136 lipids Karleskind, A., ed. (1992). Manuel des corps gras, 2 vols., Tec & Doc, Paris. Lie Ken Jie, M.S.F. and Pasha, M.K. (1998). Fatty Acids, Fatty Acid Analogues and their Derivatives, Nat. Prod. Rep., 15, 607-629. Wolff, J.-P. (1991). Analyse et dosage des lipides, in "Techniques d'analyse et de controle dans les industries agro-alimentaires", (Multon, J.-L., Ed.), vol. 4, p. 157-199, Tec & Doc, Paris. Lipids: Vegetable Oils 1. Oils subject to a Monograph in the Pharmacopoeia (European, [3rd] or French, [10th]).....138 Almond Oil..........................................................................................................138 Peanut Oil............................................................................................................139 Corn Oil...............................................................................................................141 Persic Oil.............................................................................................................142 Olive Oil..............................................................................................................143 Castor Oil............................................................................................................144 Sesame Oil..........................................................................................................146 Soybean Oil ........................................................................................................147 Soybean Lecithins............................................................................149 Other Emulsifiers.............................................................................149 2. Common Dietary Oils..................................................................................................150 Rapeseed Oil.......................................................................................................150 Sunflower Oil......................................................................................................151 3. Other Dietary Oils........................................................................................................152 Palm Oils.............................................................................................................153 4. Miscellaneous Oils.......................................................................................................155 A. Y-Linolenic Acid-Containing Oils .................................................................155 Evening Primrose Oil.......................................................................157 Borage Oil........................................................................................157 B. Sapotaceae Oils..............................................................................................158 5. Unsaponifiable Matter and Related Compounds.........................................................159 A. Unsaponifiable Matter - Avocado..................................................................159 B. Unsaponifiable Matter - Tocopherols.............................................................160 C. Compounds Related to the Unsaponifiable Matter........................................161 LIPIDS vegetable oils Prunus africana Kalkm....................................................................161 Saw Palmetto....................................................................................162 6. Bibliography................................................................................................................164 1. OiLS SUBJECT TO A MONOGRAPH IN THE PHARMACOPOEIA (EUROPEAN 3rd EDiTiGM, OR FRENCH, 10th EDITION) • Almond Oil According to the 3rd edition of the European Pharmacopoeia, this oil is «the fatty oil obtained by cold expression from the ripe seeds of Prunus dulcis (Miller) D.A. Webb var. dulcis or Prunus dulcis (Miller) D.A. Webb var. arnara (D.C.) Buchheim or a mixture of both varieties*. The Pharmacopoeia also describes refined almond oil. The Plant, the Drug. The almond tree is a Rosaceae with white or pinkish flowers very widely cultivated around the Mediterranean, including in Spain, Italy, Greece, Turkey, and North Africa, but also in Iran and in the western United States. The fruit is an oblong drupe with light green velvety epicarp; the seed is oval, flattened, and has a thin and wrinkly tegument that is easy to peel off. It tastes mild, oily, and slightly sweet. The seeds of the two varieties, amara and dulcis, are rich in oil (50-60%) and can only be distinguished by the occurrence in the amara variety of a cyanogenic glycoside, the gentiobioside of mandelonitrile: amygdalin. Its hydrolysis yields two molecules of glucose and, by decomposition of mandelonitrile, benzaldehyde and hydrocyanic acid. Fatty acid composition * of the oil (major fatty acids, %, Eur. Ph., 3rd Ed.): shorter than Ci6< 0.1; palmitic, 4-9; palmitoleic, <0.6; margaric, <0.2; stearic, <3; oleic, 62-86; linoleic, 20-30; linolenic, <0.4; arachidic, gadoleic, behenic, and erucic, <0.1. The unsaponifiable matter (<0.7%) contains sitosterol, A5-avenasterol (73-87% and >10% of total sterols, respectively); the cholesterol content is <0.7%, brassicasterol <0.3% (Eur. Ph.). a-Tocopherol is dominant: 92-99% of total tocopherols. Tests. In addition to the common tests, the French Pharmacopoeia prescribes a search for persic oil or peach kernel oil (no color with nitric acid), as well as sesame oil (no blue-green color with a furfural solution in acetic anhydride in the presence of sulfuric acid [verification of the absence of sesamol]). The composition of the sterol fraction and the fatty acid composition (and the absence of foreign fixed oils) are determined by GC. Tl ■v Uses. Almond oil is mainly used in cosmetology and dermatology. It is often substituted for by hazelnut oil (Corylus avellana L. *, Corylaceae) which has a similar composition (the kernel contains 50-60% oil). The cosmetic industry also uses a fraction containing essentially low molecular-weight proteins associated with carbohydrates. This active fraction is said to relieve skin irritation and the sensation of heat (after-sun lotions, after-shaves, makeup removers, and so on). Bitter almonds (but also other Rosaceae seeds, such as apricot kernels) are also used to produce essential or volatile oil of almonds. After elimination of the epicarp, the oil is extracted from the almonds of these various species, and the cattle cake undergoes steam extraction. The crude essential oil is treated with ferrous sulfate and calcium hydroxide to eliminate hydrocyanic acid, then submitted to another steam distillation. This essential oil of almonds, in competition with synthetic benzaldehyde**, is used as flavor, chiefly in food technology. Packaged under nitrogen, it must be stored protected from air to prevent the formation of benzoic acid. It can be stabilized by the addition of ethanol. o Peanut Oil Peanut oil (Eur. Ph., 3rd Ed.), one of the most consumed in the world, is obtained from the shelled seed of a Fabaceae, Arachis hypogaea L., the peanut, also called groundnut, earthnut, or arachis. This species, native to the South American tropics, has been used since early times: the culture of tlacacahuatl —later to become the French cacahuete—is documented in Peru during the third millennium B.C. Introduced in western Africa in the 16th century, then in Asia, it is now one of the oilseed crops most cultivated on the planet, including in China, India, western Africa (e.g., Nigeria, Senegal, Sudan, Congo), the United States, and Indonesia The Plant, the Drug. Botanically we shall merely emphasize the peculiarity of this annual herb of modest size, which stands erect or lies down, a curiosity which is linked to its mode of fructification. First, the ovary of the flower is borne by a short support, the gynophore; after fertilization, the latter lengthens and lengthens, bows toward the earth, and gradually buries beneath it the fertilized ovary; there, the ovary * For official oils, the values listed in this chapter are from the pharmacopoeias. For non- nffiri'll nV.r: t'hp vniu^c nr;--> imtpcc r»fh<*^wic*» inr!ir.nt.= rl fmm the* 1-iM,-»HKr.^-.V fttlc Viv A. * Oleic acid: 66-83%, linoleic acid: 8-25%, triolein, 44-60%. The leaves of this indigenous shrub are also used for medicinal virtues. They are traditionally used [French Expl. Note, 1998]: for the subjective symptoms of the functional troubles of venous insufficiency, such as fullness or tiredness in the legs, and for hemorrhoids; for the symptomatic treatment of mild diarrhea; and locally (collutoria, lozenges) as antalgics in diseases of the buccal cavity and/or of the oropharynx. The composition of the drug is ill-known. It is known to contain proanthocyanidols; see Parcerisa, J., Richardson, D.G., Rafecas, M., Codony, R. and Boatella, J. (1997). Fatty Acid Distribution in Polar and Nonpolar Lipid Classes of Hazelnut Oil (Corylus avellana L.), J. Agric. Food Chem.. 45, 3887-3890. ** The natural origin of this essential oi!—FFPA, i.e., free from grussic acid—can be verified vegetable oils 141 turns into an indehiscent pod with bumps where it contains 1-3 seeds: this is the peanut. The seed consists of two oily cotyledons covered by a thin tegument of variable color. The oil content of the kernel may exceed 50% (in the industry, 100 kg of fruit yield 70 kg of seeds, which yield, by expression-extraction, 34 kg of oil). The cattle cake may be used as animal feed, as the protein content of the seed ranges from 20 to 50%. Fatty acid composition of the oil (major fatty acids, %, Eur. Ph., 3rd Ed.): 93%, cholesterol and A7-stigmasterol <0.5%, stigmasterol M n U/J(í L the pericarp, and the nut, in other words the seed surrounded by the endocarp, is pressed or extracted with solvents to give palm kernel oil. These oils, like copra, are solid in temperate climates; the presence of carotenoids explains the deep color of palm oil, sometimes called «red oil». The main uses of palm oil are in the margarine and soap industries. Chemical composition (major fatty acids, %): 1- copra caprylic : myristic : 5-10 16-21 2- palm kernel oil caprylic : 2.4-6.2 myristic : 14-18 3- palm oil myristic linoleic 0.5-2 6.5-12 capnc palmitic capnc palmitic palmitic stearic 4.5-8 7.5-10 2.6-5 6.5-10 41-47 5.5-6 lauric : oleic : lauric oleic oleic : 43-51 5-10 41-55 12-19 36-44 The unsaponifiable matter of palm oil is high in carotenes (0.5-0.7 g/kg of oil) and its tocopherol fraction contains over 80% tocotrienols. These tocotrienols are also characteristic of the unsaponifiable matter of copra oil. 4. MISCELLANEOUS OILS A. Oils with y-Linolenic Acid Fats are required nutrients, and it is generally accepted that they must constitute 30 to 35% of the daily caloric intake in a normal diet. Although fats provide a substantial amount of energy in a small volume, it must be noted that all the fatty acids that constitute them do not have the same role or the same worth. Some polyunsaturated fatty acids are in fact indispensable: they are called essential {essential fatty acid = EFA) because they are not synthesized by the human body (for example linolenic acid), or are synthesized in sufficient amounts only by the young and healthy body (arachidonic acid). EFAs have an important biological role: as constituents of the phospholipids of cell membranes, they may contribute to ensuring their fluidity; they are also the precursors of eicosanoids (prostaglandins, leukotrienes, and thromboxanes), which have multiple known functions as intra- and intercellular mediators, and as agents in platelet aggregation ox/Va the inflammatory process. The biosynthesis of these compounds involves arachidonic acid, which normally arises from the de-saturation 156 lipids vegetable oils 157 desaturation leading to arachidonic acid (C2o:4). It is this acid which is the substrate upon which cyclooxygenase and lipoxygenase will act to form eicosanoids. Thus, linoleic acid is necessary regardless of age or health status, and the need is estimated at about 6-8% of the caloric ration and is satisfied by the consumption of vegetable fats. The same applies to the 0.5-1% of the caloric ration in a-linolenic acid indispensable for a balance 155d diet *. Linolenic acid deficiency manifests itself by dermatological signs (such as eczema lesions, impetigo, and erythema), delayed growth, hypertension, and poor platelet aggregation. Desaturation, elongation-desaturation: formation of arachidonic acid. Origin of leukotrienes C02H Arachidonic acid C02H CO,H LTBt Leukotriene A * A diet based on a decrease in animal proteins (red meat) consumption, an increased consumption of fruits and vegetables, and the replacement of saturated fats by products high in oleic and a-linolenic acid is effective in preventing coronary disease. See de Lorgeril, M., Renaud, S., Mamelle, N., Salen, P., Martin, J.-L., Monjaud, I., Guidollet, J., Touboul, P. and Delaye, J. (1994). Mediterranean Alpha-linolenic Acid-rich Diet in Secondary Prevention of Coronary Heart Disease, Lancet, 343, 1454-1459. Polyunsaturated n-3 fatty acids also appear to provide protection against colon carcinogenesis (on the contrary, the cancer-promoting effect of an excess of lipids is well accepted, despite the fact that half the published studies fail to confirm it): Corbet, D.E. and Gerber, M. (1997). Alimentation mediterraneenne et sante, partie 1. Caracteristiques. Maladies cardiovasculaires et autres affections. Med. Nut d Certain factors may lead to a marked decrease in A6-desaturase activity: stress, aging, alcoholism, nicotine addiction, hepatic insufficiency, and diabetes mellitus, among others. Diet must then fulfill the needs in polyunsaturated fatty acids, especially in arachidonic acid, present in eggs and livers, but absent in vegetable oils. a-Linolenic acid is present in most vegetable oils, but Y-linolenic acid is much more rare: it is found in Onagraceae (CEnothera), in Saxifragaceae (for example Ribes nigrum L. and R. rubrum L.), in various species of the genera Anchusa, Borago, Cynoglossum, Onosma, Onosmodium. and Symphytum, of the Boraginaceae, but also in some species of Anemone and in Cannabis seeds. The most interesting sources appear to be black currant seeds, evening primrose seeds, and borage seeds. • Evening Primrose, Oenothera biennis L., Onagraceae The evening primrose is easy to identify by its large ephemeral flowers with four yellow emarginate petals, which bloom at night, hence the name (Nachtkene in German). Originally from North America, this species is common in Mediterranean, as well as Atlantic coastal regions. It is cultivated in the United Kingdom for the production of seeds. The drug—it consists of the seed, small (1-2 x 0.5-1 mm) and angular-—contains up to 25% of an oil rich in unsaturated fatty acids: y-linolenic acid (8-14%), linoleic acid (65-80%), and oleic acid (6-11%). The oil is extracted by cold expression, and like all other highly unsaturated oils, it is very difficult to preserve. Evening primrose oil is used in the formulation of cosmetic products and toiletries. These products are said to have the potential for preserving skin elasticity and preventing wrinkle formation. Several studies have attempted to support various indications for evening primrose oil by the oral route: breast pain, premenstrual syndrome, hypercholesterolemia, eczema, cirrhosis, rheumatoid arthritis, psoriasis, and more. Various authors believe that evening primrose oil can relieve the mild mastodynia of premenstrual syndrome. Yet placebo-controlled clinical trials conducted with strict inclusion criteria showed that although most of the symptoms were improved, the difference was not significant. Whether evening primrose oil is of interest for oral administration in the treatment of atopic eczema is just as controversial: some authors think that it is efficacious, others that it is potentially useful, and rigorous clinical trials indicate no activity beyond that of a placebo. Other proposed uses are based, at best, on contradictory and fragmented data. Modest results may justify its use for cyclic breast pains, but the other proposed uses rely on contradictory and fragmented data. ® Borage, Borago officinalis L(, Boraginaceae Its flowers and flowering tops are official in France (see p. 838), and borage is .158 lipids although the yield from the seeds is uncertain: blooming is not synchronized, therefore seed maturation is not uniform, and ripe seeds fall on the ground before and during the harvest. The oil content varies from 13 to 33% depending on the mode of extraction and the degree of ripeness. This is an unsaturated fatty acid-containing oil, with linoleic acid (30-40%), oleic acid (15-19%), and y-linolenic acid (18-25%) dominating. The uses of this unstable oil are the same as those of evening primrose oil; its efficacy in the indications that are claimed are just as controversial. unsaponifiable matter 159 HÖ H OH PGFja + other PGs Arachidonic acid Oxydation by cyclooxygenase. Formation of prostaglandins, thromboxanes, prostacyclins (examples). B. Sapotaceae Oil; OH PGI2, Prostacyclin CO,H TXAo Sapotes^es llm7^7oLitTt ^ SkeeIs) 18 a th^ sterols derived from cycloartane, but no sitosterol. The cattle cake contains saponins which are bidesmosides of polyhydroxylated acids from the oleanane series. Argan oil is used in cosmetic formulation. K a rite nut butter or shea butter is the fat obtained from the seeds of a plant grown mainly in Nigeria, Mali, Burkina, and Ghana. The pericarp of the fruit of this species, Vitellaria paradoxa Gaertner/. (= Butyrospermum parkii Kotschy.) is edible. Its composition is stearic acid (28-45%), oleic acid (42-59%), linoleic acid (3-9%); the unsaponifiable matter (7-10%) contains a specific hydrocarbon (20-30 g/kg). Market outlets are limited to cosmetology, and the formulation of a few healing and protective ointments (sunblocks, skin protectors). macassar Oil. This oil, used in the formulation of cosmetic and personal hygiene products (e.g., shampoos), is obtained from the seeds of the Ceylon oak, Schleichera oleosa (Lour) Oken (= S. trijuga). The oily seeds of other Sapotaceae have local dietary uses, e.g., Madhuca longifolia (Koenig) Macbr. or illipe nuts, which give illipe butter and illipe oil (and must not be confused with the seeds of the Shorea of Borneo [Dipterocarpaceae], also known as illipe nuts). 5. UNSAPONIFIABLE MATTER AND RELATED COMPOUNDS The unsaponifiable matter, composed of the non-glyceride constituents of oils, represents from 0.3 to 2% of the weight of the oil. The composition of the unsaponifiable matter is often complex: the most common constituents are hydrocarbons, carotenoids, sterols, (sitosterol, stigmasterol, A'-sterols), tocopherols, high molecular weight-aliphatic alcohols, and terpenoid alcohols. A. Unsaponifiable Matter - Avocado The avocado tree, Persea americana Miller, is a Lauraceae from South America. Cultivated in Africa, in America (Mexico, United States, Brazil), and in Israel, it is a tree with pear-shaped fruits - the avocados - with voluminous seeds. The fleshy mesocarp of this fruit yields a viscous, brownish-green oil with a fruity odor. The oil content and its composition depend on the variety, and include palmitic acid (17-29%), palmitoleic acid (6-12%), oleic acid (42-63%), linoleic acid (9-16), and linolenic acid (<1%). Branched hydrocarbons account for half of the unsaponifiable matter, the level of which may reach 1%; it contains 20% sterols and unidentified, highly reducing triols. In rats, the combination of unsaponifiable materials from avocado and soybean lipids basic treatment for periodontitis, and used in rheumatology as an adjunctive therapy for arthritis pain. B. Tocopherols Tocopherols are prenylated derivatives of benzodihydropyran. Tocopherols and tocotrienols are distinguished by their lateral chain, which is either saturated or unsaturated, respectively; in either series the position and the nature of the substituents define four different compounds (a, (3, y, 8). Biosynthetically, tocopherols are derived from homogentisic acid. Ri HO. R, = R2 = CH3: a-Tocopherol; R, = CH3, R2 = H : ^-Tocopherol Ri = H, R2 = CH3: y-Tocopherol; Ri = R2 = H : ^-Tocopherol The tocopherols constitute what some call vitamin E, a natural antioxidant, especially for fatty acids: the tocopherols are highly oxidizable, form an epoxide first, then by opening and dehydration, a p-quinone. Oxidized vitamin E is then reduced by ascorbic acid. The normal consumption of oils, margarines, and cereals easily fulfill the daily needs (10-12 mg/day). Although the basis for supraphysiological intake has not been demonstrated, at least it is apparently harmless (except in subjects deficient in vitamin K, either as a result of poor absorption or as a side effect of treatment with anticoagulants). A maximum safe dose is recommended by the Conseil superieur d'hygiene publique de France : 40 mg/day. Because lipoprotein oxidation might play a role in atherogenesis, many studies have attempted to show a possible protective effect of vitamin E against cardiovascular disease. These studies suggest that a diet rich in vitamin E has a protective effect, but they are not without bias, therefore they fail to show a significant correlation between vitamin E intake and the risk of coronary disease. To date, the results of placebo-controlled prevention trials have been either negative or not significant (in primary prevention), or divergent (in secondary prevention). Vitamin E intake also has no impact on degenerative diseases such as Huntington's chorea. It is possible that vitamin E has a protective effect during the early phases of carcinogenesis induction (digestive tract, lungs), but the formal proof of such an activity remains to be established. a-Tocopherol acetate is indicated for the treatment and prevention of vitamin E deficiency. It is proposed by some authors: 1. for the treatment of urinary incontinence in women and of progressive myopia; 2. as an adjunct in the dietary regimen of patients with high blood lipoproteins who are nni elio-iMp fi->r t^n^^t unsaponifiable matter lower blood lipids, a proposal which other authors have good reasons to find debatable. It is also found, but in small doses, in dozens of proprietary drugs, over-the-counter drugs, and dietary supplements, in combination with other vitamins, flavonoids, fish oil, minerals, and more. It is frequently incorporated in dietetic preparations. In food technology, tocopherols are authorized antioxidants, whether they are natural extracts from edible vegetable oils rich in tocopherols (Eur. id. code e306) or synthetic tocopherols (a, y, 5, i.e., E307-9). Pharmaceutical technology also finds uses for the antioxidant properties of these molecules, often in synergy with ascorbic acid. C. Compounds Related to the Unsaponifiable Matter m PRUNUS AFRIČANA, Kalkm., Rosaceae The Plant, the Drug. Still often (erroneously) referred to as Pygeum africanum Hook., called «African plum tree», this African forest species grows mostly in mountain areas with heavy rainfall. It is a tall tree, which may reach 30 m, with elliptic, weakly acuminate, thick, and coriaceous leaves. The flowers are small, white, and pentamerous. The fruit is a tough red akene with a depression at the top. The drug consists of the bark: red or dark brown, it smells weakly of hydrocyanic acid. The product most commonly used is a lipid and sterol extract obtained by organic solvent extraction. Chemical Composition. Analysis of the extract shows that it contains a lipid fraction (C12_24 fattY acids), phytosterols (free and conjugated fj-sitosterol, campesterol), triterpenoid pentacyclic acids (ursolic, oleanolic, and their homologs di- or trihydroxylated at C-2, C-3, and/or C-24, sometimes acylated by ferulic acid), and linear aliphatic alcohols: n-tetracosanol and n-docosanol, which seem to occur in the extract as ferulic acid esters. Pharmacological Activity. The mechanism of action of the extract of P. africana has not been elucidated completely. There may be several factors, particularly the inhibition of 5-lipoxygenase in the polymorphonuclear leucocytes that infiltrate prostatic tissue (the extract is an anti-inflammatory). Interaction with testosterone metabolism is excluded by most published studies, although a 1996 publication showed, in vitro, a partial inhibition of 5a-reductase and of aromatase, therefore the possibility of an action on tissues whose growth is hormone-dependent. It is also known that the extract regenerates the prostatic epithelium in rats and dogs. More recently, it was shown on cell cultures of rat prostatic fibroblasts that the extract inhibits the cell proliferation induced by the main growth factors responsible for the normal and pathological development of prostatic tissue: EGF (Epidermal Growth Factor, CI50 = 4.5 p.g/mL), bFGF (basic Fibroblast Growth Factor), IGF-1 (hisulin-^ - T^--*-- n ti,<» inKiKtinn nf nrnliferntinn is also observed with cells in 162 lipids the absence of stimulation, and with cells stimulated by a protein kinase C activator, TPA (see p. 654). No cytotoxicity is associated with the P. africana extract. Other studies in rabbits showed that at high doses, it prevents the functional problems with bladder contractility and metabolism that are induced by a partial obstruction of the urethra, but does not decrease the compensatory bladder hypertrophy (a consequence of the increase in bFGF). Clinical trials * that have been published for the extract state a significant difference from a placebo for nocturnal pollakiuria and other symptoms of benign prostatic hyperplasia (post-voiding residual volume, maximum urinary flow rate) as well as for subjective symptoms; it has no action on the volume of the adenoma. Other trials show that the activity is, in similar conditions, comparable to that of Serenoa repens fruit extracts. Uses. P. africana extract is used orally (100 mg/day in 6-8-week cycles) for the following indication: to treat moderate bladder outlet obstruction symptoms due to benign prostatic hyperplasia (BPFf). The treatment is no dispensation from having a physician monitor the BPH. Ongoing research is taking into account the international recommendations and will help determine if this drug is of interest (International Prostate Symptom Score = I-PSS). • Saw Palmetto, Serenoa repens (Bartr.) Small = Sabal serrulata Rohm. & Schult., Palmae The Plant, the Drug. The saw palmetto or dwarf American palm is a palm with «fan-shaped leaves» with a fairly short single stipe (0.5-2 m), with bluish-green, deeply split leaves, borne by a petiole lined on the edge by small sharp needles, with small flowers gathered into a spadix (raceme-like panicle). The fruit constitutes the drug and is globose (2-3 x 1.5 cm), monoseeded, and bluish to black at maturity. The species grows wild in sandy soils of the southern United States where it often forms impenetrable groves. Chemical Composition. There is not much literature on the chemical composition of the drug. Fruits and seeds are rich in a triacylglycerol-containing oil, with nearly 50% of the fatty acids containing 14 or fewer carbon atoms. These fatty acids, especially lauric acid, are present in the commercial lipid and sterol hexane extract, which also contains linear alkanes (C9-C28), aliphatic alcohols (hexacosanol [Cjg], octacosanol [C2g], triacontanol [C30], and their esters) and monounsaturated * Recall that the WHO experts were highly critical of the quality of the clinical trials conducted with most of the products that are widely proposed to treat benign prostatic hyperplasia. unsaponifiable matter 163 alkenes (C12, C13, and C24), phytosterols (sitosterol, campesterol, cycloartenol, and sitosterol derivatives: 3-O-glycoside, 3-O-palmitate, 3-O-myristate, 6'-0-acyl-3-0-glucosyl, and others), and polyprenols. Pharmacological Activity. The pharmacology of the hexane extract has been studied extensively. In the mouse and the castrated rat, it exerts a peripheral anti-androgenic effect, a consequence of its complex interaction with the metabolism and the mode of action of testosterone in the prostate. In vitro (cell culture), it inhibits steroid 5a-reductase and 3a-reductase; in vitro and in vivo (rat), it decreases the binding between dihydrotestosterone (DHT) and cytosolic and nuclear androgen receptors. Contradictory data were obtained from other studies: the inhibition of the 5a-reductase and of the binding of androgens to their receptors would in fact be due to the use of very high doses, therefore the mechanism would be nonspecific (on the same model, the IC50 of the saw palmetto extract is 5.6 mg/L whereas that of finasteride is 1 (Xg/l). Other authors distinguish the effects on both type 1 and type 2 isoforms of 5a-reductase. The anti-androgen activity should lead to a decrease in the prostate volume; but again the published results seem contradictory. The acidic lipophilic fraction of a supercritical carbon dioxide extract inhibits cyclooxygenase and lipoxygenase in vitro, an effect which might explain the antiinflammatory and antiedema activity that is attributed to the saw palmetto extract. A spasmolytic activity and inhibitory effects on growth factor-induced prostatic cell proliferation have also been considered. The daily, short- or long-term administration of saw palmetto lipidosterolic extract (320 mg/day) does not significantly alter plasma levels of DHT; it also has no effect on plasma levels of prostate-specific antigen (PSA). Long-term use apparently results in a decrease in hormonal receptors in the prostate. Alongside many uncontrolled trials, a few clinical trials that were controlled, but did not use normalized inclusion criteria, attempted to determine whether Serenoa repens is of clinical interest for benign prostatic hyperplasia. Overall, their results are convergent, and show that 1 to 3 months of treatment (320-480 mg/day) lead to an increase in urinary flow rate, a marked decrease in post-voiding residual urine, and more generally, to an improvement of the symptoms. As noted by several authors, the key question raised by these trials is undoubtedly why, with one exception, the clinical trial subjects treated with a placebo do not report a significant improvement of their symptoms, while it is well accepted that at least 30-50% of BPH patients report an improvement of their symptoms after treatment with a placebo, and that the percentage is about the same after simple monitoring *. Only one study—recent, but not placebo-controlled—quantitates the symptoms with a normalized questionnaire (I-PSS); it reveals a decrease of 35% of the initial score after 3 months of treatment. Another study, controlled and including a large number of patients, showed an * Monitoring 282 untreated patients (for B-5 years) revealed a spontaneous decrease in subjective symptoms in 38 % of the patients and an improvement of the objective parameters in 22 % of 164 lipids bibliography 165 efficacy similar to that of finasteride, at least in terms of I-PSS score and quality of life score. Uses. The lipidosterolic extract of the saw palmetto is marketed with the following indication (320 mg/day, per os): treatment of moderate bladder outlet obstruction symptoms linked to benign prostatic hyperplasia. The product is very well tolerated in the vast majority of cases (administration on an empty stomach can cause nausea). 6. BIBLIOGRAPHY Aparicio, R., Morales, M.T. and Alonso, V. (1997). Authentication of European Virgin Olive Oils by their Chemical Compounds, Sensory Attributes, and Consumers' Attitudes, J. Agric. Food Chem., 45, 1076-1083. Bougnoux, P. Corpet, D. and Gerber, M. 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