Suche
Relation
Koo HJ, Lee KR, Kim HS, Lee BM. Detoxification effects of aloe polysaccharide and propolis on urinary metabolite excretion in smokers. (Link removed). 2019;130:99-108.
Study objective
To evaluate the potential use of aloe polysaccharide and propolis as chemoprevention in smokers by measuring the effects of these natural agents on the urinary excretion of major tobacco carcinogens and nicotine. To study the synergistic effects of aloe polysaccharide and propolis by using a combination of these active ingredients at lower doses.
Draft
Randomized, multi-arm, blinded, placebo-controlled study, duration 4 weeks
Participants and intervention
A total of 50 participants divided into 5 groups of 10 people each.
Forty healthy smokers (20-40 cig/day x 1-10j) and 10 healthy non-smokers (never smokers). All men, 20 to 28 years old. All students from Sungkyunkwan University, Suwon, Republic of Korea.
Group 1. 10 non-smokers. Placebo.
Group 2. 10 smokers. placebo
Group 3. 10 smokers. 600 mg/day aloe polysaccharide extract
Group 4. 10 smokers. 600 mg/day propolis extract
Group 5. 10 smokers: Mixture of 420 mg/day aloe polysaccharide and 180 mg/day propolis
Study parameters assessed
- Ausscheidung von Benzo über den Urin[a]Pyren (BaP) und Cotinin
- Blutspiegel von Kreatinin, Glukose und Gesamtbilirubin
Primary outcome measures
- Urinspiegel von BaP und Cotinin
- Blutspiegel von Kreatinin, Glukose und Gesamtbilirubin
Study Restrictions
All participants were young, East Asian men.
Key insights
The excretion of BaP and cotinine in urine was significantly increased in a time-dependent manner by treatment with aloe polysaccharide, propolis and a mixture of the two active ingredients. Treatment with aloe polysaccharide alone had a greater impact on urinary excretion of BaP and cotinine (BaP, 2.23-fold increase; cotinine, 2.64-fold increase versus smoking placebo group) than treatment with propolis (BaP, 1.30-fold increase; cotinine, 2.08-fold increase;P<0.05).
The mixture of aloe polysaccharide and propolis at lower doses had a similar effect (BaP, 2.33-fold increase; cotinine, 2.28-fold increase over the smoking placebo group) as that of aloe polysaccharide alone at a higher dose, demonstrating the synergistic effects of aloe and propolis products.
Increased clearance of carcinogens may be chemopreventive by limiting the interaction of electrophilic carcinogens with biomolecules.
Blood levels of creatinine, glucose, and total bilirubin were decreased by aloe polysaccharide alone (15.24%, 40.22%, and 48.82%, respectively), propolis alone (16.83%, 36.25%, and 52.59%, respectively), and the mixture of aloe polysaccharide and propolis (16.36%, 46.37%, and 39.20%, respectively). %;P<0.05).
Practice implications
Tobacco products cause numerous types of cancer, as well as cardiovascular, respiratory and various inflammatory diseases. According to the World Health Organization, around 8 million people worldwide die every year as a result of tobacco consumption; More than 7 million deaths are the result of direct tobacco consumption and 1.2 million are due to secondhand smoke.1In the United States, cigarette smoking is the leading cause of preventable illness and death. Despite declining smoking trends, more than 34 million American adults continue to smoke, more than 16 million live with a smoking-related illness, and approximately 480,000 die each year as a result of tobacco use.2
A current worrying trend is the rapid increase in the use of electronic cigarettes, or e-cigarettes. Some people who used to smoke regular cigarettes are now switching to e-cigarettes because they think they are a safer alternative.3Another worrying development is the use of e-cigarettes by young people; They are the most commonly used tobacco product among middle and high school students.4.5E-cigarettes are highly addictive products that produce a variety of chemicals. A CDC press release dated September 6, 2019,6stated that severe lung disease has been linked to e-cigarette products. While it is unclear which chemical components cause the most harm, users of both THC and nicotine-containing products are affected.7
Healthcare providers have a unique opportunity to educate patients about smoking cessation and provide them with tools to help them quit smoking. A short and effective intervention can take less than 10 minutes. An easy way to do this is to use the 5 As:
- Fragen Sie nach der Verwendung
- Zum Aufhören raten
- Versuchsbereitschaft einschätzen
- Beim Aufhören helfen
- Vereinbaren Sie eine Nachsorge
Even in patients who are not yet ready to quit smoking, simply talking to a doctor about a smoking habit has been shown to increase motivation and increase the likelihood of quitting smoking in the future.8
The 5 R strategy can be helpful in motivational counseling:
- Relevanz (machen Sie es für den Patienten persönlich relevant)
- Risiken (akute, chronische und Umweltauswirkungen adressieren)
- Belohnungen (z. B. verbesserte Gesundheit, verbessertes Aussehen und gespartes Geld)
- Straßensperren (Entzug, Heißhunger und Ressourcen)
- Wiederholung (bei unmotivierten Patienten jedes Mal wiederholen; die meisten Menschen unternehmen mehr als einen Versuch aufzuhören).
In addition to counseling techniques, several first-line medications have been shown to increase rates of long-term smoking abstinence, including bupropion SR, varenicline, and nicotine-containing products (e.g., chewing gum). Appropriate advice about possible side effects and expectations is a must when adding concomitant medications. While both counseling and medication can be used individually, combining the two is more effective.8
Given the current epidemic of tobacco use and its impact on global health, research such as that described in this article to circumvent the harmful effects of tobacco products is timely. In this study, aloe polysaccharide and propolis extracts, both individually and in combination, limited exposure to carcinogens by increasing their urinary excretion. Tobacco smoke contains at least 70 human carcinogens. BaP, one of the first carcinogens identified, was most effectively excreted in the urine of individuals who received aloe polysaccharide either alone or in combination with propolis extract.
This study also measured the excretion of cotinine, a major metabolite of nicotine and a marker of choice for monitoring tobacco smoke inhalation. Cotinine excretion was also improved by aloe and propolis products. Aloe polysaccharide extract alone was more effective than propolis extract alone, and the combination of the two extracts had a similar effect to that of aloe polysaccharides alone. The authors of this study suggest that enhanced clearance of carcinogens may be chemopreventive by limiting the interaction of electrophilic carcinogens with biomolecules.
Aloe vera has long been used as a folk remedy for the topical treatment of wounds and burns. It has also been suggested to have antimicrobial, antidiabetic, antioxidant and analgesic effects. It has been used in patients with skin diseases, arthritis and stomach ulcers.9Aloe plants consist of an outer bark, sheath cells of the leaves called latex, and an inner clear gel. Anthraquinone glycosides (e.g. emodin) are obtained from latex and have a laxative effect. Aloe polysaccharides are the main components of the inner leaf gel of aloe and have been shown to have chemopreventive and immunomodulatory effects.10Aloe polysaccharide extract was used in the present study.
Propolis is a natural resin mixture produced by honey bees from substances collected from plant parts, buds and exudates. It is known to have antibacterial, antifungal, antioxidant and anti-inflammatory activities,11as well as antidiabetic and hepatoprotective activity.12In this study, a water-soluble powder preparation was prepared by freeze-drying ethanol extract.
In addition to improving the excretion of BaP and cotinine, aloe polysaccharide and propolis also reduced blood levels of creatinine, glucose and total bilirubin, which are associated with protective effects on the kidneys and liver as well as antidiabetic activity.
Both aloe polysaccharides and propolis have excellent safety records and could be useful as potential chemopreventive agents in patients who are current smokers or trying to quit smoking.