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Plantas medicinais com aplicação em ginecologia: Actaea racemosa na menopausa
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Abstract(s)
A fitoterapia, também designada por herbalismo, dedica-se ao estudo dos efeitos medicinais das plantas e da sua utilização no tratamento ou na cura de diversas doenças, sendo que cerca de 80% da população, principalmente nos países em desenvolvimento, recorrem a esta prática como primeira se não a única estratégia terapêutica. Com o decorrer dos anos, apesar do desenvolvimento científico e da produção de novos fármacos sintéticos, a fitoterapia tem vindo a ganhar popularidade nos países industrializados devido a diversos fatores. Actaea racemosa é uma planta medicinal, proveniente da América, que tem uma longa história de utilizações para diferentes fins terapêuticos, sendo que atualmente esta encontra-se mais associada ao tratamento dos sintomas que as mulheres manifestam na menopausa (e.g. afrontamentos, suores noturnos, distúrbios do sono, irritabilidade, etc.).
Apesar dos anos de estudo com esta planta, o mecanismo através do qual os constituintes da mesma desempenham a sua função terapêutica ainda não se encontra claro. Primeiramente presumiu-se que o seu mecanismo envolvia a sinalização hormonal através dos recetores estrogénicos, tal como as outras terapias de substituição hormonal, no entanto existem resultados contraditórios referente à atividade estrogénica de A. racemosa. Alguns estudos dizem que não apresenta qualquer atividade estrogénica, enquanto outros propõem a existência de um efeito modulador seletivo de estrogénio pelo facto de apresentar atividade agonista no osso e no eixo hipotálamo-hipófise sem efeitos estimulantes no tecido mamário e endometrial. Recentemente tem sido demonstrado que A. racemosa pode ter uma ação mais central, atuando nos recetores de serotonina, dopaminérgicos e até mesmo recetores opioides.
Tanto a eficácia como a segurança desta planta ainda não são conhecidas na totalidade. Isto deve-se sobretudo ao facto de que tanto ensaios pré-clínicos como clínicos realizados apresentarem resultados um quanto contraditórios relativamente à eficácia e toxicidade que a planta apresenta. A discrepância de resultados observados aquando a comparação de ensaios pré-clínicos como de clínicos pode ser atribuída a impurezas, adulterações, à utilização de diferentes dosagens, dos extratos de A. racemosa ou de espécies diferentes de Actaea.
Phytotherapy, also known as herbalism, is dedicated to the study of the medicinal effects of plants and their use in the treatment or cure of various diseases, with some 80% of the population, mainly in developing countries, using this practice as the first if not the only therapeutic strategy. Over the years, despite scientific development and the production of new synthetic drugs, phytotherapy has gained popularity in industrialised countries due to several factors. Actaea racemosa is a medicinal plant from America with a long history of use for different therapeutic purposes, but currently it is more associated with the treatment of symptoms that women experience during menopause (e.g. hot flashes, night sweats, sleep disturbances, irritability, etc.). Despite years of study with this plant, the mechanism by which its constituents carry out their therapeutic function is still unclear. It was first assumed that its mechanism involved hormone signalling through oestrogen receptors, as with other hormone replacement therapies, but there are conflicting results regarding the oestrogenic activity of A. racemosa. Some studies say that it does not show any oestrogenic activity, while others propose the existence of a selective oestrogen-modulating effect due to its agonist activity on bone and the hypothalamic-pituitary axis, without stimulating effects on mammary and endometrial tissue. Recently it has been shown that A. racemosa may have a more central action, acting on serotonin receptors, dopaminergic receptors and even opioid receptors. Both the efficacy and safety of this plant are not yet fully known. This is mainly due to the fact that both pre-clinical and clinical trials carried out show somewhat contradictory results regarding the efficacy and toxicity of the plant. The discrepancy in results observed when comparing pre-clinical and clinical trials can be attributed to impurities, adulteration, the use of different dosages of the extracts of A. racemosa or different species of Actaea.
Phytotherapy, also known as herbalism, is dedicated to the study of the medicinal effects of plants and their use in the treatment or cure of various diseases, with some 80% of the population, mainly in developing countries, using this practice as the first if not the only therapeutic strategy. Over the years, despite scientific development and the production of new synthetic drugs, phytotherapy has gained popularity in industrialised countries due to several factors. Actaea racemosa is a medicinal plant from America with a long history of use for different therapeutic purposes, but currently it is more associated with the treatment of symptoms that women experience during menopause (e.g. hot flashes, night sweats, sleep disturbances, irritability, etc.). Despite years of study with this plant, the mechanism by which its constituents carry out their therapeutic function is still unclear. It was first assumed that its mechanism involved hormone signalling through oestrogen receptors, as with other hormone replacement therapies, but there are conflicting results regarding the oestrogenic activity of A. racemosa. Some studies say that it does not show any oestrogenic activity, while others propose the existence of a selective oestrogen-modulating effect due to its agonist activity on bone and the hypothalamic-pituitary axis, without stimulating effects on mammary and endometrial tissue. Recently it has been shown that A. racemosa may have a more central action, acting on serotonin receptors, dopaminergic receptors and even opioid receptors. Both the efficacy and safety of this plant are not yet fully known. This is mainly due to the fact that both pre-clinical and clinical trials carried out show somewhat contradictory results regarding the efficacy and toxicity of the plant. The discrepancy in results observed when comparing pre-clinical and clinical trials can be attributed to impurities, adulteration, the use of different dosages of the extracts of A. racemosa or different species of Actaea.
Description
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2021, Universidade de Lisboa, Faculdade de Farmácia.
Keywords
Actaea racemosa Cimicifuga racemosa Menopausa Toxicologia Mecanismo de acção Mestrado integrado - 2021