| 1. |
Pharmacological modes of plant-derived compounds for targeting inflammation in rheumatoid arthritis: A comprehensive review on immunomodulatory perspective.
Nazakat L, Ali S, Summer M, Nazakat F, Noor S, Riaz A
BACKGROUND: Rheumatoid arthritis (RA) is one of the most prevalent autoimmune, chronic, inflammatory disease characterized by joint inflammation, synovial swelling, loss of articular structures, swelling, and pain. RA is a major cause of discomfort and disability worldwide, associated with infectious agents, genetic determinants, epigenetic factors, advancing age, obesity, and smoking. Although conventional therapies for RA alleviate the symptoms, but their long-term use is associated with significant side effects. This necessitates the urge to discover complementary and alternative medicine from natural products with minimum side effects.
PURPOSE: In this review, natural product's potential mechanism of action against RA has been documented in the setting of in-vivo, in-vitro and pre-clinical trials, which provides new treatment opportunities for RA patients. The bioefficacy of these natural product's bioactive compounds must be further studied to discover novel natural medications for RA with high selectivity, improved effectiveness, and economic replacement with minimum side effects.
STUDY DESIGN AND METHODS: The current review article was designed systematically in chronological order. Plants and their phytochemicals are discussed in an order concerning their mode of action. All the mechanisms of action are depicted in diagrams which are thoroughly generated by the Chembiodraw to maintain the integrity of the work. Moreover, by incorporating the recent data with simple language which is not incorporated previously, we tried to provide a molecular insight to the readers of every level and ethnicity. Moreover, Google Scholar, PubMed, ResearchGate, and Science Direct databases were used to collect the data.
SOLUTION: Traditionally, various plant extracts and bioactive compounds are effectively used against RA, but their comprehensive pharmacological mechanistic actions are rarely discussed. Therefore, the objective of this study is to systematically review the efficacy and proposed mechanisms of action of different plants and their bioactive compounds including Tripterygium wilfordii Hook F (celastrol and triptolide), Nigella sativa (thymoquinone), Zingiber officinale (shogaols, zingerone), Boswellia serrata (boswellic acids), Curcuma longa (curcumin), and Syzygium aromaticum (eugenol) against rheumatoid arthritis.
CONCLUSION: These plants have strong anti-inflammatory, anti-oxidant, and anti-arthritic effects in different study designs of rheumatoid arthritis with negligible side effects. Phytomedicines could revolutionize pharmacology as they act through alternative pathways hence seeming biocompatible.
Inflammopharmacology. 2025 Apr;33(4):1537-1581.
PMID: 40074996 [PubMed - indexed for MEDLINE]
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| 2. |
Phytochemical Analysis and Pharmaceutical Applications of Monoterpenoids Present in the Essential Oil of (Omani Luban).
Khan F, Rashan L
Due to its intricacy and long-term usefulness, traditional medicine continues to be practiced in several nations. Among the many medicinal plants found in the Dhofar region of Oman, the aromatic oleo-gum resin generated by , commonly referred to as frankincense, stands out for its medical and commercial significance. Resin-carrying ducts are unique to members of the family. Flueck is one of the 29 species in the genus (Burseraceae) and has long been cultivated for its aromatic gums and resins for use as incense. In addition to the resins (60%-80% alcohol soluble), gums (15%-20% water soluble), and essential oil (5%-7%), other components, including polysaccharides and polymeric compounds, also exist in smaller amounts. Physiochemical analyses indicate that resin oil is made up of 42.5% diterpenes, 13.1% monoterpenes, and 1% sesquiterpenes. Traditional medicine makes extensive use of frankincense for the treatment of stomach diseases, Alzheimer's disease, and hepatic illnesses. The bioactive chemicals present in frankincense, particularly boswellic acids, are plentiful. The current review examines various compounds present in different species of , especially , along with their structure.
Adv Pharmacol Pharm Sci. 2025;2025():3536898.
PMID: 40040632 [PubMed - as supplied by publisher]
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| 3. |
Exploring the anti-inflammatory effects of phytochemicals in attenuating interstitial cystitis-a literature review.
Anjum I, Nasir A, Naseer F, Ibrahim A, Rehman B, Bashir F, Tul Ain Q
Interstitial cystitis is a fierce syndrome affecting the quality of life of thousands of individuals around the globe. It causes immense pain in the bladder and associated viscera along with inflammation-like lesions. The current medicinal and pharmacological research focuses on the protective and curative effects of phytochemicals in several ailments. Phytochemicals derived from many medicinal plants have shown potent outcomes in protection against various pathological conditions including interstitial cystitis. This review has summarized the insights of and studies regarding the effects of phytochemicals in fading the inflammation in bladder tissue and exhibiting a protective effect on the urothelium. Hemorrhagic cystitis is a common manifestation in patients undergoing chemotherapy with cyclophosphamide and related alkylating agents. Sodium 2-mercaptoethane sulfonate (Mesna) has traditionally been employed in clinical practice to counter cyclophosphamide-induced cystitis in humans. However, cyclophosphamide has been employed in developing animal models of interstitial cystitis in studies. Phytochemicals including quercetin, beta-caryophyllene, curcumol, boswellic acid, caftaric acid, some flavonoids and other secondary metabolites being a consequential component of numerous medicinal plants, have displayed a significant reduction in the levels of proinflammatory cytokines including TNF-α, NFĸB, IL-1β, NLRP3 inflammasome, IL-6, IL-2, matrix metalloproteinases etc. Uroprotective outcomes of these phytochemicals have been found to result in diminished oxidative stress and restoration of glutathione, superoxide dismutase, and related proteins in the inflamed bladder tissue. Many studies involving cyclophosphamide-induced interstitial cystitis have confirmed these findings. The coupling of phytotherapy with novel drug delivery systems such as nanoparticles, liposomes, nanotubes, quantum dots, etc. can help translate these beneficial effects of phytochemicals into clinical practice. Further investigations of these phytochemicals can provide intuition regarding the development of newer drug molecules having exclusive activity for attenuating interstitial cystitis.
Front Pharmacol. 2025;16():1483548.
PMID: 39974737 [PubMed - as supplied by publisher]
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| 4. |
Recent advances in the management of knee osteoarthritis: a narrative review.
Shtroblia V, Petakh P, Kamyshna I, Halabitska I, Kamyshnyi O
Knee osteoarthritis (OA) is a common condition that causes pain and reduces the quality of life for many people. It also leads to high health and financial costs. Managing knee OA pain requires using different methods together for the best results. This review overviews current therapeutic options for knee OA pain, focusing on their efficacy, safety, and potential roles in clinical practice. Topical treatments, such as NSAIDs and capsaicin, offer significant pain relief with minimal systemic side effects and are suitable for initial therapy, together with nonpharmacologic interventions like exercise and, when relevant, weight loss. Oral analgesics, including acetaminophen and opioids, have limited efficacy and serious side effects, making them appropriate only for short-term or rescue therapy. Intra-articular injections, such as corticosteroids, hyaluronic acid, and platelet rich plasma, demonstrate varying levels of efficacy and safety. Nutritional supplements, including curcumin, , and glucosaminechondroitin combinations, offer modest benefits and are best used as adjuncts to standart treatment. Nonpharmacological treatments, such as transcutaneous electrical nerve stimulation (TENS), acupuncture, and local heat therapy, provide variable pain relief and should be customized based on individual patient responses. Targeted biologic agents, such as antibodies to TNF-α, IL-1, and NGF, hold promise for more precise pain relief; however, further research is required to establish their routine use. Treating knee OA pain should be personalized, combining several methods. Research must continue to improve treatments and make them safer.
Front Med (Lausanne). 2025;12():1523027.
PMID: 39906596 [PubMed - as supplied by publisher]
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| 5. |
Plant Resin Delivery by Nanovectors as an Emerging Approach to Boost Solubility, Permeability and Bioavailability.
Truzzi E, Vanti G, Grifoni L, Maretti E, Leo E, Bilia AR
Resins are complex mixtures of natural constituents containing non-volatile and volatile terpenes, in combination with gums and polyphenols, used since ancient times for their medicinal properties. Current research has evidenced their therapeutic value with a plethora of activities. The main limits of resins and their constituents for their clinical use are low water solubility, poor stability and bioavailability. Therefore, nanovectors including vesicles, solid lipid nanoparticles, micelles, nanoemulsions, microemulsions and mesoporic nanoparticles have been investigated to optimize the biopharmaceutical properties after topical or oral administration of resins or fractions from them, including essential oils or single constituents. In this review, we report the results evidencing that developed nanovectors were able to entrap high amounts of resins or their components, modify the release properties, enhance their cellular uptake and penetration across biological barriers and optimize the biopharmaceutical properties. In addition, the resins or their fractions as enhancer penetration molecules can optimize the architecture and properties of nanovectors in their capacity to circumvent biological barriers. Although no clinical studies have been reported until now, nanovectors represent a huge platform for upgrading therapies and emerging new treatments of resins such as wound healing therapy.
Pharmaceutics. 2025 Jan;17(1):.
PMID: 39861701 [PubMed - as supplied by publisher]
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| 6. |
Selected Use of Complementary and Alternative Medicine (CAM) Agents in IBD.
Dzwonkowski M, Bahirwani J, Rollins S, Muratore A, Christian V, Schneider Y
PURPOSE OF REVIEW: Inflammatory bowel disease (IBD) can cause significant psychological, physical, and economic burdens on patients and healthcare systems. Studies show over one-fifth of patients will seek nontraditional methods of treatment for managing their symptoms. Understanding the benefits - and potential harms - of these therapies is important to provide holistic and evidence-based care to our IBD patients.
RECENT FINDINGS: In this review, we present several studied herbal therapies for the management of both Crohn's disease and ulcerative colitis. These include cannabinoids, Tripterygium wilfordii, Chios mastic gum, Boswellia serrata, Indigo Naturalis, curcumin, resveratrol, and Zingiber officinale. While these herbal remedies have been shown to have anti-inflammatory effects and positive outcomes in IBD patients, larger scale studies are lacking and the use may be limited by bioavailability, lack of standardization of formulations, and adverse reactions. In reviewing the literature, we discuss the current data available including benefits, adverse reactions, and considerations for use surrounding several of the more common herbal remedies used for IBD.
Curr Gastroenterol Rep. 2025 Jan;27(1):1.
PMID: 39821707 [PubMed - indexed for MEDLINE]
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| 7. |
Effect of boswellia () supplementation on glycemic markers and lipid profile in type 2 diabetic patients: a systematic review and meta-analysis.
Karimi M, Vakili K, Rashidian P, Razavi-Amoli SK, Akhbari M, Kazemi K
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a significant global health challenge whose prevalence is projected to increase alarmingly. Recently, due to better safety and fewer adverse effects, herbal medicines have been used to manage T2DM. This study aimed to evaluate the efficacy of boswellia in improving glycemic markers and lipid profiles in T2DM patients.
METHODS: A comprehensive search was conducted on the PubMed, Web of Science, and Scopus databases for all relevant studies published up to April 30, 2024. The effects of boswellia supplementation were evaluated using glycemic markers and lipid profiles. The data were extracted and meta-analyzed using Stata software.
RESULTS: This meta-analysis included five studies with a total of 287 patients with T2DM. It was found that boswellia in patients with T2DM compared to the placebo or control group significantly reduced hemoglobin A1C (HbA1C) (SMD: -1.01; 95%CI: -1.55 to -0.46; P=0.00), total cholesterol (TC) (SMD: -0.44; 95%CI: -0.68 to -0.21; P=0.00), Triglycerides (TG) (SMD: -0.42; 95%CI: -0.66 to -0.19); P=0.00) and low-density lipoprotein (LDL) (SMD: -0.43; 95%CI: -0.73 to -0.12); P=0.006) levels, while reduced fasting blood glucose (FBG) but it was not significant (SMD: -1.34, 95%CI: -2.68 to 0.00; P=0.05). Notably, it did not affect high-density lipoprotein (HDL) (SMD: 0.56, 95%CI: -0.14 to -1.26; P=0.118).
CONCLUSION: In summary, boswellia supplementation has the potential to improve glycemic markers and lipid profiles in patients with T2DM. It may help diabetic patients in addition to a controlled diet and other treatments.
SYSTEMATIC REVIEW REGISTRATION: crd.york.ac.uk/PROSPERO/display_record.php?RecordID=538347, identifier CRD42024538347.
Front Clin Diabetes Healthc. 2024;5():1466408.
PMID: 39449720 [PubMed - as supplied by publisher]
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| 8. |
Insights into frankincense and myrrh research: A comprehensive analytical study of patterns and perspectives.
Abdelwahab SI, Taha MME, Jerah AA, Farasani A, Abdullah SM, Aljahdali IA, Oraibi O, Oraibi B, Alfaifi HA, Alzahrani AH, Babiker YOH
OBJECTIVE: Frankincense () and Myrrh () are natural substances that have a long history of traditional use and potential therapeutic applications. This study aimed to provide comprehensive insights into the literature on Frankincense and Myrrh research (FMR) by examining patterns, perspectives, and research trends within the research landscape.
METHODS: This bibliometric study utilized MeSH-generated terms, followed the PRISMA guidelines, and analyzed English-based bibliographic data from original studies retrieved from the Scopus database. The VOSviewer and Bibliometrix applications were employed to analyze the CVS and BibTex data consisting of 955 records. This study focuses on publication trends, research topics, citation counts, research impacts, and collaboration dynamics.
RESULTS: The analysis revealed a steady increase in FMR, indicating growing interest in these substances. Egypt, the United States, and Saudi Arabia are the most prolific countries in terms of research output. FMR primarily focuses on chemical composition, pharmacological properties, and medicinal applications. Key research topics include identification and analysis of bioactive compounds, optimization of extraction techniques, and evaluation of their therapeutic potential. Surprisingly, the thematic map was overwhelmed by the niche, motor, basic, and emerging themes. Trending topics in FMR include "Myrrh oil", "sesquiterpene", "tapping", "triterpenoids", and "allergic contact dermatitis". Collaboration networks highlight the involvement of diverse stakeholders, indicating the importance of multidisciplinary and international collaboration in advancing the field.
CONCLUSIONS: These insights contribute to a better understanding of the research landscape of FMR, guiding future studies and facilitating the utilization of these natural substances for the benefit of society.
Heliyon. 2024 Oct;10(19):e38102.
PMID: 39416835 [PubMed - as supplied by publisher]
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| 9. |
Triterpenoids from Frankincense and Boswellia: A focus on their pharmacology and C-NMR assignments.
Rehman NU, Rafiq K, Avula SK, Gibbons S, Csuk R, Al-Harrasi A
Here we report for the first time the entire C-NMR spectral assignments of 119 (out of 127) triterpenoids from the oleo-gum resins of the medicinally important genus Boswellia, which includes the culturally highly valuable Frankincense species. The complete C-NMR resonances of these triterpenoids isolated between 1998 and 2024 and their biological activities are presented. C-NMR spectroscopy is a highly powerful tool for the characterization of these bioactive natural products. The compounds are arranged according to their skeletons, i.e., ursane, oleanane, lupane, dammarane, and tirucallane triterpenes. This review will be a future reference for the identification of these compounds, which have key medicinal properties in the areas of cytotoxicity and inflammation.
Phytochemistry. 2025 Jan;229():114297.
PMID: 39401649 [PubMed - indexed for MEDLINE]
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| 10. |
Efficacy of Extracts of Oleogum Resin of Boswellia in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis.
Dalmonte T, Andreani G, Rudelli C, Isani G
Knee osteoarthritis (OA) has recently been ranked as the 11th highest contributor to global disability. More than 40% of patients use complementary and alternative medicine including supplements containing phytoextracts with anti-inflammatory properties as those from the Boswellia genus. The aim of this meta-analysis was to evaluate the efficacy of phytoextracts from the oleogum resin of the Boswellia genus as supplementation for patients affected by knee OA. Four electronic databases were used for the research and PRISMA statements were followed throughout the study. The following inclusion criteria were used: (a) the subjects of the study were humans with a diagnosis of knee OA reported by medical staff; (b) randomization and the presence of control (placebo, negative or positive control), and (c) outcomes reported with WOMAC and/or visual analog scale (VAS) score. Publication bias was assessed with a funnel plot and through the Egger test. The Jadad scale was used in order to assess the quality of the studies included. The statistical heterogeneity was assessed using I statistics. Results of meta-analysis and subgroup analysis were reported using a forest plot. A total of 13 studies involving 850 (WOMAC) and 1185 (VAS) patients met the inclusion criteria. The meta-analysis did not detect a significant effect of the use of Boswellia extracts between the control and the treatment groups due to the high heterogeneity of the studies (p = 0.0865 for WOMAC) and (p = 0.3966 VAS). However, the subsequent subgroup analysis demonstrated the significant beneficial effect of Boswellia extracts in the treatment of knee OA with respect to a placebo (lower WOMAC score in the treatment groups). This was also confirmed in the meta-regression applied to the WOMAC scores. This is an important finding as people exposed to NSAID-related adverse effects could benefit from the use of Boswellia extracts. However, further high-quality studies are needed to establish the clinical efficacy of extracts from the genus Boswellia.
Phytother Res. 2024 Dec;38(12):5672-5689.
PMID: 39314013 [PubMed - indexed for MEDLINE]
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| 11. |
Literature-based Survey of Medicinal Plants Since 1900: A Case Study to Treat Cancer in the Sultanate of Oman.
Khan A, Khan A, Murad W, Ahsan Halim S, Ahmad Jan H, Al-Broumi M, Al-Harrasi A
ETHNOPHARMACOLOGICAL RELEVANCE: Due to the high prevalence of cancer, researchers for the past decades have made considerable efforts for its management and treatment. Medicinal plants have always been exploited to discover novel anticancer agents. Oman's huge biodiversity has created a rich source of traditional medicine.
OBJECTIVE: The current survey has aimed to document the traditionally used medicinal plants of Oman and their therapeutic role in the treatment of cancer.
MATERIALS AND METHODS: This study comprises of literature-based survey through different databases, including Google, Scopus, Google Scholar, Web of Science, Science Direct, Springer Link, BioMed Central and PubMed.
RESULTS: The current review revealed a total of 57 plant species that belong to 35 families that are used in the treatment of cancer in Oman. Most documented plants belong to Solanaceae (6 sp.), Apocyanaceae (5 sp.) and Lamiaceae (4 sp.). The literature reveals that the residents of the area mostly use leaves (38.5%) and prepare their recipes in the form of decoction (40.3%). Moreover, herbs are the most dominant life form (43.85%). Among all forms of cancer in Oman, breast (47%), wound (26), and lung cancer (0.5%) were found dominantly. A literature study confirmed that the medicinal plants used for cancer in Oman are rich in phytochemicals such as quercetin, allicin, coumarin, alliin, kaempferol, solamargine, rutin, lupeol, ursolic acid and luteolin that have shown significant biological activities including anti-cancer potential. It reflects the efficacy of these plants to be used as a medicine in clinical trials. Among all, Flueck. is of key importance due to the presence Boswellic acid being used for the treatment of different types of cancer.
CONCLUSION: The residents of Oman have great knowledge about the traditional use of medicinal plants for the treatment of various diseases like cancer. The therapeutic potential and physiological efficacy of Omani medicinal plants should be further explored at a molecular level and experiments.
Curr Top Med Chem. 2025;25(8):921-942.
PMID: 39171593 [PubMed - indexed for MEDLINE]
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| 12. |
Therapeutic Potential of Nanocarriers in the Management of Rheumatoid Arthritis.
Mittal V, Sharma A, Sharma D
RA is characterized by chronic inflammation, joint damage, and systemic complications. Despite available treatments, many patients experience inadequate responses or adverse effects. Novel therapeutic strategies are needed to address these challenges. Nanoparticulate technologies offer promising opportunities to enhance drug delivery and targeting in RA treatment. The main objective is to explore recent advancements in nanoparticulate technologies for RA treatment, focusing on their potential to improve drug delivery and efficacy while minimizing adverse effects. This review examines recent studies on nanoparticulate technologies for treating rheumatoid arthritis (RA), focusing on the use of nanocarriers for targeted drug delivery. Studies investigating the effectiveness of nanocarriers in delivering drugs specifically for RA treatment were included in the analysis. Nanoparticulate technologies have shown promise in improving the delivery and efficacy of RA treatments. Various nanocarriers, such as liposomes, polymeric nanoparticles, and micelles, have been developed to enhance drug delivery to inflamed joints. These nanocarriers loaded with curcumin, Aceclofenac, Boswellic acid, methotrexate, resveratrol, etc. can improve drug stability, prolong circulation time, and enhance targetability to inflamed tissues. By overcoming the limitations of traditional therapies, these technologies have the potential to improve patient outcomes and quality of life. Future research should focus on optimizing nanocarrier design, evaluating long-term safety, and conducting clinical trials to validate their efficacy in RA management.
Curr Rheumatol Rev. 2024 Jul;():.
PMID: 39082179 [PubMed - as supplied by publisher]
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| 13. |
Phytoconstituents as modulators of NF-κB signalling: Investigating therapeutic potential for diabetic wound healing.
Yadav JP, Verma A, Pathak P, Dwivedi AR, Singh AK, Kumar P, Khalilullah H, Jaremko M, Emwas AH, Patel DK
The NF-κB pathway plays a pivotal role in impeding the diabetic wound healing process, contributing to prolonged inflammation, diminished angiogenesis, and reduced proliferation. In contrast to modern synthetic therapies, naturally occurring phytoconstituents are well-studied inhibitors of the NF-κB pathway that are now attracting increased attention in the context of diabetic wound healing because of lower toxicity, better safety and efficacy, and cost-effectiveness. This study explores recent research on phytoconstituent-based therapies and delve into their action mechanisms targeting the NF-κB pathway and potential for assisting effective healing of diabetic wounds. For this purpose, we have carried out surveys of recent literature and analyzed studies from prominent databases such as Science Direct, Scopus, PubMed, Google Scholar, EMBASE, and Web of Science. The classification of phytoconstituents into various categorie such as: alkaloids, triterpenoids, phenolics, polyphenols, flavonoids, monoterpene glycosides, naphthoquinones and tocopherols. Noteworthy phytoconstituents, including Neferine, Plumbagin, Boswellic acid, Genistein, Luteolin, Kirenol, Rutin, Vicenin-2, Gamma-tocopherol, Icariin, Resveratrol, Mangiferin, Betulinic acid, Berberine, Syringic acid, Gallocatechin, Curcumin, Loureirin-A, Loureirin-B, Lupeol, Paeoniflorin, and Puerarin emerge from these studies as promising agents for diabetic wound healing through the inhibition of the NF-κB pathway. Extensive research on various phytoconstituents has revealed how they modulate signalling pathways, including NF-κB, studies that demonstrate the potential for development of therapeutic phytoconstituents to assist healing of chronic diabetic wounds.
Biomed Pharmacother. 2024 Aug;177():117058.
PMID: 38968797 [PubMed - indexed for MEDLINE]
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| 14. |
Therapeutic potential of boswellic acids: an update patent review (2016-2023).
Hussain H, Wang D, El-Seedi HR, Rashan L, Ahmed I, Abbas M, Mamadalieva NZ, Sultani HN, Hussain MI, Shah STA
INTRODUCTION: Boswellic acids (BAs) are a group of pentacyclic triterpenoids of the ursane and oleanane type. They have shown very interesting biological properties that have led to the development of a number of synthesis protocols. Both natural BAs and their synthetic derivatives may be useful in the treatment of a variety of cancers, viral infections and inflammatory diseases.
AREAS COVERED: This review covers patents relating to the therapeutic activities of natural BAs and their synthetic derivatives. The latest patented studies of boswellic acids (are summarized by using the keywords 'boswellic acid,' in SciFinder, PubMed, and Google Patents and databases in the year from 2016 to 2023.
EXPERT OPINION: Boswellic acids have shown potent antiviral, anticancer and anti-inflammatory potential. Few BAs analogues have been prepared by modification at the C24-COH functional groups. In particular, the C-24 amide and amino analogues have shown enhanced anticancer effects compared to the parent AKBA. In addition, BAs have the ability to form conjugates with other antiviral, anti-inflammatory and anticancer drugs that synergistically enhance their biological efficacy. In addition, this conjugation strategy will increase the solubility and bioavailability of BAs, which is one of the most important issues in the development of BAs.
Expert Opin Ther Pat. 2024 Aug;34(8):723-732.
PMID: 38965930 [PubMed - indexed for MEDLINE]
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| 15. |
Frankincense: A neuronutrient to approach Parkinson's disease treatment.
Calabrese V, Osakabe N, Khan F, Wenzel U, Modafferi S, Nicolosi L, Fritsch T, Jacob UM, Abdelhameed AS, Rashan L
Parkinson's disease (PD), characterized by tremor, slowness of movement, stiffness, and poor balance, is due to a significant loss of dopaminergic neurons in the substantia nigra pars compacta and dopaminergic nerve terminals in the striatum with deficit of dopamine. To date the mechanisms sustaining PD pathogenesis are under investigation; however, a solid body of experimental evidence involves neuroinflammation, mitochondrial dysfunction, oxidative stress, and apoptotic cell death as the crucial factors operating in the pathogenesis of PD. Nutrition is known to modulate neuroinflammatory processes implicated in the pathogenesis and progression of this neurodegenerative disorder. Consistent with this notion, the Burseraceae family, which includes the genera and , are attracting emerging interest in the treatment of a wide range of pathological conditions, including neuroinflammation and cognitive decline. Bioactive components present in these species have been shown to improve cognitive function and to protect neurons from degeneration in , animal, as well as clinical research. These effects are mediated through the anti-inflammatory, antiamyloidogenic, anti-apoptotic, and antioxidative properties of bioactive components. Although many studies have exploited possible therapeutic approaches, data from human studies are lacking and their neuroprotective potential makes them a promising option for preventing and treating major neurodegenerative disorders.
Open Med (Wars). 2024;19(1):20240988.
PMID: 38911256 [PubMed - as supplied by publisher]
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| 16. |
Chemical Constituents and Pharmacological Properties of Frankincense: Implications for Anticancer Therapy.
Wu YR, Xiong W, Dong YJ, Chen X, Zhong YY, He XL, Wang YJ, Lin QF, Tian XF, Zhou Q
The discovery of novel antitumor agents derived from natural plants is a principal objective of anticancer drug research. Frankincense, a widely recognized natural antitumor medicine, has undergone a systematic review encompassing its species, chemical constituents, and diverse pharmacological activities and mechanisms. The different species of frankincense include Boswellia serrata, Somali frankincense, Boswellia frereana, and Boswellia arabica. Various frankincense extracts and compounds exhibit antitumor, anti-inflammatory, and hepatoprotective properties and antioxidation, memory enhancement, and immunological regulation capabilities. They also have comprehensive effects on regulating flora. Frankincense and its principal chemical constituents have demonstrated promising chemoprophylactic and therapeutic abilities against tumors. This review provides a systematic summary of the mechanism of action underlying the antitumor effects of frankincense and its major constituents, thus laying the foundations for developing effective tumor-combating targets.
Chin J Integr Med. 2024 Aug;30(8):759-767.
PMID: 38816637 [PubMed - indexed for MEDLINE]
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| 17. |
The Therapeutic Potential of Essential Oils in Managing Inflammatory Skin Conditions: A Scoping Review.
Dontje AEWK, Schuiling-Veninga CCM, van Hunsel FPAM, Ekhart C, Demirci F, Woerdenbag HJ
Conventional therapy is commonly used for the treatment of inflammatory skin conditions, but undesirable effects, such as erythema, dryness, skin thinning, and resistance to treatment, may cause poor patient compliance. Therefore, patients may seek complementary treatment with herbal plant products including essential oils (EOs). This scoping review aims to generate a broad overview of the EOs used to treat inflammatory skin conditions, namely, acne vulgaris, dermatitis and eczema, psoriasis, and rosacea, in a clinical setting. The quality, efficacy, and safety of various EOs, as well as the way in which they are prepared, are reviewed, and the potential, as well as the limitations, of EOs for the treatment of inflammatory skin conditions are discussed. Twenty-nine eligible studies (case studies, uncontrolled clinical studies, and randomized clinical studies) on the applications of EOs for inflammatory skin conditions were retrieved from scientific electronic databases (PubMed, Embase, Scopus, and the Cochrane Library). As an initial result, tea tree () oil emerged as the most studied EO. The clinical studies with tea tree oil gel for acne treatment showed an efficacy with fewer adverse reactions compared to conventional treatments. The uncontrolled studies indicated the potential efficacy of ajwain () oil, eucalyptus () oil, and cedarwood () oil in the treatment of acne, but further research is required to reach conclusive evidence. The placebo-controlled studies revealed the positive effects of kānuka () oil and frankincense ( spp.) oil in the treatment of psoriasis and eczema. The quality verification of the EO products was inconsistent, with some studies lacking analyses and transparency. The quality limitations of some studies included a small sample size, a short duration, and the absence of a control group. This present review underscores the need for extended, well-designed clinical studies to further assess the efficacy and safety of EOs for treating inflammatory skin conditions with products of assured quality and to further elucidate the mechanisms of action involved.
Pharmaceuticals (Basel). 2024 Apr;17(5):.
PMID: 38794141 [PubMed - as supplied by publisher]
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| 18. |
Osteoarthritis: Insights into Diagnosis, Pathophysiology, Therapeutic Avenues, and the Potential of Natural Extracts.
Coppola C, Greco M, Munir A, Musarò D, Quarta S, Massaro M, Lionetto MG, Maffia M
Osteoarthritis (OA) stands as a prevalent and progressively debilitating clinical condition globally, impacting joint structures and leading to their gradual deterioration through inflammatory mechanisms. While both non-modifiable and modifiable factors contribute to its onset, numerous aspects of OA pathophysiology remain elusive despite considerable research strides. Presently, diagnosis heavily relies on clinician expertise and meticulous differential diagnosis to exclude other joint-affecting conditions. Therapeutic approaches for OA predominantly focus on patient education for self-management alongside tailored exercise regimens, often complemented by various pharmacological interventions primarily targeting pain alleviation. However, pharmacological treatments typically exhibit short-term efficacy and local and/or systemic side effects, with prosthetic surgery being the ultimate resolution in severe cases. Thus, exploring the potential integration or substitution of conventional drug therapies with natural compounds and extracts emerges as a promising frontier in enhancing OA management. These alternatives offer improved safety profiles and possess the potential to target specific dysregulated pathways implicated in OA pathogenesis, thereby presenting a holistic approach to address the condition's complexities.
Curr Issues Mol Biol. 2024 Apr;46(5):4063-4105.
PMID: 38785519 [PubMed - as supplied by publisher]
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| 19. |
Emerging Natural Therapies for the Treatment of Inflammatory Bowel Disease.
Joshi M, Pandey M, Shankar R, Ved A
The term "inflammatory bowel disease," which includes Crohn's disease (CD) and ulcerative colitis (UC), refers to a chronic inflammatory condition of the digestive system. There are many different treatment options, such as corticosteroids, biologics, 5-aminosalicylate, and immune-suppressants, but none of them can maintain the disease remission for a longer period, which is the ultimate goal of treatment. Furthermore, they have numerous serious side effects like nephrotoxicity, infertility, congestive heart failure, myopathy, etc. So, in order to treat these conditions, researchers are concentrating more on natural medicine that is less expensive and has fewer side effects. The current analysis includes a list of plants showing promising activity against IBD. These include , and many others. These plants need to be further investigated in terms of preclinical and clinical studies to obtain the safety and efficacy data necessary for their commercialisation. Global regulatory norms will facilitate simple commercialisation. Also, more investigation is required to pinpoint the precise mechanism of action to confirm clinical success.
Curr Pharm Biotechnol. 2025;26(8):1175-1188.
PMID: 38716550 [PubMed - indexed for MEDLINE]
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| 20. |
Nature's Pharmacy: Herbal Interventions in Rheumatoid Arthritis Treatment: A Comprehensive Review.
Mittal V, Barak A, Sharma A, Singhal A
Rheumatoid Arthritis (RA) is an inflammatory disease that causes severe joint destruction and persistent inflammation. This review aims to evaluate the efficacy, safety, and mechanisms of action of various herbal interventions in managing RA, providing valuable insights for patients and healthcare practitioners. To investigate the anti-inflammatory and antioxidant properties of selected herbal interventions, including turmeric, ginger, Boswellia serrata (frankincense), green tea, and Ashwagandha, to assess their potential as complementary treatments for RA, a comprehensive analysis is performed on the anti-inflammatory mechanisms and antioxidant effects of selected herbs. Emphasis is placed on the modulation of key inflammatory pathways and their ability to counteract oxidative stress, which are crucial factors in RA progression. Safety profiles and potential adverse effects of herbal remedies are also scrutinized. The review reveals promising evidence supporting the efficacy of turmeric and ginger in alleviating RA symptoms by modulating inflammatory pathways. Additionally, Boswellia serrata shows potential as an adjunct therapy for joint health and inflammation. The antioxidant-rich properties of green tea and Ashwagandha are highlighted, suggesting their role in counteracting oxidative stress associated with RA. In conclusion, while herbal remedies like turmeric, ginger, Boswellia serrata, green tea, and Ashwagandha offer potential complementary treatments for RA, their safety profiles and adverse effects warrant careful consideration. Rigorous clinical trials are needed to confirm their efficacy and safety, highlighting the necessity for further research in this area. These findings are crucial for patients and healthcare providers in making informed decisions about incorporating herbal interventions into RA treatment strategies.
Curr Rheumatol Rev. 2024 Apr;():.
PMID: 38676473 [PubMed - as supplied by publisher]
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| 21. |
Treatment of Cachexia in Gastric Cancer: Exploring the Use of Anti-Inflammatory Natural Products and Their Derivatives.
Loyala JV, Down B, Wong E, Tan B
(1) Background: Gastric cancer is a significant cause of cancer-related mortality worldwide. Weight loss and malnutrition associated with cancer are linked with increased mortality rates and reduced quality of life. Cancer cachexia, characterised by the loss of skeletal muscle, is associated with approximately 20% of cancer-related deaths and differs from malnutrition in that it cannot be fully reversed by nutritional support alone. It is now recognised that the primary pathophysiological process underlying cancer cachexia is chronic inflammation leading to increased calorie consumption. Current treatments that focus on nutritional supplementation, psychological counselling, appetite stimulation and reducing inflammation are lacking in efficacy. This review focuses on the evidence supporting the potential roles of natural anti-inflammatory products and their derivatives including fatty acids, probiotics, amino acids, curcumin, fucoidan, epigallocatechin-3-gallate, ginger, resveratrol and Boswellia serrata in the management of gastric cancer cachexia. (2) Results: While natural anti-inflammatory products show promise in a number of in vitro and in vivo studies, there are only a small number of human studies available. Where present, the evidence base is heterogeneous, with varying study methodologies and outcomes. (3) Conclusions: Natural anti-inflammatory products represent a potential adjunctive therapy for gastric cancer cachexia. Further research, particularly well-designed clinical trials, is needed to elucidate their optimal role, dosing and safety profiles in the management of gastric cancer cachexia.
Nutrients. 2024 Apr;16(8):.
PMID: 38674936 [PubMed - indexed for MEDLINE]
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| 22. |
Sports-Related Gastrointestinal Disorders: From the Microbiota to the Possible Role of Nutraceuticals, a Narrative Analysis.
Bertuccioli A, Zonzini GB, Cazzaniga M, Cardinali M, Di Pierro F, Gregoretti A, Zerbinati N, Guasti L, Matera MR, Cavecchia I, Palazzi CM
Intense physical exercise can be related to a significant incidence of gastrointestinal symptoms, with a prevalence documented in the literature above 80%, especially for more intense forms such as running. This is in an initial phase due to the distancing of the flow of blood from the digestive system to the skeletal muscle and thermoregulatory systems, and secondarily to sympathetic nervous activation and hormonal response with alteration of intestinal motility, transit, and nutrient absorption capacity. The sum of these effects results in a localized inflammatory process with disruption of the intestinal microbiota and, in the long term, systemic inflammation. The most frequent early symptoms include abdominal cramps, flatulence, the urge to defecate, rectal bleeding, diarrhea, nausea, vomiting, regurgitation, chest pain, heartburn, and belching. Promoting the stability of the microbiota can contribute to the maintenance of correct intestinal permeability and functionality, with better control of these symptoms. The literature documents various acute and chronic alterations of the microbiota following the practice of different types of activities. Several nutraceuticals can have functional effects on the control of inflammatory dynamics and the stability of the microbiota, exerting both nutraceutical and prebiotic effects. In particular, curcumin, green tea catechins, boswellia, berberine, and cranberry PACs can show functional characteristics in the management of these situations. This narrative review will describe its application potential.
Microorganisms. 2024 Apr;12(4):.
PMID: 38674748 [PubMed - as supplied by publisher]
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| 23. |
[Phytotherapeutic recommendations in medical guidelines for the treatment of gastroenterological diseases - a systematic review].
Utz S, Bittel M, Langhorst J
Phytotherapeutics are gaining influence in the treatment of gastroenterological diseases. Their popularity and growing evidence of efficacy contribute to their integration into medical guidelines. A systematic screening identified recommended phytotherapeutic approaches. Based on current scientific data, some recommendations for the use of phytotherapeutic agents are given. For the use of is "strongly recommended", especially for pain and flatulence. Other phytotherapeutics such as , Tibetan or warm pads have proven effective in alleviating symptoms. It is "recommended" to integrate them into the treatment concept. For , 30g of fiber per day is recommended. Best data exists for with moderate evidence and . In case of , as well as the combination of , and can be used as a complementary treatment in maintaining remission. There is also an "open recommendation" for for both, remission induction and maintenance. Some phytotherapeutic treatments (e.g., , ) show evidence of effectiveness for the treatment of , but data are not yet sufficient for recommendations. Cannabis-based medicines can be considered for abdominal pain and clinically relevant appetite loss if standard therapy is ineffective or contraindicated, but they should not be used for acute inflammation in active Crohn's disease. Further recommendations for other gastroenterological diseases are discussed. The safety and tolerability of the phytotherapeutics were rated as predominantly "very good" to "acceptable". Some clear recommendations for the use of phytotherapeutics to treat gastroenterological diseases show their great potential. Due to their wide range of effects, phytotherapeutics can be used very well as a complement to conventional medicines in case of complex regulatory disorders. However, further methodologically well-conducted impact studies would be helpful in order to be able to make further recommendations.
Z Gastroenterol. 2024 Jul;62(7):1060-1073.
PMID: 38604221 [PubMed - indexed for MEDLINE]
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| 24. |
A Panoramic Review on the Management of Rheumatoid Arthritis through Herbalism.
Chaudhary S, Sharma S, Fuloria S
Arthritis is a chronic inflammatory condition that affects millions of individuals worldwide. The conventional treatment options for arthritis often come with limitations and potential side effects, leading to increased interest in herbal plants as alternative therapies. This article provides a comprehensive overview of the use of herbal plants in arthritis treatment, focusing on their traditional remedies, active components, mechanisms of action, and pharmaceutical approaches for enhancing their delivery. Various herbal plants, including turmeric, ginger, Boswellia, and willow bark, have shown anti-inflammatory and analgesic properties, making them valuable options for managing arthritis symptoms. The active components of these herbal plants, such as curcumin, gingerols, and boswellic acids, contribute to their therapeutic effects. To enhance the delivery of herbal medicines, pharmaceutical approaches like nanoparticle-based drug delivery systems, liposomes, polymeric nanoparticles, nanoemulsions, microneedles, and inhalation systems have been explored. These approaches aim to improve bioavailability, targeted delivery, and controlled release of herbal compounds. Safety considerations, including potential interactions with medications and the risk of allergic reactions, are also discussed. Future perspectives for this field involve conducting well-designed clinical studies, enhancing standardization and quality control measures, exploring novel drug delivery systems, and fostering collaborations between traditional medicine practitioners and healthcare professionals. Continued research and development in these areas will help unlock the full potential of herbal plants in arthritis treatment, offering personalized and effective care for affected individuals.
Curr Rheumatol Rev. 2025;21(1):4-24.
PMID: 38591212 [PubMed - indexed for MEDLINE]
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| 25. |
[Chemical and pharmacological progress on a Tibetan folk medicine formula Bawei Chenxiang Powder].
Wang JM, Cao JR, Gao XL, Kang LL, Yang ZZ, Sha-Na W, Li JJ, Tu PF, Chai XY
Bawei Chenxiang Powder is a traditional Tibetan folk medicine formula, consisting of resinous wood of Aquilaria sinensis, kernel of Myristica fragrans, fruit of Choerospondias axillaris, travertine, resin of Boswellia carterii or B. bhaw-dajiana, stem of Aucklandia lappa, fruit of Terminalia chebula(roasted), and flower of Gossampinus malabarica. It has the function of clearing heart heat, nourishing heart, tranquilizing mind, and inducing resuscitation, which has been used for the treatment of coronary heart disease and angina pectoris. Modern research shows that the medicine materials of this formula mainly contain terpenoids like sesquiterpenes and triterpenes and polyphenols like flavonoids, lignans, and tannins, displaying some pharmacological activities such as anti-myocardial ischemia, anti-cerebral ischemia, and spatial learning and memory promotion. This review summaries the traditional uses, chemical constituents, and pharmacological activities research progress, hopefully to provide a reference for clarification of its pharmacological active ingredients.
Zhongguo Zhong Yao Za Zhi. 2020 May;45(9):2063-2072.
PMID: 32495555 [PubMed - indexed for MEDLINE]
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| 26. |
Management of periorbital hyperpigmentation: An overview of nature-based agents and alternative approaches.
Sawant O, Khan T
Periorbital hyperpigmentation (POH) is a common dermatological condition that presents as dark periorbital area beneath the lower eyelids, and it is commonly found in females belonging to the age group of 16 to 45 years. The data presented in this review include studies conducted on patients with a clinical/histological diagnosis of POH or melasma. Many diverse topical depigmenting agents comprising an array of naturally obtained actives such as arabinoxylans, α-arbutin, asiaticoside, azelaic acid, beta-carotene, boswellic acid, caffeine, chrysin, curcumin, cyanidin-3-glucoside, d-glucoronic acid, dihydrochalcone, dipalmitoyl-hydroxyprolene, fucoxanthin, genistein, glabridin, b-glucogallin, hyaluronic acid, lactic acid, lycopene, niacinamide, pycnogenol, retinol, salidroside, and xymenynic acid demonstrated significant benefits in the management of POH. An exhaustive literature search revealed that other techniques such as blepharoplasty, carboxytherapy, calcium hydroxylapatite fillers, tear trough implant, Q-switched ruby laser, medicated tattoo, fat transfer, micro-needling, chemical peels, nitrogen plasma skin regeneration, intense pulsed light, and radiofrequency have been evaluated and reported to be beneficial in the treatment of POH. The use of topical depigmenting agents is the most widely reported method in the clinical management of POH. Of these, α-arbutin, caffeine, cyanidin-3-glucoside, and dihydrochalcone are reported to exhibit significant benefits. Combination products containing a blend of actives are reported to be better than single active containing products. This review aims to provide a comprehensive perspective on the role of several topical actives in the modulation of melanin and tyrosinase biosynthesis pathway involved in the complex pathophysiology of POH. It also presents the advantages of combination products and other alternative therapies used in the management of POH.
Dermatol Ther. 2020 Jul;33(4):e13717.
PMID: 32472659 [PubMed - indexed for MEDLINE]
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| 27. |
Genus as a new candidate for neurodegenerative disorders.
Rajabian A, Sadeghnia H, Fanoudi S, Hosseini A
Neurodegenerative diseases, characterized by progressive loss of neurons, share common mechanisms such as apoptotic cell death, mitochondrial dysfunction, inflammation, and oxidative stress. Genus is a genus in the Burseraceae family. It comprises several species traditionally used for treatment of chronic inflammatory diseases, cerebral edema, chronic pain syndrome, gastrointestinal diseases, tumors, as well as enhancing intelligence. Many studies have been carried out to discover therapeutic approaches for neurodegenerative diseases such as Alzheimer's diseases, Parkinson's disease, Huntington's disease, multiple sclerosis and amyotrophic lateral sclerosis, stroke, and concomitant cognitive deficits. However, no curative treatment has been developed. This paper provides an overview of evidence about the potential of the Boswellia species and their main constituents, boswellic acids, as modulators of several mechanisms involved in the pathology of the neurodegenerative diseases. , animal, and clinical studies have confirmed that Boswellia species contain bioactive components that may enhance cognitive activity and protect against neurodegeneration. They exert the beneficial effects via targeting multiple pathological causes by antioxidative, anti-inflammatory, antiamyloidogenic, and anti-apoptotic properties. The Boswellia species, having neuroprotective potential, makes them a promising candidate to cure or prevent the neurodegenerative disorders.
Iran J Basic Med Sci. 2020 Mar;23(3):277-286.
PMID: 32440312 [PubMed - as supplied by publisher]
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| 28. |
The Anti-inflammatory Potential of Selected Plant-derived Compounds in Respiratory Diseases.
Wieczfinska J, Sitarek P, Kowalczyk T, Skała E, Pawliczak R
Inflammation plays a major role in chronic airway diseases like asthma, COPD, and cystic fibrosis. Inflammation plays a crucial role in the worsening of the lung function resulting in worsening symptoms. The inflammatory process is very complexed, therefore the strategies for developing an effective treatment for inflammatory airway diseases would benefit from the use of natural substances. Plant products have demonstrated anti-inflammatory properties on various lung disease models and numerous natural plant agents have successfully been used to treat inflammation. Naturally occurring substances may exert some anti-inflammatory effects by modulating some of the inflammatory pathways. These agents have been used in different cultures for thousands of years and have proven to be relatively safe. Parthenolide, apocynin, proanthocyanidins, and boswellic acid present different mechanisms of actions - among others, through NF-kB or NADPH oxidase inhibition, therefore showing a wide range of applications in various inflammatory diseases. Moreover, some of them have also antioxidant properties. This review provides an overview of the anti-inflammatory effects of some of the natural agents and illustrates their great potential as sources of drugs to cover an extensive range of pharmacological effects.
Curr Pharm Des. 2020;26(24):2876-2884.
PMID: 32250214 [PubMed - indexed for MEDLINE]
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| 29. |
Editorial for the special issue on frankincense.
Csuk R, Al-Harrasi A
Phytochemistry. 2020 May;173():112299.
PMID: 32113066 [PubMed - indexed for MEDLINE]
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| 30. |
Anti-inflammatory and anti-cancer activities of frankincense: Targets, treatments and toxicities.
Efferth T, Oesch F
The oleogum resins of Boswellia species known as frankincense have been used for ages in traditional medicine in India, China and the Arabian world independent of its use for cultural and religious rituals in Europe. During the past two decades, scientific investigations provided mounting evidence for the therapeutic potential of frankincense. We conducted a systematic review on the anti-inflammatory and anti-cancer activities of Boswellia species and their chemical ingredients (e.g. 3-O-acetyl-11-keto-β boswellic acid, α- and β-boswellic acids, 11-keto-β-boswellic acid and other boswellic acids, lupeolic acids, incensole, cembrenes, triterpenediol, tirucallic acids, and olibanumols). Frankincense acts by multiple mechanisms, e.g. by the inhibition of leukotriene synthesis, of cyclooxygenase 1/2 and 5-lipoxygenase, of oxidative stress, and by regulation of immune cells from the innate and acquired immune systems. Furthermore, frankincense modulates signaling transduction responsible for cell cycle arrest and inhibition of proliferation, angiogenesis, invasion and metastasis. Clinical trials showed the efficacy of frankincense and its phytochemicals against osteoarthritis, multiple sclerosis, asthma, psoriasis and erythematous eczema, plaque-induced gingivitis and pain. Frankincense revealed beneficial effects towards brain tumor-related edema, but did not reduce glioma size. Even if there is no treatment effect on brain tumors itself, the management of glioma-associated edema may represent a desirable improvement. The therapeutic potential against other tumor types is still speculative. Experimental toxicology and clinical trials revealed only mild adverse side effects. More randomized clinical trials are required to estimate the full clinical potential of frankincense for cancer therapy.
Semin Cancer Biol. 2022 May;80():39-57.
PMID: 32027979 [PubMed - indexed for MEDLINE]
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| 31. |
An Anecdote About Arthritis and Boswellia serrata.
Shader RI
Clin Ther. 2018 May;40(5):669-671.
PMID: 29735296 [PubMed - as supplied by publisher]
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| 32. |
Comment on: Efficacy of Curcumin and Boswellia for knee osteoarthritis: Systematic review and meta-analysis.
Mobasheri A, Henrotin Y
Semin Arthritis Rheum. 2019 Feb;48(4):e25-e26.
PMID: 29735172 [PubMed - indexed for MEDLINE]
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| 33. |
Effectiveness of a novel boswellic acids delivery form (Casperome®) in the management of grade II ankle sprains due to sport trauma - a registry study.
Feragalli B, Ippolito E, Dugall M, Cacchio M, Belcaro G, Cesarone MR, Abdel-Tawab M, Riva A, Togni S, Eggenhoffner R, Giacomelli L
OBJECTIVE: In this study, we evaluated a novel delivery form of boswellic acids (Casperome®) in the management of signs and symptoms associated with ankle sprain grade II due to sport trauma.
PATIENTS AND METHODS: In this supplement registry study, 72 otherwise healthy subjects with grade II ankle sprain induced by sport activities were advised to either follow a standard management (SM, 37 subjects) for the condition or the SM with the additional daily intake of 1 tablet containing 250 mg Casperome® (35 subjects). Subjects were allowed to use rescue medications (ketoprofen tablets, 25 mg/tablet), and their intake was measured at the end of the management period of 7 days. Each individual was subjected to several non-invasive examinations (self-reported pain at rest and under moderate exercise, range of active and passive movement, presence of local hematomas by ultrasonography) at the following time periods: at inclusion, to evaluate the basal conditions of the subject before the beginning of the study, at day 3 and at the end of the week to evaluate the response differences between the two groups. Additionally, a blood sample from the Casperome® treated subjects (34 out of 35 subjects) was taken at day 7 and analyzed for the systemic concentration of boswellic acids.
RESULTS: The 72 individuals recruited in this study spontaneously decided which management to follow, either SM (n=37) or SM+Casperome® (n=35). Supplementation with Casperome® 250 mg/day showed beneficial effects in the reduction of signs and symptoms of ankle sprains evaluated at day 3 and day 7, and was shown to induce measurable plasma level of boswellic acids. Moreover, the supplementary use of Casperome® was well-tolerated and devoid of side effects.
CONCLUSIONS: Our pilot registry study showed the effectiveness of Casperome® supplementation in improving recovery after ankle sprain of mild severity (grade II), suggesting a potentially beneficial role in relieving the trauma associated with sport activities and in decreasing the use of rescue drugs.
Eur Rev Med Pharmacol Sci. 2017 Oct;21(20):4726-4732.
PMID: 29131239 [PubMed - indexed for MEDLINE]
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| 34. |
Efficacy and Tolerability of Phytomedicines in Multiple Sclerosis Patients: A Review.
Farzaei MH, Shahpiri Z, Bahramsoltani R, Nia MM, Najafi F, Rahimi R
Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disorder of the central nervous system (CNS) that can cause cognition, mobility, and sensory impairments. It is considered one of the most common non-traumatic causes of disability in the world. The aim of the present article was to review the clinical evidence related to medicinal plants in the management of MS symptoms. Electronic databases, including the Cochrane Library, Pubmed, and Scopus, were searched for entries from 1966 to February 2017. Only clinical studies were included in this review. Different medicinal plants have positive effects on MS, including Andrographis paniculata, Boswellia papyrifera, Ruta graveolens, Vaccinium spp., Camellia sinensis, Panax ginseng, Aloysia citrodora, Ginkgo biloba, Oenothera biennis, and Cannabis sativa. C. sativa had the highest level of clinical evidence, supporting its efficacy in MS symptoms. Proanthocyanidins, ginkgo flavone glycosides, ginsenosides, epigallocatechin-3-gallate, cannabinoids (including delta-9-tetrahydrocannabinol and cannabidiol), boswellic acid, and andrographolide were presented as the main bioactive components of medicinal plants with therapeutic benefits in MS. The main complications of MS in which natural drugs were effective include spasticity, fatigue, scotoma, incontinence, urinary urgency, nocturia, memory performance, functional performance, and tremor. Herbal medicines were mostly well tolerated, and the adverse effects were limited to mild to moderate. Further well-designed human studies with a large sample size and longer follow-up period are recommended to confirm the role of medicinal plants and their metabolites in the management of MS.
CNS Drugs. 2017 Oct;31(10):867-889.
PMID: 28948486 [PubMed - indexed for MEDLINE]
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| 35. |
Drug-Herb Interactions in the Elderly Patient with IBD: a Growing Concern.
Rahman H, Kim M, Leung G, Green JA, Katz S
Inflammatory bowel disease (IBD), which includes conditions such as Crohn's disease and ulcerative colitis, is becoming more prevalent with the elderly being the fastest growing group. Parallel to this, there is an increasing interest in the use of complementary and alternative medicine (CAM). Nearly half of patients with IBD have used CAM at one time. The elderly patients, however, are burdened by comorbid conditions, polypharmacy, and altered functional status. With increasing use of complementary and alternative medicine in our elderly patients with IBD, it is vital for the provider to provide counsel on drug-herb potential interactions. CAM includes herbal products, diet, dietary supplements, acupuncture, and prayer. In this paper, we will review common CAM, specifically herbs, that are used in patients with IBD including the herb background, suggested use, evidence in IBD, and most importantly, potential interactions with IBD medications used in elderly patients. Most important evidence-based adverse events and drug-herb interactions are summarized. The herbs discussed include Triticum aestivum (wheat grass), Andrographis paniculata (chiretta), Boswellia serrata, tormentil, bilberry, curcumin (turmeric), Plantago ovata (blond psyllium), Oenothera biennis (evening primrose oil), germinated barley foodstuff, an herbal preparation of myrrh, chamomile and coffee extract, chios mastic gum, wormwood (absinthe, thujone), Cannabis sativa (marijuana, THC), tripterygium wilfordii (thunder god vine), Ulmus rubra (slippery elm bark), trigonella foenugraecum (fenugreek), Dioscorea mexicana (wild yam), Harpagophytum procumbens (devil's claw), ginger, cinnamon, licorice, and peppermint.
Curr Treat Options Gastroenterol. 2017 Dec;15(4):618-636.
PMID: 28918484 [PubMed - as supplied by publisher]
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| 36. |
Oral herbal medicines marketed in Brazil for the treatment of osteoarthritis: A systematic review and meta-analysis.
Del Grossi Moura M, Lopes LC, Biavatti MW, Kennedy SA, de Oliveira E Silva MC, Silva MT, de Cássia Bergamaschi C
Herbal medications are commonly used to manage symptoms associated with osteoarthritis (OA). This systematic review evaluated the effectiveness and safety of oral medications used in Brazil for the treatment of OA. Randomized clinical trials involving adults with OA treated by a herbal medicine or a control group were eligible. The primary outcomes measured were pain, physical function, swelling, stiffness and quality of life; and the secondary outcomes were adverse events, activity limitations and treatment satisfaction. Sixteen studies were included (n = 1,741 patients) in the systematic review and nine studies in the meta-analysis, representing 6 of the 13 herbal medicines studied: Boswellia serrata (n = 2), Curcuma longa (n = 3), Harpagophytum procumbens (n = 1), Salix daphnoides (n = 3), Uncaria guianensis (n = 2) and Zingiber officinale (n = 5). B. serrata was more effective than both placebo and valdecoxib for improvement of pain and physical function. No difference was observed for H. procumbens, C. longa and U. guianensis compared with control. Z. officinale showed improvement of pain over placebo. The evidence was insufficient to support the effective and safe use of these herbal medicines, because the quality of evidence of studies was low. This study guides managers of the Brazilian public health system and prescribers in decision-making regarding the use of these herbal medicines for OA. Copyright © 2017 John Wiley & Sons, Ltd.
Phytother Res. 2017 Nov;31(11):1676-1685.
PMID: 28872719 [PubMed - indexed for MEDLINE]
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| 37. |
Antioxidant Supplements and Gastrointestinal Diseases: A Critical Appraisal.
Khan I, Samson SE, Grover AK
The gastrointestinal tract digests and absorbs dietary nutrients, protects the body against physical and chemical damage from contents in its lumen, provides immunity against external antigens, and keeps an optimum environment for the gut microbiota. These functions cannot be performed normally in several diseases of which the following are discussed here: irritable bowel syndrome and inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis. Because these diseases are associated with oxidative stress, a host of antioxidant supplements are used for maintenance and recovery of the gut functions. However, the benefits of these supplements have not been established. The available 80 human trials were rated for levels of confidence and for benefits of the antioxidant supplements. For Crohn's disease, the supplements for which clear benefits occurred in at least 2 studies were allopurinol, Boswellia serrata (frankincense or shallaki), Artemesia species (wormwood), Tripterygium wilfordii (léi gōng téng), and omega-3 fatty acids. Similar beneficial supplements for ulcerative colitis were allopurinol, Matricaria chamomilla (chamomile), Curcuma longa (curcumin in turmeric), and omega-3 fatty acids. There was also a clear benefit for ulcerative colitis in 2 studies where a multiherbal Chinese medicine preparation and an Ayurvedic medicine preparation were used. For irritable bowel syndrome, there was only a marginal benefit of some of the antioxidant supplements. Thus, some antioxidant supplements may be beneficial at certain stages of specific diseases. This is consistent with the current concept that antioxidants act by inhibiting oxidative stress pathways in a tissue- and environment-specific manner and not by simply acting as scavengers.
Med Princ Pract. 2017;26(3):201-217.
PMID: 28278495 [PubMed - indexed for MEDLINE]
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| 38. |
Phytomedicine in Joint Disorders.
Dragos D, Gilca M, Gaman L, Vlad A, Iosif L, Stoian I, Lupescu O
Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from pain-killers to biological agents) is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even though many of them have been proven effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarize the available scientific information on the following joint-friendly medicinal plants, which have been tested in human studies: spp., spp., , spp., , , , , and .
Nutrients. 2017 Jan;9(1):.
PMID: 28275210 [PubMed - indexed for MEDLINE]
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| 39. |
Management strategies for knee osteoarthritis: Aflapin ().
Suva MA, Kheni DB, Sureja VP
Ayu. 2017;38(1-2):94.
PMID: 29861602 [PubMed - as supplied by publisher]
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| 40. |
The role of dietary supplements in inflammatory bowel disease: a systematic review.
Rossi RE, Whyand T, Murray CD, Hamilton MI, Conte D, Caplin ME
Inflammatory bowel diseases (IBD) are chronic immune disorders of unclear aetiology. Dietary deficiencies may be a potential pathogenic factor in their development. Patients often take food supplements without knowledge of any evidence base. We have therefore assessed the evidence for food supplementation in the management of IBD. A PubMed search was performed for the terms Inflammatory bowel disease; nutritional deficiencies; dietary supplements; curcumin; green tea; vitamin D/other vitamins; folic acid; iron; zinc; probiotics; andrographis paniculata; and boswellia serrate. PubMed was used to search for all relevant articles published between January 1975 and September 2015. Curcumin supplementation has been reported to be effective in reducing the symptoms and the inflammatory indices in IBD patients. Similar results have been observed for green tea; however, pertinent studies are limited. Vitamin D supplementation may help to increase bone mineral density in IBD patients and to reduce disease activity. IBD patients with ileal resections higher than 20 cm may develop vitamin B12 deficiency that requires parenteral supplementation. There is no current evidence to support fat-soluble vitamin supplementation in IBD patients. Zinc and iron should be supplemented in selected cases. Probiotics (VSL#3) may reduce disease activity in IBD patients with pouchitis. Complementary and alternative medicines are used by IBD patients and some studies have shown promising results. In summary, attention to dietary factors such as curcumin, green tea and vitamins, including vitamins D and B12, appears to be beneficial and, if necessary, supplementation may be appropriate.
Eur J Gastroenterol Hepatol. 2016 Dec;28(12):1357-1364.
PMID: 27769076 [PubMed - indexed for MEDLINE]
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| 41. |
Boswellic Acids and Their Role in Chronic Inflammatory Diseases.
Ammon HP
UNLABELLED: Boswellic acids, which are pentacyclic triterpenes belong to the active pharmacological compounds of the oleogum resin of different Boswellia species. In the resin, more than 12 different boswellic acids have been identified but only KBA and AKBA received significant pharmacological interest. Biological Activity: In an extract of the resin of Boswellia species multiple factors are responsible for the final outcome of a therapeutic effect, be it synergistic or antagonistic. Moreover, the anti-inflammatory actions of BAs are caused by different mechanisms of action. They include inhibition of leukotriene synthesis and to a less extend prostaglandin synthesis. Furthermore inhibition of the complement system at the level of conversion of C3 into C3 and C3. A major target of BAs is the immune system. Here, BEs as well as BAs including KBA and AKBA, have been shown to decrease production of proinflammatory cytokines including IL-1, IL-2, IL-6, IFN-γ and TNF-α which finally are directed to destroy tissues such as cartilage, insulin producing cells, bronchial, intestinal and other tissues. NFĸB is considered to be the target of AKBA. The complex actions of BEs and BAs in inflamed areas may be completed by some effects that are localized behind the inflammatory process as such tissue destruction. In this case, in vitro- and animal studies have shown that BAs and BEs suppress proteolytic activity of cathepsin G, human leucocyte elastase, formation of oxygen radicals and lysosomal enzymes.
PHARMACOKINETICS: Whereas KBA is absorbed reaching blood levels being close to in vitro IC AKBA which is more active in in vitro studies than KBA, but undergoes much less absorption than KBA. However, absorption of both is increased more than twice when taken together with a high-fat meal.Clinical Studies There are a variety of chronic inflammatory diseases which respond to treatment with extracts from the resin of Boswellia species. Though, the number of cases is small in related clinical studies, their results are convincing and supported by the preclinical data. These studies include rheumatoid arthritis, osteoarthritis, chronic colitis, ulcerative colitis, collagenous colitis, Crohn's disease and bronchial asthma. It can not be expected that there is cure from these diseases but at least improvement of symptoms in about 60-70 % of the cases. Side Effects The number and severity of side effects is extremely low. The most reported complaints are gastrointestinal symptoms. Allergic reactions are rare. And most authors report, that treatment with BEs is well tolerated and the registered side effects in BE- and placebo groups are similar.
Adv Exp Med Biol. 2016;928():291-327.
PMID: 27671822 [PubMed - indexed for MEDLINE]
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| 42. |
Therapeutic potential of boswellic acids: a patent review (1990-2015).
Hussain H, Al-Harrasi A, Csuk R, Shamraiz U, Green IR, Ahmed I, Khan IA, Ali Z
Boswellic acids (BAs), a group of pentacyclic triterpenoids, have demonstrated very interesting biological properties that resulted in a number of protocols being developed for their synthesis. During the last twenty-five years (1990-2015), numerous BAs have been prepared. Both natural BAs and their synthetic derivatives can be used to treat various cancers as well as inflammatory diseases. Areas covered: This review covers patents on therapeutic activities of natural BAs and their synthetic derivatives published in last twenty-five years (1990-2015). Only BA patents to treat cancer and inflammation are available. A discussion about structure-activity relationships (SAR) of these analogs is also included. Expert opinion: BAs possess excellent anticancer and anti-inflammatory properties. A large number of BAs and their analogues have been prepared through modification at the C-OH and C-COH functional groups. Most importantly, the C-24 amide and amino derivatives demonstrated increased anticancer and anti-inflammatory activity compared with other BA derivatives. Furthermore, BAs have the potential to form conjugates with other anticancer drugs that will synergistically enhance their anticancer effects; and we believe that in order to get lead compounds, there needs to be a greater focus on the synthesis of halo derivatives of BAs.
Expert Opin Ther Pat. 2017 Jan;27(1):81-90.
PMID: 27646163 [PubMed - indexed for MEDLINE]
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| 43. |
Role of angiogenic factors of herbal origin in regulation of molecular pathways that control tumor angiogenesis.
Kumar M, Dhatwalia SK, Dhawan DK
The formation of blood capillaries to sustain development and growth of new tissues is referred to as angiogenesis. Angiogenesis is pivotal in both carcinogenesis and metastasis since capillaries are the sole source of supplying nutrients and oxygen to the proliferating tumor cells; therefore, this dependency of tumor growth on angiogenesis challenges researchers to halt tumor growth by targeting angiogenesis with the help of either synthetic or natural inhibitors. Many synthetic inhibitors of angiogenesis have not only come into force but also resulted in some severe adverse effects. Natural compounds may effectively fit into this condition and possibly decrease the time of treatment. In the recent past, literature is replete with evidences advocating the usefulness of natural compounds that target multiple biochemical pathways. The additional advantage of natural compounds is that their active principles interact with one another and work synergistically to give more meaningful and reliable effects than individual principle. Hence, if we are somehow able to combine more than two natural compounds, then it may be possible to enhance their potential by many folds, which shall prove to be very effective in combating tumor angiogenesis. This review shall discuss the concept of angiogenesis, molecular pathways, and angiogenic inhibitors and their specific targets and potential of natural compounds to greatly enhance the current knowledge of angiogenesis-inhibiting factors.
Tumour Biol. 2016 Nov;37(11):14341-14354.
PMID: 27614685 [PubMed - indexed for MEDLINE]
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| 44. |
Favorable results from the use of herbal and plant products in inflammatory bowel disease: evidence from experimental animal studies.
Triantafillidis JK, Triantafyllidi A, Vagianos C, Papalois A
The use of herbal therapy for inflammatory bowel disease is increasing worldwide. The aim of this study was to review the available literature on the efficacy of herbal therapy in experimental colitis. All relevant studies published in Medline and Embase up to June 2015 have been reviewed. The results of bowel histology and serum parameters have been recorded. A satisfactory number of published experimental studies, and a quite large one of both herbal and plant products tested in different studies have been reported. The results showed that in the majority of the studies, herbal therapy reduced the inflammatory activity of experimental colitis and diminished the levels of many inflammatory indices, including serum cytokines and indices of oxidative stress. The most promising plant and herbal products were tormentil extracts, wormwoodherb, Aloe vera, germinated barley foodstuff, curcumin, Boswellia serrata, Panax notoginseng, Ixeris dentata, green tea, Cordia dichotoma, Plantago lanceolata, Iridoidglycosides, and mastic gum. Herbal therapies exert their therapeutic benefit via various mechanisms, including immune regulation, anti-oxidant activity, inhibition of leukotriene B4 and nuclear factor-κB, and antiplatelet activity. Large, double-blind clinical studies assessing these natural substances should be urgently conducted.
Ann Gastroenterol. 2016;29(3):268-81.
PMID: 27366027 [PubMed - as supplied by publisher]
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| 45. |
Pharmacological evidences for cytotoxic and antitumor properties of Boswellic acids from Boswellia serrata.
Khan MA, Ali R, Parveen R, Najmi AK, Ahmad S
ETHNOPHARMACOLOGICAL RELEVANCE: Increasing research on traditional herbal medicines and their phytoconstituents has recognized their usefulness in complementary as adjuvant to chemotherapy in various types of cancers. The oleo-gum resin of Boswellia serrata tree is one such folk medicine, which has been traditionally used for religious, cosmetic as well as medical purposes since ages. The oleo-gum resin of the plant has been used in traditional medicine to treat variety of conditions including inflammatory diseases like arthritis, asthma, chronic pain, bowel conditions and many other diseases. This review presents an overview of scientific studies on cytotoxic and antitumor properties of B. serrata and its constituents.
MATERIALS AND METHODS: Literature search was carried out for activities of B. serrata and various isolated boswellic acids such as β-boswellic acid, 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid reported in various cancer types in vitro as well as in vivo.
RESULTS: The triterpenoidal fraction of B. serrata (containing boswellic acids) is responsible for the cytotoxic and antitumor properties. Among the screened compounds, 3-O-acetyl-11-keto-β-boswellic acid has been found to be most promising cytotoxic molecule. The cytotoxic and antitumor effects are mainly due to induction of apoptosis through caspase activation, increased Bax expression, NF-κB down regulation and induction of poly (ADP)-ribose polymerase (PARP) cleavage.
CONCLUSIONS: Boswellic acids appear to be promising candidates for anticancer drug development in future. However, further in vivo studies are needed. Studies in combination with clinically used anticancer drugs and QSAR studies on individual boswellic acid also need to be carried out.
J Ethnopharmacol. 2016 Sep;191():315-323.
PMID: 27346540 [PubMed - indexed for MEDLINE]
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| 46. |
Nutraceutical supplement in the management of tendinopathies: a systematic review.
Fusini F, Bisicchia S, Bottegoni C, Gigante A, Zanchini F, Busilacchi A
BACKGROUND: nutraceuticals are common support therapy for management of tendinopathies. Even if they are widely diffused, our knowledge is still poor. The aim of this systematic review is to analyze the most commonly used nutraceuticals and their effects on tendons.
METHODS: glucosamine and chondroitin sulphate, vitamin C, hydrolazed type 1 collagen, arginine alpha-keto-glutarate, bromelain, curcumin, boswellic acid, and methil-sulfonil-methane were considered. During the last week of Dicember 2015 a comprehensive research of main databases for each substance was made in relation with tendinopathy. Repeated articles, articles not in English nor in Italian, not common nutraceuticals, and articles not related with tendons or tenocytes were excluded. Clinical article quality was assessed independently by two reviewers using the modified Coleman methodology score.
RESULTS: preclinical and clinical data from 46 articles from all databases were analyzed. All these nutraceuticals demonstrated several effects on normal and pathological tendons. Preclinical and clinical studies showed a possible role on collagen synthesis, inflammation, mechanical properties, and maturation of collagen bundles, antioxidant effect, edema, and analgesia. The majority clinical studies had some methodological limitations with an average Modified Coleman Methodology Score of 51.3 points and SD of 20.5 points. In particular, there were very low values in power, error, outcome assessment, and clinical effect.
CONCLUSION: preclinical results are very encouraging, however they are not fully confirmed by clinical studies. There are few clinical papers on the use of nutraceuticals in tendon disorders, and their methodological quality is poor. Furthermore, in most of the studies more than one supplement was administered at the same time. This may bias the results, and the effect of each single component cannot be determined. Furthermore, the interactions between nutraceuticals and drugs, or other dietary supplements (especially at high doses) has not been evaluated, neither their effects on chronic diseases. For these reasons, it is not possible to draw any definitive raccomendations on the use of nutraceutical supplementation in tendinopathies.
Muscles Ligaments Tendons J. 2016;6(1):48-57.
PMID: 27331031 [PubMed - as supplied by publisher]
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| 47. |
Frankincense--therapeutic properties.
Al-Yasiry AR, Kiczorowska B
Recently, increasing interest in natural dietary and therapeutic preparations used as dietary supplements has been observed. One of them is frankincense. This traditional medicine of the East is believed to have anti-inflammatory, expectorant, antiseptic, and even anxiolytic and anti-neurotic effects. The present study aims to verify the reported therapeutic properties of Boswellia resin and describe its chemical composition based on available scientific studies. The main component of frankincense is oil (60%). It contains mono- (13%) and diterpenes (40%) as well as ethyl acetate (21.4%), octyl acetate (13.4%) and methylanisole (7.6%). The highest biological activity among terpenes is characteristic of 11-keto-ß-acetyl-beta-boswellic acid, acetyl-11-keto-ß-boswellic acid and acetyl-α-boswellic acid. Contemporary studies have shown that resin indeed has an analgesic, tranquilising and anti-bacterial effects. From the point of view of therapeutic properties, extracts from Boswellia serrata and Boswellia carterii are reported to be particularly useful. They reduce inflammatory conditions in the course of rheumatism by inhibiting leukocyte elastase and degrading glycosaminoglycans. Boswellia preparations inhibit 5-lipoxygenase and prevent the release of leukotrienes, thus having an anti-inflammatory effect in ulcerative colitis, irritable bowel syndrome, bronchitis and sinusitis. Inhalation and consumption of Boswellia olibanum reduces the risk of asthma. In addition, boswellic acids have an antiproliferative effect on tumours. They inhibit proliferation of tumour cells of the leukaemia and glioblastoma subset. They have an anti-tumour effect since they inhibit topoisomerase I and II-alpha and stimulate programmed cell death (apoptosis).
Postepy Hig Med Dosw (Online). 2016 Jan;70():380-91.
PMID: 27117114 [PubMed - indexed for MEDLINE]
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| 48. |
The potential role of boswellic acids in cancer prevention and treatment.
Roy NK, Deka A, Bordoloi D, Mishra S, Kumar AP, Sethi G, Kunnumakkara AB
Despite the extensive research carried out in the field of cancer therapeutics, cancer is one of the most dreadful diseases in the world with no definitive treatment to date. The key attributes responsible for this are the various limiting factors associated with conventional chemotherapeutics that primarily include adverse side-effects and development of chemoresistance. Hence, there is an utter need to find compounds that are highly safe and efficacious for the prevention and treatment of cancer. Boswellic acid, a group of pentacyclic compounds, seems to be promising enough due to its inherent anti-cancerous properties. Considering this perspective, the present review highlights the established studies related to the anti-cancer potential of boswellic acid against different cancer types. The molecular mechanisms underlying the targets of boswellic acid that are accountable for its potent anti-cancer effect are also discussed. Overall, this review projects the pieces of evidence that reveal the potential of boswellic acid as a suitable candidate that can be appropriately developed and designed into a promising anti-cancer drug.
Cancer Lett. 2016 Jul;377(1):74-86.
PMID: 27091399 [PubMed - indexed for MEDLINE]
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| 49. |
Survey on the Quality of the Top-Selling European and American Botanical Dietary Supplements Containing Boswellic Acids.
Meins J, Artaria C, Riva A, Morazzoni P, Schubert-Zsilavecz M, Abdel-Tawab M
In consideration of the increasing popularity of frankincense and the widely published quality problems associated with botanical dietary supplements, a survey was conducted for the first time on the quality of frankincense containing botanical dietary supplements. Six US products representing 78 % of the units sold and 70 % of the market value, and 11 European products representing 30 % of the units sold and 40 % of the market value were tested for their boswellic acid composition profile, label compliance, and claimed health benefits. Special focus was also set on the statements made with regard to the frankincense applied.Only five products out of seventeen disclosed all relevant information for the Boswellia extract, mentioning the species, the part of plant used, and the boswellic acid content. Whereas all products but one claimed to use Boswellia serrata, three products did not mention the resin as the part applied and 10 products did not declare the boswellic acid content. Apart from the different boswellic acid composition determined with a sensitive LC/MS method, 41 % of the products did not comply with the label declaration. Hence, one product from Italy did not contain any of the six characteristic boswellic acids (KBA, AKBA, αBA, βBA, AαBA, AβBA) at all and another US product contained only traces, suggesting the absence of frankincense or the use of Boswellia frereana instead of B. serrata. In another product, the ratios of the individual boswellic acids were different from B. serrata gum resin, indicating the use of another species such as Boswellia sacra or Boswellia carterii. Furthermore, two products revealed different boswellic acid contents from those declared on the label. Further, two products did not declare the use of manipulated Boswellia gum resin extract being enriched in acetyl-11-keto-boswellic acid content reaching up to 66 %. In addition, consumers could be misled by outdated literature or references to in vitro studies performed at dosages that can never be achieved in humans following oral administration.In summary, this survey reveals that in spite of increased regulations on botanical dietary supplements, the problem of mislabeling still exists and needs to be addressed by the manufacturers, so that consumers get greater confidence in the botanical dietary supplements they use.
Planta Med. 2016 Apr;82(6):573-9.
PMID: 27054914 [PubMed - indexed for MEDLINE]
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| 50. |
Benefits of antioxidant supplements for knee osteoarthritis: rationale and reality.
Grover AK, Samson SE
Arthritis causes disability due to pain and inflammation in joints. There are many forms of arthritis, one of which is osteoarthritis whose prevalence increases with age. It occurs in various joints including hip, knee and hand with knee osteoarthritis being more prevalent. There is no cure for it. The management strategies include exercise, glucosamine plus chondroitin sulfate and NSAIDs. In vitro and animal studies provide a rationale for the use of antioxidant supplements for its management. This review assesses the reality of the benefits of antioxidant supplements in the management of knee osteoarthritis. Several difficulties were encountered in examining this issue: poorly conducted studies, a lack of uniformity in disease definition and diagnosis, and muddling of conclusions from attempts to isolate the efficacious molecules. The antioxidant supplements with most evidence for benefit for pain relief and function in knee osteoarthritis were based on curcumin and avocado-soya bean unsaponifiables. Boswellia and some herbs used in Ayurvedic and Chinese medicine may also be useful. The benefits of cuisines with the appropriate antioxidants should be assessed because they may be more economical and easier to incorporate into the lifestyle.
Nutr J. 2016 Jan;15():1.
PMID: 26728196 [PubMed - indexed for MEDLINE]
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| 51. |
Dietary Supplement Therapies for Inflammatory Bowel Disease: Crohn's Disease and Ulcerative Colitis.
Parian A, Limketkai BN
Inflammatory bowel disease (IBD) including ulcerative colitis and Crohn's disease are chronic relapsing and remitting chronic diseases for which there is no cure. The treatment of IBD frequently requires immunosuppressive and biologic therapies which carry an increased risk of infections and possible malignancy. There is a continued search for safer and more natural therapies in the treatment of IBD. This review aims to summarize the most current literature on the use of dietary supplements for the treatment of IBD. Specifically, the efficacy and adverse effects of vitamin D, fish oil, probiotics, prebiotics, curcumin, Boswellia serrata, aloe vera and cannabis sativa are reviewed.
Curr Pharm Des. 2016;22(2):180-8.
PMID: 26561079 [PubMed - indexed for MEDLINE]
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| 52. |
A review of commercially important African medicinal plants.
Van Wyk BE
ETHNOPHARMACOLOGICAL RELEVANCE: Data on the relative importance and research status of commercially relevant African medicinal plants are needed for developing new research strategies in order to stimulate much-needed ethnopharmacological research and to promote the commercialization of African plants.
AIM OF THE STUDY: To present an illustrated bird's eye view and comparative analysis of the relative popularity and importance of commercialized African medicinal plants. A comparison is made between the general popularity and commercial importance of the species (as indicated by their footprint on the World Wide Web) and their scientific popularity and importance (as indicated by the number of research publications). The inventory and review is strongly focussed to cover all or most of the medicinal plant raw materials in the international trade that are exported from African countries, with less emphasis on those that are regularly traded on local and regional markets within Africa.
MATERIALS AND METHODS: The review is based on literature data, Scopus and Google searches, commercial information and the author's own experience and observations.
RESULTS: More than 5400 plant species are used in traditional medicine in Africa, of which less than 10% have been commercially developed to some extent. Africa is home to more than 80 valuable commercial species that are regularly traded on international markets, including phytomedicines (e.g. Harpagophytum procumbens and Pelargonium sidoides), functional foods (e.g. Adansonia digitata and Hibiscus sabdariffa) and sources of pure chemical entities (e.g. caffeine from Coffea arabica and yohimbine from Pausinystalia johimbe). According to the Scopus results, about 60% of all recent publications on African medicinal plants appeared in the last decade, with an average of 280 papers (28 per year) for 85 prominent species of international trade. The most popular African species for research (number of publications in brackets) were: Ricinus communis (5187), Aloe vera (2832), Catharanthus roseus (2653), Sesamum indicum (2534), Strophanthus gratus (2514), Coffea arabica (2431), Citrullus lanatus (2215), Momordica charantia (2047), Withania somnifera (1767), Trigonella foenum-graecum (1687), Acacia senegal (1373), Centella asiatica (1355), Griffonia simplicifolia (1010), Hibiscus sabdariffa (987), Tamarindus indica (973) and Catha edulis (947). The top species in terms of recent research interest (% of publications in last decade) were: Hoodia gordonii (95%), Cyclopia genistoides (93%), Sceletium tortuosum (90%), Agathosma betulina (89%), Pelargonium sidoides (86%), Boswellia papyrifera (85%), Lessertia (Sutherlandia) frutescens (84%), Boswellia sacra (83%), Mondia whitei (81%), Hibiscus sabdariffa (80%), Hypoxis hemerocallidea (80%) and Tylosema esculentum (80%). Both lists reflect the recent interest in functional foods and dietary supplements.
CONCLUSION: Despite a marked recent increase in the number of publications on indigenous medicinal plants and dietary supplements, Africa lags behind Europe and Asia in terms of the number of products that have been commercialised and the percentage of the flora that is utilized for international trade. There is a tremendous potential for developing new crops and new products but much work remains to be done to generate more focussed and relevant pre-clinical data and convincing proof of concept through clinical studies.
J Ethnopharmacol. 2015 Dec;176():118-34.
PMID: 26498493 [PubMed - indexed for MEDLINE]
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| 53. |
A comment about the use of Boswellia-based cream for prevention of adjuvant radiotherapy skin damage in mammary carcinoma.
Fiorica F
Eur Rev Med Pharmacol Sci. 2015 Jun;19(12):2141-2.
PMID: 26166632 [PubMed - indexed for MEDLINE]
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| 54. |
Medical Plant Extracts for Treating Knee Osteoarthritis: a Snapshot of Recent Clinical Trials and Their Biological Background.
Walzer SM, Weinmann D, Toegel S
In light of the growing global health problem associated with osteoarthritis, herbal remedies have become an important research focus in the scientific and medical community, and numerous studies have been published to identify their biological effects and mechanisms in vitro and in vivo. This review is a snapshot of the most recent clinical trials on the efficacy of medical plant extracts in knee osteoarthritis patients, and provides relevant background information on the biological mechanisms that may underlie the clinical observations. Therefore, we performed a PubMed literature survey and discussed a selection of clinical trials in the field, with special attention being drawn to the design and outcome measures of the studies. We further spotlighted on issues relating to the efficacy and safety of the plant extracts and discussed major challenges for upcoming studies in the field, which include the need for rigorously designed in vivo and in vitro studies, as well as the elucidation of potential additive effects and structure-modifying activities beyond symptom relief.
Curr Rheumatol Rep. 2015 Aug;17(8):54.
PMID: 26163305 [PubMed - indexed for MEDLINE]
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| 55. |
Herbal and plant therapy in patients with inflammatory bowel disease.
Triantafyllidi A, Xanthos T, Papalois A, Triantafillidis JK
The use of herbal therapy in inflammatory bowel disease (IBD) is increasing worldwide. The aim of this study was to review the literature on the efficacy of herbal therapy in IBD patients. Studies on herbal therapy for IBD published in Medline and Embase were reviewed, and response to treatment and remission rates were recorded. Although the number of the relevant clinical studies is relatively small, it can be assumed that the efficacy of herbal therapies in IBD is promising. The most important clinical trials conducted so far refer to the use of mastic gum, tormentil extracts, wormwood herb, , , germinated barley foodstuff, and . In ulcerative colitis, gel, riticum aestivum, andrographis paniculata extract and topical Xilei-san were superior to placebo in inducing remission or clinical response, and curcumin was superior to placebo in maintaining remission; gum resin and seeds were as effective as mesalazine, whereas oenothera biennis had similar relapse rates as ω-3 fatty acids in the treatment of ulcerative colitis. In Crohn's disease, mastic gum, , and were superior to placebo in inducing remission and preventing clinical postoperative recurrence, respectively. Herbal therapies exert their therapeutic benefit by different mechanisms including immune regulation, antioxidant activity, inhibition of leukotriene B4 and nuclear factor-kappa B, and antiplatelet activity. Large, double-blind clinical studies assessing the most commonly used natural substances should urgently be conducted.
Ann Gastroenterol. 2015;28(2):210-220.
PMID: 25830661 [PubMed - as supplied by publisher]
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| 56. |
Prospects of boswellic acids as potential pharmaceutics.
Du Z, Liu Z, Ning Z, Liu Y, Song Z, Wang C, Lu A
Boswellic acids have long been considered the main bioactive components of frankincense, and many studies in vitro and in animals as well as several clinical studies have confirmed their various bioactivities. In particular, a large number of mechanistic studies have confirmed their anti-inflammatory and antitumor activities. However, not every boswellic acid exhibits a satisfactory pharmacological performance, which depends on the chemical structure and functional groups of the acid. To enhance the pharmacological values of boswellic acids, derivatization has been specifically applied with the aim of discovering more active derivatives of BAs. In addition, the preliminary pharmacokinetic studies of these compounds using various standard methods show their poor bioavailability in humans and rodents, which has led to questions of their pharmacological relevance and potentially limits their use in clinical practice and pharmaceutical development. To improve these effects, some approaches have shown some improvements in effectiveness, and the new formula compatibility approach is considered a very reasonable method for improving the bioavailability of boswellic acids.
Planta Med. 2015 Mar;81(4):259-71.
PMID: 25714728 [PubMed - indexed for MEDLINE]
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| 57. |
Scientific evaluation of medicinal plants used for the treatment of abnormal uterine bleeding by Avicenna.
Mobli M, Qaraaty M, Amin G, Haririan I, Hajimahmoodi M, Rahimi R
PURPOSE: Abnormal uterine bleeding (AUB) is one of the prevalent gynecological disorders that cause considerable morbidity and management of that plays an important role in protecting women's health. This review focuses on medicinal plants mentioned by Avicenna, a great Iranian philosopher and physician (A.D. 980-1037), in his book Canon for treatment of AUB.
METHODS: Medicinal plants mentioned in Canon for treatment of AUB were elicited and searched in electronic databases including PubMed, Scopus, Google Scholar and Cochrane library to find studies that confirmed their efficacy. Data were collected for the years 1980-2014.
RESULTS: The findings included 23 plants belonging to 18 families. Scientific findings have revealed that these plants control AUB through four mechanisms of action including inhibition of inflammatory process, inhibition of prostaglandins production, antiproliferative activity on human cervical cancer cells (HeLa), and estrogenic activity. All of the plants exhibited anti-inflammatory activity in vitro and/or in vivo. Cuscuta chinensis and Portulaca oleracea exhibited estrogenic activity. Boswellia carteri, Lens culinaris, Myrtus communis, Polygonum aviculare, Pistacia lentiscus, and Punica granatum have revealed inhibitory activity on biosynthesis of prostaglandins. Some of the mentioned plants including: Ceratonia siliqua, Cuscuta chinensis, Cuscuta epithymum, Cydonia oblonga, Paeonia sp., Portulaca oleracea, Solanum nigrum, Rumex acetosa and Onopordum acanthium have shown antiproliferative activity on HeLa cells.
CONCLUSION: Investigation of traditional Iranian medicine literatures can lead to the identification of effective natural medicines for the management of AUB; however, conclusive confirmation of the efficacy and safety of these treatments needs more evaluations.
Arch Gynecol Obstet. 2015 Jul;292(1):21-35.
PMID: 25637505 [PubMed - indexed for MEDLINE]
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| 58. |
Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases.
Langhorst J, Wulfert H, Lauche R, Klose P, Cramer H, Dobos GJ, Korzenik J
OBJECTIVE: We performed a systematic review for Complementary and Alternative Medicine [CAM] as defined by the National Institute of Health in Inflammatory Bowel Disease [IBD], ie Crohn's disease [CD] and ulcerative colitis [UC], with the exception of dietary and nutritional supplements, and manipulative therapies.
METHODS: A computerized search of databases [Cochrane Library, Pubmed/Medline, PsychINFO, and Scopus] through March 2014 was performed. We screened the reference sections of original studies and systematic reviews in English language for CAM in IBD, CD and UC. Randomized controlled trials [RCT] and controlled trials [CT] were referred and assessed using the Cochrane risk of bias tool.
RESULTS: A total of: 26 RCT and 3 CT for herbal medicine, eg aloe-vera gel, andrographis paniculata, artemisia absinthium, barley foodstuff, boswellia serrata, cannabis, curcumin, evening primrose oil, Myrrhinil intest®, plantago ovata, silymarin, sophora, tormentil, wheatgrass-juice and wormwood; 1 RCT for trichuris suis ovata; 7 RCT for mind/body interventions such as lifestyle modification, hypnotherapy, relaxation training and mindfulness; and 2 RCT in acupuncture; were found. Risk of bias was quite heterogeneous. Best evidence was found for herbal therapy, ie plantago ovata and curcumin in UC maintenance therapy, wormwood in CD, mind/body therapy and self-intervention in UC, and acupuncture in UC and CD.
CONCLUSIONS: Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.
J Crohns Colitis. 2015 Jan;9(1):86-106.
PMID: 25518050 [PubMed - indexed for MEDLINE]
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| 59. |
Warfarin interactions with medicinal herbs.
Milić N, Milosević N, Golocorbin Kon S, Bozić T, Abenavoli L, Borrelli F
Recognition of the adverse effects of medicinal herbs is not routine and the reports on such effects are even less frequent in clinical practice. Potential herb-drug interactions are of a major safety concern, especially for drugs with narrow therapeutic indices like warfarin, which can lead to severe adverse reactions that are sometimes life-threatening. The interactions between warfarin and medicinal herbs described in the literature have been summarized in this paper relying on Medline database (via PubMed) using the key words: warfarin, herbal supplements and interactions. The references on the analyzed literature have been investigated in order to collect the existing data. The case reports with severe adverse effects such as spontaneous postoperative bleeding, formation of hematomas, hematemesis, melena, thrombosis, subarachnoid hemorrhage and/or subdural hematomas after concomitant use of warfarin and the medicinal herbs: Panax ginseng, Hypericum perforatum, Salvia milthiorizza, Gingko biloba, Serenoa repens, Angelica sinensis, Vaccinium species, Allium sativum, Zingiber officinale, Tanacetum parthenium, Lucium barbarum, Matricaria chamomilla, Boswellia serrata and Camellia sinensis have been estimated. Some of the interactions between warfarin and medicinal herbs have been well assessed proving that they are closely-dependent. The interactions between warfarin and medicinal herbs, not generally reported in previous reviews, are presented in our review. The health professionals who are involved in treating the patients are expected to be fully informed about the interactions between warfarin and medicinal herbs in order to minimize the health risks of the patients.
Nat Prod Commun. 2014 Aug;9(8):1211-6.
PMID: 25233607 [PubMed - indexed for MEDLINE]
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| 60. |
Ayurvedic interventions for osteoarthritis: a systematic review and meta-analysis.
Kessler CS, Pinders L, Michalsen A, Cramer H
Ayurveda is one of the fastest growing systems within complementary and alternative medicine. However, the evidence for its effectiveness is unsatisfactory. The aim of this work was to review and meta-analyze the effectiveness and safety of different Ayurvedic interventions in patients with osteoarthritis (OA). 138 electronic databases were searched through August 2013. Randomized controlled trials, randomized crossover studies, cluster-randomized trials, and non-randomized controlled clinical trials were eligible. Adults with pre-diagnosed OA were included as participants. Interventions were included as Ayurvedic if they were explicitly labeled as such. Main outcome measures were pain, physical function, and global improvement. Risk of bias was assessed using the Cochrane risk of bias tool. 19 randomized and 14 non-randomized controlled trials on 12 different drugs and 3 non-pharmaceutical interventions with a total of 2,952 patients were included. For the compound preparation, Rumalaya, large and apparently unbiased effects beyond placebo were found for pain (standardized mean difference [SMD] -3.73; 95 % confidence interval [CI] -4.97, -2.50; P < 0.01) and global improvement (risk ratio 12.20; 95 % CI 5.83, 25.54; P < 0.01). There is also some evidence that effects of the herbal compound preparation Shunti-Guduchi are comparable to those of glucosamine for pain (SMD 0.08; 95 % CI -0.20, 0.36; P = 0.56) and function (SMD 0.15; 95 % CI -0.12, 0.36; P = 0.41). Based on single trials, positive effects were found for the compound preparations RA-11, Reosto, and Siriraj Wattana. For Boswellia serrata, Lepidium Sativum, a Boswellia serrata containing multicomponent formulation and the compounds Nirgundi Taila, Panchatikta Ghrita Guggulu, and Rhumayog, and for non-pharmacological interventions like Ayurvedic massage, steam therapy, and enema, no evidence for significant effects against potential methodological bias was found. No severe adverse events were observed in all trials. The drugs Rumalaya and Shunti-Guduchi seem to be safe and effective drugs for treatment of OA-patients, based on these data. However, several limitations relate to clinical research on Ayurveda. Well-planned, well-conducted and well-published trials are warranted to improve the evidence for Ayurvedic interventions.
Rheumatol Int. 2015 Feb;35(2):211-32.
PMID: 25062981 [PubMed - indexed for MEDLINE]
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| 61. |
Winter warmth from Cochrane.
McDonald S, Turner T
Med J Aust. 2014 Jul;201(1):14.
PMID: 24999874 [PubMed - indexed for MEDLINE]
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| 62. |
Complementary and alternative medicine (CAM) use in an Italian cohort of pediatric headache patients: the tip of the iceberg.
Dalla Libera D, Colombo B, Pavan G, Comi G
The use of complementary alternative medicine (CAM) in paediatric populations is considerably increased, especially for pain and chronic conditions, as demonstrated by epidemiological surveys both in Europe and in the USA. In our study, CAM was used in 76 % patients of a cohort of 124 children affected by headache (age 4-16 years; 67 % female; 70 % migraine without aura, 12 % migraine with aura, 18 % tensive headache according to IHS criteria) consecutively recruited at a Pediatric Headache University Center. CAM was used as preventive treatment in 80 % cases. The main reasons for seeking CAM were: the wish of avoiding chronic use of drugs with their related side effects, the desire of an integrated approach, the reported inefficacy of conventional medicine, and a more suitable children disposition to CAM than to pharmacological compound. Female gender, younger age, migraine without aura, parents' higher educational status, maternal use of CAM and other associated chronic conditions, correlated with CAM use (p < 0.05). 73 % patients chose CAM also to treat other diseases (i.e. allergies, colitis, asthma, insomnia, muscle-scheletric disorders and dysmenorrhoea). The most assumed CAM were: herbal remedies (64 %) such as Valeriana, Ginkgo biloba, Boswellia serrata, Vitex agnus-castus, passion flower, Linden tree; vitamins/minerals supplements (40 %) with magnesium, 5-Hydroxytryptophan, vitamin B6 or B12, Multivitamin compounds; Homeopathy (47 %) with Silicea, Ignatia Amara, Pulsatilla, Aconitum, Nux Vomica, Calcarea phosphorica; physical treatment (45 %) such as Ayurvedic massage, shiatsu, osteopathy; yoga (33 %); acupuncture (11 %). CAM-often integrated with conventional care-was auto-prescribed in 30 % of the cases, suggested by non-physician in 22 %, by the General Practitioner in 24 % and by paediatrician in 24 %. Both general practitioners and neurologists were mostly unaware of their patients' CAM use. In conclusion, neurologists should inquire for CAM use and be prepared to learn about CAM therapies or to directly interact with CAM trained experts, in order to coordinate an integrative approach to health, as especially required in paediatric headache patients and their parents. Further studies are required to investigate safety and efficacy of CAM in pediatric headache, as a possible side-medicine to conventional pharmacological approach.
Neurol Sci. 2014 May;35 Suppl 1():145-8.
PMID: 24867852 [PubMed - indexed for MEDLINE]
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| 63. |
Oral herbal therapies for treating osteoarthritis.
Cameron M, Chrubasik S
BACKGROUND: Medicinal plant products are used orally for treating osteoarthritis. Although their mechanisms of action have not yet been elucidated in full detail, interactions with common inflammatory mediators provide a rationale for using them to treat osteoarthritic complaints.
OBJECTIVES: To update a previous Cochrane review to assess the benefits and harms of oral medicinal plant products in treating osteoarthritis.
SEARCH METHODS: We searched electronic databases (CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, ISI Web of Science, World Health Organization Clinical Trials Registry Platform) to 29 August 2013, unrestricted by language, and the reference lists from retrieved trials.
SELECTION CRITERIA: Randomised controlled trials of orally consumed herbal interventions compared with placebo or active controls in people with osteoarthritis were included. Herbal interventions included any plant preparation but excluded homeopathy or aromatherapy products, or any preparation of synthetic origin.
DATA COLLECTION AND ANALYSIS: Two authors used standard methods for trial selection and data extraction, and assessed the quality of the body of evidence using the GRADE approach for major outcomes (pain, function, radiographic joint changes, quality of life, withdrawals due to adverse events, total adverse events, and serious adverse events).
MAIN RESULTS: Forty-nine randomised controlled studies (33 interventions, 5980 participants) were included. Seventeen studies of confirmatory design (sample and effect sizes pre-specified) were mostly at moderate risk of bias. The remaining 32 studies of exploratory design were at higher risk of bias. Due to differing interventions, meta-analyses were restricted to Boswellia serrata (monoherbal) and avocado-soyabean unsaponifiables (ASU) (two herb combination) products.Five studies of three different extracts from Boswellia serrata were included. High-quality evidence from two studies (85 participants) indicated that 90 days treatment with 100 mg of enriched Boswellia serrata extract improved symptoms compared to placebo. Mean pain was 40 points on a 0 to 100 point VAS scale (0 is no pain) with placebo, enriched Boswellia serrata reduced pain by a mean of 17 points (95% confidence interval (CI) 8 to 26); number needed to treat for an additional beneficial outcome (NNTB) 2; the 95% CIs did not exclude a clinically significant reduction of 15 points in pain. Physical function was 33 points on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) 0 to 100 point subscale (0 is no loss of function) with placebo, enriched Boswellia serrata improved function by 8 points (95% CI 2 to 14); NNTB 4. Assuming a minimal clinically important difference of 10 points, we cannot exclude a clinically important benefit in some people. Moderate-quality evidence (one study, 96 participants) indicated that adverse events were probably reduced with enriched Boswellia serrata (18/48 events versus 30/48 events with placebo; relative risk (RR) 0.60, 95% CI 0.39 to 0.92). Possible benefits of other Boswellia serrata extracts over placebo were confirmed in moderate-quality evidence from two studies (97 participants) of Boswellia serrata (enriched) 100 mg plus non-volatile oil, and low-quality evidence from small single studies of a 999 mg daily dose of Boswellia serrata extract and 250 mg daily dose of enrichedBoswellia serrata. It was uncertain if a 99 mg daily dose of Boswellia serrata offered benefits over valdecoxib due to the very low-quality evidence from a small single study. It was uncertain if there was an increased risk of adverse events or withdrawals with Boswellia serrata extract due to variable reporting of results across studies. The studies reported no serious adverse events. Quality of life and radiographic joint changes were not measured.Six studies examined the ASU product Piasclidine®. Moderate-quality evidence from four studies (651 participants) indicated that ASU 300 mg produced a small and clinically questionable improvement in symptoms, and probably no increased adverse events compared to placebo after three to 12 months treatment. Mean pain with placebo was 40.5 points on a VAS 0 to 100 scale (0 is no pain), ASU 300 mg reduced pain by a mean of 8.5 points (95% CI 1 to 16 points); NNTB 8. ASU 300 mg improved function (standardised mean difference (SMD) -0.42, 95% CI -0.73 to -0.11). Function was estimated as 47 mm (0 to 100 mm scale, where 0 is no loss of function) with placebo, ASU 300 mg improved function by a mean of 7 mm (95% CI 2 to 12 mm); NNTB 5 (3 to 19). There were no differences in adverse events (5 studies, 1050 participants) between ASU (53%) and placebo (51%) (RR 1.04, 95% CI 0.97 to 1.12); withdrawals due to adverse events (1 study, 398 participants) between ASU (17%) and placebo (15%) (RR 1.14, 95% CI 0.73 to 1.80); or serious adverse events (1 study, 398 participants) between ASU (40%) and placebo (33%) (RR 1.22, 95% CI 0.94 to 1.59). Radiographic joint changes, measured as change in joint space width (JSW) in two studies (453 participants) did not differ between ASU 300 mg treatment (-0.53 mm) and placebo (-0.65 mm); mean difference of -0.12 (95% CI -0.43 to 0.19). Moderate-quality evidence from a single study (156 participants) confirmed possible benefits of ASU 600 mg over placebo, with no increased adverse events. Low-quality evidence (1 study, 357 participants) indicated there may be no differences in symptoms or adverse events between ASU 300 mg and chondroitin sulphate. Quality of life was not measured.All other herbal interventions were investigated in single studies, limiting conclusions. No serious side effects related to any plant product were reported.
AUTHORS' CONCLUSIONS: Evidence for the proprietary ASU product Piasclidine® in the treatment of osteoarthritis symptoms seems moderate to high for short term use, but studies over a longer term and against an apparently active control are less convincing. Several other medicinal plant products, including extracts of Boswellia serrata, show trends of benefits that warrant further investigation in light of the fact that the risk of adverse events appear low.There is no evidence that Piasclidine® significantly improves joint structure, and limited evidence that it prevents joint space narrowing. Structural changes were not tested for with any other herbal intervention.Further investigations are required to determine optimum daily doses producing clinical benefits without adverse events.
Cochrane Database Syst Rev. 2014 May;2014(5):CD002947.
PMID: 24848732 [PubMed - indexed for MEDLINE]
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| 64. |
Complementary and alternative medicine in inflammatory bowel diseases: what is the future in the field of herbal medicine?
Gilardi D, Fiorino G, Genua M, Allocca M, Danese S
The use of complementary and alternative medicine is wide-spread not only in Eastern countries, but also in the Western world. Despite the increasing evidence on the harmful effects induced by several naturopathic/homeopathic products, patients seem to appreciate these remedies, in particular because they consider them to be absolutely safe. This same phenomenon is common among inflammatory bowel disease (IBD) patients. As a result there is a significant request for scientific data to evaluate both the efficacy and safety of these remedies, and to support the use of such medications as adjuvant treatments to biological and synthetic drugs. We aimed to review the current evidence on efficacy and safety of some natural products that are believed to be effective in inflammatory bowel disease. Further perspectives for the clinical use of herbal products and strategies for improving knowledge about herbal products in IBD are also discussed.
Expert Rev Gastroenterol Hepatol. 2014 Sep;8(7):835-46.
PMID: 24813226 [PubMed - indexed for MEDLINE]
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| 65. |
Frankincense ( rǔ xiāng; boswellia species): from the selection of traditional applications to the novel phytotherapy for the prevention and treatment of serious diseases.
Hamidpour R, Hamidpour S, Hamidpour M, Shahlari M
Frankincense ( Rǔ Xiāng; Boswellia Species), the resinous extract from the trees of the genus Boswellia, has been used for centuries in cultural ceremonies, as a cosmetic agent, and as a traditional medicine to treat a variety of ailments, especially inflammatory diseases including asthma, arthritis, cerebral edema, chronic pain syndrome, chronic bowel diseases, cancer, and some other illnesses. Boswellic acids are the active compounds of frankincense and AKBA (3-O-acetyl-11-keto-β-boswellic acid) is the most important and effective acid among them. Some studies have shown that the use of frankincense can also improve the learning and enhance the memory in animals and human beings. It seems that frankincense might have a potential ability to be used as an alternative natural medicine not only for chronic and inflammatory diseases but also for brain and memory disorders.
J Tradit Complement Med. 2013 Oct;3(4):221-6.
PMID: 24716181 [PubMed - as supplied by publisher]
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| 66. |
Induction of clinical response and remission of inflammatory bowel disease by use of herbal medicines: a meta-analysis.
Rahimi R, Nikfar S, Abdollahi M
AIM: To evaluate the efficacy and tolerability of herbal medicines in inflammatory bowel disease (IBD) by conducting a meta-analysis.
METHODS: Electronic databases were searched for studies investigating efficacy and/or tolerability of herbal medicines in the management of different types of IBD. The search terms were: "herb" or "plant" or "herbal" and "inflammatory bowel disease". Data were collected from 1966 to 2013 (up to Feb). The "clinical response", "clinical remission", "endoscopic response", "endoscopic remission", "histological response", "histological remission", "relapse", "any adverse events", and "serious adverse events" were the key outcomes of interest. We used the Mantel-Haenszel, Rothman-Boice method for fixed effects and DerSimonian-Laird method for random-effects. For subgroup analyses, we separated the studies by type of IBD and type of herbal medicine to determine confounding factors and reliability.
RESULTS: Seven placebo controlled clinical trials met our criteria and were included (474 patients). Comparison of herbal medicine with placebo yielded a significant RR of 2.07 (95%CI: 1.41-3.03, P = 0.0002) for clinical remission; a significant RR of 2.59 (95%CI: 1.24-5.42, P = 0.01) for clinical response; a non-significant RR of 1.33 (95%CI: 0.93-1.9, P = 0.12) for endoscopic remission; a non-significant RR of 1.69 (95%CI: 0.69-5.04) for endoscopic response; a non-significant RR of 0.64 (95%CI: 0.25-1.81) for histological remission; a non-significant RR of 0.86 (95%CI: 0.55-1.55) for histological response; a non-significant RR of 0.95 (95%CI: 0.52-1.73) for relapse; a non-significant RR of 0.89 (95%CI: 0.75-1.06, P = 0.2) for any adverse events; and a non-significant RR of 0.97 (95%CI: 0.37-2.56, P = 0.96) for serious adverse events.
CONCLUSION: The results showed that herbal medicines may safely induce clinical response and remission in patients with IBD without significant effects on endoscopic and histological outcomes, but the number of studies is limited to make a strong conclusion.
World J Gastroenterol. 2013 Sep;19(34):5738-49.
PMID: 24039370 [PubMed - indexed for MEDLINE]
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| 67. |
Triterpenoid resinous metabolites from the genus Boswellia: pharmacological activities and potential species-identifying properties.
Zhang Y, Ning Z, Lu C, Zhao S, Wang J, Liu B, Xu X, Liu Y
The resinous metabolites commonly known as frankincense or olibanum are produced by trees of the genus Boswellia and have attracted increasing popularity in Western countries in the last decade for their various pharmacological activities. This review described the pharmacological specific details mainly on anti-inflammatory, anti-carcinogenic, anti-bacterial and apoptosis-regulating activities of individual triterpenoid together with the relevant mechanism. In addition, species-characterizing triterpenic markers with the methods for their detection, bioavailability, safety and other significant properties were reviewed for further research.
Chem Cent J. 2013 Sep;7(1):153.
PMID: 24028654 [PubMed - as supplied by publisher]
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| 68. |
Systematic review: the efficacy of herbal therapy in inflammatory bowel disease.
Ng SC, Lam YT, Tsoi KK, Chan FK, Sung JJ, Wu JC
BACKGROUND: Complementary and alternative medicine (CAM), particularly herbal therapy, is widely used by patients with inflammatory bowel disease (IBD) but controlled data are limited.
AIM: To systematically review the literature on the efficacy of herbal therapy in the treatment of ulcerative colitis (UC) and Crohn's disease (CD).
METHODS: Publications in English and non-English literatures (MEDLINE, EMBASE, EBM Reviews, AMED, Global Health) were searched from 1947 to 2013 for controlled clinical studies of herbal therapy in IBD. Outcome measures included response and remission rates.
RESULTS: Twenty-one randomised controlled trials (14 UC; 7 CD) including a total of 1484 subjects (mean age 41, 50% female) were analysed. In UC, aloe vera gel, Triticum aestivum (wheat grass juice), Andrographis paniculata extract (HMPL-004) and topical Xilei-san were superior to placebo in inducing remission or response, and curcumin was superior to placebo in maintaining remission; Boswellia serrata gum resin and Plantago ovata seeds were as effective as mesalazine, whereas Oenothera biennis (evening primrose oil) had similar relapse rates as omega-3 fatty acids in the treatment of UC. In CD, Artemisia absinthium (wormwood) and Tripterygium wilfordii were superior to placebo in inducing remission, and preventing clinical recurrence of post-operative CD respectively.
CONCLUSIONS: Randomised controlled trials of herbal therapy for the treatment of IBD show encouraging results but studies remain limited and heterogenous. Larger controlled studies with stricter endpoints and better-defined patient groups are required to obtain more conclusive results on the use of CAM therapies in IBD.
Aliment Pharmacol Ther. 2013 Oct;38(8):854-63.
PMID: 23981095 [PubMed - indexed for MEDLINE]
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| 69. |
Boswellic acid and its inhibitory effect on tumor growth in systemic malignancies: an emerging concept in oncology.
Kapoor S
Future Oncol. 2013 May;9(5):627-8.
PMID: 23647290 [PubMed - indexed for MEDLINE]
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| 70. |
Adverse effects of herbal medicines: an overview of systematic reviews.
Posadzki P, Watson LK, Ernst E
This overview of systematic reviews (SRs) aims to evaluate critically the evidence regarding the adverse effects of herbal medicines (HMs). Five electronic databases were searched to identify all relevant SRs, with 50 SRs of 50 different HMs meeting our inclusion criteria. Most had only minor weaknesses in methods. Serious adverse effects were noted only for four HMs: Herbae pulvis standardisatus, Larrea tridentate, Piper methysticum and Cassia senna. The most severe adverse effects were liver or kidney damage, colon perforation, carcinoma, coma and death. Moderately severe adverse effects were noted for 15 HMs: Pelargonium sidoides, Perna canaliculus, Aloe vera, Mentha piperita, Medicago sativa, Cimicifuga racemosa, Caulophyllum thalictroides, Serenoa repens, Taraxacum officinale, Camellia sinensis, Commifora mukul, Hoodia gordonii, Viscum album, Trifolium pratense and Stevia rebaudiana. Minor adverse effects were noted for 31 HMs: Thymus vulgaris, Lavandula angustifolia Miller, Boswellia serrata, Calendula officinalis, Harpagophytum procumbens, Panax ginseng, Vitex agnus-castus, Crataegus spp., Cinnamomum spp., Petasites hybridus, Agave americana, Hypericum perforatum, Echinacea spp., Silybum marianum, Capsicum spp., Genus phyllanthus, Ginkgo biloba, Valeriana officinalis, Hippocastanaceae, Melissa officinalis, Trigonella foenum-graecum, Lagerstroemia speciosa, Cnicus benedictus, Salvia hispanica, Vaccinium myrtillus, Mentha spicata, Rosmarinus officinalis, Crocus sativus, Gymnema sylvestre, Morinda citrifolia and Curcuma longa. Most of the HMs evaluated in SRs were associated with only moderately severe or minor adverse effects.
Clin Med (Lond). 2013 Feb;13(1):7-12.
PMID: 23472485 [PubMed - indexed for MEDLINE]
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| 71. |
Plant food supplements with anti-inflammatory properties: a systematic review (II).
Di Lorenzo C, Dell'Agli M, Badea M, Dima L, Colombo E, Sangiovanni E, Restani P, Bosisio E
The aim of this systematic review is to summarize the evidence for or against the efficacy of plant food supplements (PFS) for coping inflammatory conditions by considering epidemiological and human intervention studies. The review considers six botanical species commonly used as food supplements/medicinals: Urtica dioica L., Symphytum officinalis L., Calendula officinalis L., Curcuma longa L., Boswellia serrata Roxb., and Harpagophytum procumbens L. The search retrieved 579 publications. By removing the duplicates and applying the inclusion/exclusion criteria, the final number of papers was 47. No epidemiological data were found. The bibliographic search found no paper regarding the anti-inflammatory effects of Calendula officinalis L. and Symphytum officinalis L. by oral use. In spite of the long-term traditional use for inflammatory disorders, Curcuma longa L. and Harpagophytum procumbens L. warrant further investigation, whereas the efficacy of Urtica dioica L, even if the available data on hard endpoints are promising, requires other trials. Boswellia serrata Roxb. was found to be the most promising, since it shows the best efficacy for the treatment of pain/inflammatory conditions. In conclusion, it is advisable to conduct further studies with more homogeneous population and larger number of subjects by avoiding the heterogeneity of the herbal preparations considered.
Crit Rev Food Sci Nutr. 2013;53(5):507-16.
PMID: 23391017 [PubMed - indexed for MEDLINE]
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| 72. |
Unifying mechanisms of action of the anticancer activities of triterpenoids and synthetic analogs.
Safe SH, Prather PL, Brents LK, Chadalapaka G, Jutooru I
Triterpenoids such as betulinic acid (BA) and synthetic analogs of oleanolic acid [2-cyano-3,12-dioxooleana-1,9-dien-28-oic acid (CDDO)] and glycyrrhetinic acid [2-cyano-3,11-dioxo-18β-oleana-1,12-dien-30-oc acid (CDODA)] are potent anticancer agents that exhibit antiproliferative, antiangiogenic, anti-inflammatory and pro-apoptotic activities. Although their effects on multiple pathways have been reported, unifying mechanisms of action have not been reported. Studies in this laboratory have now demonstrated that several triterpenoids including BA and some derivatives, celastrol, methyl ursolate, β-boswellic acid derivatives, and the synthetic analogs CDDO, CDODA and their esters decreased expression of specificity protein (Sp) transcription factors and several pro-oncogenic Sp-regulated genes in multiple cancer cell lines. The mechanisms of this response are both compound- and cell context-dependent and include activation of both proteasome-dependent and -independent pathways. Triterpenoid-mediated induction of reactive oxygen species (ROS) has now been characterized as an important proteasome-independent pathway for downregulation of Sp transcription factors. ROS decreases expression of microRNA-27a (miR-27a) and miR-20a/miR-17-5p and this results in the induction of the transcriptional "Sp-repressors" ZBTB10 and ZBTB4, respectively, which in turn downregulate Sp and Sp-regulated genes. Triterpenoids also activate or deactive nuclear receptors and G-protein coupled receptors, and these pathways contribute to their antitumorigenic activity and may also play a role in targeting Sp1, Sp3 and Sp4 which are highly overexpressed in multiple cancers and appear to be important for maintaining the cancer phenotype.
Anticancer Agents Med Chem. 2012 Dec;12(10):1211-20.
PMID: 22583404 [PubMed - indexed for MEDLINE]
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| 73. |
Boswellia serrata, a potential antiinflammatory agent: an overview.
Siddiqui MZ
The resin of Boswellia species has been used as incense in religious and cultural ceremonies and in medicines since time immemorial. Boswellia serrata (Salai/Salai guggul), is a moderate to large sized branching tree of family Burseraceae (Genus Boswellia), grows in dry mountainous regions of India, Northern Africa and Middle East. Oleo gum-resin is tapped from the incision made on the trunk of the tree and is then stored in specially made bamboo basket for removal of oil content and getting the resin solidified. After processing, the gum-resin is then graded according to its flavour, colour, shape and size. In India, the States of Andhra Pradesh, Gujarat, Madhya Pradesh, Jharkhand and Chhattisgarh are the main source of Boswellia serrata. Regionally, it is also known by different names. The oleo gum-resins contain 30-60% resin, 5-10% essential oils, which are soluble in the organic solvents, and the rest is made up of polysaccharides. Gum-resin extracts of Boswellia serrata have been traditionally used in folk medicine for centuries to treat various chronic inflammatory diseases. The resinous part of Boswellia serrata possesses monoterpenes, diterpenes, triterpenes, tetracyclic triterpenic acids and four major pentacyclic triterpenic acids i.e. β-boswellic acid, acetyl-β-boswellic acid, 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid, responsible for inhibition of pro-inflammatory enzymes. Out of these four boswellic acids, acetyl-11-keto-β-boswellic acid is the most potent inhibitor of 5-lipoxygenase, an enzyme responsible for inflammation.
Indian J Pharm Sci. 2011 May;73(3):255-61.
PMID: 22457547 [PubMed - as supplied by publisher]
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| 74. |
Anti-inflammatory agents from plants: progress and potential.
Recio MC, Andujar I, Rios JL
The identification of substances that can promote the resolution of inflammation in a way that is homeostatic, modulatory, efficient, and well-tolerated by the body is of fundamental importance. Traditional medicines have long provided front-line pharmacotherapy for many millions of people worldwide. Medicinal extracts are a rich source of therapeutic leads for the pharmaceutical industry. The use of medicinal plant therapies to treat chronic illness, including rheumatoid arthritis (RA) and inflammatory bowel disease (IBD), is thus widespread and on the rise.The aim of this review is to present recent progress in clinical anti-inflammatory studies of plant extracts and compound leads such as green tea polyphenols, curcumin, resveratrol, boswellic acid, and cucurbitacins, among others, against chronic inflammatory diseases, mainly RA and IBD. In this context, the present paper also highlights the most promising experimental data on those plant extracts and pure compounds active in animal models of the aforementioned diseases.
Curr Med Chem. 2012;19(14):2088-103.
PMID: 22414101 [PubMed - indexed for MEDLINE]
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| 75. |
Herbal medicine in the treatment of ulcerative colitis.
Ke F, Yadav PK, Ju LZ
Ulcerative colitis (UC) is a refractory, chronic, and nonspecific disease occurred usually in the rectum and the entire colon. The etiopathology is probably related to dysregulation of the mucosal immune response toward the resident bacterial flora together with genetic and environmental factors. Several types of medications are used to control the inflammation or reduce symptoms. Herbal medicine includes a wide range of practices and therapies outside the realms of conventional Western medicine. However, there are limited controlled evidences indicating the efficacy of traditional Chinese medicines, such as aloe vera gel, wheat grass juice, Boswellia serrata, and bovine colostrum enemas in the treatment of UC. Although herbal medicines are not devoid of risk, they could still be safer than synthetic drugs. The potential benefits of herbal medicine could lie in their high acceptance by patients, efficacy, relative safety, and relatively low cost. Patients worldwide seem to have adopted herbal medicine in a major way, and the efficacy of herbal medicine has been tested in hundreds of clinical trials in the management of UC. The evidences on herbal medicine are incomplete, complex, and confusing, and certainly associated with both risks and benefits. There is a need for further controlled clinical trials of the potential efficacy of herbal medicine approaches in the treatment of UC, together with enhanced legislation to maximize their quality and safety.
Saudi J Gastroenterol. 2012;18(1):3-10.
PMID: 22249085 [PubMed - indexed for MEDLINE]
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| 76. |
Targeting inflammatory pathways by triterpenoids for prevention and treatment of cancer.
Yadav VR, Prasad S, Sung B, Kannappan R, Aggarwal BB
Traditional medicine and diet has served mankind through the ages for prevention and treatment of most chronic diseases. Mounting evidence suggests that chronic inflammation mediates most chronic diseases, including cancer. More than other transcription factors, nuclear factor-kappaB (NF-κB) and STAT3 have emerged as major regulators of inflammation, cellular transformation, and tumor cell survival, proliferation, invasion, angiogenesis, and metastasis. Thus, agents that can inhibit NF-κB and STAT3 activation pathways have the potential to both prevent and treat cancer. In this review, we examine the potential of one group of compounds called triterpenes, derived from traditional medicine and diet for their ability to suppress inflammatory pathways linked to tumorigenesis. These triterpenes include avicins, betulinic acid, boswellic acid, celastrol, diosgenin, madecassic acid, maslinic acid, momordin, saikosaponins, platycodon, pristimerin, ursolic acid, and withanolide. This review thus supports the famous adage of Hippocrates, "Let food be thy medicine and medicine be thy food".
Toxins (Basel). 2010 Oct;2(10):2428-66.
PMID: 22069560 [PubMed - indexed for MEDLINE]
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| 77. |
Targeting Sp1 transcription factors in prostate cancer therapy.
Sankpal UT, Goodison S, Abdelrahim M, Basha R
Transcription factors are proteins that regulate gene expression by binding to specific DNA sequences within gene promoter regions. Specificity protein (Sp) family transcription factors play a critical role in various cellular processes and have been shown to be associated with tumorigenesis. The Sp family consists of several members that contain a highly conserved DNA-binding domain composed of three zinc fingers at the C-terminus and serine/threonine- and glutamine-rich transactivation domains at the N-terminal. Sp1 is elevated in several cancers including prostate and is associated with the prognosis of patients. Sp1, Sp3, and Sp4 regulate a variety of cancer associated genes that are involved in cell cycle, proliferation, cell differentiation, and apoptosis. Studies have shown that in prostate cancer, Sp1 regulates important genes like androgen receptor, TGF-β, c-Met, fatty acid synthase, matrix metalloprotein (MT1-MMP), PSA, and α-integrin. These results highlight the importance of Sp1 in prostate cancer and emphasize the potential therapeutic value of targeting Sp1. Several strategies, including the use of natural and synthetic compounds, have been used to inhibit Sp1 in prostate cancer. These include polyphenol quercetin, betulinic acid, acetyl-11-keto-beta-boswellic acid, tea phenols, isothiocyanates, thiazolidinediones, arsenic trioxide, and selenium. This review will describe the association of Sp proteins in prostate cancer with a special emphasis on some of the agents tested to target Sp proteins for the treatment of this malignancy.
Med Chem. 2011 Sep;7(5):518-25.
PMID: 22022994 [PubMed - indexed for MEDLINE]
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| 78. |
Boswellia serrata: an overall assessment of in vitro, preclinical, pharmacokinetic and clinical data.
Abdel-Tawab M, Werz O, Schubert-Zsilavecz M
Non-steroidal anti-inflammatory drug (NSAID) intake is associated with high prevalence of gastrointestinal or cardiovascular adverse effects. All efforts to develop NSAIDs that spare the gastrointestinal tract and the cardiovasculature are still far from achieving a breakthrough. In the last two decades, preparations of the gum resin of Boswellia serrata (a traditional ayurvedic medicine) and of other Boswellia species have experienced increasing popularity in Western countries. Animal studies and pilot clinical trials support the potential of B. serrata gum resin extract (BSE) for the treatment of a variety of inflammatory diseases like inflammatory bowel disease, rheumatoid arthritis, osteoarthritis and asthma. Moreover, in 2002 the European Medicines Agency classified BSE as an 'orphan drug' for the treatment of peritumoral brain oedema. Compared to NSAIDs, it is expected that the administration of BSE is associated with better tolerability, which needs to be confirmed in further clinical trials. Until recently, the pharmacological effects of BSE were mainly attributed to suppression of leukotriene formation via inhibition of 5-lipoxygenase (5-LO) by two boswellic acids, 11-keto-β-boswellic acid (KBA) and acetyl-11-keto-β-boswellic acid (AKBA). These two boswellic acids have also been chosen in the monograph of Indian frankincense in European Pharmacopoiea 6.0 as markers to ensure the quality of the air-dried gum resin exudate of B. serrata. Furthermore, several dietary supplements advertise the enriched content of KBA and AKBA. However, boswellic acids failed to inhibit leukotriene formation in human whole blood, and pharmacokinetic data revealed very low concentrations of AKBA and KBA in plasma, being far below the effective concentrations for bioactivity in vitro. Moreover, permeability studies suggest poor absorption of AKBA following oral administration. In view of these results, the previously assumed mode of action - that is, 5-LO inhibition - is questionable. On the other hand, 100-fold higher plasma concentrations have been determined for β-boswellic acid, which inhibits microsomal prostaglandin E synthase-1 and the serine protease cathepsin G. Thus, these two enzymes might be reasonable molecular targets related to the anti-inflammatory properties of BSE. In view of the results of clinical trials and the experimental data from in vitro studies of BSE, and the available pharmacokinetic and metabolic data on boswellic acids, this review presents different perspectives and gives a differentiated insight into the possible mechanisms of action of BSE in humans. It underlines BSE as a promising alternative to NSAIDs, which warrants investigation in further pharmacological studies and clinical trials.
Clin Pharmacokinet. 2011 Jun;50(6):349-69.
PMID: 21553931 [PubMed - indexed for MEDLINE]
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| 79. |
Traditional herbal remedies that influence cell adhesion molecule activity.
Spelman K, Aldag R, Hamman A, Kwasnik EM, Mahendra MA, Obasi TM, Morse J, Williams EJ
Many traditional medicines have demonstrated immune activity, however, research has largely neglected their effects on cell adhesion molecules (CAMs). This review reports on extracts from 37 medicinal plant species, similar to or replicating traditional preparations, that up- or downregulate either gene or protein activity of CAMs. The majority of the investigations were in vitro, primarily of the immunoglobulin superfamily of CAMs, specifically intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) and secondarily on the integrin (CD11b or MAC-1) and selectin (E-selectin and P-selectin) families of CAMs. The following plant species have demonstrated modulation of multiple CAMs: Artemisia asiatica, Boswellia serrata, Canscora decussata, Cinnamomum povectum, Dehaasia incrassate, Ganoderma lucidum, Ginkgo biloba, Hypericum perforatum, Juglans regia, Lycopus lucidus, Panax notoginseng, Rheum undulatum, Salvia miltiorrhiza. Many other species have documented activity on one CAM. Currently there are limited in vivo/ex vivo investigations, including a clinical trial on Mahonia aquifolium. Although further evidence is needed, the data suggest that the reviewed botanical medicines may have the potential to provide therapeutic potential in disease processes involving CAMs. Additionally, the reported success of many of these plant extracts by traditional cultures and modern phytotherapists may involve the modulation of CAMs.
Phytother Res. 2011 Apr;25(4):473-83.
PMID: 21105177 [PubMed - indexed for MEDLINE]
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| 80. |
A review of the efficacy of traditional Iranian medicine for inflammatory bowel disease.
Rahimi R, Shams-Ardekani MR, Abdollahi M
The etiology of inflammatory bowel disease (IBD) is not yet known, but many factors such as defects in the immune system, oxidative stress, microbial content in the gastrointestinal tract, nuclear factor (NF)-κB, nitric oxide (NO), cyclooxygenase-2 (Cox-2), and leukotriene B4 (LB4) are thought to play a role in its pathogenesis. In traditional Iranian medicine (TIM), several medicinal plants are thought to be effective for the treatment of IBD. In this study, information on all of these remedies were derived from all available old sources such as documents or notes and books and were added to the information derived from modern medical databases covering all in vitro, in vivo and clinical trials. For some of these plants, only one or two mechanisms of action have been found such as in Cassia fistula, Lepidium sativum, and Bunium persicum. However, for some plants various mechanisms of action are known. For example, Commiphora mukul is effective in IBD due to its immunomodulatory, antioxidant, and antibacterial properties and it decreases NF-κB, NO and Cox-2. Another herb, Plantago ovata, has immunomodulatory, antioxidant, anti-inflammatory and wound healing activities and decreases NO and LB4. Considering the mechanisms of action of these plants, the combination of some of them may be useful because of their many mechanisms of action such as Pistacia lentiscus, Bunium persicum, Solanum nigrum, Plantago ovata, Boswellia, Solanum nigrum, Plantago ovata and Commiphora mukul. For some of the herbal products used in TIM such as oleogum resin from Commiphora myrrha, seeds of Ocimum basilicum, seeds of Linum usitatissimum, gum resin of Dracaena cinnabari, seeds of Plantago major, seeds of Lallementia royleana, and seeds of Allium porrum, there is no or not enough studies to confirm their benefits in IBD. It is suggested that an evaluation of the effects of these plants on different aspects of IBD should be performed.
World J Gastroenterol. 2010 Sep;16(36):4504-14.
PMID: 20857519 [PubMed - indexed for MEDLINE]
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| 81. |
Modulation of the immune system by Boswellia serrata extracts and boswellic acids.
Ammon HP
Extracts from the gum resin of Boswellia serrata and some of is constituents including boswellic acids affect the immune system in different ways. Among the various boswellic acids 11-keto-beta-boswellic acid (KBA) and acetyl-11-keto-beta-boswellic acid have been observed to be active. However, also other boswellic acids may exhibit actions in the immune system. In the humoral defence system a mixture of boswellic acis at higher doses reduced primary antibody titres; on the other hand lower doses enhanced secondary antibody titres following treatment with sheep erythrocytes. In the cellular defence boswellic acides appear to increase lymphocyte proliferation whereas higher concentrations are even inhibitory. Moreover, BAs increase phagocytosis of macrophages. BAs affect the cellular defence system by interaction with production/release of cytokines. Thus, BAs inhibit activation of NFkappaB which is a product of neutrophile granulocytes. Consequently a down regulation of TNF-alpha and decrease of IL-1, IL-2, IL-4, IL-6 and IFN-gamma, which are proinflammatory cytokines by BEs and BAs has been reported. Suppressions of the classic way of the complement system was found to be due to inhibition of the conversion of C3 into C3a and C3b. However, which of these pharmacological actions contribute to the therapeutic effects and which is finally the best dosage of a standardized extract needs further examination. And it is also a question whether or not a single BA will have the same therapeutic effect as a standardized extract. Among the mediators of inflammatory reaction, mast cell stabilisation has been described by a BE. Inhibition of prostaglandin synthesis appears to play only a minor role as far as the anti-inflammatory effect is concerned. On the other hand the inhibitory action of BAs on 5-LO leading to a decreased production of leukotrienes has received high attention by the scientific community since a variety of chronic inflammatory diseases is associatied with increased leukotriene activity. At the end of the cascade of events in the cellular immune system as far as it directs to various tissues of the body - i.e. autoimmune diseases - formation of oxygen radicals and proteases (for example elastase) play an important destructive role. Here, BEs as well as BAs have been found to be inhibitory. From the pharmacological properties of BEs and BAs it is not surprising that positive effects of BEs in some chronic inflammatory diseases including rheumatoid arthritis, bronchial asthma, osteoarthritis, ulcerative colitis and Crohn's disease have been reported.
Phytomedicine. 2010 Sep;17(11):862-7.
PMID: 20696559 [PubMed - indexed for MEDLINE]
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| 82. |
Herbal interventions for chronic asthma in adults and children: a systematic review and meta-analysis.
Clark CE, Arnold E, Lasserson TJ, Wu T
AIMS: To assess the efficacy of herb and plant extracts in the management of asthma.
METHOD: Systematic review and meta-analysis. Multiple database searches identified randomised placebo controlled trials of herbal interventions reporting at least one primary outcome measure. Where possible data were combined for meta-analysis. Primary outcome measures were lung function, exacerbations and reduction in corticosteroid use. Secondary outcome measures were symptoms and symptom scores, use of reliever medications, changes in rates of consultation and adverse effects.
RESULTS: Twenty-six studies reporting on 20 herbal preparations were included. Two of six studies reporting change in FEV1 were positive. Little data was available on frequency of exacerbations. For primary outcomes single studies of Boswellia, Mai-Men-Dong-Tang, Pycnogenol, Jia-Wei-Si-Jun-Zi-Tang and Tylophora indica showed potential to improve lung function, and a study of 1.8-Cineol (eucalyptol) showed reduced daily oral steroid dosage.
CONCLUSIONS: Improvements in symptoms were not strongly supported by objective changes. Most trials were of small sample size, short duration, and poor methodology. Further adequately powered trials are needed to assess these compounds. Such trials should conform to CONSORT guidance, report standardised spirometry, and use validated symptom and severity scores. No recommendations for herbal treatment of asthma can be made from the current evidence.
Prim Care Respir J. 2010 Dec;19(4):307-14.
PMID: 20640388 [PubMed - indexed for MEDLINE]
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| 83. |
Complementary therapies, herbs, and other OTC agents: Boswellia (Boswellia serrata).
Cassileth B
Oncology (Williston Park). 2009 Nov;23(12):1108.
PMID: 20017295 [PubMed - indexed for MEDLINE]
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| 84. |
Boswellia resin: from religious ceremonies to medical uses; a review of in-vitro, in-vivo and clinical trials.
Moussaieff A, Mechoulam R
OBJECTIVES: Despite its historical-religious, cultural and medical importance, Boswellia has not been thoroughly studied, and gaps still exist between our knowledge of the traditional uses of the resin and the scientific data available. Here we review the pharmacology of Boswellia resin and of the small molecules identified as the active ingredients of the resin.
KEY FINDINGS: The resin of Boswellia species ('frankincense', 'olibanum') has been used as incense in religious and cultural ceremonies since the beginning of written history. Its medicinal properties are also widely recognized, mainly in the treatment of inflammatory conditions, as well as in some cancerous diseases, wound healing and for its antimicrobial activity. Until recently, work on Boswellia focused on the immunomodulatory properties of the resin and boswellic acids were considered to be the main, if not the only, active ingredients of the resin. Hence, this family of triterpenoids was investigated by numerous groups, both in vitro and in vivo. These compounds were shown to exert significant anti-inflammatory and pro-apoptotic activity in many assays: in vitro, in vivo and in clinical trials. We recently found incensole acetate and its derivatives, which are major components of Boswellia resin, to be nuclear factor-kappaB inhibitors, thus suggesting that they are, at least in part, responsible for its anti-inflammatory effects. Incensole acetate also exerts a robust neuroprotective effect after brain trauma in mice. Furthermore, it causes behavioural as well as anti-depressive and anxiolytic effects in mice. It is also a potent agonist of the transient receptor potential (TRP)V3 channel. It thus seems that incensole acetate and its derivatives play a significant role in the effects that Boswellia resin exerts on biological systems.
CONCLUSIONS: Altogether, studies on Boswellia resin have provided an arsenal of bio-active small molecules with a considerable therapeutic potential that is far from being utilized.
J Pharm Pharmacol. 2009 Oct;61(10):1281-93.
PMID: 19814859 [PubMed - indexed for MEDLINE]
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| 85. |
Recent developments in anti-inflammatory natural products.
Gautam R, Jachak SM
Many of the inflammatory diseases are becoming common in aging society throughout the world. The clinically used anti-inflammatory drugs suffer from the disadvantage of side effects and high cost of treatment (in case of biologics). Alternative to these drugs are traditional medicines and natural products, which offer a great hope in the identification of bioactive lead compounds and their development into drugs for treating inflammatory diseases. Since ancient times traditional medicines and phytopharmaceuticals are being used for the treatment of inflammatory and other disorders. The present review article describes anti-inflammatory natural products derived from plants and marine sources reported during last decade. The compounds described belong to different chemical classes such as alkaloids, steroids, terpenoids, polyphenolics, phenylpropanoids, fatty acids and lipids, and various miscellaneous compounds. The attempt is also being made to enumerate the possible leads, e.g. curcumin, resveratrol, baicalein, boswellic acid, betulinic acid, ursolic acid, and oleanolic acid, for further development with the help of structure-activity relationship (SAR) studies and their current status. In addition SAR studies carried out on the anti-inflammatory activity of flavonoid compounds and clinical studies performed on anti-inflammatory natural products are also discussed.
Med Res Rev. 2009 Sep;29(5):767-820.
PMID: 19378317 [PubMed - indexed for MEDLINE]
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| 86. |
Boswellic acids: a group of medicinally important compounds.
Shah BA, Qazi GN, Taneja SC
This review, containing over 276 references, covers the progress made in the chemistry and bioactivity of this important group of triterpenoids. Though initially known for their anti-inflammatory and anti-arthritic activities through a unique 5-LO inhibition mechanism, boswellic acids have recently attained significance due to their anti-cancer properties. The phytochemistry and chemical modifications, including mechanism of action, are discussed.
Nat Prod Rep. 2009 Jan;26(1):72-89.
PMID: 19374123 [PubMed - indexed for MEDLINE]
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| 87. |
Interventions for treating microscopic colitis: a Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Review Group systematic review of randomized trials.
Chande N, MacDonald JK, McDonald JW
OBJECTIVES: To conduct a systematic review to determine effective treatments for patients with collagenous colitis or lymphocytic colitis, the two subtypes of microscopic colitis.
METHODS: Relevant papers were identified via the MEDLINE, PUBMED, and Cochrane Collaboration databases, manual searches of the references of identified papers and review papers on microscopic colitis, as well as searches of abstracts from major gastroenterological meetings.
RESULTS: All studies assessing treatment of microscopic colitis had relatively small sample sizes. A total of 10 randomized trials included patients with collagenous colitis. Budesonide was studied for induction of response in three trials and for maintenance of response in two trials. The pooled odds ratio for inducing clinical response with budesonide was 12.32 (95% confidence interval, CI 5.53-27.46), and for maintaining clinical response was 8.82 (95% CI 3.19-24.37), with a number needed to treat (NNT) of 2 patients for each outcome. Budesonide also induced and maintained histological response and was well tolerated. Bismuth subsalicylate, prednisolone, and mesalamine with or without cholestyramine may be effective, whereas Boswellia serrata extract and probiotics were ineffective for treating collagenous colitis. Three randomized trials included patients with lymphocytic colitis. Budesonide was shown in one study to be effective for inducing clinical response (OR 9.00; 95% CI 1.98-40.93), with an NNT of three patients. Budesonide also induced histological response and was well tolerated. Bismuth subsalicylate and mesalamine with or without cholestyramine may be effective for treating lymphocytic colitis. No trials assessed maintenance of response in patients with lymphocytic colitis.
CONCLUSIONS: Budesonide is effective and well tolerated for inducing and maintaining clinical and histological responses in patients with collagenous colitis, and for inducing clinical and histological responses in patients with lymphocytic colitis. Determining the magnitude of benefit is limited by the small sample sizes of the studies. The evidence for other agents, including bismuth subsalicylate, prednisolone, B. serrata extract, probiotics, and mesalamine with or without cholestyramine is weaker. It is not clear that any of these agents induce or maintain actual remission of collagenous or lymphocytic colitis, as opposed to clinical or histological response.
Am J Gastroenterol. 2009 Jan;104(1):235-41; quiz 234, 242.
PMID: 19098875 [PubMed - indexed for MEDLINE]
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| 88. |
Frankincense: systematic review.
Ernst E
OBJECTIVE: To assess evidence from randomised clinical trials about the effectiveness of extracts of Boswellia serrata (frankincense).
DESIGN: Systematic review.
DATA SOURCES: Electronic searches on Medline, Embase, Cinahl, Amed, and Cochrane Library. Hand searches of conference proceedings, bibliographies, and departmental files.
REVIEW METHODS: All randomised clinical trials of B serrata extract as a treatment for any human medical condition were included and studies of B serrata preparations combined with other ingredients were excluded. Titles and abstracts of all retrieved articles were read and hard copies of all relevant articles were obtained. Selection of studies, data extraction and validation were done by the author. The Jadad score was used to evaluate the methodological quality of all included trials.
RESULTS: Of 47 potentially relevant studies, seven met all inclusion criteria (five placebo controlled, two with active controls). The included trials related to asthma, rheumatoid arthritis, Crohn's disease, osteoarthritis, and collagenous colitis. Results of all trials indicated that B serrata extracts were clinically effective. Three studies were of good methodological quality. No serious safety issues were noted.
CONCLUSIONS: The evidence for the effectiveness of B serrata extracts is encouraging but not compelling.
BMJ. 2008 Dec;337():a2813.
PMID: 19091760 [PubMed - indexed for MEDLINE]
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| 89. |
[Gold, frankincense and myrrh].
Mayer JG
Dtsch Med Wochenschr. 2008 Dec;133(51-52):2665-8.
PMID: 19067267 [PubMed - indexed for MEDLINE]
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| 90. |
In vitro screening for the tumoricidal properties of international medicinal herbs.
Mazzio EA, Soliman KF
There is growing use of anticancer complementary and alternative medicines (CAMs) worldwide. The purpose of the current study is to assess a sizeable variety of natural and plant sources of diverse origin, to ascertain prospective research directives for cancer treatment and potential new chemotherapy drug sources. In this study, 374 natural extracts (10 microg/mL-5 mg/mL) were evaluated for dose-dependent tumoricidal effects using immortal neuroblastoma of spontaneous malignant origin. The findings indicate no pattern of tumoricidal effects by diverse plants with similar families/genus under the classes Pinopsida, Equisetopsida, Lycopodiosida, Filicosida, Liliopsida Monocotyledons or Magnoliopsida Dicotyledons. The results indicate that many of the most commonly used CAMs exhibited relatively weak tumoricidal effects including cats claw, astragalus, ginseng, echinacea, mistletoe, milk thistle, slippery elm, cayenne, chamomile, don quai, meadowsweet, motherwort and shepherd's purse. The data demonstrate that the most potent plant extracts were randomly dispersed within the plantae kingdom (LC(50) = 31-490 microg/mL) in order of the lowest LC(50) Dioscorea villosa (Dioscoreaceae) > Sanguinaria canadensis (Papaveraceae) > Dipsacus asper (Dipsacaceae) > Populus balsamifera (Salicaceae) > Boswellia carteri (Burseraceae) > Cyamopsis psoralioides (Fabaceae) > Rhamnus cathartica (Rhamnaceae) > Larrea tridentate (Zygophyllaceae) > Dichroa febrifuga (Hydrangeaceae) > Batschia canescens (Boraginaceae) > Kochia scoparia (Chenopodiaceae) > Solanum xanthocarpum (Solanaceae) > Opoponax chironium (Umbelliferae) > Caulophyllum thalictroides (Berberidaceae) > Dryopteris crassirhizoma (Dryopteridaceae) > Garcinia cambogia (Clusiaceae) > Vitex agnus-castus (Verbenaceae) > Calamus draco (Arecaceae). These findings show tumoricidal effect by extracts of wild yam root, bloodroot, teasel root, bakuchi seed, dichroa root, kanta kari, garcinia fruit, mace, dragons blood and the biblically referenced herbs: balm of gilead bud, frankincense and myrrh gum.
Phytother Res. 2009 Mar;23(3):385-98.
PMID: 18844256 [PubMed - indexed for MEDLINE]
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| 91. |
Boswellia serrata. Monograph.
Altern Med Rev. 2008 Jun;13(2):165-7.
PMID: 18590352 [PubMed - indexed for MEDLINE]
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| 92. |
Interventions for treating collagenous colitis.
Chande N, McDonald JW, Macdonald JK
BACKGROUND: Collagenous colitis is a cause of chronic diarrhea. Treatment has been based mainly on anecdotal evidence. This review was performed to identify therapies for collagenous colitis that have been proven in randomized trials.
OBJECTIVES: To determine effective treatments for patients with collagenous colitis.
SEARCH STRATEGY: Relevant papers published between 1970 and December 2007 were identified via the MEDLINE and PUBMED databases. Manual searches from the references of identified papers, as well as review papers on collagenous or microscopic colitis were performed to identify additional studies. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. Finally, the Cochrane Controlled Trials Register and the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register were searched for other studies.
SELECTION CRITERIA: Ten randomized trials were identified. Seven of these compared active treatment to placebo for treating active disease. Of these, 1 trial studied bismuth subsalicylate, 1 trial studied Boswellia serrata extract, 3 trials studies budesonide, 1 trial studied prednisolone, and 1 trial studied probiotics. One trial compared mesalamine to mesalamine + cholestyramine for treating active disease. Two trials compared budesonide to placebo in maintaining response induced by budesonide.
DATA COLLECTION AND ANALYSIS: Data were extracted independently by each author onto 2x2 tables (treatment versus comparator and response versus no response). For therapies assessed in one trial only, P-values were derived using the chi-square test. For therapies assessed in more than one trial, summary test statistics were derived using the Peto odds ratio and 95% confidence intervals. Data were combined for analysis only if the outcomes were sufficiently similar in definition.
MAIN RESULTS: In treating active disease, there were 9 patients with collagenous colitis in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks). Clinical response occurred in 100% of patients who received bismuth subsalicylate compared to 0% of patients who received placebo (P = 0.03). Thirty-one patients were enrolled in the trial studying Boswellia serrata extract (three 400 mg capsules daily for 8 weeks). Clinical response occurred in 44% of patients who received Boswellia serrata extract compared to 27% of patients who received placebo (P = 0.32). A total of 94 patients were enrolled in 3 trials studying budesonide (9 mg daily or in a tapering schedule for 6 to 8 weeks). Clinical response occurred in 81% of patients who received budesonide compared to 17% of patients who received placebo (P < 0.00001). The pooled odds ratio for clinical response to treatment with budesonide was 12.32 (95% CI 5.53 to 27.46), with a number needed to treat of 2 patients. Statistically significant histological response occurred with treatment in all 3 trials studying budesonide therapy. Eleven patients were enrolled in the trial studying prednisolone (50 mg daily for 2 weeks). Clinical response occurred in 63% of patients who received prednisolone compared to 0% who received placebo (P = 0.15). Twenty-nine patients were enrolled in the trial studying probiotics (2 capsules containing 0.5 x 10(10) CFU each of L. acidophilus LA-5 and B. animalis subsp. lactis strain BB-12 twice daily for 12 weeks). Clinical response occurred in 29% of patients who received probiotics compared to 13% of patients who received placebo (P = 0.38). Twenty-three patients were enrolled in the trial studying mesalamine (800 mg three times daily) with or without cholestyramine (4 g daily) for 6 months. Clinical response occurred in 73% of patients who received mesalamine alone compared to 100% of patients who received mesalamine + cholestyramine (P = 0.14). In maintaining response, 80 patients who had responded to open-label budesonide were enrolled in 2 trials studying budesonide (6 mg daily for 6 months). Clinical response was maintained in 83% of patients who received budesonide compared to 28% of patients who received placebo (P = 0.0002). The pooled odds ratio for maintenance of clinical response to treatment with budesonide was 8.40 (95% CI 2.73 to 25.81), with a number needed to treat of 2 patients. Histological response was maintained in 48% of patients who received budesonide compared to 15% of patients who received placebo (P = 0.002).
AUTHORS' CONCLUSIONS: Budesonide is effective for inducing and maintaining clinical and histological response in patients with collagenous colitis. The evidence for benefit with bismuth subsalicylate and for mesalamine with or without cholestyramine is weak. There is no evidence for the effectiveness of Boswellia serrata extract, prednisolone, or probiotics. These agents and other therapies require further study.
Cochrane Database Syst Rev. 2008 Apr;(2):CD003575.
PMID: 18425892 [PubMed - indexed for MEDLINE]
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| 93. |
Bioactive constituents of myrrh and frankincense, two simultaneously prescribed gum resins in chinese traditional medicine.
Shen T, Lou HX
Chem Biodivers. 2008 Apr;5(4):540-53.
PMID: 18421746 [PubMed - indexed for MEDLINE]
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| 94. |
A database on endemic plants at Tirumala hills in India.
Latheef SA, Prasad B, Bavaji M, Subramanyam G
UNLABELLED: Medicinal plants play an important role in health care. The use of medicinal plants for treatment is growing in view of cost and non-compliance of modern medicine as in case of non-communicable diseases. Plants such as Boswellia, ovalifoliolata, Cycas beddomei, Pimpinella tirupatiensis, Pterocarpus santalinus, Shorea thumbuggaia, Syzygium alternifolium, Terminalia pallida are endemic to Tirumala hills of seshachalam range falling under the Eastern Ghats of India. These plants species have medicinal properties such as anti-tumorogenic, anti-microbial, purgative, hypoglycemic, abortificient, analgesic, anti-septic, anti-pyretic and anti-inflammatory. We created a database named DEPTH in an attempt to communicate data of these plants to the scientific community. DEPTH contains data on scientific name, vernacular name, family name, morphological description, economic importance, known medicinal compounds and medicinal importance.
AVAILABILITY: http://svimstpt.ap.nic.in/MedicinalPlants/mainpage.htm.
Bioinformation. 2008 Jan;2(6):260-2.
PMID: 18317578 [PubMed - as supplied by publisher]
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| 95. |
A review of complementary and alternative approaches to immunomodulation.
Clarke JO, Mullin GE
Current Western therapies for inflammatory diseases are suboptimal; increasingly, patients are turning to complementary and alternative medicine for symptom relief and improved quality of life. There is emerging evidence that many of these therapies have the ability to modulate the immune system and disrupt the proinflammatory cascade through a variety of mechanisms, including antioxidant effects, alterations in cell signaling (in particular the nuclear factor (NF)-kappaB pathway), cytokines, proinflammatory mediators, and disruption of bacterial flora. Using inflammatory bowel disease (IBD) as a model of inflammation, we explore the principal complementary and alternative medicine treatments that show promise in this regard, namely, resveratrol, green tea, curcumin, boswellia, fish oil, vitamin D, and probiotics. With each agent, we detail the mechanisms that have been described with regard to immune modulation, discuss the medical conditions for which it has been evaluated, and explore the data to date for the prevention or treatment of IBD.
Nutr Clin Pract. 2008 Feb;23(1):49-62.
PMID: 18203964 [PubMed - indexed for MEDLINE]
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| 96. |
Nutraceuticals in the management of osteoarthritis.
Clayton JJ
Orthopedics. 2007 Aug;30(8):624-9; quiz 630-1.
PMID: 17727018 [PubMed - indexed for MEDLINE]
|
| 97. |
CEC and EKC of natural compounds.
Scherz H, Huck CW, Bonn GK
In this review, an overview of CEC and EKC methods with their developments are summarized for different natural compounds. It is divided into three main parts. The first part elaborates the separation of lipophilic compounds without any charged groups. The second part constitutes CEC and EKC of lipophilic compounds containing ionizable functional groups whereas the third part contains hydrophilic compounds. Packed, monolithic, coated, or raw fused-silica (FS) capillaries are among the choice for stationary phases. Applications of these phases on the above-mentioned three classes of compounds, coupled with different detection methods, e.g. MS or LIF, are explored and their advantages and disadvantages are discussed.
Electrophoresis. 2007 Jun;28(11):1645-57.
PMID: 17450533 [PubMed - indexed for MEDLINE]
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| 98. |
Evidence of effectiveness of herbal antiinflammatory drugs in the treatment of painful osteoarthritis and chronic low back pain.
Chrubasik JE, Roufogalis BD, Chrubasik S
Treatment with herbal medicines is very popular in Europe. In order to get information on the evidence of effectiveness of oral herbal medicines in the treatment of pain in the joints or lower back, OVID(MEDLINE), PUBMED and COCHRANE COLLABORATION LIBRARY were searched back to 1985 for systematic reviews. The level of evidence of effectiveness was defined as strong - at least two confirmatory studies demonstrating a clinical relevant effect, moderate - one confirmatory study with a clinical relevant effect and/or multiple exploratory studies of good quality; otherwise the evidence was insufficient or conflicting in the case of inconsistent findings. Fifteen systematic reviews were identified. The evidence of effectiveness was strong for a proprietary unsaponifiable avocado soybean fraction and Harpagophytum preparations containing > 50 mg harpagoside in the daily dosage, moderate for ginger and a proprietary rose hip and seed powder, insufficient for Boswellia serrata gum resin and other herbal preparations and inconsistent for a proprietary willow bark extract. Further rigorous studies are required to confirm the usefulness of herbal medicines in the treatment of osteoarthritic complaints and chronic low back pain in order to enable acceptance of the herbal medicines into the treatment guidelines.
Phytother Res. 2007 Jul;21(7):675-83.
PMID: 17444576 [PubMed - indexed for MEDLINE]
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| 99. |
Boswellic acids: biological actions and molecular targets.
Poeckel D, Werz O
Gum resin extracts of Boswellia species have been traditionally applied in folk medicine for centuries to treat various chronic inflammatory diseases, and experimental data from animal models and studies with human subjects confirmed the potential of B. spec extracts for the treatment of not only inflammation but also of cancer. Analysis of the ingredients of these extracts revealed that the pentacyclic triterpenes boswellic acids (BAs) possess biological activities and appear to be responsible for the respective pharmacological actions. Approaches in order to elucidate the molecular mechanisms underlying the biological effects of BAs identified 5-lipoxygenase, human leukocyte elastase, toposiomerase I and II, as well as IkappaB kinases as molecular targets of BAs. Moreover, it was shown that depending on the cell type and the structure of the BAs, the compounds differentially interfere with signal transduction pathways including Ca(2+/-) and MAPK signaling in various blood cells, related to functional cellular processes important for inflammatory reactions and tumor growth. This review summarizes the biological actions of BAs on the cellular and molecular level and attempts to put the data into perspective of the beneficial effects manifested in animal studies and trials with human subjects related to inflammation and cancer.
Curr Med Chem. 2006;13(28):3359-69.
PMID: 17168710 [PubMed - indexed for MEDLINE]
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| 100. |
Conservation biology: unkind cuts for incense.
Moore PD
Nature. 2006 Dec;444(7121):829.
PMID: 17167465 [PubMed - indexed for MEDLINE]
|
| 101. |
Interventions for treating collagenous colitis.
Chande N, McDonald JW, MacDonald JK
BACKGROUND: Collagenous colitis is a disorder that is recognized as a cause of chronic diarrhea. Treatment has been based mainly on anecdotal evidence. This review was performed to identify therapies for collagenous colitis that have been proven in randomized trials.
OBJECTIVES: To determine effective treatments for patients with clinically active collagenous colitis.
SEARCH STRATEGY: Relevant papers published between 1970 and June 2006 were identified via the MEDLINE and PUBMED databases. Manual searches from the references of identified papers, as well as review papers on collagenous or microscopic colitis were performed to identify additional studies. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. Finally, the Cochrane Controlled Trials Register and the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register were searched for other studies.
SELECTION CRITERIA: Seven randomized trials were identified. One trial studied bismuth subsalicylate (published in abstract form only), one trial studied Boswellia serrata extract (published in abstract form only), one trial studied probiotics, one trial studied prednisolone, and 3 trials studied budesonide for the therapy of collagenous colitis.
DATA COLLECTION AND ANALYSIS: Data were extracted independently by each author onto 2x2 tables (treatment versus placebo and response versus no response). For therapies assessed in one trial only, p-values were derived using the chi-square test. For therapies assessed in more than one trial, summary test statistics were derived using the Peto odds ratio and 95% confidence intervals. Data were combined for analysis only if the outcomes were sufficiently similar in definition.
MAIN RESULTS: There were 9 patients with collagenous colitis in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks). Those randomized to active drug were more likely to have clinical (p = 0.003) and histological (p = 0.003) improvement than those assigned to placebo. Eleven patients were enrolled in the trial studying prednisolone (50 mg daily for 2 weeks). There was a trend towards clinical response in patients on active medication compared to placebo (p = 0.064). The effect of prednisolone on histologic improvement was not studied. Thirty-one patients were enrolled in the Boswellia serrata extract trial. Clinical improvement was noted in 44% of patients who received active treatment compared to 27% of patients who received placebo (p = 0.32). Twenty-nine patients were enrolled in the probiotics trial. Clinical improvement was noted in 29% of patients who received probiotics compared to 13% of patients who received placebo (p = 0.635). A total of 94 patients were enrolled in 3 trials studying budesonide (9 mg daily or in a tapering schedule for 6 to 8 weeks). The pooled odds ratio for clinical response to treatment with budesonide was 12.32 (95% CI 5.53-27.46), with a number needed to treat of 2 patients. There was significant histological improvement with treatment in all 3 trials studying budesonide therapy. Budesonide also appears to improve patients' quality of life.
AUTHORS' CONCLUSIONS: Budesonide is effective for the treatment of collagenous colitis. The evidence for benefit with bismuth subsalicylate is weaker. The effectiveness of prednisolone, Boswellia serrata extract, probiotics and other therapies for induction or maintenance of remission of collagenous colitis is unknown and requires further study.
Cochrane Database Syst Rev. 2006 Oct;(4):CD003575.
PMID: 17054177 [PubMed - indexed for MEDLINE]
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| 102. |
Boswellic acids in chronic inflammatory diseases.
Ammon HP
Oleogum resins from BOSWELLIA species are used in traditional medicine in India and African countries for the treatment of a variety of diseases. Animal experiments showed anti-inflammatory activity of the extract. The mechanism of this action is due to some boswellic acids. It is different from that of NSAID and is related to components of the immune system. The most evident action is the inhibition of 5-lipoxygenase. However, other factors such as cytokines (interleukins and TNF-alpha) and the complement system are also candidates. Moreover, leukocyte elastase and oxygen radicals are targets. Clinical studies, so far with pilot character, suggest efficacy in some autoimmune diseases including rheumatoid arthritis, Crohn's disease, ulcerative colitis and bronchial asthma. Side effects are not severe when compared to modern drugs used for the treatment of these diseases.
Planta Med. 2006 Oct;72(12):1100-16.
PMID: 17024588 [PubMed - indexed for MEDLINE]
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| 103. |
Systematic review: microscopic colitis.
Nyhlin N, Bohr J, Eriksson S, Tysk C
BACKGROUND: Collagenous and lymphocytic colitis are fairly common causes of chronic non-bloody diarrhoea, especially in elderly female.
AIM: To present a systematic review of microscopic colitis.
METHODS: A PubMed search using the MeSH terms microscopic colitis, collagenous colitis, lymphocytic colitis and chronic diarrhoea was performed.
RESULTS: Annual incidence of each disorder is 4-6/100,000 inhabitants. The aetiology is unknown. Clinical characteristics are well described and there is an association with autoimmune diseases. Budesonide is the best-documented short-term treatment of collagenous colitis. In meta-analysis pooled odds ratio for clinical response after 6-8 weeks of treatment was 12.3 (95% CI: 5.5-27.5) in comparison with placebo. The evidence for bismuth subsalicylate is weaker and the effectiveness of other alternatives such as loperamide, cholestyramine, aminosalicylates, probiotics, or Boswellia serrata extract is unknown. Although unproven, in unresponsive severe disease azathioprine or methotrexate may be tried. No controlled trials have been carried out in lymphocytic colitis. The long-term prognosis of microscopic colitis is good, serious complications are rare and there is no increased mortality.
CONCLUSIONS: Clinical and epidemiological aspects of microscopic colitis are well described. Budesonide is the best-documented short-term therapy in collagenous colitis, but the optimal long-term strategy needs further study. Controlled treatment data of lymphocytic colitis are awaited for.
Aliment Pharmacol Ther. 2006 Jun;23(11):1525-34.
PMID: 16696800 [PubMed - indexed for MEDLINE]
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| 104. |
Natural products and anti-inflammatory activity.
Yuan G, Wahlqvist ML, He G, Yang M, Li D
The aim of this review paper was to summarise some commonly available natural products and their anti-inflammatory activity. We have collected data from MEDLINE, Current Contents and scientific journals, which included 92 publications. There are numerous natural products detailed in this literature; however we have summarized a few of the most commonly available and potent ones. In this paper, the natural products with anti-inflammatory activity including curcumin, parthenolide, cucurbitacins, 1,8-cineole, pseudopterosins, lyprinol, bromelain, flavonoids, saponins, marine sponge natural products and Boswellia serrata gum resin were reviewed. Natural products play a significant role in human health in relation to the prevention and treatment of inflammatory conditions. Further studies are being conducted to investigate the mechanism of action, metabolism, safety and long term side effect of these natural products, as well as interactions between these natural products with food and drug components.
Asia Pac J Clin Nutr. 2006;15(2):143-52.
PMID: 16672197 [PubMed - indexed for MEDLINE]
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| 105. |
Review article: complementary and alternative therapies for inflammatory bowel disease.
Langmead L, Rampton DS
Complementary and alternative medicine includes a wide range of practices and therapies outside the realms of conventional western medicine. Despite a lack of scientific data in the form of controlled trials for either efficacy or safety of complementary and alternative medicine, use by patients with inflammatory bowel disease, particularly of herbal therapies, is widespread and increasing. There is limited controlled evidence indicating efficacy of traditional Chinese medicines, aloe vera gel, wheat grass juice, Boswellia serrata and bovine colostrum enemas in ulcerative colitis. Encouraging results have also been reported in small studies of acupuncture for Crohn's disease and ulcerative colitis. Contrary to popular belief, natural therapies are not necessarily safe: fatal hepatic and irreversible renal failure have occurred with some preparations and interactions with conventional drugs are potentially dangerous. There is a need for further controlled clinical trials of the potential efficacy of complementary and alternative approaches in inflammatory bowel disease, together with enhanced legislation to maximize their quality and safety.
Aliment Pharmacol Ther. 2006 Feb;23(3):341-9.
PMID: 16422993 [PubMed - indexed for MEDLINE]
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| 106. |
Interventions for treating collagenous colitis.
Chande N, McDonald JW, Macdonald JK
BACKGROUND: Collagenous colitis is a disorder that is recognized as a cause of chronic diarrhea. Treatment has been based mainly on anecdotal evidence. This review was performed to identify therapies for collagenous colitis that have been proven in randomized trials.
OBJECTIVES: To determine effective treatments for patients with clinically active collagenous colitis.
SEARCH STRATEGY: Relevant papers published between 1970 and June 2005 were identified via the MEDLINE and PUBMED databases. Manual searches from the references of identified papers, as well as review papers on collagenous or microscopic colitis were performed to identify additional studies. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. Finally, the Cochrane Controlled Trials Register and the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register were searched for other studies.
SELECTION CRITERIA: Six randomized trials were identified. One trial studied bismuth subsalicylate (published in abstract form only), one trial studied Boswellia serrata extract (published in abstract form only), one trial studied prednisolone, and 3 trials studied budesonide in the therapy of collagenous colitis.
DATA COLLECTION AND ANALYSIS: Data were extracted independently by each author onto 2x2 tables (treatment versus placebo and response versus no response). For therapies assessed in one trial only, p-values were derived using the chi-square test. For therapies assessed in more than one trial, summary test statistics were derived using the Peto odds ratio and 95% confidence intervals. Data were combined for analysis only if the outcomes were sufficiently similar in definition.
MAIN RESULTS: There were 9 patients with collagenous colitis in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks). Those randomized to active drug were more likely to have clinical (p = 0.003) and histological (p = 0.003) improvement than those assigned to placebo. Eleven patients were enrolled in the trial studying prednisolone (50 mg daily for 2 weeks). There was a trend towards clinical response in patients on active medication compared to placebo (p = 0.064). The effect of prednisolone on histologic improvement was not studied. Thirty-one patients were enrolled in the Boswellia serrata extract trial. Clinical improvement was noted in 44% of patients who received active treatment compared to 27% of patients who received placebo (p = 0.32). A total of 94 patients were enrolled in 3 trials studying budesonide (9 mg daily or in a tapering schedule for 6 to 8 weeks). The pooled odds ratio for clinical response to treatment with budesonide was 12.32 (95% CI 5.53 - 27.46), with a number needed to treat of 2 patients. There was significant histological improvement with treatment in all 3 trials studying budesonide therapy. Budesonide also appears to improve patients' quality of life.
AUTHORS' CONCLUSIONS: Budesonide is effective for the treatment of collagenous colitis. The evidence for benefit with bismuth subsalicylate is weaker. The effectiveness of prednisolone and Boswellia serrata extract and other therapies for induction or maintenance of remission of collagenous colitis is unknown and requires further study.
Cochrane Database Syst Rev. 2005 Oct;(4):CD003575.
PMID: 16235328 [PubMed - indexed for MEDLINE]
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| 107. |
Boswellia: an evidence-based systematic review by the Natural Standard Research Collaboration.
Basch E, Boon H, Davies-Heerema T, Foppo I, Hashmi S, Hasskarl J, Sollars D, Ulbricht C
An evidence-based systematic review including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
J Herb Pharmacother. 2004;4(3):63-83.
PMID: 15829470 [PubMed - indexed for MEDLINE]
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| 108. |
Patented antiinflammatory plant drug development from traditional medicine.
Darshan S, Doreswamy R
Patents secured on antiinflammatory plant drugs derived from 38 plants are reviewed. An attempt has been made to compare the modern and traditional use of plant drugs and to establish the relevance of folk claims in developing modern drugs. The role of plant botanicals such as polysaccharides, terpenes, curcuminoids, alkaloids, etc. in alleviating inflammatory diseases including arthritis, rheumatism, acne skin allergy and ulcers is highlighted. Chemicals that alleviate swelling are derived from plants including grape, boswellia, turmeric, devil's claw and some essential oils such as clove, eucalyptus, rosemary, lavender, mint, myrrh, millefolia and pine have been patented and used as mixed formulations. Plants containing polysaccharides are the most potent in curing inflammatory diseases.
Phytother Res. 2004 May;18(5):343-57.
PMID: 15173991 [PubMed - indexed for MEDLINE]
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| 109. |
Nutritional and botanical modulation of the inflammatory cascade--eicosanoids, cyclooxygenases, and lipoxygenases--as an adjunct in cancer therapy.
Wallace JM
Emerging on the horizon in cancer therapy is an expansion of the scope of treatment beyond cytotoxic approaches to include molecular management of cancer physiopathology. The goal in these integrative approaches, which extends beyond eradicating the affected cells, is to control the cancer phenotype. One key new approach appears to be modulation of the inflammatory cascade, as research is expanding that links cancer initiation, promotion, progression, angiogenesis, and metastasis to inflammatory events. This article presents a literature review of the emerging relationship between neoplasia and inflammatory eicosanoids (PGE2 and related prostaglandins), with a focus on how inhibition of their synthesizing oxidases, particularly cyclooxygenase (COX), offers anticancer actions in vitro and in vivo. Although a majority of this research emphasizes the pharmaceutical applications of nonsteroidal anti-inflammatory drugs and selective COX-2 inhibitors, these agents fail to address alternate pathways available for the synthesis of proinflammatory eicosanoids. Evidence is presented that suggests the inhibition of lipoxygenase and its by-products-LTB4, 5-HETE, and 12-HETE-represents an overlooked but crucial component in complementary cancer therapies. Based on the hypothesis that natural agents capable of modulating both lipoxygenase and COX may advance the efficacy of cancer therapy, an overview and discussion is presented of dietary modifications and selected nutritional and botanical agents (notably, omega-3 fatty acids, antioxidants, boswellia, bromelain, curcumin, and quercetin) that favorably influence eicosanoid production.
Integr Cancer Ther. 2002 Mar;1(1):7-37; discussion 37.
PMID: 14664746 [PubMed - indexed for MEDLINE]
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| 110. |
[Boswellic acids (the active agent in incense) for the treatment of chronic inflammatory diseases].
Ammon HP
Med Monatsschr Pharm. 2003 Sep;26(9):309-15.
PMID: 14526615 [PubMed - indexed for MEDLINE]
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| 111. |
Immunomodulatory triterpenoids from the oleogum resin of Boswellia carterii Birdwood.
Badria FA, Mikhaeil BR, Maatooq GT, Amer MM
The immunomodulatory bioassay-guided fractionation of the oleogum resin of frankincense (Boswellia carterii Birdwood) resulted in the isolation and identification of 9 compounds; palmitic acid and eight triterpenoids belonging to lupane, ursane, oleanane, and tirucallane skeleta were isolated form the resin. These triterpenoids are lupeol, beta-boswellic acid, 11-keto-beta-boswellic acid, acetyl beta-boswellic acid, acetyl 11-keto-beta-boswellic acid, acetyl-alpha-boswellic acid, 3-oxo-tirucallic acid, and 3-hydroxy-tirucallic acid. The structures of the isolated compounds were deduced based on spectroscopic evidences. The lymphocyte transformation assay of the isolated compounds proved that the total extract retained more activity than that of any of the purified compounds.
Z Naturforsch C J Biosci. 2003;58(7-8):505-16.
PMID: 12939036 [PubMed - indexed for MEDLINE]
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| 112. |
[Boswellic acids (components of frankincense) as the active principle in treatment of chronic inflammatory diseases].
Ammon HP
Preparations from the gum resin of Boswellia serrata have been used as a traditional remedy in Ayurvedic medicine in India for the treatment of inflammatory diseases. Compounds from the gum with genuine antiinflammatory effects are pentacyclic triterpenes of the boswellic acid type. Boswellic acids inhibit the leukotriene biosynthesis in neutrophilic granulocytes by a non-redox, noncompetitive inhibition of 5-lipoxygenase. The effect is triggered by boswellic acids binding to the enzyme. Moreover certain boswellic acids have been described to inhibit elastase in leukocytes, to inhibit proliferation, induce apoptosis and to inhibit topoisomerases of leukoma- and glioma cell lines. A series of chronic inflammatory diseases are thought to be perpetuated by leukotrienes. In clinical trials promising results were observed in patients with rheumatoid arthritis, chronic colitis, ulcerative colitis, Crohn's disease, bronchial asthma und peritumoral brains edemas.
Wien Med Wochenschr. 2002;152(15-16):373-8.
PMID: 12244881 [PubMed - indexed for MEDLINE]
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| 113. |
The etiologies, pathophysiology, and alternative/complementary treatment of asthma.
Miller AL
A chronic inflammatory disorder of the respiratory airways, asthma is characterized by bronchial airway inflammation resulting in increased mucus production and airway hyper-responsiveness. The resultant symptomatology includes episodes of wheezing, coughing, and shortness of breath. Asthma is a multifactorial disease process with genetic, allergic, environmental, infectious, emotional, and nutritional components. The underlying pathophysiology of asthma is airway inflammation. The underlying process driving and maintaining the asthmatic inflammatory process appears to be an abnormal or inadequately regulated CD4+ T-cell immune response. The T-helper 2 (Th2) subset produces cytokines including interleukin-4 (IL-4), IL-5, IL-6, IL-9, IL-10, and IL-13, which stimulate the growth, differentiation, and recruitment of mast cells, basophils, eosinophils, and B-cells, all of which are involved in humoral immunity, inflammation, and the allergic response. In asthma, this arm of the immune response is overactive, while Th1 activity, generally corresponding more to cell-mediated immunity, is dampened. It is not yet known why asthmatics have this out-of-balance immune activity, but genetics, viruses, fungi, heavy metals, nutrition, and pollution all can be contributors. A plant lipid preparation containing sterols and sterolins has been shown to dampen Th2 activity. Antioxidant nutrients, especially vitamins C and E, selenium, and zinc appear to be necessary in asthma treatment. Vitamins B6 and B12 also may be helpful. Omega-3 fatty acids from fish, the flavonoid quercetin, and botanicals Tylophora asthmatica, Boswellia serrata and Petasites hybridus address the inflammatory component. Physical modalities, including yoga, massage, biofeedback, acupuncture, and chiropractic can also be of help.
Altern Med Rev. 2001 Feb;6(1):20-47.
PMID: 11207455 [PubMed - indexed for MEDLINE]
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| 114. |
Boswellia serrata.
Altern Med Rev. 1998 Aug;3(4):306-7.
PMID: 9734240 [PubMed - indexed for MEDLINE]
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| 115. |
Salai Guggal - Boswellia serrata: from a herbal medicine to a non-redox inhibitor of leukotriene biosynthesis.
Ammon HP
Eur J Med Res. 1996 May;1(8):369-70.
PMID: 9360935 [PubMed - indexed for MEDLINE]
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| 116. |
Salai Guggal - Boswellia serrata: from a herbal medicine to a specific inhibitor of leukotriene biosynthesis.
Ammon HP
Phytomedicine. 1996 May;3(1):67-70.
PMID: 23194863 [PubMed - as supplied by publisher]
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| 117. |
Recent progress in the study of anticancer drugs originating from plants and traditional medicines in China.
Han R
Drugs of plant origin have received much attention due to their enormous potential for the prevention and treatment of cancer. Recent progress in the study of anticancer drugs originating from plants and traditional medicines in China is reviewed in this paper, with particular emphasis on taxol, daidzein, acetyl boswellic acid, curcumin and ginsenosid Rh2.
Chin Med Sci J. 1994 Mar;9(1):61-9.
PMID: 7916218 [PubMed - indexed for MEDLINE]
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