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Medicinal properties of Echinacea: A critical review
Abstract
Preparations from Echinacea purpurea are among the most widely used herbal medicines. Most uses of E. purpurea are based on the reported immunological properties. A series of experiments have demonstrated that E. purpurea extracts do indeed demonstrate significant immunomodulatory activities. Among the many pharmacological properties reported, macrophage activation has been demonstrated most convincingly. Phagocytotic indices and macrophage-derived cytokine concentrations have been shown to be Echinacea-responsive in a variety of assays. Activation of polymorphonuclear leukocytes and natural killer cells has also been reasonably demonstrated. Changes in the numbers and activities of T- and B-cell leukocytes have been reported, but are less certain. Despite this cellular evidence of immunostimulation, pathways leading to enhanced resistance to infectious disease have not been described adequately. Several dozen human experiments--including a number of blind randomized trials--have reported health benefits. The most robust data come from trials testing E. purpurea extracts in the treatment for acute upper respiratory infection. Although suggestive of modest benefit, these trials are limited both in size and in methodological quality. Hence, while there is a great deal of moderately good-quality scientific data regarding E. purpurea, effectiveness in treating illness or in enhancing human health has not yet been proven beyond a reasonable doubt.
... Increased total white blood cell count [72,73] Increased activity of T-lymphocytes, NK-cells, dendritic cells and macrophages [72,[74][75][76][77] Increased secretion of pro-inflammatory cytokines [72][73][74][75][76][77] Expectorant [71] Increased presentation of viral antigens by infected cells [73] Anti-inflammatory effects:Inhibition of COX-1, COX-2 and 5-LOX [72,73,76] Decreased viral binding [71,78] Increased antibody-dependent and innate NK-mediated activity [73] 3. ...
... Increased total white blood cell count [72,73] Increased activity of T-lymphocytes, NK-cells, dendritic cells and macrophages [72,[74][75][76][77] Increased secretion of pro-inflammatory cytokines [72][73][74][75][76][77] Expectorant [71] Increased presentation of viral antigens by infected cells [73] Anti-inflammatory effects:Inhibition of COX-1, COX-2 and 5-LOX [72,73,76] Decreased viral binding [71,78] Increased antibody-dependent and innate NK-mediated activity [73] 3. ...
... Increased total white blood cell count [72,73] Increased activity of T-lymphocytes, NK-cells, dendritic cells and macrophages [72,[74][75][76][77] Increased secretion of pro-inflammatory cytokines [72][73][74][75][76][77] Expectorant [71] Increased presentation of viral antigens by infected cells [73] Anti-inflammatory effects:Inhibition of COX-1, COX-2 and 5-LOX [72,73,76] Decreased viral binding [71,78] Increased antibody-dependent and innate NK-mediated activity [73] 3. ...
Reducing inappropriate antibiotic (AB) use by using effective non-antibiotic treatments is one strategy to prevent and reduce antimicrobial resistance (AMR). Andrographis paniculata (Burm. f.) Wall. ex Nees, Pelargonium sidoides DC., Echinacea species and a combination of ivy (Hedera helix L.), primrose (Primula veris L./Primula elatior L.) and thyme (Thymus vulgaris L./Thymus zygis L.) have promising clinical effects in uncomplicated, acute upper respiratory tract infections (URTI) treatment. However, mechanistic evidence of these herbal treatments is lacking. The objective of this Pstudy is to provide an overview of mechanistic evidence for these effects. Thirty-eight databases were searched. Included studies were mechanistic studies (in vitro, animal, and human studies and reviews) on these herbs; published before June 2021. Non-mechanistic studies or studies on combinations of herbs other than ivy/primrose/thyme were excluded. Furthermore, three experts in traditional, complementary and integrative healthcare (TCIH) research and pharmacognosy were interviewed to collect additional expert knowledge. The results show that A. paniculata acts through immunomodulation and antiviral activity, possibly supplemented by antibacterial and antipyretic effects. P. sidoides acts through antiviral, indirect antibacterial, immunomodulatory and expectorant effects. Echinacea species likely act through immunomodulation. The combination of ivy/primrose/thyme combines secretolytic and spasmolytic effects from ivy with antibacterial effects from thyme. Studies on primrose were lacking. This mechanistic evidence supports the difference-making evidence from clinical studies, contributes to evidence-based recommendations for their use in URTI treatment, and guides future mechanistic studies on URTI treatments.
... It has been widely studied in laboratory animals (Skaudickas et al., 2004;Jiang et al., 2014;Boyko & Brygadyrenko, 2016;Cadiz et al., 2019;Gutyj et al., 2022), and is also being continuously studied in humans for its potential clinical applications (Šutovská et al., 2015;Stevenson et al., 2016). Echinacea purpurea is used for various diseases: depression, mental and physical fatigue, tonsillitis, inflammatory diseases of internal organs, acute infectious diseases, wounds, ulcers and burns (Barrett, 2003;Barnes et al., 2005;Ali, 2008;Arafa, 2010;Hudson, 2012). Regardless of the extract type or preparation, E. purpurea is considered an immune response enhancer, and its main indications are the prevention and treatment of cold, flu, and infections of the upper respiratory tract or lower urinary tract (Sperber et al., 2004;De Rosa et al., 2019;Cheng et al., 2020). ...
... Only four main groups of compounds in echinacea preparations have been determined to stimulate the immune response: the phenylpropanoids related to caffeic acid derivatives (caftaric acid, cynarine, cichoric acid and echinacoside), the alkylamides (2-ene and 2,4-diene), glycoproteins and polysaccharides (Bauer, 1999;Dobrange et al., 2019). Among the described mechanisms of the immunomodulatory effect, the evidence is the activation of macrophages, polymorphonuclear leukocytes and natural killers, the ability to change the number and activity of T-and B-lymphocytes (Gurbuz et al., 2002;Barrett, 2003). The ability of E. purpurea to improve the immune function of the organism due to the activation of innate immune responses and the possibility of enhancing humoral immunity has also been studied (Hall et al., 2007). ...
... Preclinical studies have confirmed the hypothesis that Echinacea acts through immune mechanisms. A critical review by Barrett (2003) indicated that the ability of Echinacea extracts to activate macrophages, polymorphonuclear leukocytes and natural killers, as well as to increase the number of T-and B-lymphocytes. Echinacea purpurea extracts have also been clinically proven to be effective as anti-inflammatory agents only at the onset of upper respiratory symptoms; but long-term use of Echinacea preparations has not shown positive results (Block & Mead, 2003). ...
The impact of excess fat and high-calorie intake on the human body is an acute problem for many economically developed countries. Modelling the effects on the health of rats of supplementing their diet with crushed seeds of Echinacea purpurea (L.) Moench and Sylibum marianum (L.) Gaertn was carried out in a laboratory experiment. In the control group of animals, body weight increased by 700 mg/day, with the addition of E. purpurea seeds – by 1394 mg/day and with the addition of S. marianum seeds – by only 155 mg/day. A hypercaloric diet supplemented with E. purpurea caused a significant decrease in the relative weight of the liver, thymus, spleen, stomach, and brain. The supplementation with S. marianumseeds to the diet of animals significantly reduced only the relative weight of the thymus. Adding E. purpurea to the diet caused a strong increase in blood alkaline phosphatase activity, an increase in the cholesterol content, and a sharp increase in the atherogenic index. The seeds of S.marianumincreased the alkaline phosphatase activity, reduced the glucose concentration, and triglycerides, significantly reduced the atherogenic index and lowered the C-reactive protein concentration in the rats’ blood when compared with the control group. The seeds of E. purpurea contributed to an increase in the erythrocyte and lymphocyte number in the blood, and the seeds of S.marianum – to a decrease in the thrombocyte concentration. The research results show the possibility of wider use of S. marianumfruits as a dietary supplement in the diet of patients with hypertension and impaired liver function.
... Як відомо, в препараті Есберітокс присутні 7 груп біологічно активних речовин [7,10]: ...
... Також вона підсилює активність Т-клітин, збільшує синтез інтерлейкіна-2, прискорює диференціювання В-лімфоцитів [9]. Ефірна олія туї має виражену бактеріостатичну, фунгістатичну дію і противірусну активність [10]. ...
... Аналогічні результати були отримані в експериментах із застосуванням екстракту Thujae occidentalis [10,30]. Використання зазначених екстрактів не дозволяє однозначно стверджувати про їх виражену противірусну активність in vivo, оскільки терапевтичні дози значно нижчі, ніж ті, які досліджували в експериментах [13,15]. ...
Every year, influenza and other acute respiratory viral infections (ARVI) cause significant morbidity and mortality worldwide. Most people infected with respiratory viruses have an asymptomatic and uncomplicated course of the disease. ARVI is the most common infectious disease affecting all age groups. Among the causes of temporary loss of working capacity, they occupy the first place – even in the inter-epidemic period, 1/6 of the planet’s population is sick because of them. The objective: to analyse the efficacy of immunostimulating agent in treatment of ARVI on outpatient level. Materials and methods. 322 patients from 18 to 65 years old with symptoms of acute respiratory disease participated in the study. Patients were divided into two groups: 250 people who received symptomatic treatment were included in the control group, 72 patients who received symptomatic treatment and immunostimulating drug – in the experimental group. Results. The study showed that in the experimental group the average time for temperature normalization was 5.0 days, while in the control group it was 7.47 days (p<0.05); disappearance of headache occurs in 5.57 and 7.4 days respectively (p<0.05), disappearance of muscle pain – in 5.0 and 7.4 days (p<0.05). Conclusions. Non-specific drugs with wide spectrum of action are increasingly used in treatment of acute viral respiratory diseases, in particular, – remedies for stimulation of the immune response in the early stages of the disease, which can significantly shorten the period of fever and improve the general patients wellbeing. Timely treatment with immunostimulants can alleviate the severity and duration of clinical symptoms, help to avoid hospitalization and development of complications, reduce the burden on the outpatient department and use of antibiotics.
... 11 It has antiinflammatory and antioxidant properties, as well as anti-fungal, anticancer, and anti-viral properties. 12 It has wide therapeutic window of safety between the typical doses consumed orally (200 to 2000 mg in 50-80 kg adults = 2.5-40 mg/kg body wt.) and the estimated intravenous lethal dose of2500 mg/kg body wt. 12 In a human lymphocyte genotoxicity test, Echinacea showed no evidence of mutagenicity. 13 Echinacea used in coughs and colds, bronchitis, upper respiratory infections, gingivitis, influenza, canker sores, yeast infections, ear infections, vaginitis, some inflammatory conditions, HIV, and AIDS. ...
... 12 It has wide therapeutic window of safety between the typical doses consumed orally (200 to 2000 mg in 50-80 kg adults = 2.5-40 mg/kg body wt.) and the estimated intravenous lethal dose of2500 mg/kg body wt. 12 In a human lymphocyte genotoxicity test, Echinacea showed no evidence of mutagenicity. 13 Echinacea used in coughs and colds, bronchitis, upper respiratory infections, gingivitis, influenza, canker sores, yeast infections, ear infections, vaginitis, some inflammatory conditions, HIV, and AIDS. ...
... 13 Echinacea used in coughs and colds, bronchitis, upper respiratory infections, gingivitis, influenza, canker sores, yeast infections, ear infections, vaginitis, some inflammatory conditions, HIV, and AIDS. 12 Echinacea has an immune modulatory and immune stimulant activities in the skin which destroyed the warts. 14-16 Echinacea Purpurea (EP) roots combined with Echinacea Angustifolia (EA) could be used as a post-treatment for genital condylomatosis after destructive therapy with Co2 Laser. ...
Background:
Immunotherapy has emerged as a critical therapeutic tool for the treatment of warts. Immunotherapy for warts is currently restricted to recalcitrant lesions. A small number of regimens appear to be extremely effective. Furthermore, there is a scarcity of evidence-based research.
Objective:
Furthermore, in the majority of cases, their safety and effectiveness have not been evaluated in double-blind, controlled clinical trials, making the reproducibility of many of the listed treatments difficult to analyze and a possible placebo effect difficult to rule out.
Methods:
Analyzing and discussing different types of systemic immunotherapy. The different types of immunotherapy for warts are mentioned in this report.
Results:
Systemic immunotherapeutic modalities commonly used in the treatment Echinacea, propolis, oral retinoids, glycyrrhizinic acid, levamisole, cimetidine, and zinc sulfate have all been reported as effective treatment modalities for different types of warts.
Conclusion:
Immunotherapy has emerged as one of the most important therapeutic modalities for warts. Such treatment is required not only for recalcitrant or multiple lesions, but also in the majority of treated cases.
... Furthermore, it has been recognized to have minimum toxicity and side effects and is safe for a wide range of patients. [14,15] Its anti-inflammatory activity is performed through the downregulation of important inflammatory mediators such as TNF-α, IL-1 β, IL-6, IL-8, IFN-ɣ, and increased production of anti-inflammatory cytokines such as IL-4 and IL-10. [16][17][18] Even though OLP is one of the common inflammatory diseases of oral mucosa and the use of corticosteroids has various side effects in reducing pain and clinical symptoms of OLP, no study was found on use of Echinacea purpurea extract in the management of OLP. ...
... Different components of this herbal drug (including caffeic acid derivatives, phenols, chicoric acid, and polysaccharides) have been shown to play a role in immune-mediated pathways and therefore affect inflammation or oxidation processes. [14] For example, in a study conducted in 2005, topical Echinacea was administered on vocal fold injuries of animal subjects. The results of this study revealed that the healing of vocal fold wounds in the Echinacea group is accompanied by a more stable hyaluronan content compared with the control group. ...
Background:
Oral lichen planus (OLP) is a chronic immune-mediated mucocutaneous disorder, with an unknown etiology. Since, both pain and discomfort are observed in patients with the erosive type, many drugs have been studied to alleviate pain and clinical symptoms. The present study aimed to assess the effectiveness of systemic Echinacea on clinical indices of OLP.
Materials and methods:
In this randomized, double-blind, placebo-controlled trial, 70 patients with erosive OLP were randomly divided into two groups, and each was treated with Echinacea tablets or placebo, 3 times a day, for 35 days. In addition, betamethasone lotion (0.1%) or nystatin (100,000 units) mouthwash were used by patients. The pain severity (visual analog scale [VAS]), lesion size, and the number of lesions were assessed at baseline and on days 10, 25, and 35 after study initiation. Finally, the obtained data were analyzed by statistical software, and Mann-Whitney test, Wilcoxon test, KaplanMeier, Chi-squared, and paired t-test.
Results:
The VAS scores in the Echinacea group were significantly reduced at each visit compared to the placebo group (P < 0.001). We observed a significant difference between the two groups (P < 0.01).
Conclusion:
We showed that Echinacea is an effective and complementary therapy for OLP. Furthermore, in short-term usage, Echinacea is almost completely tolerable.
... Widely referred to as coneflowers, the herbaceous purple-petalled flowering plants of the genus Echinacea are from the aster family (Asteraceae) [1]. These plants are native to North America, where they frequently grow in regions ranging from dry to wet prairies and open wooded areas. ...
... These plants are native to North America, where they frequently grow in regions ranging from dry to wet prairies and open wooded areas. They have since been naturalised in Europe [1]. Out of nine echinacea species, only three have been used for medicinal purposes: Echinacea angustifolia, Echinacea purpurea, and Echinacea pallida [2,3]. ...
... Due to caffeic acid derivatives of Echinacea Purpurea in the "İmmunal" drug, it destroys herpes and influenza viruses. Thus, the main mechanism of biologically active substances action in the preparation is as follows: the drug regulates the phagocytic activity of granulocytes and macrophages, as well as increases the number of lymphocytes in the human body, thereby destroying microorganisms.This drug increases the number of granulocytes, as well as activates the reductoendothelial system of the liver [20]. İt regulates the synthesis of Tlymphocytes and granulocytes, increases the activity of Tsuppressors;regulates the synthesis of interferon. ...
... The first flacon was no longer used. At next step, a new portion of alcohol extractant (20) ml was poured to the second flacon and kept for a day. After this period, this extract (50 ml) from flacon III is filtered into a receiver. ...
One of thepressing issues facing the sciencetists of pharmacy field in medicine is the preparation of complex syrups rich in a of biologically active substances for the treatment of the immune system diseases. In recent years, Echinacea-based drugs have been successfully used in the immune system regulation. Especially in pediatric practice, Echinacea-based syrups are used as an optimal medicine. These remedy forms, namely syrups, are characterized by a high rate of absorption and excretionof the drug, affordability, painless administration and accurate dosing. At present, the main taste regulated oral liquid medicines are syrups. Taking into account the expected advantages of Echinacea syrup, we decided to conduct research in this field.We have developed a formula for obtaining a drug rich in healing substances based on Еchinacea using the following technology. First, echinacea roots were crushed and its extract obtained. Then the required amount of extractant was prepared in two versions: sucrose(saccharose) solution and separately-sorbitol solution. The required amount of Еchinacea extract was kept in a solution of saccharose and sorbitol. This allowed us to obtain 2 kind of syrups simultaneously: one for consumption by wide population (saccharose-based), the other one-sorbitol-based syrup for patients with glucose intolerance. The standardization indicators of both syrups, determined according to the State Pharmacopoeia, corresponded to the required standards.
... Another natural alternative treatment for acne is Echinacea, for which safety and efficacy have been reported in vivo for other skin lesions, including in wound healing [39,40]. Both antimicrobial and anti-inflammatory activity has been attributed to Echinacea. ...
... An in vitro study reported that Echinacea was able to inactivate C. acnes and inhibit the derived proinflammatory cascade. Echinacea was also reported to exhibit antioxidant activity [39][40][41], which could be useful to reduce the free radical production in acne. Thus, considering the in vitro and in vivo activities on different [18]. ...
Introduction:
Treatments other than topical and systemic antibiotics are needed to restore the dysbiosis correlated with acne onset and evolution. In this view, probiotics and botanical extracts could represent a valid adjunctive therapeutic approach. The purpose of this study was to test the efficacy of a dietary supplement containing probiotics (Bifidobacterium breve BR03 DSM 16604, Lacticaseibacillus casei LC03 DSM 27537, and Ligilactobacillus salivarius LS03 DSM 22776) and botanical extract (lupeol from Solanum melongena L. and Echinacea extract) in subjects with mild to moderate acne over an 8-week study period.
Methods:
Monocentric, randomized, double-blind, four-arm, placebo-controlled clinical study involving 114 subjects.
Results:
A significant (p < 0.05) effect on the number of superficial inflammatory lesions was reported over the study period in the subjects taking the study agent (group II) (-56.67%), the botanical extracts (group III) (-40.00%), and the probiotics (group IV) (-38.89%) versus placebo (-10.00%). A significant (p < 0.05) decrease in mean desquamation score, sebum secretion rate, and porphyrin mean count versus baseline was also reported, and the effect was most evident for group II. The analysis of log relative abundance after 4 and 8 weeks of treatment compared with baseline showed a significant (p < 0.01) decrease in Cutibacterium acnes and S. aureus, along with a contextually and significant (p < 0.05) increase in Staphylococcus epidermidis, especially in group II. No significant changes were reported for group I.
Conclusion:
The results from this study suggest that the administration of the dietary supplement under study was effective, safe, and well tolerated in subjects with mild to moderate acne and could represent a promising optional complement for the treatment of inflammatory acne as well as for control of acne-prone skin.
... Echinacea purpurea is the best known one of the genus Echinacea, known as common purple coneflower, characterized by erect main stems up to two meters in height, alternate leaves on long stalks, coarse hairs, and solitary spiny, reddish-orange flowers surrounded by purplish bracts. Echinacea purpurea is cultivated widely throughout the North Africa, United States, Canada and Europe, especially in Germany for its beauty and medicinal properties (Barrett, 2003 andMiller andYu, 2004).The phytochemical composition of Echinacea purpurea including polysaccharides, flavonoides, caffeic acid derivatives (chicoric acid), essential oils, polyacetylenes and alkylamides. The polysaccharides and chicoric acid are primary have an immunostimulatory effect (Ahmed et al., 2008;Kumar and Ramaiah, 2011). ...
... This improvement may be referred to the biological effectiveness derived from Echinacea purpurea root that had free radical scavenging and transition metal chelating properties (Izzo and Ernst, 2001). On other hand Echinacea preparation had biologic effectiveness through the destruction of peroxidation products and their toxic metabolites, also stabilization of the organism's antioxidant system state that caused by biologically active substances in its composition such as polyphenols, flavonoids, alkaloids, caffeine acid, betaine, vitamins, macro and microelements that stimulate opportunities of the body antioxidant system and stimulate GSH synthesis resulting in antioxidant and membrane-stabilizing properties of Echinacea (Barrett, 2003) and (Gerush and Gerush, 2010). This result agrees with Hermenean et al. (2008) who concluded that administration of Echinacea purpurea in Cyclophosphamide treated rats ameliorated the biochemical alterations induced by Cyclophosphamide . ...
The present work was held to assay the protective effect of Echinacea purpurea root extract against the negative impact of Cyclophosphamide (Cy). Sixty rats were divided into six equal groups, first group (control) take only normal saline, second one treated with Cyclophosphamide (50 mg/kg BW once every week IM), third (E1) and fourth (E2) groups treated with Echinacea purpurea root extract (100 or 500 mg/kg BW orally daily) respectively, fifth (E1+ Cy) and sixth (E2+ Cy) groups treated with Echinacea purpurea root (100 and 500 mg/kg BW orally daily) with Cyclophosphamide (50mg/kg BW once every week IM) respectively. At the end of 6th week whole blood and serum were collected to evaluate hematological and biochemical parameters as well as liver and kidney specimens for histopathological examination. The Cy treatment induced a significant decrease in erythrocyte count (RBCs), hemoglobin concentration (Hb), Packed cell volume (PCV%) and platelet counts. Meanwhile the liver enzymes (ALT, AST, ALP & LDH), total bilirubin, direct bilirubin, A/G ratio, triglycerides, cholesterol, glucose, urea and creatinine were significantly increased. Otherwise total protein, albumin and globulin levels were decreased. Upon the Cy treatment liver microscopically showed necrosis and hemorrhage additionally the kidney has congestion and lymphohistiocytic exudate in the interstitial tissue. The Echinacea purpurea treatment markedly ameliorated the altered hematological, biochemical and histopathological features and did not have any side effects. In conclusion the data from our study revealed that both doses of Echinacea purpurea root extract
... Among which the food that we eat becomes a major source for building our body's immunity; thus, it is necessary for individuals to consume immune-boosting foods. Naturally occurring fruits and vegetables like apple (Hyson 2011), raspberry (York et al. 2002), blueberry (Smith et al. 2000), blackberry (Dai et al. 2007), cranberry (Dinh et al. 2014), blackcurrant (Nyanhanda et al. 2014), cherry (Ferretti et al. 2010), cocoa (Sanbongi et al. 1997), pomegranate (Zhao et al. 2016), grape (Percival 2009), avocado (Duarte et al. 2016), broccoli (Mukherjee & Mishra 2015), tomato (Blum et al. 2005), carrot (Sharma & Karki 2012), spinach (Bergman et al. 2001), sweet potato (Shih et al. 2009), kiwi (Tyagi et al. 2015), ginger (Srinivasan 2017), garlic (Tsai et al. 2012), turmeric (Singletary 2010b), mango (Sivakumar et al. 2011), onion (Suleria et al. 2015), lettuce (Kim et al. 2016), beetroot (Clifford et al. 2015), cabbage (Maria Alexandra et al. 2013), cauliflower (Köksal & Gülçin 2008), pineapple (Hossain et al. 2015), strawberry (Afrin et al. 2016), citrus fruits (Mohanapriya et al. 2013), pepper (Singletary 2010a), almonds (Kamil & Chen 2012) and Echinacea (Barrett 2003) are the most important immune boosting foods in which dietary antioxidants like Vitamin A, C, E, flavonoids and carotenoids are present. These antioxidants that are obtained from diet are called exogenous antioxidants, whereas, the antioxidants that are produced from the body itself is called endogenous antioxidants. ...
Naturally available foods contain nutrients like vitamins (A, C, E, and D), zinc, calcium, magnesium, folate iron, omega fatty acids, selenium, and phytochemicals that have profound protective effects (boosting immunity) on human from diseases. The critical component of obtaining incredible health is to maintain proper diet with healthy food, proper sleep, and regular exercise. This review is drafted with an aim to lay out the importance of consuming immune boosting foods, present various nutritional compounds available and their mechanism in maintaining immunity, and briefly discuss some of the exotic immunity building food sources, nutrients present, health benefits, and its utilization. Some of the immune-boosting foods like almonds, spinach, citrus fruits, avocado, red bell pepper, pomegranate, kiwi, garlic, ginger, and passion fruit are deliberated to have positive impact on ameliorating cancer, diabetics, heart disease, skin, eyesight, bone health, blood pressure, brain development, anti-stress, antimicrobial, antibacterial, antifungal, anti-aging, anti-allergenicity, antimalarial, anti-mutagenicity, and anti-inflammatory. This review on immune boosting foods further emphasizes on the need and proved the importance of consuming natural fruits, vegetables, nut, and meat products for strengthening the immune system. Thus, the consumption of immune boosting foods is mandatory for maintaining the health and protecting our body from harmful pathogen and degenerative diseases naturally.
Novelty impact statement
Exploring diet-health approach is very important in the domain of food for enhancing immune response and activation in humans. Natural food that has health and nutritional benefits has made a noteworthy influence on changing consumer's lifestyles. The immune-strengthening foods with proper dietary recommendation play a significant role to increase the immunity of people.
Graphical Abstract
... Moreover, there is a strong correlation between the DM intake and factors affecting the extent of digestion (Keady and Hanrahan, 2015). A plant community with a diverse array of PSMs may allow animals to harvest larger amounts of nutrients; they can have beneficial effects on animal nutrition and health at low doses and in appropriate mixtures (Barrett, 2003). Nonetheless, high doses of these compounds can negatively impact cells and metabolic processes, reducing forage intake (Cheeke,1988;Athanasiadou and Kyriazakis, 2004). ...
Ligularia virgaurea is the most widely functional native herbage in the alpine meadow pastures of the Qinghai-Tibet Plateau (QTP) and has multiple pharmacological and biological activities. The effect of L. virgaurea as a dietary component on the digestion and metabolism of sheep was evaluated by conducting feeding trials in metabolic cages. Thirty-two Tibetan yearling rams (29 ± 1.56 kg BW) were randomly allotted to four groups included in a completely randomised design with eight animals per treatment. Sheep were fed a basal diet (freshly native pasture) without the addition of L. virgaurea (control) or with the addition of L. virgaurea (100, 200, or 300 mg/kg BW per day) for 45 days. Addition of L. virgaurea to the diet of Tibetan sheep was found to influence the average daily gain (quadratic [Q], P 0.05; Q, P
... In the case of the Western herb Echinacea, the strongest data for its potential use in the treatment of URIs is likely in the form of Echinacea purpurea. [11][12][13][14][15][16][17] In the case of the mineral zinc, the greatest potential benefit of its usage in the management of URIs may be in ionizable forms of zinc, such as zinc acetate. [18][19][20][21] The utility of vitamin C supplementation in either the prevention or treatment of URIs has yielded mixed results in randomized clinical trials (RCTs), but may provide more benefit in the prevention of URIs in patients doing heavy exercise and undergoing similar short term physical stress. ...
Background:
Growing antibiotic resistance is among the most serious threats to public health, with antibiotic misuse considered a leading driver of the problem. One of the largest areas of misuse is in outpatient upper respiratory infections (URIs). The purpose of this research is to evaluate the efficacy of EZC Pak, a combination Echinacea-Zinc-Vitamin C dose pack with or without Vitamin D, on the duration of illness and symptom severity of non-specific URIs as an alternative to antibiotics when none are deemed clinically necessary. A secondary analysis was carried out on patient satisfaction.
Methods:
A total of 360 patients across the United States were enrolled and randomized in a double-blind manner across two intervention groups, EZC Pak, EZC Pak+Vitamin D, and one placebo group. The study utilized a smartphone-based app to capture data. Once a participant reported the first URI symptom, they were instructed to take the intervention as directed and complete the daily symptom survey score until their symptoms resolved.
Results:
The average EZC Pak participant recovered 1.39 days (90% CI 1.05 to 1.73) faster than the average placebo participant (p=0.017). The average EZC Pak participant reported a 17.43% (90% CI 17.1 to 17.8) lower symptom severity score versus placebo (p=0.029). EZC Pak users reported 2.9 times higher patient satisfaction versus placebo users (p=0.012). The addition of Vitamin D neither benefited nor harmed illness duration or symptom severity.
Conclusion:
The findings support the potential use of EZC Pak as an alternative to patient request for antibiotics when none are deemed clinically necessary at the time of initial clinical presentation. The decision to replete vitamin D in the acute phase of URI is an individualized decision left to the patient and their clinician. EZC Pak may play a critical role in improving outpatient URI management and antibiotic stewardship (ClinicalTrials.gov number, NCT04943575).
... The tested new formulations reduced time to recovery by 1-1.4 days, which is similar to the reduction in symptom duration for the common cold by 1.4 days compared to placebo in a large meta-analysis (22). Comparison of our results with previous data is hampered by the variety of different Echinacea products and formulations available worldwide which vary in plant species and parts used, harvesting region and season, extraction methods, formulation, and dosages (23). Therefore, each preparation has to be evaluated individually or at least grouped by similar formulations. ...
Background
Echinacea purpurea has clinical antiviral activity against respiratory viruses and modulates immune functions. In this study, we compared higher doses of new Echinacea formulations with conventional formulations at lower, preventive doses for therapy of respiratory tract infections (RTIs).
Methods
In this randomized, blinded, controlled trial, healthy adults (n = 409) were randomized between November 2018 and January 2019 to one of four Echinacea formulations, which were taken in case of an RTI for up to 10 days. New formulations A (lozenges) and B (spray) delivered an increased dose of 16,800 mg/d Echinacea extract during days 1–3 and 2,240–3,360 mg/d afterward; as controls, conventional formulations C (tablets) and D (drops) delivered a lower daily dose of 2,400 mg, usually taken for prevention. The primary endpoint was time to clinical remission of first RTI episodes based on the Kaplan–Meier analysis of patient-reported, investigator-confirmed, respiratory symptoms assessed for up to 10 days. In a sensitivity analysis, the mean time to remission beyond day 10 was calculated by extrapolating the treatment effects observed on days 7 to 10.
Results
A total of 246 participants (median age 32 years, 78% female participants) were treated for at least one RTI. Recovery by day 10 (complete absence of symptoms) was achieved in 56 and 44% of patients with the new and conventional formulations, respectively, showing a median time to recovery of 10 and 11 days, respectively (p = 0.10 in intention-to-treat analysis, p = 0.07 in per-protocol analysis). In the extrapolated sensitivity analysis, new formulations resulted in a significantly shorter mean time to remission (9.6 vs. 11.0 days, p < 0.001). Among those with an identified respiratory virus, viral clearance until day 10 based on real-time PCR from nasopharyngeal swabs was more frequent with new formulations (70 vs. 53%, p = 0.046). Tolerability and safety (adverse events: 12 vs. 6%, p = 0.19) were good and similar between formulations. There was one severe adverse event with a potential hypersensitivity reaction in a recipient of the novel spray formulation.
Conclusion
In adults with acute RTI, new Echinacea formulations with higher doses resulted in faster viral clearance than conventional formulations in prophylactic dosages. The trend for faster clinical recovery was not significant by day 10 but became so upon extrapolation. A dose increase during acute respiratory symptoms might improve the clinical benefits of orally administered Echinacea formulations.
Trial registration
The study was registered in the Swiss National Clinical Trials Portal (SNCTP000003069) and on ClinicalTrials.gov (NTC03812900; URL https://clinicaltrials.gov/ct2/show/NCT03812900?cond=echinacea&draw=3&rank=14).
... Phytopreparations from the coneflower rhizome with roots or herbs are also widely used in the 21st century in the pharmaceutical industry. They are the best-selling herbal drugs in the USA and Europe as effective natural immunomodulators [50]. ...
The immune system protects the body from infectious agents such as bacteria, viruses, or fungi. Once encountered with pathogens or antigens, the innate and adaptive arms of the immune sys-tem trigger a strong immune response to eliminate them from the system and protect the body. Thus, well-balanced immunity is pivotal for maintaining human health, as an insufficient level of immune defense leads to infections and tumors. In contrast, the excessive functioning of the immune system causes the development of autoimmune diseases and allergies. Strong immuni-ty requires adequate nutrition, dietary interventions, and sufficient intake of certain vitamins (vitamin C, vitamin D, and folic acid) and minerals (magnesium, zinc, and selenium). Therefore, nutritional and micronutrient deficiencies lead to compromised immunity. Several natural in-gredients have shown potent immunomodulatory properties. The immune-enhancing proper-ties of many plants and fungi are due to containing bioactive phytoconstituents such as poly-phenols, terpenoids, β-glucans, vitamins, etc. Probiotics and prebiotics can be used as innovative tools to reduce intestinal inflammation and downregulate hypersensitivity reactions. Plant sources of melatonin, a multifunctional molecule with proven anti-inflammatory and im-munomodulatory properties, have been discovered relatively recently. The bioactive com-pounds augment the immune response by directly increasing the cytotoxic activity of natural killer cells, macrophages, and neutrophils. Many phytoconstituents prevent cell damage due to their powerful antimicrobial, antioxidant, and anti-inflammatory properties. The present review attempts to understand the molecular mechanisms underlying the immune-enhancing proper-ties of some bioactive compounds from plants, fungi, animals, microorganisms, and other natu-ral sources.
... It is probably the most widely used herbal medicine in the English-speaking world (Bone, 1997). The annual sales of Echinacea products have been estimated at $300 million in the U.S. A alone (Barrett, 2003). This plant has traditional medicinal uses, including application as an immunostimulant for flu and colds, and as a healing promoter for wounds and throat infections; the most frequent therapeutic and prophylactic applications are for: chronic and recurrent infections of respiratory and urogenital organs, chronic inflammations and allergies, tonsillitis and sinusitis, infected wounds, eczema and psoriasis, chronic bronchitis, and malignancies. ...
... (Abou El-Fadl et al., 1990). Also Echinacea extracts showed antioxidative, antibacterial, antiviral, antifungal properties and are used for treating common cold, respiratory and urinary diseases (Barrett, 2003). ...
... Barrett [68] has noted that polysaccharides from E. purpurea increased macrophage activity in mouse, rat and human experiments. Moreover, subsequent in vivo studies found that the purified polysaccharides provided protection against Listeria monocytogenes and Candida albicans infections by enhancing the activity of phagocytes [21,60,69,70]. ...
The cultivation of Echinacea purpurea for commerce and obtaining high-quality plant material on a large scale remain a challenge for growers. Another challenge for the following decades is to create sustainable agriculture that meets society’s needs, has no environmental impact, and reduces the use of fertilizers and pesticides. The aims of this overview were: (1) to present the importance of the chemical compounds reported in E. purpurea; (1) to synthesize results about cultivation of the E. purpurea with arbuscular mycorrhizal fungi (AMF) and associated microorganisms; (2) to exemplify similar research with plants from the Asteraceae family, due to the limited number of published Echinacea studies; (3) to collect recent findings about how the inoculation with AMF affects gene expressions in the host plants; (4) to propose perspective research directions in the cultivation of E. purpurea, in order to increase biomass and economic importance of secondary metabolite production in plants. The AMF inocula used in the Echinacea experiments was mainly Rhizophagus irregularis. The studies found in the selected period (2012–2022), reported the effects of 21 AMFs used as single inocula or as a mixture on growth and secondary metabolites of 17 plant taxa from the Asteraceae family. Secondary metabolite production and growth of the economic plants were affected by mutualistic, symbiotic or parasitic microorganisms via upregulation of the genes involved in hormonal synthesis, glandular hair formation, and in the mevalonate (MVA), methyl erythritol phosphate (MEP) and phenylpropanoid pathways. However, these studies have mostly been carried out under controlled conditions, in greenhouses or in vitro in sterile environments. Since the effect of AMF depends on the variety of field conditions, more research on the application of different AMF (single and in various combinations with bacteria) to plants growing in the field would be necessary. For the identification of the most effective synergistic combinations of AMF and related bacterial populations, transcriptomic and metabolomic investigations might also be useful.
... It is also commercially available as standardized preparations in solution or capsule form, often in combination with ginseng, goldenseal, or garlic [3,4]. Echinacea preparations belong to the group of best-selling botanical drugs in the USA and Europe [5]. Dietary supplements to treat the common cold based on Echinacea species are among the most frequently used natural products in the USA [4,6]. ...
Echinacea is a widely used plant medicine, valued especially for its well-documented ability to stimulate the immune system. It has been suggested that melanin could be one of the bioactive factors responsible for the immunostimulatory properties of the plant. The biological functions of melanin pigments are closely related to their chemical composition and structural features. The aim of this study was to characterize the melanin from Echinacea purpurea based on the analysis of thermal degradation products of the well-purified pigment extracted from the dried herb. The melanin was pyrolyzed, and the resulting products were separated by gas chromatography and identified using a triple quadrupole mass spectrometer operating in full scan and multiple reaction monitoring modes. Three groups of marker products were detected in the melanin pyrolysate: polyphenol derivatives, nitrogen-containing heterocycles devoid of sulfur, and benzothiazines/benzothiazoles. This suggests that E. purpurea produces three structurally different melanin pigments: allomelanin, eumelanin, and pheomelanin, which in turn may affect the biological activity of the herb. Our results provide the first-ever evidence that plants are capable of synthesizing pheomelanin, which until now, has only been described for representatives of the animal and fungal kingdoms.
... In the case of the Western herb Echinacea, the strongest data for its potential use in the treatment of URIs is likely in the form of Echinacea purpurea. 10,11,12,13,14,15,16 In the case of the mineral zinc, the greatest potential benefit of its usage in the management of URIs may be in ionizable forms of zinc, such as zinc acetate. 17,18,19,20 The utility of vitamin C supplementation in either the prevention or treatment of URIs has yielded mixed results in randomized clinical trials (RCTs), but may provide more benefit in the prevention of URIs in patients doing heavy exercise and undergoing similar short term physical stress. ...
Background: Growing antibiotic resistance is among the most serious threats to healthcare systems and public health globally with antibiotic misuse considered a leading driver of this problem. One of the largest areas of antibiotic misuse is in outpatient upper respiratory infections (URIs), the most common infection in humans. The purpose of this research is to evaluate the efficacy of EZC Pak, a combination Echinacea-Zinc-Vitamin C dose pack with or without Vitamin D, on the duration of illness and symptom severity of non-specific URIs as an alternative to antibiotics when none are deemed clinically necessary. A secondary analysis was carried out on patient satisfaction with using EZC Pak.
Methods: A total of 360 patients across the United States were enrolled and randomized in a double-blind manner across two intervention groups, EZC Pak, EZC Pak+Vitamin D, and one placebo group. The study was conducted virtually utilizing a smartphone-based app to screen, enroll and capture study data of the participants. Once a study participant reported the first symptoms of a URI, they were advised to take the intervention as directed and complete the daily symptom survey score until their symptoms resolved.
Results: The average EZC Pak participant recovered 1.39 days faster than placebo (p=0.017) than the average placebo participant. The average EZC Pak participant reported a 17.43% lower symptom severity score versus placebo (p=0.029). EZC Pak users reported 2.9 times higher patient satisfaction versus users of the placebo (p=0.012). The addition of Vitamin D during this acute phase of illness neither benefited nor harmed illness duration or symptom severity.
Conclusions: The findings support the potential use of EZC Pak as a viable alternative to patient request for antibiotics when none are deemed clinically necessary at the time of initial clinical presentation. The decision to replete vitamin D in the acute phase of URI is an individualized decision left to the patient and their clinician. EZC Pak may play a critical role in improving outpatient URI management and antibiotic stewardship. (ClinicalTrials.gov number, NCT04943575.)
... It stimulates the immune system by increasing the production and activation of leukocytes, lymphocytes, monocytes and cytokines (Kim, Waters & Burkholder 2002) and the nonspecific cellular and humoral immunity (Gajalakshmi et al. 2012). Echinacea purpurea is popularly used for the treatment of common cold, coughs, bronchitis, influenza and inflammation of mouth and pharynx and ranks in the second position in sales of over-the-counter herbal products (Barrett 2003; Barrett, Vohmann & Calabrese 1999; Blumenthal no date; Robbers & Tyler 1999). Echinacea purpurea is a perennial plant native to North America, used by the Delaware Indians for the treatment of venereal diseases and Plain Indians for the treatment of respiratory infections and fever (Tyler 1992). ...
Background: Humanity is faced with various kinds of infections (viral, bacterial and fungal). The recent spread of coronavirus disease 2019 (COVID-19) has led the World Health Organization to declare the coronavirus disease outbreak as a global pandemic. Medical experts suggested that people with high immunity tend to survive the infection more than those with low immunity. Hence, people must boost their immunity by consuming more fruit and vegetable or medications with immune-boosting potential to survive any form of unforeseen infections.
Aim: This study aimed to review horticultural fruit, vegetables and medicinal plants with immune-boosting potentials that may be useful in drug formulations to combat infectious diseases.
Methods: A literature search was conducted on electronic databases such as Google Scholar, Scopus and Web of Science. Several terms and free text words were combined in an appropriate manner to perform the search. Identified articles were reviewed independently for eligibility and extract of information.
Results: The study highlighted medicinal and horticultural crops with the potential to combat the symptoms of Covid-19 such as cold, cough, chest pain and high fever. Details about how despite effective vaccines, respiratory infections such as asthma, tuberculosis, pneumonia and measles are causing significant death worldwide.
Conclusion: This review highlights the fact that pharmaceutical companies should be encouraged to maximise the use of medicinal plants suggested for drug formulation strategies and humans should consume more fruit and vegetables to boost their immune systems.
Contribution: The use of natural products is now receiving global attention against synthetic ones to combat infections and the recent COVID-19 outbreak has called for innovative methods of treating the disease and its symptoms. This review provided information about medicinal plants with immune-boosting potential that when consumed or used in drug formulations can boost immune systems against various forms of infections. Insights on how the burden of diseases can be reduced and healthy lifestyles enhanced naturally are provided for social and economic developments.
... Echinacea purpurea (L.) Moench belongs to the Echinacea genus in the Asteraceae family as one of the most economically important medicinal plants [1][2][3]. Originally discovered in North America, Echinacea plants are now cultivated worldwide for their high medicinal value and several industrial applications in both pharmaceutical and food industries [4]. Thanks to their content of various phytochemicals, including caffeic acid derivatives (CADs), alkylamides and polysaccharides, E. purpurea extracts have antioxidant, anti-inflammatory, and immuno-stimulating properties [5][6][7]. ...
Echinacea purpurea (L.) Moench is one of the most economically important medicinal plants, cultivated worldwide for its high medicinal value and with several industrial applications in both pharmaceutical and food industries. Thanks to its various phytochemical contents, including caffeic acid derivatives (CADs), E. purpurea extracts have antioxidant, anti-inflammatory, and immuno-stimulating properties. Among CADs, chicoric acid is one of the most important compounds which have shown important pharmacological properties. The present research was aimed at optimizing the production of chicoric acid in E. purpurea cell culture. Methyl jasmonate (MeJa) at different concentrations and for different duration of treatments was utilized as elicitor, and the content of total polyphenols and chicoric acid was measured. Several genes involved in the chicoric acid biosynthetic pathway were selected, and their expression evaluated at different time points of cell culture growth. This was performed with the aim of identifying the most suitable putative molecular markers to be used as a proxy for the early prediction of chicoric acid contents, without the need of expensive quantification methods. A correlation between the production of chicoric acid in response to MeJa and an increased response to oxidative stress was also proposed.
... The antifungal job was found near UV light ra-diation, and the anti-candida job was even more advanced in modern times than E. purpurea extracts (Barrett, 2003). Action in the direction of piece meal yeast strains, including Candida albicans, were earlier termed by Saccharomyces cerevisiae due to n-hexane extracts from E. purpurea sources (Bins et al., 2000). ...
The modern-day study objectives at assessing the in-vitro usage of extracts of Echinacea to evaluate their inhibitory effect on pathogenic microorganisms (7 species) were isolated from different environments The methanolic crude extract of leaves of Echinacea purpurea were prepared using soxhlet apparatus. These extracts were examined to inhibited microbial strains like Pseudomonas aeruginosa, S. aureus, Klebsiella pneumonia, E. coli, Streptococcus epidermidis, Aspergillus niger, and C. albicans using the disc diffusion method. Methanol extract is more effective against resistance zone 14 mm against streptococcus. Against the MCF7 cell line, this percentage was increased after 48 hours. To consider the cytotoxic properties of herbal extract alongside human breast cancer (MCF7) cell lines with a concentration range of Echinacea purpurea extracts (6.25,12.5, 25,50,100,400 g/ml). With the maximum percentage increase resistance (97%) observed in treatment with 400mg / ml against the MCF7 cell line. The lowest ratios were discussed with MCF7 having a permanent cure (20%) at 12.5 mg / mL. Finally, GC mass analysis was performed for crude extracts to identify the most active chemical compounds of Echinacea purpurea extract, resulting in the existence of 26 biologically dynamic composites, including nine composites with antioxidant and anticancer activity.
... Studies have shown that, when taken at the onset of a cold or flu, Echinacea can help patients recover faster and reduce their symptoms while they are sick, and reduces symptoms such as headache, lethargy, cough, and aching limbs [90,91], when administered to people with flu-like diseases. Traditionally, the various types of extracts, prepared from aerial parts and roots of Echinacea, were used in North America in the treatment of respiratory infections, wounds, and other inflammatory conditions [92]. It has become very popular in many parts of the world as "cold and flu" medication. ...
Antiviral effects of phytochemical, resolving the respiratory disorders by botanical extracts.
... Studies have shown that, when taken at the onset of a cold or flu, Echinacea can help patients recover faster and reduce their symptoms while they are sick, and reduces symptoms such as headache, lethargy, cough, and aching limbs [90,91], when administered to people with flu-like diseases. Traditionally, the various types of extracts, prepared from aerial parts and roots of Echinacea, were used in North America in the treatment of respiratory infections, wounds, and other inflammatory conditions [92]. It has become very popular in many parts of the world as "cold and flu" medication. ...
Several medicinal plant species have been recorded globally to treat a myriad of diseases. In medicinal plants, there are various phytochemicals, that is, alkaloids, quinones polyphenols, terpenes, proanthocyanidins flavonoids, saponins, lignins, tannins, polysaccharides, steroids, thiosulfonates, and coumarins were found prominent, which have been observed to combat viral infections. This, therefore, implies that all hope is not lost in finding drugs for viral infections and other diseases that have claimed so many lives.
... Another molecular docking research in which one of the plant's components, L-chicoric acid was docked against the protein HIV-1 (Human immunodeficiency virus type 1) integrase, showed very good binding modes between the ligand and the viral integrase 13 . Animal studies of different preparations of Echinacea species have also demonstrated low toxicity 11 . ...
Background:
HPV 16 is the primary etiologic agent of cervical cancer and the presence of L1 and E6 oncoproteins are largely responsible for its virulence. It was the objective of this study to identify HPV16 isolates from suspected cases of cervical cancer at Specialist Hospital Sokoto and Sir Yahaya Memorail Hospiatal Birnin Kebbi, Nigeria and also to identify potent HPV16's L1 protein inhibitor using in silico analysis.
Methods:
A total of 144 cervical samples consisting of 21 low grade squamous intraepithelial lesion, 6 high grade lesion and 117 negative pap smears were collected. The samples were subjected for molecular detection using PCR targeting E6 gene of the virus. Data generated for the molecular prevalence was statistically analyzed using Chi-square method. AutoDock Vina was used to carry out the molecular docking between 2hr5 and Chicoric acid, curcumin and Echinacoside.
Results:
Out of the 144 samples, 24 samples were positive for the PCR representing 16.9% molecular prevalence rate. There is statistically significant association between cyto-diagnoses and presence of HPV16 (P < 0.05). Docking analysis showed that the Chicoric acid components of Echinacea purpurae have strong binding affinity (-8.7 kcal/mol) to the L1 protein of the HPV.
Conclusion:
This study provides data on HPV 16 epidemiology in northern Nigeria, and also provides novel evidence for consideration on certain interacting residues, when synthesizing Anti-HPV compounds in the wet lab.
... Many bioactivities of EP have been discovered in modern pharmacological investigations, including immunomodulatory, anti-inflammatory, antioxidant, antiviral and antifungal activities [63,64]. ...
Echinacea purpurea (L.) Moench (EP)is a perennial herbaceous flowering plant, commonly known as purple coneflower and it belongs to the Asteraceae family. The Echinacea genus is originally from North America, in the United States, and its species are widely distributed throughout. There are nine different species of Echinacea, but only three of them are used as medicinal plants with wide therapeutic uses: Echinacea purpurea (L.) Moench, Echinacea pallida (Nutt.) Nutt. and Echinacea angustifolia DC. Several significant groups of bioactive compounds with pharmacological activities have been isolated from Echinacea species. Numerous beneficial effects have been demonstrated about these compounds. The immunomodulatory effect was initially demonstrated, but over time other effects have also been highlighted. The present review gives a comprehensive summary of the chemical constituents, bioactive compounds, biological effects and therapeutical uses of purple coneflower. Research shows that such a well-known and recognized species needs to be further studied to obtain efficient products with a guarantee of the safety.
... are recommended to treat colds and flu. These diseases have in the causal sphere both infection with various bacterial and viral pathogens, and deficiency of the immune system [131,132]. ...
Background. Nowadays, phytotherapy offers viable solutions in managing respiratory infections, disorders known for considerable incidence in both children and adults. In a context in which more and more people are turning to phytotherapy, finding new remedies is a topical goal of researchers in health and related fields. This paper aims to identify those traditional medicinal plants that show potentially antibacterial effects against four Gram-negative germs (Chlamydia pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, and Moraxella catarrhalis), which are considered to have high involvement in respiratory infections. Furthermore, a comparison with Romanian folk medicines was performed. Methods. An extensive review of books and databases was undertaken to identify vegetal species of interest in the context of the topic. Results. Some traditional Romanian species (such as Mentha × piperita, Thymus vulgaris, Pinus sylvestris, Allium sativum, Allium cepa, Ocimum basilicum, and Lavandula angustifolia) were identified and compared with the plants and preparations confirmed as having antibacterial effects against specific germs. Conclusions. The antibacterial effects of some traditionally used Romanian medicinal plants are poorly investigated, and deserve further attention.
... The interest in this plant has increased due to its promising effects on human health and well-being. Echinacea spp. is extensively used in the treatment of certain diseases, mainly as an immunomodulator, and there is scientific evidence regarding the safety of products derived from this plant [89,90]. A patented sunscreen formulation successfully included Echinacea extracts, Cynara scolymus extract and organic or inorganic synthetic sun filters. ...
Human skin works as a barrier against the adverse effects of environmental agents, including ultraviolet radiation (UVR). Exposure to UVR is associated with a variety of harmful effects on the skin, and it is one of the most common health concerns. Solar UVR constitutes the major etiological factor in the development of cutaneous malignancy. However, more than 90% of skin cancer cases could be avoided with appropriate preventive measures such as regular sunscreen use. Plants, constantly irradiated by sunlight, are able to synthesize specialized molecules to fight against UVR damage. Phenolic compounds, alkaloids and carotenoids constitute the major plant secondary metabolism compounds with relevant UVR protection activities. Hence, plants are an important source of molecules used to avoid UVR damage, reduce photoaging and prevent skin cancers and related illnesses. Due to its significance, we reviewed the main plant secondary metabolites related to UVR protection and its reported mechanisms. In addition, we summarized the research in Mexican plants related to UV protection. We presented the most studied Mexican plants and the photoprotective molecules found in them. Additionally, we analyzed the studies conducted to elucidate the mechanism of photoprotection of those molecules and their potential use as ingredients in sunscreen formulas.
Ethnopharmacological relevance:
Echinacea purpurea (L.) Moench (EP) is a perennial herbaceous flowering plant, commonly known as purple conical flower. It was widely used to treat skin inflammation and gastrointestinal diseases.
Aim of study:
Ulcerative colitis (UC) is a chronic and nonspecific inflammatory disease. Recent evidence shows that immune disorders are involved in the pathogenesis of UC. To evaluate the protective effect of Echinacea purpurea (L.) Moench exact (EE) on UC and explore the role of complement system in the treatment of UC.
Materials and methods:
UC model was induced in rats by 2,4,6-trinitrobenzene sulfonic acid (TNBS), and then rats were administered with EE for 10 days. Collect colon tissues for analysis of relevant mechanisms.
Results:
EE could reduce the weight loss and diarrhea of UC rats. In addition, EE could improve the integrity of intestinal epithelial barrier in UC rats. EE inhibited the level of proinflammatory cytokines and promoted the antioxidation. Furthermore, EE suppressed the expression of C3aR, CFB, CD55, TLR4 and NLRP3.
Conclusion:
These results indicate that EE may achieve therapeutic effect by inhibiting C3a/C3aR signal pathway, suggesting that EE may be used as a medicinal plant to alleviate UC.
In ancient time people used plants as drugs. They used parts of plants like leaves, fruits, roots, stem, flowers, seeds, bark or whole plant. Traditional medicine is known as the primary health care in the world, about 70% of developing countries depends on the plant based treatment. In current scenarios most of the institutes promoting the use of plant based medicines. For the treatment of kidney stone tribal people uses several plant or juice of the plants for example Momordica charantia, Moringaolieferia, Amnivisnaga, Terbulusterrestris, Dolichosbiflorus, Arvalanata, Cotusspiralis,Vaccinumoxycoccos, Coriendrumsativum, Embelicaofficinalis, Petroselinum crispum, Barosmabetulina etc. Keywords: Kidney Stone, Herbal Treatment, Medicinal Plants, Antioxidants, Uric Acid, UTIs, Cysteine, Struvite, Diuretics
Echinacea purpurea is a herbal medicinal plant native to the North America. It is a perennial herbaceous plant commonly known as purple coneflower, red sun flower and rudbekia. Purple coneflower is a flowering plant of genus Echinacea and belongs to the family Asteraceae. This species of plant is spread along the wild of eastern, south eastern and Midwest of United States. The Indian origin of Echinacea purpurea is called Andrographis paniculate commonly known as kalmegh. This is commonly used for common cold in India. The Echinacea purpurea contains various chemical constituents mainly the polysaccharide, alkylamides, phenolic compounds such as caffeic derivatives like chicoric acid which is more abundant, caftaric acid, caffeic acid and flavonoids, glycoproteins. Different sections of the plant contains different chemical constituents and its presence varies. The Echinacea purpurea constituents are extracted by alcohol and is analyzed by various analytical methods such as UV spectrophotometry, HPLC and coulometric electrochemical and electrospray ionization mass spectrometry. The Echinacea purpurea shows various pharmacological activities such as anti-oxidant, anti-bacterial, antiviral, anti-immunosuppressant and anti-inflammatory and this activity is shown by various constituents of the plant present. The efficacy of Echinacea purpurea is not completely revealed and from the data available it is identified that the Echinacea is well tolerated. This article reviewed the brief introduction about Echinacea purpurea, its bioactive compounds present and pharmacological activity with the toxicology.
There are numerous foods and herbal plants that boost the immune system. They stimulate the activity of cells responsible for fighting infections. In fact, over centuries, people have relied on herbs and other plants for treating medical conditions and boosting immunity. Considering the worldwide coronavirus pandemic, natural immune boosters are being sought after in the current war against this viral infection. Most likely, immune-boosting plants help human health by tackling viruses, bacteria, and abnormal cells in the form of prevention, to support and strengthen the body’s natural immune system. In this chapter, we review several terrestrial species and plants from various sources including China, India, Europe, and Africa, which have long folklore use, and we provide information on the chemistry and biological activity where available.KeywordsFolklore medicines from Africa and ChinaImmune boost plantsElderberry (Sambucus nigra)Echinacea spp.
Astragalus
Ganoderma lucidum
India—Astavarga plants
The influenza viral infection is threatening the general public since ages due to its high mortality and morbidity rates. There are only few medications available currently for the management of the infection. Both these classes of drugs provide only symptomatic relief, required in high doses, but it also linked with several harmful effects. To minimize various risks of adverse effects and to provide an alternative cure for influenza infection, plant bioactives have been explored since many decades. There are various Chinese traditional medicines, which provide effective therapeutic treatment against the influenza virus. Most importantly, the roots of the Isatis indigotica (Banlangen) and Lianhuaqingwen have significant action against the virus as compared to synthetic drugs. So, there is much other herbal therapeutics, which showed remarkable activity against the influenza infection. This chapter explained about the several bioactives and their mechanism of actions associated with the management of the infection caused by influenza virus.
Ethnopharmacological relevance
Asari Radix et Rhizoma (ARR), including 3 major plants of genus Asarum Linn, A. heterotropoides Fr. Schmidt var. mandshuricum (Maxim.) Kitag., A. sieboldii Miq. f. sieboldii and A. sieboldii Miq f. seoulense (Nakai) C. Y. Cheng et C. S. Yang, is one of the most important traditional herbal medicine in Asia with tremendous pharmacological activities. For a long time, researchers focus attention on studing asarinin and essential oils, the indicating ingredients of ARR, but paid less attention to another characteristic component, alkamides. The role of alkamides in the major efficacy of ARR medication remains to be elucidated.
Aim of the study
This study aims to investigate the contribution of alkamides in the efficacy of ARR according to the evaluation of antinociceptive and anti-inflammatory effects and in vivo pharmacokinetics processes.
Materials and methods
For pharmacodynamic study, the analgesic and anti-inflammatory effects of alkamides-enriched fraction (ARRA) were comparatively evaluated by writhing test, hot plate test, and ear swelling test in mice after oral administration. For pharmacokinetic study, an UHPLC-MS/MS method was developed for the simultaneous determination of N-isobutyl-2E,4E,8Z,10Z/E-dodecatetraenamide (DDA) and other 6 major characteristic ingredients of ARR in rat plasma. The analytical method was validated and successfully applied to the pharmacokinetic study of ARR extract and DDA.
Results
Pharmacodynamic study show that the ARR and ARRA can significantly inhibit the writhing times of mice caused by acetic acid administration, increase the pain threshold of thermal stimulation, and inhibit xylene treated ear swelling degree by reduce PGE2 and TNF-α levels in the inflamed tissue. For pharmacokinetic study, the pharmacokinetic parameters of Vd/F and CL/F after intravenous administration in rats of DDA are 63.94 ± 32.12 L/kg and 0.33 ± 0.06 L/min/kg, respectively. The plasma drug concentration declined with the T1/2 value of 2.25 ± 0.96 h, and the MRT0-∞ was 2.23 ± 1.02 h. The absolute bioavailability of DDA after oral administration was calculated as 10.73%. DDA, methyleugenol, and asarinin have relatively high AUC0-∞ values when the ethanol and water extract of ARR is orally administered.
Conclusions
ARRA is a kind of active ingredients with potential analgesic and anti-inflammatory effects that played a significant role in the major efficacy of ARR. DDA, the major compound of ARRA, has a high level of exposure in vivo, which could be is suitable for the pharmacokinetic marker or new quality marker of ARR.
Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging infectious disease that has infected more than 13 million people with over 500,000 deaths just within 7 months. Unfortunately, no effective treatment have been approved so far for this contagious infection. The first line of defense against this disease is the immune system. Several naturally derived antioxidant compounds play fundamental roles in boosting immunity against COVID-19. In this chapter, we introduce the concept of oxidative stress and immune system for the management of viral infections, particularly SARS-CoV-2. The indispensable roles of the antioxidant phytochemicals, vitamins, and minerals were discussed.
Plants are a rich source of biologically active compounds such as essential fatty acids, flavonoids, carbohydrates, glycosides, vitamins, essential oils, proteins, and minerals. These compounds show, among others nourishing, soothing, antioxidant, anti-inflammatory, antibacterial, antifungal, and antiviral activities. Of all vitamins, Vitamin D and vitamin C can play a major role in reducing the risk of respiratory infections caused by SARS-Cov-2. Vitamin D supplementation may be a useful risk-reducing agent for SARS-Cov-2. Through several mechanisms, vitamin D can significantly reduce the risk of Plants sources of vitamins against SARS-CoV-2 Chapter | 8 165
infection. Because vitamin D occurs naturally only in a few foods, such as in some fatty fish (mackerel, salmon, sardines), fish liver oils, vitamin D-fed chicken eggs, and mushrooms exposed to sunlight or UV rays, various enrichment attempts should be made for vitamin D fortification.
The SARS-CoV-2 pandemic is currently the most challenging challenge
worldwide. To fight it, it is necessary to achieve and maintain good nutritional status. Human nutrition is influenced by factors such as gender, age, health status, lifestyle, medication and supplement intake. Human nutrition has been used as the basis for resistance to stress during the pandemic. Optimal nutrition and nutrient intake affect the immune system, which is why the only balanced way to survive a pandemic is to strengthen the immune system. There is no
evidence that dietary supplements can heal the immune system, except for vitamin C, which is one of the better ways to improve human immunity. Good eating practices, proper nutrition, and a healthy lifestyle can ensure the body’s well-being in overcoming the virus.
Devising strategies to synthesize nanoformulations against infectious diseases is an actively growing area of research in recent times. Especially, plant-based nanoformulations against human viral infections have gained more importance due to the superior properties such as low cytotoxicity, biocompatibility, enhanced therapeutic effect, and low side-effects. Considering the pandemic situation due to COVID-19, it is important to revisit the nanoformulations developed using plant systems against wide range of infectious diseases caused by RNA viruses in humans, which could be useful to identify the potential antiviral agents to combat new coronavirus, SARS-CoV-2. This chapter presents a comprehensive overview of the phyto-derived nanoparticles used as antiviral agents against RNA virus known to cause human viral diseases. Also, the possible ways that these nanoparticles could inhibit the replication of SARS-CoV-2 is presented with supporting literature. The recent developments in nanoformulations against COVID-19 are also discussed.
Environmental and occupational exposure to chromium compounds, especially hexavalent chromium [Cr(VI)], is widely recognized as a potential nephrotoxic in humans and animals. Its toxicity is associated with the overproduction of free radicals, which induces oxidative damage. Echinacea purpurea (L.) Moench is an herbaceous perennial plant rich in phenolic components and frequently used for its medicinal benefits. The current work evaluated the effectiveness of E. purpurea (EP) against oxidative stress and nephrotoxicity induced by potassium dichromate in male rats. Male Wistar rats were divided into four groups: control, E. purpurea (EP; 50 mg/kg; once daily for 3 weeks), hexavalent chromium (Cr(VI); 15 mg/kg; single intraperitoneal dose), and EP + Cr(VI) where rats were pretreated with EP for 3 weeks before receiving CrVI, respectively. Results revealed that rats exposed to Cr(VI) showed a significant increase in PC, TBARS, and H2O2, kidney function biomarkers (Urea, creatinine, and uric acid), lactate dehydrogenase activity (LDH), TNF‐α, IL‐18, nuclear factor kappa B (NFκB), and IGF‐1 (Insulin‐like growth factor‐1) levels as well as a considerable decline in metallothionein (MT), glutathione (GSH) content, enzymatic antioxidants (SOD, CAT, GPx, GR, and GST), alkaline phosphatase (ALP) activities, and protein content. Cr(VI) induced apoptosis in kidney tissues as revealed by upregulation of Bax and caspase 3 and downregulation of Bcl‐2. Furthermore, EP treatment ameliorated the Cr(VI)‐induced histopathological and ultrastructure variations of kidney tissue, which was confirmed by the biochemical and molecular data. It is clear from the results of this study that EP exerts nephroprotective effects by improving the redox state, suppressing inflammatory reaction and cell apoptosis as well as ameliorating the performance of kidney tissue architecture, which is eventually reflected by the improvement of kidney function in rats.
Introduction
Rapidly emerging diseases, such as viral infections, cancer, and autoimmune disorders are becoming an increasing global health concern. Natural products, including plant extracts and compounds, possess an enormous spectrum of pharmacological activities, including antiviral, anticancer, immunomodulatory, anti-asthma, anti-diabetic, anti-hypertension, and anti-rheumatism activities. Among them, the genus Uncaria (Rubiaceae family), rich in alkaloids and triterpenes, is believed to have vast therapeutic potential. This genus is mostly found in tropical regions, such as Africa, Southeast Asia, and Southeast America. In this review, we aim to summarize the studies on plant substances of genus Uncaria showing promising antimicrobial, anticancer, and immunomodulatory activities.
Methodology
A total of 814 studies were identified through database searches, of which 681 studies were excluded due to duplication and irrelevance to antimicrobial, immunomodulatory, and pharmacology activity. 133 studies were included, out of which 16 studies were related to antimicrobial and 117 studies related to the pharmacology of Uncaria.
Conclusion
According to the collected data Uncaria species proved to have a broad range of pharmacological activities, which makes it more interesting for further studies, to explore more about its antimicrobial, immunomodulatory, and other potential pharmacological properties.
Bull fertility is an important economic trait in sustainable cattle production, as infertile
or subfertile bulls give rise to large economic losses. Current methods to assess
bull fertility are tedious and not totally accurate. The massive collection of functional
data analyses, including genomics, proteomics, metabolomics, transcriptomics, and
epigenomics, helps researchers generate extensive knowledge to better understand
the unraveling physiological mechanisms underlying subpar male fertility. This review
focuses on the sperm phenomes of the functional genome and epigenome that are
associated with bull fertility. Findings from multiple sources were integrated to generate
new knowledge that is transferable to applied andrology. Diverse methods encompassing
analyses of molecular and cellular dynamics in the fertility-associated molecules and
conventional sperm parameters can be considered an effective approach to determine
bull fertility for efficient and sustainable cattle production. In addition to gene expression
information, we also provide methodological information, which is important for the rigor
and reliability of the studies. Fertility is a complex trait influenced by several factors and
has low heritability, although heritability of scrotal circumference is high and that it is a
known fertility maker. There is a need for new knowledge on the expression levels and
functions of sperm RNA, proteins, and metabolites. The new knowledge can shed light
on additional fertility markers that can be used in combination with scrotal circumference
to predict the fertility of breeding bulls. This review provides a comprehensive review of
sperm functional characteristics or phenotypes associated with bull fertility.
In phytotherapy, Echinacea purpurea L. is generally used in the form of water-alcohol extracts, which contain phenylpropanoids exhibiting anti-inflammatory, hypoglycemic and moderate antiproliferative effects. The relevance of using plants of the genus Echinacea as a phytomaterial is due to the high demand of consumers; nowadays, the level of sales of water-alcohol extracts in the world is quite high. Considering the importance of using these plants, the present work aimed to determine phenolic compounds in water-alcohol extracts of echinacea obtained by various extraction methods. The biological activity of echinacea is related to hydroxycinnamic acids and their derivatives (chlorogenic, caftaric and chicoric acids). In this study, conditions for the identification and determination of phenolic compounds using such chromatographic methods as HPLC-DAD-MS and GC-MS allowing to expand the range of target analytes in water-alcohol extracts of echinacea have been proposed. A number of unknown compounds of phenolic nature and monosaccharides have been identified in water extracts of echinacea by implementing the SPAD technique on a sorbent for solid-phase extraction - Strata C18-E. The effectiveness of various extraction methods and their influence on the composition of extracted phenolic compounds from plant raw materials was studied. Subcritical extraction at 120°C was established to provide maximum extraction of rutin, caffeic and caftaric acids. Chlorogenic and chicoric acids are most effectively extracted by traditional methods described in the Pharmacopoeia. The influence of growing conditions on the total content of phenolic compounds in echinacea was studied; the increase in the altitude above sea level results in higher contents of phenolic compounds. The assessment of the content of phenolic compounds in industrially manufactured preparations based on echinacea was carried out. The possibility of using the ratio of chicoric to caftaric acids as an indicator of the quality and authenticity of extracts and preparations based on them was shown.
The chapter describes molecular aspects of herbal medicine toxicity. Several studies have shown that certain medicinal herbs can be poisonous and may produce a variety of undesirable or adverse reactions that are life-threatening and even deadly. In industrialized countries, the craze for products of natural origin is a relatively recent phenomenon, developed, in particular, in favour of aggressive marketing campaigns inducing in the public mind notions as false as they are dangerous such as the assertion “what is natural is harmless”. Several intoxications, often deadly, after herbal treatments have been reported which draws attention to the dangers of excessive use and the no control on this therapeutic model.
Are Echinacea products associated with a reduced incidence and a shorter duration of common colds compared with placebo?
Individual prophylaxis trials show no association with prevention of the common cold, but exploratory meta-analysis suggests that Echinacea products may be associated with a small reduction in cold incidence. In treatment trials, there was no association of Echinacea products with a shorter duration of colds.
Extrapolations from pharmacological research have led some authors to suggest restrictions or contraindications for the use of Echinacea. This article examines the known chemistry and pharmacology of the various Echinacea species and products, and challenges some of these popular concepts. In particular, the hypotheses that Echinacea is a T cell activator and that it will accelerate pathology in HIV/AIDS, are found to be unsupported by careful analysis of known data. These misunderstandings have arisen mainly from enthusiastic extrapolations of in vitro data on polysaccharide components. The low levels of polysaccharides in most Echinacea products, particularly traditional extracts and tinctures, and their poor bioavailability suggest in most cases the therapeutic activity of Echinacea is due to other component fractions, including the alkylamides. The suggestion that Echinacea should not be prescribed for extended periods of time will be examined in a second article.
The authoritative and comprehensive modern textbook on western herbal medicine - now in its second edition This long-awaited second edition of Principles and Practice of Phytotherapy covers all major aspects of herbal medicine from fundamental concepts, traditional use and scientific research through to safety, effective dosage and clinical applications. Written by herbal practitioners with active experience in clinical practice, education, manufacturing and research, the textbook is both practical and evidence based. The focus, always, is on the importance of tailoring the treatment to the individual case. New insights are given into the herbal management of approxiately 100 modern ailments, including some of the most challenging medical conditions, such as asthma, inflammatory bowel disease and other complex autoimmune and inflammatory conditions, and there is vibrant discussion around the contribution of phytotherapy in general to modern health issues, including health ageing. Fully referenced throughout, with more than 10, 000 citations, the book is a core resource for students and practitioners of phytotherapy and naturopathy and will be of value to all healthcare professionals - pharmacists, doctors, nurses - with an interest in herbal therapeutics.
We measured the levels of the cytokines IL‐1‐α, IL‐1‐β, IL‐2, IL‐6, TNF‐α, and IFN‐γ in culture supernatants of stimulated whole blood cells derived from 23 tumor patients undergoing a 4‐week oral treatment with a spagyric extract from Echinacea angustifolia, Eupatorium perfoliatum, and Thuja occidentalis (Echinacea complex). All patients had had curative surgery for a localized solid malignant tumor. Blood was taken before treatment and after 2 and 4 weeks of therapy. Twelve untreated tumor patients at the same clinical stage, also after curative surgery, served as a control group. In the blood cell cultures of all patients, a rather wide range of cytokine levels was found. After therapy with Echinacea complex, no significant alteration in the production of the cytokines could be seen in comparison to the controls, and also the leukocyte populations remained constant. We conclude that at this application and dosage, the therapy with Echinacea complex has no detectable effect on tumor patients' lymphocytes activity as measured by their cytokine production. © 1996 Wiley‐Liss, Inc.
Although lots of books have been published about herbal therapy, a comprehensive overview of the adverse effects of botanical medicines is not available. Yet such an overview is badly needed, because of the enormous rise in the use of herbal remedies. The book series will provide approximately 150 monographs on herbal remedies and plant-derived drugs. Each monograph will provide introductory information on Botany, Chemistry, Pharmacology and Uses, followed by an Adverse Reaction Profile subdivided according to organ and function. The World Health Organization Regional Office for Europe (Copenhagen) has decided to support the book in the form of an acknowledgement that it has been preparedin cooperation with this Office.
The US Phytotherapeutical Market still increases considerably. The article presents the different reasons which are responsible for this expansion and lists the most important herbal medicines of the USA including the categories of use. The US regulatory categories for herbal products are presented as well as the current efforts which are undertaken in order to guarantee product quality and to establish the effectiveness of herbal products.
The terms “immunostimulants” and “adaptogens” both describe drugs capable of increasing the resistance of an organism against Stressors of variable origin. Both types of drugs achieve this enhancement primarily by nonspecific mechanisms of actions. Immunostimulants generally stimulate, in a non-antigen dependent manner, the function and efficiency of the nonspecific immune system in order to counteract microbial infections or immunosuppressive states. Adaptogens are believed to reinforce (increase) the non-specific power of resistance of the body against physical, chemical or biological noxious agents. With respect to the mechanisms of action immunostimulants influence primarily the humoral and cellular immune system, whereas adaptogens are thought to between the immune and endocrine system it is very often difficult or impossible to discriminate between the two mechanisms of action. Therefore, it is not surprising that both classes of drugs can influence both systems at the same time.
In recent years, Echinacea preparations have developed into the best selling herbal immunostimulants. Most of the products are derived from either the aerial or the underground parts of Echinacea purpurea, and from the roots of E. angustifolia or E. pallida. The common products in Europe mainly represent expressed juice preparations or alcoholic tinctures. The different species and preparations can be clearly distinguished phytochemically by their typical constituents. The most relevant compounds for standardization are caffeic acid derivatives (cichoric acid, echinacoside), alkamides, polyacetylenes, and glycoproteins/polysaccharides. Pharmacological studies have shown that cichoric acid, alkamides, and glycoproteins/polysaccharides possess immunomodulatory activity. Therefore they might be considered as active principles and best suited for standardization purposes. Clinical effects have been demonstrated for the expressed juice of the aerial parts of Echinacea purpurea in the adjuvant therapy of relapsing infections of the respiratory and urinary tracts, as well as for alcoholic tinctures of E. pallida and E. purpurea roots as adjuvants in the therapy of common cold and flu.
Two preparations of Echinacea purpurea and a preparation of Eleutherococcus senticosus increased the in vitro phagocytosis of Candida albicans by granulocytes and monocytes from healthy donors by 30-45%. The chemotactic migration of granulocytes in the Boyden Chamber was increased by 45% with an Echinacea purpurea extract. The two herbal preparations had no effect in either direction on intracellular killing of bacteria or yeasts. Echinacea and Eleutherococcus preparations did not induce in vitro transformation of lymphocytes. The mistel toe preparation examined (Viscum album) did not influence the tested functions of granulocytes, monocytes or lymphocytes of health donors.
Echinacea, an herbal remedy originally used by the plains Indians of North America, has gained credibility as an immunostimulator, used especially for the treatment of incipient colds and "flu". We examined the effect of over-the- counter preparations of Echinacea, on mouse spleen cells in vitro. All products were diluted to provide equivalent amounts of Echinacea, based on the suggested product dose. We measured the effect on proliferation of BALB/c spleen cells and on production of IgM, IgG sub-classes, and IgA by the cultured cells. Of the 6 products tested, #1 (an extract in glycerol) showed a 10 fold stimulation of spleen cell proliferation, the same company's extract in alcohol (#2) showed an 8 fold stimulation, but the other companies' products (#s 3-6) showed from no effect to a maximum of 4 fold stimulation. With respect to immunoglobulin production, product #1 increased IgM production from 2 μg/ml in unstimulated cells to 18 μg/ml. None of the other products increased IgM production to above 4 μg/ml. IgG subclass production was stimulated to a different extent, depending on the subclass. IgA production was increased from 0.2 μg/ml to 3.4 μ/ml by product #1. We also prepared our own Echinacea extract and it showed stimulatory properties similar to those of commercial product #1. Preliminary results with human spleen cells paralleled those with mouse spleen cells. Our studies confirm that Echinacea extracts stimulate immune system cells, but as there was great discordance in the effects of the commercial preparations, our results support the necessity for increased regulation of herbal products.
Limitations on the use of Echinacea preparations, specifically the duration and indications of use, have been proposed recently. It has been suggested that Echinacea not be used for extended periods of time, nor utilized in autoimmune disorders, due to the belief that Echinacea might have either harmful long-term effects on the immune system or may initiate immune stimulation in an already pathologically overstimulated immune system. These recommendations seem to be based on misinterpretations of the Echinacea research and/or a failure to take into account the strong traditional use of Echinacea. This article will show that the best way to overcome this clinical dilemma might be to view Echinacea as an immunomodulator, rather than as an immunostimulant.
Ethanolic extracts of Echinacea purpurea, E. pallida and E. angustifolia roots were examined for immunological activity in the carbon clearance test with mice and in the granulocyte test. In the in vivo experiment all extracts, administered orally, were found to enhance phagocytosis significantly. These results correlate with the stimulation of phagocytosis in the in vitro granulocyte test. The lipophilic fractions of the extracts appeared to be more active than the polar fractions. All extracts were analyzed by HPLC in order to correlate the chemical constituents with the immunological activities.
The effects of daily oral pretreatment for 28 days with the pressed juice of Echinacea purpurea (Echinacin EC31®) or magnesium supplements on the changes in immunological variables in response to a triathlon sprint (mean duration ± SD: 69.5 ± 10.1 min) were investigated in a randomised, placebo-controlled, parallel group study. Forty-two male triathletes (mean age 27.5 years), undergoing regular training, all with a VO(2max) > 52 ml/kg/min, were randomised to one of three treatments. Fluorescence activated flow cytometry analysis of blood cell populations, serum and urine levels of interleukin 6 (IL-6) and soluble interleukin 2 receptor (sIL-2R) together with routine sports laboratory, clinical chemical and haematological variables were determined at baseline (day 0), after treatment (day 28) and 1 h and 20 h after the competition (days 29 and 30). Pretreatment with Echinacin produced slight changes in total peripheral (CD3+) T-lymphocytes, NK (CD3-CD56+) cells and CD8+ lymphocyte counts which remained within the range of baseline variation. In comparison to the placebo group, Echinacin markedly decreased sIL-2R in urine before the competition and enhanced the exercise-induced decrease in serum sIL-2R. It further enhanced the exercise-induced increases in urine IL-6 and serum cortisol. None of the Echinacin-treated athletes developed upper respiratory infections, which were reported by 3/13 and 4/13 subjects treated with magnesium and placebo, respectively. Echinacin appears to reduce sIL-2R release, facilitate IL-6 release in response to exercise and in the present study reduced the documented incidence of respiratory infections, possibly as a result of monocyte/macrophage stimulation.
In Northamerican folk medicine Echinacea purpurea L. Moench (purple coneflower) was used as a medicinal plant. Nowadays various formulations containing stabilized or dried pressed juice from Echinacea purpurea as an active ingredient are often administered to treat common colds. These preparations are very well tolerated and safe. Allergic reactions, mainly reversible skin reactions, may occur especially in persons showing hypersensibility after contact with plants from the Compositae family. Pharmacological data let assume purple coneflower pressed juice preparations stimulate the innate immune system and increase the resistance to common colds. In this context the stimulation of the oxidative burst as well as the modulation on monokine secretion by the pressed juice of purple coneflower are reviewed. Also relevant clinical studies are presented concerning the treatment of infections respectively of common cold.
In about one third of cases the duration of pertussis may be reduced to five days by giving three repeated injections of echinacine (2 ml/day in children, 1 ml/day in infants) on three consecutive days; this procedure is particularly successful in an early stage of the disease. A combination of echinacine and antibiotic is not equally effective but may be superior to treatment with an antibiotic alone. Moreover, it must not be overlooked that the latter is only required in high risk children, although it is often claimed to be necessary with regard to 'elimination of bacteria' and 'prevention of complications'. Injections of echinacine are tolerated well; temperature rises up to 39° C on the day of treatment were only seen in isolated cases. Erythema and localized pain at the injection site were occasionally reported. The question as to whether the 'reduction' in the efficacy of echinacine during concurrent therapy with antibiotic is to be attributed to epithelial lesions by B. pertussis, cellular changes in the bronchial tract or inhibition of opsonification or phagocytosis due to antibiotics remains to be clarified and should be discussed further.
▪ Objective: To determine whether naproxen, a propionic acid inhibitor of cyclooxygenase, alters the course of experimental rhinovirus colds.
▪ Design: A randomized, double-blind, controlled trial.
▪ Setting: Rhinovirus challenge model in volunteers cloistered in individual hotel rooms.
▪ Volunteers: Eighty-seven healthy young adults with serum neutralizing antibody titers of ≤ 1:2 to the challenge virus; 79 were evaluable.
▪ Intervention: Thirty-nine participants received naproxen (loading dose, 400 mg or 500 mg followed by 200 mg or 500 mg three times daily for 5 days). Forty participants received placebo. Treatment was started 6 hours after viral challenge.
▪ Measurements: Daily measurement of viral titers, symptoms, nasal mucus production, and nasal tissue use; incidence of infection and illness; and measurement of homotypic serum neutralizing antibody responses.
▪ Results: Viral titers and serum homotypic antibody responses were similar in the naproxen and placebo groups. Significant reductions in headache, malaise, myalgia, and cough occurred in the naproxen group. A 29% reduction was noted in the total (5-day) symptom score in the naproxen group (95% Cl, 16% to 42%).
▪ Conclusion: Naproxen treatment did not alter virus shedding or serum neutralizing antibody responses in participants with experimental rhinovirus colds, but it had a beneficial effect on the symptoms of headache, malaise, myalgia, and cough. Prostaglandins may be among the inflammatory mediators that play a role in the pathogenesis of rhinovirus colds.
Objectives.
—To assess incidence and preventability of adverse drug events (ADEs) and potential ADEs. To analyze preventable events to develop prevention strategies.Design.
—Prospective cohort study.Participants.
—All 4031 adult admissions to a stratified random sample of 11 medical and surgical units in two tertiary care hospitals over a 6-month period. Units included two medical and three surgical intensive care units and four medical and two surgical general care units.Main Outcome Measures.
—Adverse drug events and potential ADEs.Methods.
—Incidents were detected by stimulated self-report by nurses and pharmacists and by daily review of all charts by nurse investigators. Incidents were subsequently classified by two independent reviewers as to whether they represented ADEs or potential ADEs and as to severity and preventability.Results.
—Over 6 months, 247 ADEs and 194 potential ADEs were identified. Extrapolated event rates were 6.5 ADEs and 5.5 potential ADEs per 100 nonobstetrical admissions, for mean numbers per hospital per year of approximately 1900 ADEs and 1600 potential ADEs. Of all ADEs, 1% were fatal (none preventable), 12% life-threatening, 30% serious, and 57% significant. Twenty-eight percent were judged preventable. Of the life-threatening and serious ADEs, 42% were preventable, compared with 18% of significant ADEs. Errors resulting in preventable ADEs occurred most often at the stages of ordering (56%) and administration (34%); transcription (6%) and dispensing errors (4%) were less common. Errors were much more likely to be intercepted if the error occurred earlier in the process: 48% at the ordering stage vs 0% at the administration stage.Conclusion.
—Adverse drug events were common and often preventable; serious ADEs were more likely to be preventable. Most resulted from errors at the ordering stage, but many also occurred at the administration stage. Prevention strategies should target both stages of the drug delivery process.(JAMA. 1995;274:29-34)
Background
Echinacea products are among the most popular phytomedicines on the North American market. Since at least half of all pregnancies are unplanned, many women inadvertently use echinacea in their first trimester. Presently, there is a paucity of information regarding the gestational safety of this herb. The primary objective of this study was to evaluate the safety of echinacea in pregnancy when used for upper respiratory tract ailments.
Patients and Methods
The study group consisted of women who were prospectively followed up after contacting the Motherisk Program regarding the gestational use of echinacea. This cohort was disease-matched to women exposed to nonteratogenic agents by maternal age, alcohol, and cigarette use. Rates of major and minor malformations between the groups were compared.
Results
A total of 206 women were enrolled in the study group after using echinacea products during pregnancy; 112 women used the herb in the first trimester. There were a total of 195 live births, including 3 sets of twins, 13 spontaneous abortions, and 1 therapeutic abortion. Six major malformations were reported, including 1 chromosomal abnormality, and 4 of these malformations occurred with echinacea exposure in the first trimester. In the control group, there were 206 women with 198 live births, 7 spontaneous abortions, and 1 therapeutic abortion. Seven major malformations were reported. There were no statistical differences between the study and control groups for any of the end points analyzed.
Conclusions
This first prospective study suggests that gestational use of echinacea during organogenesis is not associated with an increased risk for major malformations.
HPLC methods are described for the determination of cichoric acid and alkamides (dodecatetraenoic acid isobutylamides) with an aim towards standardization of Echinacea purpurea preparations prepared from expressed juice. Analysis of commercial samples reveals the present quality status of a selection of these preparations. Regarding alkamides, the content ranges from 0.1 to 1.8 mg/ml. The content of cichoric acid varies more dramatically (0.0–0.4%) likely due to inconsistent inhibition of the enzymatic degradation of cichoric acid.
The aim of this randomized, double-blind, placebo controlled study was to investigate the efficacy and safety of different doses and preparations of Echinacea purpurea in the treatment of common cold. 246 of 559 recruited healthy, adult volunteers caught a common cold and took 3 times daily 2 tablets of either Echinaforce® (Echinacea purpurea-preparation from 95% herba and 5% radix), Echinacea purpurea concentrate (same preparation at 7 times higher concentration), special Echinacea purpurea radix preparation (totally different from that of Echinaforce®) or placebo until they felt healthy again but not longer than 7 days. The primary endpoint was the relative reduction of the complaint index defined by 12 symptoms during common cold according to the doctor's record. Echinaforce® and its concentrated preparation were significantly more effective than the special Echinacea extract or placebo. All treatments were well tolerated. Among the Echinacea groups the frequency of adverse events was not significantly higher than in the placebo group. Therefore, Echinacea concentrate as well as Echinaforce® represent a low-risk and effective alternative to the standard symptomatic medicines in the acute treatment of common cold.
Immunostimulants [1, 2] or immunopotentiators are drugs leading predominantly to a non-specific stimulation of immunological
defence mechanisms. Most of them are not real antigens but antigenomimetics or so-called mitogens. Non-specific and non-antigen
dependent stimulants do not affect immunological memory cells and, since their pharmacological efficacy fades comparatively
quickly, they have to be administered either in intervals or continuously. Some immunostimulants may also stimulate T-suppressor
cells and thereby reduce immune resistance, hence the term immunomodulation or immunoregulation, denoting any effect on, or
change of, immune responsiveness is also very often used.
Preparations containing extracts of the plant Echinacea (family Cornpositae) are widely used by patients and practitioners in some European countries for preventing and treating upper respiratory tract
infections as well as more generally for “stimulating the body’s own defense mechanisms.” At present, about 1000 preparations
are obtainable which contain extracts of Echinacea alone or in combination with other plant extracts [1]. In 1993 German physicians prescribed over 3 million daily doses of
the five leading preparations with a cost of 50 million DM [2]. As these preparations are often sold over the counter the
actual overall use is probably much more widespread. Despite this frequent use, there is considerable debate about the effectiveness
of Echinacea extracts, and doubts have been raised about safety in the (relatively rare)case of parenteral application [3,4].
Plant extracts have been used for their therapeutic properties for thousands of years. Many of the well known drugs still
in widespread use today, such as morphine, digoxin or salicylic acid, were originally isolated from plants such as the poppy,
the foxglove and the willow [1–3]. Yet plant extracts, as such, still have a place in therapy alongside synthetic chemical
products. With increasing concern among both practising physicians and the lay public about the possible risks associated
with drug treatment, there is an understandable desire to treat with traditionally well-tolerated drugs. Over-the-counter
medicines are being used increasingly in the developed countries, particularly for children, and concern has been expressed
as to whether parents are sufficiently well-informed about the benefits and risks of the products they keep at hand in the
kitchen cupboard [4]. Many plant-derived products are regarded as well-tolerated by their proponents and ridiculed as inefficacious
by their critics. In this controversial atmosphere, it is important to assess objectively the facts about individual therapeutic
products.
Echinacea phytopharmaceuticals represent the most popular group of herbal immunostimulants in Europe and in the USA [1, 2]. According
to a recent report, Echinacea products have been the best selling herbal products in natural food stores in the USA in 1997 with 11.93% (1996: 9.6%) of
herbal supplement sales [3]. Including homeopathic preparations, more than 800 Echinacea-containing drugs are currently on the market in Germany. Most of the preparations contain the expressed sap of Echinacea purpurea aerial parts, or hydroalcoholic tinctures of E. pallida or E. purpurea roots. They are mainly used for the treatment of colds and infections [4]. Clinical effects have been demonstrated for the
expressed sap of the aerial parts of Echinacea purpurea in the adjuvant therapy of relapsing infections of the respiratory and urinary tracts, as well as for alcoholic tinctures
of E. pallida and E. purpurea roots as adjuvants in the therapy of the common cold and flu [5, 6]. In the USA, it is mostly encapsulated powders from roots
and aerial parts, but also tinctures from the roots and aerial parts that are used. Many investigations of the constituents
of Echinacea have been undertaken. So far, compounds from the classes of caffeic acid derivatives, flavonoids, polyacetylenes, alkamides,
pyrrolizidine alkaloids, polysaccharides and glycoproteins have been isolated [7]. For the main interest of finding the active
component, but also for standardization purposes, the question on the chemical composition of Echinacea herbs and preparations is essential. Therefore, the present knowledge on the chemical constituents, analysis, and immunomodulatory
effects of Echinacea preparations shall be reviewed.
The use of extracts of Echinacea angustifolia and E. purpurea by the American Indians and later in the Traditional medicine of Europe against wounds, burns, swellings of the lymph glands
(mumps), measles and various infections has initiated a thorough chemical and pharmacological search for the active components
of the drugs. Since the weak antimicrobial activity found for the extract and the isolated caffeic acid derivative echinacoside,
isolated from the root of Echinacea angustifolia, could not explain the therapeutic efficacy of the drug, in vitro and in vivo immunological investigations were started. They resulted in the isolation of several low and high molecular weight compounds
such as caffeic acid derivatives, poly-acetylenes, alkylamides, and polysaccharides (see chapter by R. Bauer, this volume).
Among them the 2,3–O dicaffeoyl tartaric acid (cichoric acid) and the polysaccharides, a 4–O–methylglucuronoarabinoxylan (EPS-XG)
(MW ≅ 35 kDa) and an acidic arabinorhamnogalactan (EPS-AG) (MW ≅ 50 kDa) turned out to be the most active compounds in several
in vitro and in vivo immunological assays [1, 2] (Fig. 1). The expensive isolation procedure of the polysaccharides in a pure form and the difficulty
of obtaining them with reproducible activity prompted one of us to produce them from tissue cultures of Echinacea purpurea leaves. From the growth medium two homogeneous polysaccharides, i.e. a neutral fucogalactoxyloglucan (MW ≅ 25 kDa) and an
acidic arabinogalactan (MW ≅ 75 kDa) could be isolated [3] (Fig. 2a, b).