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#Gastroenterology #Hepatology #Multispeciality
Metabolic syndrome (MetS), a highly prevalent, multifactorial and complex disease is related to augmented risk of developing diabetes and other major cardiovascular complications. Various genetic, epigenetic, and environmental factors are responsible for the increased prevalence of MetS. Its development is also enhanced by low physical activity and high-energy diets. Therefore, lifestyle changes along with the use of pharmacological agents that can alter specific biochemical pathways employed in the metabolism of nutrients are targeted for management of MetS risk factors. However, pharmaceutical drugs are not considered as economical to general population and have several adverse effects.
Therefore, another effective treatment approach of MetS risk factors is the utilization of medicinal plants having various therapeutic benefits. These plants are easily accessible and possess numerous biologically active compounds known as phytochemicals that target specific biological pathways. Abundant studies have revealed complex biochemical, metabolic, and physiological mechanisms of phytochemicals that has the potential to influence sustainable health and well-being of individuals. Although certain phytochemicals forms the foundation of conventional prescribed drugs, such as metformin, reserpine, quinine, and salicin, it is essential to recognize and use more medicinal plants that can be applied for the management of components of MetS.
Plethora of studies suggest that various plants and/or different parts of the same plant are used for the management of diabetes. Bioactivity of medicinal plants is influenced by the presence and levels of phytochemicals which is also dependent on genetics and environmental factors, such as soil types, climate, types of vegetation, and presence of other organisms. Plants that possess high levels of phenolic compounds have a high antioxidative capacity and thus, can benefit in the treatment of diabetic complications caused by high oxidative stress. Phytochemicals such as terpenes, alkaloids, and saponins may improve insulin secretion, glucose uptake and its utilization. Various researches have shown that Hypoxis argentae, Tarchonanthus camphoratus, Euclea undulata, Strychnos henningsii, Cissampelo campensis, Elaeodendron transvaalense, and Schkuria pinnata have hypoglycemic effects and can increase the uptake of glucose in cultured muscle cells, hepatic cells, or preadipocytes. Moreover, plants such as Senna alexandri, Cymbopogon citrutus, Nuxia floribunda, and Curcubita pepo containing α-amylase and α-glucosidase inhibitors may decrease post-prandial hyperglycemia. Other plants like Carica papaya and H. argentae, can aid in preserving and increasing the regeneration of pancreatic β-cells, thereby increasing insulin release.
Mounting evidences demonstrated that in order to prevent complications associated with cardiovascular disorders, lowering high blood pressure is the most targeted therapy. Some traditional healers used to administer oral decoctions of Helichrysum ceres to treat hypertension, whose potential of lowering blood pressure is due to of natriuretic and diuretic bioactive phytochemical compounds. In vivo studies have revealed that the ethanolic leaf extracts of this plants also act on vascular smooth muscles, that leads to a vasodilatory effect, which further decreases the total peripheral resistance, which also causes hypotensive effects. Another mode of reducing cardiovascular complications is modulating renin–angiotensin–aldosterone system (RAAS), a key signaling pathway fundamental in blood pressure regulation. Several studies proved the efficacy of aqueous and ethanolic extracts of Stangeria eriopus, Amaranthus dubius, Amaranthus ybridus, Asystasia gangetica, Galinsoga parviflora, Justicia flava, Oxygonum sinuatum, Physalis viscosa, and Tulbaghia violacea in the treatment of hypertension, which is attributed to the theire potential of inhibiting ACE activity.
Besides, medicinal plants are also advantageous in managing NAFLD by demonstrating biological demonstrate activity against hepatic steatosis. It has been shown in a trial that aqueous extracts of Terminalia sericea leaves prevented the development of NAFLD in experimental animals who were fed a high-fructose diet. Herbal tea made from the aerial parts of Rooibos Aspalathus linearis is useful in inhibiting hepatic insulin resistance and modulating AMP-activated protein kinase (AMPK) pathways. H. gordonii is considered a potential candidate for the management of NAFLD, due to its appetite-suppressing effects. Moreover, aloe vera is also used worldwide for its medicinal efficacy against hepatic steatosis. Moringa oleifera extracts reduces hepatic lipid accumulation and can be used to prevent the development of NAFLD. Opuntia ficus seed extract can also prevent hepatic steatosis, induce macrophage polarization, and suppresse inflammatory signaling pathways related to Toll-like 4 receptors, tumor necrosis factor alpha, and interleukin 6.
Source: Nyakudya, T.T.; Tshabalala, T.; Dangarembizi, R.; Erlwanger, K.H.; Ndhlala, A.R. The Potential Therapeutic Value of Medicinal Plants in the Management of Metabolic Disorders. Molecules 2020, 25, 2669.