Persistent macrophage-mediated inflammation under hyperglycemic conditions is an important feature of the inflammatory microenvironment associated with diabetic wounds. α-Mangostin (α-MG), a natural xanthone derived from Garcinia mangostana, has been reported to exert anti-inflammatory activity in various experimental models. However, its effects on high-glucose-induced macrophage inflammation and oxidative stress remain insufficiently characterized. This study aimed to investigate the effects of α-MG on inflammatory and oxidative responses in high-glucose-stimulated macrophages and to explore its potential molecular mechanisms using an integrative strategy combining network pharmacology, molecular docking, molecular dynamics simulation, and in vitro assessment. Potential targets of α-MG were collected and intersected with diabetic wound-associated genes to identify candidate targets. Protein-protein interaction analysis and functional enrichment analyses were performed to identify hub targets and related biological pathways. Molecular docking was used to evaluate the binding affinity between α-MG and key targets, followed by a 110 ns MD simulation of the α-MG-TNF complex and a 50 ns supplementary MD simulation of the α-MG-PTGS2 complex. In vitro experiments were performed using high-glucose-stimulated RAW264.7 macrophages, with mannitol included as an osmotic control. The effects of α-MG on inflammatory mediators, oxidative stress markers, PTGS2/COX-2 expression, and NF-κB activation were further evaluated. A total of 24 overlapping targets between α-MG and diabetic wound-associated genes were identified. Enrichment analyses suggested that these targets were mainly associated with inflammatory and immune-related biological processes, with TNF and IL-17 signaling pathways identified as computationally predicted and potentially relevant pathways. Molecular docking showed favorable binding interactions between α-MG and several hub targets, including PTGS2, AKT1, TNF, and PARP1. The 110 ns molecular dynamics simulation further suggested that the α-MG-TNF complex remained relatively stable during the simulation period. A supplementary 50 ns MD simulation also supported the conformational stability of the α-MG-PTGS2 complex. In high-glucose-stimulated RAW264.7 macrophages, α-MG significantly reduced the mRNA expression and secretion of pro-inflammatory cytokines, including TNF-α, IL-1β, and IL-6. α-MG also decreased PTGS2/COX-2 expression and inhibited NF-κB p65 phosphorylation. In addition, α-MG alleviated high-glucose-induced oxidative stress, as indicated by increased GSH content and SOD activity, together with reduced MDA levels. The inclusion of the mannitol control helped distinguish glucose-associated inflammatory and oxidative responses from osmotic stress-related effects. α-MG attenuated high-glucose-induced inflammatory and oxidative responses in RAW264.7 macrophages. The integrative computational analysis suggested that computationally predicted TNF- and IL-17-related pathways may be involved, whereas the in vitro experiments provided supportive evidence only for changes in inflammatory cytokines, PTGS2/COX-2, oxidative stress markers, and NF-κB activation. These findings provide preliminary experimental and computational evidence for the anti-inflammatory and antioxidant potential of α-MG under diabetic-like macrophage inflammatory conditions. However, direct pathway-specific validation and functional diabetic wound-related models are required before drawing conclusions regarding TNF/IL-17 pathway regulation or therapeutic efficacy in diabetic wound healing.
Complementary and alternative medicine (CAM) is widely used by oncology patients to manage symptoms, reduce stress, and improve quality of life. Unlike conventional treatments, CAM is rarely reimbursed in Germany, resulting in significant out-of-pocket costs. These expenses may contribute to financial burden and financial toxicity, yet this dimension remains understudied. This multicenter, open-label, cross-sectional study was conducted in 2024. A standardized anonymous questionnaire collected demographic, socioeconomic, and medical data, CAM utilization, out-of-pocket expenditures, and distress levels (NCCN Distress Thermometer). Descriptive statistics, Chi-square tests, Pearson correlations, and independent t-tests were applied. A total of 209 patients (median age 62.6 years, 52.6% female) participated; 57.4% reported CAM use. Female patients were more likely than males to use CAM (p < 0.001). Among CAM users, 71.7% incurred out-of-pocket expenses, averaging €124/month for women and €153/month for men. Expenditures were highest among patients with hematological malignancies (€229/month). A strong positive correlation was observed between the number of CAM modalities used and monthly costs (p < 0.001). No significant difference in distress was found between CAM users and non-users; however, female CAM users reported lower distress than their male counterparts (p < 0.05). CAM use is common among German oncology patients and generates substantial out-of-pocket costs, particularly in vulnerable subgroups. When combined with cancer-related income loss, these expenditures increase financial burden and may contribute to financial toxicity. Integrative oncology models, reimbursement strategies, and patient counseling are essential to mitigate economic vulnerability and ensure equitable access to supportive care.
Complementary and alternative medicine (CAM) therapies are increasingly popular; however, comprehensive data on their usage patterns and types remain limited, especially in South Korea. We investigated the patterns and economic impact of CAM use in thyroid cancer after lobectomy. We utilized data from the MASTER study, a prospective, multicenter, randomized, controlled trial on patients with differentiated thyroid cancer post-lobectomy. Data on CAM usage in 1,166 patients at baseline and at 3, 6, and 12 months postoperatively were included. Logistic regression quantified the effect of levothyroxine treatment on CAM usage. CAM use was reported by 58% of participants. Dietary nutritional products were the most used CAM modality, with usage rates of 42.5% at baseline, decreasing to 37.7% at 12 months. Exercise and physical therapies also showed significant differences, with 19.2% using these modalities at baseline, increasing to 27.1% at 12 months. The median cost for CAM varied, with dietary products consistently costing 144 USD (200,000 KRW) and exercise costs rising from 144 USD (200,000 KRW) to 288 USD (400,000 KRW) over time. Patients on levothyroxine were less likely to use CAM, with an odds ratio (OR) of 0.57 (95% confidence interval [CI] = 0.45-0.72, P < 0.001). However, levothyroxine users who did use CAM were more likely to use multiple CAM modalities, with an OR of 3.66 (95% CI = 1.88-7.14, P = 0.001) at baseline, though this association did not remain significant later. CAM is integrated into thyroid cancer treatment, indicating a need for healthcare professionals to discuss its safety and effective care integration.
The urgent need for novel antimicrobial agents arises from the escalating threat of antibiotic-resistant pathogens. Tackling the resistance mechanisms through the application of resistance modifying agents in combination to antimicrobials represents an effective strategy to combat antimicrobial resistance and to enhance the antimicrobial activity. Screening of plant extracts, essential oils and their active compounds for potential resistance modifying properties has proven effective on both a small and large scale. In this study, we define the metabolomic profile of essential oils extracted from different parts of Cymbopogon citratus (DC.) Stapf (lemongrass), and characterize their antioxidant and virulence attenuating activities. The major active ingredients of essential oils extracted from different parts of Cymbopogon citratus (lemongrass) were identified by GC-MS analysis. The minimum inhibitory concentration (MIC) of the essential oils against P. aeruginosa PAO1, Staphylococcus aureus ATCC 6538, and Candida albicans ATCC 10,261 was determined using the broth microdilution assay. Antibiofilm and antiprotease activities were phenotypically evaluated for the extracted lemongrass essential oils for the same standard strains and clinical isolates for the same microbes. Also, the effects on microbial virulence were validated by RT-qPCR against a subset of genes regulating biofilm, quorum sensing, and stress response in P. aeruginosa, and S. aureus. Furthermore, the antioxidant activities of the different essential oils extracted were evaluated using DPPH, β-carotene/linoleic acid and FRAP methods. GC-MS analysis of the essential oils of Cymbopogon citratus revealed the presence of 47 different compounds distributed in the different plant organs. Active constituents such as geranial, neral, myrcene, nerolic acid, linalool, iso-citral, trans iso-citral, and neryl acetate were more abundant in the essential oil extracted from leaves (89.77%), followed by stems (82.92%) and finally roots (52.02%). S. aureus, and C. albicans were more sensitive to C. citratus essential oils than Gram negative P. aeruginosa. Incorporation of sub-MIC doses of essential oils into the culture media was sufficient to disrupt the formation of microbial biofilms in P. aeruginosa, S. aureus, and C. albicans, and to inactivate the proteolytic activities of microbial proteases. The essential oils of C. citratus showed promising and broad-spectrum biofilm eradicating activity. Sub-MIC doses of lemongrass oil dramatically reduced the expression of relA, pslA, and spoT in P. aeruginosa, and agrA, icaA, and sigB in S. aureus indicating a broad-spectrum anti-virulence activity. Our study identifies C. citratus essential oils as potential virulence-attenuating agents. Essential oils extracted from the leaves, stems, and roots of C. citratus exhibited significant antimicrobial, anti-biofilm, anti-virulence, and antioxidant activities, effectively combating microbial resistance. These findings suggest that C. citratus essential oils could be a valuable natural alternative in the fight against resistant pathogens.
Dental caries is a highly prevalent and costly biofilm-dependent disease that affects about 2.3 billion people in their permanent teeth and 532 million people in their primary teeth according to the World Health Organization. The condition is often accompanied by inflammation of the pulp and root apex. Given the high cost of dental procedures, and also the toxicity and antimicrobial resistance linked to antibiotic use, emphasis should be placed on prevention and alternative therapies. Hence, the present study was aimed at evaluating the ethnopharmacology of some plants used in the management of dental caries.Information on plant use, indications, and preparation methods was collected from participants (dental caries patients and traditional medicinal practioners) using the snowball/purposive sampling technique. Quantitative phytochemical analysis and evaluation of free radical scavenging (antioxidant) activity of hydroethanolic extracts were done using spectrophotometry. Anticariogenic activity was assessed in vitro using antibacterial broth microdilution and antibiofilm assays, while lytic and outer membrane permeability activities were also determined spectrophotometrically.Twenty participants reported the effectiveness of medicinal plants in the management of pulpitis, leading to the documentation of 14 plant species. Phytochemical analysis revealed varying concentrations of the assayed compounds. ET (Vitellaria paradoxa) had the highest total phenol content (142.57 ± 2.49 mg GAE/g), while total flavonoid and tannin contents were dominated by PB (Persea americana) (39.04 ± 2.31 mg QE/g) and EP (Euphorbia prostata) (18.46 ± 0.75 mg TAE/g) respectively. Antioxidant evaluation showed notable activities, with EP (Euphorbia prostrata) demonstrating the strongest DPPH radical scavenging activity (IC₅₀ = 1.12 ± 0.11 µg/mL) and FRAP activity (135.03 ± 0.33 µmol FeSO₄/g), as well as concentration-dependent hydroxyl radical scavenging activity. ET (Vitellaria paradoxa) showed the highest antibacteial activities of 64 and 128 µg/ml respectively for MIC and MBC and also demonstrated the strongest antibiofilm activity, with inhibition and eradication rates of 92.72 ± 2.68% and 81.41 ± 0.08%, respectively. In addition, PB (Persea americana) showed the highest lytic activity while ET (Vitellaria paradoxa) produced the highest outer membrane permeability effect.Hydroethanolic extracts of plants in the present study showed good anticariogenic and antioxidant activities. The high phenolic contents could explain their use as anti-inflammatories. These findings suggest that the studied plants and their bioactive constituents may serve as potential sources of novel anticariogenic agents for the prevention and management of dental caries.
A recent report showed that Stephania japonica chloroform fraction has potential anticholinesterase and antioxidant activities and is able to improve learning and memory in mice. Therefore, the aim of the present study was to isolate and identify compounds from the chloroform fraction with cholinesterase inhibitory and antioxidant activity that may be useful as new candidates for the treatment of AD. Chromatographic methods were used for isolation of compounds and the isolated compounds were analyzed by spectroscopic methods for structure elucidation. Acetyl- and butyryl-cholinesterase inhibitory activity were evaluated for by Ellman's method and the antioxidant activity by several in vitro models such as DPPH and hydroxyl radicals scavenging, reducing power, total antioxidant activity, and inhibition of brain lipid peroxidation. The interaction of cholinesterase enzymes and isolated compounds were examined by molecular docking studies. Bioactivity guided approach led to the isolation of four compounds from the chloroform fraction and identified as aknadinine, aknadilactam, aknadicine and stephisoferuline on the basis of their 1H-NMR and 13C-NMR spectral data. All the compounds were of hasubanan type. They showed significant inhibition against acetylcholinesterase and butyrylcholinesterase, with at least two fold increased affinity for butyrylcholinesterase than acetylcholinesterase. The IC50 values of the alkaloids were in the range of 9.36-14.89 µg/mL against acetylcholinesterase and 3.97-6.66 µg/mL against butyrylcholinesterase. Kinetic analysis revealed that all the four compounds exhibited mixed type of inhibition against both acetylcholinesterase and butyrylcholinesterase. The interaction of compounds with several amino acids of enzymes was supported by molecular docking studies. All the hasubanan alkaloids showed antioxidant activity in all in vitro assays and inhibited peroxidation of brain lipid. The IC50 values of the compounds for scavenging of DPPH and hydroxyl radicals, and lipid peroxidation inhibition were found to be in the range of 5.1-40.91, 10.44-19.41, and 20.60-31.72 µg/mL, respectively. The hasubabanan alkaloids isolated from S. japonica may represent a new class of anti-cholinesterase compounds. The multitargeted activity of hasubanan alkaloids may lead to new candidates for the treatment of AD.
Despite the availability of conventional drugs, the use of medicinal plants for typhoid and malaria remains widespread in Nigeria. This study investigated the indigenous use of Cajanus cajan (pigeon pea) and Azadirachta indica (neem) in rural and urban Nsukka. We assessed: (i) socio-demographic factors influencing knowledge and use; (ii) the association between treatment practices and perceived efficacy; and (iii) socio-economic drivers of continued reliance on these herbal remedies. A cross-sectional survey of 400 respondents selected via stratified random sampling (200 urban, 200 rural) was conducted using structured questionnaires, where the primary outcome of this study was current herbal use, while knowledge was treated as a secondary outcome. Data were analyzed using generalized linear models (GLMs) and multinomial logistic regression (MLR) in R Statistical Software (version 4.3.0). Results indicated that rural residents relied more on herbal remedies due to accessibility, affordability, and family traditions, while urban respondents, despite higher education levels, also used herbal extracts and often alternated them with prescription drugs. Residence, occupation, and age were significant predictors of knowledge and use (P < 0.05), whereas education was not. Nonetheless, perceived efficacy and high prescription costs further sustained herbal use. While these findings highlight socio-cultural and economic factors sustaining herbal medicine use, they also support the need for public health education and integration of evidence-based traditional practices into primary healthcare to ensure safer use. However, the cross-sectional design limits causal inference. Future studies should combine questionnaire-based surveys with laboratory-based assessments.
Mental disorders among adolescents and young adults (AYA) are a serious public health concern, particularly in low- and middle-income countries. Despite the growing impact, access to conventional mental healthcare remains limited, leading to high traditional medicine (TM) reliance. However, correlates of TM utilization by AYA with mental health challenges remain underexplored in academic literature. In this study, we investigated the correlates of TM utilization among students with self-reported mental disorders in central and eastern Uganda. In this cross-sectional study, we analyzed secondary data from a subsample of 302 students with self-reported history of a mental health disorder out of a sample of 1970 who completed the survey. In the primary study, stratified random sampling was used to select schools, and participants were selected proportionally. We used modified Poisson regression to examine the factors independently associated with TM use including demographic characteristics and the presence of emotional or behavioral disorders. Statistical significance was set at a p-value of less than 0.05. Most participants were female (53.31%) and aged between 15 and18 years (71.6%). The majority of the participants had completed ordinary level of secondary education (92.54%), from the Central region (74.5%) and attended schools in urban areas (54.04%). The median monthly family income was $83.3, with over half earning ≤$100 monthly (58.8%). Nearly half of the participants reported a family history of mental health disorder (49.8%), and a notable percentage had at least one behavioral disorder (25.8%) or emotional disorder (21.2%). The adjusted model suggested that rural school attendees had a 1.3 times higher prevalence of TM utilization [aPR:1.30(1.01-1.68), p = 0.04] compared to urban ones, and those with parents or guardians who completed college/university had a 38% lower prevalence [aPR:0.62 (0.41-0.94), p = 0.025] of TM utilization compared to those with parents or guardians without formal education. A large proportion of the students utilized TM, largely influenced by rural residence, and parents' education status. The high prevalence of TM use underscores the need for leveraging TM providers as a link to timely biomedical healthcare utilization and improving access to comprehensive treatment for mental health disorders with a focus on socio-economic disparities.
Inflammatory response and oxidative stress interact with each other and are involved in the pathogenesis of various chronic diseases. Senkyunolide A (SenA) is a phthalide compound isolated from the traditional Chinese medicine Chuanxiong Rhizoma (Ligusticum chuanxiong Hort.). At present, the anti‑inflammatory and anti‑oxidative stress effects of SenA remain unclear. In this study, we adopted an integrated strategy combining network pharmacology, bioinformatics analysis, molecular docking, molecular dynamics simulation, bio‑layer interferometry (BLI), and in vitro experiments to explore the anti‑inflammatory and anti‑oxidative stress effects and potential targets of SenA. Through network pharmacology and bioinformatics analysis, we identified four core target genes (Il1b, Ptgs2, Nos2, and Hmox1) of SenA against LPS‑induced inflammation in RAW264.7 cells. Direct binding of SenA to IL‑1β and PTGS2 was confirmed by molecular docking, molecular dynamics simulation, and BLI assays. In vitro experiments showed that SenA pretreatment effectively inhibited LPS‑induced inflammatory response and oxidative stress in RAW264.7 cells, as evidenced by reduced expression of pro‑inflammatory cytokines (TNF‑α, IL‑6, and IL‑1β), decreased levels of NO, ROS, and MDA, increased GSH levels, and alleviated cell swelling and mitochondrial damage. In addition, SenA pretreatment downregulated the mRNA expression levels of the core target genes Il1b, Ptgs2, Nos2, and Hmox1. In conclusion, our findings demonstrate that SenA exerts significant anti‑inflammatory and anti‑oxidative stress effects and may serve as a candidate compound for the treatment of inflammation‑related diseases.
Medicinal baths are an important component of traditional Chinese medicine and are widely used for postpartum recovery, neonatal care, and general health maintenance. Although medicinal bathing practices among ethnic groups such as the Yao and Tibetan have been relatively well documented, ethnobotanical research on Hakka medicinal baths in Guangdong remains limited, despite their widespread use among postpartum women and newborns. Field investigations were conducted in 19 Hakka settlements in northern Guangdong from 2023 to 2024. Data were collected through semi-structured interviews, individual consultations, and field observations involving 138 Hakka informants. Fidelity Level (FL) and Informant Consensus Factor (FIC) were used to evaluate the cultural importance of medicinal bath plants and the degree of agreement among informants. A total of 108 medicinal bath plant species were documented, most of which were herbaceous. The most frequently used plant parts were the whole plant, leaves, and stems. Knowledge of medicinal bath practices was mainly concentrated among older women, who play a central role in postpartum and neonatal care. These plants were reported to be used for the prevention and management of more than 30 health conditions. FIC values ranged from 0.61 to 0.87, with the highest agreement observed for postpartum recovery, respiratory diseases, and skin diseases. Ten plant species had a Fidelity Level (FL) of 100%, indicating high cultural recognition and importance. Compared with the medicinal bath practices of neighboring Yao communities, Hakka practices are characterized by milder remedies, simpler formulations, and a stronger emphasis on family-based healthcare, particularly for mothers and infants. Hakka medicinal baths reflect intergenerational knowledge transmission, practical healthcare strategies, and culturally embedded healing practices. This study systematically documents the medicinal bath plants used by the Hakka in Guangdong and provides a basis for the conservation of traditional knowledge and the sustainable use of medicinal plant resources. The findings also highlight the relevance of Hakka medicinal bath practices in postpartum care, infant healthcare, and community-based complementary healthcare.
Impaired wound healing and persistent infection are major challenges in diabetic wounds. This study aimed to investigate the therapeutic effects of topical thymoquinone formulated in peanut oil on wound healing and bacterial burden in an infected diabetic wound model. Diabetes was induced in rats using streptozotocin, followed by creation of standardized full-thickness excisional wounds that were subsequently infected with Staphylococcus aureus. Animals were randomly assigned to four groups: untreated negative control, vehicle (peanut oil), thymoquinone, and positive control (topical mupirocin). Treatments were applied topically once daily for 14 days. Wound closure was assessed at predefined time points, bacterial load was quantified as log₁₀ CFU/g tissue, and histopathological evaluation was performed using semi-quantitative scoring of re-epithelialization, inflammatory cell infiltration, granulation tissue formation, and collagen deposition. Mean wound closure rates in the thymoquinone group were 27.6 ± 6.1% on day 3, 55.1 ± 8.4% on day 7, 72.4 ± 7.5% on day 10, and 88.2 ± 5.6% on day 14, which were significantly higher than those observed in the untreated negative control group (12.4 ± 4.6%, 28.7 ± 6.9%, 41.9 ± 8.1%, and 58.6 ± 9.3%, respectively) and the vehicle (peanut oil) group (18.9 ± 5.2%, 36.4 ± 7.3%, 52.7 ± 8.6%, and 69.8 ± 8.9%, respectively; p = 0.004 on day 3, p = 0.002 on day 7, p = 0.001 on day 10, and p = 0.001 on day 14), while remaining comparable to the positive control (mupirocin) group without demonstrating statistical superiority. Mean bacterial counts were 5.94 ± 0.46 log₁₀ CFU/g on day 3 and 4.73 ± 0.51 log₁₀ CFU/g on day 7 in the thymoquinone group, compared with 7.62 ± 0.41 and 6.89 ± 0.44 log₁₀ CFU/g in the negative control group and 7.18 ± 0.38 and 6.32 ± 0.40 log₁₀ CFU/g in the peanut oil group (p = 0.003 on day 3 and p = 0.002 on day 7). Histopathological evaluation revealed significantly improved re-epithelialization (3.8 ± 0.4 vs. 1.6 ± 0.5 in controls, p = 0.002), increased granulation tissue formation (4.0 ± 0.5 vs. 1.8 ± 0.6, p = 0.003), and enhanced collagen deposition (3.9 ± 0.4 vs. 1.5 ± 0.5, p = 0.002), together with reduced inflammatory cell infiltration (1.9 ± 0.4 vs. 4.1 ± 0.4, p = 0.001) in thymoquinone-treated wounds compared with controls. Topical thymoquinone formulated in peanut oil improved wound closure, reduced bacterial burden, and enhanced histopathological indicators of tissue repair in this experimental infected diabetic wound model. Further studies are warranted to confirm these findings and explore their translational relevance.
The impact of long-COVID can be substantial for individuals, health systems and the economy, nevertheless, treatment and support options are limited. Yoga offers a potential solution to reduce the burden of long-COVID, demonstrating positive impacts on the biological mechanisms implicated in long-COVID, key long-COVID symptoms and associated mental health challenges. Yoga interventions can also be designed for people with limited physical ability, and online delivery can increase accessibility. To understand the perceptions and experiences of yoga among people with long-COVID (PWLC), and assess its potential benefits. An online survey of PWLC, comprised closed and open response questions on: long-COVID symptoms, support needs, perceptions of a yoga intervention and its components and yoga use. Participants (n = 171) were recruited via Prolific. Inclusion criteria were long-COVID (formal diagnosis or self-reported) and living in the UK. Inductive thematic analysis was used for open ended responses. Analysis identified unmet needs among PWLC that align with the potential benefits of a yoga intervention, particularly in supporting symptom management, self-management and associated psychological symptoms. Additionally, a yoga intervention could provide acknowledgment and support to PWLC who feel despondent about their condition and abandoned by health professionals. Participants reported a high level of interest in a yoga intervention, perceiving it could be of benefit. Barriers to yoga practise included anxiety regarding the group setting, fitting sessions into schedules, lack of energy and concerns about suitability for long-COVID. Those already practising yoga with long-COVID reported that yoga helped to manage symptoms and associated psychological challenges, as well as increasing flexibility and providing a safer alternative to exercise. Many PWLC have positive perceptions of yoga and there is a good level of interest in a yoga intervention among this population. These findings suggest that yoga is a suitable intervention for study in future research as well as delivery in the community by qualified yoga instructors with a knowledge of long-COVID - provided that any intervention is appropriately tailored to fit the ability and address the concerns of PWLC. It should be offered in the context of health professional validation of symptoms.
Patients admitted to intensive care (IC) settings are exposed to a set of inevitable environmental stressors, such as high noise levels, inadequate lighting conditions, long-term immobilization, and prolonged administration of psychopharmaceuticals, the combination of which is known to be associated with clinical challenges, including poor sleep quality, dysregulation of circadian rhythms, agitation, anxiety, disorientation, or delirium. Due to the great complexity of the IC setting, these conditions are difficult to address with conventional means. The goal of the current study was to assess from the perspective of IC nurses the implementation of an integrative medicine approach based on topically applied herbal medicine substances to attend to some of these challenges. External applications of for instance Rosmarinus officinalis, Oxalis acetosella, and other herbal substances can have beneficial effects on peripheral circulation, sleep cycles, and digestion; they are considered safe with little drug interactions, hence presenting a valid candidate for the IC context. Employing a qualitative research approach, we used a series of focus groups with a sample of N = 49 specialized IC nurses working at the IC department of the University Hospital Bern, Switzerland. The qualitative data was analyzed using computer-assisted thematic analysis. Four main theme clusters, each consisting of various sub-clusters, emerged from the analysis. Overall, participants considered the integrative medicine methods a valuable expansion to their therapeutic toolkit, as they offer additional, readily available, non-invasive, and low risk care options they could apply at their own discretion for their often greatly challenged patients. They described favorable experiences, but also reported barriers, like time constraints, or ineffective operational procedures and offered concrete suggestions on how to improve these. Taken together, while not assessing clinical effects, this work suggests tailored topical herbal medicines were perceived by IC nurses as feasible and acceptable complementary care options in selected situations. Not applicable.
Pediatric anorexia is a common condition that can adversely affect the physical growth, nutritional status, and psychosocial development of children. Despite the clinical relevance of Korean medicine, standardized treatment guidelines rooted in the same have not yet been established. This study aimed to develop evidence-based Korean Medicine Clinical Practice Guidelines (KM-CPGs) for pediatric anorexia to support clinical decision-making and ensure safe and effective care. The KM-CPG were developed using evidence-based methodologies, including systematic reviews, meta-analyses, and expert consensus (Delphi method). The level of evidence and grade of recommendation were derived using the grading of recommendation assessment, development, and evaluation (GRADE) approach. A total of 15 key recommendations were derived for Korean medicine interventions, which included herbal medicine, acupuncture, Chuna manual therapy, and acupoint herbal patching, either as monotherapies or in combination with conventional medicine. Most Korean medicine interventions showed moderate to low levels of evidence, but demonstrated meaningful improvements in anorexia-related outcomes, with a low risk of adverse events. The KM-CPG for pediatric anorexia present standardized, evidence-based guidance on Korean medicine treatments and may serve as a foundation for improved clinical care and further research.
Knee osteoarthritis (OA) is a prevalent degenerative joint disease associated with pain, functional limitation, and reduced quality of life. Although nonsteroidal anti-inflammatory drugs are widely prescribed, long-term use is limited by safety concerns. Green-lipped mussel powder (GLMP) has demonstrated anti-inflammatory and chondroprotective effects in preclinical studies. This trial evaluated the efficacy and safety of GLMP supplementation in adults with knee OA. Adults aged 40-75 years with symptomatic radiographic knee OA were randomly assigned (1:1) to receive GLMP (1,000 mg/day) or placebo for 12 weeks. Assessments occurred at baseline, week 6, and week 12. The primary endpoint was change in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score. Secondary endpoints were WOMAC subscales (pain, stiffness, physical function), visual analog scale (VAS) pain, and inflammatory biomarkers (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]). The per-protocol (PP) set included 93 participants (GLMP, 47; placebo, 46); the intention-to-treat (ITT) set included 100. A total of 100 participants were randomized and included in the ITT population, and 93 completed the study and were included in the PP population. In the PP analysis, GLMP resulted in greater improvement in WOMAC total score at week 12 than placebo (between-group difference - 3.66; 95% CI - 6.87 to - 0.45; p = 0.032). Significant between-group differences were also observed for WOMAC pain (p = 0.026), WOMAC physical function (p = 0.027), and VAS pain (between-group difference - 19.93 mm; 95% CI - 25.31 to - 14.55; p < 0.001). In the ITT analysis, the overall pattern of results was consistent with that observed in the PP analysis. WOMAC physical function (p = 0.042) and VAS pain (p < 0.001) remained significantly improved with GLMP, whereas WOMAC total score showed a non-significant trend favoring GLMP (p = 0.061). No significant between-group differences were observed in CRP or ESR levels. No clinically meaningful safety concerns were identified. Twelve-week supplementation with GLMP was associated with improvements in pain and physical function in adults with mild-to-moderate knee OA. Improvements in pain-related outcomes were observed consistently across PP and ITT analyses, although the primary WOMAC total outcome reached statistical significance only in the PP population. GLMP was well tolerated and may have potential as a complementary nutritional intervention for symptom management in individuals with knee OA. The study was registered with the Clinical Research Information Service (CRIS; registration number KCT0008821) on September 22, 2023, and the full study protocol is available on the CRIS website ( https://cris.nih.go.kr ).
Traditional medicine remains a crucial component of primary healthcare in Ethiopia. This study assessed phytopharmaceutical practices and integrative health perspectives among traditional herbal practitioners in Tigray, Ethiopia. A community-based mixed-method cross-sectional study was carried out from March to May 2024 among 58 purposively selected traditional herbal practitioners across five zones in Tigray. A semi-structured interviews, observational assessments and medicinal plant specimen documentation were employed. Quantitative data were analyzed using descriptive statistics and binary logistic regression, while qualitative data were analyzed using thematic content. The findings revealed that the mean age of practitioners was 56.5 years, with males constituting 62.07% participants. Most of the practitioners' experience exceeded 20 years and practiced herbal remedy on a part-time basis. A total of 22 medicinal plant species were documented for the treatment of infectious, physical and spiritual illnesses. Leaves (47.80%), roots (23.80%) and stem barks (16.41%) were the most extensively used plant parts. Greater informant consensus was observed for gastrointestinal disorders (ICF = 0.95) and respiratory diseases (ICF = 0.86). Fidelity level analysis indicated strong agreement on the utilization of Osimum lamifolium for respiratory disorders (93.1%), Ruta chalepensis for gastrointestinal ailments (92%) and Aloe vera for skin infections (90%). Formal education (OR = 6.00, p = 0,046), both family influence and experiential source of knowledge (OR = 11.67, p = 0.032), and prior training (OR = 3.82, p = 0.015) were significantly associated with openness towards integration with modern healthcare systems, whereas older age was reversibly associated with integration willingness (OR = 0.17, p = 0.05). Environmental degradation (98.28%), knowledge erosion (96.55%), lack of formal recognition (89.66%), and inadequate documentation (87.93%) were cited as major challenges to the sustainable practice of traditional medicine. In conclusion, the findings underscore the significance of traditional herbal medicine in community healthcare of Tigray. However, inadequate documentation, environmental factors and poor regulatory framework threatens sustainability of the knowledge. Improving documentation systems, regulatory frameworks and culturally sensitive integration strategies may enhance the sustainability and integration of traditional herbal medicine with the modern healthcare system.
The richness of flora and traditional medical knowledge in the West African country Benin translate into the integral role of medicinal plants in local healthcare. This study explored the current status of traditional medicine research in Benin by evaluating data from ethnopharmacological and ethnobotanical surveys carried out between 2014 and 2023 and identifying knowledge gaps within the sustainable use of plant-based remedies. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol was used to guide the execution of the review. A total of 129 studies identified in scientific databases were analysed. The top 20 cited plant species were subjected to a comprehensive literature review to evaluate the experimental evidence to support the reported traditional uses. A total of 765 plant species belonging to 141 botanical families were cited in the included studies to treat various animal and human diseases, including infectious diseases, digestive disorders and metabolic diseases. Severe gaps in the documentation of plant collection practices, preparation stability, and preservation techniques were observed. Khaya senegalensis A.Juss. (41 citing studies), Parkia biglobosa (Jacq.) R.Br. ex G. Don (37 citing studies) and Ocimum gratissimum L. (33 citing studies) were the most frequently cited plants. Comparison of the scientific literature on the 20 most cited plant species revealed a lack of experimental evidence, even for the most frequent traditional uses. This study illustrated the wide spectrum of plant species applied in Beninese traditional medicine and the critical lack of experimental evidence for their traditional applications and the conservation of medicinal preparations. These findings underscore the need for sustainable harvesting practices, community-based conservation measures, and evidence-based use of plant resources to preserve biodiversity and support long-term availability. This calls for a national database, quality standards, and better integration of traditional medicine into modern healthcare.
Breast cancer(BC) is a major cause of cancer-related mortality in women worldwide, with current therapies often limited by toxicity and drug resistance. Pachymic acid (PA), a natural compound, demonstrates antitumor potential with relatively low systemic toxicity. However, its mechanism in triple-negative breast cancer (TNBC) remains unclear. This study aims to deeply explore the anti-tumor effect of PA on TNBC. The intersection targets of PA and BC were screened through multiple databases, and the key genes were determined through TCGA survival analysis. The potential mechanism was simulated and studied through methods such as network pharmacology, molecular docking and molecular dynamics. Cell proliferation ability was evaluated by CCK-8 assay and colony formation assay. Cell migration and invasion abilities were detected by scratch assay and Transwell assay respectively. Gene expression levels were analyzed by qPCR and Western Blot, and the degree of lipid peroxidation was evaluated by malondialdehyde (MDA) assay. Through multi-database screening and TCGA survival analysis, PTGS2, NOS2 and ABCB1 were identified as key targets. The TNBC cell line MDA-MB-231 was used as the experimental model. PA significantly inhibited the proliferation, migration and invasion of MDA-MB-231 cells. Mechanistic studies demonstrated that PA concurrently upregulates PTGS2 and NOS2 expression while downregulating ABCB1. Notably, the upregulation of PTGS2 was significantly correlated with increased lipid peroxidation, suggesting its crucial role in ferroptosis. The coordinated upregulation of NOS2 and downregulation of ABCB1 further enhanced cellular sensitivity to ferroptosis. This study is the first to reveal that PA induces ferroptosis in TNBC cells by regulating the PTGS2/NOS2/ABCB1 signaling axis, providing new potential targets for TNBC treatment. However, this study has limitations, as validation has been conducted only at the cellular level and not yet confirmed in animal models or clinical samples. Future research should validate this mechanism in more TNBC models and across different molecular subtypes of breast cancer to promote the clinical application of PA.
Annona muricata L., known for its medicinal properties, has been explored for its potential in treating benign prostatic hyperplasia (BPH). While previous studies have noted its numerous health benefits, this research evaluated the therapeutic potential of seed extract of Annona muricata (SEAM) against BPH in rats by exploring in vivo and in silico approaches. SEAM extraction, phytochemical analysis, in vitro antioxidant activities, and acute toxicity were achieved using standard methods. Thirty male Wistar rats (weight: 158-192 g) were randomly divided into six groups of five rats each. The groups were assigned as follows: (1) normal control, (2) negative control, (3) positive control, and (4-6) experimental groups. BPH was induced in rats of groups (2-6) by subcutaneous injection of 3 mg/kg body weight (b.w) testosterone for 28 days, followed by daily oral treatment with 5 mg/kg b.w. Finasteride, 200, 400 and 600 mg/kg b.w SEAM, respectively for 21 days. The effect of SEAM treatment on changes in rats' biochemical, hematological, and histological indices was assessed. Extraction of 3000 g of A. muricata seeds yielded 255.6 g SEAM. GC-MS analysis of SEAM revealed flavonoids, alkaloids, polyphenols, and saponins. SEAM exhibited strong radical scavenging activity in vitro. BPH induction in rats triggered significant (p < 0.05) alterations in some biochemical, hematological and histological profiles of test rats. Notably, SEAM significantly (p <0.05) normalized altered levels of prostate-specific antigen, testosterone, antioxidant enzymes, and hematological parameters of treated rats, and is comparable to the standard drug, Finasteride. Molecular docking studies revealed strong binding interactions between SEAM phytochemicals and 5-alpha reductase, suggesting inhibition of this enzyme as a key mechanism of SEAM action. Our study not only confirms the therapeutic potential of SEAM in BPH management but also provides insights into novel biochemical pathways and molecular interactions. These findings indicate that SEAM possess significant anti-BPH property through antioxidant activity and 5-alpha reductase inhibitory activity, providing scientific validation for its potential as a natural remedy for BPH, and setting the stage for further mechanistic studies and clinical trials.
Manuka honey contains bioactive phenolic and flavonoid chemicals with antibacterial and anti-inflammatory effects. The chemical profile and therapeutic efficiency of Manuka honey against Helicobacter pylori infection were investigated utilizing in-vitro and in-vivo models. The phenolic and flavonoid contents were profiled using HPLC. The antibacterial property of Manuka honey extract was determined using inhibitory zones, MIC, MBC, and time-kill tests. An H. pylori rat model was utilized to investigate changes in weight, bacterial burden, histological modifications, NF-κB expression, inflammatory cytokines (TNF-α, IL-4), oxidative stress indicators (CAT, SOD, MDA, NO), and biochemical parameters such as kidney and liver functioning. HPLC examination identified seven phenolic chemicals, the most prevalent of which were coumaric, cinnamic, and chlorogenic acids, as well as seven flavonoids, dominated by chrysin, rutin, and kaempferol. Manuka honey demonstrated strong anti-H. pylori activity (inhibition zone 15.1 mm), equivalent to conventional medications with MIC 31.25 µg/mL and MBC 62.5 µg/mL. Time-kill curves revealed no significant differences from normal therapy. Manuka honey treated infected rats by restoring body weight, reducing stomach bacterial load, improving histology, and downregulating NF-κB expression. The treated rats showed decreased TNF-α, increased IL-4, improved antioxidant enzyme levels, lower oxidative stress indicators, and normalized liver and kidney functioning. Manuka honey has substantial anti-H. pylori capacity, substantial anti-inflammatory properties, oxidative stress regulation, and protection of gastric tissue, hepatic, and renal functions, indicating its therapeutic usefulness as a natural complementary to H. pylori infection.