos encontrados e analisados nessa revisão de literatura integrativa demonstraram que o Cymbopogon citratus (capim-limão) apresenta potencial terapêutico no que se refere a suas propriedades antimicrobianas, sendo considerado benéfico e promissor na inibição de patógenos colonizadores bacterianos e fúngicos dentários, além de demonstrar baixa citotoxicidade. Conclusão: Apesar da existência de diversas pesquisas in vitro que demonstram eficácia e segurança do uso de diversos compostos de origem natural, nota-se que há poucos protocolos específicos que orientem o profissional cirurgião-dentista para o uso de terapias à base de plantas medicinais e/ou fitoterápicos, como no caso do Cymbopogon citratus (capim-limão). Portanto, são necessários mais estudos para explicar e fundamentar melhor os efeitos do capim-limão na odontologia.

Introduction: Cymbopogon citratus (lemon grass) is an herbaceous species belonging to the Poaceae family, which includes approximately 500 genera and 8,000 species. Objectives: To analyze the available scientific evidence about therapeutic applications of Cymbopogon citratus (lemon grass) in Dentistry over the past ten years. Methods: This is an integrative literature review, which involved the following steps: elaboration of the guiding question, establishment of keywords and criteria for inclusion and exclusion of articles, selection and critical analysis of articles, results, discussion, and conclusion. Results: 8% of the articles found and analyzed in this integrative literature review demonstrated that Cymbopogon citratus (lemon grass) has therapeutic potential because its antimicrobial properties, being considered beneficial and promising in the inhibition of bacterial and fungal dental colonizing pathogens, in addition presents low cytotoxicity. Conclusion: Despite the existence of several in vitro studies that demonstrate the efficacy and safety of natural compounds utilization, there are few specific protocols guiding the dental professional about using based therapies of medicinal and/or phytotherapeutic plants, as in the case of Cymbopogon citratus (lemon grass). Therefore, more studies are necessary to explain and provide a better validation of lemon grass effects in the dentistry practice.

Worsening of Oxidative Stress, DNA Damage, and Atherosclerotic Lesions in Aged LDLr-/- Mice after Consumption of Guarana Soft Drinks.

BACKGROUND: Excessive consumption of soft drinks (SD) has become a health problem worldwide due to its association with related cardiovascular diseases. We investigated the possible impacts associated with the consumption of Brazilian guarana (normal and zero) SD in dyslipidemic mice, thus mitigating potential clinical confounders such as poor-quality diet, lifestyle, body composition, and/or comorbidities. METHODS: Sixteen-month-old LDLr-/- mice were divided into the following groups: (1) control; (2) GSD: normal guarana SD; and (3) Z-GSD: zero guarana SD. All were fed ad libitum, and blood pressure was measured noninvasively. After 8 weeks, aorta, blood, liver, and stomach samples were collected for histological and biochemical analyses. RESULTS: Guarana soft drinks increased atherosclerosis (~60%) and were associated with hypercholesterolemia, hypertension, oxidative stress, DNA fragmentation, and apoptosis (~2-fold) of blood cells, besides presenting an increase in liver and gastric damage even in normoglycemia. Interestingly, Z-GSD did not cause the aforementioned changes, except in hemodynamic and renal parameters. CONCLUSIONS: Chronic administration of GSD is prooxidative, compromising the cardiovascular, gastric, and hepatic systems; the effects are due at least in part to free sugar consumption but not to guarana extract per se.

Silymarin protects against radiocontrast-induced nephropathy in mice.

Silymarin, an extract from Silybum marianum (milk thistle) containing a standardized mixture of flavonolignans that ameliorates some types of liver disease and, more recently, kidney damage, could be used for the ROS-scavenging effect of these antioxidants. Furthermore, contrast-induced nephropathy (CIN) is an iatrogenic impairment of renal function in patients subjected to angiographic procedures for which there is not yet a successful preventative treatment. Recent evidence has shown that this event is related to tubular/vascular injury activated mainly by oxidative stress. However, whether this bioavailable and pharmacologically safe extract protects against CIN is not clear. We proposed to evaluate the possible protective role of the antioxidant silymarin in an experimental model of CIN. Adult male Swiss mice were separated into 6 groups and pretreated orally with silymarin (50, 200 and 300 mg/kg), N-acetylcysteine (200 mg/kg) or vehicle for 5 days before the CIN and control groups. Renal function was analyzed by plasma creatinine, urea and cystatin C levels. Additionally, blood reactive oxygen species (ROS) were evaluated using ROS bioavailability, protein oxidation and DNA damage. Renal oxidative damage was evaluated using apoptosis/cell viability assays and histological analysis. We showed that silymarin preserved renal function and decreased systemic and renal oxidative damage (antigenotoxic and antiapoptotic properties, respectively) in a dose-dependent manner and was superior to conventional treatment with N-acetylcysteine. Histologically, silymarin treatment also had beneficial effects on renal glomerular and tubular injuries. Therefore, silymarin prophylaxis may be an interesting strategy for the prevention of CIN.

Chronic administration of antioxidant resin from Virola oleifera attenuates atherogenesis in LDLr -/- mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Virola oleifera (Schott) A. C. Smith, Myristicaceae has been largely used in traditional folk medicine in Brazil as an anti-inflammatory agent and our previous data indicated the antioxidant properties in other oxidative stress-related models. However, its effects on atherosclerosis (AT) are not yet investigated. AIMS OF THE STUDY: To evaluate the influence of resin from Virola oleifera (RV) on progression of AT in LDLr-/- mice. MATERIALS AND METHODS: LDLr-/- mice were divided into 4 groups: 1) The ND group received a normal diet without treatment. 2) The HD group received a high-fat diet without treatment. 3) The HD-V50 received a high-fat diet and was orally treated with RV at 50mg/Kg. 4) The HD-V300 received a high-fat diet and was orally treated with RV at 300mg/Kg. After 4 weeks, blood was collected to quantify biochemical parameters and ROS total and the aorta was removed to measure the lipid deposition by en face analysis. The liver was also collected to determine total lipids and lipid and protein oxidation. In order to investigate in more detail the contributions of RV in the vascular structure, we carried out the in vitro tests using four cellular types: macrophages, fibroblasts, vascular smooth muscle and endothelial cells. RESULTS: We showed that the chronic treatment of RV at both doses reduced vascular lipid accumulation (~50%, p<0.05), probably through systemic and hepatic antioxidant effects, independent of dyslipidemia. Moreover, the in vitro assay results demonstrated that RV develops antioxidant properties on the vascular smooth muscle and endothelial cells, reinforcing the protective role of RV in progression of AT. LPS-stimulated macrophages treated with RV resulted in a significant reduction of NO production in a concentration-dependent manner. CONCLUSIONS: Chronic treatment with RV diminishes lipid deposition in atherosclerotic mice, which may be justified, at least in part, by antioxidant systemic and local mechanisms, reinforcing the protective role this resin in the setting of vascular lipid deposition, independent of hypercholesterolemia.

Coadjuvants in the Diabetic Complications: Nutraceuticals and Drugs with Pleiotropic Effects.

Because diabetes mellitus (DM) is a multifactorial metabolic disease, its prevention and treatment has been a constant challenge for basic and clinical investigators focused on translating their discoveries into clinical treatment of this complex disorder. In this review, we highlight recent experimental and clinical evidences of potential coadjuvants in the management of DM, such as polyphenols (quercetin, resveratrol and silymarin), cultured probiotic microorganisms and drugs acting through direct/indirect or pleiotropic effects on glycemic control in DM. Among several options, we highlight new promising therapeutic coadjuvants, including chemical scavengers, the probiotic kefir and the phosphodiesterase 5 inhibitors, which besides the reduction of hyperglycemia and ameliorate insulin resistance, they reduce oxidative stress and improve endothelial dysfunction in the systemic vascular circulation. In the near future, experimental studies are expected to clear the intracellular pathways involving coadjuvants. The design of clinical trials may also contribute to new strategies with coadjuvants against the harmful effects of diabetic complications.