Exploration of herbal medicine practices, perceptions and knowledge among Spanish community pharmacists: A cross-sectional survey study.

INTRODUCTION: Herbal medicine has seen remarkable growth in consumption over the past few years. Community pharmacists are health care professionals who have an important role in the dispensing and counselling of these products. The aim of this study was to evaluate perceptions, professional practices and knowledge about herbal medicine among community pharmacists in Tenerife (Canary Islands, Spain). METHOD: A descriptive cross-sectional study was conducted in community pharmacies in Tenerife using a questionnaire that included demographic data, perceptions, professional practices and knowledge of herbal medicine. Data from 610 community pharmacists was analyzed using SPSS 26.0 software program. RESULTS: Most of the responders had a positive attitude towards herbal medicine, considering its products useful (80.9%), safe (64.2%) and those sold in pharmacies of high quality and standardized (84.6%). They thought that these products should only be sold in pharmacies (78.0%) and that it was their responsibility to provide information about them (95.5%). However, only 32.1% believed they are well prepared to provide herbal pharmaceutical care services and 36.1% that there are reliable and easily accessible sources of information. Moreover, 60.7% considered lack of training a barrier to recommending herbal medicinal products, being interested in updating their knowledge on it (96.9%). CONCLUSION: This study showed that community pharmacists have a positive perception of herbal medicines, considering them beneficial and safe. However, participants requested reliable sources of information, easy access, and more training to dispense, counsel, and safely label these products. Education and training programs in herbal medicine are needed to enhance their ability to provide herbal pharmaceutical care.

Bioactive Potential: A Pharmacognostic Definition through the Screening of Four Hypericum Species from the Canary Islands.

In this work, we propose a general methodology to assess the bioactive potential (BP) of extracts in the quest of vegetable-based drugs. To exemplify the method, we studied the anticancer potential (AP) of four endemic species of genus Hypericum (Hypericum canariense L, Hypericum glandulosum Aiton, Hypericum grandifolium Choisy and Hypericum reflexum L.f) from the Canary Islands. Microextracts were obtained from the aerial parts of these species and were tested against six human tumor cell lines, A549 (non-small-cell lung), HBL-100 (breast), HeLa (cervix), SW1573 (non-small-cell lung), T-47D (breast) and WiDr (colon). The methanol-water microextracts were evaluated further for cell migration, autophagy and cell death. The most promising bioactive polar microextracts were analyzed by UHPLC-DAD-MS. The extraction yield, the bioactivity evaluation and the chemical profiling by LC-MS suggested that H. grandifolium was the species with the highest AP. Label-free live-cell imaging studies on HeLa cells exposed to the methanol-water microextract of H. grandifolium enabled observing cell death and several apoptotic hallmarks. Overall, this study allows us to select Hypericum grandifolium Choisy as a source of new chemical entities with a potential interest for cancer treatment.

Cimicifuga racemosa (L.) Nutt. en el tratamiento de los síntomas vasomotores de la menopausia: revisión / Cimicifuga racemosa (L.) Nutt. in the treatment of vasomotor symptoms of menopause: a review

Introducción: Diversos estudios han puesto de manifiesto que los preparados a base de los rizomas y raíces de cimicífuga (Cimicifuga racemosa (L.) Nutt.) pueden ser útiles para aliviar los síntomas menopáusicos. El objetivo de este trabajo es realizar una revisión de la eficacia y seguridad de estos preparados en el tratamiento de los síntomas vasomotores de la menopausia. Método: Se realizó una búsqueda de los artículos publicados desde enero de 2005 a marzo de 2021 en el buscador de recursos de la Universidad de La Laguna, “el Punto Q”. Se seleccionaron los ensayos clínicos aleatorizados y controlados, que tuvieran las palabras claves en el resumen, texto o título, tanto en inglés como en español.Resultados:Se identificaron 13 ensayos clínicos que incluían los criterios de selección establecidos. Se encontró que los preparados de cimicífuga (principalmente extractos comerciales estandarizados en su contenido en principios activos) produjeron en la mayoría de los estudios una reducción significativa comparada con el placebo de los síntomas vegetativos (sofocos y sudores nocturnos) y psicológicos de la menopausia, así como una mejoría de la calidad de vida. No se observaron efectos adversos serios a las dosis utilizadas. Conclusiones: Los extractos de cimicífuga pueden ser eficaces y seguros para el tratamiento de los síntomas vegetativos y psicológicos de la menopausia, siendo bien tolerados. No obstante, son necesarios más ensayos clínicos con mayor número de pacientes, más extensos, uso de preparaciones estandarizadas, así como con criterios similares de inclusión y valoración de los síntomas, para obtener datos más concluyentes.(AU)

Introduction: Several studies have shown that preparations based on the rhizomes and roots of black cohosh (Cimicifuga racemosa (L.) Nutt.) can be useful in alleviating the menopausal symptoms. The aim of this study is to perform an update bibliographic review of the efficacy and safety of black cohosh in the treatment of the vasomotor symptoms of menopause. Method: A review of published articles from January 2005 to March 2021 in the resource search engine of the University of La Laguna, el punto Q”. Randomized and controlled clinical trials, which had the key words in the abstract, text or title, in both English and Spanish, were selected.Results:We found 13 trials which met the selection criteria. The studies reviewed showed that the black cohosh preparations (mainly commercial extracts standardized in their content of active ingredients) produced in most of the studies a significant reduction compared to placebo in the vegetative (hot flashes and night sweats) and psychological symptoms of menopause, as well as an improvement in the quality of life. No serious adverse effects were reported at the dose administered. Conclusions: Cimicifuga racemosa extracts can be effective and safe for the treatment of vegetative and psychological symptoms of menopause, being well tolerated. However, more clinical trials with a larger number of patients, more extensive, the use of standardized preparations, as well as similar criteria for inclusion and assessment of symptoms, are necessary to obtain more conclusive data.(AU)

Phenolic acids, antioxidant and antiproliferative activities of Naviglio® extracts from Schizogyne sericea (Asteraceae).

Schizogyne sericea, well-known as 'salado', is a halophytic shrub widespread on coastal rocks of Tenerife (Canary Islands). This plant is used traditionally as analgesic, astringent, anti-inflammatory and vulnerary agent. In the present work, we have analysed the aqueous and ethanolic extracts of S. sericea for the content of phenolic acids by HPLC-DAD. The dynamic solid-liquid Naviglio® extractor was used to extract the flowering aerial parts. Aqueous extracts showed higher levels of phenolics than ethanolic extracts. S. sericea extracts were rich in chlorogenic and isochlorogenic acids. The Naviglio® extracts obtained were assayed for in vitro biological activities, namely antioxidant, antimicrobial and cytotoxicity on tumour cells by DPPH, ABTS, FRAP, agar disc-diffusion and MTT methods, respectively. Results showed that aqueous extracts, being richer in phenolic acids, are endowed with relevant radical scavenging activity (TEAC values in the range 208-960 µmol TE/g) while ethanolic extracts exhibited noteworthy antiproliferative effects on tumour cells.

Bioactive Secondary Metabolites from Schizogyne sericea (Asteraceae) Endemic to Canary Islands.

Schizogyne sericea (Asteraceae) is a halophytic shrub endemic to the Canary Islands and traditionally employed as analgesic, astringent, anti-inflammatory, and vulnerary. A comprehensive phytochemical investigation was conducted on the flowering aerial parts by analyzing both essential oil constituents and polar compounds. The essential oil was dominated by p-cymene, with the noteworthy occurrence of ß-pinene and thymol esters. From the EtOH extract, eight compounds were isolated and structurally elucidated. Essential oil, polar fractions, and isolates (2), (4), and (5) were separately in vitro assayed for antiproliferative activity on human tumor cell lines (A375, MDA-MB 231, and HCT116) by MTT assay, for antioxidant potential by DPPH, ABTS, and FRAP assays, and for antimicrobial activity by the agar disk diffusion method. Results revealed that essential oil and compounds 1 and 2 exert a strong inhibition on tumor cells, and in some cases, higher than that of cisplatin. Fractions containing thymol derivatives (1 and 2) and caffeoylquinic acid derivatives 4 and 5 displayed antioxidant activity comparable to that of Trolox, making S. sericea extract an interesting natural product with potential applications as preservative or in the treatment of diseases in which oxidative stress plays an important role.

Antioxidant activity and cytotoxicity on tumour cells of the essential oil from Cedronella canariensis var. canariensis (L.) Webb & Berthel. (Lamiaceae).

Cedronella canariensis is a lemon-scented species of the family Lamiaceae endemic to the Canary Islands where it is used in the traditional medicine to prepare infusions or inhalations for anti-catarrhal, tonic, diuretic, hypoglycaemiant, hypotensive, anti-inflammatory and decongestant of the respiratory tract. In this work we investigated for the first time the antioxidant activity of the essential oil and its inhibitory effects on tumour cells (A375, MDA-MB-231, HCT 116) proliferation by DPPH, ABTS, FRAP and MTT assays, respectively. The oil, analysed by GC-ionisation flame detector and GC-MS, was characterised by pinocarvone (58.0%) and ß-pinene (10.8%) as the major constituents, being typical of the chemotype 'canariensis'. Noteworthy was the cytotoxic activity of the oil against the tumour cells examined, with IC50 values of 4.3, 7.3 and 11.4 µg/mL on A375, MDA-MB-231 and HCT 116 tumour cells, respectively, as well as the scavenging activity against the ABTS radical (IC50 of 10.5 µg/mL).

Phytochemical analysis and in vitro biological activity of three Hypericum species from the Canary Islands (Hypericum reflexum, Hypericum canariense and Hypericum grandifolium).

In the present work we carried out a phytochemical and biological investigation on three Hypericum species, i.e. Hypericum reflexum, Hypericum canariense and Hypericum grandifolium, from the Canary Islands where they are traditionally used as diuretic, wound healing, vermifuge, sedative and antidepressive agents. The polar extracts of the top flowering aerial parts, prepared by Soxhlet apparatus using a methanol-acetone (1:1) extracting mixture, were analyzed by HPLC-DAD and HPLC-MS for the content of eight biomarkers such as hypericin, hyperforin, chlorogenic acid, rutin, hyperoside, isoquercitrin, quercitrin and quercetin, whereas the hydrodistilled essential oils were analyzed by GC-FID and GC-MS. The three Hypericum species had different results in both polar and volatile constituents, H. reflexum being the only one endowed with a small amount of naphtodianthrones (hypericin and pseudohypericin), and containing high levels of chlorogenic acid, rutin and volatile mono- and sesquiterpenes. After chemical characterization, all products were in vitro biologically assayed for antiproliferative activity on human tumor cell lines by MTT assay, for antioxidant potential by DPPH, ABTS and FRAP assays, and for antimicrobial activity by the agar disc diffusion and microdilution methods. Results revealed interesting bioactivities and differences between polar extracts and essential oils, with the former being endowed with significant antioxidant activity and the latter with comparable inhibition effects on the tumor cells (A375, MDA-MB 231 and HCT 116) to that of cisplatin.

Behavioural effects of thieno and pyrazolo [2,1] benzothiazepine derivatives in mice.

Behavioural studies were conducted in mice with a number of hetero[2,1]benzothiazepine derivatives, analogues of tianeptine. Previously published studies in mice have shown that some of these compounds were effective in the tetrabenazine and Porsolt tests. In the present study, four of the 15 compounds under study potentiated the actions of 5-hydroxytryptophan (5-HTP, 50 mg/kg i.p.), but no significant antagonism of the apomorphine (16 mg/kg s.c.)-induced hypothermia and potentiation of the amphetamine actions was found. Moreover, some of them inhibited the stereotyped behaviour and/or climbing behaviour of low doses of apomorphine and compound 2 was effective in the plus-maze test. These compounds also produced a slight inhibition of exploratory behaviour in the holeboard test. On the other hand, no significant muscle relaxant and anticonvulsant activities were observed at any dose employed. Together, these data suggest that some of the compounds under study combine the antidepressant effects with additional neuroleptic or anxiolytic activities in mice.

Psychopharmacological effects of tianeptine analogous hetero[2,1] benzothiazepine derivatives.

The psychopharmacological effects of a number of thieno and pyrazolo[2,1] benzothiazepine derivatives as well as several synthetic intermediate compounds were investigated in mice. Previously published studies in mice have shown that some of these compounds were effective in the tetrabenazine and Porsolt tests. In the present study, 7 of the 15 compounds under study clearly antagonized the apomorphine (16 mg/kg s.c.)-induced hypothermia, but no significant potentiation of the 5-hydroxytryptophan (5-HTP) and amphetamine actions was found. Five of them inhibited the syndrome induced by 5-HTP (250 mg/kg i.p.). Moreover, some of them were effective in the plus-maze test and antagonized the apomorphine (3 mg/kg s.c.)-induced effects. On the other hand, these compounds produced a moderate inhibition of exploratory behaviour in the hole-board test, but they had no significant muscle relaxant and anticonvulsant activities. The results indicate that some of the compounds under study combine a spectrum of antidepressant, anxiolytic and neuroleptic properties in mice with a lack of muscle relaxant and anticonvulsant activities.

Neuropharmacological study of hetero[2,1]benzothiazepine derivatives analogues of tianeptine.

Neuropharmacological studies were conducted in mice with a number of hetero[2,1]benzothiazepine derivatives, analogues of tianeptine. Seven of the 12 compounds under study potentiated the actions of 5-hydroxytryptophan (5-HTP, 50 mg/kg i.p.) and/or antagonised the hypothermia induced by high doses of apomorphine. Moreover, some of them inhibited the head twitches induced by 5-HTP (250 mg/kg i.p.) and the stereotyped behaviour and/or climbing behaviour of low doses of apomorphine. These compounds also produced a slight inhibition of exploratory behaviour in the holeboard test. On the other hand, no significant muscle relaxant, anticonvulsant and anxiolytic activities were observed at any dose employed. Together, these data suggest that some of the compounds under study exert antidepressant and neuroleptic effects in mice with no muscle relaxant, anxiolytic and anticonvulsant activities.

Evaluation of the central properties of several Hypericum species from the Canary Islands.

The infusions of the aerial parts in blossom of Hypericum canariense, H. glandulosum, H. reflexum and H. grandifolium (Hypericaceae) were evaluated for their pharmacological activity on the central nervous system in mice using various behavioural models including locomotor and muscle relaxant activity, effect on normal body temperature, pentobarbital-induced sleep, oxotremorine and tetrabenazine-induced syndrome, apomorphine-induced hypothermia and 5-hydroxytryptophan-induced head twitches, as well as a forced swimming test. These infusions did not alter significantly the locomotor activity, pentobarbital induced sleeping time and body temperature, with the exception of H. canariense which produced a slight but significant hypothermia. Additionally, no muscle relaxant or anticholinergic activity were observed. These infusions antagonized the ptosis and/or motor depression induced by tetrabenazine as well as shortening the immobility time in the forced swimming test. The observations suggest that the infusions of these Hypericum species possess antidepressant activity in mice, without inducing muscle relaxation, anticholinergic and sedative properties.