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      Phytomedicine in Joint Disorders

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          Abstract

          Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from pain-killers to biological agents) is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even though many of them have been proven effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarize the available scientific information on the following joint-friendly medicinal plants, which have been tested in human studies: Arnica montana, Boswellia spp., Curcuma spp., Equisetum arvense, Harpagophytum procumbens, Salix spp., Sesamum indicum, Symphytum officinalis, Zingiber officinalis, Panax notoginseng, and Whitania somnifera.

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          Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care.

          G. Peat, R. McCarney, P. Croft (2001)
          Osteoarthritis is the single most common cause of disability in older adults, and most patients with the condition will be managed in the community and primary care. To discuss case definition of knee osteoarthritis for primary care and to summarise the burden of the condition in the community and related use of primary health care in the United Kingdom. Narrative review. A literature search identified studies of incidence and prevalence of knee pain, disability, and radiographic osteoarthritis in the general population, and data related to primary care consultations. Findings from UK studies were summarised with reference to European and international studies. During a one year period 25% of people over 55 years have a persistent episode of knee pain, of whom about one in six in the UK and the Netherlands consult their general practitioner about it in the same time period. The prevalence of painful disabling knee osteoarthritis in people over 55 years is 10%, of whom one quarter are severely disabled. Knee osteoarthritis sufficiently severe to consider joint replacement represents a minority of all knee pain and disability suffered by older people. Healthcare provision in primary care needs to focus on this broader group to impact on community levels of pain and disability.
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            Ginger--an herbal medicinal product with broad anti-inflammatory actions.

            Reinhard Grzanna, Lars Lindmark, Carmelita Frondoza (2005)
            The anti-inflammatory properties of ginger have been known and valued for centuries. During the past 25 years, many laboratories have provided scientific support for the long-held belief that ginger contains constituents with antiinflammatory properties. The original discovery of ginger's inhibitory effects on prostaglandin biosynthesis in the early 1970s has been repeatedly confirmed. This discovery identified ginger as an herbal medicinal product that shares pharmacological properties with non-steroidal anti-inflammatory drugs. Ginger suppresses prostaglandin synthesis through inhibition of cyclooxygenase-1 and cyclooxygenase-2. An important extension of this early work was the observation that ginger also suppresses leukotriene biosynthesis by inhibiting 5-lipoxygenase. This pharmacological property distinguishes ginger from nonsteroidal anti-inflammatory drugs. This discovery preceded the observation that dual inhibitors of cyclooxygenase and 5-lipoxygenase may have a better therapeutic profile and have fewer side effects than non-steroidal anti-inflammatory drugs. The characterization of the pharmacological properties of ginger entered a new phase with the discovery that a ginger extract (EV.EXT.77) derived from Zingiber officinale (family Zingiberaceae) and Alpina galanga (family Zingiberaceae) inhibits the induction of several genes involved in the inflammatory response. These include genes encoding cytokines, chemokines, and the inducible enzyme cyclooxygenase-2. This discovery provided the first evidence that ginger modulates biochemical pathways activated in chronic inflammation. Identification of the molecular targets of individual ginger constituents provides an opportunity to optimize and standardize ginger products with respect to their effects on specific biomarkers of inflammation. Such preparations will be useful for studies in experimental animals and humans.
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              An overview on ashwagandha: a Rasayana (rejuvenator) of Ayurveda.

              Narendra Singh, Mohit Bhalla, Prashanti de Jager … (2011)
              Withania somnifera (Ashawagandha) is very revered herb of the Indian Ayurvedic system of medicine as a Rasayana (tonic). It is used for various kinds of disease processes and specially as a nervine tonic. Considering these facts many scientific studies were carried out and its adaptogenic / anti-stress activities were studied in detail. In experimental models it increases the stamina of rats during swimming endurance test and prevented adrenal gland changes of ascorbic acid and cortisol content produce by swimming stress. Pretreatment with Withania somnifera (WS) showed significance protection against stress induced gastric ulcers. WS have anti-tumor effect on Chinese Hamster Ovary (CHO) cell carcinoma. It was also found effective against urethane induced lung-adenoma in mice. In some cases of uterine fibroids, dermatosarcoma, long term treatment with WS controlled the condition. It has a Cognition Promoting Effect and was useful in children with memory deficit and in old age people loss of memory. It was also found useful in neurodegenerative diseases such as Parkinson's, Huntington's and Alzeimer's diseases. It has GABA mimetic effect and was shown to promote formation of dendrites. It has anxiolytic effect and improves energy levels and mitochondrial health. It is an anti-inflammatory and anti-arthritic agent and was found useful in clinical cases of Rheumatoid and Osteoarthritis. Large scale studies are needed to prove its clinical efficacy in stress related disorders, neuronal disorders and cancers.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Nutrients
                Journal ID (iso-abbrev): Nutrients
                Journal ID (publisher-id): nutrients
                Title: Nutrients
                Publisher: MDPI
                ISSN (Electronic): 2072-6643
                Publication date (Electronic): 16 January 2017
                Publication date Collection: January 2017
                Volume: 9
                Issue: 1
                Electronic Location Identifier: 70
                Affiliations
                [1 ]Medical Semiology Department, Faculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, B-dul “Eroilor Sanitari” nr. 8, Sector 6, 76241 Bucharest, Romania; dordrag@ 123456drdorindragos.ro
                [2 ]Nephrology Clinic, University Emergency Hospital Bucharest, 050098 Bucharest, Romania
                [3 ]Biochemistry Department, Faculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, B-dul “Eroilor Sanitari” nr. 8, Sector 6, 76241 Bucharest, Romania; marilenagilca@ 123456gmail.com (M.G.); glauraelena@ 123456gmail.com (L.G.)
                [4 ]Physiology Department, Faculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, B-dul “Eroilor Sanitari” nr. 8, Sector 6, 76241 Bucharest, Romania; adelina_munteanu@ 123456yahoo.com
                [5 ]R&D IRIST LABMED SRL, Str. Miraslau, nr. 24, Sector 3, 031235 Bucharest, Romania; iristlabmed@ 123456gmail.com
                [6 ]Orthopaedic and Trauma Clinic 2, Faculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, 020022 Bucharest, Romania; olivera_lupescu@ 123456yahoo.com
                [7 ]Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
                Author notes
                [* ]Correspondence: irina.stoian@ 123456umf.ro or irina_stoian64@ 123456yahoo.com ; Tel.: +40-748-038-284
                Article
                Publisher ID: nutrients-09-00070
                DOI: 10.3390/nu9010070
                PMC ID: 5295114
                PubMed ID: 28275210
                SO-VID: 561652f7-e84d-4c79-bfad-59b43daceb82
                Copyright © © 2017 by the authors; licensee MDPI, Basel, Switzerland.
                License:

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 12 December 2016
                Date accepted : 12 January 2017
                Categories
                Subject: Review

                ScienceOpen disciplines: Nutrition & Dietetics
                Keywords: osteoarthritis,rheumatoid arthritis,medicinal plants,herbs
                Data availability:
                ScienceOpen disciplines: Nutrition & Dietetics
                Keywords: osteoarthritis, rheumatoid arthritis, medicinal plants, herbs

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