Greater Plantain (Plantago major) and Skin irritation: evidence and sources

Context The leaves of Plantago major have been used for the treatment of wounds and inflammation in folk medicine from prehistoric times. However there is no report on the use of P. major to treat inflammation in oral epithelial cell lines. Objective The present study was undertaken to reveal possible anti-inflammatory effects of Plantago major leaf extracts on oral epithelial cells in-vitro. Materials and methods Water- and ethanol-based extracts of P. major leaves were prepared from freeze-dried plant material, and tested in-vitro using the oral epithelial cell line H400. The anti-inflammatory activity of P. major was tested against E. coli lipopolysaccharide (LPS) using the nuclear factor kappa beta (NF-kB) assay. Results Both the water- and the ethanol-based extracts, as well as a combination of the two extracts, showed anti-inflammatory activity. A concentration of 0.1 mg/mL (on dry weight basis) yielded the best results for all extracts. Discussion and conclusion The results show that synergistic effects of both polyphenols and water-soluble compounds (possibly polysaccharides) are responsible for anti-inflammatory activities of P. major .

Objective The aim of this study was to investigate anti-inflammatory and hepatoprotective activities of Plantago major L. (PM). Materials and methods Anti-inflammatory activity: Control and reference groups were administered isotonic saline solution (ISS) and indomethacin, respectively. Plantago major groups were injected PM in doses of 5 mg/kg (PM-I), 10 mg/kg (PM-II), 20 mg/kg (PM-III) and 25 mg/kg (PM-IV). Before and three hours after the injections, the volume of right hind-paw of rats was measured using a plethysmometer. HEPATOPROTECTIVE ACTIVITY: The hepatotoxicity was induced by carbon tetrachloride (CCl4) administration. Control, CCl4 and reference groups received isotonic saline solution, CCl4 and silibinin, respectively. Plantago major groups received CCl4 (0.8 ml/kg) and PM in doses of 10, 20 and 25 mg/kg, respectively for seven days. Blood samples and liver were collected on the 8th day after the animals were killed. Results Plantago major had an anti-inflammatory effect matching to that of control group at doses of 20 and 25 mg/kg. It was found that reduction in the inflammation was 90.01% with indomethacin, 3.10% with PM-I, 41.56% with PM-II, 45.87% with PM-III and 49.76% with PM-IV. Median effective dose (ED50) value of PM was found to be 7.507 mg/kg. Plantago major (25 mg/kg) significantly reduced the serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels when compared to the CCl4 group. The histopathological findings showed a significant difference between the PM (25 mg/kg) and CCl4 groups. Conclusion The results showed that PM had a considerable anti-inflammatory and hepatoprotective activities.

A hexane extract of Plantago major was investigated by bioactivity-directed fractionation, using an in vitro cyclooxygenase-2 (COX-2) catalyzed prostaglandin biosynthesis inhibition assay, and resulted in the isolation of ursolic acid (1). This triterpenoid showed a significant COX-2 inhibitory effect, directly on the enzyme activity, with an IC50 value of 130 microM and a COX-2/COX-1 selectivity ratio of 0.6. The structural isomer oleanolic acid (2) was found to be less active than 1, with an IC50 value of 295 microM, but showed a similar selectivity ratio (0.8). Furthermore, no significant inhibition on COX-2 or COX-1 was observed by the triterpenoid, 18beta-glycyrrhetinic acid (3). The direct inhibitory effect of 1 and 2 on COX-2 catalyzed prostaglandin biosynthesis increased with preincubation, indicating a time-dependent inhibition, while the effect on COX-1 was found to be independent of preincubation time.

This study aimed to validate the pharmacological effects of Plantago major L., a medicinal plant used to decrease pain and inflammation. The aqueous extract (AE) was prepared from the dried ground leaves. Pretreatment with AE (1 g/kg, p.o.) decreased writhing induced by acetic acid in mice, but it did not change the tail flick responses to heat nociceptive stimuli. In rats, AE (1 g/kg, p.o.) reduced the paw edema and pleurisy induced by carrageenin, but it did not alter the paw edema induced by dextran. The effect of AE on the carrageenin inflammatory responses was more intense than that obtained on the ear edema induced by croton oil in mice. In addition, daily treatment with AE (1 g/kg/day during 8 days, p.o.) inhibited the exudative process induced by croton oil injected into the air pouch of rats. The results indicate that the aqueous extract of Plantago major is endowed with effective antiinflammatory and analgesic activities.

The large plantain has been widely used since ancient times to treat many diseases, including constipation, cough and ulcers. The purpose of this study is to review the traditional use, botanical characteristics, pharmacological activity, phytochemical effects and toxicity of Plantago major. Some o f its traditional properties, including wound healing, antipyretic, antitussive, anti-infective, anti-hemorrhagic, anti-inflammatory, diuretic, laxative, astringent and hemostatic, have been confirmed by recent studies. Phytochemical studies have shown that Plantago major contains volatile compounds, triterpenoids, phenolic acids and flavonoids. Current pharmacological studies have proven some of the traditional uses of Plantago major. However, additional studies of this plant are needed, since it can be used for the production of various natural preparations.The healing properties of the great plantain have been recognized all over the world for hundreds of years. This plant contains a number of effective chemical components, such as flavonoids, alkaloids, terpenoids, phenolic acid derivatives, iridoid glycosides, fatty acids, polysaccharides and vitamins, which contribute to its specific therapeutic effect. Accordingly, studies have shown that the large plantain is effective as a wound healing agent, as well as as an anti-cancer, antidiabetic, antidiarrheal, anti-inflammatory, antinociceptive, antibacterial and antiviral agent. It also fights fatigue and cancer, is an antioxidant and neutralizes free radicals.

PURPOSE: To determine the in vitro effectiveness of Plantago major extract, along with two of its active components, aucubin and baicalein, on the inhibition of Candida albicans growth, biofilm formation, metabolic activity, and cell surface hydrophobicity. MATERIALS AND METHODS: Twofold dilutions of P. major, aucubin, and baicalein were used to determine the minimum inhibitory concentration (MIC), minimum fungicidal concentration (MFC), and the minimum biofilm inhibitory concentration (MBIC) of each solution. Separately, twofold dilutions of P. major, aucubin, and baicalein were used to determine the metabolic activity of established C. albicans biofilm using a 2,3-bis (2- methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-carboxanilide reduction assay. Twofold dilutions of P. major, aucubin, and baicalein were used to determine the cell surface hydrophobicity of treated C. albicans biofilm by a two-phase assay using hexadecane. The hydrophobicity percentage of the cell surface was then calculated. A mixed-model ANOVA test was used for intergroup comparisons. RESULTS: The MICs of P. major extract (diluted 1:2 to 1:8), aucubin (61 to 244 μg/ml), and baicalein (0.0063 to 100 μg/ml) on the total growth of C. albicans were noticeable at their highest concentrations, and the inhibition was dose dependent. The MFC was evaluated after 48 hours of incubation, and aucubin (244 μg/ml) exhibited a strong fungicidal activity at its highest concentration against C. albicans growth. The MBIC indicated no growth or reduced growth of C. albicans biofilm at the highest concentrations of aucubin (61 to 244 μg/ml) and baicalein (25 to 100 μg/ml). Similarly, the effects of these reagents on C. albicans biofilm metabolic activity and hydrophobicity demonstrated high effectiveness at their highest concentrations. CONCLUSION: P. major extract, aucubin, and baicalein caused a dose-dependent reduction on the total growth, biofilm formation, metabolic activity, and cell surface hydrophobicity of C. albicans. This demonstrates their effectiveness as antifungals and suggests their promising potential use as solutions for C. albicans biofilm-related infections.

Purpose Oral mucositis is one of the most common adverse effects of chemotherapy and radiotherapy. The aim of this study was to compare the efficacy of Plantago major extract versus chlorhexidine 0.12% versus sodium bicarbonate 5% in the symptomatic treatment of chemotherapy-induced oral mucositis in solid tumour cancer patients. Method Multicentre randomised controlled trial estimated sample of 45 solid tumour patients with grade II-III mucositis. The participants were randomised to one of three treatments, consisting of sodium bicarbonate 5% aqueous solution together with: an additional dose of sodium bicarbonate 5% aqueous solution, Plantago major extract, or chlorhexidine 0.12%. The primary outcomes were severity of mucositis, pain intensity, oral intake capacity and quality of life. The independent variable was treatment group, and confounders included sociodemographic data, neutrophil count, chemotherapy drug and dose received. Results Of the 50 patients enrolled, 68% (n = 34) achieved grade 0 mucositis (none), with those using the double sodium bicarbonate rinse healing in five days on average (95% CI 3.9, 6.5) versus seven days (95% CI 5.3, 9,0) for the chlorhexidine group and seven days (95% CI 5.3, 8.5) for the Plantago major group. The pain experienced by the participants lessened over the 14 days of treatment, but differences in pain intensity between the three groups did not show statistical significance (p = 0.762). Conclusions Healing time was shorter with the double sodium bicarbonate solution compared to the other two rinses, but the differences were not significant. Our results suggest it may be time to reconsider the use of Plantago major extract in the management of oral mucositis.

The effect of different extraction procedures on functional properties of mucilage extracted from Plantago major seed were investigated using response surface methodology. Extraction at 75°C, using 1:60 water:seed ratio at pH 6.8 was the best condition for maximum yield (15.18%), emulsion stability (67.4%), foam stability (88.4%), solubility (97.36%) and water absorption capacity (39.74g/g) of mucilage. At this optimum point, PMSM had, on average 82.85% carbohydrate, 76.79 mgGAE/g dry total phenol content, 97.8mgg -1 total flavonoid content and 915.54μgml -1 antioxidant activity. The results indicated that PMSM had average molecular weight of 1.2×10 6 Da. FTIR analysis demonstrated the presence of carboxyl, hydroxyl and methyl groups and glycoside bonds. The chain flexibility parameter, activation energy, ζ-potential and droplet size for PMSM were determined as 946.09, 0.78×10 7 J/kgmol, 15.23mV (at neutral pH) and 448.56nm, respectively. Intrinsic viscosity for PMSM in deionized water was 14.24dlg -1 .