Download Echinacea

Purple Coneflower
Echinacea purpurea
Echinacea angustifolia
Echinacea pallida
Presented by: Henry Tran, Paul St. Romain, & Margaret Wells
Names of Echinacea




Family: Asteraceae Genus: Echinacea
Greek origin: echinos = sea urchin or hedgehog
Perennial Plant; 1-2ft. Tall, spiny appearance
AKA: American Coneflower, Black Sampson, Comb Flower, Echinacea
angustifolia, Echinacea pallida, Echinacea purpurea, Indian Head,
Purple Coneflower, Rudbeckia, Sampson Head, Scurvy Root,
Snakeroot, Helichroa (Rafinesque)
 Original genus name = Rudbeckia
 1794 Conrad Moench used Echinacea , but not adopted by the
scientific community until circa 1848
History of Echinacea
 Found in the U.S. & Canada
 Home: Great Plains Region (from Texas into Canada and from the
Rocky Mountains into Kentucky)
 Other States/Regions: CO, IL, IA, KS, KY, LA, MN, MO, MT, NE, NM,
ND, OK, SD, TX, WY; Canada (AB, MB,SK)
 Used by Native Americans (i.e. Blackfoot, Lakota, Choctaw,
Delaware, Cheyenne, Comanche, Sioux & Dakota)
 E. purpurea, E. angustifolia, and E. pallida
 Blackfoot & Lakota used E. angustifolia as toothache remedy
(isobutylamides found in root which creates numbing sensation)
Historical Uses
 E. purpurea used by Choctaw as cough medicine and as G.I. aid
 Delaware for venereal disease; Comanche use for sore throat &
toothache
 E. pallida used by western tribes (Cheyenne used it for antirheumatic, cold
remedy, & as dermatological aid; Decoction of the root as vermifuge & eye medicine; Sioux
use for analgesic properties & for snake bites)
 Used for a wide variety of conditions (18th,19th, early 20th by American
Settlers for infections and inflammation)
 First Written Record in 1762; Flora Virginica (John Clayton)
 Eclectic Physicians first to realize therapeutic benefits
of E. purpurea
 “Red Sunflower” in Dispensatory of Eclectic
Physcians in 1852; recommended use for patients
with syphilis
 Eclectic Physicians and Topical Wound Healing
(1950’s)
Introduction to Euro-American Society
 Dr. H.C. F. Meyer sent J.Lloyd (Lloyd Brothers Pharmaceuticals)
& Dr. J. King sample of root
 “Meyers Blood Purifier” in 1885
 1886 E. angustifolia arrives for Lloyd & King
 Lloyd sets out to negate claims via pharmaceutical tests
 Favorable results
 1887 King statement in The Eclectic Medical Journal
“…should it be found to contain only one-half the virtues he (H.C.
F. Meyer) attributes to it, it will form an important addition to our materia
medica.”
 Lloyd Pharmaceuticals; multiple products (creams, liquids & mouth wash);
Fermentation & Echafolta
Historical Uses Con’t.
 In 1910, decline in U.S. use began due to 3 reasons
 First = A. Flexner comparison study of allopathic vs.
faltering botanico-medical education
 Second = Direct results of antibiotics vs. general
immune response of Eichinacea species
 Third major reason = Hostility among practitioners
 Patentable antibiotics
 1916-1947 E. angustifolia & E. pallida root & rhizome
recognized by the U.S. National Formulary (NF)
 1910 only 47% of USP was based on medicinal plant
drugs
German Research & Commission E
 German equivalent to our FDA
 1920’s Gerhard Madaus; 1930’s to present extensive German
research (peaked in 80’s)
 Research done on common communicable diseases & immune
response
 Two varieties approved (E. Purpurea & E. Pallida, but not roots)
 Believed that E. Angustifolia is stronger (problem = no official clinical data
to support claim)
 PDR for Herbal Medicines states multiple uses (used as treatment for
common colds, bronchitis, UTI’s, mouth & pharynx inflammation, wounds, burns & weak
I.S.)
Active Components
 Polysaccharides
4-0-methylglucuronoarabinoxylan
Rhamnoarabinogalactin
 Polyacetylenes
 Alkylamides (echinaceine)
Parts Used & Administration
 Parts of plant that are used: aboveground roots, rhizome &
leaves
 In U.S. used as tea, squeezed (expressed) juice (alcohol and/or glycerin
based), capsules (herbal powder for URI), tincture (gargling &
swallowing), topically, & as an injection (not recommended in U.S.)
 In Germany many times administered intravenously along with
traditional medical treatments
 Dosage, type of administration, & duration of treatment vary in
patient care
Present Day & Future Hopes
 U.S. research peaked again in 1990’s to present
 DSHEA act & active research (NCCAM)
 Journal: Economic Medicinal Plant Research (through 1991; 360 studies on
Echinacea)
 Extremely Popular & Profitable
 Some studies show it does help I.S., “septic” conditions, &
increases hyaluronic acid when topically applied
 Echinacin ointment for inflammatory skin diseases
 Need more clinical trials & dosage specifications
 Hope of proving effectiveness on immune system
Research
Common Cold
 Cancer prevention
The Cold
What is it?
Symptoms
Duration
http://www.kennislink.nl/upload/115174_962_1091519871529-rhinovirus.jpg
Infection
Inhaled particles
Cold virus attachment
Infected
Incubation period: 8-12 hours
Peak of symptoms: 36-72 hours
Neat facts about colds
Infection rate
Being cold?
Feed a cold, starve a fever
Children
Research – Echinacea & the
Common cold
Is it effective?
Is it worth it?
Is it toxic?
Efficacy
Positive results
Reduced symptoms
and duration
Negative results
Not useful for
prevention
Why contradictory research?
Hard to quantitatively measure
symptoms
Psychological effects vary
Many different types of cold viruses
Preparations are not standardized
Meta analysis
Value
Significantly important difference – is
treatment worth it based on cost, effect
and duration of infection?
Echinacea: 2nd to Vitamin C – people
thought it would be worth it if it reduced
colds by 36.8 hours
Zinc and prescription in 60 to 90 hour
range
Reactions & Toxicity
 Could negatively affect patients with progressive systemic
diseases & autoimmune disorders (i.e. tuberculosis, lupus & connective
tissues disorders, HIV/AIDS), pregnant women & children under two
years of age
 Patients with asthma & atopy (genetic tendency to have allergic
reactions) are more susceptible
 According to NCCAM website; rare allergic reactions found to
be rashes, increased asthma and anaphylaxis
 Allergic reaction possible if person is allergic to plants in daisy
family (i.e. ragweed, chrysanthemums, marigolds & daisies)
 Gastrointestinal side effect most common in studies
Mode of Action
 Bioactive substances capable of stimulating innate immunity.
 What is the innate immune response?
 Nonspecific
Type
Mechanism
Chemical Mediators



Interfeurons induce anti-viral state in uninfected cells
Complement lyses facilitates phagocytosis
Toll-like receptors recognize microbial molecules; signal
secretion of immunostimulatory cytokines
Phagocytic Barriers


Various cells endocytose and break down foreign molecules
Specialized leucocytes digest and kill microorganisms
Inflammatory Barriers

Infection induces leakage of vascular fluid and influx of
phagocytes into infected issue
Macrophages stimulated to release cytokines and
chemokines that initiate inflammatory response
•
•
•
•
Cytokines cause dilation of local small blood vessels and changes in
endothelial cells
Lead to movement of leukocytes (neutrophils and monocytes) from to blood
vessels into the infected tissue
Leucocytes are guided by chemokines produced by macrophages
Blood vessels become more permeable, allowing plasma proteins and fluid to
leak into the tissues
Mode of Action cont.
Immune response ascribed to
polyssacharides
Study: Incubation of human macrophages
with purified polysaccharide:
Increased the motility of granulocytes and their cytotoxic
activity against staphylococci
Stimulated proliferation of human lymphocytes
Induced production of TNF-a, IL-1, and IL-6
Purified polysaccharides from E. purpurea induced
macrophage production of IL-1, IL-6, and TNF-a
Figure 8-22
Mode of Action, cont.
 Evidence supporting polysaccharide function of
extract:
 Augmented the phagocytosis of yeast particles or opsonized
zymosan by human granulocytes by 23% and 34%
 Intravenous treatment of mice:
 Mice injected with lethal doses of Candida albicans and Listeria
monocytogenes
 Treatment significantly increased survival rate of both healthy
and immunosuppressed mice.
Mode of Action, cont.
Akylamides from Echinacea:
Modulate TNF-a mRNA expression in human
monocytes and macrophages via the CB2
cannabinoid receptor
Bind to CB2 more strongly than endogenous
cannabinoids
Dodeca-2E,4E,8Z,10Z-tetrenoic acid isobutylamide (A1)
Docea-2E,4E-dienoic acid isobutylamide (A2)
Mode of Action, cont.
 Anti-inflammatory effects
 Lipoxygenase (LOX) and cyclooxygenase (COX) inhibition
 Polysaccharide fraction known to inhibit the action of the
enzyme hyaluronidase
 Echinacoside provides protective effect against free radical
induced degradation of collagen
Summary
Echinacea appears to activate non-specific
cellular and humoral immunity and the
complement system by increasing the
production and activity of:
Leukocytes
Granulocytes
Lymphocytes
Monocytes
Cytokines
Bibliography
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Echinacea. 2006 [cited 2006 04/23/06]; A database summarizing the research on various supplements.
Part of the site is member only.]. Available from:
http://supplementwatch.com/suplib/supplement.asp?DocId=1101&templateId=100.
Agnew, L.L., et al., Echinacea intake induces an immune response through altered expression of leucocyte
hsp70, increased white cell counts and improved erythrocyte antioxidant defences. J Clin Pharm Ther, 2005.
30(4): p. 363-9.
Barnes, J., et al., Echinacea species (Echinacea angustifolia (DC.) Hell., Echinacea pallida (Nutt.)
Nutt.,Echinacea purpurea (L.) Moench): a review of their chemistry, pharmacology and clinical properties. J
Pharm Pharmacol, 2005. 57(8): p. 929-54.
Barrett, B., et al., Using benefit harm tradeoffs to estimate sufficiently important difference: the case of the
common cold. Med Decis Making, 2005. 25(1): p. 47-55.
Barrett, B.P., et al., Treatment of the common cold with unrefined echinacea. A randomized, double-blind,
placebo-controlled trial. Ann Intern Med, 2002. 137(12): p. 939-46.
Borchers, A.T., et al., Inflammation and Native American medicine: the role of botanicals. Am J Clin Nutr,
2000. 72(2): p. 339-47.
Flannery, M.A. 1999. From Rudbeckia to Echinacea: The Emergence of the Purple Cone Flower in Modern
Therapeutics, Pharmacy in History, Vol. 41 (2):52-58
Flannery, M.A. 2004. Civil War Pharmacy: A History of Drugs, Drug Supply and Provision, and Therapeutics
for the Union and Confederacy. The Haworth Press, Inc, Binghamton, NY.
Goel, V., et al., Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common
cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther, 2004. 29(1): p. 75-83.
Jack M. Gwaltney, M., Frederick G. Hayden, MD Common Cold. 1999-2005 [cited 2006 04/23/06]; General
information over the common cold drawn from over 70 medical resources]. Available from:
http://www.commoncold.org/index.htm.
11.
12.
13.
14.
15.
16.
17.
Kim, L.S., R.F. Waters, and P.M. Burkholder, Immunological activity of larch
arabinogalactan and Echinacea: a preliminary, randomized, double-blind, placebocontrolled trial. Altern Med Rev, 2002. 7(2): p. 138-49.
Kligler, B., Echinacea. Am Fam Physician, 2003. 67(1): p. 77-80.
Linde, K., et al., Echinacea for preventing and treating the common cold. Cochrane
Database Syst Rev, 2006(1): p. CD000530.
Raduner, S., et al., Alkylamides from Echinacea are a new class of cannabinomimetics
- CB2-receptor dependent and independent immunomodulatory effects. J Biol Chem,
2006.
Sperber, S.J., et al., Echinacea purpurea for prevention of experimental rhinovirus
colds. Clin Infect Dis, 2004. 38(10): p. 1367-71.
Turner, R.B., et al., An evaluation of Echinacea angustifolia in experimental rhinovirus
infections. N Engl J Med, 2005. 353(4): p. 341-8.
Website: http://nccam.nih.gov/health/echinacea/#intro. 2005. Herbs at a Glance:
Echinacea. NCCAM Publication No. D271.