Effect of Dietary Supplementation of Rubus Sanctus (Wild Blackberry) Root Extract on Disease Prognosis in Graves' Disease: A Randomized Controlled Clinical Trial

Humanity has fought many battles for survival. One of the most important of these battles is the fight against disease. The imbalance between free radicals and antioxidants in the body leads to oxidative stress, which in turn contributes to a range of diseases, including autoimmune diseases. To avoid diseases that may arise from oxidative stress, it is recommended that individuals ensure they consume adequate amounts of antioxidants in their routine diet, avoid harmful habits that increase oxidant production, such as smoking and alcohol, exercise regularly, and get adequate sleep.

Since ancient times, various parts of plants have been used to treat illnesses. The blackberry plant, with its fruit, leaves, stem, and root, is considered one of these plant products. The blackberry plant belongs to the Rubus genus of the Rosaceae family. Rubus sanctus is the most common species in the Muğla region. Wild blackberries are strong, thorny shrubs that grow primarily in forests, vacant lots, and along roadsides. The fruit is usually black and edible. It is reported in the literature that extracts of the aboveground parts of the blackberry plant are used to heal infected insect bites and skin wounds, teas obtained from the plant roots are used in the autoimmune disease rheumatoid arthritis and to relieve pain, and extracts obtained from the leaves and roots are used in diarrhea due to their antimicrobial effects.

The beneficial health effects of blackberry root extract are attributed to its polyphenol content. The polyphenols found in blackberry root extract include the phenolic acids gallic acid, the flavonoids quercetin, apigenin, and catechins, the tannins ellagic acid, the terpenes triterpenes, including betulinic acid, which has anti-carcinogenic effects, and α-tocopherol.

Mice studies have determined that different doses of blackberry root extract have anti-inflammatory properties, promote wound healing and skin symptoms, and exhibit neuropharmacological effects. Another study reported that blackberry root extract exhibits antibacterial activity against Staphylococcus aureus. An in vitro study demonstrated that blackberry root (Rubus sanctus) extract possesses potential anticancer, antioxidant, anti-lipase, and α-amylase inhibitory activity. The study concluded that blackberry root extract may be a promising resource for applications in the functional food, nutraceutical, and pharmaceutical industries.

Autoimmune thyroid diseases are defined as a group of diseases in which the immune system targets and attacks the thyroid gland. These diseases include Hashimoto's thyroiditis and Graves' disease, and have two extreme clinical presentations. Both conditions are characterized by thyroid dysfunction, but they differ in their pathogenesis and clinical symptoms. There is evidence in the literature that the COVID-19 pandemic has led to an increase in autoimmune thyroid diseases. The global prevalence of autoimmune thyroid diseases varies depending on geographic, ethnic, and environmental factors. However, these diseases are considered a significant health problem worldwide and are, on average, 5-7 times more common in women. The prevalence of Graves' disease ranges from 0.5% to 1.0%.