Hemorrhoids are a common problem. The diagnosis and treatment can be challenging. Gastroenterologists have much to offer these patients. The purpose of this American Gastroenterological Association (AGA) Clinical Practice Update Expert Review is to provide best practice advice (BPA) covering the diagnosis and treatment of hemorrhoid disease.

Many insects manipulate plants by injecting effector proteins. In one extreme example of this molecular "hijacking", Hormaphis cornu aphids inject bicycle proteins into Hamamelis virginiana (Witch Hazel), contributing to the development of novel organs called galls. Bicycle proteins share no amino acid sequence similarity with proteins of known function. Here, we report the crystal structures of two divergent bicycle proteins. Both proteins contain saposin-like folds: one with multiple disulfide bonds exhibits a helix swap; the other has no disulfide bonds and possesses two tandem domains. To explore the structural evolution of bicycle proteins, we predicted bicycle protein structures with Alphafold2 (AF2). While AF2 did not recover the two experimental structures using existing databases, it succeeded after we provided multiple sequence alignments (MSAs) containing protein sequences encoded in new genome sequences from closely related aphid species. Using this customized approach at scale, we generated 2400 high-confidence predictions for bicycle proteins from seven aphid species. This dataset revealed that bicycle proteins without cysteines are outliers in fold space and appear to have evolved from ancestral proteins with disulfide-bonded saposin-like folds. While all bicycle proteins contain predicted saposin-like folds, they display a vast diversity of structural and physicochemical properties. While this diversity thwarts prediction of conserved functions encoded in structure, it suggests that bicycle proteins have evolved to target diverse plant processes and/or to evade plant immune surveillance.

The European Commission requested the EFSA Panel on Plant Health to prepare and deliver risk assessments for commodities listed in Commission Implementing Regulation (EU) 2018/2019 as 'High risk plants, plant products and other objects'. This Scientific Opinion covers plant health risks posed by rooted plants in pots of Hamamelis mollis imported from the United Kingdom (UK). The assessment was performed considering the available scientific information, including the technical information provided by the UK. All pests associated with the commodities were evaluated against specific criteria. Two EU regulated pests (Phytophthora ramorum non-EU isolates and Scirtothrips dorsalis), present in the UK and potentially associated with the commodity, were considered as relevant for this Opinion. No pests non-regulated in the EU were identified to be selected for further evaluation.

While experiments have explored shared predator effects on multiple prey, frequency-dependent foraging in natural settings remains understudied. We investigated whether predator learning induces negative frequency-dependent predation and associational effects among galls formed by two aphid species, Hamamelistes miyabei and H. betulinus, on Hamamelis japonica. Field observations revealed that rodent predation (mainly by Apodemus argenteus and Glirulus japonicus) shifted with the relative frequency of the two gall types: as the proportion of H. miyabei galls increased, predation on H. betulinus galls decreased. Laboratory experiments with A. argenteus showed that naive individuals exhibited no preference and consumed both gall types equally. However, after repeated exposure, they preferred H. miyabei galls due to higher foraging efficiency. This learned preference resulted from short handling time and higher predation efficacy on H. miyabei, while the more structurally complex H. betulinus galls conferred protection because of their lower predation efficiency. These findings suggest that gall structural complexity and predator learning interact to create associational effects that reduce predation on less frequent gall types. This mechanism may promote the coexistence of closely related galling aphids and maintain morphological diversity. Our results indicate that associational effects mediated by predator learning contribute to gall diversity by potentially creating novel ecological niches.

Hamamelis virginiana (witch hazel) is traditionally used in dermatology for its antibacterial and anti-inflammatory effects. However, the number of studies on its chemical composition and potentials in skin protection remains limited. This study aimed to investigate the qualitative and quantitative composition of polyphenolic compounds in the leaves and bark of the plant, as well as to explore their antioxidant, anti-inflammatory, and extracellular matrix (ECM)-protective activities in skin-relevant cell models. Human dermal fibroblasts and keratinocytes were exposed to oxidative and inflammatory stimuli and pretreated with leaf and bark extracts. ROS levels, antioxidant enzyme activity (SOD, GPx, CAT), pro-inflammatory cytokines (IL-6, IL-1β, TNF-α), and inhibition of collagenase, hyaluronidase, and elastase were assessed. Both extracts strongly reduced ROS levels, enhanced SOD activity, and significantly decreased pro-inflammatory cytokines. Bark extract also exhibited potent inhibitory activity against collagenase and elastase. UPLC-DAD-MS analysis revealed that both plant parts contained high levels of tannins; however, the leaf extract showed a more diverse composition, including more complex tannin forms and a significant amount of flavonoids from the quercetin and kaempferol class. In conclusion, H. virginiana leaf and bark extracts demonstrate multifunctional antioxidant and anti-inflammatory properties, supporting their potential use in cosmeceuticals and dermatological formulations targeting skin aging and inflammation.

Alcoholic liver disorder (ALD) is one of the most prevalent hepatic ailments worldwide, with oxidative stress and inflammation playing a vital role in disease progression. The current study intended to assess the anti-inflammatory nature of Hamamelitannin (HAM), a gallotannin from Hamamelis virginiana barks, which was predicted to possess anti-inflammatory properties based on in-silico docking analysis. To further explore its effects, we examined the therapeutic effect of HAM against ethanol-mediated inflammation using an in-vivo zebrafish larvae model. Ethanol exposure led to liver inflammation, oxidative stress, lipid accumulation, and hepatocyte apoptosis. However, our findings demonstrated that co-treatment with HAM significantly normalized the larvae's antioxidant enzymes such as SOD (35.81 U/mg protein), CAT (33.83 μ mol/mg protein) and GPx (33.35 U/mg Protein), nitric oxide (NO), lipid accumulation, reactive oxygen species (19.9%), cell death (15.43%), LPO (17.4%), and macrophage infiltration. A gene expression analysis was performed to gain deeper insights into ethanol-induced hepatotoxicity and the protective role of HAM. The results revealed that ethanol exposure led to the upregulation of Inflammation-inducing markers, including iNOS, TNF-α, COX-2, and IL-1β. In contrast, HAM co-treatment mitigated hepatocyte damage by effectively downregulating these inflammatory mediators. Collectively, these findings suggest that HAM exhibits promising hepatoprotective and anti-inflammatory properties, indicating its therapeutic potential for ALD and other inflammation-driven ailments.

Hamamelis virginiana L. (witch hazel) is a traditionally used medicinal plant, well-known for its dermatological applications. The plant's bark and leaves contain a rich array of bioactive compounds, including phenolic acids, flavonoids, catechins, proanthocyanidins, and tannins, many of which exhibit antimicrobial, anti-inflammatory, antioxidant, and wound-healing properties. These activities have been verified by numerous in vitro and in vivo studies, as well as limited clinical trials. The H. virginiana extracts have demonstrated effectiveness against bacteria, fungi, and some viruses. Moreover, the extracts exert anti-inflammatory effects by modulating cytokine expression and NF-κB signaling, improve skin regeneration, and protect against UV-induced damage and pollution. This review highlights H. virginiana as a complex botanical resource to be used in dermatology and cosmetology and shows that current research offers encouraging results for its future therapeutic use, especially in skin treatment.

Burns are severe injuries with significant medical and socio-economic impacts. For this purpose, a three-layer pH-responsive nanofibrous wound dressing was developed for burn treatment using the electrospinning method. The dressing consists of an external layer of polycaprolactone (PCL) nanofibers, a middle layer of hybrid PCL nanofibers and Hamamelis virginiana (HV) extract in chitosan/polyvinyl alcohol (CS/PVA) nanofibers, and an internal layer of hybrid PCL nanofibers and Diclofenac Sodium (DF) in CS/PVA nanofibers. The dressing was characterized through in vitro and in vivo analysis. The addition of DF and HV extract increased the nanofiber diameters to 170 nm and 157 nm, respectively. DF release was 63.8 % at alkaline pH, 73.7 % at neutral pH and 83.5 % at acidic pH, while HV release was 56.1 % at alkaline pH, 64 % at neutral pH and 87 % at acidic pH. All formulations maintained ≥85 % cell viability with low cellular adhesion and controlled release, suggesting potential for wound healing. Ultimately, in vivo experiments showed that HV/DF-loaded nanofibers achieved ∼98 % wound closure within 21 days, demonstrating superior healing in both visual and histological evaluations. Overall, the results suggest HV/DF-loaded nanofibers formulation as a potential treatment for burn wounds.

Excessive generation of free radicals disrupts redox equilibrium, inducing oxidative stress. Dementia and other related neurodegenerative illnesses are important ailments associated with oxidative stress. Antioxidant treatment proves effective in reducing oxidative stress and associated neurodegeneration. This study examined the therapeutic potential of Hamamelitannin, a hydrolyzable tannin derived from the barks of Hamamelis virginiana L., against the hydrogen peroxide-induced oxidative stress. Hamamelitannin (10-50 μM) had no effects on the hatching, heart rates, and also no lethal malformations were observed. Hammamelitannin exposure significantly (p < 0.05) improved the alterations in swimming behavior and the cognitive impairment caused by H2O2 in a concentration-dependent manner from 10 to 50 μM. It also showed significant restoration of antioxidant enzymes (SOD, CAT, GPx, GST, and GSH), and acetylcholinesterase activity was observed in larvae exposed to hydrogen peroxide compared to the control. Hamamelitannin lowered the MDA and nitric oxide levels in group treated with H2O2. The Cell death and intracellular ROS levels were assessed using acridine orange and dichlorofluorescein diacetate staining methods. Hamamelitannin significantly (p < 0.05) reduced apoptosis and ROS levels caused by hydrogen peroxide. Furthermore, Hamamelitannin upregulated the expression of antioxidant enzyme genes, indicating its potential in combating oxidative stress. These findings suggest that Hamamelitannin has substantial therapeutic value against neurological disorders associated with ROS accumulation.

Oxidative stress, caused by an imbalance between harmful prooxidants and the body's natural antioxidant defenses, plays a major role in the development of cancer. Plant-based compounds, especially polyphenols, are being widely explored for their ability to fight oxidative damage and support cancer therapy. Hamamelitannin (HAM), a natural gallotannin found in Hamamelis virginiana, has shown promising biological activity, but its effects on oxidative stress and cancer are not yet well understood. In this study, we explored the antioxidant and anticancer potential of HAM using a combination of laboratory experiments and computer-based analyses. HAM was found to scavenge free radicals effectively in several in vitro assays, including DPPH, ABTS, hydrogen peroxide, and superoxide tests. In liver cancer (HepG2) cells, HAM reduced cell viability and increased LDH release, suggesting its ability to induce cell damage selectively. It also boosted the activity of key antioxidant enzymes (SOD, CAT, GPx) and reduced oxidative stress. Gene expression analysis revealed that HAM promoted cancer cell death by increasing pro-apoptotic markers (Bax, caspase-3, caspase-9). Molecular docking showed strong interactions between HAM and several key proteins involved in oxidative stress and apoptosis, which were further supported by molecular dynamics simulations confirming stable binding. Together, these findings suggest that HAM can protect cells from oxidative damage while promoting cancer cell death, pointing to its potential as a therapeutic agent for oxidative stress-related diseases like liver cancer. Further in vivo studies are needed to fully understand its effectiveness and underlying mechanisms.

Hemorrhoids are an anorectal problem that is prevalent and commonly managed with corticosteroids, analgesics, and phlebotonics. These conventional treatments are, however, only temporary in serving relief and come with adverse side effects when used long-term. Alternative herbal remedies, created from traditional medicine with all the evidence of their pharmacological action, promise good results. The effectiveness of various botanicals with the potential of being anti-inflammatory, venotonic, astringent, antioxidant, and wound healing in alleviating hemorrhoidal symptoms is discussed in this review. Therapeutically notable plants such as witch hazel (Hamamelis virginiana), horse chestnut (Aesculus hippocastanum), and triphala have shown beneficial therapeutic effects on pain, bleeding, and swelling, as well as preventing recurrence. Moreover, Triphala Guggulu and Pilex are polyherbal formulations that offer synergistic benefits in addition to foods rich in polyphenols and the dietary compound, rutin. These promising findings have so far faced challenges related to the standardization, quality control, and clinical validation. The incorporation of these herbal therapies into clinical practice is a well-tolerated holistic approach to the management of hemorrhoids, which requires further investigation to gain evidence-based validation.