VITAL POTENTIAL OF MULTIPLE HERBS IN PROPHYLAXIS OF OBESITY
Objective: Allopathic medications are associated with several inconveniences such as drug dependency. More than 2000 herbal medicines have been proved to have a therapeutic effect in multiple disorders. The prominent aim of this review paper is to compute the therapeutic effect of herbal drug against obesity along with their different mechanisms.
Methods: Data have been selected by evaluating merger of specific review and research papers through filtering through data bases such as PubMed, and Google Scholar of last 10 years 2009–2019.
Results: On the basis of our interpretations, we have concluded that the herbal drugs constituting active constituents’ as tannins, alkaloids, resins, saponins, and flavonoids are effective in lowering the blood triglycerides level, lipid accumulation in liver, fat accumulation, adipocyte differentiation, and ultimately decrease body weight with almost negligible toxicity.
Conclusion: Obesity is highly related to elevated morbidity rate as well as has become cause of various disorders. Herbal drugs have potential to treat obesity through different mechanisms including lipid peroxidation, free-radical scavenging activity, and inhibition of fat accumulation.
 Fernando Manzur MD, CiroAlvear QF, Alayon AN. Adipocitos, obesidad visceral, inflamacionyenfermedad cardiovascular adipocytes,visceral obesity, inflammation and
cardiovascular disease. RevistaColombianan de Cardiología. 2010; 17:5.
Yoon YS, Kwon AR, Lee YK, Oh SW.Circulating adipokines and risk of obesity related cancers: A systematic review and meta-analysis.Obes Res ClinPract. 2019;13(4):329-339.Ahirwar R, MondalPR. Prevalence of obesity in India: A systematic review.2019;13(1): 318-321.
Bjelanovic J, Velicki R, Popovic M, Bjelica A, Jevtic M. Prevalence and somerisk factors of childhood obesity. Nutrition 2017; 19 (2), 138–145.
Lagerros YT, Rossner S, Obesity management: what brings success? Ther. Adv.Gastroenterol. .2013;6: 77–88.
 Ptael DK, StandfordFC.Safety and tolerability of new-generation anti-obesitymedications: a narrative review, Postgrad. Med. 2018; 130: 173–182.
Wharton S, Current perspectives on long-term obesity pharmacotherapy.Can J Diabetes. 2016; 40(2):184-91.
Adan RA.Mechanisms underlying current and future anti-obesity drugs. Trends Neurosci. 2013;36(2):133-40.
Chellan N, Joubert E, Strijdom H, Roux C, Louw J, Muller CJ. Aqueous extract of unfermented honeybush (Cyclopiamaculata) attenuates STZ-induced diabetes and ?-cell cytotoxicity, Planta Med. 2014; 80(8-9):622-9.
 Schulze AE , Beer D , Mazibuko SE, Muller CJ , Roux C, Willenburg EL. et al. Assessing similarity analysis of chromatographic fingerprints of Cyclopiasubternata extracts as potential screening tool for in vitro glucose utilization.Analytical and Bioanalytical Chemistry2015; 408(2):639-649.
Joubert E, Richards ES, Merwe JD, Beer D, Manley M, Gelderblom WC. Effect of species variation and processing on phenolic composition and in vitro antioxidant activity of aqueous extracts of Cyclopiaspp. J Agric Food Chem. 2008 ;56(3):954-63.
 DudhiaZ,LouwJ,Muller C, JoubertE, Beer D, KinnearC, C. Pheiffer,CyclopiamaculataandCyclopiasubternata(honeybush tea) inhibits adipogenesis in 3T3-L1 pre-adipocytes, Phytomed. Int. J. Phytother. Phytopharm. 2013; 20:401–408.
 Pheiffer C, Dudhia Z, Louw J, Muller C, Joubert E. Joubert, Cyclopiamaculata (honeybush tea) stimulates lipolysis in 3T3-L1 adipocytes. Phytomedicine. 2013;20(13):1168-71.
 Muller CJF, Joubert E, Gabuza K, Beer D, Fey SJ, Louw J. Assessment of the antidiabetic potential of an aqueous extract of honeybush (Cyclopia intermedia) in streptozotocin and obese insulin resistant wistar rats, in: I. Rassoli (Ed.),Phytochem. 2011;113-332.
 Meydani M, Hasan ST. Dietary polyphenols and obesity, Nutrients .2010;2:737–751.
 Wang S, Moustaid N, Moussa L, ChenH Mo, Shastri A, Su R. et al.Novel insights of dietary polyphenols and obesity, J. Nutr. Biochem. 2014; 25:1-18.
 Abdel-Sattar E, Mehanna E, Ghaiesh SH, Mohammad MFH, Elgendy HA. et al.Pharmacological Action of a Pregnane Glycoside, Russelioside B, in Dietary Obese Rats: Impact on Weight Gain and Energy Expenditure.FrontPharmacol. 2018; 9: 990.
 Kim JH, Kang SA, Han S, Shim I, Comparison of the antiobesity effects of the protopanaxadiol?and protopanaxatriol?type saponins of red ginseng, Phyther. Res. 2009; 23:78- 85.
 Sharma S, Hatware K, Deshpande A, Karri S, Dande P. ntiobesity potential of fresh cow urine and its distillate - a biomedicine for tomorrow, Indian J. Pharm. Educ. Res. 2017; 51: 712- 721.
 RomieuI,Dossus L, Barquera S, BlottiereH.M,Franks P. W, Gunter M.et al. Energy balance andobesity: what are the main drivers? Cancer Causes Control 2017; 28:247–258.
 Jo J, Gavrilova O, Pack S, Jou W, Mullen S, Sumner AE et al.Hypertrophy and/or hyperplasia: dynamics of adipose tissue growth, PLoSComput. Biol. 2009; 5:(3): e1000324.
 Kim S M, Lun M, Wang M, Senyo SE, Guillermier C, Patwari P. et al. Steinhauser, Loss of white adipose hyperplastic potential is associated with enhanced susceptibility to insulin resistance, Cell Metab. 2014;20: 1049–1058.
 Sun K, Kusminiski CM, Scherer PE. Adipose tissue remodeling and obesity, J.Clin. Invest.2011;121; 2094- 2101.
 Boutens L, Stienstra R, Adipose tissue macrophages: going off track during obesity,
Diabetologia. 2016; 59: 879- 894.
 Morris DL, Singer K, Lumeng CN, Lumeng, Adipose tissue macrophages: phenotypicplasticity and diversity in lean and obese states,Curr. Opin. Clin. Nutr. Metab.Care. 2011;341–346.
 CintiS,Mitchell G, Barbatelli G, Murano I, Ceresi E, Faloia E, et al.Adipocyte death defines macrophage localization and function in adipose tissue of obese mice and humans, J. Lipid Res.
 Bahceci M, Gokalp D, Bahceci S, Tuzcu A, AtmacaS,ArikanS.The correlation between adiposity and adiponectin, tumor necrosis factor ?, interleukin-6 and high sensitivity C-reactive protein levels. Is adipocyte size associated with inflammation in adults? J. Endocrinol. Invest.2007; 30:210–214.
 Lumeng CN, SaltielAR.Saltiel, Inflammatory links between obesity and metabolic disease, J. Clin. Invest. 2011;121: 2111 – 2117.
 Jung U J, Choi MS. Obesity and its metabolic complications: the role of adipokinesand the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease, Int. J. Mol. Sci. 2014;15:6184–6223.
 ChoeSS,Huh JY, Hwang IJ, Kim JI, Kim JB. Adipose tissue remodeling: its role in energy metabolism and metabolic disorders Front. Endocrinol.2016;7:30.
 Guri AJ, Bassaganya-Riera J. Systemic effects of white adipose tissue dysregulation and obesity-related inflammation, Obesity 2011;19:689–700.
 YangH,RalleM,Wolfgang MJ, DhawanN,Burkhead JL, Rodriguez S.et al. Copper-dependent amino oxidase 3 governs selection of metabolic fuels in adipocytes, PLoS Biol. 2018;16: e2006519.
 Balkau B, Valensi P, Eschwege E, Slama G. A review of the metabolic syndrome. Diabetes & Metabolism.2007;33:405-413.
 Lumeng CN, SaltielAR.Inflammatory links between obesityand metabolic disease. The Journal of Clinical Investigation. 2011; 121:2111-2117.
 Rutkowski JM. The cell biology of fat expansion. The Journal of Cell Biology. 2015; 208:501-512.
 Palou A, Bonet ML, Pico C,Rodriguez AM. Nutrigenomics and obesity. RevistadeMedicina de la Universidad de Navarra. 2004; 48:36-48.
 Singh B, Arora S, Goswami B, Mallika V. Metabolic syndrome: A review of emerging markets and management. Diabetes and Metabolic Syndrome: Clinical Research and Reviews.2009;3:240-254.
 Sugii S. PPAR? activation in adipocytes is sufficient for systemic insulin sensitization. Proceedings of the National Academy of Sciences.2009;106:22504-22509.
 Rodgers JT. Metabolic adaptations through the PGC-1 alpha and SIRT1 pathways. FAEBLetters. 2008; 582:46-53.
 Yu YH, Ginsberg HN. Adipocyte signaling and lipid homeostasis:Sequelae of insulin resistant adipose tissue. Circulation Research.2005;96:1042-1052.
 Havsteen BH. The biochemistry and medical significance of the flavonoids. Pharmacol. Ther. 2002; 96:67–202.
 Middleton E, Kandaswami J, Theoharides C. The effects of plant flavonoids on mammalian cells:Implications for inflammation, heart disease, and cancer. Pharmacol. Rev. 2000; 52, 673–751.
 Prasad S, Phromnoi K, Yadav VR, Chaturvedi MM, Aggarwal BB.Targeting inflammatory pathways by flavonoids for prevention and treatment of cancer. Planta Med. 2010; 76, 1044–1063.
 Castellarin SD, Gaspero. Transcriptional control of anthocyanin biosynthetic genes in extreme phenotypes for berry pigmentation of naturally occurring grapevines. BMC Plant Biol. 2007;7, 46.
 Barnes S,Prasain, J. Current progress in the use of traditional medicines and nutraceuticals. Curr. Opin. Plant Biol. 2005; 8: 324–328.
 Prasain J, Carlson S, Wyss J. Flavonoids and age-related disease: Risk, benefits and critical windows. Maturitas2010; 66: 163–171.
 MiddletonE.Effect of Plant Flavonoids on Immune and Inflammatory Cell Function;Springer: Berlin,Germany, 1998; 175–182.
 Hossain MK, Choi HY, Hwang JS, Dayem AA, Kim JH, KimYBetal.Antiviralactivity of 3, 4’-dihydroxyflavone on influenza a virus. J. Microbiol. 2014; 52:521–526.
 Kumar S, Gupta A, Pandey AK. Calotropisprocera root extract has the capability to combat free radicalmediated damage. ISRN Pharmacol. 2013;9:691372.
Sen S, De B, Devanna N, Chakraborty R.Total phenolic, total flavonoid content, and antioxidant capacity of the leaves of MeynaspinosaRoxb., an Indian medicinal plant.Chin J Nat Med. 2013;11(2):149-57.
 Cook N, Samman S. Flavonoids—chemistry, metabolism, cardioprotective effects, and dietary sources.J. Nutr. Biochem. 1996; 7:66–76.
. Rice-evans CA, Miller NJ, Bolwell PG, Bramley PM, Pridham JB. The relative antioxidant activities ofplant-derived polyphenolic flavonoids. Free Radic. Res. 1995; 22: 375–383.
 Demontya I, Lamarchea B, Lamarchea Y, JacquesaH.Role of soy isoflavones in the hypotriglyceridemic effect of soy proteinin the rat.JNutrBiochem. 2002;13(11):671-677.
 Hwang JT, Park IN, Shin JI, Lee YK, Lee SK, Baik HW et al. Genistein, EGCG, and capsaicin inhibit adipocyte differentiation process via activating AMP-activated protein kinase.BiochemBiophys Res Commun. 2005;16;338(2):694-9.
 Rauter AP, Martins A, Borges C,Mota-Filipe H, Pinto R, SepodesB,etal.Antihyperglycaemic and protective effects of flavonoids on streptozotocin-induced diabetic rats. Phytother. Res. 2010;24: 133–138.
 Kim MS, Hur HJ, Kwon DY, HwangJT,Tangeretin stimulates glucose uptake via regulation of AMPKsignaling pathways in C2C12 myotubes and improves glucose tolerance in high-fat diet-induced obese mice.Mol. Cell. Endocrinol. 2012; 358:127–134.
 IkarashiN, Toda T, OkaniwaT, Ito K, OchiaiW, Sugiyama K, Anti-obesity andanti-diabetic effects of acacia polyphenol in obese diabetic KKAy mice fed high-fatdiet, Evidence-Based Complement, Altern. Med. 2011;1-10.
 Imran A, Butt MS, Arshad M. S, Arshad MU, Saeed F, SohaibM.Exploring the potential of black tea based flavonoids against hyperlipidemia relateddisorders, Lipids Health Dis. 17;2018: 57.
 Hostettmann K, Marston A. Saponins: Chemistry and Pharmacology ofNatural Products. Cambridge University Press, Cambridge, UK. 1996;59; (1):96-96
. Vincken JP, Heng L, de Groot A, Gruppen H, Saponins, classification and
occurence in the plant kingdom. Phytochemistry2007;68: 275–297.
 Guclu-Ustundag O, Mazza G, Saponins: properties, applications and processing. Crit. Rev. Food Sci. Nutr. 2007; 47:231–258.
 San Martin R, Briones R, Industrial uses and sustainable supply of Quillajasaponaria (Rosaceae) saponins. Econ. Bot. 1999; 53:302–311.
 Asl MN, Hosseinzadeh H. Review of pharmacological effects of Glycyrrhiza sp. and its bioactive compounds. Phytother. Res. 2008; 22:709–724.
 Xiang YZ, Shang HC, Gao XM, Zhang BL. A comparison of the ancient use of ginseng in traditional Chinese medicine with modern pharmacological experiments and clinical trials. Phytother. Res. 2008; 22:851–858.
 Sun SX, Li YM, Fang WR, Cheng P, Liu L. et al. Effect and mechanism of AR-6 in experimental rheumatoid arthritis. Clin. Exp. Med. 2010;10: 113–121.
 Cinatl J, Morgenstern B, Bauer G, Chandra P, Rabenau H, Doerr HW, Glycyrrhizin, an active component of liquorice roots, and replication of SARS associated coronavirus. Lancet 2003:361:2045–2046.
 Musende AG, Eberding A, Wood C, Adomat H, Fazli L, Hurtado Coll A.et al Pre-clinical evaluation of Rh2 in PC-3human xenograft model for prostate cancer in vivo: formulation, pharmacokinetics, biodistributionand efficacy. Cancer Chemother. Pharmacol. 2009; 64:1085–1095.
 Coleman JJ, Okoli I, Tegos GP, Holson EB, Wagner FF, Hamblin MR, et alCharacterization of plant-derived saponin natural products against Candida albicans. ACS Chem. Biol. 2010; 5:321–332.
ChenY, Miao Y, Huang L, Li J, Haiyan S, Zhao Y et al. Antioxidant activities of saponins extracted from Radix Trichosanthis: an in vivo and in vitro Evaluation. Chen et al. BMC Complementary and Alternative Medicine 2014; 14:86.
 EuCHA, Lim WYA, Ton SH, Kadir KA. Glycyrrhizic acid improved lipoprotein lipase expression, insulin sensitivity, serum lipid and lipid deposition in high-fat diet-induced obese rats. Lipids in Health and Disease 2010, 9:81
 Thiyagarajan P, Chandrasekaran C V, DeepakH B. Modulation of lipopolysaccharide-induced pro-inflammatory mediators by an extract of Glycyrrhiza glabra and its phytoconstituentsAmit Agarwal Inflammopharmacol 2011;19:235–241
 Kim JK, Oh S, Kwon HS, Oh YS, Lim SS, Shin HK. Anti-inflammatory effect of roasted licorice extracts on lipopolysaccharide-induced inflammatory responses in murine macrophages. Biochem.2006;345: 1215- 1223.
 Han LK, Zheng YN, Xu BJ, Okuda H, Kimura Y. Saponins from Platycodi Radix Ameliorate High Fat Diet–InducedObesity in Mice.J. Nutr. 2002; 132: 2241–2245.
 GuoL,ZiyangG,Zhang L, Guo F,Chen Y, Li Y. et al. Saponin-enriched sea cucumber extracts exhibit an antiobesity effect throughinhibition of pancreatic lipase activity and upregulation of LXR-? signaling.Pharmaceutical Biology.2015,54(8), 1312-1325.
 Khanbabaee K, Van.Ree T. Tannins: classification and definition. Natural Product Report 2001; (9); 18:641.
 De BruyneT, Pieters L, DeelstraH, Vlietinck A. Condensed vegetable tannins: biodiversity in structure and biological activities. BiochemSystEcol 1999;(27); 44:559.
 SieniawskaE. Activities of Tannins – from in Vitro Studies to Clinical Trials. Natural Product Communications2015;10(11):1877-1884.
Brillouet JM, RomieuCh, SchoefsB, Solymosi K, CheynierV, FulcrandH, et al. The tannosome is an organelle forming condensed tannins in the chlorophyllous organs of tracheophyta. Ann Bot Lond 2013;112(6):1003-14.
 Okuda T, Yoshida T, HatanoT, Ito H Ellagitannins renewed the concept of tannins. In: Quideau S, editor. Chemistry and biology of ellagitannins: an underestimated class of bioactive plant polyphenols. World Scientific; 2009;1-54.
 Okuda T, Ito H. Tannins of constant structure in medicinal and food plants hydrolyzable tannins and polyphenols related to tannins. Molecules 2011; 16:2191-217.
 SerranoJ, Puupponen-PimiR, Dauer A, Aura. AM, Saura-CalixtoF. Tannins: current knowledge of food sources, intake, bioavailability and biological effects. MolNutr Food Res 2009; 53:310-29.
 Okuda T. Systematics and health effects of chemically distinct tannins in medicinal plants. Phytochemistry2005; 66:2012-31.
 Tian Y, Zou B, LiCM, Yang J, Xu SF, Hagerman AE. High molecular weight persimmon tannin is a potent antioxidant both ex vivo and in vivo. Food Res Int2012; 45:26-30.
 Jerez M, Tourio S, SineiroJ, Torres JL, NuezMJ. Procyanidins from pine bark: relationships between structure, composition and antiradical activity. Food Chem2007; 104:518-27.
 Liu J, Peng Y, Yue Y, Shen P. Epigallocatechin-3-Gallate Reduces Fat Accumulation in Caenorhabditiselegans. and Yeonhwa Park Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA. Prev. Nutr. Food Sci. 2018;23(3):214-219.
 Han LK, Takaku T, Li J, Kimura Y, Okuda H.Anti-obesity action of oolong tea.International Journal of Obesity.1999;(23)98- 105.
 Cao ZN, Gu DH, Lin QY, Xu ZQ, Huang QC, Rap H et al.Effect of Pu-erh Tea on Body Fat and Lipid Profiles in Rats with Diet-induced Obesity. Phytother. Res.,2011;25, 234–238.
 Murase T, Nagasawa A, Suzuki J, Hase T, Tokimitsu I. Beneficial effects of tea catechins on diet-induced obesity: stimulation of lipid catabolism in the liver. International Journal of Obesity.Nature Publishing 2002; (26), 1459–1464.
MuraseT., Misawa. K., Minegishi Y., Aoki M., Ominami H., Suzuki Y., Coffee polyphenols suppress diet-induced body fat accumulation by downregulating SREBP-1c and related molecules in C57BL/6J mice Biological Science Laboratories, Kao Corporation, Tochigi, JapanAm J PhysiolEndocrinolMetab 2010;(13):122-133.
 Kar, A. Pharmacognosy and pharmacobiotechnology,2nd ed.; New Age International Ltd: New Delhi: 2003.
 Svendsen, A.B.,Verpoorte, R. Chromatography of alkaloids. Part A: thin-layer chromatography, vol. 23A.; Elsevier Scientific Publishing Company: Amsterdam_Oxford_New York,1983.
 Aniszewski, T.Alkaloidssecrets of life. Alkaloid chemistry, biological significance, applications and ecological role, 1sted.; Elsevier: Netherlands: 2007.
 IPCS, International Programme on Chemical Safety (WHO). Pyrrolizidine alkaloids.EnvironmentalHealthCriteria80.Geneva;http://www.inchem.org/documents/ehc/ehc/ehc080.htm; 198.
Kim KJ, Lee MS, Jo K, Hwang JK. Piperidine alkaloids from Piper retrofractumVahl. protect against high-fat diet-induced obesity by regulating lipid metabolism and activating AMP-activated protein kinase. BiochemBiophys Res Commun. 2011;411(1):219-25.
 Choi H, Eo H, Park K, Jin M, Park EJ, Kim SH, et al. A water-soluble extract from Cucurbita moschatashowsanti-obesity effects by controlling lipid metabolism in a high fatdiet-induced obesity mouse model.BiochemBiophys Res Commun. 2007;359:(3):419-25.
 Kim GN, Shin MR, Shin SH, Lee AR, Lee JY, Seo BI et al. Study of Antiobesity Effect through Inhibition of Pancreatic Lipase Activity of Diospyros kaki Fruit and Citrus unshiuPeel.BioMed Research International. 2016; 1723042:1-8.
HaazS, Fontaine KR, CutterG, Limdi N, Perumean-Chaney S, AllisonDB.Citrusaurantiumandsynephrine alkaloids in thetreatment of overweight and obesity: an update.Obes Rev. 2006 ;7(1):79-88.
 XuY, ZhangM, WuT, DaiS, XuJ, Zhou Z. Food Funct. The anti-obesity effect of green tea polysaccharidespolyphenols and caffeine in rats fed with a high-fat diet 2015;6(1):297-304.
BARNETT JR. Langenheim JH. Plant resins: chemistry, evolution, ecology, and ethnobotany. Ann Bot. 2004 Jun; 93(6): 784–785.
 PerveenA, JahanN, Abdul W, TanwirAM. Methods of processing of Lac (Laccifer lacca Kerr) described in Unani system of medicine. Res J Pharm Sci 2013;2(8):5-7.
 BohlmannJ., Keeling. CI. Terpenoid biomaterials. Plant J 2008; 54:656-69.
Mahendra P, Bisht S. Ferula asafoetida: Traditional uses and pharmacological activity.Pharmacogn Rev. 2012; 6(12): 141–146.
 Carvalho KM, Marine Filho JD, de Melo TS, Araújo AJ, Quetz S. et al. The Resin from Protiumheptaphyllum Prevents High-Fat Diet-Induced Obesity in Mice: Scientific Evidence and Potential Mechanisms. Evidence-Based Complementary and Alternative Medicine.2015;106157:13.
 Aziziani H, Rezvani E, Esmaeilidehaj M, Majid S, SadoughiBS.Anti-Obesity, Fat Lowering and Liver Steatosis Protective Effects of Ferulaasafoetida Gum in Type 2 Diabetic Rats: PossibleInvolvement of Leptin.iranian journal of diabetes and obesity. 2012; 4:(3):120 – 125.
 Yadav KD, Chaudhary AK. New world syndrome (obesity) gone by guggul: a review.jour. of ayurveda& holistic medicine2014; 9: 2.
Nammi S, Sreemantula S, Roufogalis BD. Protective effects of ethanolic extract of Zingiberofficinale rhizome on the development of metabolic syndrome in high-fat diet-fed rats.BasicClinPharmacolToxicol. 2009;104(5):366-73.
 Kim JH, Kim OK, Yoon HG, Park J, You Y. Anti-obesity effect of extract from fermented Curcuma longa L. through regulation of adipogenesis and lipolysis pathway in high-fat diet-induced obese rats. Food Nutr Res. 2016; 60: 10.34028.
 MohammedS,Ellulu, Patimah I, Khaza’ai H, Rahmat A, Abed Y.Obesity and inflammation: the linking mechanism and the complicationsArch Med Sci 2017; 13, (4): 851–863.
 Danesh J, Kaptoge S, MannAG. et al. Long-term interleukin- 6 levels and subsequent risk of coronary heart disease: two new prospective studies and a systematic review. PLoS Med 2008; 5:78.
 HanssonGK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005; 352: 1685-95.
 Sarvottam K, YadavRK. Adiponectin, interleukin-6, and endothelin-1 correlate with modifiable cardiometabolicrisk factors in overweight/obese men. J AlternComplementMed 2014; 20: 419-20.
 Chen SJ, Yen CH, Huang YC, Lee BJ, Hsia S, Lin PT. Relationships between inflammation, adiponectin, and oxidative stress in metabolic syndrome. PLoS One. 2012;7(9):e45693.
 AricanO, AralM, SasmazS, Ciragil P. Serum levels of TNF-alpha, IFN-gamma, IL-6, IL-8, IL-12, IL-17, and IL-18 in patients with active psoriasis and correlation with disease severity. Mediators Inflamm 2005;(5): 273-9.
 Trayhurn P, Wood I. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr2004;92: 347-55.
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