Ethnomedicinal Evaluation of Medicinal Plants Used against Gastrointestinal Complaints.

Aim of the present study was to document ethnomedicinal plants used against gastrointestinal complaints in five selected remote regions of Pakistan and to select potential medicinal plants for further in vitro and in vivo investigation. Data on ethnomedicinal plants and ethnographic profile of respondents was documented using semistructured questionnaires. The present study revealed utilization of 52 medicinal plants for the treatment of different gastrointestinal infections in studied regions. Apiaceae was the most dominant family reported to be used for the treatment of these infections (4 plants). Among all the plant parts fruit (24%), whole plants and leaves (23% each) were the most preferred plant parts used by the healers. Dosage of recipe was found to be related with the age of the patient. Highest degree of informant consensus was reported for vomiting, nausea (0.92 each), abdominal pain (0.9), and diarrhea (0.89). Withania coagulans scored highest FL value (86%) followed by Mentha longifolia and Melia azadirachta ranked second with FL value (75% each). Young generation was found to possess little traditional knowledge about utilizing plant recipes against these infections. Plants with high Fic and FL values should be subjected for further phytochemical and pharmacological investigation for scientific validation.

Traditional uses, phytochemistry and pharmacological properties of the genus Peucedanum: a review.

ETHNOPHARMACOLOGICAL RELEVANCE: The genus Peucedanum (Apiaceae) comprising more than 120 species is widely distributed in Europe, Asia and Africa. The ethnopharmacologial history of this genus indicated that some extracts of aerial and underground parts of several Peucedanum species have been used in folk medicine for treatment of various conditions, such as cough, cramps, pain, rheumatism, asthma and angina. This review focuses on ethnopharmacological uses of Peucedanum species, as well as the phytochemical, pharmacological and toxicological studies on this genus. Through this review, I intend to highlight the known and potential effects of the Peucedanum species or their isolated compounds and show which traditional medicine uses have been supported by pharmacological investigations. METHODS: Information on the Peucedanum species was collected from scientific journals, books, thesis and reports via a library and electronic search (using Google Scholar, Pubmed, Scopus, Web of Science and ScienceDirect). This review covers the available literature from 1970 to the end of September 2013. RESULTS: Although, there are about 120 species in this genus, so far many species have received no or little attention and most of pharmacological studies were performed on just about 20 species. Many phytochemical investigations on this genus confirmed that Peucedanum species are rich in essential oils and coumarins. The present review article shows that Peucedanum species have a wide spectrum of pharmacological activities and the most reported activities of Peucedanum plants come back to the presence of coumarins, flavonoids, phenolics and essential oils. CONCLUSIONS: The present review confirms that some Peucedanum species have emerged as a good source of the traditional medicine for treatment of inflammation, microbial infections, cardiopulmonary diseases and provides new insights for further investigations on isolated compounds, especially on praeruptorins, to find novel therapeutics and aid drug discovery. However, for using Peucedanum species to prevent and treat various diseases, additional pharmacological studies to find the mechanism of action, safety and efficacy of them before starting clinical trials are required.

Intoxicación con anís de estrella en niños menores de 12 meses, en el Hospital Nacional de Niños Doctor Carlos Sáenz Herrera durante el periodo 2001-2005 / Star anise intoxication in children less than 12 months old, at the National Children´s Hospital Doctor Carlos Sáenz Herrera during the period 2001-2005

Objetivo: Siendo el uso de anís de estrella nocivo en muchos casos es importante obtener los datos correspondientes a nuestro país para convertirlo en un tema de interés público y lograr, en base a evidencia clara, la intervención del Ministerio de Salud y poder evitar la venta libre de este producto que se utiliza popularmente sin ninguna restricción. La idea principal de obtener estos datos locales es divulgar la información a padres de familia y comunidad médica en relación al uso del anís de estrella y sus efectos secundarios enfatizando el adecuado manejo del cólico del lactante, así como de las madres durante la lactancia. Métodos: Es un estudio retrospectivo y descriptivo, en el cual se revisará la presentación clínica y la epidemiología de la toxicidad por anís de estrella en niños menores de 12 meses, que fueron hospitalizados en el Hospital Nacional de Niños Dr. Carlos Sáenz Herrera, durante el período comprendido del 1 de Enero 2001 al 31 de diciembre 2005. Los pacientes se reclutaron utilizando la base de Documentos Médicos y Estadística del HNN y los registros del Centro Nacional de Intoxicaciones en el periodo descrito. Resultados: Durante el periodo de estudio se reportaron como ingresos 68 casos de intoxicación por anís de estrella, de los cuales solo 47 fueron incluidos. El 53.2 por ciento eran mujeres. La edad promedio fue de 34.4 días, rango 3-111 días, de ellos el 91.5 por ciento eran recién nacidos de termino. Los síntomas gastrointestinales se presentaban previo a la intoxicación fueron distensión abdominal en un 61.7 por ciento y vómitos en un 14.8 por ciento. Un 91.5 por ciento se intoxicaron por la ingestión del te y un 4.25 por ciento por lactancia materna. La causa más frecuente por la que se utilizó el te fue por cólicos, 57.4 por ciento, con una exposición a una dosis leve en el 53 por ciento de los niños, menos de 5 estrellas. La estancia hospitalaria promedio fue de 2 días. Entre los síntomas y signos más comunes presentes en los casos estudiados se encuentran los de índole neurológica, como: la irritabilidad en un 97.8 por ciento, seguida por espasticidad en 70 por ciento, desviación de mirada 57.4 por ciento, hiperreflexia 49 por ciento, pobre succión 44.7 por ciento, movimientos oculogiros 36 por ciento y convulsiones 32 por ciento entre otros. De la sintomatología gastrointestinal, la distensión abdominal se presento en un 40.4 por ciento y los vómitos en el 55.3 por ciento. Conclusiones: La mayoría de los casos ocurren el lactantes de termino menores de 2 meses, en los cuales el te fue administrado por síntomas gastrointestinales, presentando manifestaciones neurológicas a pesar de una exposición leve al tóxico. Se debe instar al Ministerio de Salud a una adecuada comercialización de dicho producto, y a los médicos sobre una adecuada educación e información a la población general sobre los posibles efectos adversos y consecuencias de una intoxicación con anís de estrella.

Curry spice allergy associated with pollen-food allergy syndrome and latex fruit-syndrome.

We report a 22-year-old woman with urticaria, dyspnea and bronchial asthma-like attacks after eating curried rice. We found the symptoms to be due to an immediate-type allergy caused by spice antigens contained in curry spices by detailed questioning, skin test and measurement of specific immunoglobulin (Ig)E antibodies. This case was complicated with pollen-food allergy syndrome (PFAS) from melon and latex allergy (LA) to natural rubber latex (NRL) antigen and she had also had atopic dermatitis, allergic rhinitis and pollinosis. Serum specific IgE antibodies to birch profilin (Bet v 2), latex profilin (Hev b 8), and timothy profilin (Phl p 12) were detected. She also showed positive reactions to several Apiaceae families, fruits and latex antigens in skin prick test. Based on these findings, we considered her symptoms to be involved with spice allergy, PFAS and latex-fruit syndrome.

Intoxicación por anís de estrella / Star anise poisoning

El anís de estrella es un producto peligroso para los niños, as. Al Centro Nacional de Intoxicaciones se reportaron en el 2005, 14 casos de intoxicación por anis de estrella. El anís estrellado, illicium verum Hook, es un producto de uso en las casas para controlar los cólicos infantiles. Si se mezcla con el anís de estrella japonés, illicium anisatum Siebold, aumenta su toxicidad. Las neurotoxinas con actividad farmacológica son responsables de los síntomas neurológicos, principalmente de las convulsiones. Para el tratamiento no se conoce antídoto y se utiliza tratamiento sintomático sobretodo para el manejo de las convulsiones, los síntomas neurotóxicos suelen remitir a las 24 a 48 horas post ingesta

Phytophotodermatitis in Rijeka region, Croatia.

Contact with plants can cause phototoxic or rarely photoallergic reactions. Phototoxic dermatitis (photophytodermatitis) occurs after contact or ingestion of plants containing furocumarins i.e. psoralens and followed by sun exposure. Skin lesions develop usually after 24-48 hours with erythema, bulla formation, itch or pain, followed by a long lasting hyperpigmentation. Furocumarins can be linear i.e. psoralens (5-MOP, 8-MOP), or angular like angelicin and pimpinellin. Their binding to DNA causes cellular damage. This can happen in florists, gardeners, farmers, horticulturists, food handlers, and botanists. The plants causing phototoxic reaction can vary with the local flora but are commonly a member of the family apiaceae (formerly umbelliferae), family rutaceae, leguminosae and moraceae. The authors give special consideration to the phytophotodermatitis that appeared in their region in spring and summer during a three year period.

[Two cases of apiaceae spice allergy].

BACKGROUND: Many cases of spice allergy have been reported especially from Scandinavian countries, but in contrast there are few reports in Japan. This time we experienced two cases of apiaceae spice allergy and practiced some kinds of examinations. We report here these two cases with the consideration concerning mechanism of spice allergy. METHODS AND SUBJECTS: We practiced 1) specific IgE of pollens and foods, 2) prick tests of spices and apiaceae vesitables, 3) immunoblot of spices, against two cases suspected spice allergy from their clinical courses. Clinically Case 1 32 y.o. male had been no history of pollinosis, in contrast Case 2 46 y.o. female had been suffered from pollinosis during spring and autumn seasons. RESULTS: In Case 1 the scores of specific IgE of pollens were almost negative and immunoblot examination of spices revealed positive reaction at the site of 10 approximately 12 kDa and 60 kDa. In Case 2 the scores of specific IgE of pollens were positive in many species and immunoblot examination of spices reacted positively at the site of 14 kDa and 60 kDa. Both of them showed positive reactions against many kinds of apiaceae spices in prick tests, so we diagnosed them as apiaceae spice allergy. CONCLUSION: According to these results we suspected Case 1 as class 1 allergy induced by the sensitization of spices themselves and Case 2 as class 2 allergy caused by the cross reactions with pollinosis. So there may be some different mechanisms in the occurrence of spice allergy. In the future the occurrence of spice allergy will be supposed to increase and it will be necessary for us to pay much more attention to spice allergy even in Japan.

Phytophotodermatitis in grounds operatives.

Occupational dermatoses account for a significant proportion of work-related morbidity. Phytophotodermatitis is an unusual work-related dermatosis, but should be considered in the differential diagnosis of such conditions. An outbreak of 'strimmer rash' is described in three grounds operatives. The identification, aetiology and management of the condition are discussed.

Immunological cross-reactivity between lipid transfer proteins from botanically unrelated plant-derived foods: a clinical study.

BACKGROUND: Lipid transfer proteins (LTP) are highly conserved and widely distributed throughout the plant kingdom. Recent studies demonstrated immunological cross-reactivity between LTP from many botanically unrelated fruits and vegetables and concluded that LTP are pan-allergens. This study aimed to evaluate the clinical relevance of such cross-reactivity in a group of subjects monosensitized to LTP. METHODS: Twenty LTP-hypersensitive patients were selected from a population of about 600 subjects with history of Rosaceae allergy by means of: 1) negative skin prick test (SPT) with a commercial birch pollen extract; 2) positive SPT with a commercial plum extract, rich in LTP but virtually lacking both Bet v 1-like proteins and profilin; 3) in-vitro IgE reactivity to the 9-10 kDa fraction of peach peel or immunoblot with peach peel showing a single band at 10 kDa; and 4) total inhibition of reactivity to whole peach extract (containing Bet v 1-related allergen, profilin, and LTP) by purified peach LTP on enzyme-linked immunoassay (ELISA). Allergy to foods other than Rosaceae was ascertained by careful interview and analysis of medical recordings. SPT with a large series of plant-derived foods were carried out as well. The cross reactivity between LTPs from botanically unrelated plant-derived foods was assessed by ELISA inhibition tests using walnut and peanut extracts as substrate, and peach LTP as inhibitor. RESULTS: All patients reported allergic reactions after the ingestion of at least one from a large number of vegetable foods other than Rosaceae, and in several cases clinical reactions were very severe (anaphylaxis, asthma, urticaria/angioedema). Nuts and peanuts were the most frequently reported causes of allergic reactions (80% and 40% of patients, respectively). All patients showed positive SPT to several non-Rosaceae food extracts. SPT with nuts, peanut, legumes, celery, rice, and corn were positive in the majority of patients. In ELISA inhibition studies, absorption of sera with peach LTP caused complete inhibition of IgE reactivity to walnut and peanut in all cases. CONCLUSION: LTP is a clinically relevant pan-allergen. Most Rosaceae-allergic, LTP-hypersensitive patients experience adverse reactions after ingestion of botanically unrelated plant-derived foods as well. In view of the high prevalence and severity of the allergic reactions induced, hazelnut, walnut, and peanut should be regarded as potentially hazardous for these patients.

Anís estrellado, ¿es realmente inocuo? / Star anise: is it really innocuous?

El anís estrellado se utiliza en lactantes y niños pequeños por sus propiedades eupépticas. Su administración en altas dosis puede llegar a desencadenar cuadros de toxicidad neurológica. Presentamos un caso de posible intoxicación por anís estrellado, en el que predominaba la sintomatología neurológica. Se realizó una detallada anamnesis, exploración fisica y pruebas complementarias, y sólo se encontró el antecedente de ingestión de anís estrellado en dosis superiores a las recomendadas (AU)

Celery allergy confirmed by double-blind, placebo-controlled food challenge: a clinical study in 32 subjects with a history of adverse reactions to celery root.

BACKGROUND: Celery root is a frequent cause of food allergy in pollen-sensitized patients. Because of problems in blinding challenges with fresh vegetables and the risk of anaphylactic reactions, no double-blind, placebo-controlled, food challenges (DBPCFCs) with celery have been published so far. OBJECTIVE: The aim of the study was to confirm the clinical relevance of celery as a food allergen by DBPCFCs and to evaluate current diagnostic procedures in patients with true allergy. METHODS: DBPCFCs were performed in 32 patients with a history of an allergic reaction to celery. The patients underwent skin prick tests (SPTs) with celery extracts, crude celery, and different pollen extracts. Specific IgE for celery was determined by using the CAP method. RESULTS: Twenty-two of 32 patients had a positive DBPCFC result. Two patients reacted to placebo, and 8 patients did not respond to the challenge. Of the nonresponders, 4 reacted to an open provocation with celery. The sensitivity of CAP determination for specific IgE (> or =0.7 kU/L) to celery in patients with a positive DBPCFC result was 73%, 48% to 86% for SPTs (> or =3 mm) with commercial extracts, and 96% for prick-to-prick tests with crude celery. The positive predictive value of the SPT and CAP tests was between 87% and 96%, whereas the specificity and negative predictive values were poor. CONCLUSION: This study confirms the importance of celery as a food allergen for use in DBPCFCs. The SPT and CAP methods proved to be reliable for the diagnosis of a relevant allergy to celery in regard to sensitivity and positive predictive value but not to specificity and negative predictive value.

Celery allergens in patients with positive double-blind placebo-controlled food challenge.

BACKGROUND: Recently, for the first time, allergy to celery was confirmed by double-blind placebo-controlled food challenge (DBPCFC). Api g 1, Api g 4, cross-reactive carbohydrate determinants (CCD), and a 60 kDa allergen have been described as celery allergens. OBJECTIVE: To get insights in IgE responses of patients with a positive DBPCFC to celery tuber (celeriac) compared with patients with a negative challenge test. METHODS: Specific IgE to native and heated celery tuber and to recombinant Api g 1, the major celery allergen, were determined by enzyme allergosorbent test and immunoblotting. IgE binding to Api g 1, Api g 4, and CCD was confirmed by inhibition experiments that used recombinant Api g 1, recombinant Api g 4, pure N-glycans, and extracts of celeriac, lychee fruit, and pollens of birch, mugwort, and timothy grass as inhibitors. RESULTS: Immunoblotting with sera from 22 patients with a positive DBPCFC to celeriac confirmed the presence of known allergenic structures: The major allergen Api g 1 (16 kDa) was recognized by IgE from 13 of 22 patients (59%). Another major allergen was CCD, determined by IgE reactivity in 12 of 22 patients (55%). Celery profilin, Api g 4, was recognized by IgE from 5 of 22 patients (23%). CONCLUSION: Our DBPCFC-positive patients exclusively presented IgE to known celery allergens, although the prevalences were slightly different than were previously reported. No obvious differences were found in patients with positive IgE antibody but negative challenge test. IgE binding to all 3 structures in celeriac extract was inhibited by birch pollen extract, whereas mugwort pollen extract could only inhibit IgE reactivity to Api g 4 and CCD. Inhibition experiments with a purified carbohydrate moiety clearly showed that the IgE epitope mannose-xylose-fucose-glycan (Manalpha1-6[Xylbeta1-2]Manbeta1-4GlcNAcbeta1-4[ Fucalpha1-3]GlcNAc) or a closely related structure is present in celeriac extract and is important in patients with clinical allergy to celery.

Cloning of the minor allergen Api g 4 profilin from celery (Apium graveolens) and its cross-reactivity with birch pollen profilin Bet v 2.

BACKGROUND: Profilin is a panallergen that is recognized by IgE from about 20% of birch pollen- and plant food-allergic patients. A subgroup of celery-allergic patients shows IgE-reactivity with this minor allergen. To investigate the IgE-binding potential and cross-reactivity of celery profilin at the molecular level, this study was aimed at the cloning and immunological characterization of this allergen. OBJECTIVES: Cloning, expression and purification of profilin from celery tuber to characterize its immunological properties and its cross-reactivity with birch pollen profilin. METHODS: Cloning of celery profilin was performed by polymerase chain reaction using degenerated primers and a 5'RACE method for the identification of the unknown 5'-end of the cDNA. Expression was carried out in Escherichia coli BL21 (DE3) using a modified vector pET-30a. The recombinant profilin was purified by affinity chromatography on poly L-proline coupled to sepharose. Immunological characterization was performed by immunoblotting, EAST and IgE-inhibition experiments. RESULTS: The coding region of the cDNA of celery profilin was identified as a 399-bp open reading frame, coding for a protein of 133 amino acids with a calculated molecular weight of 14.3 kDa. The deduced amino acid sequence of the corresponding protein showed high identity with other plant profilins (71-82%) recently described as allergens. Celery profilin was isolated as highly pure nonfusion protein. The IgE-reactivity of celery profilin was similar to that of natural protein. Seven of 17 celery-allergic patients tested presented specific IgE-antibodies to the recombinant protein tested by immunoblotting. Inhibition experiments showed high cross-reactivity of IgE with both profilins from celery and birch pollen. Moreover, the biological activity of recombinant celery profilin was demonstrated by a histamine release assay. CONCLUSIONS: Celery profilin is an important allergenic compound in celery and shows high homology to birch pollen profilin, Bet v 2. According to the revised IUIS allergen nomenclature, we suggest naming the celery profilin Api g 4. In addition to the cross-reacting major allergens Api g 1 and Bet v 1, birch pollinosis and associated allergies to celery can therefore additionally be explained by the cross-reactivity between homologous profilins. Moreover, recombinant Api g 4 may be used for target-specific diagnosis and structural analyses.

Anaphylaxis to dill.

BACKGROUND: Allergic symptoms caused by spices and herbs are infrequent and usually mild, although occasionally, severe allergic reactions do occur. Symptoms of pruritus, rhinitis, cough, and edema have been reported to spices including curry, paprika, pepper, and mustard. To our knowledge, this is the first case of confirmed dill allergy, and the patient had severe allergic symptoms. OBJECTIVE: It is important to alert physicians to the possibility of allergic reactions caused by dill. METHODS AND RESULTS: The patient, who has a history of allergic rhinitis, developed symptoms of oral pruritus, tongue and throat swelling, urticaria, and immediate vomiting and diarrhea following ingestion of foods cooked with dill and subsequently with inhalation of foods prepared with dill. Skin testing with fresh dill preparation was positive. CONCLUSION: These findings confirm that dill can cause IgE-mediated reactions.