Medical Bulletin 21/ August/ 2024
Here are the top medical news for the day:
Herbal Solutions for Lifestyle Diseases in India
A study published recently in Future Integrative Medicine suggests that the use of herbal-based nutraceuticals offers potential benefits for managing lifestyle diseases such as obesity, diabetes, hypertension, cardiovascular diseases, and metabolic disorders, which are primarily caused by unhealthy lifestyle choices like sedentary behaviour, poor dietary habits, and stress.
The author highlights popular herbal remedies such as turmeric, Ashwagandha, Indian gooseberry, Aloe vera, Neem, flaxseed, cinnamon, and green tea offering potential benefits to the consumers.
The Indian population has experienced a significant change in lifestyle, resulting in a marked increase in health awareness. This trend has created a supportive context for the adoption of herbal-based nutraceuticals as both practical and affordable solutions. As a result, Indian consumers are becoming more aware of and interested in the advantages of these natural remedies, which has led to a rise in their popularity and use. This shift underscores a heightened recognition of the benefits of natural treatments and a growing inclination towards alternative health management approaches.
Even though herbal-based nutraceuticals are commonly used, selecting high-quality supplements from reputable sources is crucial. These supplements can interact with other medications, making it essential to consult a healthcare provider before using them. Additionally, they should not replace a healthy lifestyle, which involves maintaining a balanced diet, engaging in regular exercise, and effectively managing stress.
India has a deep-rooted tradition of using herbal remedies to address various health issues, with knowledge and practices handed down through generations. Unlike conventional medications, herbal remedies are often more accessible and cost-effective, especially in rural areas where healthcare resources may be limited. Additionally, many people view herbal remedies as having fewer side effects compared to pharmaceutical drugs, which makes them appealing to those seeking natural alternatives.
Reference: Singh, A. (2024). Herbal-based nutraceuticals in management of lifestyle diseases: Experience from Indian population. Future Integrative Medicine, 3(2), 106-115. https://doi.org/10.14218/FIM.2023.00055
How 'Dancing Molecules' Could Transform Osteoarthritis Treatment
A recent study in the Journal of the American Chemical Society investigated the use of a cyclic peptide mimicking TGF-β1 to promote cartilage repair.
Osteoarthritis is a prevalent and long-lasting condition often characterized by cartilage damage. Researchers are exploring methods to tackle this issue, and a recent study has introduced 'dancing molecules' that may play a crucial role in enhancing cartilage repair.
Current treatments for osteoarthritis typically emphasize managing symptoms, but researchers are also exploring what is necessary for effective cartilage repair. One promising area of investigation is the potential use of the protein transforming growth factor (TGF)-β1 to facilitate cartilage repair.
Researchers developed a specific molecular compound incorporating peptide amphiphiles (PAs), which are self-assembling molecules, and a mimetic epitope of transforming growth factor (TGF)-β1. Mimetic epitopes are synthetic molecules designed to replicate the structures and functions of natural molecules on specific proteins.
The study revealed that a cyclic growth factor mimetic peptide was more effective than a linear one. The researchers tested this cyclic epitope on human joint chondrocytes and found that it successfully activated TGF-β1 signaling within the cartilage cells. Additionally, they discovered that a cyclic epitope assembly with greater mobility was more effective in promoting the production of factors essential for cartilage regeneration.
These findings suggest that enhancing the movement of these epitope assemblies improves their ability to stimulate a positive response in chondrocytes compared to less mobile assemblies.
The researchers transformed their assemblies into what they refer to as “dancing molecules,” discovering that these were more effective at promoting cartilage repair.
Reference: Yuan, S. C., Álvarez, Z., Lee, S. R., Pavlović, R. Z., Yuan, C., Singer, E., Weigand, S. J., Palmer, L. C., & Stupp, S. I. (2024). Supramolecular motion enables chondrogenic bioactivity of a cyclic peptide mimetic of transforming growth factor-β1. Journal of the American Chemical Society, 146(31). https://doi.org/10.1021/jacs.4c00000
The Liver Risks of Six Popular Herbal Supplements
A new study published in the journal JAMA network open indicates that popular six herbal supplements like ashwagandha, black cohosh, Garcinia Cambogia, green tea extract, red yeast rice, turmeric or curcumin are found to be hepatotoxic.
Although herbs and plants have been used medicinally for thousands of years, their popularity has surged recently. Despite being considered “natural,” herbal supplements are not automatically safe and do not undergo review or approval by the U.S. FDA before reaching the market. Furthermore, herbal supplements can cause side effects and may interact with medications that individuals are currently taking.
For this current study, researchers examined data from over 9,500 adults, with an average age of 47.5, from 2017 to 2020. This data included information on prescription drug and herbal supplement use. The scientists specifically investigated the use of six herbal supplements identified in previous studies as potentially harmful to the liver such as ashwagandha, black cohosh, Garcinia cambogia, green tea extract, red yeast rice, and turmeric (or curcumin).
At the end of the study, researchers discovered that approximately 58% of participants had used a herbal or dietary supplement at least once in the past 30 days. Around 5% of these individuals reported having used at least one of the six potentially liver-damaging botanicals within the same period.
Researchers suggest that the use of these potentially liver-damaging botanicals is comparable to the number of people prescribed potentially hepatotoxic medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and simvastatin, a drug used to lower bad cholesterol levels.
Reference: Likhitsup A, Chen VL, Fontana RJ. Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults. JAMA Netw Open. 2024;7(8):e2425822. doi:10.1001/jamanetworkopen.2024.25822
Dialysis May Not Be Optimal for All Older Adults with Kidney Failure
A recent study published in the journal Annals of Internal Medicine found that older adults who were not healthy enough for a kidney transplant, starting dialysis when their kidney function fell below a certain threshold — rather than waiting — afforded them roughly one more week of life.
Patients with kidney failure who are in good enough health to undergo transplantation can benefit from a donated kidney, which helps remove toxins and excess fluid from their blood. However, this option is not available to many older adults who have additional health issues such as heart disease, lung disease, or cancer.
For patients who cannot undergo a kidney transplant, physicians frequently recommend dialysis, a treatment that performs the blood-cleaning functions of healthy kidneys. Kidney failure is diagnosed when a patient’s estimated glomerular filtration rate (eGFR), an indicator of kidney function, drops below 15.
The researchers aimed to assess the impact of dialysis on older adults who are not eligible for a kidney transplant, focusing on its effects on life extension and the number of days spent in inpatient settings such as hospitals, nursing homes, or rehabilitation centres.
The team analyzed health records from 2010 to 2018 for 20,440 patients (98% of whom were men). These patients, aged 65 and older, had chronic kidney failure, were not under evaluation for a transplant, and had an eGFR below 12.
They divided patients into two groups: those who began dialysis immediately and those who postponed it for at least a month. Over three years, approximately half of those who delayed dialysis never eventually started it.
Patients who began dialysis right away lived, on average, nine days longer than those who waited, but they spent 13 more days in an inpatient facility. Age played a role in the outcomes: patients aged 65 to 79 who started dialysis immediately lived 17 fewer days on average and spent 14 more days in an inpatient facility, while patients aged 80 and older who started dialysis immediately lived 60 more days on average but spent 13 additional days in an inpatient setting.
Patients who never started dialysis, on average, died 77 days sooner than those who began dialysis right away but spent 14 more days at home.
Researchers concluded that older adults who began dialysis when their eGFR dropped below 12 mL/min/1.73 m² and were not considered for a transplant experienced only modest increases in life expectancy and spent less time at home.
Reference: Montez-Rath, M. E., Thomas, I.-C., Charu, V., Odden, M. C., Seib, C. D., Arya, S., Fung, E., O’Hare, A. M., Wong, S. P. Y., & Kurella Tamura, M. (2024). Effect of starting dialysis versus continuing medical management on survival and home time in older adults with kidney failure: A target trial emulation study. Annals of Internal Medicine. https://doi.org/10.7326/M23-3028
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