Statin Drugs and Botanicals Anti-Inflammatory Effects

Cardiac Bypass2_Heart_lung_machine

Statin Drugs Anti-Inflammatory Effects Reduce Mortality after Cardiac Surgery.

Would Botanicals Be Better?

For those of us with heart disease requiring cardiac bypass surgery (CABG), The New York Times advises we all take statins drugs, since studies show 50% reduction in mortality for those taking statin drugs after CABG.(1)  I was somewhat amazed and perplexed by this, since I had already written a previous article ridiculing the idea that statin drugs prevent surgical complications.  Now I thought I might have to eat my hat and issue a retraction.  Header image: Cardiac Bypass Operation courtesy of wikimedia commons.

Statins – Pleiotropic Effects

The two studies on this statin drug benefit for cardiac bypass by Curtis and Barakat refer to the anti-inflammatory “pleiotropic effects” of statin drugs.  Cardiac bypass is associated with massive release of proinflammatory cytokines and intense systemic inflammatory response.(2,3)  Statin drugs can help with all this inflammation by down regulating Nuclear Factor Kappa Beta  (NF-κ B), the master controller of the inflammatory response.(2,3)  So, yes, there is a potential benefit for Statins as anti-inflammatory agents.  Statin drugs block the inflammatory cytokine release in the post operative patient, thus reducing mortality from the procedure.

Lipophilic statin drugs such as atorvastatin, simvastatin seem to work best. Surprising, the authors comment that there was no proven reduction in myocardial infarction post cardiac bypass with statin drug use. This was a disappointment. The reduction in mortality was thought to be due to reduction in systemic inflammatory response.(2,3)  There was another benefit with reduction in episodes of atrial fibrillation.(2,3)

It appears that the benefit of statin drugs in this population is not as cholesterol lowering agents.  The benefits are due to anti-inflammatory properties of statins. If so, then one might consider other anti-inflammatory interventions which down regulate NFkB.  Here is a list of widely available Botanicals which exert anti-inflammatory effect by down regulating Nuclear Factor Kappa Beta (NF-κ B) .

Anti-inflammatory Botanicals

  1. Curcumin
  2. Ginger (Zingiber officinale)
  3. Holy Basil (Ocimum )
  4. polygonum cuspidatum
  5. Berberine (Coptis Chineensis and Barberry, Oregon grape)
  6. Oregano
  7. Chinese Skullcap (Baicalein/ Oroxylin A)
  8. Rosemary

Although these can be purchased separately on Amazon or your local vitamin store, New Chapter has created a combination product which includes them all in product called Zyflamend, containing a shopping bag of herbal extracts.  Some are super critical extracts, a technique requiring expensive equipment, revealing the higher quality of the product.

Chinese SkullcapBlocking Inflammation by

Down Regulating Nuclear Factor Kappa Beta

Inflammation triggered by Nuclear Factor Kappa Beta (NF-κ B) is up-regulated in many other diseases such as osteo-arthritis, viral infections and cancer, so you might predict that many of the individual components of Zyflamend are useful for them all.  You would be quite correct.

Left Image Chinese Skullcap Courtesy of wikimedia commons.


Zyflamend, or the individual components would be useful for reducing joint inflammation associated with cartilage loss in osteoarthritis or rheumatoid arthritis.  For example, Curcumin alone has been proposed as a new paradigm in the management of osteoarthritis. (56)  Many of the testimonials on the Amazon Zyflamend product page are from people attesting to good results for arthritis relief.(56)

Anti-Cancer Studies –  Prostate Cancer

Most of the anti-cancer effects of Zyflamend have been prostate cancer models, with considerable benefits(4-8)  Thus, the prostate version, Zyflamend Prostate,  or something similar, would be an excellent choice for a “Watch and Wait” nutritional program for elevated PSA.  A few other items such as Pterostilbene and Serrapeptidase would be included.  We have followed a number of men with this scenarios and all PSA’s have remained stable or decreased over time.  (see my article on Pterostilbene for prostate cancer prevention)

Zyflamend also showed cancer suppression in a DMBA induced oral cancer model in hamsters.(10)  An in-vitro cell culture study showed Zylfamend suppressed melanoma cells.(11)

Many Other Anti-Cancer Studies

Studies on Curcumin, Berberine, Ginger, Holy Basil, and Chinese Skullcap have all shown anti-cancer activity.(12-54)   Berberine and curcumin are actually synergistic in anti-cancer activity against breast cancer cells.(24)

Benefits for Cardiovascular Disease

If cardiovascular disease and atherosclerosis is caused by inflammation, as many now believe, this would explain many of the benefits of statin drugs which are, after all, anti-inflammatory drugs.  Statins were originally developed as an anti-cholesterol drug, it was only much later that the anti-inflammatory effects were discovered.

My previous article reported that statin drugs are a failure for reducing calcium score, and may actually accelerate calcium score progression.  The cardiovascular benefit of Aged Garlic is far superior to statin drugs for reducing calcium score.

Perhaps anti-inflammatory herbals such as Zyflamend would be more effective than Statin Drugs with fewer adverse side effects for reducing calcium score if combined with Aged Garlic and Vitamin K2.  We await these studies.

In the mean-time, studies on the Zyflamend individual components such as Berberine have shown remarkable benefits in prevention and treatment of cardiovascular disease.(25-29)

Curcumin has been shown effective in retarding atherosclerosis in an Apo E mouse model of atherosclerosis.(55)

Chinese Skullcap (bacailein) has remarkable benefits for preventing cardiovascular disease by decreasing the oxidation of LDL and suppressing inflammatory responses in macrophages”.(31)(33-35)

Anti-Viral Herbal Agents

As mentioned in my previous article on Anti-Viral Herbal Agents, Chinese Skullcap has both anti-viral and anti-inflammatory properties.  Dr Stephen Buhner mentions in his book the more virulent and deadly viral illnesses such as the 1918 influenza epidemic are so dangerous because of the viral induced “cytokine storm”, a severe inflammatory response which overwhelms and kills the patient.  Botanicals like Chinese Skullcap are not only potent anti-viral agents, they also turn off this cytokine storm, thereby exerting powerful anti-inflammatory effects.(31)


One might wonder about the outcome of an NIH funded study comparing the anti-inflammatory effects of statin drugs to a botanical product like Zyflamend in such diverse conditions such as arthritis, atherosclerosis, and cancer, as well as mortality after bypass graft surgery.  Perhaps botanicals would have superior anti-inflammatory effects, compared to Statin Drugs, without the adverse effects of CoQ-10 depletion, myalgia, neuropathy, diabetes etc.

However, considering the current state of NIH research funding, this study would never happen.  It the mean time, those of us who don’t have the luxury of time will incorporate the anti-inflammatory botanicals into our routines whenever possible.

Update 2018: The Benefits of Co-Enzyme Q10 for the Cardiac Bypass Patient

Dr Patrick Honore in  a 2016 article in  Ann Translat Med, is not so enthusiastic about Statin Drugs for the Cardiac Surgery Patient.  Dr Patrick Honore says  “statins are actually not advocated and probably should be discouraged,” reminding us that statin drugs cause CoQ10 depletion resulting in  statin induced kidney injury in the cardiac bypass patient.(57)  He says:

“statin therapy, despite significantly lowering low-density lipoprotein cholesterol and C-reactive protein, did not prevent postoperative AF (atrial fribrillation) or peri-operative myocardial injury but was associated with an increased incidence of AKI (acute kidney injury) at 48 hours (24.7% vs. 19.3%;)”(57)

In conclusion, despite being armed with an impressive “back catalogue” of pleiotropic beneficial effects beyond cholesterol lowering, statins are actually not advocated and probably should be discouraged for prevention of CS-AKI.(cardiac surgery-related acute kidney injury ) The main culprit behind this failure might be statin-induced depletion of CoQ10 stores perturbing bio-energetic kidney homeostasis.”(57)

Rather than use a statin drug as a preventive measure during cardiopulmonary bypass cardiac surgery, Dr Honore recommends Co-Q10, quoting a study by Dr de Frutas.(57-58)

A recent systematic review and meta-analysis by (de Frutos,2014) showed that prophylactic CoQ10 therapy in patients undergoing cardiac surgery with CPB (Cardio Pulmonay Bypass) was safe and associated with less need for inotropic support and a lower incidence of ventricular arrhythmias. (57-58)

One might speculate better results in cardiac bypass patients using using the trio of CoQ10, D-Ribose, and L Carnitine which work together in synergy to provide improved bio-energetics for cardiac muscle, as described by Dr Stephen Sinatra in his book, Metabolic Cardiology.

Selenium and Vitamin C Levels ?

Since observational studies show the majority of patients undergoing cardiopulmonary bypass are selenium deficient, It would also be prudent to check selenium levels, and provide selenium supplementation to replenish levels. (59)  Likewise checking serum ascorbate level, and providing vitamin C supplements as part of an overall nutritional program has been suggested.(59)

Buy my new book, Heart Book on Amazon by Jeffrey Dach MD

Buy Zyflamend on Amazon.

Buy CoQ10- PQQ on Amazon

Buy CoQ10, L-Carnitine, D-Ribose  combined in one capsule on Amazon

Jeffrey Dach MD
7450 Griffin Road Suite 190
Davie, Florida 33314

Articles with related Interest:

Statins Reduce Perioperative Mortality Surely Your Joking

Berberine Antidote for an Epidemic

Aged Garlic Benefits for Reducing Calcium Score

LPS Theory of Coronary Artery Disease


1)   Having Heart Surgery? Don’t Stop Your Statins
By NICHOLAS BAKALAR MARCH 16, 2017 New York Times

2)  Curtis, Michael, et al. “Effect of Dose and Timing of Preoperative Statins on Mortality After Coronary Artery Bypass Surgery.” The Annals of Thoracic Surgery (2017).
Thirty-day all-cause mortality was significantly lower for patients taking a statin 24 hours or less preoperatively (1.7%) compared with 24 to 72 hours (2.9%), more than 72 hours, or no dose (3.8%). Multivariate analysis of a propensity-matched cohort showed taking statins 24 hours or less preoperatively was associated with reduced 30-day all-cause mortality (odds ratio 0.52, 95% confidence interval: 0.28 to 0.98, p = 0.04) versus more than 24 hours or no dose. For preoperative statin dose, 30-day all-cause mortality was significantly lower when taking 20 mg or less(1.8%) or more than 20 mg atorvastatin or equivalent (2.1%) than when taking none (3.8%). In multivariate analysis of the propensity-matched cohort, more than 20 mg preoperative dose was associated with a 68% reduction of 30-day all-cause mortality (odds ratio 0.32, 95% confidence interval: 0.13 to 0.82, p = 0.02) compared with no preoperative statin. However, a 20 mg or less preoperative dose showed no mortality reduction.

statin benefits may extend beyond lipid control [4, 16]. These lipid-independent mechanisms, called pleiotropic effects, involve antiinflammatory, antioxidant, antithrombotic, and vasodilatory pathways. Specifically, in addition to being a precursor for cholesterol, HMG-CoA is a precursor for other nonsteroidal isoprenoid products (eg, farnesyl pyrophosphate and geranylgeranyl pyrophosphate) [17]. These molecules are essential for the posttranslational modification of intracellular guanosine triphosphate-binding proteins, such as Rho, Ras, and Rac1 GTPases [17, 18]. Rho activates nuclear factor-κB, which signals initiation of several inflammatory responses and the reduction of endothelial nitric oxide synthase [19, 20].

3) Barakat, Amr F., et al. “Perioperative statin therapy for patients undergoing coronary artery bypass grafting.” The Annals of thoracic surgery 101.2 (2016): 818-825.
Coronary artery bypass grafting is associated with an intense systemic inflammatory response, which is linked to postoperative complications. Beyond lipid lowering, statins exert a constellation of beneficial actions, including an antiinflammatory role, known as pleiotropic effects. There is increasing evidence that perioperative statin therapy improves outcomes in patients undergoing coronary artery bypass grafting. Statins are underused in the coronary artery bypass grafting population, because perioperative discontinuation remains a common practice.


4) Yang, Peiying, et al. “Zyflamend®-mediated inhibition of human prostate cancer PC3 cell proliferation: effects on 12-LOX and Rb protein phosphorylation.” Cancer biology & therapy 6.2 (2007): 228-236.

5) Capodice, Jillian L., et al. “Zyflamend in men with high-grade prostatic intraepithelial neoplasia: results of a phase I clinical trial.” Journal of the Society for Integrative Oncology 7.2 (2009): 43. “Forty-eight percent of subjects demonstrated a 25 to 50% decrease in PSA after 18 months.”

6) Bemis, Debra L., et al. “Zyflamend®, a Unique Herbal Preparation With Nonselective OX Inhibitory Activity, Induces Apoptosis of Prostate Cancer Cells That Lack COX-2 Expression.” Nutrition and cancer 52.2 (2005): 202-212.  Zyflamend Induces Apoptosis Prostate Cancer Cells Bemis Debra Nutrition cancer 2005

7) Huang, E-Chu, Michael F. McEntee, and Jay Whelan. “Zyflamend, a combination of herbal extracts, attenuates tumor growth in murine xenograft models of prostate cancer.” Nutrition and cancer 64.5 (2012): 749-760.

8) Rafailov, Samuil, et al. “The role of Zyflamend, an herbal anti-inflammatory, as a potential chemopreventive agent against prostate cancer: a case report.” Integrative cancer therapies 6.1 (2007): 74-76.

9) Sandur, Santosh K., et al. “Zyflamend, a Polyherbal Preparation, Inhibits Invasion, Suppresses Osteoclastogenesis, and Potentiates Apoptosis Through Down-Regulation of NF-κ B Activation and NF-κ B–Regulated Gene Products.” Nutrition and cancer 57.1 (2007): 78-87.

10) Yang, Peiying, et al. “Zyflamend® reduces LTB4 formation and prevents oral carcinogenesis in a 7, 12-dimethylbenz [α] anthracene (DMBA)-induced hamster cheek pouch model.” Carcinogenesis 29.11 (2008): 2182-2189.

11) Ekmekcioglu, Suhendan, et al. “Zyflamend mediates therapeutic induction of autophagy to apoptosis in melanoma cells.” Nutrition and cancer 63.6 (2011): 940-949.


12) Fadus, Matthew C., et al. “Curcumin: An age-old anti-inflammatory and anti-neoplastic agent.” Journal of Traditional and Complementary Medicine (2016). CurcuminRich Double Strength Theracurmin

13)  Wang, Ke, et al. “Curcumin inhibits aerobic glycolysis and induces mitochondrial-mediated apoptosis through hexokinase II in human colorectal cancer cells in vitro.” Anti-cancer drugs 26.1 (2015): 15-24.

14) Dasiram, Jade Dhananjay, et al. “Curcumin inhibits growth potential by G1 cell cycle arrest and induces apoptosis in p53-mutated COLO 320DM human colon adenocarcinoma cells.” Biomedicine & Pharmacotherapy 86 (2017): 373-380.

15) Ravindran, Jayaraj, Sahdeo Prasad, and Bharat B. Aggarwal. “Curcumin and cancer cells: how many ways can curry kill tumor cells selectively?.” The AAPS journal 11.3 (2009): 495-510.

Shanmugam, Muthu K., et al. “The multifaceted role of curcumin in cancer prevention and treatment.” Molecules 20.2 (2015): 2728-2769.

17) free pdf
Zhang, Jianbin, et al. “Curcumin targets the TFEB-lysosome pathway for induction of autophagy.” Oncotarget 7.46 (2016): 75659-75671.


free pdf
18) Ansari, Jamal Akhtar, et al. “Anticancer and Antioxidant activity of Zingiber officinale Roscoe rhizome.” (2016).

19) Food Chem Toxicol. 2010 Oct;48(10):2872-80. doi: 10.1016/j.fct.2010.07.020. Epub 2010 Jul 18.  Aqueous extract of ginger shows antiproliferative activity through disruption of microtubule network of cancer cells.
Choudhury D1, Das A, Bhattacharya A, Chakrabarti G.
Ginger has a long history of use as traditional medicine for varied human disease. Our present study has shown that the aqueous extract of ginger (GAE) interacts directly with cellular microtubules and disrupts its structure and induces apoptosis of cancer cells as well. The IC(50) values of GAE, as determined from cell viability experiment on human non-small lung epithelium cancer (A549) cells and human cervical epithelial carcinoma (HeLa), were 239.4+7.4 and 253.4+8.9 μg/ml, respectively. It has been found that the apoptosis of A549 cells by GAE is mediated by up regulation of tumor suppressor gene p53 and alteration of the normal Bax/Bcl-2 ratio followed by down regulation of cellular pro-caspase3. The morphological change of cells upon GAE treatment has also been demonstrated. Both the structural and functional properties of tubulin and microtubule were lost, as confirmed by both ex vivo and invitro experiments. The major component of GAE is poly-phenols (around 2.5%), which consist of ∼ 80% flavones and flavonols. Poly-phenolic compounds are well known to have anti-mitotic properties, and may be further screened for the development of a potential anti-cancer agent.


holy Basil

20) Manaharan, Thamilvaani, et al. “Purified essential oil from Ocimum sanctum Linn. triggers the apoptotic mechanism in human breast cancer cells.” Pharmacognosy magazine 12.Suppl 3 (2016): S327.

21)  Manaharan, Thamilvaani, et al. “Antimetastatic and Anti-Inflammatory Potentials of Essential Oil from Edible Ocimum sanctum Leaves.” The Scientific World Journal 2014 (2014).
Green tea

22) Green Tea for prevention of Skin cancer
polygonum cuspidatum

free pdf
23) Peng, W., et al. “Botany, phytochemistry, pharmacology, and potential application of Polygonum cuspidatum Sieb. et Zucc.: a review.” Journal of ethnopharmacology 148.3 (2013): 729-745.
Polygonum cuspidatum has a wide spectrum of pharmacological effects including lipid regulating effect, anti-shock effect, anti-inflammatory effect, antioxidant effect, anticancer effect, hepato-protective effect, antiviral effect, and antibacterial and antifungal effects

Coptis Chineensis and Barberry (Berberine)
24) Wang, Kai, et al. “Synergistic chemopreventive effects of curcumin and berberine on human breast cancer cells through induction of apoptosis and autophagic cell death.” Scientific reports 6 (2016).

24) Sun, Yiyi, et al. “A systematic review of the anticancer properties of berberine, a natural product from Chinese herbs.” Anti-cancer drugs 20.9 (2009): 757-769.

Berberine in Cardiovascular Disease

25) Zhang, Ming, et al. “Therapeutic Potential and Mechanisms of Berberine in Cardiovascular Disease.” Current Pharmacology Reports 2.6 (2016): 281-292. and

26) Jeong, Hyun Woo, et al. “Berberine suppresses proinflammatory responses through AMPK activation in macrophages.” American Journal of Physiology-Endocrinology and Metabolism 296.4 (2009)

Lau, Chi‐Wai, et al. “Cardiovascular actions of berberine.” Cardiovascular Drug Reviews 19.3 (2001): 234-244.

December 2016, Volume 2, Issue 6, pp 281–292
Therapeutic Potential and Mechanisms of Berberine in Cardiovascular Disease.  Ming Zhang Linjing Feng Junnan LiLi Chen

Researchers studied the effects of berberine on individuals with ventricular tachyarrhythmias and found that 62% of patients had 50% or greater, and 38% of patients had 90% or greater, suppression of ventricular premature contractions.7 No severe side effects were observed from berberine therapy. In humans with refractory congestive heart failure, berberine produced several significant changes: a 48% decrease in systemic and a 41% decrease in pulmonary vascular resistance, along with a 28% decrease in right atrium and 32% decrease in left ventricular end-diastolic pressures.8 A measurable increase in cardiac index (45%), stroke index (45%), and left ventricular ejection fraction (56%) were also observed. There were increases in the indices of left ventricular performance and a decrease in arteriovenous oxygen uptake (28%) with no changes in total body oxygen uptake, arterial oxygen tension, or hemoglobin dissociation properties.


free pdf
30) Coccimiglio, John, et al. “Antioxidant, Antibacterial, and Cytotoxic Activities of the Ethanolic Origanum vulgare Extract and Its Major Constituents.” (2016).

skullcap anti inflammatory

31) Eur J Med Chem. 2017 Mar 6;131:68-80. Therapeutic potentials of baicalin and its aglycone, baicalein against inflammatory disorders.Dinda B1, Dinda S2, DasSharma S2, Banik R3, Chakraborty A4, Dinda M5.

The flavonoids, baicalin (5,6-dihydroxy-2-phenyl-4H-1-benzopyran-4-one-7-O-d-β-glucuronic acid) 1 and its aglycone, baicalein 2 are found in edible medicinal plants, Scutellaria baicalensis Georgi and Oroxylum indicum (L.) Kurz in abundant quantities. The antioxidant and anti-inflammatory effects of these flavonoids have been demonstrated in various disease models, including diabetes, cardiovascular diseases, inflammatory bowel diseases, gout and rheumatoid arthritis, asthma, neurodegenerative-, liver- and kidney diseases, encephalomyelitis, and carcinogenesis.

These flavonoids have almost no toxicity to human normal epithelial, peripheral and myeloid cells. Their antioxidant and anti-inflammatory activities are largely due to their abilities to scavenge the reactive oxygen species (ROS) and improvement of antioxidant status by attenuating the activity of NF-κB and suppressing the expression of several inflammatory cytokines and chemokines including monocyte chemotactic protein-1 (MCP-1), nitric oxide synthase, cyclooxygenases, lipoxygenases, cellular adhesion molecules, tumor necrosis factor and interleukins. In this review, we summarize the antioxidant and anti-inflammatory effects of baicalin and baicalein with molecular mechanisms for their chemopreventive and chemotherapeutic applications in the treatment of inflammatory-related diseases.


32)  Rejuvenation Res. 2016 Mar 15. [Epub ahead of print]
A Bioinformatic Approach for the Discovery of Antiaging Effects of Baicalein from Scutellaria baicalensis Georgi.
Gao L1, Duan DD1,2, Zhang JQ1, Zhou YZ1, Qin XM1, Du GH1,3.
Aging is one of the most complicated phenomena and is the main risk factor for age-related diseases. Based on the public aging-related gene data, we propose a computational approach to predict the antiaging activities of compounds. This approach integrates network pharmacology and target fishing methods with the aim of identifying a potential antiaging compound from Scutellaria baicalensis Georgi. Utilizing this approach and subsequent experimental validation, it was found that baicalein at concentrations of 0.04, 0.2, and 1 mg/mL extended the mean, median, and maximum life spans in Drosophila melanogaster. Particularly, 0.2 mg/mL baicalein extends the mean and median life spans in male flies by 19.80% and 25.64%, respectively. Meanwhile, it was discovered that baicalein improved fertility in flies. Baicalein exerts antiaging effects likely through attenuating oxidative stress, including increases of CAT activity and GSH level and decrease of GSSG level.


33) Chan, Shih-Hung, et al. “Baicalein is an available anti-atherosclerotic compound through modulation of nitric oxide-related mechanism under oxLDL exposure.” Oncotarget 7.28 (2016): 42881.

34) Kim, Ohn Soon, et al. “Extracts of Scutellariae Radix inhibit low-density lipoprotein oxidation and the lipopolysaccharide-induced macrophage inflammatory response.” Molecular medicine reports 12.1 (2015): 1335-1341.

35)  O.S. Kim, C.S. Seo, Y. Kim, H.K. Shin, H. Ha
Extracts of Scutellariae Radix inhibit low-density lipoprotein oxidation and the lipopolysaccharide-induced macrophage inflammatory response. Mol Med Rep, 12 (2015), pp. 1335–1341
Traditional herbal formulas made from Scutellariae Radix (SR), the root of Scutellaria baicalensis, have previously been used in the treatment of inflammatory diseases, such as atherosclerosis. The aim of the present study was to investigate the effects of SR on low-density lipoprotein (LDL) oxidation and inflammation in macrophages, which are early events in the development of atherosclerosis. High-performance liquid chromatography photo-diode array analysis was used to obtain a three-dimensional chromatogram of SR. The antioxidative effects of SR were evaluated by determining its scavenging activities against ABTS and DPPH radicals. The inhibitory effect of SR on LDL oxidation was examined using a thiobarbituric acid-reactive substance assay and a relative electrophoretic mobility assay. In addition, the anti-inflammatory effects of SR were evaluated in lipopolysaccharide (LPS)-induced RAW264.7 murine macrophage cells. The results showed that SR exhibited radical-scavenging activities in a dose-dependent manner; in addition, SR attenuated the Cu2+-induced oxidation of LDL as well as significantly inhibited nitric oxide (NO) production and inducible NO synthase (iNOS) expression in LPS-induced RAW264.7 cells. Furthermore, SR induced the protein expression of heme oxygenase-1 (HO-1) in RAW264.7 cells. In conclusion, the results of the present study demonstrated that SR decreased the oxidation of LDL and suppressed inflammatory responses in macrophages, which occurred at least in part via the induction of HO-1. These results therefore suggested that SR may be a potential therapeutic agent for the treatment of atherosclerosis.

Anti-Cancer Skullcap

36) Liu, Hui, et al. “The Fascinating Effects of Baicalein on Cancer: A Review.” International Journal of Molecular Sciences 17.10 (2016): 1681.

37)  Wu, Xue, et al. “Advances of wogonin, an extract from Scutellaria baicalensis, for the treatment of multiple tumors.” OncoTargets and therapy 9 (2016): 2935.

38) Lee, Donghyun, et al. “Use of Baicalin-Conjugated Gold Nanoparticles for Apoptotic Induction of Breast Cancer Cells.” Nanoscale Research Letters 11.1 (2016): 381.


39) Wei, L., et al. “Oroxylin A induces dissociation of hexokinase II from the mitochondria and inhibits glycolysis by SIRT3-mediated deacetylation of cyclophilin D in breast carcinoma.” Cell death & disease 4.4 (2013): e601.

40) Wei, L., et al. “Oroxylin A inhibits glycolysis-dependent proliferation of human breast cancer via promoting SIRT3-mediated SOD2 transcription and HIF1α destabilization.” Cell death & disease 6.4 (2015): e1714.

41) Wang, Ke, et al. “Curcumin inhibits aerobic glycolysis and induces mitochondrial-mediated apoptosis through hexokinase II in human colorectal cancer cells in vitro.” Anti-cancer drugs 26.1 (2015): 15-24.

42) Eur J Pharmacol. 2009 Jan 28;603(1-3):22-8. Oroxylin A suppresses invasion through down-regulating the expression of matrix metalloproteinase-2/9 in MDA-MB-435 human breast cancer cells.Sun Y1, Lu N, Ling Y, Gao Y, Chen Y, Wang L, Hu R, Qi Q, Liu W, Yang Y, You Q, Guo Q.

Our previous study revealed that oroxylin A, a naturally occurring monoflavonoid isolated from Scutellariae radix, could inhibit the proliferation of human hepatocellular carcinoma HepG2 cells through inducing the apoptosis in these cells. However, the molecular mechanism of its anticancer activity remains poorly understood and warrants further investigations. In this study, we examined the anti-invasive activities of oroxylin A in vitro. The results showed that oroxylin A suppressed MDA-MB-435 cell adhesion to the fibronectin-coated substrate in a concentration-dependent manner. It inhibited the wound healing migration of MDA-MB-435 cells and invasion of MDA-MB-435 cells through reconstituted extracellular matrix (matrigel). Zymography revealed that oroxylin A decreased the secretion of matrix metalloproteinases-2 (MMP-2) and metalloproteinases-9 (MMP-9). Oroxylin A also inhibited the expressions of MMP-2 and MMP-9 in MDA-MB-435 cells. Additionally, oroxylin A exerted an inhibitory effect on the phosphorylation of extracellular regulated proteinkinases1/2 (ERK1/2). Collectively, these data provided a molecular basis for the antiinvasive effects of oroxylin A. Taken together, these findings strongly suggest that oroxylin A had potential anti-metastatic effect in vitro and shed light on the investigation of oroxylin A on breast cancer metastasis in vivo.

43) Li, Hua-Nan, et al. “Apoptosis induction of oroxylin A in human cervical cancer HeLa cell line in vitro and in vivo.” Toxicology 257.1 (2009): 80-85.

44) Yang, Yong, et al. “Oroxylin A induces G2/M phase cell‐cycle arrest via inhibiting Cdk7‐mediated expression of Cdc2/p34 in human gastric carcinoma BGC‐823 cells.” Journal of Pharmacy and Pharmacology 60.11 (2008): 1459-1463.

45) Hu, Yang, et al. “Oroxylin A induced apoptosis of human hepatocellular carcinoma cell line HepG2 was involved in its antitumor activity.” Biochemical and biophysical research communications 351.2 (2006): 521-527.

46) Gao, Ying, et al. “Oroxylin A inhibits angiogenesis through blocking vascular endothelial growth factor-induced KDR/Flk-1 phosphorylation.” Journal of cancer research and clinical oncology 136.5 (2010): 667-675.

47) Mu, Rong, et al. “Involvement of p53 in oroxylin A‐induced apoptosis in cancer cells.” Molecular carcinogenesis 48.12 (2009): 1159-1169.

48) Yao, Jing, et al. “Oroxylin a prevents inflammation‐related tumor through down‐regulation of inflammatory gene expression by inhibiting NF‐κB signaling.” Molecular carcinogenesis 53.2 (2014): 145-158.

49) Hsieh, Y., et al. “The lipoxygenase inhibitor, baicalein, modulates cell adhesion and migration by up‐regulation of integrins and vinculin in rat heart endothelial cells.” British journal of pharmacology 151.8 (2007): 1235-1245.

50) Song, Xiuming, et al. “Oroxylin A, a classical natural product, shows a novel inhibitory effect on angiogenesis induced by lipopolysaccharide.” Pharmacological Reports 64.5 (2012): 1189-1199.

51) Tseng, Tzu-Ling, et al. “Oroxylin-A rescues LPS-induced acute lung injury via regulation of NF-κB signaling pathway in rodents.” PLoS One 7.10 (2012): e47403.

52) Wang, Hong, et al. “An estrogen receptor dependent mechanism of Oroxylin A in the repression of inflammatory response.” PloS one 8.7 (2013): e69555.

53) Ye, Fei, et al. “Molecular mechanism of anti-prostate cancer activity of Scutellaria baicalensis extract.” Nutrition and cancer 57.1 (2007): 100-110.

Rosemary Anti Cancer

54) Nutrients. 2016 Nov; 8(11): 731. Anticancer Effects of Rosemary (Rosmarinus officinalis L.) Extract and Rosemary Extract Polyphenols
Jessy Moore,1 Michael Yousef,1 and Evangelia Tsiani1,2,*
1Department of Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada;
2Centre for Bone and Muscle Health, Brock University, St. Catharines, ON L2S 3A1, Canada

Curcumin Inhibits Atherosclerosis in Apo E Mouse

55) J Physiol Pharmacol. 2005 Dec;56(4):627-35.
Effect of curcumin on atherosclerosis in apoE/LDLR-double knockout mice.
Olszanecki R1, Jawień J, Gajda M, Mateuszuk L, Gebska A, Korabiowska M, Chłopicki S, Korbut R.
It is widely appreciated that inflammation and oxidant stress contribute to atherogenesis. Curcumin, a polyphenolic natural compound has been reported to possess anti-inflammatory and anti-oxidant actions. We hypothesized that curcumin could inhibit the development of atherosclerosis in the apoE/LDLR-double knockout mice fed with Western diet (21% fat, 0.15% cholesterol w/w, without cholic acid). Curcumin (purity>or=98%), premixed with diet, was given for 4 months at a dose of 0.3 mg/ per day/ per mouse. In this model curcumin inhibited atherogenesis, measured both by “en face” method (25,15+/-2,9% vs. 19,2+/-0,6%, p<0,05) and “cross-section” method (565867+/-39764 microm2 vs. 299201+/-20373 microm2, p<0,05). Importantly, curcumin influenced neither the concentrations of cholesterol and triglycerides in blood nor animal body weight. To our knowledge, this is the first report that shows the anti-atherogenic effect of low dose of curcumin in fine model of atherosclerosis: gene-targeted apoE/LDLR-double knockout mice.

56) Henrotin, Yves, Fabian Priem, and Ali Mobasheri. “Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management.” Springerplus 2.1 (2013): 56. Curcumin new paradigm treatment osteoarthritis Henrotin Yves Springerplus 2013

57) Honore, Patrick M., et al. “Statins barely touch the heart but bite the kidneys after cardiac surgery. Coenzyme Q10 deficiency in the dock?.” Annals of translational medicine 4.Suppl 1 (2016).In conclusion, despite being armed with an impressive “back catalogue” of pleiotropic beneficial effects beyond cholesterol lowering, statins are actually not advocated and probably should be discouraged for prevention of CS-AKI.(cardiac surgery-related acute kidney injury ) The main culprit behind this failure might be statin-induced depletion of CoQ10 stores perturbing bio-energetic kidney homeostasis.

Zheng et al. recently studied perioperative use of rosuvastatin versus placebo in 1922 cardiac surgery patients (5). Primary endpoint of the study was the incidence of atrial fibrillation (AF) and myocardial injury. Occurrence of CS-AKI was part of a panel of secondary study outcome endpoints. They found that statin therapy, despite significantly lowering low-density lipoprotein cholesterol and C-reactive protein, did not prevent postoperative AF or peri-operative myocardial injury but was associated with an increased incidence of AKI at 48 hours (24.7% vs. 19.3%;

A recent systematic review and meta-analysis showed that prophylactic CoQ10 therapy in patients undergoing cardiac surgery with CPB was safe and associated with less need for inotropic support and a lower incidence of ventricular but not atrial arrhythmias (14). de Frutos F, Gea A, Hernandez-Estefania R, Rabago G Interact Cardiovasc Thorac Surg. 2015 Feb; 20(2):254-9.

58)  de Frutos, Fernando, et al. “Prophylactic treatment with coenzyme Q10 in patients undergoing cardiac surgery: could an antioxidant reduce complications? A systematic review and meta-analysis.” Interactive cardiovascular and thoracic surgery 20.2 (2014): 254-259.Coenzyme Q10 (CoQ10) is a lipid-soluble antioxidant that could have beneficial effects in patients undergoing cardiac surgery with cardiopulmonary bypass. We aimed to conduct a systematic review and meta-analysis of the literature to elucidate the role of coenzyme Q10 in preventing complications in patients undergoing cardiac surgery with cardiopulmonary bypassEight clinical trials met our inclusion criteria. Patients with CoQ10 treatment were significantly less likely to require inotropic drugs after surgery {OR [95% confidence interval (CI) 0.47 (0.27–0.81)]}, and to develop ventricular arrhythmias after surgery [OR (95% CI) 0.05 (0.01–0.31)]. However, CoQ10 treatment was not associated with Cardiac index 24 h after surgery [mean difference (95% CI) 0.06 (−0.30 to 0.43)], hospital stay (days) [mean difference (95% CI) −0.61 (−4.61 to 3.39)] and incidence of atrial fibrillation [OR (95% CI) 1.06 (0.19–6.04)]. Since none of the clinical trials included in this review report any adverse effects associated to CoQ10 administration, and coenzyme Q10 has been demonstrated to be safe even at much higher doses in other studies, we conclude that CoQ10 should be considered as a prophylactic treatment for preventing complications in patients undergoing cardiac surgery with cardiopulmonary bypass. However, better quality randomized, controlled trials are needed to clarify the role of CoQ10 in patients undergoing cardiac surgery with cardiopulmonary bypass.

59) Hill, Aileen, et al. “Current Evidence about Nutrition Support in Cardiac Surgery Patients—What Do We Know?.” Nutrients 10.5 (2018): 597.
4.2. Selenium
Selenium is a trace element that is important for many of the body’s regulatory and metabolic functions, especially during times of stress [112,113]. In an observational study, the majority of patients undergoing cardiac surgery exhibited a significant selenium deficiency prior to CPB, which was further aggravated with increasing CPB time, leading to an insufficient capacity to withstand the stress of surgery [113]. In a subsequent non-randomized interventional trial, a high-dose selenium supplementation was effective in preventing this decrease of intraoperative circulating selenium levels and clinical outcomes were superior in this supplemented group compared with a historical control group [114]. Recently, a randomized controlled study demonstrated the safety and feasibility of high-dose selenium supplementation (4000 µg) in cardiac surgery patients, whereas no significant clinical effects could be detected [115]. In view of these data, a large-scale multicenter trial is currently being performed to evaluate the clinical significance of high-dose (2000 µg) perioperative sodium selenite supplementation in patients at high risk after cardiac surgery [116].

Jeffrey Dach MD
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Davie, Fl 33314

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Statin Drugs and Botanicals Anti-Inflammatory Effects
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Statin Drugs and Botanicals Anti-Inflammatory Effects
Statin Drugs Anti-Inflammatory Effects Reduce Mortality after Cardiac Surgery. Are Botanicals Be Better?
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