Black Cohosh Research Articles

Effectiveness of the short-term use of Cimicifuga racemosa in the endothelial function of postmenopausal women: a double-blind, randomized, controlled trial

Objective: This study aimed to assess the effects of daily use of Cimicifuga racemosa on endothelial function through flow-mediated dilation of the brachial artery, when used for 28 days by healthy postmenopausal women.Methods: The double-blind, randomized, placebo-controlled study included two groups of postmenopausal women (n = 31 each). The subjects were clinically assessed and flow-mediated dilation of the brachial artery was measured before and after 28 days of treatment. Patients received dry extract corresponding to 160 mg C. racemosa (extract with 4 mg of triterpene glycosides) or placebo.Results: Mean age, time since menopause, and body mass index in the two groups were similar. The measurements of flow-mediated dilation of the brachial artery, pre and post treatment, respectively, showed a significant increase in patients who used C. racemosa (p = 0.006), unlike patients who used placebo, who did not present changes in the outcome of flow-mediated dilation of the brachial artery after 28 days of use (p ≥ 0.05). When comparing the number of women in both groups who showed an increase in flow-mediated dilation, a significant difference was found in the measurements of the treated group after the use of the medication (p = 0.018).Conclusions: Daily use of 160 mg C. racemosa extract by postmenopausal women for 28 days beneficially influences endothelial function by promoting elasticity of the brachial artery.

Authentication of black cohosh (Actaea racemosa) dietary supplements based on chemometric evaluation of hydroxycinnamic acid esters and hydroxycinnamic acid amides.

Ester and amide derivatives of hydroxycinnamic acids are found in black cohosh (Actaea racemosa) and other Actaea plants. These two compound groups were evaluated for authentication of black cohosh dietary supplements. The hydroxycinnamic acid esters (HCAE) were profiled by ultra-performance liquid chromatography-photodiode array detection (UPLC-PDA). The hydroxycinnamic acid amides (HCAA) were acquired simultaneously by mass spectrometry-multiple reaction monitoring (UPLC-MRM) mode. In contrast with the traditional HCAE method using 8 compounds, profiles of HCAA using only 4 feruloyl dopamine-O-hexosides was more convenient for peak by peak comparison. Partial least square discriminant analysis (PLS-DA) was applied to both HCAE and HCAA datasets. Authenticated plant samples of five Actaea species were randomly divided into training and test sets to build and validate the two PLS-DA models. Both models provided reasonable estimates for the classification of A. racemosa and other Actaea plant samples. However, HCAA model performs better in sensitivity, specificity, and accuracy. Assessment of supplement samples provided quite different results for the solid and liquid dietary supplement samples, indicating the dosage form could affect the composition of marker compounds. Graphical abstract.

The efficacy of herbal medicines on anxiety and depression in peri- and postmenopausal women: A systematic review and meta-analysis.

Objective The main objective in this systematic review was to analyse herbal medicine interventions for anxiety and depression to detect possible benefits of herbal medicines in peri- and postmenopausal women. Material and method The trials published since inception to August 2017 were searched on the databases of MEDLINE, ISI Web of Science, Scopus and Cochran central register of controlled trials Results Twenty-one trials were included into systematic review. The anxiety score (standardized mean difference = −1.19; p = 0.04; six trials) and depression (standardized mean difference = −0.952; p = 0.023; five trials) was lower in the phytoestrogen group compared to the placebo. However, the heterogeneity was notably high among trials that assessed anxiety outcome (p < 0.0001; I2 = 97.12%) and depression (p < 0.0001; I2 = 94.51%), and we were unable to reduce the heterogeneity to below 90% after one with one exclusion of the studies; 1000 mg of fenugreek extract on depression and anxiety, 600 mg of Trigonella foenum‐graecum de‐husked seed extract on psychosocial symptoms, 0.4 mg/ml Maca extract on anxiety, 500 mg of Hop plant on depression and anxiety, 80 mg or more than 80 mg of red clover-derived isoflavones on psychological symptoms had significant effect. Non-significant effect was observed in black cohosh on anxiety. However, significant effect of black cohosh was seen on psychological symptoms. Fennel had a positive effect in both patients with anxiety or depression and healthy women. Flaxseed group showed a non-significant effect on psychological symptoms. Conclusion The present systematic review found that some of the herbal medicines may have good effect in the relief of the anxiety and the depression.

Infertility in the digital age: an opportunity for REI physicians to combat the spread of misinformation and fill support gaps in infertility care online

To examine infertility related content posted on Instagram, including content of posts and identity of content posters. Retrospective content analysis. Data from Instagram were obtained on April 20, 2019. One author queried 42 popular hashtags, including both medical and lay person terminology, related to infertility diagnosis, treatment and procedures. The total number of posts from each hashtag was recorded. Each of the top ten posts (as determined by Instagram’s internal algorithm) for the 42 hashtags was then analyzed to qualitatively identify the content of each post. The post category was determined by the lead author based on the content of the post and the overall message it sent to its readers. The number of likes and comments were also recorded for each post. Lastly, data on the individual who posted were also recorded by analyzing that poster’s Instagram profile. A total of 5,814,691 posts were tagged with the 42 unique hashtags queried for this study. 315 of the 420 “top posts” met inclusion criteria. Of the hashtags, #PCOS had the highest number of posts associated with it (2,000,000 posts). From the 315 included posts, 271 unique posters were identified. 239 of these posters were non-healthcare related individuals (88%) and 32 (12%) were healthcare related persons. There were 14 self-identified US physicians. All but one had verified credentials. By far, the most common type of post for non-healthcare related individuals was related to their infertility journey (60%). In contrast, the majority of posts created by healthcare-related individuals were educational (41%). When comparing US verified physician posting versus all other posters, US physicians were more likely to post educational (33% vs 9%, p= 0.0006) and promotional posts (33% vs 1%, p= <0.0001) and less likely to post about a personal infertility journey (5% vs 58%, p= <0.0001). There was no significant difference in ‘likes’ between the two groups (194±200 for US physicians vs 430±787 for all other posters, p=1.71). There was a significant difference in the number of comments between the two groups, with fewer comments in response to US physicians than all other posters (12±16 vs 36±51, p=0.015). No infertility postings by verified US physicians contained medical advice or medical questions. In contrast, 5% and 2% of postings by all other individuals gave medical advice or asked a medical question, respectively. Some of the medical advice given included taking 40mg/day of black cohosh for ovulation induction, using cannabis suppositories to shrink fibroids, and recommending supplements to increase fertility (who were often sold by the poster). Instagram and other social media platforms have the potential to be highly influential in the infertility population. Physicians, particularly board-certified reproductive endocrinologists, should consider taking steps towards having a stronger presence online to combat the spread of misinformation that currently dominates these highly used platforms, and to help bridge gaps in access to infertility care.

Evaluating Sufficient Similarity of Botanical Dietary Supplements: Combining Chemical and In Vitro Biological Data.

Botanical dietary supplements are complex mixtures with numerous potential sources of variation along the supply chain from raw plant material to the market. Approaches for determining sufficient similarity (ie, complex mixture read-across) may be required to extrapolate efficacy or safety data from a tested sample to other products containing the botanical ingredient(s) of interest. In this work, screening-level approaches for generating both chemical and biological-response profiles were used to evaluate the similarity of black cohosh (Actaea racemosa) and Echinacea purpurea samples to well-characterized National Toxicology Program (NTP) test articles. Data from nontargeted chemical analyses and gene expression of toxicologically important hepatic receptor pathways (aryl hydrocarbon receptor [AhR], constitutive androstane receptor [CAR], pregnane X receptor [PXR], farnesoid X receptor [FXR], and peroxisome proliferator-activated receptor alpha [PPARα]) in primary human hepatocyte cultures were used to determine similarity through hierarchical clustering. Although there were differences in chemical profiles across black cohosh samples, these differences were not reflected in the biological-response profiles. These findings highlight the complexity of biological-response dynamics that may not be reflected in chemical composition profiles. Thus, biological-response data could be used as the primary basis for determining similarity among black cohosh samples. Samples of E. purpurea displayed better correlation in similarity across chemical and biological-response measures. The general approaches described herein can be applied to complex mixtures with unidentified active constituents to determine when data from a tested mixture (eg, NTP test article) can be used for hazard identification of sufficiently similar mixtures, with the knowledge of toxicological targets informing assay selection when possible.

Profiles of Phenolic Acids and Triterpene Glycosides in Commercial and Cultivated Black Cohosh

The medicinal plant Actaea racemosa is a perennial, whose rhizome (black cohosh rhizome) is usually wild harvested on a multiton scale to meet market requirements. Since this North American species is increasingly endangered, cultivation is needed. Even though studies prove that cultivation is possible, it has not been widely established. This may be due to a different quality of cultivated material, which does not comply with current pharmacopoeial requirements. This study compares contents and chromatographic fingerprints of phenolic acids and triterpene glycosides in different types of black cohosh rhizomes. Commercial batches from wild harvests were compared to individual plants from the wild and from cultivation. Phenolic acids' contents and profiles were generally comparable between wild harvesting and cultivation. On the contrary, the total triterpene glycoside content was significantly lower in cultivation (p ≤ 0.001). In individual plants, different profiles of triterpene glycosides occurred. Possibly, specimen or chemotype selection for cultivation would cause a shift of the triterpene glycoside profile of cultivation batches away from the common pattern found in batches from wild harvesting. Potentially, such differences have an impact on the efficacy of black cohosh herbal products, if cultivated plant material is used for manufacturing.

31-Year-Old Woman With Jaundice and Abdominal Pain

31-Year-Old Woman With Jaundice and Abdominal Pain

Medicinal plants in traumatic brain injury: Neuroprotective mechanisms revisited.

Traumatic brain injury (TBI) is the most prevalent health problem affecting all age groups, and leads to many secondary problems in other organs especially kidneys, gastrointestinal tract, and heart function. In this review, the search terms were TBI, fluid percussion injury, cold injury, weight drop impact acceleration injury, lateral fluid percussion, cortical impact injury, and blast injury. Studies with Actaea racemosa, Artemisia annua, Aframomum melegueta, Carthamus tinctorius, Cinnamomum zeylanicum, Crocus sativus, Cnidium monnieri, Curcuma longa, Gastrodia elata, Malva sylvestris, Da Chuanxiong Formula, Erigeron breviscapus, Panax ginseng, Salvia tomentosa, Satureja khuzistanica, Nigella sativa, Drynaria fortune, Dracaena cochinchinensis, Polygonum cuspidatum, Rosmarinus officinalis, Rheum tanguticum, Centella asiatica, and Curcuma zedoaria show a significant decrease in neuronal injury by different mechanisms such as increasing superoxide dismutase and catalase activities, suppressing nuclear factor kappa B (NF-κB), interleukin 1 (IL-1), glial fibrillary acidic protein, and IL-6 expression. The aim of this study was to evaluate the neuroprotective effects of medicinal plants in central nervous system pathologies by reviewing the available literature.

AN UPDATED OVERVIEW OF POLYCYSTIC OVARY SYNDROME

Polycystic ovary syndrome (PCOS), also known as Stein-Leventhal Syndrome, was first described in 1935. PCOS, which may also be referred to as polycystic ovary disease is the most common hormonal disorder found in premenopausal women. PCOS is the most common endocrine disorder in women of reproductive age and is the most common cause of infertility due to ovulation. A PCOS is an endocrine disorder which affects the adolescent girls. A PCOS is a condition in which a woman has an imbalance of female sex hormones. This may lead to changes in the menstrual cycle, cyst in the ovary, failure to conceive, and other health problems. It is a common health problem among teenagers and young women. It affects 5–10% of women in their reproductive years. These problems cause infertility. Two principal components to diagnose this syndrome are menstrual dysfunction and clinical or laboratory hyperandrogenism in which these items are used in clinical diagnosis. PCOS is a hormonal disorder that affects between 5% and 10% of women of reproductive age and remains the most enigmatic reproductive disorders. The most common symptoms of PCOS are obesity, acne, amenorrhea, irregular menstrual cycles, hirsutism, insulin resistance (IR), and high cholesterol. Due to the varied nature of PCOS and the large range of possible signs and symptoms, health personnel need a thorough knowledge of the disorder and its management. It is a major disorder characterized by elevated levels of male hormones (androgens), acne, and hirsutism. It can even cause IR, anovulation, and infertility on prolonging incidence of cysts. One of the treatments for PCOS is the use of synthetic medicine, which can help to treat PCOS but with side effects. However, many women who suffer from PCOS opt to use alternative medicine in conjunction with traditional medicine to improve their condition. There are some herbs that are very helpful in treating PCOS. Since PCOS is a curable disorder, it can be cured by the use of natural remedies or allopathic medication. There is a growing interest in herbal remedies or allopathic medication to cure the PCOS. There is a need to change the lifestyle management, diet to control the PCOS level. The natural remedies include treatment with phytoestrogenic and non-estrogenic herbs such as Licorice, Ginseng, Black cohosh, Dong, soy, evening primrose, honey, fenugreek, Schisandra root, and many other which are effective and safe. Many plants have been highly esteemed sources and have advantages which reduce PCOS and also having a hypoglycemic effect. In this review, an attempt has been made to study the use of natural remedy for the treatment of PCOS.

Cimicifuga heracleifolia is therapeutically similar to black cohosh in relieving menopausal symptoms: evidence from pharmacological and metabolomics studies.

In the market of botanical dietary supplements, Cimicifuga heracleifolia (CH) has always been considered as an adulterated species of Cimicifuga racemosa (CR), a conventional American herb with promising benefits to counteract troubles arising from the menopause. However, the detailed comparison of their therapeutic effects is lacking. In present study, the pharmacological and metabolomics studies were comparatively conducted between CH and CR in ovariectomized (OVX) female rats. Specifically, estrogen-like, anti-hyperlipidemia and anti-osteoporosis effects were evaluated through measuring serum biochemical parameters, histopathological examination and micro computed tomography (Micro-CT) scanning. At the same time, a gas chromatography-mass spectrometry (GC-MS)-based serum metabolomics method was employed to profile the metabolite compositional changes. As a result, both CR and CH displayed anti-osteoporosis and anti-hyperlipemia on menopause syndrome. Meanwhile, their potentials in improving the OVX-induced metabolic disorders were discovered. In conclusion, these results demonstrated that CH is therapeutically similar to CR in relieving menopausal symptoms and CH could be considered as a promising alternative to CR instead of an adulterant in the market of botanical dietary supplements.

Black cohosh (Cimicifuga racemosa) is a non-estrogenic alternative to hormone replacement therapy

Заместительная гормональная терапия по-прежнему является популярным и наиболее эффективным методом лечения вазомоторных симптомов и профилактики потери костной массы в постменопаузе, но не без риска. Это заставило многих женщин климактерического возраста искать альтернативы, главным образом – натуральные продукты. Однако фитоэстрогены, содержащие препараты сои или красного клевера, при приеме в рекомендуемых суточных дозах оказались неэффективными для сокращения количества климактерических жалоб и предотвращения остеопороза. С другой стороны, препараты Cimicifuga racemosa (CR) продемонстрировали облегчение климактерического дистресса. Экстракты CR традиционно применяются для облегчения климактерических жалоб; этот эффект был продемонстрирован в ряде двойных слепых плацебо-контролируемых исследований. Однако низкие или промежуточные дозы более эффективны, чем высокие. Экстракты CR не содержат эстрогенных соединений: они проявляют свою эффективность с помощью механизмов, связанных с наличием дофаминергических, норадренергических, серотонинергических и ГАМК-ергических действующих веществ, но от них нельзя ожидать эстрогенной активности. Существует широко распространенное, но ложное мнение о том, что эффективность препаратов CR связана с присутствием фитоэстрогенов в растении. Этот обзор направлен на обобщение имеющихся доказательств исследований in vitro и in vivo, свидетельствующих о том, что соединения в экстрактах CR не связываются с рецепторами к эстрогенам и, таким образом, не оказывают эстрогенного эффекта на матку и молочные железы, как показано in vivo в экспериментах на крысах после овариоэктомии и клинически у женщин в постменопаузе. Исследования на крысах после овариоэктомии и у женщин, страдающих от климактерических явлений, показали, что вещества, обладающие действием, подобным действию нейромедиаторов, оказывают благоприятное воздействие на постменопаузальные симптомы, такие как приливы. Некоторые из этих соединений, такие как тритерпены с ГАМК-ергической активностью и аналог серотонина, присутствуют и идентифицированы в экстрактах CR. Авторы пришли к выводу, что эти действия, скорее всего, объясняют благоприятное воздействие экстрактов CR на климактерические проявления.

Metabolic effects of Cimicifuga racemosa extract Ze450 on neuronal cells

Mitochondria are key regulators of energy metabolism and, therefore, an emerging focus of research on metabolic, neurodegenerative and other age-related diseases. Estrogen depletion is well known to induce common menopausal complaints; however, mounting evidence suggests additional effects, such as increasing oxidative stress which may contribute to the development of metabolic disorders [ [1] Sekhon, L.H., Agarwal, A., Humana Press, Totowa, NJ. 181-203. Google Scholar ].

Antiproliferative effects of cimicifuga racemosa root extract Ze 450 mediated by inhibition of oxidative phosphorylation and indirect AMPK activation

Antiproliferative effects of cimicifuga racemosa root extract Ze 450 mediated by inhibition of oxidative phosphorylation and indirect AMPK activation

A BAHD hydroxycinnamoyltransferase from Actaea racemosa catalyses the formation of fukinolic and cimicifugic acids.

The nucleotide sequence of a BAHD hydroxycinnamoyltransferase was amplified from Actaea racemosa (Ranunculaceae) and expressed in E. coli. The protein catalysed the formation of cimicifugic acids and thus is named hydroxycinnamoyl-CoA:piscidic acid hydroxycinnamoyltransferase (ArHPT1; cimicifugic acid synthase). Actaea racemosa (syn. Cimicifuga racemosa) is known to contain triterpene lactone glycosides and cimicifugic acids. The latter are esters of various hydroxycinnamic or benzoic acids with piscidic or fukiic acid. Amplification of a nucleotide sequence from A. racemosa, that was already known as HCT1 from an EST approach, and its expression in E. coli resulted in a protein that was able to catalyse the formation of several cimicifugic acids. For the characterisation of this hydroxycinnamoyltransferase (hydroxy)cinnamoyl-coenzyme A thioesters were synthesised as donor substrates and piscidic acid isolated as acceptor substrate. The lowest Km-value with 6.8µM was determined for p-coumaroyl-CoA. More than 30 possible acceptor substrates were tested, but only piscidic acid and putatively fukiic acid were accepted. The apparent Km-value for piscidic acid was 32.3µM. High expression of the hydroxycinnamoyltransferase gene was found in roots, but the content of cimicifugic acids was higher in leaves and flowers than in roots. This work describes for the first time a biosynthetic step in the formation of cimicifugic acids catalysed by a so far uncharacterised hydroxycinnamoyltransferase accepting piscidic acid as acceptor substrate thus being a hydroxycinnamoyl-CoA:piscidic acid hydroxycinnamoyltransferase (ArHPT1; cimicifugic acid synthase).

Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015

ObjectiveAssessing adverse drug reactions (ADRs) is a proven method to estimate the safety of medicines. The ADRs to herbal medicines in Australia (and by inference, the safety of herbal medicines in Australia) remain unknown. This study examines spontaneous ADR cases to four of the most popular herbs in Australia from 2000 to 2015: echinacea (Echinacea purpurea), valerian (Valeriana officinalis), black cohosh (Actaea racemosa) and ginkgo (Ginkgo biloba). MethodsADRs of echinacea, valerian, black cohosh and ginkgo reported to the Australian Therapeutic Goods Administration (TGA) between 2000 and 2015 were obtained from the TGA database. Data were collated and analysed according to age, sex, severity, type of ADR and body system affected. Statistics were calculated using GraphPad Prism software. ResultsMost ADRs were mild or moderate. However, every herbal medicine was associated with life-threatening ADRs. In each life-threatening case, the herbal medicine was taken concomitantly with prescription medications. Black cohosh was associated with a significant number of severe ADRs (30.3% of the total), with 39.4% of these ADRs being associated with abnormal hepatic function, hepatitis or hepatotoxicity. ConclusionThis study highlights the lack of public awareness with regard to herb–drug interactions, since most of the severe ADRs involved a herb–drug interaction.

Potential Pharmacokinetic Herb-Drug Interactions: Have we Overlooked the Importance of Human Carboxylesterases 1 and 2?

Herbal products have grown steadily across the globe and have increasingly been incorporated into western medicine for healthcare aims, thereby causing potential pharmacokinetic Herb-drug Interactions (HDIs) through the inhibition or induction of drug-metabolizing enzymes and transporters. Human Carboxylesterases 1 (CES1) and 2 (CES2) metabolize endogenous and exogenous chemicals including many important therapeutic medications. The growing number of CES substrate drugs also underscores the importance of the enzymes. Herein, we summarized those potential inhibitors and inducers coming from herbal constituents toward CES1 and CES2. We also reviewed the reported HDI studies focusing on herbal products and therapeutic agents metabolized by CES1 or CES2. We searched in PubMed for manuscript published in English after Jan 1, 2000 combining terms "carboxylesterase 1", "carboxylesterase 2", "inhibitor", "inducer", "herb-drug interaction", "inhibitory", and "herbal supplement". We also searched specific websites including FDA and EMA. The data of screened papers were analyzed and summarized. The results showed that more than 50 natural inhibitors of CES1 or CES2, including phenolic chemicals, triterpenoids, and tanshinones were found from herbs, whereas only few inducers of CES1 and CES2 were reported. Systemic exposure to some commonly used drugs including oseltamivir, irinotecan, and clopidogrel were changed when they were co-administered with herb products such as goldenseal, black cohosh, ginger, St. John's Wort, curcumin, and some Chinese compound formula in animals. Nonclinical and clinical studies on HDIs are warranted in the future to provide safety information toward better clinical outcomes for the combination of herbal products and conventional drugs.

Effect of cimicifuga racemosa on menopausal syndrome caused by LHRH-a in breast cancer

Ethnopharmacological relevanceCimicifuga racemose is previously proved effective on nature menopausal syndrome (MPS). However, its clinical value in treating with MPS induced by luteinizing-hormone releasing hormone analogue (LHRH-a) therapy of pre-/peri-menopausal breast cancer patients is still unknown. Aim of studyThis perspective randomised-design study is to investigate the effect and safety of cimicifuga racemosa on MPS induced by LHRH-a in breast cancer (clinical trial registered: NCT03339882). Materials and methodsBreast cancer patients planning for LHRH-a treatment were randomly divided into 2 groups. The control group which was being treated with the standard treatment of LHRH-a. The other group was being treated with Remifemin, the commercialized product of cimicifuga racemose extract, combined with LHRH-a, called Remifemin group. Our main endpoint was Kupperman menopause index (KMI). Hormone levels in peripheral blood and gynecological complications were also evaluated. ResultsTotally, 85 patients (42 in Remifemin group and 43 in control group) were enrolled in Zhejiang Cancer Hospital. At the 4th, 8th and 12th week after using LHRH-a, the KMI were all significantly lower in Remifemin group than in control group (P < 0.01), while the hormone levels, including estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were similar in the two groups. In addition, the incidence of cervical cyst in Remifemin group was higher than that in control group (P = 0.02), and there was no significant difference in the other gynecological complications, including endometrial thickening, ovarian cyst or uterine fibroid (P > 0.05). ConclusionsCimicifuga racemose is effective, oncological safe and reliable for treatment of MPS caused by LHRH-a in breast cancer.

Black Cohosh (Cimicifuga Racemosa) as Treatment of Menopause-Related Symptoms: A Mini Review

Black Cohosh (Cimicifuga Racemosa) as Treatment of Menopause-Related Symptoms: A Mini Review

Abstract P1-11-11: Cimicifuga racemosa extract prevents menopausal syndrome in LHRHa treatment of breast cancer: A prospective randomized research

Abstract BACKGROUND Menopausal syndrome (MPS) is common in pre/peri-menopausal breast cancer patient receiving luteinizing-hormone releasing hormone analogue (LHRHa). According to the results of TEXT &amp; SOFT study, it could affect patients' life quality seriously and even caused 8%˜23% treatment break. Cimicifuga racemosa (Remifemin) is previously proved effective for MPS in nature menopause patients. We aim to design a prospective randomized research for investigating the effect of Remifemin on MPS which caused by LHRHa in breast cancer (NCT03339882). METHODS The pre/peri-menopausal patients diagnosed as early breast cancer planning for LHRHa were identified and randomly divided into two groups after surgery and chemotherapy if necessary: the Remifemin group (Remifemin 20mg twice a day for 12 weeks) and the control group. The primary endpoint is Kupperman menopause index (KMI). The estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH) levels in blood were also evaluated. RESULTS From January 2017 to December 2017, totally 85 patients (42 in Remifemin group and 43 in control group) were enrolled in Zhejiang Cancer Hospital and there were no significant differences in baseline characteristics including age, BMI, tumor stage, ER, PR, HER2, KMI and hormone levels between two groups (Table 1). At the time of 4, 8, 12 weeks after treatment, the KMI of Remifenmin group were all significantly lower than control group (Table 2, P&amp;lt;0.01) while no significant difference in E2, FSH and LH levels between the two groups (Table 2, P&amp;gt;0.05).There was no significant difference in endometrial thickness, ovarian cyst and Uterine fibroids except cervical cyst (P=0.02). CONCLUSION The use of Remifemin is oncological safe and reliable in preventing MPS which caused by LHRHa in breast cancer. The clinical characteristics of two groups Remifemin groupControl groupP n=42n=43 N(%)N(%) Age(years) 37.74±6.6037.16±6.280.68BMI (body mass index) 21.90±2.8321.65±3.010.69T stage02(4.76)2 (4.65)0.16 113 (30.95)22 (51.16) 227 (64.29)19 (44.19) N stage021 (50.00)24 (55.82)0.63 110 (23.81)12 (27.91) 26 (14.29)5 (11.63) 35 (11.90)2 (4.65) ERPositive30 (71.43)35 (81.40)0.28 Negative12 (28.57)8 (18.60) PRPositive30 (71.43)32 (74.42)0.76 Negative12 (28.57)11 (25.58) HER2Positive8 (19.05)10 (23.26)0.64 Negative34 (80.95)33 (76.74) Category of LHRHaGoserelin32 (76.19)28 (65.12)0.26 Leuprorelin10 (23.81)15 (34.88) Category of endocrine drugNone10 (23.81)6 (13.95)0.20 SERM5 (11.90)11 (25.58) AI27 (64.29)26 (60.47) The endpoints of two groups Remifemin groupControl groupP n=42n=43 KMI*Base line2.45±1.452.30±1.360.62 4th week3.83±1.868.37±4.19&amp;lt;0.01 8th week4.21±1.8011.00±4.48&amp;lt;0.01 12th week4.67±2.1611.98±4.93&amp;lt;0.01E2Base line134.24±64.14143.49±84.190.57 4th week20.26±14.8125.24±13.310.11 8th week13.55±8.1415.65±8.020.23 12th week10.83±7.3512.53±6.350.26FSHBase line8.88±11.4010.17±9.910.58 4th week8.23±9.935.40±6.450.12 8th week4.83±8.496.53±11.500.44 12th week3.65±7.557.28±16.010.19LHBase line6.77±6.319.62±10.590.14 4th week9.08±4.877.93±4.830.28 8th week11.76±11.8210.18±12.210.55 12th week7.27±4.956.90±4.380.72*Wilcoxon test Citation Format: Yu X, Wang C, Liang C, Xuan H, Yang H. Cimicifuga racemosa extract prevents menopausal syndrome in LHRHa treatment of breast cancer: A prospective randomized research [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-11.

The antiestrogenic effects of black cohosh on BRCA1 and steroid receptors in breast cancer cells.

BackgroundBlack cohosh (BC) is an herbal remedy often used by women to treat symptoms associated with menopause. Research has shown that the molecular activity of BC is associated with estrogen receptor alpha (ER-α) regulation. Progesterone receptor (PR) expression is found to be consistent with ER expression and mutations in the BRCA1 gene, a tumor-suppressor gene, are known to be responsible for about 40%–45% of hereditary breast cancers.PurposeThe objective of this study was to determine the effects of BC alone, as well as in combination with hormones and antihormones, on cell viability and expression of ER-α, PR, and BRCA1 in both T-47D and MCF-7 cell lines.MethodsCells were cultured in charcoal-stripped serum prior to their treatment and subsequent protein extraction. Western blot analyses were performed following a Bio-Rad Bradford protein assay and SDS-PAGE gel electrophoresis, with ECL luminescence and Image Studio Lite software. Cellular viability assays were performed using propidium iodine (PI) staining, and the distribution of fluorescent structures was evaluated through confocal microscopy. RT-qPCR analysis was performed on extracted cellular RNA. All statistical analyses were performed using SPSS software, and data was subjected to Kruskal-Wallis testing, followed by post-hoc analysis using the Mann-Whitney U-test to determine the statistical significance of all findings.ResultsWestern blot analysis displayed significant alterations of ER-α, PR, and BRCA1 protein levels after 24-hour treatment with 80–500 μM BC. BC displayed a concentration-dependent decrease on ER-α and BRCA1 expression, with an 87% reduction of ER-α expression and a 43% of BRCA1 expression in T-47D cells compared to control. After six days of treatment with 400 μM BC, a 50% decrease in cell proliferation was observed. Following 24 hours of co-treatment with 400 μM BC and 10 nM E2, ER-α was downregulated by 90% and BRCA1 expression was reduced by 70% compared to control. The expression of PR, following the same treatment, exhibited similar effects. The proliferative effect of E2 was reduced in the presence of BC.ConclusionBlack Cohosh demonstrates substantial anti-cancer properties, and this study may significantly aid in the understanding of the molecular effects of BC on ER-α, PR, and BRCA1 in breast cancer cells.