Non-targeted chemical analysis of consumer botanical products labeled as blue cohosh (Caulophyllum thalictroides), goldenseal (Hydrastis canadensis), or yohimbe bark (Pausinystalia yohimbe) by NMR and MS.

Consumers have unprecedented access to botanical dietary supplements through online retailers, making it difficult to ensure product quality and authenticity. Therefore, methods to survey and compare chemical compositions across botanical products are needed. Nuclear magnetic resonance (NMR) spectroscopy and non-targeted mass spectrometry (MS) were used to chemically analyze commercial products labeled as containing one of three botanicals: blue cohosh, goldenseal, and yohimbe bark. Aqueous and organic phase extracts were prepared and analyzed in tandem with NMR followed by MS. We processed the non-targeted data using multivariate statistics to analyze the compositional similarity across extracts. In each case, there were several product outliers that were identified using principal component analysis (PCA). Evaluation of select known constituents proved useful to contextualize PCA subgroups, which in some cases supported or refuted product authenticity. The NMR and MS data reached similar conclusions independently but were also complementary.

Randomised Controlled Trial on Prophylaxis of Mastitis-Metritis-Agalactia Syndrome in Swine using Caulophyllum Logoplex and Lachesis Logoplex.

BACKGROUND: Mastitis-metritis-agalactia (MMA) syndrome occurs in the first days post-partum and causes piglet losses mainly due to malnutrition. One possibility for prophylaxis of MMA is via homeopathy. In this veterinary study, the effectiveness of a prophylactic administration of homeopathic remedies for the prevention of the occurrence of MMA in swine was evaluated. METHODS: In a randomised and blinded study, 60 sows were examined. Sows were randomly distributed in two groups: the experimental group (CL/LL) received a prophylactic administration of the complex homeopathic remedies Caulophyllum Logoplex and Lachesis Logoplex, and the placebo group was administered a sodium chloride (NaCl) solution in the same injection scheme as the experimental group. Clinical signs of MMA, behavioural changes, as well as production parameters, were recorded beginning with the day of farrowing until 5 days post-partum. RESULTS: The treatment group showed no significant effect on the occurrence of MMA in sows (CL/LL: 56.67% MMA positive sows; NaCl: 53.53% MMA positive sows). Treatment group had also no significant effect on health parameters (vaginal discharge, raised rectal temperature, shortage of milk) or behavioural parameters (impaired feeding behaviour and impaired general condition). For the production parameter average weight gain, statistically significant effects in the treatment group were detected. CONCLUSIONS: Prophylaxis with the homeopathic remedies Caulophyllum Logoplex and Lachesis Logoplex showed neither an improvement in MMA prevention nor an improvement in health parameters or behavioural traits in the present herd of sows.

Caulophyine A, a Rare Azapyrene Alkaloid from the Roots of Caulophyllum robustum.

A novel alkaloid caulophyine A (1) was isolated from the roots of Caulophyllum robustum Maxim., along with six known alkaloids 2-7. The structure of 1 was elucidated by extensive NMR and high resolution-time-of-flight (HR-TOF)-MS analyses, it is a rare nitrogen containing polycyclic aromatic hydrocarbon. The in vitro bioassays revealed that 2 presented remarkable cytotoxicity against A549 with an IC50 value of 3.83 µM in comparison with the positive control etoposide (IC50 = 11.63 µM). Compounds 1 and 2 also displayed weak Acetylcholinesterase (AChE) inhibitory activity with IC50 values of 123.03 and 80.74 µM respectively.

Analysis of bioactive components and pharmacokinetics of Caulophyllum robustum in rat plasma after oral administration by UPLC-ESI-MS/MS.

A UPLC-MS/MS method was developed and validated the determination and pharmacokinetic study of magnoflorine, cauloside C, hederagenin, and oleanolic acid from Caulophyllum robustum. Digoxin was used as the internal standard. The pretreated plasma samples were carried out on a Waters ACQUITYUPLC HSS T3 column at 35 °C with a mobile phase of acetonitrile-water (90:10, v/v) at a flow rate of 0.2 mL/min. This article describes the most simple, sensitive, and validated UPLC-MS/MS method to date for the simultaneous successful determination of four compounds in rat plasma after oral administration of the extract of C. robustum and their pharmacokinetic studies.

HPLC-MS/MS method for the determination and pharmacokinetic study of six compounds against rheumatoid arthritis in rat plasma after oral administration of the extract of Caulophyllum robustum Maxim.

Caulophyllum robustum Maxim (CRM) is a well-known traditional Chinese medicine (TCM) mainly present in the northeast, northwest and southwest regions of China, which is belong to the family Berberidaceae. The roots and rhizomes of CRM have been used as a famous TCM for the treatment of rheumatoid arthritis (RA). The selective, sensitive and accurate high-performance liquid chromatography-electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) method for the determination and pharmacokinetic study cauloside H, leonticin D, cauloside G, cauloside D, cauloside C and magnoflorine in rat plasma was developed and validated in this paper. Chromatographic separation was achieved by using a Waters ACQUITY UPLC HSS T3 (100 mm × 2.1 mm, 1.7 µm) with gradient elution using a mobile phase consisting of acetonitrile and 0.1 % formic acid in water at a flow rate of 0.4 mL/min. The detection was performed in multiple reaction monitoring (MRM) mode and electrospray ionization (ESI) in positive and negative modes. The linearity, precision, accuracy, extraction recovery, matrix effects and stability were assessed to validate the current high-performance liquid chromatography/mass spectrometry (HPLC-MS) assay. Good linearity was achieved for each analyte with a correlation coefficient (r2) > 0.99). All the precision (RSD) data were less than 12.20 %, the accuracies ranged from -12.39 % to 10.55 %, the recovery rates from the rat plasma ranged from 85.48%-98.69 %, and the matrix effects ranged from 80.96 % to 91.35 %. The validated approach was successfully applied to study the pharmacokinetic characteristics of saponins and alkaloids in plasma after administering CRME to rats, and this assay provides a platform for studying the active components of multicomponent traditional Chinese medicines and provides useful information for further clinical studies.

Mechanism of Caulophyllum robustum Maxim against rheumatoid arthritis using LncRNA-mRNA chip analysis.

BACKGROUND: Caulophyllum robustum Maxim (CRM) is a medicinal compound of the Northeast and is commonly used in China for the treatment of rheumatic pain and rheumatoid arthritis (RA). A preliminary study found that CRM has good anti-inflammatory, analgesic and immunosuppressive effects. However, the specific links and targets for its function remain unclear. Our study aimed to provide a mechanism for the action of Caulophyllum robustum Maxim extraction (CRME) against RA and to establish a method for studying disease treatment using Chinese medicine. METHODS: The 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium bromide (MTT) method was used to detect the toxicity of CRME in L929 cells, and the concentration ranges of the blank, model, and CRME drug groups were determined. Differentially expressed long non-coding RNAs (lncRNAs) and messenger RNAs (mRNAs) were identified between the three groups. Gene Ontology (GO) and pathway enrichment analyses were performed to analyze the biological functions and pathways of the differentially expressed genes. Expression of Hist1h2bj, Hist1h2ba, Zfp36, Ccl3, Cxcl2 and Egr1 in the blank, model and drug groups was detected by quantitative real-time PCR (qRT-PCR), and the role of CRME on the above factors was determined to ensure consistency with the chip data. RESULTS: A total of 329 significantly upregulated genes and 141 downregulated genes were identified between the blank and model groups. A total of 218 significantly upregulated genes and 191 downregulated genes were identified between the CRME drug group and model group. CRME has a significant role in multiple pathways involved in the occurrence and development of RA. Additionally, Hist1h2bj, Hist1h2ba, Zfp36, Ccl3, Cxcl2, and Egr1 were observed in modules of the lncRNA-mRNA weighted co-expression network, consistent with the chip data. CONCLUSIONS: CRME has regulatory effects on inflammatory factors, the histone family, chemokines and their ligands that are related to RA-related cytokines, the RA pathway, the TNF signaling pathway, the Toll receptor-like signaling pathway, the chemokine signaling pathways and other pathways are related to the course of RA.

Systematic screening and characterization of prototype constituents and metabolites of triterpenoid saponins of Caulopphyllum robustum Maxim using UPLC-LTQ Orbitrap MS after oral administration in rats.

Triterpenoid saponins are the main bioactive components in Caulopphyllum Robustum Maxim (CRM), and they have been reported to have extensive pharmacological properties, such as anti-inflammatory, immunomodulatory, and anti-tumor effects. Cauloside C, Cauloside D, Leonticin D and Cauloside H are the main active chemical constituents of CRM in the treatment of rheumatoid arthritis (RA). However, their metabolic processes and products remain unclear. Therefore, the purpose of this study was to analyze the metabolic components and metabolic pathways of total saponins after oral administration of CRM effective part (CRME) in rats. In this work, we collected plasma, bile, urine and feces of rats at different sampling time points after intragastric administration. The saponins and reference substances were separated from CRME and analyzed via Thermo Scientific™ Ultra Performance Liquid Chromatography-Orbitrap Elite Combined High resolution Mass Spectrometry. According to the structural characteristics of the compounds in CRM, the pyrolysis behavior of various components was inferred in the negative ion mode. Twenty-two components were found in rat plasma, bile, urine and stool; among these components, there were 8 prototypes and 14 metabolites. Seven prototypes and 8 metabolites were found in rat plasma; no prototype and 6 metabolites were found in bile; 5 prototypes and 8 metabolites were found in urine; and 4 prototypes and 9 metabolites were found in stool. The metabolites include deglycosylation products, sapogenin products, sulfides, and glucuronide conjugates. The same metabolites were also found in biological samples, and these products may be important metabolic pathways of triterpene saponins in rats. The current findings clarified the metabolic pathways of the main active ingredients in CRME and further elucidated the anti-RA drug-responsive substance basis of CRM.

Piperidine alkaloids and xanthone from the roots of Caulophyllum robustum Maxim.

Two undescribed piperidine racemates, (±)-caulophines A and B (1 and 2), a new N-containing xanthone derivative (3), together with six known piperidines, were isolated from the roots of Caulophyllum robustum Maxim. Their structures were determined by extensive spectroscopic techniques. Compounds 3 and 7 exhibited weak cytotoxicities against human palace cancer hela cell line with inhibitory rates of 32.2% and 39.7%, respectively, at the concentration of 40 µM.

Tratamento homeopático eugênico na gestação tardia / Eugenic homeopathic treatment in late gestation

O objetivo do presente trabalho é relatar um caso clínico de paciente primigesta sendo a gestação tardia, através de método de fertilização in vitro e com insucesso na primeira tentativa do procedimento devido a aborto após a mesma, buscou o tratamento homeopático para prepará-la para um segundo procedimento e para obter uma gestação eugênica. Optou em buscar a homeopatia médica como auxílio para a adequada formação fetal, e acompanhamento homeopático durante a gestação, fez uso dos medicamentos homeopáticos na gestação desde o primeiro trimestre ao último trimestre e até ao parto, com supervisão multidisciplinar pelo médico homeopata, médico ginecologista especializado em infertilidade no primeiro momento e após pelo ginecologista ­ obstetra para o pré-natal. A paciente apresentava sintomas de tristeza após perda do concepto na primeira fertilização in vitro, indecisão, medo de ser mãe, indiferença afetiva, intolerância á contradições, e extrema aversão e irritabilidade ao consolo do marido, sentindo- se culpada e vazia após o aborto. Metodologia: A paciente foi acompanhada em consultório particular durante 12 meses, foram realizadas três consultas e três retornos em que foi avaliada subjetivamente e clinicamente concomitante o pré-natal obstétrico. Obteve êxito na segunda fertilização in-vitro, foi prescrito Sépia succus (Potências progressivas 30 CH, 200 CH, 1 M/FC, 10 M/FC, 50 M/FC), Calcárea carbônica 12 CH ás segundas- feiras, Calcárea phosphórica 12 CH ás quartas-feiras, Calcárea fluorica 12 CH ás sextas- feiras, Psorinum 200 CH dose única no primeiro trimestre, Medorrhinum 200 CH no segundo trimestre em dose única, Luesinum 200 CH dose única no terceiro trimestre, e quinze dias antes do parto foi medicada com Caulophyllum thalictroides 12 CH e Cimicífuga racemosa 12 CH duas vezes por semana. Resultados: Nos primeiros parâmetros observamos a melhora gradativa do humor, conforme o aumento das potências do medicamento homeopático Sépia succus, até a melhora da aceitação da gravidez com sentimentos de autoconfiança em ser uma boa mãe, mais paciente com o marido, melhora geral do seu quadro de tristeza e indiferença afetiva aos familiares, melhora do sono e ausência dos transtornos por sonhos desagradáveis do inicio, também relatou durante a gestação aversão a doces, sem queixas de travar os dentes que apresentava anteriormente, clinicamente manteve-se hemodinamicamente estável, sem edemas, mantendo ganho de peso proporcional a idade gestacional, níveis pressóricos arteriais adequados, níveis glicêmicos normais, ausência de infecções urinárias na gestação, ganho de peso e crescimento fetal compatíveis, movimentos fetais adequados durante os exames de ultra-som gestacional e sentidos pela paciente que após o tratamento acariciava constantemente a barriga, apresentava comportamento carinhoso observado durante toda a consulta homeopática. Os resultados obtidos mostraram sucesso no tratamento homeopático durante toda a gestação, o que sugere através das matérias médicas e experimentação em homem são, que o medicamento homeopático trouxe sensação subjetiva de bem estar geral, a paciente evoluiu sem depressão pós-parto, foi realizado parto cesárea devido a idade avançada da parturiente e início de aumento dos níveis de pressão arterial ao final da gestação, também a paciente compareceu a consulta em perfeito estado clínico até a véspera do parto. (AU)

Anti-Inflammatory Triterpenoids from the Caulophyllum robustum Maximin LPS-Stimulated RAW264.7 Cells.

Caulophyllum robustum Maxim is widely distributed in China and used as a traditional herbal medicine to induce childbirth, ease the pain of labor, rectify delayed or irregular menstruation, alleviate heavy bleeding and pain during menstruation, and treat external injuries and irregular menses. According to our detailed chemical investigation, three new triterpene derivatives (1⁻3), together with seven known compounds, were isolated from the root and rhizome of C. robustum Maxim. Their structures were elucidated by 1D- and 2D-NMR spectroscopic analysis and physio-chemical methods. They were identified as (1) 23-hydroxy-3,19-dioxo-olean-12-en-28-oic-acid; (2) 23-hydroxy-3,11-dioxo-olean-12-en-28-oic acid; and (3) 16α,23-dihydroxy-3-oxo-olean-12-en-28-oic acid. Compounds (1⁻10) inhibited the LPS-activated NO production in RAW264.7 cells. Furthermore, the anti-inflammatory characteristics of these compounds were confirmed on the basis of decreases in iNOS and NF-κB protein expression in RAW264.7 cells.

Heart Toxicity Related to Herbs and Dietary Supplements: Online Table of Case Reports. Part 4 of 5.

BACKGROUND: The purpose of this review was to create an online research summary table of heart toxicity case reports related to dietary supplements (DS; includes herbs). METHODS: Documented PubMed case reports of DS appearing to contribute to heart-related problems were used to create a "Toxic Table" that summarized the research (1966 to April, 2016, and cross-referencing). Keywords included "herb," "dietary supplement," and cardiac terms. Case reports were excluded if they were herb combinations (some exceptions), Chinese herb mixtures, teas of mixed herb contents, mushrooms, poisonous plants, self-harm (e.g. suicide), excess dose (except vitamins/minerals), drugs or illegal drugs, drug-herbal interactions, and confounders of drugs or diseases. The spectrum of heart toxicities included hypertension, hypotension, hypokalemia, bradycardia, tachycardia, arrhythmia, ventricular fibrillation, heart attack, cardiac arrest, heart failure, and death. RESULTS: Heart related problems were associated with approximately seven herbs: Four traditional Chinese medicine herbs - Don quai (Angelica sinensis), Jin bu huan (Lycopodium serratum), Thundergod vine or lei gong teng (Tripterygium wilfordii Hook F), and Ting kung teng (Erycibe henryi prain); one an Ayruvedic herb - Aswagandha, (Withania somnifera); and two North American herbs - blue cohosh (Caulophyllum thalictroides), and Yohimbe (Pausinystalia johimbe). Aconitum and Ephedra species are no longer sold in the United States. The DS included, but are not limited to five DS - bitter orange, caffeine, certain energy drinks, nitric oxide products, and a calming product. Six additional DS are no longer sold. Licorice was the food related to heart problems. CONCLUSION: The online "Toxic Table" forewarns clinicians, consumers and the DS industry by listing DS with case reports related to heart toxicity. It may also contribute to Phase IV post marketing surveillance to diminish adverse events that Government officials use to regulate DS.

Spectrum-Effect Relationships between Fingerprints of Caulophyllum robustum Maxim and Inhabited Pro-Inflammation Cytokine Effects.

Caulophyllum robustum Maxim (CRM) is a Chinese folk medicine with significant effect on treatment of rheumatoid arthritis (RA). This study was designed to explore the spectrum-effect relationships between high-performance liquid chromatography (HPLC) fingerprints and the anti-inflammatory effects of CRM. Seventeen common peaks were detected by fingerprint similarity evaluation software. Among them, 15 peaks were identified by Liquid Chromatography-Mass Spectrometry (LC-MS). Pharmacodynamics experiments were conducted in collagen-induced arthritis (CIA) mice to obtain the anti-inflammatory effects of different batches of CRM with four pro-inflammation cytokines (TNF-α, IL-ß, IL-6, and IL-17) as indicators. These cytokines were suppressed at different levels according to the different batches of CRM treatment. The spectrum-effect relationships between chemical fingerprints and the pro-inflammation effects of CRM were established by multiple linear regression (MLR) and gray relational analysis (GRA). The spectrum-effect relationships revealed that the alkaloids (N-methylcytisine, magnoflorine), saponins (leiyemudanoside C, leiyemudanoside D, leiyemudanoside G, leiyemudanoside B, cauloside H, leonticin D, cauloside G, cauloside D, cauloside B, cauloside C, and cauloside A), sapogenins (oleanolic acid), ß-sitosterols, and unknown compounds (X3, X17) together showed anti-inflammatory efficacy. The results also showed that the correlation between saponins and inflammatory factors was significantly closer than that of alkaloids, and saponins linked with less sugar may have higher inhibition effect on pro-inflammatory cytokines in CIA mice. This work provided a general model of the combination of HPLC and anti-inflammatory effects to study the spectrum-effect relationships of CRM, which can be used to discover the active substance and to control the quality of this treatment.

Homeopatía durante la gestación: un análisis crítico / Homoeopathy during pregnancy: a critical appraisal

Objetivos: realizar una revisión sobre la eficacia y seguridad de los tratamientos homeopáticos durante la gestación Métodos: revisión de la literatura. Resultados: los productos homeopáticos más utilizados durante la gestación, en el trabajo del parto y durante el puerperio, son: Caulophyllum, Actaea racemosa, Árnica montana y China rubra. Existen pocos estudios comparativos que hayan analizado la eficacia de estos productos frente a placebo o frente a tratamientos médicos tradicionales. Una revisión Cochrane no encontró evidencias para recomendar el uso de homeopatía en el trabajo de parto. Además, los tratamientos homeopáticos no están exentos de posibles efectos secundarios. Conclusiones: no existe evidencia científica de calidad para apoyar el uso de tratamientos homeopáticos durante la gestación y el trabajo de parto (AU)

Objectives: To assess the efficacy and safety of homoeopathy during pregnancy through a literature review. Methods: Literature review. Results: The homoeopathic treatments most commonly used during pregnancy, labour and the postpartum period are Caulophyllum, Actaea racemosa, Árnica montana and China rubra. Few studies have compared homoeopathy with either placebo or traditional treatments. A Cochrane review found no evidence to recommend the use of homoeopathy during labour. Moreover, homoeopathic treatments are not free from possible side effects. Conclusion: There is insufficient good quality evidence to support the use of homoeopathy during pregnancy and labour (AU)

Energy-resolved technique for discovery and identification of malonyl-triterpene saponins in Caulophyllum robustum by UHPLC-electrospray Fourier transform mass spectrometry.

Malonyl-triterpene saponins (MTSs) attract scientific attentions because of their structural diversities and valuable bioactivities. However, its thermal instability brings a huge amount of challenges for isolation and purification of this class of compounds. To our best knowledge, there has been no report on isolation and analysis of MTSs from genus Caulophyllum. In this study, a strategy combining data acquisition using an energy-resolved technique and the narrow widow extracted ion chromatograms as data mining method was developed for discovery and identification of MTSs in Caulophyllum robustum hair roots by ultra high liquid chromatography coupled to electrospray ionization Fourier transform mass spectrometry. The method was performed at an independent MS full scan using our bottom-up energies by in-source collision induced dissociations with 0, 25, 50 and 100 eV in both positive and negative modes. Precursor ion as well as fragment ion information was simultaneously collected from four energy-resolved MS spectra in a single run of 18 min. The fragmentation pathways of intact deprotonated, protonated and sodium ions of MTSs were proposed for the structural elucidation of Caulophyllum MTSs. A flowchart involving a stepwise procedure based on key fragments from ESI- /ESI+ -FT-MS(1, 1) to MS(1, 4) spectra was constructed for the identification of structural elements in the MTSs. As a result, a total of 23 MTSs were discovered and tentatively identified, which had not been reported from Caulophyllum species before. All of these were potentially new compounds. This study provides an excellent example for discovery and identification of MTSs in herb medicines. Copyright © 2016 John Wiley & Sons, Ltd.

Analysis of oligosaccharide sequences of trace Caulophyllum robustum saponins by direct infusion multiple-stage tandem mass spectrometry.

The saponins in Caulophyllum robustum have not yet been fully characterized. Furthermore these saponins are often present in trace amounts and are structurally complex. Here, a simple direct infusion electrospray ion trap multiple-stage tandem mass spectrometry (DI-ESI-IT-MS(n)) method was described for the characterization of trace C. robustum saponins. Eight reference saponins from the C. robustum hairy root were investigated by DI-ESI-IT-MS(n) in positive ion mode. Some fragmentation approaches were proposed through analysis of the [M+Na](+) ions: (1) preferential cleavage of the C-28 ester glycosidic bond to provide complementary [Y0α+Na](+) and [Bα+Na](+) ions for bidesmosidic saponins; (2) diagnostically neutral loss of CO2 from free carboxyl groups at C-28 for monodesmosidic saponins; and (3) the ion intensity ratio between [C2ß+Na](+) and [B2ß+Na](+), which is sensitive to the structural differences between the two isomeric ß-sugar chains (Glc → (2)Ara and Glc → (3)Ara). The DI-ESI-IT-MS(n) method was successfully used for the analysis of trace C. robustum saponins with [M+Na](+) ions at m/z 1745.6, 1729.5, 1583.7, 1567.7, 1421.7 and 1405.7. This article highlights the discovery and identification of complex α- and ß-oligosaccharide moieties in Caulophyllum saponins by glycosidic product ions along with cross ring cleavage product ions. Five oligosaccharide moieties were unambiguously or tentatively identified as Rha → (4)Glc → (6)Glc → (4)Rha → (4)Glc → (6)Glc, Glc → (4)Glc → (6)Glc → (4)Rha → (4)Glc → (6)Glc, Rha → Glc → Glc (Glc) → (2,3)Ara, Glc → Glc (Glc) → (2,3)Ara and Glc (Glc) → (2,3)Ara. Accuracy of the analytical procedure was demonstrated by structural identification of two saponins isolated using 1D and 2D-NMR spectroscopy. The DI-ESI-IT-MS(n) method facilitates rapid discovery and analysis of trace Caulophyllum saponins and is a powerful and practical tool for structural characterization of complex oligosaccharide moieties in triterpene saponins.

Impacto socioeconómico del Caulophyllum en pacientes con inmadurez cervical / Social and economic impact of Caulophyllum in patients with cervical immaturity

Se realizó un estudio descriptivo y transversal de 1 994 mujeres, ingresadas en el Hospital Ginecoobstétrico Docente Tamara Bunke Bider, de Santiago de Cuba, desde enero del 2011 hasta diciembre del 2012, con vistas a valorar el tratamiento con Caulophyllum en la maduración cervical y propiciar el trabajo de parto espontáneo antes de las 42 semanas o la respuesta positiva a la inducción, así como la determinación del impacto socioeconómico de este método. En la casuística disminuyeron las inducciones y cesáreas, a la vez que se incrementaron los partos eutócicos, lo cual garantizó una mejor calidad en la atención a las pacientes, con menos gastos de recursos materiales y capital humano, así como también con reducción de los costos hospitalarios¿AU)

A descriptive and cross sectional study of 1 994 women, admitted in Tamara Bunke Bider Teaching Gynecological and Obstetrical Hospital in Santiago de Cuba was carried out from January, 2011 to December, 2012, with the aim of evaluating the treatment with Caulophyllum in the cervical maturation and to propitiate the spontaneous childbirth before the 42 weeks or the positive response to the induction, as well as the determination of the socioeconomic impact of this method. The inductions and caesarean sections decreased in the case material, at the same time eutocic childbirths were increased, which guaranteed a better quality in the care to these patients, with less expenses of material resources and human capital, as well as with reduction of the hospital costs(AU)

Impacto socioeconómico del Caulophyllum en pacientes con inmadurez cervical / Social and economic impact of Caulophyllum in patients with cervical immaturity

Se realizó un estudio descriptivo y transversal de 1 994 mujeres, ingresadas en el Hospital Ginecoobstétrico Docente "Tamara Bunke Bider", de Santiago de Cuba, desde enero del 2011 hasta diciembre del 2012, con vistas a valorar el tratamiento con Caulophyllum en la maduración cervical y propiciar el trabajo de parto espontáneo antes de las 42 semanas o la respuesta positiva a la inducción, así como la determinación del impacto socioeconómico de este método. En la casuística disminuyeron las inducciones y cesáreas, a la vez que se incrementaron los partos eutócicos, lo cual garantizó una mejor calidad en la atención a las pacientes, con menos gastos de recursos materiales y capital humano, así como también con reducción de los costos hospitalarios.

A descriptive and cross sectional study of 1 994 women, admitted in "Tamara Bunke Bider" Teaching Gynecological and Obstetrical Hospital in Santiago de Cuba was carried out from January, 2011 to December, 2012, with the aim of evaluating the treatment with Caulophyllum in the cervical maturation and to propitiate the spontaneous childbirth before the 42 weeks or the positive response to the induction, as well as the determination of the socioeconomic impact of this method. The inductions and caesarean sections decreased in the case material, at the same time eutocic childbirths were increased, which guaranteed a better quality in the care to these patients, with less expenses of material resources and human capital, as well as with reduction of the hospital costs.

A strategy for characterization of triterpene saponins in Caulophyllum robustum hairy roots by liquid chromatography with electrospray ionization quadrupole time-of-flight mass spectrometry.

Triterpene saponins are important bioactive constituents widely distributed in many plants. Saponins present in Caulophyllum (Berberidaceae) have not been fully characterized. In this study, we studied triterpene saponins from Caulophyllum robustum using liquid chromatography combined with electrospray ionization quadrupole time-of-flight mass spectrometry (LC-qTOF-MS). Rapid identification of Caulophyllum saponins was facilitated using low and high MS cone voltages to induce controlled fragmentation in positive mode. The full scan spectra at low cone voltage of 40V provided considerable structural information relating to aglycone skeletons, sugar types, and linked sequences for Caulophyllum saponins. Seven Caulophyllum aglycones were differentiated and identified by their diagnostic fragment ions combined with accurate mass measurements and characteristic fragmentation pathways. Peak intensity ratio of [aglycone+H-2H2O](+) to [aglycone+H-H2O](+) in full scan spectra acquired with low cone voltage is correlated with structural features of hederagenin and echinocystic acid and is useful for the discrimination of these positional isomers. However, at a high voltage of 200V, the saponin [M+H](+) ion and its fragmentation ions were not present; and the single saponin [M+Na](+) generated [Bα+Na](+) and [Y0α+Na](+) by in-source fragmentation, which provided structural information on the α- and ß-sugar chains in the saponins. This approach enabled simultaneous acquisition of structural information on both aglycones and sugar chains from full scan spectra in one injection. Based on the developed strategy, 51 triterpene saponins of seven different classes were fully characterized or tentatively identified, of which 32 constituents were the first to be reported in genus Caulophyllum and 18 compounds were characterized as potentially new compounds.

Toxins in botanical dietary supplements: blue cohosh components disrupt cellular respiration and mitochondrial membrane potential.

Certain botanical dietary supplements have been associated with idiosyncratic organ-specific toxicity. Similar toxicological events, caused by drug-induced mitochondrial dysfunction, have forced the withdrawal or U.S. FDA "black box" warnings of major pharmaceuticals. To assess the potential mitochondrial liability of botanical dietary supplements, extracts from 352 authenticated plant samples used in traditional Chinese, Ayurvedic, and Western herbal medicine were evaluated for the ability to disrupt cellular respiration. Blue cohosh (Caulophyllum thalictroides) methanol extract exhibited mitochondriotoxic activity. Used by some U.S. midwives to help induce labor, blue cohosh has been associated with perinatal stroke, acute myocardial infarction, congestive heart failure, multiple organ injury, and neonatal shock. The potential link between mitochondrial disruption and idiosyncratic herbal intoxication prompted further examination. The C. thalictroides methanol extract and three saponins, cauloside A (1), saponin PE (2), and cauloside C (3), exhibited concentration- and time-dependent mitochondriotoxic activities. Upon treatment, cell respiration rate rapidly increased and then dramatically decreased within minutes. Mechanistic studies revealed that C. thalictroides constituents impair mitochondrial function by disrupting membrane integrity. These studies provide a potential etiological link between this mitochondria-sensitive form of cytotoxicity and idiosyncratic organ damage.

Primary constituents of blue cohosh: quantification in dietary supplements and potential for toxicity.

Dietary supplements containing dried roots or extracts of the roots and/or rhizomes of blue cohosh (Caulophyllum thalictroides) are widely available. This botanical has a long history of use by Native Americans and its use continues to the present day. The primary constituents of blue cohosh are its alkaloids and saponins. The structures of the alkaloids magnoflorine, baptifoline, anagyrine, and N-methylcytisine have been known for many years. The last 10 years have seen a great increase in isolation and identification of the large number of saponins present in blue cohosh. Important developments in nuclear magnetic resonance techniques have contributed substantially to the increase in elucidation of the structures of the complex saponins. Several authors have described quantitative methods for both the alkaloids and saponins in blue cohosh. Such methods have made it possible to quantify these constituents in dietary supplements containing this botanical ingredient. Concentrations of both alkaloids and saponins vary substantially in dietary supplements of blue cohosh. The nicotinic alkaloid, N-methylcytisine, a potent toxicant, has been found in all dietary supplements of blue cohosh analyzed. The teratogenic alkaloid anagyrine has been found in some but not all dietary supplements.