GUIDELINES IN PHYTOTHERAPY

 Consensus Conference held in S. Miniat (Pisa) on 31 October 1998

 

Meeting report

 SCIENTIFIC COMMUNICATIONS

1.Antidepressive activity of special extracts of hypericum containing the same concentration of hypericin and hyperforin but different concentratin of flavonoids.

Calapai G*,Crupi A**,Firenzuoli F***,Costantino G*,Campo GM*,Caputi AP*.

Institute of Pharmacology, University School of Medicine of Messina*;Pharmalife-Italia,Airuno (Lecco)**;Service of Phytotherapy,St.Joseph Hospital,ASL 11,Empoli (Firenze).

Hypericum perforatum in a recent meta-analysis in double-blind clinical studies of depression has showed an efficacy greater than placebo, and comparable to synthetic antidepressants. Nonetheless proved clinical efficacy, the mechanism of action is still unknowed. In our study we evalued the effects of acute administration by oral route of two extracts of Hypericum perforatum: LI 160 S (Lichter, 125-500 mg/kg) and Ph-50 (Pharmalife-Italia, 125-500 mg/kg), containing the same concentration of hyperforin (4,5%) and hypericin (0,3%), but a different concentration of flavonoids (respectively 5% in LI 160 S and 50% in Ph-50). We evaluated the forced swimming test (discriminating the antidepressant action of drugs by their capability in reducing the time of immobility during the test) and content of triptophan, serotonin and indoleacetic acid in the cortex, dienchephalon and encephalic trunk in male Sprague-Dawley rats. Results have been compared to those obtained using the same parameters and administering fluoxetine (20-80 mg/kg). Ph-50 (containing 50% of flavonoids) and fluoxetine have reduced significantly the time of immobility in the forced swimming test, while LI 160 S has produced similar effects only with the highest dose. All treatments have produced an increased level of serotonin in the cortex. Only the administration of Ph-50 has induced an increase of serotonin and indoleacetic acid in diencephalon. In the encephalic trunk, serotonin has increased only in rats treated with Ph-50 and fluoxetine. Results, while confirming the antidepressant action of extracts of hypericum, indicate that flavonoids have an important part in therapeutic activity

2.Effects of the administration of a special extract of Gingko biloba and vitis vinifera in amodel of cerebral ischemia

Calapai G*,Crupi A**,Firenzuoli F***,Costantino G*,Campo GM*,Caputi AP*.

Institute of Pharmacology, University School of Medicine of Messina*;Pharmalife-Italia,Airuno (Lecco)**;Service of Phytotherapy,St.Joseph Hospital,ASL 11,Empoli (Firenze).

In our study we have utilized male Mongolian gerbils. We have evalued after bilateral common carotid occlusion lasting 5 minutes, followed by reperfusion, cerebral levels of malonylaldheyde (index of lipidic peroxidation), hyppocampal cerebral edema and neuronal retarded death in the area CA1 of hyppocampus at seven days from ischemia.

Animals have been treated by oral route for 15 days before ischemia as follows: Gingko biloba (37,5-150 mg/kg) + Vitis vinifera (20-80 mg/kg); only Gingko biloba (150 mg/kg); Vitis vinifera (80 mg/kg). In the group treated with Gingko biloba and Vitis vinifera has been observed a dose-dependent reduction of the post-ischemic levels of malonylaldheyde, of cerebral edema in the hyppocampal region and retarded neuronal loss in the area CA1.

3. Prevention of recurrent respiratory infections in children < 6 y.o. treated with a special phytotherapeutical immunomodulant extract vs. an oral bacterial lysate.

Corti G.

Pediatric Unit, St. Joseph Hospital - Empoli.

We studied 40 children which had presented a number of respiratory infectious episodes > 6 per year . Patients have been dvided in 2 groups of 20 children. Group A, has taken a special extract containing Uncaria tomentosa, Astragalus membranaceus, Curcuma longa, Eleuterococcus senticosus and group B, an oral lysate. In group A the average annual frequency of recurrent infections has been 4.2 , while in group B 5.6. In both groups the average frequency of episodes has been < 6 per years, the limit over which the frequency is considered pathologic, and however inferior to the frequency before treatment. The most significative datum has been the median score that was 19.7 points in group A, while 26.1 points in group B. Besides, patients in group A, have taken less frequently antibiotic drugs than those in group B.

4. A clinical study for the evaluation of chiropractic associated with a special extract of Boswellia serrata in benign ostheoarticular vertebral disease.

Gori L, Firenzuoli F

Service of Phytotherapy, St. Joseph Hospital, ASL 11,Empoli (Firenze).

We evaluated 60 patients affected by vertebral hypomobility and pain lasting at least two weeks. All the patients underwent standard Rx of the vertebral column in toto aimed to exclude primary and secondary illness that do not permit safe vertebral manipulation. All the patients have been requested to classify the pain by a scale from 1 to 10 and vertebral hypomobility by a scale from 1 to 5 at the first consultation. Patients underwent one manipulation every week for one month. Patients in group A took 800 mg/day of a special extract of Boswellia serrata for one month, while patients in group B took a placebo for the same period. Patients have been followed-up at 1,2,3 and 4 months from tha last manipulation. Both groups after the treatment had an almost complete remission of sintomatology, but after 4 months patients in group A had a pain average score of 1 vs. 3 in group B; and a hypomobility average score of 0.4 in group A vs. 2 in group B.

5. Cardiovascular toxicity of Citrus Aurantium extracts.

G. Calapai*, F. Firenzuoli**, A. Saitta ***, F. Squadrito*, M.A.Arlotta*, G.Inferrera*,G.Costantino*, A.Caputi*.

Institute of Pharmacology, School of Medicine, University of Messina, Italy*; ** Service of Phytotherapy,Ospedale S.Giuseppe,ASL 11,Empoli, Italy; *** Dep. of Internal Medicine, School of Medicine, University of Messina,Italy.

Citrus aurantium is a phytotherapeutic extract recently introduced in Western markets for the treatment of obesity. We tested Citrus aurantium in Sprague-Dawley male rats weighting 240-280 gr. A special extract of Citrus aurantium titrated in synephrine (6%) was administered by oral route utilizing a gastroesophageal probe in a daily dose of 2,5-20 mg/kg for 28 days. Another group of rats was treated only with a vehicle (NaCl 0.9 %) as control. We evalued the following parameters: mortality, daily food and water intake, weight loss, electrocardiographic abnormalities and blood pressure (at 7, 15 and 28 days of treatment). We observed a relevant reduction in food intake and weight loss in rats treated with Citrus aurantium vs placebo group. But in the verum group showed a dose-dependent mortality (10-50 %) and electrocardiographic abnormalities (ventricular arhythmias with enlargement of QRS complex), in the group treated in the lowest dose of Citrus aurantium too. Blood pressure did not show any abnormality in both groups. Results demonstrate that Citrus aurantium, although it can posses interesting effects on alimentary behaviour and weight loss of rats, it has lethal effects probably due to the activity of synephrine on the heart.