Perspectiva actual de usuarios, médicos y curanderos sobre la práctica de la medicina ancestral andina en Cuenca, Ecuador

Antecedentes. En la cosmovisión andina, el concepto de salud está asociado al equilibrio energético interno del hombre y externo con los otros seres de la naturaleza. Adicionalmente, la fuerte influencia de la religión católica, heredada de España, generó un sincretismo manifestado en la introducción de símbolos y objetos cristianos en la práctica médica andina. En este contexto, la medicina ancestral posee no solamente un carácter cultural sino también religioso. Sin embargo, la globalización y la migración pueden influenciar sobre una posible carencia de conocimiento y ausencia de identificación cultural de las nuevas generaciones respecto a los saberes y prácticas de la medicina ancestral andina. Así, la perspectiva actual sobre el uso de la medicina ancestral en el ejercicio de atención en salud es un fenómeno que va más allá de lo exclusivamente étnico pues implica comprender la diversidad generacional, cultural, económica y social del ser humano y reconocer su influencia al momento de optar por esta alternativa terapéutica en nuestro país. Objetivo general. Describir la perspectiva actual de los usuarios, curanderos y médicos sobre la práctica de la medicina ancestral andina en el cantón Cuenca, Ecuador. Metodología. Estudio cualitativo con diseño fenomenológico. Los participantes fueron seleccionados mediante muestreo por conveniencia. La información se recolectó mediante la ejecución de tres grupos focales, dieciocho entrevistas semi-estructuradas y cuatro observaciones no-participativas. Adicionalmente se recolectó la información sociodemográfica de los participantes para situarla en su contexto al momento del análisis. La información referida por los participantes se registró en una grabadora de voz y se transcribió a documentos de Word para su posterior análisis. Conclusiones. El uso de la medicina tradicional predomina en el área rural donde muchas veces constituye la única forma de cobertura de las necesidades sanitarias. En lo referente a su efectividad, se describió la capacidad terapéutica de la medicina ancestral no solamente en relación con las concepciones culturales-mágico-religiosas que la envuelven sino también por los principios terapéuticos que la rigen y los saberes botánicos, zoológicos, ecológicos y tecnológicos que reúne, mismos que inclusive han constituido el fundamento para desarrollar algunos medicamentos occidentales. Por otra parte, la principal limitación de los curanderos para la transmisión del conocimiento ancestral se asocia principalmente a la falta de espacios de diálogo para el rescate de saberes, situación que los aparta de sus comunidades y de las nuevas generaciones. En referencia a las ventajas que ofrece la medicina ancestral se menciona principalmente, el costo accesible por los servicios y el tratamiento prescrito, así como una relación más cercana entre el usuario y el curandero.Facultad de Humanidades y Ciencias de la Educació

Actividad anticonvulsiva del aceite de cúrcuma y sus constituyentes en los modelos biológicos de pez cebra y ratón

La epilepsia es un problema neurológico que presenta una prevalencia importante a nivel mundial. El 70% de los casos de epilepsia pueden tratarse farmacológicamente con resultados satisfactorios. Sin embargo, el 30% de estos pacientes presenta problemas referentes a la terapia farmacológica actualmente disponible. Entre las principales limitaciones terapéuticas se encuentran las relacionadas con la fármaco-resistencia y con la presencia de reacciones adversas. Por ello, se hace evidente la necesidad de buscar nuevas alternativas, efectivas y seguras, para el tratamiento de la epilepsia. En este con- texto, los productos naturales representan una fuente interesante de nuevos principios activos con potencial capacidad anticonvulsiva. Un ejemplo de ello es la cúrcuma (Curcuma longa L.), una hierba perenne nativa de la India, tradicionalmente empleada en la cocina asiática como condimento alimentario. A través de los estu- dios fito-farmacológicos descritos en el presente capítulo, el aceite de cúrcuma y sus principales constituyentes fueron caracterizados far- macológicamente con la finalidad de evaluar su capacidad anticon- vulsiva y seguridad en los modelos biológicos de pez cebra y ratón

Pharmacological evaluation in rodents of novel anticonvulsants identified using the zebrafish pentylenetetrazol seizure model

Epilepsy is a life-shorteningbrain disorder that currently affects 1% of worldwide population. Despite theavailability of a number of antiepileptic drugs (AEDs), severe side effectssuch as cognitive and affective disorders, teratogenicity, hepatotoxicity,among others, have been reported after chronic administration. In addition to thetoxic effects, ~30% of patients with epilepsy remain refractory to the activityof the available AEDs. Hence, there is a current need for discovery anddevelopment of new molecules effective against all types of seizures withminimal or no adverse side effects. Nature is an interesting source ofpotential drug candidates for the treatment of pharmacoresistant epilepsy (PRE)due to the highly diverse and complex chemical structures of bioactivecompounds present in vegetal samples. Thus, a number of plants wereselected on the basis of their ethnomedical use against convulsions andevaluated in the zebrafish model. In this model, seizures are chemicallyinduced in zebrafish larvae using the proconvulsant pentylenetetrazol (PTZ).From this primary screening, the anticonvulsant properties of Curcuma longa and Baccharis cf. obtusifolia were identified. A further confirmationof the anticonvulsant activity was carried out in mouse models of acuteseizures.Therhizome powder of Curcuma longa,known as turmeric, is commonly used in India as a dye and food additive butalso in ethnomedicine, for epilepsy. Until our research study, theanticonvulsant properties of turmeric were exclusively attributed to the actionof curcuminoids. For the first time, we revealed the anticonvulsant propertiesof turmeric oil and its main bisabolene sesquiterpenoids, ar-turmerone, alfa-, ß-turmeroneand alfa-atlantoneas the compounds responsible for this pharmacological activity. From the groupof bisabolene sesquiterpenoids, ar-turmerone was selected to be furtheranalyzed due to the chemical stability conferred by the presence of an aromaticring in its structure. In addition to the anticonvulsant activity observed inthe zebrafish model, ar-turmerone displayed anticonvulsant activity in the i.v.PTZ model in a dose-dependent manner and was also active in the 6-Hz model.Thirty minutes after i.p administration of ar-turmerone in mice, the electricalstimulation was delivered, evidencing complete protection in a wide rangeofdoses (0.1 50 mg/kg). In the beam walking test, ar-turmerone showed no signof toxicity (motor impairment, loss of balance) at the highest administereddose (i.p. and i.v.; 50 mg/kg). Furthermore, the concentration-time profilerevealed the capabilities of ar-turmerone to cross the blood-brain barrier(BBB) in mouse brains starting at 15 min after i.p. injection and to remain inthe brain up to 24 h reaching a constant low concentration of ~200 ng/mg overtime. Based on the finding of 24 h residence time of ar-turmerone in mousebrains, its anticonvulsant properties were also assessed after 1 day of i.p.administration (50 mg/kg). The protective activity of ar-turmerone in this testwas confirmed for 70% of treated mice. Additionally, in presence of PTZ, theexpression of c-fos, wassignificantly downregulated in zebrafish larvae treated with ar-turmerone.Likewise,the anticonvulsant properties of Bacchariscf. obtusifolia, were initially identified in the zebrafish PTZ model incombination with EEG analysis in larval zebrafish brains. Baccharis cf. obtusifolia is a medicinal plant traditionally usedin Ecuador as a remedy against convulsions. A further characterization of itsanticonvulsant activity was completed in the mouse PTZ model. A bio-assay guidedisolation in the zebrafish model allowed the identification of kaempferide(kaempferol 4'-methyl ether), naringenin 4'-methyl ether and naringenin7-methyl ether as the active compounds accountable for the anticonvulsantactivity of Baccharis. The capabilityof controlling PTZ-induced seizure onset was investigated in the commerciallyavailable compounds: kaempferide, kaempferol, naringenin 7-O-methyl ether(sakuranetin), naringenin and naringenin 4 , 7-dimethyl ether using thezebrafish model in combination with a transcriptional analysis of the geneexpression of c-fos. To the best ofour knowledge, this in vivoevaluation constitutes the first scientific approach investigating thetraditional use of herbal remedies as a treatment against convulsions inEcuadorian ethnomedicine. Thus,the present research project summarizes our investigation carried out on theanticonvulsant properties of ar-turmerone and naringenin 4 ,7-dimethyl ether,two potential AED candidates isolated from Curcumalonga and Baccharis cf. obtusifolia,respectively. Our findings support further characterization of theanticonvulsant properties of the active compounds and demonstrate theusefulness of the zebrafish and mouse models as valuable toolboxes in thesearch for novel AEDs. Normal 0 21 false false false NL-BE X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}ACKNOWLEDGEMENTS I SUMMARY V SAMENVATTING VII LIST OF ABBREVIATIONS XI TABLE OF CONTENTS XV CHAPTER 1: INTRODUCTION 1 1.1. GENERAL DEFINITIONS 1 1.2. CLASSIFICATION OF EPILEPTIC SEIZURES 1 1.3. CLASSIFICATION OF ELECTROCLINICAL SYNDROMES AND OTHER EPILEPSIES 2 1.4. DIAGNOSIS OF EPILEPSY 2 1.5. TREATMENT OF EPILEPSY 4 1.5.1. Pharmacological treatment 4 1.5.2. Epilepsy surgery 8 1.5.3. Vagus nerve stimulation 9 1.5.4. Ketogenic diet 9 1.6. PROBLEMS RELATED TO THE PHARMACOLOGICAL TREATMENT 9 1.6.1. Pharmaco-resistant epilepsies 9 1.6.2. Adverse side effects 13 1.7. ANTIEPILEPTIC DRUGS UNDER DEVELOPMENT 13 1.8. ANIMAL MODELS FOR EPILEPSY DRUG DISCOVERY 15 1.8.1. Rodent models 15 1.8.1.1. Identification 15 1.8.1.2. Quantification 17 1.8.1.3. Differentiation 18 1.8.1.4. Advanced studies 19 1.8.2. The zebrafish model 20 1.8.2.1. Locomotor activity 20 1.8.2.2 Tectal field recordings 21 1.9. MEDICINAL PLANTS AND EPILEPSY TREATMENT 22 CHAPTER 2: AIMS OF STUDY 25 CHAPTER 3: ANTICONVULSANT ACTIVITY OF BISABOLENE SESQUITERPENOIDS OF Curcuma longa IN ZEBRAFISH AND MOUSE SEIZURE MODELS 27 3.1. ABSTRACT 28 3.2. INTRODUCTION 28 3.3. MATERIALS AND METHODS 30 3.4. RESULTS 36 3.5. DISCUSSION 45 3.6. ACKNOWLEDGMENTS 47 3.7 SUPPLEMENTARY FIGURES 48 3.8. REFERENCES 51 CHAPTER 4: INSIGHTS FROM ZEBRAFISH AND MOUSE MODELS ON THE ACTIVITY AND SAFETY OF AR-TURMERONE AS A POTENTIAL DRUG CANDIDATE FOR THE TREATMENT OF EPILEPSY 57 4.1. ABSTRACT 58 4.2 INTRODUCTION 58 4.3. MATERIALS AND METHODS 60 4.4. RESULTS 66 4.5. DISCUSSION 74 4.6. ACKNOWLEDGEMENTS 79 4.7. REFERENCES 80 CHAPTER 5: ANTICONVULSANT ACTIVITY OF FLAVONOIDS FROM Baccharis cf. obtusifolia, A MEDICINAL PLANT TRADITIONALLY USED IN ECUADOR AGAINST CONVULSIONS 87 5.1. ABSTRACT 88 5.2. INTRODUCTION 88 5.3. MATERIALS AND METHODS 91 5.4. RESULTS 96 5.5. DISCUSSION 103 5.6. REFERENCES 106 CHAPTER 6: DISCUSSION AND PERSPECTIVES 111 GENERAL REFERENCES 117 CURRICULUM VITAE 127 LIST OF SCIENTIFIC PUBLICATION

Steviol glycosides from stevia rebaudiana: an updated overview of their sweetening activity, pharmacological properties, and safety aspects

This literature-based review synthesizes the available scientific information about steviol glycosides as natural sweeteners and molecules with therapeutic potential. In addition, it discusses the safety concerns regarding human consumption. Steviol glycosides exhibit a superior sweetener proficiency to that of sucrose and are noncaloric, noncariogenic, and nonfermentative. Scientific evidence encourages stevioside and rebaudioside A as sweetener alternatives to sucrose and supports their use based on their absences of harmful effects on human health. Moreover, these active compounds isolated from Stevia rebaudiana possess interesting medicinal activities, including antidiabetic, antihypertensive, anti-inflammatory, antioxidant, anticancer, and antidiarrheal activity. The described bioactivities of steviol glycosides deserve special attention based on their dose dependence and specific pathological situations. Further clinical research is needed to understand underlying mechanisms of action, therapeutic indexes, and pharmacological applications

Andean traditional medicine plants. The case of “Limpia” (Cleansing ceremony)

The Andean worldview embraces a holistic understanding of well-being. For Andean Traditional Medicine (ATM), health comprises the internal energetic equilibrium of the individual and the equivalent energetic balance with the surrounding environment. The human being should be in harmony with the family, the community, Nature and the Cosmos to achieve complete welfare (Mathez-Stiefel et al. 2007).Rupture of this energetic balance causes disease. Therefore, treatment focuses on restoring the original stability in the body and the soul (Bautista-Valarezo et al. 2020). For this purpose, plants are the primary therapeutic resources described in ATM (Houghton 1995). The World Health Organization (WHO) promotes the rational use of complementary therapy—including herbal remedies—to ensure widespread therapeutical coverage, especially in developing countries. The application of herbal medicines as co-adjuvant of prescribed drugs could support the administration of minimum effective doses to lessen the probability of dose-dependent adverse reactions. They may contribute to improving adherence to the prescribed pharmacological therap

Nutraceutical and functional properties of the andean grain amaranthus caudatus L

A nutraceutical is a naturally occurring food compound marketed as a dietary supplement in a dosage form. This compound may possess beneficial health effects when administrated in higher quantities than those present in food. Moreover, when consumed as part of the diet in recommended amounts for daily intake, a functional food provides an adequate nutritional effect and contributes to health improvement or reduces the risk of disease (Luengo 2007). In this context, due to its characteristic protein composition with a unique qualitative and quantitative protein profile and its appealing pharmacological properties, Amaranthus caudatus is currently considered an appealing nutraceutical, functional food and drug candidate. Worldwide interest in amaranth (A. caudatus) began in the 1980s, mainly favored by a recognition endorsed by the U.S. National Academy of Sciences. Then, amaranth was included among the world’s most promising crops due to its nutritional value (National Research Council 1984

Pharmacological Profile, Bioactivities, and Safety of Turmeric Oil

The pharmacological attributes of turmeric have been extensively described and frequently related to the action of curcuminoids. However, there is also scientific evidence of the contribution of turmeric oil. Since the oil does not contain curcuminoids in its composition, it is crucial to better understand the therapeutic role of other constituents in turmeric. The present review discusses the pharmacokinetics of turmeric oil, pointing to the potential application of its active molecules as therapeutic compounds. In addition, the bioactivities of turmeric oil and its safety in preclinical and clinical studies were revised. This literature-based research intends to provide an updated overview to promote further research on turmeric oil and its constituents

Pharmacological profile, bioactivities, and safety of turmeric oil

The pharmacological attributes of turmeric have been extensively described and frequently related to the action of curcuminoids. However, there is also scientific evidence of the contribution of turmeric oil. Since the oil does not contain curcuminoids in its composition, it is crucial to better understand the therapeutic role of other constituents in turmeric. The present review discusses the pharmacokinetics of turmeric oil, pointing to the potential application of its active molecules as therapeutic compounds. In addition, the bioactivities of turmeric oil and its safety in preclinical and clinical studies were revised. This literature-based research intends to provide an updated overview to promote further research on turmeric oil and its constituents. © 2022 by the authors

Interactions of clinical relevance associated with concurrent administration of prescription drug and food or medicinal plants: a systematic review protocol

An inadequate combination of prescription drugs with food or medicinal plants could cause adverse effects in patients or produce negative therapeutic results. Therefore, this generic systematic review protocol aims to identify and synthesize the literature on clinical characteristics and safety issues of these types of pharmacological interactions occurring in children, adolescents, adults, pregnant/lactating women, and older adults.An inadequate combination of prescription drugs with food or medicinal plants could cause adverse effects in patients or produce negative therapeutic results. Therefore, this generic systematic review protocol aims to identify and synthesize the literature on clinical characteristics and safety issues of these types of pharmacological interactions occurring in children, adolescents, adults, pregnant/lactating women, and older adults

Turmeric oil: potential alternative for the treatment of metabolic epilepsy.

Epilepsy is a life-shortening brain disorder that currently affects ~ 1% of the worldwide population. Despite the availability of several antiepileptic drugs (AEDs), severe side effects such as cognitive and affective disorders, teratogenicity, hepatotoxicity, among others, have been reported after chronic administration. Also, some patients remain refractory to the available AEDs. Such is the case of metabolic epilepsy. Hence, there is a current need for the discovery of novel active principles with minimal or no adverse side effects. Nature is an exciting source of potential drug candidates for the treatment of pharmacoresistant epilepsy (PRE) due to the highly diverse and complex chemical structures of bioactive vegetal compounds. In this context, we analyzed the rhizome powder of Curcuma longa, commonly known as turmeric. Until our study, the anticonvulsant properties of turmeric were exclusively attributed to its curcuminoids. For the first time, we revealed the anticonvulsant properties of turmeric oil and its main bisabolene sesquiterpenoids, ar-turmerone, α-, β-turmerone, and α-atlantone. Thus, the present chapter discusses the botanical aspects of turmeric, the chemical composition and phytopharmacological aspects of turmeric, curcumin and turmeric oil as well as our results obtained from the anticonvulsant activity characterization of turmeric oil and ar-turmerone. Our findings support further characterization of the anticonvulsant properties of these active compounds and demonstrate the usefulness of the zebrafish and mouse models for searching novel AEDs. Also, the potential therapeutic application of turmeric oil and ar- turmerone for the treatment of metabolic epilepsy is discussed