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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">87</journal-id>
      <journal-id journal-id-type="index">urn:lsid:arphahub.com:pub:A116C711-4C18-5A38-8F1E-5E97753A8A64</journal-id>
      <journal-title-group>
        <journal-title xml:lang="en">Folia Medica</journal-title>
        <abbrev-journal-title xml:lang="en">FM</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">0204-8043</issn>
      <issn pub-type="epub">1314-2143</issn>
      <publisher>
        <publisher-name>Plovdiv Medical University</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.3897/folmed.66.e115800</article-id>
      <article-id pub-id-type="publisher-id">115800</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original Article</subject>
        </subj-group>
        <subj-group subj-group-type="scientific_subject">
          <subject>Chemistry &amp; biophysics</subject>
          <subject>Immunology</subject>
          <subject>Pharmacology</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Anti-inflammatory and in vitro antioxidant activities of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> dry extract</article-title>
      </title-group>
      <contrib-group content-type="authors">
        <contrib contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Vilmosh</surname>
            <given-names>Natalia</given-names>
          </name>
          <email xlink:type="simple">nat9vilm@gmail.com</email>
          <uri content-type="orcid">https://orcid.org/0000-0001-7984-1256</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Georgieva-Kotetarova</surname>
            <given-names>Maria</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Kandilarov</surname>
            <given-names>Ilin</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Zlatanova-Tenisheva</surname>
            <given-names>Hristina</given-names>
          </name>
          <uri content-type="orcid">https://orcid.org/0000-0003-2555-4600</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Murdjeva</surname>
            <given-names>Mariana</given-names>
          </name>
          <uri content-type="orcid">https://orcid.org/0000-0002-1357-6717</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Kirina</surname>
            <given-names>Veselina</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Dimitrova</surname>
            <given-names>Stela</given-names>
          </name>
          <uri content-type="orcid">https://orcid.org/0000-0001-5831-2574</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Katsarova</surname>
            <given-names>Mariana</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Denev</surname>
            <given-names>Petko</given-names>
          </name>
          <xref ref-type="aff" rid="A2">2</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Kostadinova</surname>
            <given-names>Ivanka</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
      </contrib-group>
      <aff id="A1">
        <label>1</label>
        <addr-line>Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria</addr-line>
      </aff>
      <aff id="A2">
        <label>2</label>
        <addr-line>Department of Medical Microbiology and Immunology Prof. Dr. Elissay Yanev, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria</addr-line>
      </aff>
      <aff id="A3">
        <label>3</label>
        <addr-line>Research Institute of Medical University of Plovdiv, Plovdiv, Bulgaria</addr-line>
      </aff>
      <aff id="A4">
        <label>4</label>
        <addr-line>Department of Bioorganic Chemistry, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria</addr-line>
      </aff>
      <aff id="A5">
        <label>5</label>
        <addr-line>Laboratory of Biologically Active Substances, Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Plovdiv, Bulgaria</addr-line>
      </aff>
      <author-notes>
        <fn fn-type="corresp">
          <p>Corresponding author: Natalia Vilmosh, Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Medical University of Plovdiv, 15A Vassil Aprilov Blvd., 4002 Plovdiv, Bulgaria; Email: <email xlink:type="simple">nat9vilm@gmail.com</email>; <email xlink:type="simple">Tel</email>.: +<email xlink:type="simple">359</email><email xlink:type="simple">878</email><email xlink:type="simple">460</email><email xlink:type="simple">196</email></p>
        </fn>
      </author-notes>
      <pub-date pub-type="collection">
        <year>2024</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>29</day>
        <month>02</month>
        <year>2024</year>
      </pub-date>
      <volume>66</volume>
      <issue>1</issue>
      <fpage>114</fpage>
      <lpage>122</lpage>
      <uri content-type="arpha" xlink:href="http://openbiodiv.net/19F1AED2-EAA4-5729-8D15-797783F95E14">19F1AED2-EAA4-5729-8D15-797783F95E14</uri>
      <history>
        <date date-type="received">
          <day>15</day>
          <month>11</month>
          <year>2023</year>
        </date>
        <date date-type="accepted">
          <day>29</day>
          <month>12</month>
          <year>2023</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Natalia Vilmosh, Maria Georgieva-Kotetarova, Ilin Kandilarov, Hristina Zlatanova-Tenisheva, Mariana Murdjeva, Veselina Kirina, Stela Dimitrova, Mariana Katsarova, Petko Denev, Ivanka Kostadinova</copyright-statement>
        <license license-type="creative-commons-attribution" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
        </license>
      </permissions>
      <abstract>
        <label>Abstract</label>
        <p><bold>Introduction</bold>: Many chronic somatic and psychiatric diseases are associated with oxidative stress and inflammation, both of which have detrimental effects on human health.</p>
        <p><bold>Aim</bold>: To investigate the in vitro antioxidant and in vivo immunomodulatory activities of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> dry extract.</p>
        <p><bold>Material and methods</bold>: The in vitro antioxidant activity of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> dry extract was assessed using <abbrev xlink:title="Oxygen Radical Absorbance Capacity" id="ABBRID0EFAAC">ORAC</abbrev>, <abbrev xlink:title="Hydroxyl Radical Averting Capacity" id="ABBRID0EJAAC">HORAC</abbrev>, and electrochemical methods. Immunomodulatory activity was evaluated in acute and chronic stress models by measuring the serum levels of cytokines TNF-α, IL-6, and IL-1β in a cohort of 112 male 8-week-old Wistar rats. The rats were randomly divided into 7 groups for each of both stress models and then subjected to ELISA analysis (14 groups with 8 rats in each group). The rodents were gavaged with a dry extract of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> (250 mg/kg and 500 mg/kg), rosmarinic acid (15 mg/kg), and carvacrol (500 mg/kg) for 14 days and 60 days, respectively.</p>
        <p><bold>Results</bold>: We demonstrated that, for all employed in vitro methods, the dried extract of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> exhibited considerable antioxidant activity. <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> did not significantly lower serum concentrations of TNF-α, IL-6, or IL-1β in either stress model as compared to the positive saline control group. On the other hand, in the acute stress model, a dose of 250 mg/kg of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> significantly decreased IL-6 in comparison to carvacrol and significantly reduced TNF-α and IL-6 in comparison to rosmarinic acid.</p>
        <p><bold>Conclusion</bold>: Although <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> dry extract has significant antioxidant activity in vitro, its influence on systemic inflammation is still unknown. Future research will look into how it affects serum levels of pro-inflammatory cytokines.</p>
      </abstract>
      <kwd-group>
        <label>Keywords</label>
        <kwd>carvacrol</kwd>
        <kwd>cytokines</kwd>
        <kwd>oxidative stress</kwd>
        <kwd>rosmarinic acid</kwd>
        <kwd>
          <italic>
            <tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name>
          </italic>
        </kwd>
      </kwd-group>
      <funding-group>
        <funding-statement>The study was financially supported by Doctoral and postdoctoral project program of Medical University of Plovdiv – DPDP-15/2020</funding-statement>
      </funding-group>
    </article-meta>
    <notes>
      <sec sec-type="Citation" id="SECID0EDDAC">
        <title>Citation</title>
        <p>Vilmosh N, Georgieva-Kotetarova M, Kandilarov I, Zlatanova-Tenisheva H, Murdjeva M, Kirina V, Dimitrova S, Katsarova M, Denev P, Kostadinova I. Anti-inflammatory and in vitro antioxidant activities of <italic>Satureja montana</italic> dry extract. Folia Med (Plovdiv) 2024;66(1):114-122. doi: <ext-link xlink:type="simple" ext-link-type="doi" xlink:href="10.3897/folmed.66.e115800">10.3897/folmed.66.e115800</ext-link>.</p>
      </sec>
    </notes>
  </front>
  <body>
    <sec sec-type="Introduction" id="SECID0E1DAC">
      <title>Introduction</title>
      <p>Free radicals play an important role in maintaining homeostasis as they are normally generated through enzymatic and non-enzymatic reactions within the human body.<sup>[<xref ref-type="bibr" rid="B1">1</xref>]</sup> The levels of free radicals are influenced by both internal and external factors.<sup>[<xref ref-type="bibr" rid="B2">2</xref>]</sup> Oxidative stress occurs when there is an excessive production of free radicals that overwhelms the endogenous antioxidant systems, leading to the development of various chronic somatic and psychiatric diseases.<sup>[<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B4">4</xref>]</sup></p>
      <p>There is a close connection between oxidative stress and inflammation.<sup>[<xref ref-type="bibr" rid="B5">5</xref>]</sup> Inflammatory cells produce free oxygen radicals that can lead to oxidative stress. At the same time, free radicals can stimulate the inflammatory response.<sup>[<xref ref-type="bibr" rid="B6">6</xref>, <xref ref-type="bibr" rid="B7">7</xref>]</sup> One possible mechanism underlying this interaction involves the activation of nuclear factor kappa B (NF-𝜅B) and the inflammasome, as well as the upregulation of pro-inflammatory cytokines<sup>.<xref ref-type="bibr" rid="B6">[</xref>6</sup>]</p>
      <p>While acute inflammation serves an important purpose in the human body by eliminating harmful agents and promoting tissue repair, uncontrolled chronic low-grade inflammation can contribute to the development of chronic diseases<sup>.<xref ref-type="bibr" rid="B8">[</xref>8,9</sup>] The prevention and treatment of oxidative stress and inflammation are essential, given their important role in the pathogenesis of socially significant diseases that impact quality of life.</p>
      <p>Various mechanisms exist to counteract free radicals and inflammation, including the use of natural/plant or synthetic molecules<sup>.<xref ref-type="bibr" rid="B3">[</xref>3,10</sup>] Studies have shown that certain medications, such as fluoxetine, sitagliptin, beta blockers, and calcium antagonists, possess in vitro antioxidant activity<sup>.[11-13</sup>] Other drugs, including angiotensin receptor blockers (<abbrev xlink:title="angiotensin receptor blockers" id="ABBRID0EHGAC">ARBs</abbrev>), metformin, omega 3 fatty acids, probiotics, and vitamin D, have been found to have an impact on inflammation<sup>.<xref ref-type="bibr" rid="B14">[1</xref>4</sup>]</p>
      <p>Medicinal plants and their active compounds, such as polyphenols and flavonoids, are also being extensively researched for their antioxidant and anti-inflammatory effects in the treatment of oxidative stress and inflammation.<sup>‌<xref ref-type="bibr" rid="B1">[</xref>1,5</sup>] However, despite the growing interest in medicinal plants, only a small part of them have been chemically and pharmacologically researched<sup>.<xref ref-type="bibr" rid="B15">[1</xref>5</sup>]</p>
      <p><italic><tp:taxon-name>
            <tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>, commonly known as winter savory, is one of the most pharmacologically active plants within the <tp:taxon-name><tp:taxon-name-part taxon-name-part-type="family">Lamiaceae</tp:taxon-name-part></tp:taxon-name> family, which consists of over 230 genera and more than 7000 species<sup>.<xref ref-type="bibr" rid="B16">[1</xref>6,17</sup>] This plant is distributed on the Balkan Peninsula and in Bulgaria<sup>.<xref ref-type="bibr" rid="B18">[1</xref>8</sup>] The pharmacological effects of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>, such as antioxidant, antibacterial, and antiviral effects are described in the available scientific data<sup>.<xref ref-type="bibr" rid="B19">[1</xref>9</sup>] These effects are closely related to the type of extract used in the different studies, as well as to the active compounds in its composition.</p>
    </sec>
    <sec sec-type="Aim" id="SECID0EYIAC">
      <title>Aim</title>
      <p>However, there is insufficient information on other pharmacological effects of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>, prompting further examination of its in vitro antioxidant activity and its potential to reduce inflammation in the present study.</p>
    </sec>
    <sec sec-type="materials|methods" id="SECID0EJJAC">
      <title>Materials and methods</title>
      <sec sec-type="In vitro antioxidant activity" id="SECID0ENJAC">
        <title>In vitro antioxidant activity</title>
        <p>
          <bold>Oxygen radical absorbance capacity</bold>
        </p>
        <p>The Oxygen Radical Absorbance Capacity (<abbrev xlink:title="Oxygen Radical Absorbance Capacity" id="ABBRID0EUJAC">ORAC</abbrev>) technique developed by Ou et al. was used, with a few modifications detailed by Denev et al.<sup><xref ref-type="bibr" rid="B20">[20</xref>, <xref ref-type="bibr" rid="B21">21</xref>]</sup> This method assesses an in vitro antioxidants ability to neutralize peroxide radicals. The method is based on inhibiting fluorescein fluorescence decline during oxidation in the presence of an in vitro antioxidant. As a peroxide radical generator, the thermal breakdown of 2,2-azobis (2-amidinopropane) dihydrochloride (AAPH) was used. The results are given in terms of mol Trolox equivalents per gram of extract (TE/g). FLUOstar OPTIMA fluorimeter (BMG LABTECH, Offenburg, Germany) was used for the measurements. The excitation wavelength was 485 nm, and the emission wavelength was 520 nm.</p>
      </sec>
      <sec sec-type="Hydroxyl radical averting capacity" id="SECID0ECKAC">
        <title>Hydroxyl radical averting capacity</title>
        <p>The Hydroxyl Radical Averting Capacity (<abbrev xlink:title="Hydroxyl Radical Averting Capacity" id="ABBRID0EIKAC">HORAC</abbrev>) method developed by Ou et al.<sup><xref ref-type="bibr" rid="B22">[22</xref>]</sup> assesses an in vitro antioxidant’s ability to form complexes in Fenton-like reaction caused by the interaction of Co (II) with H<sub>2</sub>O<sub>2</sub>. The results are given in terms of mol gallic acid equivalents per gram of extract (GAE/g). FLUOstar OPTIMA fluorimeter (BMG LABTECH, Offenburg, Germany) was used for the measurements. The excitation wavelength was 485 nm, and the emission wavelength was 520 nm.</p>
      </sec>
      <sec sec-type="methods" id="SECID0EWKAC">
        <title>Electrochemical method</title>
        <p>The electrochemical technique was used for evaluating the antioxidant activity in vitro.<sup><xref ref-type="bibr" rid="B23">[23</xref>]</sup> The methodology of the experiment consists in recording voltamperograms of cathodic electroreduction of oxygen with the “Analyst AOA” (RU.C.31.113.A N28715) linked to a PC. The in vitro antioxidant activity of the investigated samples was calculated using the kinetic criteria K (in micromoles per liter/minute), which indicates the quantity of reactive oxygen species in time and is represented as a percentage of the Trolox kinetic criterion via the formula:</p>
        <p>АOA = K<sub>sample</sub> / K<sub>Trolox</sub></p>
      </sec>
      <sec sec-type="Laboratory experiments" id="SECID0EHLAC">
        <title>Laboratory experiments</title>
        <p>
          <bold>Animals</bold>
        </p>
        <p>All experiments are in agreement with the approval of the Ethics Committee of Medical University of Plovdiv (as of protocol No. 01-2/10.04.2020) and the approval of the Bulgarian Food Safety Agency (as of protocol No. 258), based on the position of the Ethic Committee, Bulgarian Food Safety Agency No. 174 from October 8, 2019.</p>
        <p>Rats were raised in the vivarium of the Medical University of Plovdiv and housed under standard conditions: 20°–22°C, 12-hour light/dark cycle, with free access to food and water.</p>
      </sec>
      <sec sec-type="Substance preparation" id="SECID0EOLAC">
        <title>Substance preparation</title>
        <p>Carvacrol and rosmarinic acid (<abbrev xlink:title="rosmarinic acid" id="ABBRID0EULAC">RA</abbrev>) were bought from Sigma-Aldrich (St. Louis, Missouri, USA). Carvacrol was dissolved in olive oil and <abbrev xlink:title="rosmarinic acid" id="ABBRID0EYLAC">RA</abbrev> was dissolved in saline. Both solutions were administered orally via stomach gavage (1 ml/100 g b.w.).</p>
        <p>The dry extract of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> (SME) was prepared by methodology of Vesselino EOOD, Kazanlak, Bulgaria via methanol-aqueous (70:30) extraction, followed by spray drying at 40°C until complete evaporation of both solvents. The extract was dissolved in saline and applied orally via stomach gavage in the volume of 0.5 ml/100 g b.w. (for a dose of 250 mg/kg b.w.) and 1 ml/100 g b.w. (for a dose of 500 mg/kg b.w.).</p>
      </sec>
      <sec sec-type="Investigation of pro-inflammatory cytokines levels in acute and chronic stress models" id="SECID0EJMAC">
        <title>Investigation of pro-inflammatory cytokines levels in acute and chronic stress models</title>
        <p>
          <bold>Acute stress model</bold>
        </p>
        <p>For investigation of the impact of dry SME on the serum concentration of pro-inflammatory cytokines IL-1β, IL-6, and TNF-α in acute cold stress model, 56 male 8-week-old Wistar rats with average bodyweight 110 g (range 100-120 g) were used. The rodents were randomly divided into 7 groups (n=8). One of the groups was sham control, which was only gavaged without administration of substances. The rest groups were treated daily for 14 days orally via stomach gavage with saline and olive oil – 1 ml/100 g b.w. (positive controls), dry SME at doses of 250 mg/kg b.w. and 500 mg/kg b.w., carvacrol 500 mg/kg b.w., and <abbrev xlink:title="rosmarinic acid" id="ABBRID0EQMAC">RA</abbrev> 15 mg/kg b.w. – experimental groups.</p>
        <p>On day 15 from the beginning of the experiment, rodents from both positive controls and all experimental groups were exposed to the stress factor, −4°C for 60 minutes in the refrigerator. Animals were placed in plastic boxes 20×20 cm, and allowed to move freely into the box. At the same time, there were four animals in the refrigerator, each of it in a single box. Boxes were cleaned with 70% alcohol after each animal. The sham group was not exposed to the stress factors.</p>
        <p>Fifteen minutes after removing the rodents from the refrigerator, they were decapitated under narcosis with ether and 2 ml blood was collected. The blood was centrifuged and 1 ml of serum was separated. The investigation of serum levels of IL-1β, IL-6, and TNF-α was performed with ELISA method and Ebioscience kits (ThermoFisher Scientific, USA).</p>
      </sec>
      <sec sec-type="Chronic unpredictable mild stress model" id="SECID0EWMAC">
        <title>Chronic unpredictable mild stress model</title>
        <p>To investigate the effect of dry SME on the serum pro-inflammatory cytokines IL-1β, IL-6, and TNF-α in a chronic unpredictable mild stress model, 56 male, 8-week-old Wistar rats with average bodyweight of 110 g (100-120 g) were used. They were randomly divided in 7 groups (n=8), which were similar to these, described above in acute stress model. From the first day of the experiment, animals from both positive controls and all experimental groups were exposed to mild stress stimuli – food or water deprivation for 24 hours, placing an empty water bottle for 1 hour, tilting of home cage (45° for 3 hours), leaving of light for 24 hours, soiling the bedding (200 ml, 25°C water per 100 g bedding material), predator sounds (two rounds of 20 minutes). Stress factors were applied 60 minutes after the daily treatment. Each stressor was used once a week and the order was changed every week of the experiment to avoid habituation to them. The sham group was not exposed to the stress stimuli.</p>
        <p>On day 60, one hour after the exposure to the stressor, the rodents were decapitated under narcosis with ether and 2 ml of blood was collected. This blood was centrifuged and 1 ml of serum was separated. The investigation of serum levels of IL-1β, IL-6, and TNF-α was performed as described above in the section of acute stress model.</p>
      </sec>
      <sec sec-type="Serum cytokine measurement in treated rat groups by ELISA" id="SECID0E3MAC">
        <title>Serum cytokine measurement in treated rat groups by ELISA</title>
        <p>Diluted rat serums (1:2) for IL-1, IL-6, and TNF, as well as internal controls and test standards, were dripped on solid phase with monoclonal antibodies against the respective cytokine for quantitative cytokine testing. A peroxidase conjugate (second anti-species antibody) is added after incubation and washing to generate a cytokine complex. A second wash is used to eliminate any unbound conjugate. A color response occurs when a chromogenic substrate is introduced to the enzyme, indicating the presence of cytokines. Absorption is evaluated colorimetrically on a TECAN ELISA reader at 450 nm and 620 nm and is proportional to cytokine concentration. A standard curve is used to determine the concentration of each cytokine in pg/ml.</p>
      </sec>
      <sec sec-type="Statistical analysis" id="SECID0EBNAC">
        <title>Statistical analysis</title>
        <p>The results were analyzed statistically using one-way ANOVA and LSD post hoc tests with IBM SPSS 19.0 software. Results were expressed as arithmetic means (X̅), standard error of the mean (±SEM for cytokine levels) ,and standard deviation (±SD for the antioxidant activity). A <italic>p</italic>-value ≤0.05 was considered statistically significant. For each one-way ANOVA test F statistics and p value is given. Statistical significance between groups, which is found with post hoc analyses, is presented as a <italic>p</italic>-value.</p>
      </sec>
    </sec>
    <sec sec-type="Results" id="SECID0ELNAC">
      <title>Results</title>
      <sec sec-type="In vitro antioxidant activity" id="SECID0EPNAC">
        <title>In vitro antioxidant activity</title>
        <p>The dry SME showed in vitro antioxidant activity in all used methods. The results are presented in <bold>Table <xref ref-type="table" rid="T1">1</xref></bold>.</p>
        <table-wrap id="T1" position="float" orientation="portrait">
          <label>Table 1.</label>
          <caption>
            <p>In vitro antioxidant activity of dry SME</p>
          </caption>
          <table id="TID0EAPAE" rules="all">
            <tbody>
              <tr>
                <td rowspan="1" colspan="1">
                  <bold><abbrev xlink:title="Oxygen Radical Absorbance Capacity" id="ABBRID0EGWAE">ORAC</abbrev>, µmol TE/g X̅±SD</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold><abbrev xlink:title="Hydroxyl Radical Averting Capacity" id="ABBRID0ETWAE">HORAC</abbrev>, µmol GAE/g X̅±SD</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>АOA = K<sub>sample</sub> / K<sub>Trolox</sub> 16.236/0.634</bold>
                </td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">8529.3±159.0</td>
                <td rowspan="1" colspan="1">2114.4±17.6</td>
                <td rowspan="1" colspan="1">25.6</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
      </sec>
      <sec sec-type="Measurement of serum cytokines levels in models of acute and chronic stress" id="SECID0E2NAC">
        <title>Measurement of serum cytokines levels in models of acute and chronic stress</title>
        <p>
          <bold>Acute stress model</bold>
        </p>
        <p>Acute cold stress significantly increased the serum concentrations of TNF-α and IL-6 in the positive controls, treated with olive oil (<italic>p</italic>=0.041 and <italic>p</italic>&lt;0.001, respectively). In the positive saline control, a statistically significant increase was found only in IL-6 serum concentrations (<italic>p</italic>=0.003). The same cytokine was found to be statistically higher in the groups treated with dry SME 500 mg/kg b.w., <abbrev xlink:title="rosmarinic acid" id="ABBRID0EIOAC">RA</abbrev>, and carvacrol compared with sham control (<italic>p</italic>=0.028, <italic>p</italic>&lt;0.001, and <italic>p</italic>&lt;0.001, respectively). TNF-α was statistically increased in the groups that received <abbrev xlink:title="rosmarinic acid" id="ABBRID0ESOAC">RA</abbrev> and carvacrol when compared to the sham control (<italic>p</italic>=0.003, <italic>p</italic>=0.015, respectively).</p>
        <p>None of all tested substances had a significant impact on lowering the serum cytokine levels compared to corresponding positive control <italic>(p</italic>&gt;0.05 for all measurements). The results are presented on <bold>Fig. <xref ref-type="fig" rid="F1">1A–B</xref></bold>.</p>
        <p>The dry SME at a dose at 250 mg/kg b.w. decreased significantly the serum concentration of IL-6 and TNF-α compared to <abbrev xlink:title="rosmarinic acid" id="ABBRID0EGPAC">RA</abbrev> (<italic>p</italic>=0.011 and <italic>p</italic>=0.036). When the same dose of dry SME was compared with the carvacrol treated group, a significant impact was found only on the IL-6 levels (<italic>p</italic>=0.019). The higher dose of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> dry extract did not show significant anti-inflammatory effect compared to <abbrev xlink:title="rosmarinic acid" id="ABBRID0E2PAC">RA</abbrev> and carvacrol. The results are presented in <bold>Fig. <xref ref-type="fig" rid="F2">2</xref></bold>.</p>
        <fig id="F1" position="float" orientation="portrait">
          <object-id content-type="arpha">46E4DBD6-5DE9-5437-881A-8147C3943031</object-id>
          <label>Figure 1.</label>
          <caption>
            <p><bold>A</bold> Effect of dry extract of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>, rosmarinic acid, and carvacrol on serum concentration of IL-6 and TNF-α in acute stress experimental model. <bold>B</bold> Effect of dry extract of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>, rosmarinic acid, and carvacrol on serum concentration of IL-1β in acute stress experimental model. Comparison of the results with one-way ANOVA test yielded the following results: IL-6: F=3.605; <italic>p</italic>&lt;0.0001; TNF-α: F=2.642; <italic>p</italic>=0.007. The further comparison of the groups with LSD post hoc test found the following: * A significant increase of serum concentration of IL-6 when compared with sham control; # A significant increase of serum concentration of TNF-α when compared with sham control; + A significant increase of serum concentration of TNF-α when compared with positive saline control. Comparison of the results with one-way ANOVA test found following results IL-1β: F=1.055.</p>
          </caption>
          <graphic xlink:href="foliamedica-66-1-e115800-g001.jpg" position="float" orientation="portrait" xlink:type="simple" id="oo_995035.jpg">
            <uri content-type="original_file">https://binary.pensoft.net/fig/995035</uri>
          </graphic>
        </fig>
        <fig id="F2" position="float" orientation="portrait">
          <object-id content-type="arpha">465099FF-4E06-5714-B0DE-8CE9627EEFE6</object-id>
          <label>Figure 2.</label>
          <caption>
            <p>Comparative effect of dry extract of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>, rosmarinic acid, and carvacrol on serum cytokines levels in acute cold stress model. Comparison of the results with one-way ANOVA gave the following results: IL-6: F=3.605; <italic>p</italic>&lt;0.0001; IL-1β: F=1.055; <italic>p</italic>=0.413; TNF-α: F=2.642; <italic>p</italic>=0.007. Further comparison of the groups with LSD post hoc test found the following: * A significant decrease of IL-6 serum concentration in the group treated with <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> 250 mg/kg b.w. compared with <abbrev xlink:title="rosmarinic acid" id="ABBRID0EA1AE">RA</abbrev> treated group (<italic>p</italic>=0.011); # A significant decrease of IL-6 serum concentration in the group treated with <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> 250 mg/kg b.w. compared with carvacrol treated group (<italic>p</italic>=0.019); ^ A significant decrease of TNF-α serum concentration in the group treated with <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> 250 mg/kg b.w. compared with <abbrev xlink:title="rosmarinic acid" id="ABBRID0E51AE">RA</abbrev> treated group (<italic>p</italic>=0.036).</p>
          </caption>
          <graphic xlink:href="foliamedica-66-1-e115800-g002.jpg" position="float" orientation="portrait" xlink:type="simple" id="oo_995036.jpg">
            <uri content-type="original_file">https://binary.pensoft.net/fig/995036</uri>
          </graphic>
        </fig>
      </sec>
      <sec sec-type="Chronic unpredictable mild stress model" id="SECID0EGAAE">
        <title>Chronic unpredictable mild stress model</title>
        <p>Chronic stress significantly increased serum concentrations of IL-6 and TNF-α in the positive olive oil control group (<italic>p</italic>=0.001 and <italic>p</italic>=0.006, respectively) as well as IL-6 in the positive saline control group (<italic>p</italic>=0.015). The chronic stress had no impact on serum levels of IL-1β.</p>
        <p>The dry SME decreased non-significantly the serum concentrations of IL-6 and TNF-α compared to the positive saline control (<italic>p</italic>&gt;0.05 for all measurements). <abbrev xlink:title="rosmarinic acid" id="ABBRID0EWAAE">RA</abbrev> increased statistically significantly IL-6 compared to the sham control (<italic>p</italic>=0.013) and showed non-significant anti-inflammatory effect compared to the positive saline control (<italic>p</italic>&gt;0.05). Carvacrol decreased significantly serum concentrations of IL-6 and TNF-α compared to the olive oil control (<italic>p</italic>=0.011 and <italic>p</italic>=0.004, respectively). The results are presented in <bold>Fig. <xref ref-type="fig" rid="F3">3</xref></bold>.</p>
        <p>Both doses of the dry SME 250 mg/kg b.w. and 500 mg/kg b.w. did not show significant effect on serum concentrations of IL-6 and TNF-α when compared with the <abbrev xlink:title="rosmarinic acid" id="ABBRID0EKBAE">RA</abbrev> or the carvacrol treated groups (<italic>p</italic>&gt;0.05 for all measurements). Visualization of results is not shown.</p>
        <fig id="F3" position="float" orientation="portrait">
          <object-id content-type="arpha">93C94816-7A19-5134-9F4F-388B4463AB06</object-id>
          <label>Figure 3.</label>
          <caption>
            <p>Effect of dry extract of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>, rosmarinic acid, and carvacrol on serum concentration of IL-6, IL-1β, and TNF-α in a chronic unpredictable mild stress experimental model. Comparison of the results with one-way ANOVA found the following results: IL-6: F=3.605; <italic>p</italic>&lt;0.0001; IL-1β: F=1.055; <italic>p</italic>= 0.413; TNF-α: F=2.642; <italic>p</italic>=0.007. Further comparison of the groups with LSD post hoc test found the following: * A significant increase of serum concentration of IL-6 compared to the sham control; ** A significant decrease of serum concentrations of IL-6 in carvacrol treated group compared; to positive olive oil control; # A significant increase of serum concentration of TNF-α compared to the sham control; ## A significant decrease of serum concentrations of TNF-α in carvacrol treated group compared to positive olive oil control.</p>
          </caption>
          <graphic xlink:href="foliamedica-66-1-e115800-g003.jpg" position="float" orientation="portrait" xlink:type="simple" id="oo_995038.jpg">
            <uri content-type="original_file">https://binary.pensoft.net/fig/995038</uri>
          </graphic>
        </fig>
      </sec>
    </sec>
    <sec sec-type="Discussion" id="SECID0EQBAE">
      <title>Discussion</title>
      <p>The presence of multiple methods for determining in vitro antioxidant activity leads to results that are incomparable across different studies. To ensure the accuracy of these findings, it is necessary to employ more than one in vitro method for verification.<sup><xref ref-type="bibr" rid="B24">[24</xref>]</sup> In the present study, three specific assays were chosen for their precision.<sup><xref ref-type="bibr" rid="B25">[25</xref>]</sup></p>
      <p>The in vitro antioxidant capacity of the dry <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> extract (dry SME) analyzed in this study was found to be lower than that reported by Moreira SA.<sup><xref ref-type="bibr" rid="B26">[26</xref>]</sup> These variations can be attributed to differences in the quantitative and qualitative composition of the extracts used in both studies. External factors such as geographic region, weather conditions, and vegetative period contribute to differences in the composition of medicinal plants.<sup><xref ref-type="bibr" rid="B27">[27</xref>]</sup> It should be noted that, to the best of our knowledge, no other research team has used the electrochemical and <abbrev xlink:title="Hydroxyl Radical Averting Capacity" id="ABBRID0E1CAE">HORAC</abbrev> methodologies to assess <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>’s in vitro antioxidant activity.</p>
      <p>The in vitro antioxidant activity of the dry SME is attributed to the presence of phenolic compounds in the medicinal plant’s composition.<sup><xref ref-type="bibr" rid="B28">[28</xref>]</sup> Our previous study identified rosmarinic acid (<abbrev xlink:title="rosmarinic acid" id="ABBRID0ERDAE">RA</abbrev>) and carvacrol as active ingredients in the dry SME with an average amount of 45 mg/g and 0.02 mg/g, respectively.<sup><xref ref-type="bibr" rid="B29">[29</xref>]</sup> Carvacrol is known to have a lower capacity to neutralize reactive oxygen species compared to other phenolic derivatives.<sup><xref ref-type="bibr" rid="B30">[30</xref>]</sup> For that reason, we suppose that the observed in vitro antioxidant activity of the dry SME is mainly due to the presence of <abbrev xlink:title="rosmarinic acid" id="ABBRID0EBEAE">RA</abbrev> in its composition. This hypothesis is supported by several other researchers.<sup><xref ref-type="bibr" rid="B31">[31</xref>]</sup></p>
      <p>Based on the results obtained for the antioxidant activity of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>, an investigation of serum concentrations of TNF-α, IL-6, and IL-1β was conducted. It is well-known that both acute and chronic stress lead to increase in the serum concentrations of pro-inflammatory cytokines.‌<sup><xref ref-type="bibr" rid="B32">[32</xref>, <xref ref-type="bibr" rid="B33">33</xref>]</sup> The results obtained in both positive control groups when compared to the sham control are consistent with the existing literature data.<sup><xref ref-type="bibr" rid="B32">[32</xref>, <xref ref-type="bibr" rid="B33">33</xref>]</sup></p>
      <p><abbrev xlink:title="rosmarinic acid" id="ABBRID0EMFAE">RA</abbrev> and carvacrol are known to decrease pro-inflammatory cytokines.<sup><xref ref-type="bibr" rid="B34">[34</xref>, <xref ref-type="bibr" rid="B35">35</xref>]</sup> However, in the present study, these two phenolic compounds exhibited contradictory effects, likely due to the experimental method used to induce systemic inflammation. To the best of our knowledge, no other study has investigated the effects of both phenolic compounds on pro-inflammatory cytokines in stress models. It is possible that the anti-inflammatory activity of <abbrev xlink:title="rosmarinic acid" id="ABBRID0E1FAE">RA</abbrev> and carvacrol is insufficient to counteract the pathogenic changes involved in inflammation.</p>
      <p>No data were found regarding the effect of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> on pro-inflammatory cytokines, making it challenging to compare the results obtained in this study. It is possible that the lack of significance in the results is due to the extract’s inability to counteract all activated inflammatory mechanisms. Additionally, there may be potentiation or synergism between <abbrev xlink:title="rosmarinic acid" id="ABBRID0ELGAE">RA</abbrev> and carvacrol in the composition of the dry SME, as well as the development of tolerance with long-term use. Furthermore, carvacrol demonstrated a significant anti-inflammatory effect in the chronic stress model, which was not observed in the <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic>-treated groups. This discrepancy may be attributed to the small amount of carvacrol present in the extract’s composition (0.020 mg/g).</p>
    </sec>
    <sec sec-type="Conclusion" id="SECID0E1GAE">
      <title>Conclusion</title>
      <p>The results of our study indicate that <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> dry extract demonstrates in vitro antioxidant activity across all methods used, confirming the potential of wild-growing Bulgarian <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> to decrease the oxidants levels. However, the impact of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Satureja">Satureja</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="montana">montana</tp:taxon-name-part></tp:taxon-name></italic> dry extract on systemic inflammation remains inconclusive. Confirming or rejecting the effect of that medicinal plant on the serum concentrations of pro-inflammatory cytokines will be the subject to further studies.</p>
    </sec>
    <sec sec-type="Acknowledgments" id="SECID0EBIAE">
      <title>Acknowledgments</title>
      <p>The study was financially supported by the Doctoral and Postdoctoral Project program of the Medical University of Plovdiv (DPDP-15/2020).</p>
    </sec>
  </body>
  <back>
    <ack>
      <title>Conflict of Interests</title>
      <p>The authors of this manuscript have declared that no conflict of interests exists.</p>
    </ack>
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