Kava and St. John's wort : current evidence for use in mood and anxiety disorders

Background: Mood and anxiety disorders pose significant health burdens on the community. Kava and St John’s wort (SJW) are the most commonly used herbal medicines in the treatment of anxiety and depressive disorders, respectively. Objectives: To conduct a comprehensive review of kava and SJW, to review any evidence of efficacy, mode of action, pharmacokinetics, safety and use in Major Depressive Disorder (MDD), Bipolar Disorder (BP), Seasonal Affective Disorder (SAD), Generalized Anxiety Disorder (GAD), Social Phobia (SP), Panic Disorder (PD), Obsessive-Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD). Methods: A systematic review was conducted using the electronic databases MEDLINE, CINAHL, and The Cochrane Library during late 2008. The search criteria involved mood and anxiety disorder search terms in combination with kava, Piper methysticum, kavalactones, St John’s wort, Hypericum perforatum, hypericin and hyperforin. Additional search criteria for safety, pharmacodynamics , and pharmacokinetics was employed. A subsequent forward search was conducted of the papers using Web of Science cited reference search. Results: Current evidence supports the use of SJW in treating mild-moderate depression, and for kava in treatment of generalized anxiety. In respect to the other disorders, only weak preliminary evidence exists for use of SJW in SAD. Currently there is no published human trial on use of kava in affective disorders, or in OCD, PTSD, PD or SP. These disorders constitute potential applications that warrant exploration. Conclusions: Current evidence for herbal medicines in the treatment of depression and anxiety only supports the use of Hypericum perforatum for depression, and Piper methysticum for generalized anxiety.

Potential of St John's Wort for the treatment of depression : the economic perspective

The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with complementary and alternative medicines. Meta-analyses of randomized controlled trials have found Hypericum perforatum preparations to be superior to placebo and similarly effective as standard antidepressants in the acute treatment of mild to moderate depression. A clear advantage over antidepressants has been demonstrated in terms of the reduced frequency of adverse effects and lower treatment withdrawal rates, low rates of side effects and good compliance, key variables affecting the cost-effectiveness of a given form of therapy. The most important risk associated with use is potential interactions with other drugs, but this may be mitigated by using extracts with low hyperforin content. As the indirect costs of depression are greater than five times direct treatment costs, given the rising cost of pharmaceutical antidepressants, the comparatively low cost of Hypericum perforatum extract makes it worthy of consideration in the economic evaluation of mild to moderate depression treatments.

中国黑龙江省嘉荫地区乌云组古果实学研究

白垩纪末至第三纪初（K/T界限，距今约65Ma），恐龙大规模灭绝，爬行类的优势地位被哺乳动物所取代;裸子植物和蕨类急剧衰退，被子植物蓬勃发展，并逐渐成为地表植被的主体，研究这一时期的植物群的结构和特征进而揭示植物演化和环境变迁的规律及其相互关系是当今地球科学、生命科学和环境科学的重要研究内容。黑龙江省嘉荫地区的乌云组产有丰富的植物化石，其地质时代虽未定论，但不超出晚白垩世马斯特里赫特期至早第三纪古新世的范围，处于K/T界限，对其植物群的研究意义重大。乌云植物群以往的研究在古果实学研究方面明显不足、在植物群的性质的认识及乌云组时代的确定等方面存在很大争议。本文重点研究了乌云组的果实和种子化石，增添了新的植物类群，丰富了此植物群的研究内容，对乌云组的时代问题的确定提供了新的证据。 本文研究了乌云组的Nordenskioldia borealis（昆兰树科）、Nyssidium jianyinense sp. nov. （连香树科）、Hypericum zhuii sp. nov. （金丝桃科）、Amersinia obtrullate（广义山茱萸科）、Acer wuyunense sp. nov.（槭树科）等5种果实和种子化石。Nordenskioldia borealis的果无柄、为分果、小果瓣环绕中央柱轮状排列。Nyssidium jianyinense的果序为圆锥果序、蓇葖对生、蓇葖腹缝相对、果皮三层。Hypericum zhuii的种子外形呈长椭圆形、端部具乳突、表面网状、种脊明显、种皮两层、外种皮细胞的垂周壁明显加厚。Amersinia obtrullate果序头状、果镘形、3果室。Acer wuyunense果为翅果、小坚果被明显侧翼、翅强烈下延，包围小坚果。经修订和补充，乌云植物群目前共有维管植物48属60种，其中，蕨类植物4属6种、裸子植物7属7种、被子植物37属48种，被子植物占总种数的80%、占总属数的77%，被子植物占绝对优势。当时的群落类型湿生群落和中生群落类型为主，湿生群落主要有：由Sequoia、Metasequoia、Taxodium、Glyptostrobus等组成的针叶林;以Nyssidium、Trochodendroides占优势的阔叶林。 以Metasequoia占优势的针叶林和以Nyssidium、Trochodendroides等占优势的阔叶林。乌云植物群中热带和亚热带成分占种子植物总属数的54%，而温带成分则占36%，亚热带成分占优势，当时的气候-植被类型为亚热带常绿林或常绿夏绿混交林。Nordenskioldia、Nyssidium、Amersinia、Acer化石的地质分布不早于古新世的地层，这—证据不支持乌云组的地质时代划为晚白垩世，而支持划归古新世的观点。

青蒿开花与青蒿素生物合成相关性的研究-金丝桃和百金花二苯甲酮合酶基因的克隆，异源表达及功能分析

第一部分：青蒿开花与青蒿素生物合成相关性的研究 青蒿素是从中药青蒿中分离出的倍半萜内酯化合物，目前是世界上唯一有效的治疗脑型疟疾和抗氯喹恶性疟疾的药物。青蒿植株中青蒿素含量在开花期最高，但是目前尚不清楚开花与青蒿素生物合成的关系。为此，我们用光周期（短日照）诱导青蒿提前开花，不仅同时获得了开花与不开花的青蒿植株，而且还成功地在同一植株上诱导部分分枝开花，另一部分分枝保持营养生长状态。这一实验体系为研究青蒿开花与青蒿素生物合成的相关性奠定了基础。实验结果表明，开花与不开花青蒿植株青蒿素含量有明显差异。开花植株的青蒿素含量在前2周内逐渐提高，第三周（开花期）达到最高，并保持一周左右，在随后的2周内下降。青蒿植株开花后，叶片便开始老化变黄，逐渐死亡。未开花青蒿植株的青蒿素含量动态在前三周内与开花植株类似，但是这种高青蒿素含量状态能保持较长时间，至少在随后的2周内没有下降。未开花植株的叶片依然保持绿色。这一结果表明，开花不是导致青蒿素含量提高的直接原因。 扫描电镜观察结果表明，幼嫩叶片上的毛状腺体( trichrome)结构是完整的，而在老化的叶片上，则观察到了相当比例(40-50%)破损的腺体。这可能是导致青蒿素含量下降的直接原因。 不同生态型青蒿对光周期的反应是不同的。在北京地区，本地青蒿在8月初便开始开花，而来自四川武陵的青蒿则要到9月份才能开花。根据这一特性，采用“南蒿北栽”的方法，能够使青蒿保持较长时间的营养生长状态，延长适于采收的时间。 第二部分：金丝桃和百金花二苯甲酮合酶基因的克隆，异源表达及功能分析 植物次生代谢物山屯酮( Xanthones)仅存在于龙胆科和藤黄科植物中。它们具有抑制单胺氧化酶，细胞毒素及抗肿瘤活性。 含有1 3个碳原子的二苯甲酮是山屯酮生物合成的中间产物，是由二苯甲酮合酶催化合成的，这一反应是山屯酮生物合成的关键步骤。二苯甲酮合酶已经在金丝桃和百金花细胞悬浮培养系统中检测到，并进行了细致的生化水平上的研究。本研究是在上述研究的基础上，进一步克隆该酶的基因，并进行异源表达及功能分析工作，以便更好地了解和调控山屯酮的生物合成。 用PCR和RT-PCR技术，从金丝桃cDNA文库和逆转录产物中分别克隆到一个基因HBPS1和HBPS2，从百金花cDNA文库中克隆到一个基因CBPS1。HBPS1含有1402个碱基，其开放阅读框架编码390个氨基酸，分子量为42.7 kDa，等电点为6.55。HBPS2含有1398个碱基，其开放阅读框架编码395个氨基酸，分子量为42.8 kDa，等电点为5.78。CBPS1含有1383个碱基，其开放阅读框架编码389个氨基酸，分子量为42.7 kDa，等电点为7.88。与GenBank中序列同源性比较结果表明：在氨基酸水平上，HBPS1与茶（Camellia sinensis）查尔酮合酶的同源性高达92%，HBPS2与萝卜（Raphanus sativus）查尔酮合酶的同源性为64%，CBPS1与茶（Camellia sinensis）查尔酮合酶的同源性为71%。HBPS1与HBPS2的同源性仅为62%。 将三个新克隆的基因的ORF整合到载体pGEX-G上的谷胱甘肽还原酶S基因下游，构建成转化质粒，并在大肠杆菌中诱导表达。结果表明，这三个基因的ORF片段均能被表达成约68 kDa的产物，这与期望的结果一致。 活性检测结果表明，HBPS1是查尔酮合成酶，其底物为香豆酰辅酶A和丙二酸单酰辅酶A，对这两种底物的亲和性KM分别为：香豆酰辅酶A 2.8μM，丙二酸单酰辅酶A，11.2μM。最适反应条件是350C，pH7.0，DTT浓度10 μM。 HBPS2是二苯甲酮合酶，其底物是苯甲丙氨酰辅酶A，和丙二酸单酰辅酶A，对这两种底物的亲和性KM分别为：苯甲丙氨酰辅酶A 2.4 μM，丙二酸单酰辅酶A 9.6μM。最适反应条件是350C，pH 6.5，DTT浓度50 μM。而CBPS1则没有检测到任何活性。从同一种植物中同时获得了查尔酮合酶和二苯甲酮合酶，对研究这两种十分相近的酶的差异表达，酶促反应机制等问题将非常有利。

Herbal medicine: the science of the art

In the last 50 years science has provided new perspectives on the ancient art of herbal medicine. The present article discusses ways in which the evidence base for the professional use of 'Western' herbal medicine, as therapy to treat disease, known as phytotherapy, can be strengthened and developed. The evidence base for phytotherapy is small and lags behind that for the nutritional sciences, mainly because phytochemicals are ingested as complex mixtures that are incompletely characterised and have only relatively recently been subject to scientific scrutiny. While some methodologies developed for the nutritional sciences can inform phytotherapy research, opportunities for observational studies are more limited, although greater use could be made of patient case notes. Randomised clinical trials of single-herb interventions are relatively easy to undertake and increasing numbers of such studies are being published. Indeed, enough data are available on three herbs (ginkgo (Ginkgo biloba), St John's wort (Hypericum perforatum) and saw palmetto (Serenoa repens)) for meta-analyses to have been undertaken. However, phytotherapy is holistic therapy, using lifestyle advice, nutrition and individually-prescribed mixtures of herbs aimed at reinstating homeostasis. While clinical experience shows that this approach is applicable to a wide range of conditions, including chronic disease, evidence of its efficacy is scarce. Strategies for investigating the full holistic approach of phytotherapy and its main elements are discussed and illustrated through the author's studies at the University of Reading.

Effect of antidepressants on melatonin metabolite in depressed patients

Antidepressants increase melatonin levels, but it is still unclear whether this effect is related to the improvement of depressive symptoms or to unrelated pharmacological action of antidepressants. To answer this question, the effect of antidepressants on 6-sulphatoxymelatonin (aMT6s), the main melatonin urinary metabolite, was examined in drug-free depressed patients - most of them antidepressant-naive. aMT6s was evaluated in 34 depressed patients, before and after 8 weeks of placebo (n = 12) or antidepressant (n = 22; fluoxetine, duloxetine or Hypericum perforatum). Both groups showed an improvement of depressive symptoms after treatment compared to baseline (Hamilton Depression scores): 17.0 +/- 1.4 vs. 9.0 +/- 2.8, P = 0.007 for placebo, and 18.6 +/- 1.1 vs. 11.8 +/- 1.6, P < 0.001 for antidepressants). After treatment, aMT6s levels increased after antidepressants (P < 0.01), but not after placebo (P > 0.05). As depressive symptoms improved both in patients taking antidepressant and in those taking placebo, but an effect of antidepressants could only be seen in those taking antidepressants, we suggest that melatonin changes after antidepressants are more likely due to a pharmacological action of these drugs on melatonin secretion.

Estudo da qualidade da informação constante nas bulas dos principais medicamentos fitoterápicos registrados no Brasil

Os objetivos deste trabalho foram: fazer um levantamento das dez espécies vegetais que compõem o maior número de apresentações farmacêuticas de fitoterápicos simples registradas na ANVISA; realizar o diagnóstico da oferta e da qualidade das informações contidas nas bulas das apresentações contendo as cinco espécies vegetais mais utilizadas; e definir as informações técnicas que devem estar contidas na bula de especialidades farmacêuticas que contenham como ingredientes ativos unicamente extratos preparados a partir destas espécies. O levantamento das dez espécies vegetais abrangeu o período de 01/01/1998 a 30/06/2003 e foi realizado através de consulta ao OPTLINE (www.i-helps.com). Os medicamentos fitoterápicos representam 7,76% (1888) das apresentações de registro de medicamentos no Brasil, sendo 1311 (5,38 %) apresentações de medicamentos fitoterápicos simples. Cinqüenta e oito espécies vegetais constituíam os registros de medicamentos fitoterápicos simples, sendo as dez com maior número de apresentações Ginkgo biloba L.: 302 (23,04%); Hypericum perforatum L.: 126 (9,61%); Piper methysticum F.: 87 (6,64%); Cimicifuga racemosa Nutt: 79 (6,03%); Valeriana officinalis L.: 76 (5,80%); Vitis vinifera L.: 69 (5,26%); Echinacea purpurea L.: 58 (4,42%); Aesculus hippocastanum L.: 53 (4,04%); Panax ginseng C. A Mayer: 48 (3,66%) e Cynara scolymus L.: 31 (2,36%). O diagnóstico da oferta e da qualidade das informações contidas nos textos das bulas foi realizado comparando-se estas informações com aquelas apresentadas na base de dados Medline (PubMed - www.ncbi.nhm.nhi.gov) dos últimos 5 anos e em obras bibliográficas de referência aceitas pela ANVISA, além de outras, clássicas na área de farmacognosia e fitoterapia . Foram avaliadas vinte e oito bulas. As informações de todas as bulas apresentavam incompatibilidades com as informações da literatura consultada. Os problemas mais freqüentemente encontrados foram relativos à sinonímia popular, eficácia, via de administração, contra-indicações, uso em idosos, crianças e grupos de risco, reações adversas e interações medicamentosas. Para cada uma das cinco espécies mais citadas, as informações científicas e técnicas compiladas foram organizadas como uma proposta de bula para o Profissional de Saúde a ser incluída no Compêndio de Bulas de Medicamentos (CBM), conforme previsto na Resolução-RDC nº 140/03, o qual consiste em um conjunto de bulas de medicamentos comercializados, editado pelo órgão regulador e com conteúdo da bula para o paciente e da bula para o profissional de saúde.

Enraizamento de plantas cultivadas in vitro

The adventitious rooting process of in vitro cultured plantlets is a technique that has been employed for the vegetative propagation of a significant number of native and exotic species. Many factors are associated with the rooting stage influencing positive and/or negatively the establishment of micropropagation protocols. The objective of this work was a literature review of the main inherent factors concerning in vitro rooting process including the correlation among others the endogenous and exogenous auxins levels, juvenility, genotype, mineral nutrition, culture medium conditions, addition of growth regulators and other substances as phenolic compounds and active coal besides growth environmental conditions of in vitro cultures. Although the complete elucidation of all processes involved with rooting of in vitro cultured plants has not been achieved so far, a comprehensive study of the main factors that interfere on rooting is fundamental for the establishment of new researches that might contribute for the rooting of economically important plants.

Diversidade específica e de hábitat dos Cosmarium de parede lisa (Zygnemaphyceae) do estado de São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Local clinical phototreatment of herpes infection in Sao Paulo

The clinical use of topical photodynamic therapy in herpes simplex lesions in Sao Paulo is presented and discussed. Although previous attempts utilising this type of approach in the USA were discontinued in the early 1970s due to several presentations of post-treatment Bowen's disease, none of the cases from the clinic presented here have displayed any complications on follow-up. In addition, lesion recrudescence periods are generally much longer than with conventional approaches. This is thought to be due to improvements in the treatment protocol, viz, use of the non-toxic photosensitisers methylene blue and Hypericum perforatum extract in place of proflavine and neutral red in the original trials, differences in photosensitisation pathway and illumination of the treatment site with red rather than fluorescent/UV light. Post-treatment cosmesis is also excellent. (C) 2012 Elsevier B.V. All rights reserved.

Zentrale cholinerge Wirkungen von Hyperforin, einem Inhaltsstoff des Johanniskrauts

Die vorliegende Arbeit beschreibt die Wirkung von Hyperforin, einem Johanniskraut-Inhaltsstoff, auf das zentrale cholinerge System. Da der HACU Na+-abhängig operiert und Hyperforin den transmembranären Na+-Gradienten verringert, wurde an Rattenkortex-Synaptosomen in vitro geprüft, ob der HACU durch Hyperforin gehemmt wird. Es wurde gefunden, dass Hyperforin den HACU mit einer Hemmkonstante IC50 von 8.5 µM inhibiert. Da die de novo-ACh-Synthese direkt HACU-Aktivitäts-abhängig ist, wurde in vivo mittels Mikrodialyse-Technik verifziert, ob die cholinerge Transmission beeinflusst wird. Lokale Infusionen von 100 µM Hyperforin in das Striatum resultierten in einer Reduktion der ACh-Freisetzung bei parallelem Ch-Spiegel-Anstieg bedingt durch die HACU-Inhibition. Infusionen niedrigerer Konzentration (10 und 30 µM) führten hingegen zu einer konzentrations-abhängigen Stimulation der ACh-Freisetzung bei simultaner Ch-Spiegel-Senkung. Systemische Applikation von 1 und 10 mg/kg i.p. resultierten in einer verstärkten ACh-Freisetzung im Striatum und im Hippokampus; diese Dosen führen zu therapeutisch relevanten Plasmaspiegeln. Die Ergebnisse im Striatum und im Hippokampus erklären die motilitätsverringernden Effekte im Tierexperiment bzw. die benignen Effekte in Verhaltensmodellen für Lernen und Gedächtnis. Die vergleichende Analyse der Mikrodialyse-Experimente ergab, dass eine antidepressive Johanniskraut-Begleitmedikation bei Parkinson ungünstig, jedoch Alzheimer günstig zu bewerten ist.

Post-surgical scalp wounds with exposed bone treated with a plant-derived wound therapeutic

To evaluate the efficacy of a plant-derived wound dressing, a mixture of hypericum oil (Hypericum perforatum) and neem oil (Azadirachta indica), in scalp wounds with exposed bone.

A homeopathic remedy from arnica, marigold, St. John's wort and comfrey accelerates in vitro wound scratch closure of NIH 3T3 fibroblasts

Background Drugs of plant origin such as Arnica montana, Calendula officinalis or Hypericum perforatum have been frequently used to promote wound healing. While their effect on wound healing using preparations at pharmacological concentrations was supported by several in vitro and clinical studies, investigations of herbal homeopathic remedies on wound healing process are rare. The objective of this study was to investigate the effect of a commercial low potency homeopathic remedy Similasan® Arnica plus Spray on wound closure in a controlled, blind trial in vitro. Methods We investigated the effect of an ethanolic preparation composed of equal parts of Arnica montana 4x, Calendula officinalis 4x, Hypericum perforatum 4x and Symphytum officinale 6x (0712–2), its succussed hydroalcoholic solvent (0712–1) and unsuccussed solvent (0712–3) on NIH 3T3 fibroblasts. Cell viability was determined by WST-1 assay, cell growth using BrdU uptake, cell migration by chemotaxis assay and wound closure by CytoSelect ™Wound Healing Assay Kit which generated a defined “wound field”. All assays were performed in three independent controlled experiments. Results None of the three substances affected cell viability and none showed a stimulating effect on cell proliferation. Preparation (0712–2) exerted a stimulating effect on fibroblast migration (31.9%) vs 14.7% with succussed solvent (0712–1) at 1:100 dilutions (p < 0.001). Unsuccussed solvent (0712–3) had no influence on cell migration (6.3%; p > 0.05). Preparation (0712–2) at a dilution of 1:100 promoted in vitro wound closure by 59.5% and differed significantly (p < 0.001) from succussed solvent (0712–1), which caused 22.1% wound closure. Conclusion Results of this study showed that the low potency homeopathic remedy (0712–2) exerted in vitro wound closure potential in NIH 3T3 fibroblasts. This effect resulted from stimulation of fibroblasts motility rather than of their mitosis.

Influence of an electromagnetic field on high dilutions measured by ultraviolet light spectroscopy

Background: High dilutions of various starting materials, e.g. copper sulfate, Hypericum perforatum and sulfur, showed significant differences from controls and amongst different dilution levels in ultraviolet light (UV) transmission [1,2]. Exposure of high dilutions to external physical factors such as UV light or elevated temperature (37°C) also yielded significantly different UV transmissions compared to unexposed dilutions [2,3]. In a study with highland frogs it was shown that animals incubated with thyroxine 30c but not with thyroxine 30c exposed to electromagnetic fields (EMFs) of a microwave oven or mobile phone metamorphosed more slowly than control animals [4]. Aims: The aim was to test whether the EMF of a mobile phone influences the UV absorbance of dilutions of quartz and Atropa belladonna (AB). Methodology: Commercially available dilutions of 6x, 12x, 15x, 30x in H2O and 19% ethanol of quartz (SiO2) and of 4x, 6x, 12x, 15x, 30x in H2O and 19% ethanol of AB were used in the experiments (Weleda AG, Arlesheim, Switzerland). Four samples of each dilution were exposed to the EMF of a mobile phone (Philips, Savvy Dual Band) at 900 MHz with an output of 2 W for 3 h, while control samples (4 of each dilution) were kept in a separate room. Absorbance of the samples in the UV range (from 190 to 340 nm) was measured in a randomized order with a Shimadzu UV-1800 spectrophotometer equipped with an auto sampler. In total 5 separate measurement days will be carried out for quartz and for AB dilutions. The average absorbance from 200 to 340 nm and from 200 to 240 nm was compared among dilution levels using a Kruskal-Wallis test and between exposed and unexposed samples using a Mann-Whitney-U test. Results: Preliminary results after 2 measurement days indicated that for quartz the absorbance of the various dilution levels was different from each other (except 12x and 15x), and that samples exposed to an EMF did not show a difference in UV absorbance from unexposed samples. Preliminary results after one measurement day indicated that for AB the absorbance of the various dilution levels was different from each other. The samples exposed to an EMF did not show a difference in UV absorbance from unexposed samples (except 4x in the range from 200 – 240 nm). Conclusions: These results suggest that exposure of high dilutions of quartz and AB to a mobile phone EMF as used here does not alter UV absorbance of these dilutions. The final results will show whether this holds true.