Treatment on Nature’s lap:Use of herbal products in the management of hyperglycemia

Diabetes mellitus(DM)is characterized by persistently elevated blood glucose concentration that lead to multisystem complications.There are about 400 medicinal plants cited to have a beneficial effect on DM.We must choose products wisely based on data derived from scientific studies.However,a major obstacle in the amalgamation of herbal medicine in modern medical practices is the lack of clinical data on its safety,efficacy and drug interaction.Trials of these herbal products often underreport the side effects and other crucial intervention steps deviating from the standards set by Consolidated Standards of Reporting Trials.Due to a lack of knowledge of the active compounds present in most herbal medicines,product standardization is difficult.Cost-effectiveness is another issue that needs to be kept in mind.In this mini-review,we focus on the antihyperglycemic effect of herbal products that are commonly used,along with the concerns stated above.

A strategy for rapid discovery of traceable chemical markers in herbal products using MZmine 2 data processing toolbox:A case of Jing Liqueur

Objective:The quality evaluation of herbal products remains a big challenge.Traceable markers are the core concept of the authentication of herbal products.However,the discovery of traceable markers is labor-intensive and time-consuming.The aim of this study is to develop a convenient approach to rapidly screen the traceable markers for herbal product authentication.Methods:Commercial Jing Liqueur and its 22 species of herbal ingredients were analyzed using HPLCQTOF-MS and GC–MS to characterize nonvolatile and volatile chemicals.The acquired data were imported into MZmine 2 software for mass detection,chromatogram building,deconvolution and alignment.The aligned data were exported into a csv file and then traceable markers were selected using the built-in filter function in Excel.Finally,the traceable markers were identified by searching against online databases or publications,some of which were confirmed by reference standards.Results:A total of 288 chemical features transferred from herbal materials to Jing Liqueur product were rapidly screened out.Among them,52 markers detected by HPLC-QTOF-MS were annotated,while nine volatile markers detected by GC–MS were annotated.Moreover,30 of these markers were confirmed by comparing with reference standards.A chemical fingerprint consisting of traceable markers was finally generated to ensure the authentication and quality consistency of Jing Liqueur.Conclusion:A strategy for rapid discovery of traceable markers in herbal products using MZmine 2 software was developed.

RECOMMENDATIONS FROM THE HERBAL MEDICINES AND PRACTITIONERS WORKING GROUP IN THE UK: RAISING THE STANDARDS OF MANUFACTURED HERBAL PRODUCTS

The UK government set up a Herbal Medicines and Practitioners Working Group(HMPWG)to assess possibilities of:1.Setting up Statutory Regulation of Herbal Medicine Practitioners;2.Allowing continued public access to valuable herbal medicines.On 26th March 2015 the HMPWG published the key recommendations after over a year of meetings and consultation with experts.

Medicinal Plant Use in Ghana: Advancement and Challenges

In Ghana, the use of medicinal plants is a known and an acceptable practice common to all the regions and ethnic groups, with about 60% to 70% of Ghanaians depending on traditional medicine for their healthcare needs. Even though medicinal plants are all over the country and are of great benefits to a lot of Ghanaians, there is little or no proper documentation on medicinal plants use in Ghana;how it all started and where it is today, as well as what is being done to promote its use and some challenges being faced with its use as a country. This paper therefore sought to assess and compile generally, Medicinal plants use in Ghana;focusing on the use of some plant medicine, development and advancement in the herbal medicine practice, as well as associated challenges. Available literature and information on medicinal plants use in Ghana were compiled by searching through electronic database such as Google Scholar, PubMed, Science direct, SciFinder and other relevant websites, as well as books and reports. A brief history, measures taken to develop and advance plant medicine use and some specific challenges facing plant medicine practice and use in the county have been discussed in detail in this write-up. This compilation is believed to bring to book the value of some medicinal plants in Ghana and the efforts being made to promote herbal drugs to complement orthodox medication.

Biomonitoring for traditional herbal medicinal products using DNA metabarcoding and single molecule, real-time sequencing

Global concerns have been paid to the potential hazard of traditional herbal medicinal products(THMPs). Substandard and counterfeit THMPs, including traditional Chinese patent medicine, health foods, dietary supplements, etc. are potential threats to public health. Recent marketplace studies using DNA barcoding have determined that the current quality control methods are not sufficient for ensuring the presence of authentic herbal ingredients and detection of contaminants/adulterants. An efficient biomonitoring method for THMPs is of great needed. Herein, metabarcoding and single-molecule, realtime(SMRT) sequencing were used to detect the multiple ingredients in Jiuwei Qianghuo Wan(JWQHW), a classical herbal prescription widely used in China for the last 800 years. Reference experimental mixtures and commercial JWQHW products from the marketplace were used to confirm the method. Successful SMRT sequencing results recovered 5416 and 4342 circular-consensus sequencing(CCS) reads belonging to the ITS2 and psb A-trn H regions. The results suggest that with the combination of metabarcoding and SMRT sequencing, it is repeatable, reliable, and sensitive enough to detect species in the THMPs, and the error in SMRT sequencing did not affect the ability to identify multiple prescribed species and several adulterants/contaminants. It has the potential for becoming a valuable tool for the biomonitoring of multi-ingredient THMPs.

THE REGISTRATION OF TCM PRODUCTS UNDER EU TRADITIONAL HERBAL MEDICINAL PRODUCT DIRECTIVE

The Traditional Herbal Medicinal Products Directive(THMPD)2004/24/EC is a regulatory process established to enable high quality herbal medicines to be registered as an OTC product,with medical claims(as allowed for OTC drugs)on the packaging and in the patient information leaflet.For those products which are eligible to be registered they must firstly,be only for mild and self-limiting ailments。

Analysis of an Adulterated Herbal Medicinal Product Using Ultra-Performance Liquid Chromatography Coupled with QTOF Mass Spectrometry

The reports of severe adverse effects and fatalities associated with herbal medicinal products adulterated with synthetic compounds have raised global concerns.The objective of this study is to analyze one commercial herbal medicinal product suspected to be adulterated with synthetic drugs in order to identify potential adulterants,to verify if the product contained the herbs listed as ingredients in label claim and to determine quality consistency among different batches of the product.Analyses of suspected product obtained from seven different batches were performed using ultra performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS) with multiple data processing tools and multivariate analyses.In addition,23 individual powdered herbs(12 as per label claim and 11 suspected herbs),11 marker compounds of the labeled herbs and five suspected synthetic drugs as adulterants were also concurrently analyzed to have clear understanding of product composition.Based on our analysis,the major ingredients of studied product were found to be 5 synthetic compounds:caffeine,chlorphenamine,piroxicam,betamethasone and oxethazaine.Three of them have been found to exceed their recommended doses.From the herbal composition analysis,Gan Cao(Glycyrrhizae radix et rhizoma) was found to be the main ingredient,which is not among the claimed 12 herbs that were supposed to be in the product.Other herbs detected as minor ingredients were Mu Gua(Chaenomelis fructus),Dang Gui(Angelicae sinensis radix),and Huang Qi(Astragali radix),which are among the 12 herbs that were supposed to be in the product.Based on our results we demonstrated that UPLC-QTOF MS is an effective and versatile tool for the analysis of herbal medicinal products.It is highly desirable to have a streamlined process with automatic workflow and fit-forpurpose database to increase efficiency and productivity of sample analysis.Results of this work also highlight the need for the better quality control and regulatory measures to protect consumers from the potentially harmful effects of such adulterated products.

Herbal Medicines for Acute Kidney Injury: Evidence, Gaps and Frontiers

Acute kidney injury(AKI) is a major health threat worldwide. The literature on herbal intervention in AKI was searched from English and Chinese databases and reports were critically analyzed in terms of preventing AKI, promoting repair and regeneration, enhancing extrarenal clearance of uremic toxins, and preventing progression to chronic kidney disease(CKD). Altogether, 16 herbal formulae and a few extracts derived from individual herbs were reported to prevent or mitigate AKI in animal models induced by renal ischemia/reperfusion, cisplastin,gentamicin, glycerol, adenine, sepsis or physical exhaustion. Four formulae and six individual herbs were reported to accelerate recovery and/or to prevent CKD in established AKI animal models. Intrarectal herbal medicines, with or without simultaneous oral administration, were reported in six clinical trials and in an animal model to increase extrarenal clearance of uremic toxins. Additional 13 clinical trials reported oral or intravenous herbal interventions in AKI of different etiologies. Despite recurring problems, notably poor compliance with good practice guidelines for clinical trials and for authentication, naming and quality control of herbal materials, accumulating experimental data on the preventive effects of herbal medicines in AKI look encouraging and urge for better, definitive trials to guide clinical practice. Herbal enemas promoting extrarenal clearance of uremic toxins seem cost-effective, but better clinical evidence is certainly needed before any affirmative recommendation be made for AKI patients without access to dialysis. New frontiers, however, lie in those herbal remedies that promote repair/regeneration and prevent chronicity after AKI. Recent experimental data suggest that this may be possible.

An Innovative Herbal Product for the Prevention of Osteoporosis

Objective： To prevent the deterioration of osteopenia, a triple herb product Bo-gu Ling （补骨灵, ELP） was created for a clinical trial on post-menopausal women suffering from osteopenia. Methods： The design of the clinical trial was of randomized, double-blind, placebo-controlled nature. A total of 150 women aged 40-60 years, who were after menopause for at least 1 year and their lumbar spine bone mineral density （BMD） must be lower than 0.891 g/cm2, were recruited and randomly divided into the ELP group treated with ELP and the placebo group, with 75 in each group. The primary endpoint was the BMD of the lumbar spine that was assessed at baseline, 6 and 12 months after treatment. Secondary endpoints included peripheral quantitative computed tomography （pQCT） measurements of distal tibia and the changes in the quality of life （QOL）. Results： The spine BMD of the ELP group was increased by 0.69% in the subjects who were more than 10 years after menopause. In contrast, the placebo group of the same stratum decreased by 0.61% （P=0.067）. In the subjects with more than 10 years duration of menopause, the hip BMD increased by 0.21% in the ELP group, compared with a decrease of 0.52% in the placebo group （P=0.159）. The tibia strengthstrain index was increased by 1.94% in the ELP group compared with 0.33% in the placebo group （P=0.047）. Physical function of SF-36 QOL questionnaire was remarkably improved compared with the baseline, but did not show dominance over the placebo group. Conclusion： ELP showed potential benefit in improving BMD on the women who experienced over 10 years of menopause.

New Chinese Herbal Product Launched in the US

A new form of Chinese medicine that has dominated the Japanese OTC herb market for decades is now available in the U.S.The new medicines,called"Prime Herbs Granules",are produced through a process involving strict controls and advanced technology at every stage.Nevertheless,consumers agree that the benefits are worth