Role of dietary polyphenols in the management of peptic ulcer

Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers.Despite medical advances,the management of peptic ulcer and its complications remains a challenge,with high morbidity and death rates for the disease.An accumulating body of evidence suggests that,among a broad reach of natural molecules,dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers.The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by:improving cytoprotection,re-epithelialization,neovascularization,and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthasederived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance,antacid,and antisecretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration.In addition,anti-inflammatory activity due to downregulation of proinflammatory cytokines and cellular and int e r c e llular adhe s ion age nt s,s uppr e s s ing leukocyte-endothelium interaction,inhibiting nuclear signaling pathways of inflammatory process,and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols.In conclusion,administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer.Further welldesigned preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer.

Protective effect of essential oil of Pistacia atlantica Desf. on peptic ulcer: role of α-pinene

OBJECTIVE: To evaluate the efficacy of Pistacia atlantica Desf. oleoresin essential oil on peptic ulcer(PU) and its antibacterial effect on metronidazole-resistant Helicobacter pylori, as well as chemi-cal composition of the essential oil.METHODS: The essential oil was standardized using gas chromatography mass spectrometry(GC/MS) analysis. Acute toxicity of the essential oil was assessed in animal model. In vitro anti-Helicobacter pylori activity was performed through disc diffusion and minimum inhibitory concentration method. For gastroprotective assay, rats received Pistacia atlantica Desf. essential oil(25, 50 and 100 mg/kg orally) 1 h before induction of ulcer by ethanol.Macroscopic(ulcer index and protection rate) and microscopic examination were performed.RESULTS: The GC/MS analysis of the essential oil led to the identification of twenty constituents andα-pinene is predominant constituent. The essential oil was safe up to 2000 mg/kg. All Helicobacter pylori strains were susceptible to the essential oil and the MIC ranged from 275 to 1100 μg/m L. The ulcer index for treated groups was significantly reduced compared to control(P < 0.001) with EC50 value of 12.32 mg/kg. In microscopic examination, Pistacia atlantica attenuated destruction and necrosis of gastric tissue.CONCLUSION: Current study exhibited protective effect of standardized Pistacia atlantica essential oil against ethanol-induced gastric ulcer and its antibacterial activity on Helicobacter pylori. α-pinene might be the responsible agent.

Parsley: a review of ethnopharmacology, phytochemistry and biological activities

OBJECTIVE:To summarize comprehensive information concerning ethnomedicinal uses, phytochemistry, and pharmacological activities of parsley. METHODS: Databases including PubMed, Scopus, Google Scholar, and Web of Science were searched for studies focusing on the ethnomedicinal use, phytochemical compounds and biological and pharmacological activities of parsley. Data were collected from 1966 to 2013. The search terms were: "Parsley" or "Petroselinum crispum" or "Petroseli-num hortence ". RESULTS: Parsley has been used as carminative, gastro tonic, diuretic, antiseptic of urinary tract, anti-urolithiasis, anti-dote and anti-inflammatory and for the treatment of amenorrhea, dysmenorrhea, gastrointestinal disorder, hypertension, cardiac disease, urinary disease, otitis, sniffle, diabetes and also various dermal disease in traditional and folklore medicines. Phenolic compounds and flavonoids particularly apigenin, apiin and 6"-Acetylapiin; essential oil mainly myristicin and apiol; and also coumarins are the active compounds identified in Petroselinum crispum. Wide range of pharmacological activity including antioxidant, hepatoprotective, brain protective, anti-diabetic, analgesic, spasmolytic, immunosuppressant, anti-platelet, gastroprotective, cytoprotective, laxative, estrogenic, diuretic, hypotensive, antibacterial and antifungal activities have been exhibited for this plant in modern medicine. CONCLUSION: It is expectant that this study resulted in improvement the tendencies toward Petroselinum crispum as a useful and important medicinal plant with wide range of proven medicinal activity.

Medicinal properties of Peganum harmala L. in traditional Iranian medicine and modern phytotherapy: a review

OBJECTIVE: To review the pharmacological activities of Peganum harmala L.(P. harmala, Nitrariaceae) in traditional Iranian medicine(TIM) and modern phytotherapy.METHODS: Opinions of TIM and modern phytotherapy about safety and acceptable dosage of this plant are discussed. Various medical properties of P.harmala were collected from important TIM references and added to scientific reports derived from modern medical databases like Pub Med, Scirus, Science Direct and Scopus.RESULTS: The main medicinal part of the plant is the seed. In TIM resources, this plant possesses various Pharmacological activities such as carminative,galactagogue, diuretic, emmenagogue, antithrom-botic and analgesic. In modern phytotherapy, P. harmala demonstrated numerous medicinal effects including cardiovascular, neurologic, antimicrobial,insecticidal, antineoplasmic, antiproliferative, gastrointestinal and antidiabetic effects. Adverse events such as neuro-sensorial symptoms, visual hallucination, bradycardia, hypotension, agitation,tremors, ataxia, abortion and vomiting cause people to use this plant cautiously. P. harmala is contraindicated during pregnancy, due to its abortive and mutagenic activities. Because of increasing the expression of CYP1A2, 2C19, and 3A4 and inhibition of monoamine oxidase, the pharmacokinetic parameters of drugs which are mainly metabolized by these enzymes may be affected by P. harmala.CONCLUSION: The medicinal properties declared for this plant in TIM are compared with those showed in modern phytotherapy. Some of the TIM properties were confirmed in modern phytotherapy like emetic and analgesic activities and some have not been evaluated in modern phytotherapy such as its therapeutic effects on paralysis, epilepsy and numbness. Finally, the current review provides the evidence for other researchers to use TIM properties of P. harmala as an efficacious natural drug.Further preclinical and clinical studies for adequate evaluating safety and therapeutic efficacy are recommended.

Gastroprotective effect of aqueous stem bark extract of Ziziphus jujuba L.against HCl/Ethanol-induced gastric mucosal injury in rats

OBJECTIVE: To evaluated the gastroprotective effects of standardized aqueous extract of Ziziphus jujuba(Z. jujuba) stem bark against acidified ethanol-induced gastric ulcers as well as anti helicobacter pylori activity of the plant extract in rats.METHODS: Five groups of rats were orally pre-treated with normal saline(0.9%) as ulcer group, 150 mg/kg of ranitidine as positive control group, 100, 200 and 400 mg of standardized extract solution as the experimental groups. Two hours later, acidified ethanol solution was given by gavages in order to induce of gastric ulcer. The antibacterial effect of extract against clinical strains of Helicobacter pylori(H. pylori) was evaluated through disc diffusion test.RESULTS: The ulcer group exhibited significantly severe mucosal injury as compared with ranitidine or extract group which shows significant protective action against gastric mucosal injury. The extract showed no effect on H. pylori.CONCLUSION: The present study indicates that Z.jujuba stem bark extract had a potential antiulcer activity which might be due to its protective activity, providing a direct, protective effect on the gastric mucosa. Our study showed that anti-H. pylori activity was not among gastroprotective mechanism of Z. jujuba. Further pre-clinical and clinical investigations for evaluating natural active agents and efficacy of this plant are recommended.

Evaluation of anti-aphthous activity of decoction of Nicotiana tabacum leaves as a mouthwash： a placebo-controlled clinical study

OBJECTIVE: To determine the effects of decoction derived from the leaves of Nicotiana tabacum(L.)as a mouthwash on minor recurrent aphthous.METHODS: A randomized double-blinded placebo-controlled clinical trial was conducted on 60 patients with minor recurrent aphthous. Treatment comprised of application of tobacco or placebo mouthwash(10 m L 3 times a day) for 5 days. Clinical evaluation included pain level using a visual analog scale and ulcer size on days 1, 3, and 5 were measured. Adverse effects after mouthwash application were recorded, and the oral mucosa was examined by the investigator at each visit.RESULTS: A total of 54 subjects with the mean age(38 ± 10) years fulfilled the study. No minor and major adverse effects were observed. In the treatment group, ulcer pain score was decreased by 79.2%and 93.8% and ulcer size was reduced by 69.1%and 92.2%(days 3 and 5, respectively), which was significantly greater than the control group(P <0.01).CONCLUSION: The decoction prepared with of Nicotiana tabacum leaves, used as mouthwash are well-tolerated and safe, and can be used for the management of recurrent aphthous.

Pharmacological activity of Mentha longifolia and its phytoconstituents

Current paper reviews the pharmacological activities, therapeutic indications and phytochemicals of M. longifolia. This herb has been consumed traditionally for the treatment of various diseases, including gastrointestinal disorders, respiratory disorders, infectious diseases, inflammatory diseases, as well as menstrual disorders. In the modern era, various pharmacological activities have been confirmed for M. longifolia, such as anti-parasitic, antimicrobial, anti-insect, antimutagenic, antinociceptive, anti-inflammatory, antioxidant, keratoprotective, hepatoprotective, anti-diarrhea, and spasmolytic effects. The plant showed therapeutic benefits in irritable bowel syndrome, amenorrhea and oligomenorrhea, and oxidative stress-associated diseases as well. A vast variety of natural components such as flavonoids, phenolic acids, cinnamates, ceramides, sesquiterpenes, terpenes, and terpenoids have been suggested to be responsible for the pharmacological action of M. longifolia. These natural products can be considered as novel medicinal sources for developing new drugs. Further investigations to explore therapeutic efficacy, tolerability,and pharmaceutical properties of M. longifolia phytochemical agents are recommended.

Efficacy and safety of Hemoheal cream in patients with hemorrhoids:a randomized double-blind placebo controlled clinical trial

OBJECTIVE:To evaluate the efficacy and safety of Hemoheal cream,an anti-hemorrhoid herbal preparation,(inspired by Persian medicine literatures in a double-blind,randomized placebo-controlled trial.METHODS:Hemoheal cream consists of aqueous extract of Allium ampeloprasum L.,Commiphora mukul(Hook.Ex Stocks)Engl and the oil of Sesamum indicum L.Fifty-two patients with symptomatic hemorrhoids were randomized to receive hemoheal cream or placebo for 3 weeks.The patients were evaluated before and after the intervention in terms of the severity of anal irritation,bleeding,anal itching,pain,defecation discomfort and swelling sense,and overall subjective improvement(%),as well as any reported adverse events.RESULTS:The results showed that after 3 weeks of treatment,distribution of anal irritation,bleeding,pain as well as swelling sense were significantly different(P<0.05),while the analysis showed no significant differences between two groups for anal itching and defecation discomfort(P>0.05).Furthermore,a significant difference was observed between the overall subjective improvement of Hemoheal cream and placebo groups(P=0.012).One patient in the treatment group complained of rashes on the application site.CONCLUSION:The present study showed a positive effect of Hemoheal cream in improving clinical signs and symptoms in patients with hemorrhoids.