Antioxidant action of natural health products and Chinese herbs

The scavenging effects of reactive oxygen species (ROS) by two natural health products, antioxidant analogs (AOA), and green magma (GM), and 16 medical Chinese herbs were investigated in two in vitro ROS-generating systems, activated neutrophils and xanthine-xanthine oxidase. Native, unheated AOA and GM products significantly reduced ROS levels, while unheated Chinese herbs had a negligible effect on ROS levels. In contrast, heat-extracted Chinese herbs and AOA markedly, and GM mildly, suppressed the levels of ROS in both systems. The ROS scavenging activity of these native, unheated products was unaffected by dialysis, but that of heated products was markedly diminished by dialysis. Further, the incubation of these products with gastric juice obtained by a gastric tube from healthy volunteers revealed results comparable to those induced by heat treatment with or without dialysis. Although the antioxidant activity of these natural products appears to be partly due to enzymes such as superoxide dismutase (SOD), the predominant factor seems to be low-molecular-weight ROS scavengers that are liberated or activated by gastric juice digestion as observed after heat treatment.     

中药诱导骨髓间充质干细胞的成骨分化

背景：某些中药可以诱导骨髓间充质干细胞的成骨分化。骨髓间质干细胞向成骨分化的潜能,与中药治疗骨质疏松症、骨折、骨坏死、骨缺损等骨相关疾病有着理论上的相通性。 目的：了解中药诱导骨髓间充质干细胞成骨分化的发展现状,为进一步的研究奠定基础。 方法：由第一作者检索2000-01/2010-06中国期刊全文数据库(CNKI)(http://www.cnki.net/)及Pubmed数据库(http://www.ncbi.nlm.nih.gov/PubMed)。中文检索词为“中药,骨髓间充质干细胞,成骨分化”。英文检索词为“chinese herb, mesenchymal stem cells, osteogenic differentiation”。文献检索语种限定为中文和英文,纳入中药单体、单味中药、中药复方等及其含药血清在体内或体外对人或动物骨髓间充质干细胞成骨分化作用的研究文献,排除重复研究。 结果与结论：共纳入32篇文献,有关骨髓间充质干细胞研究背景的文献2篇;有关单味中药的文献5篇,其中补肾药4篇,补气药1篇;有关中药复方的文献10篇,其中补肾方6篇,补肾活血方4篇;有关中药有效组分的文献15篇。补肾、补气及活血类中药可以诱导骨髓间充质干细胞向成骨细胞分化,但以补肾类中药为主,在一定程度上阐释了“肾主骨”理论的科学内涵,并为体外大量扩增骨髓间充质干细胞、促成骨分化及组织工程骨提供了更多的种子细胞来源。     

Artemisinin inhibits inflammatory response via regulating NF-κB and MAPK signaling pathways

Artemisinin, isolated from the Chinese plant Artemisia annua, has been used for many years to treat different forms of malarial parasites. In this study, we explored the anti-inflammatory activity of artemisinin and the underlying mechanism of this action. We demonstrated that the anti-inflammatory effects of artemisinin in TPA-induced skin inflammation in mice. Then the artemisinin significantly inhibited the expression of NF-κB reporter gene induced by TNF-α in a dose-dependent manner. Artemisinin also inhibited TNF-α induced phosphorylation and degradation of IκBα, p65 nuclear translocation. Artemisinin also has an impact on upstream signaling of IKK through the inhibition of expression of adaptor proteins, TNF receptor-associated factor 2 (TRAF2) and receptor interacting protein 1 (RIP1). Furthermore, pretreatment of cells with artemisinin prevented the TNF-α-induced expression of NF-κB target genes, such as anti-apoptosis (c-IAP1, Bcl-2, and FLIP), proliferation (COX-2, cyclinD1), invasion (MMP-9), angiogenesis (VEGF), and major inflammatory cytokines (TNF-α, iNOS, and MCP1). We also proved that artemisinin potentiated TNF-α-induced apoptosis. Moreover, artemisinin significantly impaired the ROS production and phosphorylation of p38 and ERK, but did not affect the phosphorylation of JNK. Taken together, artemisinin may be a potentially useful therapeutic agent for inflammatory-related diseases.     

Bioactivities of major constituents isolated from Angelica sinensis (Danggui)

Danggui, also known as Angelica sinensis (Oliv.) Diels (Apiaceae), has been used in Chinese medicine to treat menstrual disorders. Over 70 compounds have been isolated and identified from Danggui. The main chemical constituents of Angelica roots include ferulic acid, Z-ligustilide, butylidenephthalide and various polysaccharides. Among these compounds, ferulic acid exhibits many bioactivities especially anti-inflammatory and immunostimulatory effects; Z-ligustilide exerts anti-inflammatory, anti-cancer, neuroprotective and anti-hepatotoxic effects; n-butylidenephthalide exerts anti-inflammatory, anti-cancer and anti-cardiovascular effects.     

Anthelmintic activity of Artemisia annua L. extracts in vitro and the effect of an aqueous extract and artemisinin in sheep naturally infected with gastrointestinal nematodes

There is no effective natural alternative control for gastrointestinal nematodes (GIN) of small ruminants, with Haemonchus contortus being the most economically important GIN. Despite frequent reports of multidrug-resistant GIN, there is no new commercial anthelmintic to substitute failing ones. Although trematocidal activity of artemisinin analogs has been reported in sheep, neither artemisinin nor its plant source (Artemisia annua) has been evaluated for anthelmintic activity in ruminants. This study evaluated the anthelmintic activity of A. annua crude extracts in vitro and compared the most effective extract with artemisinin in sheep naturally infected with H. contortus. A. annua leaves extracted with water, aqueous 0.1 % sodium bicarbonate, dichloromethane, and ethanol were evaluated in vitro by the egg hatch test (EHT) and with the bicarbonate extract only for the larval development test (LDT) using H. contortus. The A. annua water, sodium bicarbonate (SBE), ethanol, and dichloromethane extracts tested in vitro contained 0.3, 0.6, 4.4, and 9.8 % of artemisinin, respectively. The sodium bicarbonate extract resulted in the lowest LC₉₉ in the EHT (1.27 μg/mL) and in a LC₉₉ of 23.8 μg/mL in the LDT. Following in vitro results, the SBE (2 g/kg body weight (BW)) and artemisinin (100 mg/kg BW) were evaluated as a single oral dose in naturally infected Santa Inês sheep. Speciation from stool cultures established that 84–91 % of GIN were H. contortus, 8.4–15.6 % were Trichostrongylus sp., and 0.3–0.7 % were Oesophagostomum sp. Packed-cell volume and eggs per gram (EPG) of feces were used to test treatment efficacy. The SBE tested in vivo contained no artemisinin, but had a high antioxidant capacity of 2,295 μmol of Trolox equivalents/g. Sheep dosed with artemisinin had maximum feces concentrations 24 h after treatment (126.5 μg/g artemisinin), which sharply decreased at 36 h. By day 15, only levamisole-treated sheep had a significant decrease of 97 % in EPG. Artemisinin-treated and SBE-treated sheep had nonsignificant EPG reductions of 28 and 19 %, respectively, while sheep in infected/untreated group had an average EPG increase of 95 %. Sheep treated with artemisinin and A. annua SBE maintained blood hematocrits throughout the experiment, while untreated/infected controls had a significant reduction in hematocrit. This is the first time oral dose of artemisinin and an aqueous extract of A. annua are evaluated as anthelmintic in sheep. Although oral dose of artemisinin and SBE, at single doses, were ineffective natural anthelmintics, artemisinin analogs with better bioavailability than artemisinin should be tested in vivo, through different routes and in multiple doses. The maintenance of hematocrit provided by artemisinin and A. annua extract and the high antioxidant capacity of the latter suggest that they could be combined with commercial anthelmintics to improve the well-being of infected animals and to evaluate potential synergism.     

The isolation and characterization of kadsurenone from haifenteng (Piper futokadsura) as an orally active specific receptor antagonist of platelet-activating factor

A natural product, kadsurenone, was isolated from the Chinese herbal preparation haifenteng (Caulis piperis futokadsurae) and characterized as an orally-active specific antagonist of the platelet-activating factor (PAF). Kadsurenone inhibits the specific binding of 3H-PAF to a receptor preparation from rabbit platelet membrane in a competitive and reversible manner, its Ki being 3.88 X 10(-8) M. It inhibits the aggregation of rabbit platelets in plasma induced by PAF with a pA2 of 6.28, but not those induced by arachidonic acid, epinephrine, ADP or A-23187. It inhibits the aggregation of isolated human neutrophils with a pA2 of 6.32. It also inhibits PAF-induced degranulation and release of beta-D-glucuronidase at 2-24 microM in vitro. In the rat, kadsurenone at 8-40 mg/kg i.p. inhibits the increases of plasma lysosomal enzymes and haematocrit induced by intravenous PAF. In the guinea pig, kadsurenone at 25-50 mg/kg p.o. reduces the increase of cutaneous vascular permeability induced by PAF. These results indicate that kadsurenone is a specific and effective receptor antagonist of PAF in several in vitro and in vivo systems.     

CXCR4 and CCR5 expression on CD4+ T cells in vivo and HIV-1 antigen beta-chemokine production in vitro after treatment with HIV-1 immunogen (REMUNE)

BACKGROUND: The chemokine receptors CXCR4 and CCR5 have been identified as the major coreceptors for HIV-1 on CD4+ cells and macrophages. The natural ligands for these receptors are SDF-1 and the beta-chemokines (MIP-1alpha, MIP-1beta, RANTES), respectively, and are the products of a variety of immune cells, including CD8+ T lymphocytes. STUDY DESIGN/METHODS: We hypothesized that the ability to stimulate the natural ligands for these receptors using an immune based therapy might influence in vivo chemokine receptor expression. RESULTS: In vivo CXCR4 expression remained stable after treatment with an HIV-1 Immunogen (REMUNE), whereas CCR5 expression on CD4+ T cells decreased (p < .05). Furthermore, HIV-1 antigen-specific production of beta-chemokines in vitro was also augmented (P < .05). CONCLUSIONS: These preliminary results suggest that this HIV-1-specific immune-based therapy can stimulate antigen-specific beta-chemokine production in vitro and downregulate CCR5 receptor expression on CD4 cells in vivo.     

新型组织工程支架材料

主要对近几年可吸收降解生物材料的研究状况做了一简要综述。包括胶原、纤维蛋白、甲壳素及其衍生物、天然珊瑚等天然材料，也包括聚乳酸、聚乙醇酸、聚原酸酯、聚磷腈、聚酸酐等合成材料。     

Curcumin nanoformulations: A review of pharmaceutical properties and preclinical studies and clinical data related to cancer treatment

Curcumin, a natural yellow phenolic compound, is present in many kinds of herbs, particularly in Curcuma longa Linn. (turmeric). It is a natural antioxidant and has shown many pharmacological activities such as anti-inflammatory, anti-microbial, anti-cancer, and anti-Alzheimer in both preclinical and clinical studies. Moreover, curcumin has hepatoprotective, nephroprotective, cardioprotective, neuroprotective, hypoglycemic, antirheumatic, and antidiabetic activities and it also suppresses thrombosis and protects against myocardial infarction. Particularly, curcumin has demonstrated efficacy as an anticancer agent, but a limiting factor is its extremely low aqueous solubility which hampers its use as therapeutic agent. Therefore, many technologies have been developed and applied to overcome this limitation. In this review, we summarize the recent works on the design and development of nano-sized delivery systems for curcumin, including liposomes, polymeric nanoparticles and micelles, conjugates, peptide carriers, cyclodextrins, solid dispersions, lipid nanoparticles and emulsions. Efficacy studies of curcumin nanoformulations using cancer cell lines and in vivo models as well as up-to-date human clinical trials are also discussed.     

Pharmacological effects of medicinal components of <Emphasis Type="Italic">Atractylodes lancea</Emphasis> (Thunb.) DC.

Atractylodes lancea Thunb. DC. (AL) has a long history as one of the important herbs used in East Asia. This review is on the purpose of providing a comprehensive summary of the pharmacological effects of AL and its extractions. The publication from PubMed, ScienceDirect, Springer, and Wiley database was collected and summarized. The potential application of AL on the disease could be attributed to its pharmacological properties such as anti-cancer, anti-inflammatory and other essential effects. Hence, this review aims at providing evidence of the pharmacological activities of AL as one of natural products used in clinical trial.     

Drug resistance in malaria

Antimalarial chemotherapy is an important component of all malaria control programmes throughout the world. This is especially so in light of the fact that there are no antimalarial vaccines which are available for clinical use at present. Emergence and spread of malaria parasites which are resistant to many of the available antimalarials today is, therefore, a major cause for concern. Till date, resistance to all groups of antimalarials excluding artemisinin has been reported. In recent years, in vitro resistance to even artemisinin has been described. While resistance to antibacterial agents has come to prominence as a clinical problem in recent years, antiparasitic resistance in general and antimalarial resistance in particular has not received much attention, especially in the Indian scenario. The present review deals with commonly used antimalarial drugs and the mechanisms of resistance to them. Various methods of detecting antimalarial resistance and avoiding the same have also been dealt with. Newer parasite targets which can be used in developing newer antimalarial agents and antimalarials obtained from plants have also been mentioned.     

Cycloleucine fluxes during rat vasa recta and loop microinfusions in vivo and loop microperfusions in vitro

Amino acids are apparently recycled between loops of Henle and vasa recta in rat papilla in vivo. To examine this process in the absence of metabolism, we performed continuous microinfusions of rat renal papillary ascending thin limbs (ATLs) and vasa recta in vivo, and microperflusions of isolated rat renal papillary descending thin limbs (DTLs) and ATLs in vitro using the nonmetabolizable, synthetic, neutral amino acid cycloleucine. Like naturally occurring amino acids, approximately = 25% of radiolabeled cycloleucine microinfused into ATLs in vivo was reabsorbed by a process that was not saturable or inhibitable. Also, like naturally occurring amino acids, approximately = 47% (relative to inulin) of radiolabeled cycloleucine microinfused into ascending vasa recta in vivo was transferred directly into ipsilateral tubular structures (probably DTLs) by a saturable and inhibitable process. In DTLs perfused in vitro, unidirectional bath-to-lumen fluxes (Jbl) tended to exceed unidirectional lumen-to-bath fluxes (Jlb), whereas in ATLs perfused in vitro Jlb tended to exceed Jbl, but the differences were not statistically significant. Moreover, none of the unidirectional fluxes was saturable or inhibitable, an observation compatible with apparent reabsorption from ATLs in vivo but incompatible with apparent movement from vasa recta to DTLs in vivo. These in vitro observations are like those made previously for the naturally occurring neutral amino acid L-alanine. The lack of saturation and inhibition, like the previous data on L-alanine, suggest that transepithelial movement of amino acids in thin limbs of Henle's loop may occur via a paracellular route and that regulation of amino acid movement in vivo may involve vasa recta, not DTLs. They also suggest that cycloleucine is a good nonmetabolizable surrogate for the study of neutral amino acid transport in the kidney.     

Relationship of glucocorticoid suppression of arachidonic acid metabolism to alteration of neutrophil function

The role of arachidonic acid metabolism in glucocorticoid-induced suppression of neutrophil function was investigated. In vivo treatment of cattle with dexamethasone decreased the production of lipoxygenase products of arachidonic acid metabolism (leukotriene B4 [LTB4] and H-5-hydroxy-6,8,11,14-eicosatetraenoic acid [5-HETE]) in neutrophils. We previously reported that in vivo dexamethasone treatment resulted in alteration of in vitro neutrophil oxidative metabolism, iodination, antibody-dependent cell-mediated cytotoxicity (ADCC), and random migration. To determine if the decrease in production of LTB4 and 5-HETE were responsible for the changes in neutrophil function, neutrophils were treated in vitro with inhibitors of the lipoxygenase enzyme (BW755c and nordihydroguaiaretic acid), and their function was evaluated. A decrease in neutrophil oxidative metabolism and iodination was observed, but there was no effect on neutrophil random migration or ADCC. The results suggest that in vivo treatment with glucocorticoids inhibit neutrophil oxidative metabolism and iodination by decreasing the formation of lipoxygenase products of arachidonic acid metabolism but alter neutrophil random migration and ADCC by a mechanism independent of arachidonic acid metabolism.     

In vitro and in vivo evaluation of antifungal agents

The evaluation of any antifungal agent involves the determination of its in vitro and in vivo activity against pathogenic and/or opportunistic fungi. The in vitro evaluation is followed by an in vivo evaluation in animal models, and clinical trials in humans. From the first report of the efficacy of the iodides for the treatment of sporotrichosis (1903) until the introduction of the imidazoles (azoles, 1960s), the number of antifungal agents available was very limited, including griseofulvin (1939), nystatin (1950), amphotericin B (1956), and flucytosine (1964). This paper briefly reviews the status of the antifungal agents currently used, and gives a more in depth evaluation of progress during recent years in the search for new antifungal drugs. Efforts to improve the efficacy of the current antifungal agents are also reviewed.     

人肝癌细胞胰岛素抵抗模型建立及有效中药成分的筛选

背景：目前,复方中药、单味中药在体内降糖作用及其降糖机制研究较多,但体外尤其是中药单体成分对胰岛素抵抗细胞有何影响尚不清楚。 目的：体外建立人肝癌细胞(HepG2)胰岛素抵抗模型,并初步筛选可有效改善胰岛素抵抗的中药有效成分。 方法：用不同浓度的胰岛素对HepG2细胞进行不同时间的诱导,通过MTT法对细胞活性评价及葡萄糖氧化酶法对HepG2细胞葡萄糖消耗量测定,明确建立稳定的HepG2胰岛素抵抗模型的胰岛素诱导浓度及诱导时间。模型建立后,应用不同浓度的齐墩果酸、药根碱、阿魏酸、大黄酸、马钱苷、葛根素、大豆苷分别作用于胰岛素抵抗细胞24 h,用葡萄糖氧化酶法分别观察不同浓度的上述中药成分对胰岛素抵抗模型HepG2细胞葡萄糖消耗的影响,MTT法对各组细胞活性进行评价。 结果与结论：HepG2细胞在10^-6  mol/L浓度的胰岛素中作用24 h,葡萄糖消耗量明显减少(P < 0.01),说明实验成功诱导出稳定人肝癌细胞胰岛素抵抗模型。10^-5 mol/L浓度胰岛素组的胰岛素抵抗更明显(P < 0.01)。各时间点10^-5 mol/L浓度胰岛素作用的细胞成活率逐渐降低,死亡细胞增多(P < 0.05)。齐墩果酸、药根碱、阿魏酸、大黄酸、马钱苷、葛根素、大豆苷均有改善细胞胰岛素抵抗的作用。其中,质量浓度2×10^-1 g/L药根碱、大黄酸、葛根素和齐墩果酸,2×10^-5 g/L马钱苷和阿魏酸对改善人肝癌细胞胰岛素抵抗效果较好(P < 0.01)。     

In vitro and in vivo evaluation of six artemisinin derivatives against Schistosoma mansoni

Schistosomiasis is a tropical neglected disease whose socioeconomic impact is surpassed only by malaria. Until recently, praziquantel (PZQ) has been the only available drug, raising concerns that tolerant/resistant strains may appear. Since the discovery of the schistosomicidal potential of artemisinin (ART), new derivatives have been produced and evaluated. In this work, we evaluated the activity of ART derivatives against Schistosoma mansoni, both in vitro and in vivo. In the in vitro assay, worm survival, oviposition, and morphological alterations were evaluated. Further analysis of morphological alterations and membrane integrity was conducted using scanning electron microscopy and a cell-permeable, benzimidazole dye (Hoescht 33258) that binds to the minor groove of double stranded DNA. For the in vivo assay, artesunic acid (AcART) and dihydroartemisinin acetate (AcDQHS) were selected, since they showed the best in vitro results. Infected mice treated 21, 45, or 60 days post-infection (dpi), with a concentration of 100 mg/kg of either AcART or AcDQHS, showed a significant worm reduction (particularly in females), fewer eggs eliminated in feces, and a decrease of immature eggs in the intestinal tissues. Our results indicate that AcART and AcDQHS have some schistosomicidal activity against juvenile and adult stages of S. mansoni.

     

Targeting DNA repair proteins: a promising avenue for cancer gene therapy

Enhanced DNA repair in many cancer cells can be correlated to the resistance to cancer treatment, and thus contributes to a poor prognosis. Ionizing radiation and many anti-cancer drugs induce DNA double-strand breaks (DSBs), which are usually regarded as the most toxic types of DNA damages. Repair of DNA DSBs is vital for maintaining genomic stability and hence crucial for survival and propagation of all cellular organisms. Therefore, reducing the capacity of cancer cells to repair DSBs could sensitize tumors to radio/chemotherapy. Many investigators have used gene therapy strategies to down-regulate or inactivate proteins involved in the repair of DSBs in order to reduce the survival of cancer cells. Herein, are reviewed several protein candidates that have been targeted by different gene therapy approaches. Results obtained from in vitro and in vivo experiments are presented and discussed in the perspective of potential gene therapy clinical trials.     

Free radical reactions might contribute to severe alpha amanitin hepatotoxicity--a hypothesis

Alpha amanitin is a powerful natural hepatotoxin that belongs to the amatoxins isolated from deadly poisonous Amanita phalloides mushroom. The basic molecular mechanism of their toxicity was attributed to inhibition of RNA polymerase II of the eukaryotic cells. At present, the most effective clinical antidote to acute Amanita phalloides mushroom poisoning is silybin, an antioxidant possessing free radical scavenger activity and inhibiting lipid peroxidation, stabilizing membrane structure and protecting enzymes under conditions of oxidative stress. Bearing in mind the biological mechanism of silybin action and the fact that for different amatoxins (alpha, beta, and est. amanitins) does not established straight correlation between their in vivo LD50 and inhibitory constants (Ki) toward RNA polymerase III in vitro determined we supposed some additional toxic effects of these toxins might contribute to their severe hepatotoxicity. Our formerly in vitro experiments demonstrated that alpha amanitin could act either as an antioxidant or as a prooxidant depending on the treatment conditions and toxin concentration. By UV-visible spectroscopy we also shown that alpha amanitin was sensitive to oxidation by a system of lactoperoxidase/H(2)O(2) and assumed formation of free radical toxin intermediates. Having in mind some exogenic compounds including natural toxins can induce increased production of reactive oxygen species (ROS) we suggested similar generation of ROS provoked by alpha amanitin. Our recently in vitro studies have demonstrated that the alpha amanitin could increase superoxide dismutase (SOD) activity and inhibit catalase (CAT) activity to a considerable degree after together incubation of the toxin with any of enzymes. We have also shown that in vitro increased SOD activity was due to superoxide anion radical scavenging activity (SSA) of the toxin. This therefore informed the decision to study the in vivo effect of alpha amanitin on SOD and CAT activity and the level of lipid peroxidation (LPO) products in liver homogenates isolated from mice treated with the toxin. Statistical significant increased level of LPO products was found at the 6th day comparing to the 20th hour after mice treatment with a subletal dose of the toxin. Based on our previous in vitro and present in vivo studies we have made a hypothesize that in vivo during liver accumulation of the toxin it might be transformed to free radical intermediates causing increase in ROS levels. As a result a peroxidative process in hepatocytes might contribute to the severe alpha amanitin hepatotoxicity.     

Lung surfactant for replacement therapy

In recent years, several attempts have been made to treat, or prevent, the neonatal respiratory distress syndrome (RDS) with exogenous surfactants. The most successful clinical trial so far reported concerned a series of artificially ventilated RDS-patients who were treated with a mixture of bovine natural surfactant and the synthetic phospholipids dipalmitoylphosphatidylcholine (DPPC) and unsaturated phosphatidylglycerol (PG). The rationale of this combination is that enrichment of natural surfactant with DPPC and PG strikingly modifies the lin vitro surface properties of the surfactant preparation, reducing surface tension to very low values already at moderate surface compression. In other similar clinical trials, promising results have been obtained with natural surfactant suspended with CaCl2, with human surfactant purified from amniotic fluid, and with protein-free natural surfactant from bovine lungs. Encouraging results have also been reported from a recent trial in which a dry, artificial surfactant, composed of DPPC and unsaturated PG, was administered prophylactically into the airways of premature babies shortly after birth. More studies, involving a combination of in vitro and in vivo experiments, are nevertheless needed to identify the optimal composition of an artificial surfactant and to evaluate the long-term effects of surfactant replacement on the premature lung.     

Aromatic components of food as novel eliciting factors of pseudoallergic reactions in chronic urticaria

BACKGROUND: Pseudoallergic reactions (PARs) against both additives and natural foods have been reported to elicit chronic urticaria, but in natural food the responsible ingredients are largely unknown. OBJECTIVE: The study was aimed at identifying novel pseudoallergens in food and focused on evaluating tomatoes, white wine, and herbs as frequently reported food items eliciting wheal responses in urticaria. METHODS: In 33 patients with chronic urticaria and PARs to food (proved by means of elimination diet and subsequent re-exposure with provocation meals), oral provocation tests were performed with field-grown tomatoes, organically grown white wine (whole food, steam distillates, and residues), oily extracts from herbs, and food additives. In addition, skin biopsy specimens from patients were studied for in vitro mast-cell histamine release with tomato distillate alone or on subsequent stimulation with anti-IgE, substance P, and C5a. RESULTS: Seventy-six percent of patients reacted to whole tomato (steam distillate, 45%; residue, 15%), 50% to food additives, 47% to herbs, and 44% to whole wine (extract, 27%; residue, 0%). Histamine, protein, and high levels of salicylate were only found in residues. The tomato distillate was further analyzed by means of mass spectroscopy, identifying low molecular-weight aldehydes, ketones, and alcohol as major ingredients. In vitro histamine release was not caused by tomato extract itself but was enhanced by means of subsequent stimulation with substance P and C5a but not by anti-IgE. CONCLUSION: Aromatic volatile ingredients in food are novel agents eliciting PARs in chronic urticaria. Histamine, salicylate, and a direct mast-cell histamine release are not involved in this reactivity to naturally occurring pseudoallergens.