The prevalence of acute respiratory infections and their impact on quality of life underlies the need for efficacious solutions that are safe, sustainable and economically viable. Polysaccharides in several (traditional) plant extracts have been shown to be immunostimulatory, and some studies suggest beneficial effects against respiratory infections. The aim of this study was to (i) identify the active polysaccharide constituents from affordable and renewable crops (bell pepper and carrot) using activity-guided fractionation, (ii) evaluate in vitro effects on innate immune responses (phagocytosis and cytokine secretion), microbiota modulation and production of short chain fatty acids, followed by (iii) the evaluation of effects of a bell pepper extract enriched for the active component in a human proof of concept study. We identified rhamnogalacturonan-I (RG-I) as the nutricophore responsible for the immunostimulatory activity with substantial structural and functional equivalence between bell pepper (bp) and carrot (c). The in vitro studies showed that bpRG-I and cRG-I comprise similar immune- and microbiota modulatory potential and the human study demonstrated that bpRG-I was well tolerated and enhanced innate immune responsiveness in vivo. This is an important step towards testing the efficacy of RG-I from bpRG-I or cRG-I in an infection trial in humans.

The special formulation MA212 (Rosaxan) is composed of rosehip ( L.) puree/juice concentrate, nettle ( L.) leaf extract, and devil's claw ( DC. ex Meisn. or Decne.) root extract and also supplies vitamin D. It is a food for special medical purposes ([EU] No 609/2013) for the dietary management of pain in patients with gonarthritis.This 12-week randomized, placebo-controlled double-blind parallel-design study aimed to investigate the efficacy and safety of MA212 versus placebo in patients with gonarthritis.A 3D-HPLC-fingerprint (3-dimensional high pressure liquid chromatography fingerprint) of MA212 demonstrated the presence of its herbal ingredients. Ninety-two randomized patients consumed 40 mL of MA212 (n = 46) or placebo (n = 44) daily. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), quality-of-life scores at 0, 6, and 12 weeks, and analgesic consumption were documented. Statistically, the initial WOMAC subscores/scores did not differ between groups. During the study, their means significantly improved in both groups. The mean pre-post change of the WOMAC pain score (primary endpoint) was 29.87 in the MA212 group and 10.23 in the placebo group. The group difference demonstrated a significant superiority in favor of MA212 (p < 0.001; p < 0.001). Group comparisons of all WOMAC subscores/scores at 6 and 12 weeks reached same significances. Compared to placebo, both physical and mental quality of life significantly improved with MA212. There was a trend towards reduced analgesics consumption with MA212, compared to placebo. In the final efficacy evaluation, physicians (p < 0.001) and patients (p < 0.001) rated MA212 superior to placebo. MA212 was well tolerated.This study demonstrates excellent efficacy for MA212 in gonarthritis patients.

The data demonstrate effectiveness of a hydrogen carbonate-rich mineral water in alleviating heartburn frequency and severity, thereby improving quality of life. The water has excellent tolerability.

Background: Dyspepsia and heartburn are among the most frequent complaints of the upper gastrointestinal tract impacting quality of life. The present study aimed to investigate the impact of drinking a natural mineral water (medicinal product category "Heilwasser" in Germany) high in hydrogen carbonate (Staatl. Fachingen STILL) on functional dyspeptic complaints and heartburn. Methods: 56 men and women with self-reported heartburn were enrolled to this one-arm pilot study. They had to drink 1.5 L of a hydrogen carbonate rich mineral water each day over a course of six weeks. Participants reported the number and duration of heartburn episodes in a daily dairy. The Reflux Disease Questionnaire (RDQ), Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD) and the Gastrointestinal Quality of Life Index (GILQI) were used to assess the therapeutic course of the treatment and the Short Form Health Survey (SF-12) to assess general quality of life. Mean ± standard deviation were calculated and pre-and post-treatment changes were compared using the Wilcoxon test. Results: The consumption of a hydrogen carbonate rich mineral water decreased the number of heartburn episodes per week significantly by 4.8 ± 8.2 at the end of the study (p < 0.001). The duration of episodes was also significantly reduced by 25.7 minutes after six weeks of intervention (p < 0.001). Accordingly, the subjectively perceived severity of heartburn, regurgitation and dyspeptic complaints as well as the GERD dimension as assessed by Reflux Disease Questionnaire improved significantly. There was a significant improvement in the disease-specific quality of life as measured by the Gastrointestinal Quality of Life Index (p < 0.001) and by the Quality Of Life in Reflux and Dyspepsia (p < 0.001) questionnaires and the general health-related quality of life as assessed by SF-12 (p < 0.007). Conclusions: The present pilot study provides evidence that supplementation with natural mineral water rich in hydrogen * Corresponding author. U. Pohl et al. 89carbonate may improve heartburn and dyspeptic symptoms, which finally resulted in an improvement of the subjectively perceived quality of life. Drinking mineral water rich in hydrogen carbonate may be an alternative remedy for the treatment of dyspeptic symptoms and heartburn.

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