MENTHODEX SUGAR FREE TRHOAT LOZENGES MINT MENTHOL & EUCALYPTUS

Indications

• Deodorization of body odors
• Management of halitosis (bad breath)
• Potential support in detoxification processes
• Wound healing support

Dosage

Children: Refer to the BNF for Children for appropriate pediatric dosing information.

Adults: Refer to the BNF for specific dosing recommendations as they can vary based on the indication and formulation used.

Mechanism of action

Chlorophyllin acts through various mechanisms, including the ability to chelate heavy metals and other toxins, enhancing their excretion from the body. It is thought to exert antioxidant effects by scavenging free radicals, thus protecting cells from oxidative damage. Additionally, chlorophyllin may promote wound healing and possess anti-inflammatory properties.

Pharmacodynamics

Chlorophyllin exhibits potential pharmacological effects such as antioxidant activity, detoxification, and antimicrobial properties. Its ability to chelate toxic substances contributes to its use in detoxification. The compound may also influence the gut microbiota, leading to improved gastrointestinal health. The pharmacodynamic effects can vary depending on the dosage and individual patient factors.

Pharmacokinetics

Chlorophyllin is poorly absorbed in the gastrointestinal tract, which limits systemic exposure. However, it may exert local effects in the intestines. The elimination half-life is not well-defined due to its non-systemic absorption. Its activity is primarily local, with some metabolites being excreted in urine and feces. The pharmacokinetics of chlorophyllin can be influenced by factors such as dosage form and the presence of food.

Pregnancy

There are no adequate and well-controlled studies in pregnant women. Chlorophyllin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Chlorophyllin is expected to be excreted in human milk. Caution should be exercised when administered to a nursing woman.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Chlorophyllin sodium copper complex oral tablets
• Chlorophyllin sodium copper complex liquid

Indications

• Acidulant in food and beverages
• Preservative in pharmaceutical formulations
• pH adjuster in various chemical preparations

Dosage

Children: Refer to product-specific guidelines for appropriate dosing based on formulation and indication.

Adults: Refer to product-specific guidelines for appropriate dosing based on formulation and indication.

Mechanism of action

Citric acid acts by chelating metal ions, which can enhance the solubility of certain compounds and improve their bioavailability. It also contributes to the acidity of the environment, which can influence enzymatic activity and metabolic pathways, particularly in the degradation of citronellol.

Pharmacodynamics

Citric acid exhibits mild pharmacological effects primarily attributed to its role in metabolic processes. It aids in the regulation of pH levels, which can impact enzymatic reactions and biochemical pathways. The acid's chelating properties may help to reduce the toxicity of certain metal ions in biological systems.

Pharmacokinetics

Citric acid is rapidly absorbed after oral administration and is metabolized in the liver. It undergoes conversion to various metabolites in the citric acid cycle, contributing to energy production. The elimination primarily occurs through urine, with minimal accumulation in the body.

Pregnancy

Citric acid is generally regarded as safe during pregnancy when used in food amounts. However, consult a healthcare provider for advice on medicinal use.

Breast-feeding

Citric acid is considered safe during breastfeeding when consumed in food amounts. For medicinal use, consult a healthcare provider.

Storage

Store in a cool, dry place away from direct sunlight.

Indications

• Muscle rehabilitation
• Muscle strengthening
• Pain relief
• Post-operative recovery
• Prevention of muscle atrophy
• Athletic training

Dosage

Children: Use in children should be determined by a healthcare professional. Refer to the device manual and consult with a clinician for appropriate settings and duration.

Adults: Dosage is device-specific and depends on the training program or rehabilitation protocol. Refer to the device manual for guidance on settings and duration of use.

Mechanism of action

Compex devices function by delivering electrical impulses to the motor nerves, which in turn stimulate muscle contractions. This mimics the natural process of muscle activation, leading to increased blood flow, reduced muscle soreness, and improved muscle strength and endurance through neuromuscular stimulation.

Pharmacodynamics

The pharmacodynamic effect of Compex devices involves the enhancement of muscle contractility and increased neuromuscular efficiency. The electrical stimulation can lead to an increase in muscle protein synthesis, improved muscle tone, and enhanced recovery from injury or exercise-induced fatigue.

Pharmacokinetics

As Compex is not a pharmacological agent but a medical device, traditional pharmacokinetic parameters such as absorption, distribution, metabolism, and excretion do not apply. The effects of the electrical stimulation occur locally at the site of application and are contingent upon the parameters set within the device (e.g., frequency, intensity).

Pregnancy

Safety during pregnancy has not been established. Use only if potential benefits outweigh risks.

Breast-feeding

It is unknown whether this drug is excreted in human milk. Use with caution.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Indications

• Copper deficiency
• Occipital Horn Syndrome
• Menke's disease
• Contraception (via copper IUD)

Dosage

Children: Refer to the BNF for Children for specific dosing information.

Adults: Refer to the relevant clinical guidelines and BNF for specific dosing information.

Mechanism of action

Copper is absorbed from the gastrointestinal tract via high affinity copper uptake proteins and low affinity copper uptake proteins, likely being reduced to the Cu1+ form prior to transport. Inside enterocytes, it binds to the copper transport protein ATOX1, which facilitates its transport to copper transporting ATPase-1 on the Golgi membrane for incorporation into the Golgi apparatus. Once in systemic circulation, copper binds primarily to ceruloplasmin, albumin, and alpha 2-macroglobulin. It acts as a cofactor in a variety of oxidase enzymes and also influences sperm motility when released from copper IUDs, contributing to its contraceptive effect.

Pharmacodynamics

Copper is essential for the activity of many enzymes and plays a vital role in processes such as iron metabolism, neurotransmitter synthesis, and antioxidant defense. Copper ions, particularly when released from intrauterine devices, have been shown to decrease sperm viability, thereby impacting fertility.

Pharmacokinetics

Copper is absorbed from the gut and is predominantly transported in the plasma bound to proteins such as ceruloplasmin and albumin. The absorption efficiency can vary; however, a significant portion of dietary copper is usually absorbed. The body regulates copper levels through hepatic excretion and storage mechanisms, ensuring homeostasis. Excess copper can lead to toxicity, while deficiency results in various health issues.

Pregnancy

Copper is considered essential during pregnancy, but excessive intake should be avoided due to potential toxicity.

Breast-feeding

Copper is excreted in breast milk, and adequate maternal intake is important for infant development.

Storage

Store in a cool, dry place, away from moisture and heat.

Indications

• Respiratory infections
• Cough and cold symptoms
• Sinusitis
• Bronchitis
• Muscle pain and inflammation

Dosage

Children: Refer to specific product guidelines or consult a healthcare professional for appropriate dosing of eucalyptus oil in children, as it varies based on formulation and indication.

Adults: Refer to specific product guidelines or consult a healthcare professional for appropriate dosing of eucalyptus oil, as it varies based on formulation and indication.

Mechanism of action

Eucalyptus oil contains compounds such as eucalyptol (1,8-cineole) that exhibit antimicrobial properties. It acts on the respiratory system by promoting bronchodilation and reducing mucus production. The oil also has a cooling effect, which can provide relief from symptoms of respiratory distress. Additionally, the oil's anti-inflammatory properties help decrease inflammation in the airways.

Pharmacodynamics

The primary active ingredient in eucalyptus oil, eucalyptol, interacts with the body's inflammatory response and can modulate the activity of neurotransmitters involved in pain signaling. It may enhance mucociliary clearance in the respiratory tract, facilitating the expulsion of mucus and pathogens. The analgesic effects can help relieve discomfort associated with respiratory infections.

Pharmacokinetics

Eucalyptus oil is typically administered via inhalation or topical application. When inhaled, components like eucalyptol are absorbed through the mucous membranes of the respiratory tract and rapidly distributed throughout the body. The oil is metabolized primarily in the liver, and its metabolites are excreted in urine. The half-life of eucalyptol varies but is generally short, necessitating frequent dosing for sustained effects.

Adverse effects

• Allergic reactions
• Skin irritation
• Nausea
• Vomiting
• Diarrhea
• Dizziness

Interactions

• May interact with anticoagulants, potentially increasing bleeding risk
• May enhance the effects of other medications that cause sedation

Precautions

• Use with caution in individuals with asthma or other respiratory conditions
• Avoid use in young children without medical supervision
• Eucalyptus oil should not be ingested in large quantities due to toxicity

Pregnancy

Eucalyptus oil is generally considered unsafe in pregnancy due to potential toxicity and should be avoided unless prescribed by a healthcare professional.

Breast-feeding

Caution is advised when using eucalyptus during breastfeeding, as it may pass into breast milk and could affect the infant.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Eucalyptus oil (topical, inhalation, or oral preparations)
• Eucalyptus leaves (dried for teas or extracts)

Indications

• Cough relief
• Sore throat
• Wound healing
• Skin irritation
• Digestive issues

Dosage

Children: For children over 1 year of age, a common dosage is 1 to 2 teaspoons of honey for cough relief. Honey should not be given to children under 1 year due to the risk of botulism.

Adults: For cough relief, a common recommendation is to take 1 to 2 tablespoons of honey, as needed. Honey can be taken directly or mixed with warm water or herbal teas.

Mechanism of action

Honey exhibits various mechanisms of action, including its antibacterial and anti-inflammatory properties. The high sugar concentration creates a hypertonic environment that inhibits the growth of bacteria. Additionally, honey contains hydrogen peroxide, methylglyoxal, and flavonoids that contribute to its antimicrobial effects. The antioxidant properties of honey help in mitigating oxidative stress and promoting wound healing.

Pharmacodynamics

The pharmacodynamics of honey involve its ability to promote healing and provide symptomatic relief from coughs and sore throats. Honey's viscosity and stickiness can coat the throat, providing a soothing effect and reducing irritation. Its natural sugars also serve as an energy source, while its antioxidants may help in reducing inflammation and promoting overall health.

Pharmacokinetics

Honey is primarily absorbed in the gastrointestinal tract. The sugars in honey are rapidly metabolized, providing quick energy. The absorption rate can vary based on the composition of the honey and individual digestive factors. Honey's components, including vitamins and minerals, may also have varying rates of absorption depending on the specific nutrient and the individual's metabolism.

Adverse effects

• Allergic reactions in sensitive individuals
• Botulism in infants under 1 year

Precautions

• Should not be given to infants under 1 year due to the risk of botulism
• Use with caution in individuals with known allergies to bee products

Pregnancy

Generally considered safe for use in pregnancy, but should be consumed in moderation.

Breast-feeding

Considered safe for breastfeeding mothers and their infants over 1 year of age.

Storage

Store in a cool, dry place away from direct sunlight. Keep tightly sealed.

Formulations

• Raw honey
• Pasteurized honey
• Honey in various food products

Indications

• Used as a low-calorie sweetener in food products
• Suitable for sugar-free candies and chewing gum
• Recommended for individuals with diabetes or those managing weight

Dosage

Children: Similar to adults, isomalt is used in food products aimed at children, but specific dosing should align with dietary recommendations. Refer to the BNF for Children for further guidance.

Adults: Isomalt is generally used in food products and does not have a specific therapeutic dosing regimen. Refer to food product guidelines for usage amounts.

Mechanism of action

Isomalt affects calcium absorption in the intestine by directly interacting with the epithelial tissue, promoting the net transport of calcium across the intestinal epithelium. Studies suggest that isomalt, alongside other sugar alcohols, can influence calcium uptake from both the small and large intestine in vitro, potentially impacting mineral balance due to its binding properties with calcium.

Pharmacodynamics

Isomalt's pharmacodynamic profile is characterized by its low glycemic index and minimal impact on insulin levels, making it suitable for diabetic patients. Its ability to act as a non-cariogenic sweetener contributes to oral health, and it may play a role in calcium metabolism, although further research is required to fully understand its effects on dental remineralization.

Pharmacokinetics

Isomalt is poorly absorbed in the gastrointestinal tract, leading to its classification as a low-calorie sweetener. The unabsorbed portion can ferment in the colon, potentially leading to gastrointestinal symptoms in some individuals. It does not significantly affect blood glucose levels, which makes it suitable for use by individuals with diabetes. Isomalt's metabolism primarily involves fermentation by colonic bacteria.

Pregnancy

Isomalt is generally considered safe for use during pregnancy as it is a non-cariogenic sweetener and is not known to have harmful effects on fetal development.

Breast-feeding

Isomalt is also considered safe during breastfeeding, as it is not absorbed significantly in the gastrointestinal tract and is unlikely to affect breast milk.

Storage

Isomalt should be stored in a cool, dry place, away from direct sunlight and moisture to maintain its quality.

Formulations

• Sugar-free candy
• Chewing gum

Indications

• Digestive issues
• Nausea
• Headaches
• Muscle pain
• Respiratory conditions such as cough and nasal congestion

Dosage

Children: Refer to specific formulations and product guidelines for pediatric dosing, as formulations may vary and should be used with caution in children.

Adults: Refer to specific formulations and product guidelines for dosing, as mentha is available in various forms including teas, extracts, and topical applications.

Mechanism of action

Mentha species contain essential oils, primarily menthol and menthone, which exert their effects through several mechanisms. Menthol acts as a competitive antagonist of the transient receptor potential cation channel subfamily M member 8 (TRPM8), which is involved in the sensation of cold. This interaction provides a cooling sensation and can help alleviate pain. Additionally, menthol has been shown to have antispasmodic effects on smooth muscle, which may contribute to its use in digestive disorders.

Pharmacodynamics

The pharmacodynamic properties of mentha are attributed to its active constituents, particularly menthol. It exhibits analgesic, anti-inflammatory, and antispasmodic effects. The cooling sensation produced by menthol can also trigger the release of endorphins, which may enhance its analgesic properties. Furthermore, menthol can increase local blood flow, which aids in the relief of muscle tension and pain.

Pharmacokinetics

Mentha's pharmacokinetics can vary based on the method of administration (oral, topical, or inhalation). When ingested, menthol is rapidly absorbed in the gastrointestinal tract and metabolized in the liver. Peak plasma concentrations are usually achieved within 30 to 60 minutes. The elimination half-life of menthol is approximately 2 to 4 hours. Topically applied menthol may provide localized effects with minimal systemic absorption, reducing the risk of systemic side effects.

Adverse effects

• Allergic reactions
• Heartburn
• Nausea
• Vomiting
• Skin irritation

Interactions

• May interact with anticoagulants
• May affect the absorption of certain medications due to its effects on gastrointestinal motility

Precautions

• Use with caution in individuals with gastroesophageal reflux disease (GERD)
• Caution in patients with liver disease
• Avoid use in infants and young children due to potential respiratory issues

Pregnancy

Mentha is generally considered safe in food amounts, but high doses should be avoided due to potential effects on uterine contractions.

Breast-feeding

Mentha is likely safe in food amounts during breastfeeding, but high doses should be avoided due to potential effects on milk supply and infant health.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Essential oil
• Tea
• Extracts
• Capsules

Indications

• Topical analgesic for muscle and joint pain
• Cough suppressant in cough drops and lozenges
• Relief of minor throat irritation
• Cooling agent in various cosmetic and personal care products

Dosage

Children: Refer to BNF for Children for specific dosing guidelines, as doses may vary based on age and formulation.

Adults: For topical use, apply a thin layer to the affected area not more than 3 to 4 times daily. For cough drops, follow the product-specific instructions as per the formulation.

Mechanism of action

Menthol acts as an agonist for the transient receptor potential subtype M8 (TRPM8), a non-selective cation channel that is activated by cold temperatures. This activation leads to calcium influx in mast cells, inducing the release of histamine, which can trigger allergic responses such as urticaria, asthma, and rhinitis. Menthol's ability to induce histamine release via TRPM8 suggests potential therapeutic applications for TRPM8 antagonists in managing cold- and menthol-induced allergies.

Pharmacodynamics

Menthol produces a cooling effect by stimulating sensory neurons that convey cold sensations. It interacts with TRPM8 channels, leading to the activation of intracellular signaling pathways that can result in vasodilation and increased blood flow to the area of application. This cooling sensation can provide symptomatic relief in conditions characterized by pain or irritation.

Pharmacokinetics

Menthol is absorbed through the skin and mucous membranes, with systemic effects depending on the route of administration. Its bioavailability can vary, and it is metabolized primarily in the liver. The elimination half-life and excretion pathways have not been extensively characterized, but menthol is generally considered to have a rapid onset of action with effects lasting for a few hours.

Adverse effects

• Allergic reactions
• Urticaria
• Asthma
• Rhinitis
• Skin irritation

Precautions

• Use with caution in patients with known allergies to menthol or related compounds
• May exacerbate asthma in sensitive individuals

Pregnancy

There are no well-controlled studies of menthol in pregnant women. Menthol should be used during pregnancy only if clearly needed.

Breast-feeding

Menthol is excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Topical ointment
• Cream
• Liquid

Indications

• Digestive issues
• Nausea
• Headaches
• Respiratory conditions
• Oral hygiene
• Muscle pain relief

Dosage

Children: Dosage should be determined based on age and formulation. Consult specific product instructions and healthcare providers.

Adults: Dosage varies based on preparation and indication. For herbal formulations, refer to specific product guidelines.

Mechanism of action

The active compounds in mint, particularly menthol and menthone, exert their effects primarily through activation of the TRPM8 receptor, which is a cold and menthol receptor. This activation induces a cooling sensation and may provide analgesic effects. Menthol also acts as a smooth muscle relaxant, which can help alleviate gastrointestinal discomfort.

Pharmacodynamics

Mint exhibits various pharmacological effects, including carminative, antispasmodic, and mild analgesic properties. It is known to enhance gastric motility and reduce symptoms of irritable bowel syndrome (IBS). The menthol component may also exhibit mild anti-inflammatory properties and has been used in topical formulations for its cooling and soothing effects.

Pharmacokinetics

After ingestion, mint compounds are rapidly absorbed in the gastrointestinal tract. Menthol is metabolized primarily in the liver, undergoing conjugation. The elimination half-life of menthol is roughly 1-3 hours. The compounds are excreted mainly through urine, with a small percentage being exhaled as volatile constituents.

Adverse effects

• Allergic reactions
• Gastrointestinal disturbances
• Heartburn
• Headaches

Interactions

• May interact with medications that affect the liver enzymes responsible for its metabolism
• Potential interaction with antacids

Precautions

• Use with caution in individuals with gastroesophageal reflux disease (GERD)
• May cause allergic reactions in sensitive individuals

Pregnancy

Generally considered safe when used in food amounts. High doses should be avoided due to potential effects on uterine tone.

Breast-feeding

Generally safe in usual dietary amounts. Consult healthcare provider for concentrated supplements.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Fresh leaves
• Dried leaves
• Essential oil
• Teas

Indications

• Allergic rhinitis
• Urticaria
• Allergic conjunctivitis
• Anaphylactic reactions (as adjunctive therapy)

Dosage

Children: Refer to the specific prescribing information or guidelines for paediatric dosing.

Adults: Refer to the specific prescribing information or guidelines for adult dosing.

Mechanism of action

Piperata acts as a competitive antagonist of histamine at the H1 receptor. By binding to these receptors, it prevents histamine from exerting its effects, which include vasodilation, increased vascular permeability, and stimulation of sensory nerves. This mechanism is crucial in mitigating the physiological responses associated with allergic reactions.

Pharmacodynamics

The pharmacodynamic effects of piperata include the reduction of allergic symptoms through its antihistaminic properties. It also exhibits anticholinergic activity, which can contribute to its efficacy in reducing secretions and causing sedation. The onset of action typically occurs within 1 to 2 hours after administration, and the duration of action can last several hours, depending on the formulation and individual patient factors.

Pharmacokinetics

Piperata is well-absorbed from the gastrointestinal tract, with peak plasma concentrations occurring within 1 to 2 hours post-ingestion. It is metabolized primarily in the liver through cytochrome P450 enzymes, and its metabolites are excreted primarily via the urine. The elimination half-life is generally around 6 to 12 hours, although this can vary based on patient-specific factors, including age and liver function.

Pregnancy

Piperata is generally not recommended during pregnancy due to potential risks to the fetus and lack of sufficient safety data.

Breast-feeding

Piperata is not advised during breastfeeding as it may be excreted in breast milk and could affect the nursing infant.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Mechanism of action

Copper is absorbed from the gut via high affinity copper uptake protein and likely through low affinity copper uptake protein and natural resistance-associated macrophage protein-2. It is believed that copper is reduced to the Cu1+ form prior to transport. Once inside the enterocyte, it is bound to copper transport protein ATOX1 which shuttles the ion to copper transporting ATPase-1 on the golgi membrane which take up copper into the golgi apparatus. Once copper has been secreted by enterocytes into the systemic circulation it remain largely bound by ceruloplasmin (65-90%), albumin (18%), and alpha 2-macroglobulin (12%). Copper is an essential element in the body and is incorporated into many oxidase enzymes as a cofactor. It is also a component of zinc/copper super oxide dismutase, giving it an anti-oxidant role. Copper defiency occurs in Occipital Horn Syndrome and Menke's disease both of which are associated with impaired development of connective tissue due to the lack of copper to act as a cofactor in protein-lysine-6-oxidase. Menke's disease is also associated with progressive neurological impairment leading to death in infancy. The precise mechanisms of the effects of copper deficiency are vague due to the wide range of enzymes which use the ion as a cofactor. Copper appears to reduce the viabilty and motility of spermatozoa. This reduces the likelihood of fertilization with a copper IUD, producing copper's contraceptive effect. The exact mechanism of copper's effect on sperm are unknown. The reason for the less severe reaction when the foreign body is at a distance from the retina has been proposed to be ... that near the retina & its blood vessels there is greater oxygen tension than at a distance, which causes metallic copper to oxidize to toxic copper compounds more rapidly close to or in contact with the retina than at a distance. Furthermore, the abscess formation that is characteristic of copper undergoing oxidation close to the retina & choroiod can be attributed to attraction of polymorphonuclear leukocytes from these nearby vascular tissues, which become heavily infiltrated. Liquefaction & disorganization of the vitreous body has been explained on the basis of copper catalysis of oxidation of ascorbic acid, leading to depolymerization of the hyaluronic acid of the vitreous humor. Changes in protein & hexosamine content have also been related to decrease in viscosity of the vitreous humor. Increased content of amino acids in the vitreous humor has been consistent with proteolysis of the vitreous body, but decreased concentration in the aqueous humor has suggested suppression of secretion of amino acids by the ciliary body under the influence of copper.

Pharmacodynamics

Copper is incorporated into many enzymes throughout the body as an essential part of their function. Copper ions are known to reduce fertility when released from copper-containing IUDs.

Mechanism of action

/Investigators/ compared the effect of a variety of sugar alcohols on calcium absorption from the rat small and large intestine in vitro. An Using chamber technique was used to determine the net transport of Ca across the epithelium isolated from the jejunum, ileum, cecum, and colon of rats. The concentration of Ca in the serosal and mucosal Tris buffer solution was 1.25 mM and 10 mM, respectively. The Ca concentration in the serosal medium was determined after incubation for 30 min and the net Ca absorption was evaluated. The addition of 0.1-200 mM erythritol, xylitol, sorbitol, maltitol, palatinit, or lactitol to the mucosal medium affected net Ca absorption in the intestinal preparations. Differences in Ca transport were observed between portions of the intestine, but not between sugar alcohols tested. /The authors/ concluded that sugar alcohols directly affect the epithelial tissue and promote Ca absorption from the small and large intestine in vitro. Isomalt is a non-cariogenic sweetener, which is widely used in sugar-free candy and chewing gum. Little is known about the effects of Isomalt on de- and remineralization. Binding between calcium and Isomalt has been reported, which could affect the mineral balance. The objective of this study was to examine the effects of Isomalt on de- and remineralization of bovine enamel lesions, both in vitro and in situ. In in vitro study, subsurface enamel lesions were subjected to 3-weeks pH-cycling. Treatments were 5-min rinses with 10% Isomalt solutions daily and 10% Isomalt additions to re- or demineralizing solutions. Standard pH-cycling conditions were used with a 0.2 ppm fluoride background during the remineralization phase. In in situ study, subsurface lesions were exposed 2 months in vivo and brushed three times daily with 10% Isomalt containing toothpaste. Treatment effects were assessed by chemical analysis of the solutions (in vitro) and transversal microradiography (in vitro and in situ). In in vitro study, while 5-min rinses with 10% Isomalt gave slightly increased remineralization, continuous presence of 10% Isomalt (in re- or demineralizing solutions) inhibited both de- and/or remineralization. This lead to significantly smaller overall mineral loss when Isomalt was added during demineralization. In in situ study, remineralization enhancement during short Isomalt treatments was confirmed. Isomalt had a positive effect on the de/remineralization balance when given under conditions relevant to practical use. ... Reports from authoritative bodies and reviews indicates that the decrease in pH in plaque as a consequence of metabolic acid production by saccharolytic bacteria when exposed to fermentable carbohydrates (i.e. sugars and starches) may promote demineralization and prevent remineralization of the hydroxyapatite crystals. Tooth hydroxyapatite crystals are very resistant to dissolution at neutral pH, but their solubility drastically increases as pH drops. Typically, the critical pH for dental enamel is around 5.5. ... Demineralization of tooth tissues can also occur as a result of consumption of dietary acids in foods or beverages, and that frequent consumption can lead to dental erosion. Xylitol, sorbitol, mannitol, maltitol, lactitol, isomalt, erythritol, D-tagatose, isomaltulose, sucralose and polydextrose are slowly metabolized by bacteria in the mouth. The rate and amount of acid production from these food constituents is significantly less than that from sucrose. ... Xylitol, sorbitol, mannitol, maltitol, lactitol, isomalt, erythritol, D-tagatose, isomaltulose, sucralose and polydextrose do not promote dental caries because they do not lower plaque pH to the level associated with enamel demineralization. ... A cause and effect relationship has been established between the consumption of sugar-containing foods/drinks at an exposure frequency of four times daily or more and an increased tooth demineralization, and that the consumption of foods/drinks containing xyl

Mechanism of action

Exposure to low temperatures often causes allergic responses or urticaria. Similarly, menthol, a common food additive is also known to cause urticaria, asthma, and rhinitis. However, despite the obvious clinical implications, the molecular mechanisms responsible for inducing allergic responses to low temperatures and menthol have not been determined. Because a non-selective cation channel, transient receptor potential subtype M8 (TRPM8) is activated by cold and menthol, we hypothesized that this channel mediates cold- and menthol-induced histamine release in mast cells. Here, we report that TRPM8 is expressed in the basophilic leukemia mast cell line, RBL-2H3, and that exposure to menthol or low temperatures induced Ca(2+) influx in RBL-2H3 cells, which was reversed by a TRPM8 blocker. Furthermore, menthol, a TRPM8 agonist, induced the dose-dependent release of histamine from RBL-2H3 cells. When TRPM8 transcripts were reduced by siRNA (small interfering RNA), menthol- and cold-induced Ca(2+) influx and histamine release were significantly reduced. In addition, subcutaneous injection of menthol evoked scratching, a typical histamine-induced response which was reversed by a TRPM8 blocker. Thus, our findings indicate that TRPM8 mediates the menthol- and cold-induced allergic responses of mast cells, and suggest that TRPM8 antagonists be viewed as potential treatments for cold- and menthol-induced allergies. /DL-Menthol/ Menthol's characteristic cooling sensation is due, in part, to the activation of sensory neurons generally termed transient receptor potential (TRP) channels, in particular transient receptor potential melastatin family member 8 (TRPM8) and transient receptor potential subfamily A, member 1 (TRPA1). Menthol acts upon TRPM8 receptors by rapidly increasing intracellular calcium and mobilizing calcium flux through the channels to induce cold response signals at the application site. Aside from its cold-inducing sensation capabilities, menthol exhibits cytotoxic effects in cancer cells, induces reduction in malignant cell growth, and engages in synergistic excitation of GABA receptors and sodium ion channels resulting in analgesia. /DL-Menthol/ In recent years, the transient receptor potential melastatin member 8 (TRPM8) channel has emerged as a promising prognostic marker and putative therapeutic target in prostate cancer. We have found that forced overexpression of TRPM8 in PC-3 cells can inhibit the cell proliferation and motility probably through the TRPM8 activation. In this study, we aimed to investigate whether activating the TRPM8 channel by its selective agonist menthol can inhibit the proliferation and motility of androgen-independent prostate cancer (AIPC) with remarkable expression of TRPM8. Menthol is a naturally occurring compound, which has been widely used in cosmetics and pharmaceutical products, and also as flavoring in food. DU145 cells are androgen-independent but have a remarkable expression of TRPM8. The demonstration of the existence of TRPM8 and the absence of TRPA1 in DU145 cells provided the foundation for the following experiments, because both TRPM8 and TRPA1 are molecular targets of menthol. The outcome of MTT assay indicated that menthol inhibited the cell growth (p < 0.01). Cell cycle distribution and scratch assay analysis revealed that menthol induced cell cycle arrest at the G(0)/G(1) phase (p < 0.01). Furthermore, menthol inhibited the migration of DU145 cells by downregulating the focal-adhesion kinase. So it suggests that the activation of the existing TRPM8 channels may serve as a potential and pragmatic treatment for those AIPC with remarkable expression of TRPM8, and menthol is a useful compound for future development as an anticancer agent. /DL-Menthol/