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Antioxidant and gastric ulcer healing effect of Orthosiphon stamineus (Benth.) leaves extract in aspirin-induced rats
Abstract
Objective: In the gastrointestinal system, gastric ulcer is one of the common serious problems in human life and gives contribution against morbidity and mortality incidence. The pathophysiology of gastric ulcer is an imbalance between aggressive factor and mucosal integrity factor. Increase of aggressive factors and decrease of mucosal integrity factors have potential against developed of gastric ulcer disease. The objective of the research was to evaluate antioxidant and gastric ulcer healing effect of Orthosiphon stamineus (Benth.) leaves extract in aspirin-induced rats. Methods: In vivo antiulcer activity of Orthosiphon leaves extract was evaluated through several parameters involves gastric acidity, number of ulcers, diameters of ulcers, ulcer index (UI), and healing ratio. Dose level of Orthosiphon leaves extract which used in this study such as 250 and 500 mg/kg, respectively. Antioxidant activity of Orthosiphon leaves extract was evaluated by 1,1-diphenyl-2-picrylhydrazyl hydrate (DPPH) method. Histopathological of the stomach was performed using hematoxylin-eosin stained. Results: The results of the study showed that groups which given Orthosiphon leaves extract have significantly different for gastric ulcer healing compared to the control group and were supported by histopathological analysis. The Orthosiphon leaves extract also showed maximum scavenging activity at a concentration of 100 µg/ml (58.86% inhibition) and minimum at 50 μg/ml (29.60% inhibition) with inhibitory concentration 50% (IC50) 84.54 µg/ml when compared to ascorbic acid as the standard with IC50 5.08 µg/ml by DPPH method. Conclusion: It can be concluded that from the experimental study of O. stamineus (Benth.) leaves extract has potential antiulcer activity in aspirin-induced rats model and antioxidant effect using DPPH method. Stomach tissues regeneration in gastric ulcer model might be affected by the improvement of antioxidant status.
... Indomethacin became the first-choice drug to produce an experimental ulcer model as a result of having a higher ulcerogenic potential than other NSAIDs (Suleyman et al., 2010). This ulcer profile is comparable to that obtained in rats in a gastric ulcer model induced by absolute ethanol, aspirin and diclofenac (Choi et al., 2016 ;El-Deen et al., 2016 ;Yuniarto et al., 2017). In our study, camel milk reduced significantly the gastric lesions area and in the stomach of rats treated with ranitidine (standard drug), some petechiae in very limited number were observed. ...
... The protective capacity of ranitidine against gastric ulcers is slightly above that of camel milk without reaching significance (96% versus 74%), which is normal to a standard 51 reference product. These results agree with those obtained previously (Yuniarto et al., 2017). According to our data, it could be concluded that camel milk protected the gastric mucosa against ulcers induced by indomethacin with an efficiency comparable to some reference antiulcer drugs such as ranitidine. ...
... Maintaining the leukocyte rate in the camel milk fed rats close to that of the negative control and standard groups of rats prompts us to postulate an anti-inflammatry function to the camel milk, a hypothesis that was also previously postulated by Al-Fartosi and Al-Adhadh (2014). It has been found that hematological results corroborated histological observations showing neutrophils infiltration and edema into ulcerated gastric tissue (Choi et al., 2010 ;Jaccob et al., 2016 ;Yuniarto et al., 2017). Other studies reported that natural vegetable products have exerced their benficial effects against mucosal lesions through inhibition of neutrophils infiltration in the ulcerated tissue (Abdulla et al., 2010 ;Wasman et al., 2010). ...
Gastric ulcer associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin is a major public health problem. The present study was undertaken to determine the camel milk antioxidant activity, tested on DPPH, and its gastro-protective effect, investigated in Wistar rats subjected to gastric ulcer induced by a nonsteroidal anti-inflammatory agent, indomethacin. The study was performed on 20 adult male Wistar rats divided into 4 groups of 5 rats each. The negative control group received distilled water, the positive control group received indomethacin, the standard group received ranitidine and the fourth group was pretreated with raw camel milk, for 15 days respectively. On the 16th day, the indomethacin was administered to all rats except those of the negative control group. The ulcer-ogenic effect of indomethacin was highly significant, evidenced by a large number of ulcer lesions, a remarkably high ulcer index, and an important decrease in adherent gastric mucus. Camel milk resulted in significant gastro-protection compared to indomethacin ulcerated rats as manifested by significant decrease in ulcerative lesions number, and the ulcer index with a restored gastric mucus wall. The camel milk protection percentage is close to that of ranitidine. Additionally, in indomethacin-injured rats an increase in white blood cells, granulocytes, serum transaminases, and hemoglobin levels with a lowering in red blood cells were reported. These physiological disturbances were recovered by camel milk. Camel milk seemed to have gastro-protective effect, probably through its strong antioxidant activity, and may be recommended to patients with arthritis.
... Orthosiphon stamineus leaves extract also showed a slight increase in gastric pH. Results reveal that Orthosiphon stamineus has ulcer healing potential 45 . ...
Peptic ulcer is a gastrointestinal disorder and with increased prevalence. Peptic ulcer is breaking of endothelial lining of stomach and exposing underlying tissues. Peptic ulcer occurs due to high secretion of acid and reduced defensive factors in stomach and duodenum. It is imbalance between aggressive and defensive factors. Non-steroidal anti-inflammatory drugs and Helicobacter pylori infection also increases the risk of peptic ulcer. Indiscriminate use of synthetic drugs leads to adverse effects and concomitant use of antibiotics potentiates drug-drug interaction thus search of drugs from natural sources especially herbs is need of hour. several herbal medicines have been evaluated for its antiulcer efficacy using several ulcer inducing models in laboratory animals. Present study aims at review of gastroprotective and ulcer healing potential medicinal herbs and compilation of data. This article is only restricted to antiulcer efficacy of the medicinal plants. This review presents information about the anti-ulcer efficacy of medicinal plants and various antiulcer models used to screen them. Keywords: Peptic ulcer, Gastric ulcer, Gastroprotective activity, Phyllanthus urinaria, Adiantum lunulatum, Ulcer healing activity
... O. aristatus extract also inhibits the germination of six test fungal species [1]. Other pharmacological activity reports of the O. aristatus plant are antihyperglycemic [2], anti-epilepsy [4], analgesics antipyretic [5], rheumatoid treatment [6], and osteoarthritis arthritis [6], treatment to overcome gastric disorders [7,8], hepatoprotective effect [9,10], antioxidants [11,12], enhancing memory [13], treating cardiovascular disorders [14], antiviral [15], and immunomodulators [16][17][18][19][20][21][22]. ...
Objective: The main compounds in O. aristatus are rosmarinic acid, sinensetin, and eupatorin. Sinensetin and rosmarinic acid compounds have the potential as antiviral agents. The focus of this research is O. aristatus purple and white-purple varieties. This study aimed to determine the levels of three main secondary metabolites of O. aristatus, one of the specific standardizations. Methods: The standardization parameters to be tested were to determine the main compound levels by using thin-layer chromatography densitometry on two varieties of O. aristatus. Results: The highest value levels of sinensetin and rosmarinic acid in purple variety O. aristatus were 0.53 and 1.32% w/w, respectively. The highest level of eupatorin was 0.88% w/w in the ethanol extract of white-purple varieties of O. aristatus. The main secondary metabolites in the two varieties of O. aristatus were more significant in the leaves than in the stems. Meanwhile, the sinensetin and rosmarinic acid levels in the ethanol extract of leaves and stems of the purple variety O. aristatus were higher and significantly different than in the white-purple ones. However, the levels of eupatorin were higher and significantly (p<0.05) different in the white-purple variety compared to the purple variety. Conclusion: The purple variety is due to greater sinensetin and rosmarinic acid levels in the purple variety than in the white-purple ones.
... T he potential of the O. aristatus plant as a medicinal plant has been widely studied, including as diuretics (Arafat et al., 2008), treatment of gastric disorders (Yuniarto et al., 2017), antidiabetic (Mohamed et al., 2011), antihypertensive (Matsubara et al., 1999), hepatoprotective (Yam et al., 2007;Maheswari et al., 2008), antimicrobial (Ho et al., 2010;Hossain et al., 2008), antioxidants (Alshawsh et al., 2012;Akowuah et al., 2004), anti-epilepsy (Kar et al., 2018), memory enhancer (George et al., 2015), treatment of cardiovascular disorders (Abraika et al., 2012), rheumatoid treatment and osteoarthritis (Adawiyah et al., 2018), anticancer (Pauzi et al., 2018;Halim et al., 2017), antiviral (Ripim et al., 2018;Abdelwahed et al., 2020;Li et al., 2020;Sarkar and Das, 2020;Wondmkun and Mohammed, 2020;Lin et al., 2019;Hsieh et al., 2020;Faramayuda et al., 2021b) and immunomodulatory (Harun et al., 2015;Woottisin et al., 2011;Friedman, 2015;Kim et al., 2008;Takano et al., 2004;Sanbongi et al., 2004;Youn et al., 2003). The pharmacological activity of O. aristatus is inseparable from its main compounds, namely rosmarinic acid, sinensetin, and eupatorin (Guo et al., 2019). ...
The flowers of Orthosiphon aristatus are purple, white-purple, and white. The main chemical compounds of O. aristatus are rosmarinic acid, eupatorin and sinensetin. The O. aristatus plant's potential as traditional medicine is established, so it is necessary to produce its active compounds abundantly and to propagate purple and white-purple varieties of O. aristatus. A strategy that can be adopted to achieve plant tissue culture (callus induction). This research aim is to identify secondary metabolite in callus using thin layer chromatography (TLC). The profiling of ethanol extracts of callus of two varieties O. aristatus were carried out using solvent system toluene-ethyl acetate- formic acid-water (3:3:1:0.2). The results of monitoring TLC suggest that callus obtained from Schenk and Hildebrandt (SH) media can proceed to the suspension culture stage because it showed brighter fluorescence spot than other callus and plant extracts, especially for rosmarinic acid. This research provides new information about secondary metabolites in callus derived from two varieties of O. aristatus on various growth media.
... O. aristatus has been widely used traditionally for treating several diseases and has been used as antiviral, 1 antihypertensive, 2 antioxidants, 3,4 prevention and treatment of cancer, 5-8 rheumatoid treatment and osteoarthritis arthritis, 9 antiobesity, 10 treating cardiovascular disorders, 11 anti-epilepsy, 12 antidiabetic, [13][14][15] enhancing memory, 16 antimicrobial activity, [17][18][19] hepatoprotective effect, 20,21 diuretics, [22][23][24] treatment of gastric disorders. 10,25 Some studies also report that O. aristatus have passed clinical trials. 26,27 Safety testing of O. aristatus extracts during 60 days administration in male rats showed that all animals survived and showed no signs of toxicity. ...
Orthosiphon aristatus Blume Miq is one of the commonly used medicinal plants known to have
many benefits, including antiviral activity. Components of the main secondary metabolites of O.
aristatus are sinensetin, rosmarinic acid, and eupatorin. The development of plants or drugs that
have the potential to act as antiviral agent during the Covid-19 pandemic continues. Based on
previous research reports, the main secondary metabolite content in O. aristatus could have
antiviral activity. The present review was done by searching and analyzing research journals on
the potential for active content of O. aristatus in inhibiting the growth or replication of viruses.
There has been no previous review regarding the potential for O. aristatus as an antiviral agent,
therefore this review is expected to provide information about potential sources of antivirals
originating from the O. aristatus plant
... Pharmacological activities of O. aristatus have been tested pra-clinically and clinically. Some of the plant's pharmacological activities include antidiabetic (Mohamed et al. 2011), treatment gastric disorders (Yuniarto et al. 2017), antiviral (Ripim et al. 2018), prevention and treatment cancer (Pauzi et al. 2018;Halim et al. 2017;Abdelwahab et al. 2011), rheumatoid arthritis treatment (Bokhari et al. 2018), treatment cardiovascular disorders (Abraika et al. 2012), antioxidants (Alshawsh et al. 2012), enhancing memory (George et al. 2015), antiepilepsy (Kar et al. 2018), and antimicrobial activity (Ho et al. 2010). O.aristatus have passed clinical trials for the treatment of hypertension and kidney disorders (Adnyana et al. 2013). ...
Faramayuda F, Mariani TS, Elfahmi, Sukrasno. 2020. Short Communication: Callus induction in purple and white-purple varieties of Orthosiphon aristatus (Blume) Miq. Biodiversitas 21: 4967-4972. Orthosiphon aristatus (Blume) Miq. are known to have many benefits, including stimulating urine expenditure (diuretics) and dissolving kidney stones. O. aristatus widely planted in Indonesia are purple and white-purple. The main secondary metabolite components of O. aristatus are sinensetin, rosmarinic acid, and eupatorin. One of the initial steps to increase secondary metabolites in O. aristatus is by induction of callus using plant tissue, which later can be developed into a culture suspension for secondary metabolites. The materials used are the leaf of two varieties of O. aristatus that have been sterilized and grown on Murashige and Skoog media with growth regulatory 2,4-dichlorophenoxyacetic acid at a concentration of 0.4;1.0; 2.0 mg/L. The identification of secondary metabolites of callus was carried out by thin-layer chromatography. The best growth regulating agent for callus induction on the leaves of purple and white-purple varieties of O. aristatus is 2,4-D 0.4 mg/L on Murashige and Skoog media. These media can grow callus at a faster time, friable, and slightly white-yellow color. The identification of secondary metabolites in callus acetone extract showed the presence of sinensetin and rosmarinic acid.
... It was also supported by histopathological exmination. [69] conclusIon O. stamineus Benth. is a valued medicinal plant, growing well in many countries, especially Southeast Asian countries. This plant has a great potential value for cultivation because it contains secondary metabolites with interesting biological activities. ...
Orthosiphon stamineus Benth. (Lamiaceae) is a valued medicinal plant in traditional folk medicine. Many pharmacological studies have demonstrated the ability of this plant to exhibit antimicrobial, antioxidant, hepatoprotection, antigenotoxic, antiplasmodial, cytotoxic, cardioactive, antidiabetic, anti-inflammatory activies. This review is a comprehensive summary of the presently available chemical, pharmacological investigations as well as the traditional and therapeutic uses of this plant. Important and different experimental data have been addressed along with a review of all phytochemicals identified in this plant, including flavonoids, terpenoids, and essential oils. O. stamineus has wide traditional and pharmacological uses in various pathophysiological conditions. Therefore, it is an attractive subject for further experimental and clinical investigations.
There are millions of plants worldwide, yet most of them have not been investigated for their medicinal properties. The development and recognition of medicinal plants increase at an exponential rate in industrialized and developing nations, resulting in research works on medicinal plants congregating toward therapeutic needs. The remarkable diversity of both chemical structure and biological activities of naturally occurring secondary metabolites, the utility of novel bioactive natural compounds as biochemical probes, the development of novel and sensitive techniques to detect biologically active natural products paved way to improved approaches to isolate, purify, and structurally characterize these bioactive constituents, and advancement in solving the demand for supply of complex natural products.The main focus of this review is to highlight the potential benefits of the Lamiaceae plant derived from multiple compounds and the importance of phytochemicals for the development of biocompatible therapeutics. In addition, this review focuses on problems encountered in medicinal plant research and discusses future directions. This review suggests that conservation strategies and resource management should be considered for sustainable utilization of medicinal plants. This review also recommends that the medicinal plant research should focus on tap plant components of Orthosiphon and deliver the most beneficial health products.KeywordsLamiaceae
Orthosiphon
Natural productsNatural drugsConservationSustainable utilization
Clerodendranthus spicatus, popularly known as “kidney tea” in China, is consumed traditionally as a functional food for treatment of renal inflammation, dysuria, and gout. We evaluated the effects of C. spicatus on gout by assessing activities of anti-hyperuricemia, anti-gouty arthritis, and analgesia in vivo, and the results indicated that the ethyl acetate fraction shows potential activities. Subsequent phytochemical investigation of this fraction led to the isolation of 32 compounds consisting of 20 diterpenoids (including the new orthosiphonones E and F), 2 triterpenoids, 6 flavonoids, 2 lignanoids, and 2 phenolic acid derivatives. Pharmacological investigation of the pure compounds in cellular model of hyperuricemia indicated that 12 compounds could promote the excretion of uric acid at 10 μg/mL, and compounds 3, 4, 5, and 21 had better effects than benzbromarone, a famous uricosuric drug. Furthermore, compounds 4, 6, 7, 9, 14, 15, 23, 26, and 31 showed significant anti-gouty arthritis activity in monosodium urate (MSU)-induced joint swelling at the dose of 50 mg/kg, while compounds 4, 5, 7, 9, and 26 exhibited significant inhibition of pain induced by acetic acid. Our findings provided scientific justification to support the traditional application of “kidney tea” for treating gout and suggested its good application prospects in the future.
Rosmarinic acid (RA) is a caffeic acid derivative found in the most abundant and bioactive constituent in Java tea (Orthosiphon stamineus), which has significant biological activities. However, relatively few studies have been conducted to describe this compound's metabolites in vivo. Therefore, an ultra‐high‐performance liquid chromatography coupled to quadrupole‐time‐of‐flight tandem mass spectrometry (UHPLC‐QTOF‐MS/MS) analysis with a three‐step data mining strategy was established for the metabolic profile of RA. Firstly, the exogenously sourced ions were filtered out by the MarkerView software and incorporated with Microsoft Office Excel software. Secondly, a novel modified mass detects filter (MMDF) strategy based on the predicted metabolites was developed for screening the target ions with narrow, well‐defined mass detect ranges. Thirdly, the diagnostic product ions and neutral loss filtering strategy were applied for the rapid identification of the metabolites. Finally, a total of 16 metabolites were reasonably identified in urine, bile and feces, while metabolites were barely found in plasma. And the metabolites of RA could be distributed rapidly in liver and kidney. Glucuronidation, methylation and sulfation were the primary metabolic pathways of RA. The present findings might provide the theoretical basis for evaluating the biological activities of RA and its future application.
Objective: To evaluate the antiulcer and antioxidant activity of the methanolic extract of Allium hookerii (MEAH) leaves. Methods: In vivo antiulcer activity of MEAH was evaluated at two dose levels of 200 mg/kg and 400 mg/kg body weight by pyloric ligation, ethanol (EtOH) induced ulcer and indomethacin-induced ulcer models through estimation of gastric contents viz. gastric volume, pH, free acidity, total acidity, total hexoses, hexosamine, fucose and total protein. Antioxidant activity was evaluated by 1,1-diphenyl-2-picrylhydrazyl hydrate (DPPH) assay, reducing power assay, superoxide radical scavenging activity, and Total flavonoid content. Histopathology of the stomach was studied using hematoxylin and eosin stained sections. Results: A significant decrease in ulcer index and increase in percentage protection in ulcerated rats. After 7 days of treatment, the pH, free acidity and total acidity decreased, thereby increased the content of total hexoses, hexosamine, fucose and total protein in the gastric content. MEAH showed a significant antioxidative effect in DPPH, total flavonoid content and superoxide radical scavenging but showed very low effect in reducing power assay. Histopathological studies of the stomach in ulcer and treated groups substantiate the cytoprotective action of extract in EtOH induced ulcer animals. Conclusions: It can be concluded from the research work that A. hookerii has potent antiulcer activity and supports the in vitro antioxidative status.
Gastric mucosal damage is a common disorder of the gastrointestinal system. Non-steroidal anti-inflammatory drugs (NSAID) are known to be aggressive agents for gastric ulcer development. Leukotrienes play an important role in gastric mucosal damage induced by NSAIDs. Montelukast , a selective reversible Cysteinyl leukotriene receptor 1 antagonist, was reported to have beneficial effects in management of experimental gastric mucosal ulceration. This study designed to evaluate the role of leukotriene against acetyl salicylic acid-induced gastric mucosal damage and to evaluate the gastroprotective activity of montelukast. Thirty local domestic male rabbits had been used in this study , divided into five groups as follows: normal control group, acetylsalicylic acid (ASA) treated group, Omeprazole pretreatment group, montelukast pretreatment group, montelukast alone treatment group. At the end of the experiment, the stomach of rabbit is removed to prepare the tissue homogenate. The results revealed that after administration of ASA significantly increase the mean ulcer index along with the LTD4 concentration, LTB4 concentration. But in presence of montelukast there is a significant decreased in the mean ulcer index along with LTD4 concentration, LTB4 concentration. These results suggest that the leukotrienes play an important role in acetyl salicylic acid induced gastric ulcerations and gastroprotective activity of montelukast can be attributed to decreased activity of leukotrienes in gastric mucosa .
Helicobacter pylori (H. pylori) infection and NSAID/low-dose aspirin (ASA) use are associated with peptic ulcer disease. The risk of peptic ulcer bleeding (PUB) associated with the interaction of these factors remains unclear. The objective of this study was to determine the risk of PUB associated with the interaction between H. pylori infection and current nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose ASA use.
This was a case-control study of consecutive patients hospitalized because of PUB. Controls were matched by age, sex, and month of admission. H. pylori infection status was determined in all cases and controls by serology. Drug use was determined by structured questionnaire. Adjusted relative risk (RR) associated with different factors, and the interaction between NSAID/ASA and H. pylori infection was estimated by logistic regression analysis.
The study included 666 cases of PUB and 666 controls; 74.3% cases and 54.8% controls (RR: 2.6; 95% confidence interval (CI): 2.0-3.3) tested positive for H. pylori infection; 34.5% of cases had current NSAID use compared with 13.4% of controls (RR: 4.0; 95% CI: 3.0-5.4). Respective proportions for low-dose ASA use were 15.8 and 12%, respectively (RR: 1.9; 95% CI: 1.3-2.7). The RR of PUB for concomitant NSAID use and H. pylori infection suggested an additive effect (RR: 8.0; 95% CI: 5.0-12.8), whereas no interaction was observed with ASA use (RR: 3.5; 95% CI: 2.0-6.1).
NSAID, low-dose ASA use, and H. pylori infection are three independent risk factors for the development of PUB, but there were differences in the interaction effect between low-dose ASA (no interaction) or NSAID (addition) use and H. pylori infection, which may have implications for clinical practice in prevention strategies.Am J Gastroenterol advance online publication, 21 April 2015; doi:10.1038/ajg.2015.98.
Reactive oxygen species (ROS) are generated as by-products of normal cellular metabolic activities. Superoxide dismutase, glutathione peroxidase, and catalase are the enzymes involved in protecting cells from the damaging effects of ROS. ROS are produced in response to ultraviolet radiation, cigarette smoking, alcohol, nonsteroidal anti-inflammatory drugs, ischemia-reperfusion injury, chronic infections, and inflammatory disorders. Disruption of normal cellular homeostasis by redox signaling may result in cardiovascular, neurodegenerative diseases and cancer. ROS are produced within the gastrointestinal (GI) tract, but their roles in pathophysiology and disease pathogenesis have not been well studied. Despite the protective barrier provided by the mucosa, ingested materials and microbial pathogens can induce oxidative injury and GI inflammatory responses involving the epithelium and immune/inflammatory cells. The pathogenesis of various GI diseases including peptic ulcers, gastrointestinal cancers, and inflammatory bowel disease is in part due to oxidative stress. Unraveling the signaling events initiated at the cellular level by oxidative free radicals as well as the physiological responses to such stress is important to better understand disease pathogenesis and to develop new therapies to manage a variety of conditions for which current therapies are not always sufficient.
Orthosiphon stamineus is considered an important traditional folk medicine. In this study ethanol and aqueous extracts of O. stamineus were evaluated in vitro for their antioxidant, antimicrobial as well as for their immunomodulatory properties on human peripheral blood mononuclear cells (PBMCs). The DPPH radical scavenging method was used for the determination of antioxidant activity, while the antibacterial efficacy was investigated by both disc diffusion method and Minimum Inhibitory Concentration (MIC) against four bacterial strains (Gram-positive and Gram-negative). Furthermore, the immunomodulatory potential of the extracts was investigated through the MTT assay. Aqueous extract of O. stamineus exhibited significant free radical scavenging activity with IC₅₀ 50 9.6 µg/mL, whereas the IC₅₀ for the ethanol extract was 21.4 µg/mL. The best antimicrobial activity was shown by the aqueous extract of O. stamineus against Staphylococcus aureus, with inhibition zone of 10.5 mm and MIC value 1.56 mg/mL. Moreover, the results observed from the MTT assay showed that both plant extracts stimulated the PBMCs proliferation in vitro in a concentration-dependent manner, but the aqueous extract has remarkable activity against PBMCs. These findings indicate that O. stamineus showed high antioxidant activity and may be considered as an immunomodulatory agent.
Objective: To evaluate the gastric anti-ulcer activity of methanolic extract of Cayratia trifolia L.
(MECT) (Vitaceae) leaves in experimental animals. Methods: MECT was investigated in pylorus
ligation and ethanol induced ulcer models in Wistar rats. In both models, the common parameter
determined was ulcer index. MECT at doses of 250, 500 mg/kg (p.o.) was used to determine whether
it could produce significant inhibition of the gastric lesions induced by pylorus ligation and
ethanol. Results: The extract (250 and 500 mg/kg) showed significant (P
Non-steroidal anti-inflammatory drugs are the most commonly prescribed drugs for arthritis, inflammation, and cardiovascular protection. However, they cause gastrointestinal complications. The pathophysiology of these complications has mostly been ascribed to non-steroidal anti-inflammatory drugs' action on the cyclooxygenase inhibition and the subsequent prostaglandin deficiency. However, recent clinical demonstrated the prevalence of non-steroidal anti-inflammatory drugs-induced small intestinal mucosal injury is more often than previously expected. In this review, we discuss the defense mechanisms of stomach, and the pathophysiology of non-steroidal anti-inflammatory drugs-induced injury of stomach and small intestine, especially focused on non-steroidal anti-inflammatory drugs' action on mitochondria.
Extensive research has been carried out on Orthosiphon stamineus Benth. (lamiaceae) since the 1930s. This plant is used in several countries (especially in Indonesia, Malaysia, Thailand, Vietnam and Myanmar) as traditional medicine. From its ethnobotanical uses the plant is known for several activities. Because of those reasons, O. stamineus is potential to be developed as a new source of drugs. This report comprehensively reviews ethnopharmacological, isolated chemical compounds, pharmacological, toxicological and clinical studies of O. stamineus. Electronic databases (e.g., Pubmed, Scopus, academic journals, Elsevier, Springerlink) were used for searches. Web searches were attempted using Google applying Orthosiphon stamineus, java tea, antihypertensive, sinensetin, methylripariochromene A as keywords. Phytochemical studies reported about 116 compounds that isolated from this plant classified as monoterpenes, diterpenes, triterpenes, saponins, flavonoids, essential oil and organic acids. Pharmacological studies for whole extract, tincture, selected fraction or pure compounds isolated from this plant showed antioxidant, antitumor, diuretic and nephroprotective, antidiabetic, antihypertensive, antiinflammation, antimicrobial, antiobesity and hepatoprotective. Traditional use of O. stamineus meets its scientific evidence in aspects of phytochemical, pharmacological, toxicological as well as clinical.
Helicobacter pylori (H. pylori) infection is widely accepted as the most important factor in the pathogenesis of duodenal ulcer. However, in parallel with more effective eradication of H. pylori, the prevalence of H. pylori is changing, and H. pylori-negative peptic ulcer disease appears to be increasing. When making a diagnosis of H. pylori-negative peptic ulcer disease, it is essential to avoid misclassification because of inaccurate diagnosis. In addition, secondary causes may need to be excluded with appropriate investigations. In the absence of H. pylori, nonsteroidal anti-inflammatory drug usage is the most common cause of peptic ulcer; surreptitious nonsteroidal anti-inflammatory drug usage is a cause of unexplained ulcer disease in up to 60% of patients. Hypersecretory syndromes such as Zollinger-Ellison syndrome, although rare, need to be excluded. Once all known etiological factors are excluded, there remains a group of patients with so-called “idiopathic ulcers.” The interplay of etiological factors in the pathogenesis of idiopathic peptic ulcer disease is poorly defined but may include a genetic predisposition, altered acid secretion, rapid gastric emptying, defective mucosal defense mechanisms, psychological stress, and smoking. The management of idiopathic peptic ulcers is not defined; they appear to be more resistant to standard therapy, can be associated with more frequent complications, and those that relapse may require long-term maintenance therapy.
To review evidence relating to the strength of associations that have appeared in largely observational studies, between high-dose or long-term use of proton pump inhibitor drugs and certain possibly attributable side-effects, which emerge from studies confounded by other variables. In retrospective studies not designed to assess safety, evidence of causality is generally lacking.
The associations of fractures of hip, wrist, forearm and other sites appear weak and only slightly higher than the risks in control populations matched for age. They may increase with drug exposure, but probably do so only in individuals in whom other risk factors are also operational (smoking, alcohol, poor nutrition, steroids, etc.). The risks of Clostridium difficile colitis, other enteric infections, small bowel bacterial overgrowth and possibly spontaneous bacterial peritonitis also appear increased. Impaired gastric secretion may adversely affect the absorption of various nutrients, but their clinical impact is ill defined. Potentially more important are the consequences of hypergastrinemia, including rebound hypersecretion of acid, and possible development of various cancers, including carcinoid tumors. Effects of other drugs, including clopidogrel, on metabolism are reviewed, but clouded by uncertainties.
The safety of long-term PPI administration needs serious prospective study.
The association between nonsteroidal antiinflammatory drugs (NSAIDs) and upper gastrointestinal complications is well documented. However, epidemiologic data on the risk of clinically symptomatic but uncomplicated peptic ulcer are quite limited. The authors studied the association between prescription NSAIDs and the risk of symptomatic ulcer in a population-based cohort of 458,840 persons and 1,167,469 person-years in the United Kingdom between 1995 and 1999 and conducted a nested case-control analysis of 1,197 cases and 10,000 controls. The relative risk and 95% confidence intervals were estimated and adjusted for several factors known to be associated with gastrointestinal damage. The incidence rate of symptomatic ulcer was 1.03 (95% confidence interval (CI): 0.97, 1.08) cases per 1,000 person-years. Compared with nonusers, the relative risk was 2.9 (95% CI: 2.3, 3.6) for aspirin and 4.0 (95% CI: 3.2, 5.1) for nonaspirin NSAID users. For aspirin users, the relative risk was similar for doses up to 300 mg daily and for both gastric and duodenal ulcers. For nonaspirin NSAIDs, the relative risk was 2.6 (95% CI: 2.0, 3.5) for medium daily doses or lower and 4.9 (95% CI: 3.8, 6.5) for high daily doses; it was 5.6 (95% CI: 3.9, 8.2) for gastric and 3.1 (95% CI: 2.3, 4.2) for duodenal ulcers. The risk of symptomatic ulcer for aspirin and nonaspirin NSAIDs was elevated throughout treatment. These findings suggest that NSAIDs might not only complicate but also originate clinically relevant peptic ulcers.