Paula Viñas
José de Felippe Junior

Curiosidade do Império Bizantino – Colchicum

'Arthritis' in Byzantium (AD 324-1453): unknown information from non-medical literary sources.

Ann Rheum Dis;54(12):951-7, 1995 Dec. Lascaratos J

OBJECTIVE: To compile and analyse information contained in non-medical texts of the Byzantine historians and chroniclers concerning arthritis, and to clarify the first use of Colchicum autumnale in the treatment of gout by the fifth century physician, Jacob Psychristus. CONCLUSIONS--This material gives an indication of the problem of arthritis and, in particular, a disease resembling gout that tyrannised a great number of the population in the Byzantine Empire (AD 324-1453). Contemporary historians and chroniclers maintain that the main causes of gout ('podagra') were the over-consumption of alcoholic drinks and food. Most relevant texts include anxiety and heredity among the aetiological factors of the disease. The incidence of this group of diseases among the Byzantine Emperors (it is certain that 14 of a total of 86 had a form of arthritis) and other officials of the State indicates that these diseases were a possible factor in certain political and military difficulties of the Empire.

abacate

Avocado/soybean unsaponifiables increase aggrecan synthesis and reduce catabolic and proinflammatory mediator production by human osteoarthritic chondrocytes.
Henrotin YE, Sanchez C, Deberg MA, Piccardi N, Guillou GB, Msika P, Reginster JY.
J Rheumatol. 2003 Aug;30(8):1825-34.
Bone and Cartilage Metabolism Research Unit, University Hospital, CHU Sart-Tilman, Liege, Belgium. yhenrotin@ulg.ac.be

OBJECTIVE: To investigate the effects of avocado (A)/soybean (S) unsaponifiables on the metabolism of human osteoarthritic (OA) chondrocytes cultured in alginate beads over 12 days. METHODS: Enzymatically isolated OA chondrocytes were cultured in alginate beads in a well defined culture medium for 12 days, in the presence or not of 10-10 M interleukin 1beta (IL-1beta). DNA content was measured using a fluorometric method. Production of aggrecan (AGG), stromelysin-1 (MMP-3), tissue inhibitor of metalloproteinases-1 (TIMP-1), macrophage inflammatory protein-1beta (MIP-1beta), IL-6, and IL-8 were assayed by specific enzyme amplified sensitivity immunoassays. Prostaglandin (PG) E2 was measured by a specific radioimmunoassay and nitrite by a spectrophotometric method based on the Griess reaction. A commercial avocado and soybean mixture of unsaponifiables (A1S2) and each component separately were tested in a range of 0.625 to 40.0 micro g/ml. RESULTS: After 12 days' incubation, A1S2 increased AGG synthesis and accumulation in alginate beads in a dose and time dependent manner. A1S2 promoted the recovery of aggrecan synthesis after 3 days of IL-1beta treatment. A1S2 was a potent inhibitor of basal and IL-1beta stimulated MMP-3 production. The procedure also weakly reversed the inhibitory effect of IL-1beta on TIMP-1 production. A1S2 inhibited basal production of MIP-1beta, IL-6, IL-8, NO*, and PGE2 by OA chondrocytes and partially counteracted the stimulating effect of IL-1 on PGE2. Compared to avocado or soybean added separately, the mixture had a superior effect on NO* and IL-8 production. CONCLUSION: A1S2 stimulated aggrecan production and restored aggrecan production after IL-1beta treatment. In parallel, A1S2 decreased MMP-3 production and stimulated TIMP-1 production. These results suggest A1S2 could have structure-modifying effects in OA by inhibiting cartilage degradation and promoting cartilage repair.

Structural effect of avocado/soybean unsaponifiables on joint space loss in osteoarthritis of the hip.
Arthritis Rheum. 2002 Feb;47(1):50-8
Lequesne M, Maheu E, Cadet C, Dreiser RL.
Hopital Leopold Bellan, Paris, France. mlequesne@aol.com

OBJECTIVE: To evaluate the structural effect of avocado/soybean unsaponifiables (ASU) in the treatment of patients with symptomatic osteoarthritis (OA) of the hip. METHODS: Patients with regular painful primary OA of the hip (European League Against Rheumatism 1980 criteria) and a joint space still > or = 1 mm (Kellgren grade 1 to 3, assessed by an independent observer prior to inclusion) entered a prospective, multicenter, randomized, parallel group, double-blind, placebo-controlled trial of 2 years duration. Patients had at least a 6-month history of regular pain and an algofunctional index (AFI) > or = 4. The primary assessment criterion was a decrease of the joint space width (JSW) on plain anteroposterior radiographs of the pelvis performed in standing position, measured at the narrowest points by 2 independent readers, previously tested and selected and blinded to both the treatment and the time sequence. Secondary criteria were standard clinical outcome measurements (AFI, pain on a visual analog scale, consumption of nonsteroidal antiinflammatory drugs and patient's and investigator's global assessments). RESULTS: One hundred sixty-three patients were included: 102 men and 61 women (mean age 63.2 +/- 8.7 years). A total of 108 patients (72 men and 36 women; mean age 64 +/- 7.9 years) were radiologically evaluable at 23.7 +/- 2.6 months (ASU group; n = 55) and 23.7 +/- 3.2 months (placebo group; n = 53). Overall comparison of the evolution of JSW showed no difference between the ASU and placebo groups, from 2.35 +/- 0.93 to 1.87 +/- 1.10 mm and from 2.5 +/- 0.94 to 1.9 +/- 1.33 mm, respectively (intergroup P value at end point = 0.9). When patients were divided into 2 subgroups according to the median value of the baseline JSW (2.45 mm), the joint space loss in the most severely affected subgroup of patients (baseline JSW < or = median) was significantly greater in the placebo group than in the ASU group: from 1.69 +/- 0.58 to 0.84 +/- 0.77 mm (-0.86 +/- 0.62 mm) and from 1.66 +/- 0.42 to 1.22 +/- 0.7 mm (-0.43 +/- 0.51 mm), respectively (P < 0.01). The JSW decrease was identical, with no difference in ASU and placebo groups, in the less severely affected subgroup of patients (baseline JSW > median). Clinical parameters in the 2 groups did not differ significantly throughout the study. CONCLUSION: This pilot randomized, double-blind, placebo-controlled trial failed to demonstrate a structural effect of ASU in hip OA. However, in a post-hoc analysis, ASU significantly reduced the progression of joint space loss as compared with placebo in the subgroup of patients with advanced joint space narrowing. These results suggest that ASU could have a structural effect but require confirmation in a larger placebo-controlled study in hip OA.

Gengibre

A randomized, placebo-controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis.

Osteoarthritis Cartilage;8(1):9-12, 2000 Jan. Bliddal H; Rosetzsky A; Schlichting P; Weidner MS; Andersen LA; Ibfelt HH; Christensen K; Jensen ON; Barslev J

Parker Institute, Department of Rheumatology, Frederiksberg Hospital, Copenhagen F, DK-2000, Denmark.

Resumo: OBJECTIVE: Alternative medicine is used extensively by patients with chronic pain due to e.g., osteoarthritis. Only few of these drugs have be tested in a controlled setting and the present study was undertaken to examine the effect of ginger extract, one of the most popular herbal medications. DESIGN: Ginger extract was compared to placebo and Ibuprofen in patients with osteoarthritis of the hip or knee in a controlled, double blind, double dummy, cross-over study with a wash-out period of one week followed by three treatment periods in a randomized sequence, each of three weeks duration. Acetaminophen was used as rescue medication throughout the study. The study was conducted in accordance with Good Clinical Practice (European Guideline for GCP). RESULTS: A ranking of efficacy of the three treatment periods: Ibuprofen>ginger extract>placebo was found for visual analogue scale of pain (Friedman test: 24.65, P< 0.00001) and the Lequesne-index (Friedman test: 20.76, P< 0.00005). In the cross-over study, no significant difference between placebo and ginger extract could be demonstrated (Siegel-Castellan test), while explorative tests of differences in the first treatment period showed a better effect of both Ibuprofen and ginger extract than placebo (Chi-square, P< 0.05). There were no serious adverse events reported during the periods with active medications. CONCLUSION: In the present study a statistically significant effect of ginger extract could only be demonstrated by explorative statistical methods in the first period of treatment before cross-over, while a significant difference was not observed in the study as a whole.

Idoso Effects of ginger (Zingiber officinale Rosc.) on decreasing the production of inflammatory mediators in sow osteoarthrotic cartilage explants.

[So] Source: J Med Food;6(4):323-8, 2003. Shen CL; Hong KJ; Kim SW

Resumo: The herbal remedy Zingiber officinale (ginger root) has been used for perhaps thousands of years in the Far East to treat inflammatory diseases, including osteoarthritis. However, the anti-arthritic effect of ginger root has never been evaluated on osteoarthrotic cartilage of sow. The objective of this study was to investigate the effects of ginger root extract (GRE) on the viability and the production of nitric oxide (NO) and prostaglandin E(2) (PGE(2)) by sow osteoarthrotic cartilage explants. The cartilage explants (~20 mg/96-well plate) were grown in Ham's F-12/Dulbecco's Modified Eagle's Medium supplemented with 10% fetal bovine serum and antibiotics for 72 hours and depleted for 24 hours. GRE was then added at different concentrations (0-2,000 microg/mL), and the explants were allowed to grow for 24 hours. The cell viability was reduced (P<.05) with GRE >/=500 microg/mL, whereas it was not affected with GRE <100 microg/mL. In a follow-up experiment, the supernatants of cartilage explants with GRE (0-500 microg/mL) in the presence of interleukin-1beta (2 ng/mL), tumor necrosis factor-alpha (1 ng/mL), and lipopolysaccharides (10 microg/mL) were used to measure NO and PGE production. Increasing GRE concentration (1-100 microg/mL) reduced (P <.05) NO production by cartilage tissue explants, and a similar pattern was observed in the production of PGE(2). The inhibitory effects of GRE on NO and PGE(2) production by sow osteoarthrotic cartilage explants observed in this study suggest an important role for GRE as an anti-arthritic agent in osteoarthrosis in the sow.

Unha de Gato

Efficacy and safety of freeze-dried cat's claw in osteoarthritis of the knee: mechanisms of action of the species Uncaria guianensis.

Inflamm Res;50(9):442-8, 2001 Sep. Piscoya J; Rodriguez Z; Bustamante SA; Okuhama NN; Miller MJ; Sandoval M

Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Lima, Peru

Resumo: AIM: The purpose of this investigation was to evaluate the ability of cat's claw, an Amazonian medicinal plant, to treat osteoarthritis of the knee, collect safety and tolerance information and compare the antioxidant, and anti-inflammatory actions of Uncaria guianensis and Uncaria tomentosa in vitro. MATERIALS AND METHODS: Forty-five patients with osteoarthritis of the knee were recruited, 30 were treated with freeze-dried U guianensis, and 15 with placebo. Hematological parameters were assessed on entry and exit of the four-week trial. Pain, medical and subject assessment scores and adverse effects were collected at weeks 1, 2 and 4. The antioxidant and anti-inflammatory activity of the cat's claw species was determined by the alpha,alpha-diphenyl-beta-picrylhydrazyl (DPPH) free radical scavenging method. Inhibition of TNFalpha and prostaglandin E2 (PGE2) production was determined in RAW 264.7 cells by ELISA. RESULTS: Cat's claw had no deleterious effects on blood or liver function or other significant side-effects compared to placebo. Pain associated with activity, medical and patient assessment scores were all significantly reduced, with benefits occurring within the first week of therapy. Knee pain at rest or at night, and knee circumference were not significantly reduced by cat's claw during this brief trial. In vitro tests indicated that U guianensis and U. tomentosa were equivalent at quenching DPPH radicals (EC50, 13.6-21.7 microg/ml) as well as inhibiting TNFalpha production. However, the latter action was registered at much lower concentrations (EC50, 10.2-10.9 ng/ml). Cat's claw (10 microg/ml) had no effect on basal PGE2 production, but reduced LPS-induced PGE2 release (P < 0.05), but at higher concentrations than that required for TNFalpha inhibition. CONCLUSION: Cat's claw is an effective treatment for osteoarthritis. The species, U guianensis and U tomentosa are equiactive. They are effective antioxidants, but their anti-inflammatory properties may result from their ability to inhibit TNFalpha and to a lesser extent PGE2 production.

MISCELÂNEA

Natural remedies' in the treatment of osteoarthritis.
Drugs Aging. 2003;20(7):517-26.
Walker-Bone K.
Medical Research Council Environmental Epidemiology Unit, Southampton General Hospital, Southampton SO16 6YD, UK. kwb@mrc.soton.ac.uk

Abstract: Osteoarthritis (OA) is a common, chronic and painful condition. It is the most common of all rheumatic disorders and is destined to become one of the most prevalent and costly diseases in our society. The conventional therapeutic options employed in the management of OA are simple analgesics and NSAIDs, but these options frequently produce sub-optimal benefit and are associated with an adverse-safety profile. Unsurprisingly patients are looking to alternative and complementary medicine. The aim of this article was to review the available literature on the effectiveness and safety of 'natural remedies' for the treatment of OA. Computerised literature searches were carried out for systematic reviews and randomised controlled trials examining the role of 'natural remedies' in the treatment of OA. There have been few randomised controlled trials of 'natural remedies' that have satisfied the internationally agreed standards. There was, however, evidence of efficacy for glucosamine, chondroitin sulfate and possibly avocado/soybean unsaponifiables for the symptomatic relief of OA. To date, it is not established whether any of the 'natural remedies' are capable of chondroprotection. Even if 'natural remedies' are only modestly effective, they are widely available and well tolerated, suggesting that they may play a significant role in the management of OA in the elderly.

Nutripharmaceuticals for osteoarthritis.
Best Pract Res Clin Rheumatol. 2001 Oct;15(4):595-607
Hauselmann HJ.
Centre for Rheumatology and Bone Disease, Klinik Im Park, Bellariastr.38, CH 8038, Switzerland.

Abstract: What is the level of evidence for current symptomatic agents (SYSADOA) in patients with osteoarthritis? Existing publications which met the inclusion criteria were rated by calculating the effect size of the compounds and applying a quality assessment score of the study methodology. This produced a median effect size for the primary outcome measure, pain, of 1.37 (range 0.37-1.50) for chondroitin-sulphate and 0.57 (range 0.26-1.02) for glucosamine-sulphate in patients with knee osteoarthritis. These effect sizes were strongly diminished when only recent high-quality studies were considered (effect size of pain for chondroitin-sulphate 0.37 and for glucosamine-sulphate 0.26). Effect sizes for functional improvement and overall WOMAC index (pain, stiffness and function) were in the same range for both compounds. So far, and in contrast to recent claims, there is no reliable scientific evidence that these two substances have structure-modifying actions with respect to prohibiting, healing or restoring cartilage lesions. There is only scarce or no scientific evidence for the effects of nutrients in patients with knee, hip or hand osteoarthritis. Several large company-sponsored and independent trials with several of these nutripharmaceuticals are ongoing in Europe and the USA.

Mast cells and mast cell mediators as targets of dietary supplements .

Ann Allergy Asthma Immunol;93(2 Suppl 1):S24-34, 2004 Aug. Theoharides TC; Bielory L

Resumo: OBJECTIVE: To review the increasing amount of data that support or dispel the use of dietary supplements in the treatment of inflammatory conditions that involve mast cells, such as allergies, arthritis, and chronic pelvic pain syndrome. DATA SOURCES: A search was conducted in MEDLINE for natural substances, dietary supplements, flavonoids, and proteoglycans for their in vitro or in vivo effects on allergic and inflammatory conditions. STUDY SELECTION: Studies were selected for inclusion because of the impact factor of the journal, the definitive nature of the findings, the soundness of the study design, and the expert opinion of the authors. RESULTS: Dietary supplements include a large group of products, such as vitamins, minerals, plant, or animal extracts, as well as herbal preparations that are often called medicinal herbs. Many of the available dietary supplements contain a multitude of ingredients, the source and/or purity of which is seldom disclosed; some of these may have biologic effects of their own or may interact with other supplements or drugs, often leading to adverse effects. The most well-documented evidence published to date is on the inhibitory action of natural compounds, especially flavonoids, on mast cells and allergic symptoms. Some flavonoids have weak inhibitory activity, whereas others may have no benefit or may be detrimental. Sulfated proteoglycans could provide synergistic action but require formulations with increased absorption. CONCLUSIONS: Combining the most active flavonoids with proteoglycans could be helpful in atopic and inflammatory conditions. However, a complete list of active ingredients and their source, purity, and exact concentration should be a requirement for nutraceuticals to standardize, compare, and promote their safe use.

Anti-inflammatory activity of shikonin derivatives from Arnebia hispidissima.

Phytomedicine;10(5):375-80, 2003. Singh B; Sharma MK; Meghwal PR; Sahu PM; Singh S

Department of Botany, University of Rajasthan, Jaipur, India

Resumo: Arnebia hispidissima ethanolic extract, after chromatography, yielded a number of shikonin derivatives, which were identified as arnebin-5, arnebin-6, teracryl shikonin, arnebinone and acetyl shikonin. All these compounds were firstly reported from this plant species and evaluated to the anti-inflammatory activity of ethanolic extract and isolated shikonin derivatives, models with carrageenan-induced paw edema and complete Freund's adjuvant (CFA)-induced chronic arthritis in rats were conducted. The observed results indicated that pre-treatment with arnebinone significantly inhibited the carrageenan-induced paw edema and also suppressed the development of chronic arthritis induced by CFA.

An evaluation of the activity related to inflammation of four plants used in Thailand to treat arthritis.

J Ethnopharmacol;85(2-3):207-15, 2003 Apr. Laupattarakasem P; Houghton PJ; Hoult JR; Itharat A

Resumo: The leaves of Acanthus ebracteatus, stembark of Oroxylum indicum and the stems of Cryptolepis buchanani and Derris scandens are used as traditional remedies in Thailand for arthritis. Aqueous and alcoholic extracts were tested using three different in vitro systems for effects relevant to anti-inflammatory activity. The aqueous extracts of O. indicum and D. scandens significantly reduced myeloperoxide release. Eicosanoid production was reduced only by the aqueous extracts of A. ebracteatus and D. scandens. D. scandens extract showed potent inhibitory activity against generation of leukotriene B(4) and also displayed antioxidant activity. In the rat hind paw edema test, D. scandens extract showed significant activity when given intraperitoneally but did not produce a significant reduction when given orally. The results therefore supported to some extent the traditional use of D. scandens for arthritic conditions and provided slight indication of activity which could explain the use of O. indicum and A. ebracteatus. No relevant activity was demonstrated in any of the tests for C. buchanani extracts.

Study on antiinflammatory effect of a compound TCM agent containing ant extractive in animal models

Zhongguo Zhong Yao Za Zhi;27(3):215-8, 2002 Mar. Wei RB; Huo HR; Li XQ; Zhou AX; Shen H; Tian JL General Air Force Hospital of Chinese PLA, Beijing 100036, China.

Resumo: OBJECTIVE: To study the antiinflammatory effect of a compound TCM (Traditional Chinese Medicine) agent on animal models. The agent contains ant extractive and a blent of three herbal products, herba epimedii, fructus cnidii, and fructus lycii. METHOD: Three animal models to induce experimental inflammation in rats, including carrageenin--induced paw edema, cotton-ball granuloma and adjuvant induced arthritis, were chosen to study the antiinflammatory effect of the TCM agent. RESULT: The TCM agent showed a marked inhibitory effect on edema induced by all three types of inflammation in rats, the inhibitory rate of the TCM agent at the dose of 0.20, 0.40 and 0.80 g.kg-1 in granuloma model bing over 25% at 1 hour post oral administration, and being 23.8%, 22.7%, 39.7% at 6 hour. In addition, the TCM agent also showed a significant preventive as well as therapeutic effect on adjuvant induced arthritis in rats, and improved the pathological changes of the animal joints with the induced arthritis. CONCLUSION: TCM agent has significant antiinflammatory effects on the three above mentioned animal models.

Hypoestoxide, a novel anti-inflammatory natural diterpene, inhibits the activity of IkappaB kinase.

Cell Immunol;209(2):149-57, 2001 May 1. Ojo-Amaize EA; Kapahi P; Kakkanaiah VN; Takahashi T; Shalom-Barak T; Cottam HB; Adesomoju AA; Nchekwube EJ; Oyemade OA; Karin M; Okogun JI

Resumo: Most inflammatory agents activate nuclear factor-kappaB (NF-kappaB), resulting in induction of genes coding for cytokines, chemokines, and enzymes involved in amplification and perpetuation of inflammation. Hypoestoxide (a bicyclo [9,3,1] pentadecane) is a diterpene from Hypoestes rosea, a tropical shrub in the family Acanthacea, several members of which are used in folk medicine in Nigeria. Here, we demonstrate that hypoestoxide (HE) abrogates the production of pro-inflammatory cytokines (IL-1beta, IL-6, and TNF-alpha) in lipopolysaccharide (LPS)-activated normal human peripheral blood mononuclear cells. Moreover, HE inhibits the production of nitric oxide (NO) by IL-1beta- or IL-17-stimulated normal human chondrocytes. In vivo, oral administration of HE to mice significantly ameliorated hind paw edema induced by antibodies to type II collagen plus LPS. Furthermore, topical administration of HE to mice also significantly inhibited phorbol ester-induced ear inflammation. The anti-inflammatory activity of HE may be due in part to its ability to inhibit NF-kappaB activation through direct inhibition of IkappaB kinase (IKK) activity. Thus, HE could be useful in treating various inflammatory diseases and may represent a prototype of a novel class of IKK inhibitors.

 Suppressive effects of a plant-origin polyol, dulcitol on collagen-induced arthritis in mice

Nippon Yakurigaku Zasshi;110 Suppl 1:132P-137P, 1997 Oct. Kobayashi Y; Shen J; Li SH; Kakizoe E; Okunishi H; Chen JF

Department of Pharmacology, Shimane Medical University, Izumo, Japan.

Resumo: Dulcitol was isolated chemically from Celastrus obiculatus Thumb and determined by HPLC. Effects of dulcitol were examined on collagen-induced arthritis (CIA) in DBA/1J mice. From 6 weeks after the first immunization with bovine type II collagen, dulcitol (100 mg/kg body weight/day) was administered orally to immunized mice for 9 weeks. Clinical score of CIA was improved significantly by dulcitol intervention compared with the non-treated CIA mice. Radiographic score of phalangeal destruction was also improved by dulcitol treatment. These findings suggest that dulcitol may play a role in regulation of some inflammatory responses in the present arthritis model. Significant reduction of percentage of CD4+ and CD8+ T cell subsets in the spleen leucocytes of CIA mice was observed by flow cytometry. Almost normal level of CD4+ and CD8+ T cells was observed in dulcitol-treated groups, suggesting T cell-modifying effect of dulcitol in CIA. Weight of spleen was larger in CIA mice and it was not affected by dulcitol. Anti-collagen antibody titer was increased in CIA mice, and it was not affected by dulcitol, either. Improvement of the changes of CD4+ and CD8+ T cells in the spleen by dulcitol may suggest its modulatory effect on cellular immunity.

Salai Guggal - Boswellia serrata: from a herbal medicine to a non-redox inhibitor of leukotriene biosynthesis.

Eur J Med Res;1(8):369-70, 1996 May 24. Ammon HP

The anti-inflammatory effect of a crude aqueous extract of the root bark of [quot ]Ficus elastica[quot ] in the rat.

Arch Int Pharmacodyn Ther;281(1):169-76, 1986 May. Sackeyfio AC; Lugeleka OM

esumo: An investigation has been carried out to determine whether the aqueous extract of Ficus elastica is active as an anti-inflammatory agent in the carrageenin-induced oedema and adjuvant-induced arthritis in the rat. This investigation was prompted by the fact that practitioners of herbal medicine in West Africa use the plant for the treatment of muscle and joint pain. The results of the investigation clearly indicated that orally administered Ficus elastica extract markedly inhibited the experimentally induced inflammation in the two test models. This effect of Ficus elastica was very similar to that of indomethacin. Thus in the carrageenin-induced oedema Ficus elastica (2-10 mg/kg) and indomethacin (1-5 mg/kg) produced inhibition of the magnitude of 5.41-68.92% and 27.03-69.26%, respectively. Similarly, both the extract of Ficus elastica and indomethacin inhibited the primary as well as the secondary lesions of adjuvant arthritis in the rat. The extract used in this study was coloured buff and there is considerable evidence that flavonoids of plant origin possess anti-inflammatory activity. Therefore it may be concluded that the anti-inflammatory activity of the extract of Ficus elastica was probably due to the presence of a pigment of the flavonoid class. Further studies are in progress to elucidate the chemical characteristics of this active principle.

Anti-inflammatory actions of tannins isolated from the bark of Anacardium occidentale L.

J Ethnopharmacol;13(3):289-300, 1985 Jul. Mota ML; Thomas G; Barbosa Filho JM

Resumo: A mixture of tannins (hydrolysable and non-hydrolysable) obtained from the bark of Anacardium occidentale L., on i.p. injection, demonstrated apparent anti-inflammatory activity in carrageenan- and dextran-induced rat paw oedemas, cotton pellet granuloma test and adjuvant-induced polyarthritis in rats. At higher doses orally administered tannins also had activity in carrageenan paw oedema and adjuvant arthritis experiments. The tannins i.p. also inhibited acetic acid-induced [quot ]writhing responses[quot ] in mice and were found to antagonise the permeability-increasing effects in rats of certain mediators of inflammation and to inhibit the migration of leucocytes to an inflammatory site. While not appearing to act by the release of adrenal hormones, tannins may produce effects in a non-specific manner by their astringent properties on cell membranes thus affecting cell functions. The above results should be considered while studying the anti-inflammatory actions of plant extracts which contain tannins.

Anti-inflammatory activity of Euphorbia acaulis Roxb.

J Ethnopharmacol;10(2):225-33, 1984 Apr. Singh GB; Kaur S; Satti NK; Atal CK; Maheshweri JK

Resumo: From various extracts of Euphorbia acaulis , the n-hexane fraction showed marked anti-inflammatory activity in carrageenan induced oedema in rats and mice as compared to phenylbutazone and was equipotent in adrenal- ectomised rats. In chronic models of formaldehyde and adjuvant arthritis, its anti-arthritic activity was found to be superior to that of phenylbutazone. It had a diuretic effect but did not show any analgesic or antipyretic activity.

Phytotherapeutic profile of Nigerian herbs. I: Anti-inflammatory and anti-arthritic agents.

J Ethnopharmacol;6(3):263-74, 1982 Nov. Iwu MM; Anyanwu BN

Resumo: From a survey of anti-arthritic remedies used in Igbo tribal ethnomedicine, three plants--Lonchocarpus cyanescens, Costus afar and Terminalia ivorensis--were selected for closer study. Twenty-five volunteers were monitored while receiving treatment from two reputable herbalists, and the result of the clinical investigation prompted the pharmacological and phytochemical studies on the herbs. Differential solvent extracts of the herbs reduced carragenin-induced oedema of the rat paw, checked diarrhoea due to arachidonic acid and castor oil, and ameliorated all signs associated with adjuvant-induced polyarthritis in rats. The constituent-activity relationship of the drugs and their probable mode of action are briefly discussed.

Pharmacological properties of inulicin, a sesquiterpene lactone from Japanese inula

Trabalho Russo

Farmakol Toksikol;44(4):463-7, 1981 Jul-Aug.

Belova LF; Baginskaia AI; Trumpe TE; Sokolov SIa; Rybalko KS

Resumo: Inulicin is a sesquiterpene lactone obtained from Inula Japonica L. (Compositae) possesses a fairly wide spectrum of pharmacological action. In doses from 5 to 60 mg/kg it exerts a certain stimulant action on the central nervous system and smooth muscles of the intestine, displays an anti-inflammatory and anti-ulcer activity on pathological models of different genesis, and has capillary-strengthening diuretic properties. When given in low doses, the drug did not affect cardiac activity, while in high doses it might inhibit it. Inulicin is relatively little toxic. The LD50 for mice is 476 mg/kg intraperitoneally and 1330 mg/kg per os.

 Comparison of the anti-inflammatory activity of Commiphora mukul (an indigenous drug) with those of phenylbutazone and ibuprofen in experimental arthritis induced by mycobacterial adjuvant.

Arzneimittelforschung;27(7):1455-7, 1977 Jul. Sharma JN; Sharma JN

Resumo: In the present investigation a method of induction of experimental arthritis in animals was modified to provide a better model replica of human arthritis. Inflammatory syndrome, resembling rheumatoid arthritis in man, was induced in the right hock joint of albino rabbits by intra-articular injection of the killed mycobacterial adjuvant in liquid paraffin. Development of this arthritic syndrome was studied from a period of five months with and without drugs. Anti-inflammatory agents such as phenylbutazone, ibuprofen and fraction [quot ]A[quot ] of gum-guggual from Commiphora mukkul were administered orally at a daily dose of 100, 100 and 500 mg/kg, respectively, for a period of five months. All three drugs decreased the thickness of the joint swelling during the course of drug treatment. These results indicate the beneficial role of phenylbutazone, ibuprofen and fraction [quot ]A[quot ] of gum-guggul in experimental arthritis.

 Efficacy and tolerance of atrisin in degenerative and inflammatory joint disorders.

Phytother Res;19(4):365-8, 2005 Apr. Sohail MT; Chaudhry MI; Usman MK; Mian T; Ishaq MN

Postgraduate Medical Institute Service Hospital, Lahore, Pakistan. international@bional.nl

Resumo: In a randomized multi-centre clinical trial the efficacy and tolerance of a herbal product Atrisin three capsules/day was evaluated in 65 patients (31 male, 34 female) suffering from osteoarthritis and rheumatoid arthritis, during a period of 2 months. Assessment of pain and functional disability were made on a 10 cm horizontal visual analogue scale. The severity of osteoarthritis was evaluated by Lequesne's index.Spontaneous pain showed significant improvement. Similarly there was progressive and significant reduction in the Lequesne's functional index. At the completion of the study patients taking Atrisin were using less NSAIDs. Atrisin was tolerated well by the patients and there were no adverse cardiovascular or gastric effects reported. There was feeling of general well-being and compliance by the patients.

Pharmacological and clinical effectiveness of a fixed phytogenic combination trembling poplar (Populus tremula), true goldenrod (Solidago virgaurea) and ash (Fraxinus excelsior) in mild to moderate rheumatic complaints

Wien Med Wochenschr;149(8-10):248-53, 1999. Klein-Galczinsky C

Steigerwald Arzneimittelwerk GmbH, Darmstadt, Deutschland.

Resumo: Besides the well-known nonsteroidal antiinflammatory drugs (NSAID) for the treatment of rheumatic pain herbal medicine can also be applied successfully. Plants with antirheumatic efficacy include Fraxini cortex, Populi cortex/folia and Solidaginis herba. This review focuses on pharmacological and clinical efficacy of a combination of Fraxinus cortex, Populus cortex/folia and Solidago herba. Antiinflammatory and analgetic properties were shown in pharmacological tests. Clinical studies conducted in the indications of the different subtypes of rheumatic diseases such as rheumatoid arthritis or osteoarthritis pointed out a similar efficacy compared to NSAID applied in average dosages. Even the rate of adverse effects of the herbal combination was half of that registered in NSAID treated patients within the clinical studies.

Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study.

J Ethnopharmacol;33(1-2):91-5, 1991 May-Jun. Kulkarni RR; Patki PS; Jog VP; Gandage SG; Patwardhan B Bryamjee Jeejeebhoy Medical College, University of Poona, Pune, India.

Resumo: The clinical efficacy of a herbomineral formulation containing roots of Withania somnifera, the stem of Boswellia serrata, rhizomes of Curcuma longa and a zinc complex (Articulin-F), was evaluated in a randomized, double-blind, placebo controlled, cross-over study in patients with osteoarthritis. After a one-month single blind run-in period, 42 patients with osteoarthritis were randomly allocated to receive either a drug treatment or a matching placebo for a period of three months. After a 15-day wash-out period the patients were transferred to the other treatment for a further period of three months. Clinical efficacy was evaluated every fortnight on the basis of severity of pain, morning stiffness, Ritchie articular index, joint score, disability score and grip strength. Other parameters like erythrocyte sedimentation rate and radiological examination were carried out on a monthly basis. Treatment with the herbomineral formulation produced a significant drop in severity of pain (P less than 0.001) and disability score (P less than 0.05). Radiological assessment, however, did not show any significant changes in both the groups. Side effects observed with this formulation did not necessitate withdrawal of treatment.

External antirheumatic and antineuralgic herbal remedies in the traditional medicine of north-eastern Italy.

J Ethnopharmacol;6(2):161-90, 1982 Sep. Cappelletti EM; Trevisan R; Caniato R

Resumo: The utilization of more than 90 plant species as folk external remedies to treat rheumatic and arthritic diseases is reported, and their possible effectiveness is discussed according to present phytochemical and pharmacological knowledge. Some of the plant species used exhibit skin-irritant properties (protoanemonin, isothiocyanate or allicine yielding plants and species containing capsaicin, oleoresins, volatile oils, resinous principles, alkaloids). The effectiveness of other herbal remedies depends on their content of salicyl derivatives. A considerable number of the plant species utilized contain chemical products (triterpenoid or steroid compounds, alkaloids) for which anti-inflammatory properties have been demonstrated.

Enelbin rheumatism ointment in rheumatic diseases. Results of a double-blind study for the determination of efficacy

Enelbin-Rheuma-Salbe bei Erkrankungen des rheumatischen Formenkreises. Ergebnisse einer Doppelblind-Studie zum Wirksamkeitsnachweis..

Fortschr Med;97(28):1249-52, 1979 Jul 26. Bach GL; Fotiades P

Resumo: Enelbin-Rheuma-ointment and a reference ointment were compared with regard to effectiveness in a double-blind trial in 100 patients with gonarthrosis, osteoarthrosis of the spine and humeroscapular periarthropathy. Both ointments showed good results regarding spontaneous pain, pain on pressure and motion, reduction of mobility, swelling and muscular tension. The success of treatment was statistically significantly better in the Enelbin-Rheuma-ointment treated patients.

Pharmacology of sinomenine, an anti-rheumatic alkaloid from Sinomenium acutum.

Acta Med Okayama;30(1):1-20, 1976 Feb. Yamasaki H

Resumo: The root and stem decoctions of Sinomenium acutum Rehd. et Wils. (formerly Sinomenium diversifolius Diels, one type of Fang-chi (Chinese)) have been used as a folk remedy for neuralgia and rheumatoid arthritis in many areas of the Far East. In Japan and China various viny plants have been identified as Fang-chi (Boi in Japanese) since antiquity. This uncertain nomenclature has made it difficult to evaluate the efficacy of the Fang-chi described in the classic literature. Among traditional Fang-chi plants only Sinomeniumacutum has been demonstrated to contain the alkaloid sinomenine, which is now known to be effective in neuralgia and rheumatic diseases. Sinomenine is a unique plant alkaloid, as it potently releases histamine in association with degranulation of tissue mast cells in mammalian tissues. This action occurs preferentially in the skin and joint capsules. The released histamine is responsible for the dominant pharmacological actions of sinomenine, such as vasodilatation, increased vascular permeability, acceleration of the thoracic and peripheral lymph flow, contraction of plain muscles, increased peristalsis of the intestines, and stimulation of gastric acid secretion. At toxic doses of sinomenine, convulsive central excitation was observed in most laboratory animals. Clinical side effects encountered with high doses of injected sinomenine or of decocted Sinomenium acutum were: injection site flare, pruritus in the head and upper part of the body, edema around the lips and eyelids, and temporary cephalalgia. Most of these side effects were reduced by classical antihistamines (H1-receptor antagonists). Daily subcutaneous injections of sinomenine for more than one week produced an analgesic effect in mice. Granulation tissue growth and adjuvant arthritis induced in rats were both inhibited by daily injections of a small dose of sinomenine hydrochloride or histamine dihydrochloride. These inhibitory effects were mediated through histamine H2-receptors probably on fibroblasts (for granulation tissue growth) and on T-cells (for adjuvant arthritis), since these effects were clearly inhibited by the H2-antagonist burimamide but not by the H1-antagonist mepyramine. The anti-rheumatic effect on Sinomenium acutum are probably genuine and can probably be attributed to the histamine-releasing properties of sinomenine.

The inhibitory effect of common traditional anti-rheumatic herb formulas on prostaglandin E and interleukin 2 in vitro: a comparative study with Tripterygium wilfordii.

J Ethnopharmacol;62(2):167-71, 1998 Sep. Chou CT; Chang SC

Division of Rheumatology-Immunology, China Medical College Hospital, Taichung, Taiwan, ROC.

Resumo: To understand the clinical efficacy of traditional anti-rheumatic herbal medicines on acute and severe arthritis or immune diseases, four herbal formulas and one herb were tested in vitro to determine their effects on prostaglandin E2 (PGE2) and interleukin 2 (IL2). Peripheral blood mononuclear cells from healthy subjects were incubated with different concentrations of four herbal formulas including Shaur Yau Gan Tsao Tang (SYGTT), Shang Jong Shiah Tong Yong Tong Feng Wan (SJSTY), Shu Jin Lih An Saan (SJLAS), Ma Shing Yih Gan Tang (MSYGT) and one herb, Tripterygium wilfordii (T2) with and without mitogen stimulation. PGE2 and IL2 from culture supernatant were measured by enzyme immunoassay. The results showed that SYGTT, SJSTY, SJLAS at concentration of 100 microg and MSYGT at 500 microg/ml can significantly inhibit PGE2 release (P < 0.05) from mononuclear cells. However, T2 at 2 microg/ml expressed the same response. For the inhibition of IL2, the concentration of SYGTT, SJSTY and SJLAS must exceed 100 symbol microg/ml. MSYGT failed to inhibit IL2 at even concentrations of 500 microg/ml but T2 at a very low concentration (0.6 microg/ml) could strongly inhibit it. The findings suggest that the majority of traditional anti-rheumatic herbal formulas or herbs, except for T2, should not be used to treat acute and critical arthritis or immune diseases.

Local treatment of rheumatic diseases with propolis compounds

Orv Hetil;137(25):1365-70, 1996 Jun 23. Síró B; Szelekovszky S;Lakatos B; Mády G;Szathmári E; Karányi Z

Debreceni Orvostudományi Egyetem I. Belgyógyászati Klinika.

Resumo: The authors conducted a single blind, placebo controlled local therapy trial on a total of 190 patients involving the use of materials (i) topically and (ii) by iontophoresis for pain and/or inflammation of the organs of movement. The materials used comprised of the following: (i) purified propolis and propolis saturated with antiinflammatory trace metal elements and (ii) propolis saturated with trace metal elements and poplar bud ointment saturated with trace metal elements also. Both methods of application using all the three preparations significantly improved symptoms. The preparations saturated with metallic ions were more effective. The mild effect of the placebo treatment is explained by the treatment procedure itself. Side effects were not observed.

A combination of Populus tremula, Solidago virgaurea and Fraxinus excelsior as an anti-inflammatory and antirheumatic drug. A short review.

Arzneimittelforschung;45(2):169-71, 1995 Feb. von Kruedener S; Schneider W; Elstner EF

Lehrstuhl für Phytopathologie, Technische Universität München, Freising/Weihenstephan, Germany.

Resumo: Anti-inflammatory properties of Populus tremula are mainly deduced from its components, the well investigated salicylates. Solidago extracts have spasmolytic, antihypertensive and diuretic effects. Fraxinus excelsior itself has hardly been investigated, but its coumarin components proved to have a variety of pharmacological properties, i.e. inhibition of T-cell activation and of the arachidonic acid cascade. Phytodolor N (abbreviated as PD) is a combination of the above mentioned plants. Various in vitro and especially in vivo studies proved its anti-inflammatory and antirheumatic properties, often comparable to non-steroidal anti-inflammatories, but with little or no side effects.

Efeito Colateral

Possible toxicity of herbal remedies.

Scott Med J;43(1):7-15, 1998 Feb. Bateman J; Chapman RD; Simpson D

Department of Clinical Biochemistry, Royal Infirmary, Edinburgh.