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The effect of mastic gum on Helicobacter pylori: A randomized pilot study

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Abstract

Our aim was to study the effect of pure mastic gum on Helicobacter pylori (H. pylori) eradication in patients suffering from an H. pylori infection Fifty two patients were randomized to receive either 350mg three times a day (tid) of pure mastic gum for 14 days (Group A), or 1,05g tid of pure mastic gum (Group B) for 14 days, or pantoprazole 20mg twice a day (bd) plus pure mastic gum 350mg tid for 14 days (Group C) or pantoprazole 20mg bd plus amoxicillin 1g bd plus clarithromycin 500mg bd for 10 days (Group D). All patients harboured H. pylori before entering the study and that was confirmed by a (13)C urea breath test (UBT). H. pylori eradication was tested by a UBT 5 weeks after completion of the eradication regime. Eradication of H. pylori was confirmed in 4/13 patients in Group A and in 5/13 in Grour B. No patient in Group C achieved eradication whereas 10/13 patients in Group D had a negative UBT. There were no statistically significant differences in mean UBT values in Groups A, B, C although there was a trend in Group A (p=0.08) and in Group B (p=0.064). The difference was significant in Group D (p=0.01). All patients tolerated mastic gum well and no serious adverse events were reported. Mastic gum has bactericidal activity on H. pylori in vivo.

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... Mastic is consumed as a traditional treatment in Mediterranean region, especially Iran [4]. P.lentiscus was used in the gastric ulcer treatment [5][6] and healing burns [7]. In one study, P.lentiscus fatty oil consumed by rabbits rectally significantly reduced the alanine and aspartate transaminase in the plasma. ...
... A total of 21 male Sprague-Dewley rats (6)(7)(8) week old) weighing 200-250 g were purchased from the animal lab (Shiraz University of Medical Sciences, Shiraz, Iran). All the rats were kept in temperature and humidity-controlled rooms (20-23 °C, 50-60 %) in 12-h light/12-h dark cycle and free access to standard laboratory chow with tap water ad libitum in stainless steel cages according to the local guidelines in Shiraz University of Medical Sciences. ...
... We used mastic gum in sesame oil solution, but they used P.lentiscus fruit extract of essential oil. Mastic was effective on gastro-duodenal ulcer treatment [6]. In another study, mastic showed a potential role in the preneoplastic lesions formation in the rat liver [23]. ...
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Background: Vegetable oils recently have been evaluated in many tissues. Pistacia lentiscus (mastic) of the Anacardiaceae family and Sesamum indicum (sesame) of the Pedaliaceae family are conventionally used in the management of gastrointestinal, lung, and skin illnesses. This assay attempts to determine if the oral usage of mastic and sesame oils has any short-term toxic effects in vivo on the rat and evaluate the human anticancer effect in vitro. Materials and methods: Twenty-one male Sprague-Dewley rats were assigned to three groups randomly: (A) control, (B) mastic oil (400 mg/kg), and (C) sesame oil (2cc/kg). The effects of these oils were investigated by determining histopathological and stereological parameters after six days, and the anticancer effects were evaluated on SW48, HepG2 human cell lines. Results: A mild chronic interstitial inflammation was seen in just one kidney of mastic oil group (B) and the other ones were normal. In the sesame oil group (C), mild chronic interstitial inflammation was seen in six kidneys. In the liver samples of both groups, there were no specific pathological findings. Different concentrations of mastic oil (0.1%-5%) reduced the cell viability of SW48, HepG2, HEK293t, and human fat cells. Conclusion: Mastic and sesame oils have some side-effects on the kidney and might not be safe at high doses in rats. Sesame oil did not have any toxic effect on HepG2 and HEK293t human cancer cells. Mastic oil treatment has inhibited specific SW48 cells, so this oil seems to be a good adjuvant to chemotherapy in colon treatments.
... Mastic oil, the essential oil of mastic gum, a natural resin obtained from Pistacia lentiscus has a wide -range of therapeutic effects: anti-inflammatory, antibacterial, antifungal, antiviral, anticancer, and hypolipidemic activities [2][3][4][5][6][7][8][9][10][11][12][13]. Pistacia lentiscus is also effective in the treatment of functional dyspepsia and gastric ulcer [14][15][16] as well as in the healing of burns [17]. Because of its special taste, since antiquity Pistacia lentiscus has been extensively used in the Mediterranean and Middle Eastern countries as food/beverages flavouring additive and also as a traditional medicine without any reported toxicity [6]. ...
... Effectively, no increases in serum concentration of LDH was observed after treatment with Pistacia lentiscus oil which is in line with previously published report in vitro indicating no leakage of the cytosolic enzyme LDH into the extracellular space after treatment with Pistacia lentiscus oil [28]. No damage of the gastrointestinal mucosa or alteration in cell proliferation was observed which is in line with the capacity of Pistacia lentiscus oil to eradicate Helicobacter pylori and treat gastro-duodenal ulcer [14,16]. These results have shown that the Pistacia lentiscus oil contents have little effects on the GSH-dependent redox metabolism in treated mice for this period and dose. ...
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Background: Pistacia lentiscus (Anacardiaceae) is a flowering plant traditionally used in the treatment of various skin, respiratory, and gastrointestinal disorders. The aim of this study was to assess whether Pistacia lentiscus oil has any short term toxic effects in vivo and in vitro. Methods: Pistacia lentiscus oil (100µl) was administered orally into mice for 5 days. Results: Measurements of body weight did not show any weight loss. Serum concentration of LDH did not show any significant statistical difference when compared to control mice. Similarly, blood, kidney or liver function tests showed no toxicity with Pistacia lentiscus oil when compared to the control group. Examination of gastrointestinal tissues sections revealed similar structural features with no difference in cell proliferation. In this context, pharmacological dilutions of Pistacia lentiscus oil (10(-6) - 10(-3)) did not affect the viability (cell death and proliferation) of mouse gastric stem cells, human colorectal cancer cells HT29, human hepatoma cells HepG2. However, it appears that at the dose and time point studied, Pistacia lentiscus oil treatment has targeted various cytochrome P450s and has specifically inhibited the activities and the expression of CYP2E1, CYP3A4, CYP1A1 and CYP1A2 differentially in different tissues. Our results also demonstrate that there is no appreciable effect of Pistacia lentiscus oil on the GSH-dependent redox homoeostasis and detoxification mechanism in the tissues. Conclusion: These data suggest a good safety profile of short term oral use of Pistacia lentiscus oil as a monotherapy in the treatment of various skin, respiratory, and gastrointestinal disorders. However, due to its inhibitory effect of various cytochrome P450s and mainly CYP3A4, this might have implications on the bioavailability and metabolism of drugs taken in combination with Pistacia lentiscus oil. More attention is needed when Pistacia lentiscus oil is intended to be uses in combination with other pharmacological agents in order to avoid potential drug-drug interaction leading to toxicity. This study will help in safer use of Pistacia lentiscus oil for therapeutic purpose. © 2014 S. Karger AG, Basel.
... Their results showed a significant reduction of H. pylori infection (P < 0.01) compared to the control group (three-drug treatment protocol alone) in a 14-day treatment. [26] Based on the above-mentioned need for eradicating H. pylori, the present study was designed to investigate the synergistic effect of cumin decoction with three-and four-drug treatment protocols against H. pylori in patients with peptic ulcer. ...
... Each group is investigated based on age, sex, smoking, duration of illness, number of visits, and weight. [26,27] The project is recorded before starting in the Ethics Committee of Kermanshah University of Medical Sciences by the number of c/7/420/4148 and the system for recording clinical trials by (I RCT) IRCT2012071510291N1 number. The five studied groups included were (1) 20 mg omeprazole before breakfast and one cup of cumin decoction (100 mL) after breakfast and dinner; (2) 20 mg omeprazole before breakfast, one cup of cumin decoction (100 mL) after breakfast and dinner, 500 mg clarithromycin every 12 h, and amoxicillin 500 mg every 6 h; (3) omeprazole 20 mg before breakfast, one cup of cumin decoction (100 mL) after breakfast and dinner, bismuth subcitrate 120 mg every 6 h, amoxicillin 500 mg every 6 h, and metronidazole 500 mg every 12 h. ...
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Background: Helicobacter pylori is a major cause of peptic ulcer. On the other hand, cumin (Cuminum cyminum L.) is an effective medicinal plant for the treatment of gastrointestinal disease in traditional Persian medicine. This study aimed at investigating the synergistic effect of the decoction of cumin with the three-and four-drug protocols against H. pylori in patients with peptic ulcer. Patients with peptic ulcer infected with H. pylori were treated with cumin decoction, three-and four-drug protocols, and their co-administration to eradicate H. pylori. Materials and Methods: Patients were randomly divided into five groups, including group (1) omeprazole with cumin decoction, (2) cumin decoction with the three-protocol treatment, (3) cumin decoction with the four-drug protocol treatment, and (4 and 5) three-and four-drug protocols alone. The cumin fruit powder was given to patients in 3-g packages and decoction was prepared according to the traditional Iranian medicine guidelines. H. pylori eradication was measured by the 14 C-urea breath test (14 C-UBT) after 4 weeks of intervention. The Kolmogorov-Smirnov test, χ 2 test, logistic regression, and ANOVA (SPSS, 11.5) were used for data analyses. Results: In total, 75 patients (48 male and 27 female patients) participated in this study. The results showed that eradication of H. pylori was observed in all five study groups. Eradication of H. pylori in cumin decoction with the three-drug protocol group was more than the other groups (85.72%), although this difference was not statistically significant. In addition, this eradication was 61.5% in the cumin + omeprazole group, while the H. pylori eradication rates for the three-drug and four-drug protocols were 77.8% and 58.33%, respectively. Conclusions: The results showed that decoction of cumin could be used as a complementary treatment alongside conventional medicine therapy to increase the H. pylori eradication.
... A 2011 study presented proof that CMG prevents H. pylori inflammation by inhibiting neutrophil activation in vitro [65] . Dabos et al [66] confirmed these observations by examining the influence of CMG on H. pylori eradication in H. pylori patients. Mastic gum was well tolerated and the mild side effects were reversible. ...
... Mastic gum was well tolerated and the mild side effects were reversible. It was determined that CMG has bactericidal action against H. pylori in vivo [66] . Paraschos et al [67] found that extracts and elements of CMG were active against H. pylori. ...
Article
Many food and plant extracts have shown in vitro anti-Helicobacter pylori (H. pylori) activity, but are less effective in vivo. The anti-H. pylori effects of these extracts are mainly permeabilitization of the membrane, anti-adhesion, inhibition of bacterial enzymes and bacterial grown. We, herein, review treatment effects of cranberry, garlic, curcumin, ginger and pistacia gum against H. pylori in both in vitro, animal studies and in vivo studies.
... A double-blind, randomized controlled clinical trial demonstrated significant improvement in patients with functional dyspepsia with adjuvant supplementation of honey-based N. sativa formulation [77]. Patients (n = 70) with functional dyspepsia according to ROME III criteria, confirmed by upper gastrointestinal endoscopy, were allocated a treatment of a combination of anti-secretory agent and honey-based formulation of N. sativa (5 mL N. sativa) once daily or placebo for 8 weeks. ...
... Mastic gum demonstrated nonsignificant effects on H. pylori eradication in a randomized pilot study [77], however the antimicrobial effects were consistent in preclinical studies. Fifty-two patients were randomized in four groups to receive either pure mastic gum (350 mg, three times daily) for 14 days (group A), pure mastic gum (1 g, three times daily) for 14 days (group B), combination of pure mastic gum (350 mg three times daily) and pantoprazole (20 mg twice daily) for 14 days (group C) or standard therapy (pantoprazole 20 mg, amoxicillin 1 g and clarithromycin 500 mg) for 10 days (group D). ...
Article
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Helicobacter pylori (H. pylori) infections affect almost half of the world's population, with gradually increasing incidence in developed countries. Eradication of H. pylori may provide significant benefits to the affected individual by healing a number of gastrointestinal and extra-digestive disorders. But due to increased microbial resistance and lack of patient adherence to the therapy, the eradication rate of H. pylori is below 80% with current pharmacological therapies. The usage of botanicals for their therapeutic purposes and medicinal properties have been increased in last decades. They can be use as alternative H. pylori treatments, especially against drug-resistant strains. Epidemiological studies have revealed that people with lower vegetable and micronutrient intake may be at increased risk of H. pylori infection. We have undertaken a review of clinical trials to evaluate the efficacy of vegetable extracts and micronutrients in patients with H. pylori. Various databases, such as Google Scholar, PubMed, Scopus, Web of Science, and the Cochrane Library, were searched for the articles published in English. A total of 24 clinical studies (15 for vegetable extracts and 9 for micronutrients) were selected to be reviewed and summarized in this article. Vegetable extracts (Broccoli sprouts, curcumin, Burdock complex, and Nigella sativa) and micronutrients (vitamin C and E) were not found to be as effective as single agents in H. pylori eradication, rather their efficacy synergized with conventional pharmacological therapies. Conversely, GutGard was found to be significantly effective as a single agent when compared to placebo control.
... Mastic gum (an inexpensive exudate obtained from the food plant P lentiscus) previously documented in the clinical trial literature in the mid 1980s for its effect on treatment of duodenal and gastric ulcers was shown to kill H pylori in 1998 [131]. It has since been the subject of clinical trials with both negative [85] and positive [84] outcomes. ...
Article
We review herein the basis for using dietary components to treat and/or prevent Helicobacter pylori infection, with emphasis on (a) work reported in the last decade, (b) dietary components for which there is mechanism-based plausibility, and (c) components for which clinical results on H pylori amelioration are available. There is evidence that a diet-based treatment may reduce the levels and/or the virulence of H pylori colonization without completely eradicating the organism in treated individuals. This concept was endorsed a decade ago by the participants in a small international consensus conference held in Honolulu, Hawaii, USA, and interest in such a diet-based approach has increased dramatically since then. This approach is attractive in terms of cost, treatment, tolerability, and cultural acceptability. This review, therefore, highlights specific foods, food components, and food products, grouped as follows: bee products (eg, honey and propolis); probiotics; dairy products; vegetables; fruits; oils; essential oils; and herbs, spices, and other plants. A discussion of the small number of clinical studies that are available is supplemented by supportive in vitro and animal studies. This very large body of in vitro and preclinical evidence must now be followed up with rationally designed, unambiguous human trials. Copyright © 2015. Published by Elsevier Inc.
... Mastic oil, the essential oil of mastic gum, a natural resin obtained from Pistacia lentiscus has a wide-range of therapeutic effects: anti-inflammatory, antibacterial, antifungal, antiviral, anticancer, and has hypolipidemic activities (Marone et al., 2001;Paraschos et al., 2012). Pistacia lentiscus is also effective in the treatment of functional dyspepsia and gastric ulcer (Dabos et al., 2010) as well as in the healing of burns (Djerrou et al., 2010). Because of its special taste, since antiquity Pistacia lentiscus has been extensively used in the Mediterranean and Middle Eastern countries as food/beverages flavouring additive and also as a traditional remedy without any reported toxicity (Attoub et al., 2014;Moulos et al., 2009). ...
Article
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Pistacia lentiscus L. (Anacardiaceae) is an evergreen shrub widely distributed throughout the Mediterranean region. Pistacia lentiscus oil (PLo) was particularly known in North African traditional medicine. Thus, people of these regions have used it externally to treat sore throats, burns and wounds, as well as they employed it internally for respiratory allergies. PLo is rich in essential fatty acids, vitamin E and polyphenols. As a very active site of metabolism, liver is reported to be susceptible to arsenic (As) intoxication. The present study evaluates the protective effect of PLo against sodium arsenite-induced hepatic dysfunction and oxidative stress in experimental Wistar rats. Twenty-eight rats were equally divided into four groups; the first served as a control, the remaining groups were respectively treated with PLo (3.3 mL/kg body weight), sodium arsenite (5.55 mg/kg body weight) and a combination of sodium arsenite and PLo. After 21 consecutive days, cellular functions were evaluated by hematological, biochemical and oxidative stress markers. A significant decrease in the levels of red blood cells, haemoglobin (p ≤ 0.001), hematocrit (p ≤ 0.001), reduced glutathione and metallothionein (p ≤ 0.05) associated with a significant increase of malondialdehyde (p ≤ 0.001) were noticed in the arsenic-exposed group when compared to the control. The As-treated group also exhibited an increase in hepatic antioxidant enzymes namely superoxide dismutase, glutathione peroxidase (p ≤ 0.01) and catalase (p ≤ 0.05). However, the co-administration of PLo has relatively reduced arsenic effect. The results showed that arsenic intoxication disturbed the liver pro-oxidant/antioxidant status. PLo co-administration mitigates arsenic-induced oxidative damage in rat.
... Archaeological findings and historical references establish the medicinal, cosmetic and culinary use of mastic gum in the Mediterranean basin since the 7th century BC. 5 In the modern era, CMG has been many times the subject of scientific research, and many beneficial biological activities -anti-indigestion, anti-ulcer (acting against Helicobacter pylori), antimicrobial, antifungal, antioxidant, hypolipidemic, anti-inflammatory, anti-Crohn's disease and anti-neoplasmatic -have been reported. [5][6][7][8] CMG's main components are an insoluble polymer (25%) and a triterpenic fraction (67%), which is further sub-classified as acidic (39%) and neutral (28%) fractions. [9][10][11] The acidic fraction seems to have the greatest anti-microbial activity and its main components are the masticadienonic acid (30%), isomasticadienonic acid (30%), oleanonic acid (15%) and moronic acid (10%). ...
Article
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Chios mastic gum (CMG) possesses anti-oxidant, anti-inflammatory, anti-atheromatic, lipid- and glucose-lowering properties. We evaluated the effects of CMG on cholesterol and fasting plasma glucose (FPG) levels of healthy volunteers. A prospective, randomized, placebo-controlled, pilot study. One hundred and seventy nine volunteers with total cholesterol levels >200 mg/dl were randomized to four groups. Finally, 156 volunteers completed the follow-up period and were analysed: (1) control group (C, n = 23), receiving placebo; (2) total mastic (TM, n = 72) receiving daily a total dose of 1 g of crude CMG (330 mg capsules, tid); (3) polymer-free mastic (PFM, n = 33), receiving daily a total dose of 1 g of polymer free mastic (330 mg caps, tid); and (4) powder mastic (PM, n = 28), receiving daily a total dose of 2 g of crude CMG. After eight weeks, the TM group reduced total cholesterol by 11.5 mg/dl (p < 0.05) and FPG by 4.5 mg/dl (p < 0.05) adjusted for age, gender, BMI and baseline characteristics. The effect was stronger in overweight and obese patients (BMI > 25), with an estimated mean reduction of total cholesterol by 13.5 mg/dl (p < 0.05) and FPG by 5.1 mg/dl (p < 0.05). Administration of PFM and PM resulted in no statistically significant alteration. No effect was observed on LDL, HDL, triglycerides, uric acid and CRP. No gastrointestinal, liver or renal adverse events were recorded. CMG has a significant lowering effect on total cholesterol and glucose levels of healthy volunteers, with excellent tolerance and no detectable side effects, especially in overweight and obese individuals. © The European Society of Cardiology 2015.
... The acid fraction was found to be the most active extract ( Paraschos et al., 2007). The results of a randomized controlled trial study showed mastic gum monotherapy could be effective as an alternative regime in patients unwilling to undergo eradication with the triple therapy regime ( Dabos et al., 2010). ...
Article
Context: Helicobacter pylori is a small, spiral, Gram-negative bacillus that plays a role in the pathogenesis of a number of diseases ranging from asymptomatic gastritis to gastric cancer. Schedule compliance, antibiotic drug resistance, and side-effects of triple or quadruple therapy have led to research for novel candidates from plants. Objective: The purpose of this paper is to review the most potent medicinal plants of recently published literature with anti-H. pylori activity. For centuries, herbals have been used by traditional healers around the world to treat various gastrointestinal tract disorders such as dyspepsia, gastritis, and peptic ulcer disease. The mechanism of action by which these botanicals exert their therapeutic properties has not been completely and clearly elucidated. Anti-H. pylori properties may be one of the possible mechanisms by which gastroprotective herbs treat gastrointestinal tract disorders. Materials and methods: Electronic databases such as PubMed, Google scholar, EBSCO, and local databases were explored for medicinal plants with anti-H. pylori properties between 1984 and 2013 using key words "medicinal plants" and "Helicobacter pylori" or "anti-Helicobacter pylori". Results: A total of 43 medicinal plant species belonging to 27 families including Amaryllidaceae, Anacardiaceae, Apiaceae, Apocynaceae, Asclepiadoideae, Asteraceae, Bignoniaceae, Clusiaceae, Chancapiedra, Combretaceae, Cyperaceae, Euphorbiaceae, Fabaceae, Geraniaceae, Lamiaceae, Lauraceae, Lythraceae, Menispermaceae, Myristicaceae, Myrtaceae, Oleaceae, Papaveraceae, Plumbaginaceae, Poaceae, Ranunculaceae, Rosaceae, and Theaceae were studied as herbs with potent anti-H. pylori effects. Conclusion: Traditional folk medicinal use of some of these plants to treat gastric infections is substantiated by the antibacterial activity of their extracts against H. pylori.
... Other studies have also investigated the effect of natural substances (such as olive oil and chewing gum) on H. pylori microbial load and confirmed that, in any case, various materials in nature may have infection-fighting properties but are perhaps difficult to standardize in clinical practice [42,43]. ...
... It has also been used as a masticatory to prevent oral plaque. Mastic gum has been reported to be effective in the treatment of benign gastric ulcers and duodenal ulcers and for H. pylori infection [22][23][24] . ...
Article
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The increasing multidrug resistance in Helicobacter pylori, also correlated to its biofilm‐forming ability, underlines the need to search novel strategies to improve the eradication rate. Natural compounds are proposed as antibiotic-resistant-breakers capable to restore the efficacy of conventional drugs. Aim of this work was to evaluate the capability of Pistacia vera L. oleoresin (ORS) to synergize with levofloxacin (LVX) against resistant H. pylori strains. The antimicrobial activity of P. vera L. ORS and LVX and their combinations was determined by MIC/MBC (in neutral and acidic environments) and checkerboard tests. The anti-biofilm effect was determined by biomass quantification. In vivo Galleria mellonella model was used to confirm in vitro data. Pistacia vera L. ORS and LVX MICs ranged respectively from 780 to 3120 mg/l and from 0.12 to 2.00 mg/l, at pH 7.0 and 5.5. MBCs were similar to MICs. Pistacia vera L. ORS was able to synergize with LVX, restoring its effectiveness in LVX resistant strains. Pistacia vera L. ORS, LVX and their synergistic combinations displayed significant biofilm reduction. Pistacia vera L. ORS and LVX, showed protective effect against H. pylori infection on G. mellonella (62% and 63% of survival, respectively). Pistacia vera L. ORS can be considered a promising potentiator to restore the effectiveness of LVX tackling the H. pylori antibiotic resistance phenomenon.
... Some bioactive compounds from medicinal plants with anti-H.pylpri activity include carvacrol [115] , polyphenolic catechins [116] , tannins [113] , cinnamaldehyde, eugenol [117] , quercetin [118] , licoricidin, licoisoflavone B [119] , Berberine, sanguinarine, chelerythrine, protopine, β-hydrastine [120] , mastic [121,122] , plumbagin [123] protocatechuic acid [124] . Concerning the reducing power of plant extracts on antibiotic resistance, the anti-mutagenic properties of some plant extracts on the incidence of mutations conferring resistance to clarithromycin in H. pylori was evaluated. ...
Article
Helicobacter pylori (H. pylori) is an important major cause of peptic ulcer disease and gastric malignancies such as mucosa-associated lymphoid tissue lymphoma and gastric adenocarcinoma worldwide. H. pylori treatment still remains a challenge, since many determinants for successful therapy are involved such as individual primary or secondary antibiotics resistance, mucosal drug concentration, patient compliance, side-effect profile and cost. While no new drug has been developed, current therapy still relies on different mixture of known antibiotics and anti-secretory agents. A standard triple therapy consisting of two antibiotics and a proton-pump inhibitor proposed as the first-line regimen. Bismuth-containing quadruple treatment, sequential treatment or a non-bismuth quadruple treatment (concomitant) are also an alternative therapy. Levofloxacin containing triple treatment are recommended as rescue treatment for infection of H. pylori after defeat of first-line therapy. The rapid acquisition of antibiotic resistance reduces the effectiveness of any regimens involving these remedies. Therefore, adding probiotic to the medications, developing anti-H. pylori photodynamic or phytomedicine therapy, and achieving a successful H. pylori vaccine may have the promising to present synergistic or additive consequence against H. pylori, because each of them exert different effects.
... pylori activity of mastic gum is mainly attributed to the presence of triterpenic acids such as oleanonic acid, moronic acid, 24Z-masticadienonic acid, 24Z-isomasticadienonic acid, 24Z-masticadienolic acid, and 24Z-isomasticadienolic acid, but a synergistic effect was found. (31) Recently, Dabos and coworkers (32) confirmed that mastic gum possesses in vivo antibacterial activity against H. pylori and is able to eradicate it from patients. ...
Article
Pistacia resins are a complex mixture comprising of different bioactive compounds, with the presence of triterpenes and essential oils being characteristic for these resins. Since ancient times, Pistacia resins have been used in traditional medicine of Mediterranean and Middle Eastern countries as herbal remedies. There is accumulating evidence that suggests that Pistacia resins may contribute to the reduction of many chronic diseases, such as gastrointestinal disorders, cardiovascular diseases, and some forms of cancer, while in parallel promoting oral health and other physiological functions such as antimicrobial and antioxidant activities. This review aims at presenting and critically reviewing the health effects from the consumption of Pistacia resins whilst revealing future challenges and potential applications in the food industry.
... Mastic has in vitro antibacterial and antifungal activity (Magiatis et al. 1999), is effective against Helicobacter pylori in vitro and in vivo (Paraschos et al. 2007) also at Crohn's disease (Kaliora et al. 2007) and colon (Balan et al. 2007) or prostate cancer (He et al. 2006). Mastic also protects against functional dyspepsia (Dabos et al. 2010a and in some cases eradicates H. pylori in humans (Dabos et al. 2010b). Chios mastic gum is nowadays used extensively as a constituent of herbal drugs or functional foods (Lemonakis et al. 2011). ...
Article
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A simple, rapid, and sensitive method was developed for the simultaneous determination of 21 pesticides from different chemical classes (organophosphorus, triazines, carbamates, and anilinopyrimidine pesticides) in Chios mastic gum (Pistacia lentiscus L. var. Chia). Quick, easy, cheap, effective, rugged, and safe (QuEChERS) technique was used for the extraction of the target analytes; the mastic gum samples were initially extracted with acetonitrile (ACN), and then, the extracts were purified by dispersive solid-phase extraction using primary secondary amine (PSA) and C18 as sorbents. The determination of pesticides in the final extract was carried out by liquid chromatography coupled with tandem mass spectrometry with electrospray ionization (LC-ESI-MS/MS). The method was validated for linearity, accuracy, precision (repeatability and inter-laboratory reproducibility), limits of detection and quantification, and the matrix effect factor. Recoveries of the pesticides fortified at 5, 50, and 500 ng g−1 ranged from 49.7 % (quinalphos) to 127 % (pirimiphos-ethyl) and reproducibility (RSDR, n = 2 × 3) ranged from 4.4 % (propham) to 20 % (pirimiphos-methyl, propham, and triazophos). The detection limits of the method were 0.8 (mecarbam, pyrazophos) to 23 ng g−1 (parathion-ethyl). The uncertainty of the method was also calculated based on the Eurachem/Citac Guidelines, and the contribution of each independent parameter was investigated.
... The used dosage was well-tolerated and was free of any adverse effects. Dosage increment or pairing with drugs might exert better effect [57]. The leaf essential oil of P. lentiscus exerted strong activity against Klebsiella pneumonia [26]. ...
Article
Pistacia genus belong to family Anacardiaceae and it is versatile in that its member species have food (P. vera), medicinal (P. lentiscus) and ornamental (P. chinensis) values. Various species of this genus have folkloric uses with credible mention in diverse pharmacopeia. As a trove of phenolic compounds, terpenoids, monoterpenes, flavonoids, alkaloids, saponins, fatty acids, and sterols, this genus has garnered pharmaceutical attention in recent times. With adequate clinical studies, this genus might be exploited for therapy of a multitude of inflammatory diseases, as promised by preliminary studies. In this regard, the ethnomedicinal, phytochemistry, biological potencies, risks, and scopes of Pistacia genus have been reviewed here.
... 19 In a randomized pilot clinical study, the oleoresin of Pistacia lentiscus exhibited significant eradication of Helicobacter pylori infection. 20 Absolute ethanol induces gastric lesions through stimulating lipid peroxidation, suppressing prostaglandin production, catalase, superoxide dismutase and glutathione levels and inhibition of cytoprotective functions and depletion of mucus barrier within gastric mucosa. Our findings indicated anti-ulcer activity of essential oil of Pistacia atlantica. ...
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Objective: To evaluate the efficacy of Pistacia atlantica Desf. oleoresin essential oil on peptic ulcer (PU) and its antibacterial effect on metronidazole-resistant Helicobacter pylori, as well as chemical composition of the essential oil. Methods: The essential oil was standardized using gas chromatography mass spectrometry (GC/MS) analysis. Acute toxicity of the essential oil was assessed in animal model. In vitro anti-Helicobacter pylori activity was performed through disc diffusion and minimum inhibitory concentration method. For gastroprotective assay, rats received Pistacia atlantica Desf. essential oil (25, 50 and 100 mg/kg orally) 1 h before induction of ulcer by ethanol. Macroscopic (ulcer index and protection rate) and microscopic examination were performed. Results: The GC/MS analysis of the essential oil led to the identification of twenty constituents and α-pinene is predominant constituent. The essential oil was safe up to 2000 mg/kg. All Helicobacter pylori strains were susceptible to the essential oil and the MIC ranged from 275 to 1100 μg/mL. The ulcer index for treated groups was significantly reduced compared to control (P < 0.001) with EC(50) value of 12.32 mg/kg. In microscopic examination, Pistacia atlantica attenuated destruction and necrosis of gastric tissue. Conclusion: Current study exhibited protective effect of standardized Pistacia atlantica essential oil against ethanol-induced gastric ulcer and its antibacterial activity on Helicobacter pylori. α-pinene might be the responsible agent.
... Pistacia lentiscus L. is a native herb of Africa and Mediterranean countries with antimicrobial, antifungal, antioxidant and anti-inflammatory activities (13)(14). It has good effect on gastrointestinal diseases due to its anti Helicobacter pylori activity (14)(15). ...
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Background and Objectives Antibiotic therapy is the main choice in treatment of Escherichia coli induced infections. Using herbal medication is an alternative choice in treatment of diseases. The aim of this study was to determine the antibacterial activity of two traditionally used herbs in Iranian medicine, Anacyclus pyrethrum and Pistacia lentiscus L., on Escherichia coli. Materials and Methods The antibacterial effect of methanolic extract of Anacyclus pyrethrum and Pistacia lentiscus L. were examined in disk diffusion and skipped wells methods by measuring the diameter of inhibition zones around wells containing different concentrations of extracts from (10–1000 mg/ml) using standard broth macrodilution, method the MIC and MBC were defined. Results The methanolic extract of Anacyclus pyrethrum from 300 to 1000 mg/ml and the methanolic extract of Pistacia lentiscus L. from 30 to 1000 mg/ml showed antibacterial activity on Escherichia coli. The MIC of Anacyclus pyrethrum and Pistacia lentiscus L. methanolic based extract were 800 and 1000 mg/ml, respectively. The MBC was achieved at 800 mg/ml for methanolic extract of Anacyclus pyrethrum and Pistacia lentiscus L. Conclusion The methanolic extract of Anacyclus pyrethrum and Pistacia lentiscus L. have antibacterial effect on Escherichia coli bacteria. This activity is dose-dependent.
... L'huile essentielle des feuilles est riche en monoterpènes : myrcène (3,4-39,2%), limonène (10,3-43,8%), α-pinène (2,9-34,2%), terpinène 4-ol (8,2-34,7%), α-terpinéol (10,4-11,0%), β-pinène (2,2--terpinène (9 %), etc. Elle est aussi riche en sesquiperpènes : germacrène-D (4,3-15,8%), βgurjunène (0,0--muurolène (1,1-2,9%), α-humulène (0,9-2,6%), etc. (Ben Douissa et al. 2005 ;Bampouli et al.2014;Bachrouch et al. 2015;Aissi et al. 2016). Les extraits éthanoliques des feuilles et l'huile essentielle sont actifs contre des bactéries souvent résistantes telles les mycobactéries (Sqalli et al.2007), ou Helicobacter pylori (Dabos et al. 2010). L'huile essentielle agit sur les spores de Clostridium botulinum (Daifas et al. 2004), sur Listeria monocytogenes CECT 935 (Djenane et al. 2011), Staphylococcus aureus et Aspergillus niger (Mezni et al. 2015) ainsi que Salmonella sp., Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus sp., Enterococcus faecalis, Mycobacterium aurum, Mycobacterium smegmatis (Hafsé et al 2013). ...
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Nowadays, the food industry is constantly seeking natural, safe and low-cost antimicrobial agents in an attempt to replace synthetic additives. The objective of this study was to evaluate Pistacia lentiscus L. foliar extracts as natural additives to fresh turkey cutlets. First, in vitro antimicrobial activity of the aqueous extracts prepared by maceration, infusion, decoction and digestion and essential oil obtained by hydrodistillation of Pistacia lentiscus leaves was studied by disc-diffusion method, against seven bacterial and three fungal strains.The infused and digested extracts inhibited Enterococcus faecalis and Staphylococcus aureus more than the essential oil and were inactive towards Escherichia coli and Salmonella enteritidis. They led to an inhibition of the growth of Penicillium (35%) and Fusarium (19%). In a second step, the application on fresh turkey breast cutlets of crushed dry leaves and infused aqueous extract led to inhibit the growth of the total aerobic mesophilic flora and the fungal flora during storage at + 4°C for 8 days. In conclusion, Pistacia lentiscus L. foliar extracts can be used to reduce microbial spoilage during storage of fresh turkey breast cutlets.
... An in vivo trial revealed no significant alleviation of H. pylori infection [75]. Another human trial illustrated the dose-dependent trend of mastic gum on H. pylori eradication, although this was not statistically significant [76]. ...
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Although its prevalence is declining, gastric cancer remains a significant public health issue. The bacterium Helicobacter pylori is known to colonize the human stomach and induce chronic atrophic gastritis, intestinal metaplasia, and gastric cancer. Results using a Mongolian gerbil model revealed that H. pylori infection increased the incidence of carcinogen-induced adenocarcinoma, whereas curative treatment of H. pylori significantly lowered cancer incidence. Furthermore, some epidemiological studies have shown that eradication of H. pylori reduces the development of metachronous cancer in humans. However, other reports have warned that human cases of atrophic metaplastic gastritis are already at risk for gastric cancer development, even after eradication of these bacteria. In this article, we discuss the effectiveness of H. pylori eradication and the morphological changes that occur in gastric dysplasia/cancer lesions. We further assess the control of gastric cancer using various chemopreventive agents.
... There are only a few reports on antimicrobial activity of natural gums. Dabos, Sfika, Vlatta, and Giannikopoulos (2010) assessed the antibacterial activity of a natural resin excreted from the trunk and branches of the mastic bush (Pistacia lentiscus L.), named mastic gum against Helicobacter pylori (Goodwin et al., 1989) in vivo. They reported that the monotherapy did not achieve acceptable eradication rates but the mastic gum could be used as an alternative in patients unwilling to undergo the conventional eradication therapy regime. ...
Article
Exudates released from plants, consist of complex mixtures of organic and inorganic molecules that have been used in traditional medicine from several years. They may vary among genera, species or within a genus and mainly include latex, sap, gums, resins, seed or root exudates. Plant exudates are known to possess several biological activities including, antimicrobial, anti-inflammatory, antioxidant, wound healing and anti-nociceptive. Exudates oozed out from plants have also been used as ingredients in medicines, food, perfumes and cosmetics. The present review provides brief overview about the exudates released from plants, their biological properties and beneficial effects for human beings. Due to the presence of various compounds, different methodologies and procedures have been employed for their collection and analyses. Literature studies suggest that plant exudates have extensive therapeutic potential for curing diseases with minimal toxic effects. This aspect could be taken into account in prospective studies regarding the search of new products derived from plant exudates with pharmaceutical value.
... H. pylori was monitored by a 13 C urea breath test (UBT). The dosage used was well tolerated and free of any adverse effects [75]. However, the next study questioned the capability of mastic to eradicate H. pylori from human patients. ...
Article
A number of papers reporting antimicrobial properties of extracts, essential oils, resins and various classes of compounds isolated from higher plants has been published in recent years; however, a comprehensive analysis of plant-derived antimicrobial agents currently applied in practice for improvement of human health is still lacking. This review summarizes data on clinical efficacy, antimicrobial effects and the chemistry of commercially available antibacterial and antifungal agents of plant origin currently used in the prevention and treatment of gastrointestinal, oral, respiratory, skin, and urinary infections. As a result of an analysis of the literature, more than 40 plant-derived over-the-counter pharmaceuticals, dietary supplements, cosmetics, herbal medicines, and functional foods containing complex mixtures (e.g. Glycyrrhiza glabra extract, Melaleuca alternifolia essential oil, and Pistacia lentiscus resin), pure compounds (e.g. benzoic acid, berberine, eucalyptol, salicylic acid and thymol) as well as their derivatives and complexes (e.g. bismuth subsalicylate and zinc pyrithione) have been identified. The effectiveness of many of these products is illustrated by results of clinical trials and supported by data on their in vitro antimicrobial activity. A broad spectrum of various commercial products currently available on the market and their well-documented clinical efficacy suggests that plants are prospective sources for the identification of new types of antimicrobial agents in future. Innovative approaches and methodologies for effective proof-of-concept research and the development of new types of plant-derived products effective against recently emerging problems related to human microbial diseases (e.g. antimicrobial resistance) are also proposed in this review.
... In a randomized clinical trial where different doses of mastic, either as single therapy or in combination with pantoprazole, were administered in patients with H. Pylori infection for 14 days, it was confirmed that mastic is sufficient in achieving H. Pylori eradication in vivo. Nevertheless, failure of the combination of mastic with pantoprazole to eradicate H. Pylori was observed, attributed to the hypothesis that most of the mastic substances require an acidic environment in the stomach to be effective against H. Pylori, a condition that is changed with proton pump inhibitors that increase gastric alkalinity [23]. Underlining the need for more randomized studies to be performed, Bebb et al. reported no effect on H. Pylori status as assessed by urea breath tests in eight patients treated with mastic [24]. ...
Article
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Despite the remarkable development of the medical industry in the current era, herbal products with therapeutic potentials arise as attractive alternative treatments. Consequently, Chios mastiha, a natural, aromatic resin obtained from the trunk and brunches of the mastic tree, has recently gained increasing scientific interest due to its multiple beneficial actions. Chios mastiha is being exclusively produced on the southern part of Chios, a Greek island situated in the northern Aegean Sea, and its therapeutic properties have been known since Greek antiquity. There is now substantial evidence to suggest that mastiha demonstrates a plethora of favorable effects, mainly attributed to the anti-inflammatory and anti-oxidative properties of its components. The main use of mastiha nowadays, however, is for the production of natural chewing gum, although an approval by the European Medicines Agency for mild dyspeptic disorders and for inflammations of the skin has been given. The aim of this article is to summarize the most important data about the therapeutic actions of Chios mastiha and discuss future fields for its medical application.
... Furthermore, it contains also tricyclic and bicyclic triterpenoids, some polyphenols, and volatile compounds [40]. There are several studies investigating the antibacterial properties of mastic, wherein most of them are dominated by the effect on Helicobacter pylori [146]. Nevertheless, antibacterial activity against skin pathogens for P. lentiscus is also documented. ...
Article
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Bacterial infections of skin and wounds may seriously decrease the quality of life and even cause death in some patients. One of the largest concerns in their treatment is the growing antimicrobial resistance of bacterial infectious agents and the spread of resistant strains not only in the hospitals but also in the community. This trend encourages researchers to seek for new effective and safe therapeutical agents. The pharmaceutical industry, focusing mainly on libraries of synthetic compounds as a drug discovery source, is often failing in the battle with bacteria. In contrast, many of the natural compounds, and/or the whole and complex plants extracts, are effective in this field, inactivating the resistant bacterial strains or decreasing their virulence. Natural products act comprehensively; many of them have not only antibacterial, but also anti-inflammatory effects and may support tissue regeneration and wound healing. The European legislative is in the field of natural products medicinal use formed by European Medicines Agency (EMA), based on the scientific work of its Committee on Herbal Medicinal Products (HMPC). HMPC establishes EU monographs covering the therapeutic uses and safe conditions for herbal substances and preparations, mostly based on folk medicine, but including data from scientific research. In this review, the medicinal plants and their active constituents recommended by EMA for skin disorders are discussed in terms of their antibacterial effect. The source of information about these plant products in the review is represented by research articles listed in scientific databases (Science Direct, PubMed, Scopus, Web of Science, etc.) published in recent years.
... As there is an increasing consumer's interest for natural products as preventing and healing factors without side effects, the research interest upon the favourable effects and the mechanisms of action of natural products has increased as well. Regarding Mastiha, several researchers have investigated its antibacterial [5], antioxidant [6], anti-inflammatory [7], cytotoxic [8], hypolipidaemic activity [9] and the influence on liver and gut health [10,11]. ...
Article
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Nowadays both scientists and consumers have an increasing interest for natural products as preventing and healing factors without side effects. Mastiha, is a natural product of the Mediterranean basin with several health benefits as investigated the last decades. The present review summarises the research evidence from preclinical and clinical studies regarding the antioxidant and anti-inflammatory potential of Mastiha. MEDLINE, COHRANE and search terms “Mastiha”, “Mastic gum”, “Chios mastic” and “Pistacia lentiscus” were used. We limited our search by selecting only articles written in English literature, published between 2003 and 2019 that were experimental studies on Mastiha resinous exudate (review articles and individual case reports were excluded). Additional searches were performed using “oxidative stress” and “inflammation”. A total of 19 studies met our criteria and were included in this review. Currently, there are more preclinical than clinical data available. Taken all together, the antioxidant potential of Mastiha is most probably owed to the inhibition of protein kinase, while its anti-inflammatory capacity may be the result of the inhibition of NF-κB activation. Further clinical studies in large populations are necessary.
... After two weeks of consumption, the results showed that relieving symptoms and healing duodenal ulcers were significantly more effective than placebo [225]. Additionally, administering 350 mg of mastic three times a day for 14 days to 52 patients demonstrated an effect on eradicating H. pylori [226]. The other study was performed with five H. pylori-infected patients and three healthy controls who received 1 g of mastic daily for two months. ...
Article
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The extensive usage of antibiotics and the rapid emergence of antimicrobial-resistant microbes (AMR) are becoming important global public health issues. Many solutions to these problems have been proposed, including developing alternative compounds with antimicrobial activities, managing existing antimicrobials, and rapidly detecting AMR pathogens. Among all of them, employing alternative compounds such as phytochemicals alone or in combination with other antibacterial agents appears to be both an effective and safe strategy for battling against these pathogens. The present review summarizes the scientific evidence on the biochemical, pharmacological, and clinical aspects of phytochemicals used to treat microbial pathogenesis. A wide range of commercial products are currently available on the market. Their well-documented clinical efficacy suggests that phytomedicines are valuable sources of new types of antimicrobial agents for future use. Innovative approaches and methodologies for identifying plant-derived products effective against AMR are also proposed in this review.
... It has been used in cosmetic products, chewing gums, toothpaste, liquors, and lotions for decades. Moreover, the positive effects of MG have been shown for gastrointestinal disorders like ulcers (Al-Habbal et al., 1984), pancreatic cancer (Huang et al., 2010), Helicobacter pylori infection (Dabos et al., 2010;Huwez et al., 1998). The anticarcinogenic, cardioprotective, antibacterial, and antioxidant properties (Pachi et al., 2020) of MG make it desirable for many different fields of research. ...
Article
In this study, three natural biomaterials, Locust bean gum (LBG), Xanthan gum (XG), and Mastic gum (MG), were combined to form cryogel scaffolds. Thermal and chemical characterizations revealed the successful blend formation from LBG-XG (LX) and LBG-XG-MG (LXM) polymers. All blends resulted in macro-porous scaffolds with interconnected pore structures under the size of 400 μm. The swollen cryogels had similar mechanical properties compared with other polysaccharide-based cryogels. The mean tensile and compressive modulus values of the wet cryogels were in the range of 3.5-11.6 kPa and 82-398 kPa, respectively. The sustained release of the small molecule Kartogenin from varying concentrations and ratios of cryogels was in between 32-66 % through 21 days of incubation. Physical, mechanical, and chemical properties make LX and LXM polysaccharide-based cryogels promising candidates for cartilage and other soft tissue engineering, and drug delivery applications. Chemical compounds Locust bean gum (PubChem CID:333186), Xanthan gum (PubChem CID:47932), Kartogenin (PubChem CID:2826191)
... New studies confirm its antibacterial effectiveness: germs that are responsible for the formation of caries and periodontitis can be successfully reduced with mastic. There are also studies on the effects on oral hygiene, for example, in the case of tooth decay, xerostomia (dry mouth or oral dryness), or gingivitis, and on the skin [37][38][39][40][41]. ...
Article
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Coating, as a process in which fruits, vegetables, kernels, and nuts are covered with an edible layer, is an environmentally friendly alternative to plastic wrapping, which has been considered the most effective way to preserve them over the long term. On the other hand, prolonging the shelf life results in a reduction of spoilage and therefore achieving a goal that is very important nowadays—the reduction of food waste. The quality of preserved almonds kernels depends on factors such as grain moisture, storage temperature, relative humidity, oxygen level, packaging, and the shape of the stored nuts (along with being peeled, unpeeled, roasted, etc.). The commercial importance of the almond fruit is related to its kernel. Almonds that are peeled (without the thin brown skin) and stored have a shorter shelf life than unpeeled almonds since the reddish-brown skin, rich in antioxidants, may protect the kernels against oxidation. In this study, a bioactive edible coating has been tested, which may provide an effective barrier against oxygen permeation and moisture, thus preserving the quality of peeled fresh almonds by extending their shelf life. Mastic gum, as a natural coating agent, was used to coat the peeled fresh almond kernels in four different concentrations (0.5%, 1.0%, 1.5%, and 2.0% w/v). The effect of mastic gum coating on the quality parameters of the peeled fresh almonds (moisture uptake, oil oxidation, total yeast and mold growth, and Aspergillus species development) was studied during four months of storage. The results showed that mastic gum, as a coating agent, significantly (p < 0.05) reduced moisture absorption, peroxide and thiobarbituric acid indices, total yeast and mold growth, and Aspergillus species development in the peeled and coated fresh almonds, compared to the control, i.e., uncoated fresh almonds, during 4 months of storage, packed at room temperature (25–27 °C) inside a cabinet at 90% humidity. Therefore, mastic gum can be used as a great natural preservative coating candidate with antioxidant and antimicrobial effects.
... P. palaestina (also named known as mastaki) has antimicrobial, antioxidant, antifungal, and antiinflammatory activities (Sofowora, 1982;Paraschos et al., 2012;Orhan et al., 2006). It has good anti Helicobacter pylori effect which helps in curing many gastrointestinal diseases (Orhan et al., 2006;Dabos et al., 2010). P. palaestina methanolic extract was documented for its antimicrobial activity on Escherichia coli bacteria; such activity was found to be dose-dependent. ...
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An in-vitro evaluation of the antioxidant activities of wild Palestinian Pistacia palaestina extracts was done. In parallel, the total phenolic content (TPC) and the total flavonoids content (TFC) were measured. The antioxidant activities were determined spectrophotometrically by DPPH, FRAP, CUPRAC and the ABTS methods. The phenolic and flavonoid contents were separated and identified using LC-PDA-MS. The P. palaestina extract was found to contain many phenolic and flavonoids that enhance its reducing activity and free radical scavenging ability. Total phenolic content, and total flavonoids contents were found to be 66.5 ± 2.2 mg Gallic acid/g, and 20.3 ± 1.1 mg catechin/g, respectively. Antioxidant activity represented as FRAP, CUPRAC, DPPH and ABTS was found to be 23.5± 1.2 mmol Fe +2 /g, 4562 ± 63 µmol Trolox/g, 344 ± 11 µmol/g, 53.1 ± 6.6 µmol/g, respectively. The aim of the study is therefore to employ different antioxidant tests to evaluate the antioxidant activities of crude ethanol leaf extracts of P. palaestina, and to determine its phenolic and flavonoids content.
... Oral mastic has anti-Helicobacter pylori (H. pylori) effect [24][25][26] as well as digestive aid [16] and antioxidant [27] properties and has been studied as a complementary treatment in the Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS) [28]. In a previous study, the effect of applying 350 mg/BD of Pistacia atlantica resin for 4 weeks was compared with placebo and a significant decrease was observed in the severity and frequency of early satiation, pain, and nausea in the Pistacia atlantica-treated group compared to the placebo group [4]. ...
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Background: The main goal of the present study was to evaluate the effect of topical mastic oil, compared to placebo on treatment of functional dyspepsia (FD). Materials and Methods: Sixty-three patients with FD were included. Thirty-two subjects received the topical mastic oil (10 drops/TDS after meal) with massage and 31 patients received topical sesame oil with massage. Both groups received pantoprazole (40 mg daily) along with oil and massage. The severity of early satiation, postprandial fullness, epigastric pain and epigastric burning was assessed after 4 weeks using the Visual Analogue Scale (VAS) as well as frequency of symptoms. Satisfaction with the treatment was also assessed using a researcher-made questionnaire. Changes in the severity of symptoms were evaluated by Friedman’s test. Results: Mean and standard deviation of age of the subjects were equal to 36.95±13.64 and 50 (79.4%) patients were female. Both groups experienced a significant decrease in the severity of all the four symptoms (P<0.001). The percentage of decrease in the severity of early satiation was significantly higher in the mastic group than the control group (76.03±34.91% vs. 37.24±38.86%, P=0.003). No significant differences were found in the percentage of decrease in the severity of postprandial fullness, epigastric pain and burning between the study groups (P=0.05, 0.06, and 0.13, respectively). The frequency of symptoms was decreased similarly in both groups. Satisfaction with the treatment was reported to be significantly higher in the mastic group than the sesame group (P=0.01). There were no intolerable side effects in both groups. Conclusion: Mastic oil reduced early satiation better than the placebo. In addition, satisfaction with the treatment was higher in the mastic group than the sesame group. [GMJ.2021;10:e1965]
... [22][23][24][25] Based on this large number of potentially beneficial effects, it is currently in use in health care products and in the food industry. 26 Although gum mastic extract and powder have been used orally for many years as a food supplement, they are now being evaluated for several clinical indications, including peptic ulcers, 27 Helicobacter pylori treatment, 8,28 reduction of bacteria in the mouth that account for dental caries, 9 functional dyspepsia, 29 and possibly Crohn disease. 30 RPh201 is a novel botanical drug candidate obtained from gum mastic. ...
Article
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RPh201 is a drug extracted from gum mastic that has been studied for its anti‐inflammatory and antibacterial properties. Preclinical studies of RPh201 demonstrated neuroprotective and neuroenhancing effects. Toxicology studies in animals did not reveal safety concerns or genotoxic effects. This single‐center, phase 1, randomized, placebo‐controlled, double‐masked study in healthy volunteers assessed the safety and tolerability of RPh201, and determined the highest tolerated dose. There were 2 parts: a single ascending dose (SAD) stage, followed by a multiple ascending dose (MAD) stage. Three dosing arms were included in each stage (5 mg, 10 mg, and 20 mg). Safety data in the lower dosing arms were evaluated before higher doses were initiated. Eighteen participants were randomized in the SAD stage: 12 to RPh201 (4 at each dose) and 4 to placebo. Twenty‐one participants were randomized in the MAD stage, of which 13 received RPh201. All 18 participants in the SAD stage completed treatment. Sixteen of the 21 participants in the MAD stage completed treatment. The most frequently reported adverse events were local injection site pain and erythema. No deaths or adverse events related to changes in vital signs or electrocardiograms were reported. No occurrences of suicidal behavior or ideation were reported.
... The uses of this gum vary, including food, cosmetics, perfumery, dentistry, and chewing gum. P. lentiscus resin reportedly demonstrates therapeutic properties such as anti-inflammatory and antioxidant activities (Loizou et al. 2009;Zhou et al. 2009;Mahmoudi et al. 2010;Triantafyllou et al. 2011;Ben Khedir et al. 2016;Papada et al. 2018), as well as antibacterial activity against Helicobacter pylori, where its implication in the treatment of gastritis, gastroesophageal reflux, and ulcer has been described (Huwez et al. 1998;Marone et al. 2001;Dabos et al. 2010). Other studies have found that this resin has hypolipidemic effects (Triantafyllou et al. 2007), reduces cholesterol levels (Vallianou et al. 2011), and is associated with weight loss (Kang et al. 2007). ...
Article
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This study screened mastic gum (Pistacia lentiscus L.) for antiviral activity against herpes simplex virus type 2 (HSV-2), coxsackievirus type B3, and adenovirus type 5. The organs of this plant (leaves, stem, and seed) were macerated sequentially using solvents of increasing polarity (hexane, dichloromethane, ethyl acetate, and methanol). Only the methanol extract of stem exhibited significant activity against HSV-2. This extract showed anti-HSV-2 activity with a selectivity index of 51 (50% cytotoxic concentration = 186 µg/mL; 50% inhibitory concentration = 3.63 µg/mL), and demonstrated direct inhibition against this virus with a virucidal selectivity index of 620 (50% virucidal concentration = 0.30 µg/mL). A bio-guided assay involving thin-layer chromatography led to the isolation of two active compounds, which have been identified as dammaradienone and dammaradienol using high-performance liquid chromatography–diode array detection coupled with electrospray ionization mass spectrometry. P. lentiscus has been widely studied for other biological activities. However, to our knowledge, this is the first report of P. lentiscus L. exhibiting antiviral activity.
Article
Helicobacter pylori (HP) is a gram-negative flagellated pathogen acid-resistant bacterium; it belongs to the order Campylobacterales that is wide spread all over the world, infecting more than 50% of the world population. HP infection is etiologically associated with non-atrophic and atrophic gastritis, peptic ulcer and with 3 to 6-fold increased relative risk for developing gastric adenocarcinoma and mucosa-associated lymphoid tissue (MA LT) lymphoma. For this reason HP is recognized by the World Health Organization as a Class I human carcinogen. In the last years a lot of studies clarified the role of this pathogen in nutrition and metabolism; particularly, it has been shown that it is able to induce malabsorption of several nutrients like iron, cobalamin, vitamin C and vitamin E, with strong consequences on nutritional status. Interesting, this bacterium is able to produce different biological effects on hormones like ghrelin and leptin controlling both appetite and growth, mostly depending on the time of acquisition of the infection and of its treatment. In this review, the authors focused their attention on nutritional effects of HP infection and particularly on the role that diet, food, plants and specific nutrients can play in its treatment, considering that HP eradication rates, with standard triple-therapy, have fallen to a low level in the last years.
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Pistacia lentiscus L. is an evergreen shrub or tree of the Anacardiaceae family that is ubiquitous in Mediterranean areas under 1,100 m above sea level. The essential oil obtained from the gum/resin is commonly called mastic oil, whereas the oil obtained from the leaves is termed lentisk oil. Mastic, foliage, and fruit essential oils have served in traditional human medicine for millennia. In human medicine, aqueous extracts of leaves and young twigs are prepared as infusions or decoctions. Leaves and young twigs are used “as is” in veterinary medicine. Extracts exhibit a high concentration of phenolics and terpenes of varying composition. In addition to the traditional use of mastic resin in human medicine against stomach ulcers, evidences for anti-bacterial, antifungal, antioxidant, hepato-protective, and anti-carcinogenic properties of products sourcing from P. lentiscus, some of them controversial, are accumulating. The anthelmintic and anticoccidial properties of P. lentiscus foliage have been recently demonstrated in small ruminants. Metabolomics, encompassing new analytical procedures will probably help in elucidating the rationale of traditional medicine in using P. lentiscus for therapies or prevention. It can be expected that new cultivars will be cultivated on the basis of bio-activity.
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Helicobacter pylori, a spiral-shaped Gram-negative bacterium, has been classified as a class I carcinogen by the World Health Organization and recognized as the causative agent for peptic ulcers, duodenal ulcer, gastritis, mucosa-associated lymphoid tissue lymphomas, and gastric cancer. Owing to their alarming rate of drug resistance, eradication of H. pylori remains a global challenge. Triple therapy consisting of a proton pump inhibitor, clarithromycin, and either amoxicillin or metronidazole, is generally the recommended standard for the treatment of H. pylori infection. Complementary and alternative medicines have a long history in the treatment of gastrointestinal ailments and various compounds has been tested for anti-H. pylori activity both in vitro and in vivo; however, their successful use in human clinical trials is sporadic. Hence, the aim of this review is to analyze the role of some well-known natural products that have been tested in clinical trials in preventing, altering, or treating H. pylori infections. Whereas some in vitro and in vivo studies in the literature have demonstrated the successful use of a few potential natural products for the treatment of H. pylori-related infections, others indicate a need to consider natural products, with or without triple therapy, as a useful alternative in treating H. pylori-related infections. Thus, the reported mechanisms include killing of H. pylori urease inhibition, induction of bacterial cell damage, and immunomodulatory effect on the host immune system. Furthermore, both in vitro and in vivo studies have demonstrated the successful use of some potential natural products for the treatment of H. pylori-related infections. Nevertheless, the routine prescription of potential complementary and alternative medicines continues to be restrained, and evidence on the safety and efficacy of the active compounds remains a subject of ongoing debate.
Article
Pistacia lentiscus L. is an evergreen shrub belonging to the Anacardiaceae family, cultivated exclusively in the southern area of Chios Island. Mastic gum as a unique natural resin of the tree Pistacia lentiscus L. has been used extensively in functional foods and traditional medicine. The biological properties of Pistacia resins may be influenced by different chemical constituents. Herein the present work is aimed to further explore the diverse triterpenoids of mastic, and evaluate their anti-inflammatory activity. Two undescribed polypodane-type bicyclic triterpenoids were isolated from the Pistacia resins, their structures were elucidated using ultraviolet, infrared, high resolution electrospray ionization mass spectroscopy (HRESIMS), and nuclear magnetic resonance data. LPS-stimulated RAW264.7 macrophages were incubated with various concentrations of isolated compounds, and results showed that compounds 1 and 2 inhibited nitric oxide production in LPS-induced RAW264.7 cells with IC 50 values of 28.1 and 32.6 µM, respectively.
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Helicobacter pylori is a gram-negative bacterium that colonizes the gastric mucosa of roughly half of the world's inhabitants. The vast majority (80-85%) of H. pylori carriers never experience symptoms or complications; yet colonization can result in chronic gastritis or inflammation of the stomach lining at the site of infection. This inflammation is considered to be a major risk factor in the development of gastric ulcers, duodenal ulcers, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric adenocarcinoma. Approximately 10% of those colonized by H. pylori will ultimately develop peptic ulcer disease, and the risk of developing gastric cancer is increased by three to six times with chronic H. pylori infection. Research has demonstrated that Helicobacter pylori coevolved with humans as a member of the indigenous gastric microbiota. In fact, H. pylori once colonized almost every adult human on the planet, and only in the last century have colonization rates been declining. This decline is noted particularly in developed countries where H. pylori now infects just 30 to 40 percent of the adult population, compared with a prevalence of 80 to 90 percent in the developing world. Historically, colonization during childhood was the norm; today fewer than 10% of U.S. children are colonized by H. pylori. Current rates of colonization reflect both diminishing transmission — due to changes in sanitation and population demographics — and increasing antibiotic usage, both for H. pylori eradication and for unrelated concerns. Because H. pylori causes overt gastric disease in only a small subset of human carriers, researchers have begun to consider a potential mutualistic or protective role that H. pylori may play in the natural stomach ecology. Preliminary evidence suggests that H. pylori may play an important role in protecting from some diseases. Animal studies suggest that H. pylori has evolved to skew the adaptive immune response toward immune tolerance, which tends to promote persistent infection and to inhibit auto-inflammatory and allergic T-cell responses. Human epidemiological studies show that H. pylori colonization is associated with lower incidences of childhood asthma, allergic rhinitis, and atopic dermatitis. In addition, inverse relationships between H. pylori status and risk of developing inflammatory bowel disease and celiac disease have been documented. The prevalence of H. pylori in patients with gastroesophageal reflux disease (GERD) is also lower than in those without reflux disease. It has been postulated that H. pylori protects against GERD and its consequences, including esophageal adenocarcinoma, via its regulatory effects on gastric hormone secretion and gastric pH. Natural colonization with H. pylori is even hypothesized to play a role in preventing the development of early-life obesity via its regulatory effect on energy homeostasis mediated by gastric hormones such as leptin and ghrelin.
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Helicobacter pylori is the major component of the gastric microbiome of infected individuals and one of the aetiological factors of chronic gastritis, peptic ulcer disease and gastric cancer. The increasing resistance to antibiotics worldwide has made the treatment of H. pylori infection a challenge. As a way to overhaul the efficacy of currently used H. pylori antibiotic-based eradication therapies, alternative treatment strategies are being devised. These include probiotics and prebiotics as adjuvants in H. pylori treatment, antimicrobial peptides as alternatives to antibiotics, photodynamic therapy ingestible devices, microparticles and nanoparticles applied as drug delivery systems, vaccines, natural products, and phage therapy. This review provides an updated synopsis of these emerging H. pylori control strategies and discusses the advantages, hurdles, and challenges associated with their development and implementation. An effective human vaccine would be a major achievement although, until now, projects regarding vaccine development have failed or were discontinued. Numerous natural products have demonstrated anti-H. pylori activity, mostly in vitro, but further clinical studies are needed to fully disclose their role in H. pylori eradication. Finally, phage therapy has the potential to emerge as a valid alternative, but major challenges remain, namely the isolation of more H. pylori strictly virulent bacterio(phages).
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p>H.pylori infection is one of the most common infections in the world so that the aim of this study was to evaluate the antimicrobial P. Atlantica Kurdica gum in the eradication of H.pylori. This study is a randomized clinical trial; Patients with positive Urea Breath Test and symptoms of dyspepsia were entered. Patients were randomly divided into four groups. Group A: three drugs including 500mg of Amoxicillin twice a day (bd), Clarithromycin 500mg bd and Omeprazole 20 mg (bd) and Group B: Group A drugs plus the capsule containing 1g of powdered P. Atlantica Kurdica gum (bd). In Group C: the capsule containing 1g of powdered P. Atlantica Kurdica gum (bd) and Group D: this group took placebo-containing capsule (bd) for 14 days respectively. Dyspeptic symptoms before and after healing period and the UBT results two days before the start of treatment and 30 days after the completion were compared in 4 groups. Patients were not statistically significant difference from each other in the four groups regarding the demographic situation. Moreover, H.pylori eradication rate was 19/24 in Group A, 18/24 in Group B, 10/23 in Group C and 2/24 in Group D. Relieving symptoms of dyspepsia in Groups B and C were significantly higher than in Group D (P=0.025 and p=0.006 respectively). P. Atlantica Kurdica significantly led to the treatment of dyspepsia symptoms and H.pylori eradication.</p
Chapter
This chapter reviews the traditional Greek product Chios Mastic Gum or Mastiha, primarily known for its distinctive flavor. This is the dried exudate of the shrub-like tree Pistacia lentiscus L. var. chia of the Anacardiaceae family, cultivated exclusively in the south of the Greek island Chios. Emphasis is given on its chemistry and physicochemical properties, health effects, antioxidant and antimicrobial properties. The preparation of traditional food products based on mastic gum or essential oil, such as chewing gum, confectionery, bakery products as well as alcoholic and nonalcoholic beverages, is also discussed.
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Background: The cardinal symptoms of gastroesophageal reflux disease include heartburn (pyrosis) and regurgitation. Conventional treatment is done by proton pump inhibitors. In Persian traditional medicine, several herbs (single or combined) have been used to treat gastrointestinal disorders. Objectives: This study aimed to assess the effects of Pistacia lentiscus (mastic) and Coriander Triphala on reflux symptoms compared to omeprazole in a double-blinded randomized clinical trial. Methods: In a double-blinded, multicenter, randomized clinical trial, we assessed the effects of Pistacia lentiscus L., Coriander Triphala, and omeprazole on the symptoms of GERD in Tabriz, Iran, in 2018 - 2019. Thus, 105 patients with GERD symptoms were assigned randomly to three groups as group A (Pistacia lentiscus L., 1000 mg/TDS), group B (Coriander Triphala, 1000 mg/TDS), and group C (omeprazole, 20 mg/day plus five placebo capsules per day). The assessments were done at the beginning and the end of the study using FSSG, VAS, RS, and GERD-HRQL questionnaires. Results: In the beginning, no significant differences were observed between the groups in the background characteristics. There was no statistically significant difference between Pistacia lentiscus, Coriander Triphala, and omeprazole in the improvement of FSSG, VAS, GERD-HRQL, and reflux scores. In all groups, the FFSG, VAS, reflux, and GERD-HRQL scores significantly decreased and improved after four weeks of intervention compared to the respective baselines. The FSSG score improvements after four weeks of intervention were 73.68%, 83.33%, and 68.62%, in groups A, B, and C, respectively. The VAS score improvements were 66.66%, 75.00%, and 62.50% in groups A, B, and C, respectively. Improvements in GERD-HRQL were 90.00%, 91.28%, and 82.00%, in groups A, B, and C, respectively. Reflux improvements were 66.66%, 80.00%, and 66.66% in groups A, B, and C, respectively. Conclusions: The results showed that Pistacia lentiscus and Coriander Triphala are as effective as omeprazole in the treatment of GERD.
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Drug delivery across the skin is used for several millennia to ease gastrointestinal (GI) ailments in Traditional Persian Medicine (TPM). TPM topical remedies are generally being applied on the stomach, lower abdomen, lower back and liver to alleviate GI illnesses such as dyspepsia, gastritis, GI ulcers, inflammatory bowel disease, intestinal worms and infections. The aim of the present study is to survey the topical GI remedies and plant species used as ingredients for these remedies in TPM. In addition, pharmacological activities of the mentioned plants have been discussed. For this, we searched major TPM textbooks to find plants used to cure GI problems in topical use. Additionally, scientific databases were searched to obtain pharmacological data supporting the use of TPM plants in GI diseases. Rosa × damascena, Pistacia lentiscus, Malus domestica, Olea europaea and Artemisia absinthium are among the most frequently mentioned ingredients of TPM remedies. β-asarone, amygdalin, boswellic acids, guggulsterone, crocin, crocetin, isomasticadienolic acid, and cyclotides are the most important phytochemicals present in TPM plants with GI-protective activities. Pharmacological studies demonstrated GI activities for TPM plants supporting their extensive traditional use. These plants play pivotal role in alleviating GI disorders through exhibiting numerous activities including antispasmodic, anti-ulcer, anti-secretory, anti-colitis, anti-diarrheal, antibacterial and anthelmintic properties. Several mechanisms underlie these activities including the alleviation of oxidative stress, exhibiting cytoprotective activity, down-regulation of the inflammatory cytokines, suppression of the cellular signaling pathways of inflammatory responses, improving re-epithelialization and angiogenesis, down-regulation of anti-angiogenic factors, blocking activity of acetylcholine, etc.
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Worldwide, Helicobacter pylori (H. pylori) is regarded as the major etiological agent of peptic ulcer and gastric carcinoma. Claiming about 50 percent of the world population is infected with H. pylori while therapies for its eradication have failed because of many reasons including the acquired resistance against its antibiotics. Hence, the need to find new anti-H.pylori medications has become a hotspot with the urge of searching for alternative, more potent and safer inhibitors. In the recent drug technology scenario, medicinal plants are suggested as repositories for novel synthetic substances. Hitherto, is considered as ecofriendly, simple, more secure, easy, quick, and less toxic traditional treatment technique. This review is to highlight the anti-H. pylori medicinal plants, secondary metabolites and their mode of action with the aim of documenting such plants before they are effected by cultures and traditions that is expected as necessity.
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Ethnopharmacological relevance: Chios mastic gum constitutes a unique Greek product, produced exclusively in the southern part of the island of Chios. References about its use from local populations for the treatment of gastrointestinal disorders or as a cosmetic agent can even be encountered in ancient texts of Galen, Theophrastus and Dioscorides. Nowadays, this versatile resin has been rediscovered, not only as a traditional remedy and aromatic agent, but as a potent phytotherapeutic product with various biological properties. Aim of the study: The aim of this study is to quote the summation of the ethnopharmacology, phytochemical profile and pharmacological properties of the resin of Pistacia lentiscus var. Chia and thus provide the scientific community with a summary of the research conducted so far. Furthermore, perspectives and uses are being discussed and studied so as to broaden the field of its applications. Materials and methods: A comprehensive review of the literature on Pistacia lentiscus var. Chia was performed using as resources scientific databases such as Scopus, Sciencedirect, Pubmed and Web of science, studies and traditional books provided by the Chios Mastiha Growers Association as well as PhD and Master' s theses. Results: Chios mastic gum has been used as a traditional medicine over the last 2500 years. More than 120 chemical compounds have been identified in the resin and the major components are a natural polymer, acidic and neutral triterpenes and volatile secondary metabolites. Several plant extracts and compounds have been studied for their antibacterial, anti-inflammatory, antioxidant, anti-ulcer, anti-diabetic, cardioprotective and anti-cancer properties in vitro and in vivo. Clinical interventions and trials have also showed the therapeutic potential of Chios mastic gum. In 2015 Pistacia lentiscus L., resin (mastic) was recognized as a herbal medicinal product with traditional use by the European Medicines Agency (EMA) with two therapeutic indications (mild dyspeptic disorders & skin inflammation/healing of minor wounds). Over the last years, Chios mastic gum is widely involved in medicinal products, food supplements and cosmetics and has become object of study, also in the field of Pharmacotechnology. Conclusions: Chios mastic's beneficial properties have been demonstrated in the treatment of gastrointestinal disorders, wound healing, skin inflammations, plasma lipid and blood sugar reduction and oral care. These properties are attributed to triterpenes and volatile compounds. However, because of the resin's chemical complexity and the lack of commercial standards for its main compounds, there is a notable gap in literature concerning the biological evaluation of CMG's isolated components. Therefore, future research should focus on the development of efficient extraction, isolation and analysis techniques in order to unravel CMG's full pharmacological potential.
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Scope: As a result of the obesity epidemic, the prevalence of non-alcoholic steatohepatitis (NASH) is increasing. No drug is approved for the treatment of NASH. We have investigated the effect of a nutritional supplement, Mastiha or Chios mastic gum, on metabolic and histological parameters and on the gut microbiome in mice with NASH and fibrosis. Methods and results: Advanced NASH was induced by feeding C57BL/6J mice a diet rich in fat, sucrose and cholesterol for 41 weeks. After randomization, animals received the NASH-inducing diet with or without 0.2% (w/w) Mastiha for a further eight weeks. Disease activity was assessed by liver histology and determination of plasma transaminase activities. Fecal microbiota DNA extraction and 16S rRNA amplicon sequencing were used to determine the composition of the gut microbiome. Mastiha supplementation led to a significant reduction in circulating alanine aminotransferase (ALT) activity, improvement in hepatic steatosis and collagen content and a reduction in NAFLD activity score. Furthermore, it resulted in a partial but significant recovery of gut microbiota diversity and changes in identity and abundance of specific taxa. Conclusion: This is the first study demonstrating an improvement in disease activity in mice with advanced NASH with fibrosis by a diet containing Mastiha. This article is protected by copyright. All rights reserved.
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Scope: To assess bioavailability of terpenes in human plasma and their effect on oxidative stress biomarkers. Methods and results: In this open-label and single arm postprandial trial, seventeen healthy male volunteers (20-40 years old) followed a low-phytochemical diet for 5 days. Next, after overnight fasting, volunteers consumed Mastiha powder (a natural resin rich in terpenes) dispersed in water. Blood samples were collected on time-points 0h (before ingestion) and 0.5h, 1h, 2h, 4h, 6h, 24h (post-ingestion). Ultra High Pressure Liquid Chromatography-High Resolution Mass Spectrometry (UHPLC-HRMS) was applied for high throughput analysis of plasma. Serum resistance to oxidation and oxidized LDL (oxLDL) levels were measured. UHPLC-HRMS/MS analysis showed that major terpenes are bioavailable since 0.5h after administration, reaching a peak between 2h and 4h. Serum resistance to oxidation, expressed as difference of tLAG (time point-0h), started to increase from 0.5h. This increase reached statistical significance at 4h (402.3 ± 65.0sec), peaked at 6h (524.6 ± 62.9sec) and remained statistically significant until 24h (424.2 ± 48.0sec). oxLDL levels, expressed as %change from 0h, were reduced significantly from time point-1h until time point-6h. Conclusion: Results demonstrate the terpene bioavailability pattern after oral administration of Mastiha. Terpenes are potential mediators of antioxidant defense in vivo. This article is protected by copyright. All rights reserved.
Article
The effects of Chios mastic gum (Pistacia lentiscus var. Chia) and exercise on physical characteristics, blood lipid markers, insulin resistance, and hepatic function were investigated in healthy, non-smoking Japanese men aged ≥ 40 years. Participants were allocated to control (C, 5 g/day placebo powder, n = 7), mastic (M, 5 g/day mastic powder, n = 7), or mastic plus physical activity groups (M + PA, 5 g/day mastic powder and 30-min exercise three times/week, n = 7), and measurements were taken at baseline, 3 and 6 months. Serum triglycerides were significantly reduced at 3 months in M and M + PA compared with C (P < 0.05). Serum insulin and homeostatic model assessment of insulin resistance values were significantly reduced at 3 and 6 months in M + PA, and at 6 months in M, compared with C (P < 0.05). These results indicate that Chios mastic gum intake for 6 months reduced serum triglyceride and insulin concentrations, and additional exercise enhanced the effect on insulin.
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There is a keen research upon the effects of nutraceuticals on inflammatory bowel disease. The purpose of this study was to explore the effect of mastiha supplement, rich in bioactive nutraceuticals, in active inflammatory bowel disease. This is a randomised, double‐blind, placebo‐controlled clinical trial. Α total of 60 inflammatory bowel disease patients were enrolled and randomly allocated to mastiha (2.8 g/day) or placebo groups for 3 months adjunct to stable medical treatment. Medical and dietary history, Inflammatory Bowel Disease Questionnaire (IBDQ), Harvey‐Bradshaw index, partial Mayo score, biochemical indices, faecal, and blood inflammatory markers were assessed. A clinically important difference between groups in IBDQ was defined as primary outcome. Inflammatory Bowel Disease Questionnaire score significantly improved in verum compared with baseline (p = 0.004). There was a significant decrease in faecal lysozyme in mastiha patients (p = 0.018) with the mean change being significant (p = 0.021), and significant increases of faecal lactoferrin (p = 0.001) and calprotectin (p = 0.029) in the placebo group. Fibrinogen reduced significantly (p = 0.006) with a significant mean change (p = 0.018), whereas iron increased (p = 0.032) in mastiha arm. Our results show regulation of faecal lysozyme by mastiha supplement adjunctive to pharmacological treatments in active inflammatory bowel disease. An effect secondary to a prebiotic potency is proposed.
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Pistacia lentiscus L. (PL) is an evergreen shrub from which it is derived a precious aromatic resin called mastic gum or mastic. This extract possesses numerous proprieties, such as antimicrobial, anti-inflammatory, anticancer, etc. The aim of this study was to investigate the biological activities of a patented PL Chios mastic extract in a human small intestine mucosa model, the Caco-2 cells. PL Chios mastic extract showed no toxic effect in Caco-2 cells treated with lower concentrations (<100 μg/ml). Pro-inflammatory cytokines were not increased in Caco-2 cells and disaccharidase activity as well as sucrase–isomaltase expression were decreased at 50 μg/ml, suggesting a potential role in glycaemic control. Also paracellular permeability was reduced in Caco-2 cells and remarkably this extract induced a barrier effect useful in protecting against chemical or biological insults.
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: Antibiotic-resistant Helicobacter pylori isolates have become a global concern. The standard triple or quadruple therapies have recently become the most effective protocol for eradicating H. pylori in the gastrointestinal tract. There is evidence regarding the impact of different complementary or dietary supplements on H. pylori eradication. This review article intended to search electronic bibliographic databases for any clinical studies that evaluated the use of any herbal or dietary supplements to eradicate H. pylori up to June 2021. A total of 20 human studies met our criteria and were reviewed. Although some herbal medicines have shown their efficacy and safety in eradicating H. pylori in different clinical trials, more randomized blind, placebo-controlled human trials with a large sample size must be performed to extend our knowledge.
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To the Editor: Even low doses of mastic gum — 1 mg per day for two weeks — can cure peptic ulcers very rapidly, but the mechanism responsible has not been clear. We have found that mastic is active against Helicobacter pylori, which could explain its therapeutic effect in patients with peptic ulcers. Mastic is a resinous exudate obtained from the stem and the main leaves of Pistacia lentiscus. It is used as a food ingredient in the Mediterranean region. Clinically, mastic has been effective in the treatment of benign gastric ulcers1 and duodenal ulcers.2 In rats, mastic showed cytoprotective . . .
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To determine the ability of mastic monotherapy to eradicate Helicobacter pylori infection from mice. The susceptibility of H. pylori SS1 to mastic was assessed by broth dilution determination of the MIC and MBC. Mice were inoculated intragastrically with either a suspension of H. pylori SS1 (n = 70) or brain-heart infusion broth alone (n = 10). Mice were given antimicrobial chemotherapy 4 weeks after infection and were administered the mouse equivalent of either 2 g of mastic twice daily for 7 days or a triple therapy regimen containing the mouse equivalent of 400 mg of metronidazole, 250 mg of clarithromycin and 20 mg of omeprazole twice daily for 7 days. Mice were killed either immediately or 1 month after the completion of treatment, and their stomachs cultured for H. pylori. The mastic MIC and MBC of H. pylori SS1 were 7.80 and 31.25 mg/L, respectively. The triple therapy regimen eradicated infection from 19 of 20 SS1-infected mice. Mastic failed to eradicate infection from any of the 18 SS1-infected mice (P < 0.001) and there was no signifi- cant reduction in gastric bacterial load in mice treated with this regimen. Despite reported beneficial effects in ulcer patients and the good in vitro activity of mastic against H. pylori, this compound is unable to eradicate H. pylori infection from mice.
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Pistacia species contain oleoresins with bioactive triterpenes. In this study triterpenes, including minor components, were identified and quantified in both neutral and acidic fractions of Pistacia terebinthus var. Chia resin, grown exclusively in Chios island (Greece), collected traditionally, as well as using stimulating agents (liquid collection). It was proved that these two resin samples were composed of several different minor triterpenes, while major constituents were similar but in different proportions. Compounds that differentiated two resin samples of P. lentiscus and P. terebinthus var. Chia, both traditionally collected, were detected, in order to identify the nature of resins present in archaeological materials. In the traditionally collected resin, 37 triterpenes were identified, 12 in the acidic and 25 in the neutral fraction. In the liquid collection resin 10 compounds were identified in the acidic and 23 in the neutral fraction, while 16 compounds were not contained in the traditionally collected resin. The main triterpenes in both resin samples collected traditionally and using stimulating agents were: isomasticadienonic acid (23.6 and 26.3% w[sol ]w of the triterpenic fraction, respectively), 28-norolean-17-en-3-one (16.3 and 17.5% w[sol ]w of the triterpenic fraction, respectively) and masticadienonic acid (5.8 and 6.0% w[sol ]w of the triterpenic fraction). In this study the qualitative and quantitative composition of triterpenes was compared in the Pistacia lentiscus and P. terebinthus var. Chia resin samples collected with the traditional and new liquid techniques, and also triterpenes in resins of P. terebinthus obtained by the traditional technique and using stimulating agents. The aim of the study was also to examine whether the collection technique influenced the triterpenes contained in P. terebinthus var. Chia resin samples.
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The extracts and pure major constituents of Chios mastic gum (resin of Pistacia lentiscus var. chia) were tested for their activities against Helicobacter pylori. A total mastic extract without polymer (TMEWP) was prepared after removal of the contained insoluble polymer in order to ameliorate solubility and enhance in vivo activity. Administration of TMEWP to H. pylori SS1-infected mice over the period of 3 months with an average dose of 0.75 mg/day led to an approximately 30-fold reduction in the H. pylori colonization (1.5 log CFU/g of tissue). However, no attenuation in the H. pylori-associated chronic inflammatory infiltration and the activity of chronic gastritis was observed. To further characterize potential active mastic constituents, the TMEWP was separated into an acidic and a neutral fraction. Both were extensively characterized by nuclear magnetic resonance and mass spectroscopy to elucidate the structure of the components contained within each fraction. After chromatographic separation, the acid fraction gave the major triterpenic acids, while the neutral fraction gave several triterpenic alcohols and aldehydes. Mastic extracts and isolated pure triterpenic acids were tested for in vitro activity against a panel of 11 H. pylori clinical strains. The acid fraction was found to be the most active extract (minimum bactericidal concentration [MBC], 0.139 mg/ml), and the most active pure compound was isomasticadienolic acid (MBC, 0.202 mg/ml [0.443 mM]). Our results show that administration of TMEWP may be effective in reducing H. pylori colonization and that the major triterpenic acids in the acid extract may be responsible for such an activity.
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Guidelines on the management of Helicobacter pylori, which cover indications for management and treatment strategies, were produced in 2000. To update the guidelines at the European Helicobacter Study Group (EHSG) Third Maastricht Consensus Conference, with emphasis on the potential of H pylori eradication for the prevention of gastric cancer. Eradication of H pylori infection is recommended in (a) patients with gastroduodenal diseases such as peptic ulcer disease and low grade gastric, mucosa associated lymphoid tissue (MALT) lymphoma; (b) patients with atrophic gastritis; (c) first degree relatives of patients with gastric cancer; (d) patients with unexplained iron deficiency anaemia; and (e) patients with chronic idiopathic thrombocytopenic purpura. Recurrent abdominal pain in children is not an indication for a "test and treat" strategy if other causes are excluded. Eradication of H pylori infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are naïve users of non-steroidal anti-inflammatory drugs (NSAIDs). H pylori eradication is less effective than proton pump inhibitor (PPI) treatment in preventing ulcer recurrence in long term NSAID users. In primary care a test and treat strategy using a non-invasive test is recommended in adult patients with persistent dyspepsia under the age of 45. The urea breath test, stool antigen tests, and serological kits with a high accuracy are non-invasive tests which should be used for the diagnosis of H pylori infection. Triple therapy using a PPI with clarithromycin and amoxicillin or metronidazole given twice daily remains the recommended first choice treatment. Bismuth-containing quadruple therapy, if available, is also a first choice treatment option. Rescue treatment should be based on antimicrobial susceptibility. The global burden of gastric cancer is considerable but varies geographically. Eradication of H pylori infection has the potential to reduce the risk of gastric cancer development.
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To evaluate the effectiveness of mastic administration on the clinical course and plasma inflammatory mediators of patients with active Crohn's disease (CD). This pilot study was conducted in patients with established mild to moderately active CD, attending the outpatient clinics of the hospital, and in healthy controls. Ten patients and 8 controls were recruited for a 4-wk treatment with mastic caps (6 caps/d, 0.37 g/cap). All patients successfully completed the protocol. CD Activity Index (CDAI), Nutritional Risk Index (NRI), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), monocyte chemotactic protein-1 (MCP-1), and total antioxidant potential (TAP) were evaluated in the plasma at baseline and at the end of the treatment period. Results were expressed as mean values +/- SE and P < 0.05 was considered to indicate statistical significance. Patients exhibited significant reduction of CDAI (222.9 +/- 18.7 vs 136.3 +/- 12.3, P = 0.05) as compared to pretreament values. Plasma IL-6 was significantly decreased (21.2 +/- 9.3 pg/mL vs 7.2 +/- 2.8 pg/ mL, P = 0.027), and so did CRP (40.3 +/- 13.1 mg/mL vs 19.7 +/- 5.5, P = 0.028). TAP was significantly increased (0.15 +/- 0.09 vs 0.57 +/- 0.15 mmol/L uric acid, P = 0.036). No patient or control exhibited any kind of side effects. The results suggest that mastic significantly decreased the activity index and the plasma levels of IL-6 and CRP in patients with mildly to moderately active CD. Further double-blind, placebo-controlled studies in a larger number of patients are required to clarify the role of this natural product in the treatment of patients with CD.
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SUMMARY1. A double-blind clinical trial was carried out on thirty-eight patients with symptomatic and endoscopically proven duodenal ulcer to compare the therapeutic responses to mastic (1 g daily, twenty patients) and placebo (lactose, 1 g daily, eighteen patients) given orally over a period of 2 weeks.2. Symptomatic relief was obtained in sixteen (80%) patients on mastic and in nine (50%) patients on placebo, while endoscopically proven healing occurred in fourteen (70%) patients on mastic and four (22%) patients on placebo. The differences between treatments were highly significant (P<0.01). Mastic was well tolerated and did not produce side effects.3. It is concluded that mastic has an ulcer healing effect, but further studies are needed to establish its role in treating peptic ulcer.
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Root bark extract of the East African medicinal plant Ozoroa mucronata showed antimicrobial activity against Gram–positive bacteria. Fractionation of the extract following the results of bioassay led to isolation of the active factor C30H46O3. Spectroscopic studies indicated the olean–18–ene keto acid structure 1 („moronic acid”), isolated for the first time in nature. The relatively simple structure of this bioactive triterpene is noted.
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The effect of mastic, a concrete resinous exudate obtained from the stem of the tree Pistacia lentiscus, has been studied on experimentally-induced gastric and duodenal ulcers in rats. Mastic at an oral dose of 500 mg/kg produced a significant reduction in the intensity of gastric mucosal damage induced by pyloric ligation, aspirin, phenylbutazone, reserpine and restraint + cold stress. It produced a significant decrease of free acidity in 6-h pylorus-ligated rats and a marked cytoprotective effect against 50% ethanol in rats which could be reversed by prior treatment with indomethacin. The protective effect was not seen when it was given intraperitoneally in phenylbutazone and restraint + cold stress models. The reduction in the intensity of ulceration in cysteamine-induced duodenal ulcers was not found to be statistically significant in mastic-pretreated rats. The results suggest that mild antisecretory and a localized adaptive cytoprotectant action may be responsible for its anti-ulcer activity. These observations support the results of an earlier study on the clinical effectiveness of mastic in the therapy of duodenal ulcer.
Article
The urea breath test (UBT) has been proposed as the most accurate test for diagnosing Helicobacter pylori infection. The aim of this work was to evaluate the accuracy of the UBT and to compare the results with histologic and endoscopic findings in H. pylori infected patients. One-hundred-and-seventy-two consecutive dyspeptic outpatients were studied by means of endoscopy (with histology and culture), UBT (75 mg 13C-urea), and serology. Gastritis was classified in accordance with the Sydney criteria. In H. pylori positive patients, the bacterial load was assessed semiquantitatively, the number of bacteria in histologic specimens being counted. UBT results were expressed either as percentage cumulative dose of 13CO2 excreted at 1 h (CD60) or delta over baseline at 30' (DOB30). Of 172 patients, 126 (73%) were H. pylori positive on histology or culture. Using a cut-off value of 3.3/1000 for DOB30, the sensitivity, specificity and accuracy of the UBT were 96%, 93.5%, and 95.3%, respectively. A significant correlation was observed between DOB30 values and intragastric bacterial load (r = 0.32). Moreover, a significant difference in DOB30 values was found between patients sorted by the depth of inflammation (chi(2) = 4.36, p = 0.036). No correlation was observed between DOB30 and endoscopic findings in H. pylori positive subjects. The UBT is an accurate non-invasive diagnostic tool and can be used to predict both the intragastric bacterial load and the severity of related gastritis.
Article
In this study we evaluated the antibacterial activity of mastic gum, a resin obtained from the Pistacia lentiscus tree, against clinical isolates of Helicobacter pylori. The minimal bactericidal concentrations (MBCs) were obtained by a microdilution assay. Mastic gum killed 50% of the strains tested at a concentration of 125 microg/ml and 90% at a concentration of 500 microg/ml. The influence of sub-MBCs of mastic gum on the morphologies of H. pylori was evaluated by transmission electron microscopy. The lentiscus resin induced blebbing, morphological abnormalities and cellular fragmentation in H. pylori cells.
Article
To determine whether mastic gum suppresses or eradicates Helicobacter pylori infection in humans. Nine patients with H. pylori infection, and without gastroduodenal ulceration, were recruited from day-case endoscopy lists and treated with mastic 1 g four times daily for 14 days. [13C]Urea breath tests (UBTs) were carried out immediately before, on day 15 and 5 weeks after treatment with mastic. Mastic had no effect on H. pylori status in any of the eight completed patients; all remained H. pylori positive by UBT with no change in delta scores [pre-treatment mean +/- s.e.m. 19.1 +/- 3.7, day 15 (post-treatment) 18.7 +/- 3.8, P = 0.8, paired t-test]. Despite reported anti-H. pylori action in vitro, this preliminary study shows that mastic has no effect on H. pylori in humans.
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Since the discovery of Campylobacter-like organisms Helicobacter pylori (H pylori) more than two decades ago the possibility of a relationship with gastric cancer has been postulated, tested and supposedly proven. There have been numerous human studies of various designs from many countries around the world. Several meta-analyses have been published and more recently a small number of experimental animal studies were reported looking at the association between H pylori infection and gastric cancer. Over the years, the human epidemiological studies have produced conflicting results; the meta-analyses have as one would expect produced similar pooled estimates; while the early experimental animal studies require replication. The exact mechanisms by which H pylori might cause gastric cancer are still under investigation and remain to be elucidated.
Article
Differences may occur in the mode of transmission of Helicobacter pylori between developed and developing countries: direct human-to-human contacts have been suggested as the primary route in the former while the fecal-oral route, also, through contaminated water, in the latter. Data on intrafamilial transmission of H. pylori among children continue to be produced. The importance of low socioeconomic conditions on the acquisition of H. pylori infection has been confirmed in a number of population-based studies. Due to the improvement of living standards, the prevalence of the infection has fallen dramatically in many countries. It varies from 8.9 to 72.8% among children from developed and developing countries, respectively, the re-infection rate being also significantly higher in the latter. Conflicting data have been reported on the effect of breastfeeding against H. pylori colonization in infancy as well as on the occupational risk for acquiring H. pylori. This review summarizes recent results from the literature on these topics.
Article
Dietary toxicity of mastic gum, a natural food additive, was studied in male and female F344 rats fed 0%, 0.22%, 0.67% and 2% levels mixed into powdered basal diet for 13 weeks. No mortality or obvious clinical signs were observed in any of the animals throughout the experimental period. Body weights were significantly reduced in the high dose-treated group from week 2 to the end of the experiment in males, and at weeks 8 and 13 in females. There were increased absolute and relative liver weights in a dose-related manner or limited to the high dose group males or females, along with changes in hematological parameters, including increased WBC and platelet in high dose males. Altered serum biochemistry parameters included increases of total proteins, albumin, and total cholesterol in both sexes, and gamma-GTP in females only. However, macroscopic examination at necropsy revealed no gross lesions, and microscopic examination also revealed no treatment-related findings in any organs examined. As dietary treatment of mastic gum for 13 weeks in the present study caused decreased body weights at the high dose, especially in males, and increased liver weights in a dose-related manner in both genders without any morphological findings, it is concluded that the administration of it has a no observed adverse effect level (NOAEL) of 0.67% in the diet.
Article
Acute infection with Helicobacter pylori causes hypochlorhydria and gastrointestinal upset. As the infection persists, patients develop chronic antral-predominant or pangastritis. Gastric and duodenal ulcers arise from chronic mucosal inflammation and disordered acid secretion in the stomach. With successful eradication of H. pylori, non-NSAID-related gastric and duodenal ulcers heal even without long-term acid suppression. More importantly, peptic ulcers and their complications rarely recur. Clearing H. pylori infection also reduces the risk of mucosal injury in NSAID and aspirin users; the protective effects are more pronounced in NSAID-naïve and aspirin users. H. pylori is unlikely to be the cause of gastro-oesophageal reflux disease. However, a patient's reflux symptoms may be more difficult to control after clearing the infection. Although there is little evidence to support a causal relationship between H. pylori and non-ulcer dyspepsia, treatment of the infection gives a modest improvement of symptoms.
Article
Essential oil (EO) from aerial parts (leaves, juvenile branches, and flowers when present) of Pistacia lentiscus L. growing wild in five localities of Sardinia (Italy) was extracted by steam-distillation (SD) and analyzed by gas chromatography (GC), FID, and GC-ion trap mass spectrometry (ITMS). Samples of P. lentiscus L. were harvested between April and October to study the seasonal chemical variability of the EO. A total of 45 compounds accounting for 97.5-98.4% of the total EO were identified, and the major compounds were alpha-pinene (14.8-22.6%), beta-myrcene (1-19.4%), p-cymene (1.6-16.2%), and terpinen-4-ol (14.2-28.3%). The yields of EO (v/dry w) ranged between 0.09 and 0.32%. Similar content of the major compounds was found in samples from different origins and seasonal variability was also observed. The EOs were tested for their antifungal activity against Aspergillus flavus, Rhizoctonia solani, Penicillium commune, Fusarium oxysporum. Two samples were weakly effective against Aspergillus flavus. Furthermore, terpinenol and alpha-terpineol, two of the major components of EO of Pistacia lentiscus L., totally inhibited the mycelian growth of A. flavus. Quite good antioxidant activity of the EO was also found.