The effect of Oenothera biennis (Evening primrose) oil on inflammatory diseases: a systematic review of clinical trials.

BACKGROUND: Evening primrose oil (EPO), extracted from the seeds of Oenothera biennis, has gained attention for its therapeutic effects in various inflammatory conditions. METHOD: We performed a systematic search in multiple databases and defined the inclusion criteria based on the following PICOs: P: Patients with a form of inflammatory condition, I: EPO, C: Placebo or other therapeutic interventions, O: changes in inflammatory markers or patients' symptoms; S: randomized controlled trials. The quality of the RCTs was evaluated using Cochrane's RoB tool. RESULTS: Several conditions were investigated in the literature. In rheumatoid arthritis, mixed results were observed, with some studies reporting significant improvements in symptoms while others found no significant impact. EPO showed some results in diabetes mellitus, atopic eczema, menopausal hot flashes, and mastalgia. However, it did not demonstrate effectiveness in chronic hand dermatitis, tardive dyskinesia, psoriatic arthritis, cystic fibrosis, hepatitis B, premenstrual syndrome, contact lens-associated dry eyes, acne vulgaris, breast cyst, pre-eclampsia, psoriasis, or primary Sjogren's syndrome. Some results were reported from multiple sclerosis after EPO consumption. Studies in healthy volunteers indicated no significant effect of EPO on epidermal atrophy, nevertheless, positive effects on the skin regarding hydration and barrier function were achieved. CONCLUSION: Some evidence regarding the potential benefits of EPO in inflammatory disorders were reported however caution is due to the limitations of the current survey. Overall, contemporary literature is highly heterogeneous and fails to provide strong recommendations regarding the efficacy of EPO on inflammatory disorders. Further high-quality studies are necessitated to draw more definite conclusions and establish O. biennis oil effectiveness as an assuring treatment option in alleviating inflammatory conditions.

Comparison of the Effect of Fennel and Evening Primrose Oil on Menopausal Problems and Hormonal Levels: A Randomized Controlled Trial.

Background: Using natural oral supplements is one of the methods of complementary medicine that has been widely welcomed in the last decade Since studies have reported contradictory results for effectiveness of herbal medicines during menopause and no other more effective herbal medicine has been suggested yet, the researchers of this study decided to compare the fennel and Evening Primrose Oil (EPO) and their effect on menopause problems and sex hormones. Materials and Methods: The present study was a triple-blinded, controlled clinical trial with 125 participants randomly assigned to. An intervention group received fennel, another intervention group received evening primrose oil, and the placebo group received placebo twice daily for 8 weeks. Pre-intervention and post-intervention results were obtained using hormonal assay and the Menopause Rating Scale (MRS). Results: In this study, the mean follicle-stimulating hormone (FSH) and estradiol levels changed significantly in the fennel and EPO groups compared to placebo (p < 0.001). The difference in the mean FSH score between the fennel group and EPO group was not significant (p = 0.304), but the difference in the mean estradiol level between these groups was significant (p = 0.043). Moreover, there was a significant difference in the mean MRS score between the intervention groups before the intervention (p < 0.05). However, the difference in the mean MRS score between the fennel and EPO groups was not significant after the intervention (p = 0.322). Conclusions: Consumption of fennel and EPO can significantly change FSH, estradiol, and psychological menopausal symptoms in postmenopausal women.

Evening primrose oil for cervical ripening in term pregnancies: a systematic review and meta-analysis.

Induction of labor by using available, inexpensive and non-invasive methods with the least side effects is particularly important. A systematic review was conducted to assess the effect of evening primrose oil on cervical ripening in term pregnancies. In this systematic review and meta-analysis of clinical trials, a search was carried out in PubMed, Cochrane Library, Embase, Ovid, Scopus, Clinical Trials.gov, Google Scholar and Persian databases (Magiran, SID, and IRCT.ir) for published related articles without any time limit. The Cochrane handbook was used to determine the risk of bias of the included articles. The obtained data were analyzed in RevMan and reported in forest plots. The Odds Ratio (OR) was used to find the effect of the dichotomous data and the Mean Difference (MD) for the continuous data. The heterogeneity of the studies was assessed using I2, T2 and Chi2. The random effect was used instead of fixed effect if I2 >40%. A total of 28 titles and abstracts were extracted, 9 articles entered into the meta-analysis. The meta-analysis results showed significant differences between EPO and control groups in terms of bishop score (MD=1.32; 95% CI: 0.98 to 1.66), reducing caesarean section rate (OR= 0.61; 95% CI: 0.43 to 0.86), duration of first stage of labor (MD= -98.67; 95% CI: -140.98 to -56.38) and duration of second stage of labor (MD= -10.98; 95% CI: -21.86 to -0.09). There were no significant differences in terms of birth weight (MD= 100.97; 95% CI: -11.91 to 213.84) and the frequency of induction with oxytocin (OR= 0.53; 95% CI: 0.27 to 1.01). It seems evening primrose oil be effective for cervical ripening, reducing cesarean section rate and shortening the duration of labor. Due to the high heterogeneity of the studies, the researchers recommend further researches on the subject using a standard tool based on the CONSORT statement.

Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study.

Subfertility is a global problem affecting millions worldwide, with declining total fertility rates. Preconception dietary supplementation may improve fecundability, but the magnitude of impact remains unclear. This prospective cohort study aimed to examine the association of preconception micronutrient supplements with fecundability, measured by time to pregnancy (TTP). The study was conducted at KK Women's and Children's Hospital, Singapore, between February 2015 and October 2017, on 908 women aged 18-45 years old, who were trying to conceive and were enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO). Baseline sociodemographic characteristics and supplement intake were collected through face-to-face interviews. The fecundability ratio (FR) was estimated using discrete-time proportional hazard modelling. Adjusting for potentially confounding variables, folic acid (FA) (FR 1.26, 95% confidence interval 1.03-1.56) and iodine (1.28, 1.00-1.65) supplement users had higher fecundability compared to non-users. Conversely, evening primrose oil supplement users had lower fecundability (0.56, 0.31-0.99) than non-users. In this study, preconception FA and iodine supplementation were associated with shortened TTP, while evening primrose oil use was associated with longer TTP. Nonetheless, the association between supplement use and the magnitude of fecundability changes will need to be further confirmed with well-designed randomised controlled trials.

Effect of Evening Primrose Oil Supplementation on Selected Parameters of Skin Condition in a Group of Patients Treated with Isotretinoin-A Randomized Double-Blind Trial.

Background: Retinoids, which include isotretinoin, reduce sebum levels, the degree of epidermal wetness (CORN) and cause an increase in transepidermal water loss (TEWL). Weight gain has also been observed in isotretinoin-treated patients. An agent that can reduce the severity of isotretinoin side effects is evening primrose oil (Oenothera paradoxa). The purpose of this study was to evaluate the effect of evening primrose oil supplementation in patients with acne vulgaris treated with isotretinoin on skin hydration status (CORN), transepidermal water loss (TEWL), skin oiliness (sebum) and changes in body weight and BMI. Methods: Patients diagnosed with acne were assigned to the isotretinoin-treated group (n = 25) or the isotretinoin and evening primrose oil-treated group (n = 25). The intervention lasted 9 months. CORN (with a corneometer), TEWL (with a tewameter) and sebum (with a sebumeter) were assessed twice, as well as body weight and BMI (Tanita MC-780). Results: The isotretinoin-treated group showed statistically significant reductions in CORN (p = 0.015), TEWL (p = 0.004) and sebum (p < 0.001) after the intervention. In the group treated with isotretinoin and evening primrose oil, TEWL and sebum levels also decreased significantly (p < 0.05), while CORN levels increased from 42.0 ± 9.70 to 50.9 ± 10.4 (p = 0.017). A significant decrease in body weight (p < 0.001) and BMI (p < 0.001) was observed in both groups after 9 months of intervention. Conclusions: During isotretinoin treatment, supplementation with evening primrose oil increased skin hydration. However, there were no differences between groups in transepidermal water loss, skin oiliness, weight loss and BMI.

Evening Primrose Oil Enhances Tamoxifen's Anticancer Activity against Breast Cancer Cells by Inducing Apoptosis, Inhibiting Angiogenesis, and Arresting the Cell Cycle.

BACKGROUND: Despite advancements in cancer treatment, breast cancer (BC) is still one of the leading causes of death among women. The majority of anti-breast-cancer medications induce serious side effects and multidrug resistance. Although several natural compounds, such as evening primrose oil (EPO), have been shown to have anticancer properties when used alone, their combination with the anticancer medicine tamoxifen (TAM) has yet to be investigated. The present study aimed to investigate the anticancer efficacy of EPO, alone or in combination with TAM, in the BC cell lines MCF-7 and MDA-MB-231, as well as to elucidate the mechanism of action. METHODS: The MTT assay was used to investigate the cytotoxic effect of EPO on the two cell lines, and we discovered an acceptable IC50 that was comparable to TAM. The ELISA, qRT-PCR, flow cytometry and colorimetric techniques were used. RESULTS: The combination of EPO and TAM suppressed the VEGF level, VEGF gene expression and Cyclin D1 signaling pathways, arrested the cell cycle, and induced the apoptotic signaling pathways by increasing the Bax/Bcl-2 ratio and caspase 3 activity; this revealed significant anti-tumor activity. CONCLUSIONS: The most significant finding of this study was the confirmation of the anticancer activity of the natural product EPO, which potentiated the activity of the anticancer drug TAM against MCF-7 and MDA-MB-231 BC cell lines through the induction of apoptosis, inhibiting angiogenesis and halting cell proliferation.

Effect of Evening Primrose Oil Supplementation on Biochemical Parameters and Nutrition of Patients Treated with Isotretinoin for Acne Vulgaris: A Randomized Double-Blind Trial.

Background: Acne vulgaris is one of the most common skin diseases. One of the therapeutic options recommended for severe acne or acne that has not responded to previous therapies is isotretinoin. However, its use may lead to adverse changes in the serum lipid profile and increased levels of transaminases. In this study, we evaluated the effect of supplementation with evening primrose oil in acne vulgaris patients treated with isotretinoin on blood lipid parameters and transaminase activity. Methods: Study participants were randomly assigned to two treatments: conventional with isotretinoin (25 patients) and novel with isotretinoin combined with evening primrose oil (4 × 510 mg/day; 25 patients) for 9 months. Results: Compared to isotretinoin treatment, isotretinoin treatment combined with evening primrose oil had a positive effect on TCH concentrations (mean: 198 vs. 161, p < 0.001), LDL (95.9 vs. 60.2, p < 0.001), HDL (51.0 vs. 48.0, p < 0.001), TG (114 vs. 95.0, p < 0.001), ALT (24.0 vs. 22.0, p < 0.001), and AST (28.0 vs. 22.0, p < 0.001), but had no effect on the energy and ingredient content of the diets (p > 0.05) after treatment. Conclusion: Evening primrose oil was found to have beneficial effects on lipid profiles and transaminase activity during isotretinoin treatment. However, longer studies are needed to make more reliable decisions regarding the use of evening primrose oil and its safety in clinical practice. The evening primrose oil treatment group also showed a reduction in dietary energy due to a reduction in dietary protein and carbohydrates.

Multiple oral mucoceles treated with evening primrose oil: a report of two cases.

Multiple mucoceles of the minor salivary glands are rare in the mouth. Typically, the minor salivary glands of the soft palate are affected. We report two cases that responded entirely following systemic therapy with evening primrose oil. No recurrence was reported over a two-year follow-up period. Evening primrose oil is postulated to have an effect on the composition and/or viscosity of minor salivary gland secretions.

An updated review on efficacy and benefits of sweet almond, evening primrose and jojoba oils in skin care applications.

BACKGROUND: Renewed consumer and industry interest in natural ingredients has led to a large growth of natural cosmetics. This has put pressure on formulation skills and product claims when it comes to using natural compounds. Taking a strategic and comprehensive approach in viewing natural ingredients, including natural oils, as 'active' ingredients rather than just providing for so-called 'natural' claims, aids both innovation and development. Given the ever-increasing consumer demand for natural ingredients, and more importantly the demand for effective natural ingredients including plant oils, it is important for the cosmetic industry to re-evaluate them in this context. METHOD: The objectives of this review are to provide an update of three popular cosmetic plant oils - Sweet Almond, Evening Primrose and Jojoba - in terms of their cosmetic applications as 'active' ingredients. This review highlights the activity of these oils, in the management of dry skin, ageing skin, juvenile skin, atopic dermatitis, scalp conditions and their wider potential. Attention is given to formulation considerations where the content of these oils impacts product oxidation, skin penetration and stratum corneum homeostasis. RESULTS: Benefits of these oils have been well documented both pre-clinically and clinically. Historically, they have been used for hundreds if not thousands of years for their management and treatment of various skin and other ailments. Given the discrepancies in some clinical data presented for a variety of dermatoses, the importance of the choice of oil and how to formulate with them within the context of the epidermal barrier function, skin penetration and toxicity cannot be underestimated. Care should be taken in terms of the quality and stability of theses oils, as well as ensuring best formulation type, if the reported activities of these oils are to be achieved with consistency. Despite discrepancies in the literature and questionable study designs, it is clear that Sweet Almond, Evening Primrose and Jojoba oils do have skin care benefits for both adult and juvenile applications. CONCLUSION: They are effective ingredients for skin care preparations to strengthen stratum corneum integrity, recovery and lipid ratio. Nevertheless, further experimental data are required concerning the impact on stratum corneum physiology and structure.

CONTEXTE: Un regain d'intérêt des consommateurs et du secteur pour les ingrédients naturels a conduit à une forte croissance des cosmétiques d'origine naturelle. Cet engouement a exercé une pression sur les compétences en matière de formulation et les allégations liées aux produits lorsqu'il s'agit d'utiliser des composés naturels. L'adoption d'une approche stratégique et exhaustive axée sur les ingrédients naturels, notamment les huiles naturelles, considérés comme des ingrédients «actifs¼ plutôt que de fournir des allégations liées à des produits dits naturels contribue à l'innovation et au développement. Compte tenu de la demande croissante des consommateurs en ingrédients naturels et qui plus est, de la demande en ingrédients naturels efficaces, dont les huiles végétales, il est important pour le secteur des cosmétiques de les réévaluer dans ce contexte. MÉTHODE: Cette revue vise à actualiser les connaissances ayant trait à trois huiles végétales souvent utilisées comme cosmétiques, à savoir les huiles d'amande douce, d'onagre et de jojoba, dans le cadre des applications cosmétiques où elles jouent un rôle de substances actives. Elle souligne le caractère actif de ces huiles dans la prise en charge de la peau sèche, du vieillissement de la peau, de la peau jeune, de la dermatite atopique, des affections du cuir chevelu et de leur potentiel d'utilisation plus large. Une attention particulière est accordée aux questions relatives à la formulation lorsque la teneur en ces huiles affecte l'oxydation du produit, la pénétration dans la peau et l'homéostasie de la couche cornée. RÉSULTATS: Les bénéfices des huiles examinées apparaissent bien documentés, tant au niveau clinique que préclinique. Historiquement, ces huiles sont utilisées depuis des centaines, voire des milliers d'années, pour la prise en charge et le traitement de diverses affections cutanées et extra-cutanées. Compte tenu des divergences parmi certaines des données cliniques présentées pour de multiples dermatoses, il est important de ne pas sous-estimer l'importance du choix de l'huile et de sa formulation eu égard à la fonction barrière de l'épiderme, à la pénétration cutanée et à la toxicité. Des précautions doivent être prises en termes de qualité et de stabilité de ces huiles, ainsi que pour garantir une formulation choisie au mieux, si les activités signalées de ces huiles soient obtenues avec cohérence. Malgré les divergences d'une étude à l'autre et les conceptions critiquables de certaines études, il apparaît clairement que les huiles d'amande douce, d'onagre et de jojoba apportent des bénéfices tant dans leurs applications pour adultes que pour enfants. CONCLUSION: Ces huiles constituent des ingrédients efficaces pour les préparations de soins de la peau en termes de renforcement de l'intégrité de la couche cornée, ainsi que de l'amélioration de sa récupération et de son rapport lipidique. Toutefois, d'autres données expérimentales demeurent nécessaires en ce qui concerne leur impact sur la physiologie et la structure de la couche cornée.

The effect of evening primrose oil on labor induction and cervical ripening: A systematic review and meta-analysis.

The evening primrose oil has prostaglandin effects and is applied to soften the cervix. This systematic review and meta-analysis aimed to establish the results of clinical trials performed on the effect of evening primrose oil on labor induction and cervical ripening in pregnant women. Research studies were searched from 1990 to September 2019 in Pubmed, Science Direct, Embase, and Cochrane Library using the keywords: cervical ripening, Bishop score, labor induction, post-term pregnancy, evening primrose, and any possible combination of these keywords (Farsi, English). Data analysis was conducted using STATA (version 14.1), and I2 index and random effect forest plots to assess the heterogeneity between the studies and perform the meta-analysis, respectively. Six articles that met the inclusion criteria were extracted in which four were entered into quantitative meta-analysis. The results' high heterogeneity was 91.4% based on I2 index (p ≤ .001) and the random model was applied for meta-analysis. The result demonstrated no significant difference between the intervention and control groups in terms of mean difference of the Bishop score before and after intervention (SMD: 0.27, 95%CI: -0.41, 0.96, p = .43). Based on current meta-analysis on four studies, effectiveness of oral consumption of evening primrose on cervical ripening was not approved.

Developing and validating the Caesarean risk assessment nomogram and comparing the effect of cervical ripening balloon, evening primrose oil and misoprostol on childbirth outcomes in term pregnancies: A study protocol.

AIM: To develop and validate the nomogram for risk estimation of Caesarean delivery and to compare the effect of cervical ripening balloon, evening primrose oil (EPO) and misoprostol on Bishop Score and duration of the first stage of labour. DESIGN: The first phase is a prospective study, and the second phase is a randomized controlled trial. METHODS: In the first phase, the nomogram will be developed and validated over 300 participants, and in the second phase, the 90 participants will be allocated to three groups: vaginal 25mcg misoprostol, vaginal 4000mg EPO and double-balloon catheter, through block randomization method. The Bishop score will be evaluated every 4 hr, and if required the same dose will be repeated. Maximum waiting time for balloon is 12 hr if not effective, the catheter will be removed, and other interventions will be done according to guidelines. DISCUSSION: The nomogram will help informed decision-making for women undergoing an induction with an unfavourable cervix and introducing effective low-complication methods of labour induction can improve the pregnancy outcomes.

Effect of evening primrose oil supplementation on lipid profile: A systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: Studies have shown that evening primrose oil (EPO) supplementation might be effective in improving lipid profile, however, the results are inconsistent. This study was performed to determine the direction and magnitude of the EPO effect on the lipid profile. METHODS: PubMed, Scopus, Cochrane Library, Embase and Web of Science databases and Google Scholar were searched up to September-2019. Meta-analysis was performed using the random-effects model. Lipid profile including high-density lipoprotein (HDL), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) was considered as the primary outcome. RESULTS: A total of 926 articles were identified through database searching, of which, six RCTs were included in the meta-analysis. There were six studies on HDL, TC, and TG and four studies on LDL. EPO supplementation had no significant effect on TC, TG, LDL, and HDL. However, in subgroup analysis, a significant reduction in TG at a dose of ≤4 g/day (weighted mean difference [WMD] = -37.28 mg/dl; 95% CI: -73.53 to -1.03, p = .044) and a significant increase in HDL in hyperlipidemic subjects (WMD = 5.468 mg/dl; 95% CI: 1.323 to 9.614, p = .010) was found. CONCLUSION: Oral intake of EPO at a dose of ≤4 g/day significantly reduces serum TG levels and significantly increases HDL levels in hyperlipidemic subjects.

Fatty Acid, Triacylglycerol and Unsaponifiable Matters Profiles and Physicochemical Properties of Chinese Evening Primrose Oil.

This work focused on physicochemical property assaying, fatty acid composition, triacylglycerol (TAG) profiles, and unsaponifiable matters composition of the Chinese evening primrose oil. The cold press oil possessed very low acid value and peroxide value, and relatively high iodine value. Fatty acid composition results indicated that this oil was especially high in linoleic acid and linolenic acid. Characterization of TAG composition was achieved by a two-dimensional HPLC coupling of nonaqueous reverse-phase and silver ion HPLC with atmospheric pressure chemical ionization MS method. There was a total of 38 TAGs including 27 regioisomers which had been determined. Unsaponifiable matters composition results revealed that this oil possessed a number of phytosterols, in which ß-sitosterol and stigmasterol were most predominant.

Evening Primrose (Oenothera biennis) Biological Activity Dependent on Chemical Composition.

Evening primrose (Oenothera L.) is a plant belonging to the family Onagraceae, in which the most numerous species is Oenothera biennis. Some plants belonging to the genus Oenothera L. are characterized by biological activity. Therefore, studies were conducted to determine the dependence of biological activity on the chemical composition of various parts of the evening primrose, mainly leaves, stems, and seeds. Common components of all parts of the Oenothera biennis plants are fatty acids, phenolic acids, and flavonoids. In contrast, primrose seeds also contain proteins, carbohydrates, minerals, and vitamins. Therefore, it is believed that the most interesting sources of biologically active compounds are the seeds and, above all, evening primrose seed oil. This oil contains mainly aliphatic alcohols, fatty acids, sterols, and polyphenols. Evening primrose oil (EPO) is extremely high in linoleic acid (LA) (70⁻74%) and γ-linolenic acid (GLA) (8⁻10%), which may contribute to the proper functioning of human tissues because they are precursors of anti-inflammatory eicosanoids. EPO supplementation results in an increase in plasma levels of γ-linolenic acid and its metabolite dihomo-γ-linolenic acid (DGLA). This compound is oxidized by lipoxygenase (15-LOX) to 15-hydroxyeicosatrienoic acid (15-HETrE) or, under the influence of cyclooxygenase (COX), DGLA is metabolized to series 1 prostaglandins. These compounds have anti-inflammatory and anti-proliferative properties. Furthermore, 15-HETrE blocks the conversion of arachidonic acid (AA) to leukotriene A4 (LTA4) by direct inhibition of 5-LOX. In addition, γ-linolenic acid suppresses inflammation mediators such as interleukin 1ß (IL-1ß), interleukin 6 (IL-6), and cytokine - tumor necrosis factor α (TNF-α). The beneficial effects of EPO have been demonstrated in the case of atopic dermatitis, psoriasis, Sjögren's syndrome, asthma, and anti-cancer therapy.

Evening primrose oil and labour, is it effective? A randomised clinical trial.

The purpose of the present study was to evaluate the effects of evening primrose oil (EvPO) on the duration of pregnancy and labour. The study was performed as a triple blind placebo controlled randomised clinical trial on nulliparous low-risk women with a certain gestational age of 40 weeks of pregnancy and a Bishop score of less than 4. In the case group (EvPO group), EvPO capsules were administered, 1000 mg, twice daily, for 7 days, and in the control group, placebo was administered similarly. The women of the two groups were followed up to delivery. In total, 80 women finished the study (40 in each group). The women of the two groups did not have significant differences according to age, BMI, Bishop Score at the beginning of the study, gestational age at entering the study, employment status and education level, the number of capsules used and duration of using medications. There was no significant difference between the two groups according to gestational age at delivery, need for induction or augmentation of labour, duration of different stages of labour, neonatal weight and Apgar scores, and the indications for hospital admission. Impact statement What is already known on this subject? Evening primrose oil has been used for the treatment of systemic disorders, which are accompanied with chronic inflammation such as atopic dermatitis, rheumatoid arthritis and psoriasis. Also, it has been proposed for some women's health conditions including breast pain (mastalgia), symptoms of premenstrual syndrome and menopausal symptoms, cervical ripening and induction or augmentation of labour. What do the results of this study add? Evening primrose oil does not have any impact on Bishop Score and the duration of different stages of labour. What are the implications of these findings for clinical practice and/or further research? According to the present study and the other performed studies, there is not enough evidence confirming effectiveness of Evening primrose oil for cervical ripening and duration of labour. It is suggested that pending further data its usage should be limited to experimental RCTs and its use in clinical practice should be prevented. Also, different routes of administration and different dosages should be investigated.

Evening primrose oil or forskolin ameliorates celecoxib-enhanced upregulation of tissue factor expression in mice subjected to lipopolysaccharide-induced endotoxemia.

Celecoxib, a selective cyclooxygenase-2 inhibitor, produces thrombotic events in patients predisposed to cardiovascular risk factors. One theory reported an increase in endothelial expression of tissue factor (TF) as a predisposing factor. This work explored the effect of evening primrose oil (EPO), a source of prostaglandin E1, and forskolin (a cyclic adenosine monophosphate stimulator) against the prothrombotic effect of celecoxib in mice. Lipopolysaccharide mouse model of endotoxemia was used to induce an upregulation of TF activity. Male mice received celecoxib (25 mg/kg), celecoxib plus EPO, or celecoxib plus forskolin for 4 weeks and then subjected to a prothrombotic challenge in the form of an intraperitoneal injection of lipopolysaccharide. Results showed an increase in plasma TF activity, endothelial TF expression, and thrombin-antithrombin (TAT) but lower antithrombin III (ATIII) level in mice that received celecoxib in comparison to those that received the vehicle. Adding EPO or forskolin to celecoxib regimen significantly decreased the prothrombotic effect of celecoxib. A positive correlation (r = 0.8501) was found between TF activity and TAT. Co-administration of EPO or forskolin decreased the activity of TF and mitigated the prothrombotic effect of celecoxib. Therefore, these combinations may have the utility to abrogate the prothrombotic adverse effect of celecoxib in clinical setting.

Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis.

In the context of increasing popularity of "natural" alternatives to conventional medicine, several dietary supplements have gained the attention of researchers and consumers alike in the treatment of atopic dermatitis (AD). Readily available without a prescription and frequently perceived to have fewer side effects than traditional medications, these "natural" remedies may be featured in discussions with patients, and clinicians should therefore be familiar with their efficacy and safety. Based on trials to date, no dietary supplements can be recommended for routine use in the treatment of AD. However, some promising results have been noted from the use of probiotics and prebiotics taken in combination. Given significant differences in study design to date, however, further studies would be needed to clarify dose and strains of probiotics. Studies of vitamin D have been limited and have produced conflicting results, although further trials in selected subsets of patients may be indicated. Very limited data is available on fish oil supplements, while future studies on Chinese herbal medicine would require evaluation of comparable herbs and formulations. Finally, multiple trials of evening primrose oil and borage seed oil have shown improvement similar to placebo, and neither is currently recommended in eczema therapy.

Essential Fatty Acids as Transdermal Penetration Enhancers.

The aim of this study was to investigate the effect of different penetration enhancers, containing essential fatty acids (EFAs), on the transdermal delivery of flurbiprofen. Evening primrose oil (EPO), vitamin F, and Pheroid technology all contain fatty acids and were compared using a cream-based formulation. This selection was to ascertain whether EFAs solely, or EFAs in a Pheroid delivery system, would have a significant increase in the transdermal delivery of a compound. Membrane release studies were performed, and the results indicated the following rank order for flurbiprofen release from the different formulations: vitamin F >> control > EPO >> Pheroid. Topical skin delivery results indicated that flurbiprofen was present in the stratum corneum-epidermis and the epidermis-dermis. The average percentage flurbiprofen diffused to the receptor phase (representing human blood) indicated that the EPO formulation showed the highest average percentage diffused. The Pheroid formulation delivered the lowest concentration with a statistical significant difference (p < 0.05) compared with the control formulation (containing 1% flurbiprofen and no penetration enhancers). The control formulation presented the highest average flux, with the EPO formulation following the closest. It could, thus, be concluded that EPO is the most favorable chemical penetration enhancer when used in this formulation.

Vitamin D and Evening Primrose Oil Administration Improve Glycemia and Lipid Profiles in Women with Gestational Diabetes.

UNLABELLED: Limited data are available assessing the effects of vitamin D and evening primrose oil (EPO) administration on markers of insulin resistance and lipid concentrations in gestational diabetes mellitus (GDM). This study was designed to evaluate the effects of vitamin D and EPO administration on insulin resistance and lipid concentrations among women with GDM. In this prospective randomized, double-blind, placebo-controlled clinical trial, 60 participants with GDM were divided into 2 groups of either 1000 IU vitamin D3 and 1000 mg EPO or placebo for 6 weeks. At the beginning and end of the study, fasting blood samples were obtained from the participants to measure related variables. After 6 weeks of intervention, changes in fasting plasma glucose (-3.6 ± 7.5 vs. +1.5 ± 11.4 mg/dL, P = 0.04), serum insulin concentrations (-2.0 ± 5.3 vs. +4.6 ± 10.7 µIU/mL, P = 0.004), homeostasis model of assessment (HOMA) insulin resistance (-0.5 ± 1.1 vs. +1.1 ± 2.5, P = 0.003), HOMA-B cell function (-7.7 ± 23.3 vs. +17.4 ± 42.9, P = 0.007) and the quantitative insulin sensitivity check index (+0.01 ± 0.02 vs. -0.01 ± 0.02, P = 0.007) in the vitamin D plus EPO group were significantly different from the placebo group. In addition, compared with the placebo, vitamin D and EPO supplementation resulted in significant reductions in serum TAG (-20.0 ± 54.3 vs. +34.3 ± 38.2 mg/dL, P < 0.001), VLDL (-4.0 ± 10.9 vs. +6.9 ± 7.6 mg/dL, P < 0.001), TC (-22.1 ± 32.6 vs. +5.3 ± 20.1 mg/dL, P < 0.001), LDL concentrations (-18.0 ± 25.5 vs. +1.8 ± 15.7 mg/dL, P = 0.001) and TC/HDL (-0.3 ± 0.4 vs. +0.3 ± 0.5 mg/dL, P < 0.001). We did not observe any significant effect of vitamin D and EPO supplementation on serum HDL concentrations. CLINICAL TRIAL REGISTRATION NUMBER: http://www.irct.ir : IRCT201509115623N52.

Singlet oxygen autoxidation of vegetable oils: evidences for lack of synergy between ß-carotene and tocopherols.

The synergy between ß-carotene and tocopherols--antioxidants protecting oils from oxidation, was analyzed in a model system. The model used stripped borage and evening primrose oils. A chlorophyll extract, ß-carotene and one of the tocopherols were added together or separately to the oils. Oil oxidation was initiated by singlet oxygen that was produced by chlorophylls irradiated with the use of a xenon lamp equipped with the cut-off 600 nm filter. Experiments were carried out at two mole ratios of tocopherols to ß-carotene, i.e. at 1:1 and 23:1. Analyses were performed using absorption and fluorescence spectra in the UV+Vis region. The results demonstrated an antagonistic action of the antioxidants. The protective effect of unsaturated fatty acids was significantly better in the case of ß-carotene compared to the tocopherols. Furthermore, tocopherols were less effective in protecting the oils in the presence of ß-carotene than without it.