Abstract
Objective: Herbal immunomodulatory preparations are increasing in popularity. In vitro, in vivo and clinical trial studies are needed to ensure safety, quality and efficacy of these herbal medicines. SeptilinTM, a proprietary herbal medicinal product has been reported to have immunomodulatory effects.
 Methods: For this narrative review the author surveyed the primary literature on SeptilinTM and its ingredients with regards to immunomodulatory, nitric oxide (NO) and cytokine activity. Databases utilized included Pubmed, Science Direct and EBSCO, Google Scholar as well as a hand search through journals and bibliographies was included. English language restriction was observed. The following parameters had to be met for study inclusion: investigations on SeptilinTM as a formulation (liquid or dried form) were accepted. Research on the isolated constituents of SeptilinTM (single herbs) was also accepted. The accepted model types included; in vitro and in vivo, animal and human models. The following were also required; method of preparation of the SeptilinTM, concentration of the plant preparation and dose/exposure time. Only studies providing statistically significant results with regards to immunomodulatory, cytokine and nitric oxide activity were included.
 Results: SeptilinTM and its ingredients had effects on at least one cytokine. The most frequently studied cytokines were IL-1, IL-2, IL-4, IL-6, TNF, and IFN. Many studies also reported on NO activities. SeptilinTM and its ingredients demonstrated modulation of several cytokines with varying results on NO activity. The bulk of studies conducted on SeptilinTM and its ingredients were in vitro, the few in vivo studies were mainly conducted in rats or mice models with a few studies conducted on humans.
 Conclusion: The in vitro and in vivo research demonstrates that SeptilinTM and its ingredients modulate the secretion of multiple cytokines and NO with varying effects on cytokine and NO secretion due to divergent research methodologies. The reported therapeutic success of these herbal products by natural medicine practitioners and clinicians may be due to their effects on cytokine and NO activity.
 Bangladesh Journal of Medical Science Vol.18(4) 2019 p.675-688
Highlights
For decades there has been a significant global increase in the use of herbal medicine as curative agents.[1]
Immunoglobulin E (IgE) versus IgG type immune responses can be determined by immunoadjuvants, which can be challenging for vaccine manufacturers.[11]
Materials and methods Search strategy Titles were screened for all hits to the terms “SeptilinTM and cytokines,” “SeptilinTM and nitric oxide,” “SeptilinTM and immunomodulation,” “SeptilinTM and immunity,” as well as for the single herbs found in SeptilinTM as seen below: Mujeeb Hoosen
Summary
For decades there has been a significant global increase in the use of herbal medicine as curative agents.[1]. Immunoglobulin E (IgE) versus IgG type immune responses can be determined by immunoadjuvants, which can be challenging for vaccine manufacturers.[11] Immunostimulants enhance the overall immune response against pathogens via humoral and cellular immune responses by enhancing cytokine production or stimulating B- or T-lymphocytes.[12] Immunostimulants offer prophylactic effects in healthy individuals by potentiating the basic level of the immune response In those who have an immune impairment, immunostimulants are administered as therapeutic agents for immunity.[11] Immunosuppressants act by suppressing the immune response.[9] These drugs are commonly used to treat different types of organ transplant rejection and autoimmune diseases.[11] From a therapeutic perpective immunomodulation refers to the alteration of the immune response to a desired level which is most beneficial to the host.[9] Despite the popularity of the use of SeptilinTM there are limited in vitro and in vivo studies available.[1] Several studies report on the immunomodulatory effects of SeptilinTM using different testing models, which may lead to variation in results. Materials and methods Search strategy Titles were screened for all hits to the terms “SeptilinTM and cytokines,” “SeptilinTM and nitric oxide,” “SeptilinTM and immunomodulation,” “SeptilinTM and immunity,” as well as for the single herbs found in SeptilinTM as seen below: Mujeeb Hoosen
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