Friday, 6 May 2016

Most Common Disease of50plus: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs)- Gout - The Phytochemicals

Kyle J. Norton (Scholar and Master of Nutrients, all right reserved)Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. According to a community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home, musculoskeletal pain was reported by 57% of those interviewed(*).

Types of Musculo-Skeletal disorders in elder

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


Gout mostly effected one joint is an acute and recurrent condition of arthritis as a result of uric acid building up in blood, inducing joint inflammation.

The Phytochemicals to prevent Gout

1. Quercetin and Rutin

Quercetin is a plant pigments belongings to the group of flavonoids and its conjugate rutin is a quercetin-3-O-rutinoside and sophorin, according to Dr. Zhu JX and research team at the School of Life Sciences, Nanjing University expressed inhibition of enzyme activities in mouse liver in relation to their absorption and metabolism, and their potential application to treat gout and hyperuricemia(161). Dr. Shi Y and Dr. Williamson G said" quercetin treatment, plasma uric acid concentrations were significantly lowered by -26·5 µmol/l (95 % CI, -7·6, -45·5; P=0·008), without affecting fasting glucose, urinary excretion of uric acid or blood pressure" in a randomised, double-blinded, placebo-controlled, cross-over trial(162). The antioxidant also exerted a strong anti-inflammatory effect that may be useful for the treatment of acute gouty arthritis, TianJin University of Traditional Chinese Medicine(163)

2. Morin
Morin (3,5,7,2′,4′-pentahydroxyflavone), a phytochemical found in the twigs of Morus alba L. documented in traditional Chinese medicinal literature to treat conditions akin to gout, was demonstrated to exert potent inhibitory action on urate uptake in rat renal brush-border membrane vesicles(164). In the study of Ramulus Mori, the branch of Morus alba, is widely used in traditional Chinese medicine prescriptions to treat gout and hyperuricemia, researchers at the Nanjing University suggested that the effectiveness of the herbal medicine in treating gout, probably due to the presence of antioxidants, including morin(165).
According to the Nanchang University, luteolin exhibited a stronger synergistic effect with kaempferol than did morin at the lower concentration(166).

3. Other phytochemicals
13 flavonoids  including myricetin, kaempferol, icariin, apigenin, luteolin, baicalin, silibinin, naringenin, formonoetin, genistein, puerarin, daidzin and naringin dihydrochalcone selected to investigate for their hypouricemic action in mice, also significantly reduced liver uric acid level in hyperuricemic animals(167).

3.1. Myricetin
Myricetin is one of the flavonoid class of polyphenolic compounds, found abundantly in fruits and vegetables, including berries.
According to Dr. Li Y and colleagues, Myricetin and luteolin expressed binding to the xanthine oxidase and cyclooxygenase-2 in attenuate the complex pathogenesis of gout, a metabolic disease(168). The Sri Ramakrishna Institute of Paramedical Sciences study also exhibited the protective effect of asepigallocatechin, acacatechin, myricetin, naringenin, daidzein and glycitein in reduced the expression of in gout patients(169).
In support of the effectiveness of flavonoids for treatment of gout, Universidad Nacional de Asunción insisted that quercitrin, quercetin, myricitrin and myricetin strongly displayed the xanthine oxidase inhibitory action against the over expression of gout(170).

3.2 Kaempferol
Kaempferol is one of the flavonoid class of polyphenolic compounds, found abundantly in fruits and vegetable with formula C15H10O6. According to the Nanchang University, the phytochemical catalyze xanthine to generate uric acid and cause hyperuricemia and gout, through it direct interference of site of Xanthine oxidase (XO), a key enzyme in purine catabolism(171).
Dr. Ahmad NS and colleagues at the National University of Sciences and Technology suggested that kaempferol-3-O-beta-d-glucopyranoside isolated from Pistacia integerrima leaves, exhibited dose dependent UA lowering effect in hyperuricemic mice(172).

3.3 Icariin 
Icariin, a flavonol glycoside, type of flavonoid is a 8-prenyl derivative of kaempferol 3,7-O-diglucoside. According to the Nanjing University, icariin exhibited anti hyperuricemic and over expression of gout effects through inhibition on the liver xanthine oxidase (XOD) activities(167).

3.4. Apigenin 
Apigenin, a natural product belonging to the flavone class, remarkedly lowered serum uric acid levels in potassium oxonate induced hyperuricemic mouse, according to the study by the Beijing Institute of Pharmacology & Toxicology(173). Apigenin-7-O-β-D-glucoside, derivative of apigenin isolated from Olea europaea leaf (Ph.Eur.) extract, exhibited strongly the anti-gout property through expression of inhibitory effects on xanthine oxidase (XO)(174).

3.5. Luteolin
According to Dr. Li Y and colleagues, Myricetin and luteolin expressed binding to the xanthine oxidase and cyclooxygenase-2 in attenuate the complex pathogenesis of gout, a metabolic disease(168).

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(161) Effects of Biota orientalis extract and its flavonoid constituents, quercetin and rutin on serum uric acid levels in oxonate-induced mice and xanthine dehydrogenase and xanthine oxidase activities in mouse liver by Zhu JX1, Wang Y, Kong LD, Yang C, Zhang X.(PubMed)
(162) Quercetin lowers plasma uric acid in pre-hyperuricaemic males: a randomised, double-blinded, placebo-controlled, cross-over trial by Shi Y1, Williamson G1.(PubMed)
(163) Therapeutic properties of quercetin on monosodium urate crystal-induced inflammation in rat by Huang J1, Zhu M, Tao Y, Wang S, Chen J, Sun W, Li S.(PubMed)
(164) The dual actions of morin (3,5,7,2',4'-pentahydroxyflavone) as a hypouricemic agent: uricosuric effect and xanthine oxidase inhibitory activity by Yu Z1, Fong WP, Cheng CH.(PubMed)
(165) Uricosuric and nephroprotective properties of Ramulus Mori ethanol extract in hyperuricemic mice by Shi YW1, Wang CP, Wang X, Zhang YL, Liu L, Wang RW, Ye JF, Hu LS, Kong LD.(PubMed)
(166) Novel insights into the inhibitory mechanism of kaempferol on xanthine oxidase by Wang Y1, Zhang G, Pan J, Gong D.(PubMed)
(167) Hypouricemic action of selected flavonoids in mice: structure-activity relationships by Mo SF1, Zhou F, Lv YZ, Hu QH, Zhang DM, Kong LD.(PubMed)
(168) Virtual and in vitro bioassay screening of phytochemical inhibitors from flavonoids and isoflavones against xanthine oxidase and cyclooxygenase-2 for gout treatment by Li Y, Frenz CM, Li Z, Chen M, Wang Y, Li F, Luo C, Sun J, bohlin L, Li Z, Yang H, Wang C.(PubMed)


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