PHYTOTHERAPY IN MODERN HEALTHCARE BOOKLET

PHARMACY EDUCATION WEEK CAMPAIGN 2022

AfRO | EuRO

TABLE OF CONTENTS PHYTOTHERAPY IN MODERN HEALTHCARE

Introduction About IPSF AfRO and EuRO

Page 2

About the Project Incorporating the Greens

Page 3

Best Entries

Page 4 Page 19

Articles

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INTRODUCTION ABOUT IPSF AfRO & IPSF EuRO

IPSF EuRO IPSF European Regional Office (EuRO) is one of the five regional extensions of the International Pharmacy Students’ Federation. It pertains to all matters happening in Europe and it is comprised of 36 member associations, with approximately 100 000 students over 29 countries.

More information can be accessed through the IPSF website: www.euro.ipsf.org

IPSF AfRO IPSF African Regional Office (AfRO) was established in the 54th IPSF World Congress held in Cluj-Napoca, Romania in August 2008 when its establishment was voted in as a way of tackling the importance of decentralizing IPSF work into regions.

IPSF AfRO is the leading international advocacy organization for African pharmacy students and recent graduates with the aim to promote improved public health through the provision of information, education, networking as well as a range of publications and professional initiatives.

The African Regional Office is represented by 24 member organizations (MOs) in 23 countries of which fourteen are Full Members and ten are Members-in-Association.

More information can be accessed through the IPSF website: www.afro.ipsf.org

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ABOUT THE PROJECT PHYTOTHERAPY IN MODERN HEALTHCARE

PHYTOTHERAPY IN MODERN HEALTHCARE

Explaining the project

Pharmacy Education Week in IPSF highlights professional development and brings to light relevant topics for pharmacy students and recent graduates.

This year, IPSF European Regional Office (EuRO) and IPSF African Regional Office (AfRO), organised a week-long (14th to 19th March 2022) celebration and professional development campaign themed "Phytotherapy in Modern Healthcare".

During this campaign a call for article submission based on the theme was released where the participants could contribute by sharing their own project work or a literature review on the topic related to phytotherapy, that is, plant-based treatment approaches you find interesting.

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BEST ENTRIES PHYTOTHERAPY IN MODERN HEALTHCARE

Phytotherapy in Modern Healthcare A short review

By Rumyana Georgieva From KNPSV, Netherlands

Abstract Phytotherapy is the oldest type of pharmacological treatment. In modern times, it been cast under doubt due to lack of clinical data to support certain claims of its beneficial effects. Contrary to this belief, there is a multitude of studies focusing on different plants, herbs and other natural products that shows evidence of their significant effects, both alone and in mixtures. Phytotherapeutics could be vital as an additional treatment, in addition to traditional and well-established medicinal products. However, reproducibility, extraction, purification methods and degree of effectiveness are still major challenges for phytotherapeutic research. These issues require modern regulatory and computational solutions, that could help in the rapid gathering of more information of the effects of phytotherapeutics in different diseases and disorders.

Introduction Drug innovation and healthcare advancements have been on the rise for decades.

Medicinal research covers a broad spectrum of issues. Diseases and disorders that still do not have proper therapeutics for their treatment, usually have an unknown or complex mechanism that impedes novel drug discovery. The issues are further deepened with the lack of a proper understanding of all aspects of molecular pathways.

(1,2). These issues have led to the rise of complex biological drugs, drug delivery systems and improvement of prevention, when applicable (2–4).

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The development and production of such novel approaches are highly innovative, tough costly and often unsuccessful due to lack of desired effects or severe adverse events (2–4). People who suffer from chronic illnesses or even have a common infection often seek supplementary alternative treatments, such as traditional medicine, dietary changes, general lifestyle changes, exercise or physiotherapy (5).

Among these alternative treatments is phytotherapy.

Phytotherapy is older than any other medicinal practice on all continents (6).

Different benefits of herbs and plants have been preserved through folk healing traditions and word-of-mouth (6,7). However, most of these benefits are not officially supported by empirical data, research studies or proper biological and chemical explanations of how these compounds affect the body. Hence, usage of such approaches is often frowned upon by physicians and researchers, since positive effects can also occur through a placebo effect (6).

Despite all possible drawbacks, phytotherapy has potential as a treatment.

Especially in our current times that require more out of the box thinking for complex medicinal issues, such as the possibility to use phytotherapeutics as a means of prevention or as a supplementary co-treatment. Therefore, the aim of this review is to summarise this treatment's potential.

Phytotherapy as a treatment Phytotherapeutics overview

Herbs and plants used in phytotherapy are not made up of one compound, but from a plethora of varied contents with distinct chemical structures. These contents in turn can be extracted and purified in order for their properties and potential to be further assessed (8,9). In turn, purified compounds can be developed into drug candidates (9). Apart from the active compounds in plants, they can also contain minerals, vitamins and plant-based hormones such as phytoestrogens, which can also positively affect a person’s health (5). Mixtures of multiple plants have been made for decades as traditional treatments and have shown beneficial effects (5).

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When all these compounds enter the body, they are metabolized. This results in the production of secondary metabolites, which from an evolutionary point of view are always produced to serve a specific function – protection, environmental signalling, nutrition, etc (8,10). Depending on the role of these compounds they could be toxic and detrimental to humans or have pharmacologic effects.

Phytotherapeutics contain mostly phenol-based compounds, polysaccharides, alkaloids, polypeptides or isoprenoids (8,11). These are contained in rare herbal medicines such as Rosaceae, Salvia, Asteraceae, Viburnum as well as in common use products such as garlic, Aloe vera or cinnamon, which are also considered phytotherapeutics (5).

Effect Despite the famous claims that phytotherapy lacks enough scientific backup, thousands of studies have been carried out on phytotherapeutics (5,7 – 9,11,12). Clinical data regarding phytotherapeutics is summarized in pharmacopoeias or monographs (12).

Studies have proven that phytotherapeutics affects molecular pathways and exert detectible and statistically significant effects in vitro and in vivo (5,7 – 9,11,12).

Phytotherapeutics have been approved for use as official drugs, food supplements or nutrition additives. They are thought to possess low or no toxicity, which cannot be said for traditional drugs (7). They can affect viruses, bacteria, fungi, cell membrane receptors, enzymes, immune cells, the cell cycle, etc (9). Their effects can range from increasing apoptosis and hauling proliferation of damaged cells, modulating the immune response, anti-inflammatory, anti-oxidant effects to suppressing disease-related overactivated pathways such as NF-κB and MAPK, whose overactivation leads to increases of pro-inflammatory genes and other types of damage (5,7–9,11,12).

For viral infections, such as the current COVID-19, evidence has shown the ability of phytotherapeutics such as flavonoids, glycol compounds and carboxylic acids to affect proteins on the virus, block entry into host cells and modulation of the immune response (7). An analysis carried out in China to investigate the use of herbs during the pandemic has yielded that disease progression, symptoms and time spent in hospitals decreased during co-treatment with traditional Chinese medicine. (7,13)

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For bacterial and fungal infections, different studied Centaureinae plants have all shown inhibitory effects on fungal growth, without eliciting any detectible side effects (9).

Phytotherapeutics have also shown antimicrobial activities. There is no possibility to develop resistance to plants or herbs as opposed to antibiotics (11).

Studies have also been carried out for chronic illnesses such as endometriosis or diabetes (5,12). Phytotherapeutics can reduce glucose levels, improve lipid concentrations and increase insulin production through unknown mechanisms (12).

Cinnamon has shown effects on regulatory enzymes of glucose breakdown and production, thus improving the diabetic state of patients (5,12). In endometriosis, phytoestrogens were shown to have estrogenic activity, effectively restoring proper estrogen signalling. Moreover, cell apoptosis was increased in endometriosis lesions during treatment with different phytoestrogens (5).

Discussion As already mentioned, the beneficial effects of some phytotherapeutics have not been scientifically proven. Furthermore, even if there is a rise in studies with positive results that help in the gathering of scientific data, reproducibility is an issue (12). Unlike drug products, whose synthesis can be controlled and optimized, phytochemicals are either obtained directly by consuming plants or by being extracted, fragmented and prepared into an active compound, however, this leads to a major variability between studies (12). The concentration, purity and amount of extracted compounds will vary depending on the maturity of the plants, the extraction and the preparation method.

Furthermore, absolute purification of compounds with the goal of extracting a clinically effective concentration can be a herculean task and would discourage researchers and manufacturers who would prefer to have a readily available active concentration (8,10).

The lack of studies, also means the statements that phytotherapeutics has little to no side effects might not be fully correct. For example, phytoestrogens have shown the potential to affect COVID-19 by impeding attachment to host cells and also affecting endometriosis lesions (5,7).

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However, phytoestrogens have only been sold as dietary supplements. Their long-term effects have not been rigorously looked into as with drug products, that have to undergo different procedures for approval. Meaning their long-term side effects are actually unknown. Since phytoestrogens can mimic estrogen activity, and loosely bind to the same receptors, this could have detrimental effects as overactivation of estrogen receptors can lead to cancer. There is no such evidence for phytoestrogens, however, long-term clinical trials to assess their effect are also scarce. This is valid for other phytotherapeutics as well (14).

Moreover, dietary supplements or alternative medicines are often present only in mixtures. Then the assessment of these compounds’ join effects becomes more difficult as they can have synergistic, antagonistic or additive effects with each other. If there are more than two compounds present, assessment of their concrete effects becomes blurred and in general studies with one compound are preferred (5,8,14).

Therefore, all these drawbacks have to be tackled using model medical techniques and guidelines in order for phytotherapeutics to become more appealing to researchers.

Usage of certain concentration amounts or purification methods (10). Studies ought to be more standardized with more regulation in order to decrease variability. In recent years, programming methods and life science software have been developed in order to handle the colossal amount of data from research as well as use different predictive methods in order to make biological research less time-consuming. Metabolomics, target-prediction software and other bioinformatics resources could be used on already purified plant compounds to predict their pharmacokinetic and pharmacodynamic effects. Hence, modern omics and predictive tools could be used to facilitate phytotherapeutic research and contribute to the build-up of evidence for its beneficial effects (10,15).

Since diseases such as cancer cannot be purely tackled by phytotherapeutics and evidence for their strong effects in other aforementioned conditions is also not full, before a stable build-up of scientific evidence, plants and herbs can be used as a supplementary treatment for most major diseases and disorders.

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Conclusion Phytotherapy has shown diverse beneficial effects in numerous studies. Contrary to popular belief, plants and their active compounds can indeed elicit changes in one’s body, however mapping out the exact mechanism and interactions between compounds in mixtures and raw sources is a challenge. This challenge requires modern solutions and regulations, so that the situation can be improved in order to pave way to gathering more scientific data for phytotherapy.

References 1. He B, Lu C, Zheng G, He X, Wang M, Chen G, et al. Combination therapeutics in complex diseases [Internet]. Vol. 20, Journal of Cellular and Molecular Medicine.

J Cell Mol Med; 2016 [cited 2022 Mar 20]. p. 2231–40. Available from: https://pubmed.ncbi.nlm.nih.gov/27605177/ 2. Grover MP, Ballouz S, Mohanasundaram KA, George RA, H Sherman CD, Crowley TM, et al. Identification of novel therapeutics for complex diseases from genome-wide association data. BMC Med Genomics [Internet]. 2014 May 8 [cited 2022 Mar 20];7(SUPPL.1).

Available from: https://pubmed.ncbi.nlm.nih.gov/25077696/ 3. Xue M, Zhao R, Lin H, Jackson C. Delivery systems of current biologicals for the treatment of chronic cutaneous wounds and severe burns. Adv Drug Deliv Rev [Internet]. 2018 Apr 1 [cited 2022 Mar 20];129:219–41. Available from: https://pubmed.ncbi.nlm.nih.gov/29567398/ 4. Škalko-Basnet N. Biologics: the role of delivery systems in improved therapy.

Biologics [Internet]. 2014 Mar 19 [cited 2022 Mar 20];8:107–14. Available from: https://pubmed.ncbi.nlm.nih.gov/24672225/ 5. Corte L Della, Noventa M, Ciebiera M, Magliarditi M, Sleiman Z, Karaman E, et al. Phytotherapy in endometriosis: An up-to-date review [Internet]. Vol. 17, Journal of Complementary and Integrative Medicine. J Complement Integr Med; 2020 [cited 2022 Mar 20].

Available from: https://pubmed.ncbi.nlm.nih.gov/31532753/ PHYTOTHERAPY IN MODERN HEALTHCARE BOOKLET

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6. Fürst R, Zündorf I. Evidence-Based Phytotherapy in Europe: Where Do We Stand?

[Internet]. Vol. 81, Planta Medica. Planta Med; 2015 [cited 2022 Mar 20]. p. 962–7.

Available from: https://pubmed.ncbi.nlm.nih.gov/25922913/ 7. Huang J, Tao G, Liu J, Cai J, Huang Z, Chen JX. Current Prevention of COVID-19: Natural Products and Herbal Medicine. Vol. 11, Frontiers in Pharmacology. Frontiers Media S.A.; 2020. p. 1635.

8. Wink M. Modes of Action of Herbal Medicines and Plant Secondary Metabolites.

Medicines [Internet]. 2015 Sep 8 [cited 2022 Mar 20];2(3):251–86. Available from: /pmc/articles/PMC5456217/ 9. Nawrot J, Gornowicz-Porowska J, Nowak G. Phytotherapy Perspectives for Treating Fungal Infections, Migraine, Sebhorreic Dermatitis and Hyperpigmentations with the Plants of the Centaureinae Subtribe (Asteraceae) [Internet]. Vol. 25, Molecules (Basel, Switzerland).

Molecules; 2020 [cited 2022 Mar 20].

Available from: https://pubmed.ncbi.nlm.nih.gov/33203185/ 10. Atanasov AG, Zotchev SB, Dirsch VM, Orhan IE, Banach M, Rollinger JM, et al. Natural products in drug discovery: advances and opportunities [Internet]. Vol. 20, Nature Reviews Drug Discovery. Nature Publishing Group; 2021 [cited 2022 Mar 20]. p. 200–16. Available from: https://www.nature.com/articles/s41573-020-00114-z 11. Enioutina EY, Teng L, Fateeva T V., Brown JCS, Job KM, Bortnikova V V., et al.

Phytotherapy as an alternative to conventional antimicrobials: combating microbial resistance [Internet]. Vol. 10, Expert Review of Clinical Pharmacology. Expert Rev Clin Pharmacol; 2017 [cited 2022 Mar 20]. p. 1203–14. Available from: https://pubmed.ncbi.nlm.nih.gov/28836870/ 12. Governa P, Baini G, Borgonetti V, Cettolin G, Giachetti D, Magnano AR, et al.

Phytotherapy in the management of diabetes: A review [Internet]. Vol. 23, Molecules.

Molecules; 2018 [cited 2022 Mar 20].

Available from: https://pubmed.ncbi.nlm.nih.gov/29300317/ 13. Li Y, Liu X, Guo L, Li J, Zhong D, Zhang Y, et al. Traditional Chinese herbal medicine for treating novel coronavirus (COVID-19) pneumonia: Protocol for a systematic review and meta-Analysis. Syst Rev [Internet]. 2020 Apr 8 [cited 2022 Mar 20];9(1):1–6. Available from: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-02001343-4 14. Tempfer CB, Froese G, Heinze G, Bentz EK, Hefler LA, Huber JC. Side Effects of Phytoestrogens: A Meta-analysis of Randomized Trials. Am J Med [Internet]. 2009 [cited 2022 Mar 20];122(10). Available from: https://pubmed.ncbi.nlm.nih.gov/19786161/ 15. Zhou W, Wang J, Wu Z, Huang C, Lu A, Wang Y. Systems pharmacology exploration of botanic drug pairs reveals the mechanism for treating different diseases. Sci Rep [Internet].

2016 Nov 14 [cited 2022 Mar 20];6(1):1–17.

Available from: https://www.nature.com/articles/srep36985

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BEST ENTRIES PHYTOTHERAPY IN MODERN HEALTHCARE

Usage of the Medicinal Plants in Skin Care Parisa Kheirkhahan*, Tugba Ercetin Address: Faculty of pharmacy, Eastern Mediterranean University, North Cyprus, Turkey * Corresponding Author: parisakheirkhahan70@gmail.com

Abstract One of the important, fast-growing, and largest organs in the human body, is the skin. Not only does the skin acts as a security guard and barrier for protecting the body against external damages, such as Ultra Violet (UV) radiation, bacterial infection, heat, and temperature, but also plays an important role in human selfesteem and self-confidence. Therefore, many people have some skincare routines and take care of their skin problems. Moreover, with the increase of awareness among people, and the new trend toward a green lifestyle, customers prefer to use mostly natural source-based pharmaceutical and cosmeceutical products. Thus, in this scientific review, some of the medicinal plants, which are useful for skin care, such as antiaging and antiwrinkle, ant pigmentation, anti-scar and wound healing, and treatment of different types of skin disorders have been mentioned. According to the findings, many benefits can be achieved by utilizing organic-based ingredients in pharmaceutical and cosmeceutical products.

Keywords: phytotherapy, medicinal plants, skincare, anti-pigmentation, organic skincare

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1. Introduction Human skin contains three layers, with the outer layer being the epidermis, followed by the dermis and hypodermis underneath. Each of the skin layers has its function, protectivity, nutritional source, and mechanical properties such as elasticity. Therefore, skincare and healthy skin play a crucial role in a healthy body [1]. Moreover, by the increase of awareness among people, and the new trend towards green lifestyle, costumers prefer to use mostly natural source-based pharmaceutical and cosmeceutical products [2]. Thus, this study aims to conduct a literature search on the applications of medicinal plants in skincare.

2. Material and Methods To investigate the objective of this research, the authors searched keywords such as skincare, medicinal plant, skin protection, wound healing, anti-scar, anti-ageing, antipigmentation, as well as their relevant combinations on the Web of Science and Google Scholar database. In the primary search, the title of more than 150 articles was assessed and fileted based on their relevance to the topic and the objective of the study. After the first filtration, 53 articles were selected for abstract reading. The second filtration, after the abstracts were read, reduced the number of papers down to 20 selected articles. The full text of the mentioned outstanding studies was read and discussed between the authors in detail, during which eight more were put aside, to help narrow down the subject to the scope of this study. Finally, as the complementary search, using keywords such as cosmetics industry, new techniques, and cosmeceutical technology, the industrial aspect of the topic was investigated, and five more articles related to the new technology section in the discussion were included.

In the following, recent studies related to the treatment and prevention of skin problems are provided. Moreover, in the discussion section, the outcomes of the mentioned studies are discussed and the limitation of the study as well as the future work is mentioned.

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3. Results 3.1. Anti-ageing Some of the skin problems are the wrinkles and fine lines on the forehead, chin, and cheek area, which are commonly associated with the age of the patient. Having a healthy diet and a healthy lifestyle, prevent the prevalence of wrinkles on the skin.

Additionally, using anti-ageing and anti-wrinkle creams and products will play an important role in the prevention and speed reduction of skin ageing [3]. Ayaz, Sadiq [4] found the essential oils from a variety of medicinal plants to be very effective for skin ageing prevention [4]. Furthermore, D’Antuono, Carola [5], by applying some clinical tests, detected the artichoke with the scientific name Cynara cardunculus, as a good source, for boosting the skin elasticity, softness, and antiaging activity. Moreover, the polyphenolic extract of the artichoke shows the anti-inflammatory and antioxidant activities on the skin surface, which makes it so functional for cosmetics production [5].

Biscaro, Mussi [6] in a clinical experiment detected some Phyto cosmetics functions by the extraction of the leaves of Myrothamnus flabellifolia and the seeds of the Coffea arabica. They applied the ingredients for the duration of the fifty-six days on the face and hand skin. Biscaro and Mussi [6] showed the anti-ageing and the anti-pigmentation effects of the topical treatment of M. flabellifolia and C. arabica. Moreover, this type of Phyto cosmetics has a significant improvement in skin texture [6].

3.2. Anti-pigmentation On a normal level, melanin is the colouring agent of the skin. However, due to extreme conditions such as prolonged sun exposure during the daylight, high production of melanin occurs which is called hyperpigmentation [3]. One of the methods for preventing the excessive production of melanin and making the skin white is the inhibition of tyrosinase activity. Therefore, Liu, Sheu [7] used some medicinal plants’ extract, which suppresses the tyrosinase enzyme. Wolfiporia cocos and Paeonia lactiflora are two herbal effective extracts for the reduction of the extra production of melanin [7].

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Another effective medicinal plant is the essential oil of the Cyperus rotundus which is effective for avoiding the skin pigmentation process. Based on a randomized, double‐ blind, active‐and placebo‐controlled study with 153 participants, conducted by Mohammed [8], the efficacy, safety, and economical benefits of the Cyperus rotundus essential oils, as a whitening agent for the skin were investigated. His findings not only show a significant reduction of skin hair growth, but also the essential oils found to be effective for anti-inflammatory, and anti-pigmentation [8].

3.3. Skin protection Another harmful factor that results in skin ageing, inflammation, skin cancer, and pigmentation, is Ultra Violet (UV) radiation from the sun. Hence, applying sunscreen and sun blockers is important for skincare. There are many types of medicinal plants, which are useful in the formulation of green sunscreens. Leaves of Calendula officinalis, Aloe vera, and Camellia sinensis are the essential herbals that can be used as sun blockers [3]. Another beneficial medicinal plant is Astaxanthin. This product protects the skin from oxidation and degradation due to UV radiation. Astaxanthin is a carotenoid, which can be extracted from the microalgae. Astaxanthin not only protects the skin from radiation oxidations but also boosts skin elasticity [9].

3.4. Anti-scar and wound healing It is common among people to carry scars and skin inflammation due to internal or external skin damage from childhood. Further, major surgeries used to leave a permanent marks on the patients’ skin. These skin problems can be resolved thanks to the following as well as many other Phyto treatment methods. Osifo, Ihim [10] developed an experiment to use the fresh leaves of the Kapok tree, with the scientific name Ceiba pentendra (L.) Gaertn, for the wound healing and anti-inflammatory.

Accordingly, a promising result was achieved in their study. Moreover, catechin, apigenin, and quercitrin are some of the active biological ingredients in the function of the plant, which have been detected by the High-Performance Liquid Chromatography (HPLC) method [10].

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Furthermore, Imran, Sohail [11] used the entire parts of the Calendula officinalis, the leaves of the Azadirachta indica, and the sticks section of the Salvadora persica, to prepare an ointment, which has high efficacy for the treatment of the wounds. In addition, this oily herbal preparation accelerates the epithelization process [11].

4. Results Using medicinal plants has a historic background. Furthermore, based on the mentioned studies in the result section of this article, many benefits can be achieved by utilizing organic-based ingredients in pharmaceutical and cosmeceutical products. Therefore, by purchasing organic products, customers can have their skincare routines and treatments without exposing themselves to pesticides, and synthetic chemicals. To summarize the medicinal plants used for skincare, table 1 is provided.

Thanks to recent advancements in technologies and methods, medicinal plants can be used more easily all over the world [12]. Nanotechnology and encapsulation methods are some types of modern techniques, which are useful for boosting the efficacy and bioavailability of Active Pharmaceutical Ingredients (API) in modern natural products [13]. Furthermore, another technique that is favourable for using the different parts of medicinal plants, leaf, root, and flowers, is plant cell culture. Georgiev, Slavov [14] in a review mentioned the boosting of the bioactivity of the plant and extracting of the second metabolites with the help of the plant cell culture [14]. Moreover, high-pressure homogenized technique, cold pressing oil extraction, and delivery of the material with the help of liposomes are some of the new mechanisms for better use of the plants in our life. Using artificial intelligence, noninvasive research, microbiomes study, and artificial skins can be some movements for improving the phytotherapy for healthcare [15-17].

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Although this research was mainly focused on the benefits of usage of medicinal plants in skincare, there are a couple of limitations that need to be discussed as well.

Accordingly, information regarding the extraction methods, storage, or shelf-life extension techniques of the medicinal plants was not investigated. Given the fact that organic products tend to oxidate or depreciate more rapidly compared to chemicalbased products, further discussion about the life extension of such goods is required. By the same token, there are some challenges regarding the purchase of some of the mentioned plants in the special seasons, not to mention the economic problem for purchasing the instrument, material, and studying the toxicity and allergic reaction that needs to be assessed in the future studies.

4. Conclusion All in all, this study discussed the usage of a variety of medicinal plants in skincare.

Based on this review, many organic ingredients can be utilized to help protect the skin from harmful factors such as hyperpigmentation, skin wrinkling, wounds, scars, and UV radiations. However, it would be beneficial to see more studies regarding the recent advancements of technology such as nanotechnology, encapsulation, microencapsulation, plant cell culture, and cold pressing in organic-based pharmaceutical and cosmeceutical products.

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References 1. Barel, A.O., M. Paye, and H.I. Maibach, Handbook of cosmetic science and technology.

2014: CRC Press.

2. Lin, Y., et al., An exploratory study of consumer attitudes toward green cosmetics in the UK market. Administrative Sciences, 2018. 8(4): p. 71.

3. Ahmed, I.A., et al., Natural anti-ageing skincare: role and potential. Biogerontology, 2020. 21(3): p. 293-310.

4. Ayaz, M., et al., Neuroprotective and anti-ageing potentials of essential oils from aromatic and medicinal plants. Frontiers in ageing neuroscience, 2017. 9: p. 168.

5. D’Antuono, I., et al., Artichoke polyphenols produce skin anti-age effects by improving endothelial cell integrity and functionality. Molecules, 2018. 23(11): p. 2729.

6. Biscaro, R.C., et al., Modulation of autophagy by an innovative phytocosmetic preparation (Myrothamnus flabelifolia and Coffea arabica) in human fibroblasts and its effects in a clinical randomized placebo‐controlled trial. Journal of Cosmetic Dermatology.

7. Liu, S.-C., et al., Attenuation of in vitro and in vivo melanin synthesis using a Chinese herbal medicine through the inhibition of tyrosinase activity. Phytomedicine, 2022. 95: p. 153876.

8. Mohammed, G., Topical Cyperus rotundus essential oil for treatment of axillary hyperpigmentation: a randomized, double‐blind, active and placebo‐controlled study.

Clinical and Experimental Dermatology, 2022. 47(3): p. 534-541.

9. Ito, N., S. Seki, and F. Ueda, The protective role of astaxanthin for UV-induced skin deterioration in healthy people—A randomized, double-blind, placebo-controlled trial.

Nutrients, 2018. 10(7): p. 817.

10. Osifo, M., et al., Wound Healing and Anti-inflammatory Activities of Ceiba pentendra (l.) Gaertn. Pharmacological Research-Modern Chinese Medicine, 2022: p.

100077.

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11. Imran, H., et al., Wound Healing Potential/Activity of Polyherbal Ointment Containing Salvadora persica, Azadirachta indica and Calendula officinalis Extracts: An Experimental Study. Biological Sciences-PJSIR, 2022. 65(1): p. 55-61.

12. Nadeeshani Dilhara Gamage, D.G., et al., Global Perspective of Plant-Based Cosmetic Industry and Possible Contribution of Sri Lanka to the Development of Herbal Cosmetics. Evidence-Based Complementary and Alternative Medicine, 2022.

2022.

13. Figueroa-Robles, A., M. Antunes-Ricardo, and D. Guajardo-Flores, Encapsulation of phenolic compounds with liposomal improvement in the cosmetic industry.

International Journal of Pharmaceutics, 2021. 593: p. 120125.

14. Georgiev, V., et al., Plant cell culture as an emerging technology for production of active cosmetic ingredients. Engineering in life sciences, 2018. 18(11): p. 779-798.

15. Schürch, C., P. Blum, and F. Zülli, Potential of plant cells in culture for cosmetic application. Phytochemistry Reviews, 2008. 7(3): p. 599-605.

16. Górnaś, P., A. Siger, and D. Segliņa, Physicochemical characteristics of the coldpressed Japanese quince seed oil: New promising unconventional bio-oil from byproducts for the pharmaceutical and cosmetic industry. Industrial Crops and Products, 2013. 48: p. 178-182.

17. Van Tran, V., J.-Y. Moon, and Y.-C. Lee, Liposomes for delivery of antioxidants in cosmeceuticals: Challenges and development strategies. Journal of controlled release, 2019. 300: p. 114-140.

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ARTICLES PHYTOTHERAPY IN MODERN HEALTHCARE

Phytotherapeutic use of isoflavones in management of symptoms of menopause and perimenopause NDISI JULIE MWENDE KABARAK UNIVERSITY, NAKURU (KENYA)

To be a woman is to pass through several biological phases in life. As we come to the closure of The Women’s month, let’s have a brief look at two of these phases that cumulatively constitute her bloom and strength as she gets older. Today, I’ll talk about…Perimenopause and Menopause.

So what are perimenopause and menopause? Let’s dive deeper into the vocabulary.

Simply put peri-menopause is the stage just before menopause that’s characterized by decreasing levels of estrogen production while menopause is the stage in women’s lives when menstruation ceases due to very low estrogen levels or loss of ovarian follicles.

Both are prevalent among women of ages 45 to 55 years.

You may be wondering how one can definitively conclude to be in either of these stages, especially in this day and age where lifestyle greatly influences women’s hormonal cycle, therefore, making it difficult to forecast the usual menopause commencing age.

However, it’s important to note the common signs of perimenopause and menopause, some of which include: hot flushes whereby about 4 to 5 million women in the United States alone are largely faced by this with most experiencing it for several months to 5 years and some for up to 30 years (Kronenberg F, Downey JA.). Also present are signs of depression and mood swings, irregular or absent menses, vaginal dryness, loss of bone density, cancers of the ovary, breast and cervix and cardiovascular diseases commonly associated with dysregulated cholesterol levels and distribution.

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Conventional therapies involve hormone replacement therapies with estrogen using pills or patches. This estrogen is mostly synthetic such as estrogens (Premarin), estradiol (Estrace), and Estratab and Menest. These have been beneficial therapies but the cons can be disheartening, some of which include: a slight increase in the risk of strokes, blood clots, breast cancer and heart attack, swollen and painful breasts, headache and nausea. In the wake of such side effects, there are currently studies targeting the use of natural estrogen once its oral bioavailability is improved. This is quite promising as the therapy will have reduced side effects.

While science focuses on the synthesis of medication, let’s deviate into the phytotherapeutic management of menopause. Firstly, we understand that the estrogen hormone is of grave importance to all women. This is because it aids in maintaining bone density to prevent osteoporosis, plays a role in serotonin secretion thus contributes to good mood and also contributes to normal cardiovascular functioning, immunomodulatory function and cognitive health therefore low levels are a downside (Hannah Nichols, 2020).

While we may overlook diet and focus more on medication, what we need may just be all around us. You may be wondering what I’m trying to point to. Well, it’s all in the isoflavones preferably genistein and daidzein. These Isoflavones are phytoestrogens produced primarily by leguminous plants, such as soybeans, lentils, lupine, peas, fava bean, kudzu, psoralen, red clover, alfalfa, berries, nuts and wine. These are potentially useful both in lowering cholesterol and treating some cancers and menopausal symptoms (Random House, Inc. 2022). Studies have also demonstrated the beneficial effect of soy isoflavones on menopausal mood symptoms and fatigue such that after three months of therapy, mild symptoms showed an improvement of 40% (Ahsan, M., & Mallick, A. K. 2017).

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Genistein and daidzein bear structural similarities with the physiologically vital estrogen – 17β-estradiol (E2). both bind to and activate estrogen receptors: ERα and ERβ, therefore, mimic intracellular estrogen effects thus they are commonly called phytoestrogens (Miadoková E. 2009). According to Messina et al., 2006, the binding affinities of genistein and daidzein are greater for ERβ than for ERα, while E2 binds to both receptors with seemingly equivalent affinities. These estrogenic activities of isoflavones are presumed vital managing in menopausal symptoms and osteoporosis (Lockwood, 2008) and Arguments are being presented in considering the use of isoflavones as natural selective estrogen modulators.

The best sources of such isoflavones include soy milk, whole soybeans, soy flour, tofu, soy nuts and soy nut butter. Aside from diet by consuming the isoflavone rich legumes, there are soy isoflavone rich supplements available such as Estovon. This shows that Soy is currently receiving attention as an alternative therapy to the conventional estrogen hormone replacement therapy (Messina M, Hughes C, 2003).

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Conclusion As more studies are being conducted to investigate the independence of this therapy, it’s safe to say that its vitality cannot be ignored. While it currently may not be considered a stand-alone therapy, it surely can be complementarily used alongside the estrogen replacement therapy in the management and prevention of worsening perimenopausal and menopausal symptoms. This will not only improve the quality of life among mid-life women but also reduce mortality associated with preventable diseases that are due to low estrogen levels.

References Ahsan, M., & Mallick, A. K. (2017). The Effect of Soy Isoflavones on the Menopause Rating Scale Scoring in Perimenopausal and Postmenopausal Women: A Pilot Study.

Journal of clinical and diagnostic research: JCDR, 11(9), FC13–FC16. https://doi.org/10.7860/JCDR/2017/26034.10654 Miadoková E. (2009). Isoflavonoids - an overview of their biological activities and potential health benefits.

Interdisciplinary toxicology, 2(4), 211–218. https://doi.org/10.2478/v10102-009-0021-3 Messina M, Wood CE. Soy isoflavones, estrogen therapy, and breast cancer risk: analysis and commentary. Nutr J. 2008;7(1):17–28.

Messina M, Hughes C. Efficacy of soy foods and soybean isoflavone supplements for alleviating menopausal symptoms is positively related to initial hot flush frequency. J Med Food. 2003 Spring;6(1):1-11. doi: 10.1089/109662003765184697. PMID: 12804015.

Lockwood B. The beneficial effects of soy isoflavones in osteoporosis of the elderly.

Elderly Nutr AgroFood Ind Hi-tech. 2008;19(5):38–41.

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ARTICLES PHYTOTHERAPY IN MODERN HEALTHCARE

Modern Phytotherapy CHELIMO BETONY B. PHARM II MAKERERE UNIVERSITY, KAMPALA (UGANDA)

“Without plants, life ceases,” is a statement that receives unanimous agreement from all sound-minded individuals. Hearing this statement brings into mind the classic example of plants being the sole source of oxygen to sustain life by way of photosynthesis. However, little acknowledged is the vital role that plants play in sustaining the day to day wellbeing of mankind. Plants and plant products are essential in very many aspects of the human lifestyle ranging from nutrition, to construction, to beauty and design, to scientific study and research and well, the pharmaceutical sector is no exception. In the pharmaceutical sector, the use of plants and plant products is termed phytotherapy.

Phytotherapy can be defined as the use of herbal remedies for the treatment and prophylaxis of a disease. Phytotherapy falls under a broader system of medical interventions known as Complementary and Alternative Medicines (CAM). CAM refers to the use of medications, procedures and practices either in addition to or as a substitute for conventional/Western medicines. Over time, it has changed gradually from the trial-and-error traditional system of herbal medicine usage that was characterized, defined and regulated by culture to the modern-day evidence and research-based regulated science known as phytotherapy. In some parts of the world where cultures have not faced much evolution, however, phytotherapy is largely blended with traditional herbal medicine usage.

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Phytotherapy entails the use of phytotherapeutic preparations or phytomedicines, which are standardized preparations comprising complex mixtures of one or more plants used for the treatment and prophylaxis of various diseases. In developed countries, the science of drug acquisition from natural sources, known as pharmacognosy is well established and the use of phytomedicines is researched, standardized, well documented and even regulated. As such, the use of phytomedicines in these countries has been on the considerable rise in the recent past. The reason here is increased consumer trust in phytotherapy due to standardization. What’s more, phytotherapy receives preference from the public because it gives a “natural feel” as opposed to conventional medicine which bears an ill reputation of being toxic due to industrial processing.

In less-developed nations, however, the level of standardization is lower and phytotherapy is less developed. Nonetheless, in countries where phytotherapy is blended with traditional medicine usage, it receives preference over conventional medicine from the majority of the population because of the earlier mentioned reason of having a “natural feel”. Most of these people in developed and developing nations use these preparations for the treatment of a variety of diseases. Of these, the most commonly treated and prevented ailments are cold and cough, high blood pressure, diabetes, body pains, infertility and a variety of others, most of which are non-infectious. Some companies have even taken onto trading phytomedicines as food supplements.

Phytotherapy owes most of its development to necessity; being of much use in contemporary health care. Firstly, phytomedicine preparation is a bypass alternative to the long and costly process of drug development. These formulations are easy to prepare and many people can actually take part in their preparation as opposed to conventional medicines. On top of these, phytotherapy is an aid in antimicrobial stewardship through the synergy that phytomedicines provide, while offering an alternative to antibiotic usage.

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Despite these uses and advantages, however, the use of phytotherapy is largely stalled in very many ways. First, herbal medicine usage faces a lot of superstition as cultures have very many myths and cultures attached to herbal medicines. On top of that, quack medical practitioners use the ignorance of the public to con consumers into the use of formulations that they sell dearly and are not properly researched on, exposing consumers to danger. Sometimes, the danger is even brought about by consumers themselves, who administer the formulations without medical consultation and instead use the medications based on “common sense”, rumours or social media messages. This exposes the users to potential harm. Many other challenges are faced in the successful and smooth usage of phytotherapy and most are related to public ignorance about phytotherapy, phytomedicines and pharmacognosy as a whole. Increased research, standardization, documentation, research and regulation can help in alleviating these for a bright future in phytotherapy.

Phytotherapy must then be viewed as a supplement rather than a substitute to conventional medicines and other CAM practices if the most are to be achieved from it in regards to modern health care.

References 1. Phytotherapy approaches to treatment and prophylaxis in pediatric patients., Petkova et al, 2013.

2. Fundamentals of Pharmacognosy and Phytotherapy. By Michael Heinrich, Joanne Barnes, Simon Gibbons, Elizabeth Williamson, 2012.

3. Phytotherapy; an introduction to its history, use and application, 2013.

4. Antimicrobial resistance and synergy in herbal medicine. Lorna Mundy, Barbara Pendry, M. Mukhlesur Rahman.

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