SCHNITZLER'S SYNDROME, AN UNDERDIAGNOSED AUTOINFLAMMATORY DISEASE: CURRENT AND FUTURE PERSPECTIVE



Cite item

Full Text

Abstract

Abstract

Schnitzler's syndrome is a rare but usually underdiagnosed autoinflammatory disease, characterized by monoclonal IgM gammopathy, persistent urticaria, intermittent fever, bone pain, and arthralgia or arthritis. Although first reported by Dr. Liliane Schnitzler in 1972, the syndrome continues to pose challenges in diagnosis, and it usually takes more than five years before it is properly identified. Disorders show up in a form of urticaria, arthritis, organomegaly, fever, lymphadenopathy, high ESR, leukocytosis, and bone pain. Central to its pathogenesis are immunologic perturbations and activation of the inflammasome. It is typically diagnosed through clinical exam with history and important feature identification such as monoclonal gammopathy and acute or relapsing urticarial rash. Therapeutically synthetic agents include anakinra, canakinumab, rilonacept, and anti-IL-6 have been used with variable success. Recent research also demonstrated how natural treatments such as Terminalia chebula, Emblica offcinalis, Schinus terebinthifolia, tulsi, asafoetida, and Wedelia plants have the potential for controlling the symptoms and changing inflammatory paths. Promising medicinal possibilities for these plants, according to in-silico investigations, point to further research into their clinical uses. With new therapy paths that promise better patient outcomes, Schnitzler's illness is overall a therapeutic challenge.

About the authors

Nidhi Rani

Baddi University of Emerging Sciences & Technology, Baddi, India

Email: nidhiprajapati8@gmail.com

Academic Degree: M. Pharm, PhD;

Academic Title: Associate Professor;

Tenure and Address: 13.5 Years, Chitkara College of Pharmacy, Chitkara University, Punjab, India;

India

Manju Jakhar

University, Punjab, India

Email: manju.jakhar@baddiuniv.ac.in

Academic Degree: M. Pharm, PhD (Pursuing);

Academic Title: Assistant Professor;

Tenure and Address: 2Years, School of Pharmacy and Emerging Sciences, Baddi University of Emerging Sciences & Technology, Baddi, Distt. Solan, Himachal Pradesh 173205, India

India

Randhir Singh

Central University of Punjab, Bathinda, Punjab, India

Email: randhir.singh@cup.edu.in

Academic Degree: M. Pharm, PhD;

Academic Title: Associate Professor and HOD;

Tenure and Address: 18 Years, Central University of Punjab, Bathinda, Punjab, India;

India

Thakur Gurjeet Singh

University, Punjab, India

Author for correspondence.
Email: nidhi.prajapatik8@gmail.com

Academic Degree: M. Pharm, PhD;

Academic Title: Professor and Dean;

Tenure and Address: 17, Chitkara College of Pharmacy, Chitkara University, Punjab, India;

India

References

  1. de Koning HD, Bodar EJ, van der Meer JW, Simon A, Schnitzler Syndrome Study Group. Schnitzler syndrome: beyond the case reports: review and follow-up of 94 patients with an emphasis on prognosis and treatment. Seminars in Arthritis and Rheumatism. 2007 Dec;37(3):137-148. doi: 10.1016/j.semarthrit.2007.04.001.
  2. Lipsker D, Veran Y, Grunenberger F, Cribier B, Heid E, Grosshans E. The Schnitzler syndrome. Four new cases and review of the literature. Medicine (Baltimore). 2001 Jan;80(1):37-44. doi: 10.1097/00005792-200101000-00004.
  3. Sun, X Q and Z. Zhang. “AB1857 A First Case Report Of Schnitzler Syndrome Presenting With Acropachy And Literature Review.” Annals of the Rheumatic Diseases (2023): 2156.2-2157, 10.1136/annrheumdis-2023-eular.4231
  4. Rigante D. The Broad-Ranging Panorama of Systemic Autoinflammatory Disorders with Specific Focus on Acute Painful Symptoms and Hematologic Manifestations in Children. Mediterranean Journal of Hematology and Infectious Diseases. 2018 ;10(1):e2018067.. doi: 10.4084/mjhid.2018.067
  5. Lim W, Shumak KH, Reis M, Perez-Ordonez B, Sauder D, Fam A, Imrie KR. Malignant evolution of Schnitzler's syndrome--chronic urticaria and IgM monoclonal gammopathy: report of a new case and review of the literature. Leuk Lymphoma. 2002 Jan;43(1):181-6. doi: 10.1080/10428190210181.
  6. Asero, Riccardo & Tedeschi, Alberto & Cugno, Massimo. (2014). Treatment of Chronic Urticaria. Immunology and allergy clinics of North America. 34. 105-116. doi: 10.1016/j.iac.2013.09.013
  7. Ghosh S, Kundu S. Step By Step: Urticaria & Angioedema Management. JP Medical Ltd; 2016 May 28. Step by Step: Urticaria & Angioedema Management - Sanjay Ghosh, Saurav Kundu - Google Books
  8. Palladini G, Merlini G. The elusive pathogenesis of Schnitzler syndrome. Blood. 2018 Mar 1;131(9):944-946. doi: 10.1182/blood-2018-01-824862.
  9. Kacar M, Pathak S, Savic S. Hereditary systemic autoinflammatory diseases and Schnitzler's syndrome. Rheumatology (Oxford). 2019 Nov 1;58(Suppl 6):vi31-vi43. doi: 10.1093/rheumatology/kez448
  10. Braud A, Lipsker D. Schnitzler Syndrome: Insights into Its Pathogenesis, Clinical Manifestations, and Current Management. Biomolecules. 2024 May 31;14(6):646. doi: 10.3390/biom14060646.
  11. Nicole Fagan, Niall Conlon, Katie Ridge, DP23 Paraprotein negative Schnitzler syndrome: a new clinical entity?, British Journal of Dermatology, Volume 188, Issue Supplement_4, June 2023, ljad113.236. https://doi.org/10.1093/bjd/ljad113.236
  12. Sun, X Q and Z. Zhang. “AB1857 A First Case Report Of Schnitzler Syndrome Presenting With Acropachy And Literature Review.” Annals of the Rheumatic Diseases. 2023. 2156.2-2157 doi: 10.1136/annrheumdis-2023-eular.4231
  13. Wesselmann AS, Künstner A, Fähnrich A, Rose C, Lamprecht P, Busch H, Ludwig RJ, Recke A. Case report: Schnitzler-like syndrome without monoclonal gammopathy. Front Immunol. 2023 Mar 30;14:1166620. doi: 10.3389/fimmu.2023.1166620.
  14. Srivatsav, Varun & Milne, Ardyth & Hofeld, Karen & Abbas, Mariam. Case Report on the Rare Diagnosis of Schnitzler’s Syndrome. Canadian Journal of General Internal Medicine. (2022): 1-5, 17(4) doi: 10.22374/cjgim.v17i4.620
  15. de Koning HD. Schnitzler's syndrome: lessons from 281 cases. Clin Transl Allergy. 2014 Dec 5;4:41. doi: 10.1186/2045-7022-4-41.
  16. Martinez-Taboada VM, Fontalba A, Blanco R, Fernández-Luna JL. Successful treatment of refractory Schnitzler syndrome with anakinra: comment on the article by Hawkins et al. Arthritis Rheum. 2005 Jul;52(7):2226-7. doi: 10.1002/art.21101.
  17. Lipsker D. The Schnitzler syndrome. Orphanet J Rare Dis. 2010 Dec 8;5:38. doi: 10.1186/1750-1172-5-38.
  18. Krause K, Feist E, Fiene M, Kallinich T, Maurer M. Complete remission in 3 of 3 anti-IL-6-treated patients with Schnitzler syndrome. J Allergy Clin Immunol. 2012 Mar;129(3):848-50. doi: 10.1016/j.jaci.2011.10.031.
  19. Sokumbi O, Drage LA, Peters MS. Clinical and histopathologic review of Schnitzler syndrome: the Mayo Clinic experience (1972-2011). J Am Acad Dermatol. 2012 Dec;67(6):1289-95. doi: 10.1016/j.jaad.2012.04.027.
  20. Néel A, Henry B, Barbarot S, Masseau A, Perrin F, Bernier C, Kyndt X, Puechal X, Weiller PJ, Decaux O, Ninet J, Hot A, Aouba A, Astudillo L, Berthelot JM, Bonnet F, Brisseau JM, Cador B, Closs-Prophette F, Dejoie T, de Korwin JD, Dhote R, Fior R, Grosbois B, Hachulla E, Hatron PY, Jardel H, Launay D, Lorleac'h A, Pottier P, Moulis G, Serratrice J, Smail A, Hamidou M. Long-term effectiveness and safety of interleukin-1 receptor antagonist (anakinra) in Schnitzler's syndrome: a French multicenter study. Autoimmun Rev. 2014 Oct;13(10):1035-41. doi: 10.1016/j.autrev.2014.08.031.
  21. Rowczenio, D. M., Pathak, S., Arostegui, J. I., Mensa-Vilaro, A., Omoyinmi, E., Brogan, P., … Lachmann, H. J. (2017). Molecular genetic investigation, clinical features, and response to treatment in 21 patients with Schnitzler syndrome. Blood, 131(9), 974–981. doi: 10.1182/blood-2017-10-810366
  22. de Koning HD, Schalkwijk J, van der Ven-Jongekrijg J, Stoffels M, van der Meer JW, Simon A. Sustained efficacy of the monoclonal anti-interleukin-1 beta antibody canakinumab in a 9-month trial in Schnitzler's syndrome. Ann Rheum Dis. 2013 Oct;72(10):1634-8. doi: 10.1136/annrheumdis-2012-202192.
  23. Betrains A, Staels F, Vanderschueren S. Efficacy and safety of canakinumab treatment in schnitzler syndrome: A systematic literature review. Semin Arthritis Rheum. 2020 Aug;50(4):636-642. doi: 10.1016/j.semarthrit.2020.05.002.
  24. Krause, K., Bonnekoh, H., Ellrich, A., Tsianakas, A., Wagner, N., Fischer, J., & Maurer, M. “Long-term Efficacy of Canakinumab in the Treatment of Schnitzler Syndrome.” The Journal of allergy and clinical immunology (2020): 145:1681-1686.e5. doi: 10.1016/j.jaci.2019.12.909.
  25. Krause K, Tsianakas A, Wagner N, Fischer J, Weller K, Metz M, Church MK, Maurer M. Efficacy and safety of canakinumab in Schnitzler syndrome: A multicenter randomized placebo-controlled study. J Allergy Clin Immunol. 2017 Apr;139(4):1311-1320. doi: 10.1016/j.jaci.2016.07.041.
  26. Economides AN, Carpenter LR, Rudge JS, Wong V, Koehler-Stec EM, Hartnett C, Pyles EA, Xu X, Daly TJ, Young MR, Fandl JP, Lee F, Carver S, McNay J, Bailey K, Ramakanth S, Hutabarat R, Huang TT, Radziejewski C, Yancopoulos GD, Stahl N. Cytokine traps: multi-component, high-affinity blockers of cytokine action. Nat Med. 2003 Jan;9(1):47-52. doi: 10.1038/nm811.
  27. Krause K, Weller K, Stefaniak R, Wittkowski H, Altrichter S, Siebenhaar F, Zuberbier T, Maurer M. Efficacy and safety of the interleukin-1 antagonist rilonacept in Schnitzler syndrome: an open-label study. Allergy. 2012 Jul;67(7):943-50. doi: 10.1111/j.1398-9995.2012.02843.
  28. Hoffman HM, Wolfe F, Belomestnov P, Mellis SJ. Cryopyrin-associated periodic syndromes: development of a patient-reported outcomes instrument to assess the pattern and severity of clinical disease activity. Current Medical Research and Opinion. 2008 Sep;24(9):2531-2543 doi: 10.1185/03007990802297495.
  29. Lipsker D, Veran Y, Grunenberger F, Cribier B, Heid E, Grosshans E. The Schnitzler syndrome. Four new cases and review of the literature. Medicine (Baltimore). 2001 Jan;80(1):37-44. doi: 10.1097/00005792-200101000-00004.
  30. Néel A, Henry B, Barbarot S, Masseau A, Perrin F, Bernier C, Kyndt X, Puechal X, Weiller PJ, Decaux O, Ninet J, Hot A, Aouba A, Astudillo L, Berthelot JM, Bonnet F, Brisseau JM, Cador B, Closs-Prophette F, Dejoie T, de Korwin JD, Dhote R, Fior R, Grosbois B, Hachulla E, Hatron PY, Jardel H, Launay D, Lorleac'h A, Pottier P, Moulis G, Serratrice J, Smail A, Hamidou M. Long-term effectiveness and safety of interleukin-1 receptor antagonist (anakinra) in Schnitzler's syndrome: a French multicenter study. Autoimmun Rev. 2014 Oct;13(10):1035-41. doi: 10.1016/j.autrev.2014.08.031.
  31. Krause K, Feist E, Fiene M, Kallinich T, Maurer M. Complete remission in 3 of 3 anti-IL-6-treated patients with Schnitzler syndrome. J Allergy Clin Immunol. 2012 Mar;129(3):848-50. doi: 10.1016/j.jaci.2011.10.031.
  32. Yan, R., Cao, W., Liu, X., Li, F., & Shen, M. (2020). A Chinese case series of Schnitzler syndrome and complete remission in one tocilizumab-treated patient. Clinical Rheumatology. 2020;39:3847–3852. doi: 10.1007/s10067-020-05204-2
  33. Claus J, Vanderschueren S. Variable Responses to Tocilizumab in Four Patients with Schnitzler Syndrome. J Clin Immunol. 2019 May;39(4):370-372. doi: 10.1007/s10875-019-00644-1.
  34. Bonnekoh, Hanna & Frischbutter, Stefan & Roll, Stephanie & Maurer, Marcus & Krause, Karoline. Tocilizumab treatment in patients with Schnitzler syndrome: An open-label study. The Journal of Allergy and Clinical Immunology: In Practice. (2021):9:2486–2489. e4. doi: 10.1016/j.jaip.2021.01.024.
  35. Takimoto-Ito R, Kambe N, Kogame T, Otsuka A, Nomura T, Izawa K, et al. Refractory serum immunoglobulin M elevation during anti-interleukin (IL)-1- or IL-6-targeted treatment in four patients with Schnitzler syndrome. J Dermatol 2021;48:1789 1792. doi: 10.1111/1346-8138.16124.
  36. Bhattacharyya J, Mihara K, Morimoto K, Takihara Y, Hide M. Elevated interleukin-18 secretion from monoclonal IgM+ B cells in a patient with Schnitzler syndrome. J Am Acad Dermatol. 2012 Sep;67(3):e118-20. doi: 10.1016/j.jaad.2011.10.002.
  37. Ramadan, Khoudair M. et al. “Schnitzler syndrome: a case report of successful treatment using the anti‐CD20 monoclonal antibody rituximab.” Br J Dermatol 2007;156:1072–1074. doi: 10.1111/j.1365-2133.2007.07799.x.
  38. Westhoff TH, Zidek W, Uharek L, Steinhoff-Georgieva J, van der Giet M. Impairment of renal function in Schnitzler's syndrome. J Nephrol. 2006 Sep-Oct;19(5):660-3. PMID: 17136697.
  39. Murota H, Shoda Y, Ishibashi T, Sugahara H, Matsumura I, Katayama I. Improvement of recurrent urticaria in a patient with Schnitzler syndrome associated with B-cell lymphoma with combination rituximab and radiotherapy. J Am Acad Dermatol. 2009 Dec;61(6):1070-5. doi: 10.1016/j.jaad.2008.12.040.
  40. Cascavilla N, Bisceglia M, D'Arena G. Successful treatment of Schnitzler's syndrome with anakinra after failure of rituximab trial. Int J Immunopathol Pharmacol. 2010 Apr-Jun;23(2):633-6. doi: 10.1177/039463201002300226.
  41. Eiling E, Möller M, Kreiselmaier I, Brasch J, Schwarz T. Schnitzler syndrome: treatment failure to rituximab but response to anakinra. J Am Acad Dermatol. 2007 Aug;57(2):361-4. doi: 10.1016/j.jaad.2007.03.036.
  42. Tinazzi E, Puccetti A, Patuzzo G, Sorleto M, Barbieri A, Lunardi C. Schnitzler syndrome, an autoimmune-autoinflammatory syndrome: report of two new cases and review of the literature. Autoimmun Rev. 2011 May;10(7):404-9. doi: 10.1016/j.autrev.2011.01.003.
  43. Aouba, Achille et al. “Complete Remission of Schnitzler Syndrome and Waldenström Macroglobulinemia under Rituximab-Cyclophosphamide-Dexamethasone.” Dermatology 230 (2014): 18 - 22. doi: 10.1159/000368349
  44. Aikawa NE, Silva CA, Bonfá E, Carvalho JF. Schnitzler's syndrome improvement after anti-TNF-alpha therapy. Joint Bone Spine. 2010 Oct;77(5):491. doi: 10.1016/j.jbspin.2010.02.016.
  45. R. Thonhofer, E. Uitz, W. Graninger, Schnitzler's syndrome—exacerbation after anti-TNF treatment, Rheumatology, Volume 46, Issue 6, June 2007, Pages 1041–1042, https://doi.org/10.1093/rheumatology/kem048
  46. de Koning HD, van Vlijmen-Willems IM, Rodijk-Olthuis D, van der Meer JW, Zeeuwen PL, Simon A, Schalkwijk J. Mast-cell interleukin-1β, neutrophil interleukin-17 and epidermal antimicrobial proteins in the neutrophilic urticarial dermatosis in Schnitzler's syndrome. Br J Dermatol. 2015 Aug;173(2):448-56. doi: 10.1111/bjd.13857.
  47. Villarreal RS, VandenBoom T, Gonzalez-Gonzalez FJ, et al. Schnitzler syndrome with IgG gammopathy and elevated IL-1β and IL-17 in skin biopsy. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2018 Jan;120(1):99-101. doi: 10.1016/j.anai.2017.10.006.
  48. Rowczenio DM, Pathak S, Arostegui JI, et al. Molecular genetic investigation, clinical features, and response to treatment in 21 patients with Schnitzler syndrome. Blood. 2018 Mar;131(9):974-981. doi: 10.1182/blood-2017-10-810366.
  49. Néel A, Henry B, Barbarot S, et al. Long-term effectiveness and safety of interleukin-1 receptor antagonist (anakinra) in Schnitzler's syndrome: a French multicenter study. Autoimmunity Reviews. 2014 Oct;13(10):1035-1041. doi: 10.1016/j.autrev.2014.08.031.
  50. Takimoto-Ito R, Kambe N, Kogame T, Otsuka A, Nomura T, Izawa K, et al. Refractory serum immunoglobulin M elevation during anti-interleukin (IL)-1- or IL-6-targeted treatment in four patients with Schnitzler syndrome. J Dermatol 2021;48:1789 1792. doi: 10.1111/1346-8138.16124.
  51. Bag, A., Bhattacharyya, S. K., & Chattopadhyay, R. R. (2013). The development of Terminalia chebula Retz. (Combretaceae) in clinical research. Asian Pacific Journal of Tropical Biomedicine, 3(3), 244–252. doi: 10.1016/s2221-1691(13)60059-3
  52. Aamina M, Alhowail A, Aldubayan M, Rabbani SI. Ameliorative Effect of Terminalia chebula on Hematological Complications Induced by Doxorubicin. Biomedical and Pharmacology Journal. 2020 Sep 25;13(3):1245-9. https://dx.doi.org/10.13005/bpj/1993
  53. Garg, V., Kaur, B., Singh, S. K., & Kumar, B. (2016). Terminalia Chebula: Success From Botany To Allopathic And Ayurvedic Pharmacy. Asian Journal of Pharmaceutical and Clinical Research, 9(5), 21. doi: 10.22159/ajpcr.2016.v9vi5
  54. Henry, Deena Priscilla et al. “Exploration of anti-breast cancer effects of Terminalia chebula extract on DMBA-induced mammary carcinoma in Sprague Dawley rats.” Future Journal of Pharmaceutical Sciences. 2020 Dec;6:1-3. doi: 10.1186/s43094-020-00124-z
  55. Liu Y, Bao L, Xuan L, Song B, Lin L, Han H. Chebulagic acid inhibits the LPS-induced expression of TNF-α and IL-1β in endothelial cells by suppressing MAPK activation. Exp Ther Med. 2015 Jul;10(1):263-268. doi: 10.3892/etm.2015.2447.
  56. Sharma K, Kumar S, Prakash R, et al. Chebulinic acid alleviates LPS-induced inflammatory bone loss by targeting the crosstalk between reactive oxygen species/NFκB signaling in osteoblast cells. Free Radical Biology & Medicine. 2023 Jan;194:99-113. doi: 10.1016/j.freeradbiomed.2022.11.026.
  57. Zhang, Chenye. “Therapeutic mechanisms of ellagic acid for inflammation and related conditions.” International Conference on Modern Medicine and Global Health (2023). Sep 7 Vol. 12789, pp. 703-708. doi: 10.1117/12.2692865
  58. Hoang SH, Dao H, Lam EM. A network pharmacology approach to elucidate the anti-inflammatory effects of ellagic acid. J Biomol Struct Dyn. 2024 Sep;42(14):7409-7420. doi: 10.1080/07391102.2023.2240417.
  59. Naraki K, Rameshrad M, Hosseinzadeh H. Protective effects and therapeutic applications of ellagic acid against natural and synthetic toxicants: A review article. Iran J Basic Med Sci. 2022 Dec;25(12):1402-1415. doi: 10.22038/IJBMS.2022.64790.14267.
  60. Allam G, Mahdi EA, Alzahrani AM, Abuelsaad AS. Ellagic acid alleviates adjuvant induced arthritis by modulation of pro- and anti-inflammatory cytokines. Central-european Journal of Immunology. 2016 ;41(4):339-349. doi: 10.5114/ceji.2016.65132.
  61. Bezerra, J. J. L. (2022). Usos Medicinais De Schinus Terebinthifolia Raddi (Anacardiaceae) Em Diferentes Regiões Do Brasil: Uma Revisão. Ethnoscientia - Brazilian Journal of Ethnobiology and Ethnoecology, 7(1), 88. https://doi.org/10.18542/ethnoscientia.v7i1.10963
  62. Elaine Cruz Rosas, Luana Barbosa Correa, Maria das Graças Henriques, Chapter 28 - Antiinflammatory Properties of Schinus terebinthifolius and Its Use in Arthritic Conditions,
  63. Editor(s): Ronald Ross Watson, Victor R. Preedy,
  64. Bioactive Food as Dietary Interventions for Arthritis and Related Inflammatory Diseases (Second Edition), Academic Press, 2019,Pages 489-505 https://doi.org/10.1016/B978-0-12-813820-5.00028-3.
  65. Vasconcelos PG, Alves ÉP, Maia CM, Brito AC, Silva DR, Freires IA, Cavalcanti YW, Rehder VL, Ruiz AL, Duarte MC, Rosalen PL. Biological properties of Schinus terebinthifolia Raddi essential oil. Brazilian Journal of Pharmaceutical Sciences. 2022 Dec 2;58:e20417. https://doi.org/10.1590/s2175-97902021000X2e20417.
  66. Bui, Van-Hoai, Hong-Tham N Vo, Thanh-Tuan Duong, Se-Kwon Kim and Dai-Nghiep Ngo. “Anti-inflammatory effect of gallic acid-conjugated chitooligosaccharides in lipopolysaccharide-stimulated RAW 264.7 macrophages.” Ministry of Science and Technology, Vietnam. 2024 Mar 15;66(1):96-103. doi: 10.31276/vjste.
  67. Tsiogkas SG, Apostolopoulou K, Mavropoulos A, et al. Gallic acid diminishes pro-inflammatory interferon-γ- and interleukin-17-producing sub-populations in vitro in patients with psoriasis. Immunologic Research. 2023 Jun;71(3):475-487. doi: 10.1007/s12026-023-09361-9.
  68. Zamudio-Cuevas Y, Andonegui-Elguera MA, Aparicio-Juárez A, Aguillón-Solís E, Martínez-Flores K, Ruvalcaba-Paredes E, Velasquillo-Martínez C, Ibarra C, Martínez-López V, Gutiérrez M, García-Arrazola R, Hernández-Valencia CG, Romero-Montero A, Hernández-Valdepeña MA, Gimeno M, Sánchez-Sánchez R. The enzymatic poly(gallic acid) reduces pro-inflammatory cytokines in vitro, a potential application in inflammatory diseases. Inflammation. 2021 Feb;44(1):174-185. doi: 10.1007/s10753-020-01319-5.
  69. Nguyen-Ngo C, Salomon C, Lai A, Willcox JC, Lappas M. Anti-inflammatory effects of gallic acid in human gestational tissues in vitro. Reproduction (Cambridge, England). 2020 Oct;160(4):561-578. doi: 10.1530/rep-20-0249.
  70. Mazloom, B.F., Edalatmanesh, M.A. & Hosseini, S.E. Gallic acid reduces inflammatory cytokines and markers of oxidative damage in a rat model of estradiol-induced polycystic ovary. Comp Clin Pathol 28, 1281–1286 (2019). https://doi.org/10.1007/s00580-019-02920-3
  71. Deepika Deepanitwa Sahoo, Yasmeen Tabassum, Deoraj Sharma. Multiple health benefits of tulsi plants. J Med Plants Stud 2022;10(5):95-102. doi: 10.22271/plants.2022.v10.i5b.1471
  72. Sahiba N, Sethiya A, Agarwal DK, Agarwal S. An Overview on Immunity Booster Foods in Coronavirus Disease (COVID-19). Comb Chem High Throughput Screen. 2023;26(7):1251-1284. doi: 10.2174/1386207325666220629161828.
  73. Rao SK, Sharma A, Jain D. A review medicinal and traditional uses on Tulsi plant (Ocimum sanctum L.). World Journal of Biology Pharmacy and Health Sciences. 2023;13(1):450-6.
  74. 30574/wjbphs.2023.13.1.0058
  75. Thakur S, Choudhary S, Walia B et.al. Tulsi - a review based upon its ayurvedic and modern therapeutic uses. International Journal of Research and Review. 2021; 8(5): 263-272. DOI: https://doi.org/10. 52403/ijrr.20210534
  76. Zhao M, Wu F, Tang Z, Yang X, Liu Y, Wang F, Chen B. Anti-inflammatory and antioxidant activity of ursolic acid: a systematic review and meta-analysis. Frontiers in Pharmacology. 2023 Sep 28;14:1256946. doi: 10.3389/fphar.2023.1256946
  77. Liu SJ, Guo BD, Gao QH, et al. Ursolic acid alleviates chronic prostatitis via regulating NLRP3 inflammasome-mediated Caspase-1/GSDMD pyroptosis pathway. Phytotherapy Research : PTR. 2024 Jan;38(1):82-97. doi: 10.1002/ptr.8034.
  78. Pitaloka DAE, Cooper AM, Artarini AA, Damayanti S, Sukandar EY. Regulation of mitogen-activated protein kinase signaling pathway and proinflammatory cytokines by ursolic acid in murine macrophages infected with Mycobacterium avium. Infectious Disease Reports. 2020 Jul;12(Suppl 1):8717.
  79. doi: 10.4081/idr.2020.8717.
  80. Han NR, Park HJ, Moon PD. Resveratrol Downregulates Granulocyte-Macrophage Colony-Stimulating Factor-Induced Oncostatin M Production through Blocking of PI3K/Akt/NF-κB Signal Cascade in Neutrophil-like Differentiated HL-60 Cells. Curr Issues Mol Biol. 2022 Jan 22;44(2):541-549. doi: 10.3390/cimb44020037.
  81. Sonia Singh, Arpit Shukla, Bhupesh C. Semwal, Phytochemical and Pharmacological Potential of Ferula asafetida “Hing”, Current Bioactive Compounds; Volume 20, Issue 3, Year 2024, e260623218247.
  82. doi: 10.2174/1573407219666230626111830
  83. Bhardwaj G, Sharma A, Gohain A, Sohal HS, Bhatia T, Mutreja V. Extraction Techniques, Production and Economic Importance of Asafoetida Oleoresin. In Handbook of Oleoresins 2022 Jun 7 (pp. 101-128). CRC Press.
  84. https://doi.org/10.1201/9781003186205
  85. Iranshahy M, Iranshahi M. Traditional uses, phytochemistry and pharmacology of asafoetida (Ferula assa-foetida oleo-gum-resin)-a review. J Ethnopharmacol. 2011 Mar 8;134(1):1-10.. B) Behl, T., Kumar, K., Brisc, C., Rus, M., Nistor-Cseppento, D.C., Bustea, C., Aron, R.A., Pantiș, C., Zengin, G., Sehgal, A., Kaur, R., Kumar, A., Arora, S., Setia, D., Chandel, D., & Bungău, S.G. (2020). Exploring the multifocal role of phytochemicals as immunomodulators. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 133, 110959 .
  86. doi: 10.1016/j.jep.2010.11.067
  87. doi: 10.1016/j.biopha.2020.110959
  88. Sood R. Asafoetida (Ferula asafoetida): A high-value crop suitable for the cold desert of Himachal Pradesh, India. Journal of Applied and Natural Science. 2020 Dec 9;12(4):607-17. B) Corb Aron RA, Abid A, Vesa CM, Nechifor AC, Behl T, Ghitea TC, Munteanu MA, Fratila O, Andronie-Cioara FL, Toma MM, Bungau S. Recognizing the Benefits of Pre-/Probiotics in Metabolic Syndrome and Type 2 Diabetes Mellitus Considering the Influence of Akkermansia muciniphila as a Key Gut Bacterium. Microorganisms. 2021 Mar 17;9(3):618. doi: 10.31018/jans.v12i4.2418
  89. doi: 10.3390/microorganisms9030618.
  90. Abbas SS, Naveed S, Qamar F, Hussain SJ, Jawed SH. Exploration & wonders of medicinal plant Asafoetida (Heeng) constituent galvanic acid as an anticancerous and antimutagenic agent. IESRJ. 2015;1:15-7. EXPLORATION & WONDERS OF MEDICINAL PLANT �ASAFOETIDA�(HEENG) CONSTITUENT GALBANIC ACID AS ANTICANCEROUS AND ANTIMUTAGENIC AGENT | International Educational Scientific Research Journal - IESRJ ( Peer-Reviewed Monthly Research Journal and International Indexed Journal )
  91. Mobasheri L, Khorashadizadeh M, Safarpour H, Mohammadi M, Anani Sarab G, Askari VR. Anti-Inflammatory Activity of Ferula assafoetida Oleo-Gum-Resin (Asafoetida) against TNF-α-Stimulated Human Umbilical Vein Endothelial Cells (HUVECs). Mediators Inflamm. 2022 Aug 31;2022:5171525 doi: 10.1155/2022/5171525.
  92. Ghasemi Z, Rezaee R, Aslani MR, Boskabady MH. Anti-inflammatory, anti-oxidant, and immunomodulatory activities of the genus Ferula and their constituents: A review. Iran J Basic Med Sci. 2021 Dec;24(12):1613-1623.
  93. doi: 10.22038/IJBMS.2021.59473.13204.
  94. Khan, Md. Abdur Rashid, Md. Aminul Islam, Kushal Biswas, Md. Yusuf Al-Amin, Md. Salim Ahammed, Md. Imran Nur Manik, KM Monirul Islam, Md. Abdul Kader, AHM Khurshid Alam, Shahed Zaman, and et al. 2023. "Compounds from the Petroleum Ether Extract of Wedelia chinensis with Cytotoxic, Anticholinesterase, Antioxidant, and Antimicrobial Activities" Molecules 28, no. 2: 793.
  95. https://doi.org/10.3390/molecules28020793
  96. Tsai, Y.-T.; To, K.-Y. Plant Regeneration from Leaf Explants of the Medicinal Herb Wedelia chinensis. Horticulturae 2021, 7, 407.
  97. https://doi.org/10.3390/ horticulturae7100407.
  98. Nidhi Rani, Randhir S. Dahiya, Praveen Kumar, In silico Studies of Plant-Derived Bioactive Compounds of Wedelia Species, Anti-Infective Agents; Volume 20, Issue 5, Year 2022, e170522204885.
  99. doi: 10.2174/2211352520666220517094604
  100. Cao J, Ni Y, Ning X, Zhang H. Wedelolactone ameliorates synovial inflammation and cardiac complications in a murine model of collagen-induced arthritis by inhibiting NF-κB/NLRP3 inflammasome activation. Folia Histochem Cytobiol. 2022;60(4):301-310. doi: 10.5603/FHC.a2022.0025.
  101. Pan H, Lin Y, Dou J, Fu Z, Yao Y, Ye S, Zhang S, Wang N, Liu A, Li X, Zhang F, Chen D. Wedelolactone facilitates Ser/Thr phosphorylation of NLRP3 dependent on PKA signalling to block inflammasome activation and pyroptosis. Cell Prolif. 2020 Sep;53(9):e12868. doi: 10.1111/cpr.12868.
  102. Cuong TT, Diem GH, Doan TT, Huy NQ, Phuong N, Hung HT. Wedelolactone from Vietnamese Eclipta prostrata (L) L. Protected Zymosan-induced shock in Mice. Iran J Pharm Res. 2018 Spring;17(2):653-660. PMID: 29881422; PMCID: PMC5985182.
  103. Wedelolactone from Vietnamese Eclipta prostrata (L) L. Protected Zymosan-induced shock in Mice - PMC (nih.gov)
  104. Zhang J, Zhang M, Huo XK, et al. Macrophage Inactivation by Small Molecule Wedelolactone via Targeting sEH for the Treatment of LPS-Induced Acute Lung Injury. ACS Central Science. 2023 Mar;9(3):440-456.
  105. doi: 10.1021/acscentsci.2c01424.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) Rani D., Jakhar M., Singh R., Singh T.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № 77 - 11525 от 04.01.2002.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies