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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

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Purple coneflower

Purple Coneflower

Echinacea purpurea

Echinacea angustifolia

Echinacea pallida

Presented by: Henry Tran, Paul St. Romain, & Margaret Wells


Names of echinacea
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
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
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
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
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 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
Active Components

  • Polysaccharides

    • 4-0-methylglucuronoarabinoxylan

    • Rhamnoarabinogalactin

  • Polyacetylenes

  • Alkylamides (echinaceine)


Parts used administration
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
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
Research

  • Common Cold

  • Cancer prevention


The cold
The Cold

  • What is it?

  • Symptoms

  • Duration

http://www.kennislink.nl/upload/115174_962_1091519871529-rhinovirus.jpg


Infection
Infection

  • Inhaled particles

  • Cold virus attachment


Infected
Infected

  • Incubation period: 8-12 hours

  • Peak of symptoms: 36-72 hours


Neat facts about colds
Neat facts about colds

  • Infection rate

  • Being cold?

  • Feed a cold, starve a fever

  • Children


Research echinacea the common cold
Research – Echinacea & the Common cold

  • Is it effective?

  • Is it worth it?

  • Is it toxic?


Efficacy
Efficacy

  • Positive results

    • Reduced symptoms and duration

  • Negative results

    • Not useful for prevention


Why contradictory research
Why contradictory research?

  • Hard to quantitatively measure symptoms

  • Psychological effects vary

  • Many different types of cold viruses

  • Preparations are not standardized

  • Meta analysis


Value
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
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
Mode of Action

  • Bioactive substances capable of stimulating innate immunity.

  • What is the innate immune response?

    • Nonspecific


Purple coneflower

  • 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
Mode of Action that initiate inflammatory responsecont.

  • 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


Purple coneflower

Purified polysaccharides from that initiate inflammatory responseE. purpurea induced macrophage production of IL-1, IL-6, and TNF-a

Figure 8-22


Mode of action cont1
Mode of Action, that initiate inflammatory responsecont.

  • 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 cont2
Mode of Action, that initiate inflammatory responsecont.

  • 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 cont3
Mode of Action, that initiate inflammatory responsecont.

  • 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
Summary that initiate inflammatory response

  • 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
Bibliography that initiate inflammatory response

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.

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.


Purple coneflower

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.

Sperber, S.J., et al., Echinacea purpurea for prevention of experimental rhinovirus colds. Clin Infect Dis, 2004. 38(10): p. 1367-71.

Turner, R.B., et al., An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med, 2005. 353(4): p. 341-8.

Website: http://nccam.nih.gov/health/echinacea/#intro. 2005. Herbs at a Glance: Echinacea. NCCAM Publication No. D271.