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Therapeutic Potential of Indian Medicinal Herbs and Current Therapeutic Approach used to Mitigate the Symptoms of Chronic Fatigue Syndrome: A Review
Current Traditional Medicine
Abstract
Chronic fatigue syndrome (CFS) is a complex condition marked by severe exhaustion that lasts at least 6 months. The global prevalence of CFS ranging between 0.4% and 2.5% is growing. Women are affected by CFS more often than men. It is considered a common condition in developed countries. There is no approved treatment for CFS but symptoms can be managed and controlled persistent exhaustion causes significant impairment in daily routine activities. Lowered ATP synthesis, mitochondrial impairment, decreased oxidative phosphorylation, disruption of the hypothalamic–pituitary–adrenal (HPA) axis, and an imbalance of brain neurotransmitters play a major role in the pathophysiology of CFS. The purpose of the present study is to figure out the several plants that are used as a source of medication in chronic fatigue syndrome (CFS) and its current therapeutic approach. The Indian medicinal herbs described in this article are very efficacious in the management of chronic fatigue syndrome symptoms due to the presence of phytochemicals. This review article also covers the current therapeutic approach for chronic fatigue syndrome in a concise form that comprises CBT (Cognitive based therapy), GET (Graded exercise therapy), usage of immunoglobins, psychodynamic counseling, and yoga therapy that includes isometric yoga and yoga nidra are very beneficial in alleviating the symptoms of chronic fatigue syndrome. Antidepressants, immunomodulatory agents, and corticosteroids come under conventional medication for CFS. This article explores different Indian medicinal herbs, their pharmacological properties, and their potential role and current treatments for reducing the severity of symptoms of chronic fatigue syndrome.
Myalgic Encephalomyelitis or Chronic Fatigue Syndrome (CFS/ME) is a complex and severely disabling disease with a prevalence of 0.3% and no approved treatment and therefore a very high medical need. Following an infectious onset patients suffer from severe central and muscle fatigue, chronic pain, cognitive impairment, and immune and autonomic dysfunction. Although the etiology of CFS/ME is not solved yet, there is numerous evidence for an autoantibody mediated dysregulation of the immune and autonomic nervous system.
We found elevated ß2 adrenergic receptor (ß2AdR) and M3 acetylcholine receptor antibodies in a subset of CFS/ME patients. As both ß2AdR and M3 acetylcholine receptor are important vasodilators, we would expect their functional disturbance to result in vasoconstriction and hypoxemia. An impaired circulation and oxygen supply could result in many symptoms of ME/CFS. There are consistent reports of vascular dysfunction in ME/CFS. Muscular and cerebral hypoperfusion has been shown in ME/CFS in various studies and correlated with fatigue. Metabolic changes in ME/CFS are also in line with a concept of hypoxia and ischemia.
Here we try to develop a unifying working concept for the complex pathomechanism of ME/CFS based on the presence of dysfunctional autoantibodies against ß2AdR and M3 acetylcholine receptor and extrapolate it to the pathophysiology of ME/CFS without an autoimmune pathogenesis.
Pain is one common health problem with substantial socioeconomic impact because of its high incidence. It is associated with a number of diseases and is estimated that 80-100% of the population experience back pain at least once in the life-time [1]. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are the mainstay of treatment of pain [2]. It was reported that the risk of gastrointestinal bleeding was significantly associated with the acute use of NSAIDs like regular-dose aspirin, diclofenac, ketorolac and Piroxicam etc., increased the risk of bleeding in both acute and chronic therapy [3]. Therefore, it is necessary to search for new drugs with less adverse effects. Medicinal plants have been used in the development of new drugs and continue to play an invaluable role in the progress of drug discovery [4]. Recently, many natural medicines derived from medicinal plants such as Capsicum annuum, Cannabis sativa and Papaver somniferum were considered as effective and safer for treatment of various diseases including pain [5].
Delphinium denudatum family Ranunculaceae is a medicinal herb commonly known as jadwar and used in Unani Medicine. The roots are reported to be useful in a variety of ailments such as paralysis, epilepsy, facial palsy, insanity, mania, hysteria, atony, migraine,
numbness, tremors, infantile convulsions, aconite poisoning, snake bite, scorpion sting, arthritis, cardiac weakness, palpitation, rheumatism, toothache. Delphinium plants have been medicinally used for centuries [6,7]. Use of its root as an analgesic is found in
Unani medicine [8]. Earlier studies showed that ethanolic extract of Delphinium denudatum has analgesic activity [9,10]. The present study was performed to validate the earlier study and to screen additionally the effect of its methanol fraction.
Background:
Osteoarthritis (OA) is one of degenerative and chronic diseases of articular joints. Articular cartilage is an avascular tissue, and its primary cellular component is chondrocytes. The main characteristic of OA is non-classic inflammation and cartilage degeneration. Ginkgolide B (GB) is a component of Ginkgo biloba which has diverse bioactivities.
Objectives:
The present study uses an in vitro experimental model to detect the underlying anti-inflammatory and chondroprotective effects of GB and provides a new way for future clinical therapy of OA.
Material and methods:
Rat chondrocytes were isolated, cultured and treated with 1 μg/mL lipopolysaccharide (LPS) and/or different concentrations of GB. Cell Counting Kit-8 (CCK-8) was used to test the cell viability of chondrocytes, and chondrocytes apoptosis was detected using a cell apoptosis kit. Collagen-II and aggrecan expression were detected by immunohistochemistry. Relative expression of genes was detected by real-time PCR and western blot.
Results:
Ginkolide B did not inhibit chondrocyte proliferation, and ginkgolide B inhibited LPS induced matrixdegradation in chondrocytes. Ginkgolide B also reversed LPS-induced collagen-II and aggrecan decreased in chondrocytes via upregulated synthesis-related gene expression and downregulated matrix-degrading enzyme gene expression. Furthermore, we found that ginkgolide B significantly inhibited LPS-induced MAPK pathway activation.
Conclusions:
The results of our study suggest that ginkgolide B exerted anti-inflammatory and chondroprotective effects in LPS-induced chondrocytes, and might be an underlying therapy for OA afterwards.
Introduction: In our modern era, life style of human being changes and updates every day that may affect their health status. There is an incredible expectation that natural origin drugs lack undesirable effects not like synthetic drugs, though have the same potency and efficacy. No scientific data is available about the antianxiety properties of Delphinium denudatum root and Amaranthus spinosus leaves. In this regard, the present study was designed to carry out comparative and combined study on antianxiety properties of Delphinium denudatum root and Amaranthus spinosus leaves.
Methods: Delphinium denudatum root and Amaranthus spinosus leaves were defatted with petroleum ether, and then extracted with hydroalcoholic solvent by soxhlation process. The hydroalcoholic extract of both drugs singly and in combination were evaluated for their anxiolytic effects on Wistar albino rats in doses of 200 and 400 mg/kg using different anti-anxiety tests like Elevated Plus Maze, Staircase, Actophotometer, and Light and Dark tests.
Results: Both hydroalcoholic extracts possessed flavonoids, alkaloids, saponins, tannins, carbohydrates, proteins, amino acids, carbohydrates, steroids, sterols, etc. In the dose dependent manner, both the hydroalcoholic extracts produced good anxiolytic activity. The best result was obtained by a combination of them in higher dose.
Conclusion: Hydroalcoholic extracts of Delphinium denudatum root and Amaranthus spinosus leaves and their combination may act as a potent anxiolytic agents in rats. Amaranthus spinosus was found to be more effective than Delphinium denudatum.
Objectives
To determine whether any particular intervention or combination of interventions is effective in the treatment, management and rehabilitation of adults and children with a diagnosis of chronic fatigue syndrome / myalgic encephalomyelitis (CFS/ME).
Design
Substantive update of a systematic review published in 2002. Randomized (RCTs) and non-randomized controlled trials of any intervention or combination of interventions were eligible for inclusion. Study participants could be adults or children with a diagnosis of CFS/ME based on any criteria. We searched eleven electronic databases, reference lists of articles and reviews, and textbooks on CFS/ME. Additional references were sought by contact with experts.
Results
Seventy studies met the inclusion criteria. Studies on behavioural, immunological, pharmacological and complementary therapies, nutritional supplements and miscellaneous other interventions were identified. Graded exercise therapy and cognitive behaviour therapy appeared to reduce symptoms and improve function based on evidence from RCTs. For most other interventions, evidence of effectiveness was inconclusive and some interventions were associated with significant adverse effects.
Conclusions
Over the last five years, there has been a marked increase in the size and quality of the evidence base on interventions for CFS/ME. Some behavioural interventions have shown promising results in reducing the symptoms of CFS/ME and improving physical functioning. There is a need for research to define the characteristics of patients who would benefit from specific interventions and to develop clinically relevant objective outcome measures.
Background:
Despite the immense neuromodulatory potentials of Ginkgo biloba extract as a memory enhancer, its underlying mechanism seems inadequate particularly with regard to its anti-inflammatory properties.
Aim:
The objective of the present study is to investigate the protective potentials of Ginkgo biloba extract (GBE) against hippocampal neuronal injury induced by trimethyltin (TMT), a potent neurotoxicant.
Methods:
Male SD rats were administered trimethyltin (8.5 mg kg(-1) b.wt) single intraperitoneal (i.p.) injection, followed by Ginkgo biloba extract (100 mg kg(-1) b.wt i.p) for 21 days.
Results:
The co-administration of GBE with TMT showed marked improvement in cognitive functions. Concomitantly, there was a significant decrease in oxidative stress as evident by reduction in MDA and total ROS levels. In addition, there was a marked suppression of astrocyte activation (GFAP), transcription factor NFκB and proinflammatory cytokines (TNF-α, IL-1α, 1L-6), which were found to be elevated by TMT administration. Histopathological observations showed remarkable improvement in hippocampal neuronal injury in the conjunctive group.
Conclusion:
Therefore, it is suggested that Ginkgo biloba extract is an effective agent against trimethyltin-induced hippocampal neuronal loss owing to its antioxidative as well as anti-inflammatory properties.
Chronic fatigue syndrome (CFS) is characterized as a persistent, debilitating complex disorder of unknown etiology, whereby patients suffer from extreme fatigue, which often presents with symptoms that include chronic pain, depression, weakness, mood disturbances, and neuropsychological impairment. In this mini review and case report, we address central nervous system (CNS) involvement of CFS and present neuropathological autopsy findings from a patient who died with a prior diagnosis of CFS. Among the most remarkable pathological features of the case are focal areas of white matter loss, neurite beading, and neuritic pathology of axons in the white matter with axonal spheroids. Atypical neurons displaying aberrant sprouting processes in response to injury are observed throughout cortical gray and white matter. Abundant amyloid deposits identical to AD plaques with accompanying intracellular granular structures are observed as well. Neurofibrillary tangles are also present in the white matter of the frontal cortex, thalamus and basal ganglia. Taken together, these neuropathological findings warrant further studies into CNS disease associated with CFS.
The pomegranate, Punica granatum belongs to family lythraceae is an ancient, mystical, unique fruit borne on a small, long-living tree cultivated throughout the Mediterranean region, as far north as the Himalayas, in Southeast Asia, and in California and Arizona in the United States. Phytochemical investigation for current research seems to indicate the most therapeutically beneficial pomegranate constituents are ellagic acid ellagitannins (including punicalagins), punicic acid, flavonoids, anthocyanidins, anthocyanins, and estrogenic flavonols and flavones. Pharmacological activity proved its an antioxidant, an anticarcinogenic, and an anti-inflammatory properties of pomegranate constituents have been published, focusing on treatment and prevention of cancer, cardiovascular disease, diabetes, dental conditions, erectile dysfunction, bacterial infections and antibiotic resistance and ultraviolet radiation-induced skin damage. Other potential applications include infant brain ischemia, male infertility, Alzheimer’s disease, arthritis and obesity.
Nardostachys jatamansi DC. is an endangered, primitive and therapeutic herbal agent belonging to family Valerianaceae. The rhizomes of this hairy, perennial, dwarf and herbaceous plant are used for therapeutic effect in ayurvedic and unani system of medicine. Nardostachys jatamansi has been reported to have many therapeutic activities like antifungal, antimicrobial, antioxidant, hepatoprotective and cardio protective properties. It is used in the treatment of insomnia and CNS disorders. The vasodilator, bronchodilator, spasmolytic and platelet aggregation inhibition activities of the plant have also been reported. Jatamansone, nardostachone and actinidine are the major secondary metabolites present in the plant. This review article is summary of the potential benefits of this medicinal plant as reported in literature. The review also highlights the need for the use of this plant in Ayurvedic system of medicine and future prospects for further research.
This review summarizes the current meta-analysis literature on treatment outcomes of CBT for a wide range of psychiatric disorders. A search of the literature resulted in a total of 16 methodologically rigorous meta-analyses. Our review focuses on effect sizes that contrast outcomes for CBT with outcomes for various control groups for each disorder, which provides an overview of the effectiveness of cognitive therapy as quantified by meta-analysis. Large effect sizes were found for CBT for unipolar depression, generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders. Effect sizes for CBT of marital distress, anger, childhood somatic disorders, and chronic pain were in the moderate range. CBT was somewhat superior to antidepressants in the treatment of adult depression. CBT was equally effective as behavior therapy in the treatment of adult depression and obsessive-compulsive disorder. Large uncontrolled effect sizes were found for bulimia nervosa and schizophrenia. The 16 meta-analyses we reviewed support the efficacy of CBT for many disorders. While limitations of the meta-analytic approach need to be considered in interpreting the results of this review, our findings are consistent with other review methodologies that also provide support for the efficacy CBT.
The fruit of Cassia fistula Linn. is a legume, has antioxidant and lots of other medicinal properties. As oxidants are involved in the pathogenesis of chronic fatigue syndrome, the present study was done to evaluate the effect of ethanolic extract of fruit pulp of C. fistula Linn. (EECF) on forced swimming induced chronic fatigue syndrome (CFS). Albino mice of 25-40 grams were grouped into five groups (n=5). Group A served as naive control and group B served as stress control. Group C received EECF 200 mg/kg and group D received EECF 400 mg/kg respectively. Group E received imipramine 20 mg/kg (standard). All animals were treated with their respective agent orally daily for 7 days. Except for group A, animals in other groups were subjected to force swimming 6 min daily for 7 days to induce a state of chronic fatigue. Duration of immobility was assessed on day 1st, 3rd, 5th and 7th. Anxiety level (by elevated plus maze and mirrored chamber) and loco-motor activity (by open field test) were assessed 24 h after last force swimming followed by biochemical estimations of oxidative biomarkers in brain homogenate at the end of study. Treatment with EECF resulted in significant reduction in the duration of immobility, reduced anxiety and increased locomotor activity. Malondialdehyde level was also reduced and catalase level was increased in the extract treated group and standard group compared to stress control group. The study indicates that EECF has protective effect against experimentally induced CFS.
The effect of Shilajit was investigated for putative nootropic and anxiolytic activity, and its
effect on rat brain monoamines using Charles Foster strain albino rats. Nootropic activity
was assessed by passive avoidance learning and active avoidance learning acquisition and
retention. Anxiolytic activity was evaluated by the elevated plus-maze technique. Rat brain
monoamines and monoamine metaboliteswere estimated bya HPLC technique. The results
indicated that Shilajit had significant nootropic and anxiolytic activity. The biochemical
studies indicated that acute treatment with Shilajit had insignificant effects on rat brain
monoamine and monoamine metabolite levels. However, following subacute (5days) treatment,
there was decrease in 5-hydroxytryptamine and 5-hydroxyindole acetic acid concentrations
and an increase in the levels of dopamine, homovanillic acid and
3.4-dihydroxyphenyl-acetic acid concentrations, with insignificant effects on noradrenaline
and 3-methoxy-4- hydroxyphenylethylene glycol levels. The observed neurochemical effects
induced by Shilajit, indicating a decrease in rat brain 5-hydroxytryptamine turnover, associated
with an increase in dopaminergic activity, helps to explain the observed nootropic and
anxiolytic effects of the drug.
Chronic Fatigue Syndrome (CFS) is characterized by excessive fatigue after minimal physical or mental exertion, muscle and joint pain, poor concentration, dizziness, and sleep disturbances. We report here the effect of a yoga-based lifestyle intervention in a 30-year old male patient with a documented diagnosis of CFS with compromised quality of life (QoL) and altered personality.
The patient initially attended a short-term yoga-based lifestyle intervention program that consisted of yoga-postures, breathing exercises (pranayama), meditation, group discussions, and individualized advice on stress management, diet and physical activity besides group support. Thereafter, patient attended 5 more such programs.
There was a notable and consistent improvement in his clinical profile, positive aspects of personality and subjective well-being, and reduction in anxiety following this yoga-based lifestyle intervention.
Overall, the results suggest that lifestyle intervention may improve clinical condition and personality in patients with CFS.
Laboratory indices of thyroid function (TSH, Free T4, and T3) were measured in a randomized clinical trial in which Ashwagandha (ASW) was used to improve cognitive function in patients with bipolar disorder. This was done in light of a case-report of ASW-associated thyrotoxicosis, and data from mice administered ASW that showed significant increases in thyroxine levels. Ten (of the original 60) patients showed abnormal results in one of the thyroid measures either at the beginning or end of the 8-week study. One ASW- treated patient had subclinical hypothyroidism (TSH - 5.7 mIU/L) at baseline that normalized, and all three ASW treated patients experienced T4 increases from baseline (7%, 12%, and 24%). Six of 7 placebo-assigned patients showed decreases in T4 from baseline (4% to 23%), and one patient's TSH moved from the normal to subclinical hypothyroid range (6.96 mIU/L). As thyroid indices were done for safety, and not the primary goal of the original study, only 16.7% had abnormal thyroid indices, and as there was no sub-stratification for treatment assignment by thyroid status, unequal numbers of subjects received ASW (n = 3) or placebo (n = 7). In spite of these limitations, the subtle laboratory changes noted in thyroid indices in an 8-week study suggest that ASW may increase thyroxine levels, and therefore vigilance regarding hyperthyroidism may be warranted. Nonetheless, the thyroid enhancing properties of ASW may also represent a clinical opportunity for the treatment of subclinical hypothyroidism, and these results suggest the need for further study of the effects of ASW on thyroid indices, especially in those with bipolar and unipolar mood disorders.
In the present review, an attempt has been made to congregate the botanical, phytochemical, ethnomedicinal, pharmacological and toxicological information on Ocimum sanctum Linn. (OS, Tulsi), a medicinal herb used in the indigenous system of medicine. OS has been adored in almost all ancient ayurvedic texts for its extraordinary medicinal properties. It is pungent and bitter in taste and hot, light and dry in effect. Its seeds are considered to be cold in effect. The roots, leaves and seeds of Tulsi possess several medicinal properties. Ayurvedic texts categorise OS as stimulant, aromatic and antipyretic. While alleviating kapha and vata, it aggravates pitta. It has a wide range of action on the human body mainly as a cough alleviator, a sweat-inducer and a mitigator of indigestion and anorexia. OS has a variety of biological / pharmacological activities such as antibacterial, antiviral, antifungal, antiprotozoal, antimalarial, anthelmentic, antidiarrhoeal, analgesic, antipyretic, antiinflammatory, antiallergic, antihypertensive, cardioprotective, central nervous system (CNS) depressant, memory enhancer, antihypercholesterolaemic, hepatoprotective, antidiabetic, antiasthmatic, antithyroidic, antioxidant, anticancer, chemopreventive, radioprotective, immunomodulatory, antifertility, antiulcer, antiarthritic, adaptogenic / antistress, anticataract, antileucodermal and anticoagulant activities. This review will definitely help for the researchers as well as clinicians dealing with O. sanctum to know its proper usage as this herb is seemed to be highly valuable, possessing many pharmacological / medicinal properties.
Patients with chronic fatigue syndrome (CFS) often complain of persistent fatigue even after conventional therapies such as pharmacotherapy, cognitive behavioral therapy, or graded exercise therapy. The aim of this study was to investigate in a randomized, controlled trial the feasibility and efficacy of isometric yoga in patients with CFS who are resistant to conventional treatments.
This trial enrolled 30 patients with CFS who did not have satisfactory improvement after receiving conventional therapy for at least six months. They were randomly divided into two groups and were treated with either conventional pharmacotherapy (control group, n = 15) or conventional therapy together with isometric yoga practice that consisted of biweekly, 20-minute sessions with a yoga instructor and daily in-home sessions (yoga group, n = 15) for approximately two months. The short-term effect of isometric yoga on fatigue was assessed by administration of the Profile of Mood Status (POMS) questionnaire immediately before and after the final 20-minute session with the instructor. The long-term effect of isometric yoga on fatigue was assessed by administration of the Chalder's Fatigue Scale (FS) questionnaire to both groups before and after the intervention. Adverse events and changes in subjective symptoms were recorded for subjects in the yoga group.
All subjects completed the intervention. The mean POMS fatigue score decreased significantly (from 21.9 ± 7.7 to 13.8 ± 6.7, P < 0.001) after a yoga session. The Chalder's FS score decreased significantly (from 25.9 ± 6.1 to 19.2 ± 7.5, P = 0.002) in the yoga group, but not in the control group. In addition to the improvement of fatigue, two patients with CFS and fibromyalgia syndrome in the yoga group also reported pain relief. Furthermore, many subjects reported that their bodies became warmer and lighter after practicing isometric yoga. Although there were no serious adverse events in the yoga group, two patients complained of tiredness and one of dizziness after the first yoga session with the instructor.
Isometric yoga as an add-on therapy is both feasible and successful at relieving the fatigue and pain of a subset of therapy-resistant patients with CFS.
University Hospital Medical Information Network (UMIN CTR) UMIN000009646.
Background
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized by persistent emotional, mental, and physical fatigue accompanied by a range of neurological, autonomic, neuroendocrine, immune, and sleep problems. Research has shown that psychosocial factors such as anxiety and depression as well as the symptoms of the illness, have a significant impact on the quality of life of people with ME/CFS. In addition, individuals may suffer from deficits in memory and concentration. This study set out to explore the relationships between variables which have been found to contribute to cognitive performance, as measured by prospective and retrospective memory, and cognitive failures.
Methods
Eighty-seven people with ME/CFS answered questionnaires measuring fatigue, depression, anxiety, social support, and general self-efficacy. These were used in a correlational design (multiple regression) to predict cognitive function (self-ratings on prospective and retrospective memory), and cognitive failures.
Results
Our study found that fatigue, depression, and general self-efficacy were directly associated with cognitive failures and retrospective (but not prospective) memory.
Conclusion
Although it was not possible in this study to determine the cause of the deficits, the literature in this area leads us to suggest that although the pathophysiological mechanisms of ME/CFS are unclear, abnormalities in the immune system, including proinflammatory cytokines, can lead to significant impairments in cognition. We suggest that fatigue and depression may be a result of the neurobiological effects of ME/CFS and in addition, that the neurobiological effects of the illness may give rise to both fatigue and cognitive deficits independently.
Objective: To investigate the effect of the antifatigue agent, Trichopus zeylanicus leaf (alcohol extract) on energy metabolism in mice during exercise and at rest. Methods: Trichopus zeylanicus leaf (alcohol extract) was orally administered to male adult mice. One hour after the extract administration (25, 50, 100 and 200 mg/kg), plasma glucose level was determined or subjected to swimming performance test. The effects of an optimum dose (100 mg/kg) of the extract on plasma glucose, free fatty acids (FFA), pyruvic acid (PA) and lactic acid (LA) levels were determined at rest (1 hr after drug administration) and after swimming exercise for 45 and 90 min. Results: The alcohol extract of Trichopus zeylanicus leaf (100 mg/kg) decreased plasma glucose levels (1 hr after the administration) and increased the swimming performance of mice which was maximum at 100 mg/kg. At a dose of 100 mg/kg, the extract decreased plasma glucose levels and increased the levels of FFA without significant changes in the levels of PA and LA in the resting mice. In contrast, after exercise for 90 min, glucose level was found to be higher whereas the levels of FFA, LA and PA were found to decrease compared to control.
Previous studies have shown that the practice of yoga reduces perceived stress and negative feelings and that it improves psychological symptoms. Our previous study also suggested that long-term yoga training improves stress-related psychological symptoms such as anxiety and anger. However, little is known about the beneficial effects of yoga practice on somatization, the most common stress-related physical symptoms, and stress-related biomarkers. We performed a prospective, single arm study to examine the beneficial effects of 12 weeks of yoga training on somatization, psychological symptoms, and stress-related biomarkers.
We recruited healthy women who had no experience with yoga. The data of 24 participants who were followed during 12 weeks of yoga training were analyzed. Somatization and psychological symptoms were assessed before and after 12 weeks of yoga training using the Profile of Mood State (POMS) and the Symptom Checklist-90-Revised (SCL-90-R) questionnaires. Urinary 8-hydroxydeoxyguanosine (8-OHdG), biopyrrin, and cortisol levels were measured as stress-related biomarkers. The Wilcoxon signed-rank test was used to compare the stress-related biomarkers and the scores of questionnaires before and after 12 weeks of yoga training.
After 12 weeks of yoga training, all negative subscale scores (tension-anxiety, depression, anger-hostility, fatigue, and confusion) from the POMS and somatization, anxiety, depression, and hostility from the SCL-90-R were significantly decreased compared with those before starting yoga training. Contrary to our expectation, the urinary 8-OHdG concentration after 12 weeks of yoga training showed a significant increase compared with that before starting yoga training. No significant changes were observed in the levels of urinary biopyrrin and cortisol after the 12 weeks of yoga training.
Yoga training has the potential to reduce the somatization score and the scores related to mental health indicators, such as anxiety, depression, anger, and fatigue. The present findings suggest that yoga can improve somatization and mental health status and has implications for the prevention of psychosomatic symptoms in healthy women.Trial registration: University Hospital Medical Information Network (UMIN CTR) UMIN000007868.
Orchids are under duress species. These are becoming a rarity, losing out to human greed. These species are not only important for their aesthetic value but also because they work as ecological indicators. Their disappearance indicates a change in the quality of soil and air of the region. In the present communication diversity of orchids in Uttarakhand has been studied. 72 genera with 236 species of orchids are recorded from Uttarakhand. Among them 17 species are found medicinally important. 12 Taxa are recorded in red data book of Indian plants. Rapid depletion of orchid species requires urgent conservation measures. There is a need for educational programmes on importance of orchids and their role as essential components of state biodiversity. (Report and Opinion. 2009;1(3):47-52). (ISSN: 1553-9873).
Background:
Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is a serious disorder characterised by persistent postexertional fatigue and substantial symptoms related to cognitive, immune and autonomous dysfunction. There is no specific diagnostic test, therefore diagnostic criteria are used to diagnose CFS. The prevalence of CFS varies by type of diagnostic criteria used. Existing treatment strategies primarily aim to relieve symptoms and improve function. One treatment option is exercise therapy.
Objectives:
The objective of this review was to determine the effects of exercise therapy for adults with CFS compared with any other intervention or control on fatigue, adverse outcomes, pain, physical functioning, quality of life, mood disorders, sleep, self-perceived changes in overall health, health service resources use and dropout.
Search methods:
We searched the Cochrane Common Mental Disorders Group controlled trials register, CENTRAL, and SPORTDiscus up to May 2014, using a comprehensive list of free-text terms for CFS and exercise. We located unpublished and ongoing studies through the World Health Organization International Clinical Trials Registry Platform up to May 2014. We screened reference lists of retrieved articles and contacted experts in the field for additional studies.
Selection criteria:
We included randomised controlled trials (RCTs) about adults with a primary diagnosis of CFS, from all diagnostic criteria, who were able to participate in exercise therapy.
Data collection and analysis:
Two review authors independently performed study selection, 'Risk of bias' assessments and data extraction. We combined continuous measures of outcomes using mean differences (MDs) or standardised mean differences (SMDs). To facilitate interpretation of SMDs, we re-expressed SMD estimates as MDs on more common measurement scales. We combined dichotomous outcomes using risk ratios (RRs). We assessed the certainty of evidence using GRADE.
Main results:
We included eight RCTs with data from 1518 participants.Exercise therapy lasted from 12 weeks to 26 weeks. The studies measured effect at the end of the treatment and at long-term follow-up, after 50 weeks or 72 weeks.Seven studies used aerobic exercise therapies such as walking, swimming, cycling or dancing, provided at mixed levels in terms of intensity of the aerobic exercise from very low to quite rigorous, and one study used anaerobic exercise. Control groups consisted of passive control, including treatment as usual, relaxation or flexibility (eight studies); cognitive behavioural therapy (CBT) (two studies); cognitive therapy (one study); supportive listening (one study); pacing (one study); pharmacological treatment (one study) and combination treatment (one study).Most studies had a low risk of selection bias. All had a high risk of performance and detection bias.Exercise therapy compared with 'passive' controlExercise therapy probably reduces fatigue at end of treatment (SMD -0.66, 95% CI -1.01 to -0.31; 7 studies, 840 participants; moderate-certainty evidence; re-expressed MD -3.4, 95% CI -5.3 to -1.6; scale 0 to 33). We are uncertain if fatigue is reduced in the long term because the certainty of the evidence is very low (SMD -0.62, 95 % CI -1.32 to 0.07; 4 studies, 670 participants; re-expressed MD -3.2, 95% CI -6.9 to 0.4; scale 0 to 33).We are uncertain about the risk of serious adverse reactions because the certainty of the evidence is very low (RR 0.99, 95% CI 0.14 to 6.97; 1 study, 319 participants).Exercise therapy may moderately improve physical functioning at end of treatment, but the long-term effect is uncertain because the certainty of the evidence is very low. Exercise therapy may also slightly improve sleep at end of treatment and at long term. The effect of exercise therapy on pain, quality of life and depression is uncertain because evidence is missing or of very low certainty.Exercise therapy compared with CBTExercise therapy may make little or no difference to fatigue at end of treatment (MD 0.20, 95% CI -1.49 to 1.89; 1 study, 298 participants; low-certainty evidence), or at long-term follow-up (SMD 0.07, 95% CI -0.13 to 0.28; 2 studies, 351 participants; moderate-certainty evidence).We are uncertain about the risk of serious adverse reactions because the certainty of the evidence is very low (RR 0.67, 95% CI 0.11 to 3.96; 1 study, 321 participants).The available evidence suggests that there may be little or no difference between exercise therapy and CBT in physical functioning or sleep (low-certainty evidence) and probably little or no difference in the effect on depression (moderate-certainty evidence). We are uncertain if exercise therapy compared to CBT improves quality of life or reduces pain because the evidence is of very low certainty.Exercise therapy compared with adaptive pacingExercise therapy may slightly reduce fatigue at end of treatment (MD -2.00, 95% CI -3.57 to -0.43; scale 0 to 33; 1 study, 305 participants; low-certainty evidence) and at long-term follow-up (MD -2.50, 95% CI -4.16 to -0.84; scale 0 to 33; 1 study, 307 participants; low-certainty evidence).We are uncertain about the risk of serious adverse reactions (RR 0.99, 95% CI 0.14 to 6.97; 1 study, 319 participants; very low-certainty evidence).The available evidence suggests that exercise therapy may slightly improve physical functioning, depression and sleep compared to adaptive pacing (low-certainty evidence). No studies reported quality of life or pain.Exercise therapy compared with antidepressantsWe are uncertain if exercise therapy, alone or in combination with antidepressants, reduces fatigue and depression more than antidepressant alone, as the certainty of the evidence is very low. The one included study did not report on adverse reactions, pain, physical functioning, quality of life, sleep or long-term results.
Authors' conclusions:
Exercise therapy probably has a positive effect on fatigue in adults with CFS compared to usual care or passive therapies. The evidence regarding adverse effects is uncertain. Due to limited evidence it is difficult to draw conclusions about the comparative effectiveness of CBT, adaptive pacing or other interventions. All studies were conducted with outpatients diagnosed with 1994 criteria of the Centers for Disease Control and Prevention or the Oxford criteria, or both. Patients diagnosed using other criteria may experience different effects.
Objectives: Fatigue is a common problem in modern-day life. The aim of this study was to evaluate the effect of Delphinium denudatum (Jadwar) on fatigue.
Methods: This study was a randomized double-blind placebo-controlled clinical trial between healthy normal university students. In each group, participants were given one capsule of either WEACURE® (containing 500 milligrams of Jadwar root powder) or placebo for 15 consecutive days. Multidimensional Fatigue Inventory (MFI) questionnaire was used before and after the intervention to evaluate different aspects of fatigue.
Results: A total number of 64 participants completed the study. Data analysis showed decrease in the scores of all five domains of fatigue in Jadwar group (13.31±3.05 to 7.75±2.66, 12.31±3.55 to 7.63±2.62, 12.22±4.26 to 6.97±2.06, 11.56±4.21 to 7.28±2.37, 12.91±3.09 to 7.34±2.13 in general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue domains, respectively) which was statistically significant (P value<0.0001). This situation was significantly superior to the placebo group. Prescribed dosage of WEACURE® capsule was well tolerated.
Conclusion: As a complementary tonic agent, Jadwar have a potential to reduce fatigue in normal population. However, objective evaluation of its anti-fatigue effect should be further evaluated.
Context
Current research suggests that dark cocoa may reduce fatigue; however, the effect on fatigue in people with MS (pwMS) has never been established. The objective of this feasibility study was to explore the acute effect of high flavonoid cocoa on measures of fatigue and glycaemic response.
Methods
This was a randomised crossover participant blind exploratory study in 12 participants (2 male and 10 female) with MS-related fatigue (>4 on the Fatigue Severity Scale; FSS). After fasting overnight, participants consumed the high flavonoid cocoa drink (350 mg gallic acid equivalents {GAE}/g) or a low flavonoid cocoa control (120 mg GAE/g), consuming the alternative drink on the next visit. Fatigue was self-reported on a 100 mm visual analogue scale at 30-min time intervals for 2 h post cocoa consumption and every 2 h for the rest of the day. Fatigability was monitored using a 6 min walk test (6MWT) at the end of the visit (2 h), and activity monitors worn for 24 h commencing at 12 noon on the day of testing. The feasibility of performing the trial including outcome measures was documented.
Results
A moderate effect was found in self-reported fatigue throughout the day in favour of the high flavonoid group (Cohen's d 0.32, 95% non-central t CI −0.57 to 1.20). Fatigability measures did not change. Participants consumed and enjoyed the cocoa, all participants completed the study and outcome measures were accepted.
Conclusion
The results of this study support further trials to investigate the feasibility and efficacy of pure cocoa as a dietary supplement for fatigue in pwMS.
Exercise therapy for chronic fatigue syndrome - Volume 23 Issue 3 - Lillebeth Larun, Kjetil G. Brurberg, Jan Odgaard-Jensen, Jonathan R. Price
This comprehensive review explores the current evidence on benefits and harms of therapeutic interventions in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) and makes recommendations. CFS/ME is a complex, multi-system, chronic medical condition whose pathophysiology remains unknown. No established diagnostic tests exist; nor are any FDA-approved drugs available for treatment. Because of the range of symptoms of CFS/ME, treatment approaches vary widely. Studies undertaken have heterogeneous designs and are limited by sample size, length of follow-up, applicability and methodological quality. The use of rintatolimod and rituximab as well as counselling, behavioural and rehabilitation therapy programs may be of benefit for CFS/ME, but the evidence of their effectiveness is still limited. Similarly, adaptive pacing appears to offer some benefits, but the results are debatable: so is the use of nutritional supplements, which may be of value to CFS/ME patients with lab-proven deficiencies. To summarize, then, the recommended treatment strategies should include proper administration of nutritional supplements in CFS/ME patients with demonstrated deficiencies and personalized pacing programs to relieve symptoms and improve performance of daily activities, but a larger RCT evaluation is required to confirm these preliminary observations. At present no firm conclusions can be drawn because the few RCTs undertaken to date have been small-scale, with a high risk of bias, and have used different case definitions. Further RCTs are now urgently needed with rigorous experimental designs and appropriate data analysis, focusing particularly on the comparison of outcomes measures according to clinical presentation, patient characteristics, case criteria and degree of disability (i.e., severely ill ME cases or bedridden). This article is protected by copyright. All rights reserved.
Myalgic encephalomyelits/chronic fatigue syndrome (ME/CFS) has been both a medical mystery and a source of controversy in Western medicine for over 50 years. This article reviews the major historical developments over this period, describes the clinical pattern and spectrum of severity, and then explores the current major controversies surrounding the subject.
Many of the epiphytic orchid sare used as traditional medicine. Chemical components and pharmacology have been studied in recent 15 years. Medicinal orchids, in general, are not subjected to detailed pharmacological studies. A wide range of chemical compounds are presented including alkaloids, bibenzyl derivatives, flavonoids, phenanthrenes and terpenoids which have been isolated recently from this species. Extracts and metabolites of these plants, particularly those from flowers and leaves, possess useful pharmacological activities. Particular attention has been given to diuretic, antirheumatic, anti-inflammatory, anti-carcinogenic, hypoglycemic activities, antimicrobial, anticonvulsive, relaxation, neuroprotective, and antivirus, activities. A comprehensive account of chemical constituents and biological activities is presented and a critical appraisal of the ethnopharmacological issues is included in view of the many recent findings of importance of these orchids. A large number of orchids have been empirically used for treatment of different diseases, thus, several studies have been undertaken to provide scientific proof to justify the medicinal use of various plants in treatment of diseases. The aim of this review is to up-date and to present a comprehensive analysis of traditional and folklore uses, pharmacological reports and phyto-constituents isolated from the orchids family.
This editorial reviews the literature regarding psychological studies that are designed to address the question of not just whether, psychological interventions effect change, but how. The practicalities and implications of assessing mechanisms of treatments are considered with examples from the fields of Cognitive Behavioural Therapy (CBT) and Mindfulness. The potential for elucidating theoretical mechanisms, developing new theoretical models and modifying treatment approaches are described. In addition an overview of different types of statistical methods available to researchers for assessing mediation is given. Structural Equation Modelling (SEM) is a recommended approach. The review concludes with a summary of optimum study conditions adopted by researchers for establishing mediating effects.
Ocimum sanctum (O. sanctum) has gained special attention due to its biological properties, however, little is known about its immunomodulatory effects. The purpose of this study was to investigate effect of O. sanctum on inflammation and immune response and its effect on Th1/Th2 cytokine production by spleen cells of myelosuppressed mice model. Female Swiss albino mice were challenged with SRBC and then were grouped and treated with either O. sanctum methanolic extract 850 mg kg-1 or Prednisolone 5 mg kg-1 body weight for 15 days. Blood was collected on 16th day from retro orbital plexus to perform hematological and immunological tests. Bone marrow cellularity was determined and supernatants of splenocytes cultures were analyzed for Th1/Th2 cytokines by ELISA. Antioxidant activity of O. sanctum was evaluated by DPPH (2,2'-diphenyl-1- picrylhydrazyl) assay. Treatment with O. sanctum showed significant increase in bone marrow cellularity (p<0.01), total WBC count (p<0.01) and hemoglobin concentration (p<0.01). In addition, there was a significant increase in SRBC antibody titer (1:1024) compared to the control group (1:256). O. sanctum increased the production of TNF-α, IL-2, IFN- γ and IL-4 (p<0.05) significantly and decreased the production of IL-1β and NF-kB. The methanolic extracts of O. sanctum showed free radical scavenging activity at 140 μg mL-1 concentration as IC50. This study documented improved haemoglobin concentration with O. sanctum treatment. These results support the use of this herb for wound healing and infection. The results also suggest potential use of O. sanctum as adjuvant in cancer therapy, myelotoxicity and in nutritional anemia.
Background:
Chronic fatigue syndrome (CFS) is characterised by persistent, medically unexplained fatigue, as well as symptoms such as musculoskeletal pain, sleep disturbance, headaches and impaired concentration and short-term memory. CFS presents as a common, debilitating and serious health problem. Treatment may include physical interventions, such as exercise therapy, which was last reviewed in 2004.
Objectives:
The objective of this review was to determine the effects of exercise therapy (ET) for patients with CFS as compared with any other intervention or control.• Exercise therapy versus 'passive control' (e.g. treatment as usual, waiting-list control, relaxation, flexibility).• Exercise therapy versus other active treatment (e.g. cognitive-behavioural therapy (CBT), cognitive treatment, supportive therapy, pacing, pharmacological therapy such as antidepressants).• Exercise therapy in combination with other specified treatment strategies versus other specified treatment strategies (e.g. exercise combined with pharmacological treatment vs pharmacological treatment alone).
Search methods:
We searched The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR), the Cochrane Central Register of Controlled Trials (CENTRAL) and SPORTDiscus up to May 2014 using a comprehensive list of free-text terms for CFS and exercise. We located unpublished or ongoing trials through the World Health Organization (WHO) International Clinical Trials Registry Platform (to May 2014). We screened reference lists of retrieved articles and contacted experts in the field for additional studies
Selection criteria:
Randomised controlled trials involving adults with a primary diagnosis of CFS who were able to participate in exercise therapy. Studies had to compare exercise therapy with passive control, psychological therapies, adaptive pacing therapy or pharmacological therapy.
Data collection and analysis:
Two review authors independently performed study selection, risk of bias assessments and data extraction. We combined continuous measures of outcomes using mean differences (MDs) and standardised mean differences (SMDs). We combined serious adverse reactions and drop-outs using risk ratios (RRs). We calculated an overall effect size with 95% confidence intervals (CIs) for each outcome.
Main results:
We have included eight randomised controlled studies and have reported data from 1518 participants in this review. Three studies diagnosed individuals with CFS using the 1994 criteria of the Centers for Disease Control and Prevention (CDC); five used the Oxford criteria. Exercise therapy lasted from 12 to 26 weeks. Seven studies used variations of aerobic exercise therapy such as walking, swimming, cycling or dancing provided at mixed levels in terms of intensity of the aerobic exercise from very low to quite rigorous, whilst one study used anaerobic exercise. Control groups consisted of passive control (eight studies; e.g. treatment as usual, relaxation, flexibility) or CBT (two studies), cognitive therapy (one study), supportive listening (one study), pacing (one study), pharmacological treatment (one study) and combination treatment (one study). Risk of bias varied across studies, but within each study, little variation was found in the risk of bias across our primary and secondary outcome measures.Investigators compared exercise therapy with 'passive' control in eight trials, which enrolled 971 participants. Seven studies consistently showed a reduction in fatigue following exercise therapy at end of treatment, even though the fatigue scales used different scoring systems: an 11-item scale with a scoring system of 0 to 11 points (MD -6.06, 95% CI -6.95 to -5.17; one study, 148 participants; low-quality evidence); the same 11-item scale with a scoring system of 0 to 33 points (MD -2.82, 95% CI -4.07 to -1.57; three studies, 540 participants; moderate-quality evidence); and a 14-item scale with a scoring system of 0 to 42 points (MD -6.80, 95% CI -10.31 to -3.28; three studies, 152 participants; moderate-quality evidence). Serious adverse reactions were rare in both groups (RR 0.99, 95% CI 0.14 to 6.97; one study, 319 participants; moderate-quality evidence), but sparse data made it impossible for review authors to draw conclusions. Study authors reported a positive effect of exercise therapy at end of treatment with respect to sleep (MD -1.49, 95% CI -2.95 to -0.02; two studies, 323 participants), physical functioning (MD 13.10, 95% CI 1.98 to 24.22; five studies, 725 participants) and self-perceived changes in overall health (RR 1.83, 95% CI 1.39 to 2.40; four studies, 489 participants). It was not possible for review authors to draw conclusions regarding the remaining outcomes.Investigators compared exercise therapy with CBT in two trials (351 participants). One trial (298 participants) reported little or no difference in fatigue at end of treatment between the two groups using an 11-item scale with a scoring system of 0 to 33 points (MD 0.20, 95% CI -1.49 to 1.89). Both studies measured differences in fatigue at follow-up, but neither found differences between the two groups using an 11-item fatigue scale with a scoring system of 0 to 33 points (MD 0.30, 95% CI -1.45 to 2.05) and a nine-item Fatigue Severity Scale with a scoring system of 1 to 7 points (MD 0.40, 95% CI -0.34 to 1.14). Serious adverse reactions were rare in both groups (RR 0.67, 95% CI 0.11 to 3.96). We observed little or no difference in physical functioning, depression, anxiety and sleep, and we were not able to draw any conclusions with regard to pain, self-perceived changes in overall health, use of health service resources and drop-out rate.With regard to other comparisons, one study (320 participants) suggested a general benefit of exercise over adaptive pacing, and another study (183 participants) a benefit of exercise over supportive listening. The available evidence was too sparse to draw conclusions about the effect of pharmaceutical interventions.
Authors' conclusions:
Patients with CFS may generally benefit and feel less fatigued following exercise therapy, and no evidence suggests that exercise therapy may worsen outcomes. A positive effect with respect to sleep, physical function and self-perceived general health has been observed, but no conclusions for the outcomes of pain, quality of life, anxiety, depression, drop-out rate and health service resources were possible. The effectiveness of exercise therapy seems greater than that of pacing but similar to that of CBT. Randomised trials with low risk of bias are needed to investigate the type, duration and intensity of the most beneficial exercise intervention.
Ocimum sanctum L. is known for its medicinal properties and also has been considered sacred in India since Vedic times. The aqueous suspension of 70% alcoholic extract of Ocimum sanctum L. was investigated for antifatigue activity. Rats were subjected to Weight-loaded Forced Swim Test (WFST) every alternate day for 2 weeks. O. sanctum at a dosage of 150, 300 and 450 mg kg -1 b.wt. was administrated to rats every day. Swimming time, change in body weight, lipid peroxidation, Lactic Acid (LA), glycogen and blood biochemical parameters namely heamoglobin (Hb%), Blood Urea Nitrogen (BUN) and Creatine Kinase (CK) were evaluated as biomarkers of physical fatigue. The O. sanctum treatment was found to lower malondialdehyde (MDA) and lactic acid levels in liver and muscle tissues compared with control exercise group (p<0.05). Serum biochemical parameters viz., BUN and CK activity were also reduced as compared with control exercise group (p<0.05). The present study thus indicates that out of three studied treatments of O. sanctum (O. sanctum -150, 300 and 450); the O. sanctum at the dose of 300 mg kg -1 b.wt. showed better performance against fatigue when compared with other two treatments. As treatment at 300 mg kg -1 b.wt. facilitated the aerobic glucose metabolism and promote swimming time, suggesting that O. sanctum ameliorates the various impairments associated with physical fatigue.
Flavonoids are major active ingredient in corn silk (CS) and possess various pharmacological activities. In this study, microporous resin adsorption technology was used for obtaining purified flavonoids from corn silk (FCS) and its anti-fatigue activity was evaluated. Eight kinds of macroporous resins with different properties were tested through static adsorption and one macroporous resin labeled as AB-8 was selected. Some important parameters were optimized for most effective enrichment and preparative separation. As follows: 1. for adsorption: sample solution FCS concentration was 2.636 mg/ml; processing volume was 4 BV; flow rate was 2 BV/h; temperature was 25°C; 2. for desorption: elution solvent ethanol-water (90%, v/v) solution was 4BV; flow rate was 1.0 BV/h. Flavonoids with content of 63.15% was obtained with a flavonoid recovery of 94.27% in the purification process. The results showed that AB-8 resin revealed a good ability to purify FCS. Swimming exercise results indicated that FCS had anti-fatigue activity of mice by inhibiting the production of blood lactic acid, retarding the formation of BUN and increasing hepatic glycogen concentration.
Cited By (since 1996):1, Export Date: 18 October 2014
Curcumin and its two related compounds, that is, demethoxycurcumin and bis-demethoxycurcumin (curcuminoids) are the main secondary metabolites of Curcuma longa and other Curcuma spp. Curcumin is commonly used as coloring agent as well as food additive; curcumin has also shown some therapeutic activities. This review summarizes stability of curcumin in solutions, spectroscopy characteristics of curcumin (UV, IR, Raman, MS, and NMR), polymorphism forms, method of analysis in both of biological and nonbiological samples, and metabolite studies of curcumin. For analysis of curcumin and its related compounds in complex matrices, application of LC-MS/MS is recommended.
This study investigated the antifatigue effects of rutin, a flavonoid extracted from the ethyl acetate extract of S. involucrata. Mice were subjected to a weight-loaded forced swim test (WFST) on alternate days for 3 wk. Rutin was administered orally to the mice for 7 days in dosages of 15, 30, and 60 mg/kg body weight, and several biomarkers of physical fatigue were evaluated: swimming time, change in body weight, lipid peroxidation, lactic acid (LA), glycogen, and the activities of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx). On Day 7, the rutin-treated mice had a 3-fold longer exhaustive swimming time than the control mice, as well as significantly reduced blood LA concentrations. The 15, 30, and 60 mg/kg body weight rutin-supplemented groups displayed 11.2%, 22.5%, and 37.7% reduced malondialdehyde (MDA) concentrations, respectively, in brain and muscle tissues compared with the control exercised group. Our results indicated that the administration of rutin protected the mice against the depletion of SOD and GPx activities significantly. Following 7 days of rutin treatment, we sacrificed the mice and analyzed their soleus muscle and brain for peroxisome proliferator-activated receptor-α coactivator (PGC-1α) and sirtuin 1 (SIRT1) mRNA expression. We observed that rutin treatment increased PGC-1α and SIRT1 mRNA and protein expression. The changes in these markers of mitochondrial biogenesis were associated with increased maximal endurance capacity. The application of 2D gel electrophoresis to analyze the rutin-responsive protein profiles in the WFST mouse brain further revealed the upregulation of the CB1 cannabinoid receptor-interacting protein 1, myelin basic protein, Rho GDP dissociation inhibitor (GDI) alpha, and TPI, indicating that rutin might inhibit anxiety through the upregulation of the expression of anxiety-associated proteins. Western blot analysis of MAPK expression further confirmed the antianxiety effects of rutin. Our study results thus indicate that rutin treatment ameliorates the various impairments associated with physical fatigue.
There is no known treatment for chronic fatigue syndrome (CFS). Little is known about its pathogenesis. Human herpesvirus 6 (HHV-6) and Epstein-Barr virus (EBV) have been proposed as infectious triggers. Thirty CFS patients with elevated IgG antibody titers against HHV-6 and EBV were randomized 2:1 to receive valganciclovir (VGCV) or placebo for 6 months in a double-blind, placebo-controlled trial. Clinical endpoints aimed at measuring physical and mental fatigue included the Multidimensional Fatigue Inventory (MFI-20) and Fatigue Severity Scale (FSS) scores, self-reported cognitive function, and physician-determined responder status. Biological endpoints included monocyte and neutrophil counts and cytokine levels. VGCV patients experienced a greater improvement by MFI-20 at 9 months from baseline compared to placebo patients but this difference was not statistically significant. However, statistically significant differences in trajectories between groups were observed in MFI-20 mental fatigue subscore (P = 0.039), FSS score (P = 0.006), and cognitive function (P = 0.025). VGCV patients experienced these improvements within the first 3 months and maintained that benefit over the remaining 9 months. Patients in the VGCV arm were 7.4 times more likely to be classified as responders (P = 0.029). In the VGCV arm, monocyte counts decreased (P < 0.001), neutrophil counts increased (P = 0.037) and cytokines were more likely to evolve towards a Th1-profile (P < 0.001). Viral IgG antibody titers did not differ between arms. VGCV may have clinical benefit in a subset of CFS patients independent of placebo effect, possibly mediated by immunomodulation and/or antiviral effect. Further investigation with longer treatment duration and a larger sample size is warranted. J. Med. Virol. 9999:1-9, 2013. © 2013 Wiley Periodicals, Inc.
Hypericum perforatum (HP) belongs to the Hypericaceae family and is one of the oldest used and most extensively investigated medicinal herbs. The medicinal form comprises the leaves and flowering tops of which the primary ingredients of interest are naphthodianthrones, xanthones, flavonoids, phloroglucinols (e.g. hyperforin), and hypericin. Although several constituents elicit pharmacological effects that are consistent with HP's antidepressant activity, no single mechanism of action underlying these effects has thus far been found. Various clinical trials have shown that HP has a comparable antidepressant efficacy as some currently used antidepressant drugs in the treatment of mild/moderate depression. Interestingly, low-hyperforin-content preparations are effective in the treatment of depression. Moreover, HP is also used to treat certain forms of anxiety. However, HP can induce various cytochrome P450s isozymes and/or P-glycoprotein, of which many drugs are substrates and which are the main origin of HP-drug interactions. Here, we analyse the existing evidence describing the clinical consequence of HP-drug interactions. Although some of the reported interactions are based on findings from in vitro studies, the clinical importance of which remain to be demonstrated, others are based on case reports where causality can, in some cases, be determined to reveal clinically significant interactions that suggest caution, consideration, and disclosure of potential interactions prior to informed use of HP. Copyright © 2013 John Wiley & Sons, Ltd.
This study examined the effects and comparative efficacy of various antidepressants and herbal psychotropic drugs in a mouse model of chronic fatigue. Animals were subjected daily to forced swimming (Porsolt's forced swimming test) and the duration of the immobility period was recorded in 6-minute sessions on each day for 7 days. Chronic forced swimming resulted in significant increases in immobility time on day 7 as compared to day 1 in control mice. Pretreatment with imipramine (10 mg/kg, i.p.), desipramine (10 mg/kg, i.p.), tranyl-cypromine (10 mg/kg, i.p.), alprazolam (0.5 mg/kg, i.p.), fhioxetine (10 mg/kg, i.p.) and melatonin (10 mg/kg, i.p.) produced significant decreases in immobility time as compared to control on each day. Similar decreases in immobility periods were observed with herbal psychotropic preparations-Withania somniferaroot extract (100 mg/kg, p.o.), BR-16A(r) (200 mg/kg, p.o.), siotone(r) granules (200 mg/kg, p.o.) and evening primrose oil (0.2 ml/20 g, p.o.). However, trazodone and ida-zoxan failed to modify the immobility times on all the days. The present observations underscore the established use of antidepressants in providing symptomatic relief of fatigue in Chronic Fatigue Syndrome (CFS) patients and further reinforce the potential therapeutic usefulness of herbal psychotropic preparations in CFS patients.
Anutrition survey carried out in India revealed that the diets of the rural population are inadequate and
deficient in most of the nutrients especially protein. India being the 5th-largest producer of soybean, a protein-rich
cereal, can redress protein-energy malnutrition through diversification of soybean uses by developing high-value
and health-based food products. Tofu, a nonfermented soybean product rich in high-quality protein, B-vitamins,
and isoflavones, could be an excellent substitute for meat in Indian recipes. Tofu being rich in protein has a very short
shelf life. Hence an attempt was made to improve the shelf life using extracts of tulsi (Ocimum sanctum) commonly
available in rural areas. Tofu was prepared traditionally using MgCl2:CaSO4 as coagulating agents. Aqueous extract
of Ocimum sanctum (tulsi) was added during the preparation and storage of tofu to prolong its shelf life.Water used
in this study was free from microflora, plant extract used contained mesophilic count of 2.527×104 CFU/g, and no
yeasts and molds were detected. Tofu with tulsi extract had 76.4% moisture and was softer than control. Not much
difference in mesophilic count was observed between control and treated samples during storage; however, treated
tofu was organoleptically good until the end of the study with less lipid-peroxidation and exhibited 50% (4.7 units)
less protease activity than control (9.6 units) after 7 d. By using extracts of naturally available, easily cultivable tulsi,
the shelf life was successfully extended to 7 to 8 d from 3 to 4 d of normal storage without refrigeration.
Callosin and callosinin, two new stilbenoids, were isolated from the orchid Agrostophyllum callosum, which also afforded, 4-hydroxy-3,5-dimethoxybenzoic acid, orchinol, 6-methoxycoelonin, imbricatin, flaccidin, oxoflaccidin, iso-oxoflaccidin, flaccidinin and agrostophyllin of previously known structures. Callosin was also isolated from another orchid, Coelogyne flaccida. The structures of callosin and callosinin were established as 2,6-dihyroxy-4,7-dimethoxy-9,10- dihydrophenanthrene and 2,6,7-trimethoxy-9,10-dihydro-5H-phenanthro [4,5-bcd]pyran-5-one, respectively, from spectral and chemical evidence. For ease of comparison of the spectral data the phenanthrene numbering system is used in this paper.
The chemical polemics in the reported literature on shilajit are resolved. This study shows that humification of latex and resin-bearing plants is responsible for the major organic mass (80-85%) of shilajit. The low mol. wt. chemical markers (&lo%), viz. aucuparins, oxygenated dibenzo-K -pyrones and triterpenic acids of the tirucallane type (free and conjugated), occurring in the core structure of shilajit humus, are the major active constituents of Himalayan shilajit. The therapeutic effects of shilajit are the consequences of hormonal control and regulation of immunity.