ArticlePDF Available

An Evidence-Based Systematic Review of Blessed Thistle (Cnicus benedictus) by the Natural Standard Research Collaboration

Authors:

Abstract

An evidence-based systematic review including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
A preview of the PDF is not available
... 14,16,17 It is also used to relieve gastrointestinal distress and as an expectorant. 14,18 Centaurea benedicta is also used to treat liver diseases including jaundice. It is also useful for improving memory, as a galactagogue to increase milk production in nursing mothers, as a diuretic for increasing urine output, and for relieving menstrual pain. ...
... It is also useful for improving memory, as a galactagogue to increase milk production in nursing mothers, as a diuretic for increasing urine output, and for relieving menstrual pain. 18 When applied to the skin, it is an effective treatment for boils, wounds, and skin ulcers. 8,15 The traditional uses of C. benedicta originate from European healing systems, where the uses have been extensively verified and modified. ...
... When consumed as an infusion, it is recommended that 0.5-3 g of dried blessed thistle flowering tops be steeped in 150 mL of boiling water and consumed as a tea three times a day. 18 Alternatively, if an aqueous extract (prepared with equal amounts of dried plant material and water) or tincture (prepared with 1 part plant material to 5 parts alcohol) are used therapeutically, 1.5-2 mL or 7.5-10 mL respectively are recommended to be taken orally three times daily. ...
Article
Full-text available
Centaurea benedicta L. is an annual herbaceous plant which belongs to the Asteraceae family. It is native to the Mediterranean region and western Asia and is commonly known as blessed thistle, holy thistle, St Benedict’s thistle or spotted thistle. Traditionally, it has been used to treat bubonic plague and possesses diuretic, galactagogue, liver-strengthening and wound healing properties. Recent research studies have investigated its anticancer, antiinflammatory, antioxidant and other therapeutic properties. Several studies have also reported its antimicrobial activity against a range of bacterial pathogens. However, most of these studies were preliminary and only tested relatively high concentrations of the extracts. Additionally, most studies screened a limited number of pathogens. Cnicin is the main chemical compound present in C. benedicta and it has been widely investigated. However, few other compounds from this plant have been identified and/or investigated, and further phytochemical studies are warranted. Interestingly, pure cnicin has good anticancer activity, whilst the crude extracts lack cytotoxic properties. Phytochemical analyses of C. benedicta extracts reveal the presence of multiple flavonoids, tannins, terpenoids and lactones, although few specific phytochemicals within these phytochemical classes have been identified. A limited number of research studies have determined the toxicity profile of C. benedicta in order to evaluate its safety for human use. Substantially more detailed studies are required to rigorously investigate the therapeutic properties and phytochemistry of C. benedicta, which may ultimately lead to the development of new plant-based therapeutic medicines.
... Obsahové látky: cnicín (0,2-0,7 %), polyacetylén, absintín, triterpenoidy (a-amyrenón, a-amyrín acetát, multiflorenol acetát), lignány (trachelogenín, arctigenín, nortrachelozid), flavonoidy, polyeny, taníny (8 %), silica (0,3 %) 71) . Spôsob podania: nálev, tinktúra, podrvené nadzemné časti v kapsulách 71) . ...
... Obsahové látky: cnicín (0,2-0,7 %), polyacetylén, absintín, triterpenoidy (a-amyrenón, a-amyrín acetát, multiflorenol acetát), lignány (trachelogenín, arctigenín, nortrachelozid), flavonoidy, polyeny, taníny (8 %), silica (0,3 %) 71) . Spôsob podania: nálev, tinktúra, podrvené nadzemné časti v kapsulách 71) . Benedikt lekársky sa je laickými zdrojmi pre lepší výsledok podpory laktácie často odporúčaný v kombinácii so senovkou gréckou, toto tvrdenie nebolo zatiaľ vyvrátené ani potvrdené 72) . ...
... Mechanizmus účinku: Jedným z možných vysvetlení zvýšenia tvorby mlieka je stimulácia toku krvi do mliečnej žľazy 15) . Indikácie: Beniedikt lekársky bol tradične používaný pre zvýšenie chuti do jedla, podporu trávenia, pri dyspeptických ťažkostiach a ako abortívum 71) . Dávka: Nálev sa pripravuje z 1,5-2 g sušenej drogy 3-krát denne, tinktúru je možné užívať 3-krát denne v dávke 7,5-10 ml 71) . ...
Article
Subjective perception of insufficient milk supply is one of the most common problems of nursing mothers. For centuries, herbs have been used to increase lactation and remain popular even today. There is only a limited number of studies proving their safety and effectivity, so their use is based primarily on previous experience. The use of certain herbs has shown that they could be effective and safe, but further research is needed to define terms of use. This paper describes preliminary findings on the mechanism of action, adverse effects and possible interactions observed in some herbs frequently used to promote lactation.Key words: phytotherapy lactation herbal galactagogue.
... of drug interactions. [13][14][15][16][17]21,23,27,[32][33][34][35][36][37][38][39][40]45,47,[50][51][52][53][54][55][56][57][58][59][60][61] The number of primary studies included in the SRs ranged from 1 38 to 216. 28 The types of primary reports varied from case studies to epidemiological investigations. ...
... 26 Thirty-one SRs concluded that the HM in question was safe. [13][14][15][16][17][18][19][20][21][23][24][25][26]29,31,32,35,38,39,[42][43][44][45]47,50,53,55,[57][58][59][60] Fifteen SRs reported moderately severe AEs, 12,22,27,28,30,36,40,41,46,48,49,51,52,54,56 and four SRs concluded that the HM in question was not safe (see Supplemental Tables S1 and S2). 33,34,37,61 Thirteen SRs mentioned the duration of AEs, 18,20,22,24,26,28,33,42,[44][45][46]48,50 which ranged from 48 hours to 11 months. ...
... Forty-two SRs failed to mention conflict of interest of the authors. [13][14][15][16][17][18]22,23,[25][26][27][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] Thirty-two SRs made no mention of any source of funding. [13][14][15][16][17]22,23,27,30,[34][35][36][37][38][39][40][41]44,47,48,[50][51][52][53][54][55][56][57][58][59][60][61] The quality of the methods of the included SRs was mixed ( ...
Article
This overview of systematic reviews (SRs) aims to evaluate critically the evidence regarding the adverse effects of herbal medicines (HMs). Five electronic databases were searched to identify all relevant SRs, with 50 SRs of 50 different HMs meeting our inclusion criteria. Most had only minor weaknesses in methods. Serious adverse effects were noted only for four HMs: Herbae pulvis standardisatus, Larrea tridentate, Piper methysticum and Cassia senna. The most severe adverse effects were liver or kidney damage, colon perforation, carcinoma, coma and death. Moderately severe adverse effects were noted for 15 HMs: Pelargonium sidoides, Perna canaliculus, Aloe vera, Mentha piperita, Medicago sativa, Cimicifuga racemosa, Caulophyllum thalictroides, Serenoa repens, Taraxacum officinale, Camellia sinensis, Commifora mukul, Hoodia gordonii, Viscum album, Trifolium pratense and Stevia rebaudiana. Minor adverse effects were noted for 31 HMs: Thymus vulgaris, Lavandula angustifolia Miller, Boswellia serrata, Calendula officinalis, Harpagophytum procumbens, Panax ginseng, Vitex agnus-castus, Crataegus spp., Cinnamomum spp., Petasites hybridus, Agave americana, Hypericum perforatum, Echinacea spp., Silybum marianum, Capsicum spp., Genus phyllanthus, Ginkgo biloba, Valeriana officinalis, Hippocastanaceae, Melissa officinalis, Trigonella foenum-graecum, Lagerstroemia speciosa, Cnicus benedictus, Salvia hispanica, Vaccinium myrtillus, Mentha spicata, Rosmarinus officinalis, Crocus sativus, Gymnema sylvestre, Morinda citrifolia and Curcuma longa. Most of the HMs evaluated in SRs were associated with only moderately severe or minor adverse effects.
... x The following drugs interacted with HMPs (Table 2): anaesthetics [16], anti-arrhythmic agents [15,27], antibiotics [19,34,36,39,40,42,46,48,49,52,53], anticoagulants [13, 15, 16, 18, 24, 26, 27, 29, 33, 34, 36, 37, 39, 40, 44-46, 49, 50, 52, 53], anticholinergics [17,22], antidepressants [25,26,33,45], antidiabetics [26,27,38,40,43,47,[50][51][52][53], antihypertensives [16, 29, 33, 41, 43-46, 49, 53], anti-inflammatory agents [13,16,35,46,52,53], antimicrobials [31], antineoplastics [11,14,31,36,[39][40][41][42][43][51][52][53], antiplatelet agents [13,15,24,25,27,29,33,34,36,37,39,40,44,45,49,50,52,53], anti-epileptic drugs [13,41,45], antivirals [31,40,45,51,52], calcium channel blockers [24,26,30], cholesterol lowering agents [10,13,24,26,27,40,41,44,45,50,53], CYP-450 metabolized agents [18,21,25,29,32,34,40,42,45,48,49,53], diuretics [26,30,43], hormonal agents [18,24,26,31,40,41,43,45,49,53,54], hypoglycaemics [9,10,19,20,28], immunnosupressants [31,34,37,40,43,46,48] laxatives [27,37,50], leukotriene inhibitors [14], sedatives [12,13,23,25,45], selective serotonin re-uptake inhibitors [23,33] and vasolidators [30,44]. ...
... x The following drugs interacted with HMPs (Table 2): anaesthetics [16], anti-arrhythmic agents [15,27], antibiotics [19,34,36,39,40,42,46,48,49,52,53], anticoagulants [13, 15, 16, 18, 24, 26, 27, 29, 33, 34, 36, 37, 39, 40, 44-46, 49, 50, 52, 53], anticholinergics [17,22], antidepressants [25,26,33,45], antidiabetics [26,27,38,40,43,47,[50][51][52][53], antihypertensives [16, 29, 33, 41, 43-46, 49, 53], anti-inflammatory agents [13,16,35,46,52,53], antimicrobials [31], antineoplastics [11,14,31,36,[39][40][41][42][43][51][52][53], antiplatelet agents [13,15,24,25,27,29,33,34,36,37,39,40,44,45,49,50,52,53], anti-epileptic drugs [13,41,45], antivirals [31,40,45,51,52], calcium channel blockers [24,26,30], cholesterol lowering agents [10,13,24,26,27,40,41,44,45,50,53], CYP-450 metabolized agents [18,21,25,29,32,34,40,42,45,48,49,53], diuretics [26,30,43], hormonal agents [18,24,26,31,40,41,43,45,49,53,54], hypoglycaemics [9,10,19,20,28], immunnosupressants [31,34,37,40,43,46,48] laxatives [27,37,50], leukotriene inhibitors [14], sedatives [12,13,23,25,45], selective serotonin re-uptake inhibitors [23,33] and vasolidators [30,44]. ...
... x The following drugs interacted with HMPs (Table 2): anaesthetics [16], anti-arrhythmic agents [15,27], antibiotics [19,34,36,39,40,42,46,48,49,52,53], anticoagulants [13, 15, 16, 18, 24, 26, 27, 29, 33, 34, 36, 37, 39, 40, 44-46, 49, 50, 52, 53], anticholinergics [17,22], antidepressants [25,26,33,45], antidiabetics [26,27,38,40,43,47,[50][51][52][53], antihypertensives [16, 29, 33, 41, 43-46, 49, 53], anti-inflammatory agents [13,16,35,46,52,53], antimicrobials [31], antineoplastics [11,14,31,36,[39][40][41][42][43][51][52][53], antiplatelet agents [13,15,24,25,27,29,33,34,36,37,39,40,44,45,49,50,52,53], anti-epileptic drugs [13,41,45], antivirals [31,40,45,51,52], calcium channel blockers [24,26,30], cholesterol lowering agents [10,13,24,26,27,40,41,44,45,50,53], CYP-450 metabolized agents [18,21,25,29,32,34,40,42,45,48,49,53], diuretics [26,30,43], hormonal agents [18,24,26,31,40,41,43,45,49,53,54], hypoglycaemics [9,10,19,20,28], immunnosupressants [31,34,37,40,43,46,48] laxatives [27,37,50], leukotriene inhibitors [14], sedatives [12,13,23,25,45], selective serotonin re-uptake inhibitors [23,33] and vasolidators [30,44]. ...
Article
Objectives: The aim of this overview of systematic reviews (SRs) is to evaluate critically the evidence regarding interactions between herbal medicinal products (HMPs) and synthetic drugs. Methods: Four electronic databases were searched to identify relevant SRs. Results: Forty-six SRs of 46 different HMPs met our inclusion criteria. The vast majority of SRs were of poor methodological quality. The majority of these HMPs were not associated with severe herb-drug interactions. Serious herb-drug interactions were noted for Hypericum perforatum and Viscum album. The most severe interactions resulted in transplant rejection, delayed emergence from anaesthesia, cardiovascular collapse, renal and liver toxicity, cardiotoxicity, bradycardia, hypovolaemic shock, inflammatory reactions with organ fibrosis and death. Moderately severe interactions were noted for Ginkgo biloba, Panax ginseng, Piper methysticum, Serenoa repens and Camellia sinensis. The most commonly interacting drugs were antiplatelet agents and anticoagulants. Conclusion: The majority of the HMPs evaluated in SRs were not associated with drug interactions with serious consequences. However, the poor quality and the scarcity of the primary data prevent firm conclusions.
... One of the major constituents that exist in Cnicus benedictus is "cnicin" that belongs to the terpenes family (13,14). There are numerous documents concerning the effects of terpene on treating pain (15,16). ...
Article
Full-text available
Background and purpose: Cnicus benedictus, a medicinal herb, traditionally had been used for the treatment of stomachache pain. In this study, the possible efficacy of Cnicus benedictus leaf methanolic extract (CBHE) and also cnicin, one of its major constituents, was measured on pain. Experimental approach: In this study, pain assessment tests include writhing, tail-flick (TF), and formalin- induced paw licking test (FIPLT) were used. To understand the possible mediated anti-nociceptive mechanism of CBHE, the opioid mechanism(s), and involvement of the L-arginine/ nitric oxide/cGMP/ATP-sensitive potassium channel pathway (LNCaP) were scrutinized. Findings/results: In TF and writhing tests, CBHE (150 and 300 mg/kg, i.p) remarkably exhibited an anti-nociceptive effect compared to that of the control. Furthermore, CBHE (150 and 300 mg/kg, i.p) in comparison with the control showed a noteworthy anti-nociceptive effect (P < 0.01) in the tonic phase of FIPLT. In the writhing test, administration of selective opioid antagonist (naltrindole, nor-binaltorphimine, and naloxonazine) attenuated the anti-nociceptive effect of CBHE (300 mg/kg) in comparison with control. Moreover, pre-treatment with Nω-nitro-L-arginine methyl ester hydrochloride, L-arginine hydrochloride, and glibenclamide significantly blocked the CBHE (300 mg/kg) anti-nociception (P < 0.05) while administration of sodium nitroprusside remarkably potentiated (P < 0.05) the antinociception induced by CBHE in the tonic phase of the FIPLT. Besides, cnicin (30 mg/kg) showed noteworthy anti-nociceptive effects in writhing, TF, and FIPLT paradigms. Conclusion and implications: Taken together, we elucidate that both CBHE and cnicin demonstrated antinociceptive effects in behavioral tests. The possible mechanisms of CBHE antinociception may involve in various neural signaling and modulatory pathways including LNCaP and opioidergic mechanisms.
Preprint
Full-text available
Centaurea benedicta L., commonly known as “cardo santo,” is used as a tonic, antidepressant, anti-inflammatory, antibacterial, and antiseptic in traditional medicine. This study evaluated the topical anti-inflammatory potential of an extract (ECB) and cnicin (CNI) from C. benedicta leaves in a mouse model. Activity was assessed using the ear edema method with croton oil, phenol, capsaicin, and histamine as phlogistic agents. Myeloperoxidase (MPO), N-acetyl-β-D-glucosaminidase (NAG), nitric oxide (NO), t umor necrosis factor α (TNF-α), interleukin 6 (IL-6), and histopathology were assessed as markers of edema/inflammation. Interaction profiles between CNI and cyclooxygenase-1 and -2, induced nitric oxide synthase, and glucocorticoid receptor were examined with molecular docking. Twenty-four h after induction of inflammation, ECB and CNI treatments decreased the thickness and weight of ears by 39.59%– 94.72%. MPO, NAG, NO, TNF-α, and IL-6 levels were also reduced. Histopathological, treatments reduced edema thickness, leukocytes, and vasodilation. Inflammation induced by phenol and histamine was inhibited by ECB and CNI, and ECB suppressed capsaicin-induced inflammation. CNI interacts with cyclooxygenase-1 and nitric oxide synthase through conventional hydrogen bonds, indicating inhibition of these enzymes. ECB and its compound cnicin reduce chemically-induced inflammation in mice suggesting new possibilities for the treatment of diseases associated with dermal inflammatory processes.
Article
Full-text available
Since the emergence of the SARS-CoV-2 pandemic in 2019, it has remained a significant global threat, especially with the newly evolved variants. Despite the presence of different COVID-19 vaccines, the discovery of proper antiviral therapeutics is an urgent necessity. Nature is considered as a historical trove for drug discovery, especially in global crises. During our efforts to discover potential anti-SARS CoV-2 natural therapeutics, screening our in-house natural products and plant crude extracts library led to the identification of C. benedictus extract as a promising candidate. To find out the main chemical constituents responsible for the extract’s antiviral activity, we utilized recently reported SARS CoV-2 structural information in comprehensive in silico investigations (e.g., ensemble docking and physics-based molecular modeling). As a result, we constructed protein–protein and protein–compound interaction networks that suggest cnicin as the most promising anti-SARS CoV-2 hit that might inhibit viral multi-targets. The subsequent in vitro validation confirmed that cnicin could impede the viral replication of SARS CoV-2 in a dose-dependent manner, with an IC50 value of 1.18 µg/mL. Furthermore, drug-like property calculations strongly recommended cnicin for further in vivo and clinical experiments. The present investigation highlighted natural products as crucial and readily available sources for developing antiviral therapeutics. Additionally, it revealed the key contributions of bioinformatics and computer-aided modeling tools in accelerating the discovery rate of potential therapeutics, particularly in emergency times like the current COVID-19 pandemic.
Article
Full-text available
Purpose: The aim of this overview of systematic reviews is to summarise and critically evaluate the evidence from systematic reviews of the adulteration and contamination of herbal medicinal products (HMPs). Methods: Five electronic databases were searched to identify all relevant systematic reviews. Results: Twenty-six systematic reviews met our inclusion criteria. The most commonly HMPs were adulterated or contaminated with dust, pollens, insects, rodents, parasites, microbes, fungi, mould, toxins, pesticides, toxic heavy metals and/or prescription drugs. The most severe adverse effects caused by these adulterations were agranulocytosis, meningitis, multi-organ failure, perinatal stroke, arsenic, lead or mercury poisoning, malignancies or carcinomas, hepatic encephalopathy, hepatorenal syndrome, nephrotoxicity, rhabdomyolysis, metabolic acidosis, renal or liver failure, cerebral edema, coma, intracerebral haemorrhage, and death. Adulteration and contamination of HMPs were most commonly noted for traditional Indian and Chinese remedies, respectively. Conclusions: Collectively these data suggest that there are reasons for concerns with regards to the quality of HMPs. Adulteration and contamination of HMPs can cause serious adverse effects. More stringent quality control and its enforcement seem to be necessary to avoid health risks.
Article
A series of lignans, ie (-)-arctigenin, (-)-trachelogenin, podophyllotoxin, picropodophyllotoxin, 4'-demethylpodophyllotoxin, 4'- demethylpicropodophyllotoxin, deoxypodophyllotoxin, deoxypicropodophyllotoxin, and etoposide were tested for activity against human immunodeficiency virus type 1 (HIV-1) infection in vitro. Only the 2,3- dibenzylbutanolide (-)arctigenin and its 2-hydroxy derivative (-)- trachelogenin as well as etoposide displayed an anti-HIV-1 cytoprotective effect in vitro. Using the polymerase chain reaction technique to determine the degree of integration of proviral DNA into the cellular DNA genome, it was found that (-)-arctigenin and (-)-trachelogenin and to some extent etoposide, but not the other topoisomerase inhibitors, 4'- demethylpodophyllotoxin and 4'-demethylpicropodophyllotoxin, strongly suppressed the integration reaction.
Article
Since the discovery of the human immunodeficiency virus (HIV) as the causative agent of acquired immunodeficiency syndrome (AIDS), a number of potentially useful strategies for the antiviral therapy of AIDS have emerged. One such approach is the use of the family of dideoxynucleosides which inhibit the virally-encoded reverse transcriptase. HIV protease also represents a virus-specific target for the therapy of HIV infection. Several protease inhibitors have already shown favorable antiviral activity in patients with HIV-1 infection. However, it has become apparent that with any anti-HIV-1 drugs used so far, only partial immunologic reconstitution is seen in patients with advanced AIDS. Moreover, the improvement attained has generally been transient and the accumulating data suggest that the development of HIV-1 variants with reduced susceptibility to anti-HIV-1 drugs is related to the limited efficacy of currently available antiviral therapy. Efforts to optimize antiretroviral activities of certain anti-HIV-1 drugs have been made, and there is considerable evidence that certain combinations of drugs enable a greater and more sustained immunologic improvement than observed with any single drug, while none of the currently available therapies are curative, chemotherapy of AIDS will have a further significant impact on the morbidity and mortality of HIV infection in the near future.
Article
Extracts of plants, used in traditional Argentine medicine to treat diarrhoea, catarrh, laryngitis, pneumonia, bronchitis, and infections of the urinary tract, were tested for activity against P. aeruginosa.
Article
In the course of studying differentiation-inducers from plants, their isolation was performed from the methanolic extract of Arctium Fructus (the fruits of Arctium lappa L., Compositae), and then their phagocytic activity on differentiated mouse myeloid leukemia cells (MI) was monitored. Thirteen compounds, including five new ones, were isolated as differentiation-inducers toward MI cells. These consisted of two lignans, eight sesquilignans and three dilignans. Arctigenin (2) was the most effective compound of all those isolated, and it induced differentiation of MI cells at a concentration 0.5 μM. Sesquilignans were less effective than lignans and dilignans showed even weaker activity. These lignoids were inactive towards a human acute promyelocytic leukemia cell line (HL-60).
Article
Cnicin, a sesquiterpenlactone of germacranolide-type, reacts with polynitroaromatic compounds in alkaline medium to form intensely coloured products of the Meisenheimer complex-type. A propenide complex results from the addition of excess picrate (Baljet reagent), which is stable enough for photometric cnicin determination. Dried leaves of Cnicus benedictus L. (Blessed Thistle, Asteraceae) contain up to 2.5% of cnicin and commercial herbs between 0.2-0.7%. Shoots and flowering heads are almost free from this bitter substance. Storage of dried plant material leads to high losses due to the instability of cnicin. The approximate acute toxicity (ALD50) for mice, orally administered, is 1.6-3.2 mmol cnicin/kg body weight. Cnicin shows an antiinflammatory activity in the rat paw edema screen which is nearly equivalent to that of indomethacin. Intraperitoneal application of cnicin results in a strong irritation of tissue. In the writhing-test, cnicin causes abdominal pain in mice with an ED50 of 6.2 µmol/kg body weight.
Article
Light petrol and chloroform extracts of the herba of C ni eus benedictus yielded α–amyrenone; α–amyrine acetate; α–amyrine; oleanolic acid; multiflorenol acetat; multiflorenol and sitosteryl–3 β–D–glucoside.
Article
Plants of 27 families, encompassing 75 species, have been selected on the basis of medicinal folklore. They are being studied in a broad screening programme for their anti-inflammatory activity, using carrageenin foot oedema in rats. Only 4 species were very active, inhibiting carrageenin foot oedema by 42 to 74%, but overall 72% exhibited some anti-inflammatory activity.