Clinical Studies — anti-fatigue

American Ginseng (Panax quinquefolium L.) as a Source of Bioactive Phytochemicals with Pro-Health Properties

Posted by Michael Burmeister on

This review highlights the most important characteristics and possible applications of AG. Among numerous studies AG was documented to exert beneficial activity towards nervous system. It boosts memory, increases calmness, and enhances cognitive performance []. It has therapeutic potential in treatment of Alzheimer disease and anxiety [,]. It also affects cardiovascular system—changes cardiac structure in hypertension, reduces heart rate, inhibits hypertrophy and heart failure [,,,]. Furthermore, AG prevents oesophageal damage resulted from reflux oesophagitis and formation of ulcer in gastric mucosa [,]. Apart from that, it displays antimicrobial activity against different pathogenic strains of bacteria including resistant to antibiotics S. aureus strain []. AG is extensively investigated in terms of anti-cancer activity. It promotes apoptosis of cancer cells and alters many different signalling pathways important for cancer transformation [,,,,,,,]. It also protects normal cells from unwanted side effects of anti-cancer drugs and diminishes cancer-related fatigue [,]. However, the mechanisms underlying beneficial activity of AG in cancer is not fully understood. Administration of AG may be beneficial for individuals suffering from obesity and diabetes. It enhances sensitivity of tissues to insulin and inhibits formation of adipose tissue. Also, polysaccharides of AG were reported to display pro-health effects by stimulating the immune system. Assinewe et al. observed that polysaccharide of AG extract containing glucose, galactose, arabinose, rhamnose, and mannose displayed cytokine-stimulating activity on macrophages. In this study, aqueous extracts of AG roots (1–100 μg/mL) stimulated the release of immunoreactive TNF, contributing to the activation of macrophages []. Yu et al. also showed immunostimulatory effect of the fraction of polysaccharide present in AG extract (50–400 μg/mL). AG extract application led to enhancement of splenic lymphocyte proliferation, macrophage phagocytosis and nitric oxide production []. AG extract (125 mg/kg for 3–6 days) stimulated alveolar macrophages in rats associated with increased level of NO, TNF-α and IL-6 in plasma []. These results were in agreement with those obtained by Azike. Similarly, AdG water extract (125 mg/kg) administered to rats for 3–6 days upregulated nitric oxide, TNF-α and IL-6. Within in vitro study macrophages were incubated with different concentrations of AG. A dose-dependent immunostimulatory activity of aqueous and alcohol extracts of AG (50–200 μg/mL) in rat macrophages was observed and an in vitro effect was more pronounced than corresponding in vivo result due to relatively low bioavailability of the extract administrated orally []. As the methodology of AG separation is poorly developed, it is a promising direction for the future research.

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PURLs: Finally, a way to relieve cancer-related fatigue

Posted by Michael Burmeister on

While ginseng did not appear to significantly increase the change in fatigue scores over placebo at 4 weeks (14.4 vs 8.2; P=.07), fatigue scores at 8 weeks were significantly improved (20 vs 10.3; P=.003). Interestingly, though, there was a significant improvement in fatigue scores with ginseng at both 4 weeks (P=.02) and 8 weeks (P=.01) when researchers looked at only those patients who were currently receiving cancer treatment. On the other hand, those patients who were not currently undergoing treatment did not show a significant improvement at either time cutoff.

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Wisconsin Ginseng (Panax quinquefolius) to Improve Cancer-Related Fatigue: A Randomized, Double-Blind Trial, N07C2

Posted by Michael Burmeister on

The mechanism by which American ginseng may be able to moderate fatigue is evidenced by preclinical data. Several investigators have established a consistent link between CRF and inflammation and have provided data to support dysregulation of the hypothalamic pituitary adrenal axis (). These data suggest that chronic fatigue in cancer is associated with an inability for the hypothalamic pituitary adrenal axis to regulate inflammatory processes and that concentrations of inflammatory cytokines remain elevated instead of reachieving homeostasis (). Preclinical data evaluating the biologic activity of ginseng have demonstrated the ability of ginseng to downregulate inflammatory pathways (), decrease inflammation (), and modulate cortisol and the impact of chronic stress on the hypothalamic pituitary adrenal axis ().

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Ginseng for the Management of Cancer-Related Fatigue: An Integrative Review

Posted by Michael Burmeister on

Three of the included studies explored American ginseng for management of CRF.  completed a pilot study evaluating three different doses (750 mg, 1,000 mg, and 2,000 mg) of daily American ginseng (specifically Wisconsin ginseng, a common type of American ginseng), as compared with placebo. The duration of treatment was 8 weeks for each treatment arm. Patients included in this study were varied regarding treatment history and cancer type. Across all cohorts, 57% were undergoing active chemotherapy and 18% were receiving current radiation therapy; cancer types in the study consisted of breast (n = 109), colon (n = 29), lung (n = 35), and "combination/unknown/other" (n = 109). No significant difference in activity interface or usual fatigue between placebo and treatment arms was significant; however, a subset analysis reported a trend towards improvement of fatigue in the cohort using a daily dose of 2,000 mg.

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Integrative Therapies for Cancer-Related Fatigue

Posted by Michael Burmeister on

In the phase III trial using a dose of 2000 mg of American ginseng daily, at 8 weeks there was a significant improvement of fatigue by ~18% to 22% in the American ginseng group compared with 7% to 18% in the placebo group. Greater benefit was reported in patients receiving active cancer treatment compared with those who had completed treatment. Serious adverse events were low (approximately 3%) and did not significantly differ between groups.

Importantly, American ginseng appears not to inhibit the cytochrome p450 system and has not been found to impact the effects of tamoxifen, doxorubicin, cyclophosphamide, paclitaxel, 5-fluorouracil, and methotrexate, but was instead synergistic with these agents inhibiting growth in MCF-7 breast cancer cell lines.

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