Star Anise: A Purported Antiviral Herb with Numerous Associated Health Benefits

Abstract

Star anise belongs to the Schisandraceae family. About 166 varieties exist, and 42 species are grown in the tropics of East Asia and Southeast Asia. Many beneficial effects of star anise have been established, including ameliorating the symptoms of rheumatism and joint pain, warding off insects (insect repellant), lessening cold and flu symptoms, and potentially acting as an antioxidant against reactive oxygen species (ROS), reducing oxidative stress, inhibiting apoptosis, preventing DNA damage, and expressing a DPPHH radical scavenging effect. Following the onset of the COVID-19 pandemic, star anise has been used as a natural immune-booster and antiviral in teas and aerosol sprays. (Star anise oil is used for fragrance in soap, cosmetics, and perfume manufacturing.) However, more in-depth and extensive research needs to be conducted, investigating the efficacy of star anise's purported beneficial properties. This review discusses the distinctions between the varieties of anise, indications and beneficial effects, modes of application and administration, and contraindications and precautions.

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OPEN ACCESS EC EC CLINICAL AND MEDICAL CASE REPORTSCLINICAL AND MEDICAL CASE REPORTS
Review Article
Nicholas A Kerna1,2*, Joseph Anderson II3, Kevin D Pruitt4,5, John V Flores6,7, Mary Ann Christy Ortigas8, ND Victor
Carsrud9, Hilary M Holets6,7, Raymond Nomel10, Uzoamaka Nwokorie11 and Dorathy Nwachukwu12
1SMC–Medical Research, Thailand
2First InterHealth Group, Thailand
3International Institute of Original Medicine, USA
4Kemet Medical Consultants, USA
5PBJ Medical Associates, LLC, USA
6Beverly Hills Wellness Surgical Institute, USA
7Orange Partners Surgicenter, USA
8University of Nevada, USA
9Lakeline Wellness Center, USA
10All Saints University, College of Medicine, St. Vincent and the Grenadines
11University of Washington, USA
12Georgetown American University, Guayana
*Corresponding Author: Nicholas A Kerna, (mailing address) POB47 Phatphong, Suriwongse Road, Bangkok, Thailand 10500.
Contact: medpublab+drkerna@gmail.com.
Received: September 13, 2021; Published: November 30, 2021
Star Anise: A Purported Antiviral Herb with Numerous

Citation: Kerna NA, Anderson II J, Pruitt KD, Flores JV, Ortigas MAC, Carsrud NDV, Holets HM, Nomel R, Nwokorie U, Nwachukwu D. “Star
EC Clinical and Medical Case Reports 4.12 (2021): 63-73.
Abstract
Star anise belongs to the Schisandraceae family. About 166 varieties exist, and 42 species are grown in the tropics of East Asia and

      
reactive oxygen species (ROS), reducing oxidative stress, inhibiting apoptosis, preventing DNA damage, and expressing a DPPHH
radical scavenging effect.
Following the onset of the COVID-19 pandemic, star anise has been used as a natural immune-booster and antiviral in teas and
aerosol sprays. (Star anise oil is used for fragrance in soap, cosmetics, and perfume manufacturing.) However, more in-depth and
-
     
and contraindications and precautions.
Keywords: Antifungal; Antiviral; Carcinopreventive; Herbal Remedy; Herpes Simplex; Immune Response; Prophylaxis
Abbreviations
ATWE: Ambient Temperature Water Extract; BWE: Boiling Water Extract; CNS: Central Nervous System; MFC: Minimum Fungicidal Con-
centration; NDEA: Nitrosodiethylamine; OSP: Oseltamivir Phosphate; ROS: Reactive Oxygen Species; SAWRE: Star Anise Waste Residue
Extract
DOI: 10.31080/eccmc.2021.04.00484

Citation: Kerna NA, Anderson II J, Pruitt KD, Flores JV, Ortigas MAC, Carsrud NDV, Holets HM, Nomel R, Nwokorie U, Nwachukwu D. “Star
EC Clinical and Medical Case Reports 4.12 (2021): 63-73.

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Introduction
Star anise (Illicium verum) is an evergreen tree that bears star-shaped fruits. It is distributed widely throughout Southwestern Asia.
Apart from being an important spice, it is well-known for its potent antiviral effects. It is the source of shikimic acid, the substrate for the
-
nized as having antioxidant, antimicrobial, antifungal, anthelmintic, insecticidal, antinociceptive, gastroprotective, sedative, estrogenic,

The spice was introduced in Europe by English navigator Sir Thomas Cavendish in 1578 CE. The plant is native to South China and
Vietnam. The history of star anise dates back to about 100 BCE. It is used in soups, stews, broths, and baking. The taste is licoricey and is

essential part of the quintessential garam masala of Indian households. It is also used as a scent in cleansers, beauty care products, and

Anise varieties
   
Species include Illicium Mexicana (Mexican anise), I. anisatum, I. floridanum, I. parviflorum, and I. lancedatum  The name Illicium comes

Indonesia, Vietnam, and Jamaica. Illicium verum is a well-known source of carbohydrates, vitamin A, ascorbic acid, and a rich source of
minerals (sodium, calcium, zinc, magnesium, potassium, iron, and copper). The commercial production of star anise is restricted to China
and Vietnam. The optimal conditions for growth are woodlands with sunny edges with variegated shade, soil-rich humus, and a neutral
pH. Even though star anise can grow under diverse climatic conditions, it should be protected from low temperature, supplied with ample

The varieties of anise include common anise, star anise, Japanese star anise, and other similar plants with corresponding names. Avail-
able information on the varieties, regions cultivated, and uses are given in Table 1.
Variety Regions cultivated Uses and indications
Common anise–Pimpinella anisum Eastern Mediterranean region 
-

Star anise–Illicium verum East and Southeast Asia Asthma, bronchitis, breath freshener, rheuma-

Table 1: Uses and indications of different varieties of anise.

Star anise has multiple uses, from being a culinary spice to a wide array of pharmacological applications.

In a study by Astani A., et al. (2011), the essential oil of star anise was found to have antiviral effects against the herpes simplex virus
in vitro  
virus particles in viral suspension assays. The presence of phytoconstituent anethole in abundance is responsible for positive viral inhibi-

Citation: Kerna NA, Anderson II J, Pruitt KD, Flores JV, Ortigas MAC, Carsrud NDV, Holets HM, Nomel R, Nwokorie U, Nwachukwu D. “Star
EC Clinical and Medical Case Reports 4.12 (2021): 63-73.

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tion. On pretreatment with star anise oil, it was observed that the viral infectivity was reduced by more than 99%. The active ingredients
directly inactivate the virus by opposing the virion envelope physicality or masking the structures necessary for entry adsorption. The ef-


In vitro evaluation of antiviral activity is generally carried out using a viral yield reduction assay, cytopathic effect reduction assay, and
plaque reduction assay. The viral activity is assessed through IC50 values, and antiviral SI essential oils obtained from star anise have dem-
onstrated high anti-herpes simplex type-1 activities in vitro. The essential oil of star anise is the most potent with an IC50 value of 1µg/mL
and an SI value of 160 among the tested extracts for antiviral effect. Star anise oil exhibited the most potent activity within an IC50 value

-
tion of extracellular virus particles, prevention of attachment and entry of the virus into the host cell, prevention of replication of the viral
genomic sequence, aversion of the synthesis of viral protein, and obstruction of the assembly or release of new infectious virions, thereby

Condition 
Herpes simplex virus-1 IC50 of 1 µg/ml and SI of 160, intracellular
Herpes simplex virus-2 IC50 of 1 µg/ml and SI of 160, intracellular
 Shikimic acid in vitro
Dengue Shikimic acid in vitro
 Sesquiterpene CC50 -160 ± 30.7, EC50 -1 ± 0.1
Table 2: Viral diseases that respond to star anise [12,13].
Star anise prophylactic applications
In a study undertaken by Yadav and Bhatnagar (2007), star anise was assessed for its potential to act as an anticarcinogen. The
study was conducted by inducing carcinogenesis with a single dose of nitrosodiethylamine (NDEA) for approximately 14 weeks. NDEA

incidence and multiplicity at 20 weeks. Furthermore, it restored hepatic erythrocyte superoxide dismutase levels, decreased tumor
burden and oxidative stress, and increased phase-II enzymes. The anti-cancerous effect was attributed to anethole, and the effects were

Elmasry., et al. (2018) conducted a rat study exploring probable prophylactic effects of star anise extracts on the alterations of sexual
hormones, sperm abnormalities, the toxicity of testes, sperm count, and testicular damage caused by equigan. When administered with

Illicium verum has antimicrobial, antifungal, anthelmintic, and insecticidal properties. The trans-anethole present in Illicium ve-
rum is responsible for these properties. Illicium verum is an effective antifungal agent against plant pathogenic fungi, such as Pythium
aphanidermatum and Botryodiplodia theobromae. The essential oil from Illicium verum demonstrates a broad spectrum of inhibitory

 -


Citation: Kerna NA, Anderson II J, Pruitt KD, Flores JV, Ortigas MAC, Carsrud NDV, Holets HM, Nomel R, Nwokorie U, Nwachukwu D. “Star
EC Clinical and Medical Case Reports 4.12 (2021): 63-73.

66
anti-hypertensive and anti-arthritic activity due to the hydroxyl group that mediates redox reactions and scavenges free radicals, thereby
Illicium verum

Free radicals determine the extent of DNA damage and are precursors to carcinogenesis. Studies showed that both ambient tempera-
ture water extract (ATWE) and boiling water extract (BWE) of star anise extracts are rich in carbohydrates and polyphenols. Aqueous
extracts are antioxidants at a dosage of 25 µg and protect DNA against peroxide, mainly due to the high content of polyphenols and car-
bohydrates, along with the combined effect of all phytochemicals. Dinesha R., et al. (2019). indicated that star anise extracts reduced the

Star anise in combating multidrug resistance
The increasing incidence of multidrug resistance has led to the need for the development of immune modulators. Star anise waste
residue extract (SAWRE) was tested against numerous isolates belonging to two gram-positive and four gram-negative organisms. The
gram-positive organisms included Staphylococcus aureus and Streptococcus pneumonia. The gram-negative organisms included Klebsi-
ella pneumonia, Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa 


Illicium verum, apart from being antiviral, effectively mitigates many illnesses, some of which are listed below (Table 3) .
 Condition
Antibacterial 
Antifungal 
Carminative 
 
Anti-aging 
Antioxidant 
Chemopreventive 
Galactagogue 
Sleep aid 
Table 3: Certain health benefits and other conditions that respond to star anise.
Common conditions treated with star anise
The property of star anise as a stomachic is used to treat loss of appetite. It is also used as an expectorant and has anti-spasmodic activ-
ity in the gastrointestinal tract, thereby playing a role in relaxing smooth muscles. The high anethole content of about 75.76% is credited
with healing properties in respiratory infections, such as bronchitis. It is helpful as an antiseptic, stimulant, antidiabetic and hypotensive.
The seeds are a rich source of B complex vitamins, vitamin C, and vitamin A. The spice acts as a breath freshener, and it is an effective


Citation: Kerna NA, Anderson II J, Pruitt KD, Flores JV, Ortigas MAC, Carsrud NDV, Holets HM, Nomel R, Nwokorie U, Nwachukwu D. “Star
EC Clinical and Medical Case Reports 4.12 (2021): 63-73.

67
Star anise COVID-19 research
Following the onset of COVID-19, the public has resorted to supplementing social distancing norms with herbal decoctions. Star anise
has been infused in many homes as an antiviral agent, and ingested as tea to boost and maintain immunity. As a neuraminidase inhibitor,
Illicium verum, prevents the release of newly formed viruses from the surface of host cells. thus
   







    



Illicium verum    


An extensive quantitative and qualitative analysis of the essential oils of Illicium verum by Huang., et al.-

50) values between 0.07 milligram per ml to 0.25 milligram

The antifungal activity was examined by a vapor contact assay method. The results revealed a 94% decrease in mycelia owing to the

cosmetics, perfumes, and toothpaste. The oil is also effective in treating dyspepsia, productive cough, painful periods, and anorexia.
In a study by Vermaak I., et al. (2019), the antifungal activity of star anise was measured against two strains, such as Aspergillus fumi-
gatus and Aspergillus niger, using the agar-disk-diffusion-test method. The minimum inhibitory concentration (MIC) and the minimum
fungicidal concentration (MFC) were determined. The absolute methanol showed MIC and MFC values of about 31.2 and the highest
inhibitory effect (p < 0.05, 71%) against A. fumigatus
According to Madhu CS., et al. (2014), the antioxidant activity of star anise is due to the presence of its high polyphenol content. Car-


Star anise dosage
The suggested dosage guidelines for star anise consumption are as follows:

Citation: Kerna NA, Anderson II J, Pruitt KD, Flores JV, Ortigas MAC, Carsrud NDV, Holets HM, Nomel R, Nwokorie U, Nwachukwu D. “Star
EC Clinical and Medical Case Reports 4.12 (2021): 63-73.

68
• As a tea: 1 cup consumed orally, 4 times a day, the tea is prepared by boiling 0.5 to 1 gm of seeds in 150 ml of water for about
120 minutes and then strained.
• Star anise powder: 3g per day consumed orally.
• 
Star anise is considered safe due to its low veranisatin content; however, it may cause neurotoxicity when administered in higher
seizures, irritability, hyperexcitability, emesis, vertical nystagmus, and myoclonic move-
ments 
Star anise contraindications
      

In a study conducted by Ize-Ludlow., et al. (2004), Chinese star anise increased adverse neurological reactions in seven infants after
ingestion. The infants who ingested more than the prescribed dose reported malaise, nausea, and vomiting about two to four hours after

Star anise toxicity
Toxicity studies in mice showed lethal effects at a dose of 3 mg/kg in mice. Illicium verum possesses potent central nervous system

Chinese star anise has been generally regarded as being nontoxic and safe. However, Japanese star anise has been well documented
to cause both neurologic and gastrointestinal toxicity. There are numerous cases of Chinese anise being adulterated with Japanese anise,

Star anise drug interactions
Illicium verum may interact with antiepileptic medications due to the presence of the neurotoxin animation (I. anisatum—a Japanese
variety). The Chinese variety also contains veanisatins A, B, and C, which may interfere with regular CNS activity and cause seizures, loss

Star anise research studies
Fritz., et al. (2008) described the anatomical differences between Illicium verum and Illicium anisatum and established their relevance
et al. (2002) performed a component analysis of volatile oil derived from Illicium
verum fruit from which 14 hydrocarbon, 22 oxygenated hydrocarbon derivatives, and a small number of nitrogenous compounds were

of leaves Illicium verum et al. (2009) reported the toxicity of essential oils obtained from Illicium verum
beetle Tribolium castaneum Illicium ve-
rum fruit against Blattella germanica
Star anise sources (where to buy star anise)



Citation: Kerna NA, Anderson II J, Pruitt KD, Flores JV, Ortigas MAC, Carsrud NDV, Holets HM, Nomel R, Nwokorie U, Nwachukwu D. “Star
EC Clinical and Medical Case Reports 4.12 (2021): 63-73.

69
             
Japanese star anise is highly toxic due to anisatin, a neurotoxin (GABA antagonist). Ingestion may lead to seizures, respiratory distress,


    -
ducted, using star anise as a solitary or an adjuvant antiviral. The chemopreventive property needs to be analyzed on a large-scale basis to
gain conclusive evidence about developing an antioxidant formulation that will combat reactive oxygen species, reduce oxidative stress,

There is a broad scope for research on star anises, such as polysaccharide extraction, the development of antifungal molecules as a
solitary source, or in combinations. Such studies may provide a wide array of prospective bio-actives to be isolated and add to the emerg-
ing potency of Illicium verum, an antiviral, antifungal, chemoprotective, hepatoprotective, stomachic, and analgesic agent. The results from

Conclusion
Star anise (Illicium verum) is an evergreen tree that bears star-shaped fruits. It is recognized for its potent antiviral effects and is a
         
Star anise is known to have antioxidant, antimicrobial, antifungal, anthelmintic, insecticidal, antinociceptive, gastroprotective, sedative,
estrogenic, expectorant, secretolytic, and spasmolytic properties. Also, it has been evaluated for its potential as an anticarcinogen. The
property of star anise as a stomachic is applied to treat loss of appetite. It is also used as an expectorant and has anti-spasmodic activity in
the gastrointestinal tract, thereby performing a role in relaxing smooth muscles. Regarding COVID-19, star anise has been infused in many

Although star anise is readily available, consumers should take heed of the geographical sources where it is grown, the manufacturing
practices, and if it is produced in an FDA-approved facility or not. It is consequential to note that Japanese star anise is highly toxic due to
anisatin, a neurotoxin (antagonist). Ingestion may result in seizures, respiratory distress, and death.
     
using star anise as a solitary or an adjuvant antiviral. Its chemopreventive properties need to be analyzed on a large-scale basis to gain
conclusive evidence about developing an antioxidant formulation that will combat reactive oxygen species, reduce oxidative stress, inhibit
apoptosis, and prevent DNA damage due to its DPPHH radical scavenging effect.

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Citation: Kerna NA, Anderson II J, Pruitt KD, Flores JV, Ortigas MAC, Carsrud NDV, Holets HM, Nomel R, Nwokorie U, Nwachukwu D. “Star
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Citation: Kerna NA, Anderson II J, Pruitt KD, Flores JV, Ortigas MAC, Carsrud NDV, Holets HM, Nomel R, Nwokorie U, Nwachukwu D. “Star
EC Clinical and Medical Case Reports 4.12 (2021): 63-73.

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Volume 4 Issue 12 December 2021
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