The Use of Herbal Medicines for the Prevention of Glucocorticoid-Induced Osteoporosis

Abstract

Glucocorticoids are drugs that are widely used to suppress inflammation and the activation of the immune system. However, the prolonged use or at high doses of glucocorticoid can result in adverse side effects including osteoporosis, bone loss, and an increased risk of fracture. A number of compounds derived from natural plant sources have been reported to exert anti-inflammatory activity by interacting with the glucocorticoid receptor (GR), likely owing to their chemical similarity to glucocorticoids, or by regulating GR, without a concomitant risk of treatment-related side effects such as osteoporosis. Other herbal compounds can counteract the pathogenic processes underlying glucocorticoid-induced osteoporosis (GIOP) by regulating homeostatic bone metabolic processes. Herein, we systematically searched the PubMed, Embase, and Cochrane library databases to identify articles discussing such compounds published as of May 01, 2021. Compounds reported to exert anti-inflammatory glucocorticoid-like activity without inducing GIOP include escin, ginsenosides, and glycyrrhizic acid, while compounds reported to alleviate GIOP by improving osteoblast function or modulating steroid hormone synthesis include tanshinol and icariin.

Two case studies of persistent white hair regrowth after alopecia areata turning pigmented following treatment

“…According to our clinical experience, we believe that patients should be given methylprednisolone to inhibit the damage to follicles caused by effector T lymphocytes and prevent the progression of the disease 19 . Glycyrrhizin, the main component of compound glycyrrhizin tablets, has effects similar to those of steroid hormones but without hormone‐related adverse reactions 20 . These two drugs can regulate immunity, reduce inflammation‐induced damage to the hair follicle growth cycle, restore the normal growth cycle of hair follicles, and promote hair growth.…”

Epimedin C Alleviates Glucocorticoid-Induced Suppression of Osteogenic Differentiation by Modulating PI3K/AKT/RUNX2 Signaling Pathway

“…The beneficial properties of Chinese herbal medicine in clinical and experimental osteoporosis therapy are currently supported by published research and clinical studies ( Zhang et al, 2016 ). Multiple research reports have demonstrated that Chinese herbal medication could help individuals with GIOP elevate their bone density and relieve their clinical symptoms ( Zhang et al, 2021 ). Epimedii herba is a natural chemical that is progressively being explored in the treatment and prevention of osteoporosis due to its pharmacological properties of reducing bone resorption and accelerating bone formation ( Ming et al, 2013 ).…”

The Role of Flavonoids in the Osteogenic Differentiation of Mesenchymal Stem Cells

“…In addition to directly stimulating the osteogenesis of MSCs, flavonoids could also indirectly affect the osteogenic differentiation of MSCs by their well-known antioxidant and anti-inflammatory properties ( Schilling et al, 2014 ; Zhang ND. et al, 2016 ; Zhang L. et al, 2021 ). Besides, flavonoids were also loaded on bioscaffolds for the promotion of MSCs self-renewal and differentiation in bone regeneration.…”