BMC Complementary Medicine and Therapies最新文献

Introduction: Anzi Tiaochong Fang (ATF) is a traditional Chinese medicine (TCM) Fangji widely used to treat antiphospholipid syndrome-related recurrent pregnancy loss (APS-RPL). This study aimed to identify the quality markers and elucidate the mechanisms of ATF in treating APS-RPL.

Methods: Chemical, network pharmacology, and in vitro verification were employed to identify quality markers and mechanisms of ATF. HPLC-MS/MS was used to identify and quantify ATF compounds. APS-RPL targets were identified using databases such as HERB, similarity ensemble approach, PharmMapper, Swiss Target Prediction, Gene Expression Omnibus, Genecards, and DisGeNET. GO and Reactome analyses were conducted using KOBAS-i. In vitro verification was performed using CCK-8, FDA staining, and ELISA.

Results: This study identified 23 compounds and 942 targets, including 132 APS-RPL targets and 42 targets between ATF and APS-RPL. GO analysis demonstrated significant enrichment in cytokine-mediated signaling pathway, positive regulation of angiogenesis, response to hypoxia, inflammatory response, and platelet degranulation. Reactome analysis indicated significant enrichment in Immune System, Cytokine Signaling in the Immune system, Signaling by Interleukins, Platelet activation, signaling and aggregation, and Signaling by VEGF. Core targets identified included VEGFA, ALB, TNF, IL-6, and STAT3, with liquiritigenin, nobiletin, ginsenoside Rb1, and astragalin identified as quality markers. In vitro experiments demonstrated that ATF promoted HTR-8/SVneo cell viability, significantly reduced TNF-α and IL-1β levels, and upregulated IL-6.

Conclusions: These findings contribute to the identification and quantification of potential quality markers and elucidate the molecular mechanisms of ATF, thereby supporting its therapeutic potential in the treatment of APS-RPL.

Background: Amongst all neoplastic diseases, breast cancer represents a major cause of death among the female population in developed and developing countries. Since alkaloid drugs are commonly used in chemotherapy to manage this disease, this study investigated the anti-proliferative effectiveness of alkaloid-rich fractions of Senna didymobotrya leaves only and with laser irradiation against MCF-7 breast cancer cells.

Method and materials: A powdered sample of the plant leaves was extracted with 50% ethanol, filtered and their pH was adjusted with acid and base solution followed by partitioning with chloroform and ethyl acetate solvents. Cells were treated with 240 μg/mL of the respective extracts, while those in the photodynamic therapy groups, cells were exposed to laser (405 nm wavelength and 10 Jcm^-2) irradiation 6 h post extracts' administration.

Results: Treatment with the S. didymobotrya leaves alkaloid extracts significantly decreased the ATP concentration and overall viability of the MCF-7 cells. Reactive oxygen species (ROS) levels in cell groups treated with the extracts and laser light were considerably higher than in experimental groups treated with only the extracts. Moreover, the molecular docking analysis revealed the involvement of only hydrophobic bonds in the interactions of the plant's alkaloid-derived phytoconstituents' with selected cancer protein biomarkers.

Conclusion: Although the in silico analysis suggests that the plant-identified alkaloid phytoconstituents inhibition of estrogen receptor-alpha, human epidermal growth factor receptor-2 and progesterone receptor proteins involved in breast cancer pathogenesis could explain a possible mechanism for the observed anticancer effect, more detailed in vitro molecular experiments are necessary to confirm these findings.

Background: This study investigated whether a sound intervention tuned to 432 Hz (Hz) yields differential effects on cardiovascular parameters and psychological outcomes compared to 443 Hz, which is the concert pitch in German professional orchestras.

Methods: Using a randomized cross-over design, patients with cancer were recruited to receive both a 15-minute sound intervention with a body monochord tuned to 432-443 Hz. Before (pre) and after (post) intervention, cardiovascular parameters were measured using the VascAssist2.0. In addition, visual analogue scales (VAS) for emotional well-being, anxiety, stress, pain and sadness were also assessed pre and post intervention.

Results: 43 patients (8 male, 35 female) with a median age of 61 years (range 35-86) were included. Both interventions led to a significant reduction in heart rate with a more pronounced effect for 432 Hz (median reduction - 3 bpm (432 Hz) vs. median reduction - 1 bpm (443 Hz), p = 0.04). While heart rate variability was increased exclusively by 432 Hz (median increase + 3 ms, p = 0.01), both vascular resistance (median reduction - 5%, p = 0.008) and stiffness (median reduction %, p = 0.04) were significantly reduced by 432 Hz, which was not observed at 443 Hz. Nevertheless, these effects were not significantly different compared to 443 Hz. On the other hand, 432 Hz led to a reduced pulse wave velocity (median reduction - 0.5 m/s, p < 0.001), which was also significantly different compared to 443 Hz (p < 0.001). Improvement in VAS was observed for both groups, with significant increases in emotional well-being and reduction in fatigue, anxiety and stress for both intervention timepoints, although the majority showed no increased VAS scores even before the intervention (median values 0 for anxiety and stress).

Conclusion: Sound interventions tuned to 432-443 Hz exert both positive effects in cancer patients. While psychological outcomes are improved by both interventions, 432 Hz leads to a more pronounced but not significantly different effect to 443 Hz on objective cardiovascular parameters, which reflect deeper relaxation.

Background: Patient engagement (PE) in clinical trials has gained importance yet remains uncommon, particularly in patients with mild cognitive impairment (MCI), a critical precursor to Alzheimer's disease (AD). Cannabidiol (CBD) shows potential in slowing MCI progression due to its neuroprotective and anti-inflammatory properties. In CBD research, PE is underutilized too. To design a study on CBD for MCI, we administered an online survey to individuals with MCI to better understand their preferences for trial setup and outcomes.

Methods: We asked 209 individuals with MCI to complete an online survey assessing (i) willingness to participate in a trial using CBD; (ii) importance of improvements in various domains; (iii) acceptance of adverse events (AEs); (iv) reasons for AE-related dropout; (v) willingness to undergo blood sampling and lumbar puncture to assess AD pathology; and (vi) willingness to participate in a trial with a 50% chance of receiving a placebo. Data were analyzed with descriptive statistics.

Results: N = 118 agreed to participate and N = 88 completed the survey. Participants prioritized improvement in cognitive abilities (87.5%), followed by quality of life (63.6%), daily activities (55.7%), sleep (55.7%), pain (52.3%), mood (52.3%), behavior (48.9%), and anxiety (43.2%). Headache (55.7%) was the least accepted AE followed by nausea (46.6%), fatigue (35.2%), and diarrhea (35.2%). Persistent diarrhea (90.9%) and severe fatigue (84.1%) were the main reasons for potential dropout. While most would undergo blood sampling (67.0%), only a minority (21.6%) would accept lumbar puncture. One-third were ready to participate (34.1%), while 54.5% were interested pending details. Among those in favor of participation, 71.6% would participate even with a 50% chance of placebo.

Conclusions: Our study identified cognitive improvement as highly relevant for patients, indicating cognitive assessment tools as primary endpoints in MCI research. Given concerns about AEs, dose titration should be carefully considered to enhance acceptance and prevent AEs. Blood sampling seems well-accepted for AD biomarker assessment. Despite potential AEs, participation in a trial using CBD for MCI is seen as attractive, even under placebo-controlled conditions. This cross-sectional study emphasizes the importance of patient engagement in designing high-quality trials for using CBD to treat MCI.

Background: Reduced cardiac autophagy, inflammation, and apoptosis contribute to cardiovascular complications caused by metabolic syndrome (MetS). It is documented that the nuclear receptor 4A2 (NR4A2) could modulate autophagy and apoptosis in cardiac complications. The aim of this investigation was to assess the therapeutic potential of luteolin, with documented beneficial properties, against MetS-associated cardiac injury.

Methods: Forty male albino Wistar rats were divided into 5 groups randomly as controls, MetS, and MetS animals treated with luteolin (25, 50, 100 mg/kg ip). The animal's weight, blood pressure, lipid profile, tolerance to glucose and insulin, and cardiac histopathology were evaluated. Moreover, troponin T, creatine kinase-myocardial band (CK-MB), inflammatory profile (IL-6, IL-1β, TNF-α), transforming growth factor-β1 (TGF-β1), oxidative stress, and matrix metalloproteinase-9 (MMP-9) were analyzed to determine the cardiac state. Cardiac NR4A2 and p53, as well as apoptotic (B-cell leukemia/lymphoma 2 [BCL-2], Caspase [CASP]-3, and CASP-9) and autophagic mediators (Sequestosome-1/p62, Microtubule-associated protein 1 A/1B-light chain 3 [LC3], and Beclin-1) were measured by RT-qPCR and ELISA.

Results: Luteolin remarkably restored MetS-induced biochemical derangements and related cardiac injury via the suppression of apoptosis, inflammation, and stress but promotion of autophagy (p-value < 0.001).

Conclusion: Current findings revealed the promising therapeutical properties of luteolin against MetS-associated cardiovascular risks.

Background: Currently, there is no agreed-upon data collection tool for comprehensively structured documentation of Iranian traditional medicine (ITM) from the information management perspective. As ITM practice varies significantly from current medicine in diagnosis and treatment approaches, it is not appropriate to use data platforms or information systems developed for current medicine. Consequently, the collected data are non-comparable, reducing the verdicts' generalization. Therefore, this research aims to create a minimum data set (MDS) for unified reporting of ITM diseases and interventions.

Methods: This multi-phased method study was performed from December 30, 2022 to March 20, 2023. The first phase involved a literature review, the second phase utilized the Delphi technique, and the third phase focused on validating the MDS-ITM. A list of potential data items was prepared after searching scientific databases, and grey literature, as well as reviewing existing information systems, forms, and websites related to ITM. A modified Delphi technique, including a two-round survey, was then employed. A panel of 34 individuals with clinical and research experience in ITM, was selected via purposeful sampling to rate the importance of candidate data items for inclusion in the ITM-MDS using a 5-point Likert scale. Items with an agreement level of 80% or more were deemed acceptable for inclusion in the final ITM-MDS. Finally, the content validity of the developed MDS was assessed using the content validity ratio (CVR) and content validity index (CVI) criteria.

Results: Consensus was reached on an ITM-MDS containing 291 items grouped into seven categories: Patient admission, past medical history, six principles of health preservation, objective signs, subjective symptoms, examination of body systems, and care plans.

Conclusions: The development of this MDS will enable ITM care settings  to exchange information and share resources more easily. It also provides an inclusive dataset and structured documentation of medical records. This MDS can contribute to delivering high-quality care and improving clinical decision-making.

Background: The integration of herbal and orthodox medicines has gained momentum in global health, ensuring improved management of infectious diseases like malaria. This study explored the experiences of medical herbalists working in Ghana's diverse ecological zones to understand the contributions of integrated healthcare to malaria control.

Methods: A phenomenological design was employed to conduct in-depth interviews with 19 purposively sampled medical herbalists. Framework analytical approach and Donabedian's conceptual framework for quality of care were utilised in analysing the data.

Results: Findings revealed high awareness of integrated healthcare practices among participants. Medical herbalists perceived integrated care as instrumental in enhancing malaria management through factors such as improved quality assurance, increased accessibility to integrated health facilities, patient-centred care, follow-up practices, and opportunities for continuous professional development. However, structural and process-related challenges were identified, including inadequate healthcare personnel, medicines, and equipment. Additionally, limited promotional activities, non-comprehensive National Health Insurance Scheme (NHIS), and ineffective referral systems were recognised as barriers hindering the effectiveness of the integrated system and its potential contribution to malaria control.

Conclusion: Although national and health system-based challenges have thwarted the importance of integration on malaria control, medical herbalists feel optimistic about the intervention. To optimise the effectiveness of integrated healthcare in controlling malaria in Ghana would require policy modification and implementation. Future research could focus on developing healthcare frameworks, particularly for malaria, that prioritise quality service delivery within an integrated system.

Background: The demand for health management services has grown among individuals with physical disabilities. It is noteworthy that a significant proportion of this demographic has sought the services of traditional Korean medicine (TKM). Nevertheless, there is a lack of research on the characteristics of TKM utilization within this population. Therefore, this study aims to explore the characteristics of individuals with physical disabilities who utilize TKM services, to support future policy development in TKM for enhancing the health and quality of life for individuals with physical disabilities.

Methods: The study utilized a dataset from the Korea Health Panel (KHP) version 1.7, from the years 2008 to 2018. A panel analysis was conducted to analyze the correlation between the characteristics of participants and their influence of the TKM utilization.

Results: Based on the panel logistic regression analysis, the probability of TKM utilization was higher for individuals with physical disabilities who were female (p < 0.001), had a chronic musculoskeletal disorder (p < 0.001), Charlson Comorbidity Index of 1 (p = 0.025), and multiple chronic conditions (p = 0.025). Based on the panel hybrid regression analysis, those covered with Medical Aid spent less on TKM than those covered with National Health Insurance (p < 0.001), while those who were female (p < 0.001), had chronic musculoskeletal disorders (p = 0.007), or multiple chronic conditions (p = 0.007) had higher medical expenses for TKM utilization.

Conclusions: Individuals with physical disabilities accompanying nonfatal chronic musculoskeletal disorders or other chronic conditions frequently utilized TKM services. Those covered by Medical Aid spent less on TKM, while females and individuals with chronic musculoskeletal disorders or multiple chronic conditions incurred higher medical expenses for TKM. These results suggest the need for targeted interventions and policy changes to improve TKM access and address financial burdens for people with disabilities.

Background: Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD) characterized by damage and inflammation of hepatocytes. Some medicinal plants have shown antioxidant and anti-inflammatory effects on liver cells. We aimed to investigate the hepatoprotective effect of Heptex® capsules containing 200 mg of Dukung Anak (a powdered extract from aerial parts of Phyllanthus niruri) and 100 mg of Milk Thistle (a powdered extract from fruits of Silybum marianum) in patients with an apparent risk factor for NASH.

Methods: This was a phase II, randomized, double-blind, placebo-controlled, three-arm, interventional clinical trial. Patients were randomized in a 1:1:1 ratio to receive placebo, low dose (one capsule) of Heptex®, or high dose (two capsules) of Heptex®. After 36 weeks, liver enzymes, Fib-4 score, lipid profile, CAP score, and kPa score were evaluated. Patients were monitored for safety throughout the treatment duration.

Results: A total of 146 patients were enrolled in the study. A significant decrease was observed in ALT levels in the low-dose group (57 IU/L to 40 IU/L, p = 0.026) and the high-dose group (61 IU/L to 47.5 IU/L, p < 0.0001) and in AST levels in the high-dose group (43.5 IU/L to 32 IU/L, p = 0.001), with no significant difference between the relative percent change in ALT (p = 0.465) or AST (p = 0.632) between the three groups. No significant difference was revealed between the three groups regarding the median change in Fib-4 score at the end of treatment (p = 0.985). No significant change in the lipid profile was observed in any of the three groups except for the total cholesterol level, which significantly decreased from 210 IU/L to 187 IU/L, p = 0.031 in the low-dose group.

Conclusion: Heptex® capsules were safe and well tolerated over a treatment period of 36 weeks. However, the hepatoprotective effect in patients at risk of NASH still needs further assessment using more accurate investigation tools, a larger sample size, and/ or higher doses of the combination.

Trial registration: Retrospectively registered (registration date: 25/04/2022; trial registration number: NCT05343780).