Efficacy and safety of Derris scandens Benth extracts in patients with knee osteoarthritis.

OBJECTIVES: The objectives of this study were to determine the efficacy and safety of Derris scandens Benth extracts in pain reduction and functional improvement in patients with knee osteoarthritis (OA). DESIGN: This was a prospective, randomized, controlled trial, single-blinded (assessor). SETTINGS: The study was conducted at the Rehabilitation Medicine Department, Siriraj Hospital. SUBJECTS: One hundred and seven (107) patients with primary OA knee who had pain score of ≥ 5 were recruited. INTERVENTIONS: Patients were randomized to receive naproxen 500 mg/day or Derris 800 mg/day for 4 weeks. OUTCOME MEASUREMENTS: Western Ontario McMaster Osteoarthritis Index (WOMAC) scores and 6-minute walking distance were the outcome measurements. RESULTS: Fifty-five (55) and 52 patients were randomized to Derris and naproxen groups, respectively. The mean differences of all WOMAC scores between 2 groups at week 4 adjusted by week 0 were within ± 1 point. The mean scores of the aforementioned outcomes at weeks 0, 2, and 4 were significantly improved compared to the baseline values. There was no difference of WOMAC scores between groups. The gastrointestinal irritation and dyspepsia were observed more often in the naproxen than in the Derris group. CONCLUSIONS: Derris scandens Benth extracts were efficacious and safe for the treatment of knee OA.

Molecular evaluation of extracellular activity of medicinal herb Clinacanthus nutans against herpes simplex virus type-2.

Clinacanthus nutans (Burm. f.) Lindau (C. nutans), a medicinal herb belonging to the family Acanthaceae, has traditionally been used in herpes simplex virus (HSV) treatment in Thailand. Clinical trials have indicated that topical preparations produced from its extracts were effective in HSV-2 treatment. However, there is no clear evidence of the mechanism of action or a molecular target of C. nutans. In this study, the extracellular activity of C. nutans extracts against HSV-2 infected on HEp-2 cells was investigated in terms of its molecular aspects. HSV-2 was treated with the extracts and adsorped into the HEp-2 cells. After infection, HSV-2 DNA quantities in the infected cells were assessed and compared by the quantitative dot blot hybridisation technique. The results showed that treating the viruses with either less or more highly purified extracts before infection resulted in great reductions of viral infectivity. Further investigation was performed by Western blot analysis to determine the activities of the extracts on the viral proteins. At least eight viral proteins of the infected cell proteins (ICP) and some structural proteins, including 146, 125, 78, 69, 55, 44, 40 and 20 KDa proteins, were depleted and reduced gradually with higher and lower concentrated herb extracts, respectively. These suggest that the C. nutans extracts highly inactivated or inhibited HSV-2 before infection.

Preliminary efficacy and safety of oral suspension SH, combination of five chinese medicinal herbs, in people living with HIV/AIDS ; the phase I/II study.

OBJECTIVE: To evaluate the preliminary efficacy and safety of the mixture of drug extracts from 5 Chinese medicinal herbs (SH), in the treatment of Human Immunodeficiency Virus (HIV) infection among people living with HIV/AIDS (PLWHA). DESIGN: Open-label study. SETTING: Sanpatong Hospital, Chiang Mai, Thailand. SUBJECTS: HIV-1 infected adults with a CD4 cell count of more than 200 cell/mm3 and HIV-1 RNA > 20,000 copies/ml. MATERIAL AND METHOD: Patients received an oral suspension of SH, a combination of 5 Chinese medicinal herbs namely Glycyrrhiza glaba L., Artemisia capillaris Thumb., Morus alba L., Astragalus membranaceus(Fisch.) Bge., Carthamus tinctorius L., 5 g or 30 ml, in 3 divided doses after meals, plus sulfamethozaxole/ trimethoprim, 400/80 mg tablet, once daily after breakfast for 12 weeks. During the treatment and the follow up period, the absolute CD4 cell count and the plasma HIV-1 RNA were monitored. Adverse events were observed. RESULTS: Of the 28 enrolled patients, the number of positive response patients with reduction of plasma HIV-1 RNA more than 0.5 log during the treatment and follow up period were 4-10 (14.2-35.7%) while the number of negative response patients who had plasma HIV-1 RNA rising at least 0.5 log were 2-4 (0-14.2%). The means viral load at week 0 (baseline), 12 and 20 were 4.94, 4.83 and 4.76 log copies/ml, which were slightly declined Whilst, the mean absolute CD4 cell count of week 0 (baseline), 4, 8, 12, and 20 fluctuated within the baseline, range of 382.1, 404.2, 359.4, 404.1, 360.2 cell/mm3, respectively. All subjects had good compliance without any serious adverse events. CONCLUSION: Under the condition used, SH drug therapy is safe. Satisfactory positive response, by decreased viral load of more than 0.5 log, was found in 14%-35% of HIV-positive patients. However, the immunologic response, an increase of CD4 cell count was not clearly demonstrated. The clinical benefit of SH needs more thorough scientific support before being prescribed as adjunctive therapy for treating PLWHA.