Original Article
Split ViewerIn Vitro Antioxidant Activity and Anticonvulsant Properties on Zebrafish PTZ-Induced Seizure Model of a Tilia viridis Aqueous Extract
1Pharmacognosy Unit, Department of Pharmacology, Faculty of Pharmacy and Biochemistry, Institute of Chemistry and Drug Metabolism (IQUIMEFA UBA CONICET), University of Buenos Aires, Buenos Aires, Argentina
2Bio-nanotechnology Laboratory, Department of Technology and Science, National University of Quilmes (GBEyB, IMBICE-CONICETCICPBA), Bernal, Argentina
3Pharmacobotany Unit, Department of Pharmacology and Pharmaceutical Technology I Unit, Pharmaceutical and Technology Department (InTecFyB), Faculty of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
Correspondence to: Carla Marrassini
Pharmacognosy Unit, Department of Pharmacology, Faculty of Pharmacy and Biochemistry, Institute of Chemistry and Drug Metabolism (IQUIMEFA UBA CONICET), University of Buenos Aires, Junín 956 (C1113AAD), 2nd floor, Buenos Aires, Argentina
Tel: +54-115-287-4283
E-mail: cmarra@ffyb.uba.ar
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
J Pharmacopuncture 2024; 27(3): 211-222
Published September 30, 2024 https://doi.org/10.3831/KPI.2024.27.3.211
Copyright © The Korean Pharmacopuncture Institute.
Abstract
Methods: Study of the constituents of TE, TE’s antioxidant and anticonvulsant activities and toxicity, and analysis of the possible relation between the potential activities and the compounds present in the extract. In order to demonstrate TE’s anticonvulsant activity a zebrafish model was used. The study also assessed TE’s toxicity and antioxidant activity. To standardize the extract, total polyphenols and flavonoids were quantified and specific flavonoids were identified and quantified using HPLC-MS/MS and HPLC-UV.
Results: TE exhibited anticonvulsant activity at low concentrations and demonstrated antioxidant effects by scavenging free radicals, exhibiting superoxide dismutase and peroxidase- like activities, as well as inhibiting lipoperoxidation. These actions can be attributed to the presence of polyphenols, particularly flavonoids.
Conclusion: TE holds promise as a complementary herbal medicine in the treatment of epilepsy and may also offer benefits for other neuropathies associated with oxidative stress, such as Parkinson’s disease and Alzheimer’s disease.
Keywords
INTRODUCTION
Epilepsy is a chronic and debilitating brain disease characterized by an imbalance of excitatory and inhibitory processes that lead to seizures [1]. Seizures are unpredictable, unprovoked, and recurrent. They are characterized by the sudden and transient onset of symptoms, such as uncontrollable movements, loss of consciousness or control, and confusion, caused by synchronous, irregular, and excessive neuronal activity [2]. The main goal of epilepsy treatment is to eliminate or reduce the frequency of seizures [3]. Currently, pharmacological intervention is the primary treatment approach, but only 70% of patients achieve seizure control with antiepileptic drugs [4]. In addition, mild-to-moderate side effects such as skin hypersensitivity, visual disturbances, or weight gain, have been reported [5]. Primary generalized epilepsies are often treated with valproic acid (VPA), which requires a high therapeutic dose and is associated with impaired abstract thinking and memory and increased risk of pancreatitis and liver failure [6].
Epilepsy is associated with oxidative and nitrosative stress and neuroinflammation, processes that are also linked to stroke, age-related dementia, and carcinogenesis [7]. The brain is vulnerable to the effects of free radicals, as it contains few enzymatic antioxidants, such as catalase or glutathione peroxidase [7]. Consequently, these free radicals can oxidize neurotransmitters, such as serotonin, dopamine, or noradrenaline, disrupting their function. Neuronal membranes, which are rich in polyunsaturated fatty acids, are susceptible to lipid peroxidation, resulting in reduced membrane fluidity and altered transport [7]. Research should focus on drugs with fewer adverse effects that can be used long-term to prevent or treat epilepsy. Medicinal plants have potential as they contain novel antiseptic compounds with antioxidant and antispasmodic activity [8].
This study investigated the potential anticonvulsant effects and toxicity of a standardized 5% aqueous
MATERIALS AND METHODS
1. Plant material and extract preparation
We collected
2. Phytochemical studies
1) Quantification of polyphenols and flavonoids
We determined the total polyphenol content by the Folin-Ciocalteu method using a UV-Vis spectrophotometer (Jasco 630, Tokyo, Japan). In brief, 5 mL of Folin-Ciocalteu reagent, 10% (v/v), was added to 1.0 mL of TE (dissolved in water). Next, 4 mL of Na2CO3 solution (7.5% w/v) was added after 3-8 min. Approximately 60 min later, the absorbance was measured at 765 nm. We used a standard curve of gallic acid (10-50 µg/mL; r2 = 0.9996) to determine TE’s polyphenol concentration. The results were expressed as %w/w [15].
We quantified the total flavonoids in TE following Chang et al.’s methodologies [16]. We used a standard curve of quercetin, and added 1.5 mL of distilled water, 0.1 mL of 1M potassium acetate, 0.1 mL of 10% (w/v) aluminum chloride, and 2.8 mL of distilled water to 0.5 mL of TE. We then measured the absorbance after incubation for 30 min at room temperature. The results were expressed as %w/w.
2) Identification of flavonoids and phenolic acids by HPLC-MS/MSWe used HPLC-MS/MS to identify flavonoids and phenolic acids in TE. We used an UltiMate 3000 coupled to a TSQ Quantum Access MAX Triple Quadrupole mass spectrometer with an ESI ionization source (Massachusetts, USA). The calibration conditions were as follows: the spray voltage was 3.5 kV; the vaporizer temperature was 233℃; the capillary temperature was 314℃; the sheath gas pressure was 10 units, and the auxiliary gas was 45 units. We utilized both single ion monitoring (SIM) and selective reaction monitoring (SRM) methods. We used the positive mode for flavonoid glycosides and the negative mode for phenolic acids. We used a Hypersil C18 (150 mm × 4.6 mm and 5 μm particle diameter) column. The mobile phase consisted of A: water: 0.1% formic acid and B: methanol: 0.1% formic acid, and was run in gradient form, 15% B - 40% B for 25 min; B 40% for 25 min, 40% B - 85% B for 10 min, 100% B for 5 min, and B 100% for 10 min. The flow rate was 1.0 mL/min.
3) Identification and quantification of epicatechin and tilirosideWe determined the epicatechin content in TE according to the method described by the Institute for Nutraceutical Advancement, as used by Zokti et al. [17], using a Varian Pro Star HPLC-UV device. We used a Rheodyne injection valve (20 μL) and set the oven at 30℃. We selected 280 nm as the wavelength for the photodiode array detector and an Agilent Zorbax Eclipse XDB-C18 (250 mm × 4.6 mm and 5 μm particle diameter) as the column. The mobile phases were composed of A: H2O with 0.12% phosphoric acid and B: acetonitrile, and the flow rate was 1.0 mL/min [17]. The elution gradient ranged from 15%-25% B over 12 min, and this mobile phase composition was maintained until the 20th min. Subsequently, B was reduced to 15% by the 22nd min and was constant until the 30th min. We performed the identification and quantification by comparing the retention times (rt) and peak areas obtained with a commercial epicatechin standard (Sigma) with those of the TE sample. We dissolved TE in high-purity quality water (Milli-Q) and the epicatechin standard in methanol. We prepared the working dilutions with Milli-Q. The acetonitrile, methanol (J.T. Baker), and phosphoric acid (Carlo Erba Reagents) were HPLC grade.
We determined the tiliroside content in TE using the same equipment, temperature, and column as previously described [18]. The flow rate: 1.2 mL/min; Detector: 325 nm; Mobile phase: A: water: acetic acid (98:2) and B: methanol: acetic acid (98:2). The elution gradient: from 15% to 40% B over 30 min, from 40% to 75% in the next 10 min, from 75% to 85% in 5 min, finally 100% B in the following 5 min. TE and tiliroside standard (Extrasynthese) were dissolved in methanol: water (70:30).
3. Pharmacological study
1) Zebrafish husbandry and embryo collection
We kept adult wild-type zebrafish (Danio rerio) in glass aquaria at 28 ± 1℃ with a 14/10 h light/dark cycle. The water in the aquaria was constantly aerated and maintained at a pH of 7.0-8.0. We used TetraMinPRO®dry food (three times a day) and live brine shrimp (
We conducted all animal studies in strict accordance with the National Institutes of Health guidelines for animal care and husbandry. All protocols were approved by the Institutional Animal Care Committee of the Universidad Nacional de Quilmes (CE-UNQ 2/2014) (Buenos Aires, Argentina).
3) Anticonvulsant activity evaluationIn a 96-well plate that was maintained at 28 ± 1℃ containing E3 medium, we transferred three unhatched embryos per well one dpf. We stimulated zebrafish larvae at five dpf to exhibit epileptic behavior with the proconvulsant PTZ [14]. We exposed five dpf larvae to PTZ (0.25 to 25 mM). We then quantified spontaneous swimming activity. Subsequently, we selected the PTZ that resulted in a significant difference in spontaneous movements compared to untreated larvae for further experimentation with VPA (100 mM) and TE as anticonvulsants. The PTZ control group was only exposed to PTZ.
To investigate the anticonvulsant effect of TE, we incubated five dpf zebrafish larvae in E3 media supplemented with TE (0.1, 1, 10, 50, 100, 250, and 500 µg/mL) or VPA 1 h before PTZ exposure. We measured swimming activity after the PTZ was added.
4) Measurement of spontaneous swimming activityWe assessed spontaneous swimming activity by measuring cumulative spontaneous movements during a 15-min tracking period, 10 min and 1 h after PTZ treatment. For this purpose, the refraction of light as it passes through the zebrafish body was detected by an infrared microbeam [14, 19]. In brief, we illuminated zebrafish with two infrared microbeams per each well of a 94-well plate. The larvae moving through the light beam caused a transient signal fluctuation, which was detected by a phototransistor array. This output was digitized by a multi-channel ADC system (WMicrotracker, Designplus SRL). We continuously calculated signal activity events, defined as the number of times the larvae traversed the infrared microbeams, in real-time by capturing these slight fluctuations. We considered swimming activity the total number of these events over 15 min.
5) In vivo toxicity assessment on zebrafish larvaeAt one dpf, we transferred three unhatched embryos to each well of a 96-well plate containing E3 medium at 28 ± 1℃. We treated zebrafish larvae at five dpf as previously described, either in the presence or absence of PTZ (5 mM) and VPA (100 mM) or TE (0.1 to 500 μg/mL). After 24 h, we examined each larva for survival, posture, edema, signs of necrosis, morphology, and swim bladder health. The median lethal concentration (LC50) for TE was determined by linear regression and extrapolation of the 50% mortality [20].
4. In vitro antioxidant activities
1) DPPH free radical scavenging activity
We assessed antioxidant activity by measuring the ability to scavenge diphenyl-2-picrylhydrazyl (DPPH) [21]. In brief, we diluted TE with Milli-Q to produce solutions (0.001-1,000 µg/mL). We used Vitamin C as an antioxidant reference standard. First, we added 100 µL of each sample solution to a vial. Then, we added 400 µL of a 100 mM Tris-hydrochloride buffer and 500 µL of a 500 µM DPPH solution in absolute ethanol. The samples were then incubated in the dark for 20 min, and the absorbance was measured at 517 nm. We prepared a DPPH control using 100 mM of Tris hydrochloride buffer. We used the equation: Radical scavenging activity (%) = [(control Abs. - sample Abs.)/control Abs.]*100 to calculate the results.
2) Inhibition of lipid peroxidation: TBARS determination of egg yolkWe mixed 25 µL of diluted TE (0.1 to 2000 µg/mL) with 100 µL of distilled water and 125 µL of a 10% (v/v) egg yolk solution prepared in 1.15% (w/v) potassium chloride. We then added 375 µL of a 20% acetic acid solution and 375 µL of a 1% (w/v) thiobarbituric acid in 1.1% (w/v) sodium lauryl sulfate solution. We heated the mixture in a water bath at 95℃ for 90 min. We then added 1.250 mL of butanol and shook each tube for 10 s. After centrifugation (3,000 rpm, 10 min), we measured the butanol layer’s absorbance at 532 nm. The results were calculated as: Inhibition of lipid peroxidation (%) = [(A0-As)/A0]*100, where A0 is the oxidation control’s absorbance and As is the sample’s absorbance [22].
3) Superoxide dismutase-like activityWe determined superoxide dismutase (SOD)-like activity by assessing TE’s ability to inhibit the auto-oxidation of epinephrine to adrenochrome in the presence of atmospheric oxygen at a high pH [23]. We first mixed 50 µL of TE (0.01-2,000 µg/mL), 910 µL of phosphate buffer at pH 10.7, and 40 µL of 2 mM epinephrine (Sigma, St Louis, MO, USA). We measured the absorbance at 480 nm every 10 s for 5 min. The antioxidant activity was calculated as Inhibition of epinephrine autooxidation (%) = [(ΔAbs/min epinephrine-ΔAbs/min sample)/ΔAbs/min epinephrine]*100. Then we calculated the activity in U/mL assuming that 1 U inhibits the autooxidation of epinephrine by 50%.
4) Peroxidase-like activityWe incubated 200 μL TE (100 to 1,000 µg/mL) with 775 μL 3,3’-diaminobenzidine (DAB) (5 × 10−4 M) and 25μL H2O2 0.030 M, with DAB without H2O2 as a blank. The final volume in the reaction tube was 1,000 μL. We recorded the changes in absorbance for 5 min at 10s intervals at 465 nm and calculated the Δabsorbance/min. We constructed a calibration curve of peroxidase concentration versus Δabsorbance/min using horseradish peroxidase (linear relationship of 1.95 × 10−3 to 2.5 × 10−5 U/mL). We determined the peroxidase activity in triplicate, interpolating from the standard curve [24].
We calculated the IC50 (inhibitory concentration at 50%) for the DPPH or phospholipid peroxidation assays and the EC50 (effective concentration at 50%) for the SOD and peroxidase-like activity assays using the concentration-response curves. These calculations are based on the right triangle principle: IC50 or EC50 = D-[(A-50% max response)*X]/Y. A is the immediately higher response of 50% of the maximum response; B is the immediately lower response of 50% of the maximum response; D is the logarithm of the concentration corresponding to response A; C is the logarithm of the concentration corresponding to response B; X = D-C; and Y = A-B [25].
5. Statistical analysis
Statistical analyses were performed using GraphPad Prism 8 software (Inc., USA). In all analyses, we assumed statistical significance if the p-value was less than 0.05 (p < 0.05), indicated by *; 0.01, indicated by **; 0.001, indicated by ***; and 0.0001, indicated by ****.
RESULTS
1. Phytochemical analysis
TE’s total flavonoids and polyphenols content is detailed in Table 1. We identified and quantified tiliroside (rt: 39.5 min) and epicatechin (rt: 7.2 min) by HPLC-UV (Table 1; Fig. 1). We used HPLC-MS/MS to identify and quantify the other polyphenolic compounds (Table 2). For more information, see Supplementary Material.
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Table 1 . Quantification of total polyphenols and flavonoids by spectrophotometry and epicatechin and tiliroside by HPLC-UV in TE.
Polyphenols (%w/w) Flavonoids (%w/w) Epicatechin (%w/w) Tiliroside (%w/w) 10.74 ± 0.79 1.94 ± 0.13 0.156 ± 0.003 0.119 ± 0.003
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Table 2 . Quantification of caffeoyl derivatives and flavonoids by HPLC-MS/MS.
Compound Concentration (%w/w) Caffeic acid 0.0037 Caffeic acid isomer (as caffeic acid) 0.051 Chlorogenic acid 0.0051 Chlorogenic acid isomer (as chlorogenic acid) 0.00082 Q-3-O-xyloside 0.014 Q-3-O-arabinopyranoside 0.0069 Q-3-O-glucoside 0.15 Q-3-O-rhamnoside 0.11 Q-rham1 (as Q-3-O-r) 0.19 Q-rham2 (as Q-3-O-r) 0.69 Same MW as rutin diglicoside (as rutin) 0.2 Rutin 0.02 Procyanidin B2 0.25
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Figure 1.HPLC-UV chromatogram of TE. (A) Tiliroside at 325 nm; (B) TE at 325 nm; (C) Epicatechin at 280 nm; (D) TE at 280 nm. Representative chromatograms are shown based on three determinations.
2. Measurement of spontaneous swimming activity: TE’s anticonvulsant effects
We found that 5 mM was the PTZ concentration that induced epileptiform behavior. This resulted in erratic swimming characterized by involuntary and rapid circular movements, especially along the sides of the well. This concentration led to a 300% increase in swimming activity compared to untreated larvae, both 10 min and 1 h after administration. Although 25 mM PTZ also resulted in increased movement after 10 min, it exhibited high toxicity, with some larvae dead after 1 h. Therefore, we selected 5 mM for subsequent experiments (Fig. 2).
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Figure 2.Influence of PTZ on spontaneous movements of larvae. Larvae were exposed to different concentrations of PTZ (0.25 to 25 mM).Swimming activity was quantified as the cumulative spontaneous movements during a 15-min tracking period. Results obtained 10 min (A) and 1 h (B) after PTZ treatment. Results were presented as spontaneous movements and expressed as mean values ± SEM from two or more experiments, with at least 24 larvae tested under each condition. ****p < 0.0001 significant differences compared to control, as determined by ANOVA + Dunnett’s test.
Under basal conditions, TE showed different effects on the larvae’s swimming activity. At lower concentrations (0.1 and 1 µg/mL), TE did not significantly change the swimming behavior. However, at higher concentrations (10, 50, and 100 µg/mL), TE significantly increased swimming activity (Fig. 3A, B). We observed a significant induction of swimming activity at 10 and 50 µg/mL after 10 min, but not after 1 h post-exposure. In contrast, 100 µg/mL significantly induced swimming activity at both 10 min and 1 h (Fig. 3A, B). The highest concentration, 500 µg/mL, induced 100% larvae mortality.
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Figure 3.Influence of TE on spontaneous movements of larvae. (A, B) Effect of TE on basal condition (without PTZ) at 10 min and 1 h, respectively. (C, D) Effect of TE in the presence of PTZ (5 mM) at 10 min and 1 h, respectively. Larvae were exposed to various concentrations of TE (0.1 to 500 µg/mL), 1 h before PTZ treatment. Swimming activity was quantified as the cumulative spontaneous movements during a 15-min tracking period at 10 min and 1 h after treatment with PTZ. Results were presented as spontaneous movements and expressed as mean values ± SEM from two or more experiments, with at least 24 larvae tested under each condition. *p < 0.05; **p < 0.01; ***p < 0.001; ****p < 0.0001 indicate significant differences compared to the basal condition, as determined by ANOVA + Dunnett’s test. #p < 0.05; ##p < 0.01; ###p < 0.001 indicate significant differences compared to PTZ, as determined by ANOVA + Dunnett’s test.
In the presence of PTZ 5 mM, the larvae treated with VPA showed similar swimming behavior to the control group (Fig. 3C, D). TE at concentrations of 0.1 and 1 µg/mL significantly counteracted the convulsive effect of PTZ after 10 min, with 1 µg/mL being the only dose that significantly reversed the PTZ effect after 1 h. TE at a concentration of 10 µg/mL reduced the swimming activity induced by PTZ, although the effect was not statistically significant (Fig. 3C, D).
3. Larval toxicity
We assessed mortality after 10 min, 1 h, and 24 h. We observed no mortality in the TE treatments after 10 min and 1 h or in the control larvae after 24 h. PTZ was toxic after 24 h and demonstrated a 62.5% larvae mortality rate. Under basal conditions without PTZ, TE induced toxicity at concentrations higher than 10 µg/mL after 24 h, e.g., 50 µg/mL resulted in a mortality rate of 12.5%, 100 µg/mL resulted in a mortality rate of 20.8%, and 500 µg/mL resulted in 100% mortality (Fig. 4A). The LC50 was 247.98 µg/mL. In the presence of PTZ, VPA reduced PTZ-induced mortality by approximately 61%. However, TE did not prevent PTZ-induced mortality at low concentrations and enhanced PTZ-induced mortality at 10 µg/mL (Fig. 4B).
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Figure 4.Larval mortality rate. (A) Impact of TE on larval mortality rate. (B) Impact of VPA (100 mM) and TE in the presence of PTZ (5 mM). The mortality rate was assessed 24 h after treatment, and deceased larvae were registered. Results were presented as percentage of larval mortality rate and expressed as mean ± SEM from two or more experiments, with at least 24 larvae tested under each condition. *p < 0.05; **p < 0.01 indicate significant differences compared to PTZ (5 mM) alone, as determined by ANOVA + Dunnett’s test.
4. In vitro antioxidant activity
TE scavenged the DPPH radical, inhibited lipid peroxidation (Fig. 5A, B), and exhibited SOD- and peroxidase-like activities (Fig. 5C, D) in a concentration-response curve. The concentrations required for DPPH scavenging and SOD-like activity were lower than those required to inhibit lipid peroxidation and exhibit peroxidase-like activity. The IC50 values were 25.18 ± 0.71 µg/mL for DPPH scavenging activity and 977.23 ± 1.00 µg/mL for lipid peroxidation inhibition. The EC50 value for SOD-like activity was 297.85 µg/mL. We could not determine the EC50 value for peroxidase-like activity, as it was below the lowest concentration tested.
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Figure 5.
In vitro antioxidant activity of TE. (A) DPPH scavenger activity. (B) Inhibition of lipid peroxidation. (C) SOD-like activity. (D) Peroxidase-like activity. (A, B) results are presented as percentages compared to the control condition and expressed as mean ± SEM of three experiments made in triplicate. (C, D) results are presented as U/mL and expressed as mean ± SEM of three experiments made in triplicate. a, b, c and d, indicate significant differences between values as determined by ANOVA + Tukey’s test.
DISCUSSION
In this study, we determined the antioxidant and anticonvulsant activities of TE. TE effectively eliminated free radicals, prevented the peroxidation of egg phospholipids, and acted as SOD and peroxidase enzymes. Importantly, TE shows high efficacy in scavenging DPPH radicals and exerting SOD-like activity. TE also showed an anticonvulsant effect, especially at low concentrations. The main mechanism by which PTZ triggers seizures is thought to be its inhibitory effect on the γ-aminobutyric acid A (GABAergic) system [3]. This effect is the result of its selective blocking action on the chloride-ionosphere complex at the GABA-A receptor. This type of seizure can be prevented by drugs that enhance GABA-A receptor-mediated inhibitory neurotransmission, such as benzodiazepines and phenobarbital [26].
The anticonvulsant effect of other Tilia species, such as
Many free radicals are formed in epilepsy, which can potentially lead to oxidation and impairment of neurotransmitters such as serotonin, dopamine, or noradrenaline. Neuronal membranes may become susceptible to lipid peroxidation, leading to reduced membrane fluidity and altered membrane transport, which contributes to neurodegeneration, neurogenesis, neuronal circuit reorganization, hyperexcitability, and reduced seizure threshold [32]. Similar processes have been observed in various experimental models of epilepsy, such as the PTZ model.
One study involving VPA monotherapy in a group of 32 pediatric patients demonstrated an increase in the activity of enzymes with antioxidant properties, such as SOD, glutathione peroxidase, glutathione reductase, and catalase, and a decrease in oxidative stress markers, such as malondialdehyde [33]. The antioxidant effect of TE could play a crucial role in reducing the oxidative stress associated with epilepsy, potentially providing neuroprotection. Consequently, TE’s combined antiseizure and antioxidant activities may enhance the effectiveness of antiseizure therapy and/or limit epileptogenesis.
The antioxidant and anticonvulsive properties of natural products have been previously demonstrated. For instance, the roots and aerial parts from
Several studies have highlighted the potential of natural drugs in epilepsy treatment through the regulation of oxidative stress. Additionally, proanthocyanidins mitigate PTZ-induced epileptic seizures in mice through their antioxidant activity [36]. TE’s anticonvulsant activity may be attributed to polyphenols, particularly flavonoids. Certain flavonoids, like amentoflavone, possess anxiolytic and anticonvulsant properties and exhibit biphasic activity. These compounds as act as antagonists at nanomolar concentrations and act as negative allosteric modulators of GABA at the α1β2γ21 site at higher concentrations (μM) [37]. A similar pattern was observed with the anticonvulsant flavone hispidulin, which, at low concentrations (0.8-5 μM), exerts a positive modulatory effect on the receptor subunits α1,2,3,5,6β2γ2S, by enhancing current flow. At higher concentrations (> 30 mM), it has the opposite effect [38]. This observation may explain TE’s excitatory activity at high concentrations, even under basal conditions. Flavonoids have intricate impacts GABAergic receptors at the benzodiazepine coupling site.
Zebrafish toxicity tests and safety evaluations have been recognized by the Food and Drug Administration to assess new pharmacological agents. Zebrafish embryos and larvae models can be used to test for substances present in low quantities, as they are significantly more susceptible to toxins than adult zebrafish. TE exhibited an LC50 of 247.98 μg/mL, which is consistent with findings from other plants. For instance, the dried fruit of
The increased mortality of larvae that we observed with TE 10 μg/mL during PTZ 5 mM stimulation may result from TE’s stimulatory activity. The anticonvulsant effects of TE may be attributed to its ability to reduce oxidative damage, in addition to its interaction with GABAergic neurotransmission. Moreover, TE is an antioxidant and a potential therapeutic agent for other neurological conditions associated with oxidative stress.
CONCLUSION
This research highlights the potential of low-concentration TE as a coadjuvant for epilepsy therapies due to its anticonvulsant and antioxidant properties. TE may also offer benefits for Parkinson’s disease, Alzheimer’s disease, and other neuropathies associated with oxidative stress.
SUPPLEMENTARY MATERIALS
Supplementary data is available at https://doi.org/10.3831/KPI.2024.27.3.211.
ETHICAL APPROVAL
All animal studies were conducted in strict accordance with the National Institutes of Health guidelines for animal care and husbandry. The Institutional Animal Care Committee of the Universidad Nacional de Quilmes (CE-UNQ 2/2014) (Buenos Aires, Argentina) approved all study protocols.
AUTHORS’ CONTRIBUTIONS
Elina Malén Saint Martin: investigation, formal analysis (zebrafish experiments, phytochemical studies, determination of total polyphenols, determination of total flavonoids, quantification of CBD and epicatechin and antioxidant assays); Ayelén Sosa: investigation, formal analysis (zebrafish experiments); Carolina Martínez: investigation, supervision methodology (zebrafish experiments), review of the manuscript; Jimena Prieto: investigation, supervision methodology (zebrafish experiments), review of the manuscript; Carla Marrassini: Investigation, supervision and formal analysis (antioxidants assays and quantification of total polyphenols and flavonoids); Cecilia Dobrecky: investigation, methodology (HPLC MS/MS assays, quantifications of Tilia compounds); Maria Rosario Alonso: Investigation, supervision of methodology (HPLC-UV quantification of CBD, tiliroside, and epicatechin). Review and editing manuscript; Claudia Anesini: conceptualization, project administration, funding acquisition, supervision of the results, and writing, reviewing, and editing the manuscript.
CONFLICTS OF INTEREST
The authors declare no conflicts of interest in this work.
FUNDING
This research was funded by CONICET (PIP 112202101 00416CO 2022-2024).
References
- Patel DC, Tewari BP, Chaunsali L, Sontheimer H. Neuron-glia interactions in the pathophysiology of epilepsy. Nat Rev Neurosci. 2019;20(5):282-97.
- Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-21.
- White HS, Smith MD, Wilcox KS. Mechanisms of action of antiepileptic drugs. Int Rev Neurobiol. 2007;81:85-110.
- Bertoncello KT, Bonan CD. Zebrafish as a tool for the discovery of anticonvulsant compounds from botanical constituents. Eur J Pharmacol. 2021;908:174342.
- Löscher W, Schmidt D. Modern antiepileptic drug development has failed to deliver: ways out of the current dilemma. Epilepsia. 2011;52(4):657-78.
- Balasubramanian D, Deng AX, Doudney K, Hampton MB, Kennedy MA. Valproic acid exposure leads to upregulation and increased promoter histone acetylation of sepiapterin reductase in a serotonergic cell line. Neuropharmacology. 2015;99:79-88.
- Puttachary S, Sharma S, Stark S, Thippeswamy T. Seizure-induced oxidative stress in temporal lobe epilepsy. Biomed Res Int. 2015;2015:745613.
- Manchishi SM. Recent advances in antiepileptic herbal medicine. Curr Neuropharmacol. 2018;16(1):79-83.
- Rodriguez Brizi M, Marrassini C, Zettler G, Ferraro G, Anesini C. Comparative antiproliferative action of two extracts from
Tilia x viridis on normal and tumoral lymphocytes: relationship with antioxidant activity. Chin Med. 2012;3(1):20-9. - Castañeda R, Cáceres A, Velásquez D, Rodríguez C, Morales D, Castillo A. Medicinal plants used in traditional Mayan medicine for the treatment of central nervous system disorders: an overview. J Ethnopharmacol. 2022;283:114746.
- Suroowan S, Pynee KB, Mahomoodally MF. A comprehensive review of ethnopharmacologically important medicinal plant species from Mauritius. S Afr J Bot. 2019;122:189-213.
- Faheem M, Ameer S, Khan AW, Haseeb M, Raza Q, Shah FA, et al. A comprehensive review on antiepileptic properties of medicinal plants. Arab J Chem. 2022;15(1):103478.
- Aguirre-Hernández E, González-Trujano ME, Martínez AL, Moreno J, Kite G, Terrazas T, et al. HPLC/MS analysis and anxiolytic-like effect of quercetin and kaempferol flavonoids from Tilia Americana var. Mexicana. J Ethnopharmacol. 2010;127(1):91-7.
- Feas DA, Igartúa DE, Calienni MN, Martinez CS, Pifano M, Chiaramoni NS, et al. Nutraceutical emulsion containing valproic acid (NE-VPA): a drug delivery system for reversion of seizures in zebrafish larvae epilepsy model. J Pharm Investig. 2017;47:429-37.
- Hosseinzadeh R, Khorsandi K, Hemmaty S. Study of the effect of surfactants on extraction and determination of polyphenolic compounds and antioxidant capacity of fruits extracts. PLoS One. 2013;8(3):e57353.
- Chang CC, Yang MH, Wen HM, Chern JC. Estimation of total flavonoid content in propolis by two complementary colometric methods. J Food Drug Anal. 2002;10(3):178-82.
- Zokti JA, Sham Baharin B, Mohammed AS, Abas F. Green tea leaves extract: microencapsulation, physicochemical and storage stability study. Molecules. 2016;21(8):940.
- Marrassini C, Anesini C, Ferraro G. HPLC fingerprint of a flower extract of Tilia × viridis and correlation with antiproliferative and antioxidant activity. Phytother Res. 2011;25(10):1466-71.
- Prieto MJ, del Rio Zabala NE, Marotta CH, Carreño Gutierrez H, Arévalo Arévalo R, Chiaramoni NS, et al. Optimization and in vivo toxicity evaluation of G4.5 PAMAM dendrimer-risperidone complexes. PLoS One. 2014;9(2):e90393.
- Veeren B, Ghaddar B, Bringart M, Khazaal S, Gonthier MP, Meilhac O, et al. Phenolic profile of herbal infusion and polyphenol-rich extract from leaves of the medicinal plant
Antirhea borbonica : toxicity assay determination in zebrafish embryos and larvae. Molecules. 2020;25(19):4482. - Blois MS. Antioxidant determinations by the use of a stable free radical. Nature. 1958;181:1199-200.
- Dissanayake DP, Abeytunga DTU, Vasudewa NS, Ratnasooriya WD. Inhibition of lipid peroxidation by extracts of Pleurotus ostreatus. Pharmacogn Mag [Internet]. 2009;5(19):266-71.
- Carrillo MC, Kanai S, Nokubo M, Kitani K. (−) deprenyl induces activities of both superoxide dismutase and catalase but not of glutathione peroxidase in the striatum of young male rats. Life Sci. 1991;48(6):517-21.
- Herzog V, Fahimi HD. A new sensitive colorimetric assay for peroxidase using 3,3'-diaminobenzidine as hydrogen donor. Anal Biochem. 1973;55(2):554-62.
- Alexander B, Browse DJ, Reading SJ, Benjamin IS. A simple and accurate mathematical method for calculation of the EC50. J Pharmacol Toxicol Methods. 1999;41(2-3):55-8.
- Macdonald RL, Kelly KM. Antiepileptic drug mechanisms of action. Epilepsia. 1995;36(Suppl 2):S2-12.
- Cárdenas-Rodríguez N, González-Trujano ME, Aguirre-Hernández E, Ruíz-García M, Sampieri A 3rd, Coballase-Urrutia E, et al. Anticonvulsant and antioxidant effects of Tilia americana var. mexicana and flavonoids constituents in the pentylenetetrazole-induced seizures. Oxid Med Cell Longev. 2014;2014:329172.
- Heidari MR, Sohrevardi SM, Eskandarizadeh A, Moghadammanesh H, Heidari M, Mohebbi S. The effects of
Tilia platyphyllos scop. extract on seizure induced by picrotoxin and pentylentetrazole in mice. J Pharm Health Sci. 2012;1(1):17-24. - Herrera-Ruiz M, Román-Ramos R, Zamilpa A, Tortoriello J, Jiménez-Ferrer JE. Flavonoids from Tilia americana with anxiolytic activity in plus-maze test. J Ethnopharmacol. 2008;118(2):312-7.
- Anesini C, Werner S, Borda E. Effect of
Tilia cordata flower on lymphocyte proliferation: participation of peripheral type benzodiazepine binding sites. Fitoterapia. 1999;70(4):361-7. - Rogawski MA. Mechanism-specific pathways for new antiepileptic drug discovery. Adv Neurol. 1998;76:11-27.
- Borowicz-Reutt KK, Czuczwar SJ. Role of oxidative stress in epileptogenesis and potential implications for therapy. Pharmacol Rep. 2020;72(5):1218-26.
- Beltrán-Sarmiento E, Arregoitia-Sarabia CK, Floriano-Sánchez E, Sandoval-Pacheco R, Galván-Hernández DE, Coballase-Urrutia E, et al. Effects of valproate monotherapy on the oxidant-antioxidant status in Mexican epileptic children: a longitudinal study. Oxid Med Cell Longev. 2018;2018:7954371.
- Aldarmaa J, Liu Z, Long J, Mo X, Ma J, Liu J. Anti-convulsant effect and mechanism of Astragalus mongholicus extract in vitro and in vivo: protection against oxidative damage and mitochondrial dysfunction. Neurochem Res. 2010;35(1):33-41.
- Choudhary N, Bijjem KR, Kalia AN. Antiepileptic potential of flavonoids fraction from the leaves of Anisomeles malabarica. J Ethnopharmacol. 2011;135(2):238-42.
- Alyami NM, Abdi S, Alyami HM, Almeer R. Proanthocyanidins alleviate pentylenetetrazole-induced epileptic seizures in mice via the antioxidant activity. Neurochem Res. 2022;47(10):3012-23.
- Hansen RS, Paulsen I, Davies M. Determinants of amentoflavone interaction at the GABA(A) receptor. Eur J Pharmacol. 2005;519(3):199-207.
- Hanrahan JR, Chebib M, Johnston GA. Flavonoid modulation of GABA(A) receptors. Br J Pharmacol. 2011;163(2):234-45.
- Xia Q, Luo J, Mei X, Wang Y, Huang W, Wang J, et al. A developmental toxicity assay of Carpesii Fructus on zebrafish embryos/larvae. Toxicol Res (Camb). 2017;6(4):460-7.
- Organisation for Economic Co-operation and Development (OECD). OECD guidelines for the testing of chemicals, section 2. Paris: OECD Publishing; 2013.
Related articles in JoP
Article
Original Article
J Pharmacopuncture 2024; 27(3): 211-222
Published online September 30, 2024 https://doi.org/10.3831/KPI.2024.27.3.211
Copyright © The Korean Pharmacopuncture Institute.
In Vitro Antioxidant Activity and Anticonvulsant Properties on Zebrafish PTZ-Induced Seizure Model of a Tilia viridis Aqueous Extract
Elina Malén Saint Martin1 , Ayelen Morena Sosa2 , Carolina Soledad Martinez2 , Jimena Prieto2 , Carla Marrassini1* , Cecilia Beatriz Dobrecky3 , María Rosario Alonso1 , Claudia Anesini1
1Pharmacognosy Unit, Department of Pharmacology, Faculty of Pharmacy and Biochemistry, Institute of Chemistry and Drug Metabolism (IQUIMEFA UBA CONICET), University of Buenos Aires, Buenos Aires, Argentina
2Bio-nanotechnology Laboratory, Department of Technology and Science, National University of Quilmes (GBEyB, IMBICE-CONICETCICPBA), Bernal, Argentina
3Pharmacobotany Unit, Department of Pharmacology and Pharmaceutical Technology I Unit, Pharmaceutical and Technology Department (InTecFyB), Faculty of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
Correspondence to:Carla Marrassini
Pharmacognosy Unit, Department of Pharmacology, Faculty of Pharmacy and Biochemistry, Institute of Chemistry and Drug Metabolism (IQUIMEFA UBA CONICET), University of Buenos Aires, Junín 956 (C1113AAD), 2nd floor, Buenos Aires, Argentina
Tel: +54-115-287-4283
E-mail: cmarra@ffyb.uba.ar
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objectives: Tilia viridis (Bayer) Simonk. (Malvaceae) is widely distributed in Argentina and employed for its tranquilizing properties. Other species of the genus (Tilia europaea L., Tilia cordata Mill., Tilia platyphyllos Scop.) have been traditionally used for the treatment of epilepsy. Epilepsy affects approximately 65 million people worldwide and is characterized by an imbalance between excitatory and inhibitory processes in the brain, leading to unpredictable, unprovoked, recurrent seizures. Current pharmacological interventions often present mild to moderately severe side effects. Epilepsy has been associated with oxidative and nitrative stress as well as neuroinflammation. Herbal medicine therapies may offer new treatment options with multi-target antioxidant and anticonvulsant effects for patients whose seizures remain uncontrolled, potentially providing cost-effective solutions for individuals worldwide suffering from uncontrolled epilepsy.The aim of this study was to demonstrate the anticonvulsant activity of a standardized T. viridis aqueous extract (TE).
Methods: Study of the constituents of TE, TE’s antioxidant and anticonvulsant activities and toxicity, and analysis of the possible relation between the potential activities and the compounds present in the extract. In order to demonstrate TE’s anticonvulsant activity a zebrafish model was used. The study also assessed TE’s toxicity and antioxidant activity. To standardize the extract, total polyphenols and flavonoids were quantified and specific flavonoids were identified and quantified using HPLC-MS/MS and HPLC-UV.
Results: TE exhibited anticonvulsant activity at low concentrations and demonstrated antioxidant effects by scavenging free radicals, exhibiting superoxide dismutase and peroxidase- like activities, as well as inhibiting lipoperoxidation. These actions can be attributed to the presence of polyphenols, particularly flavonoids.
Conclusion: TE holds promise as a complementary herbal medicine in the treatment of epilepsy and may also offer benefits for other neuropathies associated with oxidative stress, such as Parkinson’s disease and Alzheimer’s disease.
Keywords: epilepsy, flavonoids, infusion, natural products
INTRODUCTION
Epilepsy is a chronic and debilitating brain disease characterized by an imbalance of excitatory and inhibitory processes that lead to seizures [1]. Seizures are unpredictable, unprovoked, and recurrent. They are characterized by the sudden and transient onset of symptoms, such as uncontrollable movements, loss of consciousness or control, and confusion, caused by synchronous, irregular, and excessive neuronal activity [2]. The main goal of epilepsy treatment is to eliminate or reduce the frequency of seizures [3]. Currently, pharmacological intervention is the primary treatment approach, but only 70% of patients achieve seizure control with antiepileptic drugs [4]. In addition, mild-to-moderate side effects such as skin hypersensitivity, visual disturbances, or weight gain, have been reported [5]. Primary generalized epilepsies are often treated with valproic acid (VPA), which requires a high therapeutic dose and is associated with impaired abstract thinking and memory and increased risk of pancreatitis and liver failure [6].
Epilepsy is associated with oxidative and nitrosative stress and neuroinflammation, processes that are also linked to stroke, age-related dementia, and carcinogenesis [7]. The brain is vulnerable to the effects of free radicals, as it contains few enzymatic antioxidants, such as catalase or glutathione peroxidase [7]. Consequently, these free radicals can oxidize neurotransmitters, such as serotonin, dopamine, or noradrenaline, disrupting their function. Neuronal membranes, which are rich in polyunsaturated fatty acids, are susceptible to lipid peroxidation, resulting in reduced membrane fluidity and altered transport [7]. Research should focus on drugs with fewer adverse effects that can be used long-term to prevent or treat epilepsy. Medicinal plants have potential as they contain novel antiseptic compounds with antioxidant and antispasmodic activity [8].
This study investigated the potential anticonvulsant effects and toxicity of a standardized 5% aqueous
MATERIALS AND METHODS
1. Plant material and extract preparation
We collected
2. Phytochemical studies
1) Quantification of polyphenols and flavonoids
We determined the total polyphenol content by the Folin-Ciocalteu method using a UV-Vis spectrophotometer (Jasco 630, Tokyo, Japan). In brief, 5 mL of Folin-Ciocalteu reagent, 10% (v/v), was added to 1.0 mL of TE (dissolved in water). Next, 4 mL of Na2CO3 solution (7.5% w/v) was added after 3-8 min. Approximately 60 min later, the absorbance was measured at 765 nm. We used a standard curve of gallic acid (10-50 µg/mL; r2 = 0.9996) to determine TE’s polyphenol concentration. The results were expressed as %w/w [15].
We quantified the total flavonoids in TE following Chang et al.’s methodologies [16]. We used a standard curve of quercetin, and added 1.5 mL of distilled water, 0.1 mL of 1M potassium acetate, 0.1 mL of 10% (w/v) aluminum chloride, and 2.8 mL of distilled water to 0.5 mL of TE. We then measured the absorbance after incubation for 30 min at room temperature. The results were expressed as %w/w.
2) Identification of flavonoids and phenolic acids by HPLC-MS/MSWe used HPLC-MS/MS to identify flavonoids and phenolic acids in TE. We used an UltiMate 3000 coupled to a TSQ Quantum Access MAX Triple Quadrupole mass spectrometer with an ESI ionization source (Massachusetts, USA). The calibration conditions were as follows: the spray voltage was 3.5 kV; the vaporizer temperature was 233℃; the capillary temperature was 314℃; the sheath gas pressure was 10 units, and the auxiliary gas was 45 units. We utilized both single ion monitoring (SIM) and selective reaction monitoring (SRM) methods. We used the positive mode for flavonoid glycosides and the negative mode for phenolic acids. We used a Hypersil C18 (150 mm × 4.6 mm and 5 μm particle diameter) column. The mobile phase consisted of A: water: 0.1% formic acid and B: methanol: 0.1% formic acid, and was run in gradient form, 15% B - 40% B for 25 min; B 40% for 25 min, 40% B - 85% B for 10 min, 100% B for 5 min, and B 100% for 10 min. The flow rate was 1.0 mL/min.
3) Identification and quantification of epicatechin and tilirosideWe determined the epicatechin content in TE according to the method described by the Institute for Nutraceutical Advancement, as used by Zokti et al. [17], using a Varian Pro Star HPLC-UV device. We used a Rheodyne injection valve (20 μL) and set the oven at 30℃. We selected 280 nm as the wavelength for the photodiode array detector and an Agilent Zorbax Eclipse XDB-C18 (250 mm × 4.6 mm and 5 μm particle diameter) as the column. The mobile phases were composed of A: H2O with 0.12% phosphoric acid and B: acetonitrile, and the flow rate was 1.0 mL/min [17]. The elution gradient ranged from 15%-25% B over 12 min, and this mobile phase composition was maintained until the 20th min. Subsequently, B was reduced to 15% by the 22nd min and was constant until the 30th min. We performed the identification and quantification by comparing the retention times (rt) and peak areas obtained with a commercial epicatechin standard (Sigma) with those of the TE sample. We dissolved TE in high-purity quality water (Milli-Q) and the epicatechin standard in methanol. We prepared the working dilutions with Milli-Q. The acetonitrile, methanol (J.T. Baker), and phosphoric acid (Carlo Erba Reagents) were HPLC grade.
We determined the tiliroside content in TE using the same equipment, temperature, and column as previously described [18]. The flow rate: 1.2 mL/min; Detector: 325 nm; Mobile phase: A: water: acetic acid (98:2) and B: methanol: acetic acid (98:2). The elution gradient: from 15% to 40% B over 30 min, from 40% to 75% in the next 10 min, from 75% to 85% in 5 min, finally 100% B in the following 5 min. TE and tiliroside standard (Extrasynthese) were dissolved in methanol: water (70:30).
3. Pharmacological study
1) Zebrafish husbandry and embryo collection
We kept adult wild-type zebrafish (Danio rerio) in glass aquaria at 28 ± 1℃ with a 14/10 h light/dark cycle. The water in the aquaria was constantly aerated and maintained at a pH of 7.0-8.0. We used TetraMinPRO®dry food (three times a day) and live brine shrimp (
We conducted all animal studies in strict accordance with the National Institutes of Health guidelines for animal care and husbandry. All protocols were approved by the Institutional Animal Care Committee of the Universidad Nacional de Quilmes (CE-UNQ 2/2014) (Buenos Aires, Argentina).
3) Anticonvulsant activity evaluationIn a 96-well plate that was maintained at 28 ± 1℃ containing E3 medium, we transferred three unhatched embryos per well one dpf. We stimulated zebrafish larvae at five dpf to exhibit epileptic behavior with the proconvulsant PTZ [14]. We exposed five dpf larvae to PTZ (0.25 to 25 mM). We then quantified spontaneous swimming activity. Subsequently, we selected the PTZ that resulted in a significant difference in spontaneous movements compared to untreated larvae for further experimentation with VPA (100 mM) and TE as anticonvulsants. The PTZ control group was only exposed to PTZ.
To investigate the anticonvulsant effect of TE, we incubated five dpf zebrafish larvae in E3 media supplemented with TE (0.1, 1, 10, 50, 100, 250, and 500 µg/mL) or VPA 1 h before PTZ exposure. We measured swimming activity after the PTZ was added.
4) Measurement of spontaneous swimming activityWe assessed spontaneous swimming activity by measuring cumulative spontaneous movements during a 15-min tracking period, 10 min and 1 h after PTZ treatment. For this purpose, the refraction of light as it passes through the zebrafish body was detected by an infrared microbeam [14, 19]. In brief, we illuminated zebrafish with two infrared microbeams per each well of a 94-well plate. The larvae moving through the light beam caused a transient signal fluctuation, which was detected by a phototransistor array. This output was digitized by a multi-channel ADC system (WMicrotracker, Designplus SRL). We continuously calculated signal activity events, defined as the number of times the larvae traversed the infrared microbeams, in real-time by capturing these slight fluctuations. We considered swimming activity the total number of these events over 15 min.
5) In vivo toxicity assessment on zebrafish larvaeAt one dpf, we transferred three unhatched embryos to each well of a 96-well plate containing E3 medium at 28 ± 1℃. We treated zebrafish larvae at five dpf as previously described, either in the presence or absence of PTZ (5 mM) and VPA (100 mM) or TE (0.1 to 500 μg/mL). After 24 h, we examined each larva for survival, posture, edema, signs of necrosis, morphology, and swim bladder health. The median lethal concentration (LC50) for TE was determined by linear regression and extrapolation of the 50% mortality [20].
4. In vitro antioxidant activities
1) DPPH free radical scavenging activity
We assessed antioxidant activity by measuring the ability to scavenge diphenyl-2-picrylhydrazyl (DPPH) [21]. In brief, we diluted TE with Milli-Q to produce solutions (0.001-1,000 µg/mL). We used Vitamin C as an antioxidant reference standard. First, we added 100 µL of each sample solution to a vial. Then, we added 400 µL of a 100 mM Tris-hydrochloride buffer and 500 µL of a 500 µM DPPH solution in absolute ethanol. The samples were then incubated in the dark for 20 min, and the absorbance was measured at 517 nm. We prepared a DPPH control using 100 mM of Tris hydrochloride buffer. We used the equation: Radical scavenging activity (%) = [(control Abs. - sample Abs.)/control Abs.]*100 to calculate the results.
2) Inhibition of lipid peroxidation: TBARS determination of egg yolkWe mixed 25 µL of diluted TE (0.1 to 2000 µg/mL) with 100 µL of distilled water and 125 µL of a 10% (v/v) egg yolk solution prepared in 1.15% (w/v) potassium chloride. We then added 375 µL of a 20% acetic acid solution and 375 µL of a 1% (w/v) thiobarbituric acid in 1.1% (w/v) sodium lauryl sulfate solution. We heated the mixture in a water bath at 95℃ for 90 min. We then added 1.250 mL of butanol and shook each tube for 10 s. After centrifugation (3,000 rpm, 10 min), we measured the butanol layer’s absorbance at 532 nm. The results were calculated as: Inhibition of lipid peroxidation (%) = [(A0-As)/A0]*100, where A0 is the oxidation control’s absorbance and As is the sample’s absorbance [22].
3) Superoxide dismutase-like activityWe determined superoxide dismutase (SOD)-like activity by assessing TE’s ability to inhibit the auto-oxidation of epinephrine to adrenochrome in the presence of atmospheric oxygen at a high pH [23]. We first mixed 50 µL of TE (0.01-2,000 µg/mL), 910 µL of phosphate buffer at pH 10.7, and 40 µL of 2 mM epinephrine (Sigma, St Louis, MO, USA). We measured the absorbance at 480 nm every 10 s for 5 min. The antioxidant activity was calculated as Inhibition of epinephrine autooxidation (%) = [(ΔAbs/min epinephrine-ΔAbs/min sample)/ΔAbs/min epinephrine]*100. Then we calculated the activity in U/mL assuming that 1 U inhibits the autooxidation of epinephrine by 50%.
4) Peroxidase-like activityWe incubated 200 μL TE (100 to 1,000 µg/mL) with 775 μL 3,3’-diaminobenzidine (DAB) (5 × 10−4 M) and 25μL H2O2 0.030 M, with DAB without H2O2 as a blank. The final volume in the reaction tube was 1,000 μL. We recorded the changes in absorbance for 5 min at 10s intervals at 465 nm and calculated the Δabsorbance/min. We constructed a calibration curve of peroxidase concentration versus Δabsorbance/min using horseradish peroxidase (linear relationship of 1.95 × 10−3 to 2.5 × 10−5 U/mL). We determined the peroxidase activity in triplicate, interpolating from the standard curve [24].
We calculated the IC50 (inhibitory concentration at 50%) for the DPPH or phospholipid peroxidation assays and the EC50 (effective concentration at 50%) for the SOD and peroxidase-like activity assays using the concentration-response curves. These calculations are based on the right triangle principle: IC50 or EC50 = D-[(A-50% max response)*X]/Y. A is the immediately higher response of 50% of the maximum response; B is the immediately lower response of 50% of the maximum response; D is the logarithm of the concentration corresponding to response A; C is the logarithm of the concentration corresponding to response B; X = D-C; and Y = A-B [25].
5. Statistical analysis
Statistical analyses were performed using GraphPad Prism 8 software (Inc., USA). In all analyses, we assumed statistical significance if the p-value was less than 0.05 (p < 0.05), indicated by *; 0.01, indicated by **; 0.001, indicated by ***; and 0.0001, indicated by ****.
RESULTS
1. Phytochemical analysis
TE’s total flavonoids and polyphenols content is detailed in Table 1. We identified and quantified tiliroside (rt: 39.5 min) and epicatechin (rt: 7.2 min) by HPLC-UV (Table 1; Fig. 1). We used HPLC-MS/MS to identify and quantify the other polyphenolic compounds (Table 2). For more information, see Supplementary Material.
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Table 1
Quantification of total polyphenols and flavonoids by spectrophotometry and epicatechin and tiliroside by HPLC-UV in TE.
Polyphenols (%w/w) Flavonoids (%w/w) Epicatechin (%w/w) Tiliroside (%w/w) 10.74 ± 0.79 1.94 ± 0.13 0.156 ± 0.003 0.119 ± 0.003
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Table 2
Quantification of caffeoyl derivatives and flavonoids by HPLC-MS/MS.
Compound Concentration (%w/w) Caffeic acid 0.0037 Caffeic acid isomer (as caffeic acid) 0.051 Chlorogenic acid 0.0051 Chlorogenic acid isomer (as chlorogenic acid) 0.00082 Q-3-O-xyloside 0.014 Q-3-O-arabinopyranoside 0.0069 Q-3-O-glucoside 0.15 Q-3-O-rhamnoside 0.11 Q-rham1 (as Q-3-O-r) 0.19 Q-rham2 (as Q-3-O-r) 0.69 Same MW as rutin diglicoside (as rutin) 0.2 Rutin 0.02 Procyanidin B2 0.25
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Figure 1. HPLC-UV chromatogram of TE. (A) Tiliroside at 325 nm; (B) TE at 325 nm; (C) Epicatechin at 280 nm; (D) TE at 280 nm. Representative chromatograms are shown based on three determinations.
2. Measurement of spontaneous swimming activity: TE’s anticonvulsant effects
We found that 5 mM was the PTZ concentration that induced epileptiform behavior. This resulted in erratic swimming characterized by involuntary and rapid circular movements, especially along the sides of the well. This concentration led to a 300% increase in swimming activity compared to untreated larvae, both 10 min and 1 h after administration. Although 25 mM PTZ also resulted in increased movement after 10 min, it exhibited high toxicity, with some larvae dead after 1 h. Therefore, we selected 5 mM for subsequent experiments (Fig. 2).
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Figure 2. Influence of PTZ on spontaneous movements of larvae. Larvae were exposed to different concentrations of PTZ (0.25 to 25 mM).Swimming activity was quantified as the cumulative spontaneous movements during a 15-min tracking period. Results obtained 10 min (A) and 1 h (B) after PTZ treatment. Results were presented as spontaneous movements and expressed as mean values ± SEM from two or more experiments, with at least 24 larvae tested under each condition. ****p < 0.0001 significant differences compared to control, as determined by ANOVA + Dunnett’s test.
Under basal conditions, TE showed different effects on the larvae’s swimming activity. At lower concentrations (0.1 and 1 µg/mL), TE did not significantly change the swimming behavior. However, at higher concentrations (10, 50, and 100 µg/mL), TE significantly increased swimming activity (Fig. 3A, B). We observed a significant induction of swimming activity at 10 and 50 µg/mL after 10 min, but not after 1 h post-exposure. In contrast, 100 µg/mL significantly induced swimming activity at both 10 min and 1 h (Fig. 3A, B). The highest concentration, 500 µg/mL, induced 100% larvae mortality.
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Figure 3. Influence of TE on spontaneous movements of larvae. (A, B) Effect of TE on basal condition (without PTZ) at 10 min and 1 h, respectively. (C, D) Effect of TE in the presence of PTZ (5 mM) at 10 min and 1 h, respectively. Larvae were exposed to various concentrations of TE (0.1 to 500 µg/mL), 1 h before PTZ treatment. Swimming activity was quantified as the cumulative spontaneous movements during a 15-min tracking period at 10 min and 1 h after treatment with PTZ. Results were presented as spontaneous movements and expressed as mean values ± SEM from two or more experiments, with at least 24 larvae tested under each condition. *p < 0.05; **p < 0.01; ***p < 0.001; ****p < 0.0001 indicate significant differences compared to the basal condition, as determined by ANOVA + Dunnett’s test. #p < 0.05; ##p < 0.01; ###p < 0.001 indicate significant differences compared to PTZ, as determined by ANOVA + Dunnett’s test.
In the presence of PTZ 5 mM, the larvae treated with VPA showed similar swimming behavior to the control group (Fig. 3C, D). TE at concentrations of 0.1 and 1 µg/mL significantly counteracted the convulsive effect of PTZ after 10 min, with 1 µg/mL being the only dose that significantly reversed the PTZ effect after 1 h. TE at a concentration of 10 µg/mL reduced the swimming activity induced by PTZ, although the effect was not statistically significant (Fig. 3C, D).
3. Larval toxicity
We assessed mortality after 10 min, 1 h, and 24 h. We observed no mortality in the TE treatments after 10 min and 1 h or in the control larvae after 24 h. PTZ was toxic after 24 h and demonstrated a 62.5% larvae mortality rate. Under basal conditions without PTZ, TE induced toxicity at concentrations higher than 10 µg/mL after 24 h, e.g., 50 µg/mL resulted in a mortality rate of 12.5%, 100 µg/mL resulted in a mortality rate of 20.8%, and 500 µg/mL resulted in 100% mortality (Fig. 4A). The LC50 was 247.98 µg/mL. In the presence of PTZ, VPA reduced PTZ-induced mortality by approximately 61%. However, TE did not prevent PTZ-induced mortality at low concentrations and enhanced PTZ-induced mortality at 10 µg/mL (Fig. 4B).
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Figure 4. Larval mortality rate. (A) Impact of TE on larval mortality rate. (B) Impact of VPA (100 mM) and TE in the presence of PTZ (5 mM). The mortality rate was assessed 24 h after treatment, and deceased larvae were registered. Results were presented as percentage of larval mortality rate and expressed as mean ± SEM from two or more experiments, with at least 24 larvae tested under each condition. *p < 0.05; **p < 0.01 indicate significant differences compared to PTZ (5 mM) alone, as determined by ANOVA + Dunnett’s test.
4. In vitro antioxidant activity
TE scavenged the DPPH radical, inhibited lipid peroxidation (Fig. 5A, B), and exhibited SOD- and peroxidase-like activities (Fig. 5C, D) in a concentration-response curve. The concentrations required for DPPH scavenging and SOD-like activity were lower than those required to inhibit lipid peroxidation and exhibit peroxidase-like activity. The IC50 values were 25.18 ± 0.71 µg/mL for DPPH scavenging activity and 977.23 ± 1.00 µg/mL for lipid peroxidation inhibition. The EC50 value for SOD-like activity was 297.85 µg/mL. We could not determine the EC50 value for peroxidase-like activity, as it was below the lowest concentration tested.
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Figure 5.
In vitro antioxidant activity of TE. (A) DPPH scavenger activity. (B) Inhibition of lipid peroxidation. (C) SOD-like activity. (D) Peroxidase-like activity. (A, B) results are presented as percentages compared to the control condition and expressed as mean ± SEM of three experiments made in triplicate. (C, D) results are presented as U/mL and expressed as mean ± SEM of three experiments made in triplicate. a, b, c and d, indicate significant differences between values as determined by ANOVA + Tukey’s test.
DISCUSSION
In this study, we determined the antioxidant and anticonvulsant activities of TE. TE effectively eliminated free radicals, prevented the peroxidation of egg phospholipids, and acted as SOD and peroxidase enzymes. Importantly, TE shows high efficacy in scavenging DPPH radicals and exerting SOD-like activity. TE also showed an anticonvulsant effect, especially at low concentrations. The main mechanism by which PTZ triggers seizures is thought to be its inhibitory effect on the γ-aminobutyric acid A (GABAergic) system [3]. This effect is the result of its selective blocking action on the chloride-ionosphere complex at the GABA-A receptor. This type of seizure can be prevented by drugs that enhance GABA-A receptor-mediated inhibitory neurotransmission, such as benzodiazepines and phenobarbital [26].
The anticonvulsant effect of other Tilia species, such as
Many free radicals are formed in epilepsy, which can potentially lead to oxidation and impairment of neurotransmitters such as serotonin, dopamine, or noradrenaline. Neuronal membranes may become susceptible to lipid peroxidation, leading to reduced membrane fluidity and altered membrane transport, which contributes to neurodegeneration, neurogenesis, neuronal circuit reorganization, hyperexcitability, and reduced seizure threshold [32]. Similar processes have been observed in various experimental models of epilepsy, such as the PTZ model.
One study involving VPA monotherapy in a group of 32 pediatric patients demonstrated an increase in the activity of enzymes with antioxidant properties, such as SOD, glutathione peroxidase, glutathione reductase, and catalase, and a decrease in oxidative stress markers, such as malondialdehyde [33]. The antioxidant effect of TE could play a crucial role in reducing the oxidative stress associated with epilepsy, potentially providing neuroprotection. Consequently, TE’s combined antiseizure and antioxidant activities may enhance the effectiveness of antiseizure therapy and/or limit epileptogenesis.
The antioxidant and anticonvulsive properties of natural products have been previously demonstrated. For instance, the roots and aerial parts from
Several studies have highlighted the potential of natural drugs in epilepsy treatment through the regulation of oxidative stress. Additionally, proanthocyanidins mitigate PTZ-induced epileptic seizures in mice through their antioxidant activity [36]. TE’s anticonvulsant activity may be attributed to polyphenols, particularly flavonoids. Certain flavonoids, like amentoflavone, possess anxiolytic and anticonvulsant properties and exhibit biphasic activity. These compounds as act as antagonists at nanomolar concentrations and act as negative allosteric modulators of GABA at the α1β2γ21 site at higher concentrations (μM) [37]. A similar pattern was observed with the anticonvulsant flavone hispidulin, which, at low concentrations (0.8-5 μM), exerts a positive modulatory effect on the receptor subunits α1,2,3,5,6β2γ2S, by enhancing current flow. At higher concentrations (> 30 mM), it has the opposite effect [38]. This observation may explain TE’s excitatory activity at high concentrations, even under basal conditions. Flavonoids have intricate impacts GABAergic receptors at the benzodiazepine coupling site.
Zebrafish toxicity tests and safety evaluations have been recognized by the Food and Drug Administration to assess new pharmacological agents. Zebrafish embryos and larvae models can be used to test for substances present in low quantities, as they are significantly more susceptible to toxins than adult zebrafish. TE exhibited an LC50 of 247.98 μg/mL, which is consistent with findings from other plants. For instance, the dried fruit of
The increased mortality of larvae that we observed with TE 10 μg/mL during PTZ 5 mM stimulation may result from TE’s stimulatory activity. The anticonvulsant effects of TE may be attributed to its ability to reduce oxidative damage, in addition to its interaction with GABAergic neurotransmission. Moreover, TE is an antioxidant and a potential therapeutic agent for other neurological conditions associated with oxidative stress.
CONCLUSION
This research highlights the potential of low-concentration TE as a coadjuvant for epilepsy therapies due to its anticonvulsant and antioxidant properties. TE may also offer benefits for Parkinson’s disease, Alzheimer’s disease, and other neuropathies associated with oxidative stress.
SUPPLEMENTARY MATERIALS
Supplementary data is available at https://doi.org/10.3831/KPI.2024.27.3.211.
ETHICAL APPROVAL
All animal studies were conducted in strict accordance with the National Institutes of Health guidelines for animal care and husbandry. The Institutional Animal Care Committee of the Universidad Nacional de Quilmes (CE-UNQ 2/2014) (Buenos Aires, Argentina) approved all study protocols.
AUTHORS’ CONTRIBUTIONS
Elina Malén Saint Martin: investigation, formal analysis (zebrafish experiments, phytochemical studies, determination of total polyphenols, determination of total flavonoids, quantification of CBD and epicatechin and antioxidant assays); Ayelén Sosa: investigation, formal analysis (zebrafish experiments); Carolina Martínez: investigation, supervision methodology (zebrafish experiments), review of the manuscript; Jimena Prieto: investigation, supervision methodology (zebrafish experiments), review of the manuscript; Carla Marrassini: Investigation, supervision and formal analysis (antioxidants assays and quantification of total polyphenols and flavonoids); Cecilia Dobrecky: investigation, methodology (HPLC MS/MS assays, quantifications of Tilia compounds); Maria Rosario Alonso: Investigation, supervision of methodology (HPLC-UV quantification of CBD, tiliroside, and epicatechin). Review and editing manuscript; Claudia Anesini: conceptualization, project administration, funding acquisition, supervision of the results, and writing, reviewing, and editing the manuscript.
CONFLICTS OF INTEREST
The authors declare no conflicts of interest in this work.
FUNDING
This research was funded by CONICET (PIP 112202101 00416CO 2022-2024).
Fig 1.
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Fig 5.
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Table 1 . Quantification of total polyphenols and flavonoids by spectrophotometry and epicatechin and tiliroside by HPLC-UV in TE.
Polyphenols (%w/w) Flavonoids (%w/w) Epicatechin (%w/w) Tiliroside (%w/w) 10.74 ± 0.79 1.94 ± 0.13 0.156 ± 0.003 0.119 ± 0.003
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Table 2 . Quantification of caffeoyl derivatives and flavonoids by HPLC-MS/MS.
Compound Concentration (%w/w) Caffeic acid 0.0037 Caffeic acid isomer (as caffeic acid) 0.051 Chlorogenic acid 0.0051 Chlorogenic acid isomer (as chlorogenic acid) 0.00082 Q-3-O-xyloside 0.014 Q-3-O-arabinopyranoside 0.0069 Q-3-O-glucoside 0.15 Q-3-O-rhamnoside 0.11 Q-rham1 (as Q-3-O-r) 0.19 Q-rham2 (as Q-3-O-r) 0.69 Same MW as rutin diglicoside (as rutin) 0.2 Rutin 0.02 Procyanidin B2 0.25
References
- Patel DC, Tewari BP, Chaunsali L, Sontheimer H. Neuron-glia interactions in the pathophysiology of epilepsy. Nat Rev Neurosci. 2019;20(5):282-97.
- Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-21.
- White HS, Smith MD, Wilcox KS. Mechanisms of action of antiepileptic drugs. Int Rev Neurobiol. 2007;81:85-110.
- Bertoncello KT, Bonan CD. Zebrafish as a tool for the discovery of anticonvulsant compounds from botanical constituents. Eur J Pharmacol. 2021;908:174342.
- Löscher W, Schmidt D. Modern antiepileptic drug development has failed to deliver: ways out of the current dilemma. Epilepsia. 2011;52(4):657-78.
- Balasubramanian D, Deng AX, Doudney K, Hampton MB, Kennedy MA. Valproic acid exposure leads to upregulation and increased promoter histone acetylation of sepiapterin reductase in a serotonergic cell line. Neuropharmacology. 2015;99:79-88.
- Puttachary S, Sharma S, Stark S, Thippeswamy T. Seizure-induced oxidative stress in temporal lobe epilepsy. Biomed Res Int. 2015;2015:745613.
- Manchishi SM. Recent advances in antiepileptic herbal medicine. Curr Neuropharmacol. 2018;16(1):79-83.
- Rodriguez Brizi M, Marrassini C, Zettler G, Ferraro G, Anesini C. Comparative antiproliferative action of two extracts from
Tilia x viridis on normal and tumoral lymphocytes: relationship with antioxidant activity. Chin Med. 2012;3(1):20-9. - Castañeda R, Cáceres A, Velásquez D, Rodríguez C, Morales D, Castillo A. Medicinal plants used in traditional Mayan medicine for the treatment of central nervous system disorders: an overview. J Ethnopharmacol. 2022;283:114746.
- Suroowan S, Pynee KB, Mahomoodally MF. A comprehensive review of ethnopharmacologically important medicinal plant species from Mauritius. S Afr J Bot. 2019;122:189-213.
- Faheem M, Ameer S, Khan AW, Haseeb M, Raza Q, Shah FA, et al. A comprehensive review on antiepileptic properties of medicinal plants. Arab J Chem. 2022;15(1):103478.
- Aguirre-Hernández E, González-Trujano ME, Martínez AL, Moreno J, Kite G, Terrazas T, et al. HPLC/MS analysis and anxiolytic-like effect of quercetin and kaempferol flavonoids from Tilia Americana var. Mexicana. J Ethnopharmacol. 2010;127(1):91-7.
- Feas DA, Igartúa DE, Calienni MN, Martinez CS, Pifano M, Chiaramoni NS, et al. Nutraceutical emulsion containing valproic acid (NE-VPA): a drug delivery system for reversion of seizures in zebrafish larvae epilepsy model. J Pharm Investig. 2017;47:429-37.
- Hosseinzadeh R, Khorsandi K, Hemmaty S. Study of the effect of surfactants on extraction and determination of polyphenolic compounds and antioxidant capacity of fruits extracts. PLoS One. 2013;8(3):e57353.
- Chang CC, Yang MH, Wen HM, Chern JC. Estimation of total flavonoid content in propolis by two complementary colometric methods. J Food Drug Anal. 2002;10(3):178-82.
- Zokti JA, Sham Baharin B, Mohammed AS, Abas F. Green tea leaves extract: microencapsulation, physicochemical and storage stability study. Molecules. 2016;21(8):940.
- Marrassini C, Anesini C, Ferraro G. HPLC fingerprint of a flower extract of Tilia × viridis and correlation with antiproliferative and antioxidant activity. Phytother Res. 2011;25(10):1466-71.
- Prieto MJ, del Rio Zabala NE, Marotta CH, Carreño Gutierrez H, Arévalo Arévalo R, Chiaramoni NS, et al. Optimization and in vivo toxicity evaluation of G4.5 PAMAM dendrimer-risperidone complexes. PLoS One. 2014;9(2):e90393.
- Veeren B, Ghaddar B, Bringart M, Khazaal S, Gonthier MP, Meilhac O, et al. Phenolic profile of herbal infusion and polyphenol-rich extract from leaves of the medicinal plant
Antirhea borbonica : toxicity assay determination in zebrafish embryos and larvae. Molecules. 2020;25(19):4482. - Blois MS. Antioxidant determinations by the use of a stable free radical. Nature. 1958;181:1199-200.
- Dissanayake DP, Abeytunga DTU, Vasudewa NS, Ratnasooriya WD. Inhibition of lipid peroxidation by extracts of Pleurotus ostreatus. Pharmacogn Mag [Internet]. 2009;5(19):266-71.
- Carrillo MC, Kanai S, Nokubo M, Kitani K. (−) deprenyl induces activities of both superoxide dismutase and catalase but not of glutathione peroxidase in the striatum of young male rats. Life Sci. 1991;48(6):517-21.
- Herzog V, Fahimi HD. A new sensitive colorimetric assay for peroxidase using 3,3'-diaminobenzidine as hydrogen donor. Anal Biochem. 1973;55(2):554-62.
- Alexander B, Browse DJ, Reading SJ, Benjamin IS. A simple and accurate mathematical method for calculation of the EC50. J Pharmacol Toxicol Methods. 1999;41(2-3):55-8.
- Macdonald RL, Kelly KM. Antiepileptic drug mechanisms of action. Epilepsia. 1995;36(Suppl 2):S2-12.
- Cárdenas-Rodríguez N, González-Trujano ME, Aguirre-Hernández E, Ruíz-García M, Sampieri A 3rd, Coballase-Urrutia E, et al. Anticonvulsant and antioxidant effects of Tilia americana var. mexicana and flavonoids constituents in the pentylenetetrazole-induced seizures. Oxid Med Cell Longev. 2014;2014:329172.
- Heidari MR, Sohrevardi SM, Eskandarizadeh A, Moghadammanesh H, Heidari M, Mohebbi S. The effects of
Tilia platyphyllos scop. extract on seizure induced by picrotoxin and pentylentetrazole in mice. J Pharm Health Sci. 2012;1(1):17-24. - Herrera-Ruiz M, Román-Ramos R, Zamilpa A, Tortoriello J, Jiménez-Ferrer JE. Flavonoids from Tilia americana with anxiolytic activity in plus-maze test. J Ethnopharmacol. 2008;118(2):312-7.
- Anesini C, Werner S, Borda E. Effect of
Tilia cordata flower on lymphocyte proliferation: participation of peripheral type benzodiazepine binding sites. Fitoterapia. 1999;70(4):361-7. - Rogawski MA. Mechanism-specific pathways for new antiepileptic drug discovery. Adv Neurol. 1998;76:11-27.
- Borowicz-Reutt KK, Czuczwar SJ. Role of oxidative stress in epileptogenesis and potential implications for therapy. Pharmacol Rep. 2020;72(5):1218-26.
- Beltrán-Sarmiento E, Arregoitia-Sarabia CK, Floriano-Sánchez E, Sandoval-Pacheco R, Galván-Hernández DE, Coballase-Urrutia E, et al. Effects of valproate monotherapy on the oxidant-antioxidant status in Mexican epileptic children: a longitudinal study. Oxid Med Cell Longev. 2018;2018:7954371.
- Aldarmaa J, Liu Z, Long J, Mo X, Ma J, Liu J. Anti-convulsant effect and mechanism of Astragalus mongholicus extract in vitro and in vivo: protection against oxidative damage and mitochondrial dysfunction. Neurochem Res. 2010;35(1):33-41.
- Choudhary N, Bijjem KR, Kalia AN. Antiepileptic potential of flavonoids fraction from the leaves of Anisomeles malabarica. J Ethnopharmacol. 2011;135(2):238-42.
- Alyami NM, Abdi S, Alyami HM, Almeer R. Proanthocyanidins alleviate pentylenetetrazole-induced epileptic seizures in mice via the antioxidant activity. Neurochem Res. 2022;47(10):3012-23.
- Hansen RS, Paulsen I, Davies M. Determinants of amentoflavone interaction at the GABA(A) receptor. Eur J Pharmacol. 2005;519(3):199-207.
- Hanrahan JR, Chebib M, Johnston GA. Flavonoid modulation of GABA(A) receptors. Br J Pharmacol. 2011;163(2):234-45.
- Xia Q, Luo J, Mei X, Wang Y, Huang W, Wang J, et al. A developmental toxicity assay of Carpesii Fructus on zebrafish embryos/larvae. Toxicol Res (Camb). 2017;6(4):460-7.
- Organisation for Economic Co-operation and Development (OECD). OECD guidelines for the testing of chemicals, section 2. Paris: OECD Publishing; 2013.