Abstract
This review aimed to provide a summary on the traditional uses, phytochemistry, and pharmacological activities in the cardiovascular system and cardiotoxicity of Melissa officinalis (MO), with the special emphasis on the protective mechanisms in different cardiovascular pathologies. MO is a perennial aromatic herb commonly known as lemon balm, honey balm, or bee balm, which belongs to Lamiaceae family. Active components are mainly located in the leaves or essential oil and include volatile compounds, terpenoid (monoterpenes, sesquiterpenes, triterpenes), and polyphenolic compounds [rosmarinic acid (RA), caffeic acid, protocatechuic acid, quercitrin, rhamnocitrin, luteolin]. For centuries, MO has been traditionally used as a remedy for memory, cognition, anxiety, depression, and heart palpitations. Up until now, several beneficial cardiovascular effects of MO, in the form of extracts (aqueous, alcoholic, and hydroalcoholic), essential oil, and isolated compounds, have been confirmed in preclinical animal studies, such as antiarrhythmogenic, negative chronotropic and dromotropic, hypotensive, vasorelaxant, and infarct size–reducing effects. Nonetheless, MO effects on heart palpitations are the only ones confirmed in human subjects. The main mechanisms proposed for the cardiovascular effects of this plant are antioxidant free radical–scavenging properties of MO polyphenols, amelioration of oxidative stress, anti-inflammatory effects, activation of M2 and antagonism of β1 receptors in the heart, blockage of voltage-dependent Ca2+ channels, stimulation of endothelial nitric oxide synthesis, prevention of fibrotic changes, etc. Additionally, the main active ingredient of MO-RA, per se, has shown substantial cardiovascular effects. Because of the vastness of encouraging data from animal studies, this plant, as well as the main ingredient RA, should be considered and investigated further as a tool for cardioprotection and adjuvant therapy in patients suffering from cardiovascular diseases.
Highlights
During the history, for centuries people have been widely using medicinal plants as remedies for various cardiovascular diseases (CVDs) such as congestive heart failure, hypertension, angina pectoris, atherosclerosis, cerebral insufficiency, venous insufficiency, and arrhythmia (Mashour et al, 1998)
All of these changes were of a less extent relative to amiodarone and attributed to both antioxidant effects of phenolic compounds in lemon balm and stimulation of muscarinic receptors, acetylcholine K+ channels, which may be connected with slower conduction in the heart and prolonged PR interval (Joukar et al, 2014)
It was found that 2 weeks of consumption lyophilized aqueous MO extract (MOE) (500 mg; two times per day) reduced heart palpitation episodes by 36% compared to 4.2% reduction in the placebo group
Summary
For centuries people have been widely using medicinal plants as remedies for various cardiovascular diseases (CVDs) such as congestive heart failure, hypertension, angina pectoris, atherosclerosis, cerebral insufficiency, venous insufficiency, and arrhythmia (Mashour et al, 1998). The number one cause of death worldwide belongs to CVDs, taking approximately 17.9 million lives each year (31%), and despite the wide spectrum of synthetic cardiovascular drugs, the prevalence of CVDs is still growing (World Health Organization, 2021) Because of this ongoing health, social, and economic problem, science has turned to investigation of alternative medicine and natural products that are marked as traditionally efficient and safe in the treatment of CVDs (Mashour et al, 1998; Li et al, 2015; World Health Organization, 2021). It is native to southern Europe and central and western Asia, especially the Mediterranean, and in gardens and naturalized in many parts of the United States (Eastern, Midwestern, and Pacific Northwest states (Abdel-Naime et al, 2016, 2020)
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