The Mechanism of Action of Cotoneaster Manna, an Iranian Herbal Medicine, in the Treatment of Neonatal Jaundice

Document Type : Scientific Review

Authors

1 Mother and Newborn Health Research Center, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Department of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

5 Department of Medical Laboratory Sciences, School of Paramedical Science, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Neonatal jaundice is a common clinical problem caused by the deposition of bilirubin in the tissue. Natural products have long been used to treat jaundice, and Iranian medicine can be a good source of natural treatments for this purpose. In this study, we investigate the mechanism of the effect of Cotoneaster, an Iranian herbal medicine, in the treatment of jaundice in neonates.
Methods: We investigated every article that evaluated Purgative manna, Cotoneaster manna, or Cotoneaster in the treatment of neonatal jaundice. We searched the databases of PubMed, Scopus, Web of Sciences, SciELO, CNKI, and Google Scholar for English articles, and a search was also done in Persian in Magiran and Scientific Information Database (SID) published until August 2023.
Results: The exact mechanism of Cotoneaster in reducing jaundice is not known, but the following mechanisms have been suggested .The most common mechanisms include increased urination, increased bile excretion from the liver, and increased defecation, as well as neutralizing the effects of oxidative agents and free radicals.
Conclusion: Considering that most studies have stated that Cotoneaster combined with phototherapy is effective in treating jaundice and herbal medicines alone cannot treat jaundice. Therefore, identifying the mechanism of Cotoneaster in reducing jaundice can lead to the creation of methods to strengthen its effect. More detailed biochemical and pharmacological studies are needed to understand the mechanism of action of Cotoneaster in reducing neonatal jaundice.

Keywords


Corresponding Author: Sedigheh Ekraminasab
View Orcid in Profile
You can search for this author in PubMed     Google Scholar Profile

1. Ekraminasab S, Manzourolhojeh M. Prevalence of sepsis among Iranian newborns with jaundice: A meta-analysis based on cross-sectional studies. World J Peri Neonatol 2022; 4(2): 115-23.
2. Haile MT, Girma H. Prevalence and contributing factors of neonatal jaundice in neonatal intensive care unit at St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2019. J Heal Med Nurs 2020; 74: 21-6.
3. Fakhri M, Farhadi R, Mousavinasab SN, Yosefi SS, Hosseinimehr J, Azadbakht M. Effect of natural products on jaundice in Iranian neonates. Jundishapur J Nat Pharm Prod 2019; 14(1): e83042.
4. Lookzadeh MH, Mirjalili SR, Ekraminasab S. Immune and non-immune etiology of thrombocytopenia: Neonatal and maternal causes. World J Peri Neonatol 2021; 3(2): 78-86.
5. Rahani T, Boskabadi H, Sadeghi T, Boskabadi MH, Gharaei R, Pasban F. Comparison of the effect of cotoneaster manna drop (Bilineaster) and massage on bilirubin in neonates under phototherapy. J Babol Univ Med Sci 2017; 19(11): 21-7.
6. Manouchehrian M, Shakiba M, Shariat M, Kamalinejad M, Pasalar M, Jafarian AA, et al. Efficacy of maternal chicory aroma water consumption for neonatal jaundice: A randomized single-blind clinical trial. GMJ 2017; 6(4): 312-8.
7. Raghuvanshi D, Dhalaria R, Sharma A, Kumar D, Kumar H, Valis M, et al. Ethnomedicinal plants traditionally used for the treatment of jaundice (Icterus) in himachal pradesh in western Himalaya-A review. Plants (Basel) 2021; 10(2): 232.
8. Raeisi R, Heidari-Soureshjani S, Asadi-Samani M, Luther T. A systematic review of phytotherapies for newborn jaundice in Iran. Int J Pharm Sci Res 2017; 8(5): 1953-8.
9. Khoshdel A, Kheiri s. Effect of shir-e-khesht (billinaster drop) consumption by the neonates or their mothers on the neonatal icter [in Persian]. J Shahrekord Univ Med Sci 2011; 13(4): 67-73.
10. Ebrahimi S, Ashkani-Esfahani S, Poormahmudi A. Investigating the efficacy of Zizyphus Jujuba on neonatal jaundice. Iran J Pediatr 2011; 21(3): 320-4.
11. Bakhshi Jouybari H, Hosseini AS, Davoodi A, Mirzaee F. Materia medica used in jaundice based on Persian medicine. Res J Pharmacogn 2018; 5(4): 83-93.
12. Ameli Z, Assarroudi A, Akrami R. Effect of bilineaster drop on neonatal hyperbilirubinemia. Evid Based Care 2017; 6(4): 66-73.
13. Rafieian-Kopaei M, Khoshdel A, Kheiri S, Shemian R. Cotoneaster: A safe and easy way to reduce neonatal jaundice. J Clin Diagnostic Res 2016; 10(4): SC01-3.
14. Monsef A, Eghbalian F, Rahimi N. Osong public health and research perspectives comparison of purgative manna drop and phototherapy with phototherapy treatment of neonatal jaundice :A randomized double-blind clinical trial. Osong Public Heal Res Perspect 2019; 10(3): 152-7.
15. Rezapour M, Mozaffarpur SA, Nikpour M, Alijanpour M. The effect of herbal medicine on neonatal jaundice : a systematic review. Int J Pediatr 10(2): 15377-88.
16. Basati G, Anbari K, Abbaszadeh S, Hamidi M. Medicinal plants used for neonatal jaundice in Shahrekord: An ethnobotanical study. J Med Plants By-products 2019; 2: 201-6.
17. Fakhri M, Farhadi R, Azadbakht M, Akbari J, Yousefi SS, Mousavinasab N, et al. Cotoneaster manna oral drop for the management of neonatal hyperbilirubinemia; a randomized, double-blinded and placebo controlled clinical trial. Immunopathol Persa 2022; 8(1): 1-8.
18. Fakhri M, Farhadi R, Mousavinasab N, Hosseinimehr SJ, Yousefi SS, Davoodi A, et al. Preventive effect of purgative manna on neonatal jaundice: A double blind randomized controlled clinical trial. J Ethnopharmacol 2019; 23(236): 240-9.
19. Fallah R, Fallahzadeh M, Noori-Shadkam M. Evaluation of safety and efficacy of purgative manna (Billinaster Drop) and glycerin suppository in icterus of healthy term newborns. Curr Drug Saf 2014; 9(1): 29-33.
20. Kicel A. An overview of the genus cotoneaster (Rosaceae): Phytochemistry, biological activity, and toxicology. Antioxidants (Basel) 2020; 9(10): 1002.
21. Panahandeh G, Khoshdel A, Sedehi M, Aliakbari A. Phytotherapy with hordeum vulgare: A randomized controlled trial on infants with jaundice. J Clin Diagnostic Res 2017; 11(3): SC16-9.
22. Sajedi F, Fatollahierad S. Effect of purgative manna on neonatal hyperbilirubinemia: A systematic review and meta-analysis. Iran J Pharm Res 2019; 18(2): 1020-31.
23. Azadbakht M, Pishva N, Samani SM, Alinejad F. The effect of purgative manna on the infant jaundice. Iran J Pharm Sci 2005; 1(2): 95-100.
24. Huang W, Zhang J, Moore DD. A traditional herbal medicine enhances bilirubin clearance by activating the nuclear receptor CAR. J Clin Invest 2004; 113(1): 137-43.
25. Lookzadeh MH, Bahrami R, Ekraminasab S. Prevalence of urinary tract infection in Iranian newborns with jaundice: A meta-analysis. World J Peri Neonatol 2021; 4(1): 40-9.
26. Amiri MS, Joharchi MR, TaghavizadehYazdi ME. Ethno-medicinal plants used to cure jaundice by traditional healers of Mashhad, Iran. Iran J Pharm Res 2014; 13(1): 157-62.
27. Salehi A, Ostovar M, Marzban M. A systematic review and meta-analysis on the effect of Cotoneaster manna on neonatal jaundice. J Med Herb 2018; 9(1): 47-54.
28. Aghababaeian H, Nirouzad F, Kiarsi M, Amirgholami N, Kalani L, Beiranvand R, et al. The effect of Bilineaster “Cotoneaster” on reducing bilirubin in neonates with jaundice -a triple-blind randomized clinical trial. J Adv Pharm Educ Res 2021; 11(1): 23-8.
29. Fakhri M, Davoodi A, Hamzegardeshi Z, Farhadi R, Mousavinasab N, Keshtkar A, et al. Is cotoneaster manna improving the treatment of neonatal jaundice? Bangladesh J Pharmacol 2018; 13(2): 168-78.