A utilização de fitoterápicos no tratamento da obesidade / Phytoterapic medicines for obesity treatment

A obesidade é considerada um dos maiores problemas de saúde pública no mundo. É um fator que predispõe outras enfermidades e está relacionada ao aumento da taxa de morbidade e mortalidade. Para o tratamento da obesidade são empregados vários métodos, dentre eles o uso da fitoterapia. O presente estudo teve como objetivo avaliar as evidências científicas sobre a utilização do Phaseolus vulgaris, Cynara scolymus e Camelia sinensis no tratamento da obesidade. Trata-se de uma revisão narrativa da literatura, desenvolvida por meio de levantamento bibliográfico de artigos científicos que relacionavam os fitoterápicos com a obesidade, e publicados nos últimos 10 anos. Foi possível observar que estes fitoterápicos podem ser alternativas para tratamento da obesidade. O Phaseolus vulgaris parece proporcionar importante redução de peso devido à redução da absorção dos carboidratos. A Cynara scolymus possui frutooligossacarideos e a inulina, que alteram o trânsito intestinal e ocasionam uma rápida eliminação do bolo fecal, e, consequentemente, reduz a absorção dos lipídeos que, em excesso, contribuem para a obesidade. A Camelia sinensis aumenta a termogênese e a oxidação lipídica, o que promove gasto energético e o emagrecimento. O tratamento da obesidade pode abranger diferentes alternativas terapêuticas, ressaltando sempre a importância da utilização de fitoterápicos indicados apenas por profissionais habilitados, a fim de se alcançar resultados desejáveis e evitar efeitos adversos

Obesity is considered one of the biggest public health problems in the world. It is a factor that predisposes other diseases and it is related to the increase of the rate of morbidity and mortality. Several methods are employed to treat obesity, among them the use of herbal medicine. The present study aimed to evaluate the scientific evidence on the use of Phaseolus vulgaris, Cynara scolymus and Camelia sinensis in the treatment of obesity. This is a narrative review of the literature, developed through a bibliographical survey of scientific articles that related phytotherapeutics to obesity, and published in the last 10 years. It was possible to observe that these phytotherapics may be alternatives for the treatment of obesity. Phaseolus vulgaris appears to provide significant weight reduction due to reduced absorption of carbohydrates. Cynara scolymus has fructooligosaccharides and inulin, which alter intestinal transit and cause a rapid elimination of faecal cake, and consequently reduces the absorption of lipids that in excess contribute to obesity. Camelia sinensis increases thermogenesis and lipid oxidation, which promotes energy expenditure and weight loss. The treatment of obesity can cover different therapeutic alternatives, always emphasizing the importance of the use of phytotherapics indicated only by qualified professionals, in order to achieve desirable results and avoid adverse effects

Case Report: Severe Hematological, Muscle and Liver Toxicity Caused by Drugs and Artichoke Infusion Interaction in an Elderly Polymedicated Patient.

BACKGROUND: Case report, in a patient with a history of diabetes and hypertension, treated with metformin, gliclazide, enalapril + hydrochlorothiazide, amlodipine, aspirin and diazepam, recently medicated for a gouty crisis with colchicine and clonixin without improvement. Believing it could help in the treatment of gouty crisis symptoms he took about 1.5 L of artichoke infusion (Cynara cardunculus). He felt better and did agriculture work but developed a distal muscle pain, severe anemia, standard biochemical liver cholestasis, increase of alkaline phosphatase and marked increase of inflammatory parameters (hyperleucocytosis) and enters in the emergency department at the hospital. OBJECTIVE: Evaluation of the cause of complaints and laboratory abnormalities and the involvement of artichoke infusion. RESULTS: The prominence of the inflammatory parameters was ruled out because of exhaustive autoimmune, infectious or para-neoplastic syndrome (blood cultures, serology, diagnostic imaging, bone marrow and bone biopsy, muscle biopsy and nerve, abdominal angiography) were carried out showing normal results. The evaluation pointed out that the concomitant intake of artichoke infusion may have been involved in the framework developed, since the drugs which were being administered to/by the patient have a metabolism mainly mediated by CYP450 3A4 and 2C9 that could be compromised when these isoenzymes are inhibited by phenolic and flavonoid compounds from plants. Colchicine was one of the last drugs took that have as side effects most of the symptoms felt by patient including diarrhea and anemia. CONCLUSION: The spontaneous and complete recovery of the patient and the negativity of research looking for other causes, conduce to a strong possibility of the interaction between artichoke and the drugs in the clinical presentation of this case.

Atividade anti-inflamatória e citotoxicidade dos extratos glicólicos de Cynara cardunculus var. scolymus (L.) Fiori (alcachofra), Myracrodruon urundeuva Allemão (aroeira-do-sertão) e de Camellia sinensis (L.) Kuntze (chá verde) / Anti-inflammatory activity and cytotoxicity of glycolic extracts of Cynara cardunculus var. scolymus (L.) Fiori (artichoke), Myracrodruon urundeuva Allemão (pepper tree) and Camellia sinensis (L.) Kuntze (green tea)

A baixa citotoxicidade e ação anti-inflamatória são características interessantes para enxaguatórios bucais, dentifrícios e medicamentos de uso odontológico. Sendo assim, é necessário avaliar estas propriedades nos extratos glicólicos vegetais que podem ser ingredientes das formulações desses produtos. O presente estudo avaliou as seguintes atividades biológicas para cada um dos extratos glicólicos de Cynara cardunculus var. scolymus (L.) Fiori (alcachofra), Myracrodruon urundeuva Allemão (aroeira-do-sertão) e Camellia sinensis (L.) Kuntze (chá verde) em culturas de macrófagos de camundongo (RAW 264.7) pelo tempo de exposição de 5 min e 24 h: a) atividade citotóxica pelo método do MTT em 11 diluições seriadas, sendo que a concentração inicial dos extratos foi de 200mg/mL. b) atividade anti-inflamatória, após estímulo com lipopolissacarídeo (LPS) de Escherichia coli pelo método ELISA quantificou IL-1, TNF- e IL-10. Os resultados foram analisados estatisticamente por ANOVA e teste de Tukey, com p 5%. A citotoxicidade dos extratos foi dose e tempo dependentes. No tempo de exposição de 5 min, o extrato de alcachofra apresentou citotoxicidade na concentração de 200 mg/mL. No tempo de exposição de 24 h, o chá verde apresentou citotoxicidade nas concentrações 50 mg/mL, aroeirado- sertão estimulou a proliferação de macrófagos na concentração de 0,39 mg/mL a 12,5 mg/mL e a alcachofra apresentou citotoxicidade nas concentrações 12,5 mg/mL. O extrato de chá verde apresentou potencial anti-inflamatório na concentração de 12,5 mg/mL e foi dose dependente, promovendo diminuição da produção de citocinas próinflamatória, como IL-1ß e TNF-. A aroeira-do-sertão apresentou ação imunopotenciadora na concentração de 12,5 mg/mL no tempo de exposição de 24 h. Com relação a alcachofra há necessidade de novos estudos para identificar sua ação imunomoduladora(AU)

The low cytotoxicity and anti-inflammatory action are interesting features for mouthwashes, toothpastes and dental medication. Therefore, it is necessary to evaluate these properties in plant glycolic extracts which can be ingredients of the formulation of these products. This study evaluated the following biological activities for each of the glycolic extracts of Cynara cardunculus var. scolymus (L.) Fiori (artichoke), Myracrodruon urundeuva Allemão (pepper tree) and Camellia sinensis (L.) Kuntze (green tea) in mouse macrophage cultures (RAW 264.7) by the exposure time of 5 min and 24 h. a) cytotoxicity by MTT method in 11 serial dilutions, the initial concentration of the extracts was 200 mg/mL. b) Anti-inflammatory activity after stimulation with lipopolysaccharide (LPS) of Escherichia coli was performed by immunoenzymatic test (ELISA) using specific antibodies to quantify IL-1, TNF- and IL-10. The results were subordinated to statistical analyses (ANOVA and Turkey test), with p 0,05. The cytotoxicity of the extracts was dependent on dose and time. At 5 min exposure time, artichoke extract showed cytotoxicity at a concentration of 200 mg/mL. At 24 h exposure time, green tea showed cytotoxicity at the concentrations 50 mg/mL, pepper tree stimulated the proliferation of macrophages in the concentrations of 0,39mg/mL to 12.5 mg/mL and artichoke showed cytotoxicity at the concentrations 12.5 mg/mL. Green tea extract showed anti- inflammatory potential at a concentration of 12.5 mg/mL and was dependent on dose, promoting a decrease production of pro-inflammatory cytokines as IL-1 and TNF-. Pepper tree presented immunopotentiating action at a concentration of 12.5 mg/mL at 24 h of exposure time. Regarding artichoke, there is a need for further studies to identify their immunomodulatory action(AU)

Avaliação da qualidade microbiológica de cápsulas e chás de plantas utilizadas na assistência ao tratamento da obesidade / Microbiological quality evaluation of herbal capsules and teas to assist the treatment of obesity

O uso de plantas diuréticas e laxativas é uma alternativa medicamentosa para muitas pessoas que objetivam o emagrecimento com menores efeitos adversos. A avaliação microbiológica é um requisito essencial para a garantia de qualidade dos produtos. A finalidade deste trabalho foi avaliar a qualidade microbiológica de cápsulas e chás de alcachofra (Cynara scolymus L.), centella asiática (Hydrocotile asiatica L.), fucus (Fucus vesiculosus L.), e sene (Cassia acutifolia Delile), através da contagem de micro-organismos viáveis totais e pesquisa de patógenos. Na contagem de micro-organismos viáveis, os chás analisados foram aprovados, pois apesar de apresentarem uma carga microbiana elevada, esta se encontrava dentro das especificações, entretanto, 16,66% e 66,66% das cápsulas analisadas foram reprovadas por apresentaram quantidades superiores de bactérias e fungos, respectivamente. Na pesquisa de patógenos, 76% das amostras (88% dos chás e 58% das cápsulas) apresentaram um ou mais de um tipo de micro-organismo. Salmonella sp. esteve presente em 33% das amostras evidenciando a qualidade microbiológica insatisfatória dos produtos encontrados no mercado. Estes resultados demonstram a necessidade da realização do controle de qualidade tanto das matérias-primas vegetais, quanto dos produtos acabados, através do controle e fiscalização rigorosa, com adoção de medidas regulamentadoras e educativas.

The use of laxative and diuretic herbal drugs is an alternative therapy for many people looking for loosing weight with fewer side effects. The microbiological evaluation is an essential requirement for the quality assurance of products. This study aimed to evaluate the microbial quality of artichoke (Cynara scolymus L.), centella (Hydrocotile asiatica L.), fucus (Fucus vesiculosus L.), and Senna (Cassia acutifolia Delile) capsules and teas, by counting the total viable aerobic microorganisms and through tests for specified microorganisms. On the total viable aerobic microorganisms count, the teas analyzed were approved, because although they had a high microbial load, this was in accordance with the specifications, however 16.66% and 66.66% of the capsules analyzed were rejected because they presented higher amounts of bacteria and fungi, respectively. In relation to the tests for specified microorganisms, 76% of the samples (88% of the teas and 58% of the capsules) presented one or more than one type of microorganisms. Salmonella sp. was present in 33% of the samples, showing the unsatisfactory microbial quality of the products in the market. These results demonstrate the necessity of performing quality control both on herbal raw material and finished products, through a rigorous control and inspection, adopting regulatory and educational measures.

Efecto de la Cynara scolymus "alcachofa" sobre la lipemia posprandial y perfil lipídico en adultos jóvenes / Effect of the Cynara scolymus

PROBLEMA: ¿Cuál es el efecto de la ingesta de Cynara scolymus sobre la lipemia posprandial y perfil lipídico en adultos jóvenes? OBJETIVO: Determinar el efecto de la ingesta de receptáculo de C. scolymus sobre la lipemia posprandial y perfil lipídico en adultos jóvenes. MATERIAL Y MÉTODOS: Veinte estudiantes fueron asignados en grupos control y experimental. El grupo experimental ingirió durante 6 semanas el receptáculo de alcachofa. Se determinó el perfil lipídico antes, a las 3 y a las 6 semanas de tratamiento. Al grupo experimental se le determinó la lipemia posprandial basal y el efecto agudo de la C. scolymus sobre la lipemia posprandial. La lipemia posprandial se determinó después de la ingesta de 88 ml. de aceite con determinaciones a la 0, 2, 4 y 6 horas. RESULTADOS: La ingesta de 6 semanas de C. scolymus produjo una disminución de los niveles de LDL (9,47%) en grupo experimental siendo las medias: Basal, 86,58 mg/ dl; 3 semanas, 94,88 mg/ dl; 6 semanas, 78.38 mg/ dl. El colesterol tuvo una reducción del 4,8 % en el grupo experimental. Los triglicéridos incrementaron significativamente siendo los valores: basal, 68,6 mg/ dl; a las 3 semanas, 78,6 mg/ dl; a las 6 semanas, 96,1 mg/ dl. El efecto agudo de la C. scolymus no afectó la lipemia posprandial, los valores de triglicéridos basal fue de 80,5 mg/ dl; a las 2 horas fue de 123,2 mg/ dl; a las 4 horas fue de 138 mg/ dl; y a las 6 horas fue de 105,4 mg/ dl. Post ingesta fue de 81,3 mg/ dl; 126,5mg/dl; 154,9 mg/dl; respectivamente. CONCLUSIONES: La ingesta crónica de C. scolymus disminuye el LDL, colesterol e incrementa los triglicéridos. La ingesta Aguda de C. scolymus no afecta la lipemia posprandial.

PROBLEM: Which is the effect of the ingestion of Cynara scofymuson posprandial lipemia and lipid profile in young adults? OBJECTIVE: To determine the effect of the ingestion of C. scolymus receptacle on postprandial lipemia and lipid profile in young adults. MATERIAL AND METHODS: Twenty voluntary students were assigned in control and experimental groups. The experimental group ingested during 6 weeks the artichoke receptacle. Lipid profile was determined before the test and 3 and the 6 weeks of treatment. Basal postprandial lipemia was determined at the experimental lipemia group and the acute effect of the C.scolymus on postprandial lipemia. Postprandial lipemia was determined after the ingestion of 88 mililiter of oil with determinations at 0,2,4 and 6 hours. RESULTS: At 6 weeks post ingestion of C. scolymus produced a diminution of the levels of LDL (9,47%) in experimental group, being the averages: 86,58 mg/ dl (Basal); 94,88 mg/ dl (3 weeks); 78.38 mg/ dl (6 weeks). There was a reduction in cholesterol levels of 4.8 % in the experimental group. The triglycerides increased significantly being the values: basal 68,6 mg/ dl; to 3 weeks 78,6 mg/dl; to the 6 weeks 96,1 mg/dl. Acute effect of the e scolymus did not affect the postprandial lipemia. The triglycerides basal values were of 80, 5 mg/ dl; at 2 hours was of 123,2 mg/ dl; to the 4 hours it was of 138 mg/ dl; and to the 6 hours it was of 105,4 mg/dl. Post ingestion was of 81,3 mg/dl; 126,5 mg/dl; 154,9 mg/dl; respectively. CONCLUSIONS: Chronic ingestion of C. scolymus diminishes the LDL, cholesterol and increases the triglycerides levels. Acute ingestion of C. scolymus does not affect postprandial lipemia.

Anaphylactic reaction to inulin: first identification of specific IgEs to an inulin protein compound.

BACKGROUND: A woman with a past history of allergy to artichoke presented with two episodes of immediate allergic reactions, one of which was a severe anaphylactic shock after eating two types of health foods containing inulin. RESULTS: Dot blot assay techniques identified specific IgEs to artichoke, to yoghurt F, and to a heated BSA + inulin product. Dot blot inhibition techniques confirmed the anti-inulin specificity of specific IgE. CONCLUSIONS: The absence of a positive reaction to an unheated milk-inulin mixture indicates the probability of protein-inulin binding. There is no cross-reactivity with the carbohydrates of the glycosylated allergens.

Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial.

BACKGROUND: This study aimed to assess the efficacy of artichoke leaf extract (ALE) in the treatment of patients with functional dyspepsia (FD). METHODS: In a double-blind, randomized controlled trial (RCT), 247 patients with functional dyspepsia were recruited and treated with either a commercial ALE preparation (2 x 320 mg plant extract t.d.s.) or a placebo. The primary efficacy variable was the sum score of the patient's weekly rating of the overall change in dyspeptic symptoms (four-point scale). Secondary variables were the scores of each dyspeptic symptom and the quality of life (QOL) as assessed by the Nepean Dyspepsia Index (NDI). RESULTS: Two hundred and forty-seven patients were enrolled, and data from 244 patients (129 active treatment, 115 placebo) were suitable for inclusion in the statistical analysis (intention-to-treat). The overall symptom improvement over the 6 weeks of treatment was significantly greater with ALE than with the placebo (8.3 +/- 4.6, vs. 6.7 +/- 4.8, P < 0.01). Similarly, patients treated with ALE showed significantly greater improvement in the global quality-of-life scores (NDI) compared with the placebo-treated patients (- 41.1 +/- 47.6 vs. - 24.8 +/- 35.6, P < 0.01). CONCLUSION: The ALE preparation tested was significantly better than the placebo in alleviating symptoms and improving the disease-specific quality of life in patients with functional dyspepsia.