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