Journal

Journal of Complementary and Integrative Medicine

Editor-in-Chief: Jeremy Y. Ng, PhD

Language: English

First published: January 1, 2004

Publication Frequency: 4 issues per year

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Objective
The Journal of Complementary and Integrative Medicine (JCIM) focuses on evidence concerning the efficacy and safety of complementary medical (CM) whole systems, practices, interventions and natural health products, including herbal and traditional medicines.

Topics
Quality, efficacy, and safety of natural health products, dietary supplements, traditional medicines and their synthetic duplicates // Efficacy and safety of complementary therapies // Evidence-based medicine and practice, including evidence of traditional use // Curriculum development, educational system and competency of complementary health programs // Methodologies on research and evaluation of traditional medicines and herbal products // Integrative medicine: basic and clinical research and practice // Innovation in CAM Curriculum // Educational Material Design

Article formats
Basic and Clinical Research Articles, Review Articles, Mini Reviews, Discussion/Opinion Papers, Short Communications, Editorials

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Network pharmacology based investigation of the multi target mechanisms of Murraya koenigii (curry leaves) in non-alcoholic steatohepatitis (NASH)

August 26, 2025

Harsh Kashyap, Jyoti Kumari, Manisha Khatri

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Objectives Non-alcoholic steatohepatitis (NASH) is a multifactorial chronic liver disease with limited treatment options. Murraya koenigii has reported hepato-protective effects against NASH in humans, but the bioactive compounds and mechanisms remain unknown. In this study, we explored the bioactive compounds of M. koenigii and their potential mechanisms for combating NASH using network pharmacology and molecular docking approach. Methods Using online platforms such as IMPPAT, GeneCards, KEGG, and DisGeNET, we identified the phytochemicals, target proteins, and genes associated with NASH. Through Venn diagram analysis, we determined 31 common targets between the bioactive compounds and NASH-related genes. Gene Ontology (GO) and KEGG pathway enrichment analyses further revealed the key targets and underlying mechanisms. Molecular docking validated the binding interactions between the identified phytochemicals and core target proteins. Results Nine key targets (NFKB, HSP90, TLR4, ESR1, STAT3, MTOR, HIF1A, PI3KA, and PKCD) were identified that interacts with 16 selected phytochemicals. Molecular docking studies indicated phytochemicals, Osthole and Spathulenol to be the promising binders to the core targets especially NF-kB and STAT3. The results represented the muti-target, multi-compound and multi-pathway mechanisms of M. koenigii against NASH. Conclusions This study provides the evidence for further research into the mechanisms of M. koenigii bioactive compounds as complementary therapies for NASH. Our study also identifies the novel drug candidates based on M. koenigii active compounds.
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Teratogenic effect of unregistered traditional Chinese medicine containing Atractylodis lancea radix, Glycyrrhiza glabra radix, Rheum officinale rhizome, and Angelica dahurica radix on fetal morphology of BALB/c mice

August 22, 2025

Fitri Rachmaini, Almahdy Ahmadin, Rahmad Abdillah, Yasherly Permata Sari

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Objectives In Indonesia, several unregistered traditional Chinese medicines (UTCM) are still used to treat gastritis in pregnancy. On the other hand, the safety of medications during pregnancy remains unresolved. This study aims to investigate the teratogenic effect of UTCM containing Atractylodis lancea radix, Glycyrrhizae glabra radix, Rheum officinale rhizome , and Angelica dahurica radix on fetal morphology. Methods A total of 80 pregnant mice were divided into four groups including the negative control (N), given vehicle, as well as treatment groups D1, D2, and D3 given a dose of 35.2 mg/kg BW, 70.5 mg/kg BW and 105.65 mg/kg BW daily respectively. The drugs were administered between the 6th and 15th days of organogenesis. On the 18th day of pregnancy, a laparotomy was conducted. The teratogenic effects were determined by measuring maternal and fetal body weight, the number of fetuses, and skeletal abnormalities in mouse fetuses, visualised with Alizarin solution. All data were analysed using ANOVA. Results The results showed that in all treatment groups, there was a substantial difference in maternal body weight, fetal number, and fetal body weight (p<0.05). There were open eyelids and clubfoot abnormalities observed in all groups, while 27 fetuses with haemorrhages were found in D3. All treatment groups had sternal, sacral, caudal, phalanges and metacarpal abnormalities. Conclusions UTCM administration showed fetal development effects at the early stage of pregnancy in mice. The dose (D3) 105.65 mg/kg BW affected maternal weight gain and fetal skeletal ossification. UTCM administration D1 (35.2 mg/kg BW), D2 0.5 mg/kg BW), and D3 (105.65 mg/kg BW) had no maternal toxicity and fetal teratogenesis.
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Effects of minas frescal cheese enriched with Lactobacillus acidophilus La-05 on bone health in a preclinical model of chronic kidney disease

August 22, 2025

Manuela Fernandes da Silva Melo, Jéssica da Costa Mota, Joana Ramos de Araujo, Patricia Pereira Almeida, Beatriz Oliveira Da Cruz, Michele Lima Brito, Renato de Souza Abboud, Eduardo Moreira da Silva, Ramon Silva Rocha, Adriano Gomes da Cruz, Jonas de Toledo Guimarães, Nathalia da Silva-Costa, Milena Barcza Stockler-Pinto

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Objectives Milk products are good vehicles for probiotics due to their physical-chemical characteristics, improving probiotic survival in food and in the gastrointestinal tract. Lactobacillus acidophilus La-05 is known to modulate gut microbiota, and probiotics have been reported to influence mineral absorption by improving the gut microbiota profile, highlighting the gut-bone axis. This intervention could be relevant in nephrology due to the high prevalence of renal osteodystrophy in chronic kidney disease (CKD). Given the potential role of gut microbiota in bone metabolism, this is the first study to evaluate the effects of consuming Minas Frescal cheese enriched with L. acidophilus La-05 on bone parameters in nephrectomized Wistar rats. Methods Rats were divided into Sham and CKD groups receiving conventional or probiotic-enriched Minas cheese (20 g/day) for 6 weeks. Bone mineral density (BMD) of the femur and tibia was measured using dual-energy X-ray absorptiometry, and femoral biomechanical properties (maximum force, breaking strength, flexural modulus) were assessed using a three-point bending test. Results CKD significantly reduced tibial (0.08 ± 0.01 vs. 0.11 ± 0.01 g/cm 3 , p=0.0147) and femoral (0.14 ± 0.01 vs. 0.16 ± 0.01 g/cm 3 , p=0.0217) BMD in rats, and probiotic supplementation did not mitigate this loss. Probiotic intervention was associated with a significant decrease in femur length in CKD rats (3.74 ± 0.14 vs. 3.92 ± 0.10 mm, p=0.0221). Conclusions Short-term probiotic supplementation in a cheese matrix did not improve BMD or femoral biomechanics, suggesting a limited effect on CKD-related bone loss.
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Experimental evaluation of the Anti-inflammatory and anti-arthritic potential of Saccharum officinarum node extract in FCA-induced arthritic models

August 15, 2025

Priyanka Nanasaheb Khamkar, Snehal Ambadas Gojare, Deepti Dinesh Bandawane, Shakuntala Narayan Kawhale

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Background Saccharum officinarum has been traditionally utilized to treat different types of inflammation in ayurvedic medicine. Scientific investigation into the therapeutic potential of plant nodes remains limited and has not been extensively explored. Objectives To investigate the pharmacological efficacy of ethanolic extract of S. officinarum node (EESO) in reducing inflammation and arthritis in experimental models. Methods EESO was obtained via ethanol extraction and analysed for its phytochemical constituents. Rat paw edema was used to check for anti-inflammatory activity by carrageenan induced model, with Methotrexate (1 mg/kg) employed as the conventional reference drug. The EESO node was administered orally to experimental animals at doses of 50, 100, and 200 mg/kg. Measurements of paw thickness were taken at 0, 1, 2, 4, and 6 h. The anti-arthritic activity was assessed in the rat through induction of arthritis using Freund’s complete adjuvant (FCA). Parameters assessed included paw edema, motor coordination, nociceptive threshold, and, post-sacrifice, biochemical (CRP, RF, ALP, AST, ALT), haematological (Hb, RBC, WBC, ESR), cytokine (TNF -α, IL -1, IL -6), radiological, and histopathological markers. Results EESO at 200 mg/kg significantly reduced paw edema by inhibiting inflammatory mediator release and downregulating pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) in FCA-induced arthritic rats. Histopathology showed decreased synovial hyperplasia and cartilage erosion due to reduced immune cell infiltration and joint inflammation. These inhibiting inflammatory mediator release, downregulating pro-inflammatory cytokines, reduced immune cell infiltration and joint inflammation scientifically validate the traditional use of EESO in managing arthritis and inflammation. This data sufficiently support the assertion that EESO can be utilized for the treatment of arthritis and inflammation. Conclusions EESO at a dose of 200 mg/kg demonstrated significant anti-inflammatory and anti-arthritic activity in the study, scientifically validating its traditional use. The findings provide adequate preclinical evidence supporting its potential therapeutic role. These results suggest that EESO could serve as a natural treatment option for managing arthritis and inflammation.
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Chronic toxicity and modulatory effects of Deprungsith formulation in Wistar Albino rats

August 8, 2025

Yosita Kasemnitichok, Monthaka Teerachaisakul, Tullayakorn Plengsuriyakarn, Kesara Na-Bangchang

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Objectives Psoriasis is a systematic skin disease. Treatment choice is limited due to unsatisfactory clinical efficacy. The study evaluated the safety of Deprungsith formulation following long-term administration (chronic toxicity test) and its potential modulatory effect on hepatic cytochrome P450 (CYP) enzymes in rats. Methods Wistar rats were randomly grouped to receive Deprungsith (125, 500, and 1,000 mg/kg/day) and the satellite (1,000 mg/kg bw) to observe reversibility, as well as distilled water (untreated control) for 9 months. The sentinel-1 group was for environmental risk assessment after 6 months, and the sentinel-2 group was for environmental risk assessment after 9 months). Clinical and behavioral signs, mortality, and histopathology were monitored. Results The chronic toxicity study of Deprungsith revealed no evidence of mortality or serious clinical signs at any dosage level. However, changes in WBC count, serum albumin, and sodium, were observed. Histopathological examination identified mild to moderate liver necrosis and renal interstitial inflammation. Low-dose (125 mg/kg bw) significantly induced CYP1A2 and CYP3A1, while high-dose (1,000 mg/kg bw) inhibited CYP1A2 and CYP3A1 activities. Conclusions Deprungsith formulation was well-tolerated with an MTD (maximum tolerated dose) and NOAEL (no-observed-adverse-effect level) of 1,000 mg/kg bw. Long-term use of Deprungsith formulation in psoriasis patients should be carefully monitored for therapeutic outcomes (side effects from accumulated levels or unsatisfactory efficacy from inadequate CYP1A2 and CYP3A1-mediated metabolism) and potential herb-drug interactions.
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Evaluating the effectiveness of pterostilbene in improving memory and offering neuroprotection in a rat model of Alzheimer’s disease induced by aluminum chloride

July 31, 2025

Ameer Raheem Waheed, Bahir Abdul Razzaq Mshimesh

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Background and Objectives Alzheimer’s disease (AD) is a neurodegenerative disease and is the predominant etiology of dementia. We hypothesize that the naturally occurring pterostilbene (PTE) at doses of 50 and 100 mg/kg would yield dose-dependent neuroprotective effects, reducing cognitive deficits and pathological hallmarks by modulating biomarkers (Amyloid Beta protein (Aβ), Phosphorylated tau protein (P-tau), Brain-Derived Neurotrophic Factor (BDNF), acetylcholinesterase (ACHE), glutamate (GLU)) and a novel synaptic marker neurogranin (NRGN) in rats induced by aluminum chloride (AlCl 3 ). This current research aims to evaluate the neuroprotective effects of pterostilbene (PTE) against neurobehavioral and pathological alterations induced by aluminum chloride (AlCl 3 ) in rats with Alzheimer’s. Methods 40 rats were divided into five groups, eight in each group. They received 70 mg/kg of body weight AlCl3 intraperitoneally for 30 days, followed by oral administration of PTE at 50 mg/kg or 100 mg/kg, or donepezil at 1 mg/kg for 14 days. The Y-maze and novel object recognition tests were used for the neurobehavioral evaluation of the rats. This was followed by a biochemical evaluation using ELISA kits to demonstrate the impact of PTE on the levels of Aβ, P-tau, BDNF, NRGN, AChE, and GLU. Additional validations were conducted through histopathological evaluation of the cortex and basal ganglia in the rat brain. Using GraphPad Prism 10, statistical data were obtained by ANOVA and Tukey’s multiple comparisons test. The histopathologic score system was determined using the non-parametric Kruskal-Wallis one-way ANOVA k-samples (all pairwise) test. Results PTE at 50 mg/kg significantly increases spontaneous alternation percentage (SAP) by 35.7 % and discrimination index (DI) by 79.7 %, while also considerably lowering Aβ by 70.6 %, P-tau by 33.9 %, BDNF by 59.7 %, NRGN by 40 %, ACHE by 28.8 %, and GLU by 28.4 %. Moreover, PTE at 100 mg/kg significantly increases SAP by 42.9 % and DI by 83.4 %, and substantially decreases Aβ by 83.8 %, P-tau by 45.5 %, BDNF by 69 %, NRGN by 42.5 %, ACHE by 69 %, and GLU by 50.9 % compared to the AlCl3 group. Histopathological evaluation of the cortex and basal ganglia in AlCl3-induced rat brains revealed pathological alterations absent in rats treated with PTE. Conclusions This study supports the hypothesis that PTE can reverse memory loss and pathological markers.
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Barriers and enablers to evidence implementation in Australian complementary medicine practice: a cross-sectional study

July 29, 2025

Matthew J. Leach

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Objectives Despite the strong impetus for complementary and integrative medicine (CIM) clinicians to engage with research evidence, the enablers and barriers to evidence implementation for most CIM disciplines remain poorly understood. Identifying these determinants represents a critical first step to facilitating the uptake of research evidence in CIM practice, which this study aimed to examine. Methods This cross-sectional study set-out to examine the enablers and barriers to evidence implementation across nine Australian CIM disciplines. Participants were invited to complete the 84-item online Evidence-Based practice Attitude and utilization Survey (EBASE). Results Two-hundred-and-three CIM practitioners completed the survey (78 % female; 65 % aged 40–59 years). CIM practitioner engagement in evidence implementation was at a low-moderate level. Attitude did not pose as a barrier, with most practitioners reporting a predominantly positive attitude toward evidence implementation. Similarly, education was not a major barrier, with most practitioners self-reporting a moderately-high skill level across 13 evidence implementation-related activities. The only factors largely reported as moderate or major barriers to evidence implementation were lack of clinical evidence in CIM, and lack of time. Conclusions This study offers important insights into the barriers and enablers of evidence implementation within CIM disciplines. While practitioners generally held positive attitudes toward EI, utilisation of evidence-based practices remained low, with structural challenges (i.e. evidence and time) the prevailing issue of concern. Potential solutions, such as decision-support systems and targeted education initiatives, warrant further investigation to ensure their feasibility and effectiveness in enhancing evidence-based practice, improving healthcare efficiency, and optimising patient outcomes in CIM.
Open Access
Effects of the intravenous application of sodium ascorbate in patients with the diagnosis of sepsis in the intensive care unit – observational, analytical, retrospective, comparative study

July 17, 2025

Adlay Martinez Ramos, Hugo Mario Galindo Salom, Helber Armando Prieto Lozano, Paulo Andres Lopez Posada, Juan Manuel Martinez, Marixa Guerrero, Carlos Alberto Carrillo Bravo

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Objectives To evaluate whether high-dose intravenous sodium ascorbate improves inflammatory markers in patients with sepsis. Methods A retrospective, observational, analytical, and comparative study was conducted on patients diagnosed with sepsis and admitted to the ICU at Clínica Estrios (Cartagena, Colombia) between July 1 and 30, 2024. Patients receiving standard treatment were compared with those who also received high-dose intravenous sodium ascorbate (>462 mg/kg/day), supplied by Biological Therapies, Australia. The main outcome was the duration of altered SIRS and SOFA scores. Results Patients treated with sodium ascorbate showed a statistically significant reduction in the duration of altered SIRS and SOFA scores ( X 2 =9.00, p=0.003) compared to those who received standard therapy. Conclusions High-dose sodium ascorbate may serve as an effective adjuvant therapy in sepsis.
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A Comparative evaluation of locally delivered licorice gel and tetracycline gel as an adjunct to non-surgical therapy in the treatment of controlled type −2 diabetic patients with periodontitis stage II and grade B – A split mouth randomized clinical trial

July 16, 2025

Mopati N. R. Gokul, Konathala S. V. Ramesh, Penmetsa S. Gautami, Naga V. S. Sruthima, Mohankumar Pasupuleti, Venkatalakshmi Mathala

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Objectives Periodontitis is an inflammatory disease affecting tooth-supporting structures due to dysbiosis in plaque bio-film. While NSPT remains the gold standard treatment, it limits in its capacity to fully eradicate pathogens, necessitating adjunct antimicrobial therapy. Local drug delivery(LDD) offers targeted treatment with fewer side effects compared to systemic antimicrobial therapy. Recent studies highlight herbal extracts, such as licorice ( Glycyrrhiza glabra ), which exhibit antimicrobial and anti-inflammatory properties, making them promising candidates for LDD. Therefore, the goal was to evaluate the effectiveness of licorice gel and tetracycline gel as a non-surgical treatment auxiliary for individuals with stage II periodontitis and grade B type-2 diabetes. Methods In this randomized, double-blind clinical trial, 20 patients with Type-II diabetes were included. Following NSPT, licorice and tetracycline gel were applied locally as adjuncts to both the test and control groups. Clinical parameters such as Probing pocket depth (PPD), Clinical attachment level (CAL), Bleeding on probing (BOP) were evaluated at base line and 1 month and Landry’s healing index at 7th day. Results In intergroup analysis, licorice gel has shown statistically significant reduction in PPD and CAL with better healing when compared to tetracycline gel.However, there was no statistically significant difference between the groups in terms of bleeding on probing. Conclusions Both licorice and tetracycline gel are equally effective in treating pockets but licorice gel as an LDD agent has shown better and encouragingoutcomes in terms of healing, PPD and CAL.
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The role of complementary medicine in the holistic, patient-centered recovery from anorexia nervosa – a narrative review

July 14, 2025

Isabel T. Carvalho

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Anorexia nervosa (AN) can be a severe psychiatric disorder associated with one of the highest mortality rates among mental health conditions. AN treatment demands a comprehensive, multidisciplinary approach. However, conventional therapies often fall short in addressing the full biopsychosocial complexity of the illness. This narrative review explores the emerging role of complementary medicine (CM) in the management of AN, emphasizing its scientific rationale, clinical applications, and relevance within integrative care models. By synthesizing findings from current literature, the review examines a range of CM interventions, such as functional nutrition, dietary supplementation, phytotherapy, aromatherapy, acupuncture, reflexology, massage therapy, mindfulness meditation, yoga, Qigong, Tai Chi, homeopathy, and Bach Flower Remedies. These modalities aim to restore nutritional equilibrium, improve psychological well-being, enhance body image, reduce stress and anxiety, foster self-regulation, and strengthen the mind-body connection. When used alongside standard treatments, CM may offer a more holistic and individualized approach to care, supporting sustained recovery and reducing relapse risk. Nevertheless, while preliminary evidence is encouraging, further high-quality research is needed to validate the efficacy of these therapies and inform the development of evidence-based integrative treatment protocols for AN.
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Impact of olive oil consumption on surgical outcomes in patients undergoing open heart surgery: a randomized clinical trial

July 14, 2025

Reza Bahrami, Abbas Ebadi, Yaser Saeid, Seyed Saeed Farzam, Elahe Gomrokchian, Malihe Sadat Moayed

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Introduction The incidence of post-surgery outcomes, such as pain and constipation, in patients undergoing coronary artery bypass surgery can impact the healing process and the quality of life of patients. This study aimed to investigate the effect of olive oil consumption on pain and constipation in adult coronary bypass surgery patients. Methods A randomized controlled trial in Qazvin, Iran (2022–2023) assigned 110 patients scheduled for coronary artery bypass surgery to two groups using four-block randomization. In the intervention group, patients received 30 cc of extra virgin olive oil daily with food from the day before the operation to 30 days after. The control group received usual care. Pain and constipation levels were measured before and after surgery and up to 30 days post-surgery using the visual pain scale (VAS) and Bristol stool form scale (BSFS). Results With similar background variables between the two groups, the results indicated that the average pain and constipation scores in the intervention group decreased more than in the control group (p-value < 0.05). Conclusions Based on the study’s findings and the positive impact of olive oil consumption on reducing pain and constipation, incorporating olive oil into the diet of heart surgery patients is recommended.
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Phytochemical innovations in oral cancer therapy: targeting oncogenic pathways with natural compounds

July 11, 2025

Punniyakoti V. Thanikachalam, Mahalakshmi Devaraji, Nandhini Jayaprakash, Harshitha Sivakumar, Divya Balamurugan, Harish Kanna Shanmugan

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Oral squamous cell carcinoma (OSCC) remains a significant global health concern due to its high mortality rate, late-stage diagnosis, and limited treatment options. Conventional therapies such as surgery, radiotherapy, and chemotherapy often face limitations including drug resistance, recurrence, and systemic toxicity, prompting the need for alternative strategies. This narrative review synthesizes recent preclinical evidence on the use of natural phytochemicals including alkaloids, flavonoids, tannins, saponins, and terpenoids for OSCC treatment. These compounds demonstrate anticancer effects through apoptosis induction, oxidative stress modulation, immunoregulation, and metastasis inhibition. In vitro and in vivo studies highlight their cytotoxicity, tumor-suppressive properties, and pharmacokinetic profiles. Additionally, nanotechnology-based delivery systems have shown potential in overcoming bioavailability barriers and enhancing therapeutic efficacy. However, most findings are preclinical, and challenges such as poor pharmacokinetics, off-target effects, and limited clinical trial data must be addressed. This review emphasizes the translational promise of phytochemicals and calls for further clinical validation to integrate these agents into OSCC management.
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The protective effect of hydrolyzed collagen gel from mackerel scad (Decapterus macarellus) to attenuate chronic UVB-induced photodamage

July 10, 2025

Elisa Herawati, Rizki S. Titisari, Helen Kristin, Filosofia F. T. A. Prasasti, Pipin Agnesia, Okid P. Astirin, Shanti Listyawati, Evi Susanti, Nuniek Herdyastuti, Noer Laily, Fatim Illaningtyas

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Objectives Hydrolyzed collagen (HC) extracted from fish skin is a safe and effective native collagen alternative that can potentially protect skin from experiencing photoaging. This study is among the first to explore HC from mackerel scad ( Decapterus macarellus ) application via in vitro and in vivo approaches. Methods The protective effects of HC were investigated on Mouse Embryonic Fibroblasts (MEFs) induced by acute and chronic UVB, followed by testing of HC gel on UVB-induced photoaging models of mice. Cell viability test using the MTT method was performed on UVB-induced MEFs treated with HC concentrations of 10, 20, 50, and 100 g/mL. A gel form HC was applied topically in UVB-induced skin tissues of animal models and analyzed with ELISA to evaluate the inhibitory effect of MMP-1 and IL-6 expression. Results In vitro analysis showed that HC (10, 20, 50 μg/mL) could increase the viability of acute UVB-induced MEFs at a 60 mJ/cm 2 dose. In chronic UVB exposure, all HC concentrations could protect the viability of induced MEFs at 40 mJ/cm 2 dose. HC gel effectively inhibited the increased expression of MMP-1 and IL-6 in UVB-exposed skin, which may be related to its ability to suppress the activation of MAPK and NF-κB signaling pathways. Furthermore, HC gel intervened in the development of epidermal thickening and dermal layer damage in photoaged skin. Conclusions These findings indicated that HC from mackerel scad skin effectively provided a protective effect against the photoaging process.
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Protective effects of citronellol on Escherichia coli septicemia-derived liver lesions in Wistar rats

July 8, 2025

Seyed Moein Ziaei Sistany, Fatemeh Zahra Gharib, Seyed Mohammad Hosseini

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Objectives Indiscriminate and widespread use of antibiotics has caused resistance among infectious bacteria. Citronellol (Cit) is a monoterpene that is defined as an essential oil and is found in lemon, rosemary, oranges, and aromatic plants. This experimental study investigated the effects of Cit on the complications caused by E-coli septicemia in liver tissue in rats. Methods 210 male Wistar rats with an approximate weight of 220 ± 20 were randomly divided into 7 groups of 30 including 1. Control group, 2. Sham group, 3. Received Cit at a dose of 100 mg/kg by intraperitoneal injection, 4. Received Cit at a dose of 200 mg/kg, 5. the E-coli group was administrated enteropathogenic E-coli bacteria O111 with a dose of 1 × 10 9 Colony-forming unit (CFU), 6. the first treatment group received E-coli and Cit at a dose of 100 mg/kg and 7. the second treatment group received E-coli and Cit at a dose of 200 mg/kg. Results Our findings showed that E-coli can cause a significant increase in alanine transaminase (ALT) and alkaline phosphatase (ALP) indices, while in the treatment groups, these indices were significantly reduced. In addition, E-coli septicemia caused oxidative stress in the liver tissue by increasing malondialdehyde (MDA) levels and reducing Superoxide dismutase (SOD) enzymes, which both were significantly regulated in the treatment groups. Conclusions Our results suggested the positive effects of Cit on the septicemia caused by E-coli in the liver tissue by upregulating the antioxidant balance and protective characteristics.
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Icariin as a therapeutic agent in breast cancer: modulating apoptosis and suppressing proliferation

July 7, 2025

Kavita Goyal, Muhammad Afzal, M. Arockia Babu, R. Roopashree, Pooja Bansal, Shivang Mishra, G. V. Siva Prasad, Md. Sadique Hussain, Poonam Negi, Saurabh Gupta, Sachin Kumar Singh, Dinesh Kumar Chellappan, Gaurav Gupta

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Breast cancer remains the leading cause of cancer-related death worldwide, underscoring the urgent need for novel therapeutic strategies. Icariin, a prenylated flavonol glycoside derived from Epimedium species, has emerged as a promising multi-targeted agent with potent anticancer activity. Preclinical studies demonstrate that icariin modulates key oncogenic pathways, including PI3K/Akt, MAPK, NF-κB/SIRT6, and AMPK/mTOR to inhibit tumor cell proliferation, induce apoptosis, and regulate autophagy. Moreover, icariin exhibits anti-metastatic effects by suppressing epithelial-to-mesenchymal transition, matrix metalloproteinase activity, and immunomodulatory actions that may enhance antitumor immunity. Despite these encouraging findings, a comprehensive understanding of its molecular mechanisms and translational potential remains limited. Here, we systematically review the latest in vitro and in vivo evidence on icariin’s pharmacological effects in breast cancer models. We highlight advances in nanoformulation approaches to improve their bioavailability and identify critical knowledge gaps. This review aims to guide future research toward optimized delivery systems and well-designed clinical trials by integrating mechanistic insights with formulation science. Ultimately, elucidating the full therapeutic profile of icariin will inform its incorporation into complementary and integrative oncology regimens, potentially improving outcomes for patients with diverse breast cancer subtypes.
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Comparing I LOVE U and field massages on weight and gastrointestinal function among NICU-admitted preterm infants: a clinical trial

July 3, 2025

Golnoush Motamedi, Jamileh Farokhzadian, Monirsadat Nematollahi, Maryam Alikamali, Zahra Jamali, Sedigheh Khodabandeh Shahraki

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Objectives Preterm infants often face multiple challenges due to immature organ systems. Given the clinical status of infants, massage can serve as a non-pharmaceutical intervention. This study evaluates the effects of I LOVE U and field massages on weight and gastrointestinal function in NICU-admitted preterm infants. Methods A controlled trial was conducted with 84 preterm infants. The infants were randomized into two intervention groups (I LOVE U and field massages) and a control group. The control group received routine care, while the intervention groups received routine care plus either I LOVE U or field massages. Massages were administered for 15 min twice daily before feeding for 5 days. Gastrointestinal variables were measured, including residual gastric volume, abdominal circumference, defecation frequency, and weight before and after the intervention. Data were analyzed with SPSS version 22. Results The study findings revealed no significant differences in weight or gastrointestinal function indices among the groups over the study period. Conclusions The findings demonstrated that infants in the massage intervention group exhibited better weight status and lost less weight than the controls post-intervention. Moreover, the I LOVE U massage technique enhanced defecation in infants, suggesting better impacts on gastrointestinal factors. Further interventional studies, however, are recommended to explore the effects of this specific massage technique. Trial registration This trial was registered with the Iranian Registry of Clinical Trials under Reg. NO. IRCT20221220056884N1.
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Neuroprotective effects of dietary inclusions of alligator pepper (Aframomum melegueta) and bastard melegueta (Aframomum danielli) seeds on scopolamine-induced amnesia in rats

July 3, 2025

Odunayo M. Agunloye, Esther A. Olawuyi, Ganiyu Oboh

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Objectives Neurodegeneration continues to drive conditions of progressive cognitive decline from amnesia to severe dementia in different age groups. Despite, the availability of standard drugs, the need for multi-targeted interventions with no side-effects remains to be explored. Hence, this study evaluates the neuroprotective effects of Aframomum melegueta and Aframomum danielli seeds dietary inclusion on neurocognitive decline in scopolamine-administered male rats. Methods Seven groups of experimental rats were studied for 14 days: normal rats (group 1), untreated scopolamine-administered rats (group 2), scopolamine-administered rats treated with donepezil (group 3), scopolamine-administered rats treated with dietary inclusions of 4 and 8 % A. melegueta (groups 4 and 5 respectively), and 4 and 8 % A. danielli (groups 6 and 7 respectively). Rats were trained with Morris water maze, pre-treated with the diets, and administered (I. P) scopolamine (3 mg/kg body weight from days 12–14). Memory functionality was evaluated using the maze test and hippocampal and cortical brain regions were analyzed biochemically. Results Scopolamine administration impaired working memory, evidenced by increased escape latency and activities of neurodegenerative biomarkers in untreated rats. A. melegueta and A. danielli dietary inclusions significantly reduced escape latency, improved working memory, and restored key biomarkers, including acetylcholinesterase, butyrylcholinesterase, monoamine oxidase, and reactive oxygen species. Treated rats also exhibited elevated total thiol levels, and improved anti-inflammatory markers (IL-10). Conclusions Both A. melegueta and A. danielli seeds showed improved neuroprotective effect in the brain of scopolamine-induced amnesia rats highlighting significant intervention against cognition. However, A. melegueta showed greater neuroprotective efficacy.
Open Access
Natural Health Products Research Society of Canada Natural Health Products and Cancer Mini-Symposium 2025

July 2, 2025

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Traditional alternative and complementary medicine: a review of undergraduate courses and curricula in Peru

June 18, 2025

Juan Huaccho-Rojas, Leonardo J. Uribe-Cavero, Angie Diaz-Mejía, Mabel R. Challapa-Mamani, Marisella Chumán-Sánchez, Oswaldo N. Vite-Gutierrez, Jeremy Yauri-Mamani, Omar C. Bellota-Segovia, Paula Regina Durand-Anahua, Yahaira M. Mamani-Ticona, Zulema Mamani-Condori, Kelly Alarcon-Ore, Kevin Anthony Martínez-Solís, Jair Noé Navarro-Cahuaza, Dante M. Quiñones-Laveriano, Martha Villar-López

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Background Traditional, Alternative, and Complementary Medicine (T&CM) encompasses a variety of health practices that differ from the conventional medical system, including the use of medicinal herbs and complementary therapies. In Peru, these practices, particularly the use of therapeutic plants, are legally protected and commonly used for treating certain conditions. However, the lack of inclusion of T&CM in medical education puts these practices at risk of disappearing. Aim To analyze the inclusion of T&CM courses in the curricula of medical schools in Peru to identify gaps and opportunities for improving medical education and ensuring comprehensive training for future healthcare professionals. Methods A cross-sectional study was conducted by reviewing the curricula of 47 Peruvian medical schools. Data on the presence, structure, and content of T&CM courses were extracted and analyzed descriptively. Results In 2024, 15 out of 47 Peruvian universities offering Human Medicine programs (31.9 %) included T&CM courses. Among them, 73 % were public institutions, and 53 % were located in coastal regions. The most common topics were Traditional Chinese Medicine (93.3 %), Traditional Peruvian Medicine (87 %), phytotherapy (93 %), and acupuncture (80 %). Course structure varied: 60 % of courses were elective, while 40 % were mandatory. Most universities (93 %) allocated 2–3 academic credits, and 80 % incorporated practical training, though structured field visits were rare (6.7 %). Additionally, 53 % of universities included research activities. The lack of standardized curricular guidelines led to variability in course content and depth across institutions. Conclusions Few universities in Peru teach T&CM, highlighting a need to enhance medical education. Increasing T&CM topics in curricula and addressing information access disparities are crucial.
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Effect of aqueous and ethanolic extracts of Dracaena arborea (Dracaenaceae) on acetic acid-induced colitis in rats

June 18, 2025

Liliane Mireille Tchoumba Tchoumi, William Yousseu Nana, Gonzal Eric Tsafack, Stephanie Flore Nguemnang Djuichou, Melvine Dorelle Djomo Tchokote, Cécile Evodie Tonpouwo, Thierry Parfait Elomo Assomo, Marius Mbiantcha, Gilbert Ateufack

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Objectives Ulcerative colitis, with a complex and poorly understood aetiology, is a chronic inflammatory disease of the colon. Current therapies present many side effects and lack efficiency. This study aimed to assess the healing properties of aqueous and ethanolic extracts from the roots of Dracaena arborea on ulcerative colitis induced in rats. Methods Acetic acid (4 %) was injected (intrarectal) to induce colitis. Prednisolone (20 mg/kg), aqueous (500 mg/kg) and ethanolic (100 mg/kg) extracts were administered orally. Clinical parameters were measured through stool consistency, relative body mass, mass-to-length ratio, macroscopic alterations of the colon, and serum and haematological parameters. Oxidative stress markers (in both serum and tissue) and anti-inflammatory parameters were evaluated. Results The results showed that both extracts significantly reduced diarrhea severity, ulcer scores, and prevented the reduction in the colon mass/length ratio. The aqueous and ethanolic extracts significantly increased red blood cell count and haematocrit percentage, as well significantly reducing white blood cell, lymphocyte, monocyte, and granulocyte counts. Regarding oxidative stress markers, in both serum and tissue, the extracts significantly reduced MDA concentrations while increasing GSH concentrations, SOD and catalase activities. The aqueous and ethanolic extracts also significantly reduced NO concentrations and MPO activity. Only the ethanolic extract significantly inhibited TNF-α, IL-6 and IL-1β production. Additionally, both extracts exhibited reparative effects on intestinal epithelium by activating tissue regeneration mechanisms. Conclusions These findings suggest that D. arborea possessed anti-colitis effects in acetic acid-induced ulcerative colitis in rats.
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Isojamaicin, one of the isoflavonoids from Millettia griffoniana Baill (Fabaceae) has anticancer effect on human prostate cancer cells

May 30, 2025

Jordan Lembe Tonga, Michael Herman K. Kamdem, Roland Nhouma Rebe, Edwin M. Mmutlane, Maurice Fotsing Tagatsing, Emmanuel Yankep, Dieudonne Njamen, Stephane Zingue, Derek Tantoh Ndinteh

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Objectives The incidence of cancer, a second leading cause of death globally, continues to rise steadily, and could reach 28.4 million cases by 2040, if no action is taken. Prostate cancer, the second most common cancer in men globally following lung cancer, accounted for 1,414,259 new cases and led to 375,304 deaths in 2022. Chemotherapy and surgery remain the major treatments however, they are associated with side effects. In this study, the anticancer potentials of ten (10) isoflavonoids from Millettia griffoniana Bail was explored. Methods Anti-cell growth (MTT), proliferative (CCK-8) and clonogenic effects of these isoflavonoids were investigated. Furthermore, the most potent compound (isojamaicin) was investigated for its potential to induce apoptosis, inhibit cell migration/invasion and cell adhesion. Results Out of the 10 isoflavonoids isolated from M. griffoniana , isojamaicin significantly inhibited PC3 and LNCaP cell growth and proliferation in a concentration dependent manner. It also significantly (p<0.001) inhibited PC3 cell clone formation. It induced a potent (near 40 %) increment of apoptotic cell population in PC3 cells at both 30 and 60 μg/mL; which was followed by a notable increase in caspase-3 activity. Isojamaicin induced potent inhibition of PC3 cell invasion/migration and increased adhesion of PC3 cells to the extracellular matrix (collagen). Conclusions This study provides an unprecedented report of the anti-prostate cancer potential of isojamaicin and its possible underlying mechanisms. It merits further in vivo research to support the in vitro findings.
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Effects of evening primrose oil on treating painful diabetic neuropathy: a randomized, double-blind, clinical trial

May 23, 2025

Ayub Gholami, Neda Koulaeinejad, Mehrali Rahimi

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Objectives Diabetic neuropathy results in chronic pain. Traditional treatments often offer limited relief, prompting the exploration of alternative therapies like Evening Primrose Oil (EPO). This study aimed to assess the efficacy of EPO in the treatment of painful diabetic neuropathy. Methods In this interventional clinical trial, Patients were randomly assigned to three groups. Group A, consisted of 24 patients, received 1,000 mg of EPO soft gel capsules every 12 h. Group B, consisted of 21 patients, received 1,000 mg of EPO soft gel capsules daily. Group C, also with 21 patients, was divided so that half of the patients received placebo capsules daily and the other half every 12 h. After 4 weeks, patients returned, and questionnaires were completed. Statistical analysis of the data was conducted using SPSS version 25. Results Groups A and B showed significant reductions in visual analog scale (VAS) pain scores, with Group A achieving the most improvement (mean pre-test: 5.96; post-test: 4.63). Analysis of covariance (ANCOVA) revealed significant differences in post-intervention scores (p<0.001) for VAS and Neuropathy total symptom score-6 (NTSS-6), indicating effective interventions. Treatment A was more effective than Treatment B for reducing pain (VAS mean difference= −0.52; p=0.044) and McGill Pain Questionnaire (MPQ) scores (mean difference= −9.56; p<0.001). Conclusions EPO could serve as a valuable alternative therapy for managing painful diabetic neuropathy with fewer side effects than traditional treatments. Further research is warranted to validate these results and explore EPO treatment long-term efficacy and safety.
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Screening the Larvicidal effect of Dawa-e-Hilteet using Instar larvae

May 22, 2025

Asiya Rashid, Ghulamuddin Sofi

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Objectives Mosquitoes are the most common vector for transmitting causative agents from an infectious source to a susceptible host. The key tool for preventing the spread of infection is vector control. Mosquito control is achieved by a variety of means, including personal protection, the use of synthetic insecticides, and so on. Mosquito resistance to chemical insecticides has resulted in mosquito control failure all over the world. This study was done to evaluate the mosquito larvicide effect of Dawa-e-Hilteet to develop an effective herbal alternative for mosquito control. Methods Five different concentrations of Dawa-e-Hilteet in the range of 25–125 ppm were taken and subjected to bioassay against late third instar larvae of Anopheles stephensi . After 24 h, mortality response was observed and compared with Neem seeds extract. Log probit regression analysis was applied to the mortality data to calculate the median lethal concentrations LC50 and LC90 for the larvae subjected to the treatment. Results 91 % mortality in larvae of Female A. stephensi was recorded at 125 ppm of Dawa-e-Hilteet . The mortality percentage increased with the increase in concentration. Hydro alcoholic extract of Dawa-e-Hilteet revealed LC50 value at 66.799 ppm and LC90 value at 119.709 ppm. Conclusions Dawa-e-Hilteet extract exhibited larvicidal activity against late third instar larvae of Female A. stephensi and was found to be more potent than Neem extract.
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The effects of spilanthol (SA3X) supplementation on muscle size and strength in healthy men – a randomized parallel-group placebo-controlled trial

May 6, 2025

Kumar Guru Mishra, Nabnita Patnaik, Nihar Ranjan Pradhan

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Objectives To assess the effects of daily spilanthol (SA3X) supplementation over three months on muscle metrics and hormonal profiles in healthy males. Methods A total of 546 participants were randomized into SA3X or placebo groups, with or without structured exercise. Muscle size (mid-arm, chest, thigh circumference) and strength (bench-press, squatting) were measured pre- and post-intervention. Serum testosterone (total and free), estradiol, and SHBG levels were assessed. Results Among the participants in the exercise groups, those given SA3X had significant increases than those given placebo in terms of muscle size – mid-arm muscle circumference (10.54 vs. 7.21 cm; p<0.05), chest circumference (15.23 vs. 10.82; p<0.05) and thigh circumference (change in quadriceps area, 12.84 vs. 9.01 cm; p<0.05) and significant increases in strength in the bench-press (85.01 vs. 65.09 kg, p<0.05) and squatting exercises (155.04 vs. 95.06 kg, p<0.05). The participants assigned to the SA3X-no-exercise group had significant increases in muscle size than those assigned to the placebo-no-exercise group (p<0.05). A significant increase was also observed in total and free testosterone levels in SA3X group as compared to placebo (p<0.05). No significant increase was seen in estradiol levels. No significant adverse effects were observed among the participants. Conclusions SA3X supplementation significantly enhanced muscle size, strength, and testosterone levels in exercising participants compared to placebo, with additional benefits observed even without exercise.
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Efficacy of mangosteen as local drug delivery for improving periodontal health in adults with periodontitis: a systematic review and meta-analysis of randomized controlled trials

May 5, 2025

Konathala SV Ramesh, Koruprolu Ramalaxmi, Naga VSG Sruthima, Pasupuleti Swetha, Budumuru Anil, Mettapalli PhaniKumar, Gurindapalli Nissi, Chennamsetti Sahithiprabha

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Mangosteen ( Garcinia mangostana L.) has garnered attention for its diverse health benefits, including antibacterial, antioxidant, anti-proliferative, anti-carcinogenic, and anti-inflammatory properties. These therapeutic effects play a central role in the pathophysiology of many conditions. Periodontal disease, a chronic inflammatory disorder of the tooth-supporting structures, is primarily caused by biofilm-forming bacteria. This systematic review focuses on the effectiveness of mangosteen in local drug delivery (LDD) for the management of periodontitis. An electronic search was conducted across multiple databases, including PubMed, LILACS, Web of Science, and Scopus. Cohen’s Kappa coefficient was used to evaluate inter-rater agreement, and the risk of bias was assessed. A random-effects model and heterogeneity were examined using I 2 statistics, while funnel plots were used to detect publication bias. Clinical outcomes, including periodontal pocket depth (PPD) and clinical attachment level (CAL), were extracted from RCTs comparing Mangosteen LDD to placebo or conventional therapies. The analysis revealed a significant reduction in PPD (effect size = −1.08, 95 % CI: −1.40, −0.77) and CAL (effect size = −0.96, 95 % CI: −1.80, −0.13) in the mangosteen-treated group. These findings suggest that mangosteen gel as an LDD can offer substantial clinical benefits by reducing PPD and CAL, thereby improving overall periodontal health. PROSPERO registration link https://www.crd.york.ac.uk/PROSPERO/view/CRD42024618658.
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Induction of mitochondrial-dependent apoptosis, activation of mitochondrial ATPase and cytochrome c release by the methanol extract of Funtumia elastica stem bark

April 14, 2025

Fatima B. Musa, Tolulope A. Oyedeji, Adeola O. Olowofolahan, Hammed O. Faleke, Olufunso O. Olorunsogo

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Objectives Natural compounds that can induce the opening of the mitochondrial membrane permeability transition (MMPT) pore may be useful therapeutic agents in treating diseases associated with mitochondrial dysfunction e.g. cancer, diabetes, and neurodegenerative diseases. This pore represents a promising target for therapeutic intervention. Therefore, this study investigated the potential of the methanol extract of Funtumia elastica stem bark on the MMPT pore, mitochondrial ATPase (mATPase), cytochrome c release (cyt c), and mitochondrial lipid peroxidation (mLPO) in rat liver. Methods Male Wistar rats (100–120 g) were used in this study. Differential centrifugation was used to isolate mitochondria from rat liver. MMPT pore opening, mATPase activity, cyt c, and mLPO were assayed. Results The results indicate that the methanol extract of F. elastica induced MMPT pore opening in the absence of calcium ions. Also, in the presence of calcium ions, the extract significantly (p<0.05) reversed the opening of the MMPT pore by 21.0, 30.0, 34.0, and 38.0 % at 12, 36, 60, and 84 μg/mL, respectively. The extract activated mitochondrial ATPase activity significantly (p<0.05) compared to the control. The extract elevated cytochrome c release with increasing extract concentration relative to the control. The extract also inhibited iron-induced mitochondrial lipid peroxidation by 29.0, 38.7, 59.9, 83.0, and 87.0 % at 150, 300, 600, 1,200, and 2,400 μg/mL, respectively. Conclusions Our results showed that the methanol extract of F. elastica contains potent phytochemicals that can trigger MMPT pore opening, activate mATPase, cyt c, and inhibit mLPO. This extract may find use in diseases associated with apoptosis dysfunction.
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Apitherapy for drug-induced kidney disease: a narrative review on its mechanisms

April 4, 2025

Andrés Jagua-Gualdrón, Nicolai Andrés García-Reyes, Holman Leonardo Africano-Lopez

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Objectives The use of medications for the treatment of various diseases often results in kidney damage. Apitherapy is a natural therapeutic tool with potential utility for this purpose. This narrative review analyzes and summarizes the scientific evidence on the use of apitherapy in drug-induced kidney disease. Content This review summarizes and analyzes recent advances in drug-induced kidney disease and explores, based on the available scientific evidence, how apitherapy can modify these mechanisms and be utilized for prevention and treatment. Summary Apitherapy (the complementary and integrative use of beehive products) is a potentially useful therapeutic system for the treatment of various diseases. This review examines the preclinical and clinical evidence available regarding its potential use in drug-induced kidney disease. Outlook Apitherapy has effects on various pathophysiological mechanisms of drug-induced kidney disease, including oxidative stress, inflammation, decreased renal blood flow, glomerular damage, increased membrane permeability, activity of the renin-angiotensin-aldosterone axis, mitochondrial dysfunction, and apoptosis. Further studies in humans are needed to evaluate its efficacy in the clinical setting, but the available evidence is promising.
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A qualitative study examining older adult usage of complementary and alternative medications and natural health products for cognitive and mental health improvement

March 19, 2025

Dalya Abdulla, Lia Tsotsos

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Objectives The use of complementary and alternative medications (CAM) and natural health products (NHPs) to enhance mood and reduce cognitive decline is well known yet research guiding Older Adult patients and their health care teams on such usage is limited. The purpose of this study was to understand CAM and NHP usage patterns for cognitive health among healthy Older Adults to enable the construct of better guidelines for health care practitioners regarding such usage. Methods A qualitative study was designed to determine usage patterns of CAM and NHPs among Older Adults. Participants were recruited from the Center for Elder Research at Sheridan College and open-ended questions were utilized during one-on-one interviews with interested participants to determine usage patterns in relation to cognitive health. Results A total of 10 participants completed the interviews with an age range of 63–86 years. Results were analyzed using the triangulation method based on a Grounded Theory approach to identify 6 main emerging themes: fear of cognitive health decline, strategies to mitigate perceived/self-diagnosed cognitive health decline, dietary influences on cognitive health, healthcare ownership and self-care, CAM and NHPs loyalty, and supporting Older Adult CAM and NHPs use. Percentages of each response within each main theme was also determined. Conclusions Older Adults appeared to be cognizant of their cognitive health and tended to rely on CAM and NHPs to improve self-perceived decline in cognitive health. Older Adults expressed a desire for their health care practitioners to become more accommodating of such usage and for the government to support them financially for expenditures on CAM and NHPs. Older Adults indicated a preference of visiting health care practitioners who supported the use of these products.
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Exploring the therapeutic promise of fisetin: molecular mechanisms and clinical aspects in lung cancer

February 28, 2025

Kavita Goyal, M. Arockia Babu, Muhammad Afzal, Arcot Rekha, Haider Ali, Saurabh Gupta, Ravindra Pal Singh, Anurag Mishra, Himmat Singh, Mohit Agrawal, Mohit Rana, Mohd Imran, Abida Khan

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Fisetin, a flavonol belonging to the flavonoid subclass, is a ubiquitous dietary flavonoid present in fruits and vegetables, including fruit peels, and has proven potential for anticancer activity, especially for lung cancer – a leading cause of cancer-related deaths globally. The current paper provides the most detailed and elaborate list of the various roles of fisetin in experimentally induced lung cancer cells, and these roles include the promotion of apoptosis, inhibition of cell proliferation, migration, and invasion, as well as the regulation of autophagy. Among the molecular targets, some identified pathways, such as PI3K/Akt, MAPK, and NF-κB, that fisetin affects are crucial for tumor formation, so it can be considered a potential chemopreventive agent. Moreover, fisetin improves the effectiveness of conventional treatments as a chemo- and radiosensitizer and minimizes side effects. However, the overall utility of fisetin for clinical use is now somewhat restricted by its poor solubility and short half-life. It is predicted that the future development of nanotechnologies for drug delivery, such as nanoparticle encapsulation, might help solve these difficulties. Further Preclinical and clinical investigations are required to uniformly determine the safety, efficacy, and standard dosage of fisetin for consumption in lung cancer therapy.
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Catechins in cancer therapy: integrating traditional and complementary approaches

February 21, 2025

Renu Dwivedi, Rajni Bala, Sumitra Singh, Rakesh K. Sindhu

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Catechin is a group of bioactive flavonoids found in various plant sources such as tea, cocoa, and fruits. Recent studies have suggested that catechins has significant potential in preventing and treating cancer. Catechin exhibits a variety of biological activities that may contribute to its anticancer effects, including antioxidant, anti-inflammatory, and pro-apoptotic properties. Studies have demonstrated that catechin can inhibit cancer cell proliferation, induce cell cycle arrest, and promote apoptosis across multiple cancer types, including skin, breast, lung, liver, prostate, and colon cancers. Furthermore, catechin has shown the ability to inhibit angiogenesis, a critical process for tumor growth and metastasis, by restricting new blood vessel formation. Catechin’s impact on cancer extends beyond its direct effects on cancer cells. It modulates various signaling pathways involved in cancer progression, such as those associated with cell survival, inflammation, and metastasis. Despite these promising findings, additional research is needed to clarify the precise mechanisms of catechin’s anticancer action, optimal dosing strategies, and long-term safety in cancer prevention and treatment. This review will explore the current research landscape on tea polyphenols, particularly catechin, and their potential role in cancer prevention and therapy.
Open Access
Prevalence and profile of New Zealand osteopaths treating people experiencing headaches and migraines

February 18, 2025

Ana Paula Antunes Ferreira, Brett Vaughan, Jerry Draper-Rodi, Lee Muddle, Loïc Treffel, Cindy McIntyre, Michael Fleischmann, Francesco Cerritelli, Kesava Kovanur Sampath, Amie Steel

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Objectives To describe the prevalence and profile of NZ osteopaths treating people experiencing headaches and migraines. This study is the first to describe this practice. Background Manual and manipulative therapy interventions are commonly sought by individuals experiencing headaches or migraines. Evidence supports the use of manual therapy as part of the management of headache and migraine disorders. Osteopaths are health professionals who provide care for individuals experiencing headaches and migraines. However, there is a lack of data concerning the profile of osteopaths treating these conditions, in addition to their diagnostic and management strategies. Methods The Osteopathy Research Connect-New Zealand (ORC-NZ), a practice-based research network for the New Zealand osteopathy profession, was established, and recruitment occurred between August to December 2018. Results Two hundred and seventy-seven respondents provided responses to the headache and migraine items on the ORC-NZ practice questionnaire. Of these respondents, 235 (84.8 %) indicated treating headaches often, and 107 (38.6 %) indicated treating migraines often. Osteopaths who reported often treating patients with migraines and headaches were more likely to report clinically supervising associates and be co-located with a general practitioner. In terms of management, they tend to use HVLA, are likely to treat TMJ in the case of migraines, and the thoracic spine for patients with headaches. Further, NZ osteopaths frequently refer patients with migraines and/or headaches to other practitioners. Conclusions NZ osteopaths treat patients with migraines and/or headaches and frequently refer them to other practitioners. NZ osteopaths are aware of the inter-professional approach required for this patient population.
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Effect of cytidine-5′-diphosphocholine alone, caffeine or their combination on oxidative stress and inflammatory response in an experimentally-induced Parkinson’s disease

February 12, 2025

Soha Mohamed Hamdy, Nada Ahmed Elsayed, Eman R. Youness, Heba Mohamed Rabie Elesh, Omar M. E. Abdel-Salam

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Objectives To investigate the effect of orally administered cytidine-5′-diphosphocholine (citicholine) (50,100,200 mg/kg), α-tocopherol (Vit E; 25 mg/kg), caffeine (10 mg/kg), L-dopa (25 mg/kg) or the combination of Vit E, caffeine with citicholine (100 mg/kg) on nigrostriatal neuronal damage induced in the mice brain by subcutaneous (s.c.) rotenone. Methods Swiss male mice received rotenone (1.5 mg/kg, s.c, three times per week) alone or with other drugs for 2 weeks. Mice were evaluated for brain malondialdehyde (MDA), reduced glutathione (GSH), and nitric oxide (NO), paraoxonase-1 (PON-1), acetylcholinesterase (ACHE), interlukin-1beta (IL-1β), nuclear factor kappa B (NF-κB) and monocyte chemoattractant protein (MCP-1). Histopathologic examination was also done. Results Cticholine co-treatment at 50, 100 or 200 mg/kg significantly decreased brain MDA and increased PON-1 activity in a dose-dependent manner. When given at 200 mg/kg, it also significantly decreased NO production, while at 100 and 200 mg/kg significantly increased GSH brain. MCP-1 significantly decreased upon treatment with 100 or 200 mg/kg of citicholine. IL-1 β and NF-κB significantly decreased and AChE significantly increased by 200 mg/kg citicholine. Oxidative stress and inflammatory biomarkers also showed favorable changes after Vit E, caffeine or L-dopa. However, the combination of Vit E and/or caffeine with 100 mg/kg citicholine was not superior to that of only citicholine at 100 or 200 mg/kg. Conclusions Citicholine is neuroprotective in acute rotenone nigrostriatal degeneration via antioxidant and anti-inflammatory properties. It is suggested that citicholine may have a role in treatment of Parkinson’s disease by decreasing neuro-inflammation and oxidative stress, preventing the development of neuronal damage.
Open Access
An in vitro investigation on the physicochemical properties of different quercetin formulations

December 13, 2024

Afoke Ibi, Chuck Chang, Yiming Zhang, Yun Chai Kuo, Min Du, Kyle Roh, Roland Gahler, Julia Solnier

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Objectives Quercetin is a naturally occurring plant flavonoid commonly used as a nutritional supplement due to its antioxidant and anti-inflammatory properties. Its well-known low bioavailability has led to the design of different quercetin formulations by various commercial entities seeking to market a highly bioavailable quercetin product. This study investigates four different commercially available quercetin formulations (LMQ, QUX, QUO, and QUV) for their physicochemical properties that influence bioavailability. LMQ and QUX are liquid-based formulations while QUO and QUV are solid powder-based formulations. Methods Studies were conducted on particle size using a particle size analyzer; solubility (in water, simulated gastric and intestinal fluid) using Ultra High Performance Liquid Chromatography (UHPLC) to quantify the quercetin content; intestinal permeability and toxicity using Caco-2 cells and HepG2 liver cells. Results LMQ and QUX had the narrowest particle size distribution as well as the highest solubility while QUO and QUV had the widest particle size distribution but the poorest solubility. One formulation (QUO) exhibited a significant reduction in cell viability with HepG2 and Caco-2 cells including a significant decrease in TEER value change (−39.0 %; p<0.01); its higher Caco-2 cell permeability (P app 2.85 × 10 −4 ± 4.22 × 10 −5 ; p<0.05) likely resulted from reduced membrane integrity. The other formulations significantly increased the TEER value within the first 4 h ( ≥ 22.7 %; p<0.05). Conclusions The particle size distribution of each of the individual formulations reflected their solubilities in water and gastrointestinal fluids. Despite QUO having the highest permeability, its negative change in TEER value over time revealed its evident cytotoxic effects. QUV performed poorly in terms of solubility, and permeability. LMQ and QUX were the most consistent across each study with LMQ performing better than QUX overall. Findings of this study present one formulation (LMQ) with superior intestinal absorption while maintaining high cell viability, thus making it one of the safer and more effective quercetin formulations.
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“Understanding and treating baras (vitiligo) in unani medicine: historical perspectives, pathophysiology, and therapeutic approaches”

September 30, 2024

Nadeem A. Shah, Rayees A. Mir, Sabba Saltanat

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Vitiligo, also known as baras in Unani medicine, causes patches of depigmented skin due to the loss of melanocytes. According to ancient Unani scholars, factors like excessive phlegm in the blood and weakened color-controlling power were believed to be the cause. This study dives into the historical insights of luminaries like Majūsī and Hakim Akbar Arzānī, alongside modern medical understanding. It explores the pathophysiology, epidemiology, and clinical features of vitiligo, while also addressing confusing definitions, dietary influences, and demographic patterns. We take a close look at the classification, prognosis, and investigative methods. The aim of this research is to bring together traditional and modern perspectives to fully understand vitiligo, covering its cultural, historical, and scientific aspects. By incorporating epidemiological data, dietary considerations, and insights into the underlying mechanisms, we enhance diagnostic and treatment approaches. In conclusion, this study establishes a cohesive connection between the historical wisdom of Unani medicine and the current scientific discourse on vitiligo. By merging these perspectives, we gain a comprehensive understanding of the condition, enabling a more holistic approach to diagnosis and management. As dermatological research continues to evolve, the integration of traditional and modern insights becomes crucial in effectively addressing complex skin disorders like vitiligo.

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CiteScore	3.2	2024, Scopus (Elsevier B.V., 2025)
SCImago Journal Rank	0.321	2024, SJR (Scimago Lab, 2025; Data Source: Scopus)
Source Normalized Impact per Paper	0.583	2024, CWTS Journal Indicators (CWTS B.V., 2025; Data Source: Scopus)

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Editor-in-Chief
Jeremy Y. Ng, PhD, Centre for Journalology, Ottawa Hospital Research Institute, Ottawa, Canada; and Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany

Editors
Dennis Anheyer, University Hospital Tuebingen, Tuebingen, Germany, dennis.anheyer@uni-tuebingen.de
Kieran Cooley, University of Toronto, Toronto, ON, Canada, kcooley@ccnm.edu
Robert Kam-Ming Ko, Hong Kong University of Science and Technology, Hong Kong, China, bcrko@ust.hk
Zacharias Suntres, Northern Ontario School of Medicine, Thunder Bay, ON, Canada, zacharias.suntres@nosm.ca
Phoebe Zhou, Western Sydney University, Sydney, NSW, Australia, p.zhou@westernsydney.edu.au

Editorial Board
Terje Alraek, The National Research Center in Complementary and Alternative Medicine (NAFKAM), Faculty of Medicine at UiT the Arctic University of Norway, Bergen, Norway
John T. Arnason, Department of Biology, University of Ottawa, Ottawa, ON, Canada
Steven K.H. Aung, Associate Clinical Professor, Departments of Medicine and Family, Medicine University of Alberta, ALB, Canada
Robert Banner, Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, ON, Canada
Zhao Xiang Bian, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
Heather Boon, Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
Alieen P. Burford-Mason, DRS Consulting, Toronto, ON, Canada
Harpal S. Buttar, Senior Scientist and Adjunct Professor, Reproduction and Urology Division, Therapeutic Products Directorate, Ottawa, ON, Canada
Dennis Chang, NICM Health Research Institute and Professor of Pharmacology at Western Sydney University, Sydney, NSW, Australia
Alistair Dias, Chemistry Department, University of Toronto, Toronto, ON, Canada
Barbara Findlay, Integrated Health Care Consultant, Richmond, BC, Canada
Gerhard Franz, Faculty of Chemistry and Pharmacy, University of Regensburg, Regensburg, Germany
Daniel F. Gallego-Pérez, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Mahabir Gupta, Facultad de Farmacia, Universidad de Panama, Rep. de Panamá
Cory Harris, Department of Biology, University of Ottawa, Ottawa, ON, Canada
Jennifer Hunter, NICM Health Research Institute, Perth, WA, Australia
Connie Kehler, Canadian Herb, Specialty Agriculture and Natural Health Product Coalition, Saskatoon, SK, Canada
Francis C.P. Law, Faculty of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada
Ye-Seul Jennifer Lee, Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, South Korea
Myeong Soo Lee, KM Science Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, South Korea
Brenada Leung, University of Lethbridge, Lethbridge, ALB, Canada
P.C. Leung, Institue Of Chinese Medicine, Chinese University of Hong Kong, Hong Kong, China
Jian-Ping Liu, Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
Maria Luz Lara-Marquez, Allergist and Immunologist, Integrative Medicine Specialist, San Diego, CA, USA
Candace Necyk, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, ALB, Canada
Siyaram Pandey, Department of Chemistry & Biochemistry, University of Windsor, Windsor, ON, Canada
Michael Smith, National Center for Natural Product Research, University of Mississippi; Oxford, MS, USA; National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
Amie Steel, Australian Research Consortium in Complementary and Integrative Medicine (ARCCIM), University of Technology, Sidney, Ultimo, NSW, Australia
Jerome Yager, Research Integrative Health Institute, University of Alberta, Edmonton, ALB, Canada
Linda Zhong, Biomedical Sciences and Chinese Medicine, School of Biological Sciences at Nanyang Technological University in Singapore, Singapore

Managing Editor
Farida Akhter, ON, Canada
Managing.Editor.JCIM@degruyter.com

Editorial Office
Heike Jahnke, Berlin, Germany
Heike.Jahnke@degruyterbrill.com

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Journal information

Additional information

eISSN:

1553-3840

Language:

English

Publisher:

De Gruyter

Additional information

First published:

January 1, 2004

Publication Frequency:

4 issues per year

eISSN: 1553-3840

Audience(s) for this journal

researchers in the field of medicine, medical sciences, traditional medicine and commercialization; complementary & integrative healthcare providers and educators; consumers

Journal of Complementary and Integrative Medicine

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