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  1. MINISTRY OF EDUCATION UNIVERSITY OF ORADEA FACULTY OF MEDICINE AND PHARMACY DOCTORAL SCHOOL OF BIOMEDICAL SCIENCES Doctoral field: PHARMACY DIANA IOANA GAVRA DOCTORAL THESIS PHYSICO-CHEMICAL CHARACTERIZATION AND EVALUATION OF THE THERAPEUTIC POTENTIAL OF THE FRACTIONS EXTRACTED FROM ENDEMIC PLANTS Scientific coordinators: Prof. univ. dr. Tünde Jurca Prof univ. dr. Ildikó Bácskay ORADEA 2022 Tarca Radu Catalin Aprob acest document 18/10/2022 13:51:42 UTC+02
  2. 2 Contents Objectives and structure of the thesis ........................................................................................8 Introduction................................................................................................................................9 FIRST PART - LITERATURE STUDY.................................................................................10 I. Current state of knowledge...................................................................................................10 I.1. Structural characteristics of polyphenols.......................................................................12 I.2. Extraction of phenolic compounds................................................................................14 I.3. Determination of the total polyphenols and flavonoids content....................................15 I.4. Evaluation of antioxidant activity..................................................................................15 I.5. Pharmacological properties of polyphenols ..................................................................16 I.5.1. Fam. Asteraceae......................................................................................................16 I.5.2. Fam. Malvaceae......................................................................................................21 I.5.3. Fam. Rosaceae........................................................................................................22 I.5.4. Fam. Ericaceae........................................................................................................24 I.5.5. Fam. Hypericaceae .................................................................................................25 I.5.6. Fam. Lamiaceae......................................................................................................26 I.5.7. Fam. Canabaceae....................................................................................................29 I.5.8. Fam. Grossulariceae ...............................................................................................29 I.5.9. Fam. Urticaceae......................................................................................................30 I.5.10. Fam. Papaveraceae ...............................................................................................31 I.6. Alternative treatment for skin diseases..........................................................................32 I.6.1. Psoriasis prevalence....................................................................................................32 I.6.2 Psoriasis classification, pathogenesis and treatment ...................................................32 I.6.3. Alternative treatment for psoriasis .............................................................................34 I.6.4. Psoriasis evaluation on clinical trials..........................................................................35 I.7. Pharmaceutical forms used in the treatment of psoriasis ..............................................36 I.8. Partial conclusions.........................................................................................................38 SECOND PART - EXPERIMENTAL STUDY......................................................................39 II. Phytochemical screening of ethanolic extracts of Rosa species .........................................39 II.1. Introduction and objectives of the chapter ...................................................................39
  3. 3 II.2. Materials and methods .................................................................................................41 II.2.1. Reagents and plant material ..................................................................................41 II.2.2. Preparation of the extracts.....................................................................................41 II.2.3. Total polyphenols content (TPC)..........................................................................42 II.2.4. Total flavonoid content (TFC) ..............................................................................42 II.2.5. Analysis of phenolic compounds by HPLC ..........................................................42 II.2.6. Determination of antioxidant capacity..................................................................43 II.3. Results..........................................................................................................................44 II.4. Discussion ....................................................................................................................55 II.5. Partial conclusions........................................................................................................57 III. The evaluation of the antimicrobial and antioxidant activity of the bioactive compounds of Rosa x damascena Mill............................................................................................................58 III.1. Introduction and objectives of the chapter..................................................................58 III.2. Materials and methods................................................................................................58 III.2.1. Reagents...............................................................................................................58 III.2.2. Microscopic Examination of Rosa x damascena Mill. petals..............................58 III.2.3. Preparation of the extract.....................................................................................59 II.2.4. Statistical analysis .................................................................................................59 III.2.5. Antimicrobial activity..........................................................................................59 III.2.6. SOD-like activity .................................................................................................60 III.2.7. Cytotoxicity assays and cell culture.....................................................................60 III.3. Results.........................................................................................................................61 III.4. Discussion...................................................................................................................65 III.5. Partial conclusion........................................................................................................68 IV. In vitro and human pilot studies of different topical formulations containing Rosa species for the treatment of psoriasis....................................................................................................69 IV.1. Introduction and objectives of the chapter..................................................................69 IV. 2. Materials and methods...............................................................................................70 IV.2.1. Preparation and characterization of dry extract...................................................70 IV.2.2. Formulation and Investigation of Self-Nano-Emulsifying Drug Delivery System ..........................................................................................................................................71
  4. 4 IV.2.3. Formulation of Ointments containing lyophilized Rose extracts and Rose- SNEDDS..........................................................................................................................72 IV.2.4. Texture analysis...................................................................................................73 IV.2.5. In vitro release Studies.........................................................................................73 IV.2.6. Superoxide Dismutase (SOD) Assay...................................................................74 IV.2.7. Cell viability study (MTT assay).........................................................................74 IV.2.8. Clinical study.......................................................................................................75 IV.3. Results.........................................................................................................................75 IV.3.1. Investigation of Self-Nano-Emulsifying Drug Delivery System.........................75 IV.3.2. Ointment formulation ..........................................................................................76 IV.3.4. Cell viability study (MTT assay).........................................................................77 IV.3.5. Texture analyzis...................................................................................................78 IV.3.6. In vitro release studies .........................................................................................78 IV.3.7. Superoxide dismutase activity of the topical formulations..................................80 IV.3.8. Clinical investigation...........................................................................................81 IV.4. Discussion...................................................................................................................93 IV. 5. Partial conclusions.....................................................................................................98 General conclusions.................................................................................................................99 The originality of the thesis ...................................................................................................100 Future perspectives ................................................................................................................101 References..............................................................................................................................102 Annexes..................................................................................................................................120 Annex 1. Decision of the research of Ethics Commission of Faculty of Medicine and Pharmacy............................................................................................................................120 Annex 2. Application for approval of clinical research to SC Echo Laboratoare SRL.....121 Annex 3. Application for approval of clinical research to CMI Dr. Frățilă Simona .........123 Annex 4. Application for approval of clinical research to CMI Dr. Endres Laura............125 Annex 5. Protocol for clinical study ..................................................................................127
  5. 5 ABBREVIATIONS AA – ascorbic acid ABTS – (2, 2 – azinobis – (3 – ethylbenzthiazoline – 6 – sulfonic acid) AE – aqueous extract BHT – a synthetic antioxidant C3GE – cyanidin – 3 – glucoside chloride CAE – caffeic acid equivalents CAT – catalase CUPRAC – Cupric Reducing Antioxidant Capacity CY – cyaniding DLQI – Dermatology Life Quality Index DM – dry mass DPPH – 2, 2 – diphenyl – 1 – picryl – hydrazyl – hydrate DW – dry weight E – ethanolic extract EC – Equivalent cyanidin FRAP – ferric reducing antioxidant power assay FTC – ferric thiocyanate method FW – fresh weight GA – gallic acid GAE – equivalent of gallic acid GPP – Generalized Pustular Psoriasis HAPX – hemoglobin ascorbate peroxidase activity inhibition assay HAT – Hidrogen atoms transfer HORAC – Hydroxyl radical antioxidant capacity HPLC – high performance liquid chromatography HPLC-MS - high performance liquid chromatography coupled with mass spectroscopy HPTLC - high performance thin layer chromatography IC50 – half-maximal inhibitory concentration IPM – isopropyl myristate LC-MS – Liquid chromatography-Mass spectrometry MRSA – methicillin-resistant Staphylococcus aureus MTT – (3 – (4, 5 – dimethylthiazol – 2 – yl) – 2, 5 – diphenyltetrazolium bromide)
  6. 6 NPF – National Psoriasis Foundation - Psoriasis Score ORAC – Oxygen Radical Antioxidant Capacity PASI – Psoriasis Area and Severity Index PGA – physician global assensment Px – peroxidase activities QE – equivalent quercetine QoL – quality of life RE – rutin equivalents RU – rutin SET – single electron transfer SOD – superoxide dismutase SNEDDS – Self-Nano-Emulsifying Drug Delivery System TAC – total anthocyanin content TE – trolox equivalents TFC – total flavonoid content TPC – Total polyphenol content
  7. 7 List of published articles 1. Gavra D.I., Pallag A., Marian E., Vicaș L., Jurca T. A comparative study of the amount of polyphenols, flavonoids and antioxidant capacity of Rosae caninae flos versus cynosbati fructus. Annals of the University of Oradea, Fascicle: Environmental Protection, vol. XXXI, 2018, p.23-30. B+ 2. Gavra, D.I.; Marian, E.; Pallag, A.; Vicaș, L.G.; Lucaciu, R.L.; Micle, O.; Ionescu, C.; Bacskay, I.; Hangan, A.C.; Sevastre, B.; et al. Phytochemical Screening and Biological Activity of Ethanolic Extract of Rosa X damascena Mill. Cultivated in the Western Region of Romania. Farmacia 2022, 70, 248–257. IF: 1.433 3. Gavra, D.I.; Endres, L.; Pető, Á.; Józsa, L.; Fehér, L.; Ujhelyi, Z.; Pallag, A.; Marian, E.; Vicas L.G.; Ghitea T.; Muresan M.; Bácskay I.; Jurca T. In vitro and human pilot studies of different topical formulations containing Rosa species for the treatment of psoriasis. Molecules 2022, 27, 5499. IF: 4.148
  8. 8 Objectives and structure of the thesis The aim of this thesis was to characterize from a physico-chemical point of view and to evaluate the therapeutic potential of fractions extracted from endemic plants in order to develop new pharmaceutical preparations that can be used as prophylactic treatment or as adjuvant treatment in various chronic conditions. The main objectives of the study are: the extraction of polyphenolic compounds from petals, the qualitative and quantitative determination of the phytochemicals of 11 Rosa sp., as well as the antioxidant capacity of the biocompounds found in the alcoholic and lyophilized extracts and the development of new pharmaceutical formulations using lyophilized extracts from petals and the evaluation of their effectiveness. This study is structured in two parts, namely: in the first part, is presented the current state of knowledge regarding the chosen research topic, and in the second part of the study, the original experimental part is presented. Chapter I presents literature study regarding the extractions of phenolic compounds, determination of the total polyphenols and flavonoids content, methods used for the evaluation of antioxidant activity, pharmacological properties of polyphenols and structural characteristics. In the same chapter are presented informations about the classification and pathogenesis of psoriasis, the conventional and alternative treatment, about clinical trials and formulations used in the treatment of psoriasis. Starting with the second chapter, the experimental part is presented, which refers to the presentation of the materials and methods used for the extraction of polyphenolic compounds from petals of 11 Rose species, their qualitative and quantitative analysis and the determination of antioxidant activity of the identified compounds. In chapter III are presented the materials, methods and the preparation of the extract in order to evaluate the antimicrobial and antioxidant activity of the bioactive compounds of Rosa x damascena Mill. Chapter IV reffers to the extensively analysis of 3 from 11 Rose sp. studied, regarding the development of different topical formulations for the treatment of psoriasis and clinical investigations to evaluate the effectiveness of the topical preparations.
  9. 9 Introduction During last decade was observed an increase of the interest for usage of medicinal plants into the traditional medicine due to their content in active substances, which can represent an alternative source for the development of new drugs. Active compounds of plant origin are used worldwide for medicinal purposes, with the World Health Organization recognizing the traditional use of medicinal plants in primary health care since 1992, and currently seeing a significant increase in this use. In maintaining human health, reactive oxygen species and free radicals play an important role and when the equilibrium between the generating and scavenging of reactive oxygen species and free radicals is destroyed, an oxidative stress may happen and it might lead to extensive oxidative damage to important cellular biomolecules, such as proteins, DNA, and lipids. Polyphenols - flavonoid, lignans and polymeric lignans, stilbene, are a very large and varied group of bioactive compounds, secondary metabolites of plants that act as a barrier against ultraviolet radiation, oxidants and pathogens, which due to their therapeutic properties, have in recent years aroused an interest in their scientific research, food production and consumption. Studies from scientific literature have shown that a high antioxidant intake is associated with a lower risk of developing disorders such as cancer, cardiovascular disease, Parkinson, different skin diseases etc. In the last years, several dietary and natural formulations that have free radical scavenging capacity have obtained attention in treating many chronic diseases. Despite of the strong radical scavenging activity of synthetic compounds, they usually have side effects and the interest to find natural antioxidants, without undesirable side effects, has increased. The antioxidative compounds, especially the phenolic ones found in plants, flowers, fruits and seeds, have received attention for their potential role in the prevention of human affections. Plant materials obtained from medicinal herbs and flowers are very successful in the pharmaceutical industry and offer new perspectives, suggesting important innovative implications for existing clinical medicine.
  10. 10 FIRST PART - LITERATURE STUDY I. Current state of knowledge For thousands of years, plants have been and continue to be an important resource in medicine. Even today, the World Health Organization estimates that up to 80% of people still rely on traditional remedies [1]. Medicinal plants and edible flowers are one of the main sources of new pharmaceutical products. A whole range of nutritional supplements derived from herbs helps maintain health and fight diseases. The role of medicinal plants in the prevention or control of diseases has been attributed to the antioxidant properties of their constituents, generally called polyphenolic compounds [2]. Different edible flowers as Centaurea cyanus L., Viola odorata L., Chrysanthemum morifolium Ramat., Lavandula sp., Rosa sp., Calendula officinalis L. and other species represent an interest for researchers and many species are deeper evaluated because of their bioactive compounds . Polyphenols (flavonoid, lignans and polymeric lignans) are phytochemical compounds found in plants, coffee, vegetables, flowers, wine, fruits, tea. A large number of polyphenols including phenolic acids, flavonoids, lignans, etc. have been identified [3]. These compounds are secondary metabolites of plants and flowers that act as a barrier against UV radiation, various oxidants and pathogens [4]. Based on therapeutic properties, in recent years, numerous studies have focused on finding new sources, especially in the food and pharmaceutical industry [5]. The dietary intake of polyphenols is estimated to be approximately 1 g of polyphenolic compounds/day [6, 7]. The bio-availability of these bio-active compounds depends on the process of extraction, gastrointestinal digestion, absorption and metabolism [8]. For absorption, polyphenols are hydrolyzed by intestinal enzymes or microflora in the colon and then conjugated in the intestinal cells and subsequently in the liver by methylation, sulfation or glucuronidation [9]. Therefore, polyphenols are distributed in the body, accumulate in the target tissue and induce biological properties; metabolites are mainly eliminated through bile and urine. Various studies in the literature have shown that these polyphenolic compounds have rapid plasma absorption, with peak plasma concentrations within 2 – 3 hours after ingestion [10]. Their biological activity has been proven by various properties: antioxidants, anti-allergic, anti-inflammatory, antiviral and antimicrobial, anti-proliferative, anti-mutagenic, anti-
  11. 11 carcinogenic, blocking free radicals, regulating cell cycle arrest, apoptosis; more interestingly, polyphenols can modulate several important cell signaling pathways, such as kappa-B nuclear factor, transcription factor for activation of proteins, extracellular signal-regulated protein kinase, (phosphoinositide 3) kinase B/protein kinase (Akt), mitogen-activated protein kinases, and nuclear factor 2 associated with erythroid nuclear factor 2 (Nrf2) [11]. The human body presents various endogenous and exogenous systems to defend against the harmful action of free radicals. There are two main mechanisms by which the body acts, which involves the action of antioxidant compounds: the first mechanism refers to enzymatic protection (superoxidismutase – SOD – which catalyzes the reaction of dismutation of anions superoxide to peroxide, catalase – CAT – which converts hydrogen peroxide into molecular oxygen and water); a second mechanism refers to the action of compounds with antioxidant capacity, without enzymatic activity, such as polyphenolic compounds, ascorbic acid, carotenoids, etc. [12]. Polyphenols are the main compounds found in medicinal plants and have the property of neutralizing free radicals. As epidemiological studies have shown that polyphenols have beneficial effects on human health, in recent decades, research interest for these compounds has increased [13]. Various herbal preparations, consumed in correct combinations and quantity, captures free radicals before determining the appearance of different diseases in the human body [14]. For this purpose, many plant and flower extracts are used in nutritional supplements. Various researchers have prepared herbal supplements containing this type of compounds in order to improve the quality of life of people with chronic diseases or to combat or prevent many diseases. Researchers [14] selected several plant, flower and fruit products, such as Vaccinium fructus, Hippophae Rhamnoides fructus, Salviae folium and Calendulae flos and showed their antioxidant ability by quantifying the phenolic content using appropriate methods. Polyphenols and their derivatives have biological and pharmacological properties, such as hepatoprotective, diuretic, spasmolytic, antioxidant, anti-allergic and anti-cancerous properties [15, 16]. It has been shown that a wide spectrum of diseases can be treated with the help of herbs, flower and fruits which are found useful due to their therapeutic properties. Also, about 35% of medicines are of plant origin. In most developing countries, the use of medicinal plants in traditional medicine has brought about an improvement in the quality of life of people [17].
  12. 12 I.1. Structural characteristics of polyphenols Polyphenols are a large and varied group of aromatic benzene ring compounds with one or more hydroxyl groups, produced by plants mainly for protection against oxidative stress, synthesized during plant development [18, 19] and in response to certain adverse conditions (UV radiation, etc.) [4, 20]. Phenolic compounds can be classified into many categories depending on the number of their phenolic rings and based on the structural elements that binds the rings to each other [21], including simple phenols, phenolic acids, coumarins, flavonoids, stilbene, up to for hydrolysable and condensed tannins, lignans and lignins. Phenolic acids comprise two main branches: hydroxybenzoic acid derivatives (protocatechic acid, gallic acid, p-hydroxybenzoic acid) and hydroxycinnamic acid derivatives (caffeic acid, chlorogenic acid, p-coumaric acid, ferulic acid, synapic acid). Palm, kiwi, cherry, apple, pear, chicory and coffee fruits are foods with high phenolic acids content [10]. Caffeic acid, p-coumaric, vanillic, ferulic and protocatechic acids are present in almost all plants [20, 22]. Figure 1. Phenolic acids [23] Flavonoids are the most abundant polyphenols in the human diet and over 4000 types have been identified. These compounds have at least two phenol sub-units, and compounds having three or more phenol sub-units called tannins (hydrolyzable and non-hydrolyzable). Flavonoids are planar molecules, ubiquitous in plants, consisting of aromatic amino-acids, phenylalanine, tyrosine and malonate [18, 19]. Flavonoids are the most abundant polyphenols in the human diet and over 4000 types have been identified. These compounds have at least two phenol sub-units, and compounds having three or more phenol sub-units, as hydrolyzable or non-hyrolizable tannins. Flavonoids are planar compounds, present in plants, consisting of aromatic amino-acids with aromatic structure as phenylalanine aminoacid, tyrosine and
  13. 13 malonate aminoacids. The flavan nucleus is the basis of flavonoid structure and it has 15 carbon atoms that are arranged in many rings (C6-C3-C6). Figure 2. Flavoid structures [23] Biocompounds as isoflavones, flavonones, flavonols, anthocyanins, flavanols and flavonones are the six subclasses of flavonoids. In the family of red fruits (strawberry, cherry, berries, etc.) we can found anthocyanins as malvidin, cyanidin compound, delfinidine or pelargonidine. Flavonols, including quercetin, kaempferol and mirycetin, were mainly detected in onions, leeks, broccoli and blueberries. Isoflavones are the most important dietary flavonoids that include daidzein, genistein and glycytaine. Stilbenes appear in the human diet in small quantities; resveratrol, one of the well-studied compounds in these groups, is largely detected in grapes and red wine [3, 10, 24].
  14. 14 Figure 3. The structures of sub-classes of flavonoids [23] I.2. Extraction of phenolic compounds Extraction of phenolic compounds from plant, flowers or fruit material is influenced by their chemical nature, extraction time and drying conditions, as well as by the presence of interfering substances. Solvent extraction is frequently used for the extraction of phenolic compounds from plants due to their ease of use, efficiency and wide applicability. Extraction depends on the type of solvent, the polarity of the solvent, the extraction time and temperature, as well as the chemical composition of the samples. A wide range of solvents, such as water, acetone, methanol, ethanol, N, N – dimethylformamide (DMF) or their mixtures with water, have been studied for their extraction efficiency due to polarity differences [25-27]. Hydrophilic polyphenols, including aglycones, glycosides and oligomers, are extracted using water, polar organic solvents such as methanol, ethanol, acetonitrile and acetone or their mixture with water. Polyphenols are more stable at low pH, because the acidic medium helps the polyphenols to remain neutral, so they can be easily extracted into organic solvents [6, 7]. The use of an alcoholic solution ensures a satisfactory extraction. Methanol, acetone and water are inefficient solvents for the total extraction of phenols from vegetal products, because polyphenols are associated with other bio-molecules such as proteins, polysaccharides, terpenes, chlorophylls, lipids and inorganic compounds. However,
  15. 15 methanolic extracts seems to be better for the extraction of catechins, epicatechin and epigalocatechin [28]. Aqueous mixtures of acetone are good solvents for polar polyphenols, and the ballast substances remain in extracts [27]. The low solubility of polyphenols in absolute organic solvents is due to the strong hydrogen bonds between polyphenols and proteins. The increase of solubility by adding water to organic solvents is due to weakening of hydrogen bonds in aqueous solutions [29]. I.3. Determination of the total polyphenols and flavonoids content In the literature, a method used for determination of the total phenol content using different solvents is the Folin-Ciocâlteu method. The Folin-Ciocâlteu reagent contains molybdenum in a higher oxidation state (+6) and has a yellow color. Polyphenolic compounds cause Mo6+ reduction at lower oxidation states (Mo4+ , Mo5+ ) having a blue color [30]. Polyphenols can be determinated by various techniques, for example: nuclear magnetic resonance spectroscopy, near-infrared reflection spectroscopy, high performance thin layer chromatography (HPTLC), liquid chromatography coupled with mass spectroscopy, electrophoresis high performance capillary and high performance liquid chromatography (HPLC). In addition to the extraction with organic solvents, qualitative and quantitative analysis techniques can be applied, as well as isolation and purification procedures for specific results. Chromatographic techniques, such as thin layer chromatography (TLC), HPLC, gas phase chromatography (GC) and later capillary electrophoresis (EC), column chromatography (CC) over Sephadex LH-20 are used for final purification, because are obtained clear solutions without residues [6, 7, 25]. Most of the results reported in the literature for the TFC were obtained using the AlCl3 colorimetric method. The principle on which the method is based is that AlCl3 forms stable complexes with carbonyl groups (keto – C – 4 and/or with hydroxyl group C – 3 or C – 5) of flavones and flavonols and with ortho-dihydroxyl groups of ring A or B of flavonoids, the absorbance of which can be measured using a spectrophotometer at a corresponding wavelength. I.4. Evaluation of antioxidant activity Many researches are focused on antioxidant activity, TFC and TPC of medicinal plants, but there are still plants that have not been studied [31]. The methods used to determine the antioxidant capacity can be divided into two major groups: SET-single electron transfer methods and HAT (Hidrogen atoms transfer) methods
  16. 16 [32]. These tests are commonly used to measure the antioxidant capacity of the extracts, but not a single test will reflect all the antioxidants present. A schematic classification of the methods for determining the antioxidant capacity is given in figure 4. Figure 4. Methods used to determine the antioxidant capacity I.5. Pharmacological properties of polyphenols In order to study the beneficial contribution of polyphenols, in this section was highlighted the relative concentration of the bioactive compounds of some plant extracts reported in literature, the methods used for their detection and quantification, as well as their antioxidant capacity. For this purpose, were selected plants with medicinal uses, frequently used in various disorders. I.5.1. Fam. Asteraceae Arnica montana L. (Fam. Asteraceae) is strictly protected in several European countries and, it is a medicinal plant of high commercial value. Alcoholic extract of the inflorescences is traditionally used to treat damages and bruises [33]. The plant is rich in lactone sesquiterpenes, phenolic acids, flavonoids and essential oils responsible for the pharmacological properties – antioxidants, antiseptics, anti-inflammatories, antibacterials properties [33, 34]. Phenolic compounds and flavonoids are among the main components of A. montana L., the total polyphenol content and antioxidant activity of A. montana L. extracts have been reported in several publications [35-37]. Studies have shown that the phenolic profile of A. montana L. depends on the environmental conditions [38, 39]. Some data about A. montana L. from the studies published in literature are reproduced in Table 1. Artemisia absinthium L. (Asteraceae) is an aromatic-bitter plant that has anthelmintic [40], antimycotic [41], antimicrobial [42] activity, antiseptic, diuretic and can be used in the
  17. 17 treatment of leukemia and sclerosis [43, 44]. Antioxidant activity has been reported for A. absinthium L. essential oil [41, 42] and for methanolic extract (by DPPH and hydroxyl radical neutralization methods) [43, 44]. The methanolic extract from A. absinthium L. at was tested for antioxidant properties using many test systems. By forced swimming tests and also, using tail suspension tests was determined antidepressant activity. Consumption of different types of edible flowers offers health benefits to the consumer, as they represent a good source of phytochemicals, including phenolic compounds [45] that can be used to prevent chronic degenerative diseases, such as diabetes, decline cognitive and cardiovascular diseases, as well as different types of cancer [46, 47]. The literature data show that Calendula officinalis L. (syn. Mariogold) and Centaurea cyanus L. are among the most popular edible flowers. Due to the content of flavonoid and phenolcarbonic acids, Achillea millefolium L. has been used for many affections as gastrointestinal and spasmodic disorders, skin inflamations. Among the many beneficial properties of this plant are cytotoxic, choleretic, antimicrobial and anti-inflammatory activity [48]. Alghazeer R. et al. [49] studied TPC and TFC in methanolic and aqueous extracts from Cynara scolymus L. rhizomes from Libya, rhizomes used in various popular medicines. The root is used in adjuvant drugs with antihypertensive, antidiabetic and hypocholesterolemic effect. The activity of neutralizing the free radicals of the extracts was investigated and compared with the ascorbic acid. The antibacterial activity of extracts from C. scolymus L. rhizomes, tested in vitro against a wide spectrum of microorganisms, may be related to their TFC and TPC [50]. Antimicrobial activity may be attributed to the presence of phenolic compounds, chlorogenic acid, caffeic acid, cinarine, and four flavonoids, luteolin – 7 – rutinoside, cyarozide, apigenin – 7 – rutinoside [51]. A medicinal plant widespread in the cultivated flora of Romania is Chrysanthemum parthenium L. whose active principles are sesquiterpene lactones, essential oils, polyphenolic compounds. It is traditionally used for the treatment of fever, headache, migraines, rheumatoid arthritis, stomach pain, tooth pain, insect bites and infertility. It has multiple pharmacological properties, including anticancer, anti-inflammatory, cardiotonic, antispasmodic and antioxidant properties [35, 52-55]. It was compared the antioxidant activity of ethanolic extract of C. parthenium L. flowers from Bulgaria [31] and from aerial parts of C.parthenium L. from Romania, and ethanolic extract from flowers had higher values than aerial parts.
  18. 18 A wide range of pharmacological properties is presented by silymarine isolated from fruits and seeds of milk thistle (Silybum marianum L.), which is a mixture of three structural components: silybinin, silyldianine and silychristine. Milk thistle is part of the Asteraceae family [56] and has multiple pharmacological activities, including antioxidant, hepatoprotective and anti-inflammatory, antibacterial, anti-allergic, antimutagenic, antiviral, anti-neoplastic, anti-thrombotic, and vasodilating action [25, 57]. Researchers [58] have suggested that silymarine can be used to prevent free radicals as a natural antioxidant dietary supplement. The constituent flavonoids are: catechin, myrcetin, quercetin, naringin, naringenin, resveratrol, rutin. Taxifoline is the only isomer of silymarine which is known for its strong antioxidant activity [59]. DPPH was used to evaluate the ability of the individual components of silymarine compared to the crude mixture of silymarine to act as free radical capture agents by determining their EC50 (lower values indicate a higher radical absorption power). The EC50 value determined for taxifoline was 32 µM. Isosilibine A (EC50=855 µM) and B (EC50=813 µM) were the least active of the seven components in the free radical capture. Silihristine and silydianine were moderately active, but more active than other tested isomers. It was determined that taxifoline is the most effective antioxidant in ORAC assay with a Trolox equivalent=2.43 and that it has a good antioxidant capacity determined by the HORAC (Hydroxyl radical antioxidant capacity) method with a GAE=0.57. Other antioxidant assays did not show significant differences between samples [60]. Table 1. Research results of plants from Asteraceae family Scientific name of the plant TPC, TFC Antioxidant activity Observations References Arnica montana L. TPC – 221.80 mM GAE/g DW TPC – 247.00 mM GAE/g DW. Not described the dried plant product at room temperature. the dried plant product at 105°C. [37] TPC1 – 23.65±1.6 mg GAE/g extract TPC2 – 24.78±1.1 mg GAE/g extract TFC1 – 1.48±0.8 mg RE/g extract. TFC2 – 1.49±0.7 mg RE/g extract 1 – IC50>200 mg/mL. 2 – IC50>200 mg/mL. 1 – methanolic extract from leaves of multiple plants 2 – methanolic extract from leaves of rooted plants. [61] 3 wild species of A. Montana L. (flowers, leaves, roots, rhizomes) TPC as caffeic acid are extracts of roots and rhizomes – 7.7839 – 15.9098% w/w d.m. obtained with solvent ethanol 70 – 80% v/v under reflux extraction TFC as hyperoside was obtained from the Not described Ethanolic extract (30 – 70% v/v), by reflux. [62]
  19. 19 extraction of flowers and leaves – 2.578– 2.7518% w/w d.m. with solvent ethanol 50 – 70% v/v in conditions of reflux. A. absinthium L (aerial plants) TPC=194.9 ± 9.7 mg EGA/g extract. TFC=12.4 ± 0.6 mg QE/g extract. DPPH: IC50 = 612 ± 30.6 µg/mL. Low nitrogen oxide activity = 0.4 - 3.2 mg/mL. IC50 was 1.77 ± 0.08 mg/mL. Methanolic extract The IC50 for H2O2 = 243 ± 12.15 µg/mL. Ascorbic acid: IC50 = 21.4 ± 1.07 BHA: IC50 =52.0 ± 2.6 μg/mL. Tested extract showed a good chelating capacity of Fe2+ (IC50= 419 ± 20.95 μg/mL). EDTA: IC50= 18 ± 0.05 μg/mL). [63] Calendula officinalis L. Lyophilized extract TPC=151.62 ± 0.03 mg GAE/100 g DW TFC=266.62 mg QE/100 g DW. Alcoholic extract TPC = 112.42 ± 0.01 mg GAE/100 g DW. TFC = 42.12 ± 2.41 mg QE/100 g DW DPPH=4.17 ± 1.31%; ABTS=6.68 ± 1.14 mmol TE/g DW FRAP=15.01 ± 0.03 mmol TE/g DW. Other researchers found a TPC= 15.12 mg GAE/g, and TFC=5.13 mg rutin/g DW. In the hydroalcoholic extract (ethanol-water 50/50) of the yellowish petals, TPC was 29.79 mg GA/g and 45.13 mg GA/g using aqueous extract. All extracts showed a strong activity of DPPH radical capture (27.31 - 96.35%). [64] [65] [66] [67] Centaurea cyanus L. and Calendula officinalis L. TPC of Centaurea cyanus L. (718.81 ± 1.12 mg GAE/100g DW) is higher, but TFC is higher in Calendula officinalis L. (4.21 ± 1.05 mg QE/100g DW). Calendula off. L. FRAP=129.5 mg TE/mL. DPPH=41.70% CUPRAC=1.56 mmol Trolox/100 g DW. Centaurea cyanus L. FRAP=78.01 mg TE/mL. DPPH=83.42% CUPRAC=1.86 mmol Trolox/100 g DW. Centaurea cyanus L. extracts registered a higher SOD-like activity compared with Calendula officinalis L. Studies showed that phenolic acids were more abundant in the non-edible part of Centaurea (5.5 ± 0.002 mg spigenin–O–7–glucoside/g extract) than in flowers (0.134 ± 0.003 mg chlorogenic acid/g extract). [68] [69] Alchillea millefolium L. TPC 58 – 64.5 mg quercetin/100 grams of leaves. Phenolic acids were more abundant in the non-edible part of Centaurea (5.5±0.002 mg spigenin–O–7– glucoside/g extract) than in flowers (0.134 ± 0.003 mg chlorogenic acid/g extract. DPPH=17.82– 18.31%. Leaf extract of A. millefolium L., using water/acetonitrile (70/30) as solvents. [70]. Not described. DPPH=308.8 µmol/g TE Inhibition of H2O2 generation in the mitochondria of the heart rat was 45%. [71]
  20. 20 Not described. ABTS=97.40% for ethanolic extract from flowers; ABTS=55.76% for aqueous extract of seeds. DPPH= 91.03% for ethanolic extract of flowers ethanolic extract of seeds (79.94%). Aqueous and ethanol extracts of the flowers, leaves and seeds of A. millefolium L. [72] Aqueous extract (flowers, leaves and seeds) TPC= 74, 134, 78 mg QE/g and 18.82, 19.30, 20.25 mg pyrocatechol equivalent/g DW. Ethanolic extract (flowers, leaves and seeds) TPC=128, 70 and 126 mg QE/g DW and 18.34, 19.78 and 18.82 mg pyrocatechol equivalent/g DW. Hydrogen peroxide scavenging capacity: 17.75– 40.63% for 100 μg extract were obtained. At 100 μg/mL, A. millefolium L. extracts inhibited 90.31-92.09% lipid peroxidation of linoleic acid emulsion. Flavonoids/g of aqueous flower extract were determined: 52 μg rutin, 24 μg resveratrol, 2 μg morin, 54 μg myricetin, 529 μg naringin, 12 μg naringenin and 673 μg total flavonoids. From one gram of aqueous leaf extract were determined 979 μg rutin, 53 μg resveratrol, 1797 μg naringin, 11 μg quercetin and 2840 μg total flavonoids. [7] Cynara scolymus L. Methanolic extract: TPC=45.11 mg GAE/g DW TFC=37.00 mg rutin/g. Aqueous extract: TPC=37.79 mg GAE/g DW TFC=15.51 mg rutin/g DW and IC50 = 66.3 µg/mL, respectively. Methanolic extract: IC50 = 17.77 μg/mL Aqueous extract: IC50 = 66.3 µg/mL Isolated flavonoids exhibited the highest free radical neutralization activity (IC50 = 13.33 µg/mL). [49] FTPC=14.16 mg/g DW (for bracts) and 9.06 mg/g DW (for heart). TFC=9.85 mg/g DW (for bracts). TFC=5.91 mg/g DW (for heart). Not described. The inner and outer part of artichoke contain a small amount of bound phenolic compounds (5.35 and 4.2 mg/g DW, respectively. Artichoke extract contains 8.1 mg tannic acid/g DW. [73] [74] C. parthenium L. TPC = 152.8 ± 0.8 mg GAE/g essential oil. DPPH = 73.8 ± 1.3% HPLC: synapic (3.86 ± 0.1 mg/g DW) and ferulic acid (2.59 ± 0.1 mg/g DW). Essential oil of T. parthenium L. with Iranian origin contains camphor (43.97%), chrysanthenyl acetate (12.46%), farnesol (7.54%), and fatty acids: palmitic acid (57.27%) and myristic acid (14.7%). [75] TPC=3.48 ± 0.17 g GAE/100 g plant product; DPPH: IC50 (μg/mL): 149.76 ± 6.23; HPLC-MS revealed the presence of phenolic acids (gentisic acid, caffeic acid and [76]
  21. 21 TFC=1.27 ± 0.07 g RE/100 g plant product. Caffeic acid derivatives=1.30 ± 0.11 g CAE/100 g plant product. SNP: 29.85 μmol GA/g plant product, EPR: 106.717 μmol GA/g plant product. chlorogenic acid), in concentrations lower than 0.2 μg/g plant product and flavonoid aglycones: quercetin, in the highest quantity (27.61 ± 0.39 μg/g plant product), apigenin (9.71 ± 0.18 μg/g plant product). I.5.2. Fam. Malvaceae The use of plants from the Malvaceae family for herbal therapy is very common in the Middle East, one of the examples being Althaea species. Althaea officinalis L. is native to Asia, Europe and the United States. Althaea rosea L. is a popular garden plant, native to China, South Europe, the Middle East, the Near East, the Mediterranean Sea and Central Asia [77]. Studies presented in literature have shown that Althaea officinalis L. has antimicrobial, anti- inflammatory, immuno-modulatory effects, is used for the demulcent and soothing, anti-tussive and many other pharmacological effects. Althaea rosea L. had numerous pharmacological effects, such as antimicrobials, antiestrogens, cytotoxic and immunomodulatory, cardiovascular and is also used to prevent urolithiasis [77]. Dudek M. et al. [78] investigated the distribution of phenolic acids in the flowers of Althaea rosea L. variety black using the methanolic and methanolic-aqueous extracts of entire flowers, petals and calyx of Althaea rosea L. and found that the plant contains cinnamic acids (ferulic, p-coumaric, caffeic), benzoic acids (p-hydroxybenzoic, vanillic, syringic) and p- hydroxyphenylacetic acid. P-coumaric, syringic and p-hydroxybenzoic acids were detected in almost all fractions. In the petals were found almost all phenolic acids detected (except caffeic acid in methanolic extract, syringic and p-hydroxyphenylacetic acids in methanolic-aqueous extract). In calyx, vanillic and p–hydroxyphenylacetic acids were not found. The total content of phenolic acids in flowers was 60 mg%, in petals 120 mg% and 30 mg% in calyx. Phenolic acids (p-hydroxybenzoic, p-coumaric, ferulic, syringic) dominated in both extracts examined (methanolic and methanolic-aqueous) and they may contribute to the estrogenic activity of this plant [78]. Was reported in literature by Hărmănescu M. et al. [37] using GA as the reference substance: for dry extract at normal temperature, 52.20 mM GAE/g and 63.40 mM GAE/g for dry extract at 105 °C. Of the polyphenols, flavonoids are the main secondary metabolites that characterize the genus Tiliae [79]. Natural antioxidants (flavonoids and polyphenols) are known to have an significant role in the cells as protecting them against free radicals, so antioxidant activity
  22. 22 consists of anticancer activities, pro-apoptotic, DNA-damaging, anti-angiogenic and immunostimulatory activity [80]. An ethanolic extract of the flowers of a species of Tiliae showed a selective anti-proliferative action on a lymphoma cell line called BW 5147, and one of its main compounds, rutin, showed antioxidant activity [81]. An extract from T. cordata Mill. has shown anti-proliferative action on BW 5147 cells [82]. Tiliae species have been used in Asia, Europe and America to treat anxiety and to treat colds and inflammation. Species reactive to oxygen (ROS) (hydrogen peroxide (H2O2) and superoxide anion (O2 . ) are involved in the proliferation/death of balance cells in lymphocytes. Brizi M. et al. [83] compared the effect of an aqueous (AE) and ethanolic (E) extract from Tilia x viridis on the proliferation of tumor and normal murine A lymphocytes stimulated in relation to antioxidant activities such as peroxidase activities (Px), catalase (CAT) and SOD involved in H2O2 modulation. Both extracts showed anti-proliferative action on both types of lymphocytes, but ethanolic extract was more selective on inhibition of tumor lymphocytes (EC50 = 50 ± 4 µg/mL) and of normal lymphocytes (EC50 = 323 ± 20 µg/mL). This action was related to high polyphenols (150 ± 10 mg GAE/g DW) and high SOD activity. Due to TPC, the extracts could be a source of antioxidant compounds that contribute to a selective anti- proliferative action on tumor cells, which act by modulating H2O2 levels. I.5.3. Fam. Rosaceae Particular interest among the endemic species containing phytochemicals are various medicinal and culinary plants, that have antioxidant capabilities and may have many benefits for human health could be used to product raw materials or other natural preparations.[84]. The literature mentions numerous plants that can be used in the treatment and prophylaxis of diabetes and complications of diabetes [85]. People with diabetes have an increased risk of cardiovascular disease 2 to 6 times higher [86], and the Agrimonia species could have a beneficial effect on diabetes. Agrimonia eupatoria L. is the most common Agrimonia species in Europe, and the aerial parts are used in the form of infusion, decoction or tincture. Kubínová R. et al. [87] studied 5 species of Agrimonia collected in the Plant Medicine Center of Masaryk University in July 2008 and estimated the highest flavonoids content (3.5 mg Q/g dry extract) in a methanolic extract from flowers of the studied species. For TPC and TFC the following results were reported: polyphenolic compounds (%) expressed as caffeic acid, between 1.03 – 1.73, respectively flavonoids (%) expressed as rutoside, between 8.03 – 11.81. Higher values of polyphenol content were obtained by researchers [87] in aqueous
  23. 23 extracts: A. procera – 104.8 ± 0.5 GA/g dry plant, A. leucantha – 90.1 ± 6.3 mg GA/g dry plant, A. japonica – 88.6 ± 2.3 mg GA/g dry plant, A.eupatoria – 72.4 ± 3.8 GA/g dry plant. The aqueous extract of Agrimonia procera works as an excellent antioxidant (86.7% of DPPH reduction). To enhance the therapeutic effect of Agrimonia species, they have been associated with other extracts from selective plants, which the literature mentions as having a hypoglycemic effect, such as Lythri salicariae herba, Myrtilii folium, for their content in flavonoids and tannins (catechic and galenic), the content in flavonoids, Phaseoli fructus - for isoflavones, soluble silicates and chromium salts [88]. The genus Crataegus is the largest genus in the subfamily Maloideae of the Rosaceae family, comprising 265 species, generally known as hawthorn [89]. Crataegus monogyna Jacq. is a spongy European shrub widely used as a sedative, diuretic, anti-inflammatory and cardiotonic [90, 91] which is prescribed by the European Pharmacopoeia and recommended by the World Health Organization. There are several reports on antioxidant capacity and phenolic compounds present in several hawthorn species, including C. monogyna Jacq., studies being conducted with HPLC-MS [90, 92]. Simirgiotis M.J. [93] studied the fruits and aerial parts of Crataegus monogyna Jacq. (German Peumo) from Re-Re, Región del Bio-Bio, Chile, harvested in May 2011. Quantitative analysis showed a TPC in fruit of C. monogyna Jacq. of 28.30 ± 0.02 mg GAE/g DW, and in aerial parts 114.38 ± 1.62 mg GAE/g DW. The TFC was found in the aerial parts (64.9 ± 0.00 mg QE/g DW), compared to fruits (8.77 ± 0.00 mg QE/g DW). Alcoholic extracts from fruits and leaves of Crataegus monogyna Jacq. were evaluated for antioxidant power by DPPH and FRAP methods. Thus, fruits and aerial parts had a high antioxidant capacity proven by the DPPH method (IC50 = 61 ± 0.01 and 3.34 ± 0.38 μg/mL respectively) and by the FRAP method (85.65 ± 0.09 and 95.05 ± 0.15 μmol TE/g). C. monogyna Jacq. fruits from Chile showed an antioxidant activity, a higher TPC and TFC than the fruits harvested from Portugal, as a result of Barreira J.C.M. et al., 2013: DPPH (15 ± 1% scavenging activity at 100 µg/mL), respectively 83 ± 2 and 51 ± 14 mg GAE. Methanolic extracts of Crataegus monogyna Jacq. from Tunisia were studied by researchers [94] and it was established that the main source of total polyphenols and flavonoids is bark, where 123.35 mg GAE/100 g DW and 198.53 mg RE/100 g DW were found. In the model system of β-carotene/linoleic acid, the extract from the fruit peel showed a relative antioxidant activity (82.23%), the DPPH value expressed by IC50 reported being 750 μg/mL. The antioxidant capacity for extracts from different parts of Crataegus fruit is very varied, from
  24. 24 5.44 to 8.88 expressed as mM Trolox/100 g dry weight to 5.68 – 9.12 mM AA/100 g dry weight. In the alcoholic extracts, the FRAP method showed that the antioxidant activity decreases in the following order: shell> pulp> seed, the results being in accordance with DPPH values. Other analyzed fruits are those of the Rosa canina L. plant of the Rosaceae family (Cynosbati fructus), due to their content in compounds with potential therapeutic activity. In the fruits of Rosa canina L. a high content of ascorbic acid, phenols and flavonoids have been reported, compounds that confer antioxidant, antimutagenic and anticarcinogenic activity [95]. Gavra D.I. et al. [96], analyzed Cynosbati fructus and Rosa canina flos, cultivated and collected from Bihor County, Romania and evaluated TPC and TFC. The highest amount of polyphenols was found in the alcoholic flower extract extract (618.07 mg GAE/mL), and the greatest value for flavonoids was found in the dried fruits (5.75 mg QE/mL). Using FRAP and CUPRAC methods, the methanolic extracts from the flowers of Rosa canina L. showed antioxidant activity: FRAP (232.52 ± 0.15 mg TE/mL), CUPRAC (2.89 ± 0.03 mM Trolox). Regarding TPC some data from the literature were reported: Nowak et al. [97] (990 mg GAE/100g DW), Fattahi et al. [98] (199 mg GAE/100g DW) and Duda-Chodak et al. [99] (110 mg GAE/100g DW). I.5.4. Fam. Ericaceae In order to prevent the complications of diabetes, numerous medicinal plants that can be used as adjuvants, such as Vaccinium myrtillus L., have been mentioned in the literature because of their high level of anthocyanins and phenolic compounds. Thus, bean pericarp is a component of herbal mixtures and remedies used in diabetes herbal medicine. It can also be applied in laryngology, where it is used for antiseptic, anti-inflammatory and astringent properties [100]. The various herbal preparations, taken in sufficient doses and correct combinations, neutralize free radicals before they lead to the appearance of diseases in the body. The total amount and proportion of different classes of phenolic compounds in the varieties of berries may be different. Wild and cultivated species of berries as "Elliot sp.", "Bluecrop sp.", "Duke sp." from Romania were compared to determine TPC, total anthocyanins, TFC, antioxidant activity which was evaluated using ABTS, FRAP, DPPH and an atom transfer of hydrogen method, ORAC. Was found a TPC of 424.84 - 819.12 mg gallic acid equivalents/100 g fresh weight, TFC of 84.33-112.5 mg quercetin equivalent/100 g fresh weight and total anthocyanins between 100.58 – 300.02 C3GE/100g fresh weight.
  25. 25 In Vaccinium myrtillus L., petunidin – 3 – glucoside and delfinidin – 3 – glucoside are the most important anthocyanins found, and in Vaccinium corymbosum L., peonidin – 3 – galactoside is the major anthocyanin. Except the ORAC test, all the antioxidant activity values obtained were correlated with the TPC. Wild blueberries had a higher polyphenol content and higher antioxidant activity compared to cultivated ones. Researchers [101] analyzed and revealed that in Turkey, wild Vaccinium sp. obtained a greater antioxidant activity than the cultivated ones. V. myrtillus L. had a TPC (11.538 – 20.742 mg GAE/g DW), TFC (1.182 – 2.676 mg QE/g DW) and anthocyanins (3.305 – 11.473 mg Cyn/g DW) higher compared to V. corymbosum L. In wild species the values of CUPRAC, FRAP and DPPH were high. Researchers [64] studied the lyophilized and the alcoholic extract of blueberries fruits and obtained a TPC of 343.93 ± 0.01, respectively 812.13 ± 0.02 mg GAE/100 DW, a TFC of 125.82 ± 8.92 using alcoholic extracts and 72.80 ± 7.61 mg quercetin equivalent/100 g dry weight in lyophilized extract. Alcohol samples exhibit the best antioxidant capacity demonstrated by the DPPH test (34.02 ± 2.01%), the anthocyanin content of 284.8 ± 17.2 mg cyanidin/100 g DW and the TPC of 812.13 ± 0.02 mg GAE/100 g DW. I.5.5. Fam. Hypericaceae The flowering branches of Hypericum perforatum L., used as a folk remedy in the treatment of various diseases, were analyzed by Fathi H. and Ebrahimzadeh M.A. [102], which determined the antioxidant activity of the extract using different in vitro testing systems. The IC50 for DPPH radical capture activity was 96.0 ± 3.7 µg/mL, the percentage of inhibition being increased with increasing extract concentration (IC50 was 21.1 ± 1.8 µg/mL). The extract of H. perforatum L. showed a strong neutralization activity of nitric oxide (6.25 and 100 µg/mL) and a good reduction power comparable to vitamin C (p> 0.05). The capacity of the chelating extract of Fe2+ was found to be very low. H. perforatum L. contains a large amount of TPC, determined by the Folin-Ciocâlteu method (505.7 ± 18 mg GAE) and a high TFC, determined by the colorimetric method with AlCl3 (23.8 ± 1.6 mg QE), which gives it good antioxidant activity. The plant product has anti-inflammatory activity and activity at the Central Nervous System level, these can be correlated with the absorption capacity of the nitric oxide. Corciovă A. et al. [103] determined from the alcoholic extract of Hyperici herba from Romania TPC (47.73 mg GA/g DW) and TFC (3.5 mg chlorogenic acid/g DW). Gioti E.M. et al. [104] analyzed the aerial parts of Hypericum peroforatum L. plant grown in Greece and determined a content of 257 ± 4 mg GAE/g DW. The best antioxidant activity has the ethanolic
  26. 26 extract (60%) of the leaves and flowers, comparable to BHT. Zou Y. et al. [105] evaluated the antioxidant activity by the DPPH method with an IC50 value of 10.63 μg/mL and identified flavonoids as kaempferol, luteolin, myricetin and quercetin. Hyperosides (hyperins) and rutin usually dominate among H. perforatum plant glycosides followed by quercitrin and isoquercitrin [105, 106]. I.5.6. Fam. Lamiaceae Plants of the Lamiaceae family are widely used in the cosmetic, food and medical industries. In addition to volatile oils, plants also contain polyphenols, compounds with biological activities useful in the prevention and treatment of many disorders [107]. A number of plants in Romania widely used as natural food additives or for health promotion in traditional medicine have antioxidant activity [108]. Oregano (Origanum vulgare L.) is part of the Lamiaceae family, originally from the Mediterranean region and Melissa officinalis L. also from the Lamiaceae family are used in traditional medicine [84]. Spiridon I. et al. [108], 2011 reported for Origanum vulgare L. a TPC of 67.8 mg GA/g extract and TFC 43.6 mg RU/g extract. Values in the literature show that different species of Origanum are a natural source of phenolic compounds with high antioxidant activity. Benchikha N. et al. [109] analyzed the alcoholic extracts from the leaves of two Origanum species from Algeria and determined values for TPC (266.86 and 194.78 mg GAE/g extract) and antioxidant activity; DPPH (IC50 = 1.37 and IC50 = 1.53 mg/L) for the majorana species L., respectively, vulgare L., respectively for the essential oil of Origanum vulgare L. (IC50 = 15.360 mg/L). Ocimum basilicum L., also from the Lamiaceae family is an aromatic plant with medicinal properties, traditionally used in the treatment of headaches, cough, constipation, warts, worms and kidney diseases [110]. The extracts of O. basilicum L. contain polyphenolic compounds, vitamins and essential oils that have insecticidal, nematicide, fungal, antimicrobial, also it have anti-inflammatory properties [111-114]. In the extract of O. basilicum L. from Romania, TPC (175.57 mg GAE/g DW), TFC (6.72 ± 0.19 mg RE/g DW) and caffeic acid derivatives (12.11 ± 0.39 mg CAE/g DW). The antioxidant activity of ethanolic extract of O. basilicum L. was evaluated using DPPH method (IC50 = 124.95 ± 4.46 µg/ml), TEAC - 25.69 ± 2.96 µmol Trolox/mg DW), HAPX – 18.84 ± 1.12 % [115]. Rosmarinus officinalis L. (Lamiaceae) is a continuous edible green shrub in the Mediterranean area, producing an essential oil with antimicrobial effect. Ursolic, oleanolic acids and micromeric acids are compounds responsible for their anti-inflammatory effects
  27. 27 [116]. Hărmănescu M. et al. [37] determined the TPC (348.0 mM GAE/g) of Rosmarinus officinalis L., and other authors determined from the rosemary extract TFC of 448.4 mg catechin/100 g DW [12]. Melissa officinalis L. is used to treat headaches, gastrointestinal disorders, nervousness and rheumatism [117]. Melissa off. L. essential oils have antimicrobial properties and a strong ability to protect against lipid peroxidation [117, 118]. Atanassova M. et al. [119] studied the composition in bio-active compounds and the antioxidant capacity of Melissa off. L., harvested from Bulgaria and have TPC (48.86 mg GAE/100g DW), TFC (45.06 mg CE/100 g DW), and by DPPH assay evaluated antioxidant capacity (IC50 = 10.87 mL/L methanolic extract). Lavandula officinalis L., known as medicinal lavender, true lavender, or common lavender, also known as Lavandula angustifolia Mill. L. is a plant with beneficial properties for humans. Bioactive compounds as anthocyanins, tannins, phytosterols, also, minerals, coumarin and essential oil with important therapeutic effects, phenolic acids and herniarin were found in Lavandula off. L.[120]. Natural products obtained fom lavender flowers are used in headaches due to the analgesic effect, in depressions or anxiety due to the sedative effect on central nervous system have sedative and analgesic properties [121]. Studies on animals using the lavender extract showed that it prevented dementia that was caused by Alzheimer's disease [122]. Lavandula off. L. essential oil has antibacterial activity at doses of 4.0 – 9.0 mg/mL [123]. A study from scientific literature that was carried out on 65 bacterial strains, confirmed the antimicrobial properties of lavender, having a better efficacy against gram-positive strains [124]. The vegetable product of Lavandulae sp. it is used for the spasmolytic, carminative, stomach, diuretic properties and is used today as a light sedative and cholagogue in different phytopharmaceuticals [125, 126]. Salvia species are generally known for their multiple pharmacological effects. Each species contains a large amount of flavonoids and tannins (caffeic acid, chlorogenic acid, ellagic acid, gallic acid) [127]. Rosmarinic acid and its derivatives are compounds responsible for the antioxidant activities of some Salvia species and for astringent, anti-inflammatory, antibacterial and antiviral activities. Some studies examined the in vitro anti-proliferative activity of crude methanolic extracts from six Salvia species and found that they can be used as potential anti-tumor agents [128, 129]. Jurca T. et al. [64], 2016 compared two types of leaf extracts from Salvia off. L., collected from Romania: the lyophilized and the alcoholic extract. For the lyophilized extract
  28. 28 they found: TPC (258.87 ± 0.01 mg GAE/100 g DW), TFC (427.23 ± 9.42 mg QE/100 g DW) and antioxidant capacity was measured by DPPH (5.61 ± 1.83%), ABTS (67.84 ± 11.78 mmol TE/g DW), FRAP (61.07 ± 0.01mmol TE/g DW). For alcoholic sage extract were found: TPC – 963.01 ± 0.01 mg gallic acid equivalent/100 g dry weight, TFC – 267.42 ± 8.21 mg quercetin equivalent/100 g dry weight, and antioxidant capacity was measured by DPPH (46.94 ± 3.56%), ABTS (244.12 ± 23.42 mmol TE/g DW), FRAP (177.62 ± 0.11 mmol TE/g DW). Due to the complex chemical composition, Mentha sp. has anti-inflammatory, antimicrobial, spasmodic, carminative, antioxidant properties. Mint is used in traditional medicine and in the cosmetic and food industry for the production of various sweets and beverages [130, 131]. Two species native to Mentha: M. viridis L. and M. longifolia L. from Cluj area, Romania were studied by Benedec D. et al, 2013 to determine TPC and antioxidant capacity. The extract of M. viridis L. (246.7 ± 0.47 mg GAE/g DW) showed the best results regarding the TPC, followed by M. longifolia L. (219.2 ± 0.97 mg GAE/g DW). The extract of M. viridis L. contains the highest amount of flavonoids (9.41 ± 0.08 mg RE/g DW) compared to M. longifolia L. (6.75 ± 0.09 mg RE/g DW). The best value for phenolic acids was determined in the extract of M. viridis L. (43.80 ± 1.39). The effect of free radical capture of M. longifolia L. at a concentration of 0.4 mg plant product extract/mL was 25.31%, followed by the extract of M. viridis L. (18.34%) at the same concentration, compared to BHT (94.77 ± 0.64 %) at the same concentration (0.4 mg/mL). Although TPC of M. viridis L. is larger than M. longifolia L., it has a lower antioxidant capacity. In another study [103]was determined the flavonoids, polyphenolic acids and TPC with potential therapeutic effects of the natural products commonly used as traditional treatments in Romania. They investigated different parts from the medicinal plants that are used in different conditions, such as: in dentistry for various infections and inflammatory disorders (Salvia officinalis L.- Lamiaceae family); gastrointestinal affections, damages and inflammatory diseases (Achillea millefolium L.-Asteraceae family), cardiovascular diseases and anxiety (Crataegus monogyna Jacq.- Rosaceae family), insomnia, colds, infections and inflammation (Chamomilla recutita L.- Asteraceae family) respiratory infections (Tilia cordata Mill.- Tiliaceae family), anxiety, sores, pustules, acalculuous gallbladder disease (Hypericum perforatum L.- Hypericaceae family).
  29. 29 I.5.7. Fam. Canabaceae Another species, Robinia pseudoacacia L., commonly named false acacia or black acacia, belongs to the Fabaceae family, is widespread as a wild species and cultivated in temperate areas around the world. False acacia flowers contain volatile compounds, flavonoids, proteins, robinins, polysaccharides and some microelements [132]. In 2000, flavonoids of acacia ethanolic extracts were extracted from acacia, including isoflavonoids (isovestitol, isomucronulatol), flavones (acacetin) [133, 134]. Recently, many investigations have referred to the antioxidant properties of different nutritional products [135]. Using HPLC analysis, Marinas C.I. et al. [136] identified catechin (0.925 μg/mL alcoholic extract), rutin (0.831 μg/mL alcoholic extract), resveratrol (0.664 μg/mL alcoholic extract) and quercetin (0.456 μg/mL alcoholic extract) in leaf extract and, catechin (0.127 μg/mL alcoholic extract), epicatechin (0.239 μg/mL alcoholic extract) and rutin (0.231 μg/mL alcoholic extract) in the seed extract. Alcoholic extracts of Robinia pseudoacacia L. presents antimicrobial activity that was evaluated using Gram-positive and negative strains, also for Candida sp. Researchers showed that flowers of R. pseudoacacia L. has high levels of polyphenols and strong antioxidant properties. The same study showed that topical formulations with false acacia can exhibit the antioxidant activity in order to reduce cellular stress and it can be used as a natural formulation for skin aging [137]. I.5.8. Fam. Grossulariceae Compounds contained in Ribes nigrum L. fruits and leaves can act preventively and therapeutically on the human body [138]. Ribes nigrum L. is a shrub that grows in temperate areas [139]. Black currant fruits contain polyphenols that have antioxidant, antimicrobial, antiviral and antibacterial properties [140]. Polyphenols protect and support many functions of organs and systems, especially the digestive system [141], the nervous system and the circulatory system [142]. Contained in black currant leaves, quercetin derivatives have antimicrobial, anti-inflammatory, antiviral, anti-toxic, antiseptic and antioxidant effects, so it is assumed that the leaves can be used as an adjuvant in the treatment of cancer [143-146]. Cytosolic phospholipase A2α (cPLA2α) is one of the potential targets for anti-inflammatory drugs, as this enzyme plays a key role in the inflammatory processes observed in health problems, such as asthma, allergic reactions, arthritis and neuronal diseases. Arnold E. et al., 2015 [147], inhibited cPLA2α with 43 methanolic extracts from polyphenol-rich medicinal plants. The extract of Ribes nigrum L. was the strongest inhibitor of cPLA2α (IC50=27.7
  30. 30 μg/mL), having the highest TPC (131.25±7.15 GAE mg/g extract). The EC50 value for DPPH radical reduction was 13.36±0.6 μg/mL extract. I.5.9. Fam. Urticaceae In the tissues of various spices and herbs with therapeutic were found constituents that have antioxidant and antimicrobial activity. Antioxidants may scavenge and neutralize the harmful and pathological effect of free radicals [148]. Urtica dioica L. has beneficial properties, which is why its extract has been used for hundreds of years in traditional world medicine to treat various conditions: rash, digestive problems, joint pain and anemia [149]. The extract of U. dioica L. made with ethyl acetate contains flavonoids and alkaloids, phenols, saponins and tannins [150]. Taraxacum officinale L. has a high concentration of phytoconstituents in stem, root and flower, such as saponins, flavonoids, alkaloids and phenols [25]. Antibacterial and antioxidant activities of extracts from Urtica dioica L.and Taraxacum officinale L. using ethyl acetate as a solvent, were compared by Kassim Ghaima K. et al. [151]. The results showed that the extract from U. dioica L. was more effective than Taraxacum off. L. on the bacterial strains and was found an inhibition area of 24 mm against B. Cereus, which was also the highest one; A. hydrophilaa had the highest resistance. U. dioica L. had a large area of inhibition comparing S. typhi (22 mm) and the highest TPC (48.3 mg GAE/g DW). Through qualitative phytochemical screening, were identified flavonoids, glycosides and phenols. Kassim Ghaima K. et al. [151], conducted a comparative study to verify antioxidant activity, using α-Tocopherol as standard by the ferric thiocyanate method (FTC). Urtica dioica L. had a greater activity (76% lipid peroxidation) in inhibiting linoleic acid emulsion, than Taraxacum off. L. (44%) and α – tocopherol (65%). Other research has shown, using the ferric thiocyanate method, that aqueous extract of U. dioica L. exhibited effective antioxidant activity at all doses (50 – 250 μg) [152]. Low antioxidant activity of Taraxacum off. L. may be due to the presence of active radical scavenging compounds such as luteolin and luteolin – 7 – o – glycoside in other parts of plants, such as flowers and roots, more than in leaves [153]. The antioxidant, hepatoprotective and anthelmintic activities of the methanolic extract from the leaves of Urtica dioica L. were investigated by Manjir Sarma Kataki et al. [154]. Significant hepatoprotective effect and maximum hepatoprotection was observed at the dose of 400 mg/kg. Using the extract as a pre-treatment of animals at all doses (100, 200 and 400 mg/kg) resulted a significant decrease in malonildehyde (MDA) level, as well as a significant increase in superoxide dismutase (SOD) level, indicating lipid inhibition, peroxidation and
  31. 31 improvement of the enzyme antioxidant defense system. The anthelmintic activity of the methanolic extract was investigated using adult worms (Pheretima posthuma), and the results revealed an increase of the anthelmintic activity that is dose dependent of the extract at concentrations of 25, 50 and 100 mg/mL [154]. The highest TPC was found by Semih Otles and Buket Yalcin [155] in the leaves of Urtica dioica L. in the Aegean region: 1941.00 ± 15.06 mg GAE/g DW followed by the extract from the roots of Urtica dioica L. in the Black Sea: 1020.16 ± 69.40 GAE/g DW. Using the DPPH test, it was found that in the root sample, the highest antioxidant activity had Urtica dioica L. in the Marmara region: 370.27 ± 0.11 mg GAE/g DW. The thermal process used for drying the plant could be the reason for the lower antioxidant activity compared to the fresh vegetable product. I.5.10. Fam. Papaveraceae Maria Laura Colombo and Enrico Bosisio [156] investigated the pharmacological activity of the species Chelidonium majus L. (syn. Celadine) and identified the antiviral, anti- tumor and antimicrobial activities, as well as the presence of flavonoids and phenolic acids. Jakovljevic Z.D. et al. [157] investigated the TPC, TFC and antioxidant activity of Chelidonium majus L. extracts in different phenological stages (rosette stage, initial flowering stage, complete flowering stage and the stage of fruit formation). For each phase, five extracts were obtained with different solvents: water, methanol, acetone, ethyl acetate and petroleum ether. The TPC determined by the Folin-Ciocâlteu method and the highest values were obtained for the rosette stage (60.96 mg GA/g extract). Of the solvents used, methanol has been shown to be most effective for the extraction of phenolic compounds from Ch. Majus L. The highest flavonoid concentration was found for the initial flowering stage (291.58 mg RU/g extract), harvested in May, and acetone and ethyl acetate were the most suitable solvents for flavonoid extraction. Antioxidant activity was determined in vitro using DPPH reagent, and the highest antioxidant activity was the plant product in the rosette stage (50.72 mg/mL extract). Hărmănescu M. et al. [37] determined TPC in seventeen samples of Ch. Majus L., dried under normal conditions and at 105o C for 4 hours. They used Folin-Ciocâlteu reagent, and the values obtained were: 105.40 mM GAE/g for drying under normal conditions, respectively 159.60 mM GAE/g for drying at 105°C. High values were also obtained by Papuc C. et al. [158] using alcoholic extracts of Ch. Majus L. The TPC expressed as mg gallic acid equivalent/100 mL extract and TFC expressed as mg cyanidin equivalent/ 100 mL extract were determined in the flower extract (381.7 ± 23.2 and 299.5 ± 18.4), while the lowest
  32. 32 concentrations were recorded in extract from the strains (52.7 ± 4.2 mg, respectively 36.75 ± 2.9). I.6. Alternative treatment for skin diseases Psoriasis is the major autoimmune skin disorder characterized by deregulated epithelial cells proliferation and chronic dermatitis [159] and it has many clinical phenotypes that results from the interaction of many factors as: genetic, environmental and immunological. Pathogenic mechanisms and effective therapies of psoriasis were elucidated after a lot of work on clinical and basic research. I.6.1. Psoriasis prevalence In Western countries the population is affected by this skin disease more and more with prevalence rates that are influenced by genetics, age, nutrition, geographic location [160]. Studies from literature showed that psoriasis is a very commonly disease, were analyzed 46 studies regarding the prevalence of psoriasis and in seven of them was showed the incidence of psoriasis in general population [161]. Results showed that in adults prevalence ranged from 0.91% to 8.5% compared to children, where the prevalence ranged from 0% to 2.1% where most affected were the persons with age between 30–39 years and 60 years. Depending on the country, the prevalence is different, having a geographical model that shows less prevalence in the countries that are closer to equator, compared with those that are more distant from equator, that also correlates the beneficial properties of UV radiation exposure and the amelioration of the disease [162]. In the countries from Europe it ranges from 0.73% to 2.9%, which could compare to the values of the Unites States (0.7% – 2.6%). The lower prevalence is in Africa, Latin America and Asia which showed a prevalence with values between 0 – 0.5%. Studies, also showed that both genders, female and male, are affected by psoriasis, equally [163, 164]. I.6.2 Psoriasis classification, pathogenesis and treatment Main forms of psoriasis were identified by International Psoriasis Council: plaque-type psoriasis, guttate psoriasis, generalized pustular psoriasis (GPP) and erythroderma, and many further subphenotypes depending on the distribution (may be localized or widespread), localization (flexural, on scalp, may appear on palms, nail or soles), depending on size (small or large) and thickness (thin or thick) of plaques, if appears early or late and disease activity, if psoriasis is active or it is stable [165]. This disease is characterized by erythema and irritation. Regarding the pathological point of view, it is chronic dermatitis, which has rapid uncontrolled epithelial cell proliferation on the surface, and hyperemia, and dense lymphocytic-infiltration on the corium side. Psoriasis
  33. 33 can start in any stage of the life and persists for a long period of time with permanent or periodic eruptions [166]. Different comorbidities as psoriatic arthritis, crohn's disease, cancer, metabolic syndrome, type 2 diabetes mellitus, increased cardiovascular risk, depression, and decreased quality of life are associated with psoriasis [167]. Smoking is also listed among the risk factors that play a role in the occurrence of psoriasis [168]. 80% of psoriasis cases are represented by the plaque type, and in contrast is the erythrodermic type with a percentage of only 1 – 2%. In adults the most common type of psoriasis is the pustular type (5%). Psoriasis has three major forms such as mild, moderate, and severe that depends on the covered area and severity of the symptoms. Regarding the mild form, 5 – 10% of total area is covered, while moderate form, covers area between 10 and 20% and severe form covers more than 20% of the body area. The exact etiology of psoriasis is yet unknown but different risk factors like genetic factors, immune system, and environmental factors have been identified to develop psoriasis like genetic factors, immune system, and environmental factors. It was observed that 30% of people suffering from psoriasis have psoriasis family history. Pathogenesis of psoriasis is well understood [169]. Helper T – cell (Th) 1/Th17 cells infiltration takes place in epithelial tissue, which triggers macrophages and dermal dendritic cells to secrete different cytokines to mediate inflammation and abnormal keratinocyte proliferation. Infiltration of activated CD4+ and CD8+ T – cells are responsible for the psoriatic plaque formation. Infiltration of CD4+ T-cells takes place in the dermis while CD8+ T – cells infiltrate into the epidermis. Development of lesions in psoriasis is due to the cytokines and chemokines released by T – lymphocytes. Keratinocyte hyper proliferation with parakeratosis and elongation or rete ridges, increased blood vessels synthesis, inflammatory cells infiltration like T lymphocytes, macrophages, neutrophils, dendritic cells, and presence of micro abscesses are the major histological features of psoriasis [169]. An important role in the pathogenesis and etiology of psoriasis is represented by diet. Some researchers show that psoriasis symptoms are reduced by vegetarian diets, low energy diets, and fasting periods. The metabolism of polyunsaturated fatty acids and suppress the inflammatory response are affected by these diets. Various combined therapies, oral inositol, intravenous omega-3 fatty acids, and vitamin D are effective in psoriasis. Low-calories diet, cyclosporine, thiazolidinedione, retinoids, fish oil, and ultraviolet B phototherapy are found effective in clinical trials [170]. Because of this disease causes some patients have physical and psychological problems and it has been observed that thoughts of suicide and self-harm are more in psoriasis patients compared to normal persons. Scalp psoriasis is very distressing and
  34. 34 patients suffer from psychological problems. It is not contagious disease but some people report that friends and colleagues consider that psoriasis is transmitted by shaking hands or skin contact. This thing makes the patient socially isolated and he suffers from depression [171]. Treatments as phototherapy and/or systemic medications are needed to treat moderate and severe forms of psoriasis. Psoriasis can be treated by exposure to narrowband ultraviolet B (NB-UVB) radiation. Radiation spectrum having wavelength b/w 311 and 312 nm is known as NBUVB and this is more beneficial and effective to treat psoriasis [172]. Due to antiproliferative, immunosuppressant and anti-inflammatory characteristics, UV radiation induces regression or controlling the evolution of dermatitis [173, 174]. Capsaicin, glycyrrhetinic acid preparation is applied on affected parts of the body. Some studies suggest that psoriasis causes a nutritional deficiency in sufferers. The outbreak of psoriasis increases with an increase in stress and anxiety. Although modern medicines including cyclosporine, acitretin, apremilast, methotrexate, secukinumab, adalimumab, ixekizumab, etanercept, infliximab, and ustekinumab are effective but they have some side effects [175, 176]. Medicinal plants are safe and efficacious [177]. In developing countries, most people rely on herbal medicine due to their easy availability, low cost, more efficacies, and not well-reported side effects. I.6.3. Alternative treatment for psoriasis Polyphenols present in plants are effective in the treatment of psoriasis due to significantly high-antioxidant activity. Nitric acid level and hydroxyl or free radical present in the blood of patients with psoriasis is reduced by antioxidants that have also antiproliferative and anti-inflammatory properties and they have the ability to inhibit calgranulins A and B genes that are involved in the inflammatory process. Plants can be used as symptomatic treatment of psoriasis and also suppress the disease for a period. Clinical efficacy in vivo/vitro has been demonstrated for Glycyrrhiza uralensis, Aloe vera [115, 178], Memecylon malabaricum [179], Capsicum annuum, Psoralea corylifolia, and Mahonia aquifolium, different parts of vegetal herbs as Matricariae flos, Calendulae flos, Hamamelidis folium, Quercus cortex, Violae tricolor, Salviae folium, Echinaceae herba, Dulcamarae stipites, Arnicae flos, Symphyti rhizome, Melaleuca hypericifolia, Melissae folium, Momordica charantia, Azadirachta indica, Arctium lappa and Caesalpinia bonduc [180].
  35. 35 I.6.4. Psoriasis evaluation on clinical trials Regarding the clinical practice, global evaluation of psoriasis progress and its effect on the quality of life of patients are applied to assess the severity of the disease and the effectiveness of the treatment. In human clinical trials are needed more validated objectives and instruments. Many instruments have been expanded and continue to be expanded to provide an evaluation of the degree of the lesions [181]. Because a lesion’s impact on patients lives varies among patients, there has been growing recognition of the need to measure the quality of life impact of the disease along with the severity of the lesions. Redness, thickness, and scaliness are the main characteristics of the lesions and assure a means on evaluating the degree of psoriasis. PASI score is the gold standard for estimation of large psoriasis [182]. It measure the damage of redness, induration, and desquamation of the lesions (each parameter have a scale from 0–4), evaluated by the affected area. Even if PASI score is a very useful measure, it has the disadvantage to show less accuracy for small affected areas. For localized psoriasis plaques, target lesion evaluations are generally performed that also measure redness, thickness, and desquamation of the target plaques. Another measure used in psoriasis clinical trials is the physician global assensment (PGA). General evaluation can be used for large psoriazis as well as for localized plaques. There are two main forms of evaluation: a static one, that measures the medical impression of the psoriasis at a single point, and a dynamic one, in which the doctor appreciates the global progress from the initial value. In clinical trials for the treatment for psoriasis, to assess the yield of the drug is necessary a predetermined primary endpoint, which must prove that more patients accomplish clinically meaningful success in using the drug treatment than the placebo [183]. Another important psoriasis measurement instruments are being developed. The physician assess the redness, induration and scaliness of the psoriasis lesion, using a scale from none to mild, moderate or severe. The percentage of affected area is also evaluated in categories of 0% affected area, <10%, 10 – 29%, 30 – 49%, 50 – 69%, 70 – 89%, 90 – 100%. By combining the percentage of affected areas with the character of the plaques, this affection can be classified into one of eight categories on a scale from clear to very severe. This method indicates a good correlation with the global assessment of the physician and PASI score and provides a better reliability than PASI [184]. Another tool is the National Psoriasis Foundation - Psoriasis Score (NPFS) that have many subdomains: induration and current and baseline body surface area, physician global evaluation, patient global evaluation, and patient evaluation of itch [185, 186]. To help improve
  36. 36 the reliability of the induration score, the tool utilises a standard reference card with levels that increase at intervals of 0.25 mm. Biopsies and photographs are two other quantitative ways to evaluate psoriasis. A major component of the evaluation of psoriasis is the examination of the quality of life that doesn`t measure in a directly manner the impact of a drug on disease, but it measure the impact of the psoriasis and the capacity of treatment to ameliorate patients lives [187, 188]. Quality of life assesments are very important because the main goal of the therapy is to increase the quality of patients lives. For the same purpouse are used nonspecific assesments as the Medical Outcome Survey Short Form 36, also, the Euro QoL, and utility measures estimate in general patients’ quality of life [189, 190]. Another specific tools, the Dermatology Life Quality Index (DLQI), also the Skindex, are methods that focus on the aspects of quality of life on psoriatic patients [191, 192]. To compare psoriasis to other medical diseases or to show the impact of it, the SF – 36 is a great or the greatest measure [193]. In psoriasis investigations to evaluate the quality of life of patients related to the skin affection the most used evaluation index is DLQI that is a questionnaire consisting of 10 questions that cover many domains gouped as: symptoms and feelings, close relationships, daily activities, work or school, leisure and trouble with psoriasis treatment. The answers are evaluated from 0 which means that quality of life is not affected, to 3, which means very much affected. DLQI index gives a range between 0 – 30 and is interpreted as the lower scores the better quality of life of patient. I.7. Pharmaceutical forms used in the treatment of psoriasis For the treatment of psoriasis there are several treatments that can be used topically. Most of them are approved or have been clinically used to treat psoriasis. The interest for the future investigations for psoriasis treatment has grown due to the valuable results obtained in the preliminary clinical evaluations. Recently, was developed a combination of drugs and photo therapies, which include UVB and UVA, also a combination of two drugs used in psoriasis treatment showed higher efficience. Most of the drugs used in psoriasis are developed as ointments, creams, lotions or hydrogels using conventional vehicles, but some novel carriers as liposomes, microemulsions are being invetigated to improve efficiency of topical therapies. Due to the epidermal hyperproliferation the penetration of skin may be difficult and many factors may improve skin penetration as drug-loaded nanometer-sized vehicles that are small particles which can result in a stronger occlusive effect due to membrane formation. An important mechanism is the interaction of lipids and surfactants in nanometer-sized vesicles
  37. 37 with skin lipids. Also, to encapsulate antipsoriatic drugs for topical treatment, solid lipid nanoparticles, micelles and nanostructured lipid carriers can be used to improve drug delivery into this skin affection. New physical methods are investigated as iontophoresis, lasers and electroporation to obtain an effective and safe therapy for psoriatic patients. Phototherapy, topical, oral or injectable drugs are the therapies used for psoriasis treatment. Topical drugs used for psoriasis comprise corticosteroids, topical retinoids, Anthralin, Calcineurin inhibitors etc. Topical corticosteroids are the first-line therapy, but chronic use or overuse of strong corticosteroids may have side effects and it can thin the skin and eventually stop working over time [194]. Different natural therapies were developed and investigated to improve the quality life of psoriatic patients. Natural plants or flowers with medicinal properties as Aloe barbadensis Mill., Azadiracta indica, Nigella sativa Linn., Psoralia corylifolia Linn., Silybum marianum and others, were incorporated as extracts in different pharmaceutical forms and were used as an auxiliary treatment in psoriasis. Natural plants and flowers are a rich source of bioactive compounds that confers great antioxidant, antiinflamatory, antiseptic, antitumor, immunomodulatory activity. A study with ethanolic extract of Nigella sativa L. seeds was reported in the literature which revealed a substantial differentiation of the epidermis in its degree of orthokeratosis compared to placebo group and indicated an effect comparable to the positive control which was tazarotene gel. The extract showed adequate anti-proliferative properties, so the study supported the use of the extract as a traditional therapy for psoriatic patients with a reduction in thickness compared to the control group [195]. Due to their medicinal benefits, Psoralea corylifolia contains babchi oil, that was analyzed by researchers in a microemulsion gel-based system for psoriasis treatment and showed a better penetration of oil in the skin and also had a great in-vivo antiinflammatory activity [196].
  38. 38 I.8. Partial conclusions Polyphenols play an important role in improving the quality of life of people by prophylaxis of the onset of diseases or preventing complications of various chronic diseases such as diabetes, skin diseases, cardiovascular diseases, neoplasms, etc. A variety of plants with therapeutic effect were studied, highlighting their bio-active compounds. The most important bioactive compounds are: phenolic acids, flavonoids, anthocyanins, lignans, tannins, with a predominant antioxidant, antimicrobial, immunostimulatory and anti- inflammatory action. In most studies, the Folin-Ciocâlteu test, respectively the colorimetric method using AlCl3, are used as methods to determine the TPC and TFC and, for the evaluation of antioxidant activity, the most used methods are DPPH, FRAP, CUPRAC, ABTS, HAPX, ORAC, β – carotene/linoleic acid assay and ferrous ion chelating activity. Pharmaceutical preparations with extracts from plants or flowers could improve psoriasis episodes by reducing dryness, itching, scaling and inflammation of the skin, compared to conventional products, which with long-term administration can produce various side reactions or even reduce the therapeutic effect.
  39. 39 SECOND PART - EXPERIMENTAL STUDY II. Phytochemical screening of ethanolic extracts of Rosa species II.1. Introduction and objectives of the chapter Phenolic compounds, including phenolic acids, flavonoids, anthocyanins and carotenoids, are natural antioxidants that are present in all parts of a plant (bark, stem, leaf, fruit, root, flower and seed), which help reduce the risk of various diseases by delaying or inhibiting oxidation. Among plant tissues, flower petals have a high content of flavonoids and are known as a potential source of natural antioxidants. Medicinal plants are used as alternative products, not only in traditional medicine, but also in a number of food and pharmaceutical products due to their nutritional value and bioactivity. Various species of the Rosaceae family have a great therapeutic importance due to their use in different food preparations and in various pharmaceutical preparations. Taxonomically, roses belong to the family Rosaceae and the genus Rosa, which comprises almost 200 species distributed worldwide, in North America, Europe, Asia, and the Middle East. Rosa x damascena Mill. is an ornamental plant, a perennial shrub that can reach a height of up to 2 meters, with large, colorful flowers and pinnate leaves, composed of 5 – 7 leaflets. It originates in the Middle East, it is part of the genus Rosa, family Rosaceae, a family with over 2500 species, cultivated for its proven pharmacological properties, as ornamental plants or for its well-known perfume effect. This plant is cultivated in Iran and Greece and around the world for its essential oil and rose water that have therapeutic properties [197]. Rosa x canina L. is well known for its high phenolic content. These compounds are known to have antioxidant, antimutagenic and anticarcinogenic effects. Polyphenolic compounds are potential antioxidant substances and protective agents against the development of human diseases. That's why rose flowers, leaves, roots, branches and fruits have been studied and used for thousands of years for their medicinal benefits. Rosehip teas have mild laxative and diuretic tendencies and help regulate the menstrual cycle, while leaf and petal teas are soothing to the skin and can help heal rashes and abrasions. Hydroalcoholic extracts represent the best way to obtain preparations enriched with phenolic compounds, while infusions are the most commonly used for regular consumption [198]. Rosa x centifolia L. is a widespread shrubby rose that grows up to 1.5 – 2 meters in height and it’s cultivated as an ornamental plant throughout India, but it is especially cultivated in Grasse for its fragrance. Leaves are imperipinnate, having 5-7 leaflets grayish green in
  40. 40 colour, with 5 – 7 ovate leaflets and green colour. Flowers may varying in colour, but it is usually pink, with many petals. It has medicinal properties and it is used in asthma, hypertension and bronchitis. Data from scientific literature show their chemical analysis for their bio-active principles [199]. The species Rosa x hybrida L. is an artificial category that includes modern roses. Among modern roses, the hybrids represent the largest class and that grows up to 1 – 2 m height with single, and well-shaped flowers that have high spiralling centres at the end of the strong and long stems; petals are shiny and sturdy, buds are pointed; leaves are large and glossy [200]. A very large number of hybrid tea varieties have been introduced by breeders over the years. This category also includes the analyzed roses purchased from rose growers as Rosa x cairo L., Rosa x ambassador L., Rosa x monica L., Rosa x Edward leone L., Rosa x eroica L., Rosa x black magic L., Rosa x mr. lincoln L., Rosa x emerad’or L. which has a high concentration of polyphenols and good antioxidant activity. There are no data in scientific literature regarding this species. These roses were created by crossing two types of roses. Many scientific studies involved different uses of seeds, petals, flowers and fruits of the genus Rosa at different stages of maturity, and there were also comparative studies between biochemical compounds and their antioxidant properties. In the research of Rosa medicinal plants, there are various reports in the literature regarding the chemical composition and few descriptions regarding their bioactivity or the mechanism of action to be explored. Currently, there is still much work that can be done in terms of developing new products with Rosa species. The objectives of this chapter are to present the chemical composition, the total content of polyphenols, flavonoids, the presentation of the antioxidant capacity and the evaluation of the results in order to choose the species with the best phytochemical profile and the highest antioxidant activity for extensive analysis in order to develop new medicinal products.
  41. 41 II.2. Materials and methods II.2.1. Reagents and plant material All chemicals and reagents used in this study have a high degree of purity. Sodium carbonate and gallic acid were provided by Fluka, Switzerland; all the other reagents used are from Sigma Aldrich, Germany. Twice-distilled water was obtained using a Milli-Q system (Millipore, Bedford, MA, USA). Rosa x damascena Mill. was purchased from S.C. Green-E Concept S.R.L., Sanicolau Roman 477, Bihor, Romania in 2019 and 2020 and the other species were purchased from rose growers from Oradea, Bihor County and identification and authentication of the specimens was done by Prof. Dr. Pallag Annamaria, Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea. II.2.2. Preparation of the extracts The petals were dried at 40° C, for 120 minutes using an UTD – 1295 Laboratory oven 50 L. The preparation method used to obtain the alcoholic extract solution was maceration, method of extraction with alcohol at a temperature of 20° C. Over 10 g petals of Rosa sp. 100 mL of 70% ethanol were added and left at 20° C, for 7 days. All subsequent determinations were performed in triplicate. A – fresh petals B – dried petals C – preparing ethanolic extract Figure 5. Fresh and dried petals of Rosa x damascena Mill. in laboratory oven
  42. 42 II.2.3. Total polyphenols content (TPC) TPC was determined using Folin-Ciocâlteu method, a widely used colorimetric method, and the total polyphenols content was calculated as gallic acid equivalents/100 g dry vegetable product (mg GAE/100 DW). Over 0.1 mL of alcoholic extract solution they were added 0.2 mL of dilute Folin-Ciocâlteu reagent (1:10), 1 mL of 20% Na2CO3; the resulted mixture was incubated for 1.5 hours, at room temperature, in the dark, then the absorbance was read on a spectrophotometer UV-VIS (Shimadzu UV-VIS 1700 PharmaSpec, Shimadzu Corp., Kyoto, Japan), at 765 nm. The determination of the total polyphenols content was done using a calibration curve [201]. II.2.4. Total flavonoid content (TFC) TFC was performed by the colorimetric method, using AlCl3, which forms a complex with the carbonyl groups of flavonoids. The absorbances of the samples were read with the UV-VIS spectrophotometer at a wavelength of 415 nm, using a blank solution as a reference. Results were expressed as mg quercetin equivalent (QE)/100 g DW, using a calibration curve. Over 1 mL of alcoholic extract, 0.3 mL of 5% NaNO2 was added, stirred and allowed to stand for 5 minutes; then, 0.3 mL of 10% AlCl3 was added, stirred and allowed to stand for 6 minutes, and 2 mL NaOH were added, stirring vigorously [202]. II.2.5. Analysis of phenolic compounds by HPLC A new LC – MS method described in literature [203] was used to identify polyphenols in extracts of Rosa sp. The chromatographic separation was performed using an analytical column (Zorbax SB-C18, 100 mm x 3.0 mm i.d., 3.5 µm) with a mixture of methanol: 0.1% acetic acid (v/v) as mobile phase and a binary gradient (start 3% methanol, at 3 min 8% methanol, at 8.5 min 20% methanol, keep 20% methanol until 10 min then rebalance column with 3% methanol). The flow rate was 1 mL/min and the injection volume was 5 μL. The qualitative detection of the compounds was performed on MS mode (SIM-MS). The MS system operated using an electrospray ion source in negative mode (capillary +3000 V, nebulizer 60 psi (nitrogen), dry gas nitrogen at 12 L/min, dry gas temperature 360ºC). The MS signal was used only for qualitative analysis based on specific mass spectra of each polyphenol. The MS spectra obtained from a standard solution of polyphenols were integrated in a mass spectra library. Later, the MS traces/spectra of the analyzed samples were compared to spectra from library, which allows positive identification of compounds, based on spectral match. The UV trace was used for quantification of identified compounds from MS detection. The quantification of a compound previously detected in MS mode was made in UV at 330 nm for
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