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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6035_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •About the Editor
- •Contents
- •Contributors
- •Abbreviations
- •Preface
- •1. Natural Products as Drug Candidates
- •1.1 Introduction
- •1.2 An array of natural products
- •1.2.1 Plant-derived natural products
- •1.2.2 Microbial natural products
- •1.3 Importance of analytical techniques
- •1.3.1 A glance at extraction techniques
- •1.3.2 Microbial culturing techniques
- •1.3.3 Outlook and perspectives in nanoparticles
- •1.4 Natural products as a guide in drug design and synthesis
- •1.5 Natural products as promising drug candidates
- •1.5.1 Antiviral drug candidates
- •1.5.2 Antiparasitic drug candidates
- •1.5.3 Neuroprotective agents
- •1.6 Conclusion
- •Keywords
- •References
- •2. Traditional Knowledge for Drug Discovery
- •2.1 Introduction
- •2.2 Databases on indian remedial flora, indigenous medicines, and phytochemicals
- •2.2.1 Cultural preservation
- •2.2.2 Sustainable practices
- •2.2.3 Biodiversity conservation
- •2.2.4 Health and medicine
- •2.2.5 Climate change adaptation
- •2.2.6 Interconnectedness and wisdom
- •2.3 History of traditional knowledge
- •2.3.1 Indigenous healing practices
- •2.3.2 Aboriginal dreamtime
- •2.3.3 Traditional agriculture
- •2.3.4 Traditional crafts
- •2.3.5 Indigenous cosmologies
- •2.3.6 Traditional music and dance
- •2.3.7 Traditional navigation
- •2.4 Traditional medicine in plant formulations
- •2.4.1 Ayurveda
- •2.4.2 Traditional chinese medicine
- •2.4.3 Indigenous healing practices
- •2.5 Drug discovery
- •2.6 Aspects of developing plant-based drugs
- •2.6.1 Selection criteria for plants
- •2.6.2 Plant material authentication
- •2.6.3 Extraction methods
- •2.6.4 Isolation and structure elucidation of bioactive components
- •2.6.5 Standardization of plant formulations
- •2.7 Conclusions
- •References
- •3. Herbal Healing: Plant-Based Natural Products
- •3.1 Introduction
- •3.2 Classification of secondary metabolites
- •3.2.1 Phenolic compounds
- •3.2.2 Terpenes
- •3.2.3 Alkaloids
- •3.3 History of natural products
- •3.4 Drug discovery from natural products
- •3.5 Drugs derived from the plants
- •3.6 Conclusions
- •Keywords
- •References
- •4. Natural Products with Antimicrobial Properties
- •4.1 Introduction
- •4.2 Plants as antimicrobial agents
- •4.3 Marine sources as antimicrobial agents
- •4.4 Antimicrobial products derived from microorganisms
- •4.5 Conclusions and future trends
- •Keywords
- •References
- •5. Natural Products with Immunomodulatory Properties
- •5.1 Introduction
- •5.2.1 Aloe vera (l.) burm.f. (family: asphodelaceae)
- •5.2.2 Andrographis paniculata (burm. f.) wall.ex.nees. (family: acanthaceae)
- •5.2.3 Acorus calamus l. (family: araceae)
- •5.2.4 Allium sativum l. (family: alliaceae)
- •5.2.5 Azadirachta indica a. juss. (family: meliaceae)
- •5.2.6 Argyreia speciosa (l.f.) sweet (family: convolvulaceae)
- •5.2.7 Bidens pilosa l. (family: asteraceae)
- •5.2.8 Baliospermum montanum (willd.) müll.arg. (family: euphorbiaceae)
- •5.2.9 Boerhaavia diffusa l. (family: nyctaginaceae)
- •5.2.10 Boswellia serrata roxb. excolebr. (family: burseraceae)
- •5.2.11 Camellia sinensis (l.) kuntze (family: theaaceae)
- •5.2.12 Capparis zeylanica l. (family: capparidaceae)
- •5.2.13 Calendula officinalis l. (family: asteraceae)
- •5.2.14 Chelidonium majus l. (family: papaveraceae)
- •5.2.15 Carica papaya l. (family: caricaceae)
- •5.2.26 Glycyrrhiza glabra l. (family: leguminosae)
- •5.2.27 Hypericum perforatum l. (family: hypericaceae)
- •5.2.28 Hippophae rhamnoides l. (family: elaeagnaceae)
- •5.2.29 Hydrastis canadensis l. (family: ranunculaceae)
- •5.2.30 Jatropha curcas l. (family: euphorbiaceae)
- •5.2.31 Mangifera indica l. (family: anacardiaceae)
- •5.2.32 Mollugo verticillata l. (family: molluginaceae)
- •5.2.33 Matricaria chamomilla l. (family: asteraceae)
- •5.2.34 Momordica charantia l. (family: cucurbitaceae)
- •5.2.35 Morinda citrifolia l. (family: rubiaceae)
- •5.2.36 Nigella sativa l. (family: ranunculaceae)
- •5.2.37 Nelumbo nucifera gaertn. (family: nymphaeceae)
- •5.2.38 Nerium oleander l. (family: apocynaceae)
- •5.2.39 Ocimum tenuiflorum l. (family: labiatae)
- •5.2.40 Premna tomentosa willd. (family: verbanaceae)
- •5.2.41 Plantago sp. (plantago major l. and plantago asiatica l.) (family: plantaginaceae)
- •5.2.42 Psoralea corylifolia l. (family: fabaceae)
- •5.2.43 Prunella vulgaris l. (family: lamiaceae)
- •5.2.44 Punica granatum l. (family: punicaceae)
- •5.2.45 Rhinacanthus nasutus (l.) kurz (family: acanthaceae)
- •5.2.46 Salvia officinalis l. (family: lamiaceae)
- •5.2.47 Tamarindus indica l. (family: leguminosae)
- •5.2.48 Tinospora cordifolia (willd.) miers (family: menispermaceae)
- •5.2.16 Centella asiatica (l.) urb. (family: umbelliferae)
- •5.2.17 Cichorium intybus l. (family: asteraceae)
- •5.2.18 Cryptolepis dubia (burm.f.) m.r. almeida (family: apocynaceae)
- •5.2.19 Citrus aurantiifolia (christm.) swingle (family: rutaceae)
- •5.2.20 Curcuma longa l. (family: zingiberaceae)
- •5.2.21 Desmodium gangeticum (l.) dc. (family: fabaceae)
- •5.2.22 Eclipta prostrata (l.) (family: asteraceae)
- •5.2.23 Phyllanthus emblica l. (family: euphorbiaceae)
- •5.2.24 Evolvulus alsinoides (l.) (family: convolvulaceae)
- •5.2.25 Ficus benghalensis l. (family: moraceae)
- •5.2.49 Terminalia chebula retz. (family: combretaceae)
- •5.2.51 Urtica dioica l. (family: urticaceae)
- •5.2.52 Withania somnifera (l.) dunal (cultivated var.) (family: solanaceae)
- •5.3 Traditional importance of research to society and researchers
- •5.4 Conclusion
- •Keywords
- •References
- •6. Natural Products with Anticancerous Properties
- •6.1 Introduction
- •6.2 Plant-derived anticancer compounds
- •6.2.1 Polyphenols
- •6.2.2 Flavanoids
- •6.2.3 Brassinosteroids
- •6.2.4 Vinca alkaloids
- •6.2.5 Taxanes
- •6.2.6 Campothecin derivatives
- •6.3 Microorganisms-based anticancer compounds
- •6.3.1 Primary metabolites
- •6.3.2 Secondary metabolites
- •6.4 Selected medicinal plants with anticancerous activities
- •6.4.1 Curcuma longa l.
- •6.4.2 Viscum album l.
- •6.4.3 Colchicum autumnale l.
- •6.4.4 Raphanus sativus l.
- •6.4.5 Tinospora cordifolia wild
- •6.4.6 Nigella sativa l.
- •6.5 Therapeutic enzymes
- •6.6 Future perspective
- •6.7 Conclusion
- •Keywords
- •References
- •7. Natural Products with Antiviral Properties
- •7.1 Introduction
- •7.2 Source of natural products with antiviral activity
- •7.3 Main components of natural products
- •7.3.1 Flavonoids
- •7.3.2 Polyphenols
- •7.3.3 Polysaccharides
- •7.3.4 Terpenoids
- •7.4 Mechanisms of action of natural compounds in viral infections
- •7.4.1 Direct antiviral effect
- •7.4.2 Anti-inflammatory effect in viral infections
- •7.4.3 Effect on autophagy process
- •7.6 Conclusions
- •Keywords
- •References
- •8. Approaches to Develop Drugs from Natural Products
- •8.1 Introduction
- •8.2 Scenario of drug discovery
- •8.3 Efficient drug discovery engines
- •8.4 Drug discovery approaches using plants
- •8.4.1 Plant selection for screening purpose
- •8.4.2 Authentication of plants
- •8.4.3 Types of molecular markers
- •8.5.1 Parallel approach
- •8.5.2 Sequential approach
- •8.6 Structure elucidation of isolated compounds
- •8.7 Biological screening of extracts/fraction/isolates
- •8.7.1 Cell culture-based assay
- •8.7.2 Dialysis
- •8.7.3 Microdialysis
- •8.7.4 Ultrafiltration
- •8.7.5 Chromatography
- •8.7.6 Ligand fishing
- •8.8 Limitations
- •8.9 Molecular modelling and np database
- •8.10 Future thrust
- •8.11 Conclusion
- •Keywords
- •References
- •9. Strategies for Isolation and Identification of Bioactive Molecules from Natural Sources
- •9.1 Introduction
- •9.2 Bioactive compounds in natural sources and their pharmacological properties
- •9.3.1 Selection of materials
- •9.3.3 Types and properties of solvent for extraction
- •9.4 Extraction methods (conventional and modern)
- •9.4.1 Conventional methods
- •9.4.2 Novel extraction methods
- •9.5 Concentration and purification of bioactive molecules using chromatographic techniques
- •9.5.1 Separation based on adsorption properties
- •9.5.2 Separation based on partition coefficient
- •9.5.3 Separation based on the molecular size
- •9.5.4 Separation based on ionic strength
- •9.5.5 Other modern separation techniques
- •9.6 Identification and characterization of bioactive molecules
- •9.6.1 Qualitative and quantitative techniques/chromatographic or nonchromatographic techniques
- •9.7 Conclusions
- •Keywords
- •References
- •10. Role of Omics in Natural Product-Based Drug Discovery
- •10.1 Introduction
- •10.2 Genomics and transcriptomics in natural product discovery
- •10.2.1 Case studies and examples of natural product discovery using genomics and transcriptomics
- •10.2.2 Limitations and challenges of using genomics and transcriptomics in natural product discovery
- •10.3 Proteomics and metabolomics in natural product discovery
- •10.3.1 Case studies and examples of natural product discovery using proteomics and metabolomics
- •10.4 Bioinformatics in natural product-based drug discovery
- •10.4.1 Role of bioinformatics in natural product-based drug discovery
- •10.4.2 The use of bioinformatics to predict and annotate natural product biosynthetic pathways, gene clusters, and metabolomics
- •10.7 Future perspectives and potential impact of omics in natural product-based drug discovery
- •10.9 Potential impact on drug discovery and development
- •10.10 Conclusion
- •Keywords
- •References
- •11. Natural Products from Endophytic Microorganisms
- •11.1 Introduction
- •11.1.1 Rational/why endophytes?
- •11.2 Diversity of endophytic microorganisms
- •11.2.1 Endophytic bacteria and endophytic actinomycetes
- •11.2.2 Endophytic fungi
- •11.3.1 ISolation methods
- •11.3.1.1.1 Dilution Plating
- •11.3.1.1.2 Direct Plating
- •11.3.2 Identification methods
- •11.4 Bioactive compounds from endophytic microorganisms
- •11.4.1 Antibiotics
- •11.4.2 Antifungal agents
- •11.4.3 Antimalarial agents
- •11.4.4 Antiviral agents
- •11.4.5 Anticancer agents
- •11.4.6 Antioxidants
- •11.5 Stepwise methods for natural product discovery from endophytic microorganisms
- •11.5.1 Plant selection rationale
- •11.5.2 Isolation and cultivation of endophytes
- •11.5.3 Characterization of endophytes
- •11.5.4 Extraction of natural products
- •11.5.5 Purification of natural products
- •11.6 Biosynthesis and strategies for the optimization of natural product discovery from endophytic microorganisms
- •11.6.1 Exploration of novel microbial sources
- •11.6.2 Metabolomics-guided discovery
- •11.6.3 Coculture
- •11.6.4 Genome mining
- •11.6.5 Modulation by ultraviolent irradiation
- •11.7 Future directions and challenges
- •11.7.1 Improving the efficiency and accuracy of screening methods
- •11.7.2 Enhancing the scalability and affordability of production methods
- •11.7.3 Ensure natural product safety and efficacy
- •11.8 Conclusions
- •References
- •12. Natural Products with Antidiabetic Properties
- •12.1 Introduction
- •12.2 Natural products that regulate glucose absorption
- •12.2.1 Serotonin-derived products
- •12.2.2 Butyl-isobutyl-phthalate from laminaria japonica
- •12.2.3 Bioactive compounds of allium cepa and allium sativum
- •12.2.4 Elatosides E and F of aralia elata
- •12.2.5 Bioactive compounds of bauhinia candicans and bauhinia forficate
- •12.3 Natural products that enhance insulin sensitivity
- •12.3.1 Astragalus membranaceus polysaccharides
- •12.3.2 Bioactive compounds of litchi chinensis
- •12.3.3 Bioactive compounds of fenugreek
- •12.3.4 Bioactive compounds of cinnamon
- •12.3.5 Bioactive compounds of gastrodia elata
- •12.3.6 Polysaccharides of dioscorea
- •12.3.7 Anthocyanins of blueberries
- •12.3.8 Bioactive compounds of psidium guajava
- •12.4.1 Gingerol from zingiber officinale
- •12.4.2 Curcumin from curcuma longa
- •12.4.3 Berberine
- •12.4.4 Capsaicin of pepper
- •12.4.5 Bioactive compounds of bitter melon
- •12.4.6 Ginsenosides of ginseng
- •12.4.7 Bioactive compounds of aloe vera
- •12.4.8 Quinides of coffee
- •12.4.9 Bioactive compounds of tinospora cordifolia
- •12.4.10 Bioactive compounds of pterocarpus marsupium
- •12.4.11 Eugenol of ocimum sanctum
- •12.4.12 Bioactive compounds of syzygium densiflorum
- •12.5 Clinical trials based on antidiabetic effects of natural products derived from plants
- •12.5.1 Gymnema sylvestre (gurmar)
- •12.5.2 Fenugreek (trigonella foenum-graecum)
- •12.5.3 Tea catechins
- •12.5.4 Coffee
- •12.5.5 Rosemary (rosmarinus officinalis)
- •12.6 Conclusion
- •12.7 Future scope
- •Keywords
- •References
- •13. Marine-Derived Natural Products with Anticancer Properties
- •13.1 Introduction
- •13.2 Marine bioactive compounds
- •13.3 Anticancer activity of marine plants
- •13.4 Anticancer agents from marine floras
- •13.5.1 Antioxidants
- •13.5.2 Immunomodulation and apoptosis
- •13.5.3 Nutritional values and anticancer effects
- •13.6 Nature and cancer chemotherapy
- •13.7 Marine organisms and cancer chemotherapy
- •13.8 Anticancer agents from marine floras
- •13.9 Marine plants
- •13.9.1 Macro algae (seaweed)
- •13.9.2 Mangroves and other higher plants
- •13.9.3 Cyanobacteria
- •13.9.4 Bacteria
- •13.9.5 Proteobacteria
- •13.9.6 Cyanobacteria
- •13.9.7 Actinomycetes
- •13.9.8 Marine fungi
- •13.9.9 Soft corals
- •13.9.10 Marine sponges
- •13.10 Anticancer bioactive antibiotics derived from marine sources
- •13.10.1 Polyphenols
- •13.10.2 Polysaccharides
- •13.10.3 Alkaloids
- •13.11 Other marine sources for anticancer compounds
- •13.11.1 Peptides
- •13.11.2 Plitidepsin
- •13.11.3 Trabectedin
- •13.11.4 Lurbinectedin
- •13.12 Marine natural products as anticancer drugs
- •13.13.1 Aquaculture/cultivation
- •13.13.2 Genetic engineering
- •13.13.3 Synthesis/semisynthesis/modification
- •13.14 Conclusions and future prospects
- •References
- •14. Natural Products as Novel Opportunities for Cathepsin Inhibitors
- •14.1 Introduction
- •14.2 Cysteine proteases (CPs)
- •14.2.1 Cathepsin
- •14.2.2 Structure and mechanism of action of cathepsins
- •14.3 NPs as cathepsins inhibitors
- •14.3.1 NPs From bacteria as cathepsin inhibitors
- •14.3.2 NPs from fungus as cathepsin inhibitors
- •14.3.3 NPs from marine organism as cathepsin inhibitors
- •14.3.4 NPs from plants as cathepsin inhibitors
- •14.4 Conclusion and future pespectives
- •Keywords
- •References
- •15. Phytoestrogens in Drug Discovery: A Focus on Mechanisms of Action and Safety Assessment
- •15.1 Introduction
- •15.2 Phytoestrogens and estrogen receptors
- •15.3 Nonestrogen receptor-mediated effects of phytoestrogens
- •15.3.1 Mitogen-activated protein kinase (MAPK) pathway
- •15.3.2 PI3K/AKT pathway
- •15.3.3 WNT pathway
- •15.3.4 G-protein-coupled estrogen receptor (GPER)
- •15.4 Structure–activity relationship (SAR) of phytoestrogens
- •15.4.1 Isoflavones
- •15.4.2 Lignans
- •15.4.3 Coumestans
- •15.4.4 Stilbenes
- •15.4.5 Diarylheptanoids
- •15.5 Comparing potency and efficacy of phytoestrogens on various pathways
- •15.5.1 Potency and efficacy of phytoestrogens on different pathways
- •15.5.2 Possible synergistic effects of phytoestrogens with other drugs
- •15.6 Effects of phytoestrogens on the human organs
- •15.7 Safety Assessment of phytoestrogens
- •15.7.1 Toxicity assays used to evaluate the safety of phytoestrogens
- •15.7.2 Potential adverse effects of phytoestrogens
- •15.8 Case study
- •15.8.1 Vaginal cellular differentiation assay
- •15.8.2 Changes in rat body weight
- •15.8.3 Changes in rats’ uterus weight
- •15.9 Current trends in phytoestrogen research
- •15.9.1 Publication trends
- •15.9.2 Analysis of contributing countries and contributing institutions
- •15.9.3 Analysis of contributing publishers and journals
- •15.9.4 Publication evolution and research areas
- •15.9.5 Limitations
- •15.10 Future directions
- •15.10.1 Exploration of unexplored plant sources
- •15.10.2 Understanding mechanisms of action
- •15.10.3 Synthesis of novel compounds
- •15.10.4 Development of SPERMs
- •15.10.5 Safety assessment
- •15.11 Conclusion
- •Keywords
- •References
- •16. Honey Bee Products with Antimicrobial Properties
- •16.1 Introduction
- •16.2 Honey
- •16.3 Bee bread (perga)
- •16.4 Bee pollen
- •16.5 Bee propolis
- •16.6 Conclusion
- •Keywords
- •References
- •17. Natural Products for the Prevention of Leaky Gut
- •17.1 Introduction
- •17.2 The physical and chemical barriers of the intestine
- •17.2.1 Thick mucus layer
- •17.2.2 Intestinal epithelial cells (IECS)
- •17.2.3 Intestinal junctional complexes
- •17.2.4 Lamina propria
- •17.2.5 Intestinal regulatory T cells
- •17.2.6 Intestinal alkaline phosphatase
- •17.2.7 Antimicrobial peptides
- •17.2.8 Lysozyme
- •17.3 Mechanistic view of factors leading to a leaky gut
- •17.3.1 Gut dysbiosis
- •17.3.2 Mucosal inflammation and oxidative stress
- •17.3.3 TJ disruption
- •17.3.4 Genetics
- •17.3.5 Drugs
- •17.4 Pathological implications of a leaky gut
- •17.5 Natural product improving gut microbial dysbiosis
- •17.5.1 Traditional herbs and polyherbal formulations managing gut micro flora
- •17.5.2 Phytocompounds in the management of intestinal barrier integrity through balancing gut microflora
- •17.6.1 Anti-inflammatory traditional medicine and plant extracts ameliorating intestinal mucosal injury
- •17.6.2 Plant active constituents preventing mucosal injury and oxidative damage
- •17.7 Traditional medicine and natural products upregulating the TJ proteins
- •17.7.1 Traditional medicine and herbal extracts promoting junction protein protection
- •17.7.2 Phytocompounds for junction protein protection
- •17.8 Natural products averting pathological conditions through maintaining intestinal barrier function
- •17.9 Conclusion
- •Keywords
- •References
- •18. Role of Natural Products in the Pharmacotherapy of Osteoporosis
- •18.1 Introduction
- •18.1.1 Effect of traditional chinese medicine (TCM)
- •18.1.2 Effect of malay traditional medicine
- •18.1.3 Antiosteoporotic agents extracted from plant sources
- •18.1.4 Treatment by different pigments
- •18.1.5 Other herbal sources
- •18.1.6 Natural plant-based alkaloids
- •18.1.7 Essential markers involved in bone formation and resorption for osteoporosis treatment
- •18.2 Conclusion
- •Keywords
- •References
- •19. Gel-Based Natural Therapeutics: Potential Alternatives to Traditional Drug Delivery Systems in Aquaculture
- •19.1 INtroduction
- •19.2 DDS
- •19.2.1 Water medication
- •19.3 Oral administration
- •19.3.1 Gavage

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intestinal permeability brought on by dysfunctional TJs that allow antigens from the gut
flora to pass results in an immune system response that can damage any organ or tissue,
resulting in a variety of fatal illnesses.
17.3.5 DRUGS
The same drugs used to “manage” physical ailments also make our gut leaky, leading to
downstream catastrophic events in our body system like metabolic disorders, allergies, and
autoimmune disorders. The most common and frequently used classes of drugs used are the
antibiotics. Antibiotics wipe out the majority of the bacteria in our gut, and some studies
also indicate that even a single course of antibiotics may inflict irreparable harm to our gut’s
microbial community and result in the disruption of gut bacteria that may otherwise serve to
keep us healthy and prevent chronic disease (Tulstrup et al., 2015). The intestinal microbiota
is altered by oral antibiotic use as a result of the interaction between the chemicals released
by the antibiotic and the commensal and pathogenic bacteria residing in the gut, increasing
the likelihood of pathogen colonization in the gut (Bäumler and Sperandio, 2016). Many
anti-inflammatory medications like aspirin and ibuprofen are also reported to cause and
increase intestinal permeability , whose long-term usage can also cause gastric and duodenal
ulcers (Lambert et al., 2012; Tugendreich et al., 2006). Prednisone and hydrocortisone, two
steroids that help restrict immunological activity and reduce inflammation, are frequently
used to treat autoimmune illnesses. These steroids cause weakening of the intestinal
epithelium by modulating the gut barrier function (Gianotti et al., 1996).
17.4 PATHOLOGICAL IMPLICATIONS OF A LEAKY GUT
What enters the bloodstream and is carried to the organs in our body is limited by the
intestinal epithelium, which acts as a protective layer of defense restricting the entry of
unwanted substances. When the TJs of intestinal walls get disrupted, bacteria and toxins
flow from the gut into the bloodstream, and this condition is referred to as “leaky gut.”
Bacteria and associated toxins in the bloodstream have the potential to produce extensive
inflammation and even set off a detrimental immunological response. Numerous problems,
including mild ones like headaches, bloating, cramps, exhaustion, and food allergies, can
be brought on by a leaky gut, as well as life-threatening ones like cancer, IBD, autoimmune
diseases, diabetes, depression, and so on. The principal causes of leaky gut being the culprit
in causing various chronic diseases are the relationship shared between the gut and the
brain, and the gut and the liver. The portal vein, commonly referred to as the gut–liver axis,
is the anatomical connection between the gut and the liver (Albillos et al., 2020). The gut–
brain axis is a two-way channel of communication between the enteric and central nervous
systems that links the brain’s emotional and cognitive centers to peripheral gastrointestinal
functions (Carabotti et al., 2015).
Increased intestinal permeability caused by a damaged mucosal barrier causes exposure
to luminal material and sets off an immune reaction that encourages intestinal inammation

434
and a change in the composition of enteric ora. This intestinal inammation leads to a
chronic stage and disease called IBD (Yu et al., 2022). Another chronic gastrointestinal
condition caused by the leaky gut is the Crohn’s disease in which luminal antigens,
bacteria, and associated toxins, and so on inltration causes high-degree inammation
predisposing to clinical relapses (Sturniolo et al., 2001). When someone has an inamma-
tory bowel condition such ulcerative colitis or Crohn’s disease, their chance of developing
colon cancer is increased (10–15%). Chronic inammation and immune system activation
brought on by disturbances or modications to the normal gut ora may have an impact on
the etiology of colorectal cancer (CRC). Gene mutations caused by chronic inammatory
diseases also promote angiogenesis and cell growth (De Waal et al., 2020).
The metabolic disorders type 2 diabetes, CVDs, NAFLD, and so on are all predisposed
to by endotoxemia brought on by a leaky gut (Novakovic et al., 2020; Pitocco et al., 2020;
Said et al., 2022). LPS translocation triggers a chronic low-grade proinammatory and
pro-oxidative stress condition that is linked to chronic metabolic diseases tied to metabolic
syndrome. This condition activates inammatory responses and other downstream disease
progression pathways (Hoshiko et al., 2021). Studies have also shown the involvement of
leaky gut condition in development of type 2 diabetes. Increased intestinal permeability
allows pathogenic agents and food antigens to enter the body, which may eventually
produce immunological responses that harm pancreatic beta cells and result in increased
cytokine production and insulin resistance (De Kort et al., 2011). NAFLD, which develops
as a result of the liver’s continuing exposure to components of intestinal origin such as
toxins linked to bacteria and other antigens, is another hepatic manifestation of leaky gut
(Kessoku et al., 2021). Figure 17.3 shows the progression of intestinal barrier disruption
resulting in leaky gut conditions and other complications.
17.5 NATURAL PRODUCT IMPROVING GUT MICROBIAL DYSBIOSIS
Disruptions in gut microflora have been linked to many gastrointestinal and metabolic
diseases. Microbiota-regulated factors like bacterial overgrowth in the small intestine,
decreased commensal to pathogenic bacteria ratio, higher levels of luminal endotoxins
along with mucosal inflammation and oxidative stress contribute toward the development
of leaky gut (Chen et al., 2019). Commensal bacteria in the gut maintain the healthy atmosphere by producing bacteriocins and generating SCFAs from dietary fibers (GonzálezQuilen et al., 2020).
Traditional medicine systems for the management of gastrointestinal ailments are wide-
spread all over the globe. Specically traditional Chinese medicine and Ayurveda have
extensive mention relating gut health, diet, herbal medicines, and overall physiological
functioning (Wallace, 2020; Zhang et al., 2020). Recent advances in system biology and
application of “omics” approaches have brought about a radical change in the traditional
medicinal approaches. Numerous studies have also demonstrated the benecial effects
of various plant extracts and isolated substances in the control of gut microbiota, hence
lowering the risk of developing intestinal barrier dysfunction or leaky gut.

435
FIGURE 17.3 The stages of disease progression of intestinal barrier disruption resulting in leaky gut condition
and its pathological complications.
⏎
17.5.1 TRADITIONAL HERBS AND POLYHERBAL FORMULATIONS MANAGING GUT MICRO FLORA
Herbal medicines have widespread use from thousands of years. These traditional medicines have shown positive results in managing chronic colonic abnormalities, reducing
mucosal inflammation and oxidative damage and also in maintaining a healthy balance of
gut microflora. Studies have revealed that plant extracts, isolated bioactive compounds,
and polyherbal formulations have immunomodulatory , anti-inflammatory, antioxidative,
and antimicrobial properties. Different herbal formulas, polyherbal preparations, single
plants, and single active phytocompounds are reported for their beneficial effect in

436
maintaining the microbial population in the intestine (Lin et al., 2019; Seo et al., 2019;
Zhang et al., 2020).
Classical Chinese herbal drugs Fufangkushen colon-coated capsule (FCC) and
Qingchang Huashi (QCHS) have been tested in randomized clinical studies to obtain
encouraging results. Uleceritis colitis patients when treated with FCC and a placebo for
eight weeks, FCC-treated group showed a positive clinical response and no adverse effect
was observed (Gong et al., 2012). Additionally, the endoscopic score of the QCHS-treated
groups also improved. Besides mucosal healing of the intestinal barrier was also reported
(He et al., 2012).
Traditional Chinese medicines and herbal preparations have gained signicant attention because of their long therapeutic claims. Since thousands of years ago, Lizhong
decoction has been used in clinical settings as a traditional medicine for the treatment of
UC. It is a polyherbal preparation composed of extracts of established anti-inammatory
and antioxidant plant extracts like Zingiber ocinale Rosc., Panax ginseng C. A. Mey.,
Atractylodes macrocephala Koidz, and Glycyrrhiza uralensis Fisch. in an equal volume
ratio (1:1:1:1). According to reports, the polyherbal formulation improved the integrity
of the barrier by decreasing colonic inammation, increasing the synthesis of proinammatory indicators, and upregulating the expression of TJ proteins. It was also found to be
modulating the microbial population on genus level. At the phylum level, the abundance
of bacteroidetes rose while the overexpression of proteobacteria decreased (Shen et al.,
2020). Baitouweng decoction, a polyherbal formulation, composed of Radix pulsatilla,
Cortex phellodendri, Rhizoma coptidis, and Cortex fraxini. This traditional preparation
was tested for its gastrointestinal protective activity in mice model. By reducing the relative population of Escherichia and Shigella and boosting the population of Lactobacillus
and Akkermansia, the decoction was proven to be effective in improving the microbial
diversity (Xuan-Qing et al., 2012). Shenling Baizhu San (Jiao et al., 2022), Huaihua san
(P. Liu et al., 2020), Garidisan (Pei et al., 2019), Rhubarb Peony Decoction (Luo et al.,
2019), Huang-lian-Jie-du decoction (Yuan et al., 2020), and Jakyakgamcho-Tang (Seo
et al., 2019) are some other traditional polyherbal preparations that have been reported to
mitigate microbial dysbiosis and ameliorate the intestinal barrier dysfunction. Through the
balancing of gut microbiota, it has been discovered that these polyherbal formulations are
efcient in exerting protective impact on the intestinal membrane of dextran sulfate sodium
(DSS)-induced UC test animals. Proinammatory cytokine levels were also upregulated,
and inammatory markers were reduced. Improvements in the disease activity index (DAI)
score, colonic length, and colon histology along with an increase in body weight were
observed in the treated groups.
Many traditionally used plants in the form of different extracts have also been explored
for their potential to modulate the intestinal microbial population with modern scientic
tools and techniques. Traditionally used plants like extract of Abelmoschus manihot (Zhang
et al., 2019), Coptis chinensis Franch and Magnolia ocinalis (Xie et al., 2022), Capparis
spinosa
(Zhu et al., 2021), Pyracantha fortuneana fruits (Xu et al., 2019), Red Ginseng,
Semen coicis (Guo et al., 2015), and Indigo naturalis (Liang et al., 2019) have been inves-
tigated for their activity against leaky gut (Table 17.1).

TABLE 17.1 Traditional Medicine and Polyherbal Formulations Improving Leaky Gut Condition through Balancing Gut Microflora
Therapeutic Agent Category of Therapeutic Agent Observations Reference
Fufangkushen Polyherbal formulation Double-blinded multicentered controlled trial in colitis patients, involves
placebo
Qingchang Huashi Polyherbal formulation Randomized clinical study He et al. (2012)
Lizhong decoction Polyherbal formulation UC mice model, improved TJ protein expression, anti-inflammatory
action, gut microbial balance
Baitouweng
decoction
Shenling Baizhu San Polyherbal formulation Prospective cohort study
Huai hua san Polyherbal formulation
Garidisan Formulation composed of wild
Rhubarb Peony
decoction
Huang-lian-Jie-du
decoction
Flos Abelmoschus
manihot
Coptis chinensis
Franch and Magnolia
officinalis
Capparis spinosa
Pyracantha
fortuneana (Maxim.)
H. L. Li
Red Ginseng and
Semen Coicis
Indigo naturalis
Polyherbal formulation Dextran sulfate-induced colitis mice model, increased diversity of gut
microbes, anti-inflammation
In-vivo study in UC mice, reduced inflammatory markers, increased
membrane protection, balanced gut microflora
UC mouse model, regulates gut bacterial population, direct influence on
poppy and Artemisia frigida Willd
Polyherbal formulation UC mouse model, restored microbial diversity, increased population of
Herbal preparation UC mice, reestablished intestinal flora homeostasis, balances the good and
Plant extract
Mixture of extracts UC rat, symptoms of diarrhea, hematochezia, regulated symptoms
Extract UC mice model, increased diversity of gut microbes and their metabolites,
Extract High-fat diet-fed rat model, improved structural integrity, reduced
Extract
Extract DSS-induced UC mice restored gut bacterial diversity, reduced the
the Lachnospiraceae family of bacteria.
Firmicutes and Actinobacteria, reduced Proteobacteria and Bacteroidetes
pathogenic bacteria
In-vivo experiment in UC mice model, balances gut microflora, regulates
short-chain fatty acid production, butyrate, and acetate levels increased
of edema, congestion, and degradation of mucus layer, probiotics
Akkermansia and Blautia was increased
improved TJP, reduced inflammation
lactulose/mannitol ratio, improved microbial balance, regulated glycolipid
homeostasis
In-vitro studies and trinitro-benzene-sulfonic acid-induced UC rats, promoted
Lactobacillus and Bifidobacteriumin vitro, balanced bacterial diversity in vivo
abundance of Turicibacter, increased Peptococcus population, ameliorated
inflammation-related conditions
⏎
Gong et al. (2012)
Shen et al. (2020)
Xuan-Qing et al.
(2012)
Jiao et al. (2022)
Liu et al. (2020)
Pei et al. (2019)
Luo et al. (2019)
Yuan et al. (2020)
Zhang et al. (2019)
Xie et al. (2022)
Zhu et al. (2021)
Xu et al. (2019)
Guo et al. (2015)
Liang et al. (2019)
437

438
d
17.5.2 PHYTOCOMPOUNDS IN THE MANAGEMENT OF INTESTINAL BARRIER INTEGRITY THROUGH BALANCING GUT MICROFLORA
The preventive action of polysaccharides, alkaloids, and polyphenols in preserving barrier
integrity through balancing gut bacteria population has been documented (Table 17.2).
Polysaccharides are one of prominently reported class of natural products with potential of
balancing gut microbial diversity. Polysaccharides are complex carbohydrate polymers not
hydrolyzed by the digestive enzymes. They are metabolized by the gut microbes to produce
SCFAs in turn maintaining gut health. The potential advantages of plant polysaccharides in
intestinal disorders have been shown in several studies. Polysaccharides from Dictyophora
indusiata
(Kanwal et al., 2020), purple sweet potato polysaccharides (Sun et al., 2020),
Arctium lappa polysaccharide (Wang et al., 2019), Georgi polysaccharide from Scutellaria
baicalensis (Cui et al., 2021) are tested for colitis mice induced by DSS and found to be
effective in preserving the gastrointestinal barrier integrity by means of reducing pathological
intestinal damage, reduced inflammatory and oxidative markers, and enhancing TJ protein
expression. Scientific evidences show that the structural variations in polysaccharides
including monosaccharide constituents, branches, and connections in the carbon skeleton
and identity of the monosaccharide units influence the activity of the polysaccharides.
SCFAs production in the gut by microbial metabolism is largely dependent on the presence
of glycosidic linkage, side-chain composition, and the solubility of the plant polysaccharides.
Polysaccharides containing rhamnose and galactose sugar are found to be anti-inflammatory
in nature with significant potential on the reduction of proinflammatory cytokines. For
the generation of SCFAs by the gut bacteria, polysaccharides having arabinogalactan,
rhamnogalacturonan, or homogalacturonan units are thought to be effective prebiotics. Even
though much research has been done on the impact of natural polysaccharides on preventing
leaky gut by preserving microbial imbalance, the underlying mechanism of action is still not
fully understood (Cui et al., 2021; Huo et al., 2022).
The isoquinoline alkaloid Berberine has been widely studied for its multilayered protec-
tion toward the intestinal barrier and inuence on the gut microbiome. Numerous studies
have shown that berberine can affect the population and variety of gut ora, control fecal
metabolites, and lower proinammatory indicators. Studies using models linking gut microora and obesity, diabetes, atherosclerosis, other metabolic and inammatory diseases, in
addition to cancer, demonstrate that the natural alkaloid’s benecial effects also extend to
various physiological conditions related to intestinal disruption (Yan et al., 2022). Further
in-vitro studies involving Sanguinarin showed reduced levels of inammatory cytokines
along with modulation of SCFAs diversity in the gut. Further human observational study
and human intervention trials conducted to investigate the effect of coffee or its active
natural product caffeine, showed greater diversity of gut microbes population relating
to more caffeine/coffee consumption (Dingeo et al., 2020). Atractylenolide-1, a lactone
alkaloid, was found to be modulating the metabolite production in the intestine thereby
modulating the gut microbiota population. DSS induction disintegrated the intestinal
membrane and increased the
-fructose and d-galactose production, which was reversed
upon the treatment with atractylenolide-1. Furthermore, it prevented the degradation of TJ
protein and mucoprotein and reestablished intestinal ora distribution (Qu et al., 2022).

439
TABLE 17.2 Natural Products Regulating Leaky Gut Condition through Modulating Gut Microbiota
Natural Product Observations References
Polysaccharides
Berberine CAC mice, regulates diversity, and population of gut microflora, regulate the fecal
Sanguinarin
Caffeine Human observational study Dingeo et al. (2020)
Atractylenolide-1 Colitis mice model, balances microbial population and regulatory genes of fructose
Luteolin
Linarin
Shikonin CAC mice model, improved relative ratio of firmicutes to bacteroidota, modulates
Quercetin
In-vivo UC model, improved gut-bacteria balance, promoted SCFAs diversity,
improved TJP, and barrier integrity
metabolites, and reduce proinflammatory markers
In-vitro, modulation of SCFAs, reduced inflammation
and galactose metabolism (SPHK1 and B4GALT2), inhibits PI3K-AKT pathway
UC rat, increased Bacteroides, Lactobacillus, Butyricicoccus, and Roseburia population,
ameliorates DNA damages, regulates recombination of proteins, nucleic acid metabolism
UC-induced C57BL/6J mice, increased relative abundance of Lactobacillus,
Roseburia, Parabacteroides and Blautia, increased SCFAs, reduced inflammation
Wnt/β-catenin signaling pathway
Mice model, enhanced the populations of good bacteria (Lactobacillus, Bacteroides,
Clostridia, and Bifidobacterium) and reduced Enterococcus and Fusobacterium
⏎
Kanwal et al. (2020), Sun et al. (2020), Wang et al.
(2019), Cui et al. (2021), Huo et al. (2022)
Yan et al. (2022)
Dingeo et al. (2020)
Qu et al. (2022)
Li et al. (2021)
Jin et al. (2022)
Lin et al. (2022)
Lin et al. (2019)

440
Polyphenolic compounds including avonoids are well-known natural antioxidants
which are abundant in many plant species. Different classes of polyphenolic compounds
are found to be benecial in maintaining the gut microbial balance and thereby reducing
the symptoms of leaky gut. Luteolin, a common dietary avone was found to be benecial
in reducing DAI score and improving colon injury occurred in UC-induced mice. Li et al.
showed that luteolin enhanced disturbances in the function of the gastrointestinal barrier
by modulating microbiota and enhancing anti-inammatory indicators (Li et al., 2021).
Another natural avone Linarin was reported to be increasing mucosa layer strength and
improving barrier function. Linarin also improved the relative abundance of SCFAs and
balanced the SCF A-producing bacterial population (Jin et al., 2022). Lin et al. reported the
CRC inhibitory activity of a natural naphthoquinone Shikonin and its acetylated derivative.
Shikonin raised the evenness of the good bacteria Muribaculaceae, Lactobacillus, and
Lachnospiraceae, lowered the population of the disadvantageous ones, and enhanced the
richness and variety of the gut ora (Lin et al., 2022). Dietary supplementation with of
the commonly encountered polyphenol quercetin and its monoglycosides are also found
to be maintaining gut dysbiosis and eliminating the symptoms of IBD. When mice with
colitis caused by Citrobacter rodentium were treated with quercetin, the populations of
Lactobacillus, Bacteroides, Clostridia, and Bidobacterium increased while Fusobacterium
and Enterococcus dropped. Quercetin supplementation also decreased inammation,
oxidative damage, and reduced colonic injury (Lin et al., 2019). Zhu and coworkers treated
DSS-induced UC mice with preparations containing quercetin (Q) with its monoglycoside
(QM) in two ratios, namely, Q:QM 98:2 and Q:QM 69:31, and reported that dietary
supplementation even at low doses could effectively reverse the condition of intestinal
disruption (Hong and Piao, 2018).
17.6 NATURAL PRODUCTS PREVENTING INFLAMMATION AND OXIDATIVE
MUCOSAL INJURY
Oxidative mucosal injury and inflammatory responses are considered one of the major
causes of the progression of leaky gut. Antioxidant plant extracts and many natural
products have been tested and reported to be beneficial in targeting oxidative injury and
inflammatory triggers.
17.6.1 ANTI-INFLAMMATORY TRADITIONAL MEDICINE AND PLANT EXTRACTS AMELIORATING INTESTINAL MUCOSAL INJURY
Due to the presence of several active phytoconstituents, plant extracts, and traditional
herbal remedies have demonstrated promising anti-inflammatory and oxidative stressreducing properties. Various studies have explored the potential of different traditional
medicines and plant extracts in the mitigation of the symptoms of leaky gut. Traditional
Chinese medicine kuijieyuan decoction has the ability to reduce inflammation and reverse
oxidative damage, according to Liu et al. in DSS-induced UC rats. Kuijieyuan decoction

441
is a polyherbal composition with major constituents being identified as the antioxidant
natural products emodin, gallic acid, paeoniflorin, palmatine, berberine, coptisine, jatrorrhizine, baicalein, and baicalin. The decoction reduced the progression of UC injury and
decreased the levels of inflammatory markers in a dose-dependent manner (Liu et al.,
2020). Another well-known traditional medicine Gegen Qinlian decoction has been
reported to be effective in improving injured colonic mucosa through Notch-signaling
pathway in both chronic and acute UC models (Zhao et al., 2020). Further antioxidant
and anti-inflammatory potential of Garcinia cambogia in colitic rats has been reported
to improve the disease condition by reducing DNA damage in the colonic cell. Portulaca
oleracea L. ethanol and ethyl acetate extracts, as well as the plant’s isolated compounds,
were studied for their potential to prevent IBD by Kim and colleagues. In mice with
injury symptoms generated by DSS, the plant extract and its isolated component cis-N-
feruloyl-3′-methoxytyramine reversed the symptoms and reduced the levels of the
proinflammatory cytokines TNF-, IL-6, and IL-1 (Kim et al., 2018). Jasonia glutinosa
(L.) DC., traditionally used in Spain for the treatment of bowel disorder was found to be
potent in xanthine oxidase and lipoxygenase inhibition as well as free radical scavenging
activities. Furthermore, the ethanolic extract of the plant, prepared through the Soxhlet
extraction technique, successfully reduced colon shortening, improved colon thickness,
and prevented intestinal damage (Valero et al., 2020). Rubus crataegifolius, Ulmus
macrocarpa, and Gar denia jasminoides plant extracts either alone or in combination were
evaluated for its protective effect against ulcer in rat models. The study reported that the
plant extracts in combination have strong antioxidant activity and successfully provide
strong protective activity in mucosal injury of test animals (Park et al., 2019). Rocha and
coworkers investigated the effect of Mentha pulegium (Pennyroyal) phenol-rich extract
for IBD mitigation and the prevention of its further progression to CRC. The extract
showed significant antioxidant and antiproliferative activity through in-vitro experiments
and reduced inflammatory markers in colitis induced murine model. Histopathological
examination showed reduced levels of intestinal injury (Rocha et al., 2019).
17.6.2 PLANT ACTIVE CONSTITUENTS PREVENTING MUCOSAL INJURY AND OXIDATIVE DAMAGE
Many natural products and bioactive natural molecules have been investigated and reported
for their activity in maintaining intestinal barrier integrity via prevention of oxidative damage
(T able 17.3). Heteropolysaccharides isolated from Camellia sinensis showed gastroprotective
potential by balancing the glutathione pool (Scoparo et al., 2016). Mai et al. reported the
inflammasome inactivation mediated intestinal damage-protecting activity of isoquinoline
alkaloid palmatine in DSS-induced UC murine model. Treatment of diseased animals with
palmatine, upregulated mitophagy which inhibited the release of dysfunctional mitochondria
in turn activating inflammasomes. This series of signaling cascade results in the inhibition
of hyperinflammation resulting in improvement of the disease condition in the UC mice
(Mai et al., 2019). Quinolizidine alkaloid oxymatrine inhibited nuclear factor-κB (NF-κB)
nuclear translocation and inflammation regulating cytokine in rodent intestinal cells.

TABLE 17.3 Herbal Medicines and Bioactive Natural Products in the Management of Leaky Gut through Reducing Intestinal Inflammation and Oxidative
Damage
Therapeutic Agent Category of
Kuijieyuan decoction Polyherbal composition UC rat model, restored UC injury, malondialdehyde, reduced inflammatory cytokines,
Gegen Qinlian
decoction
Garcinia cambogia
Portulaca oleracea
Jasonia glutinosa (L.)
DC.
Rubus crataegifolius,
Ulmus macrocarpa,
Gardenia jasminoides
Mentha pulegium
Polysaccharides Isolated natural product Acute gastric lesion in Wistar rat, maintenance of gastric mucus through treatment of
Palmatine Natural product DSS-induced mice and macrophages, levels of inflammatory markers and disease
Oxymatrine Natural product DSS-induced murine model, reduced luciferase activity , decreased colonic inflammation Guzman et al. (2013)
Quercetin Natural product Caco-2 and DSS-induced colitis mice model, alleviate the decreased cell index
Ellagic acid Natural product C57BL/6J mice, reduced intestinal permeability, endotoxemia, and liver injury
⏎
Observations Reference
Therapeutic Agent
increased the levels of antioxidant enzymes, regulates AKT/p-PI3K pathway
Polyherbal composition Acute and chronic UC mice, repaired injured colonic mucosa, increased goblet cells
in acute UC, upregulated RBP-J, MAML, and Hes1 proteins in chronic UC mice
Plant extract TNBS-induced colitis rat, improved the macroscopic damage and down-regulated,
reduced DNA damage in isolated colonocytes
Plant extract
Plant extract
Single plant extract or
mixture of extracts
Phenol rich extract
In-vitro study (RAW264.7 macrophages), ICR mouse model, inhibited proinflammatory
cytokine, increased JNK, ERK, and p38 phosphorylation in RA W264.7 macrophages
In-vitro enzymatic and cell-based assay, DSS-induced UC mice model, superoxide,
xanthine oxidase and lipoxygenase (5-LOX) inhibitory activity, reduced proinflam-
matory marker TNF-α levels, improved apical epithelial integrity in mice model
In-vivo model of gastritis and ulcer in rat, combined extract showed better effect
(83.71% reduction with respect to individual extracts)
Human colon carcinoma cell and colitis in mice, antioxidant in-vitro assays, antiproliferative activity on cancer cell, downregulation of inflammatory mediators in mice model
isolated natural product, reduction of reduced glutathione level (GSH)
activity index reduced, downregulated NLRP3 inflammasomes activation and
enhanced mitophagy-related proteins
associated with colitis, ROS inhibition, increased H2O2 generated intracellular GSH
concentration, and repaired damaged cell
through regulation of gut dysbiosis and ROS, apoptosis marker protein levels
downregulated, prevented elevated leaky gut in alcohol-treated mice
Liu et al. (2020)
Zhao et al. (2020)
dos Reis et al. (2019)
Kim et al. (2018)
Valero et al. (2020)
Park et al. (2019)
Rocha et al. (2019)
Scoparo et al. (2016)
Mai et al. (2019)
Dong et al. (2020)
Kim et al. (2021)
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