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Functional herb extracts
Ginkgo biloba (Maidenhair leaf)
Benefits of functional herb
The famous maidenhair leaf is purported to improve circulation and boost cognitive power
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Scientific Information (Did You Know?)
A. Clinical Studies of Gingko bilobaFunction 1: Vitiligo
In order to treat vitiligo, it is important to arrest the progression of the disease by inducing repigmentation. Oxidative stress has been shown to play an important role in the pathogenesis of vitiligo. Gingko biloba extract is useful as an antioxidant and immunomodulatory agent. A study was conducted to prove the efficacy of Gingko biloba in arresting the progression of the disease1.
In a double-blind placebo-controlled trial, it was evaluated for the efficacy of G.biloba extract in controlling the activity of the disease process in patients with limited and slow-spreading vitiligo and in inducing repigmentation of vitiliginous areas. Forty seven patients were evaluated by assigned into two treatment groups (A and B) in a double-blind fashion. Patients in group A were given G.biloba extract 40 mg three times daily whereas patients in group B received placebo in similar doses. A statistically significant cessation of active progression of depigmentation was noted in patients treated with G.biloba (P = 0.006). Marked to complete repigmentation was seen in 10 patients in group A, whereas only two patients in group B showed similar repigmentation. The G.biloba extract was well tolerated and it seems to be simple, safe and fairly effective therapy for arresting the progression of the disease1.Function 2: Alzheimer's
Studies from various bibliographic databases, clinical trials and randomized controlled trials were showed that high-dose gingko (240 mg) treatment was beneficial for Alzheimer's Disease, even though the results were heterogeneous. Among the patients, the treatment was beneficial over activities of daily life, cognition and accompanying psychopathological symptoms2.
Scientific study 1
A systematic review had conducted to determine the beneﬁt of treatment with Ginkgo biloba (Ginkgo) in Alzheimer’s disease (AD) concerning patient-relevant outcomes. Various databases had been searched, including bibliographic databases, clinical trial and study result registries were searched for randomized controlled trials (RCTs) in patients with AD (follow-up ≥ 16 weeks) comparing Ginkgo to placebo or a different treatment option. Manufacturers were asked to provide unpublished data. If feasible, data were pooled by meta-analysis. Six studies were eligible; overall, high heterogeneity was shown for most outcomes, except safety aspects. Among studies administering high-dose Ginkgo (240 mg), all studies favour treatment though effects remain heterogeneous. In this subgroup, a benefit of Ginkgo exists for activities of daily living. Cognition and accompanying psychopathological symptoms show an indication of a benefit. A harm of Ginkgo is not evident. An estimation of the effect size was not possible for any outcome. Further evidence is needed which focuses especially on subgroups of AD patients2.
A randomized controlled trial was conducted to compare treatments with Gingko biloba extract EGb 761® and placebo. The dosage of Gingko biloba used was 240 mg/day. The result showed the Gingko biloba extract EGb 761® was superior to the placebo, showing that Gingko biloba was beneficial in treatment of Alzheimer’s Disease3.
Scientific study 2
In a randomised, double-blind, 22-week trial 400 patients with dementia associated with neuropsychiatric features were treated with Ginkgo biloba extract EGb 761® (240 mg/day) or placebo. Patients with probable Alzheimer’s disease, possible Alzheimer’s disease with cerebrovascular disease or vascular dementia were eligible if they scored 9 to 23 on the SKT cognitive test battery and at least 5 on the Neuropsychiatric Inventory (NPI). EGb 761® was significantly superior to placebo with respect to the primary (SKT test battery) and all secondary outcome variables. The mean composite score (frequency ×severity) and the mean caregiver distress score of the NPI dropped from 21.3 to 14.7 and 13.5 to 8.7, respectively, in the EGb 761®-treated patients, but increased from 21.6 to 24.1 and 13.4 to 13.9, respectively, under placebo (p < 0.001). The largest drug-placebo differences in favour of EGb 761® were found for apathy/indifference, anxiety, irritability/lability, depression/dysphoria and sleep/nighttime behaviour3.Function 3: Parkinson's Disease
Parkinson’s Disease occur may due to oxidative stress. This condition can be effectively prevented by Ginkgo biloba EGb 761® as observed in the systemic review. However, studies selected in this systemic review were using different dosage in their treatment4.
This systemic review conducted reviewed studies that analysed the effect of Ginkgo biloba extract on Parkinson’s disease. 32 articles were selected from different databases to further analysed, and 10 articles were selected to study after the analysis after a more detailed analysis. These reports analysed and researchers believed that the a possible cause of Parkinson’s Disease might be oxidative stress, which could be effectively prevented by EGb761, as observed in the results obtained in this systematic review of the beneficial effects of the extract in animal models of Parkinson’s Disease4.Function 4: Antioxidant
Ginkgo leaves were examined to determine the flavonoid content and their antioxidant activities. Both green and yellow leave extracts were analysed to determine flavonoid content using HPLC, and antioxidant activity using DPPH radical-scavenging method. Yellow ginkgo leave had higher content of flavonoid and therefore antioxidant activity than the green leaves5.
Scientific study 1
The study conducted to determine the flavonol contents of crude extracts from Ginkgo (Ginkgo biloba L.) leaves, their antioxidant properties in model system studies, and their inhibitory action of linoleic acid oxidation in an emulsion system and of triacylglycerols (TAG) in rapeseed oil. Extracts were prepared from both green and yellow leaves of Ginkgo trees using water, aqueous acetone, and ethanol. Then, extracts were analyzed by HPLC for their presence and content of selected flavonols such as myricetin, quercetin, kaempferol, isorhamnetin, and morin. The highest level of flavonols, especially quercetin, myricetin and kaempferol, were found in the aqueous acetonic extracts. Crude extracts from yellow Ginkgo leaves contained greater amounts of flavonols. The best DPPH radical-scavenging activity amongst the Ginkgo extracts examined was determined for aqueous acetonic extracts, while the lowest was noted for the ethanolic extract of green leaves. Water infusion extracts exhibited the highest iron(II) chelating activity. The reducing power of extracts from yellow leaves was 2 higher than that of crude extracts from green leaves. Nevertheless, extracts from green Ginkgo leaves imparted a greater protection factor against TAG oxidation, as assessed by the Rancimat method. Crude extracts from yellow Ginkgo leaves were more efficacious than green ones at inhibiting oxidation of the linoleic acid emulsion5.
Antioxidant activity of yellow Ginkgo leaf extracts was tested via oxidation or stability of lipids and cholesterol in meatballs. The leaf extracts were extracted via water, acetone and ethanol. The lipid oxidation process of pork meatballs was mostly inhibited by the aqueous and ethanolic extracts of the yellow leaves. However, their antioxidant activity was higher than that of BHT. All the extracts had a stabilizing effect on cholesterol and most of them inhibited the formation of oxidized derivatives. The acetone and ethanol extracts of green leaves and the ethanol extract of yellow leaves inhibited the formation of cholesterol oxidation products formation most effectively6.
Scientific study 2
The aim of this study was to determine the effect of Ginkgo leaf extracts on the stability of lipids and cholesterol in pork meatballs over 21 days of refrigerated storage. The antioxidants used were characterized by their antioxidant activity towards lipids and cholesterol. Extracts were prepared from green and yellow leaves from Ginkgo biloba L. trees. Water, acetone and ethanol were used as extractants. The extracts showed stabilizing effects on both lipid and cholesterol oxidation processes. The lipid oxidation process of pork meatballs was mostly inhibited by the aqueous and ethanolic extracts of the yellow leaves. Their antioxidant activity was higher than that of BHT. All the extracts had a stabilizing effect on cholesterol and most of them inhibited the formation of oxidized derivatives. The acetone and ethanol extracts of green leaves and the ethanol extract of yellow leaves inhibited the formation of cholesterol oxidation products formation most effectively6.Function 5: Anticancer
Epidemiological and biological studies reviewed in this study agreed that G. biloba, perhaps through its ginkgolide A and B components may have chemopreventive properties against ovarian cancer. Authors suggested that further in-vitro and in-vivo studies, especially those that explore the biologic mechanism underlying this effect are necessary7.
Scientific study 1
The study was examined epidemiological data regarding effects of commonly used herbal supplements on risk for ovarian cancer and sought supporting biological evidence. 4.2% of 721 controls compared to 1.6% of 668 cases regularly used Ginkgo biloba for an estimated relative risk (and 95% confidence interval) of 0.41 (0.20,0.84) (p= 0.01); and the effect was most apparent in women with non-mucinous types of ovarian cancer, RR = 0.33 (0.15,0.74) (p= 0.007). In vitro experiments with normal and ovarian cancer cells showed that Ginkgo extract and its components, quercetin and ginkgolide A and B, have significant anti-proliferative effects (~40%) in serous ovarian cancer cells, but little effect in mucinous (RMUG-L) cells. For the ginkgolides, the inhibitory effect appeared to be cell cycle blockage at G0/G1 to S phase. This combined epidemiological and biological data provide supportive evidence for further studies of the chemopreventive or therapeutic effects of Ginkgo and ginkgolides on ovarian cancer7.
In in-vitro study, pancreatic cancer cell lines MIA PaCa-2 and Panc-1 were treated with kaempferol from Ginkgo extract. In the end of this study, Ginkgo biloba extract kaempferol effectively inhibits pancreatic cancer cell proliferation and induces cancer cell apoptosis8.
Scientific study 2
The study was conducted to determine the effect and mechanisms of kaempferol, one of the important constituents of ginkgo flavonoid, on pancreatic cancer cell proliferation and apoptosis. Pancreatic cancer cell lines MIA PaCa-2 and Panc-1 were treated with kaempferol, and the inhibitory effects of kaempferol on pancreatic cancer cell proliferation were examined by direct cell counting, 3H-thymidine incorporation, and MTS assay. Lactate dehydrogenase release from cells was determined as an index of cytotoxicity. Apoptosis was analyzed by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling assay. Upon the treatment with 70 μm kaempferol for 4 days, MIA PaCa-2 cell proliferation was significantly inhibited by 79% and 45.7% as determined by direct cell counting and MTS assay, respectively, compared with control cells (P < 0.05). Similarly, the treatment with kaempferol significantly inhibited Panc-1 cell proliferation. Kaempferol treatment also significantly reduced 3H-thymidine incorporation in both MIA PaCa-2 and Panc-1 cells. Combination treatment of low concentrations of kaempferol and 5-fluorouracil showed an additive effect on the inhibition of MIA PaCa-2 cell proliferation. Furthermore, kaempferol had significantly less cytotoxicity than 5-fluorouracil in normal human pancreatic ductal epithelial cells (P = 0.029). In both MIA PaCa-2 and Panc-1 cells, apoptotic cell population was increased when treated with kaempferol in a concentration-dependent manner. Ginkgo biloba extract kaempferol effectively inhibits pancreatic cancer cell proliferation and induces cancer cell apoptosis, which may sensitize pancreatic tumor cells to chemotherapy. Kaempferol may have clinical applications as adjuvant therapy in the treatment of pancreatic cancer8.Function 6: Atherosclerosis
An animal study was conducted to evaluate the effectiveness of Ginkgo biloba extract (EGb761) on diabetic obese rat model against atherosclerosis and cell culture for the same purpose. In the end of this study, treatment with EGb761 was found to reduce restenosis in obese rats with type 2 diabetes after balloon injury to the carotid artery. EGb761 significantly suppressed the proliferation and migration of VSMCs, promoted apoptosis and reduced inflammatory processes. In addition, EGb761 showed favourable effects on glucose homeostasis and on adiponectin and hsCRP levels. Among subcomponents of EGb761, kaemferol and quercetin seem to play a major role in the prevention of atherosclerosis9.
A study was conducted to investigate the effect of EGb761 and its major subcomponents (bilobalide, kaemferol, and quercetin) on preventing atherosclerosis in vitro, and in a rat model of type 2 diabetes. EGb761 (100 and 200 mg/kg) or normal saline (control) were administered to Otsuka Long-Evans Tokushima Fatty rats, an obese insulin-resistant rat model, for 6 weeks (from 3 weeks before to 3 weeks after carotid artery injury). Immunohistochemical staining was performed to investigate cell proliferation and apoptosis in the injured arteries. Cell migration, caspase-3 activity and DNA fragmentation, monocyte adhesion, and ICAM-1/VCAM-1 levels were explored in vitro. Treatment with EGb761 dose-dependently reduced intima-media ratio, proliferation of vascular smooth muscle cells (VSMCs) and induced greater apoptosis than the controls. Proliferation and migration of VSMCs in vitro were also decreased by the treatment of EGb761. Glucose homeostasis and circulating adiponectin levels were improved, and plasma hsCRP concentrations were decreased in the treatment groups. Caspase-3 activity and DNA fragmentation increased while monocyte adhesion and ICAM-1/VCAM-1 levels decreased significantly. Among subcomponents of EGb761, kaemferol and quercetin reduced VSMC migration and increased caspase activity. In conclusion, EGb761 has a protective role in the development of atherosclerosis and is a potential therapeutic agent for preventing atherosclerosis9.References
Parsad, D., Pandhi, R., Juneja, A. (2003). Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clinical Experimental Dermatology 28(3): 285-287
Janßen, I. M., Sturtz, S., Skipka, G., Zentner, A., Garrido, M. V., Busse, R. (2010). Ginkgo biloba in Alzheimer’s disease: a systematic review. Wiener Medizinische Wochenschrift 160(21–22): 539–546
Scripnikov, A., Khomenko, A., Napryeyenko, O. (2007). Effects of Ginkgo biloba Extract EGb 761® on neuropsychiatric symptoms of dementia: findings from a randomised controlled trial. Wiener Medizinische Wochenschrift 157(13–14): 295–300
Tanaka, K., S.-Galduróz, R. F., Gobbi, L. T. B., Galduróz, J. C. F. (2013). Ginkgo biloba extract in an animal model of Parkinson’s disease: a systematic review. Current Neuropharmacology, 11: 430-435.
Kobus, J., Flaczyk, E., Siger, A., Nogala-Kałucka, M., Korczak, J., Pegg, R. B. (2009). Phenolic compounds and antioxidant activity of extracts of Ginkgo leaves. European Journal of Lipid Science and Technology, 111: 1150–1160
Kobus-Cisowska, J., Flaczyk, E., Rudzińska, M., Kmiecik, D. (2014). Antioxidant properties of extracts from Ginkgo biloba leaves in meatballs. Meat Science, 97: 174–180.
Ye, B., Aponte, M., Dai, Y., Li, L., Ho, M. D., Vitonis, A., Edwards, D., Huang, T., Cramer, D. (2007). Ginkgo biloba and ovarian cancer prevention: epidemiological and biological evidence. Cancer Letters, 251: 43–52.
Zhang, Y., Chen, A. Y., Li, M., Chen, C., Yao, Q. (2008). Ginkgo biloba extract Kaempferol inhibits cell proliferation and induces apoptosis in pancreatic cancer cells. Journal of Surgical Research, 148 (1): 17-23.
Lim, S., Yoon, J. W., Kang, S. M., Choi, S. H., Cho, B. J., Kim, M., Park, H. S., Cho, H. J., Shin, H., Kim, Y. B., Kim, H. S., Jang, H. C., Park, K. S. (2011). EGb761, a Ginkgo biloba extract, is effective against atherosclerosis in vitro, and in a rat model of type 2 diabetes. PLOS ONE, 6 (6): 1-10.