Sensory Organs and the Immune System

Question 1

Which plants are associated with Eye inflammation?

Answer 1

Euphrasia officinalis L., Orobanchaceae
E. rostkoviana Hayne, Orobanchaceae
Hamamelis virginiana L., Hamamelidaceae ◦ Matricaria recutita L., Asteraceae

Question 2

Which plants are associated with Glaucoma?

Answer 2

Pilocarpus spp., Rutaceae

Physostigma venenosum Balf. f., Fabaceae

Question 3

Which plants are associated with Anterior Uveitis (Iritis)?

Answer 3

Atropa belladonna L., Solanaceae

Question 4

Which plants are associated with Ocular pressure?

Answer 4

Atropa belladonna L., Solanaceae

Erythroxylum coca Lam., Erythroxylaceae

Question 5

Which plants are associated with Excessive Cerumen (ear wax)?

Answer 5

Prunus amygdalus Batsch, Rosaceae

Olea europaea L., Oleaceae

Question 6

Which plants are associated with Ear infections?

Answer 6

Mixture of anti-infective plants with olive oil

Question 7

Which plants are associated with Irritation of Orthopharynx?

Answer 7

Thymus spp., Lamiaceae
Mentha piperita L., Lamiaceae
Salvia officinalis L., Lamiaceae

Question 8

Euphrasia officinalis & E. rostkoviana

Answer 8

Orobanchaceae
Constituents: iridoid glycosides (aucubin, geniposide, catalpol, luproside, eurostoside, euphroside, veronicoside, verproside), lignans, tannins, and polyphenolic acids.
Long history of use as eye remedy (conjunctivitis) in Europe & Asia
Clinical trial results of eye drops with this extract were good for treatment of conjunctivitis

Question 9

Hamamelis virginiana – Witch Hazel

Answer 9

Hamamelidaceae
Constituents: tannins, gallotannins, condensed catechins, proanthocyanins
Active free-radical scavengers (proanthocyandins, gallotannins and gallates)
Maceration of dormant and partially dried twigs used in eye drops and eye lotions to soother the eye and clear redness

Question 10

Matricaria recutita - Chamomile

Answer 10

Asteraceae
Warm teas or compresses used in eye rinses to treat inflammation and remove pus, grime (traditional Mediterranean therapies)
Toxicity: can actually cause allergic conjunctivitis reaction if allergic to Asteraceae

Question 11

Pilocarpine

Answer 11

Botanical sources: Pilocarpus spp., Rutaceae
Alkaloid
MOA: acts directly on cholinergic receptor sites as sympathomimetic agent (mimicking acetylcholine)
Use: miotic (constricts the pupil) in open angle glaucoma & to contract pupil after use of atropine; reduces intraocular pressure by opening channels of the trabecular meshwork
Side effects: salivation & tachycardia if taken systematically

Question 12

Physostigmine

Answer 12

Botanical sources: Physostigma venenosum, Fabaceae (Calabar bean)
Alkaloid
MOA: parasympathomimetic, specifically, a reversible cholinesterase inhibitor; miotic
Use: same as pilocarpine, but effect is shorter lasting
Side effects: not as well tolerated as pilocarpine, may cause local irritation & allergic reactions

Question 13

Atropa belladonna L.

Answer 13

Solanaceae
Atropine – a tropane alkaloid
Eyedrops or ointment to open iris for eye exams, surgical procedures, and to treat anterior uveitis
Mydriatic agent (pupil dilator); blocks the muscarinic acetylcholine receptors in the eye and pupils are no longer able to constrict (results in dilation)

Question 14

Erythroxylum coca Lam.

Answer 14

Erythroxylaceae
Cocaine - alklaoid
Mydriatic, vasoconstrictor
◦Can reduce intraocular pressure
◦Often used in combination with atropine and epinephrine

Question 15

Ear Infections

Answer 15

Otitis interna – inner ear infection = labyrinthitis
– Severe vertigo lasting 1 or more days
Otitis media
– Ear pain associated with fluid pressure; can also have fever
Otitis externa
– inflammation of the outer ear and ear canal; may be due to infection or eczema

Question 16

Excessive Cerumen (Ear Wax)

Answer 16

Prunusamygdalus Batsch (Rosaceae)
◦ Almond oil obtained from seed
◦ Constituents: triglycerides & fatty acids
Olea europaea L. (Oleacaceae) ◦ Olive oil obtained from fruits
◦ Constituents: glycerides

Question 17

Irritation of Orthopharynx

Answer 17

Oral or throat infections
Gargles or mouthwashes of different mint species
◦ Thymus spp., Lamiaceae
◦ Thymol: antiseptic, deodorizing and antiinflammatory
◦ Mentha piperita L., Lamiaceae
◦ Peppermint oil: antiseptic, deodorizing and antiinflammatory
◦ Salvia officinalis L., Lamiaceae
◦ Alpha- and beta-thujone make up 50% of essential oil: soothes inflammations of mouth and throat

Question 18

Which plants are associated with Phytoestrogens?

Answer 18

–Glycine max (L.) Merr., Fabaceae
–Trifolium pratense L., Fabaceae
–Pueraria lobata (Willd.) Ohwi, Fabaceae

Question 19

What plant is associated with Hypoglycaemics?

Answer 19

–Momordica charantia L.,

Cucurbitaceae

Question 20

Which plants are associated with Hormonal imbalance (in women)

Answer 20

–Cimifuga racemosa Nutt.,
Ranunculaceae
–Vitex agnus castus L., Verbenaceae

Question 21

What plant is associated with Weight loss?

Answer 21

–Hoodia gordonii (Masson) Sweet ex

Decne., Apocynaceae

Question 22

What plant is associated with Benign Prostatic Hyperplasia (BPH)?

Answer 22

Serenoa repens (W. Bartram) Small, Arecaceae

Question 23

Which plants are associated with Hormonal imbalance Sweeteners & Taste Modifiers?

Answer 23

–Stevia rebaudiana (Bertoni) Bertoni,
Asteraceae
–Synsepalum dulcificum (Schumach. & Thonn.) Daniell, Sapotaceae

Question 24

Hypoglycemia (low blood sugar)

Answer 24

 Occurs when the level of blood glucose drops below normal
 For diabetics, this means <70 mg/dL, and can be a side effect of insulin medications
 Other factors that can lead to this:  Not eating enough carbohydrates  Skipping/delaying a meal
 Increasing physical activity
 Drinking excessive alcohol without enough food

Question 25

Momordica charantia L., Cucurbitaceae (Bitter melon)

Answer 25

 Hypoglycemic activity – used in traditional medicine for treating
diabetes
 Active compounds:
 cucurbitane-type triterpenoids
 Polypeptide-p (an insulin-like hypoglycaemic protein)
Mechanism of Action (Asian Pac J Trop Dis. 2013 Apr; 3(2): 93–102):
M. charantia, its extracts and isolated components are believed to exert their hypoglycaemic effects via different physiological and biochemical processes. These include:
 insulin secretagogue like effect,
 stimulation of skeletal muscle and peripheral cell glucose utilization,  inhibition of intestinal glucose uptake,
 inhibition of adipocyte differentiation,
 suppression of key gluconeogenic enzymes,
 stimulation of key enzymes, HMP pathway and
 preservation of pancreatic islet cells and their functions.

Question 26

Women’s Health: Menopause

Answer 26

Menopause is the time that marks the end of your menstrual cycles.
 Menopause is diagnosed after you’ve gone 12 months without a menstrual period.
 Menopause can happen in your 40s or 50s, but the average age is 51 in the United States.
 Since the release of the Women’s Health Initiative report in 2002 and the Million Women study in 2003, women have been discouraged from using traditional hormone therapy because of the increased risk of breast cancer, coronary heart disease, stroke, and pulmonary embolism within the estrogen plus progestin arm and increased risk of stroke within the estrogen arm.
 Botanicals are commonly used as alternatives to hormone replacement therapy by women to manage menopausal symptoms

Question 27

Phytoestrogens: Isoflavones

Answer 27

Glycine max (L.) Merr., Fabaceae (Soy)
 Trifolium pratense L., Fabaceae (Red clover)
 Pueraria lobata (Willd.) Ohwi, Fabaceae (Kudzu)
 Most clinical trials have used dosages ranging from 50 to 100 mg/day isoflavones
• Poor bioavailability of genistein and daidzein may explain modest effects in clinical trials

Question 28

Glycine max (L.) Merr., Fabaceae (Soy)

Answer 28

 Soy is one of the major sources of protein in Asian diets
 Isoflavones in soy foods are mainly present as glycosides (genistin, daidzin) that are hydrolyzed by β-glucosidases in the intestine forming the estrogenic ERβ- selective aglycones, genistein and daidzein
 A review published by the Cochrane Collaborative on 43 randomized controlled trials concluded that there was no conclusive evidence that soy supplements reduced menopausal hot flashes

Question 29

Trifolium pratense L., Fabaceae (Red clover)

Answer 29

 The major isoflavones in red clover are the proestrogens biochanin A and formononetin. These are demethylated by cytochrome P450 isozymes in the intestine and liver to the estrogenic ERβ- selective genistein and daidzein
 Data suggest that red clover isoflavones might have higher bioavailability compared to soy; this could explain why the red clover clinical trials tend to show more efficacy for menopausal symptoms compared with those evaluating soy products
 Trial of 72 women randomly divided between placebo and 40 mg dried red clover daily for 12 weeks showed a significant reduction in menopausal symptoms as measured by the menopause rating scale

Question 30

Pueraria lobata (Willd.) Ohwi, Fabaceae (Kudzu)

Answer 30

 Kudzu is used in traditional Chinese medicine for the treatment of menopausal symptoms
 Major isoflavone in kudzu is puerarin (metabolized by gut bacteria), which is the C8-glucoside of daidzein
 same isoflavonoids found in red clover and soy are also found in kudzu in lower amounts
 Randomized controlled clinical trial (127 women, 50–65 years old, 3 months) receiving kudzu standardized to 100 mg isoflavones, HT, or no treatment showed no significant changes compared with control

Question 31

Benign Prostatic Hyperplasia (BPH)

Answer 31

 Enlarged prostate squeezes the urethra causing a weak stream with urination
 In puberty, prostate doubles in size, and later in life (around 25) continues to grow for rest of life (for most men)
 Common condition for older men. Not prostate cancer
 Symptoms:
 Dribbling following urination
 Difficulty beginning urination
 Weak urine stream, with stops and starts
 Frequent need to urinate, especially at night

Question 32

Serenoa repens (W. Bartram) Small, Arecaceae

Answer 32

 Dietary supplement for BPH made from saw palmetto fruits,
found in southern USA (FL, SC, AL, TX)
 Native American medicine for genitourinary disturbances.
 MOA unclear, but has some anti-inflammatory and anti-odeoma properties
 2012 Cochran review found that Serenoa repens therapy does not improve LUTS (lower urinary tract symptoms) or Qmax compared with placebo in men with BPH, even at double and triple the usual dose.
 For the past 30 years Serenoa repens has become a widely used phytotherapy in the USA and in Europe, mostly because of positive comparisons to α-blockers and 5α-reductase inhibitors.
 Two very high quality clinical trials comparing Serenoa repens to placebo and up to 6 years duration. These trials found Serenoa repens no better than placebo, even (in one trial) at escalating doses.

Question 33

Artificial Sweeteners and Taste Modifiers

Answer 33

Artificial sweeteners or a sugar substitute is a food additive that provides a sweet taste like that of sugar while containing significantly less food energy.
Taste-modifying compounds, or taste modifiers, are chemical substances that alter one or more of the Basic Tastes. Many studies have discovered numerous types of taste-modifying proteins found in nature that are categorized as having sweet, antisweet, and sweetness-inducing abilities.

Question 34

Stevia rebaudiana (Bertoni)
Bertoni, Asteraceae (stevia)

Answer 34

 Active compounds: steviol glycosides (stevioside, rebaudioside A and rebaudioside C are the major metabolites)
 These compounds are on average 250-300 times sweeter than sucrose)
 Stevia and its glycosides also possess therapeutic effects against several diseases such as cancer, diabetes mellitus, hypertension, inflammation, cystic fibrosis, obesity and tooth decay
 Many large sweeteners, such as stevioside, with much higher affinity than sucrose for the sweet taste receptor, interact with the T1R2 VFT domain

Question 35

Synsepalum dulcificum (Schumach. & Thonn.) Daniell,
Sapotaceae (Miracle Fruit)

Answer 35

 Active plant glycoprotein: miraculin
 Fruit itself does not elicit sweetness, rather the activity is observed in the presence of high acidity foods
• works in humans, but not mice
 MOA: miraculin at low pH acts on tongue taste buds

Question 36

Hoodia gordonii (Masson) Sweet ex Decne.,
Apocynaceae

Answer 36

 Used by the Khoi San people of South Africa & Namibia as appetite suppressant on long hunts
 Active compound is a pregnane glycoside: 3β-[β-D- thevetopyranosyl-(1→4)-β-D-cymaropyranosyl-(1→4)-β- D-cymaropyranosyloxy]-12β-tigloyloxy-14β- hydroxypregn-5-en-20-one – also known as P57; but >30 other pregnane glycosides in this plant may also play a role
 Putative MOA: may act via hypothalmic modulation
 Developed as food ingredient for weight loss. Annual market size for such products is estimated at over US $3 billion
 Concerns:
• No clinical evidence of appetite suppression, poses
concerns for safety and efficacy
• Adulteration of products (and even of whole plants shipped) is major concern
Hoodia compound P57