Uso de fitoterápicos no controle das alterações bucais pós-tratamento oncológico: novas alternativas na odontologia / Use of herbal medicines to control oral changes post-oncological treatment: new alternatives in dentistry

O tratamento oncológico pode ocasionar diversas alterações orais durante e após o processo que podem acarretar déficit de mastigação, fonação, deglutição, além de dor e nutrição deficiente. Nesse contexto, ainda existe uma busca na comprovação do uso de fitoterápicos na oncologia com presença de lesões na cavidade oral ocasionadas pela oncoterapia, para tratamento destas. Assim, o trabalho em questão se trata de uma revisão de literatura, com objetivo de relatar, a partir da análise de periódicos, a observação de efeitos favoráveis para o tratamento das lesões orais por consequência da quimioterapia e radioterapia, através do uso dos fitoterápicos: Camomila (Matricaria chamomilla), Romã (Punica granatum) e extrato de Própolis (Apis mellifera L.). Realizou-se busca eletrônica de dados através do Scholar Google e PubMed, utilizando os Descritores em Ciências da Saúde (Medicamentos Fitoterápicos, Neoplasias, Protocolos Antineoplásicos). Os estudos apresentados neste trabalho evidenciam que o uso destes fitoterápicos pode auxiliar no tratamento das lesões decorrentes da quimioterapia e radioterapia, por possuírem diversas ações anti-inflamatórias, antimicrobianos, antitumorais, entre outras. Por fim, os fitoterápicos apresentados podem ser considerados como uma nova alternativa sendo assim uma escolha favorável de tratamento em relação aos medicamentos convencionais (alopatia), tanto pelo fato de serem naturais e não reduzirem mais ainda a imunidade do paciente, como também pelo seu baixo custo.

The cancer treatment can cause several oral changes during and after the process that can lead to deficits in chewing, phonation, swallowing, in addition to pain and poor nutrition. In this context, there is still a search to prove the use of herbal medicines in oncology with lesions in the oral cavity caused by oncotherapy. Thus, the work in question is a literature review, with the objective of reporting, from the analysis of journals, the observation of favorable effects for the treatment of oral lesions as a result of chemotherapy and radiotherapy, through the use of herbal medicines: Chamomile (Matricaria chamomilla), Pomegranate (Punica granatum) and Propolis extract (Apis mellifera L.). Electronic data search was carried out through Scholar Google and PubMed, using the Health Sciences Descriptors (Phytotherapic Drugs, Neoplasms, Antineoplastic Protocols). The studies presented in this work show that the use of these herbal medicines can help in the treatment of injuries resulting from chemotherapy and radiotherapy, as they have several anti-inflammatory, antimicrobial and anti-tumor actions, among others. Finally, the herbal medicines presented can be considered as a new alternative, thus being a favorable treatment choice in relation to conventional medicines (allopathy), both because they are natural and do not further reduce the patient's immunity, but also because of their low cost.

Importance of phytotherapy for oral health care and quality of life in adults: A scoping review.

Medicinal plants and herbal medicines are used as integrative and complementary practices to provide comprehensive care, disease prevention, health promotion, and to improve quality of life (QoL). This scoping review aimed to identify and describe the use of phytotherapy in oral health care by adults and their outcomes, with a focus on perceptions of oral health-related QoL, healthcare access, and costs. A systematic search was conducted in six databases and supplemented in grey literature. According to a PRISMA-ScR protocol and eligibility criteria, publications were assessed for final inclusion, data charting, and narrative synthesis. Out of 4124 records, 542 publications were selected for full-text reading. A total of 32 studies were included: 21 studies assessed QoL, 7 reported access issues, and 11 reported costs issues. Herbal mouthwashes to prevent or treat non-infectious oral conditions were the most frequent treatment. Efficacy of phytotherapy was usually better than placebo or control treatment. Most studies reported QoL improvement, but several instruments were used with heterogeneous results. Limited healthcare access and high costs favoured traditional folk herbal medicine in underserved populations. It can be concluded that phytotherapy for oral health is used by adults worldwide, following modern clinical pharmacology and traditional knowledge concepts. Further studies should incorporate assessment of QoL, access, and costs in addition to clinical efficacy and safety, which are complementary aspects for delivering a comprehensive and efficient health care for all people.

Authenticity study of commercial samples of St. John's wort by paper spray ionization mass spectrometry and chemometric tools.

Hypericum perforatum L. (St. John's wort) is one of the world's most consumed medicinal plants for treating depression and psychiatric disorders. Counterfeiting can occur in the medicinal plant trade, either due to the lack of active ingredients or the addition of substances not mentioned on the labels, often without therapeutic value or even harmful to health. Hence, 43 samples of St. John's wort commercially acquired in different Brazilian regions and other countries were analyzed by paper spray ionization mass spectrometry (PS-MS) and modeled by principal component analysis. Hence, samples (plants, capsules, and tablets) were extracted with ethanol in a solid-liquid extraction. For the first time, PS-MS analysis allowed the detection of counterfeit H. perforatum samples containing active principles typical of other plants, such as Ageratum conyzoides and Senna spectabilis. About 52.3% of the samples were considered adulterated for having at least one of these two species in their composition. Furthermore, out of 35 samples produced in Brazil, only 13 were deemed authentic, having only H. perforatum. Therefore, there is a clear need to improve these drugs' quality control in Brazil.

Antiplasmodial Activity of Hydroalcoholic Extract from Jucá (Libidibia ferrea) Pods.

Malaria is an infectious and parasitic disease caused by protozoa of the genus Plasmodium, which affects millions of people in tropical and subtropical areas. Recently, there have been multiple reports of drug resistance in Plasmodium populations, leading to the search for potential new active compounds against the parasite. Thus, we aimed to evaluate the in vitro antiplasmodial activity and cytotoxicity of the hydroalcoholic extract of Jucá (Libidibia ferrea) in serial concentrations. Jucá was used in the form of a freeze-dried hydroalcoholic extract. For the cytotoxicity assay, the(3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) method with the WI-26VA4 human cell line was used. For the antiplasmodial activity, Plasmodium falciparum synchronized cultures were treated with serial concentrations (0.2 to 50 µg/mL) of the Jucá extract. In terms of the chemical composition of the Jucá extract, gas chromatography coupled to mass spectrometry measurements revealed the main compounds as ellagic acid, valoneic acid dilactone, gallotannin, and gallic acid. The Jucá hydroalcoholic extract did not show cytotoxic activity per MTT, with an IC50 value greater than 100 µg/mL. Regarding the antiplasmodial activity, the Jucá extract presented an IC50 of 11.10 µg/mL with a selective index of nine. Because of its antiplasmodial activity at the tested concentrations and low toxicity, the Jucá extract is presented as a candidate for herbal medicine in the treatment of malaria. To the best of our knowledge, this is the first report of antiplasmodial activity in Jucá.

Toxicity and Anti-Inflammatory Activity of Phenolic-Rich Extract from Nopalea cochenillifera (Cactaceae): A Preclinical Study on the Prevention of Inflammatory Bowel Diseases.

Phenolic compounds have been scientifically recognized as beneficial to intestinal health. The cactus Nopalea cochenillifera, used as anti-inflammatory in traditional medicine, is a rich source of these bioactive compounds. The present study aimed to investigate the phytochemical profile of N. cochenillifera extract and evaluate its acute toxicity and anti-inflammatory effect on 2,4-dinitrobenzenesulfonic acid (DNBS)-induced colitis in rats. The total phenolic content per gram of dry extract was 67.85 mg. Through HPLC-IES-MSn, a total of 25 compounds such as saccharides, organic acids, phenolic acids and flavonoids were characterized. The dose of 2000 mg/kg of extract by an oral route showed no signs of toxicity, mortality or significant changes in biochemical and hematological parameters. Regarding intestinal anti-inflammatory effects, animals were treated with three different doses of extract or sulfasalazine. Macroscopic analysis of the colon indicated that the extract decreased the disease activity index. Levels of IL-1ß and TNF-α decreased, IL-10 increased and MDA and MPO enzyme levels decreased when compared with the control group. In addition, a down-regulation of MAPK1/ERK2 and NF-κB p65 pathway markers in colon tissue was observed. The epithelial integrity was improved according to histopathological and immunohistological analysis. Thus, the extract provided strong preclinical evidence of being effective in maintaining the remission of colitis.

Sensibilidade de bactérias causadoras de mastite bovinaaextratos de plantas nativas do cerrado / Sensitivity of bacteria causing bovine mastitis toextractsofnative plants of the cerrado / Sensibilidad de bacterias causantes de mastitis bovinaaextractos de plantas nativas en cerrado

A mastite bovina é a doença mais onerosa da produção leiteira e é caracterizadapelainflamação da glândula mamária. O tratamento da doença, sem o controle adequado, geramicrorganismos resistentes. Desta forma o uso de fitoterápicos tem se tornado uma fontedepesquisa como possível alternativa, como as plantas nativas do cerrado Dedaleiro (Lafoensiapacari), Jatobá (Hymenaea sp.) e Barbatimão (Stryphnodendron adstringens). No presentetrabalho, bactérias isoladas de vacas com mastite subclínica foram identificadas por testesbioquímicos. Posteriormente foram feitos testes de antibiograma e pesquisa por genesderesistência a antibióticos, por fim foi realizado o teste para avaliação da sensibilidadeaosextratos das plantas do cerrado. Foram identificados Staphylococcus aureus (S.aureus), Enterobacter sp. e Escherichia coli (E. coli). Entre os isolados de S. aureus, foramencontrados resistentes a meticilina (MARS), bem como resistentes à vancomicina (VARS). Foram encontrados isolados produtores de beta-lactamases de espectro extendido(ESBL)para Entreobacter sp. e E. coli. Os extratos, principalmente de Stryphnodendron adstringenseLafoensia pacari, são uma alternativa para a terapêutica antimicrobiana.(AU)

Bovine mastitis is the most costly disease of dairy production and is characterizedbyinflammation of the mammary gland. The treatment of the disease, without adequate control, generates resistant microorganisms. In this way, the use of herbal medicines has becomeasource of research as a possible alternative, such as the native plants of the cerrado Dedaleiro(Lafoensia pacari), Jatobá (Hymenaea sp.) and Barbatimão (Stryphnodendron adstringens). In the present work, bacteria isolated from cows with subclinical mastitis were identifiedthrough biochemical tests. Subsequently, antibiogram tests and research for antibioticresistance genes were carried out, finally the test was carried out to evaluate the sensitivitytoextracts of cerrado plants. Staphylococcus aureus (S.aureus), Enterobacter sp. andEscherichia coli (E. coli). Among the S. aureus isolates, methicillin resistant (MARS) as well as vancomycin resistant (VARS) were found. Extended spectrum beta-lactamases (ESBL)producing isolates were found for Entreobacter sp. and E. coli. The extracts, mainly from Stryphnodendron adstringens and Lafoensia pacari, are an alternative for antimicrobial therapy.(AU)

La mastitis bovina es la enfermedad más costosa de la producción lechera y se caracterizaporla inflamación de la glándula mamaria. El tratamiento de la enfermedad, sin uncontrol adecuado, genera microorganismos resistentes. De esta forma, el uso de fitoterápicos sehaconvertido en fuente de investigación como posible alternativa, como las plantas nativas del cerrado Dedaleiro (Lafoensia pacari), Jatobá (Hymenaea sp.) y Barbatimão (Stryphnodendronadstringens). En el presente trabajo se identificaron mediante pruebas bioquímicas bacteriasaisladas de vacas con mastitis subclínica. Posteriormente se realizaron pruebas deantibiograma e investigación de genes de resistencia a antibióticos, finalmente se realizólaprueba para evaluar la sensibilidad a extractos de plantas de cerrado. Staphylococcus aureus(S. aureus), Enterobacter sp. y Escherichia coli (E. coli). Entre los aislamientos de S. aureus, se encontraron resistentes a la meticilina (MARS) y resistentes a la vancomicina (VARS). Seencontraron aislamientos productores de betalactamasas de espectro extendido (ESBL) paraEntreobacter sp. y E. coli. Los extractos, principalmente de Stryphnodendron adstringensyLafoensia pacari, son una alternativa para la terapia antimicrobiana.(AU)

Therapeutic bath of mint hydrolate in the control of monogenea for four tilapia species / Banho terapêutico de hidrolato de hortelã no controle de parasitas para quatro espécies de tilápia

This work aimed to evaluate a therapeutic bath of mint (Mentha x villosa) hydrolate in the control of monogeneans for four tilapia species (Oreochromis niloticus, Oreochromis aureus, Oreochromis mossambicus, and Oreochromis hornorum) reared in the same environment (pond). After two months, 60 individuals of O. niloticus were divided into six groups of ten fish each. Three of them were submitted to a 1-hour therapeutic bath of mint hydrolate at the concentration of 20 mL·L-1, and the others were used as a control group. This process was repeated for O. aureus, O. mossambicus and O. hornorum. After that, mucus and gills were analyzed to determine parasitological indices (prevalence, mean abundance, and mean intensity) for monogeneans. The efficacy of mint hydrolate bath was set as 73.5, 79, 80.7, and 84.5% for O. hornorum, O. aureus, O. mossambicus and O. niloticus, respectively, against the monogeneans in the mucus. All species in this work demonstrated similar parasitic susceptibility when reared in the same environment. In addition, the use of mint therapeutic bath demonstrated efficacy in the control of monogeneans in mucus for all evaluated species.(AU)

Este trabalho teve como objetivo avaliar um banho terapêutico de hidrolato de hortelã (Mentha x villosa) no controle de monogenéticos para quatro espécies de tilápia (Oreochromis niloticus, Oreochromis aureus, Oreochromis mossambicus e Oreochromis hornorum) criadas no mesmo ambiente (viveiro). Após dois meses, 60 indivíduos de O. niloticus foram divididos em seis grupos de dez peixes cada um. Três deles foram submetidos a um banho terapêutico de uma hora de hidrolato de hortelã na concentração de 20 mL·L-1, e os demais foram utilizados como grupo controle. Esse processo foi repetido para O. aureus, O. mossambicus e O. hornorum. Em seguida, o muco e as brânquias foram analisados para determinar os índices parasitológicos (prevalência, abundância média e intensidade média). A eficácia do banho de hidrolato de hortelã no muco foi medida em 73,5, 79, 80,7 e 84,5% para O. hornorum, O. aureus, O. mossambicus e O. niloticus, respectivamente. Todas as espécies de tilápia avaliadas neste trabalho demonstraram suscetibilidade parasitária semelhante quando criadas no mesmo ambiente, no entanto o uso do banho terapêutico de hortelã demonstrou eficácia no controle de monogenéticos no muco para todas as espécies avaliadas.(AU)

[Factitious hyperthyroidism due to intake of herbal supplements for weight reduction]. / Hipertiroidismo facticio por ingesta de suplementos herbales para reducción de peso.

Factitious thyrotoxicosis is characterized by the intentional or accidental intake of excess thyroid hormones or their derivatives. We describe 6 cases of patients who developed thyrotoxicosis and adverse effects by weight-reducing herbal medicines. Currently there is a lot of publicity about supplements that "help to lose weight", which are over-the-counter and widely distributed in health food stores or online, which is why it is common to have patients who consume them, without many noticing their possible risks. If factitious hyperthyroidism is suspected, we should request thyroglobulin and anti-thyroglobulin tests, as well as a thyroid scan or uptake curve. To make the differential diagnosis between intake of thyroxine (T4) or triiodothyronine (T3) or its derivatives, we must request the measurement of T4 and T3. In case of ingestion of T4, T4 and T3 will be elevated, but in case of ingestion of triodothyronine or its derivatives, T4 will be decreased with elevated T3.

La tirotoxicosis facticia se caracteriza por la ingesta de un exceso de hormonas tiroideas o derivados de las mismas de forma intencional o accidental. Describimos 6 casos clínicos de pacientes que desarrollaron tirotoxicosis y efectos adversos con la ingesta de suplementos de herbales de venta libre para descenso de peso. Actualmente existe mucha publicidad sobre suplementos que "ayudan al descenso de peso", los cuales son de venta libre y distribuidos ampliamente en tiendas de dietéticas o por internet por lo cual es habitual tener pacientes que los consumen, sin que muchos reparen en sus posibles riesgos. En caso de sospechar un hipertiroidismo facticio debemos solicitar tiroglobulina y anticuerpos anti tiroglobulina así como centellograma tiroideo o curva de captación. Para realizar el diagnóstico diferencial entre ingesta de tiroxina (T4) o triiodotironina (T3) o sus derivados debemos solicitar medición de T4 y T3. En caso de ingesta de T4, la T4 y T3 se encontrarán elevadas, pero en caso de ingesta de triodotironina o sus derivados la T4 se encontrará descendida con una T3 elevada.

Hipertiroidismo facticio por ingesta de suplementos herbales para reducción de peso / Factitious hyperthyroidism due to intake of herbal supplements for weight reduction

Resumen La tirotoxicosis facticia se caracteriza por la ingesta de un exceso de hormonas tiroideas o derivados de las mismas de forma intencional o accidental. Describimos 6 casos clínicos de pacientes que desarrollaron tirotoxicosis y efectos adversos con la ingesta de suplementos de herbales de venta libre para descenso de peso. Actualmente existe mucha publicidad sobre suplementos que "ayudan al descenso de peso", los cuales son de venta libre y distribuidos ampliamente en tiendas de dietéticas o por internet por lo cual es habitual tener pacientes que los consumen, sin que muchos reparen en sus posibles riesgos. En caso de sospechar un hipertiroidismo facticio debemos solicitar tiroglobulina y anticuerpos anti tiroglobulina así como centellograma tiroideo o curva de captación. Para realizar el diagnóstico diferencial entre ingesta de tiroxina (T4) o triiodotironina (T3) o sus derivados debemos solicitar medición de T4 y T3. En caso de ingesta de T4, la T4 y T3 se encontrarán elevadas, pero en caso de ingesta de triodotironina o sus derivados la T4 se encontrará descendida con una T3 elevada.

Abstract Factitious thyrotoxicosis is characterized by the intentional or accidental intake of excess thyroid hormones or their derivatives. We describe 6 cases of patients who developed thyrotoxicosis and adverse effects by weight-reducing herbal medicines. Currently there is a lot of publicity about supplements that "help to lose weight", which are over-the-counter and widely distributed in health food stores or online, which is why it is com mon to have patients who consume them, without many noticing their possible risks. If factitious hyperthyroidism is suspected, we should request thyroglobulin and anti-thyroglobulin tests, as well as a thyroid scan or uptake curve. To make the differential diagnosis between intake of thyroxine (T4) or triiodothyronine (T3) or its deriva tives, we must request the measurement of T4 and T3. In case of ingestion of T4, T4 and T3 will be elevated, but in case of ingestion of triodothyronine or its derivatives, T4 will be decreased with elevated T3.

Hydroethanolic Extract of Morus nigra L. Leaves: A Dual PPAR-α/γ Agonist with Anti-Inflammatory Properties in Lipopolysaccharide-Stimulated RAW 264.7

Inhibition of systemic inflammation has been a beneficial strategy in treating several non-communicable diseases, which represent one of the major causes of mortality in the world. The Peroxisome Proliferator-Activated Receptors (PPAR) are interesting pharmacological targets, since they can act both through the metabolic and anti-inflammatory pathways. Morus nigra L. has flavonoids in its chemical composition with recognized anti-oxidant activity and often associated with anti-inflammatory activity. Therefore, this study aimed to evaluate the hydroethanolic extract of M. nigra leaves' ability to activate PPAR and promote anti-inflammatory effects in lipopolysaccharide (LPS)-stimulated murine macrophage cells. The leaf extract was prepared by cold maceration, and the chemical profile was obtained by HPLC-DAD. Activation of PPAR α and γ was evaluated by the luciferase reporter assay. The anti-inflammatory activity was assessed by measuring the reactive oxygen species (ROS), nitric oxide (NO), and Tumor Necrosis Factor-α (TNF-α) in RAW 264.7 cells after stimulation with LPS from Escherichia coli. The HPLC-DAD analysis identified two major compounds: rutin and isoquercitrin. The extract showed agonist activity for the two types of PPAR, α and γ, although its major compounds, rutin and isoquercitrin, did not significantly activate the receptors. In addition, the extract significantly reduced the production of ROS, NO, and TNF-α. Treatment with the specific PPAR-α antagonist, GW 6471, was able to partially block the anti-inflammatory effect caused by the extract.

Alternativas fitoterápicas no controle da obesidade / Phytotherapy alternatives in obesity control / Alternativas herbales en el control de la obesidad

Nos últimos anos, a obesidade vem aumentando consideravelmente entre adultos e crianças e, segundo a OMS, estima-se que em 2025 o número de obesos ultrapasse a 2,3 milhões em todo o mundo. O indivíduo obeso apresenta maiores riscos de desenvolver doenças crônicas não transmissíveis, como diabetes, doenças cardiovasculares, dislipidemias e ainda alguns tipos de cânceres. O tratamento para a obesidade é variado e inclui mudanças no estilo de vida como: hábitos alimentares e prática de atividade física, tratamento medicamentoso, cirurgia bariátrica e fitoterápicos com o potencial de auxiliar no tratamento. O objetivo deste trabalho foi realizar uma revisão bibliográfica a fim de avaliar os benefícios da utilização de medicamentos fitoterápicos como auxiliar no tratamento da obesidade, seus principais ativos, mecanismos de ação e sua utilização popular. Dentre as plantas pesquisadas e que demonstraram potencial para atuar no tratamento da obesidade encontram-se Camelia sinensis, Citrus aurantium, Hibiscus sabdariffa, Coffea arabica, Ephedra sinica, Zingiber oficinale e Senna alexandrina. Os principais mecanismos de ação envolvidos no potencial anti-obesidade das plantas medicinais são a capacidade de controle do apetite e ingestão de energia, estímulo da termogênese, inibição da lipase pancreática e redução da absorção de gordura, diminuição da lipogênese e aumento da lipólise. Desta forma, conclui-se que as plantas selecionadas neste estudo apresentaram efeitos positivos nos parâmetros bioquímicos e físicos, podendo ser incluídas nos protocolos como coadjuvantes nos tratamentos de emagrecimento.

In recent years, obesity has increased considerably among adults and children and according to the WHO, it is estimated that in 2025 the number of obese people will exceed 2.3 million worldwide. The obese individual is at greater risk of developing non-communicable chronic diseases, such as diabetes, cardiovascular disease, dyslipidemia and even some types of cancer. The treatment for obesity is varied, including changes in lifestyle such as eating habits and physical activity, drug treatment, bariatric surgery and phytotherapy with the potential to aid in the treatment. The objective of this work was to carry out a literature review, evaluating the benefits of using herbal medicines as an aid in the treatment of obesity, their main assets, mechanisms of action and their popular use. Among the plants researched and that have shown potential to act in the treatment of obesity are Camelia sinensis, Citrus aurantium, Hibiscus sabdariffa, Coffea arabica, Ephedra sinica, Zingiber officiale and Senna alexandrina. The main mechanisms of action involved in the antiobesity potential of medicinal plants are the ability to control appetite and energy intake, thermogenesis stimulation, pancreatic lipase inhibition and reduction of fat absorption, lipogenesis decrease and lipolysis increase. Thus, it is concluded that the plants selected in this study showed positive effects on biochemical and physical parameters, and can be included in the protocols as adjuvants in weight loss treatments.

En los últimos años, la obesidad ha aumentado considerablemente entre adultos y niños y, según la OMS, se estima que en 2025 el número de obesos superará los 2,3 millones en todo el mundo. Los individuos obesos tienen un mayor riesgo de desarrollar enfermedades crónicas no transmisibles, como la diabetes, las enfermedades cardiovasculares, las dislipidemias e incluso algunos tipos de cáncer. El tratamiento de la obesidad es variado e incluye cambios en el estilo de vida como: hábitos alimenticios y práctica de actividad física, tratamiento farmacológico, cirugía bariátrica y medicamentos a base de hierbas con potencial para ayudar en el tratamiento. El objetivo de este trabajo fue realizar una revisión bibliográfica para evaluar los beneficios del uso de las hierbas medicinales como ayuda en el tratamiento de la obesidad, sus principales activos, mecanismos de acción y su uso popular. Entre las plantas investigadas y que mostraron potencial para actuar en el tratamiento de la obesidad están Camelia sinensis, Citrus aurantium, Hibiscus sabdariffa, Coffea arabica, Ephedra sinica, Zingiber oficinale y Senna alexandrina. Los principales mecanismos de acción implicados en el potencial antiobesidad de las plantas medicinales son la capacidad de controlar el apetito y la ingesta de energía, estimular la termogénesis, inhibir la lipasa pancreática y reducir la absorción de grasas, disminuir la lipogénesis y aumentar la lipólisis. Por lo tanto, se concluye que las plantas seleccionadas en este estudio mostraron efectos positivos sobre los parámetros bioquímicos y físicos, y pueden ser incluidas en los protocolos como coadyuvantes en los tratamientos de pérdida de peso.

Rosmarinic and chlorogenic acid, isolated from ferns, suppress stem cell damage induced by hydrogen peroxide.

OBJECTIVES: Evaluating the effects of rosmarinic (RA) and cryptochlorogenic (CGA) acids isolated from Blechnum binervatum extract on stem cell viability, toxicity and the protective effect on oxidative cell damage. METHODS: MTT and LDH methods were employed, using stem cells from teeth. RA and CGA were evaluated at 100, 250 and 500 µM. The negative effect of hydrogen peroxide (H2O2) (200-2200 µM) and the capacity of RA and CGA (10-100 µM) as protective agents were also evaluated. DAPI followed by fluorescent microscopy was employed to photograph the treated and untreated cells. KEY FINDINGS: At all tested concentrations, RA and CGA demonstrated the ability to maintain cell viability, and with no cytotoxic effects on the treated stem cells. RA also induced an increase of the cell viability and a reduction in cytotoxicity. H2O2 (1400 µM) induced >50% of cytotoxicity, and both compounds were capable of suppressing H2O2 damage, even at the lowest concentration. At 100 µM, in H2O2 presence, total cell viability was observed through microscope imaging. CONCLUSIONS: These findings contribute to the continued research into natural substances with the potential for protecting cells against oxidative injury, with the consideration that RA and CGA are useful in the regeneration of damaged stem cells.

Fitovigilância: avaliação das interações e reações adversas de fitoterápicos no mercado / Phytosurveillance: evaluation of interactions and adverse reactions of herbal medicines on the market

Introdução: O uso de plantas medicinais como insumos farmacêuticos ativos vegetais (IFAV), bem como o uso de fitoterápicos e suas associações com outros medicamentos fitoterápicos e os insumos farmacêuticos ativos (IFA) sintéticos, pode resultar em interações que afetem a eficácia e o uso seguro desses. O principal meio de notificações de reação adversa a medicamento (RAM) é a voluntária, o que dificulta a identificação e o monitoramento dessas RAM e retrata a importância da farmacovigilância em nosso país, realçando a necessidade de fortalecimento da cultura de notificação de eventos adversos a medicamentos (EAM). Objetivo: Analisar a ocorrência de RAM relacionada ao uso simultâneo de cinco fitoterápicos a outros sintéticos, descrevendo as possíveis interações IFAV-IFA sintéticos. Método: Foi realizada pesquisa bibliográfica sobre as interações IFAV-IFA sintéticos e suas notificações de RAM pelos principais sistemas de farmacovigilância do mundo. Resultados: Os principais mecanismos de interação entre IFAV-IFA sintéticos envolvem a metabolização pelas enzimas da família CYP450 ou a ação de transportadores de efluxo como a gp-P. Além disso, grande parte dos EAM fitoterápicos podem não estar sendo notificados, gerando possível subnotificação dessas informações no mundo. Conclusões: Sobre RAM contendo IFAV de Ginkgo biloba, Hypericum perforatum, Matricaria recutita, Allium sativum e Zingiber officinale, foram relatados 7.571 no mundo, classificados por continente, no período de 1971 a agosto de 2021, bem como lista de espécies vegetais da lista do Renisus que apresentam efeitos relatados nas enzimas CYP (1A2, 2C9, 2C19, 2D6 e 3A4), níveis de GSH, UGT e atividade da gp-P.

Introduction: The use of medicinal plants as active plant pharmaceutical ingredients (APPIs) as well as the use of herbal medicines and their associations with other herbal medicines and synthetic active pharmaceutical ingredients (API) can result in interactions that affect the efficacy and safe use of these. The main means of reporting adverse drug reactions (ADR) is voluntary, which makes the identification and monitoring of these ADRs difficult and portrays the importance of pharmacovigilance in our country, highlighting the need to strengthen the culture of reporting adverse drug events (ADE). Objective: To analyze the occurrence of ADR related to the simultaneous use of five herbal medicines with other synthetics, describing possible synthetic APPI-API interactions. Method: A literature search was carried out on synthetic APPI-API interactions and their notifications of ADR by the main pharmacovigilance systems in the world. Results: The main interaction mechanisms between synthetic APPI-API involve the metabolism by enzymes of the CYP450 family or the action of efflux transporters such as P-gp. In addition, a large part of phytotherapeutic AEM may not be being notified, generating possible underreporting of this information in the world. Conclusions: On ADR containing APPI from Ginkgo biloba, Hypericum perforatum, Matricaria recutita, Allium sativum and Zingiber officinale, 7,571 were reported worldwide, classified by continent, in the period 1971 to August 2021, as well as the list of plant species on the list of RENISUS that have reported effects on CYP enzymes (1A2, 2C9, 2C19, 2D6 and 3A4), levels of GSH, UGT and P-gp activity.

Nonpharmacological Interventions for the Management of Testosterone and Sperm Parameters: A Scoping Review.

PURPOSE: Testosterone replacement and associated pharmacologic agents are effective strategies to treat male hypogonadism; however, nutraceutical agents and lifestyle modification approaches have gained medical interest. The purpose of this scoping review is to highlight the evidence (or lack thereof) of nutraceuticals and lifestyle modification approaches in the management of testosterone levels and sperm parameters. METHODS: A scoping review of nonpharmacologic interventions (supplements, herbal medicines, diets, sleep, and exercise) with the potential to improve male health was undertaken to elucidate changes in testosterone levels and sperm parameters in men with hypogonadism or infertility compared with healthy patients. FINDINGS: A multitude of nutraceuticals and functional nutrients are purported to stimulate testosterone production; however, only a select few have had promising results, such as zinc, vitamin D (in case of hypovitaminosis D), l-arginine, mucuna, and ashwagandha, based on well-controlled randomized clinical trials of men with low testosterone levels and related problems. Except for l-arginine, these natural agents, as well as tribulus and ω3 fatty acids, can improve some degree of sperm parameters in infertile men. Before implementing these nutraceutical agents, adequate sleep, exercise, and weight loss in patients with obesity are imperative. The effects of nonpharmacologic interventions on testosterone levels are modest and hence do not directly translate into clinical benefits. Correspondingly, androgen receptor content, but not endogenous androgens, has been regarded as the principal factor in muscle hypertrophy. IMPLICATIONS: A limited number of supplements and herbal medicines can be considered as adjunctive approaches in the management of testosterone levels and sperm parameters, primarily in men with low testosterone levels and infertility, whereas most nonpharmacologic supplements appear to lack evidence. Although proper physical exercise, sleep, and diet are indisputable approaches because of the general benefits to health, the use of nutraceuticals, if considered, must be personalized by physicians and/or registered dietitians.

Conhecimento etnobotânico sobre plantas medicinais utilizadas por moradores de um município ribeirinho no interior do estado do Amazonas, Brasil / Ethnobotanical knowledge of medicinal plants used by residents of a riverside city in the Amazonas state, Brazil

Mesmo com a evolução do conhecimento científico, a utilização de plantas medicinais é uma das práticas mais antigas ainda realizadas pelo homem, especialmente pelos habitantes de comunidades e municípios do interior do Brasil, principalmente em regiões com baixos índices de desenvolvimento humano. O objetivo deste trabalho foi realizar um estudo etnobotânico sobre as plantas medicinais utilizadas pelos moradores de um bairro localizado em um município ribeirinho do interior do estado do Amazonas. Participaram do estudo cem indivíduos, e os dados obtidos pela pesquisa foram compilados por meio de um formulário, contendo 14 questões (objetivas e discursivas). Os resultados demonstraram que 95% dos moradores faziam uso de plantas medicinais. Foram citadas 89 espécies, pertencentes a 48 famílias botânicas, com destaque para a Lamiaceae. As plantas mais citadas foram: Plectranthus barbatus (boldo) ­ 6,1%, Citrus sinensis (laranjeira) ­ 5,8% e Allium sativum (alho) ­ 4,7%. No entanto, quando analisado o índice de concordância (porcentagem de uso principal = CUP), a Citrus sinensis (laranjeira) apresentou um CUP de 80,9%, seguida por Plectranthus barbatus (boldo) e Disphania ambrosioides (mastruz), com 68,1% e 61,5%, respectivamente. Com relação ao modo de preparo, 61,1% citaram infusão, e as principais enfermidades tratadas foram as dores de estômago, com 13,1%. É importante enfatizar a necessidade de mais estudos acerca dos reais benefícios dessas ervas, a fim de que a divulgação de tais informações possa complementar o conhecimento empírico já difundido entre a população local. Dessa forma, será possível ampliar o conhecimento etnobotânico como um todo e, consequentemente, promover saúde e bem-estar.

Despite the evolution of scientific knowledge, the use of medicinal plants is one of the oldest practices still used by men and, especially by the inhabitants of communities and municipalities of the interior of Brazil, mainly in regions with low human development rates. The purpose of this work was to perform an ethnobotanical study on medicinal plants used by residents of a neighborhood located in a riverside city in the interior of the state of Amazonas. A total of 100 individuals participated in the study, with data being obtained through the use of a form containing 14 open and closed-ended questions. The results showed that 95% of the residents used medicinal plants. A total of 89 species, belonging to 48 botanical families were mentioned, with emphasis to Lamiaceae. The plants that were most frequently mentioned were Plectranthus barbatus (locally known as boldo) ­ 6.1%; Citrus sinensis (orange tree) ­ 5.8%; and Allium sativum (garlic) ­ 4.7%. However, when analyzing the agreement index (percentage of main use = CUP), Citrus sinensis (orange tree) presented a CUP of 80.9%, followed by Plectranthus barbatus (boldo) and Disphania ambrosioides (Mexican tea), with 68.1 and 61.5%, respectively. In relation to the method of preparation, 61.1% cited infusion, with the main disorder treated being stomachache, with 13.1%. It is important to emphasize the need for further studies on the actual benefits of these herbs so that the dissemination of the information can complement the already widespread empirical knowledge among the local population. Thus, it will be possible to expand the ethnobotanical knowledge as a whole and, consequently, promote health and well-being.

Effects of terpenes in the treatment of visceral leishmaniasis: A systematic review of preclinical evidence.

Visceral leishmaniasis (VL) is a severe and potentially fatal neglected tropical disease, being considered a public health concern in many countries worldwide. There are still no vaccines against human VL, and the existing chemotherapy is often toxic. Thereby, alternative treatments have been investigated, and byproducts from plant metabolism have been a source of promising pharmacological compounds. Terpenes are secondary metabolites that exhibit a large spectrum of therapeutic activities. Herein, we conducted a systematic review to evaluate the effects of terpenes in the treatment of VL in rodents. After an extensive search using the PubMed/MEDLINE, Scopus, and Web of Science databases, we included 34 articles in this review. Our results revealed that triterpenes were the most used terpenes by the eligible studies. Overall, terpene treatment showed no or negligible toxicity, causing an increase in the Th1-type immune response profile and nitric oxide production. It also reduced the Th2 cytokines levels and parasite load (> 90% to > 99%). Moreover, terpenes induced apoptosis by damaging the plasma membrane and inhibiting DNA topoisomerases in the parasite. The use of terpene carriers increased the terpene bioavailability in the body, preventing their rapid excretion and promoting the drug delivery at the site of Leishmania infection. Terpene derivatives showed better pharmacokinetics than the original terpenes. Altogether, the benefits of VL treatment with terpenes in preclinical studies may open new directions for other preclinical and human trials.

Luminosity, temperature, and substrates on the germination of Solanum capsicoides

Solanum capsicoides, commonly known as red soda apple, is a little-studied species with phytotherapeutic characteristics of interest to the pharmaceutical industry. However, little is known about its agronomic characteristics. Therefore, this study aimed to assess the effect of light, different temperatures, and substrates on the germination of S. capsicoides seeds. The study consisted of two experiments: Experiment I - Germination of S. capsicoides seeds under different wavelengths. The seeds were kept on Petri dishes covered with Germitest™ paper moistened with distilled water and exposed to the monochromatic, red, far-red, and dark wavelengths. The experiment was performed in a completely randomized design with four replications of 25 seeds. Experiment II - Germination of S. capsicoides seeds on different substrates and at different temperatures. The seeds were distributed according to six substrates: paper roll, on paper, between sand, on sand, on soil + sand + manure, and between soil + sand + manure. The seeds were also subjected to the constant temperatures of 20, 25, 30, and 35 °C and the alternate temperatures of 20-30, 20-35, 25-30, and 25-35 °C, characterizing a 6 x 8 factorial arrangement. Germination rate, germination speed index, and mean germination time were evaluated. Red soda apple seeds are classified as positive photoblastic, with the highest germination rate occurring at the temperature of 20-35 °C combined with on paper, paper roll, on sand, and between sand substrates.

Herbal medicines from the industry in the unified health system: challenge faced by medical professionals

Abstract The World Health Organization recognized the use of herbal medicines as a therapeutic resource and its application in the primary attention to heath. The begin of this expansion was in 2006, with the National Policy on Integrative and Complementary practices of the Unified Health System (SUS). This research aimed to evaluate the questionnaires applied to doctors, who may have prescribed industrialized herbal medicines and to identify the difficulties involved with the implementation of this therapy as an integrative and complementary practice. It is a quantitative, observational and transversal study conducted in the municipality of Pinhais/Brazil. The questionnaire applied had as themes the experience of personal use of industrialized herbal medicines, improvement after their use. Forty-four individuals from four different nationalities: Brazilian (88.64%), Cuban (6.82%), Mexican (2.27%) and Argentinian (2.27%), ages between 25 and 69 years, mainly male sex (54.55%) answered the questionnaire. According to the study, the doctors consider herbal medicines an alternative to the conventional treatment and these medical professionals have already prescribed some industrialized herbal medications. Despite the difficulties faced by medical doctors with the prescription of herbs, it is possible to define strategies to assist these professionals, such as the incentive the actions by the governments.

Human Health Risk Assessment of Heavy Metals and Metalloids in Herbal Medicines Used to Treat Anxiety: Monitoring of Safety.

The present study estimated the human health risk assessment and daily intake of heavy metals and metalloids in herbal medicines used to treat anxiety in Brazil. Six different brands of herbal medicines were purchased in the city of Campo Grande/MS, Brazil: Pasalix®, Calman®, Serenus®, Maracugina®, Prakalmar® and Calmasyn®. In total, eight elements including As, Ba, Cd, Co, Cr, Cu, Fe, and Pb were analyzed using optical emission spectrometry with inductively coupled plasma (ICP OES). Only the concentration of As in the herbal medicine Prakalmar® is above the values established by United States Pharmacopoeia Convention (USP) and Brazilian Pharmacopoeia (BF) for permitted concentration of elemental impurities in drugs substances. The concentration of Ba, Cd, Co, Cr and Cu in all herbal medicines are lower than the values set by USP and FB. The concentration of Pb in Calman® is lower than the limits established by BF, but higher than those established by USP. Pasalix, Serenus®, Calmasyn®, Prakalmar® and Marcacugina® have a higher Pb concentration than the values allowed by USP and BF. All herbal medications have concentrations within safe ranges for human consumption, with the exception of Calmasyn®, which has Pb over the value defined by USP for oral permissible daily exposure (PDE) for elemental impurities. The values of estimated daily intake (EDI) of metal (loid)s in adults and children obtained from the consumption of the herbal medicines are below the values stipulated by the minimal risk levels (MRLs). All the hazard index (HI) values recorded in this study were below 1. However, monitoring by regulatory agency is necessary, large doses of heavy metal may cause acute or chronic toxicities.