Purple Coneflower (PowerPoint) by mikeholy


									  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 &
 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
  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
 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
    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
 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
        Active Components
 Polysaccharides

 Polyacetylenes

 Alkylamides (echinaceine)
                  Parts Used &
 Parts of plant that are used: aboveground roots, rhizome &
 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
 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
 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

Common Cold
 Cancer prevention
               The Cold
What is it?

Inhaled particles
Cold virus attachment
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
  Research – Echinacea & the
        Common cold
Is it effective?
Is it worth it?
Is it toxic?
Positive results
  Reduced symptoms
   and duration
Negative results
  Not useful for
       Why contradictory
Hard to quantitatively measure
Psychological effects vary
Many different types of cold viruses
Preparations are not standardized
Meta analysis
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
         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

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

    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
       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

     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
Echinacea appears to activate non-specific
 cellular and humoral immunity and the
 complement system by increasing the
 production and activity of:
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:
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:
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,
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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