ABSTRACT
In elderly men, benign prostatic hyperplasia (BPH) is a major risk factor for sexual dysfunctions (SDys). Additionally, the standard treatments for BPH symptoms, alpha blockers and 5-alpha-reductase inhibitors, cause SDys themselves. Preparations from saw palmetto berries are an efficacious and well-tolerated symptomatic treatment for mild to moderate BPH and have traditionally been used to treat SDys. We conducted an open multicentric clinical pilot trial to investigate whether the saw palmetto berry preparation Prostasan® influenced BPH symptoms and SDys. Eighty-two patients participated in the 8-week trial, taking one capsule of 320 mg saw palmetto extract daily. At the end of the treatment, the International Prostate Symptom Score was reduced from 14.4 ± 4.7 to 6.9 ± 5.2 (p < 0.0001); SDys measured with the brief Sexual Function Inventory improved from 22.4 ± 7.2 to 31.4 ± 9.2 (p < 0.0001), and the Urolife BPH QoL-9 sex total improved from 137.3 ± 47.9 to 195.0 ± 56.3 (p < 0.0001). Investigators' and patients' assessments confirmed the good efficacy, and treatment was very well tolerated and accepted by the patients. Correlation analyses confirmed the relationship between improved BPH symptoms and reduced SDys. This was the first trial with saw palmetto to show improvement in BPH symptoms and SDys as well. [Corrections made here after initial online publication.]
Subject(s)
Plant Extracts/therapeutic use , Prostatic Hyperplasia/drug therapy , Serenoa/chemistry , Adult , Aged , Aged, 80 and over , Fruit/chemistry , Humans , Male , Middle Aged , Pilot ProjectsABSTRACT
INTRODUCTION: Traditional plant medicines (TPMs) are plant-derived therapeutic products prepared and applied according to longstanding medical customs. Around the world they are widely used in primary and preventative health care. The World Health Organization (WHO) calls in its Traditional Medicine Strategy 2014-2023 for Member States to provide a regulatory framework so that the formal contribution of traditional therapeutics can be advanced in national systems of health care. Evidence of effectiveness and safety is paramount for the regulatory integration of TPMs; however, a presumed lack of such "evidence" is one obstacle for full integration. The consequential health policy question is how to systematically evaluate therapeutic claims relating to herbal remedies when the extant evidence is predominantly based on historical and contemporary clinical usage, i.e., is empiricist in nature. This paper introduces a new method along with several illustrative examples. METHOD: Our research design employs a longitudinal, comparative textual analysis of standard textbooks of the professional European medical literature from the early modern period (1588/1664) onwards to today. It then triangulated these intergenerationally documented clinical observations on two exemplars (Arnica and St. John's Wort) with corresponding listings in multiple qualitative and quantitative sources. A Pragmatic Historical Assessment (PHA) tool was developed and tested as a method to systematically collate the large amount of pharmacological data recorded in these judiciously selected sources. The evidential validity of longstanding professional clinical knowledge could thus be compared with therapeutic indications approved in official and authoritative sources (pharmacopoeias, monographs) and with those supported by contemporary scientific research (randomised-controlled trials [RCTs], experimental research). RESULTS: There was high congruency between therapeutic indications that are based on repeated empirical observations from professional patient care (empirical evidence), those approved in pharmacopoeias and monographs, and modern scientific evidence based on RCTs. The extensive herbal triangulation confirmed parallel records of all main therapeutic indications of the exemplars across all qualitative and quantitative sources over the past 400 years. CONCLUSIONS: Historical clinical medical textbooks and contemporary phytotherapeutic equivalents are the key repository of repeatedly evaluated therapeutic plant knowledge. The professional clinical literature proved to be a reliable and verifiable body of empirical evidence that harmonised with contemporary scientific assessments. The newly developed PHA tool provides a coding framework for the systematic collation and evaluation of empirical data on the effectiveness and safety of TPMs. It is suggested as a feasible and efficient tool to extend evidence typologies that substantiate therapeutic claims for TPMs as part of an evidence-based regulatory framework that formally integrates these medically and culturally important therapeutics.
Subject(s)
Materia Medica , Plants, Medicinal , Humans , Medicine, Traditional/methods , Phytotherapy , Plant Extracts , Plant OilsABSTRACT
Extracts from Cimicifuga racemosa (CR, synonym Actaea racemosa) have shown efficacy in trials in women with menopausal symptoms. Yet, dose dependency remains unclear. Therefore, 180 female outpatients with climacteric complaints were treated for 12 weeks in a randomized, double-blind, placebo-controlled, 3-armed trial (CR extract Ze 450 in 6.5 mg or 13.0 mg, or placebo). Primary outcome was the difference in menopausal symptoms (vasomotor, psychological, and somatic), assessed by the Kupperman Menopausal Index between baseline and week 12. Secondary efficacy variables were patients' self-assessments of general quality of life (QoL), responder rates, and safety. Compared to placebo, patients receiving Ze 450 showed a significant reduction in the severity of menopausal symptoms in a dose-dependent manner from baseline to endpoint (mean absolute differences 17.0 (95% CI 14.65-19.35) score points, P < 0.0001 for 13.0 mg; mean absolute differences 8.47 (95% CI 5.55-11.39) score points, P = 0.0003 for 6.5 mg). QoL and responder rates corresponded with the main endpoint. Changes in menopausal symptoms and QoL were inversely correlated. Reported adverse events and clinical laboratory testing did not raise safety concerns. The CR extract Ze 450 is an effective and well-tolerated nonhormonal alternative to hormone treatment for symptom relief in menopausal women.
ABSTRACT
BACKGROUND: Drugs of plant origin such as Arnica montana, Calendula officinalis or Hypericum perforatum have been frequently used to promote wound healing. While their effect on wound healing using preparations at pharmacological concentrations was supported by several in vitro and clinical studies, investigations of herbal homeopathic remedies on wound healing process are rare. The objective of this study was to investigate the effect of a commercial low potency homeopathic remedy Similasan® Arnica plus Spray on wound closure in a controlled, blind trial in vitro. METHODS: We investigated the effect of an ethanolic preparation composed of equal parts of Arnica montana 4x, Calendula officinalis 4x, Hypericum perforatum 4x and Symphytum officinale 6x (0712-2), its succussed hydroalcoholic solvent (0712-1) and unsuccussed solvent (0712-3) on NIH 3T3 fibroblasts. Cell viability was determined by WST-1 assay, cell growth using BrdU uptake, cell migration by chemotaxis assay and wound closure by CytoSelect ™Wound Healing Assay Kit which generated a defined "wound field". All assays were performed in three independent controlled experiments. RESULTS: None of the three substances affected cell viability and none showed a stimulating effect on cell proliferation. Preparation (0712-2) exerted a stimulating effect on fibroblast migration (31.9%) vs 14.7% with succussed solvent (0712-1) at 1:100 dilutions (p < 0.001). Unsuccussed solvent (0712-3) had no influence on cell migration (6.3%; p > 0.05). Preparation (0712-2) at a dilution of 1:100 promoted in vitro wound closure by 59.5% and differed significantly (p < 0.001) from succussed solvent (0712-1), which caused 22.1% wound closure. CONCLUSION: Results of this study showed that the low potency homeopathic remedy (0712-2) exerted in vitro wound closure potential in NIH 3T3 fibroblasts. This effect resulted from stimulation of fibroblasts motility rather than of their mitosis.
Subject(s)
Arnica/chemistry , Calendula/chemistry , Comfrey/chemistry , Fibroblasts/drug effects , Hypericum/chemistry , Materia Medica/pharmacology , Plant Extracts/pharmacology , Wound Healing/drug effects , Animals , Cell Movement/drug effects , Cell Proliferation/drug effects , Fibroblasts/physiology , Mice , NIH 3T3 CellsABSTRACT
Medicinal plant knowledge in Central Europe can be traced back from the present to antiquity, through written sources. Approximately 100 medicinal plant taxa have a history of continuous use. In this paper, we focus on use patterns over time and the link between historical and traditional uses with the current scientific evidence. We discuss our findings against the backdrop of changing eras and medicinal concepts. Based on use-records from totally 16 historical, popular and scientific herbals, we analyze how use categories of 102 medicinal plant taxa developed over time. Overall, 56 of the 102 taxa maintained continuous use throughout all time periods. For approximately 30% of the continuous uses, scientific evidence supporting their use exists, compared to 11% for recently added uses and 6% for discontinuous uses. Dermatology and gastroenterology are use categories that are relevant across all time periods. They are associated with a high diversity of medicinal taxa and continuously used medicinal species with scientific evidence. Antidotes, apotropaic (protective) magic, and humoral detoxification were important use categories in the past. New applications reflecting biomedical progress and epidemiological challenges are cardiovascular and tonic uses. Changes in medicinal concepts are mirrored in plant use and specifically in changes in the importance of use categories. Our finding supports the concept of social validation of plant uses, i.e., the assumption that longstanding use practice and tradition may suggest efficacy and safety.
ABSTRACT
OBJECTIVE: The antihormonal therapy of breast cancer patients with the antiestrogen tamoxifen often induces or aggravates menopausal complaints. As estrogen substitution is contraindicated, herbal alternatives, e.g. extracts of black cohosh are often used. DESIGN: A prospective observational study was carried out in 50 breast cancer patients with tamoxifen treatment. All patients had had surgery, most of them had undergone radiation therapy (87%) and approximately 50% had received chemotherapy. Every patient was treated with an isopropanolic extract of black cohosh (1-4 tablets, 2.5 mg) for 6 months. Patients recorded their complaints before therapy and after 1, 3, and 6 months of therapy using the menopause rating scale (MRS II). RESULTS: The reduction of the total MRS II score under black cohosh treatment from 17.6 to 13.6 was statistically significant. Hot flashes, sweating, sleep problems, and anxiety improved, whereas urogenital and musculoskeletal complaints did not change. In all, 22 patients reported adverse events, none of which were linked with the study medication; 90% reported the tolerability of the black cohosh extract as very good or good. CONCLUSIONS: Black cohosh extract seems to be a reasonable treatment approach in tamoxifen treated breast cancer patients with predominantly psychovegetative symptoms.
Subject(s)
Antineoplastic Agents, Hormonal/adverse effects , Breast Neoplasms/drug therapy , Cimicifuga/chemistry , Phytotherapy , Plant Extracts/therapeutic use , Selective Estrogen Receptor Modulators/therapeutic use , Tamoxifen/adverse effects , Adult , Aged , Antineoplastic Agents, Hormonal/therapeutic use , Anxiety/chemically induced , Anxiety/prevention & control , Breast Neoplasms/physiopathology , Breast Neoplasms/psychology , Breast Neoplasms/therapy , Estrogen Antagonists/adverse effects , Estrogen Antagonists/therapeutic use , Female , Hot Flashes/chemically induced , Hot Flashes/prevention & control , Humans , Menopause/drug effects , Menopause/psychology , Middle Aged , Patient Dropouts , Phytotherapy/adverse effects , Plant Extracts/adverse effects , Rhizome/chemistry , Selective Estrogen Receptor Modulators/adverse effects , Sleep Wake Disorders/chemically induced , Sleep Wake Disorders/prevention & control , Sweating/drug effects , Tamoxifen/therapeutic useABSTRACT
Herbal remedies are multicomponent mixtures by their nature as well as by pharmaceutical definition. Being a multicomponent mixture is not only a crucial property of herbal remedies, it also represents a precondition for interactions such as synergism or antagonism. Until now, only a few phytomedicines are accurately described concerning the interactions of their active components. The aim of this study was to search for interactions within such a naturally given multi-component mixture and to discuss the pharmaceutical and clinical impacts. The thyme oil chosen for the examination belongs to the essential oils with the most pronounced antimicrobial activity. Antibiotic activity of thyme oil and single active components were tested against six different strains of microorganisms. The checkerboard assay was used to search for interactions. The time-kill assay was used to verify the observed effects and to get information about the temporal resolution of the antimicrobial activity. The degree of the detected interactions corresponded with the demarcating FICI measure of 0.5, which separates the additive from the over-additive (synergistic) effects. Therefore, the observed effect was called a "borderline case of synergism" or, respectively, "partial synergism". Partial synergism was observed only in the presence of Klebsiella pneumoniae. Additive antimicrobial activity was observed for the combination of the two monosubstances carvacrol plus linalool and thymol plus linalool as well as with the combination of the two essential oils of the carvacrol and linalool chemotypes. An increase of the carvacrol oil concentration from one to two times the MIC resulted in a considerable acceleration of the kill-rate. Thyme oil is composed of several different components that show antimicrobial activity (at least: carvacrol, thymol and linalool). The antimicrobial activity of thyme oil is partly based on additive effects, which might especially enhance the rapidity of the antimicrobial action. In addition, a mixture of several active ingredients that varies in its composition from year to year and from lot to lot as is the case with herbal remedies may be more stable concerning the antimicrobial activity than mixtures containing just a single active component.
Subject(s)
Anti-Infective Agents/pharmacology , Monoterpenes/pharmacology , Oils, Volatile/pharmacology , Thymus Plant/chemistry , Anti-Infective Agents/isolation & purification , Base Composition , Cymenes , Microbial Sensitivity Tests , Monoterpenes/isolation & purification , Oils, Volatile/isolation & purification , Thymus Plant/geneticsABSTRACT
Herbal drugs are often used in patients with somatoform disorders yet, the available evidence is limited. The aim of the present short-term study was to evaluate in a pharmaco-clinical trial the additional benefit of butterbur in a fixed herbal drug combination (Ze 185 = 4-combination versus 3-combination without butterbur and placebo) in patients with somatoform disorders.For a 2-week treatment in patients with somatization disorder (F45.0) and undifferentiated somatoform disorder (F45.1), 182 patients were randomized for a 3-arm trial (butterbur root, valerian root, passionflower herb, lemon balm leaf versus valerian root, passionflower herb, lemon balm leaf versus placebo). Anxiety (visual analogue scale - VAS) and depression (Beck's Depression Inventory - BDI) served as primary parameters, Clinical Global Impression (CGI) was a secondary parameter.The 4-combination was significantly superior to the 3-combination and placebo (4-combination > 3-combination > placebo) in all the primary and secondary parameters (PP-population). Analysis of the ITT population confirmed these results. As to safety, no serious adverse events occurred. In total 9 non-serious adverse events were documented but the distribution did not differ significantly between the treatment groups.This herbal preparation (Ze185) showed to be an efficacious and safe short-term treatment in patients with somatoform disorders.
Subject(s)
Petasites/chemistry , Phytotherapy , Plant Preparations/therapeutic use , Somatoform Disorders/drug therapy , Adult , Anxiety , Depression , Drug Combinations , Female , Humans , Male , Middle Aged , Severity of Illness Index , Treatment OutcomeABSTRACT
OBJECTIVE: To investigate the suitability of measurements of mercury (Hg) concentration as a means of identifying patients with health complaints attributed to dental amalgam. METHODS: Hg in erythrocytes, plasma, urine, and saliva was determined in 27 patients complaining about health problems attributed to amalgam, 27 healthy volunteers with amalgam fillings, and 27 healthy amalgam-free volunteers. RESULTS: Concentrations of inorganic mercury in blood and of total mercury in urine and saliva differed significantly between individuals with amalgam fillings and amalgam-free volunteers, but not between symptomatic patients and healthy volunteers with amalgam fillings. Urine Hg levels tended to be better correlated with blood than with saliva data. Levels of organic Hg were equal in all groups. CONCLUSION: Concentrations of total and inorganic mercury in body fluids do not distinguish between asymptomatic amalgam bearers and those who suffer from a poorly defined syndrome of multiple nonspecific symptoms.
Subject(s)
Dental Amalgam/chemistry , Mercury Poisoning/diagnosis , Mercury/blood , Mercury/urine , Adult , Age Factors , Aged , Analysis of Variance , Clinical Chemistry Tests/methods , Fatigue/etiology , Fatigue/physiopathology , Humans , Mercury Poisoning/complications , Mercury Poisoning/physiopathology , Middle Aged , Muscle Weakness/etiology , Muscle Weakness/physiopathology , Reproducibility of Results , Risk Assessment/methods , Saliva/chemistry , Sensitivity and Specificity , Sex Factors , Spectrophotometry, Atomic/methods , Stress Disorders, Traumatic/etiology , Stress Disorders, Traumatic/physiopathologyABSTRACT
BACKGROUND: Phytotherapy is a third approach for treating lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). The lipido-sterolic extract of the fruit of Serenoa repens is one of the more widely used phytotherapeutic agents in this regard. MATERIALS AND METHODS: The effect of an ethanolic extract of S. repens (10-1000 microg/ml) was tested in hormone-sensitive LNCaP, MCF-7 and hormone-insensitive DU 145, MDA MB231 prostate, breast carcinoma cell lines, renal Caki-1, urinary bladder J82, colon HCT 116 and lung A 549 cancer cells. Its cell growth inhibitory and apoptosis-inducing effects were tested using WST-1 assay and flow cytometry (Annexin V/PI stain) and/or by colorimetric assay (APOPercentage assay). RESULTS: The S. repens extract induced a dose-dependent antiproliferative effect on all human malignant cells tested, with GI50 values between 107 and 327 pmicro/ml. In hormone-sensitive prostate LNCaP and breast MCF-7 cell lines, the effect of extract expressed in GI50 was 2.2- and 2.5-fold more potent (p < 0.01) than in hormone-insensitive DU 145 and MDA MB231 cells. The proportion of apoptotic cells, except in A549 cells, lay between 22.5-36.3%. S. repens extract did not induce apoptosis in lung cancer A 549 cells. CONCLUSION: This study showed that the antiproliferative effect exerted by the ethanolic extract of S. repens is at least triggered by induction of apoptosis. These in vitro data provide some information that may be useful for clinical use and render S. repens extract an interesting tool for new applications.
Subject(s)
Apoptosis/drug effects , Fruit/chemistry , Neoplasms/drug therapy , Phytotherapy/methods , Plant Extracts/pharmacology , Serenoa/chemistry , Breast Neoplasms/drug therapy , Cell Line, Tumor , Drug Screening Assays, Antitumor , Female , HCT116 Cells , Humans , Male , Neoplasms, Hormone-Dependent/drug therapy , Prostatic Neoplasms/drug therapyABSTRACT
BACKGROUND: The isopropanolic extract of black cohosh (iCR)b has recently been reported to exert antiproliferative and apoptosis-inducing effects on estrogen receptor-positive MCF-7, as well as estrogen receptor-negative MDA-MB 231 human breast cancer cells. To broaden observations, the anti-invasive effects of iCR and its two major fractions triterpene glycosides (TTG) and cinnamic acid esters (CAE) were tested in highly invasive MDA-MB 231 cells. MATERIALS AND METHODS: The effect of drugs upon the invasive potential of MDA-MB231 cells was studied in BD Biocoat Matrigel invasion chambers over a period of 24 h. RESULTS: The suppression of invasion reached 51.8% at 77.4 microg/ml of iCR, an extract concentration where 89% of MDA-MB231 cells were viable. TTG and CAE reduced cell invasion by 34% and 25.5%, respectively, at a dose of 5 microg/ml. The motility of cells was only moderately reduced. CONCLUSION: In this study iCR was found to suppress tumor cell invasion without affecting cell viability. This result together with the antiproliferative and apoptosis-inducing effect of iCR suggest its use as a secure agent in postmenopausal hormone replacement therapy with additional chemopreventive activity.
Subject(s)
Cimicifuga , Neoplasm Invasiveness/prevention & control , Plant Extracts/therapeutic use , Breast Neoplasms/pathology , Cell Line, Tumor , Female , HumansABSTRACT
BACKGROUND: Chronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions. METHODS AND FINDINGS: We conducted a retrospective study with all multimorbid inpatients aged ≥18 years admitted to the Department of Internal Medicine of University Hospital Zurich in 2011 (n = 1,039 patients). Data were extracted from the electronic health records and reviewed. We identified 433 hospitalizations of patients with chronic pain and analyzed their combinations of chronic conditions (multimorbidity). We then classified all analgesic prescriptions according to the World Health Organization (WHO) analgesic ladder. Furthermore, we used a Swiss drug-drug interactions knowledge base to identify potential interactions between opioids and other drug classes, in particular coanalgesics and other concomitant drugs. Chronic pain was present in 38% of patients with multimorbidity. On average, patients with chronic pain were aged 65.7 years and had a mean number of 6.6 diagnoses. Hypertension was the most common chronic condition. Chronic back pain was the most common painful condition. Almost 90% of patients were exposed to polypharmacotherapy. Of the chronic pain patients, 71.1% received opioids for moderate to severe pain, 43.4% received coanalgesics. We identified 3,186 potential drug-drug interactions, with 17% classified between analgesics (without coanalgesics). CONCLUSIONS: Analgesic drugs-related DDIs, in particular opioids, in multimorbid patients are often complex and difficult to assess by using DDI knowledge bases alone. Drug-multimorbidity interactions are not sufficiently investigated and understood. Today, the scientific literature is scarce for chronic pain in combination with multiple coexisting medical conditions and medication regimens. Our work may provide useful information to enable further investigations in multimorbidity research within the scope of potential interactions and chronic pain.
Subject(s)
Analgesics/therapeutic use , Chronic Pain/drug therapy , Drug Interactions , Inpatients , Multiple Chronic Conditions/drug therapy , Analgesics, Opioid/adverse effects , Analgesics, Opioid/therapeutic use , Demography , Drug Prescriptions , Hospital Departments , Humans , Internal Medicine , World Health OrganizationABSTRACT
Herbal drugs are being increasingly used in medical practice, often without appropriate scrutiny of their safety and efficacy. The medicinal product Padma 28 is a fixed combination with Tibetan origin, used in Europe since the 1960s for the symptomatic treatment of circulatory disorders, including those of peripheral arterial occlusive disease (PAOD). We have conducted an analysis of all available data on this herbal drug from published literature as well as from original data we obtained from contacting the authors of published papers, reports and the manufacturer. A total of 19 trials have reported on 2084 patients to date, 444 of whom were in six controlled clinical studies on PAOD. A meta-analysis of five trials showed Padma 28 to increase walking distance by >100m in 18.2% of the patients with verum, versus 2.1% with placebo (P<0.001; odds ratio: 10 [95% CI 3.03, 33.33]; RR: 0.12; number needed to treat=6.2). The safety profile appears to be favourable. Available evidence shows that Padma 28 provides significant relief from PAOD-related symptoms (i.e. walking distance), probably of the same order of magnitude as other employed medications. However, larger confirmatory RCTs are desirable.
Subject(s)
Intermittent Claudication/drug therapy , Medicine, Tibetan Traditional/methods , Phytotherapy/methods , Plant Extracts/therapeutic use , Humans , Intermittent Claudication/physiopathology , Treatment Outcome , Walking/physiologyABSTRACT
BACKGROUND: The inhibitory effects of black cohosh extracts (Cimicifuga syn. Actaea racemosa L.) on the proliferation of human breast cancer cells were reported recently. In this study, we turned examined another hormone-dependent, epidemiologically important tumor disease, prostate cancer. The cell growth inhibitory effect of an isopropanolic extract of black cohosh (iCR) on androgen-sensitive LNCaP and androgen-insensitive PC-3 and DU 145 prostate cancer cells was investigated. MATERIALS AND METHODS: The cytotoxic effect of the extract was determined by WST-1 assay. Apoptosis was determined by the appearance of apoptotic morphology, annexin V-FITC adherence and caspase activation. Cytokeratin (CK) 18 degradation was identified with M30 monoclonal antibody. RESULTS: Regardless of their hormone sensitivity, the growth of prostate cancer cells was significantly and dose-dependently down-regulated by iCR. The drug concentration producing 50% cell growth inhibition in all cell lines after 72h lay between 37.1 and 62.7 microg/ml. Increases in the level of M30 antigen of approximately 1.8-, 5.9- and 5.3-fold over untreated controls were observed in black cohosh-treated PC-3, DU 145 and LNCaP cells, respectively, with the induction of apoptosis being dose- and time-dependent. CONCLUSION: Black cohosh extract kills human hormone-responsive or-unresponsive prostate cancer cells by induction of apoptosis and activation of caspases. This finding suggests that the cell's hormone responsive status is not an important determinant of the response to the extract and that iCR extract may represent a novel therapeutic approach for the treatment of prostate cancer.
Subject(s)
Apoptosis/drug effects , Cimicifuga , Keratins/metabolism , Neoplasms, Hormone-Dependent/drug therapy , Phytotherapy/methods , Plant Extracts/pharmacology , Prostatic Neoplasms/drug therapy , 2-Propanol/chemistry , Androgens/physiology , Caspases/biosynthesis , Caspases/metabolism , Cell Growth Processes/drug effects , Cell Line, Tumor , Enzyme Induction/drug effects , Humans , Male , Neoplasms, Hormone-Dependent/enzymology , Neoplasms, Hormone-Dependent/metabolism , Neoplasms, Hormone-Dependent/pathology , Prostatic Neoplasms/enzymology , Prostatic Neoplasms/metabolism , Prostatic Neoplasms/pathologyABSTRACT
BACKGROUND: Herbal medicine is a popular part of primary health care in Switzerland. Following an ethnobotanical approach, in this study we seek to identify Swiss herbalists with broad, empirical medicinal plant knowledge and use. We aim to consider different areas of the medicinal landscape including biomedicine, complementary and alternative medicine, and self-medication. MATERIAL AND METHODS: A total of 61 expert interviews were conducted from February 2010 to November 2011. The transfer of knowledge was analyzed according to a Switzerland-related selection of historical and recent popular as well as scientific herbal books. RESULTS: A total of 254 medicinal plant species, belonging to 218 genera and 87 families, were recorded in 934 use reports. Predominantly leaves and flowers are used for the treatment of dermatological, respiratory, nervous, and gastrointestinal problems. Recent to historical herbal books are an important source of plant knowledge. CONCLUSIONS: Medicinal plants are used for self-medication and professional health care and despite different underlying medicinal concepts and philosophies, herbalists largely agree on the most important medicinal plant species.
Subject(s)
Ethnobotany , Phytotherapy/statistics & numerical data , Phytotherapy/standards , Plants, Medicinal , Complementary Therapies/statistics & numerical data , Ethnobotany/standards , Ethnobotany/statistics & numerical data , Humans , Interviews as Topic , Knowledge , Practice Patterns, Physicians' , Switzerland , WorkforceABSTRACT
Boswellic acids from frankincense were indentified as the active compounds which inhibit leukotriene biosynthesis, 5-lipoxygenase and exert antiproliferative activity toward a variety of malignant cells. Because of the relevance for the clinical application, we tested the ethanolic extract of Boswellia serrata gum resin containing a defined amount of boswellic acids for its cytotoxic, cytostatic and apoptotic activity on five leukemia (HL-60, K 562, U937, MOLT-4, THP-1) and two brain tumor (LN-18, LN-229) cell lines by WST-1 assay and flow cytometry. The Boswellia serrata extract induced dose-dependent antiproliferative effects on all human malignant cells tested with GI50 values (extract concentration producing 50% cell growth inhibition) between 57.0 and 124.1 micrograms/ml. In three haematological cell lines (K562, U937, MOLT-4) the effect of total extract expressed in GI50 was 2.8-, 3.3- and 2.3-times more potent (p < 0.05) than pure 3-O-acetyl-11-keto-beta-boswellic acid (AKBA). Morphological changes after 24-27 hours and the detection of apoptotic cells by AnnexinV-binding and/or by the detection of propidium iodide-labelled DNA with flow cytometry, confirmed the apoptotic cell death. The results of this study suggest the effectiveness of Boswellia serrata extract with defined content of boswellic acids.
Subject(s)
Antineoplastic Agents, Phytogenic/pharmacology , Apoptosis/drug effects , Triterpenes/pharmacology , Boswellia/chemistry , Cell Division/drug effects , Dose-Response Relationship, Drug , Drug Screening Assays, Antitumor , Glioma/drug therapy , Glioma/pathology , HL-60 Cells/drug effects , Humans , K562 Cells/drug effects , Leukemia/drug therapy , Leukemia/pathology , Plant Extracts/pharmacology , Tumor Cells, Cultured , U937 Cells/drug effectsABSTRACT
Hyperforin (HP) is an abundant component of St John's wort with antibiotic and antidepressive activity. We report here the ability of HP and that of polyphenolic procyanidin B2 (PB-2) to inhibit the growth of leukemia K562 and U937 cells, brain glioblastoma cells LN229 and normal human astrocytes. HP inhibited the growth of cells in vitro with GI(50) values between 14.9 and 19.9 microM. The growth inhibitory effect of PB-2 was more pronounced in leukemia cell lines K562 and U937, the GI(50) concentrations being about 12.5 microM established after 48 h incubation differed significantly (P<0.05) from those of LN229 and normal human astrocytes (103.1 and 96.7 microM), respectively. Further, HP and hypericin (HY) (a naphthodianthrone from St John's wort) acted synergistically in their inhibitory effect on leukemic (K562, U937) cell growth. Cell death occurred after 24 h treatment with HP and PB-2 by apoptosis. A dose-dependent loss of membrane phospholipid asymmetry associated with apoptosis was induced in all cell lines as evidenced by the externalization of phosphatidylserine (PS) and morphological changes in cell size and granulosity by scatter characteristics. In leukemia U937 cells, HP increased the activity of caspase-9 and caspase-3 and in K562 cells caspase-8 and caspase-3. In addition, the broad spectrum caspase inhibitor z-VAD-fmk inhibited both the appearance of PS exposure and the activation of caspases, illustrating the functional relevance of caspase activation during HP-induced apoptosis. Cytocidal effects of HP and its cooperation with HY on tumor growth inhibition in a synergistic manner make the St John's wort an interesting option in cancer warranting further in vitro and in vivo investigation.
Subject(s)
Antineoplastic Agents/pharmacology , Apoptosis/drug effects , Biflavonoids , Caspases/metabolism , Hypericum/chemistry , Perylene/analogs & derivatives , Perylene/pharmacology , Proanthocyanidins , Terpenes/pharmacology , Annexin A5/pharmacology , Anthracenes , Antioxidants/pharmacology , Astrocytes/drug effects , Bridged Bicyclo Compounds , Catechin/pharmacology , Cell Division/drug effects , Cell Line, Tumor , Cells, Cultured , Drug Synergism , Enzyme Activation , Enzyme Inhibitors/pharmacology , Humans , Phloroglucinol/analogs & derivatives , Plant Extracts/pharmacologyABSTRACT
In this study we compared, simultaneously, the growth-inhibitory effect of Hypericum perforatum L. extracts, containing various amounts of hyperforin (A 3.25%; B 2.21%; C 0.21% w/w) and flavonoids (A and B 5.3%; C 10% w/w), but closely same amounts of naphthodiantrones (0.3%) on two leukaemic cell lines K562 and U937 in the WST-1 assay. The GI50 (concentration of extracts which caused 50% of cell growth inhibition) for H. perforatum extracts analysed and characterized by HPLC for their biologically active constituents was 248.3-621.3 microg mL(-1) in K562 and 378.2-911.7 microg mL(-1) in U937 cells. The corresponding values of the three main groups were 1.6-3.9 microM naphthodianthrones, 1.0-40.7 microM phloroglucinols and 30.5-68.5 microM flavonoids. The results of this study supported the hypothesis that, apart from hyperforin and flavonoids, other components of the extract could be involved in its growth-inhibitory effect that it exerts without light activation.
Subject(s)
Antineoplastic Agents, Phytogenic/pharmacology , Flavonoids/pharmacology , Hypericum , Phloroglucinol/pharmacology , Antineoplastic Agents, Phytogenic/analysis , Bridged Bicyclo Compounds , Cell Division/drug effects , Cell Division/radiation effects , Chromatography, High Pressure Liquid , Flavonoids/analysis , Humans , Hypericum/chemistry , Inhibitory Concentration 50 , K562 Cells , Light , Phloroglucinol/analysis , Plant Extracts/analysis , Plant Extracts/pharmacology , Terpenes/pharmacology , U937 CellsABSTRACT
OBJECTIVE: The goal of the methodological approach of "quality profiling" for complementary and alternative medicine (CAM) is to offer an empirical database that would enable different participants in the health care system to evaluate the quality of a medical provider. METHODS: Quality profiling is a structured way of describing quality on the levels of infra-structure, patients, medical interventions, outcomes, and quality assurance related to one specific provider. As part of a program called "quality management and research," this type of profiling constitutes one basic step for generating knowledge in terms of evidence-based medicine as well as confidence-based medicine. Quality profiling is exemplified by a hospital for Traditional Chinese Medicine in Germany. Within 1 year all in-patients were included in the database using questionnaires for physicians and patients at the time of admission, discharge from the hospital, and follow-up inquiries at intervals up to 1 year after discharge. The frequency of diagnostic and therapeutic interventions was recorded daily. RESULTS: Data for 1036 patients (mean age 53 years old, 73% female) were analyzed. The most frequent diagnostic categories were musculoskeletal disorders (30%) and neurologic disorders (26%). Therapeutic effects were shown in various outcome measures such as reduced intensity of complaints, improved quality of life, increased satisfaction in lifestyle areas, and fewer days off work. In 6.5% of the subjects, adverse events (mostly of minor severity) were recorded. CONCLUSIONS: Quality profiles can serve as a basic tool for evaluating provider quality when the results are compared with either a predefined standard or with profiles of other providers who are offering similar medical services.