Article

A proprietary extract from the Echinacea plant (Echinacea purpurea) enhances systemic immune response during a common cold

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Abstract

In a previous paper, it was reported that Echinilin (Factors R & D Technologies, Burnaby, British Columbia, Canada) a formulation prepared from freshly harvested Echinacea purpurea plants and standardized on the basis of three known active components (alkamides, cichoric acid and polysaccharides) is effective for the treatment of a naturally acquired common cold. However, the mechanism by which this effect is achieved remains unknown. In the present study, Echinilin or placebo were administered to volunteers at the onset of their cold for a period of 7 days, with eight doses (5 mL/dose) on day 1 and three doses on subsequent days. Fasting blood samples were obtained before and during their colds. The decrease in total daily symptomatic score was more evident in the echinacea group than in the placebo group. These effects of echinacea were associated with a significant and sustained increase in the number of circulating total white blood cells, monocytes, neutrophils and NK cells. In the later part of the cold, the echinacea treatment suppressed the cold-related increase in superoxide production by the neutrophils. These results suggest that Echinilin, by enhancing the non-specific immune response and eliciting free radical scavenging properties, may have led to a faster resolution of the cold symptoms.

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... Twenty nine studies (in 31 publications) met our eligibility criteria. 17,18,[27][28][29][30][31][32][33][34][35][36]19,[37][38][39][40][41][42][43][44][45][20][21][22][23][24][25][26] Nine of these reported data for the prevention meta-analysis, [17][18][19]21,22,27,32,39,42 seven for the duration, [18][19][20][22][23][24]27 and 16 for safety. 17,19,[37][38][39]41,42,45,[20][21][22][23]25,27,32,36 Eleven studies did not provide quantitative data for a meta-analysis but met the eligibility criteria to be considered in a narrative summary. ...
... 17,19,[37][38][39]41,42,45,[20][21][22][23]25,27,32,36 Eleven studies did not provide quantitative data for a meta-analysis but met the eligibility criteria to be considered in a narrative summary. 26,28,44,[29][30][31][33][34][35]40,43 Three trials were identified as being potentially relevant but excluded after discussion between the reviewers. The trials by Berg 46 and Turner 2000 47 were excluded as they were not described as doubleblind. ...
... 27,45 Only two of the trials 21,39 used experimental virus inoculation with the rest using natural infection. In terms of the intervention; 16 of the trials reported using echinacea monotherapy; 14 with E. purpurea 17,18,[38][39][40]44,19,25,26,[30][31][32]34,37 two with E. angustifolia 21,29 and two with E. pallidae 28,41 and one trial 22 had separate groups for E. angustifolia and E. purpurea. Three trials did not specify which species of echinacea was used 23,43,45 and the remaining seven trials reported a mixed preparation treatment; 5 with E. purpurea and E. angustifolia 20,24,27,35,42 and two with E. purpurea and E. pallidae. ...
Article
Background: Echinacea preparations are commonly used to prevent and treat upper respiratory tract infection. Objectives: To assess current evidence for the safety and efficacy of echinacea containing preparations in preventing and treating upper respiratory tract infection. Data sources: MEDLINE, EMBASE, CAB extracts, Web of Science, Cochrane DARE, clinicaltrials.gov and the WHO ICTRP - 1980 to present day. Eligibility criteria: Randomised double-blind placebo-controlled trials using an echinacea preparation to prevent or treat upper respiratory tract infections. Participants and interventions: Participants who are otherwise healthy of any age and sex. We considered any echinacea containing preparation. Study appraisal and synthesis methods: We used the Cochrane collaborations tool for quality assessment of included studies and performed three meta-analyses; on the prevention, duration and safety of echinacea. Results: For the prevention of upper respiratory tract infection using echinacea we found a risk ratio of 0.78 [95% CI 0.68-0.88], for the treatment of upper respiratory tract infection using echinacea we found a mean difference in average duration of -0.45 [95% 1.85-0.94] days, finally for the safety meta-analyses we found a risk ratio of 1.09 [95% CI 0.95-1.25]. Limitations: The limitations of our review include the clinical heterogeneity - for example many different preparations were tested, the risk of selective reporting, deviations from our protocol and lack of contact with study authors. Conclusions: Our review presents evidence that echinacea might have a preventative effect on the incidence of upper respiratory tract infections but whether this effect is clinically meaningful is debatable. We did not find any evidence for an effect on the duration of upper respiratory tract infections. Regarding the safety of echinacea no risk is apparent in the short term at least. The strength of these conclusions is limited by the risk of selective reporting and methodological heterogeneity. Implications of key findings: Based on the results of this review users of echinacea can be assured that echinacea preparations are safe to consume in the short term however they should not be confident that commercially available remedies are likely to shorten the duration or effectively prevent URTI. Researchers interested in the potential preventative effects of echinacea identified in this study should aim to increase the methodological strength of any further trials. Prospero id: CRD42018090783.
... Twenty studies of the efficacy of Echinacea sp. against URTI were identified; see Table 2 (Dorn et al., 1997;Hoheisel et al., 1997;Melchart et al., 1998;Brinkeborn et al., 1999;Grimm and Muller, 1999;Lindenmuth and Lindenmuth, 2000; Turner Barrett et al., 2002Barrett et al., , 2010Schwarz et al., 2002;Goel et al., 2004Goel et al., , 2005Sperber et al., 2004;Yale and Liu, 2004;Turner et al., 2005;Schoop et al., 2006;Hall et al., 2007;O'Neil et al., 2008;Jawad et al., 2012). ...
... One study was open (Schoop et al., 2006), 19 were randomized, controlled trials (Dorn et al., 1997;Hoheisel et al., 1997;Melchart et al., 1998;Brinkeborn et al., 1999;Grimm and Muller, 1999;Lindenmuth and Lindenmuth, 2000;Turner et al., 2000Turner et al., , 2005Schulten et al., 2001;Barrett et al., 2002Barrett et al., , 2010Schwarz et al., 2002;Goel et al., 2004Goel et al., , 2005Sperber et al., 2004;Yale and Liu, 2004;Hall et al., 2007;O'Neil et al., 2008;Jawad et al., 2012). Twelve studies considered treatment of URTI (Dorn et al., 1997;Hoheisel et al., 1997;Brinkeborn et al., 1999;Lindenmuth and Lindenmuth, 2000;Schulten et al., 2001;Barrett et al., 2002Barrett et al., , 2010Goel et al., 2004Goel et al., , 2005Sperber et al., 2004;Yale and Liu, 2004;O'Neil et al., 2008); one considered only prophylaxis (Schwarz et al., 2002) and seven considered both aspects (Melchart et al., 1998;Grimm and Muller, 1999;Turner et al., 2000Turner et al., , 2005Schoop et al., 2006;Hall et al., 2007;Jawad et al., 2012). ...
... One study was open (Schoop et al., 2006), 19 were randomized, controlled trials (Dorn et al., 1997;Hoheisel et al., 1997;Melchart et al., 1998;Brinkeborn et al., 1999;Grimm and Muller, 1999;Lindenmuth and Lindenmuth, 2000;Turner et al., 2000Turner et al., , 2005Schulten et al., 2001;Barrett et al., 2002Barrett et al., , 2010Schwarz et al., 2002;Goel et al., 2004Goel et al., , 2005Sperber et al., 2004;Yale and Liu, 2004;Hall et al., 2007;O'Neil et al., 2008;Jawad et al., 2012). Twelve studies considered treatment of URTI (Dorn et al., 1997;Hoheisel et al., 1997;Brinkeborn et al., 1999;Lindenmuth and Lindenmuth, 2000;Schulten et al., 2001;Barrett et al., 2002Barrett et al., , 2010Goel et al., 2004Goel et al., , 2005Sperber et al., 2004;Yale and Liu, 2004;O'Neil et al., 2008); one considered only prophylaxis (Schwarz et al., 2002) and seven considered both aspects (Melchart et al., 1998;Grimm and Muller, 1999;Turner et al., 2000Turner et al., , 2005Schoop et al., 2006;Hall et al., 2007;Jawad et al., 2012). Three studies used viral challenge (Turner et al., 2000(Turner et al., , 2005Sperber et al., 2004) while the rest studied naturally occurring disease. ...
Article
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This review evaluates the safety of echinacea and elderberry in pregnancy. Both herbs are commonly used to prevent or treat upper respiratory tract infections (URTIs) and surveys have shown that they are also used by pregnant women. The electronic databases PubMed, ISI Web of Science, AMED, EMBASE, Natural Medicines Comprehensive Database, and Cochrane Library were searched from inception to November 2013. Relevant references from the acquired articles were included. No clinical trials concerning safety of either herb in pregnancy were identified. One prospective human study and two small animal studies of safety of echinacea in pregnancy were identified. No animal- or human studies of safety of elderberry in pregnancy were identified. Twenty clinical trials concerning efficacy of various echinacea preparations in various groups of the population were identified between 1995 and 2013. Three clinical trials concerning efficacy of two different elderberry preparations were identified between 1995 and 2013. The results from the human and animal studies of Echinacea sp. are not sufficient to conclude on the safety in pregnancy. The prospective, controlled study in humans found no increase in risk of major malformations. The efficacy of Echinacea sp. is dubious based on the identified studies. Over 2000 persons were given the treatment, but equal amounts of studies of good quality found positive and negative results. All three clinical trials of Elderberry concluded that it is effective against influenza, but only 77 persons were given the treatment. Due to lack of evidence of efficacy and safety, health care personnel should not advice pregnant women to use echinacea or elderberry against upper respiratory tract infection.
... J o u r n a l P r e -p r o o f All 17 studies were double-blind, placebo-controlled, randomized clinical trials. One study had additional arms using open-label Echinacea and no treatment (4) and several studies had multiple arms comparing different Echinacea species, commercial formulas or doses (5)(6)(7)(8). Studies were designed to assess for the prevention or treatment of ARI, primarily, the common cold. ...
... The lowest dose used was 100 mg of herb (12) while other studies used as much as 10.2g per day in capsules on the first day of treatment (4). Five studies reported using formulas that were standardized to include a specific amount of active constituent (6,(12)(13)(14). ...
... Among the two studies testing prevention and treatment in response to a viral challenge, one was rated high risk of bias (11) and one low risk of bias (8). Among the nine studies assessing treatment of new onset infections, four were rated low (4,14,17,18), four rated high (5,6,19,20) and one was rated as having some concerns (12). Reasons for a high risk of bias included per-protocol J o u r n a l P r e -p r o o f analysis (6,16), lack of description of dropouts (9), incomplete reporting of data (5,19), and lack of baseline data comparing the treatment groups (20). ...
Article
Brief overview: Current evidence suggests that Echinacea supplementation may decrease the duration and severity of acute respiratory tract infections; however, no studies using Echinacea in the prevention or treatment of conditions similar to COVID-19 have been identified. Few adverse events were reported, suggesting that this herbal therapy is reasonably safe. Because Echinacea can increase immune function, there is a concern that it could worsen over-activation of the immune system in cytokine storm; however, clinical trials show that Echinacea decreases levels of immune molecules involved in cytokine storm. Verdict: Echinacea supplementation may assist with the symptoms of acute respiratory infections (ARI) and the common cold, particularly when administered at the first sign of infection; however, no studies using Echinacea in the prevention or treatment of conditions similar to COVID-19 have been identified. Previous studies have reported that Echinacea may decrease the severity and/or duration of ARI when taken at the onset of symptoms. The studies reporting benefit used E. purpurea or a combination of E. purpurea and E. angustifolia containing standardized amounts of active constituents.Few adverse events from the use of Echinacea were reported, suggesting that this herbal therapy is reasonably safe. No human trials could be located reporting evidence of cytokine storm when Echinacea was used for up to 4 months.When assessing all human trials which reported changes in cytokine levels in response to Echinacea supplementation, the results were largely consistent with a decrease in the pro-inflammatory cytokines that play a role in the progression of cytokine storm and Acute Respiratory Distress Syndrome (ARDS), factors that play a significant role in the death of COVID-19 patients. While there is currently no research on the therapeutic effects of Echinacea in the management of cytokine storm, this evidence suggests that further research is warranted.
... E. purpurea has been studied extensively in Europe and North America. Many types of phytomedicine are commercially produced from the aerial portions of E. purpurea for the prevention and treatment of the common cold and other upper respiratory infections, and the stimulation of immunomodulation (Goel et al., 2005; Lindenmuth and Lindenmuth, 2000; Mahady et al., 2001; Vimalanthan et al., 2005). It has been recently introduced in to Taiwan and appears to grow well (Lin, 2003). ...
Article
Full-text available
Echinacea purpurea has been introduced in to Taiwan and grown successfully. However, information regarding the effects of the growing climate on its active constituents (e.g. caffeoyl derivatives) and biomass production is very limited. In this study the biomass of field-grown E. purpurea plants harvested during three different crop seasons was compared. The content of caffeoyl phenols and the production of aerial plant parts were also assayed. The results indicated that both morphological and agronomic traits were affected by crop season, with spring-grown plants producing more stems and flowers but fewer leaves than autumn-grown plants. Autumn-grown plants produced more caffeoyl phenols, particularly cichoric acid and caftaric acid, in leaf and flower tissues than spring grown plants. Thus, transplanting E. purpurea seedlings in the autumn and harvesting the aerial parts at the beginning of winter first, and then harvesting the rhizome-regenerated plants again in the following summer are technically feasible. This farming system would give commercial cultivation of E. purpurea in Taiwan a great competitive advantage over other growing regions, provided that an environmentally suitable population is selected and established in Taiwan.
... However, E. purpurea is the most cultivated and widely used of the three species, due to ease of cultivation and total use of the whole plant (Wills & Stuart, 1999; Seidler-Lozykowska & Dabrowska, 2003; Kreft, 2005). Extracts and compounds are commercially produced from the various parts of E. purpurea for the prevention of common cold, flu, respiratory infections and inflammations, and the stimulation of immunomodulation (Mahady et al., 2001; Goel et al., 2005; Vimalanthan et al., 2005; Hinz et al., 2007). The seeds of Echinacea purpurea cv. ...
Article
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Echinacea purpurea (L.) Moench was recently introduced into Taiwan. In the present study, the biomass, the contents of caffeoyl phenols, and the content of dodeca-2E,4E,8Z,10E-tetraenoic acid isobutylamide plus dodeca-2E,4E,8Z,10Z-tetraenoic acid isobutylamide (alkamides 8 and 9 respectively,) of locally selected line CLS-P2 and two introduced cultivars Magnus and White Swan of E. purpurea and an introduced E. atrorubens var. paradoxa were compared. The results indicated that both biomass and phytoactive constituents varied considerably among the introduced cultivars and selected line. Line CLS-P2 grew better and produced more aerial and ground parts than introduced cultivars Magnus and White Swan. It also produced more caffeoyl phenols, particularly cichoric acid and caftaric acid in its leaves than Magnus and White Swan. All the E. purpurea cultivars and line produced same amounts of alkamides 8 and 9 in their flower heads and leaves. But White Swan produced more alkamides 8 and 9 in its roots than CLS-P2 and Magnus. Line CLS-P2 was less homogenous in genetic background as compared to the introduced cultivars. E. atrorubens var. paradoxa also grew well in Taiwan, but it produced less aerial and ground dry mass than E. purpurea. E. atrorubens var. paradoxa produced more echinacoside in its flower heads, leaves, and root parts, while E. purpurea plants had more cichoric acid and caftaric acid in their flower heads and leaves. E. atrorubens var. paradoxa also produced more alkamides 8 and 9 in flower heads and leaves, while E. purpurea produced more alkamides 8 and 9 in roots.
... Another plant with similar properties is lemon balm (Melissa officinalis ), the antimicrobial activity of which was found by Mahady et al. (2005). Also purple coneflower (Echinacea purpurea), previously used in botanical medicine, is now the subject of research and its immunological activity is known (Goel et al., 2005). Herbal extracts can be especially useful in feeding of piglets sensitive to harmful environmental effects. ...
Article
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The effect of a mixture of herbal extracts on piglet performance was estimated on 178 piglets allocated to 3 groups comprising 6 litters each. Group I (control) was fed with the standard barley-wheatsoybean mixture. Group II received the same mixture supplemented with a blend of formic and propionic acids. Group III received the basal diet supplemented with a mixture of water extracts from sage, lemon balm, nettle and coneflower (20, 30, 30, and 20%, respectively) at 500 mg/kg feed. The experiment lasted for 84 days but on day 56 six piglets from each group were slaughtered and their gastrointestinal tract was removed. Apparent digestibility was estimated using the Cr2O 3 indicator method. Acidity of digesta was measured in the stomach, ileum, and caecum, and volatile fatty acid content was evaluated in the ileum and caecum. Amounts of bacteria and morphological structure were evaluated in the ileal digesta and epithelium, respectively. In the experimental groups less dead and culled piglets were observed than in the control group. Piglets in the herb-supplemented group grew faster than control animals and showed significantly higher final average body weights. There was no significant difference in feed utilization. Acetic acid content was higher in both groups receiving supplements. The amount of propionic acid in the caecum of animals from the herb-supplemented group was lower than in animals from groups I and II. There were no significant differences in bacteria population in ileum chyme. The herbal extract improved the structure of the ileal epithelium by significantly increasing villus height. Better digestibility of nutrients could be due to higher villi in this group.
... Dr. Basu's research addressed these complex issues and provided critical evaluations of the validity of their clinical efficacy claims, and described an approach to a randomized, double-blind placebo-controlled clinical trial, which were designed taking into account the complexities that are involved in NHPs. The plants (and their products) that he investigated include germinated wheat [27], rhubarb (rheum rhaponticum) [28][29][30], echinacea (purpurea) [31][32][33], fenugreek (trigonella foenum-graecum L.) [34,35], and North American ginseng (panax quinque folium) [36][37][38]. ...
... An accumulating number of studies have reported the effects of E. purpurea from the perspective of immune functions and systems (Brush et al., 2006;Mishima et al., 2004). The most frequently reported pharmacological activities of Echinacea are the activation of macrophages and polymorphonuclear neutrophils immune cells (Goel et al., 2005;Sullivan et al., 2008). A recent study has shown that macrophage phagocytosis and NK cell activities can be strongly activated after ex vivo exposure of these cells to E. purpurea extracts (See et al., 1997). ...
Chapter
Imbalance or malfunction of the immune systems is associated with a range of chronic diseases including autoimmune diseases, allergies, cancers and others. Various innate and adaptive immune cells that are integrated in this complex networking system may represent promising targets for developing immunotherapeutics for treating specific immune diseases. A spectrum of phytochemicals have been isolated, characterized and modified for development and use as prevention or treatment of human diseases. Many cytotoxic drugs and antibiotics have been developed from phytocompounds, but the application of traditional or new medicinal plants for use as immunomodulators in treating immune diseases is still relatively limited. In this review, a selected group of medicinal herbs, their derived crude or fractionated phytoextracts and the specific phytochemicals/phytocompounds isolated from them, as well as categorized phytocompound groups with specific chemical structures are discussed in terms of their immunomodulatory bioactivities. We also assess their potential for future development as immunomodulatory or inflammation-regulatory therapeutics or agents. New experimental approaches for evaluating the immunomodulatory activities of candidate phytomedicines are also discussed.
... In recent studies, it has been shown that alkamides contribute to the overall effect of Echinacea [2][3][4][5]. Until now, only a limited number of pharmacokinetic studies with alkamides have been reported [6][7][8][9]. No data exist about their distribution in tissues and transport through the bloodbrain barrier (BBB). ...
Article
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The present study investigated the pharmacokinetics and tissue distribution of dodeca-2 E,4 E,8 Z,10 E/ Z-tetraenoic acid isobutylamides (tetraenes), the main alkamides in ECHINACEA preparations, in rats after a single oral dose administration of 2.5 mg/kg. Plasma, liver and 4 different brain regions (hippocampus, cerebral cortex, striatum and cerebellum) were collected after 8, 15, 30 minutes and 1, 2, 3 and 6 hours after oral dosing. Plasma and tissue concentrations were determined by a rapid (5 min) liquid chromatography-tandem mass spectrometry (LC-MS/MS) method with benzanilide as internal standard (IS) using the respective [M-H] (+) ions, M/Z = 248/152 for the dodeca-2 E,4 E,8 Z,10 E/ Z-tetraenoic acid isobutylamides and M/Z = 198/105 for the IS. The lipophilic constituents were rapidly absorbed, with a T (max) of 15 minutes, distributed and appeared in the brain already within 8 minutes. The total amount of tetraenes in different brain parts was calculated as AUC (0-infinity) (range: 1764-6192 min x ng/g) and compared to the concentrations found in plasma (794 min x ng/mL) and liver tissues (1254 min x ng/g). The C (max) in plasma was 26.4 ng/mL, while the C (max) in the different brain regions varied between 33.8 ng/g and 46.0 ng/g. In the striatum the highest concentration and the longest elimination half-life of 253 minutes with a mean residence time of 323 minutes was detected. The results demonstrate that the dodeca-2 E,4 E,8 Z,10 E/ Z-tetraenoic acid isobutylamides are bioavailable in rats with a rapid passage across the blood-brain barrier.
... The convincing anticancer effects of both major CLA isomers that have been observed in human tumour cell lines and animal models of cancer provide preliminary evidence to suggest an application in humans. Dr. T.K. Basu so elegantly demonstrated during his career that one needs to demonstrate an effect first in vitro/in situ [103,104], then in the appropriate animal models345 and finally demonstrate efficacy in well designed human trials105106107. Thus, before trials can be proposed to test efficacy of CLA, it is necessary to elucidate the biological mechanism(s) that might explain the antitumour effects of the CLA isomers. ...
Article
Conjugated linoleic acid (CLA) consists of a group of naturally occurring and synthetic positional and geomet-ric (cis-trans) stereoisomers of the polyunsaturated fatty acid linoleic acid. The cis-9,trans-11 (c9,t11) CLA isomer (the most prevalent form found in ruminant-derived foods) and the trans-10,cis-12 (t10,c12) CLA isomer (present in commer-cial preparations) are the two most widely studied CLA isomers in breast cancer. Studies using both animal and cell cul-ture models indicate that these CLA isomers, when added to the diet or included in the cell culture medium, inhibit mam-mary tumour initiation, promotion and progression in rodents, and alter tumour cell viability in vitro. The mechanism of CLA's anticancer effect is not well understood, but may involve interference with the cell cycle, induction of apoptosis, modulation of gene expression via the activation of peroxisome proliferator-activated receptors, lipid peroxidation, modu-lation of the tumour microenvironment, changes to the structure and/or function of the cell membrane, and interference with growth factor receptor signaling. A greater understanding of the mechanism of action of CLA will support the devel-opment of clinical trials to evaluate the potential effectiveness of CLA in the treatment of breast cancer.
... Therefore, for some decades many studies have focused on discovering immunostimulatory agents. As a result, it has been clearly demonstrated that many plant extracts have notable and wide-ranging effects on the host immune system by modulating activation of various immune cell types, including T cells, B cells, DCs and macrophages (5)(6)(7). Among these cells, macrophages are one of the most important players in the innate immune response against microbial infection. ...
Article
Aralia cordata (AC) is a known pain reliever and anti-inflammatory drug used in traditional Asian medicine. Although several biological activities of AC have been reported, the immunomodulatory effects of a hot water extract of AC (HAC) have not been described. The aim of this study was to investigate whether HAC modulates the activation of macrophages, which play important roles in innate immune responses against microbial pathogens, and if so, to determine the molecular mechanisms by which HAC mediates this process. We found that HAC activated bone marrow-derived macrophages (BMDM) and increased levels of nitric oxide and proinflammatory cytokines in a dose-dependent manner. In addition, HAC induced the phosphorylation of NF-κB and mitogen-activated protein kinases (MAPKs), including JNK, ERK, and p38. Interestingly, these effects were absent in BMDM prepared from MyD88-knockout mice. Polysaccharides from HAC exerted stronger immunostimulatory effects compared to HAC itself. Furthermore, orally administered HAC clearly enhanced the clearance of the intracellular pathogen Listeria monocytogenes by boosting innate immune responses. These results demonstrate that HAC exerts immunostimulatory effects through the TLR/MyD88 and NF-κB/MAPK signal transduction pathways.
... Daily supplementation with large doses of vitamin C does not seem to prevent common colds, however there seems to be a modest (8 to 9%) reduction in the number of symptom days in individuals with established cold symptoms, with larger doses having greater effect (Douglas, Chalker et al. 2000). In vitro studies have shown that Echinacea can activate macrophages, increase phagocytosis, enhance cytokine production (Sharma, Arnason et al. 2006), and natural killer cell activity, and improve lymphocyte and monocyte cell counts (Goel, Lovlin et al. 2005). Current data is available in the adult population and has reported positive findings both in the treatment and prevention of upper respiratory tract infection. ...
... They are widely used for wild flower establishment, perennial gardening and as a cut flower (Wartidiningsih and Geneve, 1994). In addition, Echinacea is employed for treating common cold, flu, respiratory infections and inflammations, and stimulating immunomodulation (Goel et al., 2005;Vimalanthan et al., 2005;Senchina et al., 2006;Hinz et al., 2007). McGregor (1968) classified Echinacea into nine species and four varieties using morphological characters and chromosome numbers. ...
Article
Echinacea is an allogamous genus, thus its cultivars or populations are genetically heterogeneous. Using amplified fragment length polymorphism (AFLP) to estimate the genetic diversity of Echinacea is generally limited by the large number of individual plants and the higher cost that need to be processed. In the present study, effectiveness of several sizes of DNA bulking (10, 15, 20, 25 and 30 individuals) with 20, 36 and 55 primer pairs was compared using AFLP in determining the genetic diversity of Echinacea species. The results indicated that the use of bulked DNA-based AFLP analysis by using the selected eight primer pairs was capable of detecting genetic diversity between the tested Echinacea species, provided that the potential presence of low frequency variants was ignored and a possible bias in the estimates of genetic similarity was accepted. The assessments showed that a bulk of 15 individuals could detect sufficient AFLP variations at most genomic sites. Additionally, 20 primer pairs could generate sufficient polymorphic fragments to achieve high resolving power of AFLP for the tested Echinacea species.
... 124 In a related placebo-controlled trial on 150 adults using the same Echinacea formula (dosage=eight 5-mL units on the first day and three units daily on subsequent days for the next seven days), researchers observed decreased daily symptom scores and increases in the number of total white blood cells, monocytes, neutrophils, and NK cells in the Echinacea group versus placebo. 125 In another placebo-controlled, blinded study assessing changes in cold duration, 80 adult participants were randomly assigned to take E. purpurea herb extract or placebo at the onset of cold symptoms until symptoms subsided. The median duration of illness was six days in the Echinacea group compared to nine days in the placebo group (p=0.0112). ...
Article
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The common cold is the leading cause of doctor visits in the United States and annually results in 189 million lost school days. In the course of one year the U.S. population contracts approximately 1 billion colds. Influenza infection is still a leading cause of morbidity and mortality, accounting for 20-25 million doctor visits and 36,000 deaths per year in the United States. Conventional therapies for colds and flu focus primarily on temporary symptom relief and include over-the-counter antipyretics, anti-inflammatories, and decongestants. Treatment for influenza also includes prescription antiviral agents and vaccines for prevention. This article reviews the common cold and influenza viruses, presents the conventional treatment options, and highlights select botanicals (Echinacea spp., Sambucus nigra, larch arabinogalactan, Astragalus membranaceous, Baptisia tinctoria, Allium sativa, Panax quinquefolium, Eleutherococcus senticosus, Andrographis paniculata, olive leaf extract, and Isatis tinctoria) and nutritional considerations (vitamins A and C, zinc, high lactoferrin whey protein, N-acetylcysteine, and DHEA) that may help in the prevention and treatment of these conditions.
... The primary use of Echinacea preparations today is in the prevention and treatment of upper respiratory infections (9) such as "colds" (Picornaviridae: Rhinovirus) and "flus" (Orthomyxoviridae: Influenzavirus). Somewhat disarmingly, scientific studies both validate (9,62,141,147) and discredit (35,99,151,164) the clinical use for Echinacea in upper respiratory infections. Three species are employed commercially: E. angustifolia (narrow-leaved coneflower), E. pallida (pale coneflower), and E. purpurea (purple coneflower) (9). ...
Article
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The purpose of this paper is to critically evaluate current immunological and clinical literature regarding the effects of herbal preparations on athlete immune function. First, we review rates of herbal supplement use by athletes. Second, we use ginseng (Panax ginseng) and coneflower (Echinacea spp.) as models for examining how herbal supplements may influence immune function within the contexts of exercise and sport, while briefly considering several other popular herbal products. Third, we proffer several evidence-based hypotheses to explain apparent discrepancies among the cumulative data, concomitantly advancing a novel conceptual framework which may be useful to understanding herbal supplements and athlete immune function using Echinacea supplements as a model. Fourth, we apply the proposed framework to some prospective data regarding the effects of Echinacea pallida and Echinacea simulata on in vitro cytokine production and cell proliferation in peripheral blood mononuclear cells collected from male collegiate wrestlers and soccer players during training. Fifth and finally, we evaluate the current knowledge on herbal supplements and athlete immune function, identify gaps and limitations in knowledge, and advance several possible options for future research.
... Preparations from Echinacea, a member of the Asteraceae family, represent the most common herbal immunomodulators and are marketed mainly for the treatment and prevention of common cold and upper respiratory tract infections [7,8]. Antifungal activity and enhancement of the immune responses during respiratory tract infections have also been demonstrated for Echinacea extracts [9]. A recent Cochrane review [10] concluded that preparations from Echinacea might be effective for the early treatment of colds in adults. ...
Article
Hydroalcoholic extracts and pressed juice from Echinacea pallida were phytochemically characterised by HPLC-MS analyses. Ferulic and caffeic acid derivatives were identified as major constituents. All tested extracts and pressed juice from Echinacea pallida exhibited a low cytotoxic activity on monkey kidney cells in vitro. The inhibitory activity of Echinacea against herpes simplex virus types 1 and 2 (HSV-1, HSV-2) was analysed with plaque reduction assays. All hydroalcoholic extracts exhibited high levels of antiviral activity against both types of herpesvirus in a dose-dependent manner. Plaque formation was significantly reduced by more than 99 % or completely absent. Pressed juice from E. pallida revealed the highest antiviral activity against HSV-1 and HSV-2 when compared to hydroalcoholic Echinacea extracts and even highly diluted Echinacea pressed juice still inhibited viral infectivity. Hydroalcoholic extracts were quite active against herpetic infection when HSV-1 or HSV-2 were pretreated with the extracts. In contrast, Echinacea pressed juice revealed antiviral activity during all phases of the viral replication cycle. Additionally, Echinacea pressed juice demonstrated protection of cells against viral infection. In conclusion, hydroalcoholic E. pallida extracts interfere with free herpesvirus but pressed juice is able to interact with herpesvirus inside and outside the cell as well as to protect cells against viral infection, probably by interfering with virus attachment. Hydroalcoholic extracts and pressed juice from E. pallida demonstrated high selectivity indices, a necessary prerequisite for a potential topical treatment of herpetic infections. Different types of Echinacea preparations, such as commercial tinctures, tablets, and teas, are expected to offer different antiviral profiles.
... It is widely used as a self-medicating agent for the treatment of common cold, coughs, bronchitis, inflammation of mouth and pharynx [7]. This property was found to be due to enhanced non-specific immune response & free radical scavenging properties elicited by the herb treatment [8]. ...
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The present study investigates the therapeutic properties of in vitro E .purpurea cell suspension cultures against immunosuppressive effects of cyclophosphamide. Rats were assigned to four equal groups: normal control group, immune-suppressed groups: 2, 3 and 4 injected with cyclophosamide (50 mg/kg /day) i.m. for 3 consecutive days; group 2 kept as control positive, and the other two groups (3 & 4) were administered E.purpurea extract at doses 100 mg and 200 mg/kg, p.o., respectively & daily for 21 successive days. Blood samples were withdrawn twice; at the day 11and the 21 for blood cells count and the second for determination of cytokines level, γ-globulin, and MTT-value. Cyclophosphamide treated group showed significant decrease in total leucocytic count, anemia, and thrombocytopenia as well as humoral and cellular immunity markers; γ-globulin and MTT. E.purpurea treatment normalized the reduced blood cell elements in dose dependent manner. The extract inhibited production of TNF-, elevated IL-1 and enhanced both cellular and humoral immune response. It can conclude that extracts derived in vitro cell suspension cultures of E. purpurea has a therapeutic potential for use in patients with inadequate functioning and regulation of the immune system. Keywords: Echinacea, suspension, immunosuppressive, cyclophosphamide, rats.
... Another plant with similar properties is lemon balm (Melissa officinalis) whose antimicrobial activity in vitro was found by Mahady et al. (2005). Also, purple coneflower (Echinacea purpurea), used previously in folk medicine, is now the subject of research and its immunologic activity established (Goel et al., 2005). ...
... In modern herbal medicine, Echinacea is most commonly employed for treating upper respiratory infections, particularly viral infections such as colds (rhinoviruses) and influenza (Caruso and Gwaltney 2005). However, data are in conflict regarding its efficacy, with some studies supporting effectiveness (Goel et al. 2005) and BENHA VETERINARY MEDICAL JOURNAL, VOL. 32, NO. 2: 138-144, JUNE, 2017 others discounting it (Barrett et al. 2002;Turner et al. 2005). ...
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The present study was carried out on a total number of 90 male Albino rats (180-200 gm body weight). Rats were randomly allocated into 6 groups (15 rats/group). Group (1): control negative. Group (2): (cyclophosphamide control group) treated with 50 mg / k.g B.w intramuscular. Group (3): E.coli-infected rats at 18 th day. Group (4): E.coli + cyclophosphamide group. Group (5): E.p + cyclophosphamide + E.coli group. Group (6) control Echinacea purprea (E.P.): gavaged with E.p 130 mg/k.g B.w all over the experimental period. Results showed that TLC and granulocytes percent in E. p treated and E. p control groups revealed significant increase when compared with E. coli + cyclophosphamide-treated group and control group; respectively. Our results revealed non-significant changes in monocytes and lymphocytes counts in Echinacea treated and E. p. control groups when compared with E. coli + cyclophosphamide treated and control groups respectively. Regarding the results of cytokines, the levels of IL-1β in the serum of E. p treated group were significantly increased when compared with E.coli + cyclophosphamide-treated group at the 4 th and 14 th days after injection of E.coli and third dose cyclophosphamide. Regarding the results of IL-10 in Echinacea treated group, the levels of IL-10 were significantly increased when compared with E. coli+ cyclophosphamide treated group at the 4th day after injection of E.coli and third dose cyclophosphamide. In assessing the effect of E. purpurea on immunoglobulins, the levels of IgM in Echinacea treated group, increased significantly when compared with E. coli + cyclophosphamide treated group at the 4 th and 14 th days after injection of E. coli and third dose cyclophosphamide. The data of IgG levels obtained in our study revealed significant decrease in the levels of IgG in E. p treated group when compared with E. coli + cyclophoaphamide group. Therefore, is concluded that E. purpurea have immunostimulation effect in E. coli+ cyclophosphamide injected rats.
... En este experimento alimentaron a los ratones con el producto durante 30 días antes y 21 días después de la infección por el virus de la influenza A (H1N1) y mostraron una reducción estadísticamente significativa en la gravedad de la infección comparado con el grupo de control. Además, se observó que los ratones alimentados con Immulina ® mostraron menos pérdida de peso, aumento del apetito, disminución de los signos clí-nicos de la enfermedad y puntuaciones de histopatología pulmonar más bajas (44). ...
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The objective of the research was to carry out a bibliographic review in online databases such as Pubmed, Scopus, Medline and Elsevier of medicinal plants with antiviral potential mainly related to respiratory tract infections and that may be useful against COVID-19 infections. The studies found refer to the great potential that certain medicinal plants have against the influenza virus and others that could serve as a basis in this pandemic. © 2021, Sociedad Europea De Medicina Naturista Clasica. Seccion Espanola. All rights reserved.
... In the United States, in 2009, it was the third most popular herbal medicine, and its sales, annually, reach more than 100 million dollars. Primarily, this medicinal plant was used to treat various infections and the preparation of this plant started to be investigated, so that they observed improvement in the nonspecific immune response, in addition to causing the elimination of free radicals, it may have led to faster resolution of symptoms of the common cold (Goel et al., 2005). ...
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The objective of this work was to evaluate whether medicinal plants as active ingredients of herbal, homeopathic and floral medicines marketed in Brazil, had potential use as a therapeutic strategy for prevention, treatment and cure for COVID-19. This study took into account products marketed and regulated by Brazilian legislation with claims such as: immunomodulators, antivirals and improvement of symptoms related to respiratory system deficiency, which were calculated the absolute (n) and relative (%) frequencies. In addition, PubMed®, Web of Science® and SciVerse Scopus® databases were used to search the literature in order to obtain the scientific claims of plants found in the formulations of the evaluated products, taking into account the typical symptoms of COVID-19. 113 products were found, of which 65% were herbal medicines, 27% homeopathic medicines and 7% floral. There were 13 medicinal plants with an absolute frequency ≥ 5, in which scientific evidence was found regarding their medicinal use, as a complementary therapy in the treatment of symptoms related to COVID-19.
... Several clinical randomized double blind studies confirmed the moderate efficacy of Echinacea in the therapy of UT infections in adults over 18, but from all observed studies pregnant women were excluded [64][65][66][67][68]. In pregnant women (Table 3), in 81% of the 206 treated women Echinacea improved their upper respiratory tract ailment [69]. ...
Article
The use of herbal therapy in pregnancy is common for pregnancy related nausea, vomiting, gestational diabetes, anxiety, insomnia, and preparation for labor, as well as for treating infections. Many conventional drugs may interfere with fetal development and herbal products are considered to be safe. However, herbal therapy requires competent healthcare professional advice before prescribing. Knowledge about the possible adverse effects of active compounds of the herbs on pregnancy outcome is limited. Interference of herbal ingredients with conventional medication or the ailment should also not be excluded. For many herbal products, the pharmacological effect is not clinically proven, and the safe usage in pregnancy is not guaranteed. Here, based on published clinical trials, an overview is given of the efficacy and safety for fetal development and pregnancy outcome of the most frequently used herbs: ginger, cranberry, echinacea, mint, chamomile, valerian, flaxseed, tea and raspberry leaf.
... For these illnesses, mostly drugs with secretolytic and secretomotor actions, containing samonins and essential oils, are used (Wichtl, 2004). Echinacea is commonly used as it enhances the immune system and supports cold treatments (Giles et al., 2000;Goel et al., 2004;Goel et al., 2005). Additionally, Ballabh and Chaurasia (2007) reported that plants such as Azadirachta indica, Emblica offi cinalis, Ficus religiosa, Ferula assafoetida, Punica granatum, Terminalia chebula, Ocimum sanctum and Zingiber offi cinale can be eff ectively used against colds, coughs and fevers. ...
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Herbs and spices have been used for food and medicinal purposes for centuries – the first recorded evidence of their use dates back to 1500BC and the Ebers Papyrus, which mentioned spices such as anise, mustard, saffron, cinnamon, and cassia. Now, in the 21st century, a variety of secondary compounds produced by plants are used in many fields of industry, such as food production (to improve taste, to provide vitamins and macro- and microelements, and also to inhibit food spoilage caused by foodborne bacteria), in medicine (in the treatment of various diseases; in chemoprevention and cancer therapy; as a source of natural antimicrobials for the treatment of infectious disease), and in pharmacology and cosmetology (in dietary supplements, and as a result of the demand for preservative-free cosmetics, to reduce the risk of methylparaben allergies). The aim of this review is to present the major active compounds in herbs and spices and explore their potential applications in industry.
... Traditionally, people use it as prevention or a treatment of upper respiratory infections in common cold in nations across Europe and North America [4] [5]. In recent years, five purple coneflower products have been certified as the new veterinary drugs in China (Certification Nos. ...
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The plant growth regulator diethyl aminoethyl hexanoate (DA-6) has proved highly effective on micropropagation of the medicinal plant purple coneflower (Echinacea purpurea (L.) Moench), however, sharp variation of the effects existed among explants in the same treatment, making the application of DA-6 in micropropagation difficult. In order to clarify factors that influencing the treating results of DA-6, explants with different biomass dosage were prepared and inoculated onto medium supplemented with different concentrations of DA-6. It was found that among the three kinds of biomass dosage explants, the lowest biomass explants required the lowest concentration of DA-6, and the highest biomass explants required the highest concentration of DA-6 for the best results on adventitious buds regeneration. Similar results were obtained when regenerated buds of three different biomass dosages were cultured. It could be concluded from the above experimental results that for achieving better DA-6 application results, the concentration of DA-6 should be determined not only by the types but also by the biomass dosage of the explants. The present finding might help to improve the micropropagation efficiency in E. purpurea, and might be applicable for other species
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In the European Union, the use of traditional herbal medicinal products has recently been regulated in Directive 2004/24/EC. According to this regulation, clinical studies and pre-clinical tests are not obligatory, but quality needs to be demonstrated in any individual case. Echinacea and butterbur (Petasites) will be used as examples for demonstrating the progress in medicinal plant research. Alkamides, the major lipophilic constituents of Echinacea, have recently been found to be rapidly absorbed after oral application. Using LC-MS their pharmacokinetics have been studied and ex-vivo effects have been measured. Alkamides have also been shown to bind to cannabinoid receptors (CB2) which may represent a molecular mechanism of action of Echinacea. Extracts of the rhizomes of Petasites hybridus have been shown to inhibit 5-lipoxygenase and cyclooxygenase-2 and COX-2 expression. They are useful for the prevention of migraine and for the treatment of asthma and seasonal allergic rhinitis.
Thesis
Le sport fait partie intégrante de notre vie et de plus en plus de français le pratiquent régulièrement, cependant aucune activité sp011ive n'est sans danger et les petits maux quotidiens viennent souvent contrarier l'activité physique. Par conséquent, on observe également une augmentation du nombre de blessures et autres pathologies liées à la pratique du sport par ces amateurs. En parallèle, on observe actuellement que de plus en plus de personnes ont recours à l'automédication et aux médecines alternatives dites« douces». Ces phénomènes tendent donc à se recouper chez les sportifs amateurs de plus eu plus nombreux et qui cherchent à se soigner sans forcément aller voir un médecin qui a plutôt l'habitude d'utiliser les traitements allopathiques conventionnels. Dans le cadre de son exercice, le pharmacien peut être amené à conseiller ces sportifs faisant face à la blessure ou à tout autre évènement venant contrarier la pratique du sport. Compte tenu de l' étendue de ses connaissances dans les médecines complémentaires que représentent l 'aromathérapie, la phytothérapie et ] 'homéopathie, le pharmacien d' officine constitue un maillon important dans la prise en charge thérapeutique des sportifs amateurs souhaitant bénéficer de ces remèdes.
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There is a paradigm shift from cure to prevention when it comes to human health. We want to live a healthy life and prevent sickness using substances other than pharmaceuticals. The plant-based nutraceutical products or Natural Health Products (NHPs) as they are some times referred to are the most important groups that have the potential to fit the bill. However, these products are sold without proper science based information in spite of the fact that most researchers acknowledge the need for such information. Evidence-based scientific studies to support health and nutraceutical claims related to the use of medicinal plants and their extracts have to be undertaken. It is only through critical research efforts that we can provide strong endorsements for medicinal plant use and ensure consumer confidence in the industry. Much of the research published on the medicinal value of plants does not take into account variability generated from genetic dif-ferences among plants and their interaction with the environment. Research should be directed towards properly identify-ing plants with known medicinal properties which have been grown in environments that are conducive to consistent pro-duction of the active agents attributed to the plants. Production of dependable medicinal plant products can only be at-tained if we pay close attention to these research-based principles. This article was written with main goals: 1) To discuss the above points in greater detail with examples; and 2) to highlight life time accomplishments and significant contribu-tions of a well respected nutritionist Dr. T. K. Basu and his collaboration in development of fenugreek as a NHP. We be-lieve that collaboration among clinical and agricultural researchers is essential to make the NHPs utilized to its potential and the plants (parts such as seed, foliage or roots) should be developed to the extent that they can be used directly to take advantage of the synergistic effect of the chemical constituents.
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The Echinacea (coneflower) genus includes herbaceous flowering species mainly used for medicinal purposes, as well as the ornamental plants. Morphological similarities between Echinacea species often lead to their incorrect identification and characterization. Genome size and SCoT markers were used for identification and establishing the taxonomic relationships within Echinacea genus. The analysis of the nuclear DNA content indicated, that the majority of Echinacea species possessed intermediate genomes, and only E. pallida has a large genome size. 2C DNA content ranged from 14.31 pg/2C (E. simulata) to 28.59 pg/2C (E. pallida). Based on flow cytometric measurements (FCM) of the nuclear DNA content it was possible to distinguish three coneflower species, E. simulata, E. pallida and E. sanguinea, confirming validity of the method for initial species identification. Whereas, SCoT-PCR analysis enabled the identification of all studied accessions. Nine primers revealed polymorphism both between species, as well as varieties of E. angustifolia and E. paradoxa, demonstrating the usefulness of SCoT primers for genetic diversity studies in this genus. The phylogenetic analysis confirmed, that Echinacea species are closely related and within the investigated accessions two main phylogenetic groups exist, with one species (E. purpurea) being not clustered to any of the groups. Two methods, FCM and SCoT-PCR, can be successfully applied in identification and taxonomic relationship assessment, as well as in determination of the genetic diversity of Echinacea genus. Moreover, this is the first report on genome size that includes eight Echinacea accessions.
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In this trial we aimed to assess the effects of dietary supplementation of 4-O-methyl-glucuronoarabinoxylan (4OMG) on growth performance, thigh meat quality and small intestine development of female Partridge-Shank broilers. A total of 240 1-day-old female Partridge-Shank broilers were randomly distributed to four groups with three replicates of 20 within each group. Groups received either 0, 15, 20 or 25 g 4OMG/kg DM of diet. During the whole experiment of 60 days, broilers had ad libitum access to water and feed. At pen level, feed intake was recorded daily and broilers were weighed at the start and end of the experiment. For each group, three pens with a total of 20 broilers were randomly selected to determine the thigh meat quality and the small intestine development of broilers. Broilers fed diets with higher 4OMG had greater final liveweight (P = 0.004), daily bodyweight gain (P = 0.004) and gain-to-feed ratio (P < 0.001), muscle pH values (P = 0.031) and redness (P = 0.001), duodenal weight index (P = 0.042), jejunal (P = 0.043) and ileal length (P = 0.049), duodenal (P < 0.001) and ileal villus height (P = 0.008), but lower percentage of dead birds (P < 0.001), drip loss (P = 0.042) and shear force value (P = 0.043) of the thigh muscles. These results indicate that increasing dietary supplementation of 4OMG may improve growth performance and meat quality of female Partridge-Shank broilers through better development of small intestine.
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The herb Echinacea purpurea, also called purple coneflower, is regarded as an immune modulator. This study examined changes in cytokine production in blood samples from 30 volunteers before and during 8-day oral administration with an ethanolic extract of fresh Echinacea purpurea (Echinaforce(®)). Daily blood samples were ex vivo stimulated by LPS/SEB or Zymosan and analysed for a series of cytokines and haematological and metabolic parameters. Treatment reduced the proinflammatory mediators TNF-α and IL-1β by up to 24% (p<0.05) and increased anti-inflammatory IL-10 levels by 13% (p<0.05) in comparison to baseline. This demonstrated a substantial overall anti-inflammatory effect of Echinaforce(®) for the whole group (n=28). Chemokines MCP-1 and IL-8 were upregulated by 15% in samples from subjects treated with Echinaforce(®) (p<0.05). An analysis of a subgroup of volunteers who showed low pre-treatment levels of the cytokines MCP-1, IL-8, IL-10 or IFN-γ (n=8) showed significant stimulation of these factors upon Echinaforce(®) treatment (30-49% increases; p<0.05), whereas the levels in subjects with higher pre-treatment levels remained unaffected. We chose the term "adapted immune-modulation" to describe this observation. Volunteers who reported high stress levels (n=7) and more than 2 colds per year experienced a significant transient increase in IFN-γ upon Echinaforce(®) treatment (>50%). Subjects with low cortisol levels (n=11) showed significant down-regulation of the acute-phase proteins IL1-β, IL-6, IL-12 and TNF-α by Echinaforce(®) (range, 13-25%), while subjects with higher cortisol levels showed no such down-regulation. This is the first ex vivo study to demonstrate adapted immune-modulation by an Echinacea preparation. While Echinaforce(®) did not affect leukocyte counts, we speculate that the underlying therapeutic mechanism is based on differential multi-level modulation of the responses of the different types of leukocytes. Echinaforce(®) thus regulates the production of chemokines and cytokines according to current immune status, such as responsiveness to exogenous stimuli, susceptibility to viral infection and exposure to stress.
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The aim of this review is to evaluate and summarize the available scientific information on the commonest plant extracts marketed in Western countries. In view of the intense, ongoing search for new plant extracts with powerful anti-inflammatory activity, we paid particular attention to this topic. The aim is to provide broad coverage of as many potentially useful plants as possible and then to focus on those with the greatest therapeutic potential. Our bibliographic sources were the SciFinder databases: CAPLUS, MEDLINE, REGISTRY, CASREACT, CHEMLIST, CHEMCATS (update to October 2007). In order to assess the value of clinical trials, we focused a specific search on clinical investigations concerning nine plants with the most trial data, viz., Althaea officinalis, Calendula officinalis, Centella asiatica, Echinacea purpurea, Passiflora incarnata, Punica granatum, Vaccinium macrocarpon, Vaccinium myrtillus, Valeriana officinalis. This was carried out in several databases (update to June 2008): ISI Web of Knowledge(SM) (ISI WoK), SciFinder (CAPLUS, MEDLINE, REGISTRY, CASREACT, CHEMLIST, CHEMCATS) and PubMed (indexed for MEDLINE). Our survey covers roughly a 1000 plants, although clinical trials have been published only for 156 plants supporting specific pharmacological activities and therapeutic applications. However, for about half of the plants, in vitro and in vivo studies provide some support for therapeutic use. For one-fifth of the plants included in our search, only phytochemical studies were found. Their properties and indications were often attributed to the presence of certain compounds, but no evidence concerning the activities of the whole extracts was presented. We found that for about 12% of the plants, currently available on the Western market, no substantial studies on their properties had been published, while there was strong evidence that 1 in 200 were toxic or allergenic, so that their use ought to be discouraged or forbidden. Nine plants had considerable evidence of therapeutic effect, viz., A. officinalis, Calendula officinalis, Centella asiatica, E. purpurea, Passiflora incarnata, Punica granatum, Vaccinium macrocarpon, Vaccinium myrtillus, Valeriana officinalis. The present review provides a baseline on the level of evidence available on many herbal preparations and should be of help to those intending to research further on these topics.
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In vivo, in vitro, and animal learning studies have reported neuroactive effects of Rb1 and Rg1 ginsenosides that may be relevant to human learning and memory. The objective of this study was to assess potential learning and memory benefits of HT1001, a standardized proprietary North American ginseng (Panax quinquefolius) extract contain-ing Rb1, Rg1 and other important ginsenosides, in healthy volunteers. Neuropsychological assessments were conducted using the Clinical Memory Scale (CMS), which has two parallel forms for baseline and post-treatment assessments. A young adult sample (YAS, n = 10) and a middle aged sample (MAS, n = 10) completed the CMS at baseline and again af-ter 14 days' exposure to 200mg HT1001 daily. The CMS Memory Quotient (MQ) showed significant main effects of time, with higher CMS-MQ on the second assessment compared to the first, and of age group, with the YAS performing better than the MAS. There was no interaction between time and age group. Secondary analyses indicated benefits for both groups on free recall of word lists, cued recall of word pairs, and recognition of figures, and benefits in the YAS but not the MAS on free recall of pictures. Taken together, the results suggest that memory, as measured with the CMS-MQ, was significantly improved with open-label HT1001. While practise effects cannot be completely ruled out, the results presented here are exciting and timely given our increasingly ageing population, and provide preliminary support for a prospective placebo-controlled examination of HT1001 on learning and memory.
Chapter
Echinacea has a long history of medical use in the United States. Starting in the 1950s and increasing in recent decades, the immune-stimulating abilities of Echinacea have caught the attention of the medical community. Some Echinacea products have shown in international clinical trials that they are useful for treating and preventing upper respiratory tract infections. There is still much more research that needs to be accomplished to determine which formulation is most efficacious. Overall, Echinacea products appear to be safe and generally they are not the source of allergies or dangerous drug/herb interactions.
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Acute upper respiratory tract conditions (URTCs), including the common cold, allergic rhinitis (AR), and acute sinusitis, are among the most common afflictions worldwide, affecting millions of individuals annually in the United States alone. A common theme among these conditions is that they share similar symptomatology and are often inadequately treated. These conditions typically cause mild, albeit bothersome, symptoms for a typical duration of 7 to 10 days in the case of the common cold, ≥ 2 weeks for AR exacerbations, and > 4 weeks for acute sinusitis. The common cold and AR elicit localized (upper airway) and systemic inflammatory cascades responsible for symptoms such as cough, nasal congestion, rhinorrhea, watery eyes, sneezing, headache, and general malaise. Acute sinusitis typically occurs because of a secondary bacterial or fungal infection of mucus-clogged nasal and sinus cavities and has symptoms similar to those previously listed, with the addition of increased facial and ear pressure/pain. Acute URTC symptoms are frequently managed with over-the-counter (OTC) products. Currently available OTC options can have limited efficacy in treating the broad array of symptoms associated with acute URTCs, and some have unwanted side effects. There is an unmet need for OTC therapies that have broad clinical activity, can reduce the severity and duration of illness when taken at the first sign of symptoms, and/or provide prophylaxis. This review article examines the available evidence supporting emerging and potentially new OTC pharmacologic, nutraceutical, and nonpharmacologic therapies on the horizon for the treatment of acute URTCs. This review is not intended to be a comprehensive evaluation of all potential URTC therapies, and the approvability of many of the agents discussed for OTC use in the United States may be subject to debate.
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Echinacea species is provided as dietary supplements for various infectious and immune related disorders and has a potential role in cancer prevention. The aim of this study was to optimize the extraction of total flavonoids using different extraction methods and investigate the cytotoxic effects on various cancer cell lines (CaCo-2, MCF-7, A549, U87MG, and HeLa) and VERO (African green monkey) as a non-cancerous cell line. Box-Behnken statistical design was used to evaluate the effect of pressure (100-200 bar), temperature (40-80 degrees C) and ethanol as co-solvent (6-20 wt%) at a flow rate of 15 g/min for 60 min in supercritical CO2 extraction and the effect of temperature (60-100 degrees C), time (5-15 min) and power (300-900W) in microwave-assisted extraction. Optimum extraction conditions were elicited as 300 bar, 80 degrees C and 13% co-solvent yielding 0.472 mg rutin equivalent total flavonoids/g extract in SC-CO2 extraction, whereas 60 degrees C, 10 min and 300W yielded the highest (0.202 mg rutin equivalent) total flavonoids in microwave-assisted extraction. Additional trials with subcritical water (0.022 mg/g) and Soxhlet extraction with methanol (0.238 mg/g) yielded lower flavonoid contents. The exposures upto 50 mu g/ml of extracts revealed no significant inhibition on the proliferation of both tested cancer cells and healthy VERO cells.
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BACKGROUND:Echinacea purpurea (L.) Moench is in increasing demand worldwide owing to its medicinal value, resulting from the combined effects of several phytochemicals. In the present study, the polymerase chain reaction-amplified randomly amplified polymorphic DNA (RAPD) markers generated from 45 pre-selected primers were used to predict the contents of total phenol, caffeoyl phenol and alkamide8 + 9 (alkamide 8+ alkamide 9) in aerial parts of 70 E. purpurea accessions through stepwise regression analysis. The contents of these phytochemicals were also analyzed chemically. RESULTS: In the first trial, 16 polymorphic fragments generated by pre-selected RAPD primers showed significant correlations with the examined phytochemical traits in 59 accessions. Phytochemical traits in leaves and florets of another 11 accessions were further analyzed chemically, and the data were compared to the phytochemical data predicted using the regression equations derived from first trial. Statistical analyses revealed significant correlations in total phenol level between predicted and actual values for leaves and florets in these 11 accessions. CONCLUSION: RAPD markers coupled with stepwise regression analysis can be considered as an initial screening method for identifying E. purpurea accessions with high total phenol content in aerial parts of the plants prior to assessing their agronomic performance in the field. Copyright
Article
Background Echinacea plant preparations (family Asteraceae) are widely used in Europe and North America for common colds. Most consumers and physicians are not aware that products available under the term Echinacea differ appreciably in their composition, mainly due to the use of variable plant material, extraction methods and the addition of other components. Objectives To assess whether there is evidence that Echinacea preparations are effective and safe compared to placebo in the prevention and treatment of the common cold. Search methods We searched CENTRAL 2013, Issue 5, MEDLINE (1946 to May week 5, 2013), EMBASE (1991 to June 2013), CINAHL (1981 to June 2013), AMED (1985 to February 2012), LILACS (1981 to June 2013), Web of Science (1955 to June 2013), CAMBASE (no time limits), the Centre for Complementary Medicine Research (1988 to September 2007), WHO ICTRP and clinicaltrials.gov (last searched 5 June 2013), screened references and asked experts in the field about published and unpublished studies. Selection criteria Randomized controlled trials (RCTs) comparing mono-preparations of Echinacea with placebo. Data collection and analysis At least two review authors independently assessed eligibility and trial quality and extracted data. The primary efficacy outcome was the number of individuals with at least one cold in prevention trials and the duration of colds in treatment trials. For all included trials the primary safety and acceptability outcome was the number of participants dropping out due to adverse events. We assessed trial quality using the Cochrane 'Risk of bias' tool. Main results Twenty-four double-blind trials with 4631 participants including a total of 33 comparisons of Echinacea preparations and placebo met the inclusion criteria. A variety of different Echinacea preparations based on different species and parts of plant were used. Evidence from seven trials was available for preparations based on the aerial parts of Echinacea purpurea. Ten trials were considered to have a low risk of bias, six to have an unclear risk of bias and eight to have a high risk of bias. Ten trials with 13 comparisons investigated prevention and 15 trials with 20 comparisons investigated treatment of colds (one trial addressed both prevention and treatment). Due to the strong clinical heterogeneity of the studies we refrained from pooling for the main analysis. None of the 12 prevention comparisons reporting the number of patients with at least one cold episode found a statistically significant difference. However a post hoc pooling of their results, suggests a relative risk reduction of 10% to 20%. Of the six treatment trials reporting data on the duration of colds, only two showed a significant effect of Echinacea over placebo. The number of patients dropping out or reporting adverse effects did not differ significantly between treatment and control groups in prevention and treatment trials. However, in prevention trials there was a trend towards a larger number of patients dropping out due to adverse events in the treatment groups. Authors' conclusions Echinacea products have not here been shown to provide benefits for treating colds, although, it is possible there is a weak benefit from some Echinacea products: The results of individual prophylaxis trials consistently show positive (if non-significant) trends, although potential effects are of questionable clinical relevance.
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Echinacea is used for its immunostimulating properties and may have a role in modulating adverse immune effects of chemotherapy (i.e., use of 5-fluorouracil (5-FU); fluorouracil and its immunosuppressive effect). Patients may seek herbal remedies such as Echinacea (Echinacea angustifolia and Echinacea purpurea) for immune stimulation. Echinacea extracts have been prescribed to supplement cancer chemotherapy for their immune-supportive effects; however, the extracts may also influence tumourgenesis. Our study aimed to determine the proliferative effect of the ethanolic blend of E. angustifolia and E. purpurea on various cancer cervical and bile duct cell lines, including HELA and QBC-939. Various cancer cells (HeLa and QBC-939) and human vein epithelial cells (HUVEC) were treated with the Echinacea blend sample that was evaporated and reconstituted in Dimethyl sulfoxide (DMSO). As the extract concentration of Echinacea was increased from 12.5 μg/mL to 25 μg/mL, there was an increase in cell inhibition up to 100%, which then reduced to 90% over the next three concentrations, 50 μg/mL, 100 μg/mL, and 200 μg/mL, in HeLa cells; further inhibitory effects were observed in QBC-939 cells, from 9% inhibition at a concentration of 25 μg/mL up to 37.96% inhibition at 100 μg/mL concentration. Moreover, this is the first study to report the growth-promoting effects of this Echinacea blend in HUVEC, up to 800% at a dose concentration of 200 μg/mL. Previous studies have suggested that chicoric acid of Echinacea spp. is responsible for the increased cell growth. The results of this study show that the hydroethanolic extract of Echinacea herbal medicine promotes the growth of HeLa cells and QBC-939 cancer cell proliferation, and may interfere with cancer treatment (i.e., chemotherapy drugs such as 5-fluorouracil and Cisplatin (DDP)). However, the Echinacea blend shows potential in neurodegenerative diseases with growth-promoting effects in HUVEC. Further animal trials (in vivo effect) measuring dose toxicology are necessary to demonstrate the interaction of this blend with body and tumor growth, and also any positive synergistic or adverse interaction with chemotherapeutic drugs listed, so as to confirm the current observation and epithelial tissue growth or regeneration in a neurodegenerative disease model.
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Echinacea purpurea, Echinacea angustifoli and Echinacea pallida are frequently used as medicinal plants. Besides asking for evidence on their efficacy, there is an increasing interest for safety data. This review systematically presents the available literature on drug interactions, contraindications, adverse events, duration of use, and safety of use in pregnant and nursing women, and assesses the safety profile of corresponding Echinacea preparations. It is noteworthy that all safety data reported are as product specific as the pharmacological or efficacy data are. In pharmacokinetic herb-drug interaction studies performed in vivo, no significant inhibitions of human CYP2D6 and CYP3A4 isoforms have been found after the administration of standardized E. purpurea preparations. However, contradictory results exist in studies using liver microsomes. Adverse events reported during clinical trials following administration of Echinacea spp. mono-preparations were generally mild and mostly without causality. Due to published long term studies with continuous ingestion of different Echinacea preparations up to 6 month with no reported toxicological concerns, Echinacea can be recommended also for long-term use. Moreover, the contraindications in cases of autoimmune diseases and immune-suppression are questionable, since lipophilic Echinacea preparations containing alkamides suppress cellular immune responses, and beneficial effects in autoimmunity were reported. The same applies for the use during pregnancy. Although there has been some impact reported on embryonic angiogenesis in mice, no association with an increased risk for major or minor malformations during organogenesis was found in a literature review. Altogether, the different evaluated Echinacea preparations are well-tolerated herbal medicines in the management in children and adults alike. Georg Thieme Verlag KG Stuttgart · New York.
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In the present study, we investigated whether oral ingestion of Echinacea purpurea improves human immunity, especially of NK. cells, T-lymphocyte, and B-lymphocyte. Twenty two healthy volunteers, who feel fatigue daily, participated in our trial, and were randomly assigned to either the echinacea group or placebo group. The echinacea group ingested a preparation of Echinacea purpurea which consisted of 500mg of extracts of Echinacea purpurea and 1500 mg of diluents, whereas the placebo group ingested a placebo which consisted of 2000mg of diluents. Each participant ingested test products once a day before sleeping, for 3 weeks. We inspected the participants' immunity at initial, 1 week, and 3 weeks after the ingestion. Scoring of Immunological Vigor, which is the comprehensive assessment of human immunity, significantly improved only in the echinacea group (p= 0.030). As compared with the initial level, the growth of the numbers of lymphocytes (p=0.035) and CD4+ T-ce!ls (p=0.050) in the echinacea group at 3 weeks after the initiation of ingestion significantly increased more than those in the placebo group, and the growth of the number of T-cells (p=0.060) showed the same tendency with marginal significance. However, the number of NK-cells and its activity in both groups decreased, and the number of B-cells did not show any significant change. In summary, our results indicate that preparation of Echinacea purpurea could improve the immunological function of humans, especially in T-lymphocyte.
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Objective: To evaluate potential applicability of Echinacea use for management of respiratory tract infections in Hajj travelers. Method: The PubMed database was explored with Mesh terms "Echinacea" and "Respiratory Tract Infections". Results: A hundred journal articles were yielded but only 66 most relevant ones used for the review. Conclusion: There is a considerable amount of evidence that shows effectiveness of Echinacea products in prevention and treatment of respiratory tract infections in this setting. Although there are some controversial findings, utilization of standardized products with adequate dose or combinations with other immune-stimulants in controlled and well-designed trials will be highly encouraging.
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The purpose of the present investigation was to compare similarities and differences in immune response among Echinacea species, which are commonly used to treat upper respiratory infections. The investigation involved two components: acquisition of immunomodulatory data reported here for the first time, and combined phenetic analysis of these data along with previous reports. Experimental data were obtained by stimulating human PBMC in vitro with extracts from Echinacea spp. and assaying production of three cytokines (interleukin-1β [IL-1β] interleukin-2 [IL-2], and tumor necrosis factor α [TNF-α]). Phenetic analyses were employed to compare responses across the entire data set, including UPGMA (Unweighted Pair Group Method with Arithmetic Mean) and neighbor-joining methods. In the immune experiments conducted for this investigation, E. angustifolia,E. paradoxa, E. purpurea, E. simulata, andE. tennesseensis extracts significantly augmented IL-1 β and TNF-α production, whereas no extracts significantly modulated IL-2. All phenetic methods produced similar dendrograms, revealing two species pairs (E. angustifolia + E. simulata and E. pallida + E.sanguinea) where both species cluster tightly and have similar immune-response profiles. These two species-pairs are maximally dissimilar from each other. The remaining species (E. paradoxa, E. purpurea, and E. tennesseensis) occupy intermediate positions in the dendrogram. Our results suggest that Echinacea spp. act heterogeneously on immune function. The utility of these data for science and industry is discussed.
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Diabetes (DIAB)-related renal dysfunction is one of the most severe complications of the condition, which comes to an end with chronic renal failure. Aim: This study aimed to examine if Echinacea purpurea (E. purpurea) root extract could help protect kidneys from damage caused by DIAB in rats. Methods: DIAB was induced in four experimental rats groups (n = 10) by injecting STZ (65 mg/kg). One of the DIAB groups was left untreated, and the other three groups were treated with either E. purpurea root extract alone (200 mg/kg), metformin (Met) alone (200 mg/kg), or both together. A group of healthy rats (control) was also used for comparison. Results: In contrast to the DIAB group, E. Purpurea root extract alone and combined to Met improved body weight, kidney index, kidney function (creatinine and urea), and renal pathology. Compared to the DIAB group, the ingestion of E. purpurea extract alone or in combination with Met reduced blood glucose levels, bringing them back into the normal range in the combination group and ameliorating hemoglobin A1c(HbA1c) levels. The extract group’s antioxidant effect was clearly demonstrated by the decreased malondialdehyde (MDA) and increased superoxide dismutase (SOD) kidney concentrations in the extract group alone or in combination with Met where the combination showed superior activity. The extract group’s anti�inflammatory effect was observed from the reduced serum levels of interleukin 1β (IL-1β) and IL-6 in the extract group alone or mixed with Met, where the mixture showed a better action. Conclusion: In rats, E. purpurea root extract ameliorated DIAB-related nephrotoxicity induced by STZ. The hypoglycemic, antioxidant, and anti-inflammatory properties of the extract may be the underlying mechanisms.
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Dietary long-chain (n-3) fatty acids from fish oil and low intensity exercise have been reported, independently, to inhibit tumor growth in rats. The mechanism for these effects is not known but may be related to diet and exercise-induced alterations in immune function. To study the individual and combined effects of these interventions on anticancer immune responses, healthy Fischer 344 rats were fed, for 4 wk, one of two semi- purified diets (polyunsaturated to saturated fatty acid ratio Å 0.9), which differed only in the composition of fat (200 g/kg) and provided long-chain (n-3) fatty acids at 0 or 33 g/kg of total fat. Rats were randomly assigned to groups in a 2 1 2 experimental design to swim 3 h/d or to remain sedentary. For sedentary rats, dietary (n-3) fatty acids increased (Põ 0.05) splenic natural killer (NK) cell cytotoxicity and the percentage of activated (CD71/) T and B cells and macrophages in spleen after concanavalin A stimulation. For exercise-trained rats, feeding the high (n-3) diet decreased (P õ 0.05) the percentage of CD71/ T helper and B cells after stimulation. NK cell cytotoxicity, and the percentages of CD71/ T cells, B cells and macrophages after stimulation in the high (n-3)- fed exercise-trained group were not different than those of the low (n-3)-fed sedentary group. Thus individually, but not in combination, long-chain (n-3) fatty acids and low intensity exercise may be advantageous by augmenting cell-mediated immune function and NK cell cytotoxicity in healthy rats. J. Nutr. 128: 498-504, 1998.
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The purpose of this study was to assess the effectiveness of echinacea for the prevention of experimental rhinovirus colds. Infection occurred in 44 and 57% and illness occurred in 36 and 43% of the echinacea- and placebo-treated subjects, respectively. This preparation of echinacea had no significant effect on either the occurrence of infection or the severity of illness.
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Echinacea is a widely used herbal remedy for treatment of upper respiratory tract infections (URIs). However, there are few data on the efficacy and safety of echinacea in treating URIs in children. To determine if Echinacea purpurea is effective in reducing the duration and/or severity of URI symptoms in children and to assess its safety in this population. Randomized, double-blind, placebo-controlled trial of healthy children 2 to 11 years old recruited from a regional practice-based network and an alternative medical center in 4-month periods from 2000 through 2002. Study patients were randomized to receive either echinacea or placebo for up to 3 URIs over a 4-month period. Study medication was begun at the onset of symptoms and continued throughout the URI, for a maximum of 10 days. Primary outcomes were duration and severity of symptoms and adverse events recorded by parents; secondary outcomes included peak severity of symptoms, number of days of peak severity, number of days of fever, and a global assessment of severity of symptoms by parents of study children. Data were analyzed on 707 URIs that occurred in 407 children, including 337 URIs treated with echinacea and 370 with placebo. There were 79 children who completed their study period without having a URI. The median duration of URIs was 9 days (95% confidence interval, 8-10 days); there was no difference in duration between URIs treated with echinacea or placebo (P =.89). There was also no difference in the overall estimate of severity of URI symptoms between the 2 treatment groups (median, 33 in both groups; P =.69). In addition, there were no statistically significant differences between the 2 groups for peak severity of symptoms (P =.68), number of days of peak symptoms (1.60 in the echinacea group and 1.64 in the placebo group; P =.97), number of days of fever (0.81 in the echinacea group vs 0.64 in the placebo group; P =.09), or parental global assessment of severity of the URI (P =.67). Overall, there was no difference in the rate of adverse events reported in the 2 treatment groups; however, rash occurred during 7.1% of the URIs treated with echinacea and 2.7% of those treated with placebo (P =.008). Echinacea purpurea, as dosed in this study, was not effective in treating URI symptoms in patients 2 to 11 years old, and its use was associated with an increased risk of rash.
Conference Paper
Viral respiratory tract infections, also known as colds, are the most common infection in humans. The majority of these infections are caused by rhinoviruses. Rhinovirus deposition in the nose or the eye initiates infection. The virus attaches to the host cell intercellular adhesion molecule-1 (ICAM-1) receptors in the back of the throat. Subsequent viral replication triggers the release of inflammatory mediators and activation of neurogenic pathways, which lead to symptoms. Symptoms occur within 10 to 16 hours after virus entry into the nose and peak on days 2 to 3 of infection. Symptom duration is typically 1 week, although 25% of cases last longer. Understanding the chronology of these events is important in the timing of treatment. Because of the rapidity of symptom onset, early treatment is the key to reducing viral replication and illness. Also, early treatment may reduce the risk of transmission. (C) 2002 by Excerpta Medica, Inc.
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Background Echinacea purpurea stimulates the immune response and is promoted to reduce symptom severity and the duration of upper respiratory tract infections. We sought to determine the efficacy of a standardized preparation of E purpurea in reducing symptom severity and duration of the common cold.Methods A randomized, double-blind, placebo-controlled design was used. Patients received either 100 mg of E purpurea (freeze-dried pressed juice from the aerial portion of the plant) or a lactose placebo 3 times daily until cold symptoms were relieved or until the end of 14 days, whichever came first. Symptoms (sneezing, nasal discharge, nasal congestion, headache, sore or scratchy throat, hoarseness, muscle aches, and cough) were scored subjectively by the patient and recorded daily in a diary. Kaplan-Meier curves were used to estimate the survival function of time to resolution in each group. The Wilcoxon rank sum test was used to compare time to resolution between the 2 groups.Results One hundred twenty-eight patients were enrolled within 24 hours of cold symptom onset. Group demographic distribution was comparable for sex, age, time from symptom onset to enrollment in the study, average number of colds per year, and smoking history. No statistically significant difference was observed between treatment groups for either total symptom scores (P range, .29-.90) or mean individual symptom scores (P range, .09-.93). The time to resolution of symptoms was not statistically different (P = .73).Conclusions Some studies have concluded that Echinacea effectively reduces the symptoms and duration of the common cold. We were unable to replicate such findings. Further studies using different preparations and dosages of E purpurea are necessary to validate previous claims.
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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.
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Herbal and related remedies are becoming increasingly popular in the United States. Although some of these products have been promoted as panaceas with little scientific data to support their use, clinical data are starting to accumulate showing the benefit of specific products. For the herbal products, English translation of the German Commission E monographs greatly increases the availability of credible information. Under the 1994 Dietary Health Supplement and Education Act, these products are considered as dietary supplements rather than drugs; regulation by the Food and Drug Administration is therefore limited. This lack of regulation has contributed to drug misadventures; such adverse events should be reported to the MedWatch program of the Food and Drug Administration. One suggestion to improve the status of these products in the United States would be to adopt the German philosophy that the products be approved as drugs based on absolute proof of safety and reasonable proof of efficacy.
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Neutrophil attractant/activation protein-1 (NAP-1 [interleukin-8]) is an 8,400 D protein that is a chemoattractant and granule release stimulus for neutrophils. NAP-1 was first purified from culture fluids of lipopolysaccharide-stimulated human blood mononuclear leukocytes. It was subsequently isolated from lipopolysaccharide-stimulated lung macrophages, mitogen-stimulated lymphocytes, and virus-infected fibroblasts. Interleukin-1 or tumor necrosis factor induces NAP-1 mRNA in many cells, including monocytes, fibroblasts, and endothelial cells. NAP-1 belongs in a family of host defense small proteins, which have a degree of sequence and structural similarity. Noteworthy are the four half-cystine residues in each protein, which are in register when the protein sequences are suitably aligned. Based on cloning data and N-terminal sequence analyses, NAP-1 is secreted as a 79 residue protein after cleavage of a 20 residue signal peptide. The commonly isolated 77 and 72 residue forms are probably extracellular cleavage products. NAP-1 has considerable charge heterogeneity. Charge and length variants all have chemotactic activity. In contrast to many chemoattractants, NAP-1 does not attract monocytes. Intradermal injection of NAP-1 causes neutrophil infiltration. The wide spectrum of cell sources and production stimuli suggests that NAP-1 mediates neutrophil recruitment in host defense and disease.
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Populations of peripheral blood leukocytes were enumerated in 15 volunteers challenged by intranasal inoculation with rhinovirus serotype 25. The results demonstrated a significant decrease in total lymphocyte count among infected persons on the third day after challenge with the virus (P < .01). The change in lymphocyte count was associated with a significant decrease in total T cells, as determined by monoclonal antibodies (both Tll+ and T3+, P < .02), but not in B cells (B7+). Among the subsets ofT cells, T4+ (T helper/inducer) and T8+ (T suppressor/cytotoxic) lymphocytes both declined in number, but only the change in the T4+ subset was significant. For each of the lymphocyte populations that decreased significantly (T3+, T11+, and T4+) there was a strong correlation with increased severity of symptoms. Persons who had the greatest decrease in total lymphocyte count also shed virus most frequently. The number of nonlymphocyte leukocytes increased with the severity of the symptoms. These data show that T lymphocytes (particularly the T4+ population) are related to both the progression of infection and the symptoms of the rhinovirus common cold.
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The effect of respiratory syncytial virus (RSV) antibody complexes on the metabolism of human neutrophils was determined by examining the generation of luminol-dependent chemiluminescence, superoxide, and thromboxane B2. Incubation of neutrophils with RSV antibody complexes resulted in a significant increase in the production of chemiluminescence. The increase in chemiluminescence appeared to be due to (1) active phagocytosis of RSV antibody complexes as evidenced by 70% inhibition with cytochalasin B (P < 0.001) or (2) increased superoxide production as evidenced by 40% inhibition with superoxide dismutase (P < 0.001). The generation of superoxide was confirmed by specific analysis in a superoxide dismutase-inhibitable ferricytochrome c reduction assay. Of particular importance was the observation that RSV antibody complexes induced the release of significant quantities of thromboxane B2 from neutrophils as determined by radioimmunoassay. Oxygen radicals and/or products of arachidonic acid metabolism may, in part, mediate the pathogenesis of RSV infection through direct tissue damage and bronchoconstriction.
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The respiratory tract infection (RTI) is one of the world's most common and expensive ailments. It has been increasingly recognized that viral infections can exacerbate asthmatic symptoms 1-5 and cause airway hypersensitivity that persists weeks after the virus itself has been eradicated. 6 The major viruses responsible for RTI include rhinoviruses, parainfluenza viruses, and adenoviruses. In particular, rhinovirus infection accounts for approximately 50% of clinical colds in adults. 7 Infection by rhinovirus is thought normally to be restricted to the upper part of the respiratory tract. This is supported by the virus' optimal replication temperature of 33 ° C, which could prevent deeper body penetration under normal conditions. Evidence for any lower respiratory tract infection is thus far inconclusive, 8' 9 and there is no evidence for the virus spreading any farther than this. However, the infection can often compromise lower airway function 8 and have systemic actions. Therefore it is likely that indirect methods such as leukocyte activation, mediator release, and neurogenic modulation contribute to the systemic effects of RTIJ ° We are interested in the changes in leukocyte function under the influence of a rhinoviral infection and the possible role of mediators in orchestrating the indirect actions of the virus. Many aspects of virus-induced colds resemble events in inflammation; thus, cellular mechanisms are likely to be common to both. Studies of various leukocytes have revealed alterations in number, site of accumulation, and activation state after viral in
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Chronic granulomatous disease (CGD) is a rare recessive disorder caused by defects in the NADPH oxidase enzyme complex of phagocytes (neutrophils, eosinophils and monocytes). CGD phagocytes fail to produce superoxide and other reactive oxygen species following cell activation (Malech, 1993). The products of oxidase activation can be measured in individual cells by flow cytometry using specific fluorescent probes that increase fluorescence upon oxidation (Trinkle et al., 1987). This approach can be used to confirm a diagnosis of CGD, and to detect the normal/abnormal phagocyte mixture that characterizes the X-linked CGD carrier state. Three fluorescent probes have been described as useful for this purpose: 2'7'-dichlorofluorescin diacetate (DCF) (Bass et al., 1983), 5,6-carboxy-2'7'-dichlorofluorescein diacetate, bis(acetoxymethyl) ester (C-DCF) (Hockenbery et al., 1993) and dihydrorhodamine 123 (DHR) (Rothe et al., 1988; Kinsey et al., 1987). A direct comparison between these three probes has not been reported. In this study we performed a direct comparison between these three probes, evaluating their ability in flow cytometric analysis to maximize fluorescent separation between activated CGD patient and normal granulocytes. Using a whole blood technique with phorbol myristate acetate (PMA) as an activator, it was found that DHR loaded normal granulocytes had a fluorescence intensity which, upon activation, was 48-fold higher than that of C-DCF loaded granulocytes and seven-fold higher than DCF loaded granulocytes (P < 0.001). Use of sodium azide to decrease the catabolism of H2O2 enhanced the fluorescence of DCF by 140%, C-DCF by 45% and DHR by 25%, suggesting that DCF is primarily sensitive to H2O2. DCF and DHR were then evaluated for sensitivity in the detection of small percentages of normal cells in a CGD/normal granulocyte mixture. Normal sub-populations as small as 0.1% could clearly be distinguished using DHR, while DCF was insensitive at this level. Based on these findings, we used DHR in an effort to detect normal granulocytes in a CGD patient following therapeutic granulocyte transfusion. We were able to detect normal granulocytes in the circulation for up to 18 h after transfusion. With these data we show that DHR is the most sensitive flow cytometric indicator for the detection of oxygen reactive species in activated granulocytes and is the best probe for evaluating CGD patients and carriers. In addition, our data suggest that DHR is a useful tool for monitoring circulating normal granulocytes in CGD patients following transfusion, and potentially will be a sensitive probe for assessing the success of such future technologies as gene therapy for CGD.
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Children in a day care center underwent serial nasal lavages in order to assess nasal cytokine expression during acute upper respiratory infections (URI). Interleukin (IL)-l{j, IL-8, IL-6, and tumor necrosis factor-a (TNF-α) were markedly elevated in nasal lavage fluid during acute URI compared to baseline, and all except TNF-α decreased significantly by 2–4 weeks later. Cytokine patterns in respiratory syncytial virus—positive and —negative illnesses did not differ significantly. A subgroup of children also underwent superficial mucosal biopsy under the inferior nasal turbinate. During acute URI, biopsy cells (90%–95% epithelial) showed increased transcripts for IL-lβ, IL-8, and IL-6 in 7 of 9 subjects, suggesting that epithelial cells may be one source of cytokines during acute URI. The results show that inflammatory cytokines are elevated in nasal secretions during acute URI in preschool children. Thus, cytokines are likely to participate in regulation of respiratory virus-induced inflammation.
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Polysaccharides (EP) isolated from large scale plant cell cultures of Echinacea purpurea, have been shown to activate human and murine phagocytes. In this study we investigated the influence of EP on the nonspecific immunity in immunodeficient mice. EP was effective in activating peritoneal macrophages isolated from animals after administration of cyclophosphamide (CP) or cyclosporin A (CsA). EP-treated macrophages exhibited increased production of tumor necrosis factor-alpha (TNF) and enhanced cytotoxicity against tumor target WEHI 164 as well as against the intracellular parasite Leishmania enrietti. After a CP-mediated reduction of leukocytes in the peripheral blood, the polysaccharides induced an earlier influx of neutrophil granulocytes as compared to PBS-treated controls. EP treatment of mice, immunosuppressed with CP or CsA, restored their resistance against lethal infections with the predominantly macrophage-dependent pathogen Listeria monocytogenes and predominantly granulocyte-dependent Candida albicans. Further, the effects of EP in allogeneic bone marrow chimeric mice are discussed. These findings may have therapeutical implications in prophylactic treatment of opportunistic infections.
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Extracts of Echinacea purpurea and Panax ginseng were evaluated for their capacity to stimulate cellular immune function by peripheral blood mononuclear cells (PBMC) from normal individuals and patients with either the chronic fatigue syndrome or the acquired immunodeficiency syndrome. PBMC isolated on a Ficoll-hypaque density gradient were tested in the presence or absence of varying concentrations of each extract for natural killer (NK) cell activity versus K562 cells and antibody-dependent cellular cytotoxicity (ADCC) against human herpesvirus 6 infected H9 cells. Both echinacea and ginseng, at concentrations > or = 0.1 or 10 micrograms/kg, respectively, significantly enhanced NK-function of all groups. Similarly, the addition of either herb significantly increased ADCC of PBMC from all subject groups. Thus, extracts of Echinacea purpurea and Panax ginseng enhance cellular immune function of PBMC both from normal individuals and patients with depressed cellular immunity.
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Reading this article will reinforce the reader's knowledge of the pathogenesis of the common cold. The rationale for current and potential therapies for the common cold are reviewed in the context of current concepts of the pathogenesis of these illnesses. A MEDLINE literature search was done using the search terms common cold, rhinovirus, and viral respiratory infection. The search was restricted to the English language. Articles were selected for review if the title and/or abstract suggested the content was relevant to the subject of this review. The bibliographies of selected articles were used as a source of additional literature. Recent studies suggest that the host response to the virus is an important contributor to the pathogenesis of the common cold. Inflammatory mediators, especially the pro-inflammatory cytokines, appear to be an important component of this response and present an attractive target for new interventions for common cold therapies. Currently available treatments for the common cold have limited efficacy against specific symptoms. These therapies should be selected to treat the specific symptoms that are perceived to be the most bothersome by the patient.
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We examined the feasibility of using induced sputum to evaluate the airway inflammatory response to natural acute respiratory virus infections. We recruited eight asthmatics and nine healthy subjects on Day 4 of a cold. Viral infection was confirmed in six of the asthmatics (influenza A or B) and six of the healthy subjects (influenza A, rhinovirus, adenovirus, respiratory syncytial virus, and coronavirus). In the subjects with confirmed virus infection, five of the asthmatics had an objective exacerbation of asthma during the cold. Their sputum on Day 4 showed a high median total cell count of 19.7 x 10(6) cells/ml with a modest neutrophilia (58. 5%) and high levels of interleukin-8 (IL-8) (16,000 pg/ml), eosinophilic cationic protein (ECP) (1,880 microgram/L) and very high levels of fibrinogen (250 mg/L). In contrast, the proportion (1.3%) and absolute number of eosinophils was low. IL-2 levels were within the normal range, whereas IL-5 and interferon gamma were under the limit of detection of the assays. In the healthy subjects with a confirmed virus infection the sputum findings were qualitatively similar but significantly less prominent. Sputum IL-8 on Day 4 was strongly correlated with neutrophils (rs = 0.8, p < 0.001). This correlation was also significant when each group was analyzed separately. On Day 21 there was a fall in the absolute number of neutrophils and in ECP and fibrinogen levels in both groups. Similar results were found in the two asthmatic and three healthy subjects with a cold of comparable severity but in whom viral infection was not confirmed. We conclude that induced sputum examination can be used to study the effects of natural colds and influenza on the airways of the lungs. The results also suggest that natural colds, on Day 4, cause neutrophilic lower airway inflammation that is greater in asthmatics than in healthy subjects. The greater inflammatory response in asthmatics may be due to the changes associated with trivial eosinophilia or to the different viruses involved.
Article
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.
Article
Fluid extracts of Echinacea purpurea are widely used for the prevention and treatment of colds and respiratory infections, although the clinical efficacy of this agent has not been proven. A total of 109 patients with a history of more than 3 colds or respiratory infections in the preceding year were randomly assigned to receive 4 mL fluid extract of Echinacea purpurea or 4 mL placebo-juice twice a day in a double-blind manner. (One patient withdrew his consent before taking the first dose of the allocated medication; thus, only 108 patients were included for analysis.) The incidence and severity of colds and respiratory infections were determined during 8 weeks of follow-up, based on patient reported symptoms together with findings on physical exam. The severity of each infection was graded by the investigators. Relative risks (RR) and 95% confidence intervals (CI) were estimated. During the 8-week treatment period, 35 (65%) of 54 patients in the Echinacea group and 40 (74%) of 54 patients in the placebo group had at least one cold or respiratory infection [RR = 0.88; 95% CI (0.60, 1.22)]. The average number of colds and respiratory infections per patient was 0.78 in the Echinacea group, and 0.93 in the placebo group [difference = 0.15; 95% CI (-0.12, 0.41), P = 0.33]. Median duration of colds and respiratory infections was 4.5 days in the Echinacea group and 6.5 days in the placebo group (95% CI: -1, +3 days; P = 0.45). There were no significant differences between treatment groups in the number of infections in each category of severity. Side effects were observed in 11 patients (20%) of the Echinacea group and in seven patients (13%) of the placebo group (P = 0.44). Treatment with fluid extract of Echinacea purpurea did not significantly decrease the incidence, duration or severity of colds and respiratory infections compared to placebo.
Article
The effects of Qing Fei Tang (Sei-hai To in Japanese), a Chinese traditional medical mixture, on aspiration pneumonia were studied using mice inoculated with both Streptococcus pneumoniae and gastric juice as aspiration pneumoniae models. Daily (4 weeks) oral usage of Qing Fei Tang before inoculation reduced remarkably the mortality rate of mice. In this aspiration pneumonia model, xanthine oxidase (XO) activity in the lung tissues was elevated, but this elevation was remarkably decreased by use of Qing Fei Tang. These results suggest that Qing Fei Tang pretreatment can reduce oxygen radical production in inflammed lungs and may reduce the mortality for aspiration pneumonia.
Article
In humans, considerable circumstantial evidence exists that indicates soluble root extracts of the American coneflower, genus Echinacea, may act to ameliorate virus-mediated afflictions, such as the common cold, influenza, and even AIDS and virus-based tumors. This study was designed to quantify, in normal mice, Echinacea-mediated, quantitative, dynamic changes, with time on both mature and precursor cells, of all the hemopoietic and immune-cell lineages in the spleen and bone marrow. A specific, commercially prepared potent extract of Echinacea root was provided daily in the diet for either 1 week or 2 weeks with the aim of establishing a possible mechanism of action for this herb. The data revealed that natural-killer (NK) cells and monocytes, both mediators of nonspecific immunity and well-demonstrated killers of virus-containing cells, were numerically and significantly increased in both the bone marrow and the spleen as early as 1 week after beginning treatment with the dietary herb. In contrast to our observations with NK cells and monocytes, the sizes of all other hemopoietic and immune cell populations in these two organs remained at control levels even after 2 weeks of daily dietary Echinacea. The work has demonstrated the specific nature of Echinacea-derived phytochemicals in acting as stimulants of those cells responsible for nonspecific immunity, as the first line of defense against virus-infected/transformed cells. The observations that these cells were elevated in the bone marrow indicates that at least one mechanism of action of this herb, is to stimulate new cell production in situ. The significant elevation of these two fundamental immune-cell populations, in normal animals, suggests a prophylactic role for this herb.
Article
Methanol extracts of freeze-dried Echinacea (E. angustifolia, E. pallida, and E. purpurea) roots were examined for free radical scavenging capacities and antioxidant activities. Root extracts of E. angustifolia, E. pallida, and E. purpurea were capable of scavenging hydroxyl radical. Similar scavenging activities for each variety were found for both 1,1-diphenyl-2-picrylhydrazyl radical and ABTS radical. Meanwhile, antioxidant activities of all three varieties of Echinacea were found to delay the formation of conjugated diene hydroperoxide induced by the thermal decomposition of 2, 2'-azobis(2-amidinopropane) dihydrochloride and extend the lag phase of peroxidation of soybean liposomes. Echinacea root extracts suppressed the oxidation of human low-density lipoprotein, as evaluated by reduced agarose electrophoretic mobility following oxidative modification by Cu(2+). The mechanisms of antioxidant activity of extracts derived from Echinacea roots included free radical scavenging and transition metal chelating.
Article
Considered to have immunostimulating activity, echinacea is a widely used phytomedicinal for treatment of the common cold and upper respiratory tract infections (URTIs). We reviewed the literature from the MEDLINE database (January 1966-July 1999), International Pharmaceutical Abstracts (IPA) online database, Cambridge Scientific Abstracts Biological Sciences online database, Alt-Health Watch online database, EMBase CD-ROM database, and references from published articles, reviews, and letters to evaluate evidence from clinical trials of echinacea's purported efficacy for treating or preventing URTIs. Twelve clinical studies published from 1961-1997 concluded that echinacea was efficacious for treating the common cold, but the results are unclear due to inherent flaws in study design. Five trials were published since 1997; two showed that echinacea lacked efficacy for treating and preventing URTI symptoms, and three concluded that it was effective in reducing the frequency, duration, and severity of common cold symptoms. Again, these results are unclear because of methodologic uncertainties, such as small populations and use of noncommercially available, nonstandardized dosage forms. Although evidence for echinacea's efficacy is inconclusive, it appears to be safe. Patients without contraindications to it may not be dissuaded from using an appropriate preparation to treat the common cold.
Article
The aim of this study was to determine the efficacy of an echinacea compound herbal tea preparation (Echinacea Plus) given at early onset of cold or flu symptoms in a random assignment double-blind placebo-controlled study. A total of 95 subjects with early symptoms of cold or flu (runny nose, scratchy throat, fever) were randomly assigned to receive Echinacea Plus tea five to six cups per day titrating to 1 over 5 days or placebo in a double-blind situation. Each participant completed a questionnaire 14 days after beginning the program. The efficacy, number of days the symptoms lasted, and number of days for change were measured with a self scoring questionnaire. The study period was 90 days (January 1, 1999 to March 30, 1999). There was a significant difference between the experimental group (Echinacea Plus) and control group (placebo) for all 3 questions measured: p < 0.001. There were no negative effects reported by any of the subjects in either group. Treatment with Echinacea Plus tea at early onset of cold or flu symptoms was effective for relieving these symptoms in a shorter period of time than a placebo.
Article
Alcoholic extracts of the roots and leaves of three Echinacea species (E. purpurea, E. angustifolia and E. pallida) were analysed for the presence of characteristic chemicals by HPLC directly coupled to ultraviolet absorbance and electrospray mass spectrometric detectors. The method permitted rapid characterization and tentative identification of a large number of caffeoyl conjugates and alkamides in all the samples investigated. The roots of the three species differed markedly in their contents of characteristic compounds. Cichoric acid and verbascoside predominated in extracts of E. purpurea root whereas cynarine and dodeca-2E,4E,8Z,10Z/E-tetraenoic acid isobutylamide were the major chemicals characteristic of E. angustifolia root extracts. Echinacoside and 6-O-caffeoylechinacoside predominated in extracts of E. pallida roots. Characteristic alkamides were also examined by electrospray tandem mass spectrometry (MS/MS) and these compounds provided characteristic fragmentation patterns. Extracts of the roots and leaves of all three species were found to have antioxidant properties in a free radical scavenging assay and in a lipid peroxidation assay.
Article
Viral respiratory tract infections, also known as colds, are the most common infection in humans. The majority of these infections are caused by rhinoviruses. Rhinovirus deposition in the nose or the eye initiates infection. The virus attaches to the host cell intercellular adhesion molecule-1 (ICAM-1) receptors in the back of the throat. Subsequent viral replication triggers the release of inflammatory mediators and activation of neurogenic pathways, which lead to symptoms. Symptoms occur within 10 to 16 hours after virus entry into the nose and peak on days 2 to 3 of infection. Symptom duration is typically 1 week, although 25% of cases last longer. Understanding the chronology of these events is important in the timing of treatment. Because of the rapidity of symptom onset, early treatment is the key to reducing viral replication and illness. Also, early treatment may reduce the risk of transmission.
Article
Echinacea preparations are widely used to treat the common cold. To assess the efficacy of dried, encapsulated, whole-plant echinacea as early treatment for the common cold. Randomized, double-blind, placebo-controlled community-based trial. University of Wisconsin-Madison, Madison, Wisconsin. 148 registered students with common colds of recent onset. An encapsulated mixture of unrefined Echinacea purpurea herb (25%) and root (25%) and E. angustifolia root (50%) taken in 1-g doses six times on the first day of illness and three times on each subsequent day of illness for a maximum of 10 days. Severity and duration of self-reported symptoms of upper respiratory tract infection. No statistically significant differences were detected between the echinacea and placebo groups for any of the measured outcomes. Trajectories of severity over time were nearly identical in the two groups. Mean cold duration was 6.01 days in both groups as a whole, 5.75 days in the placebo group, and 6.27 days in the echinacea group (between-group difference, -0.52 day [95% CI, -1.09 to 0.22 days]). After controlling for severity and duration of symptoms before study entry, sex, date of enrollment, and use of nonprotocol medications, researchers found no statistically significant treatment effect (adjusted hazard ratio, 1.24 [CI, 0.86 to 1.78]). Multivariable regression models assessing severity scores over time failed to detect statistically significant differences between the echinacea and placebo groups. Compared with placebo, unrefined echinacea provided no detectable benefit or harm in these college students who had the common cold.
Article
Background: Recently, echinacea has regained popularity as one of the treatments chosen most commonly by consumers with the expectation that it will reduce the severity and duration of the common cold. However, the results from a limited number of clinical trials for this application have thus far been inconclusive. This incongruity may be the result of investigators utilizing poorly standardized echinacea products, likely devoid of sufficient quantities of active constituents necessary to exert a definitive clinical effect. Therefore, a formulation containing alkamides, cichoric acid, and polysaccharides at concentrations of 0.25, 2.5, and 25 mg/mL, respectively, was prepared from freshly harvested Echinacea purpurea plants (commercially available as Echinilin, Natural Factors Nutritional Products, Inc., Vancouver, BC, Canada). The objective of this study was to test the efficacy of this highly standardized formulation in reducing the severity and duration of symptoms of a naturally acquired common cold. Methods: In a randomized, double-blind, placebo-controlled trial, 282 subjects aged 18-65 years with a history of two or more colds in the previous year, but otherwise in good health, were recruited. The subjects were randomized to receive either echinacea or placebo. They were instructed to start the echinacea or placebo at the onset of the first symptom related to a cold, consuming 10 doses the first day and four doses per day on subsequent days for 7 days. Severity of symptoms (10-point scale: 0, minimum; 9, maximum) and dosing were recorded daily. A nurse examined the subjects on the mornings of days 3 and 8 of their cold. Results: A total of 128 subjects contracted a common cold (59 echinacea, 69 placebo). The total daily symptom scores were found to be 23.1% lower in the echinacea group than in placebo in those who followed all elements of the study protocol (P<0.01). Throughout the treatment period, the response rate to treatments was greater in the echinacea group. A few adverse event profiles were observed in both groups. Conclusions: Early intervention with a standardized formulation of echinacea resulted in reduced symptom severity in subjects with naturally acquired upper respiratory tract infection. Further studies with larger patient populations appear to be warranted.
Article
A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the ability of Echinacea purpurea to prevent infection with rhinovirus type 39 (RV-39). Forty-eight previously healthy adults received echinacea or placebo, 2.5 mL 3 times per day, for 7 days before and 7 days after intranasal inoculation with RV-39. Symptoms were assessed to evaluate clinical illness. Viral culture and serologic studies were performed to evaluate the presence of rhinovirus infection. A total of 92% of echinacea recipients and 95% of placebo recipients were infected. Colds developed in 58% of echinacea recipients and 82% of placebo recipients (P = .114, by Fisher's exact test). Administration of echinacea before and after exposure to rhinovirus did not decrease the rate of infection; however, because of the small sample size, statistical hypothesis testing had relatively poor power to detect statistically significant differences in the frequency and severity of illness.
Article
Echinacea purpurea stimulates the immune response and is promoted to reduce symptom severity and the duration of upper respiratory tract infections. We sought to determine the efficacy of a standardized preparation of E purpurea in reducing symptom severity and duration of the common cold. A randomized, double-blind, placebo-controlled design was used. Patients received either 100 mg of E purpurea (freeze-dried pressed juice from the aerial portion of the plant) or a lactose placebo 3 times daily until cold symptoms were relieved or until the end of 14 days, whichever came first. Symptoms (sneezing, nasal discharge, nasal congestion, headache, sore or scratchy throat, hoarseness, muscle aches, and cough) were scored subjectively by the patient and recorded daily in a diary. Kaplan-Meier curves were used to estimate the survival function of time to resolution in each group. The Wilcoxon rank sum test was used to compare time to resolution between the 2 groups. One hundred twenty-eight patients were enrolled within 24 hours of cold symptom onset. Group demographic distribution was comparable for sex, age, time from symptom onset to enrollment in the study, average number of colds per year, and smoking history. No statistically significant difference was observed between treatment groups for either total symptom scores (P range,.29-.90) or mean individual symptom scores (P range,.09-.93). The time to resolution of symptoms was not statistically different (P =.73). Some studies have concluded that Echinacea effectively reduces the symptoms and duration of the common cold. We were unable to replicate such findings. Further studies using different preparations and dosages of E purpurea are necessary to validate previous claims.
Herbal and related medicines
  • Bartels Cl Miller
  • Sj
Bartels CL, Miller SJ. 1998. Herbal and related medicines. Nutr Clin Pract 13: 5–19.
In vitro effects of echinacea and ginseng on natural killer and antibody dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients
  • See Dm
  • N Broumond
  • L Sahl
  • Jg
See DM, Broumond N, Sahl L, Tilles JG. 1997. In vitro effects of echinacea and ginseng on natural killer and antibody dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunopharmacology 35: 229–235.
Comparison of chemical components and antioxidants 694 V
  • Bd Sloley
  • Lj Urichuk
  • C Tywin
  • Rt Coutts
  • Pkt Pang
  • Jj Shan
Sloley BD, Urichuk LJ, Tywin C, Coutts RT, Pang PKT, Shan JJ. 2001. Comparison of chemical components and antioxidants 694 V. GOEL ET AL.