L-carnitine and Ginkgo biloba Supplementation In Vivo Ameliorates HCD-Induced Steatohepatitis and Dyslipidemia by Regulating Hepatic Metabolism.

Treatment strategies for steatohepatitis are of special interest given the high prevalence of obesity and fatty liver disease worldwide. This study aimed to investigate the potential therapeutic mechanism of L-carnitine (LC) and Ginkgo biloba leaf extract (GB) supplementation in ameliorating the adverse effects of hyperlipidemia and hepatosteatosis induced by a high-cholesterol diet (HCD) in an animal model. The study involved 50 rats divided into five groups, including a control group, a group receiving only an HCD, and three groups receiving an HCD along with either LC (300 mg LC/kg bw), GB (100 mg GB/kg bw), or both. After eight weeks, various parameters related to lipid and glucose metabolism, antioxidant capacity, histopathology, immune reactivity, and liver ultrastructure were measured. LC + GB supplementation reduced serum total cholesterol, triglyceride, low-density lipoprotein cholesterol, glucose, insulin, HOMA-IR, alanine transaminase, and aspartate transaminase levels and increased high-density lipoprotein cholesterol levels compared with those in the HCD group. Additionally, treatment with both supplements improved antioxidant ability and reduced lipid peroxidation. The histological examination confirmed that the combination therapy reduced liver steatosis and fibrosis while also improving the appearance of cell organelles in the ultrastructural hepatocytes. Finally, the immunohistochemical analysis indicated that cotreatment with LC + GB upregulated the immune expression of GLP-1 and ß-Cat in liver sections that were similar to those of the control animals. Mono-treatment with LC or GB alone substantially but not completely protected the liver tissue, while the combined use of LC and GB may be more effective in treating liver damage caused by high cholesterol than either supplement alone by regulating hepatic oxidative stress and the protein expression of GLP-1 and ß-Cat.

A scoping review on natural cholesterol lowering supplements sold in South African pharmacies.

Background: Dyslipidaemia is defined as elevated total or low-density lipoprotein (LDL) levels or low levels of high-density lipoprotein (HDL). Patients may often make use of natural cholesterol lowering supplements (NCLSs) available at the pharmacy; however, limited information on these supplements is readily available. Pharmacists should be knowledgeable about NCLSs to ensure that the use of these supplements is supported by evidence and to provide appropriate advice to patients for desirable therapeutic outcomes. Aim: This study aimed to identify the NCLSs being sold in South African pharmacies and review the scientific evidence for each of the ingredients in these NCLSs. Methods: Seventeen NCLS products were identified, and the Joanna Briggs Institute (JBI) scoping review methodology was used to conduct a literature review of NCLSs. Results: From the ingredients reviewed it is evident that co-enzyme Q10, probiotics and sterols have sufficient evidence supporting their use. However, there is still limited scientific evidence available to validate the remaining ingredients. Conclusion: Further research on NCLSs will provide practising pharmacists and practitioners with a guide of the evidence available on the various ingredients in NCLSs. Contribution: This study provides a review of the available literature on the NCLSs being sold in the pharmacies across South Africa to provide pharmacists with a collated document of the evidence behind these popular supplements to assist them in making evidence based informed decision regarding natural products for cholesterol.

Natural supplements in antiphospholipid syndrome: A case for further study.

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by thrombotic events and/or pregnancy complications in the presence of persistently positive antiphospholipid antibodies (aPL). Although long-term anticoagulation with vitamin K antagonists is considered standard of care, there is an unmet need for safe therapeutics as primary thromboprophylaxis or adjuncts to standard of care in APS. APS is driven by oxidative stress, procoagulant, proinflammatory and angiogenic pathways. For these reasons there has been an increased interest into the investigation of antithrombotic, anti-inflammatory and anti-oxidant properties of natural supplements in APS. The objective of this review is to summarize the mechanistic, epidemiologic and clinical evidence behind the use of natural supplements in APS, with a specific focus on vitamin D, omega-3 fatty acids, coenzyme Q10, gingerol, and isoquercetin. This review should serve as a compelling argument for the future study of natural supplements in APS.

Impact of Chlorogenic Acid on Peripheral Blood Mononuclear Cell Proliferation, Oxidative Stress, and Inflammatory Responses in Racehorses during Exercise.

Green coffee extract is currently of great interest to researchers due to its high concentration of chlorogenic acid (CGA) and its potential health benefits. CGA constitutes 6 to 10% of the dry weight of the extract and, due to its anti-inflammatory properties, is a promising natural supplement and agent with therapeutic applications. The purpose of our study was to discover the effects of CGA on peripheral blood mononuclear cell proliferation, and the production of pro- and anti-inflammatory cytokines as well as reactive oxidative species (ROS) in horses during exercise. According to the findings, CGA can affect the proliferation of T helper cells. In addition, at a dose of 50 g/mL, CGA increased the activation of CD4+FoxP3+ and CD8+FoxP3+ regulatory cells. Physical activity decreases ROS production in CD5+ monocytes, but this effect depends on the concentration of CGA, and the effect of exercise on oxidative stress was lower in CD14+ than in CD5+ cells. Regardless of CGA content, CGA significantly increased the release of the anti-inflammatory cytokine IL-10. Moreover, the production of IL-17 was greater in cells treated with 50 g/mL of CGA from beginners compared to the control and advanced groups of horses. Our findings suggest that CGA may have immune-enhancing properties. This opens new avenues of research into the mechanisms of action of CGA and possible applications in prevention and health promotion in sport animals.

Supplementation with a ß-glucan tablet has no effect on hyperlipidemia: a randomized, placebo-controlled clinical trial.

BACKGROUND: Clinical evidence has suggested that the oat-soluble fiber ß-glucan might have lipid-lowering effects. OBJECTIVES: The present clinical trial was conducted to evaluate the efficacy and safety of high-medium molecular weight ß-glucan on serum low-density lipoprotein (LDL) cholesterol and other lipid subfractions in subjects with hyperlipidemia. METHODS: A randomized double-blinded trial was performed to assess the efficacy and safety of ß-glucan supplementation in reducing lipid levels. Subjects with LDL cholesterol levels of >3.37 mmol/L when treated or not with a statin were randomly assigned to receive 1 of 3 daily doses of a tableted formulation of ß-glucan (1.5, 3, or 6 g) or placebo. The primary efficacy end point was the change from baseline to 12 wk in LDL cholesterol. Secondary end points of lipid subfractions and safety were also assessed. RESULTS: A total of 263 subjects were enrolled; 66 subjects were assigned to each of the 3 ß-glucan groups, and 65 subjects were assigned to the placebo group. The mean change from baseline to 12 wk in serum LDL cholesterol level was 0.08, 0.11, and -0.04 mmol/L in the 3 ß-glucan groups (P = 0.23, 0.18, and 0.72 compared with the placebo group, respectively) and -0.10 mmol/L in the placebo group. The changes in total cholesterol, small LDL cholesterol subclass particle concentration, non-high-density lipoprotein cholesterol, apolipoprotein B, very low-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were also not significant in the ß-glucan groups when compared with the placebo group. Gastrointestinal adverse events were reported in 23.4%, 34.8%, and 66.7% of patients in the ß-glucan groups and in 36.9% of patients in the placebo group (P < 0.0001 for the overall comparison across the 4 groups). CONCLUSIONS: In subjects with LDL cholesterol levels of >3.37 mmol/L, a tablet formulation of ß-glucan was not effective in reducing LDL cholesterol concentration or other lipid subfractions when compared with a placebo. This trial was registered at clinicaltrials.gov as NCT03857256.

A Randomized, Double-Blind, Controlled Clinical Trial of Omega-3 Fatty Acids and Inositol as Monotherapies and in Combination for the Treatment of Pediatric Bipolar Spectrum Disorder in Children Age 5-12.

Objectives: The aim of this study was to assess the efficacy and tolerability of omega-3 fatty acids (FAs) and inositol alone and in combination for the treatment of pediatric bipolar (BP) spectrum disorder in young children. Methods: Participants were male and female children ages 5-12 meeting DSM-IV diagnostic criteria for a BP spectrum disorder and displaying mixed, manic, or hypomanic symptoms without psychotic features at the time of evaluation. Results: Participants concomitantly taking psychotropic medication were excluded from efficacy analyses. There were significant reductions in YMRS and HDRS mean scores in the inositol and combination treatment groups (all p < 0.05) and in CDRS mean scores in the combination treatment group (p < 0.001), with the largest changes seen in the combination group. Those receiving the combination treatment had the highest rates of antimanic and antidepressant response. The odds ratios for the combination group compared to the omega-3 FAs and inositol groups were clinically meaningful (ORs ≥2) for 50% improvement on the YMRS, normalization of the YMRS (score <12) (vs. inositol group only), 50% improvement on the HDRS, 50% improvement on CDRS (vs. omega-3 FAs group only), and CGI-I Mania, CGI-I MDD, and CGI-I Anxiety scores <2. Conclusion: The antimanic and antidepressant effects of the combination treatment of omega-3 FAs and inositol were consistently superior to either treatment used alone. This combination may offer a safe and effective alternative or augmenting treatment for youth with BP spectrum disorder, but more work is needed to confirm the statistical significance of this finding.

Use of Drugs and Dietary Supplements in University Students of Sports Science: Results of a Survey-Based Cross-Sectional Study.

Dietary supplements are used to implement and balance common dietary habits. The general belief is that natural substances reduce the risk of chronic diseases and amplify sports performance with no harmful side effects. Since sports science students will become professionals of sport activities and may also have a role in suggesting the use of dietary supplements to athletes, the aim of this study was to evaluate if physical activity influences the use of drugs and dietary supplements. A modified version of the International Physical Activity Questionnaire-Short Form (IPAQSF) was administered to perform these evaluations. A total of 1452 students from the University of Messina, Italy, enrolled in sports science courses completed the survey; of these, 1075 (704 male and 371 female students) were physically active in moderate- or high-intensity training. Of those physically active students, 709 (440 male and 269 female) were competitive athletes, identified on the basis of their answer to a specific question also indicating the type of sport they practice. The results suggest that 5.6% of all respondents were regular consumers of pharmaceutical products, compared to just 1.0% of the cohort of competing athletes. In contrast, the consumption of natural supplements was similar (14% vs. 15%) between groups. The most frequently used supplements were vitamins, including vitamin C, vitamin B complex, and multivitamin complex, followed by minerals and amino acids or protein complex. The probability of using dietary supplements was mostly related to the male gender (OR 1.64; 95% CI: 1.17-2.30), having a job (OR 1.45; 95% CI: 1.07-1.96), and, most of all, performing physical activity (OR 3.53; 95% CI: 2.18-5.71). The only factor related to a higher use of drugs was female gender (OR 2.40; 95% CI: 1.52-3.79), and the most used class was antihistaminic, followed by FANS. These results suggest that among the specific population of sports science students, those performing physical activity are less prone to using pharmaceutical products and have healthier habits.

A review on the anti-inflammatory activities of Brazilian green, brown and red propolis.

Humanity has used propolis since ancient times, and its use as a food supplement has significantly increased. Several reports on propolis´ biological activity and toxicity have highlighted its anti-inflammatory properties, unlike many natural food supplements. This review addresses the anti-inflammatory roles of Brazilian green, brown, and red propolis produced by Apis mellifera, their extracts, isolated compounds, and their mode of action. Despite advances in anti-inflammatory therapies, the development of inflammatory processes in several diseases has been a concern for centuries. Demands for new anti-inflammatory drugs have led to studies on propolis products as diet components to treat and prevent inflammatory disorders. Brazilian green, brown, and red propolis are alternatives for obtaining extracts and compounds of valuable anti-inflammatory properties. PRACTICAL APPLICATIONS: Currently, propolis is a food supplement, and to the best of our knowledge, several studies have shown that despite advances in anti-inflammatory therapies, the inflammatory process continues to be a significant concern. However, due to the demand for new anti-inflammatory drugs, propolis products as dietary components can be used to treat and prevent inflammatory disorders.

Alternative medicine: therapeutic effects on gastric original signet ring carcinoma via ascorbate and combination with sodium alpha lipoate.

BACKGROUND: Gastric signet ring cell carcinoma (SRCC) is an aggressive gastric adenocarcinoma with a poor prognosis when diagnosed at an advanced stage. As alternative medicine, two natural supplements (ascorbate (AA) and sodium alpha lipoate (LA)) have been shown to inhibit various cancers with mild side effects. METHODS: These two natural supplements and a series of combinations (AA&LA, AA+LA and LA + AA) were incubated with non-SRCC cells (GPM-1), patient-derived gastric origin SRCC (GPM-2), gastric-origin SRCCs (HSC-39 and KATO-3), human pancreatic (MIA PaCa-2) and ovarian (SKOV-3) cells for evaluating their therapeutic effects. Moreover, these treatments were applied in 3D-cultured organoids to reveal the feasibility of these approaches for in vivo study. RESULTS: Analyzing their antioxidant capabilities and dose-response curves, we observed that all four gastric cell lines, including three patient-derived cell lines were sensitive to ascorbate (~ 10 mM). The influence of ascorbate incubation time was studied, with a 16-h incubation found to be optimal for in vitro studies. Moreover, a simultaneous combination of AA and LA (AA&LA) did not significantly inhibit cell proliferation, while prior LA treatment increased the growth inhibition of AA therapy (LA + AA). Anti-cancer efficacy of AA was further confirmed in 3D-cultured SRCC (KATO-3) organoids. CONCLUSIONS: This study highlights the potential of AA and LA + AA in treating gastric origin SRCC, and demonstrates the influence of order in which the drugs are administered.

Medicinal Herbs and Nutritional Supplements for Dementia Therapy: Potential Targets and Clinical Evidence.

Spices and herbs have been used for medicinal purposes for centuries. Also, in the last decades, the use of different nutritional supplements has been implemented to treat all kinds of diseases, including those that present an alteration in cognitive functioning. Dementia is a clinical syndrome in which a person's mental and cognitive capacities gradually decline. As the disease progresses, the person's autonomy diminishes. As there is not an effective treatment to prevent progressive deterioration in many of these pathologies, nutritional interventions have been, and still are, one of the most widely explored therapeutic possibilities. In this review, we have discussed a great number of potentially interesting plants, nutritional derivatives, and probiotics for the treatment of dementia around the world. Their action mechanisms generally involve neuroprotective effects via anti-inflammatory, antioxidant, anti-apoptotic, b-amyloid, and tau anti-aggregate actions; brain blood flow improvement, and effects on synaptic cholinergic and dopaminergic neurotransmission, which may optimize cognitive performance in patients with cognitive impairment. As for their efficacy in patients with cognitive impairment and/or dementias, evidence is still scarce andthe outcomes are controversial. We consider that many of these substances have promising therapeutic properties. Therefore, the scientific community has to continue with a complete research focused on both identifying possible action mechanisms and carrying out clinical trials, preferably randomized, double-blind ones, with a greater number of patients, a long-term follow-up, dose standardization, and the use of current diagnostic criteria.

The Combination of AHCC and ETAS Decreases Migration of Colorectal Cancer Cells, and Reduces the Expression of LGR5 and Notch1 Genes in Cancer Stem Cells: A Novel Potential Approach for Integrative Medicine.

The AHCC standardized extract of cultured Lentinula edodes mycelia, and the standardized extract of Asparagus officinalis stem, trademarked as ETAS, are well known supplements with immunomodulatory and anticancer potential. Several reports have described their therapeutic effects, including antioxidant and anticancer activity and improvement of immune response. In this study we aimed at investigating the effects of a combination of AHCC and ETAS on colorectal cancer cells and biopsies from healthy donors to assess the possible use in patients with colorectal cancer. Our results showed that the combination of AHCC and ETAS was synergistic in inducing a significant decrease in cancer cell growth, compared with single agents. Moreover, the combined treatment induced a significant increase in apoptosis, sparing colonocytes from healthy donors, and was able to induce a strong reduction in migration potential, accompanied by a significant modulation of proteins involved in invasiveness. Finally, combined treatment was able to significantly downregulate LGR5 and Notch1 in SW620 cancer stem cell (CSC) colonospheres. Overall, these findings support the potential therapeutic benefits of the AHCC and ETAS combinatorial treatment for patients with colorectal cancer.

A Review of Alternative Treatment Options in Diabetic Polyneuropathy.

Currently there is no recognized curative treatment for diabetic polyneuropathy (DPN). Strict glucose control and symptomatic pain relief are the first line management routes. DPN is a common complication of diabetes and has a major detrimental influence on the quality of life (QOL) for many patients. Due to the scope of the problem, it is imperative that treatment options which impede DPN's progression and restore sensorineural function should be researched comprehensively and made available to the masses at an economical cost. We reviewed a multitude of atypical treatment options for DPN including capsaicin, lidocaine, acupuncture, electrical nerve stimulation, alpha lipoic acid, benfotiamine, and acetyl-l-carnitine and explored the evidence to date regarding their safety and efficacy. Most of these options have been around for a long time and have promising pilot studies or small-scale trials focused on DPN treatment.

Dietary and Protective Factors to Halt or Mitigate Progression of Autoimmunity, COVID-19 and Its Associated Metabolic Diseases.

COVID-19 is without any doubt the worst pandemic we have faced since the H1N1 virus outbreak. Even if vaccination against SARS-CoV-2 infection is becoming increasingly available, a more feasible approach for COVID-19 prevention and therapy is still needed. Evidence of a pathological link between metabolic diseases and severe forms of COVID-19 has stimulated critical reflection and new considerations. In particular, an abnormal immune response observed in certain patients with SARS-CoV-2 infection suggested possible common predisposing risk factors with autoimmune diseases such as Type 1 Diabetes (T1D). Correct supplementation with dietary factors may be key to preventing and counteracting both the underlying metabolic impairment and the complications of COVID-19. A set of agents may inhibit the cytokine storm and hypercoagulability that characterize severe COVID-19 infection: vitamin D3, omega-3 polyunsaturated fatty acids, polyphenols like pterostilbene, polydatin and honokiol, which can activate anti-inflammatory and antioxidant sirtuins pathways, quercetin, vitamin C, zinc, melatonin, lactoferrin and glutathione. These agents could be highly beneficial for subjects who have altered immune responses. In this review, we discuss the antiviral and metabolic effects of these dietary factors and propose their combination for potential applications in the prevention and treatment of COVID-19. Rigorous studies will be fundamental for validating preventive and therapeutic protocols that could be of assistance to mitigate disease progression following SARS-CoV-2 infection.

Short- and Long-Term Effects of Vitamin D Treatment on Bacillus Calmette-Guerin-Induced Depressive-Like Behavior in Mice.

PURPOSE: Depression is one of the most common psychological disorders. The nutritional etiology of the depression proposes that vitamin D may play a significant role in the pathogenesis of depression. Further, vitamin D deficiency has been found to aggravate depression in animals. Therefore, vitamin D treatment might be a potential therapeutic aid in depression management. This study aimed to explore the antidepressant effects of vitamin D in a Bacillus Calmette-Guerin (BCG)-induced depression model. METHODS: Thirty-six mice were randomly assigned to short-term and long-term experimental groups. In each group, mice were randomly subcategorized into three subgroups: 1. control (received vehicle), 2. BCG (received BCG [107 CFU/mouse]), and 3. BCG + vitamin D (received vitamin D [60.000 IU/kg] before BCG [107 CFU/mouse] inoculation). After completion of the two experimental periods (3 days for the short-term group and 2 weeks for the long-term group), the mice underwent three behavioral tests: locomotor activity, the forced swimming test (FST), and the tail suspension test (TST). RESULTS: Locomotor activity did not significantly differ among the subgroups in either the long-term or short-term groups. In the short-term group, the total immobility time on the FST was decreased in the vitamin D-treated group compared to the BCG group. However, in the TST, no significant difference was found between the vitamin D-treated group and the BCG group. In the long-term group, the immobility time on the FST was decreased in the vitamin D-treated group compared to the BCG group. Similarly, the total immobility time on the TST was also significantly lower in the vitamin D-treated mice than in the BCG-treated mice. CONCLUSION: Vitamin D is useful in the management of depressive behavior. The potential role of vitamin D in the etiology of depression should be investigated in future work.

Alternative supplements and ms medium concentrations in the in vitro establishment of Dipteryx alata Vog / Suplementos alternativos e concentrações de meio ms no estabelecimento in vitro de Dipteryx alata Vog

Dipteryx alata Vog. (barueiro) is a native fruit of the Cerrado used in food and medicine. The species has never been domesticated and is currently at risk of extinction. Plant tissue culture is an important tool for the conservation of germplasm and for quick, large-scale propagation of quality seedlings. While, this technique has never been used with barueiro, it could be a valuable tool in the domestication of this species. The objective of this work is to evaluate concentrations of MS medium salts (25, 50, 75 and 100%) supplemented with coconut water (100 mL L-1), dwarf banana pulp (60 g L-1) or the absence of any supplement in the in vitro establishment of barueiro seeds (Dipteryx alata Vog). The experiment used a completely randomized design (CRD) with a 3x4 factorial scheme (three cultivation media types and four concentrations of MS salts) and three repetitions. The following characteristics were evaluated: germination rate, shoot length , largest root length , stem diameter , number of leaves , chlorophyll A , chlorophyll B , total chlorophyll, and the fresh and dry mass of the seedlings. The coconut water and banana pulp supplements did not improve the in vitro development of the barueiro seedlings and the full concentration of MS salts did not improve the initial development of the seedlings. However, the pure MS medium at a concentration of 25% MS salts was the best option for the in vitro establishment of Dipteyx alata.

O barueiro (Dipteryx alata Vog.) é uma fruteira nativa do bioma Cerrado e possui várias aplicabilidades, desde alimentares até medicinais. No entanto ainda não é uma espécie domesticada e encontra-se sob risco projetado de extinção. A cultura de tecidos vegetais constitui uma importante ferramenta para a conservação de germoplasma, além de proporcionar a rápida propagação de mudas de qualidade em larga escala. Porém, esta técnica não vem sendo utilizada em barueiro, podendo ser aplicada de forma valiosa contribuindo para seu processo de domesticação. Objetivou-se neste trabalho avaliar concentrações de sais do meio MS (25, 50, 75 e 100%) suplementados com água de coco (100 mL L-1), polpa de banana nanica (60 g L-1) ou ausência de suplemento no estabelecimento in vitro de sementes de barueiro (Dipteryx alata Vog). O delineamento experimental utilizado foi o inteiramente casualizado (DIC) em esquema fatorial 3x4 (três meios de cultivo e quatro doses de sais MS) com três repetições. Foram avaliadas as características: taxa de germinação, comprimento da parte aérea e da maior raiz, diâmetro do caule, número de folhas, teores de clorofila A, B e total , massa fresca e massa seca das plântulas. A água de coco e a polpa de banana como suplementos não forneceram vantagens no desenvolvimento in vitro de plântulas de barueiro e a concentração plena dos sais MS não forneceram vantagens ao desenvolvimento inicial das plântulas. Portanto, o meio MS puro a uma concentração de 25% dos sais MS é a formulação que melhor se aplica para o estabelecimento in vitro de Dipteyx alata.

DART-MS for rapid, preliminary screening of urine for DMAA.

Dimethylamylamine (DMAA) is a sympathomimetic amine found in weight-loss/workout supplements or used as an appetite suppressant. DMAA is a stimulant that is banned by the World Anti-Doping Agency (WADA). Adverse health effects as well as fatalities have been implicated with its use. Direct analysis in real time mass spectrometry (DART-MS) is an ambient ionization method that was employed to rapidly identify the presence of DMAA in various samples without any extraction or preparations whatsoever. DMAA was first identified in supplements, sampled directly in their solid forms. Furthermore, DMAA was detected directly in urine over 48 h as a means of indicating recent abuse of the substance. DART-MS analysis is instantaneous, and coupled with the high mass accuracy associated with the time-of-flight mass analyzer, results in unequivocal identification of the presence of DMAA. These features demonstrate DART-MS as an attractive potential alternative screening method for the presence of drugs and medications or for toxicological investigations.

Menorrhagia: a synopsis of management focusing on herbal and nutritional supplements, and chiropractic.

INTRODUCTION: To make chiropractors more aware of menorrhagia and how they can serve a role in their patient's care and education since women make up 60% of the population seeking chiropractic care. METHOD: A review of the biomedical literature on menorrhagia was conducted. Items that were retrieved were synthesized and interpreted in order to give the best information to practicing chiropractors. DISCUSSION: Most of the information available relative to menorrhagia is medically oriented. Other treatment options can include: chiropractic, various types of herbs, and nutritional supplements. CONCLUSION: Knowledge of medical treatment, nutritional supplements, along with chiropractic treatment options may be beneficial to doctors in their practice.