Plant-derived compound ‘may effectively treat lupus with fewer side effects’

There is no cure for lupus, but there are medications that can help manage its symptoms. However, some of these drugs cause side effects and increase the risk of other health problems. Now, researchers from the University of Houston, TX, say they have discovered a more natural treatment for the disease that uses a plant extract. So far, it has proved effective and has produced no significant side effects in mice.

The research team, led by Chandra Mohan of the Cullen College of Engineering at the University of Houston, publish their findings in the journal Arthritis & Rheumatology.

Lupus, also known as systemic lupus erythematosus (SLE), is a progressive disease in which the immune system attacks itself, causing damage to healthy tissue, cells and organs. More than 5 million people worldwide have the condition, with around 1.5 million of these living in the US.

Patients with lupus are commonly treated with corticosteroids, which help delay disease progression by curbing immune system activity completely. But the team notes that such treatment means the patient is at higher risk of infection because the immune system is not able to fight pathogens.

Furthermore, steroids can promote an array of side effects, including weight gain, increased blood pressure, mood swings and glaucoma.

CDDO compound halted lupus nephritis development in mice

In this latest study, Mohan and his team tested a synthetic, plant-derived compound called CDDO on 2-month-old mice modified to develop lupus nephritis – a form of lupus that causes kidney inflammation. The effects of the compound were compared with a placebo.

The researchers found that the compound successfully halted each phase of lupus nephritis development in the mice. “The development of lupus is a two-step reaction,” Mohan explains. “First, the immune system develops antibodies that attack the body’s own DNA, then that activated immune system attacks the kidneys. We found that CDDO may block both of these steps.”

The team says that because CDDO is plant-derived and more natural than already existing lupus treatments, it is likely to produce fewer side effects. “That’s a very important point, because many of the current therapeutic agents being used for lupus have significant side effects,” says Mohan, adding:

“As far as we have tested in these experiments, we found that the CDDO compound had no known side effects. Additionally, compared with many other test compounds we’ve previously tried for treating lupus, this one appears to be much more effective.”

The team notes that in future research, they plan to determine whether CDDO halts lupus development by cutting off activity of certain signaling pathways leading to its development, or whether it curbs immune system activity as a whole.

If the latter is true, then they say CDDO could pose the same problems as corticosteroids in that it will increase infection risk. However, they note that even if the compound does turn out to be immunosuppressive, it is still likely to produce fewer side effects.

The researchers conclude that their findings need to be validated before CDDO can be tested in humans, but Mohan says he is “encouraged” by the effectiveness of CDDO against lupus so far.

Last month, Medical News Today reported on another study published in Arthritis & Rheumatology, which claimed that within 30 days of being discharged from the hospital, 1 in 6 lupus patients are readmitted.

Written by Honor Whiteman

http://www.medicalnewstoday.com/articles/282822.php

A form of acupuncture may help relieve chronic constipation

Nearly 1 in 6 adults worldwide may suffer from chronic constipation and, over time, the disorder can cause serious complications.

Auriculotherapy, a form of acupuncture that involves stimulating targeted points on the outer ear, may help in managing constipation.

Evidence from numerous clinical studies published between 2007-2013 that evaluated the effectiveness of auriculotherapy in treating patients with constipation is presented and discussed in a Review article in The Journal of Alternative and Complementary Medicine, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on The Journal of Alternative and Complementary Medicine website until September 25, 2014.

Li-Hua Yang and coauthors from the Hospital of Nanjing University of Traditional Chinese Medicine, Jiangsu Province Hospital of Traditional Chinese Medicine, and Southeast University School of Public Health, Nanjing, China, analyzed the results of 17 published studies, comparing the effectiveness of auriculotherapy in managing and relieving constipation and in alleviating symptoms associated with constipation between affected patients and a control group.

The authors present their data and conclusions in the article “Efficacy of Auriculotherapy for Constipation in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.”

http://www.medicalnewstoday.com/releases/281524.php

Patient education and empowerment can improve health outcomes for diabetes patients

A holistic approach to educating and empowering patients with diabetes can significantly improve their health, according to a new study led by diabetes nurse educators from NewYork-Presbyterian Hospital’s Ambulatory Care Network. Participants in the study enrolled in a Diabetes Self-Management and Education program (DSME) to reduce their blood sugar, blood pressure and cholesterol levels.

Nearly one in 11 Americans have diabetes, a chronic condition associated with serious complications.

Presented at the American Association of Diabetes Educators annual meeting on August 8, the study included 1,263 diabetic patients in a low-income immigrant population in Northern Manhattan. As part of the DSME program’s multifaceted approach, participants underwent a comprehensive initial assessment and received four 30-minute individual sessions with a diabetes nurse educator, followed by group sessions focused on reinforcing self-management behaviors and individual goals. Individual patient sessions concentrated on helping patients achieve their goals, while group sessions helped give patients a deeper understanding of their condition and the implications of their actions.

The program’s components concentrated on seven self-care behaviors: healthy eating, physical activity, monitoring vital signs, medication management, problem solving, healthy coping and risk reduction. Using the holistic medical home approach to care, patients were referred to specialty services, such as endocrinologists, ophthalmologists, podiatrists, dentists, dietitians, social workers and other providers on an as needed basis.

“Apart from assessing a patient’s physical condition,” said the study’s lead educator, Yesenia Cabral, BSN, RN, disease care manager, NewYork-Presbyterian/Ambulatory Care Network, “nurse educators asked patients questions, actively listened to their responses and engaged them in conversation to capture critical information about their lifestyle and eating habits, medication adherence, stress management, self-care and a host of related issues. For example, since most patients forget to take their medication from time to time, we talk about what actually happens to the body when it doesn’t receive the proper medication dosage at the proper time. That really hits home the importance of compliance. As nurses, we believe that organized patient education can empower patients and lead to better outcomes.”

After 15 months, participants on average lowered their A1C (blood sugar) levels by 67 percent and their LDL cholesterol levels by 53 percent. Twenty-five percent of participants had high blood pressure at the end of the study, versus 32 percent beforehand. Also noteworthy, there was a 7 percent increase in participants with a recommended AIC below 7 percent at the conclusion of the study. The A1C test, which measures blood glucose levels, is an indicator of how well diabetes is being managed.

“What sets this program apart is its patient-centered approach,” said the study’s lead investigator, Lovelyamma Varghese, MS, FNP, BC, RN, director of nursing practice and quality and DSME for NewYork-Presbyterian/Ambulatory Care Network. “Nurse educators forge a strong bond with patients to help them build a foundation of knowledge and a sense of control over their condition, which allows them to manage the myriad challenges they face in making powerful changes to keep diabetes under control and avoid complications. We are able to go into their homes, speak their language and identify opportunities for behavioral changes. It’s was a win-win partnership for everyone.” She adds that the educators also partner with providers, dietitians, nurses, and community health workers to implement the program.

As a result of the study’s impressive results, best practices culled from this program are being implemented throughout New York-Presbyterian/Ambulatory Care Network.

 

http://www.medicalnewstoday.com/releases/280868.php

Diabetes-fighting potential spotted in culinary herbs

Food scientists have discovered that the popular culinary herbs rosemary, oregano and marjoram contain compounds that may have the potential to manage type 2 diabetes in a similar way to some currently prescribed drugs.

Elvira de Mejia, a professor in the Department of Food Science and Human Nutrition at the University of Illinois at Urbana-Champaign, and colleagues report their findings in the Journal of Agricultural and Food Chemistry.

The authors point out, in view of the fact type 2 diabetes affects over 8% of Americans and costs the nation around $175 billion a year, there is a need for as many ways to tackle the disease as possible.

While some people can manage the disease with changes to diet and increasing physical activity, and others do so with medication to keep blood glucose in check, not everyone can stick to changes in lifestyle or afford the prescription drugs, they add.

Herbs may offer an alternative way to keep glucose in check

Researchers found that certain herbs, such as rosemary, contain compounds that may have the potential to manage type 2 diabetes naturally.

The researchers note that recent studies have shown herbs may provide an alternative, natural way to keep glucose in check, so they decided to take a closer look.

In their paper, they describe how they investigated the properties of Greek oregano (Origanum vulgare), marjoram (Origanum majorana), rosemary (Rosmarinus officinalis), and Mexican oregano (Lippia graveolens).

They prepared extracts of these plants obtained from greenhouse-grown and commercially purchased dried forms and examined their ability to inhibit two enzymes – one called DPP-IV (also calld DPP-4) that plays a role in insulin secretion, and another called PTP1B that is involved in insulin signaling.

These enzymes have been identified as targets of drugs for managing diabetes. For example, the drugs sitagliptin and metformin are medications in the DPP-4 inhibitor family. However, searching for inhibitors of PTP1B is proving more challenging.

Prof. de Mejia and colleagues found that the greenhouse-grown herbs contained more polyphenols and flavonoids than the commercial, dried versions.

Compounds in rosemary, oregano, and marjoram showed ability to inhibit enzymes

They also found that extracts of greenhouse-grown rosemary, Mexican oregano, and marjoram were the best inhibitors of DPP-IV, while extracts from the commercial, dried versions were the best inhibitors of PTP1B.

Further analysis revealed a number of individual compounds contributed to these inhibitory effects.

The team calls for more studies to understand the role of these compounds in reducing the risk of type 2 diabetes in humans.

In January 2014, Medical News Today reported a clinical trial that found traditional Chinese herbal medicines may halt progress of type 2 diabetes. The researchers said the results show Chinese herbal medicines hold promise for slowing the progression from prediabetes to an official diabetes diagnosis.

Written by Catharine Paddock PhD

http://www.medicalnewstoday.com/articles/280063.php