Environmental Chemistry Letters
https://doi.org/10.1007/s10311-021-01373-x
EDITORIAL
River therapy
Valentina Roviello1
· Melinda Gilhen‑Baker2
· Giovanni N. Roviello3
· Eric Lichtfouse4
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021
The successive lockdowns of the coronavirus 2019 pandemic have substantially increased citizens will to escape
from the city and seek out nature for walking, cycling, swimming and other health-enhancing activities. While the heatlh
benefits of bathing in natural rivers is empirically known
since ancient times, wild swimming is actually booming as
never before, partly in response to the lockdowns imposed
by the coronavirus 2019 (COVID-19) pandemic. In the
United Kingdom, the vogue for taking a cold plunge can be
traced back to 1587 when a Cambridge don suggested using
pigs’ bladders for water wings (Macintyre 2021). In France,
king Henry IV (1553–1610), also known as the Green Gallant, enjoyed cold bathing in Paris, which marks the start
of wild swimming in the Seine river by a rising population
after 1600 (Duhau 2007). Humans benefit enormously from
the positive effects of clean rivers on human health. Good
quality river waters together with good biodiversity and a
riparian habitat structure all concur to create such a positive practice. There is quantitative evidence for the relaxing effect of the sounds made by rivers. Moreover, riparian vegetation can boost human immunity after inhalation
* Giovanni N. Roviello
giroviel@unina.it
Valentina Roviello
valentina.roviello@unina.it
Melinda Gilhen‑Baker
mgbaker@me.com
Eric Lichtfouse
eric.lichtfouse@gmail.com
1
Department of Chemical, Materials and Industrial
Production Engineering (DICMaPI), University of Naples
Federico II, Piazzale V. Tecchio 80, 80125 Naples, Italy
2
Faculty of Physical Medicine and Rehabilitation, Georgian
State Teaching University of Physical Education and Sport,
49, Chavchavadze avenue, 0162 Tbilisi, Georgia
3
IBB–CNR Mezzocannone Site and Headquarters, Istituto Di
Biostrutture E Bioimmagini, 80145 Naples, Italy
4
Aix-Marseille Univ, CNRS, IRD, INRA, CEREGE,
13100 Aix‑en‑Provence, France
of plant-emitted volatile organic compounds. River waters
carry plant metabolites that are known ingredients of traditional medicines which induce, among other beneficial
effects, antipsoriatic healing. Protecting river ecosystems
and improving water quality are therefore challenges worth
facing to improve psychological and physical wellness. Here,
we present scientific insights on river therapy, aimed at healing both psychological stress and physical disease.
Declining river health
Since early human history, rivers have been an essential
source of food and water, as well as a natural waterway for
transport. Rivers are a central feature of the planet ecology,
constituting a vital ecosystem for many species (Sadoff and
Grey 2002). Moreover, cultural and recreational uses of fluvial ecosystems such as walking, bathing, fishing and camping are now popular passtimes (Doi et al. 2013; Kistemann
et al. 2016). Such leisurely uses are only possible with good
aquatic health, which can be monitored by the abundance
and diversity of fish and other pollution-sensitive species
(Roviello and Roviello 2019). Indeed, there is a decline in
the recreational use of rivers when biodiversity and river
health decrease (Doi et al. 2013). Unfortunately, many river
ecosystems are actually highly degraded by urbanization,
industrialization and pollution (Heim et al. 2003; Terasaki et al. 2012; Wu et al. 2018). In urban areas, pollution
includes:
• eutrophication and faecal water contamination (Gecheva
and Yurukova 2013; Dsikowitzky et al. 2017),
• migration of pollutants from heating plants to river sedi-
ments (Samelak et al. 2019),
• water microplastic contamination (Wang et al. 2019),
• herbicide water contamination (Barek et al. 2009), and
• river sediment pollution by polycyclic aromatic hydro-
carbons (Barra et al. 2008).
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Environmental Chemistry Letters
Environmental pollution caused by algal and bacteria
blooms alters the recreational use of rivers by diminishing
water transparency and, in turn, conveying a negative visual
perception to inhabitants (Doi et al. 2013). Air pollution by
photochemical smog in the vicinity of highly polluted rivers
also degrades the health of human populations living along
the riverside (Juang et al. 2008; Feng et al. 2018).
River therapy
Populations who walk or live in natural forests or riparian
woodlands breathe beneficial volatile substances emitted
by plants. Such forest bathing induces positive effects on
the human immune system and has inspired the design of
green medical prescriptions (Roviello and Roviello 2021b,
2021a; Roviello et al. 2021; Robinson and Breed 2019).
Here, we present the benefits provided by pristine rivers
on human health from psychological and therapeutic perspectives (Fig. 1). Relaxing river sounds, biogenic volatile
organic compounds emitted by riparian vegetation and secondary plant metabolites found in river waters all concur to
improve human psychological and physical wellness. This
suggests the novel concept of river therapy, and highlights
the need for clean river preservation and pollution remediation in the case of highly contaminated rivers, especially in
densely populated urban areas.
Beneficial plant chemicals
We analyzed the literature for phytochemicals of biomedical
potential that are released into rivers from riparian vegetation or emitted from riverine plants as volatile compounds,
potentially inhalable by humans. Remarkably, many secondary plant metabolites, chemically heteroaromatic compounds, especially flavonoids and their glycosilated forms,
occur in river waters (Fig. 2, up) at concentrations up to
about 5 µg/L (Nanusha et al. 2020). These metabolites are
produced in large amounts depending on the plant species,
climate and environmental conditions. They control essential
plant functions such as growth and reproduction, and they
establish ecological and biological relationships with other
living organisms (Nanusha et al. 2020). The most abundant
metabolites are apiin from Apiaceae and Urtica dioica,
hyperoside from Hypericum species, Fraxinus excelsior and
Galanthus nivalis, and guanosine from Digitalis purpurea.
Living near polluted rivers increases diseases, e.g. by
inhalation of anthropogenic volatile organic compounds
such as 1,2-dibromo-3-chloropropane, hexachlorobutadiene
and 1,2-dibromoetane (Juang et al. 2008). By contrast, well
preserved riparian ecosystems offer residents health benefits
by releasing beneficial plant-emitted compounds which are
13
Fig. 1 Forest bathing refers to walking in forests to benefit from naturally healing cures such as breathing immunity-enhancing substances
emitted by plants, e.g. limonene. River therapy refers to walking near
or swimming in a river to benefit from naturally healing cures such as
water-soluble plant metabolites, e.g. apiin, and relaxing river sound.
Photo: copyright Eric Lichtfouse 2021, Ardèche river
inhaled. For instance, limonene, 3-carene and β-myrcene
were identified in the air near riparian shrubs (Khalaj et al.
2021).
Healing psoriasis with plant metabolites
Psoriasis is a chronically recurrent autoimmune inflammatory skin disease in which keratinocyte hyperplasia is
accompanied by inflammatory cell infiltration into the dermis and neovascularization, and affects more than 2% of
the global population (Wei et al. 2016). The main psoriasis
proteins studied, NF-κB, IL-17, and IL-3 can be targeted
by several plant-derived products including diterpenoids,
triterpenoids and hydroxycinnamic acids (Lo et al. 2019).
Interestingly, we found that some secondary plant metabolites such as isofraxidin which has been detected in river
waters (Fig. 2), are also ingredients of an effective antipsoriatic herbal drug that inhibits keratinocyte proliferation by
downregulating cyclin B2 (Wei et al. 2016).
Environmental Chemistry Letters
Fig. 2 Top: plant metabolites detected in river waters. In particular,
hyperoside, guanosine and apiin are among the most abundant (upper
box). Bottom: main biogenic volatile organic compounds emitted
by riparian vegetation. The most abundant limonene, 3-carene and
β-myrcene are shown in the lower box
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Environmental Chemistry Letters
Many antipsoriatic treatments are applied locally on the
skin surface as lotions, creams, shampoos and ointments
(Torsekar and Gautam 2017). Therefore, we hypothesize
that prolonged and repeated body exposure to secondary plant metabolites in river waters could treat psoriasis
and may even limit the secondary effects of the classical
administration (Zhang et al. 2019). The potential benefit of
apiin as antipsoriatic is supported by the fact that apigenin,
the product of acid hydrolysis of apiin, alleviates psoriasis
by improving skin functions (Park et al. 2020). Similarly,
quercetin, the hydrolysis product of hyperoside, exerts
in vitro and in vivo anti-inflammatory effects, indicating that
both flavonoids are promising antipsoriatic agents (Bonesi
et al. 2018).
Cold river waters could relieve the pruritus in chronic
plaque psoriasis. Indeed, under clinical conditions, low temperature water is effective in relieving the pruritus, while
conventional anti-pruritic therapies have only limited effects
(Stinco 2014). Moreover, river waters are used in India to
treat chronic psoriasis. Here, a study using Ganga river
waters reveals sustained benefits after four weeks of treatment, thus suggesting a therapeutic use of the river waters
(Jhunjhunwala and Waghralkar 2021).
Immunotherapy by inhaling volatile organic
compounds from riparian vegetation
Riparian shrubs emit various volatile compounds: monocyclic terpenes such as limonene and α-phellandrene, bicyclic terpenes including, 3-carene, camphene, α-pinene,
β-guaiene, caryophyllene and sabinene, and acyclic terpenes such as β-myrcene and β-ocimene (Khalaj et al. 2021).
Limonene accounts for more than 45% of the total amount
of these biogenic volatile organic compounds, followed by
3-carene, about 24%, and β-myrcene, about 18%. We suggest that these compounds from riparian vegetation have
health benefits similar to forest bathing (Mao et al. 2012).
Forest bathing consists of visiting green areas and walking
under the tree canopy to experience health benefits, mainly
on the body’s immune system (Li 2009). Forest bathing
induces positive effects that last several days after the trip
and increases natural killers activity, which leads to effects
on virus-infected cells. Furthermore, several volatile terpene compounds emitted by trees induce anti-inflammatory
responses, thus reducing respiratory system inflammation.
This may be of particular interest for the coronavirus 2019
pandemic (COVID-19)(Dai et al. 2021; Ufnalska and Lichtfouse 2021; He et al. 2021; Khan et al. 2021) caused by
SARS-CoV-2, as discussed in the literature (Roviello et al.
2021; Roviello and Roviello 2021a,b). Concerning riverside
forest bathing, the main volatile organic compound emitted
13
from riparian vegetation, i.e. limonene, is endowed with
immunomodulatory properties (Jin et al. 2008).
3-Carene is known for its antimicrobial properties, showing particularly strong antibacterial effects on both Grampositive Brochothrix thermosphacta and Gram-negative
Pseudomonas fluorescens bacteria. Indeed, 3-carene causes
bacterial membrane damage, DNA disruption and metabolic
perturbations, thus interfering in bacterial cellular functions (Shu et al. 2019). β-Myrcene, the third most abundant
volatile organic compound from riparian vegetation is an
antiparasitic drug. β-Myrcene was tested in vitro against
germinal cells, protoscoleces and murine cysts of Echinococcus granulosus, and in vivo as chemoprophylactic agent
in a murine model of cystic echinococcosis. Results showed
that β-myrcene displays antiparasitic activities, similarly to
albendazole, the standard drug for human echinococcosis
(Fabbri et al. 2018).
River sound therapy
Relaxation techniques give relief from negative conditions
including pain, stress, and anxiety. We searched the literature
for the possible use of river sound in psychological therapy. We found that river sounds are used as a background
in relaxation training systems based upon virtual reality
neurofeedback, developed to help people relax faster and
deeper (Gu and Frasson 2017). This relaxation training system induces a decrease of the anxiety and depression score,
a decrease in the time interval to relaxation and increases
the maximum meditation score. We also found that river
sound accompanied by relaxation exercises diminished pregnancy-related anxiety in pregnant women with a history of
perinatal loss (Duman et al. 2020). Watching a river also
relieves psychological stress. For instance, during the restoration phase at work in open-space offices, workers who saw
a video footage of a river including sound, rated themselves
as having more energy that officers who listened to office
noise (Jahncke et al. 2011).
References
Barek J, Cabalková D, Fischer J, Navrátil T, Pecková K, Yosypchuk
B (2009) Voltammetric determination of the herbicide Bifenox
in drinking and river water using a silver solid amalgam electrode. Environ Chem Lett 9(1):83–86. https://doi.org/10.1007/
s10311-009-0250-x
Barra R, Quiroz R, Saez K, Araneda A, Urrutia R, Popp P (2008)
Sources of polycyclic aromatic hydrocarbons (PAHs) in sediments
of the Biobio river in south central Chile. Environ Chem Lett
7(2):133–139. https://doi.org/10.1007/s10311-008-0148-z
Environmental Chemistry Letters
Bonesi M, Loizzo MR, Menichini F, Tundis R (2018) Flavonoids in
Treating Psoriasis. 281–294. https://doi.org/10.1016/b978-0-12-
805417-8.00023-8
Dai H, Han J, Lichtfouse E (2021) Smarter cures to combat COVID-19
and future pathogens: a review. Environ Chem Lett 19(4):2759–
2771. https://doi.org/10.1007/s10311-021-01224-9
Doi H, Katano I, Negishi JN, Sanada S, Kayaba Y (2013) Effects of
biodiversity, habitat structure, and water quality on recreational
use of rivers. Ecosphere 4 (8):art102. doi:https://doi.org/10.1890/
es12-00305.1
Dsikowitzky L, Schäfer L, Dwiyitno AF, Irianto HE, Schwarzbauer J
(2017) Evidence of massive river pollution in the tropical megacity Jakarta as indicated by faecal steroid occurrence and the
seasonal flushing out into the coastal ecosystem. Environ Chem
Lett 15(4):703–708. https://doi.org/10.1007/s10311-017-0641-3
Duhau I (2007) Les baignades en rivière d'Île-de-France: Des premiers
aménagements à la piscine parisienne Joséphine Baker. Livraisons d'histoire de l'architecture 14:9–38. https://www.persee.fr/
doc/lha_1627-4970_2007_num_14_1_1083
Duman M, DurgunOzan Y, AksoyDerya Y, TimurTaşhan S (2020) The
effect of relaxation exercises training on pregnancy-related anxiety
after perinatal loss: a pilot randomized control trial✰. Explore.
https://doi.org/10.1016/j.explore.2020.11.002
Fabbri J, Maggiore MA, Pensel PE, Albani CM, Denegri GM, Elissondo MC (2018) Could beta-myrcene be an alternative to albendazole for the treatment of experimental cystic echinococcosis?
Acta Trop 187:5–12. https://doi.org/10.1016/j.actatropica.2018.
07.013
Feng R, Wang Q, Huang C-c, Liang J, Luo K, Fan J-r, Zheng H-j
(2018) Ethylene, xylene, toluene and hexane are major contributors of atmospheric ozone in Hangzhou, China, prior to the 2022
Asian games. Environ Chem Lett 17(2):1151–1160. https://doi.
org/10.1007/s10311-018-00846-w
Gecheva G, Yurukova L (2013) Water pollutant monitoring with
aquatic bryophytes: a review. Environ Chem Lett 12(1):49–61.
https://doi.org/10.1007/s10311-013-0429-z
Gu G, Frasson C, 2017 Virtual Sophrologist: A Virtual Reality Neurofeedback Relaxation Training System 10512, 176-185 https://
doi.org/10.1007/978-3-319-67615-9_16
He S, Shao W, Han J (2021) Have artificial lighting and noise pollution caused zoonosis and the COVID-19 pandemic? A review.
Environ Chem Lett 19(6):4021–4030. https://doi.org/10.1007/
s10311-021-01291-y
Heim S, Schwarzbauer J, Kronimus A, Littke R, Hembrock-Heger A
(2003) Organic pollutants in riparian wetlands of the Lippe river
(Germany). Environ Chem Lett 1(3):169–173. https://doi.org/10.
1007/s10311-003-0040-9
Jahncke H, Hygge S, Halin N, Green AM, Dimberg K (2011) Openplan office noise: cognitive performance and restoration. J Environ
Psychol 31(4):373–382. https://doi.org/10.1016/j.jenvp.2011.07.
002
Jhunjhunwala B, Waghralkar R (2021) Observational case studies of
the effect of phage laden Ganga water on psoriasis. IP Indian J
Clin Exp Dermatol 7(3):186–190. https://d oi.o rg/1 0.1 8231/j.i jced.
2021.037
Jin K-S, Jun M-R, Park M-J, Ok S, Jeong J-H, Kang H-S, Jo W-K, Lim
H-J, Jeong W-S (2008) Promises and risks of unsaturated volatile
organic compounds: limonene, pinene, and isoprene. Food Sci
Biotechnol 17(3):447–456
Juang DE, Yuan CS, Hsueh SC, Chiou LJ (2008) Distribution of volatile organic compounds around a polluted river. Int J Environ Sci
Technol 6(1):91–104. https://doi.org/10.1007/bf03326063
Khalaj F, Rivas-Ubach A, Anderton CR, China S, Mooney K, Faiola
CL (2021) Acyclic terpenes reduce secondary organic aerosol
formation from emissions of a riparian shrub. ACS Earth Space
Chem 5(5):1242–1253. https://doi.org/10.1021/acsear thspacech
em.0c00300
Khan AH, Tirth V, Fawzy M, Mahmoud AED, Khan NA, Ahmed S,
Ali SS, Akram M, Hameed L, Islam S, Das G, Roy S, Dehghani
MH (2021) COVID-19 transmission, vulnerability, persistence
and nanotherapy: a review. Environ Chem Lett 19(4):2773–2787.
https://doi.org/10.1007/s10311-021-01229-4
Kistemann T, Schmidt A, Flemming H-C (2016) Post-industrial river
water quality–fit for bathing again? Int J Hyg Environ Health
219(7):629–642. https://doi.org/10.1016/j.ijheh.2016.07.007
Li Q (2009) Effect of forest bathing trips on human immune function.
Environ Health Prevent Med 15(1):9–17. https://doi.org/10.1007/
s12199-008-0068-3
Lo H-Y, Li C-C, Cheng H-M, Liu IC, Ho T-Y, Hsiang C-Y (2019) Ferulic acid altered IL-17A/IL-17RA interaction and protected against
imiquimod-induced psoriasis-like skin injury in mice. Food Chem
Toxicol 129:365–375. https://doi.org/10.1016/j.fct.2019.04.060
Macintyre (2021) BEN MACINTYRE 'The history of wild swimming'
Friday September 17 2021, The Times. https://www.thetimes.co.
uk/article/the-history-of-wild-swimming-kcm6svvwr
Mao G-X, Cao Y-B, Lan X-G, He Z-H, Chen Z-M, Wang Y-Z, Hu X-L,
Lv Y-D, Wang G-F, Yan J (2012) Therapeutic effect of forest bathing on human hypertension in the elderly. J Cardiol 60(6):495–502
Nanusha MY, Krauss M, Brack W (2020) Non-target screening for
detecting the occurrence of plant metabolites in river waters. Environ Sci Eur. https://doi.org/10.1186/s12302-020-00415-5
Park C-H, Min S-Y, Yu H-W, Kim K, Kim S, Lee H-J, Kim J-H, Park
Y-J (2020) Effects of apigenin on RBL-2H3, RAW264.7, and
HaCaT cells: anti-allergic, Anti-inflammatory, and skin-protective
activities. Int J of Molecular Sci 21(13):4620. https://doi.org/10.
3390/ijms21134620
Robinson JM, Breed MF (2019) Green prescriptions and their co-benefits: integrative strategies for public and environmental health.
Challenges 10(1):9
Roviello V, Roviello GN (2021a) Less COVID-19 deaths in southern
and insular Italy explained by forest bathing, Mediterranean environment, and antiviral plant volatile organic compounds. Environ
Chem Lett. https://doi.org/10.1007/s10311-021-01309-5
Roviello V, Roviello GN (2021b) Lower COVID-19 mortality in Italian forested areas suggests immunoprotection by Mediterranean
plants. Environ Chem Lett 19(1):699–710
Roviello V, Gilhen-Baker M, Vicidomini C, Roviello GN (2021)
Forest-bathing and physical activity as weapons against COVID19: a review. Environ Chem Lett. https:// d oi. o rg/ 1 0. 1 007/
s10311-021-01321-9
Roviello V, Roviello G (2019) Recent Records of the Eurasian Otter
(Lutra Lutra) in the Mercure-Lao River Valley, South Italy.
Sadoff CW, Grey D (2002) Beyond the river: the benefits of cooperation on international rivers. Water Policy 4(5):389–403
Samelak I, Balaban M, Antić M, Šolević Knudsen T, Jovančićević
B (2019) Geochromatographic migration of oil pollution from a
heating plant to river sediments. Environ Chem Lett 18(2):459–
466. https://doi.org/10.1007/s10311-019-00937-2
Shu H, Chen H, Wang X, Hu Y, Yun Y, Zhong Q, Chen W, Chen W
(2019) Antimicrobial activity and proposed action mechanism of
3-carene against brochothrix thermosphacta and pseudomonas
fluorescens. Molecules 24(18):3246. https://doi.org/10.3390/
molecules24183246
Stinco G, Trevisan G, Piccirillo F, Pezzetta S, Errichetti E, di Meo N,
Valent F, Patrone P (2014) Pruritus in chronic plaque psoriasis: A
questionnaire-based study on 230 Italian patients. Acta Dermatovenerologica Croatica 22(2):122
Terasaki M, Takemura Y, Makino M (2012) Paraben-chlorinated derivatives in river waters. Environ Chem Lett 10(4):401–406. https://
doi.org/10.1007/s10311-012-0367-1
13
Environmental Chemistry Letters
Torsekar R, Gautam M (2017) Topical therapies in psoriasis. Indian
Dermatol Online J 8(4):235. https://doi.org/10.4103/2229-5178.
209622
Ufnalska S, Lichtfouse E (2021) Unanswered issues related to the
COVID-19 pandemic. Environ Chem Lett 19(5):3523–3524.
https://doi.org/10.1007/s10311-021-01249-0
Wang Z, Qin Y, Li W, Yang W, Meng Q, Yang J (2019) Microplastic
contamination in freshwater: first observation in Lake Ulansuhai, yellow river Basin. China Environmental Chemistry Letters
17(4):1821–1830. https://doi.org/10.1007/s10311-019-00888-8
Wei J-a, Han L, Lu C-j, Zhao R-z, Sun J, Lu Y, Lin H-j (2016) Formula
PSORI-CM01 eliminates psoriasis by inhibiting the expression of
keratinocyte cyclin B2. BMC Complement Altern Med. https://
doi.org/10.1186/s12906-016-1234-6
Wu Y, Wang P, Yu S, Wang L, Li P, Li Z, Mehmood K, Liu W, Wu
J, Lichtfouse E, Rosenfeld D, Seinfeld JH (2018) Residential
13
emissions predicted as a major source of fine particulate matter
in winter over the Yangtze River Delta. China Environ Chem Lett
16(3):1117–1127. https://doi.org/10.1007/s10311-018-0735-6
Zhang Y, Xia Q, Li Y, He Z, Li Z, Guo T, Wu Z, Feng N (2019) CD44
Assists the topical anti-psoriatic efficacy of curcumin-loaded hyaluronan-modified ethosomes: a new strategy for clustering drug
in inflammatory skin. Theranostics 9(1):48–64. https://doi.org/
10.7150/thno.29715
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