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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.65.e86540</article-id>
      <article-id pub-id-type="publisher-id">86540</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original Article</subject>
        </subj-group>
        <subj-group subj-group-type="scientific_subject">
          <subject>Anatomy &amp; Morphology</subject>
          <subject>Nutrition</subject>
          <subject>Pharmacology</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Subchronic toxicity of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic>, <tp:taxon-name><tp:taxon-name-part taxon-name-part-type="family">Lamiaceae</tp:taxon-name-part></tp:taxon-name> on male Wistar rats</article-title>
      </title-group>
      <contrib-group content-type="authors">
        <contrib contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Yanchev</surname>
            <given-names>Nikolay B.</given-names>
          </name>
          <email xlink:type="simple">nikolay27@yahoo.com</email>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Delev</surname>
            <given-names>Delian P.</given-names>
          </name>
          <uri content-type="orcid">https://orcid.org/0000-0003-3695-5688</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Vilmosh</surname>
            <given-names>Natalia B.</given-names>
          </name>
          <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>Atanassova</surname>
            <given-names>Pepa K.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Hrischev</surname>
            <given-names>Petar I.</given-names>
          </name>
          <uri content-type="orcid">https://orcid.org/0000-0003-1597-3991</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
      </contrib-group>
      <aff id="A1">
        <label>1</label>
        <addr-line content-type="verbatim">Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria</addr-line>
        <institution>Medical University of Plovdiv</institution>
        <addr-line content-type="city">Plovdiv</addr-line>
        <country>Bulgaria</country>
      </aff>
      <aff id="A2">
        <label>2</label>
        <addr-line content-type="verbatim">Department of Human Anatomy, Histology and Embryology, Section Histology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria</addr-line>
        <institution>Medical University of Plovdiv</institution>
        <addr-line content-type="city">Plovdiv</addr-line>
        <country>Bulgaria</country>
      </aff>
      <aff id="A3">
        <label>3</label>
        <addr-line content-type="verbatim">Department of Physiology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria</addr-line>
        <institution>Medical University of Plovdiv</institution>
        <addr-line content-type="city">Plovdiv</addr-line>
        <country>Bulgaria</country>
      </aff>
      <author-notes>
        <fn fn-type="corresp">
          <p>Corresponding author: Nikolay B. Yanchev, 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">nikolay27@yahoo.com</email></p>
        </fn>
      </author-notes>
      <pub-date pub-type="collection">
        <year>2023</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>31</day>
        <month>08</month>
        <year>2023</year>
      </pub-date>
      <volume>65</volume>
      <issue>4</issue>
      <fpage>638</fpage>
      <lpage>643</lpage>
      <uri content-type="arpha" xlink:href="http://openbiodiv.net/E66590E5-6C6E-528F-A4A8-A77242463338">E66590E5-6C6E-528F-A4A8-A77242463338</uri>
      <history>
        <date date-type="received">
          <day>13</day>
          <month>05</month>
          <year>2022</year>
        </date>
        <date date-type="accepted">
          <day>12</day>
          <month>07</month>
          <year>2022</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Nikolay B. Yanchev, Delian P. Delev, Natalia B. Vilmosh, Pepa K. Atanassova, Petar I. Hrischev</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>: <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic>, <tp:taxon-name><tp:taxon-name-part taxon-name-part-type="family">Lamiaceae</tp:taxon-name-part></tp:taxon-name>, is a plant with anti-inflammatory, antirheumatic, digestive, and antimicrobial properties that is widely used in folk medicine throughout the Balkan Peninsula. The name derives from the Greek word ‘sideros’, meaning iron, and it is believed that the plant was also used by soldiers to heal wounds caused by cutting weapons.</p>
        <p><bold>Aim</bold>: The study aimed to assess the subchronic toxicity of a dry hydromethanolic extract from <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic>, <tp:taxon-name><tp:taxon-name-part taxon-name-part-type="family">Lamiaceae</tp:taxon-name-part></tp:taxon-name>.</p>
        <p><bold>Materials and methods</bold>: To investigate the subchronic toxicity, male Wistar rats were given orally a solution of dry hydromethanolic extract daily for 12-weeks at doses of 100, 200, and 400 mg/kg bw. Blood and blood serum were collected at the end of the experiment, and different organs were prepared for histopathological examination. Statistical analysis was performed with One-Way ANOVA test, using IBM SPSS 19.0.</p>
        <p><bold>Results</bold>: All hematological and biochemical results remained within the normal reference ranges described for the species. The histological examination showed no abnormalities in the morphology of the examined organs (brain, stomach, liver, and kidney).</p>
        <p><bold>Conclusions</bold>: The study contributes to a better understanding of the possible pharmacological effects, while documenting the absence of toxicity and safe use of the herb for future new indications.</p>
      </abstract>
      <kwd-group>
        <label>Keywords</label>
        <kwd>
          <tp:taxon-name>
            <tp:taxon-name-part taxon-name-part-type="family">Lamiaceae</tp:taxon-name-part>
          </tp:taxon-name>
        </kwd>
        <kwd>
          <italic>
            <tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name>
          </italic>
        </kwd>
        <kwd>toxicity</kwd>
        <kwd>Wistar</kwd>
      </kwd-group>
    </article-meta>
    <notes>
      <sec sec-type="Citation" id="SECID0ELH">
        <title>Citation</title>
        <p>Yanchev NB, Delev DP, Vilmosh NB, Atanassova PK, Hrischev PI. Subchronic toxicity of <italic>Sideritis scardica</italic>, Lamiaceae on male Wistar rats. Folia Med (Plovdiv) 2023;65(4):638-643. doi: <ext-link xlink:type="simple" ext-link-type="doi" xlink:href="10.3897/folmed.65.e86540">10.3897/folmed.65.e86540</ext-link>.</p>
      </sec>
    </notes>
  </front>
  <body>
    <sec sec-type="Introduction" id="SECID0EJAAC">
      <title>Introduction</title>
      <p><italic><tp:taxon-name>
            <tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic>, <tp:taxon-name><tp:taxon-name-part taxon-name-part-type="family">Lamiaceae</tp:taxon-name-part></tp:taxon-name>, also called Mursala or Pirin tea, is a plant endemic to the Balkan Peninsula, which has been known and used in ethnopharmacology for centuries. Many terpenes, flavonoids, organic acids, and polyphenolic biologically active substances are found in its composition.‌<sup>[<xref ref-type="bibr" rid="B1">1</xref>, <xref ref-type="bibr" rid="B2">2</xref>]</sup> In recent years, there has been an increased interest in expanding the indications for this traditional herb and efforts have been made to establish its safety in preclinical trials.</p>
    </sec>
    <sec sec-type="Aim" id="SECID0EOBAC">
      <title>Aim</title>
      <p>The aim of the study was to determine the toxicity of a <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic> plant preparation in Wistar rats, as well as to detect possible pathological changes in different tissues and biochemical and hematological parameters.</p>
    </sec>
    <sec sec-type="materials|methods" id="SECID0E6BAC">
      <title>Materials and methods</title>
      <p>Plant material was purchased from the NW Health Ltd, Bulgaria and a hydromethanolic extract (70% v/v) was produced using industrial spray dryer technology at Vesselino Ltd. Kazanlak, Bulgaria.</p>
      <sec sec-type="Phytochemical Analysis" id="SECID0EECAC">
        <title>Phytochemical Analysis</title>
        <p>The amount of total phenols in the obtained extracts was determined by the Folin-Ciocalteu method. The results are presented as milligram equivalents of gallic acid per gram (mg GAE/g dry matter).<sup>[<xref ref-type="bibr" rid="B3">3</xref>]</sup> The content of total flavonoids in the extracts was also determined spectrophotometrically using Al (NO<sub>3</sub>).<sup>[<xref ref-type="bibr" rid="B4">4</xref>]</sup> The results are presented as milligram equivalents of quercetin (mg QE/g dry matter). Determination of antioxidant activity was performed via the well-established methods - DPPH, ABTS, FRAP, and CUPRAC. The results of all four methods are presented as millimoles of Trolox equivalents (mM TE).<sup>[<xref ref-type="bibr" rid="B5">5</xref>, <xref ref-type="bibr" rid="B6">6</xref>]</sup></p>
      </sec>
      <sec sec-type="Subchronic toxicity" id="SECID0EEDAC">
        <title>Subchronic toxicity</title>
        <p>The subchronic toxicity experiment follows up an acute toxicity assessment in which no lethality was observed after a single oral administration of doses of 1000, 2000, 5000, and 10000 mg/kg bw.</p>
        <p>Twenty-four male Wistar albino rats were obtained from the vivarium at the Medical University of Plovdiv. The animals were housed in a room providing ventilation with a temperature range of 25±2ºC at a 12-h light-darkness cycle. Nutrition consisted of a standard feeding diet and use of tap water ad libitum. The animals were divided into four groups, each consisting of 6 rats. Group 1 was the control group which was treated with saline (2 ml). Groups 2, 3, and 4 were given orally water solution (2 ml) of a hydromethanolic dry extract from <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic> at doses of 100, 200, and 400 mg/kg bw for 12 weeks. The animals were fasted for 12 hours before serum and organ samples were taken.</p>
      </sec>
      <sec sec-type="Haematological analysis" id="SECID0EWDAC">
        <title>Haematological analysis</title>
        <p>Venous blood samples were obtained from the jugular vein under humane conditioned inhalation anesthesia. The tests were performed using RT-7600 Auto Hematology Analyzer and reagents provided by the producer.</p>
      </sec>
      <sec sec-type="Biochemical analysis" id="SECID0E2DAC">
        <title>Biochemical analysis</title>
        <p>Venous blood samples were obtained from the jugular vein under humane conditioned inhalation anesthesia. The blood samples were collected in test tubes and centrifuged at 4000 rpm for 10 minutes. The serum was immediately frozen at −20 degrees Celsius for further analysis. An analysis of a series of biochemical parameters was performed using an automatic biochemistry analyzer Rayto Chemray-120 and kits from Biomaxima, Poland. The acquired data were analyzed using one-way ANOVA test with IBM SPSS v. 19. Differences among the group means were evaluated by Tukey’s test. Mean values were considered to be statistically significant at <italic>p</italic>&lt;0.05.</p>
      </sec>
      <sec sec-type="Histological analysis" id="SECID0EDEAC">
        <title>Histological analysis</title>
        <p>Material from liver, kidney, brain, and stomach were collected from the animals of each experimental group and prepared for histological evaluation using the paraffin method. <sup>[<xref ref-type="bibr" rid="B7">7</xref>]</sup> The samples were then fixated using 10% neutrally buffered formalin and placed in paraffin molds. The paraffin blocks were cut using a microtome into 5-µm slices and stained with hematoxylin-eosin, a widely used combination for many types of tissues, as it allows a clear and contrastive differentiation of the cell nucleus and cytoplasm. The nuclei tend to achieve blue-to-violet coloring, whereas the cytoplasms remain brighter and pink. This staining allows common understanding and estimation of the organic structure and pathological alteration. The acquired samples were observed using a light microscope Olympus, and microphotographic images were supplied via the microscope camera.</p>
      </sec>
    </sec>
    <sec sec-type="Results" id="SECID0EQEAC">
      <title>Results</title>
      <sec sec-type="Phytochemical analysis (Tables 1-4; Fig. 1)" id="SECID0EUEAC">
        <title>Phytochemical analysis (Tables <xref ref-type="table" rid="T1">1</xref>–<xref ref-type="table" rid="T4">4</xref>; Fig. <xref ref-type="fig" rid="F1">1</xref>)</title>
        <table-wrap id="T1" position="float" orientation="portrait">
          <label>Table 1.</label>
          <caption>
            <p>Phytochemical properties</p>
          </caption>
          <table id="TID0E4BAE" rules="all">
            <tbody>
              <tr>
                <td rowspan="1" colspan="1">
                  <bold>Method</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>Value</bold>
                </td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Saccharose, g/100 g</td>
                <td rowspan="1" colspan="1">13.30</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Glucose, g/100 g</td>
                <td rowspan="1" colspan="1">4.61</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Fructose, g/100 g</td>
                <td rowspan="1" colspan="1">4.30</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Total sugars, g/100 g</td>
                <td rowspan="1" colspan="1">22.21</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Total polyphenols, mg GAE/g</td>
                <td rowspan="1" colspan="1">88.66±2.57</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Total flavonoids, mg QE/g</td>
                <td rowspan="1" colspan="1">22.01±1.23</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Antioxidant activity, mM TE/g</td>
                <td rowspan="1" colspan="1"/>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">DPPH</td>
                <td rowspan="1" colspan="1">693.89±3.61</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">ABTS</td>
                <td rowspan="1" colspan="1">1009.60±13.82</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">FRAP</td>
                <td rowspan="1" colspan="1">552.66±5.65</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">CUPRAC</td>
                <td rowspan="1" colspan="1">1418.60±23.39</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p>
          <bold>Subchronic toxicity</bold>
        </p>
        <p>No lethality, macroscopic alterations, or pathological behavior was observed after 12 weeks of treatment with the preparation at doses of 100, 200, and 400 mg/kg bw. The weekly weight measurements showed that the treated groups gained about 10% more weight than the controls did.</p>
      </sec>
      <sec sec-type="Bodyweight" id="SECID0EHFAC">
        <title>Bodyweight</title>
        <table-wrap id="T2" position="float" orientation="portrait">
          <label>Table 2.</label>
          <caption>
            <p>Bodyweight</p>
          </caption>
          <table id="TID0E4GAE" rules="all">
            <tbody>
              <tr>
                <td rowspan="1" colspan="1"/>
                <td rowspan="1" colspan="1">
                  <bold>Control</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>100 mg/kg</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>200 mg/kg</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>400 mg/kg</bold>
                </td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Weight gain, %</td>
                <td rowspan="1" colspan="1">54.6</td>
                <td rowspan="1" colspan="1">65.4</td>
                <td rowspan="1" colspan="1">69.1</td>
                <td rowspan="1" colspan="1">63.2</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p>
          <bold>Hematology</bold>
        </p>
        <table-wrap id="T3" position="float" orientation="portrait">
          <label>Table 3.</label>
          <caption>
            <p>Hematology</p>
          </caption>
          <table id="TID0ELJAE" rules="all">
            <tbody>
              <tr>
                <td rowspan="1" colspan="1"/>
                <td rowspan="1" colspan="1">
                  <bold>Control</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>100 mg/kg</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>200 mg/kg</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>400 mg/kg</bold>
                </td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">WBC</td>
                <td rowspan="1" colspan="1">4±0.70</td>
                <td rowspan="1" colspan="1">4.01±1.2</td>
                <td rowspan="1" colspan="1">3.74±0.84</td>
                <td rowspan="1" colspan="1">4.11±1.26</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">RBC</td>
                <td rowspan="1" colspan="1">7.93±0.46</td>
                <td rowspan="1" colspan="1">7.44±0.71</td>
                <td rowspan="1" colspan="1">7.33±0.6</td>
                <td rowspan="1" colspan="1">7.57±0.52</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">HGB</td>
                <td rowspan="1" colspan="1">147.67±8.87</td>
                <td rowspan="1" colspan="1">143.83±8.86</td>
                <td rowspan="1" colspan="1">140.5±8.85</td>
                <td rowspan="1" colspan="1">140.33±7.87</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">HCT</td>
                <td rowspan="1" colspan="1">0.42±0.02</td>
                <td rowspan="1" colspan="1">0.41±0.02</td>
                <td rowspan="1" colspan="1">0.34±0.14</td>
                <td rowspan="1" colspan="1">0.4±0.02</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">MCV</td>
                <td rowspan="1" colspan="1">52.53±1.04</td>
                <td rowspan="1" colspan="1">54.63±2.35</td>
                <td rowspan="1" colspan="1">53.48±1.65</td>
                <td rowspan="1" colspan="1">52.6±1.17</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">MCH</td>
                <td rowspan="1" colspan="1">18.63±0.33</td>
                <td rowspan="1" colspan="1">19.37±0.83</td>
                <td rowspan="1" colspan="1">18.32±1.3</td>
                <td rowspan="1" colspan="1">18.53±0.48</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">MCHC</td>
                <td rowspan="1" colspan="1">354.67±3.27</td>
                <td rowspan="1" colspan="1">355±2.68</td>
                <td rowspan="1" colspan="1">342.83±25.5</td>
                <td rowspan="1" colspan="1">352.33±3.33</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">PLT</td>
                <td rowspan="1" colspan="1">680.67±186.45</td>
                <td rowspan="1" colspan="1">546.17±315.58</td>
                <td rowspan="1" colspan="1">520.67±179.29</td>
                <td rowspan="1" colspan="1">569.83±241.87</td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <fn>
              <p>WBC: white blood cells; RBC: red blood cells; HGB: hemoglobin; HCT: hematocrit; MCV: mean corpuscular volume, MCH: mean corpuscular hemoglobin, MCHC: MCH concentration; PLT: platelets. The obtained results show no statistically significant differences between the treated and control groups.</p>
            </fn>
          </table-wrap-foot>
        </table-wrap>
        <p>
          <bold>Biochemistry</bold>
        </p>
        <table-wrap id="T4" position="float" orientation="portrait">
          <label>Table 4.</label>
          <caption>
            <p>Biochemical analysis</p>
          </caption>
          <table id="TID0ECRAE" rules="all">
            <tbody>
              <tr>
                <td rowspan="1" colspan="1"/>
                <td rowspan="1" colspan="1">
                  <bold>Control</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>100 mg/kg</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>200 mg/kg</bold>
                </td>
                <td rowspan="1" colspan="1">
                  <bold>400 mg/kg</bold>
                </td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Glu</td>
                <td rowspan="1" colspan="1">65.5±11.43</td>
                <td rowspan="1" colspan="1">81.17±19.05</td>
                <td rowspan="1" colspan="1">80.33±14.36</td>
                <td rowspan="1" colspan="1">83.83±17.94</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">ASAT</td>
                <td rowspan="1" colspan="1">135.83±16,5</td>
                <td rowspan="1" colspan="1">133±25.57</td>
                <td rowspan="1" colspan="1">117.17±23.18</td>
                <td rowspan="1" colspan="1">135.33±18.61</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">ALAT</td>
                <td rowspan="1" colspan="1">5.5±1.05</td>
                <td rowspan="1" colspan="1">7.33±2.73</td>
                <td rowspan="1" colspan="1">5.67±1.37</td>
                <td rowspan="1" colspan="1">6.17±1.94</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Cho</td>
                <td rowspan="1" colspan="1">69.79±13.11</td>
                <td rowspan="1" colspan="1">78.33±6.76</td>
                <td rowspan="1" colspan="1">72.82±15.94</td>
                <td rowspan="1" colspan="1">66.54±10.31</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Ua</td>
                <td rowspan="1" colspan="1">1.73±0.73</td>
                <td rowspan="1" colspan="1">1.82±0.67</td>
                <td rowspan="1" colspan="1">1.85±1.50</td>
                <td rowspan="1" colspan="1">1.92±0.44</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Tgc</td>
                <td rowspan="1" colspan="1">78.5±14.32</td>
                <td rowspan="1" colspan="1">62.67±9.54</td>
                <td rowspan="1" colspan="1">52.33±20.51*</td>
                <td rowspan="1" colspan="1">47±10.26*</td>
              </tr>
              <tr>
                <td rowspan="1" colspan="1">Ca</td>
                <td rowspan="1" colspan="1">8.23±0.23</td>
                <td rowspan="1" colspan="1">7.97±0.27</td>
                <td rowspan="1" colspan="1">7.2±0.74*</td>
                <td rowspan="1" colspan="1">7.7±0.30</td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <fn>
              <p>Glu: glucose, ASAT: aspartate transaminase; ALAT: alanine transaminase; Cho: cholesterol; Ua: uric acid; Tgc: triglycerides; Ca: calcium; *<italic>p</italic>&lt;0.05</p>
            </fn>
          </table-wrap-foot>
        </table-wrap>
        <p>In comparison to the control group, the results revealed a statistically significant reduction in the triglyceride levels at doses of 200 mg/kg bw (<italic>p</italic>=0.023) and 400 mg/kg bw (<italic>p</italic>=0.006), as well as the concentration of calcium at a dose of 200 mg/kg (<italic>p</italic>=0.031). Despite this, according to scientific literature sources, these parameters seem to correlate with the normal reference levels of biochemical markers in albino rats.</p>
      </sec>
      <sec sec-type="Histological analysis" id="SECID0EVFAC">
        <title>Histological analysis</title>
        <p>The organs of the animals of all examined groups demonstrated normal morphology.</p>
      </sec>
      <sec sec-type="Kidney" id="SECID0E1FAC">
        <title>Kidney</title>
        <p>We observed no changes in the microstructure of the cortex and the medulla of the treated animals. This applies for the glomeruli and all systems of tubules.</p>
      </sec>
      <sec sec-type="Stomach" id="SECID0E6FAC">
        <title>Stomach</title>
        <p>The images showed no differences in the gastric mucosae or glandulae of treated animals and the control group.</p>
      </sec>
      <sec sec-type="Liver" id="SECID0EEGAC">
        <title>Liver</title>
        <p>The liver lobules were well defined, with intact border and structure of v. centralis, triads, and cells. The hepatocytes did not display any type of alterations from normal morphology.</p>
      </sec>
      <sec sec-type="Brain" id="SECID0EJGAC">
        <title>Brain</title>
        <p>The sample images of the experimental animals showed normal structure and no remodeling of the cortex cerebri.</p>
        <fig id="F1" position="float" orientation="portrait">
          <object-id content-type="arpha">EA2B3B8D-F00B-56D0-9D9E-D8F6CD7EB144</object-id>
          <label>Figure 1.</label>
          <caption>
            <p>Kidney, stomach, liver, and brain of animals from the tested groups. HE staining.</p>
          </caption>
          <graphic xlink:href="foliamedica-65-4-e86540-g001.jpg" position="float" orientation="portrait" xlink:type="simple" id="oo_898821.jpg">
            <uri content-type="original_file">https://binary.pensoft.net/fig/898821</uri>
          </graphic>
        </fig>
      </sec>
    </sec>
    <sec sec-type="Discussion" id="SECID0EOGAC">
      <title>Discussion</title>
      <p>Although plants of the genus <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part></tp:taxon-name></italic> have been used in traditional medicine for centuries, little data has been acquired on their toxic properties. The European Medicines Agency’s Committee on Herbal Medicinal Products published a monograph on <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic> in 2015, recommending its use to treat gastrointestinal problems and cold-related cough.<sup>[<xref ref-type="bibr" rid="B8">8</xref>]</sup> Since then, numerous studies have been carried out by researchers in an effort to widen the indications for this traditional plant’s use in the treatment of neurodegenerative diseases and to uncover its cytotoxic, antibacterial, and anti-inflammatory properties.<sup>[<xref ref-type="bibr" rid="B9 B10 B11">9–11</xref>]</sup></p>
      <p>In an in vitro study by Tadic et al. involving B16 and HL-60 cells, a highly lipophilic diethyl ether extract of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">S.</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic> has been demonstrated to exert moderate cytotoxic effects.<sup>[<xref ref-type="bibr" rid="B9">9</xref>]</sup> An assessment of the toxicity of four <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic> extracts acquired via different solvents by Feistel et al. revealed no toxicity or concerns for mutagenic effects. In the same study, the authors performed an Ames test on bacterial cultures and observed no mutagenic effects, measured by the increase of revertant colony numbers as compared to control counts, for any of the extracts tested up to concentrations of 5000 µg/plate.<sup>[<xref ref-type="bibr" rid="B12">12</xref>]</sup></p>
      <p>The 12-week dosage subchronic toxicity revealed no lethality or gross pathological occurrences in the present study. Altogether, significant toxicity of the plants from the family <tp:taxon-name><tp:taxon-name-part taxon-name-part-type="family">Lamiaceae</tp:taxon-name-part></tp:taxon-name> has been associated more with the volatile components like terpenes found in the oils of different plants, which do not accumulate in an alcoholic aqueous extract.<sup>[<xref ref-type="bibr" rid="B13">13</xref>]</sup></p>
      <p>Contrary to Feistel et al., who documented an increase in calcium levels in the serum, the present study shows a statistically significant decrease in the calcium concentration <bold>(Table <xref ref-type="table" rid="T4">4</xref>)</bold>. Bearing in mind that the control group results were also below the reference values and did not illustrate a dose-effect tendency, this finding remains of minor relevance in respect to the direct toxic effects.<sup>[<xref ref-type="bibr" rid="B12">12</xref>, <xref ref-type="bibr" rid="B14">14</xref>]</sup></p>
      <p>A dose-dependent reduction of triglycerides has been documented <bold>(Table <xref ref-type="table" rid="T4">4</xref>)</bold>. Despite this fact, all the values are within the reference range.<sup>[<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B16">16</xref>]</sup> Similar effects have been observed in numerous experiments involving plant preparations that, like <tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name>, contain a high concentration of flavonoids and polyphenolic compounds and have high antioxidant activity <bold>(Table <xref ref-type="table" rid="T1">1</xref>)</bold>.<sup>[<xref ref-type="bibr" rid="B17">17</xref>, <xref ref-type="bibr" rid="B18">18</xref>]</sup> Some of the flavonoids found in the composition of the Mursala tea, such as apigenin and luteolin, have been well documented to exert a decreasing effect on serum lipids.<sup>[<xref ref-type="bibr" rid="B19">19</xref>, <xref ref-type="bibr" rid="B20">20</xref>]</sup></p>
      <p>The hematological results showed no statistically significant alterations <bold>(Table <xref ref-type="table" rid="T3">3</xref>)</bold>. A decrease in PLT levels is shown, yet it does not present a dosage effect tendency. The slight increase in bodyweight gain could be associated with the gastroprotective effects of the herb and the presence of different sugars in the extract <bold>(Table <xref ref-type="table" rid="T1">1</xref>, <xref ref-type="table" rid="T2">2</xref>)</bold>.<sup>[<xref ref-type="bibr" rid="B21">21</xref>]</sup></p>
      <p>Determining the outer morphology and histological structure of the main organs responsible for the elimination of xenobiotics and detoxication of the organism revealed no toxic effect or dysfunctionality <bold>(Fig. <xref ref-type="fig" rid="F1">1</xref>).</bold></p>
    </sec>
    <sec sec-type="Conclusions" id="SECID0EWMAC">
      <title>Conclusions</title>
      <p>The results of the present study suggest that using this <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic> preparation on Wistar rats causes no toxic effects. The decrease in the serum levels of triglycerides and calcium suggests a possible use of this medicinal herb in indications connected with metabolism and blood diseases. The documented results contribute to a better understanding and safety of <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sideritis">Sideritis</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scardica">scardica</tp:taxon-name-part></tp:taxon-name></italic> and help introduce this herb further in the ever-evolving interest in plant derived nutrition supplements.</p>
    </sec>
    <sec sec-type="Acknowledgments" id="SECID0ESNAC">
      <title>Acknowledgments</title>
      <p>This study was financially supported by the Doctoral and Postdoctoral Project Program of the Medical University of Plovdiv (DPDP-14/2020).</p>
    </sec>
    <sec sec-type="Conflict of interests" id="SECID0EXNAC">
      <title>Conflict of interests</title>
      <p>The authors of this manuscript have declared no conflict of interests.</p>
    </sec>
  </body>
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