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Commercial Herbal Products of Echinacea Nutrients

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Review Article

Commercial Herbal Products of Echinacea Nutrients

  • Muhammad Arshad Ullah 1*
  • Ali Hassan 2
  • Ameer Hamza 3

*Corresponding Author: Muhammad Arshad Ullah, Pakistan Agricultural Research Council, Islamabad, Pakistan.

Citation: Muhammad A. Ullah, Ali Hassan, Ameer Hamza, (2024), Commercial Herbal Products of Echinacea Nutrients, J. Pharmaceutics and Pharmacology Research, 7(5); DOI:10.31579/2688-7517/171

Copyright: © 2024, Muhammad Arshad Ullah. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 29 January 2024 | Accepted: 15 March 2024 | Published: 08 April 2024

Keywords: anti-inflammatory; PRRSV; T-cells.echinacea

Abstract

Echinacea preparations are among the most popular herbal products with immunomodulatory properties. While immunomodulatory aspects of an array of different biomolecules (e.g., phenolic compounds, alkamides, arabinogalactan proteins) occurring in Echinacea preparations. Echinacea and several other plants encompassed in herbal medicine (e.g., ginger, turmeric, and cannabis) have been shown to alleviate the effects of inflammation. It is interesting to note that these plants display enhanced antioxidant capacity, which could, in turn, be used to manage inflammation-related disorders induced by oxidative stress.

Fructan-related antioxidant capacity (and ability to act as ROS scavengers) has also been demonstrated in humans in both in vitro and in vivo studies, suggesting that the consumption of foods rich in fructans could exert beneficial immunomodulatory properties by acting as antioxidants. The ability of ITFs to bind to TLR2 suggests a potential role in anti-inflammatory pathways through the activation of regulatory T-cells.Echinacea, which was commonly used for the treatment of common cold, coughs, bronchitis, influenza and inflammation of mouth and pharynx, is found to rank in second position in the highest  retail sales for over‐the counter  herbal products. It is found to be the most frequently used herbal remedies in case of the treatment for adults and children and hence consumed by approximately over 10 to 20% of the herbal users. 

Echinacea purpurea root was found to reduce the oral clearance of substrates of CYP1A2 but not the oral clearance of substrates of CYP2C9 and CYP2D6. The ethanol and ethyl acetate‐soluble fractions from the leaves and stem was found to contain a potent antiviral photosensitizer, which was absent in the flower extract. Dietary Echinacea did not enhance the growth, exhibit antiviral effects to porcine reproductive and respiratory syndrome virus (PRRSV), or show any evidence of immune enhancing properties. Echinacea purpurea was found to decrease the cadmium‐induced mitotic activity of liver cells, and increased the apoptotic activity of these cells.

Summary

Echinacea preparations are among the most popular herbal products with immunomodulatory properties (Barrett, 2003 and Sharma et al., 2006). While immunomodulatory aspects of an array of different biomolecules (e.g., phenolic compounds, alkamides, arabinogalactan proteins) occurring in Echinacea preparations have been highlighted before (Bruni et al., 2018; Classen, 2018;2019 and Pugh et al., 2013), here we review knowledge on Echinacea derived inulin-type fructans (ITFs) and highlight their presence in commercially available Echinacea products.

Echinacea is a plant genus within the family Asteraceae (previously termed the Compositae) and is comprised of 11 taxa of herbaceous and flowering plants (Kim et al., 2004 and Sharifi-Rad et al., 2018). Echinacea preparations (which are mainly based on three commercially important species; Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida) are commonly used for preventing and alleviating the symptoms of bacterial and viral infections (Kim et al., 2004). Furthermore, some Echinacea preparations are known to exert antioxidant and anti-inflammatory activity espousing to its potential immunomodulatory activities (Sharifi-Rad et al., 2018 and El-Ashmawy et al., 2015).

Both in vitro and in vivo studies demonstrated that different extracts from Echinacea, either from roots, above-ground parts, or a mixture of both, could stimulate or signal immune responses (Goldrosen et al., 2004).

Immunological studies have used aqueous or alcoholic extracts, as well as purified polysaccharides. Their effects on monocytes, macrophages, natural killer (NK) cells, T cells, and dendritic cells (DC) have been thoroughly studied (El-Ashmawy et al., 2015; Goldrosen et al., 2004 and Wang et al., 2006).

Further research concluded that several purified compounds from Echinacea (e.g., glycoproteins, soluble polysaccharides, caffeic acid derivatives, phenolic compounds and alkamides) could induce transcriptional changes that activate immunomodulation pathways (Dalby-Brown et al., 2005; Pillai et al., 2007; Ramasahayam et al., 2011; Rondanelli et al., 2018; Kour and Bani, 2011; Park et al., 2011 and Raduner et al., 2006).

In general, immunomodulatory and prebiotic polysaccharides have been implicated in the overall health and well-being of humans by (i) enhancing physiological parameters (e.g., blood pressure, hematological parameters), (ii) increasing tolerance against pathogens and, (iii) modulating immune responses (Vos et al., 2007 and Delgado et al., 2010).

However, an additional signaling pathway dependent on the peptidoglycan recognition protein 3 (PGlyRP3) has also been proposed (Zenhom et al., 2019). This recognition protein, which responds to bacterial cell wall peptidoglycan, forms part of a larger group of highly conserved host defense proteins in mammals and insects. It has been demonstrated that FOS enhances the activity of peroxisome proliferator-activated receptors (PPAR), a group of nuclear receptor proteins that function as transcription factors to modulate the expression of several genes involved in lipid and carbohydrate metabolism, as well as cell proliferation, differentiation, and death (Di Giacomo et al., 2017 and Dabrowski et al., 2019).

Respiratory infections, such as the common cold and the seasonal flu, are often infectious diseases caused by different viruses (Roxas et al., 2007).

In this context, Echinacea extracts show profound antiviral activity against several viruses (including human and avian influenza viruses, H3N2-type IV, H1N1-type IV, herpes simplex, and rhinoviruses), and reversed virus-induced pro-inflammatory responses (Pleschka et al., 2009; Senchina et al., 2010 and Vimalanathan et al., 2013). It is necessary to better understand what role ITFs and other fructans may play in immunomodulation, when administered as part of a collective plant extract, given the knowledge that a variety of other herbal medicines (such as the Indian Ayurveda and Japanese Chikuyo–Sekko–To) with well-established immunomodulatory effects have been identified to contain fructans as key compounds (Lee et al., 2011 and Thakur et al., 2012).

A fructan isolated from Welsh onion (Allium fistulosum L.) demonstrated an inhibitory effect on influenza A. virus replication inmice (Hayashi et al., 2012). Intriguingly, fructans from burdock (Arctium lappa L.) strongly stimulate NO synthesis and defense signaling in plants (Guo et al., 2013), suggesting that the overall underlying mechanisms and pathways may be similar in all multicellular organisms. Both high and low DP fructans from aged and fresh garlic (Allium sativum) have the capacity to activate macrophages and subsequently phagocytosis, again in combination with a release of NO (Chandrashekar et al., 2011; 2016). Garlic is also an important component of the traditional Ayurveda Rasayana drugs, together with the Inula racemosa and Bombax ceiba. The immunomodulating properties of these three plants were attributed to their high fructan content (Balasubramani et al., 2011; Mishra et al., 2016 and Li et al., 2017). Fructans were also shown to be important immunomodulatory compounds in extracts of onion (Allium cepa), yacon (Smallanthus sonchifolius), Curcuma (Curcuma kwangsiensis), blue agave (Agave tequilana), and mugwort (Artemisia vulgaris) (Dong et al., 2015; Kumar et al., 2015; Corrêa-Ferreira et al., 2017; Gutiérrez Nava et al., 2017 and Paredes et al., 2019).

Echinacea and several other plants encompassed in herbal medicine (e.g., ginger, turmeric, and cannabis) have been shown to alleviate the effects of inflammation. It is interesting to note that these plants display enhanced antioxidant capacity, which could, in turn, be used to manage inflammation-related disorders induced by oxidative stress (Geronikaki and Gavalas, 2006).

Fructan-related antioxidant capacity (and ability to act as ROS scavengers) has also been demonstrated in humans in both in vitro and in vivo studies, suggesting that the consumption of foods rich in fructans could exert beneficial immunomodulatory properties by acting as antioxidants (Peshev et al., 2013; Shang et al., 2018 and Petkova et al., 2019). The ability of ITFs to bind to TLR2 suggests a potential role in anti-inflammatory pathways through the activation of regulatory T-cells (Tregs) (Zhang et al., 2017).

 In line with this reasoning, inulin was shown to create an immunosuppressive environment in human peripheral blood mononuclear cells (PBMC) by promoting the expression of forkhead box P3 (FOXP3; a Treg biomarker) and the secretion of the anti-inflammatory cytokine IL-10 (Amarante et al., 2018). TLR2 signaling is also known to decrease intestinal permeability, a condition directly linked to inflammatory intestinal diseases such as celiac disease, inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS) (Cario et al., 2007 and Suzuki, 2013). 

It is well-known that ITFs indirectly influence AMP-activated protein kinase (AMPK) signaling through modulation of the microbiota, for instance, by stimulating the growth of Lactobacilli and Bifidobacteria, producing short-chain fatty acids (SCFAs) that activate AMPK (Peng et al., 2009). Metformin, a popular antidiabetic drug, is known to activate AMPK and to inhibit NF-B activation (Kim et al., 2011). Surprisingly, ITFs and metformin have very similar physical outcomes (Xue et al., 2019). PPAR, modulated by ITFs, is also known to influence AMPK signaling (Lee and Kim, 2010). These properties of ITFs make them good candidates for the treatment of current inflammatory diseases such as diabetes, obesity and IBD (Tak and Firestein, 2001 and Peng et al., 2019). The immunomodulatory and anti-inflammatory properties of Echinacea preparations are well-known and have been ascribed to the myriad of compounds that display antioxidant activity (Manayi et al., 2015). Both Echinacea angustifolia and Echinacea preparations were also reported to reduce inflammatory conditions caused by insulin resistance and induced by pathogens, respectively (Sharma et al., 2009; 2010; Gargari et al., 2013; Mao et al., 2018 and Chambers et al., 2019).

Echinacea preparations were reported to stimulate increases in both the number of white and red blood cells (Modaresi, 2013). In line with the possible anticancer activities of Echinacea preparations (Miller, 2012), it has been demonstrated that Echinacea extracts are potent activators of NK cell cytotoxicity. Echinacea extracts increase the frequency of NK cell target conjugates and speed up their lytic activities (Gan et al., 2003).

Additionally, the modulation of DC activity, important for Treg induction, has been reported (Benson et al., 2010).

Further research is necessary to decipher whether, and to what extent, ITFs contribute to the observed immunomodulatory effects of Echinacea preparations. The connection between the Echinacea polysaccharides and their immunomodulating properties has been suggested multiple times (Melchart et al., 2002). 

The occurrence of ITFs in Echinacea (Wack and Blaschek, 2006) prompted us to investigate whether fructans were present in an array of commercial Echinacea preparations. A range of low and high DP ITFs was found (Dobrange et al., 2019).

More likely, ITFs present in Echinacea preparations stimulate the activity of immune cells directly by activating signaling pathways in vivo, as described (Hershberg et al., 2000 and Cario et al., 2002 and Forchielli, and Walker, 2006). Furthermore, it is important to note that the number of ITFs required for prebiotic effects (8 to 12 g a day) is much higher than the recommended daily intake of a commercially available Echinacea preparation (Cummings et al., 2001; Lewis et al., 2005 and Welters et al., 2002).

The EP was found to show good immunoregulatory, anti‐inflammatory and antioxidant capacity (Lee et al., 2009; Zhai et al., 2007) with neither the symptoms of hypersensitivity nor the side effects during the clinical trial stages (Saunders et al., 2007). The important components in the plant were found to be caffeic acid derivatives, alkamides, flavonoids, essential oils and polyacetylenes (Thygesen et al., 2007). Among them, caffeic acid derivatives and alkamides were proved to have immunoregulation effects (Matthias et al., 2008). 

Echinacea purpurea was appeared to activate the non‐specific cellular and humoral immunity and the complement system. The species was found to stimulate the immune system by means of increasing the production and activation of leukocytes, lymphocytes, monocytes and cytokines (Linda et al., 2002).  Echinacea, which was commonly used for the treatment of common cold, coughs, bronchitis, influenza and inflammation of mouth and pharynx, is found to rank in second position in the highest retail sales for over‐the‐counter herbal products (Blumenthal, 2002 and Barrett, 2003). It is found to be the most frequently used herbal remedies in case of the treatment for adults and children and hence consumed by approximately over 10 to 20% of the herbal users (Tsen et al., 2000; Tsui et al., 2001; Planta et al., 2000; O’Dea, 2003 and Cala et al., 2003). 

For example, the polysaccharide fraction was found to stimulate the macrophage activity and several other functions that were related to the cytokine production34‐36and certain groups of the phenolic compounds and alkamides was found to demonstrate the antiviral and antifungal properties (Binns et al., 2002a and Merali et al., 2003). Echinacea purpurea contains alkamides, caffeic acid esters (cichoric acid), polysaccarides and polyacetylenes (Dalby‐Brown et al., 2005 and Chen et al., 2005). 

Cichoric acid was found to be the main phenolic compound (2.27%) and the highest contents of caffeic acid derivatives were also found in E. purpurea roots (Pellati et al., 2005). Cichoric acid and verbascoside was found to be predominated in the extracts of E. purpurea roots (Sloley et al., 2001). 

Extracts of the roots and leaves was found to have the antioxidant properties in a free radical scavenging assay and in a lipid peroxidation assay (Pellati et al.,.2004). The ethanolic extract of Echinacea purpurea roots contains nearly 15 alkamides (Guiotto et al., 2008 and Spelman et al., 2009). 

Human lymphocytes that were activated with different lectins (Con A, PHA and PWM) for the study of the In vitro immune cell proliferation as a response to aqueous extract of E. purpurea root showed the increase in percentage of lymphoproliferation was greater when E. purpurea root extract was used in addition to individual lectins (Fernando et al., 2007). 

Administering aged rats with Echinacea ethanolic and water extracts showed a significant improvement in increased and decreased levels of the above-mentioned markers and returned the abnormal markers back to the normal levels (Nematalla et al., 2011). 

The plant with high potential to conduct assay on its antioxidant activity, with antioxidant activity assay further broken down to items of preventing oxidation and scavenging free radicals (Gholamreza et al., 2011). 

The proteomic analysis showed that the expressions of metabolic, cytoskeleton or NF_B signaling‐related proteins were actually regulated by the treatment with compound mixture.  Thus, the mixture was found to modulate the DC mobility and related cellular physiology in the mouse immune system (Shu‐Yi et al., 2010). 

Echinacea purpurea root was found to reduce the oral clearance of substrates of CYP1A2 but not the oral clearance of substrates of CYP2C9 and CYP2D6 (Christopher Gorski et al., 2004). 

The ethanol and ethyl acetate‐soluble fractions from the leaves and stem was found to contain a potent antiviral photosensitizer, which was absent in the flower extract (Selvarani Vimalanathan et al., 2005). 

In another study Dietary Echinacea did not enhance the growth, exhibit antiviral effects to porcine reproductive and respiratory syndrome virus (PRRSV), or show any evidence of immune enhancing properties (Hermann et al., 2003). Echinacea purpurea was found to decrease the cadmium‐induced mitotic activity of liver cells, and increased the apoptotic activity of these cells (Sara Soudi et al., 2007).

References

  1. Amarante, M.K.; Ariza, C.B.; de Oliveira, C.E.C.; Gualtieri, K.A.; Oda, J.M.M.; Watanabe, M.A.E. Inulin induces IL-10 secretion and increased FOXP3 gene expression in human peripheral blood mononuclear cells. Braz. Arch. Biol. Technol. 2018, 61, e1816059. [CrossRef]
    View at Publisher | View at Google Scholar
  2. Balasubramani, S.P.; Venkatasubramanian, P.; Kukkupuni, S.K.; Patwardhan, B. Plant-based Rasayana drugs from Ayurveda. Chin. J. Integr. Med. 2011, 17, 88–94. [CrossRef]
    View at Publisher | View at Google Scholar
  3. Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine,10: 2003, 66‐86.
    View at Publisher | View at Google Scholar
  4. Benson, J.M.; Pokorny, A.J.; Rhule, A.; Wenner, C.A.; Kandhi, V.; Cech, N.B.; Shepherd, D.M. Echinacea purpurea extracts modulate murine dendritic cell fate and function. Food Chem. Toxicol. 2010, 48, 1170–1177. [CrossRef]
    View at Publisher | View at Google Scholar
  5. Binns SE, Hudson J, Merali S, Arnason JT. Antiviral activity of characterized extracts from Echinacea spp. (Heliantheae: Asteraceae) against herpes simplex virus (HSV‐1). Planta Medica 68: 2002a, 780‐783.
    View at Publisher | View at Google Scholar
  6. Blumenthal M. Herb sales down in mainstream market, up in natural food stores. Herbal Gram, 2002, 55‐60.
    View at Publisher | View at Google Scholar
  7. Bruni, R.; Brighenti, V.; Caesar, L.K.; Bertelli, D.; Cech, N.B.; Pellati, F. Analytical methods for the study of bioactive compounds from medicinally used Echinacea species. J. Pharm. Biomed. Anal. 2018, 160, 443–477. [CrossRef] [PubMed]
    View at Publisher | View at Google Scholar
  8. Cala S, Crismon ML, Baumgartner J. A survey of herbal use in children with attention‐deficit‐hyperactivity disorder or depression. Pharmacotherapy, 23: 2003, 222‐30.
    View at Publisher | View at Google Scholar
  9. Cario, E.; Brown, D.; McKee, M.; Lynch-Devaney, K.; Gerken, G.; Podolsky, D.K. Commensal-associated molecular patterns induce selective toll-like receptor-tracking from apical membrane to cytoplasmic compartments in polarized intestinal epithelium. Am. J. Pathol. 2002, 160, 165–173. [CrossRef]
    View at Publisher | View at Google Scholar
  10. Cario, E.; Gerken, G.; Podolsky, D.K. Toll-Like Receptor 2 controls mucosal inflammation by regulating epithelial barrier function. Gastroenterology 2007, 132, 1359–1374. [CrossRef]
    View at Publisher | View at Google Scholar
  11. Chambers, E.S.; Byrne, C.S.; Morrison, D.J.; Murphy, K.G.; Preston, T.; Tedford, C.; Garcia-Perez, I.; Fountana, S.; Serrano-Contreras, J.I.; Holmes, E.; et al. Dietary supplementation with inulin-propionate ester or inulin improves insulin sensitivity in adults with overweight and obesity with distinct effects on the gut microbiota, plasma metabolome and systemic inflammatory responses: A randomised cross-over trial. Gut2019, 68, 1430–1438.
    View at Publisher | View at Google Scholar
  12. Chandrashekar, P.M.; Prashanth, K.V.H.; Venkatesh, Y.P. Isolation, structural elucidation and immunomodulatory activity of fructans fromaged garlic extract. Phytochemistry 2011, 72, 255–264. [CrossRef] [PubMed]
    View at Publisher | View at Google Scholar
  13. Chandrashekara, P.M.; Venkatesh, Y.P. Immunostimulatory properties of fructans derived from raw garlic (Allium sativum L.). Bioact. Carbohydrates Diet. Fibre 2016, 8, 65–70. [CrossRef]
    View at Publisher | View at Google Scholar
  14. Chen Y, Fu T, Tao T, Yang J, Chang Y, Kim L, Qu L and Scalzo R. Macrophage activiating effects of new alkamides from the roots of Echinacea species. Journal of Natural Product, 68: 2005, 773‐776.
    View at Publisher | View at Google Scholar
  15. Christopher Gorski J, Shiew‐Mei Huang, Amar Pinto MD, Mitchell A, Hamman BS, Janna K. Hilligoss LPN, Narjis A. Zaheer MS, Mehul Desai MD, Margaret Miller and Stephen Hall, The effect of Echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo, Clinical Pharmacology and Therapeutics, 75(1): 2004, 89‐100.
    View at Publisher | View at Google Scholar
  16. Classen, B. Arabinogalaktan-Proteine (AGPs) aus dem kurzzeiterhitzten presssaft von Echinacea purpurea. Z. Phytother. 2018, 39, 152–158. [CrossRef]
    View at Publisher | View at Google Scholar
  17. Classen, B.; Pferschy-Wenzig, E.; Geske, T.; Ardjomand-Wölkart, K.; Bauer, R. Analytische charakterisierung und vergleich medizinisch genutzter Echinacea-haltiger zubereitungen. Z. Phytother. 2019, 40, 148–157. [CrossRef]
    View at Publisher | View at Google Scholar
  18. Corrêa-Ferreira, M.L.; Verdan, M.H.; dos Reis Lívero, F.A.; Galuppo, L.F.; Telles, J.E.Q.; Alves Stefanello, M.É.; Acco, A.; de Oliveira Petkowicz, C.L. Inulin-type fructan and infusion of Artemisia vulgaris protect the liver against carbon tetrachloride-induced liver injury. Phytomedicine 2017, 24, 68–76.
    View at Publisher | View at Google Scholar
  19. Cummings, J.H.; Christie, S.; Cole, T.J. A study of fructo- oligosaccharides in the prevention of travellers’diarrhoea. Aliment. Pharmacol. Ther. 2001, 15, 1139–1145. [CrossRef]
    View at Publisher | View at Google Scholar
  20. Dabrowski, A.N.; Conrad, C.; Behrendt, U.; Shrivastav, A.; Baal, N.; Wienhold, S.M.; Hackstein, H.; N’Guessan, P.D.; Aly, S.; Reppe, K.; et al. Peptidoglycan recognition protein 2 regulates neutrophil recruitment into the lungs after Streptococcus pneumoniae infection. Front. Microbiol. 2019, 10, 199. [CrossRef]
    View at Publisher | View at Google Scholar
  21. Dalby-Brown, L.; Barsett, H.; Landbo, A.K.R.; Meyer, A.S.; Molgaard, P. Synergistic antioxidative effects ofalkamides, caffeic acid derivatives, and polysaccharide fractions from Echinacea purpurea on in vitro oxidationof human low-density lipoproteins. J. Agric. Food Chem. 2005, 53, 9413–9423. [CrossRef] [PubMed]
    View at Publisher | View at Google Scholar
  22. Delgado, G.T.C.; Tamashiro, W.; Pastore, G.M. Immunomodulatory effects of fructans. Food Res. Int. 2010, 43,1231–1236. [CrossRef]
    View at Publisher | View at Google Scholar
  23. Di Giacomo, E.; Benedetti, E.; Cristiano, L.; Antonosante, A.; d’Angelo, M.; Fidoamore, A.; Barone, D.; Moreno, S.; Ippoliti, R.; Cerù, M.P.; et al. Roles of PPAR transcription factors in the energetic metabolic switch occurring during adult neurogenesis. Cell Cycle 2017, 16, 59–72. [CrossRef] [PubMed]
    View at Publisher | View at Google Scholar
  24. Dobrange, E.; Xonti, A.; Peshev, D.; Van den Ende, W.; Loedol
    View at Publisher | View at Google Scholar
  25. , B. Fructans and their potential role as paradoxical antioxidants in Echinacea products. F1000Research 2019, 8, 1650 (poster).
    View at Publisher | View at Google Scholar
  26. Dong, C.X.; Zhang, L.J.; Xu, R.; Zhang, G.; Zhou, Y.B.; Han, X.Q.; Zhang, Y.; Sun, Y.X. Structural characterization and immune stimulating activity of a levantype fructan from Curcuma kwangsiensis. Int. J. Biol. Macromol. 2015, 77, 99–104. [CrossRef]
    View at Publisher | View at Google Scholar
  27. El-Ashmawy, N.E.; El-Zamarany, E.A.; Salem, M.L.; El-Bahrawy, H.A.; Al-Ashmawy, G.M. In vitro and in vivostudies of the immunomodulatory effect of Echinacea purpurea on dendritic cells. J. Genet. Eng. Biotechnol.2015, 13, 185–192. [CrossRef]
    View at Publisher | View at Google Scholar
  28. Fernando Chaves, Mauricio Chacón, Beatriz Badilla and Carolina Arévalo. Effect of Echinacea purpurea (Asteraceae) aqueous extract on antibody response to Bothrops asper venom and immune cell response. International Journal of Tropical Biology and conservation. 55 (1): 2007, 113‐119.
    View at Publisher | View at Google Scholar
  29. Forchielli, M.L.; Walker, W.A. The role of gut-associated lymphoid tissues and mucosal defence. Br. J. Nutr. 2006, 93, S41–S48. [CrossRef]
    View at Publisher | View at Google Scholar
  30. Gan, X.H.; Zhang, L.; Heber, D.; Bonavida, B. Mechanism of activation of human peripheral blood NK cell at the single cell level by Echinacea water soluble extracts: Recruitment of lymphocyte-target conjugates and killer cells and activation of programming for lysis. Int. Immunopharmacol. 2003, 3, 811–824. [CrossRef]
    View at Publisher | View at Google Scholar
  31. Gargari, B.P.; Dehghan, P.; Aliasgharzadeh, A.; Jafar-Abadi, M.A. Effects of high-performance inulin supplementation on glycemic control and antioxidant status in women with type 2 diabetes. Diabetes Metab. J. 2013, 37, 140–148. [CrossRef]
    View at Publisher | View at Google Scholar
  32. Geronikaki, A.; Gavalas, A. Antioxidants and inflammatory disease: Synthetic and natural antioxidants with anti-inflammatory activity. Comb. Chem. High Throughput Screen. 2006, 9, 425–442. [CrossRef]
    View at Publisher | View at Google Scholar
  33. Gholamreza Ghalamkari, Nasir Landy, Majid Toghiani, Mehrdad Modaresi, Zahra Ghalamkari. Efficiency of Echinacea purpurea on Total Antioxidant Activity in Serum of Broiler Chicks, International Proceedings of Chemical, Biological and Environmental engineering, 9: 2011, 167‐170.
    View at Publisher | View at Google Scholar
  34. Goldrosen, M.H.; Straus, S.E. Complementary and alternative medicine: Assessing the evidence for immunological benefits. Nat. Rev. Immunol. 2004, 4, 912–921. [CrossRef]
    View at Publisher | View at Google Scholar
  35. Guiotto P, Woelkart K, Grabnar I, Granzotto M and Bauer R. Pharmacokinetics and immunomodulatory effects of phytotherapeutic iozenges with Echinacea purpurea extract. Phytomedicine, 15(8): 2008, 547‐554.
    View at Publisher | View at Google Scholar
  36. Guo, Y.; Guo, M.; Zhao, W.; Chen, K.; Zhang, P. Burdock fructooligosaccharide induces stomatal closure in Pisum sativum. Carbohydr. Polym. 2013, 97, 731–735. [CrossRef] [PubMed]
    View at Publisher | View at Google Scholar
  37. Gutiérrez Nava, Z.J.; Jiménez-Aparicio, A.R.; Herrera-Ruiz, M.L.; Jiménez-Ferrer, E. Immunomodulatory effect of Agave tequilana evaluated on an autoimmunity like-SLE model induced in Balb/c mice with pristane. Molecules 2017, 22, 848.
    View at Publisher | View at Google Scholar
  38. Hayashi, K.; Umetsu, R.; Chijimatsu, T.; Hayashi, T.; Miyake, S.; Lee, J.B. Anti-influenza A virus effects of fructan from Welsh onion (Allium fistulosum L.). Food Chem. 2012, 134, 2164–2168.
    View at Publisher | View at Google Scholar
  39. Hermann JR, Honeyman MS, Zimmerman JJ, Thacker BJ, Holden PJ and Chang CC. Effect of dietary Echinacea purpurea on viremia and performance in porcine reproductive and respiratory syndrome virus‐infected nursery pigs. Journal of Animal Science, 81: 2003, 2139‐2144.
    View at Publisher | View at Google Scholar
  40. Hershberg, R.M.; Mayer, L.F. Antigen processing and presentation by intestinal epithelial cells-polarity and complexity. Immunol. Today 2000, 21, 123–128. [CrossRef]
    View at Publisher | View at Google Scholar
  41. Kim, D.H.; Heber, D.; Still, D.W. Genetic diversity of Echinacea species based upon amplified fragment length polymorphism markers. Genome 2004, 47, 102–111. [CrossRef]
    View at Publisher | View at Google Scholar
  42. Kim, H.G.; Han, E.H.; Hwang, Y.P.; Choi, J.H.; Kwon, K.I.; Kim, B.H.; Kim, S.K.; Song, G.Y.; Jeong, H.G.; Hien, T.T.; et al. Metformin inhibits P-glycoprotein expressionvia theNF-Bpathway and CRE transcriptional activity through AMPK activation. Br. J. Pharmacol. 2011, 162, 1096–1108. [CrossRef]
    View at Publisher | View at Google Scholar
  43. Kour, K.; Bani, S. Augmentationof immune responsebychicoric acid through themodulationofCD28/CTLA-4 and Th1 pathway in chronically stressed mice. Neuropharmacology 2011, 60, 852–860. [CrossRef]
    View at Publisher | View at Google Scholar
  44. Kumar, V.P.; Prashanth, K.V.H.; Venkatesh, Y.P. Structural analyses and immunomodulatory properties of fructo-oligosaccharides from onion (Allium cepa). Carbohydr. Polym. 2015, 117, 115–122. [CrossRef]
    View at Publisher | View at Google Scholar
  45. Lee TT, Chen CL, Shieh ZH, Lin JC and Yu B. Study on antioxidant activity of Echinacea purpurea L. extracts and its impact on cell viability. Afican Journal of Biotechnology 8: 2009, 5097‐ 5105.
    View at Publisher | View at Google Scholar
  46. Lee, J.B.; Fukai, T.; Hayashi, K.; Hayashi, T. Characterization of fructan from Chikuyo-Sekko-To, a Kampo prescription, and its antiherpetic activity in vitro and in vivo. Carbohydr. Polym. 2011, 85, 408–412. [CrossRef]
    View at Publisher | View at Google Scholar
  47. Lee, W.H.; Kim, S.G. AMPK-Dependent Metabolic Regulation by PPAR Agonists. PPAR Res. 2010, 2010, 549101. [CrossRef]
    View at Publisher | View at Google Scholar
  48. Lewis, S.; Burmeister, S.; Brazier, J. Effect of the prebiotic oligofructose on relapse of Clostridium diffcile-associated diarrhea: A randomized, controlled study. Clin. Gastroenterol. Hepatol. 2005, 3, 442–448. [CrossRef]
    View at Publisher | View at Google Scholar
  49. Li, S.P.; Yu, Q.T.; Deng, Y.; Yan, Y.X.; Zhao, J.; Ge, Y.Z.; Wang, Y.; Wu, D.T.; Li, M. Comparison of immunomodulatory effects of fresh garlic and black garlic polysaccharides on RAW 264.7 macrophages. J. Food Sci. 2017, 82, 765–771. [CrossRef]
    View at Publisher | View at Google Scholar
  50. Linda S. Kim, Robert F. Waters ND and Peter M. Burkholder MD. Immunological Activity of Larch Arabinogalactan and Echinacea: A Preliminary, Randomized, Double‐blind, Placebo‐controlled Trial. Alternative Medicine Review, 7(2): 2002, 138‐149.
    View at Publisher | View at Google Scholar
  51. Manayi, A.; Saeidnia, S.; Vazirian, M. Echinacea purpurea: Pharmacology, phytochemistry and analysis methods. Pharmacogn. Rev. 2015, 9, 63.
    View at Publisher | View at Google Scholar
  52. Mao, C.F.; Zhang, X.R.; Johnson, A.; He, J.L. Modulation of diabetes mellitus-induced male rat reproductive dysfunction with micro-nanoencapsulated Echinacea purpurea ethanol extract. Biomed. Res. Int. 2018, 2018, 4237354. [CrossRef]
    View at Publisher | View at Google Scholar
  53. Matthias A, Banbury L, Bone KM, Leach DN and Lehmann RP. Echinacea alkylamides modulate induced immune responses in T‐cells. Fitoterapia. 79: 2008, 53‐58.
    View at Publisher | View at Google Scholar
  54. Dalby‐Brown L, Barsett H, Landbo AK, Meyer AS and Mølgaard P. Synergistic antioxidative effects of alkamides, caffeic acid derivatives, and polysaccharide fractions from Echinacea purpurea on in vitro oxidation of human low‐density lipoproteins. Journal of Agricultural Food Chemistry 53: 2005, 9413‐9423.
    View at Publisher | View at Google Scholar
  55. Melchart, D.; Clemm, C.; Weber, B.; Draczynski, T.; Worku, F.; Linde, K.; Weidenhammer, W.; Wagner, H.; Saller, R. Polysaccharides isolated from Echinacea purpurea herba cell cultures to counteract undesired effects of chemotherapy-a pilot study. Phytother. Res. 2002, 16, 138–142. [CrossRef]
    View at Publisher | View at Google Scholar
  56. Merali S, Binns S, Paulin‐Levasseur M, Ficker C, Smith M, Baum BR, Brovelli E, Arnason JT. Antifungal and anti‐inflammatory activity of the genus Echinacea. PharmBiol 41: 2003, 412‐420.
    View at Publisher | View at Google Scholar
  57. Miller, S.C. Can herbs be useful in cancer therapy? A review of studies on the influence of Echinacea on cellsof the immune system and on tumor amelioration. Biomed. Res. India 2012, 23, 9–16.
    View at Publisher | View at Google Scholar
  58. Mishra, A.; Thakur, M.; Alok, S. Evaluation of immunomodulatory activity of polysacchride fraction of Inula racemosa, Bombax ceiba and Allium sativum. Int. J. Pharm. Sci. Res. 2016, 7, 3749–3755.
    View at Publisher | View at Google Scholar
  59. Modaresi, M. Effect of Echinacea purpurea hydro alcoholic extract on the blood parameters in mice. Asian J.Chem. 2013, 25, 1373–1375.
    View at Publisher | View at Google Scholar
  60. Nematalla Kh, Sahar M, Arafa A, Ghada, Yousef M and Zain A. Shabib. Effect of Echinacea as Antioxidant on Markers of Aging. Australian Journal of Basic and Applied Sciences, 5(2): 2011, 18‐26.
    View at Publisher | View at Google Scholar
  61. O’Dea JA. Consumption of nutritional supplements among adolescents: usage and perceived benefits. Health Educucation Research,18: 2003, 98‐107.
    View at Publisher | View at Google Scholar
  62. Paredes, L.L.R.; Smiderle, F.R.; Santana-Filho, A.P.; Kimura, A.; Iacomini, M.; Sassaki, G.L. Yacon fructans (Smallanthus sonchifolius) extraction, characterization and activation of macrophages to phagocyte yeast cells. Int. J. Biol. Macromol. 2018, 108, 1074–1081. [CrossRef] Biomolecules 2019, 9, 615 10 of 12
    View at Publisher | View at Google Scholar
  63. Park, C.M.; Jin, K.; Lee, Y.; Song, Y.S. Luteolin and chicoric acid synergistically inhibited inflammatory responses via inactivation of PI3K-Akt pathway and impairment of NF-B translocation in LPS stimulated RAW 264.7 cells. Eur. J. Pharmacol. 2011, 660, 454–459. [CrossRef]
    View at Publisher | View at Google Scholar
  64. Pellati F, Benvenuti S, Margo L, Melegari M and Soragni F. Analysis of phenolic compounds and radical scavenging activity of Echinacea species. Journacy of Pharmacy and Biomedical Analysis, 35(2): 2004, 289‐301.
    View at Publisher | View at Google Scholar
  65. Pellati F, Benvenuti S, Melegari M and Lasseigne T. Variability in the composition of antioxidant compounds in Echinacea species by HPLC. Phytochemical Analysis, 16(2): 2005, 77‐85.
    View at Publisher | View at Google Scholar
  66. Peng, L.; Li, Z.; Green, R.S.; Holzman, I.R.; Lin, J. Butyrate enhances the intestinal barrier by facilitating tight junction assembly via activation of AMP-activated protein kinase in Caco-2 cell monolayers. J. Nutr. 2009, 139, 1619–1625. [CrossRef]
    View at Publisher | View at Google Scholar
  67. Peng, X.W.; Zhou, H.H.; Dai, J.; Zhang, L. Advances on the anti-inflammatory and protective effect of AMPK activators. Sheng Li Xue Bao 2019, 71, 319–326.
    View at Publisher | View at Google Scholar
  68. Peshev, D.; Vergauwen, R.; Moglia, A.; Hideg, E.; Van den Ende, W. Towards understanding vacuolar antioxidant mechanisms: A role for fructans? J. Exp. Bot. 2013, 64, 1025–1038. [CrossRef]
    View at Publisher | View at Google Scholar
  69. Petkova, N.T.; Ivanov, I.G.; Raeva,M.; Topuzova,M.G.; Todorova, M.M.; Denev, P.P. Fructans and antioxidants in leaves of culinary herbs from asteraceae and amaryllidaceae families. Food Res. 2019, 3, 407–415. [CrossRef]
    View at Publisher | View at Google Scholar
  70. Pillai, S.; Pillai, C.; Mitscher, L.A.; Cooper, R. Use of quantitative flow cytometry to measure ex vivoimmunostimulant activity of Echinacea: The case for polysaccharides. J. Altern. Complement. Med. 2007, 13,625–634. [CrossRef] [PubMed]
    View at Publisher | View at Google Scholar
  71. Planta M, Gundersen B, Petitt JC. Prevalence of the use of herbal products in a low‐income population. Family Medicine, 32: 2000, 252‐7.
    View at Publisher | View at Google Scholar
  72. Pleschka, S.; Stein, M.; Schoop, R.; Hudson, J.B. Anti-viral properties and mode of action of standardized Echinacea purpurea extract against highly pathogenic avian Influenza virus (H5N1, H7N7) and swine-origin H1N1 (S-OIV). Virol. J. 2009, 6, 197. [CrossRef]
    View at Publisher | View at Google Scholar
  73. Pugh, N.D.; Jackson, C.R.; Pasco, D.S. Total bacterial load within Echinacea purpurea, determined using a new PCR-based quantification method, is correlated with LPS levels and in vitro macrophage activity. Planta Med. 2013, 79, 9–14. [PubMed]
    View at Publisher | View at Google Scholar
  74. Raduner, S.; Majewska, A.; Chen, J.Z.; Xie, X.Q.; Hamon, J.; Faller, B.; Altmann, K.H.; Gertsch, J. Alkylamides from Echinacea are a new class of cannabinomimetics-Cannabinoid type 2 receptor-dependentand -independent immunomodulatory effects. J. Biol. Chem. 2006, 281, 14192–14206. [CrossRef]
    View at Publisher | View at Google Scholar
  75. Ramasahayam, S.; Baraka, H.N.; Abdel Bar, F.M.; Abuasal, B.S.; Widrlechner, M.P.; El Sayed, K.A.; Meyer, S.A.Effects of chemically characterized fractions from aerial parts of Echinacea purpurea and E. angustifolia on myelopoiesis in rats. Planta Med. 2011, 77, 1883–1889. [CrossRef]
    View at Publisher | View at Google Scholar
  76. Rondanelli, M.; Miccono, A.; Lamburghini, S.; Avanzato, I.; Riva, A.; Allegrini, P.; Faliva, M.A.; Peroni, G.; Nichetti,M.; Perna, S. Evidence-based complementary and alternative medicine. Evid. Based Complement. Altern. Med. 2018, 2018, 5813095.
    View at Publisher | View at Google Scholar
  77. Roxas, M.; Jurenka, J. Colds and influenza: A reviewof diagnosis and conventional, botanical, and nutritional considerations. Altern. Med. Rev. 2007, 12, 25–48.
    View at Publisher | View at Google Scholar
  78. Sara Soudi, Seyed Mahmoud Hashemi, Ahmad Zavaran Hosseini, Amir Ghaemi and Mohammad Asghari Jafarabadi. Antileishmanial Effect of Echinacea purpurea Root Extract Cultivated in Iran. Iranian Journal of Pharmaceutical Research, 6(2): 2007, 147‐149
    View at Publisher | View at Google Scholar
  79. Saunders PR, Smith F and Schusky RW. Echinacea purpurea L. in children: safety, tolerability, compliance, and clinical effectiveness in upper respiratory tract infections. Canadian Journal of Physiology and Pharmacology 85: 2007, 1195‐1199.
    View at Publisher | View at Google Scholar
  80. Selvarani Vimalanathan, Linda Kang, Virginie Treyvaud Amiguet, John Livesey, Thor Arnason J and Jim Hudson. Echinacea purpurea Aerial Parts Contain Multiple Antiviral Compounds. Pharmaceutical Biology, 43(9): 2005, 740‐745.
    View at Publisher | View at Google Scholar
  81. Senchina, D.S.; Martin, A.E.; Buss, J.E.; Kohut, M.L. E
    View at Publisher | View at Google Scholar
  82. ects of Echinacea extracts on macrophage antiviral activities. Phyther. Res. 2010, 24, 810–816.
    View at Publisher | View at Google Scholar
  83. Shang, H.M.; Zhou, H.Z.; Yang, J.Y.; Li, R.; Song, H.; Wu, H.X. In vitro and in vivo antioxidant activities of inulin. PLoS ONE 2018, 13, e0192273. [CrossRef]
    View at Publisher | View at Google Scholar
  84. Sharifi-Rad, M.; Mnayer, D.; Morais-Braga, M.F.B.; Carneiro, J.N.P.; Bezerra, C.F.; Coutinho, H.D.M.; Salehi, B.; Martorell, M.; del Mar Contreras, M.; Soltani-Nejad, A.; et al. Echinacea plants as antioxidant and antibacterial agents: From traditional medicine to biotechnological applications. Phyther. Res. 2018, 32, 1653–1663. [CrossRef]
    View at Publisher | View at Google Scholar
  85. Sharma, M.; Arnason, J.T.; Burt, A.; Hudson, J.B. Echinacea extracts modulate the pattern of chemokine and cytokine secretion in rhinovirus-infected and uninfected epithelial cells. Phytother. Res. 2006, 20, 147–152. [CrossRef] [PubMed]
    View at Publisher | View at Google Scholar
  86. Sharma, M.; Schoop, R.; Hudson, J.B. Echinacea as an antiinflammatory agent: The influence of physiologically relevant parameters. Phyther. Res. 2009, 23, 863–867. [CrossRef]
    View at Publisher | View at Google Scholar
  87. Sharma, S.M.; Anderson, M.; Schoop, S.R.; Hudson, J.B. Bactericidal and anti-inflammatory properties of a standardized Echinacea extract (Echinaforce ® ): Dual actions against respiratory bacteria. Phytomedicine 2010, 17, 563–568. [CrossRef] Biomolecules 2019, 9, 615 11 of 12
    View at Publisher | View at Google Scholar
  88. Shu‐Yi Yin, Wen‐Hsin Wang, Pei‐Hsueh Wang, Kandan Aravindaram, Pei‐Ing Hwang, Han‐Ming Wu, Ning‐Sun Yang Yin. Stimulatory effect of Echinacea purpurea extract on the trafficking activity of mouse dendritic cells: revealed by genomic and proteomic analyses. BMC Genomics, 11: 2010, 612.
    View at Publisher | View at Google Scholar
  89. Sloley BD, Tywin C, Coutts RT, Pang PK and Shan JJ. Comparison of chemical components and antioxidants capacity of different Echinacea species. Journal of Pharmacy Pharmacology, 53(6): 2001, 849‐857.
    View at Publisher | View at Google Scholar
  90. Spelman K, Wetschler MH and Cech NB. Comparison of alkamide yield in ethanolic extracts prepared from fresh versus dry Echinacea purpurea utilizing HPLC‐ESI‐MS. Journal of Pharmacy and Biomedical Analysis, 49(5): 2009, 1141‐1149.
    View at Publisher | View at Google Scholar
  91. Suzuki, T. Regulation of intestinal epithelial permeability by tight junctions. Cell. Mol. Life Sci. 2013, 70, 631–659. [CrossRef]
    View at Publisher | View at Google Scholar
  92. Tak, P.P.; Firestein, G.S. NF-B: A key role in inflammatory diseases. J. Clin. Investig. 2001, 107, 7–11. [CrossRef]
    View at Publisher | View at Google Scholar
  93. Thakur, M.; Weng, A.; Fuchs, H.; Sharma, V.; Bhargava, C.S.; Chauhan, N.S.; Dixit, V.K.; Bhargava, S. Rasayana properties of Ayurvedic herbs: Are polysaccharides a major contributor. Carbohydr. Polym. 2012, 87, 3–15. [CrossRef]
    View at Publisher | View at Google Scholar
  94. Thygesen L, Thulin J, Mortensen A, Skibsted LH and Molgaard P. Antioxidant activity of cichoric acid and alkamides from Echinacea purpurea, alone and in combination. Food Chemistry 101: 2007, 74‐81.
    View at Publisher | View at Google Scholar
  95. Tsen LC, Segal S, Pothier M, Bader AM. Alternative medicine use in presurgical patients. Anesthesiology,93: 2000, 148‐51.
    View at Publisher | View at Google Scholar
  96. Tsui B, Dennehy CE, Tsourounis C. A survey of dietary supplement use during pregnancy at an academic medical center. American Journal of Obstetrics and Gynecology,185: 2001, 433‐7.
    View at Publisher | View at Google Scholar
  97. Vimalanathan, S.; Schoop, R.; Hudson, J. High-potency anti-influenza therapy by a combination of Echinacea purpurea fresh herb and root tinctures. J. Appl. Pharm. Sci. 2013, 3, 1–5.
    View at Publisher | View at Google Scholar
  98. Vos, A.P.; vanEsch, B.C.; Stahl, B.; M’Rabet, L.; Folkerts, G.; Nijkamp, F.P.; Garssen, J. Dietary supplementationwith specific oligosaccharide mixtures decrease parameters of allergic asthma in mice. Int. Immunopharmacol. 2007, 7, 1582–1587. [CrossRef]
    View at Publisher | View at Google Scholar
  99. Wack, M.; Blaschek, W. Determination of the structure and degree of polymerisation of fructans from Echinacea purpurea roots. Carbohydr. Res. 2006, 341, 1147–1153. [CrossRef]
    View at Publisher | View at Google Scholar
  100. Wang, C.Y.; Chiao, M.T.; Yen, P.J.; Huang, W.C.; Hou, C.C.; Chien, S.C.; Yeh, K.C.; Yang, W.C.; Shyur, L.F.;Yang, N.S. Modulatory effects of Echinacea purpurea extracts on human dendritic cells: A cell- and gene-basedstudy. Genomics 2006, 88, 801–808. [CrossRef] [PubMed]
    View at Publisher | View at Google Scholar
  101. Welters, C.F.M.; Heineman, E.; Thunnissen, F.; van den Bogaard, A.; Soeters, P.B.; Baeten, C. Effect of dietary inulin supplementation on inflammation of pouch mucosa in patients with an heal pouch-anal anastomosis. Dis. Colon Rectum 2002, 45, 621–627. [CrossRef]
    View at Publisher | View at Google Scholar
  102. Xue, J.; Li, X.; Liu, P.; Li, K.; Sha, L.; Yang, X.; Zhu, L.; Wang, Z.; Dong, Y.; Zhang, L.; et al. Inulin and metformin ameliorate polycystic ovary syndrome via anti-inflammation and modulating gut microbiota in mice. Endocr. J. 2019. [CrossRef]
    View at Publisher | View at Google Scholar
  103. Zenhom, M.; Hyder, A.; de Vrese, M.; Heller, K.J.; Roeder, T.; Schrezenmeir, J. Prebiotic oligosaccharides reduce proinflammatory cytokines in iIntestinal caco-2 cells via activation of PPAR and peptidoglycan recognition Protein 3. J. Nutr. 2011, 141, 971–977. [CrossRef] [PubMed] Biomolecules 2019, 9, 615 9 of 12
    View at Publisher | View at Google Scholar
  104. Zhai Z, Liu Y, Wu L, Senchina DS, Wurtele ES, Murphy PA, Kohut ML and Cunnick JE. Enhancement of innate and adaptive immune functions by multiple Echinacea species. Journal of Medicinal Food 10(3): 2007, 423‐434.
    View at Publisher | View at Google Scholar

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Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

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Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

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Dr Maria Dolores Gomez Barriga

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

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Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

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Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

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Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

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Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

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Lin-Show Chin

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

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Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

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Luiz Sellmann