Anti-seizure Effects and Mechanisms of Berberine: A Systematic Review.

BACKGROUND: Epilepsy is one of the most common in all age groups and disabling neurologic disorders around the world. OBJECTIVES: This systematic review was to explore whether berberine (BBR) has any anti-seizure or anti-epileptic effects and also reviewed this possible mechanism. METHODS: The EMBASE, Scopus, Cochrane Library, PubMed, and Web of Science databases were searched before Sep 2023. All types of studies that investigated the effects of BBR on epilepsy or chemical-induced seizures were eligible for inclusion. Two authors independently evaluated and reviewed titles/abstracts to identify publications for potential eligibility, and a third team member resolved discrepancies. Data were extracted in an Excel form, and the outcomes were discussed. RESULTS: BBR showed its neuroprotective properties by reducing oxidative stress, neuroinflammation, and anti-apoptosis effects. It also increases brain-derived neurotrophic factor (BDNF) release and reduces transforming growth factor-beta (TGF-ß1) and hypoxia-inducible factor 1α (HIF-1α). BBR by increasing scavenging reactive oxygen species (ROS), nuclear factor erythroid 2-related factor 2 (Nrf2), endogenous antioxidant enzymes, heme oxygenase-1 (HO-1), and inhibition of lipid peroxidation insert its antioxidant activity. Moreover, BBR showed antiinflammatory activity by reducing Interleukin (IL)-1ß, IL-6, and tumor necrosis factor-alpha (TNF-α) levels and through inhibiting cyclooxygenase-2 (COX-2), and including nuclear factor κB (NF-κB). In addition, it modulated c-fos expression and neuronal excitability in the brain. CONCLUSION: BBR indicated promising anti-seizure effects with remarkable antioxidant, antiinflammatory, anti-apoptotic, and neuroprotective activity. Future studies should be based on well-designed clinical trial studies that are integrated with new methods related to increasing bioavailability.

Combined Training Improves the Expression Profile of Inflammation-associated Antimicrobial Peptides, MicroRNAs, and TLR-4 in Patients with Multiple Sclerosis.

Some antimicrobial peptides (AMPs), microRNAs (miRs), and Toll-like receptor 4 (TLR-4) are involved in autoimmune diseases, which may be affected by exercise training. The purpose of this study was to investigate the effect of an eight-week combined exercise training (aerobic and resistance) on the expression of inflammatory factors, including, human beta-defensin-2 (hBD-2), cathelicidin (LL-37), TLR-4, miR-23b, miR-155, and miR-326 in women with relapsing and remitting multiple sclerosis (RRMS), which has not been investigated yet. Twenty-three women (20-40 years) with RRMS were randomized into the combined training (CT) and control (CON) groups. The CT group subjects completed eight weeks of supervised CT using a treadmill and stationary bicycle for aerobic exercise and weight machines for resistance exercise. The expression levels of hBD-2, LL-37, TLR-4, miR-23b, miR-155, and miR-326 were measured by real-time polymerase chain reaction (RT-PCR) at the baseline and end of the study. Although the expression of hBD-2 and miR-23b decreased in both CT and CON groups, the reduction was lower in the CT group than in the CON group (p=0.001). The expression of LL-37 in the CT group remained unchanged, but that of the CON group increased; thus, the between-group difference was significant. Although the TLR-4, miR-155, and miR-326 expression increased in both groups compared to the baseline, the increase in the CT group was lower than the CON group. Our results showed that the combined training might improve inflammatory symptoms by affecting the expression of some AMPs, miRs, and TLR-4 in patients with relapsing and remitting multiple sclerosis.

Aligned Expression of IFI16 and STING Genes in RRMS Patients' Blood.

OBJECTIVE: Multiple sclerosis (MS) is a chronic neurodegenerative disease of the central nervous system. The most common disease phenotype is Relapsing-Remitting MS (RRMS). Beta interferons are the first line of RRMS patients' treatment. Interferon-inducible protein 16 (IFI16) as a DNA sensing molecule and its downstream complex stimulator of interferon genes (STING) play a critical role in the activation of type I interferons. Hence we aimed to evaluate the expression rate of IFI16 and STING in RRMS patients' blood under a different type of IFNß treatment. METHODS: In the present study, 99 individuals participated. The participants were divided into 4 groups: 28 control subjects, 25 new cases of RRMS patients, 25 RRMS patients treated with IFNß-1a (B1a), 21 RRMS patients treated with IFNß-1b (B1b). The EDTA-treated blood samples were taken and transferred at standard conditions to the Cellular and Molecular Research Center of Shahrekord University of Medical Sciences, RNA was extracted and converted into cDNA. To evaluate the expression of IFI16 and STING, the Real-Time PCR method using SYBR Green/ROX qPCR master mix was performed done. The level of genes expression was measured using 2-ΔΔCt method. The obtained data were analyzed using SPSS v22 software. RESULTS: Comparison of the IFI and STING mRNA expression in blood samples in association with gender and age showed no significant differences (p>0.05). Also, the evaluation of IFI16 mRNA level revealed that the IFI16 genes' expressions were remarkably higher in the new case group compared to the control group, however, STING expression did not show any significant difference. The mRNA levels of IFI16 and STING in IFNß-treated groups were significantly lower than the new case group (p<0.001). Also, the genes' expressions in both the IFNß-treated groups were significantly lower compared to the control group (p<0.001). In the assessment of the correlation of IFI16 and STING expressions with age and sex in different research groups, no statistically significant differences were seen (p>0.05). CONCLUSION: Perhaps the IFNß therapy decreases the IFI16 and STING expression in a STINGdependent pathway as a negative feedback mechanism for regulation of the immune system and suppression of pro-inflammatory cytokines production. The important role of DNA sensing molecules and STING-dependent pathway in MS gives a new insight into future treatment based on STING-direct therapies.

Identification of Concepts of Spiritual Care in Iranian Peoples with Multiple Sclerosis: A Qualitative Study.

Living with multiple sclerosis (MS) often needs attention combined with receiving the holistic care. Attention to spiritual care dimension is one of the most important aspects of care for these patients. This study aims at exploring and explaining dimensions of spiritual care for MS patients in care system of Iran. This study is conducted to explore the concept of spiritual care in care system of Iran during 2015-2016. Purposive sampling is done on 25 participants through unstructured interviews and observation of obtained data through conventional content analysis approach. Four themes of participants' experiences in spiritual care include restoration of identity essence and nature; disease as a factor for nearness to God; giving meaning to life; and disease as a facilitator for self-purification. Clear understanding of spiritual care dimensions and promoting knowledge in MS nurses as the caregivers play important roles in achieving the goals of health among patients in different cultures and religions. Given the results of this study, the themes such as the restoration of identity essence and nature, the disease as a factor for nearness to God, giving meaning to life and the disease as a facilitator for self-purification play important roles in explaining the concept of spiritual care in patients with MS. Therefore, the MS nurses and other health professionals need to effectively and successfully integrate the concept of spiritual care with their professional performance by deep understanding of this concept and try to provide holistic care to respond to MS patients' intertwined needs.

Effects of family-centered empowerment intervention on stress, anxiety, and depression among family caregivers of patients with epilepsy.

OBJECTIVES: Family caregivers face numerous challenges in taking care of their family members with epilepsy. The empowerment of this group of people, who can be described as forgotten patients, should always be considered through supportive interventions; therefore, this study investigated the effect of a family-centered intervention program on stress, anxiety, and depression among family caregivers of patients with epilepsy. METHODS: In 2017, a trial was conducted in Iran among subjects selected by the convenience sampling method and randomly assigned to two groups: intervention and control. After five sessions per week over a four-week period, the intervention- and control-group data were collected using the Depression Anxiety Stress Scale (DASS) in three stages: before, immediately after, and two months after the intervention. Data were analyzed with Statistical Package for the Social Sciences (SPSS) software using descriptive and analytical statistics, an independent t-test, and repeated measures Analysis of variance (ANOVA). RESULTS: In this study, the family caregivers included 61.3% women and 38.7% men, with a mean age of 37.5 years. The findings showed no significant differences in the mean scores of stress (p = 0.93), anxiety (p = 0.91), and depression (p = 0.56) before the interventional program between the intervention and control groups, but these differences were statistically significant in the mean score of stress (p = 0.003) in the immediately after the interventional program, whereas the mean scores of depression were not decreased significantly (p = 0.3). Two months after the interventional program the mean scores of stress (p = 0.001) and anxiety (p = 0.001) were significantly decreased in the intervention group, but the mean score of depression was not decreased significantly (p = 0.09). CONCLUSION: The results suggested that a family-centered intervention program reduced the stress, anxiety, and depression of caregivers because of feasibility, simplicity, and utility of intervention. This program was focused on psychological issues of caregivers, and an emphasis on their empowerment helped them in managing their problems in the caregiving situation and achieved greater psychological potency in the caring process.

Effects of Yoga on Physiological Indices, Anxiety and Social Functioning in Multiple Sclerosis Patients: A Randomized Trial.

INTRODUCTION: Multiple sclerosis (MS) as a chronic disease could affect patients' various domains of life. AIM: This study was conducted to study the effect of yoga on the physiological indices, anxiety and social functioning of patients with MS in southwest, Iran. MATERIALS AND METHODS: In this clinical trial study, 60 MS patients were enrolled according to inclusion criteria and randomly assigned to two groups of 30 each. Prior to and after intervention, the patients' vital signs were measured. For case group yoga exercises were performed three sessions a week for 12 weeks while control group performed no exercise. The data were gathered by questionnaire and analysed by descriptive and analytical statistics in SPSS. RESULTS: Prior to intervention, there was no significant difference in fatigue severity and pain between the two groups but the mean fatigue severity and pain in case group decreased compared to the control group after the intervention. Prior to intervention, there was no significant difference in mean physiological indices between the two groups but the mean physiological indices in case group decreased significantly after the intervention (p<0.05). CONCLUSION: Yoga is likely to increase self-efficacy of MS patients through enhancing physical activity, increasing the strength of lower limbs and balance, and decreasing fatigue and pain, and finally to promote social functioning and to relieve stress and anxiety in these patients.

Comparison of regular aerobic and yoga on the quality of life in patients with multiple sclerosis.

BACKGROUND: The pathophysiology of multiple sclerosis (MS) is characterized by fatigue, motor weakness, and spasticity, to name a few. MS symptoms may lead to physical inactivity associated with the development of secondary diseases. This study was to investigate the effect of regular aerobic and yoga on the quality of life of patients with MS. METHODS: The present quasi-experimental study was conducted on 90 patients with chronic MS chosen randomly and divided into two test and one control groups. Data were analyzed using SPSS software (version 11.5) through paired t-test, ANOVA, and Tukey's post hoc. RESULTS: There were no significant differences among the scores of quality of life in the three groups prior to investigation. Although they were significant after intervention. The mean score of yoga group was higher than that of aerobic group, and aerobic group showed a higher mean score compared with the control. CONCLUSION: Yoga and aerobic exercises may improve quality of life in patients with MS. It is highly recommended that the governor along with MS societies and other organizations servicing and supporting patients start to develop sport-regulated programs to help improve quality of life for these patients.