Stachys affinis Bunge, known as Chinese artichoke, is a perennial plant originating from China, which has uprising scientific interest due to its complex and beneficial content. Chinese artichoke is rich in bioactive compounds useful for human health, including antioxidants, polyphenols, and prebiotics, and its edible tubers are high in essential nutrients and dietary fiber. Studies show its potential as a functional food ingredient in various products like rice bars, bread, and chocolate, enhancing their nutritional and sensory properties. Additionally, Chinese artichoke exhibits significant anti-inflammatory, neuroprotective, and antibacterial activities, warranting further research and utilization in the food industry. This review aims to summarize the existing knowledge of the S. affinis Bunge plant, focusing on its health-promoting aspects.

Milk coagulation is a process used for the formulation of different dairy products such as cheese. In this process, milk undergoes changes in its chemical stability thanks to acidification or enzymatic reactions. Traditionally, milk coagulation has been carried out with rennet of animal origin, but recently, the research of new types of rennet such as microbial rennet and vegetable rennet has increased. This study aims to present an organized review of the most relevant information on lactic coagulation, its relationship with vegetable rennets, and the importance of the botanical genus Cynara in the extraction of vegetable rennets, focusing on the coagulant potential of artichoke (Cynara scolymus). We conducted this literature review and found that lactic coagulation and vegetable rennets are linked through the enzymatic activity of the latter. The results of the main studies demonstrated a strong relationship between vegetable rennets and protease enzymes as well as the presence of these enzymes in extracts of cardoon (Cynara scolymus) and artichoke (Cynara scolymus). In addition, studies highlight the presence of thistle extracts in artisanal cheese preparations in the Iberian Peninsula. Based on the results of the studies, a comparison between cheeses made with vegetable rennet and those made with traditional rennet was also carried out. Although the results show that the use of vegetable rennet in the manufacture of cheese can confer undesirable characteristics, the use of extracts from Cynara plants demonstrates that vegetable rennets have an industrial potential, especially the one obtained from artichoke (Cynara scolymus) due to its high availability. Nevertheless, specific studies are required for a better understanding and application of this rennet.

OBJECTIVE: A systematic review and meta-analysis was conducted to summarise studies conducted on the effects of artichoke supplementation on liver enzymes.
METHODS: Suitable studies were detected by searching online databases, including Medline, Embase, Cochrane Library, and Scopus databases, until 05 June 2021. As liver enzymes were reported in different units, standardised mean differences (SMD) were used and data were pooled using a random-effects model. Heterogeneity, publication bias, and sensitivity analysis were also assessed.
RESULTS: Pooled analysis, of eight clinical trials, revealed that artichoke supplementation significantly reduced the concentration of aspartate aminotransferase (AST) (P = .001) and alanine transaminase (ALT) (P = .016), in comparison with placebo. Subgroup analysis suggested that artichoke administration significantly reduces AST and ALT in patients with non-alcoholic fatty liver disease (P = .003 for AST and P < .001 for ALT), and ALT among overweight/obese subjects (P = .025).
CONCLUSIONS: Artichoke supplementation elicited significant reductions in liver enzymes, especially among patients with non-alcoholic fatty liver disease.

OBJECTIVE: Clinical trials considering the effects of artichoke supplementation on blood pressure have yielded different and contradictory outcomes. Thus, a systematic review and meta-analysis were performed to assess effects of artichoke administration on blood pressure.
METHODS: Related studies were detected by searching the Cochrane Library, PubMed, Embase and Scopus databases up to 15 March 2020. Weighted Mean Differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analyses, and publication bias were evaluated using standard methods.
RESULTS: Pooled analysis of eight randomized controlled trials revealed that artichoke supplementation did not have an effect on systolic blood pressure (SBP), (WMD: -0.77 mmHg, 95 % CI: -2.76 to 1.22) or diastolic blood pressure (DBP) (WMD: -0.11 mmHg, 95 % CI: -1.72 to 1.50) when compared to the placebo group. However, subgroup analyses based on health status suggested that artichoke administration among hypertensive patients may significantly reduce SBP (WMD: -3.19 mmHg, 95 % CI: -3.32 to -3.06) and DBP (WMD: -2.33 mmHg, 95 % CI: -2.23 to -2.43), but no such reduction was found in NAFLD patients. Furthermore, our results indicated that artichoke supplementation for 12 weeks led to a significantly decreased DBP (WMD: -2.33 mmHg, 95 % CI: -2.43 to -2.23), but 8 weeks of intervention did not (WMD: 0.80 mmHg, 95 % CI: -1.06 to 2.66).
CONCLUSIONS: Artichoke supplementation may potentially lead to SBP and DBP reduction in hypertensive patients. In addition, artichoke supplementation for 12 weeks may significantly improve DBP.

BACKGROUND: Studies on the efficacy of artichoke administration on anthropometric indices gave different outcomes. Hence, a systematic review and dose-response meta-analysis were accomplished to understand the effects of artichoke administration on anthropometric indices.
METHODS: Related clinical trials were found by searching in PubMed, Embase, the Cochrane Library and Scopus databases up to 29 February 2020. Weighted Mean Differences (WMD) were analyzed using a random-effects model. Heterogeneity, publication bias and sensitivity analysis were assessed for anthropometric indices.
RESULTS: Pooled analysis of 10 randomized controlled trials (RCTs) suggested that the artichoke administration has effect on waist circumference (WMD: -1.11 cm, 95 % CI: -2.08 to - 0.14), as opposed to the other anthropometric indices including weight (WMD: -0.62 kg, 95 % CI: -1.86 to 0.61) or BMI (WMD: -0.12, 95 % CI: -0.43 to 0.20). However, the analysis of the subgroups according to the health status showed that artichoke supplementation in hypertensive patients significantly reduced weight (WMD: -2.34 kg, 95 % CI: -3.11 to -1.57) but not the other indicators (WMD: -0.06 kg, 95 % CI: 0.78 to 0.67).
CONCLUSIONS: The artichoke supplementation has effect on the waist circumference, but not on the other anthropometric indices. For establishment of more accurate conclusion more studies with longer administration duration are need to be done.

OBJECTIVE: Cynara scolymus L. (common artichoke) and its products have been considered as potential phytotherapeutic agents for various conditions, such as cardiovascular, hepatic and gastric diseases, among others. Until now, the effects of artichoke and artichoke products administration on glycemic indices have not been sufficiently appraised. The present study evaluated the effects of artichoke and artichoke products administration on the glycemic indices.
METHODS: Clinical trials were identified in the Cochrane Library, PubMed, Embase and Scopus databases; to infinity until 15 March 2020. Weighted mean differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods.
RESULTS: Pooled analysis of nine Randomized controlled trials (RCTs), demonstrated that the administration of artichoke and artichoke products led to a significant reduced fasting blood sugar (FBS) (WMD: -5.28 mg/dl, 95 % CI: -8.95, -1.61; p = 0.005). However, other glycemic indeces including fasting insulin (WMD: -0.45 μIU/dL, 95 % CI: -1.14, 0.25; p = 0.20), HOMA-IR (MD: -0.25, 95 % CI: -0.57, 0.07; p = 0.12) or Hemoglobin A1c (HbA1c) (WMD: -0.09, 95 % CI: -0.20, 0.02; p = 0.09) did not alter after the administration of artichoke and artichoke products. A subgroup analysis comparing the kind of intervention, revealed that just the supplementation of artichoke and artichoke products, in a noco-supplementation form, was efficacy for the reduction of Homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: -0.52, 95 % CI: -0.85, -0.19; p = 0.002).
CONCLUSIONS: The supplementation of artichoke and artichoke products can significantly reduce the FBS concentrations in humans. Moreover, these outcomes suggested that just the supplementation of artichoke and artichoke products is more effective in the reduction of HOMA-IR levels than the co-supplementation form. However, additional clinical trials with longer study periods are necessitated to obtain a robust conclusion for producing new guidelines as part of a healthy diet.

Medicinal plants and their derivatives are human-friendly, nutritional supplements, and their use in the poultry industry is increasing today. Cynara scolymus is a very high-quality antioxidant medicine plant that has recently attracted the attention of poultry and nutrition researchers to supplement their rations and reduce feed costs. In the present study, the effect of powder and extract of C. scolymus on broilers has reviewed. This review shows that the impact of C. scolymus on production performance, carcass characteristics, liver enzymes activity, and meat characteristics of broiler chickens are not significant. However, the negative impact of this compound on these properties has not reported. Moreover, cholesterol levels reduced by the dietary C. scolymus supplementation. The impact of C. scolymus powder and extract on chickens\' broiler immunity was not significant in the cited literature, but dietary C. scolymus powder increases Newcastle antibody titers and lowers blood pressure. Dietary C. scolymus under heat stress increased anti-sheep red blood cell titers. No substantial studies have conducted on the effect of C. scolymus on broilers. Therefore, it is not possible to determine a single dosage for the use of C. scolymus powder or extract in broiler diets to the improvement of the broiler characteristics. More researches are needed to determining the appropriate dosage to achieve maximum performance.

Current evidence has shown antioxidant activity of artichoke as a potent source of antioxidant compounds. However, it seems that the antioxidant activity of artichoke has not yet been reviewed. Therefore, the present study was designed to perform a systematic review of human studies, animal models, and in vitro systems and to conduct a meta-analysis of animal studies on the antioxidant effects of artichoke. We searched four electronic databases till April 2018 using relevant keywords. All English language articles were assessed. For animal studies, standardized mean difference was pooled using a random effects model. The included studies were evaluated for eligibility and risk of bias. Thirty-nine articles (two human, 23 animal, and 14 in vitro studies) were reviewed. The results of in vitro systems supported the antioxidant effect of artichoke, whereas limited clinical trials indicated no change or a slight improvement of antioxidant status. Finding of animal studies indicated that artichoke extract supplementation increased superoxide dismutase, catalase, glutathione, and glutathione peroxidase level in liver, as well as, decreased malondialdehyde level in liver and plasma of animals with induced disease significantly compared with comparison group. This meta-analysis provided convincing evidence for antioxidant activity of artichoke in animals.

Cardiovascular disease is a highly prevalent issue worldwide, and one of its main manifestations, dyslipidaemia, needs more attention. Cooked artichoke (Cynara scolymus) hearts or artichoke leaf extract (ALE) are believed to be helpful in the treatment of dyslipidaemia. In this narrative review, we provide a brief overview of the potential impact of artichoke consumption on lipid profile. We appraised the Cochrane, MEDLINE and Web of Science databases, and included articles published between 2000 and June 2018 on intervention in humans only. The main potential of ALE administration observed on lipid profile relates to decreased serum LDL, total cholesterol and triglyceride concentrations, although no strong evidence for increasing HDL appears to exist. Evidence suggests that decreases of 8-49 mg/dL for LDL concentration, 12-55 mg/dL for total cholesterol, and 11-51 mg/dL for triglycerides, can be attributed to 2 to 3 g/d of ALE, in which its components luteolin and chlorogenic acid may play a key role. On the other hand, the effects of cooked artichoke hearts can be attributed mainly to its soluble fibres, particularly inulin. Despite the convincing evidence on its health benefits, additional long-term clinical trials are pivotal to fully elucidate the potential effects of ALE administration on positive cardiovascular outcomes.

Artichoke is a component of the Mediterranean diet. Therefore, the aim of this meta-analysis was to determine if artichoke extract supplementation affected human lipid parameters. The search included PubMed-Medline, Scopus, Web of Science and Google Scholar databases up to March 28, 2017, to identify RCTs investigating the impact of artichoke extracts on plasma lipid levels. Quantitative data synthesis was performed using a random-effects model, with weighed mean difference (WMD) and 95% confidence interval (CI) as summary statistics. Meta-analysis of data from 9 trials including 702 subjects suggested a significant decrease in plasma concentrations of total cholesterol (WMD: -17.6 mg/dL, 95%CI: -22.0, -13.3, p < 0.001), Low Density Lipoprotein-Cholesterol (LDL-C; WMD: -14.9 mg/dL, 95%CI: -20.4, -9.5, p = 0.011) and triglycerides (WMD: -9.2 mg/dL, 95%CI: -16.2, -2.1, p = 0.011). No significant alteration in plasma High Density Lipoprotein-Cholesterol (HDL-C) concentrations was observed (WMD: 1.0 mg/dL, 95%CI: -1.1, 3.1, p = 0.333). A significant association between the LDL-lowering effect of artichoke and baseline LDL-C concentrations (slope: -0.170; 95%CI: -0.288, 0.051; p = 0.005) was observed. Thus, supplementation with artichoke extract was associated with a significant reduction in both total and LDL-C, and triglycerides, suggesting that supplementation may be synergistic with lipid-lowering therapy in patients with hyperlipidemia.