ABSTRACT
Abstract Introduction: The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the inability of antidiuretic hormone (ADH) suppression, compromising the mechanisms of water excretion and urinary concentration. It manifests as hyponatremia and its symptoms, especially neurological. There are many causes that trigger such disease, notably: central nervous system disorders, malignant neoplasm, drugs and others. Case Report: A 65 years female hypertensive patient presented clinical and laboratory manifestations of hyponatremia due to SIADH. It happened twice under use of herbal medication for osteoarthritis treatment. Discussion: The drug-related hyponatremia can be triggered by direct effect of the drug or by association with SIADH. The clinical manifestations presented could have been related to psychiatric condition and may have severe outcome if not properly diagnosed. The association of an herbal medicine to SIADH could be confirmed after a new episode of hyponatremia related to Harpagophytum procumbers reintroduction. Our literature review did not find this herbal medicine associated with SIADH, so far. Conclusion: SIADH may be caused by herbal medicine described from now on their association in the literature.
Resumo Introdução: A síndrome da secreção inapropriada do hormônio antidiurético (SIADH) consiste na incapacidade de supressão do hormônio antidiurético (ADH), comprometendo os mecanismos de excreção da água e concentração urinária. Possui como manifestações a hiponatremia e seus sintomas, sobretudo neurológicos. Há variadas causas que desencadeiam tal distúrbio, a se destacarem: distúrbios do sistema nervoso central, neoplasias malignas e drogas, dentre outros. Relato de Caso: Paciente feminina, 65 anos, hipertensa, apresentando manifestações clínicas e laboratoriais correspondentes à hiponatremia. O fato ocorreu em duas ocasiões em vigência de medicação fitoterápica para tratamento de osteoartrite. Discussão: A hiponatremia relacionada às drogas pode ser provocada pelo efeito direto do medicamento ou por desencadear SIADH. As manifestações clínicas apresentadas poderiam ter sido atribuídas a um quadro psiquiátrico, o que poderia ter desfecho grave, caso não diagnosticada corretamente. A associação de um fitoterápico à SIADH pôde ser confirmada após novo episódio de hiponatremia relacionado à reintrodução do Harpagophytum procumbers. Nossa revisão da literatura não encontrou este fitoterápico associado à SIADH, até o momento. Conclusão: SIADH pode ser ocasionada por medicamento fitoterápico doravante descrita sua associação na literatura.
Subject(s)
Humans , Female , Middle Aged , Plant Preparations/adverse effects , Harpagophytum , Inappropriate ADH Syndrome/chemically induced , Phytotherapy/adverse effectsABSTRACT
The rheumatologic diseases like osteoarthritis, rheumatoid arthritis, lowback pain and fibromyalgia are very common. The synthetic drugs available for treatment of these diseases have low efficacy and considerable adverse effects. Numerous approaches are used as alternatives and complementary to synthetic drugs to treat these diseases. One of the approaches is use of herbal medications. Here, the effects of medicinal plants and herbal active constituents used in treatment of these diseases including gammalinolenic acid, glucosamine, devil's claw [Harpagophytum procumbens], Ocimum species, Salix species, feverfew [Tanacetum parthenium], Tripterygium wilfordii, Uncaria species, nettle [Urtica dioica], ginger [Zingiber officinale], turmeric [Curcuma longa], chicory [Cichorium intybus], dog rose [Rosa canina] and avocado/soybean unsaponifiables obtained from search for english articles published in the databases PubMed and SCOPUS from 1966 to the end of 2011 using the keywords including the scientific, common and traditional names of plants are reviewed. Limited research has been conducted on the antirheumatic effects of these plants and active constituents so far. Thus it seems that further research to determine the mechanisms of action, drug interactions, efficacy and safety of medicinal plants and herbal active constituents potentially useful in treatment of these diseases are warranted
Subject(s)
Osteoarthritis/therapy , Arthritis, Rheumatoid/therapy , Low Back Pain/therapy , Fibromyalgia/therapy , Glucosamine , Harpagophytum , Ocimum , Salix , Tripterygium , Tanacetum parthenium , Uncaria , Urtica dioica , Curcuma , Zingiber officinale , Cichorium intybus , Rosa , Persea , Glycine maxABSTRACT
Peripheral nerve injuries are a commonly encountered clinical problem and often result in a chronic pain and severe functional deficits. c-Fos expression is sometimes used as a marker of increased neuronal activity. We have developed herbal bath "HAC" for pain control using the following herbs: Harpagophytum procumbens, Atractylodes japonica, and Corydalis tuber. In the present study, we investigated the effects of herbal bath "HAC" on the recovery rate of the locomotor function and the expression of c-Fos in the ventrolateral periaqueductal gray (vlPAG) region of brain following sciatic crushed nerve injury in rats. Walking track analysis for the evaluation of functional recovery and immunohistochemistry for the c-Fos expression were used for this study. In the present results, characteristic gait change with dropping of the sciatic function index (SFI) was observed and c-Fos expression in the vlPAG was suppressed following sciatic crushed nerve injury in rats. Immersion into herbal bath "HAC" enhanced SFI value and restored c-Fos expression in the vlPAG to the control value. These results suggest that herbal bath "HAC" might activate neurons in the vlPAG, and it facilitates functional recovery from peripheral nerve injury. Here we showed that herbal bath "HAC" could be used as a new therapeutic intervention for pain control and functional recovery from peripheral nerve injury.
Subject(s)
Animals , Rats , Atractylodes , Baths , Brain , Chronic Pain , Corydalis , Gait , Harpagophytum , Immersion , Immunohistochemistry , Neurons , Periaqueductal Gray , Peripheral Nerve Injuries , Track and Field , WalkingABSTRACT
OBJETIVO: O presente estudo avaliou o efeito dos extratos de H. procumbens e suas frações na atividade da COX-1 e COX-2 e produção de NO em ensaio de sangue total de voluntários sadios e pacientes com OA. MÉTODOS: A atividade da COX-1 foi determinada através da produção de TxB2 por plaquetas e da COX-2 pela produção de PGE2 por monócitos estimulados por LPS. A produção de NO2 -/NO3 - foi determinada por reação de Griess. Os ensaios in vitro foram realizados por incubação do extrato do extrato de H.procumbens e frações em sangue total. Os controles inibidores da atividade da COX-1 e COX-2 foram indometacina e etoricoxibe. A atividade enzimática das COXs e produção de NO foram avaliadas antes e após o tratamento com garra-dodiabo em pacientes com OA de coluna lombar. RESULTADOS: O tratamento com garra-do-diabo foi eficaz clinicamente e aumentou a atividade da COX-1 e COX-2 basal sem LPS. O extrato bruto do H. procumbens não alterou a atividade das COX. Entretanto, o harpagosideo inibiu a atividade da COX-1, COX-2 e a produção de NO. CONCLUSÃO: A garra-do-diabo mostrou-se eficaz no tratamento de pacientes com OA de coluna lombar. O harpagosideo deve ser alvo estudos específicos.
OBJECTIVE: The present study evaluated the effect of H. procumbens extracts and its fractions on COX-1 and COX-2 activity and NO production in whole blood assays of volunteers and OA patients. METHODS: The COX-1 and COX-2 activity was quantified as platelet TXB2 production in blood clotting and as PGE2 production in heparinized LPS-stimulated whole blood, respectively. Total NO2 -/NO3 - was determined by Griess reaction. In vitro assays were performed through incubation of the extract and fractions with whole blood from volunteers. Controls of the inhibition of COX-1 and COX-2 activity were indomethacin and etoricoxib. Before and after treating OA lumbar spine patients with devil's claw the COX-1 and COX-2 activity and NO production were evaluated in their whole blood. RESULTS: The treatment promoted clinical improvement and increase in the activity of COX-1 and basal COX-2, without LPS. The crude extract did not affect the activity of both enzymes. However, harpagoside inhibited COX-1 and COX-2 activity and NO production. CONCLUSION: Devil's claw promoted clinical improvement of OA patients and harpagoside must be focus of specific studies.
Subject(s)
Cyclooxygenase 1 , Cyclooxygenase 2 , Harpagophytum , Iridoids/therapeutic use , Nitric Oxide , OsteoarthritisABSTRACT
Harpagophytum procumbens [Harpago.] is a herpaceous plant. It has been used in traditional medicine for treatment of many diseases including headache, rheumatic diseases and inflammations. The aim of the present study is to evaluate the analgesic and anti-inflammatory effects of the herpal plant on the experimentally-induced acute inflammation [carrageenan-induced edema test] and chronic inflammation [Freund's adjuvant-induced arthritis] in adult male albino rats. In addition, these actions were compared with that of indomethacin and rofecoxib. The results of the present work revealed that Harpago. aqueous extract and indomethacin, completely, prevented the carrageenan-induced paw edema. Also, they significantly increased the paw withdrawal latency [reaction time] that reflects the analgesic effect of the drugs. The intensity of the latter effects reached maximum level when measured after 1-2 hours for both drugs. Meanwhile, rofecoxib produced significant reduction in the paw edema that induced by carrageenan and elicited an analgesic effect that reached maximum level after 3-4 hours from carragednan injection. Concerning the chronic anti-inflammatory effects, Harpago-protected the knee joint from the Freund's adjuvant-induced degenerative changes, however, this protection is much less than that produced by each of indomethacin or rofecoxib. Thus, it could be concluded that Harpagophytum procumbens has analgesic and anti-inflammatory effect in the acute and chronic inflammatory conditions which is more prominent in the acute and subacute inflammations; and its duration of action is similar to indomethacin, but shorter than that of rofecoxib