Traditional and Integrative Medicine
Volume:6 Issue: 2, Spring 2021

Bioflavonoids such as biochanin A (BCA), exhibit insulin mimetic or secretagogues activities and are considered as hypoglycemic compounds. Nesfatin-1 is secreted from the hypothalamic nuclei and recognized as a regulatory peptide, which can increase insulin sensitivity and affect glucose metabolism. In this study, effects of BCA, on serum nesfatin-1 level were examined in rats with streptozotocin (STZ)-induced diabetes. We randomly divided 30 male Wistar rats into 2 control (6 rats per group) and 3 diabetic groups. Type I diabetes was induced using STZ (55 mg/kg bw) injection. Group 1 received 0.5% DMSO; while group 2 received 10 mg/kg body weight of BCA; group 3 (diabetic controls) received 0.5% DMSO; group 4, 10 mg/kg of BCA; and group 5, 15 mg/kg of BCA. The levels of serum insulin, nesfatin-1, and fasting blood glucose (FBG) were determined after 42 days. The serum insulin level increased; while FBG level significantly decreased in the BCA treatment groups. Both treatment groups had increased nesfatin-1 levels in comparison with the control groups; however, the difference was only significant in group 5 (p value < 0.05). Considering insulin and nesfatin-1 induction, BCA has potential hypoglycemic effects. Oral administration of 15 mg/kg BW of BCA showed greater efficacy than 10 mg/kg bw of BCA.

Ulcerative colitis (UC) is an inflammatory bowel disease and its etiology has not fully understood in conventional medicine. It also influences the quality of life as a result of its recurrence and progressive clinical course, then, it has been considered an important public health concern. This study aimed to evaluate the impact of prescription therapy based on the Persian Medicine as a complementary treatment for the mitigation of the symptoms of UC as well as improvement in the disease severity. A total of 30 UC patients with an age range of 15-70 years participated in this clinical trial. They were treated with the “Sahj” capsule containing: Curcuma longa L., Punica granatum L., and Terminalia chebula Retz. for 4 weeks. The “Sahj” capsule was prepared based on the Persian Medicine resources. The bowel frequency at day/night, urgency of defecation, general health, and blood in stool were assessed pre/post intervention and the results were compared before and after the clinical trial. The “Sahj” capsule significantly enhanced the clinical findings. There was a significant increase in simple clinical colitis activity index (SCCAI) score in response to the prescription of the “Sahj” capsule (7.73 ± 1.98 before and 4.30 ± 1.12 after the trial) in which general health condition of patients was increased by 50% after the clinical trial. Bowel frequency at day was remarkably decreased by totally 15 patients with the scores of 1, 2 and 3 were enrolled to score 0. Also, bowel frequency at night was not statically significant (p = 0.267) in spite of 7 patients were improved their score (changed their score from 2 to 1).  Urgency of defecation (p 0.003) and blood in stool (p 0.0001) were significantly decreased compared with pre-intervention stage. These findings suggest an appropriate complementary treatment to reduce the symptoms of ulcerative colitis. However, further studies with larger sample size are warranted to assess the efficacy and safety of the “Sahj” capsule in the treatment of UC.

Eryngium caeruleum (Apiacea) is native to the northern forests of Iran. The anti-diabetic effect of other species of the genus Eryngium has already been reported in previous studies. In this study, the anti-diabetic effect of this extract on animal blood lipid factors was investigated. Hydroalcoholic extract was obtained from different parts of the plant, including roots, leaves, and aerial branches with fruits were prepared by maceration with 70% ethanol. Oral acute toxicity of the extracts was assayed in different doses of 2000, 4000, and 8000 mg/kg in rats. To induce diabetes in the studied animals, 60-70 mg/kg of streptozotocin (STZ) was injected intraperitoneally (IP). For the purpose of this study, 72 male Wistar rats were randomly divided into different groups of normal, diabetic, and positive controls (metformin 500 mg/kg) as well as 9 diabetic groups that orally received 200, 400, and 800 mg/kg of extracts. The effects of the treatment with extracts for a 14-day period were investigated on weight, blood glucose, and lipid profile. By comparing the control groups with the groups of hydroalcoholic extracts of E. caeruleum showed that the most effective sample on weight gain and also on reducing blood glucose was the group receiving 800 mg/kg of the aerial branches extract (P < 0.01 and P < 0.001, respectively) after 14 days. As well, the most effective sample on lowering the blood lipid factors was the hydroalcoholic extract of the root of E. coareleum with a dose of 200 mg/kg, which showed a significant effect on lowering total cholesterol in diabetic rats compared to the diabetic controls (P < 0.05). Hydroalcoholic extract of leaves with 200 mg/kg also showed a better effect on lowering the LDL and VLDL levels compared to the diabetic control group (P < 0.001). The results of pancreatic histology in the samples showed that the extracts of the aerial branch and root (800 mg/kg) had significant effects on the regeneration of the islets of Langerhans compared to the diabetic control group. In conclusion, E. caeruleum could significantly improve glycemic and lipid profiles in diabetic rats.

Natural compounds and especially herbal medicine are of great interest due to their various biological effects and their potential to act as a drug for the treatment of various neoplasms especially breast cancer that we are facing with its increasing prevalence around the world. The aim of this study was to evaluate the cytotoxic and cell death mechanism of some diterpenoids (Lathyrane or Tigliane) extracted from the Euphorbia sogdiana Popov against two breast cancer cell lines, MCF-7 and 4T1. Determination the cytotoxic effects of four various diterpenoids was performed using MTT assay against MCF-7, 4T1, and HUVEC cell lines. The IC50 of each compound against cell lines was determined by drawing the dose-response graph using graph Pad prism software. Finally, the apoptotic effects of compound with the most cytotoxic effects was determined by flow cytometry assay for 24 hrs of incubation in IC50 concentration. Statistical analysis confirmed compound (3) with the most cytotoxicity against both cancer cell lines. The IC50 of compound (3) was determined as 10.1 ± 5, 28 ± 5, and 50 ± 3 µg/ml, for MCF-7, 4T1, and HUVEC cells, respectively. Furthermore, the cells treated with 5 and 10 μg/ml of compound (3) for 24 hrs, showed 49 and 57% of apoptosis. These surveyed compounds have the potential to be considered as useful anti-breast cancer agents due to the great cytotoxicity and apoptotic effects against related cancer cell lines and safety profile according to their rational selectivity index.

Functional bloating is one of the gastrointestinal diseases that impacts the quality of life and social activities of the patients. The present study aimed to evaluate the effectiveness of lifestyle modification based on Persian Medicine (PM) on functional bloating improvement. Fifty patients with functional bloating and ROME III confirmation criteria were enrolled in the study groups of control and intervention. The intervention group received lifestyle modification education based on PM perspectives, and the control group did not receive any training. The score of implementing PM recommendations by patients was evaluated by the questionnaire of “compliance with the PM principles effective on functional bloating” once every two weeks during the two months of the study. The severity of clinical Complications Associated with Functional Bloating (CAFB) was also evaluated before and after the study by visual analog scale. Primary and secondary outcomes were analyzed by t-test and ANCOVA in SPSS version 19. The qualitative data analysis was performed via Chi-square and Mann-Whitney tests. The severity of clinical CAFB was significantly higher in women at baseline (P = 0.027). Lifestyle modification of patients led to a gradual increase in compliance with the PM principles. By the end of the study, the mean score of compliance with the PM principles in the intervention group was significantly higher compared to the pre-intervention score (P<0.0001) and also compared to the control group (P < 0.0001). Besides, the educational intervention resulted in a significant decrease (51.8%) in the mean severity of all clinical CAFB in the intervention group before and after training (P < 0.0001) and between the control group and the intervention group (P < 0.0001). Therefore, Lifestyle modification based on PM probably can be effective in improving the clinical complications of functional bloating.

The opening of the mitochondrial Permeability Transition (mPT) pore proceeds the activation of programmed cell death (apoptosis) and its functional status serves as marker of mitochondrial health. Unripe fruits of Carica papaya are used in the traditional treatment of several diseases. There is paucity of information on the level of safety of the consumption of the plant. The effects of crude Methanol Extract of Carica papaya (MECP) on the status of the mPT pore in healthy rat liver was investigated in this study. Mitochondrial FOF1 ATPase activity, mitochondrial permeability transition and mitochondrial lipid peroxidation as well as the release of cytochrome c were evaluated spectrophotometrically using standard methods. The MECP activated mPT pore opening in the absence of calcium in a concentration-dependent fashion.  Specifically, induction folds of 3.1, 6.0, 9.1, 11.9 and 14.3 were recorded at 20, 60,100, 140and 180 µg/ml, respectively. In addition, MECP potentiated calcium-induced pore opening of the mPT pore in a concentration-dependent style by   22.5, 24.1, 25.0, 25.1 and 25.5 folds, respectively at 20, 60, 100, 140 and 180 µg/mL. Furthermore, mitochondrial ATPase activity was significantly (p < 0.001) stimulated at pH (7.4) while the extent of cytochrome c release increased by 5 and 7 folds respectively at the highest concentrations tested. Interestingly, Fe2+-induced mitochondrial lipid peroxidation was inhibited by varying concentrations of MECP.  Specifically, significant (p < 0.001) reduction in levels of mitochondrial lipid peroxides were observed at 50, 100, 200, 300, 600 µg/ml MECP by 10, 22, 53, 74, 112 %, respectively. These findings indicate that unripe Carica papaya fruit extract contains bioactive compounds that cause mitochondrial injury via activation of the mitochondrial permeability transition pore opening in healthy liver cells. Hence, its use in the management of diseases should be approached with caution.

Myrtus communis Linn. (MC) is a cardiotonic plant in traditional Persian medicine. This study was conducted to evaluate the protective effect of MC on isoproterenol-induced heart failure (HF) in rats. Isoproterenol was injected subcutaneously in all groups except the control group for 4 consecutive days to induce myocardial injury in male Wistar rats. In the case of treatment groups, the animals were treated with different doses of the hydro-alcoholic extract of MC fruit or leaves (150, 300, and 700 mg/kg), and were compared with healthy and HF rats. In order to evaluate cardiac function, echocardiography was performed on day 28 after treatment. MC fruit and leaf extracts were administered to all groups except the healthy control group for 28 days by gavage. At the end of the experimental period, the animals were sacrificed and the left ventricle regions of tissue hearts were collected to measure the levels of oxidative stress factors (MDA, SOD, GSH) using ELISA methods. Cardiac fibrosis was evaluated by Mason’s trichrome staining. Hematoxylin-eosin staining was used to assess histopathological changes in cardiac structure.  Our results showed that administration of MC fruit and leaf extracts significantly reduced the MDA level and increased SOD and GSH levels in treated HF rats compared to the HF group (P<0.05). In addition, MC mitigated fibrosis and improved cardiac histological changes compared to the HF group. Collectively, our findings show that MC can be considered as a good candidate to provide cardioprotective effects in HF rats through reduction of oxidative stress and myocardial fibrosis.

Dandelion (Taraxacum officinale) belongs to the Asteraceae or sunflower family. Its leaves, stems, and roots have been used in traditional Chinese herbal for a long time because dandelion has a wide range of pharmacological properties including anti-microbial, anti-viral, anti-inflammatory, and anti-infectious as well as anti-oxidation especially in the dandelion root extract which is the most medicinal value. A clinical study of dandelion extracts on skin acne and a simple preparation method of the dandelion extract would be discussed since the dandelion extract has low toxicity on the skin, even is non-toxic based on the British Herbal Pharmacopoeia recommendation.

Persian Medicine applies various types of treatment, from changing lifestyle (known as Setteh-e-zarurieh) to using medicines and  manual interventions. Manual interventions have various types and indications in Persian Medicine. Visceral manipulation is one of them, which is defined as applying techniques to the viscera or the structures that support it in the case of disturbed motility or mobility related to a visceral system and the associated elements. Herein, Persian Medicine manuscripts were searched to find available information about visceral manipulation. There are many similarities between basic principles of visceral manipulation and Persian Medicine. Persian Medicine scholars have explained about anatomy of fascia and its components many years ago, which are very close to what today’s knowledge is. Most probably, one of the very first scholars who has mentioned the idea of visceral manipulation is Avicenna (980–1037 CE). In his Canon of Medicine, Avicenna mentioned Ghamz as a treatment for liver injury. The available in vitro and animal studies support the positive effects of visceral manipulation. Persian Medicine scholars had detected nerve fibers and collagen which are fascia components. They are pioneer in this regard, too.

The term “crisis” in medical context is an important turning point or stage which occurs in some diseases and if not managed correctly, can become life threatening. Despite the use of the term in modern medicine, it was a much wider and sophisticated traditional medical concept. The first usage has been seen in the Greek writings of Hippocrates. In the Islamic Golden Age, this concept entered Persian Medicine by translation of Greek medical treatises. Great Persian Medicine scholars have paid particular attention to the concept and have written exclusive chapters about it. One of such scholars, Hakim Mohammad Azam Khan Chishti (1814-1902), an Indo-Persian physician and medical writer, wrote several comprehensive encyclopedic books - in Persian language - about various aspects of Persian Medicine including crises. In this historical review we discuss his biography and his books, especially his important book Rokn-e-Azam, which is a comprehensive work on the concept of crisis in which he collected and discussed opinions of great medical scholars from ancient times to the 19th century. Despite his fidelity, unfortunately he rarely criticized the previous literature and thus did not add an additional value to the subject else than his comprehensive review. In the recent worldwide accepted roadmap towards Integrative Medicine, studying such inclusive traditional manuscripts may give better insight and understanding of the behavior of acute and chronic diseases and their appearance, exacerbations and remissions.