Curing Illness with Meditation in Sixth Century China

This is a syndicated post that first appeared on BuddhistDoor
By C. Pierce Salguero

Buddhistdoor Global | 2018-06-29 |

 

Though he lived in the sixth century, Zhiyi (538–597) has a lot to teach the modern practitioner of meditation, whether Buddhist or secular. He is best known as the founding patriarch of the Tiantai school of Buddhism, widely considered to be the first native East Asian school, and thus a precursor to Chan and other later developments. Among the foundational writings of Tiantai are several treatises on meditation composed by Zhiyi.

Although it is popular to think of meditation as a solution for all kinds of illness, Zhiyi knew it was more complicated. In his Shorter Treatise on Samatha and Vipasyana (in Chinese, Xiao zhiguan), Zhiyi suggests not only that not all illnesses can or should be treated with meditation, but that meditation itself can be a cause of illness: one might be unskillful in harmonizing the mind, body, and breath, and thus fall ill. But he does advise eight different healing meditation practices.

These eight practices are divided into two categories. First are the calming meditations, or, as he calls them, employing the Chinese translation of the Sanskrit samatha, “stopping” meditations:

1. Settle the mind on the location of the illness.
2. Settle the mind on the dantian,* one inch below the navel.
3. Settle the mind on the soles of the feet.
4. Abiding calmly, remain aware that all phenomena (including the illness) are empty.

Next, Zhiyi introduces what he calls “seeing” meditations. Here he uses the Chinese translation of the Sanskrit vipashyana, although most are quite different from what contemporary meditators mean by the term vipassana. There are four practices in this category:

1. The Six Breaths, a Chinese exercise in which the practitioner makes the sounds “chui,” “hu,” “xi,” “he,” “xu,” or “si,” while exhaling in order to regulate internal processes.
2. The Twelve Respirations, which are different types of Indian breathing exercises (pranayamas) intended to regulate various symptoms of illness.
3. Visualization techniques in which one concentrates on one type of qi in order to counteract ailments caused by others. (He gives the example of concentrating on fire-like qi to cure cold in the body.)
4. Finally, Zhiyi mentions using both samatha and vipasyana together to “analyze the non-existent nature” of physical and mental illnesses, resulting in their spontaneous healing.

painting of Sramana Zhiyi, founder of the Tiantai school of Buddhism. From wikipedia.org
Painting of Master Zhiyi, founder of the Tiantai school
of Buddhism. From wikipedia.org

Lamentably, Zhiyi does not give us much detail on specifically how to practice the techniques mentioned in this particular chapter. (Zhiyi did write instructions on samatha and vipasyanameditation, much of which has been translated into English. [Chih-i 1997; Zhiyi 2009]) The most detailed descriptions he gives concern the specific medical applications of the Six Breaths and for the Twelve Resiprations.

For example, each of the Six Breaths should be used as follows:

Imagine each of the Six Breaths revolving around inside your mouth and between your lips, and then make [the sounds]. If you are in meditation, use chui when you are cold and hu when you are hot. In the treatment of illnesses, chui is for eliminating cold, hu is for eliminating heat, xi is for eliminating pain and treating wind, he is for eliminating mental troubles and also flatulence, xu is for breaking up phlegm and relieving congestion, and si is for replenishing exhaustion. If you are treating the Five Viscera, the two breaths of hu and chui can treat the heart, xu is for treating the liver, he is for treating the lungs, xi is for treating the spleen, and siis for treating the kidneys.

For the Twelve Respirations, he instructs:

Now, to explain how the Twelve Respirations relate to the treatment of symptoms: the upward respiration cures weight gain, the downward respiration cures feeling spent, the falling respiration cures emaciation, the scorching respiration cures bloating, the increasing respiration cures depletion [of the Four Elements], the dissipating respiration cures [their] excess, the warming respiration cures cold, the cooling respiration cures heat, the forceful respiration cures blockages, the retained respiration cures trembling, the harmonizing respiration completely cures disharmony of the Four Elements, and the nourishing respiration nourishes the Four Elements. One who is good at using these respirations can cure any and all afflictions—but, as you can infer from this, doing them wrong can cause even more afflictions to arise.

In closing the chapter, Zhiyi offers general reflections on the practice of healing using meditation. Advising the practitioner to become skilled in all of the eight techniques, he notes that he has only provided an overview, and that we should seek out more complete instruction. Above all, Zhiyi is emphatic that healing meditations help us cultivate various good qualities. He explicitly states that if one follows 10 “dharmas,” then one’s “treatments are guaranteed to be effective and will not be in vain:”

1. Faith in the effectiveness of the methods outlined in the text.
2. Regular practice.
3. Sustained effort.
4. Staying entirely focused on the object of the meditation one chooses.
5. Clearly discriminating the causes of illness (presumably in order to apply the correct meditation).
6. Using skill in choosing the right practice for the ailment in question.
7. Maintaining a long-term perspective and not giving up when results come slowly.
8. Knowing when to continue with a beneficial practice and when to abandon a non-beneficial one.
9. Avoiding mental distractions and moral transgressions.
10. Avoiding hindrances to practice such as pride and frustration.

Zhiyi lived in a very different religious and medical culture than we do today. Throughout the essay, we see that his notion of illness revolves around traditional Asian medical concepts, such as qi and the “five viscera” from Chinese medicine and the “four elements” from Indian classical medicine. However, it is quite possible that Zhiyi’s essay is describing contemplative techniques that can be proven to be efficacious in the modern context. At the very least, he is pointing out avenues beyond the current fixation on mindfulness meditation that merit further medical research and exploration.

* Qi or energy center.

C. Pierce Salguero is an interdisciplinary humanities scholar interested in the role of Buddhism in the cross-cultural exchange of medical ideas. He has a PhD in the history of medicine from the Johns Hopkins School of Medicine, and teaches Asian history, religion, and culture at Penn State University’s Abington College. He is the author of numerous books and articles on Buddhism and medicine, including Buddhism and Medicine: An Anthology of Premodern Sources.

References

Chih-i. 1997. Stopping and Seeing: A Comprehensive Course in Buddhist Meditation. Translated by Thomas Cleary. Boulder, CO: Shambhala Publications.

Zhiyi, Shramana. 2009. The Essentials of Buddhist Meditation. Translated by Bhikshu Dharmamitra. Seattle: Kalavinka Press.

Salguero, C. Pierce, ed. 2017. Buddhism and Medicine: An Anthology of Premodern Sources. New York City: Columbia University Press.

See more

Pierce Salguero

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Antimicrobial Activities of Thai Traditional Remedy “Kheaw-Hom” and Its Plant Ingredients for Skin Infection Treatment in Chickenpox.

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Antimicrobial Activities of Thai Traditional Remedy “Kheaw-Hom” and Its Plant Ingredients for Skin Infection Treatment in Chickenpox.

J Med Assoc Thai. 2016 07;99 suupl 4:116-23

Authors: Sukkasem K, Panthong S, Itharat A

Abstract
Background: Kheaw-Hom is a Thai traditional remedy which appears in the National List of Essential Medicines 2011. This
remedy consists of eighteen Thai medicinal plants. It has long been used in folk medicine to treat fever, measles, chickenpox and skin infection, but there has been no scientific report on antimicrobial activities of this remedy.
Objective: To investigate antimicrobial activities of Kheaw-Hom remedy extracts and its plant ingredients.
Material and Method: Kheaw-Hom remedy and each of its plant ingredients were extracted by maceration in 95% ethanol and decoction in water to obtain ethanolic extract and aqueous extract, respectively. All extracts were tested for antimicrobial activities by microtiter plate-based assay to determine the minimum inhibitory concentration (MIC) and the minimum microbicidal concentration (MMC) values against Staphylococcus aureus (ATCC 25923), methicillin-resistant Staphylococcus aureus (DMST 20651), Staphylococcus epidermidis (ATCC 12228) and Candida albicans (ATCC 90028).
Results: The ethanolic extract of Kheaw-Hom remedy showed antimicrobial activities against Staphylococcus aureus, methicillinresistant Staphylococcus aureus and Staphylococcus epidermidis with MIC values of 0.625, 0.625 and 1.25 mg/ml, respectively and MMC values of 1.25, 0.625 and 2.5 mg/ml, respectively. Among all the ethanolic extracts of its plant ingredients, that of Mammea siamensis showed the highest activity with MIC values of 0.005, 0.005 and 0.039 mg/ml and MMC values of 0.005, 0.005 and 0.039 mg/ml, respectively. The weak activity against bacteria was found in the aqueous extract of some plant ingredients. The ethanolic and aqueous extracts of Kheaw-Hom remedy and the aqueous extract of its plant ingredients had no activity against C. albicans but the ethanolic extract of Sophora exigua showed the highest activities against Candida albicans with MIC values of 0.625 mg/ml and MMC values of 0.625 mg/ml.
Conclusion: The ethanolic extracts of Kheaw-Hom remedy had antimicrobial activity against S. aureus, methicillin-resistant S. aureus and S. epidermidis that are causes of skin infection from chickenpox. These results support the use of Kheaw-Hom remedy for skin infection treatment in chickenpox.

PMID: 29926689 [PubMed – in process]

Bioactivities of Ethanolic Extracts of Three Parts (Wood, Nutmeg and Mace) from Myristica fragrans Houtt.

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Bioactivities of Ethanolic Extracts of Three Parts (Wood, Nutmeg and Mace) from Myristica fragrans Houtt.

J Med Assoc Thai. 2016 07;99 Suppl 4:S124-30

Authors: Champasuri S, Itharat A

Abstract
Background: Myristica fragrans Houtt. is one of the spices that has long been used for treatment of various disorders.
M. fragrans is known as Chan-thet and its three parts i.e. wood, seed (nutmeg) and aril (mace), are ingredients in various Thai traditional remedies such as anti-pyretic, anti-allergy, anti-inflammatory remedies
Objective: To investigate the biological activities of ethanolic extracts obtained from wood, nutmeg and mace of M. fragrans according to the uses in Thai traditional medicine follow as: anti-inflammatory, anti-allergic and antioxidant activities.
Material and Method: Three parts of M. fragrans (wood, nutmeg and mace) were macerated with 95% ethanol. The extracts were examined for anti-inflammatory activity by determination of inhibitory effect on LPS induced nitric oxide production release in RAW 264.7 cell lines, anti-oxidant activity by inhibitory effect on PMA-induce superoxide radical in DMSO differentiated from HL-60 cells, and anti-allergic activity by determining inhibitory activity of β-hexosaminidase release on RBL-2H3 cells.
Results: The ethanolic extract of wood presented potent anti-inflammatory activity more than nutmeg and mace (IC50 values = 40.26+0.58, 65.42+4.95 and 75.40+4.14 μg/ml, respectively). Nutmeg and mace showed high anti-oxidant activity while wood showed moderate activity (IC50 values = 21.164+1.03, 28.897+0.39 and 71.830+1.33 μg/ml, respectively). The extracts obtained from the three parts (wood, nutmeg and mace) showed strong anti-allergic activity (IC50 values = 13.29+0.28, 20.90+1.03 and 12.95+0.89 μg/ml respectively).
Conclusion: The extracts obtained from wood of M. fragrans showed high anti-inflammatory and anti-allergic activities but moderate anti-oxidant. The extracts of nutmeg and mace presented high anti-oxidant and anti-allergic activities but less antiinflammatory activity. Therefore, extract of wood should be selected for treatment of diseases that related with inflammation while the extracts of nutmeg and/or mace should be used as an antioxidant. Finally, extracts of all 3 parts of M. fragrans could be used for allergy-related diseases because all parts showed potent activity in anti-allergy, anti-inflammatory and antioxidant roles. However, the further study should be performed in animal models for investigation of each activity of active compounds following bioassay guided isolation.

PMID: 29926690 [PubMed – in process]

Anti-inflammatory Activities of Erythrina variegata Bark Ethanolic Extract.

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Anti-inflammatory Activities of Erythrina variegata Bark Ethanolic Extract.

J Med Assoc Thai. 2016 Jul;99 Suppl 4:S166-71

Authors: Thongmee P, Itharat A

Abstract
Background: The bark of Erythrina variegata Linn.(Ev) is used in Thai traditional medicine for the treatment of many
diseases in Thailand and is an ingredient in the Mahanintangthong remedy (antipyretic) and Lomammapruek remedy (analgesic and anti-inflammatory).
Objective: To study anti-inflammatory activities of ethanolic extract of E. variegata in vitro.
Material and Method: Bark of E. variegata was extracted with 95% ethanol. In this study, Griess reagent was used to
measure the anti-inflammatory activity by inhibitory effects of extract on nitric oxide production activated by lipopolysaccharide in RAW 264.7 cell lines, COX-2 and TNF-α were also tested by using ELISA techniques.
Results: The ethanolic extract of E. variegata showed potent anti-inflammation properties by inhibiting prostaglandins production through enzyme COX-2 and inhibitory activity against lipopolysaccharide induced nitric oxide production in RAW 264.7 cell lines with an IC50 value of 9.27±0.72 and 47.1±0.21 μg/ml, respectively. However it was not effective against TNF-α release.
Conclusion: The ethanolic extracts of E. variegata bark showed higher inhibitory effect on PGE2 as acute inflammation than inhibitory effect on Nitric oxide production and TNF-α release representing chronic inflammation. This study thus supports the use of E. variegata bark for treatment of inflammation-related diseases by Thai traditional medicine.

PMID: 29926696 [PubMed – in process]

Antibacterial Activity of Thai Medicinal Plant Extracts Against Microorganism Isolated from Post-Weaning Diarrhea in Piglets.

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Antibacterial Activity of Thai Medicinal Plant Extracts Against Microorganism Isolated from Post-Weaning Diarrhea in Piglets.

J Med Assoc Thai. 2016 Jul;99 Suppl 4:S203-10

Authors: Ketpanyapong W, Itharat A

Abstract
Background: Post-weaning bacterial infections in piglets caused by resistant strains have increased dramatically. Thai medicinal plants such as Piper retrofractum, Piper leptostachyum, Piper sarmentosum, Zingiber officinale, Plumbago indica, Piper betle, Caesalpinia sappan, Garcinia mangostana etc have been widely used in Thai traditional medicine to treat diarrhea. Thus, these plants were investigated antimicrobial activity against gram negative strain isolated from piglets with diarrhea.
Objective: To investigate antimicrobial activity of Thai medicinal plants and their isolated compounds in order to develop an alternative treatment against bacteria causing post-weaning diarrhea in piglets.
Material and Method: Antimicrobial activity of some Thai medicinal plants and their compounds were tested using disc
diffusion and broth dilution methods against bacteria associated with diarrheal disease including Escherichia coli and Salmonella spp. The extraction was performed by maceration in 95% ethanol.
Results: The results showed that all tested strains were sensitive to P. betle extract. As well as Plumbagin compound from Plumbago indica also showed antimicrobial activity against all microbes the same of P. betle extract with MIC between 5 to 10 mg/ml, which are different from the group of antibiotics with MIC values between 0.19-2.5 mg/ml, P. betle extracts inhibited Escherichia coli and Salmonella spp while some antibiotics can inhibit only some types.
Conclusion: The results support the use of Thai medicinal plants for treatment of diarrhea caused by these bacteria. This study also provides basic knowledge on antimicrobial activity against diarrheal microbe isolated from piglets. These results lead to further development of an effective formula of Thai medicinal plants for diarrheal disease in post-weaned piglets and other infectious diseases in the future.

PMID: 29926714 [PubMed – in process]

Cytotoxic and Anti-inflammatory Activities of Medicinal Plants and Women’s Health Remedy Found in “Mahachotarat Scripture” of Thai Traditional Medicine.

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Cytotoxic and Anti-inflammatory Activities of Medicinal Plants and Women’s Health Remedy Found in “Mahachotarat Scripture” of Thai Traditional Medicine.

J Med Assoc Thai. 2016 Jul;99 Suppl 4:S211-21

Authors: Jaiaree N, Itharat A, Ruangnoo S

Abstract
Background: “Mahachotarat” is a lesson for woman’s care from the Thai traditional medicine book, composed of both
medicinal plants and herbal remedies that can treat both pain and cervical cancer. Medicinal plants and herbal remedies, which have often been used in the treatment of pain and cancer, were selected to investigate for biological activity related to woman’s health. They were Boesenbergia rotunda Linn, Piper nigrum Linn, Zingiber cassumunar Roxb, Zingiber officinale Roscoe, Zingiber zerumbet (L) Smith, Dioscorea birmanica Prain & Burkill including its ingredient; Prosapogenin A of dioscin and Leard-ngam remedy.
Objective: The objective was to investigate cytotoxic and anti-inflammatory activities of all sample plants.
Material and Method: Medicinal plants and Leard-ngam remedy were extracted similarly to that practiced by Thai traditional practitioners (ethanol and water extraction). Bioassay guide fractionation was used for isolating pure compound. The structure elucidation of pure compound was proven by spectrophotometry technique. These extracts were tested for their cytotoxic activity against Hela cells, cervical cancer cells, by sulforhodamine B assay, inhibition of nitric oxide and prostaglandin E2 production in lipopolysaccharide-stimulated mouse macrophage RAW 264.7 cells.
Result: This study showed that P. nigrum, Z. officinale, B. rotunda and Z. cassumunar showed potent inhibitory activity on nitric oxide and PGE2 production. The 95% ethanolic extract of Z. zerumbet had the highest cytotoxic activity on Hela cells with IC50 value of 4.42±0.20 μg/ml. Diosgenin-3-O-α-L-rhamnosyl (1→2)-β-D-glucopyranoside or Prosapogenin A of dioscin, which was purified from the 95% ethanolic extract of D. birmanica, showed strong cytotoxic activity on Hela cells with IC50 value of 6.07±0.02 μg/ml.
Conclusion: Thai medicinal plants and LG remedies which have often been used in the treatment of pain and cancer by Thai traditional practitioners, showed high anti-inflammatory properties on both pathways which represent chronic and acute inflammation. Interestingly, some medicinal plants were used daily in Thai food. In addition, Z. zerumbet and D. birmanica, which has often been used in the treatment of cancer, also showed high cytotoxic activity against cervical cancer cells.

PMID: 29926715 [PubMed – in process]

Health Services Provided at the Primary Care Network of the Faculty of Medicine, Thammasat University.

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Health Services Provided at the Primary Care Network of the Faculty of Medicine, Thammasat University.

J Med Assoc Thai. 2016 Jul;99 Suppl 4:S230-8

Authors: Buranatrevedh S, Palangrit S, Tiyoa N, Vatcharavongvan P, Triamvichanont R

Abstract
Background: Health care network of Faculty of Medicine, Thammasat University is one of Contracting Unit for Primary
Care (CUP) under Thai Universal Coverage (UC) scheme. It comprises four primary care units (PCUs): Khukhot Subdistrict Health Promoting Hospital (KSHPH), Lamsamkaeo Municipality Health Center (LMHC), Khukhot Municipality Health Center (KMHC), and Thammasat Health Center (THC, also acted as CUP).A primary objective of this research was to study health service indicators of these four health centers.
Material and Method: A retrospective study was performed. Data between January 1, 2014 and December 31, 2014 were collected. Following indicators for health service quality were collected and analyzed: 1) numbers of patients visiting PCU/number of patients visiting CUP (OP visit), 2) charge on drugs and medical supplies for outpatient services, 3) newborn and children under five mortality, 4) maternal mortality, 5) low birth weight 6) nutrition status of children under five, 7) diabetes mellitus (DM) patients with Hemoglobin A1C, low density lipoprotein, urine microalbumin tests, diabetic retinopathy screening,
and feet examination, 8) hypertension (HT) patients with lipid profile, urine protein and fasting blood sugar tests, 9) controlled DM patients, and 10) controlled HT patients.
Results: OP visit of KSHPH, LMHC, and KMHC were 0.22, 0.19, and 0.05, respectively. Charge on drugs and medical
supplies for services of KSHPH, LMHC, KMHC, and THC were 102.39, 91.47, 162.04, and 463.85 baht/visit, respectively. There was no newborn, children-under-five and maternal deaths. Percentages of low birth weight of KSHPH, LMHC, KMHC, and THC were 14.3, 14.3, 0, and 9.1%, respectively. Percentage of children under aged five with underweight of KSHPH, LMHC, KMHC, and THC were 12.6, 12.0, 5.6, and 9.1%, respectively. Percentages of children under aged five with overweight of KSHPH, LMHC, KMHC, and THC were 3.7, 22.2, 1.9, and 12.8%, respectively. Percentages of DM patients with HbA1c test of KSHPH, LMHC, KMHC, and THC were 95.4, 87.6, 74.3, and 90.8%, respectively. Percentages of DM patients with LDL tests of KSHPH, LMHC, KMHC, and THC were 98.5, 90.0, 75.7, and 81.5%, respectively. Percentages of DM patients with urine micro albumin tests of KSHPH, LMHC, KMHC, and THC were 6.9, 3.3, 10.0, and 10.2%, respectively. Percentages of DM patients with DR screening of KSHPH, LMHC, KMHC, and THC were 0, 18.7, 0, and 22.6%, respectively. Percentages of DM patients with feet examination of KSHPH, LMHC, KMHC, and THC were 0, 18.7, 0, and 22.7%, respectively. Percentages of HT patients with lipid profile tests of KSHPH, LMHC, KMHC, and THC were
90.8, 73.2, 60.2, and 92.2%, respectively. Percentages of HT patients with urine protein tests of KSHPH, LMHC, KMHC, and THC were 7.3, 17.3, 0.4, and 7.8%, respectively. Percentages of HT patients with FBS screening of KSHPH, LMHC, KMHC, and THC were 92.2, 84.3, 61.0, and 78.1%, respectively. Percentages of controlled DM patients of KSHPH, LMHC, KMHC, and THC were 54.8, 57.9, 54.8, and 61.4%, respectively. Percentages of controlled HT patients of KSHPH, LMHC, KMHC, and THC were 75.7, 19.3, 35.7, and 66.3%, respectively.
Conclusion: Several health service indicators need to be improved including: low OP visit, low birth weight, high underweight and overweight among children under aged five, low coverage of urine micro albumin, DR screening, and feet examination among DM patients, low coverage of urine protein among HT patients, and high percentage of uncontrolled DM and HT patients.

PMID: 29926717 [PubMed – in process]

Cytotoxic Activity Against Cancer Cell Lines from The Ethanolic Extracts and Its VLC Fractions of Bauhinia strychnifolia Leaves.

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Cytotoxic Activity Against Cancer Cell Lines from The Ethanolic Extracts and Its VLC Fractions of Bauhinia strychnifolia Leaves.

J Med Assoc Thai. 2016 Jul;99 Suppl 4:S110-5

Authors: Panchinda C, Ruangnoo S, Itharat A

Abstract
Background: Cancer is a leading cause of morbidity and mortality worldwide. Bauhinia strychnifolia Craib leaves is used in Thai traditional medicine for detoxification. Its leaves contain total phenolic content and also exhibit high antioxidant activity. However, there has been no report on cytotoxicity testing from its leave extracts. Thus, the present study aims to investigate its cytotoxic activity against cancer cell lines.
Objective: To study cytotoxicity from the ethanolic extracts of B. strychnifolia leaves and its vacuum liquid chromatography fraction against cholangiocarcinoma cell line (KKU-M156) and two types of colon adenocarcinoma cell lines (SW480, LS174T).
Material and Method: In vitro cytotoxic activity of the ethanolic extracts against three human cancer cell lines were investigated by using sulforhodamine B (SRB) assay.
Results: The 95% ethanolic extract of dried leaves showed the higher cytotoxic activity against KKU-M156, SW480, and
LS174T than 50% ethanolic extract of dried leaves. The chloroform fraction from the 95% EtOH extract of dried leaves showed the best cytotoxicity against KKU-M156 and SW480 with IC50 value of 5.79±0.47 and 6.9±0.14 μg/ml, respectively.
Conclusion: The chloroform fraction from the 95% ethanolic extract of dried leaves was the most effective fraction against bile duct and colon cancer cell lines, thus this extract should be further investigated for active compounds possessing those observed cytotoxic activity.

PMID: 29919996 [PubMed – in process]

Anti-cancer effects of Kaempferia parviflora on ovarian cancer SKOV3 cells.

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Anti-cancer effects of Kaempferia parviflora on ovarian cancer SKOV3 cells.

BMC Complement Altern Med. 2018 Jun 11;18(1):178

Authors: Paramee S, Sookkhee S, Sakonwasun C, Na Takuathung M, Mungkornasawakul P, Nimlamool W, Potikanond S

Abstract
BACKGROUND: Kaempferia parviflora (KP) is an herb found in the north of Thailand and used as a folk medicine for improving vitality. Current reports have shown the anti-cancer activities of KP. However, the anti-cancer effects of KP on highly aggressive ovarian cancer have not been investigated. Therefore, we determined the effects of KP on cell proliferation, migration, and cell death in SKOV3 cells.
METHODS: Ovarian cancer cell line, SKOV3 was used to investigate the anti-cancer effect of KP extract. Cell viability, cell proliferation, MMP activity, cell migration, and invasion were measured by MTT assay, cell counting, gelatin zymography, wound healing assay, and Transwell migration and invasion assays, respectively. Cell death was determined by trypan blue exclusion test, AnnexinV/PI with flow cytometry, and nuclear staining. The level of ERK and AKT phosphorylation, and caspase-3, caspase-7, caspase-9 was investigated by western blot analysis.
RESULTS: KP extract was cytotoxic to SKOV3 cells when the concentration was increased, and this effect could still be observed even though EGF was present. Besides, the cell doubling time was significantly prolonged in the cells treated with KP. Moreover, KP strongly suppressed cell proliferation, cell migration and invasion. These consequences may be associated with the ability of KP in inhibiting the activity of MMP-2 and MMP-9 assayed by gelatin zymography. Moreover, KP at high concentrations could induce SKOV3 cell apoptosis demonstrated by AnnexinV/PI staining and flow cytometry. Consistently, nuclear labelling of cells treated with KP extract showed DNA fragmentation and deformity. The induction of caspase-3, caspase-7, and caspase-9 indicates that KP induces cell death through the intrinsic apoptotic pathway. The antitumor activities of KP might be regulated through PI3K/AKT and MAPK pathways since the phosphorylation of AKT and ERK1/2 was reduced.
CONCLUSIONS: The inhibitory effects of KP in cell proliferation, cell migration and invasion together with apoptotic cell death induction in SKOV3 cells suggest that KP has a potential to be a new candidate for ovarian cancer chemotherapeutic agent.

PMID: 29891015 [PubMed – in process]

From Regulatory Approval to Subsidized Patient Access in the Asia-Pacific Region: A Comparison of Systems Across Australia, China, Japan, Korea, New Zealand, Taiwan, and Thailand.

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From Regulatory Approval to Subsidized Patient Access in the Asia-Pacific Region: A Comparison of Systems Across Australia, China, Japan, Korea, New Zealand, Taiwan, and Thailand.

Value Health Reg Issues. 2015 May;6:40-45

Authors: Cook G, Kim H

Abstract
OBJECTIVES: To compare processes and timings of regulatory and subsidized access systems for medicines across seven jurisdictions within the Asia-Pacific region.
METHODS: A questionnaire was developed focusing on regulatory and health technology assessment-based subsidized access processes and timings in each of the seven surveyant’s jurisdictions.
RESULTS: Australia and Thailand are the only two jurisdictions that formally allow the subsidized access evaluation process to be conducted in parallel with the regulatory evaluation process. Australian, Japanese, Korean, New Zealand, and Taiwanese systems afford broad coverage, whereas Chinese and Thai systems provide limited coverage for medicines under patent. Subsidized access systems for all jurisdictions except Thailand have an associated patient co-payment for each medicine/prescription. The biggest disparity across the study group relates to time from regulatory submission to subsidized access of patented medicines-ranging from just over 1 year (Japan) to a minimum of 5 years (China).
CONCLUSIONS: There is consistency across the seven jurisdictions studied in relation to regulatory and subsidized patient access processes-that is, regulatory approval is required before subsidized access review; subsidized access coverage is broad; and the cost of medicine subsidization is offset, in part, by patient co-payments. Although local differences will always exist in relation to budget and pricing negotiation, there may be efficiencies that can be applied across systems to improve time to subsidized access. Closer understanding of regulatory and subsidized access systems can lead to best-practice sharing and, ultimately, timely access and better health outcomes for patients.

PMID: 29698191 [PubMed]