BMC Complementary Medicine and Therapies最新文献

Background/objectives: Osteoarthritis (OA) is a leading cause of chronic pain. As healthcare services struggle to meet demand to treat chronic pain, many individuals self-manage their symptoms. Probiotics and palmitoylethanolamide (PEA) may be promising therapeutic options because of their anti-inflammatory properties. PEA is an endogenously produced N-acylethanolamine, considered "endocannabinoid-like" due to its structural similarity to endocannabinoids. While it has non-direct influence on the endocannabinoid system, it primarily acts via non-cannabinoid pathways, most notably through activation of peroxisome proliferator-activated receptor alpha (PPARα). PEA has demonstrated both analgesic (pain-relieving) and mood-modulating effects in preclinical studies, and preliminary clinical studies. To date, no clinical studies have investigated the combined use of PEA and probiotics for the treatment of OA pain.

Methods: A multiple baseline design (MBD) study was used over 11 weeks to assess the individual effects in four participants recruited from a naturopathic practice. Participants were randomised into one of two pathways, both starting with a placebo phase, followed by an active intervention involving probiotics and PEA. This design allowed for the concealment and blinding of the introduction of active treatment in a double-blind manner. The primary outcome was daily pain scores using a Visual Analogue Scale (VAS). Secondary outcomes incorporated a patient-reported measure which was a patient specified functional scale. Other secondary outcomes assessed wellbeing, stress, and blood indicators of inflammation. Visual analysis of time series graphs and descriptive statistics were used to analyse the data.

Results: The graph demonstrated a clear pain reduction for one participant. Analyses also suggested improvements in patient-specified functional scales, wellbeing, and anxiety for all participants.

Conclusions: This small multiple‑baseline study suggests that a probiotics‑plus‑PEA regimen may support function and wellbeing in some individuals with OA; these preliminary, hypothesis‑generating findings warrant evaluation in larger, controlled studies.

Trial registration: This trial was registered with the Australian New Zealand Clinical Trials Registry on the 18th of January 2021. The registration number is ACTRN#:12621000039886.

Background: Boswellia dalzielii (B. dalzielii) is traditionally used in African ethnomedicine to manage neurological and cognitive disorders. This study investigated the in vitro effects of its leaf, stem bark, and root bark extracts on key enzymes associated with brain function.

Methods: The leaf, stem bark, and root bark were air-dried, powdered, and extracted using water. The concentrated extracts were evaluated for their effects on acetylcholinesterase (AChE), butyrylcholinesterase (BuChE), monoamine oxidase (MAO), ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase), ecto-5'-nucleotidase, and Na⁺/K⁺-ATPase activities following standard in vitro protocols.

Results: The extracts exhibited concentration-dependent inhibition of AChE, BuChE, MAO, E-NTPDase, and ecto-5'-nucleotidase, as well as modulation of Na⁺/K⁺-ATPase activity. The stem bark extract showed the strongest inhibition of AChE and BuChE, with markedly lower IC₅₀ values (27.92 ± 1.45 and 32.20 ± 1.51 µg/mL for AChE and BuChE, respectively) than the leaf and root bark extracts and comparable potency to the standard inhibitor, Prostigmine. For MAO, the root bark extract displayed the highest inhibitory activity (IC₅₀ = 70.92 ± 1.88 µg/mL), followed by the leaf and stem bark extracts. The stem bark extract also exhibited the most potent inhibition of E-NTPDase (IC₅₀ = 31.71 ± 1.50 µg/mL for ATP and 42.01 ± 1.62 µg/mL for ADP) and ecto-5'-nucleotidase (IC₅₀ = 41.20 ± 1.62 µg/mL), while moderately enhancing Na⁺/K⁺-ATPase activity. Overall, the stem bark extract displayed the greatest enzyme modulatory capacity among the plant parts tested. Phytochemical profiling revealed the presence of stilbenoids in all plant parts.

Conclusions: These in vitro findings demonstrate that B. dalzielii extracts can modulate the activity of key enzymes related to brain function. Further in vivo and in silico investigations are underway to elucidate the pharmacological and neuroprotective relevance of these effects.

Background: The evergreen shrub Maytenus gracilipes (Celastraceae), used in Ethiopian traditional medicine to treat tonsillitis, ear infections, and malaria, is a promising source for developing antibacterial agents to address antimicrobial resistance.

Objectives: This research investigated the phytochemical composition of M. gracilipes root extract and utilized a green synthesis approach to produce silver nanoparticles. Additionally, it evaluated the antibacterial properties of both the root extract and the synthesized silver nanoparticles.

Methods: Phytochemical screening tests were performed via a standard protocol, and column chromatographic separation was used to isolate the compounds. Spectroscopic techniques such as ¹H, ¹³C, and DEPT-135 NMR were employed to determine the structures of the isolated compounds. A green synthesis approach was employed to synthesize silver nanoparticles from the root extract of M. gracilipes. The morphology, size, and crystallinity of the silver nanoparticles were confirmed via various techniques, such as X-ray diffraction, scanning electron microscopy, and transmission electron microscopy (TEM). The disc diffusion technique was used to evaluate antibacterial activity.

Results: Phytochemical screening revealed the presence of alkaloids, steroids, terpenoids, tannins, and flavonoids, but the absence of anthraquinones in the root extracts of M. gracilipes. Column chromatographic separation of dichloromethane extracts afforded two compounds: a derivative of suberosin (1) and lupeol (2). The X-ray diffraction (XRD) pattern demonstrated that the synthesized silver nanoparticles were crystalline. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) revealed that the silver nanoparticles are spherical and range from 10 to 60 nm in size. The tested extracts and biosynthesized silver nanoparticles were effective against the tested bacterial strains (Bacillus cereus, Staphylococcus aureus, Escherichia coli, and Salmonella typhi) at different concentrations (100, 50, and 25 µg/disc).

Conclusion: This study demonstrates that M. gracilipes exhibits substantial phytochemical diversity and promising antibacterial activity, emphasizing its potential as a valuable source of bioactive compounds that serve as effective capping agents in nanoparticle synthesis.

Background: Bitter kola, Garcinia kola Heckel, is a woody plant native to West and Central Africa. It is traditionally used both in social ceremonies and for treating a wide range of ailments, including malaria, respiratory infections, gastrointestinal disturbances, hepatitis, metabolic and sexual disorders. Despite its importance and popularity, a great deal of information and basic knowledge is still missing about the species. Particularly lack of studies is related to therapeutic efficacy and safety of bitter kola uses.

Aims: This study aimed to document ethnomedicinal uses of bitter kola among native populations in Nigeria, to identify commonly used plant parts and the dosages, record perceived side effects and to compare these findings with scientific evidence, and to estimate its potential clinical applications.

Methods: Data were collected by a structured questionnaire distributed both online and in-person to members of the Nigerian public.

Results: A total of 152 respondents participated, primarily from the Ibibio, Annang, and Igbo ethnic groups. Most participants reported using fresh seeds of bitter kola, mainly for treating respiratory symptoms, stomach upset, and general well-being. Regular use was common, typically, monthly or as needed, depending on the disease.

Conclusions: Several traditional uses of bitter kola are supported by clinical studies: including its antioxidant and immunomodulatory effects and its benefits for gastric, hepatic, glycemic, respiratory, reproductive and pain-modulation related conditions. Evidence also suggests antimicrobial and hepatoprotective potential. However, further studies are required to establish standardised dosages and safety profiles for different plant parts.

Background: Acupuncture has been widely applied to polycystic ovarian syndrome (PCOS) patients. This network meta-analysis (NMA) aims to compare the effects of different acupuncture methods on PCOS from the aspects of hyperandrogenism, metabolic status, sexual hormone disturbance, and infertility.

Methods: We searched eight electronic databases for randomized controlled trials on different acupuncture methods vs. placebo or standard treatment by the end of 30 October, 2023. Stata17 and R 4.5.2 were used for a Bayesian NMA, and Cochrane RoB 2.0 tool for the methodological quality assessment of the included studies.

Results: A total of 59 studies (5937 participants) were included. In terms of hyperandrogenism, acupuncture greatly reduced testosterone levels in PCOS patients compared with medicine (mean difference(MD)): 0.69; 95% credible interval [0.35, 1.03]). Based on surface under the cumulative ranking curve (SUCRA), acupoint catgut embedding (ACE) was the most recommended in decreasing testosterone levels(SUCRA = 81.7%). Compared with placebo, electro-acupuncture (E-acupuncture) was significantly effective in decreasing Ferriman-Gallwey scores in PCOS patients (MD: 1.52; 95% CrI [0.50, 2.53]), and it was also the preferred choice for reducing Ferriman-Gallwey scores (SUCRA = 84.9%). In terms of metabolic status, ACE was regard the most recommended in reducing body mass index (SUCRA = 90.9%) and waist hip rate (SUCRA = 95.3%); acupuncture was considered as the top preferred option in reducing triglyceride (SUCRA = 79.3%) and high-density lipoprotein (SUCRA = 54.8%); E-acupuncture was possibly the preferred choice for reducing low-density lipoprotein (SUCRA = 75.2%) and fasting blood glucose (SUCRA = 64.6%), and medicine was the preferred choice for reducing homeostasis model assessment of insulin resistance. For sexual hormone disturbance, ACE served as the most recommended option in reducing luteinizing hormone (LH) (SUCRA = 73.3%) and LH/follicle-stimulating hormone(FSH) ratio (SUCRA = 80.9%). For infertility, acupuncture acted as the preferred choice in increasing the pregnancy rate (SUCRA = 76.6%). Sensitivity analyses indicated that the results were generally robust.

Conclusions: No single acupuncture method is the optimal method for all indicators in PCOS patients. Clinically, clinicians may select acupuncture treatment based on patients' primary clinical concerns, acknowledging the limitations of current evidence and individualizing treatment decisions. These findings remain to be further verified by rigorously designed studies due to limitations of existing clinical studies and evidence.