Just in ( out?) this Interesting RCT with Type 2 diabetic patients using silymarin…milk thistle seems to be revealing itself as a major molecular multitasker….

The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Huseini HF, Larijani B, Heshmat R, Fakhrzadeh H, Radjabipour B, Toliat T, Raza M, Phytother Res. 2006 Oct 30;

Oxidative stresses are increasingly implicated in the pathogenesis of diabetic complications which may either cause direct pancreatic beta-cell damage or lead to metabolic abnormalities that can induce or aggravate diabetes. The valuable effect of antioxidant nutrients on the glycemic control of diabetic patients has been reported in experimental and clinical studies. The present study was designed to investigate the effects of the herbal medicine, Silybum marianum seed extract (silymarin), which is known to have antioxidant properties on the glycemic profile in diabetic patients. A 4-month randomized double-blind clinical trial was conducted in 51 type II diabetic patients in two well-matched groups. The first group (n = 25) received a silymarin (200 mg) tablet 3 times a day plus conventional therapy. The second group (n = 26) received the same therapy but a placebo tablet instead of silymarin. The patients were visited monthly and glycosylated hemoglobin (HbA(1)c), fasting blood glucose (FBS), insulin, total cholesterol, LDL and HDL, triglyceride, SGOT and SGPT levels were determined at the beginning and the end of the study. The results showed a significant decrease in HbA(1)c, FBS, total cholesterol, LDL, triglyceride SGOT and SGPT levels in silymarin treated patients compared with placebo as well as with values at the beginning of the study in each group. In conclusion, silymarin treatment in type II diabetic patients for 4 months has a beneficial effect on improving the glycemic profile. Copyright (c) 2006 John Wiley & Sons, Ltd.

PMID: 17072885 [PubMed - as supplied by publisher]

In an entirely bizarre aside, the latest Editorial in the Lancet admits that time pressed physicians only read MEDLINE abstracts to find “evidence based” information to guide clinical decisions. Well we all knew that didn’t we…?
Ironically the Editors were complaining about a journal supplement on sodium in the Journal of the American College of Nutrition which carries some unpeer-reviewed abstracts sponsored by a food manufacturing company. Heavens forbid!!! The Lancet’s ever vigilant guardians of truth omitted to say that an enormous chunk of so called “PUBMED citations” are actually neither research nor peer review at all, merely opinion, letters, or comments much like their own editorial.

The real value of this jackass editorial is the side “revelation” of the power of PubMed database TITLE and ABSTRACT FIELDS to underpin the entire edifice of mainstream misinformation..

“With over 16 million citations and 7 million abstracts, the National Library of Medicine’s MEDLINE has become an indispensable aid to research, diagnosis, and treatment. Health-care professionals, providers, and consumers around the world rely on this database as a trustworthy source of up-to-date information. Despite being designed as a retrieval tool, the fact is that for want of time, full-text access, or critical appraisal skills, many users depend solely on MEDLINE abstracts to inform decisions about care. Yet abstracts are known to be fickle representations of an article; it is the full text in which details of methods, funding, and conflicts of interest are found.”

Lancet . Volume 368, Issue 9545 , 21 October 2006-27 October 2006, Page 1394

Nancy Cartwright, one of the sharpest knives in the drawer of modern philosophy of science mentions (in The Dappled World) a famous quote by Ian Hacking in reference to the existence of fundamental particles ” If you can spray them - they’re real”. In fact, Cartwright suggests a crucial modification - “WHEN you can spray them - they’re real.”

I was reminded of this comment on reading the abstract below - not that I have anything against mass spectrometry, but if the overall conclusion is that kava root contains kavalactones, is this not all a little like cracking a herbal walnut with a technological sledge hammer…

Fourier transform ion cyclotron resonance mass spectrometry for the characterisation of kavalactones in the kava plant: elemental formulae confirmation by dual spray accurate mass measurement and structural confirmation by infrared multiphoton dissociation and sustained off-resonance irradiation collision induced dissociation.

Eur J Mass Spectrom (Chichester, Eng). 2006;12(4):223-233

Authors: Warburton E, Bristow T

Roots and extracts of the kava plant have been used in herbal medicine to treat sleep disturbances, stress and anxiety, although reported cases of liver toxicity led to many countries restricting its sale. The detection of the presence of kava in many medicinal products requires the use of methods capable of identifying the kavalactones with high certainty. Here we describe the use of FT-ICR-MS for the characterisation of six kavalactones (kavain, dihydrokavain, methysticin, dihydromethysticin, yangonin and desmethoxyyangonin) utilising accurate mass measurement for the determination of their elemental formulae and product ion MS (both SORI-CID and IRMPD) for structural confirmation. HPLC-FT-ICR-MS with a dual spray system for internal calibration of mass spectra was employed for accurate mass measurement and the determination of elemental formulae of the kavalactones in both standards and a root extract to confirm the presence of the kavalactones in the root powder. Mass accuracy of < 1ppm was achieved. For structural confirmation, the IRMPD and SORI-CID spectra of the kavalactones in standards and a kava root powder extract were compared. Accurate mass measurement of the product ions was also conducted by external calibration and the elemental formula determined to aid with structural confirmation. The presence of the same fragment ions detected in the standards as in the extract further confirmed the presence of the kavalactones in the kava root powder with high certainty.

PMID: 17057279 [PubMed - as supplied by publisher]

This study from Italy found that hexane extracts of E. pallida root induced apoptosis in an in vitro model using pancreatic and colon cancer cell lines. The effective concentrations of extract were high (100 micrograms/mL) and the mechanism suggested was caspase activation. The authors of the paper do not seem especially familiar with the echinacea literature, because although they mention the Miller data on NK cell activation, they also cite the appalling review paper by Sparreboom about herb drug interactions in oncology as an authority on “duration of use limits” with echinacea - which latter is not only the biggest myth in the business but has been clearly debunked by the same Sandra Miller.(see HERBLOG 58)

Hopefully however this paper will promote more research into the anticancer potential of the herb instead of the ridiculous and endless RCTs aimed at determining whether “echinacea works for colds”.(yawn)

Chicca, A., B. Adinolfi, et al. “Cytotoxic effects of Echinacea root hexanic extracts on human cancer cell lines.” Journal of Ethnopharmacology In Press, Corrected Proof.
Echinacea is one of the most widely used alternative medicine in the world. Intake of Echinacea preparations is common among patients with advanced malignancies enrolled onto phase I chemotherapy trials; however, to our knowledge, no data are available regarding the possible direct effect of Echinacea species on human cancer cells. The purpose of the present study was to investigate potential in vitro cytotoxic and pro-apoptotic properties of hexanic root extract of the three medicinal Echinacea (Asteraceae) species (Echinacea pallida (Nutt.) Nutt., Echinacea angustifolia DC. var. angustifolia, Echinacea purpurea (L.) Moench.) on the human pancreatic cancer MIA PaCa-2 and colon cancer COLO320 cell lines. We demonstrated, for the first time, that all the three species reduced cell viability in a concentration- and time-dependent manner; Echinacea pallida was the most active species with IC50s of 46.41 +/- 0.87 and 10.55 +/- 0.70 [mu]g/ml in MIA PaCa-2 and COLO320 cells, respectively. Echinacea pallida extract was able to induce apoptosis by increasing significantly caspase 3/7 activity and promoting nuclear DNA fragmentation. These results represent the starting point to establish viable scientific evidence on the possible role of Echinacea species in medical oncology.

Here is a great example of the depths of futile stupidity that modern meta-analysis can reach sometimes. Valerian, known for many centuries as a calming herb apparently lacks evidence for efficacy in “anxiety disorders”. That is mainly because the reviewers could only find ONE trial (n=36) that met their criteria. The banality of the exercise is hard to credit…

Of course, although Cochrane was one of the original proponents of RCTs, and later of systematic reviews, he was not stupid. The so called Cochrane collaboration was established several years after he passed away in 1993. Cochrane was an alum of my old school - King’s College Cambridge, and was, typically for King’s, a leftie. After graduating medical school he went to fight against Franco in the Spanish Civil War and later did most of his doctoring as a POW in various camps during WW2 after being captured. Links to his biography are available on the Cochrane collaboration site. Anyway, poor old Archie Cochrane would be turning in his grave if he knew what was going on his name…

Miyasaka L, Atallah A, Soares B Valerian for anxiety disorders. Cochrane Database Syst Rev. 2006;(4):CD004515

BACKGROUND: Anxiety disorders are very common mental health problems in the general population and in primary care settings. Herbal medicines are popular and used worldwide and mght be considered as a treatment option for anxiety if shown to be effective and safe. OBJECTIVES: To investigate the effectiveness and safety of valerian for treating anxiety disorders. SEARCH STRATEGY: Electronic searches: The Cochrane Collaboration Depression, Anxiety and Neurosis Cochrane Controlled Trials Register (CCDANCTR-Studies and CCDANCTR-References) searched on 04/08/2006, MEDLINE, Lilacs. References of all identified studies were inspected for additional studies. First authors of each included study, manufacturers of valerian products, and experts in the field were contacted for information regarding unpublished trials. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-randomised trials of valerian extract of any dose, regime, or method of administration, for people with any primary diagnosis of general anxiety disorder, anxiety neurosis, chronic anxiety status, or any other disorder in which anxiety is the primary symptom (panic disorder, obsessive compulsive disorder, social phobia, agoraphobia, other types of phobia, postraumatic stress disorder). Effectiveness was measured using clinical outcome measures and other scales for anxiety symptoms. DATA COLLECTION AND ANALYSIS: Two review authors independently applied inclusion criteria, extracted and entered data, and performed the trial quality assessments. Where disagreements occured, the third review author was consulted. Methodological quality of included trials was assessed using Cochrane Handbook criteria. For dichotomous outcomes, relative risk (RR) was calculated, and for continuous outcomes, the weighted mean difference (WMD) was calculated, with their respective 95% confidence intervals. MAIN RESULTS: One RCT involving 36 patients wih generalised anxiety disorder was eligible for inclusion. This was a 4 week pilot study of valerian, diazepam and placebo. There were no significant differences between the valerian and placebo groups in HAM-A total scores, or in somatic and psychic factor scores. Similarly, there were no significant differences in HAM-A scores between the valerian and diazepam groups, although based on STAI-Trait scores, significantly greater symptom improvement was indicated in the diazepam group. There were no significant differences between the three groups in the number of patients reporting side effects or in dropout rates. AUTHORS’ CONCLUSIONS: Since only one small study is currently available, there is insufficient evidence to draw any conclusions about the efficacy or safety of valerian compared with placebo or diazepam for anxiety disorders. RCTs involving larger samples and comparing valerian with placebo or other interventions used to treat of anxiety disorders, such as antidepressants, are needed.PMID: 17054208 [PubMed - in process]

Aromatherapy for travel-induced excitement in dogs. Wells DL J Am Vet Med Assoc. 2006 Sep 15;229(6):964-7

OBJECTIVE: To evaluate the efficacy of the ambient odor of lavender as a treatment for travel-induced excitement in dogs. DESIGN: Clinical trial. Animals-32 dogs with a history of travel-induced excitement in owners’ cars. PROCEDURES: Each dog was studied during travel in the owner’s car to a familiar walking site during 2 conditions of olfactory stimulation. The first condition was a control condition, during which dogs were exposed to no odor other than that arising naturally from the environment. The second condition was an experimental condition during which dogs were exposed to the ambient odor of lavender. Dogs’ behavior was recorded during the car journey for 3 consecutive days under the control condition and for 3 consecutive days under the experimental condition. The percentage of time spent moving, standing, sitting, resting, and vocalizing in each condition of olfactory stimulation was quantified for each dog. RESULTS: Dogs spent significantly more time resting and sitting and less time moving and vocalizing during the experimental condition. There was no significant relationship between dogs’ behavior and sex, castration status, day, or the order of exposure to each olfactory condition. CONCLUSIONS AND CLINICAL RELEVANCE: Traditional treatments for travel-induced excitement in dogs may be time-consuming, expensive, or associated with adverse effects. Aromatherapy in the form of diffused lavender odor may offer a practical alternative treatment for travel-induced excitement in this species.

Huang Q, Lu G, Shen HM, Chung MC, Ong CN Med Res Rev. 2006 Oct 4; Anti-cancer properties of anthraquinones from Rhubarb.

Rhubarb has been used as a traditional Chinese medicine since ancient times and today it is still present in various herbal preparations. In this review the toxicological and anti-neoplastic potentials of the main anthraquinones from Rhubarb, Rheum palmatum, will be highlighted. It is interesting to note that although the chemical structures of various anthraquinones in this plant are similar, their bioactivities are rather different. The most abundant anthraquinone of rhubarb, emodin, was capable of inhibiting cellular proliferation, induction of apoptosis, and prevention of metastasis. These capabilities are reported to act through tyrosine kinases, phosphoinositol 3-kinase (PI3K), protein kinase C (PKC), NF-kappa B (NF-kappaB), and mitogen-activated protein kinase (MAPK) signaling cascades. Aloe-emodin is another major component in rhubarb found to have anti-tumor properties. Its anti-proliferative property has been demonstrated to be through the p53 and its downstream p21 pathway. Our recent proteomic study also suggests that the molecular targets of these two anthraquinones are different. However, both components were found to be able to potentiate the anti-proliferation of various chemotherapeutic agents. Rhein is the other major rhubarb anthraquinone, although less well studied. This compound could effectively inhibit the uptake of glucose in tumor cells, caused changes in membrane-associated functions and led to cell death. Interestingly, all three major rhubarb anthraquinones were reported to have in vitro phototoxic. This re-evaluation of an old remedy suggests that several bioactive anthraquinones of rhubarb possess promising anti-cancer properties and could have a broad therapeutic potential. (c) 2006 Wiley Periodicals, Inc. Med Res Rev.

PMID: 17022020 [PubMed - as supplied by publisher]

This is a rat study. Still….

Zingiber officinale exhibits behavioral radioprotection against radiation-induced CTA in a gender-specific manner. Haksar A, Sharma A, Chawla R, Kumar R, Arora R, Singh S, Prasad J, Gupta M, Tripathi RP, Arora MP, Islam F, Sharma RK Pharmacol Biochem Behav. 2006 Jun;84(2):179-88

At the organismic level, exposure to radiation can produce taste aversion (CTA) learning and emesis, which have been proposed as behavioral endpoints that are mediated by harmful effects of radiations on peripheral systems, primarily the gastrointestinal system. Thus, the aim of the present investigation was to study the gastroprotective action of hydroalcoholic extract of zingiber rhizome (Zingiber officinale Rosc.) against radiation-induced conditioned taste aversion (CTA) in both male and female species of animals, for testing its potential as a behavioral radioprotector. Administration of zingiber extract 1 h before 2-Gy gamma-radiation was significantly effective in blocking the saccharin avoidance response, with 200 and 250 mg/kg b.wt. i.p., being the most effective doses for male and female rats, respectively. A comparison of the efficacy of zingiber extract with two antiemetic drugs, ondansteron and dexamethasone, revealed that the extract rendered comparable protection against radiation-induced CTA. Our experiments also confirmed the existence of sex dichotomy (i.e., the sex of animal greatly influenced response towards radiation exposure) in relation to behavioral responses (CTA) or differential metabolism. The observed gender variations were hypothesized to be a result of hormonal fluctuations and differences in pharmacological parameters in male and female rats. To correlate the mechanism of action, the free-radical-scavenging potential of zingiber extract to scavenge hydroxyl ion and nitric oxide was also tested, in cell-free system and a concentration of 1000 microg/ml, was found to be the most potent, which has been proposed as one the many activities assisting in its overall ability to modulate radiation-induced taste aversion. The results demonstrate that Z. officinale possesses antioxidant, radioprotective and neuromodulatory properties that can be effectively utilized for behavioral radioprotection and for efficiently mitigating radiation-induced CTA in both males and females species.

PMID: 16797061 [PubMed - indexed for MEDLINE]

Check out the hilarious last line of this abstract - “Botanicals should be used with caution by cancer patients and only under the guidance of an oncologist knowledgeable in their use” .

Of course it would be funny if it were not for the tragic fact that cancer patients are subject to an endless campaign of misinformation regarding herbal medicine - which in reality of course can help people with cancer in so many ways.

Complementary medicine in palliative care and cancer symptom management.
Mansky PJ, Wallerstedt DB Cancer J. 2006 Sep-Oct;12(5):425-31
Complementary and alternative medicine (CAM) use among cancer patients varies according to geographical area, gender, and disease diagnosis. The prevalence of CAM use among cancer patients in the United States has been estimated to be between 7% and 54%. Most cancer patients use CAM with the hope of boosting the immune system, relieving pain, and controlling side effects related to disease or treatment. Only a minority of patients include CAM in the treatment plan with curative intent. This review article focuses on practices belonging to the CAM domains of mind-body medicine, CAM botanicals, manipulative practices, and energy medicine, because they are widely used as complementary approaches to palliative cancer care and cancer symptom management. In the area of cancer symptom management, auricular acupuncture, therapeutic touch, and hypnosis may help to manage cancer pain. Music therapy, massage, and hypnosis may have an effect on anxiety, and both acupuncture and massage may have a therapeutic role in cancer fatigue. Acupuncture and selected botanicals may reduce chemotherapy-induced nausea and emesis, and hypnosis and guided imagery may be beneficial in anticipatory nausea and vomiting. Transcendental meditation and the mindfulness-based stress reduction can play a role in the management of depressed mood and anxiety. Black cohosh and phytoestrogen-rich foods may reduce vasomotor symptoms in postmenopausal women. Most CAM approaches to the treatment of cancer are safe when used by a CAM practitioner experienced in the treatment of cancer patients. The potential for many commonly used botanical to interact with prescription drugs continues to be a concern. Botanicals should be used with caution by cancer patients and only under the guidance of an oncologist knowledgeable in their use.

PMID: 17034678 [PubMed - in process]

Nice to see herbal smokes being taken seriously….
Medicinal smokes. Mohagheghzadeh A, Faridi P, Shams-Ardakani M, Ghasemi Y. J Ethnopharmacol. 2006 Sep 9; epub ahead of print

All through time, humans have used smoke of medicinal plants to cure illness. To the best of our knowledge, the ethnopharmacological aspects of natural products’ smoke for therapy and health care have not been studied. Mono- and multi-ingredient herbal and non-herbal remedies administered as smoke from 50 countries across the 5 continents are reviewed. Most of the 265 plant species of mono-ingredient remedies studied belong to Asteraceae (10.6%), followed by Solanaceae (10.2%), Fabaceae (9.8%) and Apiaceae (5.3%). The most frequent medical indications for medicinal smoke are pulmonary (23.5%), neurological (21.8%) and dermatological (8.1%). Other uses of smoke are not exactly medical but beneficial to health, and include smoke as a preservative or a repellent and the social use of smoke. The three main methods for administering smoke are inhalation, which accounts for 71.5% of the indications; smoke directed at a specific organ or body part, which accounts for 24.5%; ambient smoke (passive smoking), which makes up the remaining 4.0%. Whereas inhalation is typically used in the treatment of pulmonary and neurological disorders and directed smoke in localized situations, such as dermatological and genito-urinary disorders, ambient smoke is not directed at the body at all but used as an air purifier. The advantages of smoke-based remedies are rapid delivery to the brain, more efficient absorption by the body and lower costs of production. This review highlights the fact that not enough is known about medicinal smoke and that a lot of natural products have potential for use as medicine in the smoke form. Furthermore, this review argues in favor of medicinal smoke extended use in modern medicine as a form of drug delivery and as a promising source of new active natural ingredients.

PMID: 17030480 [PubMed - as supplied by publisher]