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Wang Q, Li L, Zhuang S, Huang M, Xiang Y. Efficacy of polyphenols in adjuvant treating ulcerative colitis: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2025; 104:e41985. [PMID: 40419878 DOI: 10.1097/md.0000000000041985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/28/2025] Open
Abstract
BACKGROUND The effectiveness and safety of polyphenols in treating ulcerative colitis remain controversial. This study aimed to evaluate the efficacy and safety of polyphenols in the treatment of ulcerative colitis. METHODS This study followed the preferred reporting items for systematic reviews and meta-analyses 2020 guidelines. A systematic search was conducted across PubMed, Embase, Web of Science, and Cochrane databases to identify relevant articles. The random-effects model was employed to calculate the odds ratio (OR) and corresponding 95% confidence intervals (CIs). RESULTS A total of 13 trials involving 742 participants were included in the meta-analysis. The clinical remission rates were higher in the polyphenol group compared to the control group, as demonstrated by both the intention-to-treat (ITT) (OR: 4.71; 95% CI: 2.02-10.99; P = .000) and per-protocol (PP) analysis (OR: 7.14; 95% CI: 3.11-16.39; P = .000). Similarly, the clinical response rate was higher in the polyphenol group compared to the control group, according to the ITT (OR: 5.40; 95% CI: 2.60-11.24; P = .000) and PP analysis (OR: 9.14; 95% CI: 4.25-19.64; P = .000). Moreover, the total endoscopic remission rate was superior in the polyphenol group, as indicated by the ITT (OR: 3.16; 95% CI: 1.20-8.37; P = .020) and PP analysis (OR: 4.92; 95% CI: 2.03-11.93; P = .000). No significant differences were observed regarding side effects between the 2 groups, according to the ITT (OR: 0.99; 95% CI: 0.56-1.76; P = .973) and PP analysis (OR: 0.99; 95% CI: 0.54-1.80; P = .971). CONCLUSION Polyphenols demonstrated effectiveness in inducing clinical remission, clinical response, and endoscopic remission in patients with ulcerative colitis. Furthermore, there was no evidence of a higher incidence of adverse effects associated with their use.
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Affiliation(s)
- Qiuxiang Wang
- Department of Traditional Chinese Medicine, Guangyuan Central Hospital, Sichuan Province, China
| | - Liuying Li
- Department of Traditional Chinese Medicine, Zigong First People's Hospital, Sichuan Province, China
| | - Shuhan Zhuang
- Zhejiang Chinese Medical University, Zhejiang Province, China
| | - Mei Huang
- The Second Hospital of Traditional Chinese Medicine of Yibin City, Sichuan Province, China
| | - Yongguo Xiang
- Department of Traditional Chinese Medicine, Guangyuan Central Hospital, Sichuan Province, China
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2
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Calvello R, Caponio GR, Cianciulli A, Porro C, Ruggiero M, Celano G, De Angelis M, Panaro MA. Antioxidant Activity and Anti-Inflammatory Effect of Blood Orange By-Products in Treated HT-29 and Caco-2 Colorectal Cancer Cell Lines. Antioxidants (Basel) 2025; 14:356. [PMID: 40227443 PMCID: PMC11939351 DOI: 10.3390/antiox14030356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2025] [Revised: 03/14/2025] [Accepted: 03/15/2025] [Indexed: 04/15/2025] Open
Abstract
Blood orange peel flour (BO-pf)-a by-product of the citrus supply chain-still contains bioactive molecules with known health benefits, such as antiradical scavenging activity or an antiproliferative activity regarding tumors. In vitro studies have demonstrated that orange polyphenols showed potential involvement in necroptosis. In addition to previous research, we tested BO-pf on two colorectal cancer cell lines. Using HT29 and Caco2 cells, our experiments confirmed the regulation of inflammasome expression. They provided valuable insights into how BO-pf influences the cancer cell features (i.e., viability, proliferation, and pro- and anti-inflammatory activity). Notably, BO-pf extract is a rich source of polyphenolic compounds with antioxidant properties. Western blot and real-time PCR analyses showed that treatment with BO-pf extract demonstrated beneficial effects by influencing the expression of both pro-inflammatory cytokines (IL-1β, IL-6) through the modulation of the TLR4/NF-kB/NLRP3 inflammasome signaling. Moreover, the results of this study demonstrate that BO-pf extracts can enhance the expression of anti-inflammatory cytokines, such as IL-10 and TGFβ, suggesting that BO-pf extracts may represent a promising functional ingredient to counteract the intestinal inflammatory responses involved in IBD.
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Affiliation(s)
- Rosa Calvello
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 125, 70125 Bari, Italy; (R.C.); (G.R.C.); (A.C.); (M.R.)
| | - Giusy Rita Caponio
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 125, 70125 Bari, Italy; (R.C.); (G.R.C.); (A.C.); (M.R.)
| | - Antonia Cianciulli
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 125, 70125 Bari, Italy; (R.C.); (G.R.C.); (A.C.); (M.R.)
| | - Chiara Porro
- Department of Clinical and Experimental Medicine, University of Foggia, Via A. Gramsci 89/91, 71121 Foggia, Italy;
| | - Melania Ruggiero
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 125, 70125 Bari, Italy; (R.C.); (G.R.C.); (A.C.); (M.R.)
| | - Giuseppe Celano
- Department of the Soil, Plant and Food Sciences (DiSSPA), University of Bari Aldo Moro, Via Amendola, 165/a, 70126 Bari, Italy; (G.C.); (M.D.A.)
| | - Maria De Angelis
- Department of the Soil, Plant and Food Sciences (DiSSPA), University of Bari Aldo Moro, Via Amendola, 165/a, 70126 Bari, Italy; (G.C.); (M.D.A.)
| | - Maria Antonietta Panaro
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 125, 70125 Bari, Italy; (R.C.); (G.R.C.); (A.C.); (M.R.)
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El Sayed S, Macri VI, Singh B, Segars JH, Islam MS. Beneficial Effects of Pomegranate Extracts for Benign Gynecologic Disorders. Reprod Sci 2025; 32:600-617. [PMID: 39733205 DOI: 10.1007/s43032-024-01776-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 12/17/2024] [Indexed: 12/30/2024]
Abstract
Pomegranate (Punica granatum) is a widely cultivated fruit historically recognized for its health benefits and is regarded as a nutritional powerhouse. Pomegranate has a unique composition of bioactive compounds including hydrolysable tannins, anthocyanins, and other polyphenolic components. Of those, punicalagin and its subsequent metabolites are the most extensively studied, demonstrating antioxidant, anti-inflammatory, anti-cancer, and anti-nociceptive activity. The compounds possess promising therapeutic potential for many diseases, including conditions affecting the female reproductive system. This scoping review examines the pharmacodynamics of pomegranate's bioactive compounds and synthesizes the current literature concerning the role in benign gynecological disorders. Pomegranate extract decreased testosterone levels, levels of oxidative stress and inflammation biomarkers in women with polycystic ovary syndrome, erstwhile favorably impacting some cardiovascular risk factors in women. Pomegranate supplementation improved menopause specific health-related quality of life in women. In a pre-clinical murine model following ovariectomy, improved bone formation and reduced vaginal atrophy were associated with pomegranate treatment. Existing data suggests that additional research on the beneficial antioxidant, anti-inflammatory, anti-proliferative, and anti-nociceptive effects of pomegranate extracts for benign gynecologic conditions is warranted.
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Affiliation(s)
- Samya El Sayed
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Valeria I Macri
- Department of Gynecology and Obstetrics, Division of Reproductive Sciences & Women's Health Re-search, Johns Hopkins Medicine, Baltimore, MD, 21205, USA
| | - Bhuchitra Singh
- Department of Gynecology and Obstetrics, Division of Reproductive Sciences & Women's Health Re-search, Johns Hopkins Medicine, Baltimore, MD, 21205, USA
| | - James H Segars
- Department of Gynecology and Obstetrics, Division of Reproductive Sciences & Women's Health Re-search, Johns Hopkins Medicine, Baltimore, MD, 21205, USA
| | - Md Soriful Islam
- Department of Gynecology and Obstetrics, Division of Reproductive Sciences & Women's Health Re-search, Johns Hopkins Medicine, Baltimore, MD, 21205, USA.
- Department of Gynecology and Obstetrics, Division of Reproductive Sciences & Women's Health Research, Johns Hopkins Medicine, 720 Rutland Ave, Ross Building, Room 624, Baltimore, MD, 21205, USA.
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Sun S, Wang D, Dan L, Fu T, Chen J, Zhang Y, Sun J, Zou D. Dietary Anthocyanin Intake, Genetic Risk, and Incident Ulcerative Colitis: A Prospective Cohort Study. Phytother Res 2024; 38:5782-5792. [PMID: 39349990 PMCID: PMC11634818 DOI: 10.1002/ptr.8341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 07/05/2024] [Accepted: 09/01/2024] [Indexed: 12/13/2024]
Abstract
evidence from animal experiments indicates that anthocyanin supplements can contribute to intestinal health. Nevertheless, no evidence has linked dietary anthocyanins to the prevention potential against inflammatory bowel disease (IBD) in humans. We leveraged data from 188,044 IBD-free individuals (mean age 59 years; 55.2% females) from the prospective cohort UK Biobank. The anthocyanin intake was estimated using dietary information from validated 24 h dietary recalls. Incident IBD was ascertained via national health-related records. Genetic susceptibility to Crohn's disease (CD) and ulcerative colitis (UC) was estimated by polygenic risk scores and further categorized into low- and high-risk groups by median value. The Cox proportional regression model was applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). During the mean follow-up of 9.7 years, we documented 255 CD and 606 UC. We found that compared with participants with the lowest quartiles of anthocyanin intake, those in the highest quartiles were associated with 24% (95% CI 6%-38%, p = 0.012; p-trend = 0.003) and 35% (95% CI 16%-49%, p = 0.001; p-trend < 0.001) reduced risk of IBD and UC, respectively. The inverse associations were stronger (p-interaction = 0.022) among individuals with a high genetic risk of UC. We did not observe a significant association between anthocyanin intake and CD (p-trend = 0.536). Higher dietary anthocyanin intake was associated with reduced risk of IBD and UC, but not CD. Genetic factors may modify the influence of dietary anthocyanin on UC susceptibility, and possible mechanisms need to be further elucidated in the future.
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Affiliation(s)
- Sishen Sun
- Department of Gastroenterology, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Danshu Wang
- Department of Gastroenterology, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Lintao Dan
- Department of Gastroenterology, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Centre for Global HealthZhejiang University School of MedicineHangzhouChina
| | - Tian Fu
- Department of Gastroenterology, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Jie Chen
- Centre for Global HealthZhejiang University School of MedicineHangzhouChina
- Department of Gastroenterology, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Yao Zhang
- Department of Gastroenterology, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jing Sun
- Department of Gastroenterology, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Duowu Zou
- Department of Gastroenterology, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
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Dogara AM, Hama HA, Ozdemir D. Update on the Potential of Punica granatum L. Traditional Uses and Pharmacological Uses: A Review. Adv Pharmacol Pharm Sci 2024; 2024:6523809. [PMID: 39649727 PMCID: PMC11625089 DOI: 10.1155/adpp/6523809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 11/17/2024] [Accepted: 11/18/2024] [Indexed: 12/11/2024] Open
Abstract
Since the dawn of civilization, humans have turned to plants as a reliable source of safe and efficient treatment for a wide variety of medical conditions. The medicinal value of Punica granatum has been recognized for some time. Inflammation, diabetes, parasitic infections, cancer, and many other diseases have all been treated with its components. This review provides a comprehensive overview of the current biological data (those from 2018 to 2023 are included in the preclinical studies while articles of clinical studies have no limit due to their scarcity) and explores the potential applications of P. granatum as a novel platform for treating various disease conditions. Electronic searches for scholarly articles were performed using Elsevier, Springer, Google Scholar, Taylor & Francis, PubMed, and Scopus. Research the following terms: "Punica granatum," "chemical composition," "antioxidant," "antibacterial," "anti-diabetic," "anticancer," and other relevant terms. It has been scientifically proven that the fruit peel exhibits antioxidant, anti-inflammatory, antimicrobial, antiparasitic, antidiabetic, hepatoprotective, nerve-recovery, antihypertensive, anti-asthma, wound healing, and anticancer activities. Based on both preclinical and clinical experimentation on P. granatum, there is considerable evidence that supports the use of P. granatum extract as therapeutic agent for different ailments. The review paved the ground to precursor evidence of P. granatum extract benefits with its antioxidant, anti-inflammatory, antimicrobial, and antidiabetic properties. Furthermore, clinical trials stand out as a substrate supporting these effects with the enhancements of ailments including post menstrual, menstrual pain, semen quality, knee joint arthritis, and cardiovascular-related diseases. Nonetheless, more controlled large-scale clinical trials are needed for all the conditions to determine the effectiveness and risk benefit profile of P. granatum extract for these diseases.
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Affiliation(s)
| | - Harmand A. Hama
- Biology Education Department, Tishk International University, Erbil, Iraq
| | - Dogan Ozdemir
- Biology Education Department, Tishk International University, Erbil, Iraq
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Hasheminasab FS, Azimi M. A review of inflammatory bowel disease from the perspective of Persian medicine. Explore (NY) 2024; 20:103041. [PMID: 39241376 DOI: 10.1016/j.explore.2024.103041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 07/18/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024]
Abstract
The initial descriptions of inflammatory bowel disease (IBD) have been a topic of discussion. Cases of persistent diarrhea have been documented as far back as ancient Greece, with even Hippocrates (∼ 460-370 BCE) exploring various potential causes of diarrhea. Persian medicine was the predominant medical practice in the Eurasia region until the 18th century and had roots in Hippocrates and the ancient civilization of the region. Scholars, such as Avicenna (980-1025 CE), extensively described a disease characterized by intestinal ulcers, bloody diarrhea, and abdominal pain in the early medieval period. While some of the definitions and etiologies of IBD in Persian medicine are based on humoral theories that differ from current medical concepts, recent studies have suggested a potential relationship between the traditional Persian medicine understanding of the disease and IBD. Persian medicine classifies patients with specific diseases into different types of disorders known as dystemperament, with the application of these differences referred to as "syndrome differentiation." These traditional classifications require distinct therapeutic approaches. Research has delved into the molecular bases of the humoral theory and the impact of syndrome differentiation on drug selection for patients, including those with IBD. However, further research is needed to explore the potential effectiveness of Persian medicine in treating IBD and to understand how this ancient classification system can contribute to improved disease management.
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Affiliation(s)
- Fatemeh Sadat Hasheminasab
- Pharmacology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran; Department of Genetic, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maryam Azimi
- Gastroenterology and Hepatology Research Center, Kerman University of Medical Sciences, Kerman, Iran; Department of Traditional Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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7
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Subudhi RN, Poonia N, Singh D, Arora V. Natural approaches for the management of ulcerative colitis: evidence of preclinical and clinical investigations. NATURAL PRODUCTS AND BIOPROSPECTING 2024; 14:42. [PMID: 39078427 PMCID: PMC11289194 DOI: 10.1007/s13659-024-00463-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 07/07/2024] [Indexed: 07/31/2024]
Abstract
Ulcerative colitis (UC) is a recurring autoimmune disorder characterized by persistent inflammation in the mucosal lining of the lower part of the large intestine. Conventional treatment options such as salicylates, corticosteroids, and immunosuppressants often come with severe side effects, limited bioavailability, and the development of drug resistance, which hampers their therapeutic effectiveness. Therefore, it is imperative to explore natural strategies as safe and alternative treatments for UC. Currently, around 40% of UC patients find relief through natural constituents, which can help reduce toxic side effects and maintain clinical remission. This review aims to provide a summary of both preclinical and clinical evidence supporting the efficacy of various natural substances in the prophylaxis of UC. These natural options include plant extracts, essential oils, nutraceuticals, and phytochemicals. Furthermore, we will delve into the potential mechanisms that underlie the protective and curative actions of these novel herbal agents. In summary, this review will explore the effectiveness of natural remedies for UC, shedding light on their preclinical and clinical findings and the mechanisms behind their therapeutic actions. These alternatives offer hope for improved treatment outcomes and reduced side effects for individuals suffering from this challenging autoimmune condition.
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Affiliation(s)
- Rudra Narayan Subudhi
- Department of Pharmaceutics, University Institute of Pharma Sciences, Chandigarh University, Gharuan, Mohali, Punjab, India
| | - Neelam Poonia
- Department of Pharmaceutics, University Institute of Pharma Sciences, Chandigarh University, Gharuan, Mohali, Punjab, India.
| | - Dilpreet Singh
- Department of Pharmaceutics, University Institute of Pharma Sciences, Chandigarh University, Gharuan, Mohali, Punjab, India
| | - Vimal Arora
- Department of Pharmaceutics, University Institute of Pharma Sciences, Chandigarh University, Gharuan, Mohali, Punjab, India
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8
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Utz S, Bittel M, Langhorst J. [Phytotherapeutic recommendations in medical guidelines for the treatment of gastroenterological diseases - a systematic review]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2024; 62:1060-1073. [PMID: 38604221 DOI: 10.1055/a-2279-5045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
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 irritable bowel syndrome the use of peppermint oil is "strongly recommended", especially for pain and flatulence. Other phytotherapeutics such as STW-5, Tibetan Padma Lax or warm caraway oil pads have proven effective in alleviating symptoms. It is "recommended" to integrate them into the treatment concept. For chronic constipation, 30g of fiber per day is recommended. Best data exists for plantago psyllium with moderate evidence and chicory inulin. In case of ulcerative colitis, plantago psyllium as well as the combination of myrrh, chamomile flower extract, and coffee charcoal can be used as a complementary treatment in maintaining remission. There is also an "open recommendation" for curcumin for both, remission induction and maintenance. Some phytotherapeutic treatments (e.g., Artemisia absintium, Boswellia serata) show evidence of effectiveness for the treatment of Crohn's disease, 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.
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Affiliation(s)
- Sandra Utz
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany
- Department of Integrative Medicine, Medicinal Faculty, University of Duisburg-Essen, Duisburg, Germany
| | - Miriam Bittel
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany
- Department of Integrative Medicine, Medicinal Faculty, University of Duisburg-Essen, Duisburg, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany
- Department of Integrative Medicine, Medicinal Faculty, University of Duisburg-Essen, Duisburg, Germany
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Zare H, Amiri Ardekani E, Tavakoli A, Bradley R, Tavakoli F, Pasalar M. Reporting of adverse effects of pomegranate in clinical studies: a systematic review. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2024; 21:154-166. [PMID: 37116077 DOI: 10.1515/jcim-2022-0247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/04/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES Numerous studies have shown the pharmacological effects of pomegranate, such as: anti-cancer, cholesterol-lowering, anti-diabetic, and antihypertensive features. Pomegranate consumption has also revealed some adverse effects. This systematic review aimed to explore the adverse effects of pomegranate reported in clinical studies. CONTENT The keywords "pomegranate", "Punica granatum", "side effect", "clinical trial", and "case report or case series" were searched for in valid databases. Reports about adverse effects of pomegranate were also collected from several international registries. SUMMARY This systematic review included a total of 66 clinical articles. Eleven articles have reported side effects of pomegranate. Twenty-one articles have recorded no side effects in the pomegranate group while 34 articles have not mentioned any side effects for this plant. The study also included 7 case report studies. The most common side effects included gastrointestinal problems, flu-like symptoms, and urinary problems. In case report studies, the most significant reported side effect was allergic reaction. OUTLOOK In summary, pomegranate and its extract seem to be safe according to the reported adverse effects. Meanwhile, conducting more robust controlled trials with pomegranate products and documentation of any probable side effect is warranted.
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Affiliation(s)
- Hamid Zare
- Department of Traditional Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Amiri Ardekani
- Department of Phytopharmaceuticals (Traditional Pharmacy), Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
- Iranian Association of Indigenous Knowledge, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Tavakoli
- Department of Traditional Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, USA
| | - Fatemeh Tavakoli
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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10
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Kucharzik T, Dignass A, Atreya R, Bokemeyer B, Esters P, Herrlinger K, Kannengiesser K, Kienle P, Langhorst J, Lügering A, Schreiber S, Stallmach A, Stein J, Sturm A, Teich N, Siegmund B. Aktualisierte S3-Leitlinie Colitis ulcerosa (Version 6.2). ZEITSCHRIFT FUR GASTROENTEROLOGIE 2024; 62:769-858. [PMID: 38718808 DOI: 10.1055/a-2271-0994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Affiliation(s)
- T Kucharzik
- Klinik für Allgemeine Innere Medizin und Gastroenterologie, Städtisches Klinikum Lüneburg, Lüneburg, Deutschland
| | - A Dignass
- Medizinische Klinik I, Agaplesion Markus Krankenhaus, Frankfurt, Deutschland
| | - R Atreya
- Medizinische Klinik 1 Gastroent., Pneumologie, Endokrin., Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - B Bokemeyer
- Interdisziplinäres Crohn Colitis Centrum Minden - ICCCM, Minden, Deutschland
| | - P Esters
- Medizinische Klinik I, Agaplesion Markus Krankenhaus, Frankfurt, Deutschland
| | - K Herrlinger
- Innere Medizin I, Asklepios Klinik Nord, Hamburg, Deutschland
| | - K Kannengiesser
- Klinik für Allgemeine Innere Medizin und Gastroenterologie, Städtisches Klinikum Lüneburg, Lüneburg, Deutschland
| | - P Kienle
- Abteilung für Allgemein- und Viszeralchirurgie, Theresienkrankenhaus, Mannheim, Deutschland
| | - J Langhorst
- Klinik für Integrative Medizin und Naturheilkunde, Sozialstiftung Bamberg Klinikum am Bruderwald, Bamberg, Deutschland
| | - A Lügering
- Medizinisches Versorgungszentrum Portal 10, Münster, Deutschland
| | - S Schreiber
- Klinik für Innere Medizin I, Universitätsklinikum Schleswig Holstein, Kiel, Deutschland
| | - A Stallmach
- Klinik für Innere Medizin IV Gastroenterologie, Hepatologie, Infektiologie, Universitätsklinikum Jena, Jena, Deutschland
| | - J Stein
- Abteilung Innere Medizin mit Schwerpunkt Gastroenterologie, Krankenhaus Sachsenhausen, Frankfurt, Deutschland
| | - A Sturm
- Klinik für Innere Medizin mit Schwerpunkt Gastroenterologie, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - N Teich
- Internistische Gemeinschaftspraxis, Leipzig, Deutschland
| | - B Siegmund
- Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité Campus Benjamin Franklin - Universitätsmedizin Berlin, Berlin, Deutschland
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Iyengar P, Godoy-Brewer G, Maniyar I, White J, Maas L, Parian AM, Limketkai B. Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:934. [PMID: 38612967 PMCID: PMC11013716 DOI: 10.3390/nu16070934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/05/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024] Open
Abstract
Herbal medicines are used by patients with IBD despite limited evidence. We present a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating treatment with herbal medicines in active ulcerative colitis (UC). A search query designed by a library informationist was used to identify potential articles for inclusion. Articles were screened and data were extracted by at least two investigators. Outcomes of interest included clinical response, clinical remission, endoscopic response, endoscopic remission, and safety. We identified 28 RCTs for 18 herbs. In pooled analyses, when compared with placebo, clinical response rates were significantly higher for Indigo naturalis (IN) (RR 3.70, 95% CI 1.97-6.95), but not for Curcuma longa (CL) (RR 1.60, 95% CI 0.99-2.58) or Andrographis paniculata (AP) (RR 0.95, 95% CI 0.71-1.26). There was a significantly higher rate of clinical remission for CL (RR 2.58, 95% CI 1.18-5.63), but not for AP (RR 1.31, 95% CI 0.86-2.01). Higher rates of endoscopic response (RR 1.56, 95% CI 1.08-2.26) and remission (RR 19.37, 95% CI 2.71-138.42) were significant for CL. CL has evidence supporting its use as an adjuvant therapy in active UC. Research with larger scale and well-designed RCTs, manufacturing regulations, and education are needed.
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Affiliation(s)
- Preetha Iyengar
- Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA;
| | | | - Isha Maniyar
- Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA;
| | - Jacob White
- Welch Library, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Laura Maas
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Alyssa M. Parian
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Berkeley Limketkai
- Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA;
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Moradi S, Bagheri R, Amirian P, Zarpoosh M, Cheraghloo N, Wong A, Zobeiri M, Entezari MH. Effects of Spirulina supplementation in patients with ulcerative colitis: a double-blind, placebo-controlled randomized trial. BMC Complement Med Ther 2024; 24:109. [PMID: 38424572 PMCID: PMC10905931 DOI: 10.1186/s12906-024-04400-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/13/2024] [Indexed: 03/02/2024] Open
Abstract
AIM We conducted a randomized placebo-controlled trial to assess the efficacy of Spirulina (SP) supplementation on disease activity, health-related quality of life, antioxidant status, and serum pentraxin 3 (PTX-3) levels in patients with ulcerative colitis (UC). METHODS Eighty patients with UC were randomly assigned to consume either 1 g/day (two 500 mg capsules/day) of SP (n = 40) or control (n = 40) for 8 weeks. Dietary intakes, physical activity, disease activity, health-related quality of life, antioxidant status, erythrocyte sedimentation rate (ESR), and serum PTX-3 levels were assessed and compared between groups at baseline and post-intervention. RESULTS Seventy-three patients (91.3%) completed the trial. We observed increases in serum total antioxidant capacity levels in the SP supplementation group compared to the control group after 8 weeks of intervention (p ≤ 0.001). A within-group comparison indicated a trend towards a higher health-related quality of life score after 8 weeks of taking two different supplements, SP (p < 0.001) and PL (p = 0.012), respectively. However, there were no significant changes in participant's disease activity score in response to SP administration (p > 0.05). Similarly, changes in ESR and PTX-3 levels were comparable between groups post-intervention (p > 0.05). CONCLUSIONS SP improved antioxidant capacity status and health-related quality of life in patients with UC. Our findings suggest that SP supplementation may be effective as an adjuvant treatment for managing patients with UC. Larger trials with longer interventions periods are required to confirm our findings.
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Affiliation(s)
- Sajjad Moradi
- Department of Nutrition and Food Sciences, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, 8174673441, Iran
| | - Parsa Amirian
- General Practitioner, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Mahsa Zarpoosh
- General Practitioner, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Neda Cheraghloo
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, 1417613151, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA
| | - Mehdi Zobeiri
- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hassan Entezari
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Bahari H, Ashtary-Larky D, Goudarzi K, Mirmohammadali SN, Asbaghi O, Hosseini Kolbadi KS, Naderian M, Hosseini A. The effects of pomegranate consumption on glycemic indices in adults: A systematic review and meta-analysis. Diabetes Metab Syndr 2024; 18:102940. [PMID: 38194826 DOI: 10.1016/j.dsx.2024.102940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/16/2023] [Accepted: 01/01/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND AND AIM Epidemiologic studies have shown that type 2 diabetes (T2D) is more prevalent worldwide; therefore, improving glycemic indices to prevent or control T2D is vital. Randomized controlled trials (RCTs) on the effects of pomegranate consumption on glycemic indices have shown inconsistent results. Therefore, we aim to evaluate the impact of pomegranate consumption on fasting blood glucose (FBG), fasting insulin, hemoglobin A1c (HbA1c), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in adults. METHODS A systematic literature search was performed using electronic databases, including PubMed, Web of Science, and Scopus, up to May 2023 to identify eligible RCTs evaluating the effect of pomegranate consumption on glycemic indices. Heterogeneity tests of the included trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference with a 95 % confidence interval. RESULTS Of 1999 records, 32 eligible RCTs were included in the current study. Our meta-analysis of the pooled findings showed that pomegranate consumption significantly reduced FBG (WMD: -2.22 mg/dL; 95 % CI: -3.95 to -0.50; p = 0.012), fasting insulin (WMD: -1.06 μU/ml; 95%CI: -1.79 to -0.33; p = 0.004), HbA1c (WMD: -0.22 %; 95% CI: -0.43 to -0.01; p = 0.037), and HOMA-IR (WMD: -0.30; 95%CI: -0.61 to -0.00; p = 0.046). CONCLUSION Overall, the results demonstrated that pomegranate consumption benefits glycemic indices in adults. However, further research with long-term interventions is required. PROSPERO REGISTRATION CODE CRD42023422780.
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Affiliation(s)
- Hossein Bahari
- Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Damoon Ashtary-Larky
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Kian Goudarzi
- Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | | | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Moslem Naderian
- Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
| | - Ali Hosseini
- Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
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14
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Moradi S, Foshati S, Poorbaferani F, Talebi S, Bagheri R, Amirian P, Parvizi F, Nordvall M, Wong A, Zobeiri M. The effects of spirulina supplementation on serum iron and ferritin, anemia parameters, and fecal occult blood in adults with ulcerative colitis: A randomized, double-blinded, placebo-controlled trial. Clin Nutr ESPEN 2023; 57:755-763. [PMID: 37739734 DOI: 10.1016/j.clnesp.2023.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/23/2023] [Accepted: 08/17/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS The present clinical trial aimed to evaluate the efficacy of spirulina administration on serum iron, ferritin, anemia parameters, and fecal occult blood test (FOBT) in adults with ulcerative colitis (UC). METHODS Eighty participants with UC were randomly assigned to take, either 1 g/day (two 500 mg capsules) spirulina (n = 40) or placebo (n = 40) in a double-blinded clinical trial for eight weeks. Dietary intake, physical activity status, serum iron and ferritin levels, anemia parameters, and FOBT were assessed in each participant at baseline and following the intervention. Seventy-three participants completed the trial. RESULTS Our results indicated significantly increased (p = 0.04) serum iron after eight weeks of spirulina supplementation compared to the placebo group. The spirulina group also demonstrated significantly increased mean corpuscular volume (p = 0.004) whereas red blood cell count (p = 0.01) and hematocrit (p = 0.03) were significantly lowered in the placebo group. No significant changes in FOBT outcomes were seen between groups at baseline (p = 0.12) and the end of the trial (p = 0.34). Eight weeks of 1 g/day spirulina supplementation improved anemia parameters in adults with UC compared to placebo. CONCLUSIONS These outcomes suggest that spirulina administration may be beneficial in the management of anemia in UC. Further clinical trials of longer duration are necessary to corroborate and expand our findings. Registered at: http://www.IRCT.ir (code: IRCT20170802035460N3).
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Affiliation(s)
- Sajjad Moradi
- Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sahar Foshati
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariborz Poorbaferani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Science, Tehran University of Medical Science, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan 8174673441, Iran
| | - Parsa Amirian
- General Practitioner, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Fatemeh Parvizi
- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Iran
| | - Michael Nordvall
- Marymount University, School of Health Sciences, Department of Health and Human Performance, Arlington, VA, USA
| | - Alexei Wong
- Marymount University, School of Health Sciences, Department of Health and Human Performance, Arlington, VA, USA
| | - Mehdi Zobeiri
- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Iran.
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15
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Kucharzik T, Dignass A, Atreya R, Bokemeyer B, Esters P, Herrlinger K, Kannengiesser K, Kienle P, Langhorst J, Lügering A, Schreiber S, Stallmach A, Stein J, Sturm A, Teich N, Siegmund B. [Not Available]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:1046-1134. [PMID: 37579791 DOI: 10.1055/a-2060-0935] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Affiliation(s)
- T Kucharzik
- Klinik für Allgemeine Innere Medizin und Gastroenterologie, Städtisches Klinikum Lüneburg, Lüneburg, Deutschland
| | - A Dignass
- Medizinische Klinik I, Agaplesion Markus Krankenhaus, Frankfurt, Deutschland
| | - R Atreya
- Medizinische Klinik 1 Gastroent., Pneumologie, Endokrin., Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - B Bokemeyer
- Interdisziplinäres Crohn Colitis Centrum Minden - ICCCM, Minden, Deutschland
| | - P Esters
- Medizinische Klinik I, Agaplesion Markus Krankenhaus, Frankfurt, Deutschland
| | - K Herrlinger
- Innere Medizin I, Asklepios Klinik Nord, Hamburg, Deutschland
| | - K Kannengiesser
- Klinik für Allgemeine Innere Medizin und Gastroenterologie, Städtisches Klinikum Lüneburg, Lüneburg, Deutschland
| | - P Kienle
- Abteilung für Allgemein- und Viszeralchirurgie, Theresienkrankenhaus, Mannheim, Deutschland
| | - J Langhorst
- Klinik für Integrative Medizin und Naturheilkunde, Sozialstiftung Bamberg Klinikum am Bruderwald, Bamberg, Deutschland
| | - A Lügering
- Medizinisches Versorgungszentrum Portal 10, Münster, Deutschland
| | - S Schreiber
- Klinik für Innere Medizin I, Universitätsklinikum Schleswig Holstein, Kiel, Deutschland
| | - A Stallmach
- Klinik für Innere Medizin IV Gastroenterologie, Hepatologie, Infektiologie, Universitätsklinikum Jena, Jena, Deutschland
| | - J Stein
- Abteilung Innere Medizin mit Schwerpunkt Gastroenterologie, Krankenhaus Sachsenhausen, Frankfurt, Deutschland
| | - A Sturm
- Klinik für Innere Medizin mit Schwerpunkt Gastroenterologie, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - N Teich
- Internistische Gemeinschaftspraxis, Leipzig, Deutschland
| | - B Siegmund
- Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité Campus Benjamin Franklin - Universitätsmedizin Berlin, Berlin, Deutschland
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16
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Benedetti G, Zabini F, Tagliavento L, Meneguzzo F, Calderone V, Testai L. An Overview of the Health Benefits, Extraction Methods and Improving the Properties of Pomegranate. Antioxidants (Basel) 2023; 12:1351. [PMID: 37507891 PMCID: PMC10376364 DOI: 10.3390/antiox12071351] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Pomegranate (Punica granatum L.) is a polyphenol-rich edible food and medicinal plant of ancient origin, containing flavonols, anthocyanins, and tannins, with ellagitannins as the most abundant polyphenols. In the last decades, its consumption and scientific interest increased, due to its multiple beneficial effects. Pomegranate is a balausta fruit, a large berry surrounded by a thick colored peel composed of exocarp and mesocarp with edible arils inside, from which the pomegranate juice can be produced by pressing. Seeds are used to obtain the seed oil, rich in fatty acids. The non-edible part of the fruit, the peel, although generally disposed as a waste or transformed into compost or biogas, is also used to extract bioactive products. This review summarizes some recent preclinical and clinical studies on pomegranate, which highlight promising beneficial effects in several fields. Although further insight is needed on key aspects, including the limited oral bioavailability and the role of possible active metabolites, the ongoing development of suitable encapsulation and green extraction techniques enabling the valorization of waste pomegranate products point to the great potential of pomegranate and its bioactive constituents as dietary supplements or adjuvants in therapies of cardiovascular and non-cardiovascular diseases.
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Affiliation(s)
- Giada Benedetti
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56120 Pisa, Italy
| | - Federica Zabini
- Istituto per la Bioeconomia, CNR, Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
| | | | - Francesco Meneguzzo
- Istituto per la Bioeconomia, CNR, Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
| | - Vincenzo Calderone
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56120 Pisa, Italy
- Interdeparmental Center of Nutrafood, University of Pisa, Via del Borghetto, 56120 Pisa, Italy
| | - Lara Testai
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56120 Pisa, Italy
- Interdeparmental Center of Nutrafood, University of Pisa, Via del Borghetto, 56120 Pisa, Italy
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17
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Rizzo G, Pineda Chavez SE, Vandenkoornhuyse E, Cárdenas Rincón CL, Cento V, Garlatti V, Wozny M, Sammarco G, Di Claudio A, Meanti L, Elangovan S, Romano A, Roda G, Loy L, Dal Buono A, Gabbiadini R, Lovisa S, Rusconi R, Repici A, Armuzzi A, Vetrano S. Pomegranate Extract Affects Gut Biofilm Forming Bacteria and Promotes Intestinal Mucosal Healing Regulating the Crosstalk between Epithelial Cells and Intestinal Fibroblasts. Nutrients 2023; 15:nu15071771. [PMID: 37049615 PMCID: PMC10097402 DOI: 10.3390/nu15071771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Background: Pomegranate (Punica granatum) can be used to prepare a bioactive extract exerting anti-inflammatory activities. Clinical studies demonstrated an improvement in clinical response in inflammatory bowel disease (IBD) patients when pomegranate extract (PG) was taken as a complement to standard medications. However, the molecular mechanisms underlying its beneficial effects are still scarcely investigated. This study investigates the effect of PG on bacterial biofilm formation and the promotion of mucosal wound healing. Methods: The acute colitis model was induced in C57BL/6N mice by 3% dextran sodium sulfate administration in drinking water for 5 days. During the recovery phase of colitis, mice received saline or PG (200 mg/kg body weight) by oral gavage for 11 days. Colitis was scored daily by evaluating body weight loss, bleeding, and stool consistency. In vivo intestinal permeability was evaluated by fluorescein isothiocyanate-conjugated dextran assay, bacterial translocation was assessed by fluorescence in situ hybridization on tissues, whereas epithelial and mucus integrity were monitored by immunostaining for JAM-A and MUC-2 markers. Bacterial biofilm formation was assessed using microfluidic devices for 24 or 48 h. Primary fibroblasts were isolated from healthy and inflamed areas of 8 IBD patients, and Caco-2 cells were stimulated with or without PG (5 μg/mL). Inflammatory mediators were measured at the mRNA and protein level by RT-PCR, WB, or Bio-plex multiplex immunoassay, respectively. Results: In vivo, PG boosted the recovery phase of colitis, promoting a complete restoration of the intestinal barrier with the regeneration of the mucus layer, as also demonstrated by the absence of bacterial spread into the mucosa and the enrichment of crypt-associated fibroblasts. Microfluidic experiments did not highlight a specific effect of PG on Enterobacterales biofilm formation, even though Citrobacter freundii biofilm was slightly impaired in the presence of PG. In vitro, inflamed fibroblasts responded to PG by downregulating the release of metalloproteinases, IL-6, and IL-8 and upregulating the levels of HGF. Caco-2 cells cultured in a medium supplemented with PG increased the expression of SOX-9 and CD44, whereas in the presence of HGF or plated with a fibroblast-conditioned medium, they displayed a decrease in SOX-9 and CD44 expression and an increase in AXIN2, a negative regulator of Wnt signaling. Conclusions: These data provide new insight into the manifold effects of PG on promoting mucosal homeostasis in IBD by affecting pathogen biofilm formation and favoring the regeneration of the intestinal barrier through the regulation of the crosstalk between epithelial and stromal cells.
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Affiliation(s)
- Giulia Rizzo
- Laboratory of Gastrointestinal Immunopathology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | | | - Elisa Vandenkoornhuyse
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | | | - Valeria Cento
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
- Unit of Microbiology and Virology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Valentina Garlatti
- Department of Pharmaceutical Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, Largo Guido Donegani, 28100 Novara, Italy
| | - Marek Wozny
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Giusy Sammarco
- Laboratory of Gastrointestinal Immunopathology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Alessia Di Claudio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Lisa Meanti
- Laboratory of Gastrointestinal Immunopathology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Sudharshan Elangovan
- Wipro Life Sciences Lab, Wipro Limited, SJP2, Sarjapur Road, Bangalore 560035, Karnataka, India
| | - Andrea Romano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Giulia Roda
- IBD Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Laura Loy
- IBD Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Arianna Dal Buono
- IBD Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Roberto Gabbiadini
- IBD Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Sara Lovisa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Roberto Rusconi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Alessandro Repici
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
- Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Clinical and Research Center-IRCCS, Rozzano, 20089 Milan, Italy
| | - Alessandro Armuzzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
- IBD Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Stefania Vetrano
- Laboratory of Gastrointestinal Immunopathology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
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Tsuzuki Y, Shiomi R, Matsumoto H, Miyaguchi K, Kusano T, Ohgo H, Nakamoto H, Imaeda H. Combined effects of granulocyte and monocyte adsorption apheresis and corticosteroids on ulcerative colitis. J Clin Biochem Nutr 2023; 72:68-73. [PMID: 36777077 PMCID: PMC9899916 DOI: 10.3164/jcbn.22-52] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/26/2022] [Indexed: 11/06/2022] Open
Abstract
Several new treatments for ulcerative colitis have been developed recently. The depletion of leukocytes by granulocyte and monocyte adsorption apheresis (GMA) was developed and adapted for patients with ulcerative colitis with rare adverse events. We investigated whether treatment with GMA and prednisolone (GMA + PSL) is more effective than PSL alone for patients with moderate to severe ulcerative colitis. Forty-seven patients with moderate to severe ulcerative colitis were retrospectively analyzed. Among the 47 patients, 27 received PSL, while 20 received GMA + PSL. The clinical activity of ulcerative colitis was evaluated using the Lichtiger clinical activity index (CAI) and serum levels of C-reactive protein. Mayo endoscopic score (MES) was used to examine endoscopic activity. The clinical remission rate was significantly higher in the GMA + PSL group than in the PSL group (65% vs 29.6%, p = 0.0206). The mucosal healing rate was also significantly higher in the GMA + PSL group than in the PSL group (60% vs 26%, p = 0.0343). The combination of GMA and steroids may be more effective than steroids alone for inducing clinical remission and mucosal healing in patients with moderate to severe ulcerative colitis.
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Affiliation(s)
- Yoshikazu Tsuzuki
- Department of Gastroenterology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
- Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Rie Shiomi
- Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Hisashi Matsumoto
- Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Kazuya Miyaguchi
- Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Takeru Kusano
- Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Hideki Ohgo
- Department of Gastroenterology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
- Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Hidetomo Nakamoto
- Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Hiroyuki Imaeda
- Department of Gastroenterology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
- Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
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Akbarian M, Hosseini M, Mirzavi F, Amirahmadi S, Arab FL, Rajabian A. Punica granatum peel supplementation attenuates cognitive deficits and brain injury in rat by targeting the Nrf2-HO-1 pathway. Food Sci Nutr 2023; 11:168-180. [PMID: 36655111 PMCID: PMC9834883 DOI: 10.1002/fsn3.3049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 08/06/2022] [Accepted: 08/14/2022] [Indexed: 01/21/2023] Open
Abstract
The critical role of nutrition to prevent neurodegenerative disorders is well documented. Punica granatum fruit is identified as a highly nutritional food for alleviating various ailments. The ameliorating properties of P. granatum peel on memory dysfunction and the possible roles of oxidative stress, acetylcholinesterase (AchE), and nuclear factor erythroid 2-related factor 2 (Nrf2)-heme oxygenase (HO)-1 pathway in the scopolamine-treated rats were assessed. The hydroethanolic extract was standardized using high-performance liquid chromatography (HPLC). The animal groups were as follows: Control, scopolamine (2 mg/kg), and treatment groups (the extract at doses of 200-800 mg/kg). The behavioral performance was evaluated using the Morris water maze (MWM) and passive avoidance equipment. Various biochemical parameters were then measured. Rats received the extract properly found on the platform location, indicated by a shorter traveling time and distance during 5 days of learning MWM. Moreover, the extract increased the delay and light time, while decreasing dark time and the frequency of entries to the dark in the passive avoidance test. The extract also exerted a significant increase in superoxide dismutase activity and thiol content, while decreasing AchE activity and lipid peroxidation in the brain of scopolamine-injured rats. Our results demonstrated the neuroprotective effects of P. granatum peel in minimizing scopolamine injury possibly through targeting the Nrf2-HO-1 pathway.
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Affiliation(s)
- Mahsan Akbarian
- Applied Biomedical Research CenterMashhad University of Medical SciencesMashhadIran
| | - Mahmoud Hosseini
- Psychiatry and Behavioral Sciences Research CenterMashhad University of Medical SciencesMashhadIran
| | - Farshad Mirzavi
- Department of Biochemistry and Nutrition, School of MedicineGonabad University of Medical SciencesGonabadIran
| | - Sabiheh Amirahmadi
- Applied Biomedical Research CenterMashhad University of Medical SciencesMashhadIran
| | - Fahimeh Lavi Arab
- Department of Immunology, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Arezoo Rajabian
- Department of Internal Medicine, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
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20
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Mo Y, Ma J, Gao W, Zhang L, Li J, Li J, Zang J. Pomegranate Peel as a Source of Bioactive Compounds: A Mini Review on Their Physiological Functions. Front Nutr 2022; 9:887113. [PMID: 35757262 PMCID: PMC9218663 DOI: 10.3389/fnut.2022.887113] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
The production and consumption of pomegranates have always been increasing owing to their taste and nutrition. However, during fruit processing, a large number of by-products are produced, such as peels and seeds, which can lead to environmental pollution problems if not handled properly. The pomegranate peel takes up about 26-30% of the total weight, while it contains abundant bioactive substances. This paper carries out a mini review of the characterization and physiological functions of key bioactive compounds in pomegranate peel, comprehensively assessing their effects on human health. The overview summarizes the main phenolic substances in pomegranate peel, including tannins, flavonoids, and phenolic acids. Dietary fiber and other bioactive substances such as alkaloids, minerals, and vitamins are also mentioned. These components act as antioxidants by improving oxidative biomarkers and scavenging or neutralizing reactive oxygen species, further contributing to their extensive functions like anti-inflammatory, anti-cancer, antibacterial, and cardiovascular protection. Overall, it is envisaged that through the deeper understanding of bioactive compounds in pomegranate peel, the waste sources can be better reused for physiological applications.
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Affiliation(s)
- Yaxian Mo
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Jiaqi Ma
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Wentao Gao
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Lei Zhang
- College of Forestry and Landscape Architecture, Xinjiang Agricultural University, Ürümqi, China
| | - Jiangui Li
- College of Forestry and Landscape Architecture, Xinjiang Agricultural University, Ürümqi, China
| | - Jingming Li
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Jiachen Zang
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
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21
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Fahmy HA, Farag MA. Ongoing and potential novel trends of pomegranate fruit peel; a comprehensive review of its health benefits and future perspectives as nutraceutical. J Food Biochem 2021; 46:e14024. [PMID: 34923641 DOI: 10.1111/jfbc.14024] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/13/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022]
Abstract
Pomegranate is an ancient shrub, globally distributed nowadays. It has been used in the middle east as a medicinal food and traditional medicine for thousands of years. Pomegranate peel (PP) constitutes about 50% of the total fruit, however, it has been previously regarded as a waste. Recent research points to PP as a rich source of phenolics (e.g., ellagitannins, flavonoids, and anthocyanins), polysaccharides, in addition to its biotransformed metabolites viz. urolithins making it a valuable waste with promising pharmacological actions. Compared to the pulp and the juice, PP exhibited stronger antioxidant and antimicrobial activities. Besides, it inhibited inflammation in several conditions, including colitis, arthritis, hepatitis, contact dermatitis, and lung inflammation. Moreover, it displayed anti-osteoporosis, anti-hyperglycemic, antidiabetic, antihypertensive, vasculoprotective, hepatoprotective, neuroprotective, and immunomodulatory effects. Additionally, it was effective as a prebiotic and in obesity control, besides it promoted wound healing. Furthermore, PP demonstrated anticancer effects against different cancer types, for example, colon, liver, thyroid, uterine, breast, bladder, prostate, leukemia, and osteosarcoma. Despite PP safety, it may interfere with the metabolism of other drugs because it inhibits cytochromes (CYP) changing their bioavailability, effectiveness, and toxicity. PP biowaste valorization not only avoids against its environmental and economic burden but can also provide a promising platform to produce novel or improved nutraceuticals. This study provides a comprehensive overview of PP biological activities with the reported action mechanisms related to its phytochemicals and further biotransformed metabolites inside the body. Future research prospects to unravel the merits of such waste and optimize its use are discussed. PRACTICAL APPLICATION: Pomegranate is widely distributed throughout the world. Although its peel was previously considered a waste, recent research regards it as a rich source of bioactive compounds with promising biological activities. Its recycling not only overcomes the bio-waste problems, but also provides a source of valuable compounds with several health benefits. In recent years, PP has been demonstrated to exhibit excellent pharmacological bioactivities, for example, antioxidant, anti-inflammatory, antimicrobial, antiosteoporosis, antihyperlipidemic, and anticancer activities. Its health-promoting power is mostly attributed to the phenolic and polysaccharide content, in addition to its amazing biotransformed metabolites. The underlying action mechanisms of such pharmacological activities are discussed and related to its chemical content. This review presents the latest research progress on the role of PP in the prevention and treatment of various chronic diseases, and its protective health effects for future research to be used in nutraceuticals.
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Affiliation(s)
- Heba A Fahmy
- Department of Pharmacognosy, Faculty of Pharmacy, Modern University for Technology & Information, Cairo, Egypt
| | - Mohamed A Farag
- Department of Pharmacognosy, College of Pharmacy, Cairo University, Cairo, Egypt.,Department of Chemistry, School of Sciences and Engineering, The American University in Cairo, Cairo, Egypt
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22
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Therapeutic Effects of Punica granatum (Pomegranate): An Updated Review of Clinical Trials. J Nutr Metab 2021; 2021:5297162. [PMID: 34796029 PMCID: PMC8595036 DOI: 10.1155/2021/5297162] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 12/22/2022] Open
Abstract
Punica granatum L. belongs to the Punicaceae family which is distributed around the world. Different parts of pomegranate like seed, peel, juice, and leaves are rich in potential bioactive compounds. These plants have found application in traditional medicine such as in treatment of gastrointestinal, cardiovascular, and endocrine diseases, among others. The present review aimed to summarize the current research on the traditional and scientific applications of P. granatum with regard to the phytochemical content and clinical applications that may be useful for future drug development. Information about P. granatum was obtained from local classic herbal literature and electronic databases, such as PubMed, Scopus, and ScienceDirect. Several phytochemical constituents including polyphenolics, flavonoids, anthocyanosides, alkaloids, lignans, and triterpenes have been reported from the plant. Randomized clinical trials have provided evidence as to the pharmacological activities of pomegranate in several diseases including diabetes, cardiovascular disease, oral cavity disorders, endocrine disorders, and cancer. The present review has provided an insight into the traditional applications of the plants, and some of them have been validated by scientific evidence, particularly their applications as treatment of cardiovascular and endocrine diseases.
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Moradi S, Zobeiri M, Feizi A, Clark CCT, Entezari MH. The effects of spirulina (Arthrospira platensis) supplementation on anthropometric indices, blood pressure, sleep quality, mental health, fatigue status and quality of life in patients with ulcerative colitis: A randomised, double-blinded, placebo-controlled trial. Int J Clin Pract 2021; 75:e14472. [PMID: 34107141 DOI: 10.1111/ijcp.14472] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/12/2021] [Accepted: 06/06/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND An emerging body of evidence has highlighted the protective role of spirulina in human health. Thus, we conducted a randomised controlled trial to discern the effects of spirulina supplementation on anthropometric indices, blood pressure, sleep quality, mood, fatigue status and quality of life among ulcerative colitis patients. METHODS Eighty participants with ulcerative colitis were randomly allocated to receive, either, 1 g/day (two 500 mg capsules) spirulina (n = 40) or placebo (n = 40), in a clinical trial for eight weeks. Dietary intake, physical activity, sleep quality, mental health, fatigue status and quality of life were assessed for each participant at baseline and trial cessation. Anthropometric indices and blood pressure were also assessed. RESULTS Seventy-three participants completed the intervention. Our results revealed that spirulina supplementation significantly reduced sleep disturbances (P = .03), while no significant changes occurred in the sleep quality score or other sleep parameters, vs the placebo group (P > .05). Furthermore, a significant reduction in stress score (P = .04) and increase in quality of life (P = .03) was detected; but not anxiety, depression or fatigue scores (P > .05). Additionally, anthropometric indices and blood pressure did not significantly change (P > .05). CONCLUSION An improved quality of life was observed among ulcerative colitis patients following spirulina supplementation, which could be attributed to improved sleep disturbance and stress status. Further clinical studies, with longer duration interventions and suitably powered sample sizes, are necessary to elucidate the veracity of our findings.
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Affiliation(s)
- Sajjad Moradi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Zobeiri
- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Mohammad Hassan Entezari
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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24
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Guerrero-Solano JA, Bautista M, Velázquez-González C, De la O-Arciniega M, González-Olivares LG, Fernández-Moya M, Jaramillo-Morales OA. Antinociceptive Synergism of Pomegranate Peel Extract and Acetylsalicylic Acid in an Animal Pain Model. Molecules 2021; 26:5434. [PMID: 34576905 PMCID: PMC8469324 DOI: 10.3390/molecules26185434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 01/29/2023] Open
Abstract
Several modern drugs, which are derived from traditional herbal medicine are used in contemporary pharmacotherapy. Currently, the study of drug-plant interactions in pain has increased in recent years, looking for greater efficacy of the drug and reduce side effects. The antinociception induced by intragastric co-administration of the combination of pomegranate peel extract (PoPEx) and acetylsalicylic acid (ASA) was assessed using the isobolographic analysis in formalin test (nociceptive and inflammatory pain). The effective dose that produced 30% of antinociception (ED30) was calculated for both drugs from the logarithmic dose-response curves, subsequently generating a curve with the combination on fixed proportions (1:1) of PoPEx and ASA. Through isobolographic analysis, this experimental ED30 was compared with the calculated theoretical additive ED30. The result was a synergistic interaction, the experimental ED30 was significantly smaller (p < 0.05) than the theoretical ED30. The antinociceptive mechanism of the PoPEx-ASA combination involves the l-Arginine/NO/cGMP pathway, antioxidant capacity, and high content of total phenols. These findings suggest that an interaction between PoPEx and ASA could be a novel treatment for inflammatory and nociceptive pain, also diminish the secondary reactions of ASA.
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Affiliation(s)
- José Antonio Guerrero-Solano
- Institute of Health Sciences, Academic Area of Pharmacy, Autonomous University of the State of Hidalgo, Circuito Ex Hacienda La Concepción S/N Carretera Pachuca Actopan, San Agustín Tlaxiaca, Hidalgo 42160, Mexico; (J.A.G.-S.); (C.V.-G.); (M.D.l.O.-A.)
| | - Mirandeli Bautista
- Institute of Health Sciences, Academic Area of Pharmacy, Autonomous University of the State of Hidalgo, Circuito Ex Hacienda La Concepción S/N Carretera Pachuca Actopan, San Agustín Tlaxiaca, Hidalgo 42160, Mexico; (J.A.G.-S.); (C.V.-G.); (M.D.l.O.-A.)
| | - Claudia Velázquez-González
- Institute of Health Sciences, Academic Area of Pharmacy, Autonomous University of the State of Hidalgo, Circuito Ex Hacienda La Concepción S/N Carretera Pachuca Actopan, San Agustín Tlaxiaca, Hidalgo 42160, Mexico; (J.A.G.-S.); (C.V.-G.); (M.D.l.O.-A.)
| | - Minarda De la O-Arciniega
- Institute of Health Sciences, Academic Area of Pharmacy, Autonomous University of the State of Hidalgo, Circuito Ex Hacienda La Concepción S/N Carretera Pachuca Actopan, San Agustín Tlaxiaca, Hidalgo 42160, Mexico; (J.A.G.-S.); (C.V.-G.); (M.D.l.O.-A.)
| | - Luis Guillermo González-Olivares
- Institute of Basic Sciences and Engineering, Academic Area of Chemistry, University of the State of Hidalgo, Carretera Pachuca-Tulancingo km 4.5 s/n, Mineral de la Reforma, Hidalgo 42184, Mexico;
| | - Monserrat Fernández-Moya
- Life Sciences Division, Nursing and Obstetrics Department, Campus Irapuato-Salamanca, University of Guanajuato, Ex Hacienda el Copal, km. 9 Carretera Irapuato- Silao, A.P. 311, Irapuato, Guanajuato 36500, Mexico;
| | - Osmar Antonio Jaramillo-Morales
- Life Sciences Division, Nursing and Obstetrics Department, Campus Irapuato-Salamanca, University of Guanajuato, Ex Hacienda el Copal, km. 9 Carretera Irapuato- Silao, A.P. 311, Irapuato, Guanajuato 36500, Mexico;
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25
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Giménez-Bastida JA, Ávila-Gálvez MÁ, Espín JC, González-Sarrías A. Evidence for health properties of pomegranate juices and extracts beyond nutrition: A critical systematic review of human studies. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.06.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Giang J, Lan X, Crichton M, Marx W, Marshall S. Efficacy and safety of biophenol-rich nutraceuticals in adults with inflammatory gastrointestinal diseases or irritable bowel syndrome: A systematic literature review and meta-analysis. Nutr Diet 2021; 79:76-93. [PMID: 33960587 PMCID: PMC9290971 DOI: 10.1111/1747-0080.12672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 12/19/2022]
Abstract
Aim Biophenol‐rich nutraceuticals may be an adjuvant treatment for Crohn's disease (CD), ulcerative colitis (UC), symptomatic uncomplicated diverticular disease (SUDD), and irritable bowel syndrome (IBS). This systematic review and meta‐analysis aimed to determine the efficacy and safety of biophenol‐rich nutraceutical supplementation on CD, UC, SUDD, and IBS on gastrointestinal symptoms (GIS), quality of life (QoL), inflammatory and oxidative stress biomarkers, and adverse events compared to usual care or placebo. Methods PubMed, Embase, CINAHL, and CENTRAL were searched for randomised controlled trials until 27 April 2020. Outcomes were GIS, inflammatory and oxidative stress markers, QoL, and adverse events. The Cochrane Risk of Bias tool and GRADE were used to appraise studies. Data were pooled using Revman. Results Twenty‐three trials in CD, UC, and IBS patients were included. Compared with placebo, biophenol‐rich nutraceuticals improved GIS (SMD: 0.43 [95%CI: 0.22, 0.63]; GRADE: very low) in UC, CD, and IBS participants. In UC and CD participants, biophenol‐rich nutraceuticals improved CRP by 1.6 mg/L [95%CI:0.08, 3.11; GRADE: low], malondialdehyde by 1 mmol/L [95%CI:0.55, 1.38; GRADE: low]; but only resveratrol improved QoL (SMD: −0.84 [95%CI: −1.24, −0.44; GRADE: high). Resveratrol (for UC and CD participants) and peppermint oil (for IBS participants) had greater certainty in the evidence for improving GIS and QoL (GRADE: moderate to high). There was no effect on adverse events (P > .05). Conclusions Biophenol‐rich nutraceuticals may be an effective and safe adjuvant treatment for the management of CD, UC, and IBS; with higher certainty of evidence for resveratrol for UC and CD and peppermint oil for IBS.
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Affiliation(s)
- Joanna Giang
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Xiao Lan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Megan Crichton
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Wolfgang Marx
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Skye Marshall
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
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Machado APDF, Geraldi MV, do Nascimento RDP, Moya AMTM, Vezza T, Diez-Echave P, Gálvez JJ, Cazarin CBB, Maróstica Júnior MR. Polyphenols from food by-products: An alternative or complementary therapy to IBD conventional treatments. Food Res Int 2021; 140:110018. [PMID: 33648249 DOI: 10.1016/j.foodres.2020.110018] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022]
Abstract
Inflammatory bowel diseases (IBD) are illnesses characterized by chronic intestinal inflammation and microbial dysbiosis that have emerged as a public health challenge worldwide. It comprises two main conditions: Crohn's disease and ulcerative colitis. Currently, conventional therapy to treat IBD are not free from side effects, such as liver and kidney toxicity, drug resistance, and allergic reactions. In view of this, there is growing research for alternative and complementary therapies that, in addition to acting in the prevention or the control of the disease, do not compromise the quality of life and health of individuals. In this sense, a growing body of evidence has confirmed the benefits of natural phenolic compounds in intestinal health. Phenolic compounds or polyphenols are molecules widely distributed throughout the plant kingdom (flowers, vegetables, leaves, and fruits), including plant materials remaining of the handling and food industrial processing, referred to in the scientific literature as by-products, food waste, or bagasse. Since by-products are low-cost, abundant, easily accessible, safe, and rich in bioactive compounds, it becomes an exciting option to extract, concentrate or isolate phenolic compounds to be posteriorly applied in the therapeutic approach of IBD. In this article, we have reviewed the main phenolic compounds present in various plants and by-products that have shown beneficial and/or promising effects in experimental pre-clinical, clinical, and in vitro research with IBD. In addition, we have mentioned and suggested several plants and by-products originated and produced in Latin America that could be part of future research as good sources of specific phenolic compounds to be applied in the prevention and development of alternative treatments for IBD. This review may offer a valuable reference for studies related to IBD administering phenolic compounds from natural, cheap, and easily accessible raw and undervalued materials.
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Affiliation(s)
| | - Marina Vilar Geraldi
- University of Campinas, School of Food Engineering, 80 Monteiro Lobato Street, 13083-862 Campinas, SP, Brazil
| | | | | | - Teresa Vezza
- University of Granada, Department of Pharmacology, CIBER-EHD, Institute of Biosanitary Research of Granada (ibs.GRANADA), Biomedical Research Center (CIBM), Campus de la Salud, 18071 Granada, Spain
| | - Patricia Diez-Echave
- University of Granada, Department of Pharmacology, CIBER-EHD, Institute of Biosanitary Research of Granada (ibs.GRANADA), Biomedical Research Center (CIBM), Campus de la Salud, 18071 Granada, Spain
| | - Julio Juan Gálvez
- University of Granada, Department of Pharmacology, CIBER-EHD, Institute of Biosanitary Research of Granada (ibs.GRANADA), Biomedical Research Center (CIBM), Campus de la Salud, 18071 Granada, Spain
| | - Cinthia Bau Betim Cazarin
- University of Campinas, School of Food Engineering, 80 Monteiro Lobato Street, 13083-862 Campinas, SP, Brazil
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28
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Melgarejo-Sánchez P, Núñez-Gómez D, Martínez-Nicolás JJ, Hernández F, Legua P, Melgarejo P. Pomegranate variety and pomegranate plant part, relevance from bioactive point of view: a review. BIORESOUR BIOPROCESS 2021; 8:2. [PMID: 38650225 PMCID: PMC10973758 DOI: 10.1186/s40643-020-00351-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/22/2020] [Indexed: 02/06/2023] Open
Abstract
Pomegranate (Punica granatum L.) belongs to the Punicaceae plant family. It is an important fruit due to its nutritional and medicinal properties. Pomegranates are widely distributed around the world and, therefore, have a broad genetic diversity, resulting in differences in their phytochemical composition. The scientific community has focused on the positive health effects of pomegranate as a whole, but the different varieties have rarely been compared according to their bioactive compounds and bioactivity. This review aims to provide a holistic overview of the current knowledge on the bioactivity of pomegranate trees, with an emphasis on differentiating both the varieties and the different plant parts. This review intends to provide a general and organized overview of the accumulated knowledge on pomegranates, the identification of the most bioactive varieties, their potential consumption pathways and seeks to provide knowledge on the present gaps to guide future research.
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Affiliation(s)
- Pablo Melgarejo-Sánchez
- Plant Production and Microbiology Department, Orihuela Polytechnical High School (EPSO), Miguel Hernandez University, Ctra. Beniel Km 3.2, 03312, Orihuela, Spain
| | - Dámaris Núñez-Gómez
- Plant Production and Microbiology Department, Orihuela Polytechnical High School (EPSO), Miguel Hernandez University, Ctra. Beniel Km 3.2, 03312, Orihuela, Spain.
| | - Juan J Martínez-Nicolás
- Plant Production and Microbiology Department, Orihuela Polytechnical High School (EPSO), Miguel Hernandez University, Ctra. Beniel Km 3.2, 03312, Orihuela, Spain
| | - Francisca Hernández
- Plant Production and Microbiology Department, Orihuela Polytechnical High School (EPSO), Miguel Hernandez University, Ctra. Beniel Km 3.2, 03312, Orihuela, Spain
| | - Pilar Legua
- Plant Production and Microbiology Department, Orihuela Polytechnical High School (EPSO), Miguel Hernandez University, Ctra. Beniel Km 3.2, 03312, Orihuela, Spain
| | - Pablo Melgarejo
- Plant Production and Microbiology Department, Orihuela Polytechnical High School (EPSO), Miguel Hernandez University, Ctra. Beniel Km 3.2, 03312, Orihuela, Spain
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Zobeiri M, Momtaz S, Parvizi F, Tewari D, Farzaei MH, Nabavi SM. Targeting Mitogen-Activated Protein Kinases by Natural Products: A Novel Therapeutic Approach for Inflammatory Bowel Diseases. Curr Pharm Biotechnol 2020; 21:1342-1353. [PMID: 31840607 DOI: 10.2174/1389201021666191216122555] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/01/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022]
Abstract
An increase in the prevalence of Inflammatory Bowel Diseases (IBD) as a multifactorial intestinal chronic inflammation as well as the absence of a certain cure, has created an innovative era in the management of IBD by molecule/pathway-based anti-inflammatory approaches. There are credible documentations that demonstrate Mitogen-Activated Protein Kinases (MAPK) acts as IBD regulator. Upon the activation of MAPK signalling pathway, the transcription and expression of various encoding inflammatory molecules implicated in IBD are altered, thereby exacerbating the inflammation development. The current pharmacological management of IBD, including drug and biological therapies are expensive, possess temporary relief and some adverse effects. In this context, a variety of dietary fruits or medicinal herbs have received worldwide attention versus the development of IBD. Infact, natural ingredients, such as Flavaglines, Fisetin, Myricitrin, Cardamonin, Curcumin, Octacosanol and Mangiferin possess protective and therapeutic effects against IBD via modulation of different segments of MAPK signaling pathway. This review paper calls attention to the role of MAPK signaling triggered by natural products in the prevention and treatment of IBD.
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Affiliation(s)
- Mehdi Zobeiri
- Internal Medicine Department, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeideh Momtaz
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran,Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), and Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran,Gastrointestinal Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Fatemeh Parvizi
- Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Devesh Tewari
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144 411, India
| | - Mohammad H Farzaei
- Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed M Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Seyed Hashemi M, Namiranian N, Tavahen H, Dehghanpour A, Rad MH, Jam-Ashkezari S, Emtiazy M, Hashempur MH. Efficacy of Pomegranate Seed Powder on Glucose and Lipid Metabolism in Patients with Type 2 Diabetes: A Prospective Randomized Double-Blind Placebo-Controlled Clinical Trial. Complement Med Res 2020; 28:226-233. [PMID: 33302270 DOI: 10.1159/000510986] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/16/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Pomegranate is known as a functional food which has multiple health-promoting activities. It has been assessed for patients with metabolic syndrome. Specifically, an antidiabetic activity of its juice and plausible mechanisms for its action have been shown in multitudinous studies. The aim of this study was assessing the effects of complementary treatment with pomegranate seed powder (PSP) oral supplementation on patients with type 2 diabetes mellitus (T2DM). METHODS Sixty patients were treated for 8 weeks by 5 g PSP or placebo, twice daily. Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol, and triglyceride (TG) were recorded as the outcome measures at the beginning and after the intervention. The findings were analyzed using the independent t test and Mann-Whitney U test. RESULTS After 8 weeks, the mean differences of FBG, HbA1c, cholesterol, and TG were significantly decreased in the PSP group when compared with the placebo group (p value <0.05). In addition, post-intervention values of FBG and HbA1c were significantly lower in patients treated with PSP compared to the placebo group (p values = 0.02 and 0.01, respectively). However, the latter comparison regarding cholesterol and TG showed no significant differences (p values = 0.51 and 0.26, respectively). CONCLUSION It seems that complementary treatment with PSP may have beneficial effects on FBG and HbA1c of patients with T2DM. However, its effect on TG and cholesterol was equivocal.
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Affiliation(s)
- Monire Seyed Hashemi
- Department of Persian Medicine, The School of Persian Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasim Namiranian
- Yazd Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hemaseh Tavahen
- Department of Persian Medicine, The School of Persian Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abolfazl Dehghanpour
- Department of Persian Medicine, The School of Persian Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hadi Rad
- Agricultural and Natural Resource Research and Education Center, Agriculture Research Education and Extension Organization (AREEO), Yazd, Iran
| | - Saeedeh Jam-Ashkezari
- Yazd Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Majid Emtiazy
- Department of Persian Medicine, The School of Persian Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Research Center of Persian Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hashem Hashempur
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran, .,Department of Persian Medicine, Fasa University of Medical Sciences, Fasa, Iran,
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Kucharzik T, Dignass AU, Atreya R, Bokemeyer B, Esters P, Herrlinger K, Kannengießer K, Kienle P, Langhorst J, Lügering A, Schreiber S, Stallmach A, Stein J, Sturm A, Teich N, Siegmund B. [Not Available]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2020; 58:e241-e326. [PMID: 33260237 DOI: 10.1055/a-1296-3444] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Torsten Kucharzik
- Klinik für Allgemeine Innere Medizin und Gastroenterologie, Klinikum Lüneburg, Lüneburg, Deutschland
| | - Axel U Dignass
- Medizinische Klinik I, Agaplesion Markus Krankenhaus, Frankfurt am Main, Deutschland
| | - Raja Atreya
- Medizinische Klinik 1, Universitätsklinikum Erlangen, Deutschland
| | - Bernd Bokemeyer
- Gastroenterologische Gemeinschaftspraxis Minden, Deutschland
| | - Philip Esters
- Medizinische Klinik I, Agaplesion Markus Krankenhaus, Frankfurt am Main, Deutschland
| | | | - Klaus Kannengießer
- Klinik für Allgemeine Innere Medizin und Gastroenterologie, Klinikum Lüneburg, Lüneburg, Deutschland
| | - Peter Kienle
- Allgemein- und Viszeralchirurgie, Theresienkrankenhaus und Sankt Hedwig-Klinik GmbH, Mannheim, Deutschland
| | - Jost Langhorst
- Klinik für Integrative Medizin und Naturheilkunde, Klinikum am Bruderwald, Bamberg, Deutschland
| | - Andreas Lügering
- Medizinisches Versorgungszentrum Portal 10, Münster, Deutschland
| | | | - Andreas Stallmach
- Gastroenterologie, Hepatologie und Infektiologie, Friedrich Schiller Universität, Jena, Deutschland
| | - Jürgen Stein
- Innere Medizin mit Schwerpunkt Gastroenterologie, Krankenhaus Sachsenhausen, Frankfurt/Main, Deutschland
| | - Andreas Sturm
- Klinik für Innere Medizin mit Schwerpunkt Gastroenterologie, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - Niels Teich
- Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten, Leipzig, Deutschland
| | - Britta Siegmund
- Medizinische Klinik I, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland
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Rezayat F, Hashempur MH, Tavahen H, Salmanroghani H, Emtiazy M. The efficacy of Ramak (a traditional herbal medicine preparation) for patients with ulcerative colitis: A pilot, randomized, triple-blinded, placebo-controlled clinical trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Emam NM, Anjum S, Okail HA, Ibrahim MAR, Ahmad T. Pomegranate peel extract protects against carbon tetrachloride-induced nephrotoxicity in mice through increasing antioxidants status. Biomed Rep 2020; 13:13. [PMID: 32765852 PMCID: PMC7391291 DOI: 10.3892/br.2020.1320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/01/2020] [Indexed: 11/21/2022] Open
Abstract
Carbon tetrachloride (CCl4) is a notorious environmental pollutant known for its toxicity. The aim of the present study was to evaluate the possible protective effects of aqueous pomegranate peel extract (PPE) against CCl4 induced nephrotoxicity in mice. Adult male mice were divided into four groups: Group one was used as the control; Group two was treated with a daily oral dose of PPE (400 mg/kg) for 15 days; the third group was intraperitoneally injected with a dose (1 ml/kg) of CCl4 twice a week for two weeks; and the final group was injected with the same dose of CCl4 twice a week concomitantly with a daily oral dose of PPE (400 mg/kg). Biochemical and histopathological data were analyzed along with the gene expression levels of the antioxidant enzymes and immunohistochemistry of the kidney tissue. CCl4 resulted in a significant increase in the serum urea and creatinine levels with detectable degenerative changes in the Bowman's capsule and glomerulus, with cells exhibiting vacuolization and evidence of necrosis. Co-administration of animals with CCl4 and PPE resulted in improved biochemical and histopathological conditions. Similarly, increased production of the Caspase-3 and collagen fibers were reduced in mice treated with PPE. Quantitative analysis of superoxide dismutase, catalase and glutathione peroxidase further accentuated the effects of PPE treatment significantly improving the conditions of the CCl4-administered group. The results of the present study demonstrate that the phenolic derivative rich PPE is a potent nephroprotective agent and suppresses CCl4-induced nephrotoxicity in mice.
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Affiliation(s)
- Nahed Mohmmad Emam
- Department of Zoology, Faculty of Science, Al-Arish University, El Arish, Egypt
| | - Sadia Anjum
- Department of Biology, College of Science, University of Hail, Hail, Kingdom of Saudi Arabia
| | - Hanan Ali Okail
- Department of Zoology, Faculty of Science, Sohag University, Sohag, Egypt
| | | | - Tahir Ahmad
- Atta-ur Rhaman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
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Sadeghi O, Milajerdi A, Siadat SD, Keshavarz SA, Sima AR, Vahedi H, Adibi P, Esmaillzadeh A. Effects of soy milk consumption on gut microbiota, inflammatory markers, and disease severity in patients with ulcerative colitis: a study protocol for a randomized clinical trial. Trials 2020; 21:565. [PMID: 32576228 PMCID: PMC7310397 DOI: 10.1186/s13063-020-04523-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 06/16/2020] [Indexed: 02/06/2023] Open
Abstract
Background Several strategies are recommended to alleviate clinical symptoms of ulcerative colitis (UC). Soy milk may affect UC through its anti-inflammatory properties. However, no study has examined the effects of soy milk consumption on gut microbiota and inflammatory biomarkers in patients with UC. The current study will be done to examine the effects of soy milk consumption on UC symptoms, inflammation, and gut microbiota in patients with UC. Methods This study is a randomized clinical trial, in which thirty patients with mild to moderate severity of UC will be randomly allocated to receive either 250 mL/day soy milk plus routine treatments (n = 15) or only routine treatments (n = 15) for 4 weeks. Assessment of anthropometric measures and biochemical indicators including serum concentrations of high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interferon gamma (IFN-γ) will be done at the study baseline and end of trial. In addition, the quantity of butyrate-producing bacteria including Clostridium cluster IV, Faecalibacterium prausnitzii, and Roseburia spp.; prebiotic bacteria including Lactobacillus spp. and Bifidobacteria spp.; and mucus-degrading bacteria including Akkermansia muciniphila, Bacteroides fragilis, and Ruminococcus spp., as well as calprotectin and lactoferrin levels, will be explored in fecal samples. Also, the Firmicutes to Bacteroidetes ratio which is of significant relevance in human gut microbiota composition will be assessed. Discussion Altered gut microbiota has been reported as an important contributing factor to inflammation in patients with inflammatory bowel disease (IBD). Soy milk contains several components such as phytoestrogens with potential anti-inflammatory properties. This product might affect gut microbiota through its protein and fiber content. Therefore, soy milk might beneficially affect systemic inflammation, gut microbiota, and then clinical symptoms in patients with UC. Trial registration Iranian Registry of Clinical Trials (www.irct.ir) IRCT20181205041859N1. Registered on 27 January 2019.
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Affiliation(s)
- Omid Sadeghi
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Alireza Milajerdi
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Seyed Davar Siadat
- Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Seyed Ali Keshavarz
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Sima
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran. .,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Vučić V, Grabež M, Trchounian A, Arsić A. Composition and Potential Health Benefits of Pomegranate: A Review. Curr Pharm Des 2020; 25:1817-1827. [PMID: 31298147 DOI: 10.2174/1381612825666190708183941] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pomegranate (Punica granatum L.) fruits are widely consumed and used as preventive and therapeutic agents since ancient times. Pomegranate is a rich source of a variety of phytochemicals, which are responsible for its strong antioxidative and anti-inflammatory potential. OBJECTIVE The aim of this review is to provide an up-to-date overview of the current knowledge of chemical structure and potential health benefits of pomegranate. METHODS A comprehensive search of available literature. RESULTS The review of the literature confirms that juice and extracts obtained from different parts of this plant, including fruit peel, seeds, and leaves exert health benefits in both in vitro and in vivo studies. The antidiabetic, antihypertensive, antimicrobial and anti-tumour effects of pomegranate fruit are of particular scientific and clinical interest. CONCLUSION Further investigations are required to clarify the mechanism of action of the bioactive ingredients and to reveal full potential of pomegranate as both preventive and therapeutic agent.
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Affiliation(s)
- Vesna Vučić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, studentskitry 1, Belgrade, Serbia
| | - Milkica Grabež
- Faculty of Medicine, University of Banja Luka, Bosnia and Herzegovina, Republika Srpska
| | - Armen Trchounian
- Department of Biochemistry, Microbiology and Biotechnology, Yerevan State University, Yerevan 0025, Armenia
| | - Aleksandra Arsić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, studentskitry 1, Belgrade, Serbia
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Cao F, Liu J, Sha BX, Pan HF. Natural Products: Experimental Efficient Agents for Inflammatory Bowel Disease Therapy. Curr Pharm Des 2020; 25:4893-4913. [DOI: 10.2174/1381612825666191216154224] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 12/12/2019] [Indexed: 02/06/2023]
Abstract
:
Inflammatory bowel disease (IBD) is a chronic, elusive disorder resulting in relapsing inflammation of
intestine with incompletely elucidated etiology, whose two representative forms are ulcerative colitis (UC) and
Crohn’s disease (CD). Accumulating researches have revealed that the individual genetic susceptibility, environmental
risk elements, intestinal microbial flora, as well as innate and adaptive immune system are implicated in
the pathogenesis and development of IBD. Despite remarkable progression of IBD therapy has been achieved by
chemical drugs and biological therapies such as aminosalicylates, corticosteroids, antibiotics, anti-tumor necrosis
factor (TNF)-α, anti-integrin agents, etc., healing outcome still cannot be obtained, along with inevitable side
effects. Consequently, a variety of researches have focused on exploring new therapies, and found that natural
products (NPs) isolated from herbs or plants may serve as promising therapeutic agents for IBD through antiinflammatory,
anti-oxidant, anti-fibrotic and anti-apoptotic effects, which implicates the modulation on nucleotide-
binding domain (NOD) like receptor protein (NLRP) 3 inflammasome, gut microbiota, intestinal microvascular
endothelial cells, intestinal epithelia, immune system, etc. In the present review, we will summarize the research
development of IBD pathogenesis and current mainstream therapy, as well as the therapeutic potential and
intrinsic mechanisms of NPs in IBD.
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Affiliation(s)
- Fan Cao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jie Liu
- School of Traditional Chinese Medicine, China Pharmaceutical University, 639 Longmian Avenue, Nanjing, Jiangsu, China
| | - Bing-Xian Sha
- Department of Clinical Medicine, Tongji University, 50 Chifeng Road, Shanghai, China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
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El-Seedi HR, Khalifa SAM, Yosri N, Khatib A, Chen L, Saeed A, Efferth T, Verpoorte R. Plants mentioned in the Islamic Scriptures (Holy Qur'ân and Ahadith): Traditional uses and medicinal importance in contemporary times. JOURNAL OF ETHNOPHARMACOLOGY 2019; 243:112007. [PMID: 31170516 DOI: 10.1016/j.jep.2019.112007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 05/29/2019] [Accepted: 05/29/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Over the past thousand years, Islamic physicians have collected cultural, philosophical, sociological and historical backgrounds for understanding diseases and medications. The Prophet Mohammed (Peace Be Upon Him (PBUH) said: "There is no disease that Allah has created, except that Allah also has created its cure." Therefore, Islamic scholars are encouraged to explore and use both traditional and modern forms of medicine. AIM OF THE STUDY (1) To identify some of the medicinal plants mentioned in the Holy Qur'ân and Ahadith textbooks of the period 700-1500 AD; (2) to compare them with presently used traditional medicines; (3) to evaluate their value based on modern research; and (4) to investigate the contributions of Islamic scholars to the development of the scientific branches, particularly medicine. MATERIALS AND METHODS A literature search was performed relating to 12 medicinal plants mentioned in the Holy Qur'ân and Ahadith using textbooks, Al-Azhar scholars, published articles, the plant list website (http://www.theplantlist.org/), the medicinal plant names services website (http://mpns.kew.org/mpns-portal/) and web databases (PubMed, Science Direct, and Google Scholar). RESULTS AND DISCUSSION The Islamic Golden Age was a step towards modern medicine, with unique insights and multi-disciplinary aspects. Traditional Islamic Medicine has had a significant impact on the development of various medical, scientific and educational activities. Innumerable Muslim and non-Muslim physicians have built on the strong foundation of Traditional Islamic Medicine by translating the described natural remedies and effects. The influences of different ancient cultures on the traditional uses of natural products were also documented in Islamic Scriptures in the last part of the second millennium. The divine teachings of Islam combine natural and practical healing and incorporate inherited science and technology. CONCLUSION In this review, we discuss Traditional Islamic Medicine with reference to both medical recommendations mentioned in the Holy Qur'ân and Prophetic Traditional Medicine (al-Tibb al-Nabawi). Although the molecular mechanisms and functions of some of the listed medicinal plants and their derivatives have been intensively studied, some traditional remedies have yet to be translated into clinical applications.
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Affiliation(s)
- Hesham R El-Seedi
- Pharmacognosy Group, Department of Medicinal Chemistry, Uppsala University, Biomedical Centre, Box 574, 751 23, Uppsala, Sweden; Al-Rayan Research and Innovation Center, Al-Rayan Colleges, Medina, 42541, Saudi Arabia; Department of Chemistry, Faculty of Science, Menoufia University, 32512, Shebin El-Kom, Egypt.
| | - Shaden A M Khalifa
- Department of Molecular Biosciences, Stockholm University, The Wenner-Gren Institute, SE-106 91, Stockholm, Sweden; Clinical Research Centre, Karolinska University Hospital, Huddinge, Sweden
| | - Nermeen Yosri
- Department of Chemistry, Faculty of Science, Menoufia University, 32512, Shebin El-Kom, Egypt
| | - Alfi Khatib
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, 25200, Pahang, Malaysia
| | - Lei Chen
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian, 350002, China
| | - Aamer Saeed
- Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Johannes Gutenberg University, Staudinger Weg 5, 55128, Mainz, Germany
| | - Rob Verpoorte
- Natural Products Laboratory, IBL, Leiden University, PO Box 9505, 2300RA, Leiden, The Netherlands
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Torres J, Ellul P, Langhorst J, Mikocka-Walus A, Barreiro-de Acosta M, Basnayake C, Ding NJS, Gilardi D, Katsanos K, Moser G, Opheim R, Palmela C, Pellino G, Van der Marel S, Vavricka SR. European Crohn's and Colitis Organisation Topical Review on Complementary Medicine and Psychotherapy in Inflammatory Bowel Disease. J Crohns Colitis 2019; 13:673-685e. [PMID: 30820529 DOI: 10.1093/ecco-jcc/jjz051] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 02/26/2019] [Indexed: 12/11/2022]
Abstract
Patients with inflammatory bowel disease [IBD] increasingly use alternative and complementary therapies, for which appropriate evidence is often lacking. It is estimated that up to half of all patients with IBD use various forms of complementary and alternative medicine during some point in their disease course. Considering the frequent use of such therapies, it is crucial that physicians and patients are informed about their efficacy and safety in order to provide guidance and evidence-based advice. Additionally, increasing evidence suggests that some psychotherapies and mind-body interventions may be beneficial in the management of IBD, but their best use remains a matter of research. Herein, we provide a comprehensive review of some of the most commonly used complementary, alternative and psychotherapy interventions in IBD.
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Affiliation(s)
- Joana Torres
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Pierre Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - Jost Langhorst
- Department of Internal Medicine and Integrative Gastroenterology, Kliniken Essen-Mitte and Chair for Integrative Medicine and Translational Gastroenterology, Klinikum Bamberg, University Duisburg-Essen, Germany
| | | | - Manuel Barreiro-de Acosta
- Department of Gastroenterology, IBD Unit, University Hospital Santiago De Compostela (CHUS), Santiago De Compostela, Spain
| | - Chamara Basnayake
- Department of Gastroenterology, St. Vincent's Hospital Melbourne, Fitzroy, Melbourne, Australia
| | - Nik John Sheng Ding
- Department of Gastroenterology, St. Vincent's Hospital Melbourne, Fitzroy, Melbourne, Australia
| | - Daniela Gilardi
- IBD Centre, Department of Gastroenterology, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
| | - Konstantinos Katsanos
- Department of Gastroenterology and Hepatology, Division of Internal Medicine, University and Medical School of Ioannina, Ioannina, Greece
| | - Gabriele Moser
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Randi Opheim
- Department of Gastroenterology, Oslo University Hospital, and Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Carolina Palmela
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Sander Van der Marel
- Department of Gastroenterology and Internal Medicine, Haaglanden Medisch Centrum, The Hague, The Netherlands
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Farzaei MH, El-Senduny FF, Momtaz S, Parvizi F, Iranpanah A, Tewari D, Naseri R, Abdolghaffari AH, Rezaei N. An update on dietary consideration in inflammatory bowel disease: anthocyanins and more. Expert Rev Gastroenterol Hepatol 2018; 12:1007-1024. [PMID: 30136591 DOI: 10.1080/17474124.2018.1513322] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Inflammatory bowel disease (IBD) is a chronic idiopathic inflammatory disorder. A wealth of data pointed out that various aspects of chronic inflammation may be affected by several specific dietary factors. This paper calls attention to anthocyanins enriched plant food and anthocyanin dietary supplements, whose role in the management of IBD and its associated oncogenesis deems crucial. Area covered: We updated the most relevant dietary anthocyanins with potential anti-colitis and preventive effect on inflammatory associated colorectal cancer based on the recent animal and human researches along with revealing the major cellular and molecular mechanisms of action. Mounting evidence reported that anthocyanins enriched plant foods perform their protective role on IBD and inflammatory-induced colorectal cancer via different cellular transduction signaling pathways, including inflammatory transcription factors, SAPK/JNK and p38 MAPK cascade, JAK/STAT signaling, NF-kB/pERK/MAPK, Wnt signaling pathway, Nrf2 cytoprotective pathway as well as AMPK pathway and autophagy. Expert commentary: Combination of anthocyanins enriched dietary supplements with existing medications can provide new therapeutic options for IBD patients. Further, well-designed randomized control trials (RCTs) are essential to evaluate the role of anthocyanins enriched medicinal foods as well as isolated anthocyanin components as promising preventive and therapeutic dietary agents for IBD and its associated oncogenesis.
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Affiliation(s)
- Mohammad Hosein Farzaei
- a Pharmaceutical Sciences Research Center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Fardous F El-Senduny
- b Biochemistry division, Chemistry Department , Mansoura University , Mansoura , Egypt
| | - Saeideh Momtaz
- c Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center , Tehran University of Medical Sciences , Tehran , Iran
- d Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Fatemeh Parvizi
- e Medical Biology Research Center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Amin Iranpanah
- f Students research Committee, Faculty of Pharmacy , Kermanshah University of Medical Sciences , Kermanshah , Iran
- g PhytoPharmacology Interest Group (PPIG) , Universal Scientific Education and Research Network (USERN) , Kermanshah , Iran
| | - Devesh Tewari
- h Department of Pharmaceutical Sciences, Faculty of Technology, Bhimtal Campus , Kumaun University , Nainital , Uttarakhand , India
| | - Rozita Naseri
- a Pharmaceutical Sciences Research Center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Amir Hossein Abdolghaffari
- c Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center , Tehran University of Medical Sciences , Tehran , Iran
- d Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center , Tehran University of Medical Sciences , Tehran , Iran
- i Department of Pharmacology, Pharmaceutical Sciences Branch , Islamic Azad University , Tehran , Iran
- j Gastrointestinal Pharmacology Interest Group (GPIG) , Universal Scientific Education and Research Network (USERN) , Tehran , Iran
| | - Nima Rezaei
- k Research Center for Immunodeficiencies, Children's Medical Center , Tehran University of Medical Sciences , Tehran , Iran
- l Department of Immunology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
- m Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA) , Universal Scientific Education and Research Network (USERN) , Tehran , Iran
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40
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Mijan MA, Lim BO. Diets, functional foods, and nutraceuticals as alternative therapies for inflammatory bowel disease: Present status and future trends. World J Gastroenterol 2018; 24:2673-2685. [PMID: 29991873 PMCID: PMC6034142 DOI: 10.3748/wjg.v24.i25.2673] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/19/2018] [Accepted: 06/09/2018] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a serious health concern among western societies. The disease is also on the rise in some East Asian countries and in Australia. Health professionals and dietitians around the world are facing an unprecedented challenge to prevent and control the increasing prevalence of IBD. The current therapeutic strategy that includes drugs and biological treatments is inefficient and are associated with adverse health consequences. In this context, the use of natural products is gaining worldwide attention. In vivo studies and clinical evidence suggest that well-planned dietary regimens with specific nutrients can alleviate gastrointestinal inflammation by modulating inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin 1 (IL-1), IL-6, IL-1β, and IL-10. Alternatively, the avoidance of high-fat and high-carbohydrate diets is regarded as an effective tool to eliminate the causes of IBD. Many functional foods and bioactive components have received attention for showing strong therapeutic effects against IBD. Both animal and human studies suggest that bioactive functional foods can ameliorate IBD by downregulating the pro-inflammatory signaling pathways, such as nuclear factor κB, STAT1, STAT6, and pro-inflammatory cytokines, including IL-1β, IL-4, IL-6, COX-2, TNF-α, and interferon γ. Therefore, functional foods and diets have the potential to alleviate IBD by modulating the underlying pathogenic mechanisms. Future comprehensive studies are needed to corroborate the potential roles of functional foods and diets in the prevention and control of IBD.
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Affiliation(s)
- Mohammad Al Mijan
- Department of Integrated Biosciences, College of Biomedical & Health Science, Konkuk University, Chungju 380-701, South Korea
| | - Beong Ou Lim
- Department of Integrated Biosciences, College of Biomedical & Health Science, Konkuk University, Chungju 380-701, South Korea
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Kim S, Lee BH, Zhang X, Park JW, Lee S, Lee H. Adjunctive herbal medicine therapy for inflammatory bowel disease: A systematic review and meta-analysis. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Khan I, Samson SE, Grover AK. Antioxidant Supplements and Gastrointestinal Diseases: A Critical Appraisal. Med Princ Pract 2017; 26:201-217. [PMID: 28278495 PMCID: PMC5588418 DOI: 10.1159/000468988] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 03/08/2017] [Indexed: 12/21/2022] Open
Abstract
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.
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Affiliation(s)
- Islam Khan
- Department of Biochemistry, Kuwait University, Kuwait, Kuwait
| | - Sue E. Samson
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ashok Kumar Grover
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- *Dr. Ashok Kumar Grover, Department of Medicine, McMaster University, 1280 Main Street W., Hamilton, ON L8S 4K1 (Canada), E-Mail
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The Role of Syndrome Differentiation in the Clinical Efficacy of Punica granatum on Patients with Ulcerative Colitis. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.40810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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