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Journal of Ethnopharmacology Jun 2020Withania somnifera popularly known as Aswagandha or Indian Ginseng/Poison Gooseberry have thousands years of history of use in Indian traditional medicine. Besides,...
ETHNOPHARMACOLOGICAL RELEVANCE
Withania somnifera popularly known as Aswagandha or Indian Ginseng/Poison Gooseberry have thousands years of history of use in Indian traditional medicine. Besides, finding place root of the plant as Indian Ginseng, Ayurveda also uses root of this plant as general health tonic, adaptogenic, nootropic, immunomodulatory etc. With its widespread and growing use, it becomes prudent to scientifically evaluate and document both the efficacy and safety of this plant in humans.
AIM OF THE STUDY
Aswagnadha root is rapidly gaining popularity abroad for use as medicine. Current article attempts to primarily review the human efficacy and safety of Aswagandha generated through clinical trials.
METHODS
A systematic search both for indexed and non-indexed literature was made for W. somnifera using various search engines and databases and the details of research articles pertaining to all clinical trials/human studies, animal studies addressing safety issues of CNS, CVS, general toxicity, mutagenicity, genotoxicity, reproductive safety and herb-drug interactions were reviewed and compiled comprehensively from full texts.
RESULTS
A total of 69 (39 pre-clinical and 30 clinical) studies documenting efficacy and safety aspects were identified and the desired information of these studies is comprehensively presented in this review. Retrieved thirty(30) human studies demonstrated reasonable efficacy of root preparations in subclinical hypothyroidism (1), schizophrenia (3), chronic stress (2), insomnia (2), anxiety (1), memory and cognitive improvement (2), obsessive-compulsive disorder (1), rheumatoid arthritis (2), type-2 diabetes (2), male infertility (6), fertility promotion activity in females (1), adaptogenic (3), growth promoter in children (3) and chemotherapy adjuvant (1). Reasonable safety of root preparations of Aswagandha has been established by these retrieved 30 human trials. No serious adverse events or any changes in haematological, biochemical or vital parameters were reported in these human studies. Only mild and mainly transient type adverse events of somnolence, epigastric pain/discomfort and loose stools were reported as most common (>5%); and giddiness, drowsiness, hallucinogenic, vertigo, nasal congestion (rhinitis), cough, cold, decreased appetite, nausea, constipation, dry mouth, hyperactivity, nocturnal cramps, blurring of vision, hyperacidity, skin rash and weight gain were reported as less common adverse events. Pre-clinical chronic toxicity studies conducted up to 8 months also found root extracts to be safe. No mutagenicity or genotoxicity was reported for the root; only mild CNS depression and increase in thyroxine (T4) levels were reported with rootby some studies. Further, there was no in vitro and in vivo inhibition seen for CYP3A4 and CYP2D6, the two major hepatic drug metabolizing enzymes.
CONCLUSION
Root of the Ayurvedic drug W. somnifera (Aswagandha) appears a promising safe and effective traditional medicine for management of schizophrenia, chronic stress, insomnia, anxiety, memory/cognitive enhancement, obsessive-compulsive disorder, rheumatoid arthritis, type-2 diabetes and male infertility, and bears fertility promotion activity in females adaptogenic, growth promoter activity in children and as adjuvant for reduction of fatigue and improvement in quality of life among cancer patients undergoing chemotherapy. Properly designed, randomized-controlled, large-size, prospective trials with standardized preparations are needed to ascertain efficacy of Aswagandha root in previously studied and other new indications.
Topics: Herb-Drug Interactions; Humans; Patient Safety; Plant Extracts; Plant Roots; Risk Assessment; Risk Factors; Withania
PubMed: 32201301
DOI: 10.1016/j.jep.2020.112768 -
European Journal of Clinical... Aug 2021Acute cough due to viral upper respiratory tract infections (URTIs) and bronchitis is a common reason for patients to seek medical care. Non-antibiotic over-the-counter...
PURPOSE
Acute cough due to viral upper respiratory tract infections (URTIs) and bronchitis is a common reason for patients to seek medical care. Non-antibiotic over-the-counter cough medications such as ivy leaf extract are frequently used but their efficacy is uncertain. Our purpose was to update our previous systematic review and evaluate the effectiveness and tolerability of ivy leaf in the treatment of acute URTIs in adult and pediatric populations.
METHODS
We searched MEDLINE, EMBASE, the Cochrane Library, and clinical trial registries from December 2009 to January 2020. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), and observational studies (OSs) investigating ivy leaf mono- or combination preparations were included. Two independent reviewers assessed records for eligibility and risk of bias and performed data extraction.
RESULTS
Six RCTs, 1 CCT, and 4 OSs were identified. Since the publication of our previous review, the number of RCTs has increased. All studies concluded that ivy leaf extract is an effective and safe option for the treatment of cough due to URTIs and bronchitis. Three RCTs reported a more rapid reduction in cough severity and/or frequency under ivy leaf treatment. The clinical significance of these effects appears to be minimal. No serious adverse effects were reported. The overall quality of reporting was low and the risk of bias was high.
CONCLUSIONS
Ivy leaf preparations are safe for use in cough due to acute URTIs and bronchitis. However, effects are minimal at best and of uncertain clinical importance.
Topics: Cough; Drug Compounding; Hedera; Humans; Patient Acuity; Plant Extracts; Plant Leaves; Quality of Life; Respiratory Tract Infections
PubMed: 33523253
DOI: 10.1007/s00228-021-03090-4 -
International Journal of Impotence... Jun 2024Testosterone boosters are heavily marketed on social media and marketplaces to men with claims to significantly increase testosterone. Lax industry regulation has...
Testosterone boosters are heavily marketed on social media and marketplaces to men with claims to significantly increase testosterone. Lax industry regulation has allowed sales of supplements to thrive in the absence of verification of their purported benefits. Our primary objective was to systematically review all data published in the last two decades on testosterone boosters and determine their efficacy. Our outcome of interest was total testosterone increase versus placebo in four different populations: male athletes, men with late-onset hypogonadism infertile men and healthy men. Following search and screening, 52 studies were included in our review, relating to 27 proposed testosterone boosters: 10 studies of cholecalciferol; 5 zinc/magnesium; 4 Tribulus terrestris and creatine; 3 Eurycoma longifolia and Withania somnifera; 2 betaine, D-aspartic acid, Lepidium meyenii and isoflavones; while the remainder were single reports. Our findings indicate that most fail to increase total testosterone. The exceptions were β-hydroxy β-methylbutyrate and betaine, which can be considered effective for male athletes. Eurycoma longifolia, a blend of Punica granatum fruit rind and Theobroma cacao seed extracts (Tesnor) and purified Shilajit extract (PrimaVie) can be considered possibly effective for men with late-onset hypogonadism; Eurycoma longifolia and Withania somnifera possibly effective for healthy men; and a non-hormonal aromatase inhibitor (Novadex XT) possibly effective for male athletes.
Topics: Humans; Male; Athletes; Creatine; Dietary Supplements; Hypogonadism; Infertility, Male; Plant Extracts; Testosterone; Tribulus
PubMed: 37697053
DOI: 10.1038/s41443-023-00763-9 -
BMC Complementary Medicine and Therapies Feb 2021Childbearing women have been using various herbs to assist with pregnancy, labour and birth for centuries. One of the most common is raspberry leaf. The evidence base...
BACKGROUND
Childbearing women have been using various herbs to assist with pregnancy, labour and birth for centuries. One of the most common is raspberry leaf. The evidence base for the use of raspberry leaf is however under-developed. It is incumbent on midwives and other maternity care providers to provide women with evidence-based information so they can make informed choices. The aim of this study was to review the research literature to identify the evidence base on the biophysical effects, safety and efficacy of raspberry leaf in pregnancy.
METHODS
A systematic, integrative review was undertaken. Six databases were searched to identify empirical research papers published in peer reviewed journals including in vitro, in vivo, human and animal studies. The search included the databases CINAHL, MEDLINE, Cochrane Library, Scopus and Web of Science Core Collection and AMED. Identified studies were appraised independently by two reviewers using the MMAT appraisal instrument. An integrative approach was taken to analysis.
RESULTS
Thirteen studies were included. Five were laboratory studies using animal and human tissue, two were experiments using animals, and six were human studies. Included studies were published between 1941 and 2016. Raspberry leaf has been shown to have biophysical effects on animal and human smooth muscle including the uterus. Toxity was demonstrated when high doses were administered intravenously or intaperitoneally in animal studies. Human studies have not shown any harm or benefit though one study demonstrated a clinically meaningful (though non-statistically significant) reduction in length of second stage and augmentation of labour in women taking raspberry leaf.
CONCLUSIONS
Many women use raspberry leaf in pregnancy to facilitate labour and birth. The evidence base supporting the use of raspeberry leaf in pregnancy is weak and further research is needed to address the question of raspberry leaf's effectiveness.
Topics: Animals; Female; Humans; Mice; Plant Extracts; Plant Leaves; Pregnancy; Pregnancy Outcome; Rats; Rubus; Uterine Contraction; Uterus
PubMed: 33563275
DOI: 10.1186/s12906-021-03230-4 -
Mini Reviews in Medicinal Chemistry 2021In the era of antimicrobial resistance, fungal pathogens are not an exception. Several strategies, including antimicrobial stewardship programs and high throughput...
In the era of antimicrobial resistance, fungal pathogens are not an exception. Several strategies, including antimicrobial stewardship programs and high throughput screening of new drugs, are being implemented. Several recent studies have demonstrated the effectiveness of plant compounds with antifungal activity. In this systematic review, we examine the use of natural compounds as a possible avenue to fight fungal infections produced by Candida albicans, the most common human fungal pathogen. Electronic literature searches were conducted through PubMed/MEDLINE, Cochrane, and Science Direct limited to the 5 years. A total of 131 articles were included, with 186 plants extracts evaluated. Although the majority of the natural extracts exhibited antifungal activities against C. albicans (both in vivo and in vitro), the strongest antifungal activity was obtained from Lawsonia inermis, Pelargonium graveolens, Camellia sinensis, Mentha piperita, and Citrus latifolia. The main components with proven antifungal activities were phenolic compounds such as gallic acid, thymol, and flavonoids (especially catechin), polyphenols such as tannins, terpenoids and saponins. The incorporation of nanotechnology greatly enhances the antifungal properties of these natural compounds. Further research is needed to fully characterize the composition of all herbal extracts with antifungal activity as well as the mechanisms of action of the active compounds.
Topics: Antifungal Agents; Camellia sinensis; Candida albicans; Citrus; Humans; Lawsonia Plant; Mentha piperita; Microbial Sensitivity Tests; Pelargonium; Plant Extracts
PubMed: 32600229
DOI: 10.2174/1389557520666200628032116 -
Food & Function Feb 2023Mulberry leaf (ML) and mulberry leaf extract (MLE) have numerous biological properties, such as regulating sugar and lipid metabolism, reducing blood glucose, and... (Meta-Analysis)
Meta-Analysis Review
Mulberry leaf (ML) and mulberry leaf extract (MLE) have numerous biological properties, such as regulating sugar and lipid metabolism, reducing blood glucose, and increasing insulin secretion. The aim of this study was to perform a systematic review and meta-analysis of randomized clinical trials to examine the effect of ML/MLE supplementation on glycemic traits in adults, including fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), and fasting plasma insulin (FPI). Twelve clinical trials (615 participants) fulfilled the eligibility criteria for the present meta-analysis, which included sensitivity analysis and GRADE (grading of recommendations assessment, development, and evaluation) certainty. Based on the heterogeneity between included studies, a random effects model was applied in the meta-analysis, and the results are expressed as WMD (weighted mean differences) with 95% CI (confidence intervals). Meta-analysis showed that ML/MLE supplementation resulted in a significant reduction in FBG by -0.47 mmol L, HbA1c by -2.92 mmol mol, and FPI by -0.58 μIU mL. In addition, subgroup analysis indicated that long-term supplementation of ML/MLE (≥8 weeks) was more effective for regulation of the glycemic traits in the non-healthy and baseline FPG >6.1 mmol L subgroups. Glycemic regulation by ML/MLE may be attributed to the phytochemicals they contain, which are mainly 1-deoxynojirimycin, flavonoids, phenolics, and polysaccharides.
Topics: Adult; Humans; Blood Glucose; Glycated Hemoglobin; Morus; Fruit; Plant Extracts; Diabetes Mellitus, Type 2
PubMed: 36644880
DOI: 10.1039/d2fo02645g -
Journal of Ethnopharmacology Feb 2023Salvadora persica L., also known as miswak, is an indigenous plant most prevalent in the Middle Eastern, some Asian, and African countries. It has medicinal and... (Meta-Analysis)
Meta-Analysis Review
ETHNOPHARMACOLOGICAL RELEVANCE
Salvadora persica L., also known as miswak, is an indigenous plant most prevalent in the Middle Eastern, some Asian, and African countries. It has medicinal and prophylactics function for numerous illnesses, including periodontal disease. Various trials, apart from World Health Organization encouragement have contributed to the production and use of S. persica in extract form in the formulation of mouthwash. This systematic review and meta-analysis aimed to compare the clinical effect of Salvadora persica-extract mouthwash and chlorhexidine gluconate mouthwash for anti-plaque and anti-gingivitis functions.
METHODS
Using the PRISMA 2020 Protocol, a systematic search of the publications was undertaken from the MEDLINE, CENTRAL, Science Direct, PubMed, and Google Scholars for randomized control trials published through 31st January 2022 to determine the effectiveness of Salvadora persica-extract mouthwash relative to chlorhexidine gluconate as anti-plaque and anti-gingivitis properties.
RESULTS
A total of 1809 titles and abstracts were screened. Of these, twenty-two studies met the inclusion criteria for the systematic review while only sixteen were selected for meta-analysis. The overall effects of standardized mean difference and 95% CI were 0.89 [95% CI 0.09 to 1.69] with a χ statistic of 2.54, 15 degrees of freedom (p < 0.00001), I = 97% as anti-plaque function and 95% CI were 0.12 [95% CI -0.43 to 0.67] with a χ statistic of 0.68 with 10 degree of freedom (p < 0.00001), I = 89% as anti-gingivitis.
CONCLUSION
This review suggests that Salvadora persica-extract mouthwash causes a significant reduction of plaque and gingival inflammation. While the improvement is inferior to chlorhexidine gluconate mouthwash, S. persica-extract mouthwash may be considered as a herbal alternative to the user pursuing periodontal care with natural ingredients.
Topics: Humans; Mouthwashes; Salvadoraceae; Plant Extracts; Chlorhexidine; Gingivitis
PubMed: 36283639
DOI: 10.1016/j.jep.2022.115863 -
BMC Complementary and Alternative... Oct 2019Carica papaya (CP) extract is becoming popular as an unlicensed herbal remedy purported to hasten recovery in dengue infection, mostly based on observations that it may... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Carica papaya (CP) extract is becoming popular as an unlicensed herbal remedy purported to hasten recovery in dengue infection, mostly based on observations that it may increase platelet counts. This systematic review and meta-analysis aims to critically analyze the evidence from controlled clinical trials on the efficacy and safety of CP extract in the treatment of dengue infection.
METHODS
PubMed, LILACS and Google Scholar were searched for randomized or non-randomized trials enrolling patients with suspected or confirmed dengue where CP extract was compared, as a treatment measure, against standard treatment. Recovery of platelet counts as well as other clinical indicators of favourable outcome (duration of hospital stay, prevention of plasma leakage, life threatening complications, and mortality) were assessed.
RESULTS
Nine studies (India-6, Pakistan-1, Indonesia-1, Malaysia-1) met the inclusion criteria. Seven studies showed an increase in platelet counts in patients receiving CP extract, while one study showed no significant difference between the two groups, and direct comparison was not possible in the remaining study. Serious adverse events were not reported. CP extract may reduce the duration of hospital stay (mean difference - 1.98 days, 95% confidence interval - 1.83 to - 2.12, 3 studies, 580 participants, low quality evidence), and cause improvement in mean platelet counts between the first and fifth day of treatment (mean difference 35.45, 95% confidence interval 23.74 to 47.15, 3 studies, 129 participants, low quality evidence). No evidence was available regarding other clinical outcomes.
CONCLUSIONS
The clinical value of improvement in platelet count or early discharge is unclear in the absence of more robust indicators of favourable clinical outcome. Current evidence is insufficient to comment on the role of CP extract in dengue. There is a need for further well designed clinical trials examining the effect of CP on platelet counts, plasma leakage, other serious manifestations of dengue, and mortality, with clearly defined outcome measures.
Topics: Antiviral Agents; Carica; Clinical Trials as Topic; Dengue; Humans; Plant Extracts; Plant Leaves
PubMed: 31601215
DOI: 10.1186/s12906-019-2678-2 -
Current Topics in Medicinal Chemistry 2021Type 2 diabetes (adult onset diabetes) is the most common type of diabetes, accounting for around 90% of all diabetes cases with insulin resistance and insulin secretion...
BACKGROUND
Type 2 diabetes (adult onset diabetes) is the most common type of diabetes, accounting for around 90% of all diabetes cases with insulin resistance and insulin secretion defect. The key goal of anti-diabetic therapy is to increase the development of insulin, immunity and/or decrease the amount of blood glucose. While many synthetic compounds have been produced as antidiabetic agents, due to their side effects and limited effectiveness, their usefulness has been hindered.
METHODS
This systematic review investigated the bioactive compounds reported to possess activities against type 2 diabetes. Three (3) databases, PubMed, ScienceDirect and Google Scholar were searched for research articles published between January 2010 and October 2020. A total of 6464 articles were identified out of which 84 articles were identified to be elligible for the study.
RESULT AND DISCUSSION
From the data extracted, it was found that quercetin, Kaempferol, Rosmarinic acid, Cyanidin, Rutin, Catechin, Luteolin and Ellagic acid were the most cited bioactive compounds which all falls within the class of polyphenolic compounds. The major sources of these bioactive compounds includes citrus fruits, grapes, onions, berries, cherries, broccoli, honey, apples, green tea, Ginkgo biloba, St. John's wort, green beans, cucumber, spinach, tea, Rosmarinus officinalis, Aloe vera, Moringa oleifera, tomatoes, potatoes, oregano, lemon balm, thyme, peppermint, Ocimum basilicum, red cabbage, pears, olive oil and walnut.
Topics: Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents; Plant Extracts
PubMed: 33966619
DOI: 10.2174/1568026621666210509161059 -
The British Journal of Dermatology Oct 2013Patients with psoriasis frequently use preparations of plant extracts. Physicians need to be aware of the current evidence concerning these products. This review... (Meta-Analysis)
Meta-Analysis Review
Patients with psoriasis frequently use preparations of plant extracts. Physicians need to be aware of the current evidence concerning these products. This review evaluates the efficacy and safety of preparations of plant extracts used topically for psoriasis. Searches were conducted in PubMed, Embase, the Cochrane library, two Chinese databases and article reference lists. Randomized controlled trials investigating extracts of single plants were included. Preparations of multiple plants and combinations of plant extracts plus conventional therapies were excluded. Two authors conducted searches, extracted data and assessed risk of bias. Outcomes used in meta-analyses were: clinical efficacy, Psoriasis Area and Severity Index score, and quality of life and symptom scores. The 12 included studies investigated extracts of: Mahonia aquifolium (n = 5), Aloe vera (n = 3), indigo naturalis (n = 2), kukui nut oil (n = 1) and Camptotheca acuminata nut (n = 1). Methodological quality was variable. Six studies provided data suitable for meta-analysis of clinical efficacy, and five were vs. placebo (relative risk 3·37, 95% confidence interval 1·36-8·33). Experimental studies indicate components of indigo naturalis, Mahonia and Camptotheca have anti-inflammatory, antiproliferative and other actions of relevance to psoriasis. The clinical trial evidence provides limited support for preparations containing extracts of M. aquifolium, indigo naturalis and Aloe vera for the topical management of plaque psoriasis based on multiple studies. No serious adverse events were reported. Because of the small size of most studies and methodological weaknesses, strong conclusions cannot be made. The magnitudes of any effects cannot be measured with accuracy, so it is difficult to assess the clinical relevance of these preparations.
Topics: Administration, Cutaneous; Adult; Aged; Aloe; Camptotheca; Drugs, Chinese Herbal; Female; Humans; Mahonia; Male; Middle Aged; Nuts; Phytotherapy; Plant Extracts; Plants, Medicinal; Psoriasis; Randomized Controlled Trials as Topic; Treatment Outcome; Young Adult
PubMed: 23909714
DOI: 10.1111/bjd.12557