| 1. |
Effect of a Boswellia and Ginger Mixture on the Memory Dysfunction of the Mild Traumatic Brain Injury Patients: A Randomized, Double-Blind Controlled Trial.
Yousefi O, Ghazi-Mirsaiid S, Azami P, Karimi G, Mani A, Niakan A, Khalili H
OBJECTIVE: To study a Boswellia and ginger mixture on the memory dysfunction of the mild traumatic brain injury (mTBI) patients
METHODS: Patients with mTBI were asked about memory impairment following the injury. One hundred mTBI patients were visited and assessed using an auditory-visual learning test (AVLT) questionnaire. By using random permuted blocks, patients were given the Memoral (a mixture of 360 mg of Boswellia and 36 mg of ginger) or placebo and were asked to consume it for a month. Patients were assessed one and three months afterward using the second and third steps of AVLT, respectively.
RESULTS: One hundred patients were included in the study and divided into control and intervention groups. The mean age of the patients was 36.83±14.71, and there were no significant differences between the two groups (=0.41). There were no statistically significant differences in the baseline scores of different AVLT parameters between the two groups. All patients had improvements in different parameters after three months. But some factors include the scores' change in total learning, retroactive interference score, forgetting rate, and net positive score were significantly higher in treatment groups at one-month and three-month follow-ups compared to the placebo group. In contrast, word span and hit parameters had the same pattern of improvement in both groups.
CONCLUSION: The herbal medication can have a satisfactory effect on eliminating post-mTBI memory dysfunction while having no considerable adverse effects. The effect of these components can also be sustained after a two-month timeframe. These results may assist patients to have less mental involvement.
Bull Emerg Trauma. 2022;10(4):157-164.
PMID: 36568722 [PubMed - as supplied by publisher]
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| 2. |
Boswellia serrata extract shows cognitive benefits in a double-blind, randomized, placebo-controlled pilot clinical trial in individuals who suffered traumatic brain injury.
Meshkat S, Mahmoodi Baram S, Rajaei S, Mohammadian F, Kouhestani E, Amirzargar N, Tafakhori A, Shafiee S, Meshkat M, Balenci L, Kiss A, Riazi A, Salimi A, Aghamollaii V, Salmani F, Karima S
BACKGROUND: Traumatic brain injury (TBI) is a major cause of death and disability. TBI can result in neuropsychiatric and cognitive problems as well as neurodegenerative pathologies that can appear right after or develop and persist years after injury.
METHOD: We conducted a double-blind, randomized, placebo-controlled clinical trial on patients who suffered from TBI three months to three years ago. The patients were randomized to placebo (n = 34) or K-Vie™ group (n = 46) for a treatment period of 3 months. The main primary outcomes include cognitive assessment in the Rey Auditory Verbal Learning Test-Recognition Test (RAVLT), Wechsler adult intelligence Digit Symbol Substitution Test (DSST) and trail-making test part B (TMT-B). Assessments were performed at baseline and at the month 3 follow-up visit. Linear mixed models were carried out to evaluate cognitive changes from baseline across all cognitive assessment tests.
RESULT: The current study showed significant (p < 0.05) improvement in cognitive function of patients who were given K-Vie™ compared with placebo across the RAVLT, DSST and TMT-B performance assessments. A larger cohort would be beneficial to further confirm the clinical utility of K-Vie™ and assess its effects in acute phases of TBI.
Brain Inj. 2022 Mar;36(4):553-559.
PMID: 35385330 [PubMed - indexed for MEDLINE]
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| 3. |
3-O-Acetyl-11-keto-β-boswellic acid ameliorates acquired, consolidated and recognitive memory deficits through the regulation of hippocampal PPAR γ, MMP9 and MMP2 genes in dementia model.
Gunasekaran V, Avarachan J, Augustine A, Khayum A, R A
Pentacyclic Phytomolecule 3-O-Acetyl-11-keto-β-boswellic acid (AKBA) from Frankincense family has proven for the neuroprotection and recognized as an orphan drug for the treatment of cerebral edema. Nonetheless, AKBA have promising indications with Peroxisome proliferator activated receptor gamma (PPARγ) associated to cognitive function not deliberated so far. In order to substantiate the potential role of AKBA on memory function, we examine the contribution of PPARγ activation and its downstream process. Modified method of scopolamine induced dementia rats were treated with AKBA (5, 10&15 mg/kg,i.p) and Donepezil (2.5 mg/kg,i.p). Scopolamine induced short term spatial, working memory and recognition memory impairment was reversed significantly after AKBA treatment. AKBA administration diminished the Acetylcholine esterase (AchE) activity and preserved brain GABA and glutamate mediated neuronal excitability. Further, gene expression study reveals AKBA ameliorates the memory impairment via activating PPARγ and its downstream regulators, matrix metalloproteinase 2 (MMP2) and matrix metalloproteinase 9 (MMP9) genes in hippocampus. This study concludes that the treatment with AKBA can be a novel Phyto-molecule of interest for treating dementia via up-regulating hippocampus genes mediated cholinergic activation.
Heliyon. 2021 Dec;7(12):e08523.
PMID: 34926858 [PubMed - as supplied by publisher]
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| 4. |
Potential therapeutic effects of boswellic acids/Boswellia serrata extract in the prevention and therapy of type 2 diabetes and Alzheimer's disease.
Gomaa AA, Farghaly HA, Abdel-Wadood YA, Gomaa GA
The link between diabetes and cognitive dysfunction has been reported in many recent articles. There is currently no disease-modifying treatment available for cognitive impairment. Boswellia serrata (B. serrata) is used traditionally to treat chronic inflammatory diseases such as type 2 diabetes (T2D), insulin resistance (IR), and Alzheimer's disease (AD). This review aims to highlight current research on the potential use of boswellic acids (BAs)/B. serrata extract in T2D and AD. We reviewed the published information through June 2021. Studies have been collected through a search on online electronic databases (Academic libraries as PubMed, Scopus, Web of Science, and Egyptian Knowledge Bank). Accumulating evidence in preclinical and small human clinical studies has indicated that BAs/B. serrata extract has potential therapeutic effect in T2D and AD. According to most of the authors, the potential therapeutic effects of BAs/B. serrata extract in T2D and AD can be attributed to immunomodulatory, anti-inflammatory, antioxidant activity, and elimination of the senescent cells. BAs/B. serrata extract may act by inhibiting the IκB kinase/nuclear transcription factor-κB (IKK/NF-κB) signaling pathway and increasing the formation of selective anti-inflammatory LOX-isoform modulators. In conclusion, BAs/B. serrata extract may have positive therapeutic effects in prevention and therapy of T2D and AD. However, more randomized controlled trials with effective, large populations are needed to show a definitive conclusion about therapeutic efficacy of BAs/B. serrata extract in T2D and AD.
Naunyn Schmiedebergs Arch Pharmacol. 2021 Nov;394(11):2167-2185.
PMID: 34542667 [PubMed - indexed for MEDLINE]
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| 5. |
Non-drug pain relievers active on non-opioid pain mechanisms.
Marchesi N, Govoni S, Allegri M
This review is aimed to summarize the pain-relieving effect of non-drug substances, mostly prescribed as integrators in treatment of pain, including especially in chronic postoperative pain (CPSP) and in chronic back pain after acute episodes. Their use reflects the fact that the current treatments for these syndromes continue to pose problems of unsatisfactory responses in a significant portion of patients and/or of an excess of side effects like those noted in the present opioid crisis. As integrators are frequently introduced into the market without adequate clinical testing, this review is aimed to collect the present scientific evidence either preclinical or clinical for their effectiveness. In particular, we reviewed the data on the use of: B vitamins; vitamin C; vitamin D; alpha lipoic acid (ALA); N-acetylcysteine; acetyl L-carnitine; curcumin; boswellia serrata; magnesium; coenzyme Q10, and palmitoylethanolamide. The combination of preclinical findings and clinical observations strongly indicate that these compounds deserve more careful attention, some of them having interesting clinical potentials also in preventing chronic pain after an acute episode. In particular, examining their putative mechanisms of action it emerges that combinations of few of them may exert an extraordinary spectrum of activities on a large variety of pain-associated pathways and may be eventually used in combination with more traditional pain killers in order to extend the duration of the effect and to lower the doses. Convincing examples of effective combinations against pain are vitamin B complex plus gabapentin for CPSP, including neuropathic pain; vitamin B complex plus diclofenac against low back pain and also in association with gabapentin, and ALA for burning mouth syndrome. These as well as other examples need, however, careful controlled independent clinical studies confirming their role in therapy.
Pain Pract. 2022 Feb;22(2):255-275.
PMID: 34498362 [PubMed - indexed for MEDLINE]
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| 6. |
A Placebo-Controlled, Pseudo-Randomized, Crossover Trial of Botanical Agents for Gulf War Illness: Curcumin ( Boswellia (), and French Maritime Pine Bark ().
Donovan EK, Kekes-Szabo S, Lin JC, Massey RL, Cobb JD, Hodgin KS, Ness TJ, Hangee-Bauer C, Younger JW
This report is part of a larger study designed to rapidly and efficiently screen potential treatments for Gulf War Illness (GWI) by testing nine different botanicals. In this placebo-controlled, pseudo-randomized, crossover clinical trial of 20 men with GWI, we tested three botanical agents with putative peripheral and central anti-inflammatory actions: curcumin (), boswellia (), and French maritime pine bark extract (). Participants completed 30 +/- 3 days of baseline symptom reports, followed by 30 +/- 3 days of placebo, 30 +/- 3 days of lower-dose botanical, and 30 +/- 3 days of higher-dose botanical. Participants then repeated the process with a new botanical until completing up to three botanical cycles. Data were analyzed using linear mixed models. Curcumin reduced GWI symptom severity significantly more than placebo at both the lower ( < 0.0001) and higher ( = 0.0003) dosages. Boswellia was not more effective than placebo at reducing GWI symptoms at either the lower ( = 0.726) or higher ( = 0.869) dosages. Maritime pine was not more effective than placebo at the lower dosage ( = 0.954) but was more effective than placebo at the higher dosage ( = 0.006). This study provides preliminary evidence that curcumin and maritime pine may help alleviate symptoms of GWI. As a screening study, a final determination of the efficacy of these compounds for all individuals with GWI cannot be made, and further studies will need to be conducted to determine strength and durability of effects, as well as optimal dosage. These results suggest that GWI may, at least in part, involve systemic inflammatory processes. This trial was registered on ClinicalTrials.gov (NCT02909686) on 13 September 2016.
Int J Environ Res Public Health. 2021 Mar;18(5):.
PMID: 33802272 [PubMed - indexed for MEDLINE]
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| 7. |
Efficacy of high-dissolution turmeric-sesame formulation for pain relief in adult subjects with acute musculoskeletal pain compared to acetaminophen: A randomized controlled study.
Rudrappa GH, Chakravarthi PT, Benny IR
BACKGROUND: Acetaminophen (paracetamol) is one of the most commonly used over-the-counter for pain relief. Management of acute pain with plant-based nutrients has remained suboptimal due to an absence of data supporting acute relief of pain. In the present study, it was hypothesized that high-dissolution liquid treatment of black sesame extract oil, Curcuma longa and Boswellia serrata may provide pain relief in people with acute musculoskeletal pain as quickly as acetaminophen.
METHODS: In this randomized active controlled open label study, 88 healthy subjects with acute musculoskeletal pain were randomized to receive treatment capsule (Rhuleave-K; 1,000 mg/d) or 1,000 mg/d acetaminophen for 7 days. Change in pain intensity and pain relief at first 6 hours, 3 days, and 7 days were measured. The onset of analgesia was measured by perceptible pain relief and meaningful pain relief. Other measures were McGill Pain Questionnaire and Patient Global Impression Change.
RESULTS: The treatment formulation resulted in average magnitude of pain relief comparable to the acetaminophen. Sixty-six percent of subjects in the treatment group reported positive response in pain relief (≥50% max TOTPAR; total pain relief) after 6 hours, compared to 73% of control. Seventy-three percent of subjects on treatment were considered positive responders, compared to 80% in the control group. The average time of onset of analgesia was 1 hour for the treatment group, versus 0.83 hour for control. At the end of day 3 and 7, there was significant improvement (P < .001 for day 3 and day 7) in the pain condition of treatment group and was comparable to control (P = .436 for day 3 and P = .529 for day 7). The total McGill Pain score showed significant reduction in pain with the treatment irrespective of the pain intensity statistically equal (P = .468) to control. Both the groups were equal in providing sensory pain relief (P = .942), but the treatment was 8.57 times significantly better (P = .027) than acetaminophen in reducing the unpleasantness and emotional aspects (affective domain) involved with acute pain.
CONCLUSION: The results showed that the treatment used in the study may act as a natural, fast acting, and safe alternative for acute pain relief comparable to acetaminophen.
Medicine (Baltimore). 2020 Jul;99(28):e20373.
PMID: 32664057 [PubMed - indexed for MEDLINE]
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| 8. |
Functional improvement and immune-inflammatory cytokines profile of ischaemic stroke patients after treatment with boswellic acids: a randomized, double-blind, placebo-controlled, pilot trial.
Baram SM, Karima S, Shateri S, Tafakhori A, Fotouhi A, Lima BS, Rajaei S, Mahdavi M, Tehrani HS, Aghamollaii V, Aghamiri SH, Mansouri B, Gharahje S, Kabiri S, Hosseinizadeh M, Shahamati SZ, Alborzi AT
Ischaemic stroke represents one of the main causes of disability. According to the broad investigations, it is widely assumed that the contribution of inflammatory mediators is strongly involved in its pathogenesis. Hence, it seems that stroke treatment needs more efficient and inflammatory-targeted compounds to modulate inflammatory-related pathways. Such strategies paved the way to achieve better clinical outcomes along with conventional therapies. Boswellic acids (BAs), the main bioactive compounds of Boswellia sp. resin; are triterpenoids with well-documented anti-inflammatory properties. Compared with NSAIDs, BAs cross blood-brain barrier yet they do not cause serious gastrointestinal adverse effects. Considering BAs anti-inflammatory features, we conducted a randomized double-blind placebo-controlled pilot trial of these compounds as a supplementary therapy. This trial randomized 80 ischaemic stroke patients (40-80-years old) with a 4-20 score according to the National Institutes of Health Stroke Scale (NIHSS), within 72 h of neurological sign onset, in 1-month follow-up period. We assessed NIHSS as primary and plasma levels of TNF-α, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IFN-γ, IP-10, MCP-1, 8-isoprostane, and PGE2 as secondary outcomes. According to NIHSS evaluation, patients who were allocated to BA group had a significant recovery in neurological function during the 1-month follow-up, compared with the placebo. The levels of plasma inflammatory markers were significantly decreased in BA group after 7 days of intervention in TNF-α, IL-1β, IL-6, IL-8, and PGE2. As a preliminary controlled trial in ischaemic stroke, BAs could improve clinical outcome in the early phases of stroke along with promising changes in plasma inflammatory factors.Clinical trial registrationhttps://www.irct.ir Unique identifier: IRCT20170315033086N5. IRCT is a primary registry in the WHO registry network (https://www.who.int/ictrp/network/primary/en/).
Inflammopharmacology. 2019 Dec;27(6):1101-1112.
PMID: 31407195 [PubMed - indexed for MEDLINE]
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| 9. |
A novel lecithin-based delivery form of Boswellic acids as complementary treatment of radiochemotherapy-induced cerebral edema in patients with glioblastoma multiforme: a longitudinal pilot experience.
Di Pierro F, Simonetti G, Petruzzi A, Bertuccioli A, Botta L, Bruzzone MG, Cuccarini V, Fariselli L, Lamperti E
BACKGROUND: Glioblastoma multiforme (GBM) is an extremely challenging neurological disease for which the development of more effective therapeutic options and of adjuvant/complementary treatment is needed. We investigated the effects of an innovative phytosome-based delivery form of boswellic acids extract (Monoselect AKBA™) on radiochemotherapy-induced cerebral edema in patients with primary GBM.
METHODS: Patients with de novo GBM treated with surgery, radiotherapy and chemotherapy with temozolomide were enrolled in this longitudinal study and received boswellia-based product 4500 mg/die for a maximum of 34 weeks. Cerebral edema was assessed at 4, 12, 22 and 34 weeks post-surgery, together with steroids consumption and patients' psychological status.
RESULTS: A total of 20 patients were included in the study. The percentage of patients with reduced edema was constant during the study, while the percentage of those with reduced or stable edema tended to increase over time. Of note, two patients achieved a considerable reduction in brain edema, which led to a more favorable and beneficial surgical resection. In addition, a good percentage of patients assumed a stable/reduced steroids dose or were dexamethasone free during the study. Lastly, patients' QoL and psychological state were maintained throughout the study.
CONCLUSIONS: Complementary treatment with Monoselect AKBA™ might exert a beneficial effect in reducing radiochemotherapy-induced cerebral edema, thanks to the anti-inflammatory properties of the boswellia serrata extract. The reduction in brain edema might diminish dexamethasone assumption, thus minimizing steroids-induced side effects, and in few cases may allow a complete surgical excision of the tumor mass.
J Neurosurg Sci. 2019 Jun;63(3):286-291.
PMID: 31096725 [PubMed - indexed for MEDLINE]
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| 10. |
Combined acetyl-11-keto-β-boswellic acid and radiation treatment inhibited glioblastoma tumor cells.
Conti S, Vexler A, Edry-Botzer L, Kalich-Philosoph L, Corn BW, Shtraus N, Meir Y, Hagoel L, Shtabsky A, Marmor S, Earon G, Lev-Ari S
Glioblastoma multiforme (GBM) is the most common and most aggressive subtype of malignant gliomas. The current standard of care for newly diagnosed GBM patients involves maximal surgical debulking, followed by radiation therapy and temozolomide chemotherapy. Despite the advances in GBM therapy, its outcome remains poor with a median survival of less than two years. This poor outcome is partly due to the ability of GBM tumors to acquire adaptive resistance to therapy and in particular to radiation. One of the mechanisms contributing to GBM tumor progression and resistance is an aberrant activation of NF-ĸB, a family of inducible transcription factors that play a pivotal role in regulation of many immune, inflammatory and carcinogenic responses. Acetyl-11-keto-β-boswellic acid (AKBA) is a pentacyclic terpenoid extracted from the gum Ayurvedic therapeutic plant Boswellia serrata. AKBA is anti-inflammatory agent that exhibits potent cytotoxic activities against various types of tumors including GBM. One of the mechanisms underlying AKBA anti-tumor activity is its ability to modulate the NF-ĸB signaling pathway. The present study investigated in vitro and in vivo the effect of combining AKBA with ionizing radiation in the treatment of GBM and assessed AKBA anti-tumor activity and radio-enhancing potential. The effect of AKBA and/or radiation on the survival of cultured glioblastoma cancer cells was evaluated by XTT assay. The mode of interaction of treatments tested was calculated using CalcuSyn software. Inducing of apoptosis following AKBA treatment was evaluated using flow cytometry. The effect of combined treatment on the expression of PARP protein was analysed by Western blot assay. Ectopic (subcutaneous) GBM model in nude mice was used for the evaluation of the effect of combined treatment on tumor growth. Immunohistochemical analysis of formalin-fixed paraffin-embedded tumor sections was used to assess treatment-related changes in Ki-67, CD31, p53, Bcl-2 and NF-ĸB-inhibitor IĸB-α. AKBA treatment was found to inhibit the survival of all four tested cell lines in a dose dependent manner. The combined treatment resulted in a more significant inhibitory effect compared to the effect of treatment with radiation alone. A synergistic effect was detected in some of the tested cell lines. Flow cytometric analysis with Annexin V-FITC/PI double staining of AKBA treated cells indicated induction of apoptosis. AKBA apoptotic activity was also confirmed by PARP cleavage detected by Western blot analysis. The combined treatment suppressed tumor growth in vivo compared to no treatment and each treatment alone. Immunohistochemical analysis showed anti-angiogenic and anti-proliferative activity of AKBA in vivo. It also demonstrated a decrease in p53 nuclear staining and in Bcl-2 staining and an increase in IĸB-α staining following AKBA treatment both alone and in combination with radiotherapy. In this study, we demonstrated that AKBA exerts potent anti-proliferative and apoptotic activity, and significantly inhibits both the survival of glioblastoma cells in vitro and the growth of tumors generated by these cells. Combination of AKBA with radiotherapy was found to inhibit factors which involved in cell death regulation, tumor progression and radioresistence, therefore it may serve as a novel approach for GBM patients.
PLoS One. 2018;13(7):e0198627.
PMID: 29969452 [PubMed - indexed for MEDLINE]
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| 11. |
Chemical Variation in Essential Oils from the Oleo-gum Resin of Boswellia carteri: A Preliminary Investigation.
DeCarlo A, Johnson S, Poudel A, Satyal P, Bangerter L, Setzer WN
Frankincense, the oleo-gum resin of Boswellia species, has been an important element of traditional medicine for thousands of years. Frankincense is still used for oral hygiene, to treat wounds, and for its calming effects. Different Boswellia species show different chemical profiles, and B. carteri, in particular, has shown wide variation in essential oil composition. In order to provide insight into the chemical variability in authentic B. carteri oleoresin samples, a hierarchical cluster analysis of 42 chemical compositions of B. carteri oleo-gum resin essential oils has revealed at least three different chemotypes, i) an α-pinene-rich chemotype, ii) an α-thujene-rich chemotype, and iii) a methoxydecane-rich chemotype.
Chem Biodivers. 2018 Jun;15(6):e1800047.
PMID: 29696822 [PubMed - indexed for MEDLINE]
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| 12. |
The effect of tablet containing Boswellia serrata and Melisa officinalis extract on older adults' memory: A randomized controlled trial.
Taghizadeh M, Maghaminejad F, Aghajani M, Rahmani M, Mahboubi M
BACKGROUND: Memory deficits and age-related memory loss are currently two significant concerns in older adults. In Iranian herbal medicine, there are some prescriptions for memory improvement.
OBJECTIVE: This study was designed to investigate the effect of tablet containing Boswellia serrata (BS) extract and Mellisa officinalis (MO) extract on memory of the older adults.
METHOD: This is a randomized, parallel, double-blind, placebo-controlled clinical trial that performed among 70 older adults who referred to healthcare centers of Kashan University of Medical Sciences, Iran. Subjects were randomly assigned to receive either tablets (n = 35) or placebo (n = 35) for a month (n = 30). Data were collected using a demographic questionnaire and the Wechsler Memory Scale-Revised (WMS-R). Data were analyzed using Chi-square, independent-samples t-tests, paired t-test, repeated measure ANOVA, and ANCOVA using SPSS v13.
RESULT: Participants' baseline characteristics were similar in the two groups. The study was completed by 53 participants. However, as the analysis was based on an intention-to treat approach, all 70 older adults were included in the final analysis. Comparison of the two groups with showed that the total scores of the WMS-R and the subscales, including auditory immediate, immediate memory, visual immediate and working memory, were increased after consumption of the containing BS and MO tablets (p < 0.0001).
CONCLUSION: The BS and MO tablet in older adults can be beneficial on improvement of memory. This is still necessary to investigate effects and durability of the tablets on older adults with memory impairments in future studies.
Arch Gerontol Geriatr. 2018;75():146-150.
PMID: 29306113 [PubMed - indexed for MEDLINE]
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| 13. |
Evaluating the efficacy of mixture of , , and on severity of symptoms, anxiety, and depression in irritable bowel syndrome patients.
Kazemian A, Toghiani A, Shafiei K, Afshar H, Rafiei R, Memari M, Adibi P
BACKGROUND: Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorders (FGIDs) that affects in different aspects of life and patients experienced depression and anxiety more than others. There are several herbal medicines with positive effects in these patients. The aim of this study is to evaluate the effects of mixture of , , and on severity of symptoms, anxiety, and depression in IBS patients.
MATERIALS AND METHODS: This clinical trial study was done in sixty IBS patients (with mild-to-moderate symptoms) divided into two case and control groups. Patients were assessed at the beginning, 1 month, and 3 months after by IBS-severity scoring system (IBS-SSS) and Hospital Anxiety and Depression Scale. IBS-SSS is used for quality of life evaluation too.
RESULTS: Sixty IBS patients (with mild to moderate symptoms) with a mean age of 38.75 ± 11.74 participated that 55.4% of cases and 72.8% of controls were men. The most prevalent type of IBS was the mixed type of IBS. The mean score of abdominal pain severity and frequency, bloating score, and depression and anxiety score were decreased in patients administered herbal medication, but changes in these variables in controls were not statistically significant. The changes in quality of life score between cases and controls were significant in men ( = 0.01) although it was not significant in women.
CONCLUSION: A mixture of , , and is effective in eliminating IBS symptoms and its related depression and anxiety and using herbal medicine in IBS treatment is suggested.
J Res Med Sci. 2017;22():120.
PMID: 29259631 [PubMed - as supplied by publisher]
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| 14. |
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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| 15. |
Use of an alpha lipoic, methylsulfonylmethane and bromelain dietary supplement (Opera) for chemotherapy-induced peripheral neuropathy management, a prospective study.
Desideri I, Francolini G, Becherini C, Terziani F, Delli Paoli C, Olmetto E, Loi M, Perna M, Meattini I, Scotti V, Greto D, Bonomo P, Sulprizio S, Livi L
Chemotherapy-induced peripheral neuropathy (CIPN) is a major clinical problem associated with a number of cytotoxic agents. OPERA (GAMFARMA srl, Milan, Italy) is a new dietary supplement where α-lipoic acid, Boswellia Serrata, methylsulfonylmethane and bromelain are combined in a single capsule. The aim of this prospective study was to determine the efficacy and safety of OPERA supplementation in a series of patients affected by CIPN. We selected 25 subjects with CIPN evolving during or after chemotherapy with potentially neurotoxic agents. Patients were enrolled at the first clinical manifestation of neuropathy. CIPN was assessed at the enrollment visit and subsequently repeated every 3 weeks until 12 weeks. Primary endpoint was the evaluation of changes of measured scores after 12 weeks of therapy compared to baseline evaluation. Secondary endpoints were the evaluation of neuropathy reduction at 12 weeks after beginning of therapy with OPERA. Analysis of VAS data showed reduction in pain perceived by patients. According to NCI-CTC sensor and motor score, mISS scale and TNSc scale, both pain and both sensor and motor neuropathic impairment decreased after 12 weeks of treatments. Treatment with OPERA supplement was well tolerated; no increase in the toxicity profile of any of the therapeutic regimen that the patients were undergoing was reported. OPERA was able to improve CIPN symptoms in a prospective series of patients treated with neurotoxic chemotherapy, with no significant toxicity or interaction. Prospective RCT in a selected patients' population is warranted to confirm its promising activity.
Med Oncol. 2017 Mar;34(3):46.
PMID: 28205185 [PubMed - indexed for MEDLINE]
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| 16. |
The use of aromasticks to help with sleep problems: A patient experience survey.
Dyer J, Cleary L, McNeill S, Ragsdale-Lowe M, Osland C
To document the use of aromasticks to facilitate sleep in a cancer centre in the UK. Sleep disturbance is a common problem amongst patients diagnosed with cancer. Essential oils may be inhaled by means of an aromastick (a personal inhaler device containing essential oils) as a means of improving sleep. A prospective audit of aromasticks given to help facilitate sleep. Sixty-five aromasticks were given out over a 13 week period. 94% of patients reported that they did use their aromastick to help them sleep and 92% reported that they would continue to do so. An improvement of at least one point on a Likert scale measuring sleep quality was shown by 64% of patients following the use of an aromastick. Bergamot (Citrus bergamia) and sandalwood (Santalum austrocaladonicum); and frankincense (Boswellia carterii), mandarin (Citrus reticulata) and lavender (Lavandula angustifolia) were the essential oils used in the two blends chosen by patients.
Complement Ther Clin Pract. 2016 Feb;22():51-8.
PMID: 26850806 [PubMed - indexed for MEDLINE]
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| 17. |
Effect of Boswellia papyrifera on cognitive impairment in multiple sclerosis.
Sedighi B, Pardakhty A, Kamali H, Shafiee K, Hasani BN
BACKGROUND: Cognitive impairment is one of the most crucial disorders among multiple sclerosis (MS) patients. Since MS is an inflammatory disease and Boswellia papyrifera has anti-inflammatory effects, the influence of B. papyrifera on cognitive impairment in MS patients has been investigated in the present study.
METHODS: In this clinical trial, 80 MS patients who referred to the clinic of Shafa Hospital, Kerman, Iran were selected. Having completed a written consent form, patients with relapsing remitting MS, with no occurrence of a new attack throughout 1 month before the study, with no pregnancy or breastfeeding entered the study. The patients were randomly divided into two groups; then Brief International Cognitive Assessment for MS (BICAMS) test was carried out. One group received B. papyrifera (capsule 300 mg, twice a day) while the other group received placebo with the same dose for 2 months. After 2 months of treatment, BICAMS was redone and changes were analyzed. The significant change value on the before-after BICAMS points were considered to be 8, 13, and 7 points for the symbol digit modality test (SDMT), the California verbal learning test (CVLT), and the brief visual-spatial memory test revised (BVMT-R), respectively.
RESULTS: The patients' mean age was 36.58 8.50 years. The mean duration of disease was 7.41 4.13 years. About 84.2% (n = 64) of the patients was female. In the BVMT-R, 13 patients (34.2%), who had already taken B. papyrifera, were shown to have significant improvement compared to the placebo group with no improvement (P < 0. 001). About 12 and 8 patients in the treatment and placebo groups in the SDMT, respectively (P = 0.200) and 17 and 12 patients in the treatment and placebo groups in the CVLT, respectively (P = 0.170) had significant change values.
CONCLUSION: B. papyrifera showed significant improvement in visuospatial memory, but had no effect on verbal memory and information processing speed.
Iran J Neurol. 2014 Jul;13(3):149-53.
PMID: 25422734 [PubMed - as supplied by publisher]
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| 18. |
A randomized, double blind, placebo controlled, cross over study to evaluate the analgesic activity of Boswellia serrata in healthy volunteers using mechanical pain model.
Prabhavathi K, Chandra US, Soanker R, Rani PU
OBJECTIVE: Experimental pain models in human healthy volunteers are advantageous for early evaluation of analgesics. All efforts to develop nonsteroidal anti-inflammatory drugs (NSAIDs) which are devoid of gastrointestinal and cardiovascular system effects are still far from achieving a breakthrough. Hence we evaluated the analgesic activity of an ayurvedic drug, Boswellia serrata by using validated human pain models which has shown its analgesic activity both in-vitro and preclinical studies to evaluate the analgesic activity of single oral dose (125 mg, 2 capsules) of Boswellia serrata compared to placebo using mechanical pain model in healthy human subjects.
MATERIALS AND METHODS: After taking written informed consent, twelve healthy subjects were randomized (1:1) to receive single oral dose of Boswellia serrata (Shallaki (®)) 125 mg, 2 capsules or identical placebo in a crossover design. Mechanical pain was assessed using Ugo basile analgesymeter (by Randall Selitto test) at baseline and at 1 hr, 2 hrs and 3 hrs after test drug administration. Pain Threshold force and time and Pain Tolerance force and time were evaluated. Statistical analysis was done by paired t-test.
RESULTS: Twelve healthy volunteers have completed the study. Mean percentage change from baseline in Pain Threshold force and time with Boswellia serrata when compared to placebo had significantly increased [Force: 9.7 ± 11.0 vs 2.9 ± 3.4 (P = 0.05) and time: 9.7 ± 10.7 vs 2.8 ± 3.4 (P = 0.04)] at third hr. Mean Percentage change from baseline in Pain Tolerance force and time with Boswellia serrata when compared to placebo had significantly (P ≤ 0.01) increased at 1 hr, 2 hrs and 3 hrs.
CONCLUSION: In the present study, Boswellia serrata significantly increased the Pain Threshold and Pain Tolerance force and time compared to placebo. Both study medications were well tolerated. Further multiple dose studies may be needed to establish the analgesic efficacy of the drug.
Indian J Pharmacol. 2014;46(5):475-9.
PMID: 25298573 [PubMed - indexed for MEDLINE]
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| 19. |
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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| 20. |
The effect of Boswellia Serrata on neurorecovery following diffuse axonal injury.
Moein P, Abbasi Fard S, Asnaashari A, Baratian H, Barekatain M, Tavakoli N, Moein H
OBJECTIVES: This pilot trial was conducted to establish whether Boswellia Serrata (BS), a traditional herbal medicine, could improve the outcome of patients who have diffuse axonal injury (DAI).
METHODS: In total, 38 patients with pure DAI were enrolled in this 12-week, double-blind, randomized, cross-over study. The patients were randomly assigned to receive either placebo (group A, n = 20) or BS capsules (group B, n = 18) for 6 weeks and then switched to the other intervention for another 6 weeks. The disability rating scale (DRS) was used to assess the outcome at 2-, 6- and 12-weeks post-trauma.
RESULTS: A non-significant trend for improvement of DRS total scores was observed after the use of BS. Regarding the DRS sub-scores, however, there was significant improvement in 'cognitive ability to self-care' during the second 6 weeks in group A on BS compared to an insignificant spontaneous recovery in group B during the same period on placebo. Moreover, both groups experienced a close-to-significant increase in the cognitive function-related items of the DRS during the periods they were on BS. The reported adverse events were all of mild quality and had similar frequency between the groups.
CONCLUSION: These results suggest that BS resin does not significantly affect general outcome, but may enhance the cognitive outcome of patients with DAI.
Brain Inj. 2013;27(12):1454-60.
PMID: 24088189 [PubMed - indexed for MEDLINE]
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| 21. |
Long-term efficacy of Boswellia serrata in four patients with chronic cluster headache.
Lampl C, Haider B, Schweiger C
BACKGROUND: Cluster headache is an extremely severe and debilitating trigemino-autonomic pain syndrome. About 10% of patients with cluster headache manifest a chronic form (CCH).The present case series study aims to evaluate the long-term efficacy of Boswellia serrata (Sallaki H15) on headaches and disturbed sleep in patients with CCH.
CASE RESULTS: In an open-label study, four patients with CCH and disturbed sleep received oral B. serrata.
CONCLUSION: The results provide Class IV evidence that oral B. serrata reduces the intensity and frequency of headaches in patients with CCH.
Cephalalgia. 2012 Jul;32(9):719-22.
PMID: 22767962 [PubMed - indexed for MEDLINE]
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| 22. |
Aboriginal uses and management of ethnobotanical species in deciduous forests of Chhattisgarh state in India.
Kala CP
A study on the native uses of ethnobotanical species was carried out in the south Surguja district of Chhattisgarh state in India with the major objective of identifying different food and medicinal plant species and also to understand their ongoing management and conservation. Through questionnaire and personal interviews, a total of 73 ethnobotanical species used by tribal and non-tribal communities were documented, of these 36 species were used in curing different types of diseases and 22 were used as edible food plants. This rich traditional knowledge of local people has an immense potential for pharmacological studies. The outside forces, at present, were mainly blamed to change the traditional system of harvesting and management of ethnobotanical species. The destructive harvesting practices have damaged the existing populations of many ethnobotanical species viz., Asparagus racemosus, Dioscorea bulbifera, Boswellia serrata, Buchnania lanzan, Sterculia urens and Anogeissus latifolia. The sustainable harvesting and management issues of ethnobotanical species are discussed in view of their conservation and management.
J Ethnobiol Ethnomed. 2009 Aug;5():20.
PMID: 19653889 [PubMed - indexed for MEDLINE]
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| 23. |
[Effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer].
Chang SY
PURPOSE: The purpose of this study was to examine the effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer.
METHODS: This study was a nonequivalent control group pretest-posttest design. The subjects were 58 hospice patients with terminal cancer who were hospitalized. Twenty eight hospice patients with terminal cancer were assigned to the experimental group (aroma hand massage), and 30 hospice patients with terminal cancer were assigned to the control group (general oil hand massage). As for the experimental treatment, the experimental group went through aroma hand massage on each hand for 5 min for 7 days with blended oil-a mixture of Bergamot, Lavender, and Frankincense in the ratio of 1:1:1, which was diluted 1.5% with sweet almond carrier oil 50 ml. The control group went through general oil hand massage by only sweet almond carrier oil-on each hand for 5 min for 7 days.
RESULTS: The aroma hand massage experimental group showed more significant differences in the changes of pain score (t=-3.52, p=.001) and depression (t=-8.99, p=.000) than the control group.
CONCLUSION: Aroma hand massage had a positive effect on pain and depression in hospice patients with terminal cancer.
Taehan Kanho Hakhoe Chi. 2008 Aug;38(4):493-502.
PMID: 18753801 [PubMed - indexed for MEDLINE]
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