Sunday, 30 June 2013

Curcuminoids and resveratrol as anti-Alzheimer agents.
Taiwan J Obstet Gynecol. 2012 Dec;51(4):515-25
Authors: Villaflores OB, Chen YJ, Chen CP, Yeh JM, Wu TY
Abstract
Alzheimer disease (AD) is by far the most common cause of dementia globally. This neurodegenerative disorder of the brain is chronic and progressive, characterized clinically by the deterioration in the key symptoms of behavioral and cognitive abilities. Treatment options for this disease currently are limited. Deposition of amyloid-β and tau hyperphosphorylation are cardinal pathologic features of AD that lead to the formation of neuronal plaques and neurofibrillary tangles, respectively. In addition to mounting research on herbal compounds for the treatment of AD, curcuminoids and resveratrol appear to be beneficial as anti-AD agents. Curcuminoids (curcumin and demethoxycurcumin) and resveratrol possess unique properties that make them especially worthy of further studies. This review article revisits and presents the current research done on the potential of the curcuminoids curcumin and demethoxycurcumin and the polyphenolic compound resveratrol as anti-AD compounds.
PMID: 23276553 [PubMed - indexed for MEDLINE

Saturday, 29 June 2013

Anti-inflammatory properties of anthraquinines

Anti-inflammatory properties of anthraquinones and their relationship with the regulation of P-glycoprotein function and expression.
Eur J Pharm Sci. 2013 Jan 23;48(1-2):272-81
Authors: Choi RJ, Ngoc TM, Bae K, Cho HJ, Kim DD, Chun J, Khan S, Kim YS
Abstract
There is a growing interest in natural products that potentially have anti-inflammatory properties and inhibit P-glycoprotein (P-gp) function. In this report, we assessed the effects of anthraquinone derivatives from rhubarb on LPS-induced RAW 264.7 macrophages to determine their anti-inflammatory potential. The derivatives were also tested in Caco-2 cell lines to evaluate the inhibition of the drug efflux function of P-gp. The transport abilities were examined and the cellular accumulation of rhodamine-123 (R-123) was also measured. Electorphoretic mobility shift assay (EMSA) was performed to check the activator protein-1 (AP-1) DNA binding affinity. Five anthraquinones were tested to determine their inhibitory activities on NO production and the protein and mRNA expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). Furthermore, the level of prostaglandin E(2) (PGE(2)) was determined in LPS-induced RAW264.7 macrophages. Emodin was found to be the most potent inhibitor, and it also reduced paw swelling in the mouse model of carrageenan-induced paw edema. In Caco-2 cells, emodin elevated the accumulation of R-123 and decreased the efflux ratio of R-123, which indicates the inhibition of P-gp function. The inhibition of COX-2 protein by emodin paralleled the decrease in P-gp expression. In addition, mitogen-activated protein kinase (MAPK) expression was decreased through the prevention of AP-1 DNA binding, which leads to downregulation in the expression of P-gp. Our data indicate that the decrease of P-gp expression is caused by the decreased expression of COX-2 through the MAPK/AP-1 pathway. Based on our results, we suggest that anti-inflammatory drugs with COX-2 inhibitory activity might be used to modulate P-gp function and expression.
PMID: 23174748 [PubMed - indexed for MEDLINE

Friday, 28 June 2013

Aged garlic extract reduces blood pressure in hypertensives: a dose-response trial.

Aged garlic extract reduces blood pressure in hypertensives: a dose-response trial.
Eur J Clin Nutr. 2013 Jan;67(1):64-70
Authors: Ried K, Frank OR, Stocks NP
Abstract
BACKGROUND/OBJECTIVES: Hypertension affects about 30% of adults worldwide. Garlic has blood pressure-lowering properties and the mechanism of action is biologically plausible. Our trial assessed the effect, dose-response, tolerability and acceptability of different doses of aged garlic extract as an adjunct treatment to existing antihypertensive medication in patients with uncontrolled hypertension.
SUBJECTS/METHODS: A total of 79 general practice patients with uncontrolled systolic hypertension participated in a double-blind randomised placebo-controlled dose-response trial of 12 weeks. Participants were allocated to one of three garlic groups with either of one, two or four capsules daily of aged garlic extract (240/480/960 mg containing 0.6/1.2/2.4 mg of S-allylcysteine) or placebo. Blood pressure was assessed at 4, 8 and 12 weeks and compared with baseline using a mixed-model approach. Tolerability was monitored throughout the trial and acceptability was assessed at 12 weeks by questionnaire.

Metabolomics

Emerging Applications of Metabolomics in Studying Chemopreventive Phytochemicals.
AAPS J. 2013 Jun 22;
Authors: Wang L, Chen C
Abstract
Phytochemicals from diet and herbal medicines are under intensive investigation for their potential use as chemopreventive agents to block and suppress carcinogenesis. Chemical diversity of phytochemicals, together with complex metabolic interactions between phytochemicals and biological system, can overwhelm the capacity of traditional analytical platforms, and thus pose major challenges in studying chemopreventive phytochemicals. Recent progresses in metabolomics have transformed it to become a robust systems biology tool, suitable for examining both chemical and biochemical events that contribute to the cancer prevention activities of plant preparations or their bioactive components. This review aims to discuss the technical platform of metabolomics and its existing and potential applications in chemoprevention research, including identifying bioactive phytochemicals in plant extracts, monitoring phytochemical exposure in humans, elucidating biotransformation pathways of phytochemicals, and characterizing the effects of phytochemicals on endogenous metabolism and cancer metabolism.

Thursday, 27 June 2013

Anti cancer activity of Zea Mays

Anticancer Activity of Zea mays Leaf Extracts on Oxidative Stress-induced Hep2 Cells.
J Acupunct Meridian Stud. 2013 Jun;6(3):149-158
Authors: Balasubramanian K, Padma PR
Abstract
Cancer is one of the leading causes of death in humans. It is believed that plants can provide potential bioactive compounds for the development of "new leads" to combat cancer and other diseases. The present study focuses on the ability of the different extracts (aqueous, methanol, and chloroform) of the leaves of Zea mays in influencing the process of apoptosis induced by hydrogen peroxide (H2O2) in Hep2 (laryngeal carcinoma) cells. Various apoptosis-related parameters, such as cell viability, morphological changes, nuclear changes, and apoptotic index were characterized. sulforhodamine B and MTT assays were used to quantify the extent of cell death in the group exposed to H2O2, plant extracts, and their combination.

Wednesday, 26 June 2013

Cosmology

I have already spoken about the importance of a wide ranging and deep case history. A patient's world view is another key  to unlocking an avenue for therapeutic intervention
Scientifically, cosmology is the study of the origin of the universe. In relation to folklore, Mary Magoulick uses the term, to contain the myths, rituals and belief systems that may direct social action and decisions. “Myths are symbolic tales of the distant past (often primordial times) that concern cosmogony and cosmology (the origin and nature of the universe), may be connected to belief systems or rituals, and may serve to direct social action and values.”Cosmology in an individual or community basis may be seen as the overarching world-view that influences and even directs particular actions. Within herbal medicine, it may be used to describe the range of beliefs that make up an individual’s world-view, some of which may lead to physical or psychological illness.

Tuesday, 25 June 2013

Pharmacovigilance of herbal medicine

Pharmacovigilance of herbal medicines: the potential contributions of ethnobotanical and ethnopharmacological studies.
Drug Saf. 2013 Jan;36(1):1-12
Authors: Rodrigues E, Barnes J
Abstract
Typically, ethnobotanical/ethnopharmacological (EB/EP) surveys are used to describe uses, doses/dosages, sources and methods of preparation of traditional herbal medicines; their application to date in examining the adverse effects, contraindications and other safety aspects of these preparations is limited. From a pharmacovigilance perspective, numerous challenges exist in applying its existing methods to studying the safety profile of herbal medicines, particularly where used by indigenous cultures.

Monday, 24 June 2013

Optimization model research on efficacy in treatment of chronic urticaria by Chinese and Western medicine based on a genetic algorithm.

Optimization model research on efficacy in treatment of chronic urticaria by Chinese and Western medicine based on a genetic algorithm.
J Tradit Chin Med. 2013 Feb;33(1):60-4
Authors: Yan M, Ye F, Zhang Y, Cai X, Fu Y, Yang X
Abstract
OBJECTIVE: To investigate the potential rules and knowledge of Traditional Chinese Medicine (TCM) and Western Medicine (WM) treatment on chronic urticaria (CU) based on data-mining methods.
METHODS: Sixty patients with chronic urticaria, treated with TCM and WM, were selected. Gray correlation analyses were adopted to determine therapeutic efficacy.

Phytochemicals and their impact on adipose tissue inflammation and diabetes.

This abstract may serve as a pointer to an  effective prescription for your patient with obesity.

Phytochemicals and their impact on adipose tissue inflammation and diabetes.
Vascul Pharmacol. 2013 Jan;58(1-2):3-20
Authors: Leiherer A, Mündlein A, Drexel H
Abstract
Type 2 diabetes mellitus is an inflammatory disease and the mechanisms that underlie this disease, although still incompletely understood, take place in the adipose tissue of obese subjects. Concurrently, the prevalence of obesity caused by Western diet's excessive energy intake and the lack of exercise escalates, and is believed to be causative for the chronic inflammatory state in adipose tissue.

Sunday, 23 June 2013

BPH and urinary tract infections


Initial assessment, follow-up and treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: guidelines of the LUTS committee of the French Urological Association.
Prog Urol. 2012 Dec;22(16):977-88
Authors: Descazeaud A, Robert G, Delongchamps NB, Cornu JN, Saussine C, Haillot O, Devonec M, Fourmarier M, Ballereau C, Lukacs B, Dumonceau O, Azzouzi AR, Faix A, Desgrandchamps F, de la Taille A, Comité des troubles mictionnels de l’homme de l’association française d’urologie
Abstract
AIM: To elaborate guidelines for the diagnosis, the follow-up, and the treatment of benign prostatic hyperplasia (BPH).

Saturday, 22 June 2013

Plant sterols and LDL

Dose-dependent LDL-cholesterol lowering effect by plant stanol ester consumption: clinical evidence.
Lipids Health Dis. 2012;11:140
Authors: Laitinen K, Gylling H
Abstract
Elevated serum lipids are linked to cardiovascular diseases calling for effective therapeutic means to reduce particularly LDL-cholesterol (LDL-C) levels. Plant stanols reduce levels of LDL-C by partly blocking cholesterol absorption. Accordingly the consumption of foods with added plant stanols, typically esterified with vegetable oil fatty acids in commercial food products, are recommended for lowering serum cholesterol levels. A daily intake of 1.5 to 2.4 g of plant stanols has been scientifically evaluated to lower LDL-C by 7 to 10% in different populations, ages and with different diseases. Based on earlier studies, a general understanding is that no further reduction may be achieved in intakes in excess of approximately 2.5 g/day.

Friday, 21 June 2013

Fermented turmeric powder and raised ALT

The effectiveness of fermented turmeric powder in subjects with elevated alanine transaminase levels: a randomised controlled study.
BMC Complement Altern Med. 2013;13:58
Authors: Kim SW, Ha KC, Choi EK, Jung SY, Kim MG, Kwon DY, Yang HJ, Kim MJ, Kang HJ, Back HI, Kim SY, Park SH, Baek HY, Kim YJ, Lee JY, Chae SW
Abstract
BACKGROUND: Previous animal studies have shown that Curcuma longa (turmeric) improves liver function. Turmeric may thus be a promising ingredient in functional foods aimed at improving liver function. The purpose of the study is to investigate the hepatoprotective effect of fermented turmeric powder (FTP) on liver function in subjects with elevated alanine transaminase (ALT) levels.

Thursday, 20 June 2013

Astragalus polysaccharide

Astragalus polysaccharide injection integrated with vinorelbine and cisplatin for patients with advanced non-small cell lung cancer: effects on quality of life and survival.
Med Oncol. 2012 Sep;29(3):1656-62
Authors: Guo L, Bai SP, Zhao L, Wang XH
Abstract
A platinum-based two-drug regimen is currently the standard of care for patients with advanced non-small-cell lung cancer (NSCLC). However, chemotherapy-induced side effects still remain a significant clinical problem. Astragalus polysaccharide (APS) is a polysaccharide isolated from the radix of astragalus membranaceus, a commonly used herbal compound in traditional Chinese medicine. APS was reported to increase tumor response, stabilize and improve performance status, and reduce chemotherapy toxicity.

Review of traditional plants for T2DM

Phytochemicals targeting genes relevant for type 2 diabetes.
Can J Physiol Pharmacol. 2013 Jun;91(6):397-411
Authors: Anuradha CV
Abstract
Nutrigenomic approaches based on ethnopharmacology and phytotherapy concepts have revealed that type 2 diabetes mellitus (T2DM) may be susceptible to dietary intervention. Interaction between bioactive food components and the genome may influence cell processes and modulate the onset and progression of the disease. T2DM, characterized by insulin resistance and beta cell dysfunction, is one of the leading causes of death and disability.

Wednesday, 19 June 2013

Therapeutic milieu


The therapeutic milieu is different to the concept of therapeutic landscape. Where landscape may be hard, objective and external, this is soft, fluid and internal. It generally refers to a structured group setting, where the existence of the group is beneficial to the healing outcome of the patient. A formalised therapeutic milieu is one that has been set up in an inpatient setting, and where healthy patterns are established, as well as the experience of a secure and trusting environment. It may also refer to the informal support networks available to a patient within the family and community

Tuesday, 18 June 2013

Therapeutic landscapes

Continuing my reflections on taking a patient's case history, I find that there are three other factors that need to be taken into account. These are the therapeutic landscape, the therapeutic milieu and cosmology.
Therapeutic landscape.
This refers to landscapes that promote healing and well being. These can range from gardens designed for the elders and active living, to gardens specially designed for the visually impaired, and those with senile dementia. This term also includes the benefits of well-designed civic landscapes. The web site www.healinglandscapes.org/resources/read-five.html elaborates on this concept, and gives detailed reference to resources. In clinical practice it is important, as unhappiness with, or disconnectedness from one’s surroundings may point to an early indication of illness and fatigue, as well as depression. Likewise, the ability to engage with landscape is a sign of healing, and growth of well being.

Sunday, 16 June 2013

Luibhlia

Before the destruction of the Irish way of life, as a result of the Irish defeat in the Battle of Kinsale in 1602, Irish physicians were an important part of the fabric of Irish life. Patronised by the clan Chief or Taoiseach, their duties involved the maintenance of health, not only in the Taoiseach's family but in the community at large.
In Ireland today, members of the Irish Institute of Medical Herbalists (IIMH), seek to emulate and transmit the skills and knowledge of these eminent men. Like the professionals of former times, they too integrate the best of modern research and clinical science with the traditional and empirical knowledge of old.
All medical herbalists in the IIMH work at primary care level and  one of the seeming conundrums that my patients have, is what title to call me. I am quite happy with my first name, but some are not happy with this. What is the problem in medicine, that requires titles such as doctor or nurse?  I suppose such titles help to keep a certain objectivity and neutrality in the clinical situation, which is not necessary when communicating with the vet about a sick calf or the accountant about a tax bill. 
What would be the resolution to this dilemma of title? There are some interesting possibilities:
Hoctor
Luibhlia (herbal physician) pronounced 'livlea'
Lia
Hurse  but this is too like hearse and that is a bit too close for comfort!

Any other ideas?

Cystostop Rapid

I recently posted the results of a research paper regarding the effectiveness of Cystostop Rapid in uncomplicated cystitis. As cystitis is a common and uncomfortable complaint. I decided to check out the composition of this 'food supplement'  at  http://neopharm.bg/en/cystostop/rapid

Each CYSTOSTOP RAPID tablet contains:
  • D-Mannose – 1000 mg;
  • Standardized dry extract of birch leaves – 50 mg
  • Standardized dry extract of American cranberry – 50 mg;
BetaVacTM-Patented combination of 3,5,7,3',4'- Pentahydroxyflavone, 3,7,3',4'- Tetrahydroxyflavone and epicatechin -(4β→6)- epicatechin -(4β→8, 2β→O→7)- epicatechin.
Other tablet ingredients are calcium phosphate, corn starch, Copovidone, Povidone, magnesium stearate.
CYSTOSTOP RAPID is a food supplement.

My comments:

D-Mannose is not a herb per se, but it is extracted from European birch and beech. It is a glucose isomer and is a natural sugar.  It is good for eliminating E coli from the urinary tract. 

Birch and cranberry  are used traditionally for urinary tract infections. 

This product then, is building on age old tradition and the range of knowledge that your local medical herbalist would have at his or her finger tips + a lot more.

My concern with effective over the counter remedies (OTC) is that repeated recurrence of urinary tract infections (UTIs) may indicate a deeper problem. If UTIs recur on a regular basis, it may be a good idea to visit your local medical herbalist to rule out any underlying issues. 









Uncomplicated cystitis

[A multicenter comparative observation on the effectiveness and the rapidness of the effect of Cystostop Rapid versus antibiotic therapy in patients with uncomplicated cystitis].
Akush Ginekol (Sofiia). 2012;51(7):49-55
Authors: Panchev P, Slavov Ch, Mladenov D, Georgiev M, Yanev K, Paskalev E, Simeonov P, Gerassi R, Bogov B, Saltirov I
Abstract
The currently available treatment for uncomplicated urinary tract infections includes only antibiotics and chemotherapeutic agents. Experience in the management of acute uncomplicated infections using non-antibiotic products is very limited. The aim of this observation was to study to what extent the response to Cystostop Rapid would be more rapid and more effective compared to antibiotic therapy in patients with acute uncomplicated urinary bladder infections. The secondary objective was to determine the time to improvement of cystitis symptoms following the start of treatment, as well as the duration of patients' disablement. A total of 158 female subjects were included, assessed microbiologically, and evaluated for incidence and severity of symptoms, before the start of treatment and after completion of treatment. A visual analogue scale was used for patient self-assessment of the severity of symptoms, the improvement of symptoms, as well as the time to improvement of symptoms. Results: 158 females, eligible according to the inclusion criteria of the study, were allocated to one of the two groups according to time of enrollment: Group A included 86 subjects: assigned to Cystostop Rapid for 3 days and administered according to the manufacturer's recommended regimen; and Group B included 72 women: assigned to ciprofloxacin 500 mg twice daily for 3 days according to the Product Registration File with the BDA. The clinical and microbiological effectiveness of Cystostop Rapid was comparable to that of ciprofloxacin, providing a two-fold more rapid improvement of cystitis symptoms, at a mean time to improvement of 24 hours (p < 0.02) versus 46 hours for ciprofloxacin. Clinical improvement within 48 hours of Cystostop Rapid regimen occurred in 97% (p < 0.02) of patients, vs. 65.3% of patients on ciprofloxacin. Improvement of symptoms within 12 hours was reported in 36% of patients on Cystostop Rapid vs. 5.5% of patients in the ciprofloxacin group (p < 0.02). No adverse events or intolerability to the therapy were reported throughout the course of the study.
PMID: 23610918 [PubMed - indexed for MEDLINE]

Saturday, 15 June 2013

A Deiseal

  
A Deiseal

This photograph captures the movement of time as it moves from left to right, or from east to west. In Irish, it is known as a deiseal or  a clockwise direction. This east - west path of the sun, informed many traditions in Ireland, including one's final journey to the grave. In many places today, a coffin is taken to the grave, in an east-west or clockwise direction, even though the most logical way to go, may be either in a straight line, or from west to east. This captures beautifully, the end of one's time on earth.  Just as the sun sets in the west, this east to west movement  towards one's final resting place in a cemetry, symbolizes our time of setting also.

Friday, 14 June 2013

More on Calendula

In Irish, Calendula officinalis is known as Bláth Mhuire/Liathán/ ór Mhuire. Its common name is marigold. According to Maloney (1919), it was used to give a deep colour to butter. It was also used in the form of a lotion for wounds, sprains and bruises. Internally, it was given as a uterine tonic.
Interestingly, in older herbals, it is described as cold and dry but no degree is given. It is also recommended to use it fresh, which raises some interesting questions about the best way of processing this herb. It could be a very valuable exercise to analyse its constituent profile, both fresh, dried, and in other forms. We are also told, that it is nourishing against every poison, and if drunk in wine or ale, it will  open oppilation (obstruction) of the liver and spleen.
Other uses mentioned are, the use of this herb for warts, and a simple infusion of it for nine days as a remedy for jaundice.Of course today, we see this herb very much as an anti-inflammatory.

Calendula

Calendula.

Its common name is marigold and it is a very useful herb. Plant the common variety and you will be rewarded with it, reseeding itself with abandon.
File:Calendula officinalis-2.JPG


It is very good for reducing inflammation in arthritis, and this can be done very easily as a poultice. Tear a few flower heads and place in a bowl. Barely cover with  boiling water, and let steep for 5 minutes. Add this mush to a clean, thin cloth and place on painful joint. Leave until cool, and then replace with another if you can. Osteoarthritis is worse in the evening, so this is a remedy that can be carried out as you are watching TV.

The Importance of the patient's case history

After clinic yesterday, I was pondering on the importance of taking a very good case history. 
This came about as a result of reviewing a patient's  family history. One of her siblings had already died of cardio-vascular disease and all her siblings (7) had cardio-vascular problems. Interestingly, she did not have cardio-vascular health issues.
I had visited a famine village in Co. Clare last weekend, - 12 cottage ruins where all occupants had died in the Irish famine of the 1840s, - and by coincidence, I had also read about the 'Hongerwinter', which was a famine that took place in German occupied Holland in 1944-45.  
This famine led to a new understanding of the role of epigenetics, as the limited food intake of the mothers in the early stages of pregnancy altered the genetic material of the embryos.