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Frontiers in Pharmacology 2024As a bioactive metabolite preparation widely used in acute ischemic stroke (AIS), the efficacy and safety of saponins injections (PNSI) in patients with AIS after...
BACKGROUND
As a bioactive metabolite preparation widely used in acute ischemic stroke (AIS), the efficacy and safety of saponins injections (PNSI) in patients with AIS after intravenous thrombolysis remain to be evaluated.
METHODS
This study included randomized controlled trials published before 26 April 2024 in 8 databases. AIS patients who received intravenous thrombolysis were included. The control group receiving conventional treatment and the treatment group receiving additional PNSI. Primary outcomes were selected as mortality, disability, and adverse events. Secondary outcomes were selected as all-cause mortality, improvement of neurological deficit, quality of life, and cerebral injury indicators. The revised Cochrane Risk of Bias tool was used to assess risk of bias. Risk ratio (RR) and mean differences (MD) were calculated for binary variables and continuous variables, respectively, based on a 95% confidence interval (CI).
RESULTS
A total of 20 trials involving 1,856 participants were included. None of them reported mortality or disability. There was no significant difference in the adverse events [RR: 1.04; 95% CI: 0.60 to 1.81] and hemorrhagic transformation [RR: 0.99; 95% CI: 0.36 to 2.70] between the two groups. Compared to the control group, the treatment group had a better effect in neurological improvement assessed by National Institutes of Health Stroke Scale [MD: -2.91; 95% CI: -4.76 to -1.06], a better effect in activities of daily living changes in Barthel Index [MD: 9.37; 95% CI: 1.86 to 16.88], and a lower serum neuron-specific enolase level [MD: -2.08; 95% CI: -2.67 to -1.49].
CONCLUSION
For AIS patients undergoing intravenous thrombolysis, the use of PNSI improved neurological deficits and enhanced activity of daily living in the short term without increasing the occurrence rate of adverse events. However, due to the moderate to very low certainty of evidence, it is advisable to conduct high-quality clinical trials to validate the findings of this study.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=466851, Identifier CRD42023466851.
PubMed: 38898926
DOI: 10.3389/fphar.2024.1376025 -
The Journal of Sports Medicine and... Jun 2024According to the PRISMA guidelines, this systematic review of randomized controlled trials examined whether Panax ginseng supplementation reduces resistance to...
INTRODUCTION
According to the PRISMA guidelines, this systematic review of randomized controlled trials examined whether Panax ginseng supplementation reduces resistance to exercise-induced muscle damage (EIMD).
EVIDENCE ACQUISITION
Web of Science, SPORTDiscus and Medline databases were searched from the 16 of December 2021 to the 18 of February 2022. Inclusion criteria were studies in humans consuming Panax ginseng that employed resistance training as the damaging muscle protocol and measured markers implicated in the etiology of EIMD (muscle damage, muscle function and muscle soreness). The PEDro risk of bias assessment tool was used to appraise the studies critically.
RESULTS
Conflicting evidence was evident in markers of muscle damage, muscle function and muscle soreness. The quality assessment suggested that all studies had some level of bias.
CONCLUSIONS
From 180, six studies were included in the systematic review. The main findings suggest that Panax ginseng does not attenuate markers of EIMD following resistance training. However, research is still preliminary. Adequately powered sample sizes and well-controlled studies are warranted to clarify Panax ginseng's efficacy.
PubMed: 38888561
DOI: 10.23736/S0022-4707.24.15832-X -
Current Pharmaceutical Design Jun 2024This systematic review and meta-analysis aimed to evaluate the overall impact of Panax ginseng on lipid profile by synthesizing existing evidence. Cardiovascular Disease... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This systematic review and meta-analysis aimed to evaluate the overall impact of Panax ginseng on lipid profile by synthesizing existing evidence. Cardiovascular Disease (CVD) is the leading cause of morbidity and mortality among the elderly population, and serum lipids play a crucial role in its development. Maintaining optimal levels of triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol is essential in reducing the risk of CVD. Ginsenosides, the active constituents in ginseng, have shown positive effects on lipid metabolism. This review aimed to provide a comprehensive understanding of the potential benefits of ginseng in managing dyslipidemia, which could have significant implications for the prevention and treatment of CVD.
METHODS
A comprehensive analysis of 29 Randomized Controlled Trials (RCTs) was conducted to assess the effects of ginseng supplementation on lipid profile, including Triglyceride (TG), Total Cholesterol (TC), High- -density Lipoprotein Cholesterol (HDL-C), and Low-density Lipoprotein Cholesterol (LDL-C) levels. A systematic search was done in online databases, such as MEDLINE, Scopus, and Clarivate Analytics Web of Science, using relevant keywords and MeSH terms to identify relevant studies until January 2024.
RESULTS
The Weighted Mean Differences (WMD) and 95% Confidence Intervals (CI) for TG, TC, LDL-C, and HDL-C did not show significant changes with ginseng supplementation.
CONCLUSION
Taking into account the results, using ginseng did not have a statistically significant influence on lipid profile parameters in individuals with different health conditions. Further, well-designed RCTs focusing on specific diseases are needed to clarify the potential beneficial effects of ginseng and its derivatives on lipid profile.
PubMed: 38877862
DOI: 10.2174/0113816128306300240522074056 -
Frontiers in Pharmacology 2024This study aimed to assess the efficacy and safety of saponin (PNS) injection, when combined with conventional treatment (CT), for acute myocardial infarction (AMI)....
This study aimed to assess the efficacy and safety of saponin (PNS) injection, when combined with conventional treatment (CT), for acute myocardial infarction (AMI). Comprehensive searches were conducted in seven databases from inception until 28 September 2023. The search aimed to identify relevant randomized controlled trials (RCTs) focusing on PNS injection in the context of AMI. This meta-analysis adhered to the PRISMA 2020 guidelines, and its protocol was registered with PROSPERO (number: CRD42023480131). Twenty RCTs involving 1,881 patients were included. The meta-analysis revealed that PNS injection, used adjunctively with CT, significantly improved treatment outcomes compared to CT alone, as evidenced by the following points: (1) enhanced total effective rate [OR = 3.09, < 0.05]; (2) decreased incidence of major adverse cardiac events [OR = 0.32, < 0.05]; (3) reduction in myocardial infarct size [MD = -6.53, < 0.05]; (4) lower ST segment elevation amplitude [MD = -0.48, < 0.05]; (5) mitigated myocardial injury as indicated by decreased levels of creatine kinase isoenzymes [MD = -11.19, < 0.05], cardiac troponin T [MD = -3.01, < 0.05], and cardiac troponin I [MD = -10.72, < 0.05]; (6) enhanced cardiac function, reflected in improved brain natriuretic peptide [MD = -91.57, < 0.05], left ventricular ejection fraction [MD = 5.91, < 0.05], left ventricular end-diastolic dimension [MD = -3.08, < 0.05], and cardiac output [MD = 0.53, < 0.05]; (7) reduced inflammatory response, as shown by lower levels of C-reactive protein [MD = -2.99, < 0.05], tumor necrosis factor-α [MD = -6.47, < 0.05], interleukin-6 [MD = -24.46, < 0.05], and pentraxin-3 [MD = -2.26, < 0.05]; (8) improved vascular endothelial function, demonstrated by decreased endothelin-1 [MD = -20.56, < 0.05] and increased nitric oxide [MD = 1.33, < 0.05]; (9) alleviated oxidative stress, evidenced by increased superoxide dismutase levels [MD = 25.84, < 0.05]; (10) no significant difference in adverse events [OR = 1.00, = 1.00]. This study highlighted the efficacy and safety of adjunctive PNS injections in enhancing AMI patient outcomes beyond CT alone. Future RCTs need to solidify these findings through rigorous methods. : (https://www.crd.york.ac.uk/PROSPERO/), identifier (CRD42023480131).
PubMed: 38576488
DOI: 10.3389/fphar.2024.1353662 -
Antioxidants (Basel, Switzerland) Mar 2024Spinocerebellar ataxia type 3 (SCA3) is an autosomal dominant neurodegenerative disorder that gives rise to motor incoordination and progressive functional disabilities.... (Review)
Review
Spinocerebellar ataxia type 3 (SCA3) is an autosomal dominant neurodegenerative disorder that gives rise to motor incoordination and progressive functional disabilities. Although pharmacological interventions have revealed promising prospects in the management of SCA3, adverse effects may become unbearable. The use of herbal remedies in traditional Chinese medicine (TCM) may serve as potential alternative medicines to delay the progression of the disease. This systematic review is intended to identify, appraise, and summarize the findings of studies pertaining to the therapeutic roles of herbal remedies in TCM targeting oxidative stress in the management of SCA3. A literature search for relevant articles published from 1 January 2013 to 30 June 2023 in three databases, namely PubMed, Web of Science, and Scopus, was carried out according to the procedures of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A total of ten preclinical studies met the inclusion criteria of the systematic review. We recognized the therapeutic potential of , , sp., , , , , , sp., , , , , and . We identified the types of preclinical models expressing polyglutamine (polyQ) expanded mutant protein (mATXN3), inducers of oxidative stress that mimic the SCA3 pathogenesis, and effective doses of the herbal remedies. The modes of action contributing to the attenuation of oxidative stress are activation of antioxidant pathways, ubiquitin-proteasome system and autophagy, regulation of apoptosis, proinflammatory signaling pathway and chaperones, regulation of mitochondrial function and biogenesis, and restoration of neurotransmission and synaptic plasticity. In conclusion, herbal remedies in TCM may possibly delay the progression of SCA3, therefore providing justification for clinical trials.
PubMed: 38539908
DOI: 10.3390/antiox13030375 -
Frontiers in Pharmacology 2024Effective and safe treatments for mild cognitive impairment (MCI) are limited. Chinese herbal medicine (CHM) is commonly used in China to manage MCI. However, its...
Effective and safe treatments for mild cognitive impairment (MCI) are limited. Chinese herbal medicine (CHM) is commonly used in China to manage MCI. However, its efficacy and safety remain uncertain. This review aims to evaluate the efficacy and safety of CHM for MCI. Nine databases were searched from their inceptions to January 2023. Randomized, placebo-controlled trials of oral CHM for MCI were included. Study quality was assessed using the Cochrane risk-of-bias tool 2.0, and the certainty of evidence was evaluated via the GRADE approach. Thirteen studies, involving 1,043 participants, were analyzed. Most of the studies (10 out of 13) were associated with "some concerns" regarding the overall risk of bias. Meta-analyses results indicated that CHM significantly improved cognitive function compared to placebo in terms of Mini-Mental State Examination (MMSE) (MD: 1.90 [1.22, 2.58], I = 87%, 11 studies, 823 participants) and Montreal Cognitive Assessment (MoCA) (MD: 2.88 [1.69, 4.06], I = 81%, 3 studies, 241 participants). The certainty of evidence for MMSE was assessed as "moderate", while it was "low" for MoCA. One study did not report adverse events (AEs), one study reported no statistical difference between the groups in terms of AEs, and 11 studies provided detailed numbers of AE cases where gastrointestinal symptoms were the most commonly reported AEs. Two studies reported no SAEs among participants and one study found no significant difference in SAEs proportions between groups. The meta-analysis revealed no significant difference in AEs between the two groups (RR: 1.31 [0.92, 1.87), I = 0%, 11 studies, 839 participants). The cognitive-enhancing function of commonly used herbs ( C.A.Mey., var. Besser, and Willd.) may be attributed to mechanisms including antioxidant, anti-apoptotic, anti-neurotoxic, anti-cytotoxic, and anti-inflammatory actions. Chinese herbal medicine holds potential as an effective intervention to improve cognitive function in MCI patients, supported by meta-analyses evidence of low to moderate certainty. Although current data suggests CHM is generally safe, caution is advised due to the lack of AE reporting or detailed information in some instances. : https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=400292, identifier [CRD42023400292].
PubMed: 38425647
DOI: 10.3389/fphar.2024.1341074 -
Food & Function Mar 2024American ginseng () has gained recognition as a medicinal and functional food homologous product with several pharmaceutical, nutritional, and industrial applications.... (Review)
Review
American ginseng () has gained recognition as a medicinal and functional food homologous product with several pharmaceutical, nutritional, and industrial applications. However, the key regulators involved in ginsenoside biosynthesis, the spatiotemporal distribution characteristics of ginsenosides, and factors influencing ginsenosides are largely unknown, which make it challenging to enhance the quality and chemical extraction processes of the cultivated American ginseng. This review presents an overview of the pharmacological effects, biosynthesis and spatiotemporal distribution of ginsenosides, with emphasis on the impacts of biotic and abiotic factors on ginsenosides in American ginseng. Modern pharmacological studies have demonstrated that American ginseng has neuroprotective, cardioprotective, antitumor, antidiabetic, and anti-obesity effects. Additionally, most genes involved in the upregulation of ginsenoside biosynthesis have been identified, while downstream regulators (OSCs, CYP450, and UGTs) require further investigation. Futhermore, limited knowledge exists regarding the molecular mechanisms of the impact of biotic and abiotic factors on ginsenosides. Notably, the nonmedicinal parts of American ginseng, particularly its flowers, fibrous roots, and leaves, exhibit higher ginsenoside content than its main roots and account for a considerable amount of weight in the whole plant, representing promising resources for ginsenosides. Herein, the prospects of molecular breeding and metabolic engineering based on multi-omics to improve the unstable quality of cultivated American ginseng and the shortage of ginsenosides are proposed. This review highlights the gaps in the current research on American ginseng and proposes solutions to address these limitations, providing a guide for future investigations into American ginseng ginsenosides.
Topics: Ginsenosides; Flowers; Plant Leaves; Panax; Plant Roots
PubMed: 38323507
DOI: 10.1039/d3fo03434h -
Plants (Basel, Switzerland) Jan 2024Tobacco ( L.) is a major industrial crop that has being cultivated for centuries for the manufacturing of cigarettes, cigars, and other smoking products. Due to its... (Review)
Review
Tobacco ( L.) is a major industrial crop that has being cultivated for centuries for the manufacturing of cigarettes, cigars, and other smoking products. Due to its negative effects on both human health and the environment, the European Union has adopted strict policies that aspire to reduce the consumption of tobacco. Herbal cigarettes are alternative smoking products that are often advertised as healthier than conventional tobacco cigarettes and are especially popular in Asian markets. Even though the available literature suggests that they are equally detrimental to human health, the introduction of tobacco-alternative crops (TACs) to the European tobacco industry could smoothen the abandonment of tobacco, and eventually smoking products altogether, in the EU. The aim of the present systematic review was to compile a list of possible TACs that could be incorporated in the European smoking industry, and highlight their strengths and weaknesses. The most dominant crops in the literature (and in the existing market products) were calendula ( L.), mullein ( L.), ginseng ( C.A.Mey.), tea ( (L.) Kuntze), chamomile ( L.), and mentha ( spp.). Even though these crops are promising, further research is required for their incorporation in the European tobacco industry.
PubMed: 38256796
DOI: 10.3390/plants13020236 -
Phytomedicine : International Journal... Mar 2024Panax notoginseng saponins (PNS) are the primary active components of an ancient Chinese herb Panax notoginseng. Hypercoagulable state of blood (HCS) is an independent... (Meta-Analysis)
Meta-Analysis
Clinical efficacy and safety of Panax notoginseng saponins in treating chronic obstructive pulmonary disease with blood hypercoagulability: A meta-analysis of randomized controlled trials.
BACKGROUND
Panax notoginseng saponins (PNS) are the primary active components of an ancient Chinese herb Panax notoginseng. Hypercoagulable state of blood (HCS) is an independent risk factor and a cause of death in chronic obstructive pulmonary disease (COPD). Several vivo studies have demonstrated the use of PNS preparations for treating COPD with HCS.
PURPOSE
This study aimed to systematically evaluate the clinical efficacy and safety of PNS preparations in treating COPD with HCS.
STUDY DESIGN
Meta-analysis of the randomized controlled trials (RCTs) was conducted to review data.
METHODS
RCTs on the treatment of COPD with HCS and PNS preparations were searched from PubMed, Cochrane Library, Embase, Web of Science, Chinese National Knowledge Infrastructure, Vip Information Database, Wanfang data, and Chinese Biomedical Literature Database. Relevant data were extracted from the included studies and methodological quality evaluation was performed. R language (version 4.2.3) was applied for the meta-analysis.
RESULTS
Twenty RCTs involving 1831 patients were analyzed. The results revealed that PNS preparations considerably increased the total clinical efficiency, improved forced expiratory volume in one second percent of predicted, and forced expiratory volume/forced vital capacity ratio. Further, PNS preparations improved fibrinogen, plasma d-dimer, whole blood viscosity at high cut, whole blood viscosity at low cut, and plasma viscosity levels. The results obtained for activated partial thromboplastin and prothrombin times were not statistically significant. Finally, PNS preparations increased partial pressure of oxygen and decreased carbon dioxide pressure.
CONCLUSION
This is the first relatively comprehensive systematic review of the clinical efficacy and safety of PNS preparations for treating COPD with HCS. The study revealed that PNS preparations considerably improve lung function, hypoxia, and blood hypercoagulability in patients with COPD and HCS without increasing the risk of hemorrhage and has a good safety profile; therefore, it can be used as a new modulating agent and anticoagulant.
Topics: Humans; Panax notoginseng; Pulmonary Disease, Chronic Obstructive; Randomized Controlled Trials as Topic; Saponins; Thrombophilia; Treatment Outcome
PubMed: 38216446
DOI: 10.1016/j.phymed.2023.155244 -
Frontiers in Pharmacology 2023Stroke is the major cause of mortality and permanent disability and is associated with an astonishing economic burden worldwide. In the past few decades, accumulated...
Stroke is the major cause of mortality and permanent disability and is associated with an astonishing economic burden worldwide. In the past few decades, accumulated evidence has indicated that Xuesaitong (XST) has therapeutic benefits in cases of acute ischemic stroke (AIS). Our study aimed to provide the best current body of evidence of the efficacy and safety of XST for patients with AIS. This is a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched eight electronic databases from inception to 17 July 2023 for relevant RCTs. The investigators independently screened trials, extracted data, and assessed the risk of bias. A meta-analysis was conducted using RevMan 5.3 and STATA 16.0 software. In total, 46 RCTs involving 7,957 patients were included. The results showed that XST improved the long-term functional outcomes with lower modified Rankin Scale (mRS) scores (MD = -0.67; 95% CI [-0.92 to -0.42]; < 0.00001) and a higher proportion of functional independence (mRS ≤2) (RR = 1.08; 95% CI [1.05 to 1.12]; < 0.00001). Low-quality evidence indicated that XST improved the activities of daily living (MD = 10.17; 95% CI [7.28 to 13.06]; < 0.00001), improved the neurological impairment (MD = -3.39; 95% CI [-3.94 to -2.84]; < 0.00001), and enhanced the total efficiency rate (RR = 1.19; 95% CI [1.15 to 1.23]; < 0.00001). No significant difference was found in the all-cause mortality or incidence of adverse events between the XST and control groups. The certainty of evidence was estimated as moderate to very low. Presently, the administration of XST within 14 days of AIS is associated with favorable long-term functional outcomes. In addition, XST can improve activities of daily living, alleviate neurological deficits, and has shown good tolerability. However, the current evidence is too weak, and the confidence of evidence synthesis was restricted by the high risk of bias. Given the insufficient evidence, appropriately sized and powered RCTs investigating the efficacy and safety of XST for patients with AIS are warranted. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=446208, CRD42023446208.
PubMed: 37908976
DOI: 10.3389/fphar.2023.1280559