Apoptosis, the cell’s natural mechanism for death, is a promising target for anticancer therapy. Both the intrinsic and extrinsic pathways use caspases to carry out apoptosis through the cleavage of hundreds of proteins. In cancer, the apoptotic pathway is typically inhibited through a wide variety of means including overexpression of antiapoptotic proteins and under-expression of proapoptotic proteins. Many of these changes cause intrinsic resistance to the most common anticancer therapy, chemotherapy. Promising new anticancer therapies are plant-derived compounds that exhibit anticancer activity through activating the apoptotic pathway.

https://www.mdpi.com/1422-0067/19/2/448/pdf

Apoptosis: A Target for Anticancer Therapy

Polycystic ovary syndrome (PCOS) is a prevalent, complex endocrine disorder characterised by polycystic ovaries, chronic anovulation and hyperandrogenism leading to symptoms of irregular menstrual cycles, hirsutism, acne and infertility. Evidence based medical management emphasises a multidisciplinary approach for PCOS, as conventional pharmaceutical treatment addresses single symptoms, may be contra-indicated, is often associated with side effects and not effective in some cases. In addition women with PCOS have expressed a strong desire for alternative treatments. This review examines the reproductive endocrine effects in PCOS for an alternative treatment, herbal medicine. The aim of this review was to identify consistent evidence from both pre-clinical and clinical research, to add to the evidence base for herbal medicine in PCOS (and associated oligo/amenorrhoea and hyperandrogenism) and to inform herbal selection in the provision clinical care for these common conditions. We undertook two searches of the scientific literature. The first search sought pre-clinical studies which explained the reproductive endocrine effects of whole herbal extracts in oligo/amenorrhoea, hyperandrogenism and PCOS. Herbal medicines from the first search informed key words for the second search. The second search sought clinical studies, which corroborated laboratory findings. Subjects included women with PCOS, menstrual irregularities and hyperandrogenism. A total of 33 studies were included in this review. Eighteen pre-clinical studies reported mechanisms of effect and fifteen clinical studies corroborated pre-clinical findings, including eight randomised controlled trials, and 762 women with menstrual irregularities, hyperandrogenism and/or PCOS. Interventions included herbal extracts of Vitex agnus-castus, Cimicifuga racemosa, Tribulus terrestris, Glycyrrhiza spp., Paeonia lactiflora and Cinnamomum cassia. Endocrine outcomes included reduced luteinising hormone (LH), prolactin, fasting insulin and testosterone. There was evidence for the regulation of ovulation, improved metabolic hormone profile and improved fertility outcomes in PCOS. There was evidence for an equivalent effect of two herbal medicines and the pharmaceutical agents bromocriptine (and Vitex agnus-castus) and clomiphene citrate (and Cimicifuga racemosa). There was less robust evidence for the complementary combination of spirinolactone and Glycyrrhiza spp. for hyperandrogenism. Preclinical and clinical studies provide evidence that six herbal medicines may have beneficial effects for women with oligo/amenorrhea, hyperandrogenism and PCOS. However the quantity of pre-clinical data was limited, and the quality of clinical evidence was variable. Further pre-clinical studies are needed to explain the effects of herbal medicines not included in this review with current clinical evidence but an absence of pre-clinical data.

/pdf/herbal-medicine-for-the-management-of-polycystic-ovary-38cz4cudc6.pdf

Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism; a review of the laboratory evidence for effects with corroborative clinical findings

Possible risks from even short-term hormone therapy have led many women to try herbs, multibotanical supplements, and dietary soy as alternative treatments for vasomotor symptoms occurring at or after menopause. The Herbal Alternatives for Menopausal Trial (HALT) was a 12-month double-blind, randomized, controlled study assessing the effectiveness and safety of three naturopathic measures as compared to hormone therapy and placebo in 351 women 45 to 55 years of age who were either in late menopausal transmission (52%) or postmenopausal (48%). The participants had at least two vasomotor symptoms each day. Five interventions were compared: 160 mg of black cohosh daily; a multibotanical containing 200 mg of black cohosh daily and nine other ingredients; the multibotanical plus dietary soy counseling; 0.625 mg daily of conjugated equine estrogen, with or without 2.5 mg daily of medroxyprogesterone acetate; and placebo. The rate and intensity of vasomotor symptoms were scored from 1 (mild) to 3 (severe), and the Wiklund Vasomotor Symptom Subscale was used to assess symptoms after 3, 6, and 12 months. At baseline, the women in this study averaged 6.5 vasomotor symptoms daily and symptom intensity averaged 1.8 on the 1-to-3 scale. The number of symptoms per day as well as Wiklund scores decreased in the first 3 months in all groups. No significant differences in either the number of daily symptoms or their intensity was found between the herbal interventions and placebo at 3, 6, or 12 months, with the exception of more intense symptoms at 12 months with the multibotanical plus soy intervention than in the placebo group. Negative findings also were obtained when hot flashes and night sweats were analyzed separately. At no time did Wiklund scores differ significantly between the herbal intervention and placebo groups. In contrast, differences favoring hormone therapy over placebo were significant at all follow-up intervals. Women taking hormone therapy experienced more breast pain and menstrual disorders than did placebo recipients, but there were no significant differences in gastrointestinal symptoms, nausea and vomiting, fatigue, malaise, or headache. Adherence to assigned treatment averaged 86% during the 12-month follow-up period. In view of the urgent need for safe ways of relieving vasomotor symptoms in perimenopausal and menopausal women, it is unfortunate that these results fail to support the use of black cohosh-alone or as part of a multibotanical product-to control these symptoms.

/pdf/treatment-of-vasomotor-symptoms-of-menopause-with-black-30o9xp97rx.pdf

Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo : A randomized trial

Bioactive natural products for chemoprevention and treatment of castration-resistant prostate cancer

Herbal teas are used as therapeutic vehicles in many forms of traditional medicine and are a popular global beverage. The purpose of this scoping review was to examine the evidence relating to the clinical efficacy and safety of herbal teas, and to identify the main research themes and gaps in knowledge to inform further work. A scoping review methodology was followed that set out the research question and described the sourcing, selection and analysis of studies. Overall, a total of 145 research publications were retrieved from global bibliographic databases, and after applying exclusion criteria, 21 remained. These studies looked at herbal tea use in female health, diabetes, heart disease and weight loss, with plant species including lavender, chamomile, fenugreek, stinging nettle, spearmint, hibiscus, yerba mate, echinacea and combinations of herbs. Observational studies explored associations between herbal tea consumption and cancer risk, liver health, and the risks linked to the consumption of environmental contaminants in the plant material. Despite plant materials being the basis for drug discovery, and the popularity of herbal teas, the number of articles exploring clinical efficacy and safety is small. In this review we discuss how herbal teas may be beneficial in some areas of clinical and preventative health, and what further research is required to understand whether regular consumption can contribute to healthy living more generally.

Herbal Teas and their Health Benefits: A Scoping Review.

Anti-androgens are an assorted group of drugs and compounds that reduce the levels or activity of androgen hormones within the human body. Disease states in which this is relevant include polycystic ovarian syndrome, hirsutism, acne, benign prostatic hyperplasia, and endocrine related cancers such as carcinoma of the prostate. We provide an overview and discussion of the use of anti-androgen medications in clinical practice and explore the increasing recognition of the benefits of plant-derived anti-androgens, for example, spearmint tea in the management of PCOS, for which some evidence about efficacy is beginning to emerge. Other agents covered include red reishi, which has been shown to reduce levels 5-alpha reductase, the enzyme that facilitates conversion of testosterone to dihydrotestosterone (DHT); licorice, which has phytoestrogen effects and reduces testosterone levels; Chinese peony, which promotes the aromatization of testosterone into estrogen; green tea, which contains epigallocatechins and also inhibits 5-alpha reductase, thereby reducing the conversion of normal testosterone into the more potent DHT; black cohosh, which has been shown to kill both androgenresponsive and non-responsive human prostate cancer cells; chaste tree, which has a reduces prolactin from the anterior pituitary; and saw palmetto extract, which is used as an anti-androgen although it shown no difference in comparison to placebo in clinical trials.

Shamin Ramasamy

Papers

An Update on Plant Derived Anti-Androgens