hypericum and Diabetic-Neuropathies

Painful diabetic peripheral neuropathy (DPN) is a common complication of diabetes and the few approved therapies for the management of pain have limited efficacy and side effects. With the aim to explore and develop new pharmacological treatments, we investigated the antihyperalgesic properties of St. John's Wort (SJW) and feverfew in streptozotocin (STZ)-diabetic rats. Acute administration of a SJW seed extract reversed mechanical hyperalgesia with a prolonged effect. A SJW extract obtained from the aerial portion of the plant and a feverfew flower extract partially relieved neuropathic pain whereas a feverfew leaf extract was ineffective. The antihyperalgesic efficacy of these herbal drugs was comparable to that of clinically used antihyperalgesic drugs (carbamazepine, lamotrigine, l-acetyl-levocarnitine). Further examinations of SJW and feverfew composition revealed that hyperforin and hypericin might be responsible for the antihyperalgesic properties of SJW whereas the efficacy of feverfew seems to be related to the presence of parthenolide. Rats undergoing treatment with SJW and feverfew did not show any behavioral side effect or sign of altered locomotor activity. Our results suggest that SJW and feverfew extracts may become new therapeutic perspectives for painful DPN.

Topics: Animals; Anthracenes; Diabetes Mellitus, Experimental; Diabetic Neuropathies; Flowers; Hyperalgesia; Hypericum; Perylene; Phloroglucinol; Phytotherapy; Plant Components, Aerial; Plant Extracts; Rats; Seeds; Sesquiterpenes; Tanacetum parthenium; Terpenes

As companies, including large pharmaceutical houses, try to market supplemental nutrients and herbal products to ever-increasing numbers of consumers, diabetics will start to approach their physicians about these alternative remedies. A whole new industry know as "neutraceuticals" has evolved. This new industry is a combination of the vitamin supplement and herbal industries trying to work with regulatory agents to develop good manufacturing processes to ensure that consumers obtain good products. In fact, some diabetics may be taking herbal or nutritional supplements without their physician's knowledge. Therefore, it is important to query diabetic patients at least once a year as to whether they are using any herbal or nutritional products. Once it is determined that a patient is using these products, physicians must decide if they or someone else should address the issue of taking these products. Physicians who have a good comfort level with herbal products by all means should recommend them to their patients. If such a comfort level is lacking or low, patients can be referred for a consultation on the use of supplements or told that information will be forwarded to them after contact is made with someone who has knowledge of diabetes and use of appropriate supplements. This article reviews nine nutrient and herbal remedies commonly used for diabetes to facilitate such patient education.

Topics: Depression; Diabetes Mellitus; Diabetic Neuropathies; Dietary Supplements; Humans; Hypericum; Nutritional Physiological Phenomena; Phytotherapy; Plants, Medicinal