In Vitro Assessment of Kalanchoe pinnata and Metformin Preparation
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Metformin is the most common oral medication prescribed by doctors for the management of type II diabetes. As healthcare costs continue to rise, many affected by the disease are turning to alternative medicine for treatment and are combining them with modern medicine. Kalanchoe pinnata (K. pinnata) is currently being used as a “cure-all” by herbal practitioners in various countries. However, there is a shortage of scientific literature that supports the use of K. pinnata as a treatment for diabetes, the safety of the plant extract, and possible drug interactions for those concurrently taking metformin. In this study, combined preparations of K. pinnata and metformin were investigated to determine cytotoxicity, anti-oxidative, and anti-inflammatory activity in human skeletal muscle myoblasts (HSMM) and human diabetic skeletal muscle myoblasts (DHSMM). The effects of the combined preparations on the cytotoxicity of stress induced hydrogen peroxide-challenge in HSMM cell cultures were determined. Results showed that combinatorial preparations sustained cell viability for three days in both HSMM and DHSMM cells. However, a significant decrease in cellular viability occurred for both cell lines 72 hours post-treatment with a combinatorial preparation. They also showed that a Kalanchoe pinnata treatment (400 μg/mL) significantly increased catalase (CAT) activity for non-diabetic and diabetic human skeletal muscle myoblasts and an H2O2 stress-induced human skeletal muscle myoblast cell line, and significantly lowered malondialdehyde (MDA) levels. Diabetic and non-diabetic human skeletal muscle cells showed increased superoxide dismutase (SOD) activity when treated with metformin only. Stress induced HSMM cells were observed to have significantly higher SOD activity when treated with a combinatorial preparation of metformin and K. pinnata (100 μM metformin with 100 μg/mL K. pinnata). Combined metformin and K. pinnata at concentrations of 50 μM and 150 μg/mL respectively resulted in a significant increase in reduced glutathione levels in non-diabetic and diabetic human skeletal muscle myoblasts, and H2O2 stress-induced human skeletal muscle myoblasts. Combined preparations of metformin and K. pinnata may modulate immune responses by significantly elevating concentrations of interleukin (IL) 2, tumor necrosis factor-alpha (TNF-α), and interleukin-10 in HSMM and DHSMM cells. Treatment with 400 μg/mL of K. pinnata only reduces oxidative damage to human skeletal muscle. However, the combined preparation of metformin and K. pinnata, at concentrations of 50 μM and 150 μg/mL respectively was noted to be an effective treatment for lowering cellular oxidation by increasing the level of reduced glutathione in the cell.
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