Effective Medicinal Plants in the Treatment of the Cyclic Mastalgia (Breast Pain): A Review.

INTRODUCTION: Mastalgia is the most common benign breast disorder during the fertility period of women. So far a wide range of natural or complementary medicines is used to cure mastalgia. Sanitary organizations need complete and suitable details to help women, for making the proper decision for alternative treatment based on the evidence. The aim of the present study is to introduce medicinal plant-based treatments about mastalgia and summarizes clinical trials about this disorder. METHOD: The articles were provided using mixture of keywords including cyclic pain, breast, treatment, therapeutics, therapy, clinical trial, herbal, drug, mastalgia and all the probable terms, in national and international databases SID, Iran Medex, Magiran, PubMed, Scopus, Medline, Science direct and Cochrane library, in both Persian and English languages. All cross-sectional and review articles about herbal treatment of mastalgia until 2018 November were studied. RESULTS: Nineteen articles from all of the available articles (45 cases) and a sample size about of (1987 cases) were included in our study. The articles were clinical trials. The results revealed that mastalgia could be healed by Nigella sativa, Vitex agnus-castus, curcumin, Hypericum perforatum, Citrus sinensis, wheat germ, and Ginkgo biloba. CONCLUSION: Most of the evaluated medicinal plants possessing antioxidant compounds with anti-inflammatory and analgesic properties, exhibited healing effects in the treatment of mastalgia. Thus, medicinal plants can be considered in the treatment of mastalgia; however, further investigations are needed to obtain more details about their probable side effects.

A Systematic Review on Prevention and Treatment of Nipple Pain and Fissure: Are They Curable?

Averagely 80% to 90% of breastfeeding women experience the nipple pain and fissures. The important factor for successful breastfeeding is to treat this problem. This study has done as a review with the aim of analysis of the clinical trials in the field of the prevention and treatment of the nipple fissures and pain due to the importance of breastfeeding. For this purpose, the key words of sore, nipples, fissure, trauma, wound, prevention, treatment, therapeutics, therapy, clinical trial, breastfeeding and their Persian synonyms and all of their possible combinations were searched in the national databases: SID and Iran Medex and Magiran, and in the international databases: PubMed, Scopus, Medline, Science direct by May 2017. The Jadad criterion was used to assess the quality of the articles and the articles with a score of 3 or more were included in this study. Finally, 48 clinical trials were reviewed that 17 of them (sample size 1801) scored 3 or more based on the Jadad criterion. Seven articles were also in the non- drug treatment group (sample size 491) and 2 articles in the drug treatment group (sample size 337) and 8 articles in the herbal treatment group (sample size 973).The results show that menthol and warm water compress as well as teaching the correct breastfeeding methods are effective treatments to prevent and treat the nipple pain and fissures. Moreover, applying the herbal medicine for prevention and treatment of the issues raised from breastfeeding may have beneficial such as Aloe vera, Portulaca olearacea. However, more studies with a great methodology are necessary to obtain more accurate evidence.

Protective effects of hydro-ethanolic extract of Terminalia chebula on primary microglia cells and their polarization (M1/M2 balance).

Teminalia chebula (TC) has been traditionally used in the Iranian traditional medicine (ITM) and Ayurvedic medicine primarily for neurologic disorders and inflammation. Mainly, its fruits have been applied for CNS disorders. The effects of Terminalia chebula as herbal medicine with anti-inflammatory and anti-oxidant properties were aimed on lipopolysaccharide (LPS)-induced microglial inflammation. Cytotoxicity of TC extract (0-80) µg/ml on microglial cells was evaluated using the MTT assay. Also, the protective effect of TC extract concentrations with specified amount of LPS-induced mice microglial cells was studied. The concentrations of TNF-α (Tumor Necrosis Factor-α), IL-1ß (Interleukin-1ß), IL-6 and PGE-2 (Prostaglandin-E2) were evaluated using ELISA. Gene expression of TNF-α, IL-1ß, IL-6, COX-2 (Cyclooxygenase-2), iNOS and arginase-1 was also evaluated using the Real-Time PCR method. Nitrite oxide and urea were measured using biochemical methods. The studied concentrations of TC extract did not affect the viability of microglial cells but significantly protected the viability after treatment with LPS. The concentrations and expression levels of pro-inflammatory factors (TNF-α, IL-1ß, IL-6, PGE-2, COX-2) were significantly decreased after TC extract treatment in LPS-induced microglial cells with dose dependent manner. The extract also significantly decreased the levels of nitric oxide, increased urea and down regulated the expression of nitric oxide synthesis while arginase-1 expression was enhanced. Our results suggest that TC extract reduces inflammation in microglial cells and can be used as a potential anti-inflammatory agent in central nervous system inflammatory diseases.

ß-Amyrin, the cannabinoid receptors agonist, abrogates mice brain microglial cells inflammation induced by lipopolysaccharide/interferon-γ and regulates Mφ1/Mφ2 balances.

BACKGROUND: Inflammation is a primary response to infection that can pathologically lead to various diseases including neurodegenerative diseases. The purpose of this study was to evaluate the effect of ß-Amyrin, a naturally occurring pentacyclic triterpenoid compound, on inflammation induced by lipopolysaccharide (LPS) and interferone-γ (IFN-γ) in rat microglial cells. MATERIALS AND METHODS: Cytotoxicity of ß-Amyrin (3-100) µM on microglial cells was evaluated using the MTT assay. Also, the protective effect of various ß-Amyrin (2-16 µM) concentrations with LPS/IFN-γ-induced mice microglial cells was studied. The concentrations of TNF-α (Tumor Necrosis Factor-α), IL-1ß (Interleukin-1ß), IL-6 (Interleukin-6) and PGE-2 (Prostaglandin E2) were evaluated using ELISA. Gene expressions of TNF-α, IL-1ß, IL-6, COX-2 (Cyclooxygenase-2), iNOS and arginase-1 were also evaluated using the Real-Time PCR method. Nitrite oxide and urea were measured using biochemical methods. RESULTS: The studied concentrations ​​of ß-Amyrin had no significant effects on the viability of microglial cells. Interestingly, ß-Amyrin concentration dependently and significantly increased the reduced cell proliferation concerning to LPS/IFN-γ exposure (p < 0.001). The concentrations and expression levels of pro-inflammatory factors including TNF-α, IL-1ß, IL-6, PGE-2, COX-2 were significantly reduced after ß-Amyrin treatment in LPS/IFN-γ-induced microglial cells (p < 0.05-0.001). ß-Amyrin also decreased the levels of nitric oxide, increased urea and down regulated the expression of nitric oxide synthesis while arginase-1 expression was enhanced (p < 0.001). The ratio of NO/urea and iNOS/Arg1 were also markedly increased in comparison to the LPS/IFN-g group (p < 0.001). CONCLUSION: ß-Amyrin reduces inflammation in microglial cells and can be used as a potential anti-inflammatory agent in central nervous system neurodegenerative diseases such as Alzheimer and multiple sclerosis, by affecting the inflammatory cytokine and differentiation of microglia as resident CNS macrophages.