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Author: Sylvia Marinova, PhD student in the Genomic Stability Laboratory at BAS

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Atopic dermatitis causes the appearance of red and itchy spots on the skin. The disease is the most common form of eczema and is more commonly known as atopic eczema.

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Its onset is usually in early childhood, but it can occur at any age. Although its etiology is not fully understood, there seems to be a complex relationship between impaired barrier function of the skin, dysfunction of the immune system, infectious factors and those of the environment. The disease is also associated with food allergies, asthma and allergic rhinitis.

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In this article you will read what science thinks about the root causes of atopic dermatitis, what are its triggers and what is the connection with other diseases. You will also learn how to take proper care of the good condition of the skin and prevent exacerbations of its condition in you or your child.

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Children are prone to atopic dermatitis

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Atopic dermatitis is observed in 10% to 30% of children and in 1% to 3% of adults in developed <a href="https://www.ncbi.nlm.nih.gov/books/NBK448071/" target="_blank" rel="noopener">countries</a> [ref.1] and in recent decades there has been a significant increase in the spread of the disease. It is more common in areas with a high latitude. Perhaps this is due to the fact that the humidity is low and access to sunlight is more limited than in areas closer to the equator.

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Atopic eczema usually occurs in early childhood . Up to 60% of cases begin in children even before their first birthday. Often the diseaseis "growing" by the age of 12, but in other cases it remains chronic and has its exacerbations in the later stages of life.

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An initial occurrence of atopic dermatitis is also possible in adulthood after puberty. Another unusual form of the disease is the so-called senenium dermatitis - dermatitis, which occurs for the first time in adult individuals over 60 years of age.

What-is-atopic-dermatitis

What is atopic dermatitis

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Symptoms of atopic dermatitis are individual and vary from person to person. As a rule, it is characterized by the appearance of skin redness, which usually cause severe itching. Since the disease is chronic, alternation of periods of exacerbation of the condition with those of remission (complete recovery) throughout life or part of it is observed.

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Other symptoms include:

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<ul>
<li>Dry skin - due to a lack of good hydration due to the impaired functions of the skin,</li>
<li>Itching - can be very strong especially at night,</li>
<li>Disturbed sleep - due to itching,</li>
<li>Cracked and coarse skin,</li>
<li>Sometimes inflamed skin maybe secreted or peeled</li>
</ul>

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It is important to note that the impaired protective function of the skin makes it more prone to secondary infections with fungi, viruses or bacteria.

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There <a href="https://www.bioseek.eu/en/eng/research/pubmed/Atopic_dermatitis_30275844" target="_blank" rel="noopener"></a> is a difference [ref.2] between the place of occurrence of atopic zones in children andadults.

What-causes-atopic-dermatitis

What causes atopic dermatitis

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The etiology of atopic <a href="https://www.bioseek.eu/en/eng/research/pubmed/Atopic_dermatitis_30275844" target="_blank" rel="noopener"></a> dermatitis is not yet fully understood.

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<ul>
<li style="font-weight: 400;">
Role of genetics - it is known that the protein filagrin (more <a href="../p/kakva_ie_razlikata_miezhdu_bieltk_i_protiein_b1b6b96e_e340_46d2_9768_ac9fa8cd6adc" target="_blank" rel="noopener"></a> on what proteins are found<a href="https://ghr.nlm.nih.gov/gene/FLG" target="_blank" rel="noopener"></a> here [ref.4]) is involved in the formationof the outermost layer of the skin, called the stratumcorneum. 
</li>
</ul>

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Homozygous mutations in the filamine gene (this means that both copies of the gene are damaged) are associated with the early onset of atopic dermatitis and the development of more serious symptoms. Heterozygous mutations result in disorders in 50% of the protein produced. About <a href="https://www.bioseek.eu/en/eng/research/pubmed/Filaggrin_mutations_associated_with_skin_and_allergic_diseases_21991953" target="_blank" rel="noopener">10% of Europeans</a> [ref.6]heterozygous carriers of this defect.

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The aforementioned mutation in filagarine cannot give a complete genetic justification for the occurrence of atopic dermatitis. It is known that differences in genes involved in immune system pathways are also a predisposing factor. Recent studies also indicate epigenetic changes (these are changes affecting which gene and when it will manifest itself) that play a role in the development of the disease. These changes are also due to interaction with environmental factors.

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<ul>
<li style="font-weight: 400;">
Disregulation of the immune system - impaired regulation of certain components of the immune system is observed, as a consequence of which is the increased secretion of specific interleukins such as IL4, IL13, IL31, IL33. This leads to a violation of the barrier function of the stratum corneum of the skin, allergic inflammatory processes and suppression of the secretion of antimicrobial peptides.
</li>
<li style="font-weight: 400;">
Neuroimmunological mechanisms - TSLP, as well as the aforementioned interleukins, lead to activation of signaling pathways that cause characteristic itching in patients. There is also a group of sensory neurons in the skin that produce histamine, which is again associated with inflammation and itching.
</li>
<li style="font-weight: 400;">
Dysfunction of the epidermis - it is the result of impaired regulation of the gene expression of proteins, Interestingly, <a href="https://www.bioseek.eu/en/eng/research/pubmed/The_skin_as_a_target_for_prevention_of_the_atopic_march_29413338" target="_blank" rel="noopener"></a> the malfunctioning of the epidermis not only leads to the development of atopic dermatitis, but also increases the risk [ref.7] of developing other allergies (such as food allergies) and leads to hyperactivity of the respiratory tract. 
</li>
<li style="font-weight: 400;">
Different lipid composition of the epidermis - different lipids have an important role in maintaining the barrier function of the stratum corneum. In patients with atopic eczema, their composition is different.
</li>
<li style="font-weight: 400;">
Disorders in the microbiome - last but not least, we will mention changes in the microbiome of patients with atopic dermatitis. <a href="../p/zashcho_chrievniiat_mikrobiom_ie_tolkova_vazhien_za_nas_i_nashieto_biebie_f1c8c877_5195_4564_831e_1e2eef76df59" target="_blank" rel="noopener">As</a> we know [ref.8] the microbiome is the coexistence of multiple microorganisms in different <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991899/" target="_blank" rel="noopener"></a> organs of our body. in our body as much as cells. 
</li>
</ul>

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The skin of patients with atopic dermatitis is characterized by pronounced dysbiosis especially during acute conditions. Some bacteria develop over-the-counter at the expense of others, disrupting the overall fine balance anddiversity.

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In other words - it is very important to maintain the good condition of the skin and intestines with the right care and lifestyle, but on this we will pay more detailed attention below.

What-are-the-risk-factors-for-atopic-dermatitis

What are the risk factors for atopic dermatitis

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Atopic skin can be affected by some additional factors, since it isespecially sensitive:

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<ul>
<li>Stress - research <a href="https://www.bioseek.eu/en/eng/research/pubmed/Psychoneuroimmunology_of_psychological_stress_and_atopic_dermatitis_pathophysiologic_and_therapeutic_updates_22101513" target="_blank" rel="noopener"></a> suggests a link [ref.10] between atopic eczema and stress.</li>
<li>Asthma or allergies (food or hay fever);</li>
<li>Materials of clothing - examples are wool and nylon. Exacerbation can cause including some dyes in clothes;</li>
<li>Cleaning products and cosmetics;</li>
<li>Too hot or warm weather - large and sharp temperature amplitudes too;</li>
<li>Cigarette smoke</li>
</ul>

How-to-diagnose-atopic-dermatitis

How to diagnose atopic dermatitis

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Laboratory tests are not needed to diagnose atopic dermatitis . The treating dermatologist will examine you or your child and, based on a clinical picture and family history, will be able to assess whether thisdiagnosis is involved. At least three of the four main clinical findings in atopic dermatitis are needed:

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<ul>
<li style="font-weight: 400;">pruritus (itching),</li>
<li style="font-weight: 400;">chronic or intermittent dermatitis,</li>
<li style="font-weight: 400;">family encumbrivity,</li>
<li style="font-weight: 400;">typical lesion location (described above)</li>
</ul>

How-to-treat-atopic-dermatitis

How to treat atopic dermatitis

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The treatment of atopic skin is aimed at relieving symptoms. Depending on the severity of thedisease, there are various medications that your treating dermatologist can refer to. Here are a few tips foryour own skin care:

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<ul>
<li style="font-weight: 400;">Avoiding the sing-in,</li>
<li style="font-weight: 400;">Avoidance of triggers such as allergens and stress,</li>
<li style="font-weight: 400;">Regular use of emollients - they keep theskin hydrated , which is extremely important both in the calmphases and in the stages of exacerbation of the condition,</li>
<li style="font-weight: 400;">It is recommended that the showers be lukewarm and not toohot.</li>
<li style="font-weight: 400;">Some detergents and fragrances may irritate the skin,</li>
<li style="font-weight: 400;">It should be approached with great care to cosmetics - it is good to avoid the use of soaps and creams with an alcohol content</li>
<li style="font-weight: 400;">Baths can be made that relieve itching</li>
</ul>

Myths-about-atopic-dermatitis

Myths about atopic dermatitis

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For the finale, we'll debunk afew myths that are going on on social media aboutatopic skin:

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<ul>
<li style="font-weight: 400;">Atopic dermatitis is infected - perhaps this idea has spread due to the redness and itching it causes, but as we explained above, the causes of its appearance are internal;</li>
<li style="font-weight: 400;">Children "grow it" - in some cases it is true, in others it is not;</li>
<li style="font-weight: 400;">Corticosteroids are the best treatment - corticosteroids are used to suppress the reaction of the immune system and relieve redness and itching. It is good to use them in more severe cases and for a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901393/" target="_blank" rel="noopener">limited</a> period [ref.11] from time to time, as it is mandatory to be with a doctor's prescription;</li>
<li style="font-weight: 400;">Pets predispose to the appearance of atopic dermatitis - there are numerous studies in this direction and the topic is controversial. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052969/" target="_blank" rel="noopener"></a> In general, there is no conclusive data [ref.12] for a negative effect, and there is even research showing that cohabitation at an early age lowers the risk of developing the disease.</li>
</ul>

Atopic dermatitis. NCBI, 2020

<a href="https://www.bioseek.eu/en/eng/research/pubmed/Atopic_dermatitis_30275844" target="_blank" rel="noopener">Atopic dermatitis</a>. Allergy, Asthma and Clinical Immunology, 2018

<a href="https://www.bioseek.eu/en/eng/research/pubmed/Pathophysiology_of_atopic_dermatitis_Clinical_implications_30819278" target="_blank" rel="noopener">Pathophysiology of atopic dermatitis: Clinical implications</a>. Allergy and Asthma Proceedings, 2019

<a href="../p/kakva_ie_razlikata_miezhdu_bieltk_i_protiein_b1b6b96e_e340_46d2_9768_ac9fa8cd6adc" target="_blank" rel="noopener">What is the difference between protein and protein</a>

FLG gene

<a href="https://www.bioseek.eu/en/eng/research/pubmed/Filaggrin_mutations_associated_with_skin_and_allergic_diseases_21991953" target="_blank" rel="noopener">Filaggrin mutations associated with skin and allergic diseases.</a> New England Journal of Medicine, 2011

<a href="https://www.bioseek.eu/en/eng/research/pubmed/The_skin_as_a_target_for_prevention_of_the_atopic_march_29413338" target="_blank" rel="noopener">The skin as a target for prevention of the atopic march</a>. Annals of Allergy, Asthma and Immunology, 2018

<a href="../p/zashcho_chrievniiat_mikrobiom_ie_tolkova_vazhien_za_nas_i_nashieto_biebie_f1c8c877_5195_4564_831e_1e2eef76df59" target="_blank" rel="noopener">The intestinal microbiome is extremely important to us and our baby</a>

Revised Estimates for the Number of Human and Bacteria Cells in the Body, NCBI, 2016

<a href="https://www.bioseek.eu/en/eng/research/pubmed/Psychoneuroimmunology_of_psychological_stress_and_atopic_dermatitis_pathophysiologic_and_therapeutic_updates_22101513" target="_blank" rel="noopener">Psychoneuroimmunology of psychological stress and atopic dermatitis: pathophysiologic and therapeutic updates.</a> Acta Dermato-Venereologica, 2012

Use of systemic corticosteroids for atopic dermatitis: International Eczema Council consensus statement, Br. J.Dermatol, 2018

Does Exposure to Cats or Dogs in Early Life Alter a Child's Risk of Atopic Dermatitis? J. Pediatr, 2011

Most common causes of recurrent pregnancy loss

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Chamomile is an herb known and used since ancient times. It has a variety of healing properties and its presence in the home first aid kit is mandatory. Find out why!

Chamomile - "The Panacea For All Diseases"

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Pregnancy is a delicate period and, as with any thing at this time, it is also necessary to approach herbs with due respect. Some of them contain active substances that cause contractions and their consumption should be limited.

Herbs To Avoid During Pregnancy

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Thalassemia and sickle cell anemia are relatively rare genetic diseases associated with mutations affecting hemoglobin. The quality of life of sufferers can be improved with appropriate supplements, vitamins, minerals and medicinal plants.

Herbs and Supplements to Help Thalassemia and Sickle Cell Disease Sufferers

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Hair is especially important for one's self-esteem but unfortunately your body can react with hair loss to various stressors from the external and internal environment. What are they and how to deal with hair loss using home remedies?

Hair loss: causes, treatment and home remedies to prevent it

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In recent years omega-3 fatty acids have gained popularity due to their numerous health benefits. They are an important part of lipid metabolism of animals and play a significant role in human health.

Omega-3 fatty acids: health benefits and sources

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It is known that children who live in modern societies and in urban environments suffer more often from autoimmune diseases, asthma, allergies, atopic dermatitis, than children who live closer to nature. There are many reasons for this...

Children need to play outside for a healthy immune system

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Atopic Dermatitis in Children and Adults

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 Atopic Dermatitis in Children and Adults

Силвия Маринова

Author: Yana Nencheva, Biochemist, PhD candidate in Biophysicist

Every 10 seconds, <a href="http://www.mh.government.bg/bg/informaciya-za-grazhdani/svetovni-zdravni-dni/svetoven-den-za-borba-s-diabeta-14-noemvri/" target="_blank" rel="noopener"></a>one person on the planet dies of diabetes and two are diagnosed with the disease. The World Health Organization (WHO) expects that in about ten years, more than 500 million people will be affected by diabetes.<a href="https://usbale.org/wp-content/uploads/2018/03/Doklad_Diabetes_Reg_2016_.pdf" target="_blank" rel="noopener"></a>

What-is-diabetes?

What is diabetes?

What-is-diabetes?_0_0

The hormone insulin is responsible for the metabolism of glucose (blood sugar). When for some reason the body can not provoke a normal reaction to the "orders" that insulin gives, or it is not produced in sufficient quantity, the path of glucose is disturbed.

What-is-diabetes?_0_1

In general, diabetes is an impaired metabolism that leads to high levels of glucose in the blood. By its very nature, diabetes mellitus is a chronic disease. The most common types of the disease are: type 1 diabetes, type 2 diabetes and gestational diabetes (in pregnancy). Type 2 diabetes is the most prevalent, accounting for 90% of the cases.

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Detailed information on causes, symptoms and treatment can be found on the following links:

What-is-diabetes?_0_3

<ul>
<li style="font-weight: 400;"><a href="/p/vsichko_za_diabiet_tip_1_na_iedno_miasto_751da342_2d55_43af_ae7f_1e1c89cd3800" target="_blank" rel="noreferrer">All about type 1 diabetes in one place</a> </li>
<li style="font-weight: 400;"><a href="/p/vsichko_za_diabiet_tip_2_na_iedno_miasto_9b1be4d6_84a7_42c6_8e37_de3bd6480ba1" target="_blank" rel="noreferrer">All about type 2 diabetes in one place</a> </li>
<li style="font-weight: 400;"><a href="/p/diabiet_po_vriemie_na_briemiennost_simptomi_riskovie_i_svieti_245acb17_9bf9_4af8_a562_bd8e4664e6e5" target="_blank" rel="noreferrer">Diabetes during pregnancy: symptoms, risks and advice</a> </li>
</ul>

What-are-the-five-herbs-that-might-help-in-diabetes

What are the five herbs that might help in diabetes

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We will consider 5 of the most famous herbs, which are considered useful in people suffering from diabetes and those who are at risk of the disease. Do they really help, or is it just a myth that science debunks?

Chamomile-(Matricaria-chamomilla)

1. Chamomile (Matricaria chamomilla)

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Chamomile (Matricaria chamomilla L. ) is a famous herb that is consumed in the form of tea worldwide. Studies have been conducted with rats that examine the influence of chamomile extract in hot water (and its main components respectively) on the prevention of hyperglycemia, prevention and treatment of complications in diabetes mellitus.

Chamomile-(Matricaria-chamomilla)_1_2

The extract was found to have a moderate suppressive effect on sugar in the short term. On the other hand, the long-term study (21 days of intake) reveals that the same doses of extract indicate a significant suppression of blood glucose levels.

Chamomile-(Matricaria-chamomilla)_1_3

Aldose reductase 2 (ALR2) <a href="/p/kakva_e_ienzim_i_koienzim_q10_0753d3e3_8aa2_4d4b_8933_5cff5c6c7a2f" target="_blank" rel="noreferrer"></a>is an enzyme whose activity increases in these tissues of the body, which are less sensitive to insulin and the amount of glucose is increased. It turns out that chamomile extract shows a strong inhibitory effect against aldose reductase 2.

Chamomile-(Matricaria-chamomilla)_1_4

The results suggest that daily consumption of chamomile tea may have its benefits on the prevention of the development of hyperglycemia and diabetic complications, but there is still much research to be done on how and to what extent this happens [<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Protective_effects_of_dietary_chamomile_tea_on_diabetic_complications_18681440" target="_blank" rel="noopener">ref. 1</a>].

Is-cinnamon-debunked-by-science

2. Is cinnamon debunked by science

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The effectiveness of cinnamon in patients with type 2 diabetes has received much media attention since the publication of a study in 2003. But the positive impact of cinnamon on diabetes patients has not been proven [<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Effect_of_cinnamon_on_glucose_control_and_lipid_parameters_17909085" target="_blank" rel="noopener">ref. 2</a>], and many patients who seek other therapies to supplement their doctor's prescription are misled.

Is-cinnamon-debunked-by-science_1_2

There are two randomized, double-blind, placebo-controlled, peer-reviewed clinical trials and one placebo-controlled clinical trial that evaluated the action of cinnamon in patients with type 2 diabetes. That's three studies with a total of 164 patients.

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Two of the studies reported that some patients had slight improvements in lowering blood glucose levels. And the third study showed no significant difference between the cinnamon effect and the placebo effect in terms of lowering blood glucose levels.

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In conclusion, it is strongly emphasised that clinicians refrain from recommending cinnamon instead of proven methods of dealing with diabetes, which include lifestyle change, oral antidiabetic agents and insulin therapy [<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Cinnamon_supplementation_in_patients_with_type_2_diabetes_mellitus_17381386" target="_blank" rel="noopener">ref. 3</a>].

Rosemary---part-of-the-Mediterranean-diet,-to-help-diabetics

3. Rosemary - part of the Mediterranean diet, to help diabetics

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Rosemary---part-of-the-Mediterranean-diet,-to-help-diabetics_1_1

It is believed that the Mediterranean diet protects against or delays the onset of cardiovascular disease, diabetes and various cancers. Rosemary (Rosmarinus officinalis) is a common spice in this type of diet and is often the reason to study its properties.

Rosemary---part-of-the-Mediterranean-diet,-to-help-diabetics_1_2

Over the past few years, regulators (including the European Union) have approved the use of rosemary extract as a preservative and have standardized it [<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Rosemary_Rosmarinus_officinalis_extract_modulates_CHOP_GADD153_to_promote_androgen_receptor_degradation_and_decreases_xenograft_tumor_growth_24598693" target="_blank" rel="noopener">ref. 4</a>].

Rosemary---part-of-the-Mediterranean-diet,-to-help-diabetics_1_3

Studies have shown that rosemary lowers blood glucose and cholesterol levels and suppresses weight gain. However, the mechanisms by which this is happening are currently unknown.

Rosemary---part-of-the-Mediterranean-diet,-to-help-diabetics_1_4

One of the studies investigated the effects of rosemary extract on metabolism and concluded that it has the potential to enhance liver glycolysis and fatty acid oxidation by activating key metabolic pathways [<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Rosemary_Rosmarinus_officinalis_L_extract_regulates_glucose_and_lipid_metabolism_by_activating_AMPK_and_PPAR_pathways_in_HepG2_cells_23432097" target="_blank" rel="noopener">ref. 5</a>].

The-role-of-dill-in-Asian-traditional-medicine

4. The role of dill in Asian traditional medicine

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Dill (Anethum graveolens) has been used for centuries in Asian traditional <a href="/p/kakvo_priedstavliava_altiernativnata_mieditsina_i_kakvi_sa_polzitie_ot_nieia_e2ecb339_f300_472f_a460_f58ef33f08ee" target="_blank" rel="noreferrer">medicine</a> and its ingredients are thought to have beneficial effects against diabetes (reduces complications associated with it) and cardiovascular disease (it has hypolipidemic and hypoglycemic effects).

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A study was conducted on historical and ethnopharmacological literature, as well as studies published in reputable scientific journals (available in Scopus, PubMed and Web of Science) to make a pharmacological and phytochemical evaluation of dill.

The-role-of-dill-in-Asian-traditional-medicine_1_3

It highlights the therapeutic effects of the plant, which would help to safely use it in the treatment of diabetes and cardiovascular <a href="https://www.bioseek.eu/bg/eng/research/pubmed/The_Role_of_Anethum_graveolens_L_Dill_in_the_Management_of_Diabetes_27829842" target="_blank" rel="noopener"></a> disease. Naturally, this requires even more serious research and clinical trials to determine the dose and the exact mechanism. You can read the full report at the following <a href="https://www.bioseek.eu/en/eng/research/pubmed/The_Role_of_Anethum_graveolens_L_Dill_in_the_Management_of_Diabetes_27829842" target="_blank" rel="noopener">this link</a>.

Cumin-and-Vitamin-E

5. Cumin and Vitamin E

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Cumin-and-Vitamin-E_1_1

The results obtained in one of the studies indicate that cumin (Cuminium cyminum) is a promising antidiabetic agent and exhibits pharmacodynamic interaction together with glibenclamide, also known as glyburide, to alleviate the symptoms of diabetes mellitus [<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Pharmacodynamic_interaction_of_cumin_seeds_Cuminum_cyminum_L_with_glyburide_in_diabetes_31348760" target="_blank" rel="noopener">ref. 6</a>].

Cumin-and-Vitamin-E_1_2

Vitamin E improves sensitivity to insulin, while cumin is effective in remission of diabetes. Therefore, this study was intended to evaluate the effect of essential oil on cumin and vitamin E. In the double-blind clinical trial, 95 patients with diabetes were examined, which were randomly divided into three groups.

Cumin-and-Vitamin-E_1_3

<ul>
<li style="font-weight: 400;">The first group takes essential oil of cumin in the form of capsules.</li>
<li style="font-weight: 400;">The second group takes Vitamin E.</li>
<li style="font-weight: 400;">The third group was controlled - participants in it took gelatin placebo capsules for three months.</li>
</ul>

Cumin-and-Vitamin-E_1_4

After assessing blood results before and after intake, the results showed that cumin, compared to vitamin E, has a broader impact on the key parameters for diabetes and is more useful in terms of the ability to reduce the diabetic index [<a href="https://www.bioseek.eu/bg/eng/research/pubmed/A_Comparison_Between_the_Effect_of_Cuminum_Cyminum_and_Vitamin_E_on_the_Level_of_Leptin_Paraoxonase_1_HbA1c_and_Oxidized_LDL_in_Diabetic_Patients_28357199" target="_blank" rel="noopener">ref. 7</a>]. Of course, it cannot replace the complete treatment, which is complex.

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