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The Cochrane Database of Systematic... Jul 2017Lymphocytic colitis is a cause of chronic diarrhea. It is a subtype of microscopic colitis characterized by chronic, watery, non-bloody diarrhea and normal endoscopic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Lymphocytic colitis is a cause of chronic diarrhea. It is a subtype of microscopic colitis characterized by chronic, watery, non-bloody diarrhea and normal endoscopic and radiologic findings. The etiology of this disorder is unknown.Therapy is based mainly on case series and uncontrolled trials, or by extrapolation of data for treating collagenous colitis, a related disorder. This review is an update of a previously published Cochrane review.
OBJECTIVES
To evaluate the efficacy and safety of treatments for clinically active lymphocytic colitis.
SEARCH METHODS
The MEDLINE, PUBMED and EMBASE databases were searched from inception to 11 August 2016 to identify relevant papers. Manual searches from the references of included studies and relevant review articles were performed.Abstracts from major gastroenterological meetings were also searched to identify research submitted in abstract form only. The trial registry web site www.ClinicalTrials.gov was searched to identify registered but unpublished trials. Finally, the Cochrane Central Register of Controlled Trials and the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register were searched for other studies.
SELECTION CRITERIA
Randomized controlled trials assessing medical therapy for patients with biopsy-proven lymphocytic colitis were considered for inclusion DATA COLLECTION AND ANALYSIS: Data was independently extracted by at least two authors. Any disagreements were resolved by consensus. Data were analyzed on an intention-to-treat (ITT) basis. The primary outcome was clinical response as defined by the included studies. Secondary outcome measures included histological response as defined by the included studies, quality of life as measured by a validated instrument and the occurrence of adverse events. Risk ratios (RR) and 95% confidence intervals (CI) were calculated for dichotomous outcomes. The methodological quality of included studies was evaluated using the Cochrane risk of bias tool. The overall quality of the evidence supporting the primary outcome and selected secondary outcomes was assessed using the GRADE criteria. Data were combined for analysis if they assessed the same treatments. Dichotomous data were combined using a pooled RR along with corresponding 95% CI. A fixed-effect model was used for the pooled analysis.
MAIN RESULTS
Five RCTs (149 participants) met the inclusion criteria. These studies assessed bismuth subsalicylate versus placebo, budesonide versus placebo, mesalazine versus mesalazine plus cholestyramine and beclometasone dipropionate versus mesalazine. The study which assessed mesalazine versus mesalazine plus cholestyramine and the study which assessed beclometasone dipropionate versus mesalazine were judged to be at high risk of bias due to lack of blinding. The study which compared bismuth subsalicylate versus us placebo was judged as low quality due to a very small sample size and limited data. The other 3 studies were judged to be at low risk of bias. Budesonide (9 mg/day for 6 to 8 weeks) was significantly more effective than placebo for induction of clinical and histological response. Clinical response was noted in 88% of budesonide patients compared to 38% of placebo patients (2 studies; 57 participants; RR 2.03, 95% CI 1.25 to 3.33; GRADE = low). Histological response was noted in 78% of budesonide patients compared to 33% of placebo patients (2 studies; 39 patients; RR 2.44, 95% CI 1.13 to 5.28; GRADE = low). Forty-one patients were enrolled in the study assessing mesalazine (2.4 g/day) versus mesalazine plus cholestyramine (4 g/day). Clinical response was noted in 85% of patients in the mesalazine group compared to 86% of patients in the mesalazine plus cholestyramine group (RR 0.99, 95% CI 0.77 to 1.28; GRADE = low). Five patients were enrolled in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks versus placebo). There were no differences in clinical (P=0.10) or histological responses (P=0.71) in patients treated with bismuth subsalicylate compared with placebo (GRADE = very low). Forty-six patients were enrolled in the trial studying beclometasone dipropionate (5 mg/day or 10 mg/day) versus mesalazine (2.4 g/day). There were no differences in clinical remission at 8 weeks (RR 0.97; 95% CI 0.75 to 1.24; GRADE = low) and 12 months of treatment (RR 1.29; 95% CI 0.40 to 4.18; GRADE = very low). Although patients receiving beclometasone dipropionate (84%) and mesalazine (86%) achieved clinical remission at 8 weeks, it was not maintained at 12 months (26% and 20%, respectively). Adverse events reported in the budesonide studies include nausea, vomiting, neck pain, abdominal pain, hyperhidrosis and headache. Nausea and skin rash were reported as adverse events in the mesalazine study. Adverse events in the beclometasone dipropionate trial include nausea, sleepiness and change of mood. No adverse events were reported in the bismuth subsalicylate study.
AUTHORS' CONCLUSIONS
Low quality evidence suggests that budesonide may be effective for the treatment of active lymphocytic colitis. This benefit needs to be confirmed by a large placebo -controlled trial. Low quality evidence also suggests that mesalazine with or without cholestyramine and beclometasone dipropionate may be effective for the treatment of lymphocytic colitis, however this needs to be confirmed by large placebo-controlled studies. No conclusions can be made regarding bismuth subsalicylate due to the very small number of patients in the study, Further trials studying interventions for lymphocytic colitis are warranted.
Topics: Anti-Inflammatory Agents; Antidiarrheals; Beclomethasone; Bismuth; Budesonide; Cholestyramine Resin; Colitis, Lymphocytic; Humans; Mesalamine; Organometallic Compounds; Randomized Controlled Trials as Topic; Salicylates
PubMed: 28702956
DOI: 10.1002/14651858.CD006096.pub4 -
Journal of Ethnopharmacology Jan 2023Anadenanthera colubrina (Vell.) Brenan is an endemic tree to South America and different parts of it are used by the population for the treatment of various diseases, as... (Review)
Review
ETHNOPHARMACOLOGICAL RELEVANCE
Anadenanthera colubrina (Vell.) Brenan is an endemic tree to South America and different parts of it are used by the population for the treatment of various diseases, as well as in indigenous rituals. This species has high pharmacological potential but may present toxic potential due to the presence of psychotropic compounds.
AIM OF THE STUDY
To review published studies with the species A. colubrina regarding ethnobotanical, phytochemical, pharmacological and toxicological aspects, as well as discuss perspectives for new research and protection of this species.
MATERIALS AND METHODS
A literature review was performed by accessing published articles on databases such as: PubMed, Science Direct, Scielo, Scopus, Taylor and Francis online, Springer Link, National Center for Biotechnology Information (NCBI), ACS Publications, Chemspider and Google Scholar. The keywords used were: "Anadenanthera colubrina" or "Mimosa colubrina" or "Piptadenia colubrina" or "Piptadenia macrocarpa" or "Piptadenia grata" or "Anadenanthera macrocarpa" and "medicinal plants" or "pharmacological" or "phytochemicals" or "traditional use" or "toxicological" or "ethnobotanical" or "pre-clinical trial" or "clinical". Articles found by database searches and search engines were screened at four stages: (i) title screening, (ii) locality screening, (iii) abstract screening, and (iv) full text. Other articles found through supplementary searches were screened in the full text whenever available. Each article was assessed by three reviewers at the title and abstract screening stages, except for those found in Portuguese databases that were assessed by the native reviewer.
RESULTS
This robust tree has been popularly useful for agroeconomic, medicinal and as a hallucinogen in religious rituals. According to the published studies, the main parts of the plant are the bark and seeds that are mostly used for respiratory conditions and as entheogens, respectively. It is a rich traditional herbal medicine with many pharmacological properties such as anti-inflammatory, antinociceptive, antidiarrheal, wound healing, antimicrobial, antitumoral, antioxidant, antiaddictive, insecticide and allelopathic that were described in in vitro and in vivo assays, and approximately 56 compounds were identified, suggesting a therapeutic potential for this species. Although most relate to medicinal uses, these are preliminaries and do not show the mechanism of action. The phytochemical assays showed the presence of phenolic compounds, flavonoids, triterpenes, steroids and alkaloids. Some of the compounds are anadanthoflavone, which is exclusive to this species, and no pharmacological or toxicological studies have yet demonstrated this compound. Another important compound is bufotenine which was isolated from seeds and is related to hallucinogenic and antiviral activity. The extracts made from leaves, bark, gum, and fruits appear to be safe, according to both in vivo and in vitro toxicology testing, which all shown low toxicity. Due to the presence of bufotenine in the seeds, it can be toxic, however, it was not found in toxicological assays with the seed extracts.
CONCLUSIONS
Therefore, part of the studies confirms the popular use of A. colubrina, however, more assays with isolated compounds and with the different extracts are necessary to corroborate other uses and the mechanism of action of their pharmacological effects needs to discuss in more detail. Therefore, the present review would be identified the gaps and suggests further studies oriented to validate the popular use. Thus, it must be noted that the use of this species must be controlled in order to minimize the environmental impact, as most of the pharmacological potential was shown with the bark and seeds. Due to its wide use in folk medicine, it is part of the Brazilian medicinal species with priority for conservation.
Topics: Alkaloids; Analgesics; Anti-Inflammatory Agents; Antidiarrheals; Antioxidants; Antiviral Agents; Brazil; Bufotenin; Colubrina; Ethnopharmacology; Fabaceae; Flavonoids; Hallucinogens; Insecticides; Phytochemicals; Phytotherapy; Plant Extracts; Plants, Medicinal; Triterpenes
PubMed: 36162548
DOI: 10.1016/j.jep.2022.115745 -
Pharmaceuticals (Basel, Switzerland) Mar 2023Wall. is an important medicinal plant with reported therapeutic benefits. The current work sought to investigate the antidiarrheal properties of extracts both in vivo...
Wall. is an important medicinal plant with reported therapeutic benefits. The current work sought to investigate the antidiarrheal properties of extracts both in vivo and in silico. This study applied molecular docking to unravel the molecular mechanism of and to find the most effective phytocompounds with antidiarrheal effects. The antidiarrheal activity of was assessed utilizing the castor oil-induced diarrhea assay and the charcoal meal assay. Antidiarrheal characteristics were evaluated by measuring parameters such as intestinal motility, fecal score, and hypersecretion. The extract had a dose-dependent and statistically significant impact in the charcoal meal assay and castor oil-induced diarrhea assay. In the castor oil-induced diarrhea assay, the ethyl acetate fraction (65.96%) showed the highest percentage of defecation inhibition at the highest dose (300 mg/kg (bw)), followed by the uncorrected crystalline compound (63.83%), crude alkaloids (63.83%), chloroform fraction (63.83%), and crude flavonoids (55.32%), while the aqueous fraction (40.43%) and n-Hexane fraction (42.55%) revealed the lowest antidiarrheal potential. In addition, the molecular docking investigation showed emetine, quercetin, and violanthin, isolated chemicals of , to have the highest binding affinity to the target μ and δ opioid receptors with significant inhibitory capacity. These pharmacologically active metabolites in were effective in treating diarrhea. This study lends credence to the traditional usage of in treating gastrointestinal disorders.
PubMed: 37111246
DOI: 10.3390/ph16040489 -
PloS One 2019As antibiotic contamination increases in wastewater and aqueous environments, the reduction of antibiotics has become a pertinent topic of research regarding water...
As antibiotic contamination increases in wastewater and aqueous environments, the reduction of antibiotics has become a pertinent topic of research regarding water treatment. Clay minerals, such as smectite or kaolinite, are important adsorbents used in water treatment, and sufficient removal of antibiotics by clay minerals is expected. In this study, the adsorption of oxytetracycline (OTC) on kaolinite was investigated. The experimental data of OTC adsorption on kaolinite fit the pseudo-second-order kinetics model well (R2>0.98). After 24 h, adsorption equilibrium of OTC on kaolinite was reached. The Langmuir model was better fitting with the adsorption isotherms generated from experimental data and OTC adsorption occurred on the external surface of kaolinite. The analysis of several thermodynamic parameters indicated that the adsorption of OTC on kaolinite was spontaneous and thermodynamically favorable. With the increase of the pH of a solution, the adsorption capacity increased and then decreased. The adsorption coefficient (Kd) of 102-103 were obtained for adsorption process of OTC on kaolinite.
Topics: Adsorption; Hydrogen-Ion Concentration; Kaolin; Kinetics; Oxytetracycline; Temperature; Thermodynamics
PubMed: 31730641
DOI: 10.1371/journal.pone.0225335 -
Molecules (Basel, Switzerland) Nov 2022Locust bean gum (LBG), a vegetable galactomannan extracted from carob tree seeds, is extensively used in the food industry as a thickening agent (E410). Its molecular... (Review)
Review
Locust bean gum (LBG), a vegetable galactomannan extracted from carob tree seeds, is extensively used in the food industry as a thickening agent (E410). Its molecular conformation in aqueous solutions determines its solubility and rheological performance. LBG is an interesting polysaccharide also because of its synergistic behavior with other biopolymers (xanthan gum, carrageenan, etc.). In addition, this hydrocolloid is easily modified by derivatization or crosslinking. These LBG-related products, besides their applications in the food industry, can be used as encapsulation and drug delivery devices, packaging materials, batteries, and catalyst supports, among other biopharmaceutical and industrial uses. As the new derivatized or crosslinked polymers based on LBG are mainly biodegradable and non-toxic, the use of this polysaccharide (by itself or combined with other biopolymers) will contribute to generating greener products, considering the origin of raw materials used, the modification procedures selected and the final destination of the products.
Topics: Vegetables; Biological Products; Galactans; Plant Gums; Mannans; Colloids
PubMed: 36500357
DOI: 10.3390/molecules27238265 -
BioMed Research International 2016. is traditionally used for treating diarrhea, wounds, cold, fever, hepatitis, dyspepsia, and heat stroke. . To investigate the qualitative phytochemical constituents...
. is traditionally used for treating diarrhea, wounds, cold, fever, hepatitis, dyspepsia, and heat stroke. . To investigate the qualitative phytochemical constituents of hydromethanol (HMPB) and petroleum benzene extract of barks (PBMPB) and to evaluate their antinociceptive and antidiarrheal activities. . Phytochemical constituents and antinociceptive and antidiarrheal activities were determined and evaluated by different tests such as Molisch's, Fehling's, Mayer's, Wagner's, Dragendorff's, frothing, FeCl, alkali, Pew's, and Salkowski's test, general test of glycosides, Baljet and NHOH test, formalin-induced paw licking, acetic acid-induced writhing, tail immersion, and hot plate tests, and castor oil and MgSO induced diarrheal tests. . These extracts revealed the presence of saponins, flavonoids, and triterpenoids and significantly ( < 0.05, versus control) reduced paw licking and abdominal writhing of mice. At 30 min after their administration, PBMPB revealed significant increase in latency ( < 0.05, versus control) in tail immersion test. In hot plate test, HMPB and PBMPB 200 mg/kg showed significant increase in response latency ( < 0.05, versus control) at 30 min after their administration. Moreover, both extracts significantly ( < 0.05, versus control) inhibited percentage of diarrhea in antidiarrheal models. Study results indicate that . may provide a source of plant compounds with antinociceptive and antidiarrheal activities.
Topics: Analgesics; Animals; Antidiarrheals; Benzene; Diarrhea; Drug Evaluation, Preclinical; Female; Male; Malvaceae; Methanol; Mice; Pain; Pain Measurement; Petroleum; Phytotherapy; Plant Bark; Plant Extracts; Treatment Outcome; Water
PubMed: 27777944
DOI: 10.1155/2016/3167085 -
Basic & Clinical Pharmacology &... Jan 2018Adulteration of drugs with poisonous substances during production or consumption has caused numerous health problems. Among contaminants that have the potential of... (Review)
Review
Adulteration of drugs with poisonous substances during production or consumption has caused numerous health problems. Among contaminants that have the potential of producing poisonous effects are the heavy metals lead, arsenic and thallium that make up an important group of toxic substances. The emergence of these new health problems related to opioid abuse has precipitated this MiniReview on the status of the most hazardous and common opioid adulterants. In fact, adulterated opium is a major public health problem and can threaten the health of users. In this study, we searched for information on opium, opiates, lead poisoning, toxicity, intoxication, Iran and heavy metals in the TUMS Digital Library, PubMed, Scopus, EMBASE and Google Scholar bibliographical databases. This MiniReview primarily included articles on lead poisoning, signs and symptoms, and management in opioid-dependent individuals. Exclusion criteria were articles dealing with animal studies, specific paediatric studies, adulterants other than heavy metals and substances other than opioids. Adulterated opium is one of the new sources of exposure to lead and has precipitated an increase in lead-poisoned cases owing to the widespread use of opium. The toxicology of lead and general guidelines on diagnosis and treatment of lead poisoning is briefly reviewed. The symptoms of lead toxicity mimic several diseases often leading to unnecessary diagnostic methods, misdiagnoses and even surgery. Finally, owing to the fact that lead toxicity shows non-specific signs and symptoms, screening for this disease, by taking blood samples and assessing blood lead levels in high-risk people, should be given an utmost priority. It is recommended that screening tests are adopted and applied for any drug-abusing patient with non-specific subacute signs and symptoms like abdominal pain, constipation and anaemia.
Topics: Antidotes; Drug Contamination; Gastric Lavage; Humans; Iran; Lead; Lead Poisoning; Mass Screening; Opioid-Related Disorders; Opium
PubMed: 28802093
DOI: 10.1111/bcpt.12855 -
Lakartidningen Mar 2023The basic principle for treatment of idiopathic diarrhea is to delay transit through the gut in order to promote absorption of electrolytes and water. Under mild...
The basic principle for treatment of idiopathic diarrhea is to delay transit through the gut in order to promote absorption of electrolytes and water. Under mild conditions bulking agents may suffice. With increasing severity, antidiarrheal pharmaceuticals may be added in a stepwise manner. Bile salt malabsorption is a clear indication for adsorptive resins, while in idiopathic diarrhea peripherally-acting opioid receptor agonists, such as loperamide, is the first-line treatment. Second-line treatment with approved indication for severe diarrhea when other treatment options fail includes opium drops. More advanced treatments are to be used by clinicians with specialist knowledge and experience in the field.
Topics: Humans; Diarrhea; Antidiarrheals; Loperamide; Gastrointestinal Agents
PubMed: 36994929
DOI: No ID Found -
BMC Complementary Medicine and Therapies Apr 2021Colocasia gigantea, locally named as kochu is well-known due to its various healing power. This research is to investigate the antidiarrheal, antimicrobial and...
Antidiarrheal, antimicrobial and antioxidant potentials of methanol extract of Colocasia gigantea Hook. f. leaves: evidenced from in vivo and in vitro studies along with computer-aided approaches.
BACKGROUND
Colocasia gigantea, locally named as kochu is well-known due to its various healing power. This research is to investigate the antidiarrheal, antimicrobial and antioxidant possibilities of the methanol soluble extract of Colocasia gigantea.
METHODS
The antidiarrheal investigation was performed by using in vivo castor oil-induced diarrheal method whereas in vitro antimicrobial and antioxidant investigation have been implemented by disc diffusion and DPPH scavenging method respectively. Moreover, in silico studies were followed by molecular docking analysis of several secondary metabolites that were appraised with Schrödinger-Maestro v11.1 and Biovia Discovery Studio.
RESULTS
The induction of plant extract (200 and 400 mg/kg, b.w, p.o) has minimized the castor oil mediated diarrhea by 16.96% (p < 0.01) and 38.89% (p < 0.001) respectively compared to control group. The methanol extract of C. gigantea showed mild sensitivity against almost all the tested strains but it shows high consistency of phenolic content and yielded 67.68 μg/mL of IC value in the DPPH test. In the PASS prediction, selected isolated compounds have demonstrated significant antidiarrheal and antimicrobial activity following the Lipinski drug rules which have ascertained efficacy with the compounds in molecular docking study.
CONCLUSION
The results of this scientific research reflects that the methanol soluble extract of C. gigantea is safe and may provide possibilities of alleviation of diarrhea along with being a potential wellspring of antioxidant and antimicrobial agents which can be considered as an alternate source for exploration of new medicinal products in near future.
Topics: Animals; Anti-Bacterial Agents; Antidiarrheals; Antioxidants; Biphenyl Compounds; Colocasia; Disease Models, Animal; Escherichia coli; Female; Inhibitory Concentration 50; Male; Mice; Molecular Docking Simulation; Phytotherapy; Picrates; Plant Extracts; Plant Leaves
PubMed: 33845836
DOI: 10.1186/s12906-021-03290-6 -
Biomedicine & Pharmacotherapy =... Sep 2020Gastrointestinal diseases are very common problems; available treatments are very limited and come with a range of side effects. Coumarins are an extensive class of...
Gastrointestinal diseases are very common problems; available treatments are very limited and come with a range of side effects. Coumarins are an extensive class of phenolic compounds that can be found in plants, fungi and bacteria. The 7-hydroxycoumarin, also known as umbelliferone (UMB), is a compound that comes from coumarin and has been showing biological activities in other studies. As of this scenario, the present study was designed to evaluate the acute oral toxicity, mutagenic, antidiarrheal, anti-bacterial, and antiulcerogenic effects, and antioxidant capacity of UMB. An investigation was conducted through the hippocratic screening method and through histopathological analysis in animals to evaluate the effects of acute oral administration of a dose of 50, 100 and 200 mg/kg of UMB. A micronucleus test on peripheral blood of Swiss mice, which were orally treated with three doses (50, 100 and 200 mg/kg), was conducted to evaluate mutagenic activities. The antiulcerogenic activity was accomplished through the ethanol-induced damage method. Antidiarrheal activities were tested for inducing diarrhea with castor oil and evaluating intestinal transit duration; additionally, the antimicrobial effect against some enteropathogenic bacteria was analyzed. Finally, the antioxidant capability was determined by the capacity of the UMB sample to kidnap the stable radical 2,2-diphenyl-1-picrylhydrazyl. Of the evaluated doses, signs of toxicity after acute administration of the compound were not observed. UMB presented antiulcerogenic activity (100 and 200 mg/kg), which was explained because of its antioxidant capacity. A gastro protective effect was similar to the positive control, and the UMB was able to significantly reduce intestinal transit, and also diarrheal symptoms. Furthermore, UMB had an anti-bacterial effect with minimum inhibitory concentration fluctuating between 62.5 and 1000 μg/mL. Based on these findings, we can suggest that UMB has important biological activities in vivo and in vitro and is not toxic under the evaluated circumstances, which demonstrates its large potential for pharmacological use.
Topics: Animals; Anti-Bacterial Agents; Anti-Ulcer Agents; Antidiarrheals; Bacteria; Castor Oil; Defecation; Diarrhea; Disease Models, Animal; Ethanol; Gastrointestinal Motility; Male; Mice; Stomach; Stomach Ulcer; Umbelliferones
PubMed: 32768935
DOI: 10.1016/j.biopha.2020.110432