RESUMO
Introducción: con un número creciente de estudios científicos y los avances en la legislación nacional e internacional, la fitoterapia se consolida como una opción de terapia complementaria a la medicina tradicional. La Relación Nacional de Medicamentos Esenciales (RENAME) en el Sistema Único de Salud (SUS), publicada en 2014, tiene en su reparto 12 hierbas medicinales, las cuales, por falta de información clara y científica, aún no son conocidas y prescritas por los profesionales de la salud. Objetivo: realizar una revisión sobre los medicamentos a base de hierbas de la RENAME, con sus declaraciones y presentaciones, con base técnica y científica, creando así un material fácil de entender por los profesionales de la salud.Métodos: se realizó un examen descriptivo y de naturaleza cualitativa de la fitoterapia en el SUS, utilizando la página web del Ministerio de Sanidad y artículos disponibles en bases de datos electrónicas Scielo, Lilacs y Medline. Resultados: se encontró que existen numerosos artículos científicos relacionados con el tema y sobre todo información sobre las indicaciones de las hierbas medicinales presentes en la RENAME. Conclusión: es necesario que los profesionales de la salud conozcan las señales, eficacia clínica y seguridad de los fitofármacos de la Relación Nacional de Medicamentos Esenciales. Sin embargo, queda mucho por hacer en términos de formación de recursos humanos involucrados en la prescripción de medicamentos a base de hierbas(AU)
Introduction: Due to the growing number of scientific studies and the advances in national and international legislation, phytotherapy has consolidated as a therapeutic option complementary to traditional medicine. The National List of Essential Medicines (RENAME), published by the Unified Health System (SUS) in 2014, contains 12 medicinal herbs. However, due to lack of clear scientific information, these herbs are not known or prescribed by health professionals. Objective: Conduct a review about the herbal drugs included in the National List of Essential Medicines (RENAME), their specifications and forms of presentation, applying a technical and scientific approach, so as to develop a material easy to understand by health professionals. Methods: A descriptive qualitative study was conducted of the phytomedicines listed in the SUS, based on the webpage of the Ministry of Health and papers available in the electronic databases Scielo, Lilacs and Medline. Results: It was found that there is a large number of papers about the topic, mainly information about indications for the medicinal herbs included in the RENAME. Conclusion: Health professionals should be aware of the signals, clinical effectiveness and safety of the phytomedicines included in the National List of Essential Medicines. However, much remains to be done in terms of training of the human resources involved in the prescription of herbal medicines
Introdução: com um número cada vez maior de estudos científicos e com os avanços na legislação brasileira e mundial, a fitoterapia se concretiza como uma opção de terapia complementar a medicina tradicional. A Relação Nacional de Medicamentos Essenciais (RENAME) no Sistema Único de Saúde (SUS), publicada em 2014, traz em seu elenco 12 fitoterápicos, os quais, por falta de informações claras e científicas, ainda não são conhecidos e prescritos pelos profissionais de saúde. Objetivo: realizar uma revisão sobre os medicamentos fitoterápicos da Relação Nacional de Medicamentos Essenciais com suas indicações e apresentações, com embasamento técnico-científico, criando assim um material de fácil entendimento para os profissionais da saúde. Métodos: trata-se de uma revisão de teor descritivo e natureza qualitativa sobre fitoterapia no SUS utilizando-se o site do Ministério da Saúde e artigos disponíveis nas bases eletrônicas Scielo, Lilacs e Medline. Resultados: verificou-se que existem inúmeros artigos científicos relacionado à temática e principalmente informações sobre as indicações dos fitoterápicos presentes na RENAME. Conclusão: e necessário que os profissionais da área saúde conheçam as indicações, a eficácia clínica e a segurança dos fitoterápicos da RENAME. No entanto, há muito por se fazer no que ser refere aos recursos humanos envolvidos na prescrição de fitoterápicos(AU)
Assuntos
Humanos , Medicamentos Essenciais , Preparações de Plantas/uso terapêutico , BrasilRESUMO
Solidago chilensis Meyenmost (Asteraceae), popularly known as "Brazilian arnica" or "arnica-do-campo," is widely used in the folk medicine to treat gastric disorders. Based on this, the gastroprotective activity of S. chilensis methanolic extract was investigated. Besides, a phytochemical study allowed isolation of two flavonoids (quercitrin and afzelin). The gastroprotective effects were investigated in acute gastric ulcer models, and the antisecretory activity was assessed in vivo and in vitro. The adhered mucus levels, reduced glutathione (GSH) content and myeloperoxidase (MPO) activity were quantified in ulcerated tissues. The contribution of isolated compounds in extract effects was evaluated, and its doses were calculated according to its yield. To evaluate the in vivo healing properties of S. chilensis methanolic extract, a chronic gastric ulcer was induced in mice by 10 % acetic acid. Evaluation of tumor necrosis factor (TNF) levels was also performed at the site of the acetic acid-induced gastric ulcer. In parallel, effects on cell viability and cell proliferation of fibroblasts (L929 cells) were determined by in vitro trials. Firstly, the S. chilensis methanolic extract (100 or 300 mg/kg) reduced the ulcer area induced by ethanol/HCl in mice when compared to the vehicle group. Moreover, the S. chilensis extract (300 mg/kg) prevented the mucus depletion, the increase in MPO activity and the decrease in the GSH levels in the ulcerated gastric tissue. The S. chilensis extract also was able to decrease the indomethacin-induced gastric ulcer in rats at a dose of 100 mg/kg. The antisecretory effect of the extract (100 mg/kg, intraduodenal (i.d.)) was confirmed by the reduction in the volume and acidity in parallel to an increase in the pH of gastric content. In addition, quercitrin (1.38 mg/kg, but not 0.46 mg/kg) and afzelin (0.026 and 0.078 mg/kg) decreased the ethanol/HCl-induced gastric ulcer. In this model, quercitrin (1.38 mg/kg) prevented the depletion of gastric GSH content and both quercitrin (1.38 mg/kg) and afzelin (0.078 mg/kg) reduced the MPO activity. These compounds also inhibited the H(+),K(+)-ATPase activity at a concentration of 1-100 µg/ml. In addition, the participation of quercitrin and afzelin in these effects also was confirmed. Furthermore, after 4 days of the treatment, an oral administration of S. chilensis methanolic extract (100 mg/kg) reduced the area of the gastric ulcer induced by acetic acid and the regeneration of the gastric mucosa was accompanied by a reduction in gastric TNF levels. The healing properties of the extract also were confirmed by enhancement of proliferation and coverage of scratched wounds in a fibroblast monolayer. Together, our results confirmed the gastroprotective effect of S. chilensis methanolic extract as well as its gastric healing potential and provided some support to the traditional use of S. chilensis for prevention and treatment of gastric lesions in complementation to its known anti-inflammatory properties.
Assuntos
Antiulcerosos/farmacologia , Mucosa Gástrica/efeitos dos fármacos , Manosídeos/farmacologia , Metanol/química , Extratos Vegetais/farmacologia , Proantocianidinas/farmacologia , Quercetina/análogos & derivados , Solidago/química , Solventes/química , Úlcera Gástrica/prevenção & controle , Cicatrização/efeitos dos fármacos , Animais , Anti-Inflamatórios/farmacologia , Antiulcerosos/química , Antiulcerosos/isolamento & purificação , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Feminino , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Fibroblastos/patologia , Mucosa Gástrica/metabolismo , Mucosa Gástrica/patologia , Glutationa/metabolismo , ATPase Trocadora de Hidrogênio-Potássio/metabolismo , Concentração de Íons de Hidrogênio , Manosídeos/química , Manosídeos/isolamento & purificação , Camundongos , Fitoterapia , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Folhas de Planta , Plantas Medicinais , Proantocianidinas/química , Proantocianidinas/isolamento & purificação , Inibidores da Bomba de Prótons/farmacologia , Quercetina/química , Quercetina/isolamento & purificação , Quercetina/farmacologia , Coelhos , Ratos Wistar , Úlcera Gástrica/induzido quimicamente , Úlcera Gástrica/metabolismo , Úlcera Gástrica/patologia , Fator de Necrose Tumoral alfa/metabolismoRESUMO
Dugesia tigrina is a non-parasitic platyhelminth, which has been recently utilized in pharmacological models, regarding the nervous system, as it presents a wide sensitivity to drugs. Our trials aimed to propose a model for an in vivo screening of substances with inhibitory activity of the enzyme acetylcholinesterase. Trials were performed with four drugs commercialized in Brazil: donepezil, tacrine, galantamine and rivastigmine, utilized in the control of Alzheimer's disease, to inhibit the activity of acetylcholinesterase. We tested five concentrations of the drugs, with an exposure of 24 h, and the mortality and the inhibition of acetylcholinesterase planarian seizure-like activity (pSLA) and planarian locomotor velocity (pLMV) were measured. Galantamine showed high anticholinesterasic activity when compared to the other drugs, with a reduction of 0.05 µmol·min(-1) and 63% of convulsant activity, presenting screw-like movement and hypokinesia, with pLMV of 65 crossed lines during 5 min. Our results showed for the first time the anticholinesterasic and convulsant effect, in addition to the decrease in locomotion induced by those drugs in a model of invertebrates. The experimental model proposed is simple and low cost and could be utilized in the screening of substances with anticholinesterasic action.
Assuntos
Inibidores da Colinesterase/farmacologia , Convulsivantes/farmacologia , Galantamina/farmacologia , Indanos/farmacologia , Piperidinas/farmacologia , Rivastigmina/farmacologia , Tacrina/farmacologia , Animais , Donepezila , Locomoção/efeitos dos fármacos , Modelos Biológicos , Planárias/efeitos dos fármacos , Planárias/enzimologia , Convulsões/induzido quimicamente , Taxa de SobrevidaRESUMO
Mimusops spp. is used as plant-based antiulcer drugs in Indian traditional medicine. In this study, a bio-guiding study of methanolic extracts of Mimusops balata edible fruits was performed to identify an antiulcer gastric compound. The gastric lesions induced by HCl/ethanol in mice were significantly improved by methanolic extract from seed (MESe, 300 mg/kg), but not by methanolic extract from peel (MEPe, 300 mg/kg) or pulp (MEPu, 300 mg/kg), when compared to the vehicle group. Treatment with MESe also decreased gastric ulceration induced by indomethacin. The antiulcerogenic activity of MESe appears to involve the maintainance of GSH levels, reduction of LPO content, inhibition of neutrophil migration (as evidenced by a decrease in the MPO activity) and a potent free radical scavenger activity (IC50 = 3.4 µg/ml). Moreover, MESe decrease the gastric volume, pH, total acidity, and pepsin activity in the gastric juice. Exceptionally, MESe showed a high content of phenolic compound, identified by layer chromatography and Folin-Ciocalteu reagent. Considering the better pharmacological and phytochemical profile, MESe was successively partitioned and resulted in isolation and identification of a constituent, the flavonoid taxifolin, identified by spectroscopic methods ((1)H, (13)C NMR, and HPLC). Taxifolin also inhibited the ulcerogenic effect of HCl/ethanol at a low dose of 1.14 mg/kg and inhibited in vitro H+/K(+)-ATPase activity by 41% at a concentration of 100 µg/ml. Taken together, these results evidenced the gastroprotective potential of fruits from M. balata and showed that this effect is exclusive to the seeds.