Fabio Firenzuoli

• Managing Director at University of Florence

The use of natural compounds to prevent and treat infective diseases is increasing its importance, especially in the case of multidrug-resistant (MDR) microorganisms-mediated infections. The drug resistance phenomenon is today a global problem, so it is important to have available substances able to counteract MDR infections. Syzygium aromaticum (L...

Phytochemical screening of four commercial products containing Salvia officinalis was carried out. Total phenolic content was estimated spectrophotometrically through the use of the Folin–Ciocalteau method, flavonoid content was measured through the use of aluminum chloride and 2,4-dinitrophenylhydrazine colorimetric assays, and isoflavones and α/β...

The safety of Serenoa repens (SR)-containing products was evaluated conducting a retrospective worldwide analysis of pharmaco- and phytovigilance report forms of suspected adverse reactions (SARs) collected up to 31 January 2022. Multivariate logistic regression was performed to estimate the odds ratios (ORs) of serious SAR. A total of 1810 report...

Vitamin D (VitD) is largely used in Italy, often inappropriately; thus, an evaluation of its safety is a crucial issue. This study analyses the adverse reactions (ARs) associated with the use of products containing VitD (VitDps) reported to the Italian National Pharmacovigilance and Phytovigilance networks. From March 2002 to August 2022, a total o...

This research aims to provide a comprehensive overview of the key demographic, psychosocial, and lifestyle-related characteristics of forest therapy participants in Italy. A survey was conducted among 1070 adults who had engaged in standardized forest therapy experiences between June 2021 and October 2022. The findings indicate that most forest the...

The urban plan of Palermo (Sicily, Italy) has evolved throughout Punic, Roman, Byzantine, Arab, and Norman ages until it stabilized within the borders that correspond to the current historic center. During the 2012 to 2013 excavation campaign, new remains of the Arab settlement, directly implanted above the structures of the Roman age, were found....

Important evidence is being reported on the antimicrobic and antagonistic properties of bacterial endophytes in Echinacea purpurea and their role in the modulation of plant bioactive compounds synthesis. Here, endophytic fungi were isolated from E. purpurea tissues, and the dual culture approach was applied to deepen insight into the complex plant-...

Lavender oil, rich in linalool and linalyl acetate, has a long-standing traditional use as a tranquilizer to relieve symptoms of mental stress and as a sleep aid. The three main botanical species of lavender harvested for medicinal purposes are Lavandula angustifolia (the most used one), Lavandula latifolia, and Lavandula × intermedia. Available sc...

Acmella oleracea L. is an edible and medicinal plant commonly known for its local anaesthetic effect induced by the alkylamide spilanthol. It is also rich of secondary metabolites of biological interest, mainly phenolic acids and glycosylated flavonoids. This study evaluated for the first time alkylamides and phenolic compounds in aerial parts and...

In Italy, since 2002, a Phytovigilance system has collected spontaneous reports of suspected adverse reactions associated with food supplements, herbal products, and compounded preparations containing plants. The system is coordinated by the Italian National Institute of Health. Reports are collected though an online reporting system. Causality ass...

Introduction: Products containing anthraquinones (AQ) are associated with an increased risk of serious adverse events (AEs). We performed an update of the available evidence retrieved by the spontaneous reports of AE associated with herbal dietary supplement (DS) and over-the-counter medications (OTC-M) used as laxatives. Methods: Analysis and e...

The authors wish to make the following corrections to this paper [...]

The purpose of this analytical study was to develop an advanced formulation of medical Cannabis oil (MCO) comparing the chemical profile of different extracts obtained with two existing methods (SIFAP and CALVI) and one original upgraded (CERFIT) method. Preparation methods were applied with varying solvent, temperature, and duration of the decarbo...

This systematic review and meta-analysis were conducted to determine the effects of anthraquinone (AQ) laxatives on colorectal cancer (CRC). We searched PubMed, Embase, Google Scholar, and CENTRAL from inception until March 2021, for randomized controlled trials (RCTs) and observational studies. Through the systematic review, we identified 8 observ...

OBJECTIVE: Current demographic trends show an increase in world population ageing with the urgent necessity to identify sustainable strategies for supporting healthy ageing. The aim of this review was to assess whether forest bathing can improve elderly subjects’ well-being and quality of life. DESIGN AND METHOD: This study was designed as a narrat...

Immersion in forest environments was shown to produce beneficial effects to human health, in particular psychophysical relaxation, leading to its growing recognition as a form of integrative medicine. However, limited evidence exists about the statistical significance of the effects and their association with external and environmental variables an...

Introduction. Environmental health research has recently started to study the effects on health of well-being promoting practices based on forest exposure. This review aims to understand whether forest exposure can directly improve respiratory function. Methods. This study was designed as a narrative literature review. PubMed, Cochrane Library and...

Environmental health research has recently started to study the health effects of well-being-promoting practices based on forest exposure. This narrative review aims to understand whether forest exposure can directly improve respiratory function. PubMed, Cochrane Library and Google Scholar were screened, up until April 2021, for clinical studies ab...

The aim of this review was to outline the most relevant benefits of forest bathing for well-being promotion. This study was designed as an umbrella literature review. Medline (via PubMed), EMBASE, Web of Science, Cochrane Library, Google Scholar, Scopus, PsycINFO, CINAHL and the DOAJ were systematically searched for relevant reviews up to February...

Supplementary Table A. Relevant narrative reviews about the effects on individual well-being of forest bathing and other forest-related interventions. Supplementary Table B. Relevant systematic reviews about the effects on children’s well-being of forest camps and other forest-based experiences. Supplementary Table C. Quality of included systematic...

Echinacea purpurea is a plant cultivated worldwide for its pharmaceutical properties, mainly related to the stimulation of the immune system in the treatment of respiratory infections. The cypselas (fruits) of E. purpurea were examined in order to investigate the presence, localization and potential function(s) of endophytic microorganisms. Electro...

Introduction The involvement of the upper respiratory tract is common in COVID-19, and the majority of patients are treated at home with a mild-to-moderate form of the disease. Many approaches based on essential oils have been proposed for the symptomatic treatment of COVID-19. This work aims to outline the potential and safe evidence-based uses of...

Response to: Low WK, Pok WN. Effectiveness of acupuncture for tinnitus. Longhua Chin Med 2020;3:14.

In this chapter we analyze the profound relationship between man and Forest. We describe this relationship by hinting at historical, psychological and spiritual references.

Definition Bergamot essential oil (BEO) is the result of the mechanical manipulation (cold pressing) of the exocarp (flavedo) of the hesperidium of Citrus limon (L.) Osbeck Bergamot Group (synonym Citrus × bergamia Risso & Poit.), resulting in the bursting of the oil cavities embedded in the flavedo and the release of their contents. It is chemical...

Medicinal plants (MPs) have been used since antiquity in traditional and popular medicine, and they represent a very important source of bioactive molecules, including antibiotic, antiviral, and antifungal molecules. Such compounds are often of plant origin, but in some cases, an origin or a modification from plant microbiota has been shown. Actual...

Acmella oleracea L. is an important medicinal plant, commonly known as the toothache plant. It is a rich source of secondary metabolites used for the treatment of different human disorders. The demand for Acmella oleracea L. has increased due to its putative health benefits (in terms of both biomass quantity and bioactive compound purification). In...

In recent years, the role of vitamin D in the immune system has been explored. In light of the global burden of COVID-19, this literature overview aims to understand whether vitamin D can be a useful integrative option for COVID-19 prevention. A PubMed-based overview of reviews (date of search: 7 December 2020). After a database search, 305 article...

Una dieta bilanciata, ricca di fibre e con il giusto apporto di vitamine e micronutrienti, può essere un valido alleato per la salute del sistema immunitario. In questo articolo, pubblicato sul magazine "Elisir di salute", vengono dati alcuni suggerimenti pratici per fare in modo che il nostro regime alimentare fornisca al sistema immunitario tutto...

Lavender oil, rich in linalool and linalyl acetate, has a long-standing traditional use as a tranquilizer to relieve symptoms of mental stress and as a sleep aid. The three main botanical species of lavender harvested for medicinal purposes are Lavandula angustifolia (the most used one), Lavandula latifolia, and Lavandula × intermedia. Available sc...

In questo capitolo sarà analizzato il legame intimo che nella storia ha connesso l'uomo alla natura e, in particolare, alla foresta, con specifico riguardo a elementi psicologici, culturali e spirituali. Inoltre saranno discusse l'origine e la natura di questo legame, che rimandano al percorso evolutivo dell'uomo e al modo con cui tale percorso ha...

Inalare i Composti Organici Volatili (COV) rilasciati dagli alberi nella foresta può avere un'azione antiossidante, antinfiammatoria e balsamica sulle vie respiratorie. Inoltre, l'effetto farmacologico di alcuni di essi può essere benefico per il cervello in termini di rilassamento psico-fisico, performance cognitiva e tono dell'umore. Infatti, gli...

Terapia forestale Cnr - Istituto per la bioeconomia CAI - Club Alpino Italiano Cnr Edizioni Curatori: Francesco Meneguzzo, Federica Zabini Versione digitale: pdf scaricabile gratuitamente ISBN 978 88 8080 430 7 A partire dal ruolo insostituibile delle foreste per la vita umana e dal rapporto speciale che da sempre lega l’uomo alla foresta, il...

Introduction. Lentinan is a polysaccharide isolated from Lentinula edodes, a mushroom traditionally used in Asian medicine for the treatment of various ailments, including oncologic diseases. The aim of this umbrella review is to understand whether lentinan can be a useful integrative remedy for cancer patients. Methods. PubMed, EMBASE, Web of Scie...

Introduction. Schisandra chinensis is a plant of Chinese origin with characteristic red berries ("five flavor fruit") used for various medicinal purposes. The aim of this review is to understand if S. chinensis and its active compounds can have beneficial effects for age- and disease-related cognitive decline. Methods. PubMed, Cochrane Library, and...

Introduction: Turmeric is the common name for the rhizome of Curcuma longa L. In the recent years, food supplements containing turmeric have been marketed and widely used by an increasing number of consumers. Spontaneous reports of suspected adverse reactions to food supplements are collected within the Phytovigilance system. Methods: An ad hoc...

Introduction. Pomegranate (Punica granatum) Juice (PJ) has been traditionally proposed as an integrative remedy for various health conditions. From a pharmacological point of view, the main active substances of PJ are believed to be phenolic compounds like punicalagin, ellagic acid, flavonoids, and anthocyanins. The aim of the present umbrella rev...

Botanicals in COVID Patients: our Comments on the Position of the ANSES, French Agency for Food, Environmental and Occupational Health & Safety

Inhaling forest Volatile Organic Compounds (VOCs) like limonene and pinene can result in useful antioxidant and anti-inflammatory effects on the airways, and the pharmacological activity on the brain of some terpenes absorbed through inhalation may induce psychophysical relaxation and improve mood. An immune-boosting effect has ben also hypothesize...

Background: Tinnitus is a condition characterized by an annoying auditory phantom sensation with a heterogeneous etiology, often associated with an impairment of health-related quality of life. This umbrella review aims to determine whether acupuncture can be a useful remedy for the symptomatic management of patients with tinnitus. Methods: PubMed,...

The aim of this research work is to analyze the chemistry and diversity of forest VOCs (volatile organic compounds) and to outline their evidence-based effects on health. This research work was designed as a narrative overview of the scientific literature. Inhaling forest VOCs like limonene and pinene can result in useful antioxidant and anti-infla...

The differences in volatile profile of Echinacea purpurea plants not-inoculated (EpC) and inoculated with their endophytes from roots (EpR) and stem/leaves (EpS/L) were analysed and compared by GC-FID/GC-MS in an in vitro model. Non-terpenes and sesquiterpene hydrocarbons were the most abundant classes with an opposite behaviour of EpS/L showing a...

Aims Several cases of acute non‐infectious cholestatic hepatitis recently appeared in Italy following consumption of Curcuma longa‐containing dietary supplements. The aim of this research was to describe the Tuscan (Italy) cases of acute hepatitis and to compare them with similar cases of hepatotoxicity published in the literature by performing a s...

Background The aim of the review was to assess whether ginseng can be a useful supplementation for seasonal acute upper respiratory infections (SAURIs). Methods All clinical studies investigating ginseng efficacy for the treatment or prevention of SAURIs were included in the review. Medline, EMBASE, Web of Science, Scopus, Cochrane Library, Google...

Review question: does ginseng supplementation have any significant clinical effect in the treatment or prevention of seasonal acute upper respiratory infections? This is a review protocol registered in PROSPERO (international prospective register of systematic reviews) under the following code number: CRD42020156235.

The insurgence of antibiotic resistance and emergence of multidrug-resistant (MDR) pathogens prioritize research to discover new antimicrobials. In this context, medicinal plants produce bioactive compounds of pharmacological interest: some extracts have antimicrobial properties that can contrast different pathogens. For such a purpose, Origanum vu...

Literature reviews can be directly used by clinicians and other health professionals to support many decision-making processes. This review aims to offer health professionals an essential practical guide to critically evaluate and properly understand results of review articles published in the scientific literature. An evidence-based methodological...

This supplementary material provides the reader with practical instructions to interpret reviews of the scientific literature. PART 1: items analyzed in the essential guide to evaluate and understand results of review articles. PART 2: how to apply the proposed guide to read and interpret an existing review article. This is an appendix of “Reading...

Recently, an epidemic disease outbreak caused by a novel human coronavirus has surged worldwide. Our aim is to briefly describe the potential help of phytotherapy research in finding new integrative therapeutic options against human coronaviruses, and to provide researchers with some essential hints to be used for planning future studies. Existing...

Introduction: Products containing anthraquinones (AQ) are mainly used as laxatives and have several biological effects. Long-term use of AQ laxatives is associated with an increased risk of serious adverse events (AEs), such as colorectal cancer (CRC). We will systematically synthesize the evidence on the potential association between the use of A...

The role of the interaction(s) between medicinal plants (MPs) and their endophytes (bacterial microbiome) in the production of bioactive compounds (BCs) with therapeutic properties is emerging. Here, we propose Echinacea purpurea (L.) Moench as a new model to reveal the intimate crosstalk between MPs and bacterial endophytes, aiming to discover (ne...

Aims Despite a significant increase in using cannabis for medical purposes, current evidence on its safety in real‐world clinical practice is still poorly characterised. By a case‐by‐case analysis of spontaneous reports of suspected adverse events (AEs) collected in Tuscany within the Italian Phytovigilance database, the aim of the present study wa...

INTRODUCTION: Cocoa, obtained from Theobroma cacao L., contains substances like polyphenols and methylxanthines which can promote weight loss. However, cocoa-based products usually provide a high caloric intake. METHODS: An umbrella review was performed, searching Medline, Embase, Scopus, Cochrane Library, and Google Scholar for systematic reviews...

Supplementary Table A Characteristics of NRS studies; Supplementary Table B Risk of Bias assessment; Supplementary Table C Qualitative synthesis of results with references; Supplementary Table D Detailed characteristics, relevant comorbidities and eligible criteria of populations analyzed in included studies; Supplementary Table E Baseline and post...

Background Anxiety is one of the uprising psychiatric disorders of the last decades and lavender administration has been traditionally suggested as a possible treatment. The objective of this review is to assess the efficacy of lavender, in any form and way of administration, on anxiety and anxiety-related conditions. Methods The PRISMA guidelines...

Background: Cannabidiol (CBD) is a major chemical compound present in Cannabis sativa. CBD is a nonpsychotomimetic substance, and it is considered one of the most promising candidates for the treatment of psychiatric disorders. Objective: The aim of this review is to illustrate the state of art about scientific research and the evidence of effec...

Pollen has been used for centuries as a tonic and a multipurpose remedy in traditional medicine. The present umbrella review aims to qualitatively assess the therapeutic efficacy of orally administered pollen in the management of nonallergic diseases. MEDLINE via PubMed, Embase, Scopus, Web of Science, CINAHL, Cochrane Library, and Google Scholar w...

The controversial anti-proliferative effects of Echinacea purpurea (L.) Moench (Asteraceae) might be related to different plant metabolites contained in plant samples, extracts and products. The influence of bacterial endophytes on the synthesis of bioactive compounds in the medicinal plants has been previously demonstrated but there are only few s...

Dear Editor, In Italy, in the past 6 months, an outbreak of acute non-infectious cholestatic hepatitis, including severe cases, has occurred, and these events have been related to the consumption of turmeric-based dietary supplements manufactured by various producers; all of them transparently reported in the website of the Italian Ministry of Hea...

Background Echinacea-endophyte interaction might affect plant secondary metabolites content and influence bacterial colonization specificity and plant growth, but the underlying mechanisms need deepening. An in vitro model, in which E. purpurea axenic plants as host species and E. angustifolia and Nicotiana tabacum as non-host species inoculated wi...

Background: Depression represents a serious public health concern, imposing a high burden, both in epidemiological and clinical terms. Crocus sativus (Saffron) is a herbal remedy that has anti-cancer, anti-oxidant, anti-inflammatory and anti-platelet properties. However, the exact mechanisms of Saffron in treating depression are not yet clear. This...

Background: Dietary supplements and homeopathic medicines are largely used in children as complementary and alternative medicine (CAM) to treat different health conditions. Safety of CAM is unknown when they are marketed. This study analysed suspected CAM-related adverse reaction (AR) in pediatric population. Methods: The Italian Phytovigilance...

Introduction: Magistral preparations of therapeutic cannabis are extracted from standardized products imported from Holland or from the Florence Military Pharmaceutical Chemical Works, but extraction protocols differ among galenic laboratories. This study assessed the inter-laboratory variability in concentrations of cannabidiol (CBD), cannabinol (...

Distribution of concentrations of cannabidiol (CBD), cannabinol (CBN), tetrahydrocannabinol (THC), and tetrahydrocannabinolic acid (THCA) in cannabis olive oil preparations of Bediol, Bedrocan and Bedrolite 70 and 100 mg/ml from three different laboratories.

Distribution of concentrations of CBD, CBN, THC, and THCA in cannabis olive oil preparations of FM-2 70 and 100 mg/ml from three different laboratories.

In the last years, the debate on the use of psychedelics in psychotherapeutic settings has intensified, attracting a lot of interest and attention from the scholarly community as well as from clinicians and paving the way for new therapeutic paradigms. Besides classical addictions and addictive behaviors, there exist forms of addictions, the so-cal...

Introduction: Complementary and alternative medicines (CAMs) are commonly used among lactating women, despite the poor knowledge of these products and of their safety. Perception of pregnancy- and breastfeeding-related difficulties and consequent use of CAMs may differ in bereaved women, by force of the distress related to previous loss, although...

In the last decades, one of the psychedelic substances which has gained high attention for its implications in several para-psychological phenomena (including out-of-body states, deep changes in sensory perception, mood, and thought, travels in "hyperspace", and meetings with disincarnate entities, as well as other "breakthrough experiences") is di...

A key factor in the study of plant-microbes interaction is the composition of plant microbiota, but little is known about the factors determining its functional and taxonomic organization. Here we investigated the possible forces driving the assemblage of bacterial endophytic and rhizospheric communities, isolated from two congeneric medicinal plan...

Herbal weight-loss supplements are sold as self-medication products, and are often used under the misconception that their natural origin guarantees their safety. Food supplements are not required to provide any benefit/risk profile evaluation before marketing; however, possible risks associated with use of herbal extracts in food supplements are b...

Aims: Use of complementary and alternative medicines (CAMs) during breastfeeding is commonly increasing, mainly due to their presumed higher safety compared to conventional medications. Indeed, CAMs can cause serious adverse effects, and high-quality evidence supporting their use during lactation is limited. In Italy, specific investigations on th...

We examined the effects of essential oil from legal (THC <0.2% w/v) hemp variety on the nervous system in 5 healthy volunteers. GC/EIMS and GC/FID analysis of the EO showed that the main components were myrcene and β -caryophyllene. The experiment consisted of measuring autonomic nervous system (ANS) parameters; evaluations of the mood state; and e...

Background: High expectations about acupuncture might contribute to larger treatment effects (Prady et al., 2015). However, problems in the assessment are well known: 1) floor or ceiling effects lower variance; 2) expectation measures include general beliefs about complementary medicine; 3) construct validity of expectation measures remains unclear...

Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM) and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA) and failure modes and effects analysis (FMEA). Methods: SEA is the selected tool for...

The influence of the interaction(s) between the medicinal plant Echinacea purpurea (L.) Moench and its endophytic communities on the production of alkamides is investigated. To mimic the in vivo conditions, we have set up an infection model of axenic in vitro E. purpurea plants inoculated with a pool of bacterial strains isolated from the E. purpur...

Aim: To investigate the activity and mechanisms of action of six essential oils (EOs) against Burkholderia cepacia complex, opportunistic human pathogens highly resistant to antibiotics. Materials & methods: Minimal inhibitory concentration of EOs alone, plus antibiotics or efflux pump inhibitors was determined. Results: Origanum vulgare, Thym...

Oregano essential oils (EOs) could represent interesting therapeutic strategies to treat multidrug-resistant (MDR) pathogens as Pseudomonas aeruginosa, responsible for respiratory infections in cystic fibrosis (CF) patients. There could be a great variability in EOs composition when extracted from different plant species. The aim of this study was...

We announce here the draft genome sequence of Arthrobacter sp. strain EpSL27, isolated from the stem and leaves of the medicinal plant Echinacea purpurea and able to inhibit human-pathogenic bacterial strains. The genome sequencing of this strain may lead to the identification of genes involved in the production of antimicrobial molecules.

In this announcement, we detail the draft genome sequence of the Pseudomonas sp. strain Ep R1, isolated from the roots of the medicinal plant Echinacea purpurea . The elucidation of this genome sequence may allow the identification of genes associated with the production of antimicrobial compounds.

Burkholderia cepacia complex bacteria (Bcc) represent a serious threat for immune-compromised patient affected by Cystic Fibrosis (CF) since they are resistant to many substances and to most antibiotics. For this reason, the research of new natural compounds able to inhibit the growth of Bcc strains has raised new interest during the last years. A...

Neurotoxicity is a major side effect of platinum derivatives both during and after treatment. In the absence of effective pharmacological compounds, the opportunity to identify safe adjuvant treatments among medicinal plants seems appropriate. Astragali radix is an adaptogenic herbal product recently analyzed in platinum-treated cancer patients. Wi...

Background: According to the literature an increasing number of cancer patients demand for complementary therapies during their disease. Research has demonstrated that some of these therapies are effective and safe as adjunctive treatments in specific symptoms of these patients. Methods: The aims of the paper are to review the main and recent paper...