Mapa de evidências sobre a efetividade clínica da medicina antroposófica: informe executivo / Evidence map on the clinical effectiveness of anthroposophic medicine: executive report

O mapa apresenta uma visão geral das evidências sobre os efeitos da Medicina Antroposófica, referida na PNPIC como Antroposofia Aplicada à Saúde, em função de sua natureza multiprofissional. A partir de uma ampla busca bibliográfica foram incluídos no mapa 33 estudos de revisão que analisaram o efeito de intervenções com medicamentos antroposóficos, terapias antroposóficas e terapias multimodais para desfechos clínicos. No mapa estão representadas 63 associações entre 5 tipos de intervenções e 19 desfechos clínicos, com indicação do efeito reportado e nível de confiança da evidência reportada nos estudos. Principais Achados: • As intervenções foram organizadas em três grupos: Medicamentos Antroposóficos (Viscum album ­ 22 revisões e Outros medicamentos ­ 4 revisões), Terapias Antroposóficas (Euritmia ­ 2 revisões e Outras terapias ­ 1 revisão) e Terapias Multimodais (Em Geral ­ 4 revisões). • As intervenções foram associadas a 19 desfechos ordenados em cinco grupos: Bem-estar e Qualidade de Vida, Câncer, Atenção à Saúde, Indicadores Fisiológicos e Metabólicos e Outras Condições Patológicas. • A maioria das associações foi para o grupo de desfecho Câncer, seguido pelo grupo Bem-estar e Qualidade de Vida. Dentre os desfechos, destaque para: Qualidade de Vida (12 revisões), Sobrevida (9 revisões), Segurança do Paciente (8 revisões) e Sintomas de Quimioterapia e Radioterapia (7 revisões). • Dentre as intervenções, a maioria das associações foi para Viscum album (48 associações). • As intervenções multimodais, outros medicamentos, Euritmia e outras terapias foram associadas aos desfechos: Resultado do tratamento (5 associações), Satisfação e Segurança do paciente (2 associações cada), Infecções respiratórias (3 associações), Coordenação cardiorrespiratória, Transtornos gastrointestinais e Edema (1 associação cada). Implicações para a prática e pesquisa: • Considerando os efeitos positivos reportados (em 27 associações), destaque para o uso de medicamento antroposófico Viscum album (19 associações) para os desfechos Qualidade de Vida, Segurança do Paciente e Sintomas de Quimioterapia e Radioterapia. • Quanto aos efeitos potencialmente positivos (em 21 associações), a maioria foi associado ao Viscum album (18 associações) para os desfechos: Sobrevida ao câncer, Sintomas de Quimioterapia e Radioterapia e Qualidade de Vida. • Identificaram-se efeitos inconclusivos em 15 associações para 11 diferentes desfechos, o que sugere uma necessidade de novos estudos primários sobre intervenções com medicamentos e terapias antroposóficas. • Não foram identificados estudos com ausência de efeito ou efeitos negativos.

Evidence map on the clinical effectiveness of anthroposophic medicine: executive report

The map provides an overview of the evidence on the effects of Anthroposophic Medicine, referred to in the National Policy on Integrative and Complementary Practices (PNPIC) as applied Anthroposophy in Health, due to its multiprofessional nature. Based on an extensive literature search, the map includes 33 review studies that analyzed the effects of interventions with anthroposophic medicines, anthroposophic therapies, and multimodal therapies on clinical outcomes. The map represents 63 associations between 5 types of interventions and 19 clinical outcomes, indicating the reported effect and level of confidence in the evidence reported in the studies. Key Findings: • The interventions were organized into three groups: Anthroposophic Medicines (Viscum album - 22 reviews and Other medicines - 4 reviews), Anthroposophic Therapies (Eurythmy - 2 reviews and Other therapies - 1 review), and Multimodal Therapies (Overall - 4 reviews). • The interventions were associated with 19 outcomes grouped into five categories: Well-being and Quality of Life, Cancer, Healthcare, Physiological and Metabolic Indicators, and other Pathological Conditions. • The majority of associations were found in the Cancer outcome group, followed by the Well-being and Quality of Life group. Notable outcomes included Quality of Life (12 reviews), Survival (9 reviews), Patient Safety (8 reviews), and Chemotherapy and Radiotherapy Symptoms (7 reviews). • Among the interventions, the majority of associations were related to Viscum album (48 associations). • Multimodal interventions, other medicines, eurythmy, and other therapies were associated with outcomes such as Treatment Outcome (5 associations), Patient Satisfaction and Safety (2 associations each), Respiratory Infections (3 associations), Cardiorespiratory Coordination, Gastrointestinal Disorders, and Edema (1 association each). Implications for Practice and Research: • Considering the reported positive effects (in 27 associations), the use of anthroposophic medicines Viscum album (19 associations) stands out for Quality of Life, Patient Safety, and Chemotherapy and Radiotherapy Symptoms outcomes. • Regarding potentially positive effects (in 21 associations), the majority were associated with Viscum album (18 associations) for Cancer Survival, Chemotherapy and Radiotherapy Symptoms, and Quality of Life outcomes. • Inconclusive effects were identified in 15 associations for 11 different outcomes, suggesting a need for further primary studies on interventions with anthroposophic medicines and therapies. • No studies were identified with no effect or negative effects.

Viscumalbum L. homeopathic mother tinctures: metabolome and antitumor activity

Viscum album L. is a semi-parasitic plant with antitumor activity attributed to theaqueous extracts. However, European V. album ethanolic extracts (VAE) have also demonstrated invitro activity in tumor models. Aims: Evaluate the metabolic profiles of fifty VAE harvested duringsummer and winter seasons and their antitumor activity through 2D and 3D models. Methodology:VAEwerepreparedbymacerationfrom:V.albumsubsp.albumgrowingonMalus domestica,Quercus sp.and Ulmus sp.; V. album subsp. austriacum from Pinus sylvestris; V. album subsp. abietis from Abies alba.Chemical analyses were performed through liquid chromatography coupled with high resolutionmass spectrometry and Partial Least Squares Discriminant Analysis (PLS-DA) was performed in theMetaboanalyst 4.0. The antitumor potential of the selected VAE was evaluated in 2D and 3D models(MDA-MB-231 cancer cells) by MTT, crystal violet and glycolytic pathway analysis. Results anddiscussion:Thefirst3principalcomponentsinPLS-DAexplained60%and40%ofdatavariationin positive andnegativemodesrespectively.Threegroupswereformedandshowedchemicalsimilarityamong V. album subspecies. The compounds responsible for group separation were tentativelyidentifiedas:pinobankasinornaringenin hexoside;isorhamnetin-3-hexoside,meglutolanddifferent aminoacids.ThesummerVAEat0.5%v/vinducedhighercytotoxicdamagethanthewinterpreparations, and Abies alba and Quercus sp. VAE promoted 49% and 42% reduction of tumorviability in 3D model (72h incubation), respectively. MDA-MB-231 glycolytic pathway in 2D modelshowed a decrease in the glucose consumption and extracellular lactate production. Also, PFK (6-phosphofructo-1-kinase)andPK(Pyruvatekinase)activitieswereinhibitedbyAbiesalbaandQuercus sp. VAE at 48h of incubation. Conclusion: VAE extracts showed different metabolomes andthe glycolytic pathway should be an important target involved in the inhibition of tumor growth bytheseextracts

In vitro evaluation of the effects of Viscum album homeopathic preparations on murine melanoma cells

Viscum album extract (VA) is a complementary treatment in cancer, with in vitro and in vivo cytotoxic effects on several tumor types when applied in phytochemical doses. However, highly diluted ethanolic homeopathic preparations' effects and mechanisms need further study. Aims:To assess the in vitro effects of highly diluted VA from the subspecies V. album abietis and V. album album at different potency levels in different dilution ratios on murine melanoma cells. Methodology:The VA mother tinctures (MT)from Abies alba (MTA) and Quercus robur (MTQ) were prepared with summer and winter samples, harvested in Switzerland. They were submitted to homeopathic ethanolic maceration and a subsequent dynamization process. MTA, MTQ and the following respective potencies were tested in B16F10 murine cells: 3x, 12x, 30x, 6cH, 12cH, 200cH, 2LM, 3LM, and 5LM. Dynamized water, dynamized and non-dynamized ethanol, and carboplatin were used as control groups. The mitochondrial activity and cell viability analysis were performed at 1, 24, 48, and 72 hours by in vitro incubation. MTA and MTQ harvested in summer, as well as 12x, 200cH and 5LM potencies were also tested to cell apoptosis and necrosis markers, reactive oxygens species (ROS) production, inflammatory cytokines profile, cell morphology, and migratory capacity. Results and discussion: MTA and MTQ induced a decrease in cell metabolism and higher cytotoxicity within 1 hour, with significant morphological changes and increased production of ROS and inflammatory cytokines. Both homeopathic dilutions 12x and 5LM showed an influence on cell metabolism, cell replication, and oxidative stress modulation with inflammatory cytokines, mitosis, and migration pattern changes. On the other hand, Quercus robur and Abies alba 200cH showed increased on cytotoxicity and ROS levels, respectively. Conclusion:The in vitro effects of Viscum album homeopathic solutions in melanoma cells highlight the promising antitumoral potential and reinforce the need for further research to better understanding their mechanisms of action.

Floral ontogeny and anatomy of the hemiparasitic shrub Gaiadendron punctatum and a comparison of floral characters in the tribes Gaiadendrinae and Nuytsiae (Loranthaceae) / Ontogenia floral y anatomía del arbusto hemiparasítico Gaiadendron punctatum y comparación de caracteres florales en las tribus Gaiadendrinae y Nuytsiae (Loranthaceae)

Abstract Introducction: Gaiadendron punctatum is a hemiparasitic species of Loranthaceae (Tribe Gaiadendreae) that is widely distributed in mountainous regions of Central and South America. Embryological and phylogenetic studies in the family indicate a trend towards reduction of the gynoecium and ovules, the morphology of which supports the current circumscription of Tribe Gaiadendreae (Gaiadendron and Atkinsonia). Molecular phylogenetic studies suggest that Nuytsia, Atkinsonia and Gaiadendron diverged successively, forming a grade at the base of the Loranthaceae, but support values are low. Objetive: In the present study, the floral anatomy of Gaiadendron punctatum was investigated in order to provide additional data to permit comparisons among the three basal-most genera in the Loranthaceae and reevaluate their relationships. Methods: Flowers of G. punctatum were collected at different developmental stages and serial sections were prepared and analyzed by light microscopy. Results: Inflorescence development is acropetal; the flowers are bisexual with an inferior ovary surmounted by a calyculus, a ring-shaped structure lacking vascular tissue; the ovary is comprised of seven basal locules, each with an ategmic, tenuinucellate ovule. Above the locules is a mamelon that is fused with the adjacent tissues. The androecium is comprised of seven epipetalous stamens, the anthers with fibrous endothecium dehiscence through a single longitudinal slit, releasing tricolpated pollen. Conclusions: The results of this study show that Gaiadendron and Atkinsonia share versatile, dorsifixed anthers, while Gaiadendron and Nuytsia share the same mode of anther dehiscence. On the other hand, Gaiadendron shares with members of Tribe Elytrantheae an amyliferous mamelon and an unvascularized calyculus. Combined phylogenetic analyses of morphological and molecular data are desirable to determine whether Tribe Gaiadendreae comprises a clade, a grade or if the two genera are more distantly related.

Resumen Introducción: Gaiadendron punctatum es una especie hemiparásita perteneciente a uno de los tres géneros basales de la familia Loranthaceae, siendo los otros dos Nuytsia y Atkinsonia. El género está conformado por dos especies distribuidas en regiones montañosas de Sudamérica y Centroamérica. Tanto los estudios embriológicos, como los filogenéticos, indican una tendencia hacia la reducción del gineceo y de los óvulos en la familia, cuya morfología respalda la circunscripción de la tribu Gaiadendreae (Gaiadendron y Atkinsonia). Estudios filogenéticos moleculares sugieren que Nuytsia, Atkinsonia y Gaiadendron divergieron sucesivamente, formando un grado en la base de la familia Loranthaceae, pero los valores en los que se sustenta son bajos. Objetivo: En el presente trabajo se describe la anatomía floral de la especie Gaiadendron punctatum con el objetivo de complementar la información embriológica, de manera que se pueda comparar directamente la morfología floral y los caracteres embriológicos entre los tres géneros basales de la familia Loranthaceae y reevaluar sus relaciones. Métodos: Las flores de G. punctatum fueron recolectadas en diferentes estados de desarrollo, se realizaron cortes histológicos seriados, se tiñeron con azul de astra y fucsina, y se analizaron mediante microscopía óptica. Resultados: Las inflorescencias mostraron un desarrollo acrópeto, las flores bisexuales presentaron ovario ínfero con presencia de una estructura en forma de anillo, carente de tejidos vasculares llamada calículo; el ovario se compone por siete lóculos basales, cada uno con un óvulo atégmico tenuinucelar. Por encima de los óvulos, el mamelón se fusiona con los tejidos adyacentes. El androceo está conformado por siete estambres epipétalos, las anteras presentan un endotecio fibroso y granos de polen tricolpados. La dehiscencia de las anteras es mediante una sola apertura longitudinal. Conclusiones: Los resultados del presente trabajo demuestran que Gaiadendron y Atkinsonia comparten anteras dorsifijas y versátiles, mientras Gaiadendron y Nuytsia comparten el tipo de dehiscencia anteral y por otro lado Gaiadendron comparte los caracteres de mamelón amilífero y calículo no vascularizado con la tribu Elytrantheae. La clasificación del género Gaiadendron con respecto a los dos géneros basales de la familia debe ser objeto de investigación (análisis filogenético combinado) que permita dirimir si la tribu Gaiadendrae es un clado, un grado o dos géneros más lejanamente emparentados.

Homoeopathic Viscum album (10-3) is More Cytotoxic to in vitro Culture of Human Breast Cancer Cell Line than to Human Mesenchymal Stem Cells

BackgroundBreast cancer has been considered a public health problem and homeopathic treatments are becoming increasingly recommended due to its ways of action and absence of adverse effects. MCF-7 is an adenocarcinoma of human breast cell line useful as preclinicalmodel to screen therapeutic agents such as ultra-diluted Viscum album, an European plant which extract is commonly used in cancer therapy. AIMS MCF-7 and mesenchymal stem cells (MSC) were used to evaluate the in vitrocytotoxicity of homoeopathic Viscum album 1x10-3(VA3X). Methodscells were cultured for 24 hours in controlled environment (37.5oC and 5% CO2) in 96-well plates. After this time, VA3X was added to the culture medium in concentrations varying from 10 to 100 L/mL.A control group was maintained with culture medium only. Cells were cultivated for 48 hours in these conditions for evaluation of cell viability by MTT assay. ResultsHigher cytotoxicity was observed in MCF-7 when compared to MSC, as the lower concentration of VA3X was capable of inducing tumor cell death and not healthy cell death. The MTT assay results were that 42 L/mL of VA3X reduced MCF-7 cells viability to 50% and 62 L/mL reduced MSC cells to the same percentage, what means that tumor cells are more sensible to VA3X than heathy cells. ConclusionViscum albumpresented higher cytotoxic action on human breast cancer cell line culture than on mesenchymal stem cells. This medicine is extensively used against cancer, and the use of the homoeopathic form of it brings new possibilities as no or fewer adverse effects would be present.(AU)

Variación de los perfiles de polifenoles en Ligaria cuneifolia (R. et. P) Tiegh (Loranthaceae), su estudio mediante electroforesis capilar y su relación con la actividad farmacológica. / Polyphenolic profile variation in Ligaria cuneifolia (R. et P.) Tiegh (Loranthaceae), capillary electrophoretic analysis and its relationship with the pharmacological activity

Ligaria cuneifolia (R. et P.) Tiegh. ­Loranthaceae­ es una especie hemiparásita que se desarrolla sobre diferentes hospedantes. Es conocida con el nombre vulgar de "liga" o "liguilla". Debido a su similitud morfológica, constituye el sustituto natural del "muérdago europeo", por lo cual es denominado "muérdago criollo". Las drogas vegetales son matrices complejas en las cuales múltiples componentes actúan en forma sinérgica y son responsables de la acción farmacológica. Con el fin de dar sustento científico al uso folclórico de L. cuneifolia se estudiaron distintas formas de obtención de los extractos, se evaluaron diferentes hospedantes y regiones fitogeográficas. Se desarrolló y validó un método de electroforesis capilar para construir fingerprints o perfiles cromatográficos característicos que permitan evaluar los distintos componentes con el fin de estandarizar los extractos. Se efectuó la comparación con otras técnicas cromatográficas, tales como en cromatografía en capa delgada (TLC) y líquida de alta resolución (HPLC). A su vez, se procedió al aislamiento, purificación y análisis estructural de los compuestos de interés por técnicas espectroscópicas y cromatográficas. Se identificaron diez compuestos, de los cuales cuatro son reportados por primera vez en esta especie. La electroforesis capilar probó ser una técnica adecuada para el control de calidad de los extractos y una alternativa atractiva a las técnicas cromatográficas tradicionales.

Ligaria cuneifolia (R. et P.) Tiegh. ­Loranthaceae­ is a hemiparasite plant which grows on different host trees. It is popularly referred to as "liga" or "liguilla". Due to its morphological similarity, it is considered as the natural substitute for the European mistletoe, for which is known as the "Argentine mistletoe". Herbal drugs are complex matrices in which multiple components acting synergistically are responsible for the pharmacological activity. In order to provide scientific support to the popular use of L. cuneifolia, a capillary electrophoretic method was developed and validated to build a chromatographic profile or fingerprint that allows the evaluation of different components for extract standardization. A comparison was made with other chromatographic techniques such as TLC and HPLC. Isolation, purification and structural analysis of compounds were performed by chromatographic and spectroscopic methods. Ten analytes were identified, four of which are reported for the first time in L. cuneifolia. Capillary electrophoresis proved to be an appropriate tool for the quality control of herbal drugs, as well as an attractive alternative to traditional chromatographic techniques.

Two symmetrical unsaturated acids isolated from Viscum album / 中国天然药物

In the present study, two new acetylene conjugate compounds, dibutyl (2Z, 6Z)-octa-2, 6-dien-4-yne dioate (1), and dibutyl (2E, 6E)- octa-2, 6-dien-4-yne dioate (2), were isolated from the dry stem leaves of Viscum album, along with nine known compounds (3 - 11). Their structures were confirmed on the basis of spectroscopic data. Compounds 1 and 8 showed antioxidant activity against xanthine oxidase (XOD) and 1,1-diphenyl-2-picrylhydrazyl radical 2,2-diphenyl-1-(2,4,6-trinitrophenyl) hydroxyl (DPPH), with the IC of 1.22 and 1.33 μmol·L, and the SC of 4.34 and 8.22 μmol·L, respectively.

Correlation study on chemical constitutes of cardiac glycosides in Taxillus chinensis and its Nerium indicum host by UPLC-Q-TOF-MS/MS / 中国中药杂志

To build up an identification method on cardiac glycosides in Taxillus chinensis and its Nerium indicum host, and evaluate the influence on medicine quality from host to T. chinensis, ultra-performance liquid chromatography coupled with quadrupole-time-of-flight tandem mass-mass spectrometry(UPLC-Q-TOF-MS/MS)was applied. The samples of T. chinensis(harvested from N. indicum)and its N. indicum host were collected in field. The samples of T. chinensis(harvested from Morus alba)and its M. alba host was taken as control substance. All samples were extracted by ultrasonic extraction in 70% ethanol. Chromatographic separation was performed on an ACQUITY UPLC HSS T3 C_(18)(2.1 mm×100 mm,1.8 μm)column at 40 ℃. Gradient elution was applied, and the mobile phase was consisted of 0.1% formic acid water and acetonitrile. The 0.5 μL of sample solution was injected and the flow rate of the mobile phase was kept at 0.6 mL·min~(-1) in each run. It was done to identify cardiac glycosides and explore the chemical composition correlation in T. chinensis and its N. indicum host by analyzing positive and negative ion mode mass spectrometry data, elemental composition, cardiac glycoside reference substance and searching related literatures. A total of 29 cardiac glycosides were identified, 28 of it belonged to N. indicum host, 5 belonged to T. chinensis(harvested from N. indicum host), none of cardiac glycoside was identified in T. chinensis(harvested from M. alba host). The result could provide a reference in evaluating the influence in T. chinensis medicine quality from host. It was rapid, accurate, and comprehensive to identify cardiac glycosides in T. chinensis and its N. indicum host by UPLC-Q-TOF-MS/MS.

Conocimiento local del género Arceuthobium en un área natural protegida del centro de México / Local knowledge of Arceuthobium genus in a natural protected area of the centre of Mexico

El género Arceuthobium (muérdago enano) es una de las principales plagas en los bosques templados de México, con antecedentes de uso medicinal y forrajero. El objetivo de este trabajo fue documentar el conocimiento local sobre los usos del muérdago enano en el Área Natural Protegida Nevado de Toluca, México, bajo las perspectivas emic y etic, a través de la etnobotánica. Mediante entrevistas se identificó que ambas especies (A. vaginatum y A. globosum) son conocidas como muérdago y forman parte de la flora del bosque; sin embargo, los entrevistados desconocen los efectos negativos dentro de los ecosistemas forestales de esta plaga. Destacan los usos lúdicos, como juguete y tinta, y los medicinales para el tratamiento de afecciones respiratorias y del sistema nervioso, siendo éste el primer registro para dicho género localmente. Se requieren estudios que validen el conocimiento local para su inclusión en programas locales de manejo de plagas forestales.

Arceuthobium (dwarf mistletoe) genus is one of the main pests in temperate forests of Mexico, with records of medicinal and forage uses. The objective of this work was to document local knowledge regarding uses of dwarf mistletoe in the Natural Protected Area Nevado de Toluca, Mexico, under emic and etic perspectives, through ethnobotany. Throughout interviews it was identified that both species (A. vaginatum and A. globosum) are known as mistletoe and they are part of flora in forest, however, interviewees are not aware of negative effects within forest ecosystems of this pest. It stands out ludic uses as a toy and ink, and medicinal ones for treatment of respiratory diseases and nervous system, being this the first record for such genus locally. Studies are required to validate the local knowledge for its inclusion in local programmes for management of forest pests.

Análisis de polifenoles e iniciación de cultivos in vitro de Ligaria cuneifolia (R. et P.) Tiegh (Loranthaceae) de ejemplares provenientes de la localidad La Población, provincia de Córdoba, Argentina / Analysis of polyphenols and initiation of in vitro cultures of Ligaria cuneifolia (R. et P.) Tiegh (Loranthaceae) from specimens from the town of La Población, province of Córdoba, Argentina

Ligaria cuneifolia (R. et P.) Tiegh (Loranthaceae) es una hemiparásita sudamericana que produce polifenoles con actividad hipolipemiante, citostática, inmunomoduladora, antioxidante y antimicrobiana. Nuestro objetivo fue determinar el perfil de polifenoles de ejemplares silvestres en distintos órganos y extractos, así como las condiciones más adecuadas para iniciar sus cultivos in vitro. Para el estudio fitoquímico se realizaron cromatografías en capa delgada de tipo monodimensional observándose la presencia de flavonoides, derivados hidroxicinámicos y proantocianidinas en los extractos de hojas, tallos primarios, tallos secundarios y flores. En cuanto al análisis cuantitativo se observaron altos valores de flavonoides en hojas (2,14 mg eq. de rutina por gramo de material seco) y de proantocianidinas en flores (7,52 mg eq. de catequina por gramo de material seco), compuestos responsables de las actividades biológicas mencionadas. Para la iniciación de cultivos in vitro se estudiaron diferentes aspectos: protocolo de desinfección, explanto de iniciación (hojas, pedicelos, frutos, tallos, meristemas y haustorios) y medios de cultivo base (reguladores de crecimiento y agentes antioxidantes). Los tratamientos más efectivos fueron HgCl2 0,05 - 0,2 % en una proporción de 25 explantos cada 100 ml de solución desinfectante y ácido cítrico 2,6 mM o L-cisteína 100 µM como antioxidantes. Solamente fue posible iniciar callos a partir de haustorios cultivados en medio Gamborg B5 con el agregado de ácido 2,4-dicloro-fenoxiacético 2,25 µM como regulador de crecimiento. (AU)

Observational and experimental evaluation of hemiparasite resistance in trees in the urban afforestation of Santarém, Pará, Brazil / Avaliação observacional e experimental da resistência a hemiparasitas em árvores da arborização urbana de Santarém, Pará, Brasil

ABSTRACT One of the problems affecting the quality of urban trees is their infestation by mistletoes (aerial hemiparasite plants of the order Santalales). Identification of the main types of trees infested, and of the causes of infestation patterns, can help infestation control and the planning of efficient planting regimes. In this sense, the aim of this study was to evaluate the patterns of hemiparasite infestation in trees in an Amazonian urban environment. We aimed to answer (1) which species of mistletoes occur on urban trees in the city of Santarém, in the Brazilian Amazon; (2) what is the proportion and intensity of infestation on infected trees; and (3) if differences in infestation rates among tree species can be explained by mistletoe-tree compatibility. We assessed mistletoe incidence and intensity of infestation on trees in the main avenues of the city. To evaluate the role of mistletoe-tree compatibility in the observed parasitism patterns, we carried out a seed inoculation experiment with seeds of the most abundant mistletoe, Passovia theloneura. Seeds were planted on three tree species (Andira inermis, Handroanthus serratifolius, and Mangifera indica). The overall infestation rate was 19.3%, with exotic tree species more infested than natives. The experiment showed that incompatibility between P. theloneura and the native H. serratifolius is primarily responsible for the observed non-infestation. Mistletoes germinated on A. inermis grew better than those on M. indica, contrary to the infestation prevalence found in the field, suggesting that patterns of infestation are also influenced by seed deposition processes.

RESUMO Um dos problemas que afetam a qualidade das árvores urbanas é sua infestação por ervas-de-passarinho (hemiparasitas aéreas da ordem Santalales). Identificação das principais espécies de árvores infestadas e das causas da infestação pode ajudar a controlar as ervas-de-passarinho e orientar o plantio de novas espécies de árvores. Nesse sentido, o objetivo deste estudo foi avaliar o padrão de infestação de hemiparasitas em árvores em um ambiente urbano da Amazônia. Nós buscamos responder: (1) quais espécies de ervas-de-passarinho ocorrem nas árvores urbanas da cidade de Santarém, na Amazônia Brasileira, (2) qual é a proporção e intensidade de infestação nas árvores afetadas e (3) se diferenças nas taxas de infestação entre as espécies de árvores podem ser explicadas pela compatibilidade entre ervas-de-passarinho e hospedeiro. Nós amostramos árvores nas principais avenidas da cidade. Para avaliar o papel da compatibilidade entre a erva-de-passarinho e o hospedeiro nos padrões de parasitismo observados, conduzimos um experimento de inoculação de sementes com a erva-de-passarinho mais abundante, Passovia theloneura. Sementes foram plantadas em três espécies de hospedeiros (Andira inermis, Handroanthus serratifolius e Mangifera indica). A taxa de infestação foi de 19,3%, com espécies exóticas mais infestadas do que as nativas. O experimento mostrou que a incompatibilidade entre P. theloneura e a nativa H. serratifolius é o principal fator responsável por sua não infestação. As ervas-de-passarinho que germinaram em A. inermis cresceram melhor do que aquelas em M. indica, contrário à prevalência de infestação encontrada no campo, o que sugere que os padrões de infestação são também influenciados por processos de deposição de sementes.

Use of GC/MS to identify chemical constituents and cytotoxic activity of the leaves of Phoradendron mucronatum and Phoradendron microphyllum (Viscaceae)

ABSTRACT Phoradendron mucronatum and P. microphyllum are plants that found in tropical and subtropical areas, used in traditional medicine and popularly known as mistle-thrush. The aim of this study was to identify the chemical constituents of different leaf extracts from P. mucronatum and P. microphyllum and assess cytotoxic activity against strains from a human tumour cells. Extracts obtained with hexane, dichloromethane, chloroform and ethyl acetate from the leaves were analysed by gas chromatography coupled with mass spectrometry (GC-MS) and the cytotoxicity was assessed by the MTT method (bromide (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide)). The tested human tumour cells were NCI-H292 (human pulmonar mucoepidermoid carcinoma), MCF-7 (human breast adenocarcinoma) and HEp-2 (epidermoid carcinoma of the larynx). Analysis by GC/MS of the extracts from leaves of P. microphyllum and P. mucronatum detected 51 different compounds, such as alkaloids, diterpenes, triterpenes, sterols, alcohols, aldehydes, fatty acids and hydrocarbons. In the cytotoxic evaluation, hexane and ethyl acetate extracts from the leaves P. microphyllum inhibited cell growth of NCI-H292 strains (72.97%) and HEp-2 (87.53%), respectively. The extracts of P. mucronatum species showed an inhibitory effect towards NCI-H292 (83.19%/hexane), MCF-7 (88.69%/dichloromethane) and HEp-2 (93.40%/hexane). The extracts showed cytotoxic activity against the tested strains, especially the P. mucronatum, which presented the highest percentages of inhibition of cell growth.

Acute Respiratory Distress Syndrome after Viscum album Pleurodesis for Primary Spontaneous Pneumothorax

A 52-year-old male patient who underwent multiple wedge resections experienced postoperative acute respiratory distress syndrome in both lungs after Viscum album pleurodesis. Despite initial rapid deterioration in clinical condition and rapid progression of bilateral lung infiltration, he exhibited a relatively smooth clinical recovery with marked response to glucocorticoid treatment. Our case report suggests that care must be taken to guard against the development of acute respiratory complications in the use of Viscum album for pleurodesis. However, in view of the clinically benign course, initial aggressive management of complications can prevent suffering and sequelae.

Chemical Pleurodesis Using Doxycycline and Viscum album Extract

BACKGROUND: In chemical pleurodesis for managing pulmonary air leak, tetracycline derivatives are commonly used, and their effectiveness has been established in many studies. Recently, a Viscum album extract was used in chemical pleurodesis. We compared the effects of V. album with those of a tetracycline derivative (doxycycline) to demonstrate the therapeutic effectiveness of the V. album extract in chemical pleurodesis for managing pulmonary air leak. METHODS: Between October 2010 and October 2016, chemical pleurodesis was performed using doxycycline in 40 patients and the V. album extract in 37 patients. Thirty-three patients were in the postoperative state after pulmonary resection, and 44 patients suffered from spontaneous pneumothorax. RESULTS: No statistically significant difference in the success rate was observed between the 2 groups (V. album extract and doxycycline). In both groups, chest pain was the most common complication. More patients in the doxycycline group complained of severe chest pain (42.1% vs. 13.5%, p=0.006). In the V. album extract group, 24.3% of the patients required a chest tube to drain the pleural effusion after cessation of the air leak (doxycycline group: 5%, p=0.022). Further, the amount of pleural effusion drained on the day after the last chemical pleurodesis in the V. album extract group was greater than that in the doxycycline group (162.2±170.2 mL vs. 97.0±77.2 mL, p=0.032). All patients were discharged from the hospital without complications after pleural effusion drainage. CONCLUSION: Considering that treatment using the V. album extract was less painful, V. album might be a feasible option for chemical pleurodesis. However, pleural effusion should be monitored carefully when using V. album extract for treating patients suffering from air leak.

Anatomía Floral de Peristethium leptostachyum (Loranthaceae) / Floral anatomy of Peristethium leptostachyum (Loranthaceae)

ResumenPeristethium leptostachyum es una especie hemiparásita de la familia Loranthaceae, distribuida en Colombia, Costa Rica, Ecuador, Perú, Venezuela y Panamá. Previamente tratada como Struthanthus leptostachyus, la especie fuerecientemente fue reubicada en Peristethium junto con otras que previamente estaban en los géneros Cladocolea y Struthanthus. La decisión de reconocer a Peristethium como género es controversial y fue tomada con base en caracteres de la inflorescencia y de la flor; en tanto que la monofilia de los tres géneros nombrados es incierta. En esta investigación se estudió la morfoanatomía de flores e inflorescencias de Peristethium leptostachyum, detallando la estructura del androceo y gineceo, así como los procesos de microgametogénesis y megagametogénesis; adicionalmente se realizaron comparaciones con especies afines y precisiones en relación con las diagnosis previas. Se recolectaron flores en diversas fases de desarrollo en Santa María (Boyacá-Colombia), se prepararon y analizaron bajo microscopio secciones histológicas teñidas con astrabluefucsina, además de disecciones bajo estereomicroscopio. Los resultados mostraron que P. leptostachyum comparte caracteres inflorenciales con Cladocolea (inflorescencia determinada, flor terminal ebracteada), pero también con Struthanthus (pares de tríadas a lo largo del eje, brácteas caducas y flores actinomorfas). Las flores de P. Leptostachyum de Santa María son claramente hermafroditas, con androceos y gineceos totalmente desarrollados; lo cual contradice la descripción hecha por Kuijt que reporta una condición dioica para esta especie. El androceo resultó afín al de Struthanthus vulgaris, con tapetum glandular y microsporogénesis simultánea; en contraste, Cladocolea loniceroides presenta tapetum periplasmodial y microesporogénesis sucesiva. El gineceo de P. leptostachyum, al igual que en Cladocolea, Struthanthus y Phthirusa, es unilocular con mamelón y tejido arquesporial orientado hacia el estilo, el cual es sólido y con tejido amilífero. P. leptostachyum es afín a Cladocolea loniceroides y difiere de Struthanthus vulgaris por presentar varios sacos embrionarios y pelvis (hipostasa) no lignificada. La presencia de un canal estilar sólido se propone como sinapomorfía de la tribu Psittacanthinae. Dado que P. Leptostachyum comparte caracteres anatómicos florales tanto con Cladocolea como con Strutanthus, la relación entre estos tres géneros no queda resuelta, se requieren estudios filogenéticos para establecer esta relación y poner a prueba las hipótesis de monofilia de cada uno de ellos.

AbstractPeristethium leptostachyum is a hemiparasite species of the family Loranthaceae, distributed in Colombia, Costa Rica, Ecuador, Peru, Venezuela and Panama. Previously treated as Struthanthus leptostachyus, the species was recently transferred to Peristethium together with other species of Cladocolea and Struthanthus. The present research describes the inflorescence and floral morphoanatomy of Peristethium leptostachyum, detailing the structure of the androecium and gynoecium and the processes of microgametogenesis and megagametogenesis, thus allowing comparison with Struthanthus and Cladocolea. Flowering material was collected in February and August 2012, in Santa María, Boyacá, Colombia. Histological sections were prepared and stained with astrablue-fuchsin and floral dissections were performed under a stereomicroscope. Peristethium leptostachyum shares inflorescence characters with Cladocolea (determinate inflorescence, ebracteate terminal flower), but also with Struthanthus (pairs of triads along the axis, deciduous bracts and actinomorphic flowers). The flowers of P. leptostachyum from Santa María are clearly hermaphrodites with androecium and gynoecium fully developed. This observation contradicts the description by Kuijt who reported this species to be dioecious. The androecium was observed to be similar to that of Struthanthus vulgaris, with a glandular tapetum and simultaneous microsporogenesis; in contrast, Cladocolea loniceroides has a periplasmodial tapetum and successive microsporogenesis. The gynoecium of P. leptostachyum, like that of Cladocolea, Struthanthus and Phthirusa, has a unilocular ovary with a mamelon and arquesporial tissue isoriented towards the style, which in turn is solid and amyliferous. Peristethium leptostachyum is similar to Cladocolea loniceroides and differs from Strutanthus vulgaris in presenting multiple embryo sacs and an unlignified pelvis (hipostase). The presence of a solid stylar canal is proposed as a synapomorphy of the tribe Psittacanthinae. Given that P. leptostachyum shares characters with both Cladocolea and Struthanthus generic placement cannot be clearly determined on the basis of anatomical evidence. Phylogenetic studies that include representative species of all three genera are desirable to test hypotheses of monophyly. The sexual system observed here in P. leptostachyum is different from that reported by Kuijt and more studies are needed to identify the factors (geographic, ecological, etc.) that influence this variation. Rev. Biol. Trop. 64 (1): 341-352. Epub 2016 March 01.

Anti-Inflammatory Properties of Flavone di-C-Glycosides as Active Principles of Camellia Mistletoe, Korthalsella japonica

The chemical components and biological activity of Camellia mistletoe, Korthalsella japonica (Loranthaceae) are relatively unknown compared to other mistletoe species. Therefore, we investigated the phytochemical properties and biological activity of this parasitic plant to provide essential preliminary scientific evidence to support and encourage its further pharmaceutical research and development. The major plant components were chromatographically isolated using high-performance liquid chromatography and their structures were elucidated using tandem mass spectrometry and nuclear magnetic resonance anlysis. Furthermore, the anti-inflammatory activity of the 70% ethanol extract of K. japonica (KJ) and its isolated components was evaluated using a nitric oxide (NO) assay and western blot analysis for inducible NO synthase (iNOS) and cyclooxygenase (COX)-2. Three flavone di-C-glycosides, lucenin-2, vicenin-2, and stellarin-2 were identified as major components of KJ, for the first time. KJ significantly inhibited NO production and reduced iNOS and COX-2 expression in lipopolysaccharide-stimulated RAW 264.7 cells at 100 μg/mL while similar activity were observed with isolated flavone C-glycosides. In conclusion, KJ has a simple secondary metabolite profiles including flavone di-C-glycosides as major components and has a strong potential for further research and development as a source of therapeutic anti-inflammatory agents.

Flora of the State of Paraíba, Brazil: Loranthaceae Juss / Flora do Estado da Paraíba, Brasil: Loranthaceae Juss

The family Loranthaceae Juss., characterized by its parasitic habit, is rarely studied in Brazil. Current research provides a taxonomic survey of Loranthaceae in the State of Paraiba, northeastern Brazil, in which ten species belonging to four genera have been recorded: Passovia (one species), Psittacanthus (two species), Pusillanthus (one species) and Struthanthus (six species). Struthanthus concinnus Mart. was found for the first time in the state of Paraíba. A key to the species identification and taxonomic descriptions is presented, with images, geographic distribution and host data.

A família Loranthaceae Juss. é caracterizada pelo hábito parasítico e é ainda escassamente estudada no Brasil. Este trabalho realizou o levantamento taxonômico de Loranthaceae no Estado da Paraíba, nordeste do Brasil, onde dez espécies pertencentes a quatro gêneros foram registradas: Passovia (1 espécie), Psittacanthus (2 espécies), Pusillanthus (1 espécie) e Struthanthus (6 espécies). Struthanthus concinnus Mart. foi registrada pela primeira vez para a flora do Estado da Paraíba. Uma chave para a identificação das espécies e descrições taxonômicas é apresentada, com imagens, dados de distribuição geográfica e de hospedeiros também fornecidos.

Flora of the State of Paraíba, Brazil: Loranthaceae Juss / Flora do Estado da Paraíba, Brasil: Loranthaceae Juss

The family Loranthaceae Juss., characterized by its parasitic habit, is rarely studied in Brazil. Current research provides a taxonomic survey of Loranthaceae in the State of Paraiba, northeastern Brazil, in which ten species belonging to four genera have been recorded: Passovia (one species), Psittacanthus (two species), Pusillanthus (one species) and Struthanthus (six species). Struthanthus concinnus Mart. was found for the first time in the state of Paraíba. A key to the species identification and taxonomic descriptions is presented, with images, geographic distribution and host data.

A família Loranthaceae Juss. é caracterizada pelo hábito parasítico e é ainda escassamente estudada no Brasil. Este trabalho realizou o levantamento taxonômico de Loranthaceae no Estado da Paraíba, nordeste do Brasil, onde dez espécies pertencentes a quatro gêneros foram registradas: Passovia (1 espécie), Psittacanthus (2 espécies), Pusillanthus (1 espécie) e Struthanthus (6 espécies). Struthanthus concinnus Mart. foi registrada pela primeira vez para a flora do Estado da Paraíba. Uma chave para a identificação das espécies e descrições taxonômicas é apresentada, com imagens, dados de distribuição geográfica e de hospedeiros também fornecidos.

Morfoanatomia foliar de phoradendron obtusissimum(miq ) eichler (viscaceae), "ka'a votyre'y", utilizado con fines medicinales en una comunidad de Colonia Independencia, Paraguay / Leaf morphoanatomy of Phoradendron obtusissimum(Miq) Eichler (V iscaceae), "ka'avotyre'y", used for medicinal purposes in a community of Colonia Independencia, Paraguay

Resumen: El "ka'avotyre'y", Phoradendron obtusissimum (V iscaceae), es una especie empleada con fines medicinales en Paraguay para tratar enfermedades hepáticas. El presente trabajo se desarrolló dentro del marco del proyecto "Conservación, fortalecimiento y uso sostenible de la flora de Itá Azul y San Gervasio, Colonia Independencia, Reserva de Recursos Manejados Ybytyruzu, Paraguay" y tuvo por objetivo describir la morfoanatomía de P . obtusissimum. Los caracteres diferenciales son: estomas paracíticos en ambas epidermis, índice estomático en epidermis adaxial (5,71)-6,62-(8,33) y en epidermis abaxial (6,45)-1 1,20-(14,29); presencia de drusas en todo el mesófilo. Se presentan así elementos de diagnóstico útiles a la hora de identificar a la especie estudiada. Palabras clave: Phoradendron obtusissimum, morfoanatomía, planta medicinal.