Traditional European Medicine Research Articles

Use and acceptance of traditional, complementary and integrative medicine in Germany-an online representative cross-sectional study.

Older representative surveys show that Traditional, Complementary and Integrative Medicine (TCIM) is used by about 60% of the German population. However, no data exists for the current nationwide situation. The main aim of this cross-sectional study is to investigate the current use and acceptance of TCIM in Germany. This study is based on a representative sample of the German population aged 18-75 years. Participants were asked about the use and acceptance of TCIM. The survey was conducted online using Computer Assisted Web Interview (CAWI) in 2022 by three renowned German market research institutes on behalf of and in close coordination with the working group. The data set was analyzed descriptively and inferentially. In total, 4,065 participants (52% female, 48% male, 0.4% diverse) responded completely (response rate: 21.5%). Among participants, 70% stated that they had used TCIM at some point in their lives, with 32% doing so in the last 12 months and 18% currently. The most common reason given (17%) was musculoskeletal pain. For their own health, 39% stated that TCIM is important. Traditional European Medicine was rated as very/mainly effective by 27% of participants and as partly effective by 44% (conventional medicine: 69% very/mainly effective, 19% partly effective). As a complementary treatment strategy to conventional medicine, 35% considered TCIM to be optimal ("Complementary Medicine"), 33% in combination with conventional medicine ("Integrative Medicine") and 5% without conventional medicine ("Alternative Medicine"). The majority of the participants were in favor of more research on TCIM and stated that the costs of TCIM services should be covered by health insurance companies (71% and 69%, respectively). These results from a representative online-population suggest that the use of TCIM in Germany remains at a high level. The nationwide relevance of TCIM should be given greater consideration in German health care policy making. TCIM should be systematically investigated using appropriate study designs and methods including high quality randomized clinical trials to investigate their effectiveness, efficacy, therapeutic safety and costs in the future.

Wound healing potential of extract from Sambucus nigra L. leaves and its fractions

Ethnopharmacological relevanceSambucus nigra L. (Viburnaceae), commonly known as black elderberry, is a native species throughout Europe and Western Asia. Elderberry leaves have been used in traditional European medicine, mainly externally, to treat skin and mucosal diseases. They are usually used as decoctions for washing hemorrhoids, ulcers, insect bites, wounds, scrapes, and gingivitis. Aim of the studyOur work aimed to scientifically verify the traditional use of the plant material in treating wounds and skin inflammations accompanied by its phytochemical characterization. Materials and methodsThe effect of 70% (v/v) ethanolic extract and its fractions of different polarities on the inflammatory response of cells involved in wound healing (fibroblasts, keratinocytes, and neutrophils) was investigated. In addition, their effect on the migration of keratinocytes to the scratch site in an in vitro wound healing assay and their impact on the activity of the enzymes involved in skin inflammation, were assessed. The chemical composition was analyzed by UHPLC-DAD-MSn, and the structure of the isolated compounds was determined by NMR. ResultsThe supportive effect of the elderberry leaves extract towards wound healing and modulation of the inflammatory response was demonstrated by induction of the keratinocytes. Additionally, the extract was shown to affect the cellular secretion of TNF-α and interleukins -1β, −6, and −8. Examinations of fractionated extract have shown that active principles were mainly contained in dichloromethane fraction. Eleven chemical constituents belonging to flavonoids, cyanogenic glycosides, and lignans were isolated and characterized. ConclusionThe beneficial effect of S. nigra leaves in treating skin diseases has been partially verified and supports its traditional use in skin ailments of different etiologies.

An Update on the Pharmacological Activity and Phytochemistry of Artemisia Absinthium L.

Abstract: Plants have been used since the earliest times to manage various diseases, and many of these plants are being used as conventional remedies for various disorders today. Biologically active ingredients isolated from medicinal plants and extracts are receiving a lot of attention these days, partly because modern-day medication has a lot of side effects and somewhat because pathogenic microorganisms are becoming more resistant to antibiotics and many other treatments. Artemisia is the broadly dispersed genus of the family Asteraceae and encompasses almost five hundred species. Amongst these species, Artemisia absinthium L. is a familiar herb called Wormwood in English and Urdu, generally known as Afsanteen. In history, this species was recognized as important, and in old Europe, it was called “the most important master against all exhaustion”. A. absinthium has various benefits in treating pathological conditions such as gastric problems, fever, inflammation, and urinary disorders. The official European medicine uses A. absinthium in both allopathy and homeopathy. The herb was used to treat bladder diseases, anemia, helminthiasis, insomnia, fever, and trouble healing wounds and to treat gastrointestinal disorders in Asian and European traditional medicine. Mono and sesquiterpenes are the major pharmacologically active constituents of A. absinthium. Wormwood is a valuable resource of chemically new constituents and requires comprehensive screening approaches to emphasize the phytoconstituents and pharmacological actions at the molecular level. The core focus of this review is to provide complete information about the scientific evidence-based pharmacological activities, traditional uses, and phytoconstituents from A. absinthium. The collation of literature has been done by using references from main databases such as PubMed, Research gate, Scopes, Science Direct, Google Scholar, Chemical Abstracts, Phytochemical and Ethnobotanical Databases, Medicinal and Aromatic Plants Abstracts, classical books, and pharmacopeias.

Mniszek (Taraxacum) w fitoterapii europejskiej i azjatyckiej

Dandelion (Taraxacum) in European and Asian phytotherapy The genus Taraxacum (family Asteraceae) belongs to the largest and most complicated apomictic complexes. So far, over 2,800 species classified in 60 sections have been described. The natural range of the genus is almost cosmopolitan, with monk seals found on every continent except Antarctica, but their distribution is very uneven. The largest centers of Taraxacum diversity are in Central Asia and Southern Europe. Species belonging to the genus Taraxacum have long been used as food. Young leaves are eaten raw in salads, and dried as an addition to teas or used as spices. Dried roots are used to prepare teas and a coffee substitute, while the flowers and infl orescences are used to produce syrups, wines and are added to beers and soft drinks. Above all, however, dandelions are valued herbal plants since ancient times, used in traditional European, Chinese and Indian medicine to treat liver diseases, kidney stones, stomach diseases, abdominal pain, diarrhea, cough, bladder diseases, gout, edema, and even cancerous. In the modern, very rich scientific literature, the medicinal properties of dandelions have been partially confirmed, but the results are often ambiguous and in some cases contradictory.

Romanian Wild-Growing Armoracia rusticana L.-Untargeted Low-Molecular Metabolomic Approach to a Potential Antitumoral Phyto-Carrier System Based on Kaolinite.

Horseradish is a globally well-known and appreciated medicinal and aromatic plant. The health benefits of this plant have been appreciated in traditional European medicine since ancient times. Various studies have investigated the remarkable phytotherapeutic properties of horseradish and its aromatic profile. However, relatively few studies have been conducted on Romanian horseradish, and they mainly refer to the ethnomedicinal or dietary uses of the plant. This study reports the first complete low-molecular-weight metabolite profile of Romanian wild-grown horseradish. A total of ninety metabolites were identified in mass spectra (MS)-positive mode from nine secondary metabolite categories (glucosilates, fatty acids, isothiocyanates, amino acids, phenolic acids, flavonoids, terpenoids, coumarins, and miscellaneous). In addition, the biological activity of each class of phytoconstituents was discussed. Furthermore, the development of a simple target phyto-carrier system that collectively exploits the bioactive properties of horseradish and kaolinite is reported. An extensive characterization (FT-IR, XRD, DLS, SEM, EDS, and zeta potential) was performed to investigate the morpho-structural properties of this new phyto-carrier system. The antioxidant activity was evaluated using a combination of three in vitro, non-competitive methods (total phenolic assay, 2,2-Diphenyl-1-picrylhydrazyl (DPPH) radical-scavenging assay, and phosphomolybdate (total antioxidant capacity)). The antioxidant assessment indicated the stronger antioxidant properties of the new phyto-carrier system compared with its components (horseradish and kaolinite). The collective results are relevant to the theoretical development of novel antioxidant agent fields with potential applications on antitumoral therapeutic platforms.

Anti-viral and Anti-inflammatory Isoflavonoids from Ukrainian Iris aphylla Rhizomes: Structure-Activity Relationship Coupled with ChemGPS-NP Analysis.

Dried Iris rhizomes have been used in Chinese and European traditional medicine for the treatment of various diseases such as bacterial infections, cancer, and inflammation, as well as for being astringent, laxative, and diuretic agents. Eighteen phenolic compounds including some rare secondary metabolites, such as irisolidone, kikkalidone, irigenin, irisolone, germanaism B, kaempferol, and xanthone mangiferin, were isolated for the first time from Iris aphylla rhizomes. The hydroethanolic Iris aphylla extract and some of its isolated constituents showed protective effects against influenza H1N1 and enterovirus D68 and anti-inflammatory activity in human neutrophils. The promising anti-influenza effect of apigenin (13: , almost 100% inhibition at 50 µM), kaempferol (14: , 92%), and quercetin (15: , 48%) were further confirmed by neuraminidase inhibitory assay. Irisolidone (1: , almost 100% inhibition at 50 µM), kikkalidone (5: , 93%), and kaempferol (14: , 83%) showed promising anti-enterovirus D68 activity in vitro. The identified compounds were plotted using ChemGPS-NP to correlate the observed activity of the isolated phenolic compounds with the in-house database of anti-influenza and anti-enterovirus agents. Our results indicated that the hydroethanolic Iris aphylla extract and Iris phenolics hold the potential to be developed for the management of seasonal pandemics of influenza and enterovirus infections.

Fomitopsis officinalis: Spatial (Pileus and Hymenophore) Metabolomic Variations Affect Functional Components and Biological Activities.

Fomitopsis officinalis is a holartic polyporous mushroom that forms large fruiting bodies on old standing trees, fallen logs, or stumps. F. officinalis is a medicinal mushroom species that is most commonly used in traditional European medicine. In this study, we explore the spatial metabolic differences in F. officinalis' mushroom parts, i.e., the cap (median and apical parts) and the hymenium. Additionally, chromatographic analysis was conducted in order to unravel the composition of specialized metabolites in the hydroalcoholic mushroom extracts. The potential antifungal and bacterial effects of extracts were tested against pathogen strains of Gram+ and Gram- bacteria, and yeast, dermatophytic, and fungal-pool species. Extracts from the apical part were the richest in terms of phenolic compounds; consistent with this finding, the extracts were also the most effective antiradical and antimicrobial agents with MIC values < 100 µg/mL for most of the tested bacterial and dermatophytic species. According to these findings, F. officinalis extracts are valuable sources of primary and secondary metabolites, thus suggesting potential applications in the formulation of food supplements with biological properties in terms of antioxidant and antimicrobial activities.

Effect of single and binary mixed metal mordant combinations on colorimetric and fastness characteristics of wool yarns dyed with Melissa officinalis L. natural colorants

Melissa officinalis L. plant has been used in European and Iranian traditional medicine since ancient times. This plant possesses various phytochemicals such as volatile compounds, triterpenoids, phenolic acids, and flavonoids. The presence of substantial amounts of flavonoids in M. officinalis L. necessitates further examination of its usage as a source of natural colorants for developing natural and beautiful shades on wool yarns in addition to its pharmaceutical, cosmetic, and food preservative applications. This will definitely add new direction to the use of M. officinalis L. as an effective natural dye source. Therefore, simple adsorption of aqueous dye extract on wool surface was done followed by the evaluation of build-up properties using different metal mordants and their binary combinations. The dyeing was carried out on pre-mordanted wool by exhaust dyeing method and dyed samples were analyzed via reflectance spectroscopy under D65 illuminant and 10° standard observer in terms of color strength, CIEL*a*b*, and CIEL*C*ho values. The results showed that overall 22 eco-friendly shades of very good to excellent washing, rubbing and light fastness properties were produced by facile use of different metallic salts and their combinations on wool fibers.

Romanian Viscum album L.-Untargeted Low-Molecular Metabolomic Approach to Engineered Viscum-AuNPs Carrier Assembly.

Viscum is one of the most famous and appreciated medicinal plants in Europe and beyond. The symbiotic relationship with the host tree and various endogenous and ecological aspects are the main factors on which the viscum metabolites’ profiles depend. In addition, European traditional medicine mentions that only in two periods of the year (summer solstice and winter solstice) the therapeutic potential of the plant is at its maximum. Many studies have investigated the phytotherapeutic properties of viscum grown on different species of trees. However, studies on Romanian viscum are relatively few and refer mainly to the antioxidant and antiproliferative activity of mistletoe grown on Acer campestre, Fraxinus excelsior, Populus nigra, Malus domestica, or Robinia pseudoacacia. This study reports the first complete low-molecular-weight metabolite profile of Romanian wild-grown European viscum. A total of 140 metabolites were identified under mass spectra (MS) positive mode from 15 secondary metabolite categories: flavonoids, amino acids and peptides, terpenoids, phenolic acids, fatty acids, organic acids, nucleosides, alcohols and esters, amines, coumarins, alkaloids, lignans, steroids, aldehydes, and miscellaneous. In addition, the biological activity of each class of metabolite is discussed. The development of a simple and selective phyto-engineered AuNPs carrier assembly is reported and an evaluation of the nanocarrier system’s morpho-structure is performed, to capitalize on the beneficial properties of viscum and AuNPs.

The effects of Melissa officinalis leaf extract on anxiety among patients undergoing orthopedic surgeries

Background andobjectivesIn European Traditional Medicine and Iranian Traditional Medicine, Melissa officinalis L. is commonly regarded as an anti-anxiety agent. This study aimed to investigate the effects of Melissa officinalis leaf extract on anxiety among patients undergoing orthopedic surgeries. MethodsIn this randomized clinical trial (RCT), 80 candidates for orthopedic surgery were selected by purposeful sampling in an urban area of Iran. These patients were assigned to intervention and control groups using minimization methods. The intervention group consumed 500 mg capsules containing Melissa officinalis leaf extract at 4 pm and 10 pm on the day before the surgery. In the control group, the patients consumed a 500 mg capsule containing starch as a placebo at hours similar to those in the intervention group. Data gathering tools were a demographic questionnaire and the Spielberger State-Trait Anxiety Inventory (STAI). The STAI questionnaires were completed before the intervention and again at 8:00 am on the next day before the surgery. Data were analyzed using SPSS 18. ResultsAccording to the results, no significant difference was found between the two groups before the intervention (Mann-Whitney test, P = 0.67). But there was a significant difference between the two groups on the next day before the surgery, and the mean anxiety level was lower in the intervention group (Mann-Whitney test, P < 0.05). ConclusionsResults of the present study showed that Melissa officinalis extract could reduce anxiety among patients before surgery.

Antihyperuricemic, Anti-Inflammatory and Antihypertensive Effect of a Dry Extract from Solidago virgaurea L. (Asteraceae)

Solidago virgaurea L. is a perennial plant used in European traditional medicine as a diuretic or a remedy for inflammatory conditions of the urinary tract but also for gout, especially in the Balkans. The present study was focused on a preclinical, in vivo evaluation of antihyperuricemic, anti-inflammatory, and antihypertensive effects of a dry extract from S. virgaurea L. (ESV). Colorimetric and HPLC–MS techniques were used to identify the main chemical constituents of ESV. Antihyperuricemic effect of ESV was assessed in a rat model of hyperuricemia induced by the administration of potassium oxonate. Antihypertensive effect of ESV was evaluated in hyperuricemic rats by monitoring systolic blood pressure with a non-invasive blood-pressure recording system. The anti-inflammatory effect of ESV was tested using a rat model of paw edema. The main chemical constituents of ESV were rutin and phenolic acids represented by chlorogenic and caffeic acid. ESV demonstrated significant antihyperuricemic effects in rats due to an uricosuric mechanism. Additionally, ESV reduced the progression of arterial hypertension in hyperuricemic rats and also showed anti-inflammatory properties slightly inferior to diclofenac. The results suggest that ESV could be a natural remedy for the treatment of gout and protection against endothelial dysfunction caused by hyperuricemia.

Artemisia abrotanum L. (Southern Wormwood)-History, Current Knowledge on the Chemistry, Biological Activity, Traditional Use and Possible New Pharmaceutical and Cosmetological Applications.

Artemisia abrotanum L. (southern wormwood) is a plant species with an important position in the history of European and Asian medicine. It is a species famous as a medicinal plant in Central Asia, Asia Minor, and in South-East and Central Europe. The raw materials obtained from this species are Abrotani herba and Abrotani folium. In the traditional European medicine, they have been used successfully most of all in liver and biliary tract diseases, in parasitic diseases in children and as antipyretic medication. In the official European medicine, this plant species is recommended by the French Pharmacopoeia for use in homeopathy. In many European countries, it is used traditionally in allopathy. The latest studies on the biological activity of extracts from the aboveground parts of the plant and/or the leaves, and/or the essential oil have provided evidence of other possible applications related to their antibacterial, antifungal, antioxidant, anticancer, and antiallergic properties. The latest studies have also focused on the repellent activity of the essential oil of this species and the possibility to use it in the prevention of diseases in which insects are the vectors. The main substances obtained from the plant that are responsible for this activity are: the essential oil, coumarins, phenolic acids, and flavonoids. Some of the latest investigations emphasize the large differences in the composition of the essential oil, determined by the geographical (climatic) origin of the plant. A. abrotanum is recommended by the European Cosmetic Ingredients Database (CosIng) as a source of valuable cosmetic ingredients. Additionally, the leaves of this species possess a well-established position in the food industry. This plant species is also the object of biotechnological studies.

Protective effects of Lavandula stoechas L. methanol extract against 6-OHDA-induced apoptosis in PC12 cells

Ethnopharmacological relevanceParkinson's disease (PD) is a neurodegenerative disorder associated with oxidative stress-induced neuronal damage and death. In European and Persian Traditional Medicine, aerial parts (leaves, stems, and flowers) of Lavandula stoechas L. have been widely used for treating neurodegenerative disorders including PD.Aim of the study: Herein, the protective effects of L. stoechas methanol extract were investigated on 6-hydroxydopamine (6-OHDA)-induced cytotoxicity and oxidative damage in PC12 cells. Materials and methodsThe cells were pretreated with a standardized L. stoechas methanol extract (2.5–20 μg/mL) for 24 h and exposed to 6-OHDA (200 μM) thereafter. The cell viability percentage was determined by AlamarBlue test. Intracellular reactive oxygen species (ROS) production was determined by a fluorimetric method using 2′,7′-dichlorodihydrofluorescein diacetate and cellular apoptosis was assessed by the fluorescent probe propidium iodide test. Finally, the expression of proteins involved in apoptosis pathway (Phospho SAPK/JNK, SAPK/JNK, p44/42 MAPK (ERK1/2) and Poly ADP ribose polymerase (PARP)) was measured via Western blot analysis. ResultsTreatment of PC12 cells with 6-OHDA could significantly increase cytotoxicity, ROS level, and cell apoptosis. Pretreatment of PC12 cells with the extract could significantly decrease 6-OHDA cytotoxicity, ROS production, (2.5 and 5 μg/mL) and cell apoptosis (5 μg/mL). Western blot analysis showed that 6-OHDA exposure could increase the expression of proteins involved in apoptosis signaling, while pretreatment with L. stoechas (5 μg/mL) reduced apoptotic proteins. ConclusionsThe present study demonstrated that L. stoechas, which has been traditionally used in Persian Medicine for treating CNS diseases, is a valuable source of active compounds with neuroprotective, anti-oxidant, and anti-apoptotic activity.

Fortified Mycelium of Fomitopsis officinalis (Agaricomycetes) as a Source of Biologically Active Substances Effective in the Prevention of Civilization Diseases

Fomitopsis officinalis is a popular species of therapeutic arboreal mushroom with a documented history of use in traditional European and Asian medicine. It was chosen as a research material not only due to its anti-inflammatory, antimicrobial, and immunostimulatory properties but also because it is endangered in Poland. The aim of this study was to determine the effects of supplementing inorganic zinc and magnesium salts to the culture medium in which F. officinalis was multiplied in vitro in 10-L bioreactors equipped with an aeration and CO2 removal system. The influence of the addition of zinc and magnesium salts to the culture medium on the quantity of bioelements and organic compounds (indole, phenolic compounds, and L-phenylalanine), as well as their bioavailability to the human body (extraction to artificial digestive juices), was determined. The lowest amount of magnesium and zinc was found in the fruiting bodies of F. officinalis (132.1 and 15.3 mg/100 g dry weight [DW], respectively), whereas the highest amount was found in the mycelium obtained on the medium enriched with sulfate salts (1261 and 182.8 mg/100 g DW, respectively). Enrichment of the medium increased the content of the studied bioelements and organic compounds in the F. officinalis mycelium. The results showed that the applied method allowed obtaining fortified mycelium of the tested species as a natural therapeutic material that can supplement the deficiency of bioelements, phenolic compounds, L-phenylalanine, and indole compounds.

Near-Infrared Spectroscopy as a Rapid Screening Method for the Determination of Total Anthocyanin Content in Sambucus Fructus.

Elderberry (Sambucus nigra L., fructus) is a very potent herbal drug, deriving from traditional European medicine (TEM). Ripe elderberries are rich in anthocyanins, flavonols, flavonol esters, flavonol glycosides, lectins, essential oils, unsaturated fatty acids and vitamins. Nevertheless, unripe elderflower fruits contain a certain amount of sambunigrin, a toxic cyanogenic glycoside, whose concentration decreases in the ripening process. Therefore, quality assurance must be carried out. The standard method described in literature is the photometric determination (pH-differential method) of the total anthocyanin content (TAC) that is the highest when the berries are ripe. The drawback of the pH-differential method is the extensive sample preparation and the low accuracy of the method. Therefore, the goal of this publication was to develop a fast non invasive near-infrared (NIR) method for the determination of TAC in whole berries. TAC of elderberries was measured using pH-differentiation method where TAC values of 632.87 mg/kg to 4342.01 mg/kg were measured. Additionally, cyanidin-3-O-glucoside, cyanidin-3-O-sambubioside and cyanidin-3-O-sambubioside-5-O-glucoside which represent more than 98% of TAC in elderberry were quantified using ultra high performance liquid chromatography-multiple wavelength detection—ultra high resolution-quadrupole-time of flight-mass spectrometry (UHPLC-MWD-UHR-Q-TOF-MS) and their sum parameter was determined, ranging between 499.43 mg/kg and 8199.07 mg/kg. Using those two methods as reference, whole elderberries were investigated by NIR spectroscopy with the Büchi NIRFlex N-500 benchtop spectrometer. According to the constructed partial least squares regression (PLSR) models the performance was as follows: a relative standard deviation (RSDPLSR) of 13.5% and root mean square error of calibration (RMSECV/RMSEC) of 1.31 for pH-differentiation reference and a RSDPLSR of 12.9% and RMSECV/RMSEC of 1.28 for the HPLC reference method. In this study, we confirm that it is possible to perform a NIR screening for TAC in whole elderberries. Using quantum chemical calculations, we obtained detailed NIR band assignments of the analyzed compounds and interpreted the wavenumber regions established in PLSR models as meaningful for anthocyanin content. The NIR measurement turned out to be a fast and cost-efficient alternative for the determination of TAC compared to pH-differential method and UHPLC-MWD-UHR-Q-TOF-MS. Due to the benefit of no sample preparation and extraction the technology can be considered as sustainable green technology. With the above mentioned inversely proportional ratio of TAC to total amount of toxic cyanogenic glycosides, NIR proves to be a reliable screening method for the ideal harvest time with maximal content of TAC and lowest content of cyanogenic glycosides in elderberry.

Characteristics of patients visiting naturopathic practitioners for maternal and reproductive health

Abstract Background Naturopathy, recognised by the World Health Organisation as a European traditional medicine system, is practiced in every world region. Patients in countries where naturopathy is practiced visit a naturopathic practitioner for a range of health concerns including maternal and reproductive health; recognised as a global health priority area. This study aims to examine the characteristics of patients visiting naturopathic practitioners for their maternal and reproductive health concerns, and the clinical care provided by naturopathic practitioners to those patients. Methods An international cross-sectional survey of typical naturopathic practices and their associated patients, conducted in naturopathic clinics in 14 countries and 4 world regions. Naturopathic practitioners(n = 54) were invited to prospectively complete an online survey for up to 20 consecutive cases within the study period. Univariate relationships were examined through chi-square tests. Backwards stepwise logistic regression was employed to explore the characteristics most likely to be associated with individuals visiting a naturopath for maternal and reproductive health. Results Naturopathic practitioners provided data for 852 patients, with 43 (5.0%) visiting a naturopath for maternal and reproductive health concerns such as fertility (54.8%), pregnancy (26.2%), preconception health (11.9%), and lactation, breastfeeding or other postnatal care (7.1%). The regression analysis indicates the practitioners are more likely to prescribe acupuncture (OR 2.71, p&amp;lt;.001) and more likely to identify gynecological (OR 4.31, p&amp;lt;.001) or endocrine (OR 3.30, p=.01) systems as important in the management of the health of these patients. Conclusions Individuals are accessing naturopathic practitioners for maternal and reproductive health. An examination of the motivations influencing this population to access naturopathic care and the outcomes of this care is urgently needed. Key messages Naturopathic practitioners throughout the world are being visited for assistance with maternal and reproductive health issues including fertility, pregnancy, preconception and postnatal care. Naturopathic practitioners are prescribing acupuncture, as well as a wide range of other treatments, for maternal and reproductive health issues.

Developmental and chemical characteristics of Melittis melissophyllum L. in limited access of sunlight

Summary Introduction: Bastard balm grows in forests, in central and southeastern part of Europe. The herb of this species is rich in phenolics, mainly flavonoids, phenolic acids and coumarins. The plant is used in traditional European medicine, in digestive problems and for aromatizing tobacco and alcohol products. Objective: The purpose of this study was to determine the influence of shading on bastard balm development and the accumulation of phenolics in its herb, with special respect to coumarin as a quality marker of this raw material. Methods: The plants were cultivated in full sunlight, in 30% and 50% shade provided by shading nets. The herb was harvested from plants in the third year of vegetation, at four subsequent developmental stages and then subjected to chemical evaluation. In the raw material, the total contents of flavonoids, phenolic acids and coumarins was determined. The content of coumarin was analyzed using HPLC-DAD. Results: Plants grown in 30% shade produced the highest number of flowers and seeds. They produced the highest mass of herb at the beginning of the seed-setting stage. The plants grown in full sunlight revealed the highest content of flavonoids and phenolic acids, especially during flowering and at the beginning of the seed-setting stage. The mass of herb obtained by plants cultivated at deep (50%) shade was the lowest, however, the content of coumarin in these plants was the highest. Conclusion: The influence of shade on bastard balm was expressed by the herb mass and coumarin content increment. The plants thrived best in 30% shade, both in terms of flowering abundance and the mass of herb, whereas those from 50% shade were the richest in coumarin.

Simultaneous quantification of thirty polyphenols in blackthorn flowers and dry extracts prepared thereof: HPLC-PDA method development and validation for quality control

The paper presents development and validation of a RP-HPLC-PDA method for quantification of 30 phenolic constituents of the blackthorn (Prunus spinosa L.) flower, a traditional European herbal medicine with a unique and complex composition. The target analytes were selected from over 50 active compounds present in the investigated plant material, and their separation was optimized on a C18 Ascentis Express fused-core column (2.7 μm, 150 mm × 4.6 mm), in a step-by-step process, in terms of elution solvents, gradient profile, temperature, and flow rate. The final procedure was carried out with an acetonitrile-tetrahydrofuran gradient at a flow rate of 1.09 mL/min and column temperature of 28°C. Under those conditions, the matrix peaks were satisfactorily separated within 35 min. The validation showed good precision (RSD < 5 %), accuracy (93.5–102.1 %), linearity (r > 0.9998), and sensitivity (LODs 0.51–2.05 ng) of the method. The real sample analysis demonstrated its applicability for quantification of the phenolics both in commercial samples of P. spinosa flowers (different manufacturers and years of collection), as well as in the extracts (of different polarity) prepared thereof. Thus, the developed procedure proved to be a useful tool in quality control, and the optimization approach might serve as a practical guideline for LC-method development in complex matrices.

How to bridge the gap? European medical plants used for treating oral mucositis: on the search for evidence

PurposeOral mucositis is a common, painful side effect of cancer treatment—be it locoregional (e.g. irradiation) or systemic (e. g. chemotherapy). Phytotherapy is often used by patients to alleviate symptoms. However, knowledge on which medical plants are recommended by literature about Traditional European Medicine (TEM), their effect(s) on symptoms and their efficacy is severely lacking. Therefore, we developed a novel approach to assess traditional knowledge of herbals used in TEM and searched the online databases for studies reporting effects of these plants.MethodsAt first, online research did not yield a satisfying number of studies (MESH terms: “mucositis” OR “stomatitis” AND “herbal” OR “herbal medicine”). Trials were labelled by the country conducting the study. In parallel, we compiled a list of 78 plants recommended for treating oral mucositis by screening 14 books on TEM. Then, a “hit list” of the plants most often mentioned was composed and used further for a second online investigation using the Latin plant designations as MESH term. Studies of both online searches were pooled for analysis.ResultsThere is a gap between traditional knowledge and trials investigating medical plants used by TEM. Overall, herbal remedies alleviate oral mucositis and especially, gingivitis well. There is good evidence for using Matricaria recutita L., Salvia officinalis L., Calendula officinalis L. and Thymus spp. L. for treating oral mucositis.ConclusionClinical trials investigating medical plants known in TEM are rare. However, following our research strategy, we could extrapolate four plants with good evidence for alleviating symptoms of oral mucositis and gingivitis.

UHPLC-DAD-ESI-MS/MS and HPTLC profiling of ash leaf samples from different commercial and natural sources and their in vitro effects on mediators of inflammation.

In European traditional medicine, common ash leaf infusion is recommended by European Medicines Agency to treat minor articular pain and to increase the amount of urine for flushing minor urinary complaints. However, a comprehensive ultra-high-performance liquid chromatography diode array detector electrospray ionisation tandem mass spectrometry (UHPLC-DAD-ESI-MS/MS) analysis of this pharmacopeial plant material has never been performed. Moreover, the number of biological and pharmacological investigations proving the usefulness of this plant material in recommended traditional uses is surprisingly small. Phytochemical profiling of ash leaf samples from different commercial and natural sources and the determination of the in vitro effects on inflammatory mediators in a model of human neutrophils. Ash leaf samples were characterised by total hydroxycinnamic acid content and by high-performance thin layer chromatography (HPTLC), UHPLC-DAD-ESI-MS/MS methods. The effects of leaf infusions on reactive oxygen species (ROS), tumor necrosis factor (TNF-α), interleukin 8 (IL-8), interleukin 1β (IL-1β), and monocyte chemoattractant protein 1 (MCP-1) production by neutrophils were measured using luminol-dependent chemiluminescence and enzyme-linked immunosorbent assay (ELISA). In ash leaf samples 64 compounds were identified or partly identified together with four unknown compounds. The major compounds detected belong to different structural groups, including phenolic acid derivatives, phenylethanoids, flavonoids, iridoids, secoiridoids and lignans. The major compounds detected in ash samples were chlorogenic acid, quercetin-3-O-rutinoside, verbascoside, oleuropein and ligstroside. However, one sample contained coumarin derivatives. This finding suggested adulteration with other Fraxinus species and/or plant parts. All infusions were able to inhibit ROS, cytokine and chemokine production. The performed phytochemical and biological analyses contribute to the knowledge about this pharmacopeial plant material and supports its traditional use to treat minor inflammatory complaints.