Journal of Complementary and Integrative Medicine

Published by De Gruyter

Volume 13 Issue 2 -

Issue of Journal of Complementary and Integrative Medicine

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Contents
Journal Overview

Publicly Available May 3, 2016

Frontmatter

Page range: i-iii

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Review

January 12, 2016

Phytochemistry and gastrointestinal benefits of the medicinal spice, Capsicum annuum L. (Chilli): a review

Amal K. Maji, Pratim Banerji

Page range: 97-122

Abstract

Dietary spices and their active constituents provide various beneficial effects on the gastrointestinal system by variety of mechanisms such as influence of gastric emptying, stimulation of gastrointestinal defense and absorption, stimulation of salivary, intestinal, hepatic, and pancreatic secretions. Capsicum annuum (Solanaceae), commonly known as chilli, is a medicinal spice used in various Indian traditional systems of medicine and it has been acknowledged to treat various health ailments. Therapeutic potential of chilli and capsaicin were well documented; however, they act as double-edged sword in many physiological circumstances. In traditional medicine chilli has been used against various gastrointestinal complains such as dyspepsia, loss of appetite, gastroesophageal reflux disease, gastric ulcer, and so on. In chilli, more than 200 constituents have been identified and some of its active constituents play numerous beneficial roles in various gastrointestinal disorders such as stimulation of digestion and gastromucosal defense, reduction of gastroesophageal reflux disease (GERD) symptoms, inhibition of gastrointestinal pathogens, ulceration and cancers, regulation of gastrointestinal secretions and absorptions. However, further studies are warranted to determine the dose ceiling limit of chilli and its active constituents for their utilization as gastroprotective agents. This review summarizes the phytochemistry and various gastrointestinal benefits of chilli and its various active constituents.

Preclinical Studies

March 26, 2016

Determination of methanol in Iranian herbal distillates

Kobra Shirani, Faezeh Vahdati Hassani, Kamal Razavi Azar-Khiavi, Zohreh Samie Moghaddam, Gholamreza Karimi

Page range: 123-127

Abstract

Background : Herbal distillates have been used as beverages, for flavoring, or as phytomedicines in many countries for a long time. Recently, the occurrence of blindness after drinking herbal distillates has created concerns in Iran. The aim of this study was to determine the concentrations of methanol in herbal distillates produced in Iran. Methods : Eighty-four most commonly used herbal distillates purchased from herbal distillate factories were analyzed for methanol contents by gas chromatography and flame ionization detection, with ethanol as internal standard. Results : In 15 herbal distillates, the methanol concentration was below the limit of quantitation. The methanol concentrations in all samples ranged from 43 to 277 mg/L. Forty-five samples contained methanol in excess of the Iranian standard. The maximum concentration was found in an herbal distillate of Mentha piperita (factory E) (277±12), and the minimum in a distillate of Carum carvi (factory B) (42.6 ± 0.5). Conclusions : Since the 45 Iranian herbal distillates containing methanol levels were beyond the legal limits according to the Iranian standard, it seems necessary to monitor the amount of methanol and give a warning to watch out for the latent risk problem of methanol uptake, and establish a definitive relationship between the degree of intoxication observed and the accumulation of methanol in the blood.

December 8, 2015

Evaluation of the antioxidant properties of tryptophan and its metabolites in in vitro assay

Bichitra N. Nayak, Harpal S. Buttar

Page range: 129-136

Abstract

Background : Human milk contains a number of nutrients and bioactive ingredients which play an important role in the growth and development of infants. One important nutrient and bioactive ingredient of human milk is L-tryptophan. L-Tryptophan is an essential aromatic α-amino acid and is required in the diet of children and adult humans. As an essential amino acid, it is needed for protein synthesis and as a precursor of key biomolecules such as serotonin, melatonin, tryptamine, niacin, quinolinic acid and kynurenic acid, nicotinamide adenine dinucleotide. The aim of the study was to evaluate the antioxidant, anti-inflammatory and antiproliferative properties of tryptophan isolated from enzymatic hydrolysates from human milk and its metabolites on human glioma U251 cells and to evaluate the effects of human recombinant (hrIFNγ) on molecular ions of tryptophan and its metabolites in human glial U251 cells. Methods : The cytotoxicity was determined by MTT (3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide) assay. The antioxidant property was assessed by the oxygen radical scavenging capacity (ORAC) method. The anti-inflammatory effect was determined by the enzyme-linked immunosorbent assay (ELISA) against cytokines IL-6 and TNF-α. The effects of recombinant human (rhIFNγ) on molecular ions of tryptophan and its catabolites were evaluated by mass spectrometry. The tryptophan was isolated from milk peptides following enzymatic digestion, followed by separation by chromatographic and mass spectrometric methods. Results : Tryptophan from human milk exhibited profoundly higher oxygen radical absorption capacity (7,986±468 µm Trolox equivalent (TE)/g) than that of whole human milk (80.4±13.3 µm TE/g). Tryptophan showed a moderate degree of anti-inflammatory activity against TNF-α and IL-6. rhIFNγ inhibited tryptophan metabolism. A low concentration of L-tryptophan (10–25 μg/mL) inhibited nearly 25% of cell growth. When U251 cells were treated with 25 μg/mL L-tryptophan and subsequently challenged with 30 ng/mL of human recombinant IFNγ, a significant inhibitory effect on cell growth was observed. Low concentrations of Xanthurenic acid, L-kynurenine, and 3-OH DL kynurenine were found to inhibit cell growth except melatonin and 3-OH anthranilic acid. Melatonin was a strong inducer of TNF-α in RAW cells, whereas 3-OH kynurenine at 25, 50 and 100 µg/mL inhibited IL-6 in RAW cells. No significant change was observed in the IL-8 profile in tryptophan-treated U251 cells except that L-kynurenine at 10 µg/mL produced significantly high level of an inflammatory cytokine IL-8. Melatonin, 3-OH, DL kynurenine at high concentrations (100 µg/mL) induced proliferation of U251 cells. Melatonin seemed to show synergistic effects with recombinant human IFNγ (rhINFγ) in promoting growth of human glioma cells. While treatment of U251 cells with tryptophan alone and subsequent treatment with rhIFNγ inhibited the growth of human cancer glioma cells, and conversely melatonin combined with rhIFNγ promoted growth of the U251 cells. Conclusions : The findings from this study suggest that human milk-derived tryptophan and its metabolites possess strong antioxidant properties. Such effects might play a significant role in regulating the cell proliferation and growth of human cancer cells in a concentration-dependent manner.

February 4, 2016

Preventive effect of curcumin on inflammation, oxidative stress and insulin resistance in high-fat fed obese rats

Nachimuthu Maithilikarpagaselvi, Magadi Gopalakrishna Sridhar, Rathinam Palamalai Swaminathan, Ramalingam Sripradha

Page range: 137-143

Abstract

Background : The present study investigated the beneficial effects of curcumin on inflammation, oxidative stress and insulin resistance in high-fat fed male Wistar rats. Methods : Five-month-old male Wistar rats (n=20) were divided into two groups (10 rats in each group). Among the two groups, one group received 30 % high-fat diet (HFD) and another group received 30 % HFD with curcumin (200 mg/kg body weight). Food intake, body weight and biochemical parameters were measured at the beginning and at the end of the study. After 10 weeks, oxidative stress parameters in skeletal muscle and hepatic triacylglycerol (TAG) content were estimated. Histological examinations of the liver samples were performed at the end of the experiment. Results : High-fat feeding caused increase in body weight, liver and adipose tissue mass. Rats fed with HFD showed increased levels of fasting plasma glucose, insulin, Homeostasis Model Assessment for Insulin resistance (HOMA-IR), total cholesterol (TC), TAG, very low density lipoprotein cholesterol (VLDL-c) and decreased high-density lipoprotein cholesterol (HDL-c). There was also increase in the plasma inflammatory markers [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP)] and skeletal muscle oxidative stress parameters [malondialdehyde (MDA), total oxidant status (TOS)] in these rats. In addition, high-fat feeding increased liver TAG content and caused fat accumulation in the liver. Treatment with curcumin significantly reduced body weight, relative organ weights (liver, adipose tissue), glucose, insulin and HOMA-IR. Curcumin supplementation decreased plasma levels of TC, TAG, VLDL-c, TNF-α and increased HDL-c. Administration of curcumin also reduced MDA, TOS in skeletal muscle, hepatic TAG content and liver fat deposition. Conclusions : Curcumin supplementation improved HFD-induced dyslipidemia, oxidative stress, inflammation and insulin resistance.

April 14, 2016

Studies on anti-inflammatory and analgesic properties of Lactobacillus rhamnosus in experimental animal models

Sarika Amdekar, Vinod Singh

Page range: 145-150

Abstract

Background : Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used for the treatment of inflammatory diseases. However, constant use of NSAID may lead to some side effects like gastrointestinal ulcers, bleeding and renal disorders. This study evaluates analgesic and anti-inflammatory activities of Lactobacillus rhamnosus in female Wistar rats. Methods : Diclofenac sodium was used as a standard drug for comparison. L. rhamnosus , drugs and vehicle were administered orally. Acetic acid-induced writhing test and carrageenan-induced paw edema model were used for evaluation. Paw edema and number of writhes were measured subsequently. Pro-inflammatory (interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α and IL-17) and anti-inflammatory (IL-4 and IL-10) cytokines were estimated in serum after 24 h. Results : Results showed that L. rhamnosus significantly decreased the paw thickness at t=24 h by 28.66 % while drug decreased by 19.33 %. Also, L. rhamnosus treatment and standard drug showed a protection of 66.66 % and 41.66 %, respectively. L. rhamnosus and diclofenac sodium treatment significantly down-regulated pro-inflammatory and up-regulated anti-inflammatory cytokines at p<0.0001. Overall, protection provided by L. rhamnosus was more pronounced in comparison to diclofenac sodium. Conclusions : The present study clearly suggests that L. rhamnosus suppressed carrageenan-induced paw edema after second phase and decreased the acetic acid-induced writhings. It ameliorated the inflammatory pathways by down-regulating pro-inflammatory cytokines. However, additional clinical investigations are needed to prove the efficacy of L. rhamnosus in treatment/management of inflammatory joint diseases.

March 15, 2016

Estrogenic properties of spices of the traditional Cameroonian dish “Nkui” in ovariectomized Wistar rats

Edwige Nana Tchoupang, Sylvin Benjamin Ateba, Stéphane Zingue, Martin Zehl, Liselotte Krenn, Dieudonné Njamen

Page range: 151-162

Abstract

Background : Besides the basic role to flavor and color foods, several health benefits have been attributed to spices. The traditional Cameroonian food “Nkui” is prepared using several spices ( Afrostyrax lepidophyllus Mildbr., Capsicum frutescens Linn., Fagara leprieurii Guill. et Perr., Fagara tessmannii Engl., Mondia whitei Hook. F. Skell., Pentadiplandra brazzeana Baill., Solanum gilo Raddi., Tetrapleura tetraptera Taub. and Xylopia parviflora A. Rich. Benthane) that are believed to have a positive impact on the female reproductive physiology. Aiming to determine the potential effect of this food on the female reproductive tract, we evaluated the estrogenic properties of aqueous and ethanol extracts of Nkui using a 3-day uterotrophic assay in ovariectomized (OVX) rats. Methods : OVX female Wistar rats were randomly separated in several groups of five animals each and submitted to a 3-day uterotrophic assay ( per os ). At the end of treatment, animals were sacrificed and uterus, vagina and mammary gland collected and fixed in 10 % formalin for histological analysis. Results : These extracts increased the uterine wet weight, the uterine and vaginal epithelial heights, and the lumen and diameter of alveoli in the mammary glands. They also altered the estradiol-induced increase of uterine wet weight. The dichloromethane and methanol fractions of the ethanol extract exhibited estrogenic properties as well by increasing uterine and vaginal endpoints. Conclusions : These results suggest that the spices of “Nkui” contain estrogenic phytoconstituents and this traditional food may be considered as functional.

April 21, 2016

Toxicology of a Peruvian botanical remedy to support healthy liver function

Hugh A. Semple, B. Duff Sloley, José Cabanillas, Andrea Chiu, Steven K. H. Aung, Francis H. Y. Green

Page range: 163-173

Abstract

Background : The purpose of these studies was to determine the safety of a botanical treatment for supporting healthy liver function developed in Peru. The formulation, A4 + , contains extracts of Curcuma longa L. rhizome (A4R), Cordia lutea Lam. flower (A4F) and Annona muricata L. leaf (A4L). The tests were used to support an application for a non-traditional Natural Health Product Licence from the Natural Health Product Directorate of Health Canada and future clinical trials. Methods : Besides reviewing the scientific and clinical information from Peru on the ingredients and conducting an initial Ames test for mutagenicity, we analysed A4 + for its chemical profile and tested genotoxicity (micronucleus test) and general toxicity (28-day repeated dose). Results : A4 + and extracts from the three plants provided distinctive chemical fingerprints. A4L contained acetogenins, requiring a second chromatographic method to produce a specific fingerprint. The Ames test proved positive at the highest concentration (5,000 μg/mL) but A4 + showed no evidence of genotoxicity in the more specific mouse micronucleus test. The 28-day repeated dose (general toxicity) study in rats showed no toxicity at 2,000 mg/kg. Conclusions : We conclude that under the conditions of these studies, A4 + shows no evidence of toxicity at the levels indicated. A no observed adverse effect level (NOAEL) of 2,000 mg/kg was assigned.

Clinical Studies

March 15, 2016

Evaluation of the effects of roselle (Hibiscus sabdariffa L.) on oxidative stress and serum levels of lipids, insulin and hs-CRP in adult patients with metabolic syndrome: a double-blind placebo-controlled clinical trial

Sedigheh Asgary, Rasool Soltani, Mohsen Zolghadr, Mahtab Keshvari, Nizal Sarrafzadegan

Page range: 175-180

Abstract

Background : Roselle ( Hibiscus sabdariffa L.) is a plant with antihyperlipidemic and antihypertensive effects. This study aimed to evaluate the effects of roselle calyces on the serum levels of lipids and insulin, inflammation, and oxidative stress in patients with metabolic syndrome (MetS). Methods : Forty adult patients with MetS were randomly assigned to receive either 500 mg of H. sabdariffa calyx powder or placebo once daily for 4 weeks. Systolic and diastolic blood pressures (SBP and DBP) and BMI (body mass index) as well as fasting serum levels of glucose (FPG; fasting plasma glucose), insulin, lipoproteins, triglycerides (TG), high-sensitivity C-reactive protein (hs-CRP), and malondialdehyde (MDA) were determined pre- and post-intervention and compared. Results : H. sabdariffa significantly reduced serum TG (p=0.044) and SBP (p=0.049) compared to placebo. All other variables were not significantly affected by the interventions. Conclusions : Daily consumption of 500 mg of H. sabdariffa L. calyx powder can decrease SBP and serum TG in MetS patients.

March 22, 2016

Effects of Tai Chi training on postural control and cognitive performance while dual tasking – a randomized clinical trial

Xi Lu, K. C. Siu, Siu N. Fu, Christina W. Y. Hui-Chan, William W. N. Tsang

Page range: 181-187

Abstract

Background : This single-blinded, randomized controlled study investigated the effects of practicing Tai Chi on the postural control and cognitive performance of older women while dual tasking. Methods : Community-dwelling older women (n=31) were recruited from community centers. They were randomized to Tai Chi group (n=15, 12-form Yang style Tai Chi training) or a control group (n=16, general interest classes) for 16 weeks. Balance was tested in single leg stance after stepping down from a step, with and without a concurrent auditory response task (auditory Stroop test). Balance was measured by total sway path and sway area of subject’s center of pressure (COP). The reaction time and the correctness of the auditory Stroop test were also measured. Results : Tai Chi subjects made fewer errors in auditory Stroop test under dual-task condition after Tai Chi training (p=0.01). They also showed significant decreases in the COP path (p<0.05) and the COP area (p<0.05) in their postural control after training in both single- and dual-task conditions. The subjects in the control group did not show any significant improvement in dual-task condition after the intervention. Conclusions : Tai Chi training improves the cognitive and postural control performance of older women when dual tasking.

April 7, 2016

Effect of 6 months intense Yoga practice on lipid profile, thyroxine medication and serum TSH level in women suffering from hypothyroidism: A pilot study

Savitri Nilakanthan, Kashinath Metri, Nagaratna Raghuram, Nagendra Hongasandra

Page range: 189-193

Abstract

Background : A significant number of women in India are suffering from hypothyroidism. Hypothyroidism is characterized by elevated lipid profiles and thyroid stimulation hormone (TSH). It leads many comorbid conditions such as coronary artery disease, obesity, depression, osteoporosis, sleep apnea, and etc. Yoga is proven to be effective in reducing weight, dyslipidemia, depression and it brings the balance in autonomous nervous system. We aimed to study the effect of 6 months yoga practice on lipid profile, thyroxine requirement and serum TSH in women suffering from hypothyroidism. Methods : Twenty-two household women suffering from hypothyroidism between the age range of 30 and 40 (mean±SD; 36.7±3.2) years, with average 4±1.12-year history of hypothyroidism were included in this study. Subjects with known cardiac issues, hypertension, history, recent surgery, slip disc and low back pain were excluded from this study. None of the subjects were on any other medication except thyroxine which was kept during the intervention phage (mean 65.78±22.74 mcg). All the subjects underwent 6 months of yoga practice 1 h daily for 4 days a week. Lipid profile, thyroxine dosage and serum TSH level were assessed before and after intervention. Data was analyzed using paired sample t test & Wilcoxon’s signed rank test. Results : The paired sample t-test showed significant reduction in total cholesterol (p=0.006; –8.99 %), low-density lipoprotein (LDL) (p=0.002; –9.81 %) and triglycerides (p=0.013; –7.6 %), and there was a significant improvement in high-density lipoprotein (HDL) (p=0.02; +9.65 %) along with nonsignificant reduction in TSH level (p=0.452; –9.72 %). Wilcoxon signed-rank test showed significant reduction in thyroxine medication score (p=0.029; –15.30 %) from. Conclusion : 6 months practice of yoga may help in improving cholesterol level, serum TSH, may also help in reducing the thyroxine requirement in female patients suffering from hypothyroidism. However, further randomized controlled studies need to be conducted to confirm the present finding.

April 21, 2016

A double-blind, randomized and placebo-controlled trial of Saffron (Crocus sativus L.) in the treatment of anxiety and depression

Mohsen Mazidi, Maryam Shemshian, Seyed Hadi Mousavi, Abdolreza Norouzy, Tayebe Kermani, Toktam Moghiman, Akram Sadeghi, Naghme Mokhber, Majid Ghayour-Mobarhan, Gordon A. A. Ferns

Page range: 195-199

Abstract

Background : Depression and anxiety are prevalent serious psychiatric disorders. Several drugs are used to treat these conditions but these are often associated with serious side effects. For this reason alternative therapies, including herbal medication such as saffron, have been proposed. We aimed to assess the effects of saffron extract for the treatment of anxiety and depression using a 12-week double-blind, placebo-controlled trial design. Methods : Sixty adult patients with anxiety and depression were randomized to receive a 50 mg saffron capsule ( Crocus sativus L. stigma ) or a placebo capsule twice daily for 12 weeks. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) questionnaires were used at baseline, 6 and 12 weeks after initiating medication. 54 subjects completed the trial. Results : Saffron supplements had a significant effect on the BDI and BAI scores of subjects in comparison to placebo at the 12 week time-point (p<0.001). Conclusions : Saffron appears to have a significant impact in the treatment of anxiety and depression disorder. Side effects were rare.

April 16, 2016

Anti-inflammatory and antioxidant effect of ginger in tuberculosis

Rashmi Anant Kulkarni, Ajit Ramesh Deshpande

Page range: 201-206

Abstract

Background : Tuberculosis (TB) has reemerged to become the world’s leading cause of death from a single infectious agent. Inflammatory cytokines play an important role during the course of the disease and may be responsible for tissue damage by lipid peroxidation. The study was aimed to explore the anti-inflammatory and antioxidant effect of ginger in pulmonary TB patients. Methods : A total of 69 pulmonary TB patients participated in a randomized and placebo-controlled study. The intervention group received 3 g of ginger extract daily for 1 month and placebo group was supplemented with starch capsule. Participants of both groups were taking standard antitubercular treatment during the study. The concentrations of tumor necrosis factor (TNF) alpha, ferritin and malondialdehyde (MDA) in blood samples were analyzed before and after the intervention by using enzyme-linked immunosorbent assay for TNF alpha and ferritin and spectrophotometry for MDA. Results : Ginger supplementation significantly reduced the levels of TNF alpha, ferritin and MDA in ginger supplemented group in comparison to baseline. Ginger supplementation with antitubercular treatment significantly lowered TNF alpha, ferritin and MDA concentrations in comparison to control group. Conclusions : Ginger was found to be effective as an anti-inflammatory and antioxidant supplement along with anti-TB therapy as it possesses strong free radical scavenging property.

About this journal

Objective
Journal of Complementary and Integrative Medicine (JCIM) focuses on evidence concerning the efficacy and safety of complementary medical (CM) whole systems, practices, interventions and natural health products, including herbal and traditional medicines. The journal is edited by Ed Lui of the University of Western Ontario.

Topics

Quality, efficacy, and safety of natural health products, dietary supplements, traditional medicines and their synthetic duplicates
Efficacy and safety of complementary therapies
Evidence-based medicine and practice, including evidence of traditional use
Curriculum development, educational system and competency of complementary health programs
Methodologies on research and evaluation of traditional medicines and herbal products
Integrative medicine: basic and clinical research and practice
Innovation in CAM Curriculum
Educational Material Design

Article formats
Research Articles, Review Articles, Mini Reviews, Discussion/Opinion Papers, Short Communications, Editorials