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At least 19 recordsLinked to original sources
PubMed2005

Echinacea species (Echinacea angustifolia (DC.) Hell., Echinacea pallida (Nutt.) Nutt.,Echinacea purpurea (L.) Moench): a review of their chemistry, pharmacology and clinical properties.

This paper reviews the chemistry, pharmacology and clinical properties of Echinacea species used medicinally. The Echinacea species Echinacea angustifolia, Echinacea pallida and Echinacea purpurea have a long history of medicinal use for a variety of conditions, particularly infections, and today echinacea products are among the best-selling herbal preparations in several developed countries. Modern interest in echinacea is focused on its immunomodulatory effects, particularly in the prevention and treatment of upper respiratory tract infections. The chemistry of Echinacea species is well documented, and several groups of constituents, including alkamides and caffeic acid derivatives, are considered important for activity. There are, however, differences in the constituent profile of the three species. Commercial echinacea samples and marketed echinacea products may contain one or more of the three species, and analysis of samples of raw material and products has shown that some do not meet recognized standards for pharmaceutical quality. Evidence from preclinical studies supports some of the traditional and modern uses for echinacea, particularly the reputed immunostimulant (or immunomodulatory) properties. Several, but not all, clinical trials of echinacea preparations have reported effects superior to those of placebo in the prevention and treatment of upper respiratory tract infections. However, evidence of efficacy is not definitive as studies have included different patient groups and tested various different preparations and dosage regimens of echinacea. On the basis of the available limited safety data, echinacea appears to be well tolerated. However, further investigation and surveillance are required to establish the safety profiles of different echinacea preparations. Safety issues include the possibility of allergic reactions, the use of echinacea by patients with autoimmune diseases and the potential for echinacea preparations to interact with conventional medicines.

Adjuvants, Immunologic↗
PubMed2002

Simultaneous analysis of alkamides and caffeic acid derivatives for the identification of Echinacea purpurea, Echinacea angustifolia, Echinacea pallida and Parthenium integrifolium roots.

A reversed-phase HPLC method was developed using a computer simulation program for the identification of dried roots of Echinacea purpurea, E. angustifolia, E. pallida and Parthenium integrifolium. Hydrophilic and lipophilic compounds were analysed simultaneously leading to a two-fold decrease in analysis time compared to traditional HPLC methods.

Asteraceae↗
PubMed2004

The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.

BACKGROUND: Echinacea is a widely available over-the-counter herbal remedy. Tinctures of echinacea have been shown to inhibit cytochrome P450 (CYP) in vitro. The effect of echinacea (Echinacea purpurea root) on CYP activity in vivo was assessed by use of the CYP probe drugs caffeine (CYP1A2), tolbutamide (CYP2C9), dextromethorphan (CYP2D6), and midazolam (hepatic and intestinal CYP3A). METHODS: Twelve healthy subjects (6 men) completed this 2-period, open-label, fixed-schedule study. Caffeine, tolbutamide, dextromethorphan, and oral and intravenous midazolam were administered before and after a short course of echinacea (400 mg 4 times a day for 8 days) to determine in vivo CYP activities. RESULTS: Echinacea administration significantly increased the systemic clearance of midazolam by 34%, from 32 +/- 7 L/h to 43 +/- 16 L/h (P =.003; 90% confidence interval [CI], 116%-150%), and significantly reduced the midazolam area under the concentration-time curve by 23%, from 127 +/- 36 microg. h/L to 102 +/- 43 microg. h/L (P =.024; 90% CI, 63%-88%). In contrast, the oral clearance of midazolam was not significantly altered (P =.655; 90% CI, 75%-124%), 137 +/- 19 L/h compared with 146 +/- 71 L/h. The oral availability of midazolam after echinacea dosing was significantly increased (P =.028; 90% CI, 108%-153%), from 0.23 +/- 0.06 to 0.33 +/- 0.13. Hepatic availability (0.72 +/- 0.08 versus 0.61 +/- 0.16; P =.006; 90% CI, 73%-90%) and intestinal availability (0.33 +/- 0.11 versus 0.61 +/- 0.38; P =.015; 90% CI, 125%-203%) were significantly altered in opposite directions. Echinacea dosing significantly reduced the oral clearance of caffeine, from 6.6 +/- 3.8 L/h to 4.9 +/- 2.3 L/h (P =.049; 90% CI, 58%-96%). The oral clearance of tolbutamide was reduced by 11%, from 0.81 +/- 0.18 L/h to 0.72 +/- 0.19 L/h, but this change was not considered to be clinically relevant because the 90% CIs were within the 80% to 125% range. The oral clearance of dextromethorphan in 11 CYP2D6 extensive metabolizers was not affected by echinacea dosing (1289 +/- 414 L/h compared with 1281 +/- 483 L/h; P =.732; 90% CI, 89%-108%). CONCLUSIONS: Echinacea (E purpurea root) reduced the oral clearance of substrates of CYP1A2 but not the oral clearance of substrates of CYP2C9 and CYP2D6. Echinacea selectively modulates the catalytic activity of CYP3A at hepatic and intestinal sites. The type of drug interaction observed between echinacea and other CYP3A substrates will be dependent on the relative extraction of drugs at hepatic and intestinal sites. Caution should be used when echinacea is coadministered with drugs dependent on CYP3A or CYP1A2 for their elimination.

Administration, Oral↗
PubMed2002

Immunological and haematinic consequences of feeding a standardised Echinacea (Echinacea angustifolia) extract to healthy horses.

This study was undertaken to compile new data on the efficacy of Echinacea in stimulating the immune system of the horse. Use of Echinacea is becoming widespread in horses, despite an absence of controlled laboratory research into its effectiveness or safety. This paper documents results of a double-blind, placebo-controlled, cross-over trial investigating the effect of standardised Echinacea extract on 8 horses. Animals were supplemented with Echinacea or placebo for 42 days, and their response to supplements recorded. Treatment with Echinacea increased phagocytic ability of isolated neutrophils, boosted peripheral lymphocyte counts and appeared to stimulate neutrophil migration from peripheral circulation into the tissues. Echinacea supplement also increased the size and concentration of peripheral red blood cells, and the concentration of haemoglobin and packed cell volume. It was concluded that Echinacea effectively stimulates equine immunocompetence, and the plant extract behaves, in equine subjects, as a haematinic agent, i.e. one which improves the quality of blood by increasing haemoglobin levels and the number of erythrocytes and which, by virtue of their effects on oxygen transport cells, are considered to improve parameters of exercise physiology and performance.

Adjuvants, Immunologic↗
PubMed2006

Growing environment and nutrient availability affect the content of some phenolic compounds in Echinacea purpurea and Echinacea angustifolia.

Medicinal plant production is different from other agricultural production systems in that the plants are grown for the production of specific phytochemical(s) for human use. To address this need, a Good Manufacturing Practice (GMP)-compliant, controlled-environment production system was developed for production of Echinacea purpurea and Echinacea angustifolia. Within the prototype facility, the growing systems, nutrient availability, water and physical environment were highly controlled. The current study was designed to evaluate the effects of different hydroponic systems, nutrient solution NO (3)(-)/NH (4)(+) ratios and mild water stress on the content of some phenolic compounds in Echinacea plants. The deep-flow solution culture system in which the plant roots were continuously immersed in the nutrient solutions was optimum for the growth of E. purpurea. Higher concentrations of caftaric acid, cynarin and echinacoside were produced in E. angustifolia plants grown in the soil-based growing media while the plants grown in the deep-flow solution system had higher levels of cichoric acid. Altering the NO (3)(-)/NH (4)(+) ratio or limited water stress did not have any significant effect on the phytochemical content of Echinacea plants. Echinacea plants grown in the controlled environment systems had higher or similar amounts of cynarin, caftaric acid, echinacoside and cichoric acid as previously reported in the literature for both field-cultivated and wild-harvested Echinacea plants. This growing system offers the advantages of year-round crop production with minimal contamination by environmental pollutants and common microbes.

Echinacea↗
PubMed2006

Safety and efficacy of echinacea (Echinacea angustafolia, e. purpurea and e. pallida) during pregnancy and lactation.

BACKGROUND: There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and safety of herbal medicines used in pregnancy and lactation. This is one article in a series that systematically reviews the evidence for commonly used herbs during pregnancy and lactation. OBJECTIVES: To systematically review the literature for evidence on the use, safety, and pharmacology of echinacea focusing on issues pertaining to pregnancy and lactation. METHODS: We searched 7 electronic databases and compiled data according to the grade of evidence found. RESULTS: There is good scientific evidence from a prospective cohort study that oral consumption of echinacea during the first trimester does not increase the risk for major malformations. Low-level evidence based on expert opinion shows that oral consumption of echinacea in recommended doses is safe for use during pregnancy and lactation. CONCLUSIONS: Echinacea is non-teratogenic when used during pregnancy. Caution with using Echinacea during lactation until further high quality human studies can determine its safety.

Administration, Oral↗
PubMed2005

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

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.

Adolescent↗
PubMed2003

Effect of Echinacea (Echinacea Purpurea L. Moench) preparations on experimental prostate gland.

This work has investigated the effect of echinacea extract on the weight of prostates in rats as well as on alterations of hystological structure and separate blood cells. This preparation was chosen for investigations due to its possible antiandrogenic effect and good immunostimulating features. Experiments were carried out with three-month old male Wistar rats, divided by six into three different groups. The first group was the control one. The rats of the second group were fed for 30 days with the usual food ration plus 50 mg/kg of echinacea extract. The third group was fed for 60 days in the same way as the second one. Clinical death of rats was caused by sodium phenobarbital, later a cervical dislocation was performed. After weighing the rats their prostates were removed and weighed. Patohystological investigations of the removed organs were carried out. Blood test for Shiling's analysis was taken. The weight of prostates in the first group of rats was 412.0+/-14.93 mg, in the second group - 403.0+/-13.33 mg, and in the third group it was 388.0+/-14.66 mg. Having calculated the proportion between prostates of rats and their body weight it was estimated that in the first group it made 0.125+/-0.009%, in the second group - 0.105+/-0.005%, and in the third group - 0.091+/-0.007%. The percentage of lymphocytes in the first group was 72+/-1.41; in the second group - 73+/-0.81; in the third group - 79+/-1,86. The percentage of segmented neutrophyle in the first group was 23+/-3.31; in the second group - 23+/-2.25; in the third group - 18+/-2.33. Having conducted analysis of the experimental results, a significantly important decrease of prostate weight of investigated rats, an increase in the number of lymphocyte as well as the alterations of hystological structures after using echinacea extract for eight weeks were observed.

Androgen Antagonists↗
PubMed1996

[Clinical application of extracts of Echinacea purpurea or Echinacea pallida. Critical evaluation of controlled clinical studies].

The phytotherapy should be understood as being integrated into the rational pharmacotherapy. The modern phytotherapy tries hard to proof effects with pharmacological and clinical studies. The task force E of the federal bureau of health of Germany has made a statement regarding this problem. This article reviews only controlled clinical trials about the application of extracts of echinacea purpura or echinacea pallida.

Adjuvants, Immunologic↗
PubMed1999

Effects of an orally applied aqueous-ethanolic extract of a mixture of Thujae occidentalis herba, Baptisiae tinctoriae radix, Echinaceae purpureae radix and Echinaceae pallidae radix on antibody response against sheep red blood cells in mice.

The influence of the oral administration of an aqueous-ethanolic extract of a mixture of Thujae occidentalis herba, Baptisiae tinctoriae radix, Echinaceae purpureae radix and Echinaceae pallidae radix, on the immune response in mice was investigated. The data show that the extract significantly enhances the antibody response to sheep red blood cells (SRBC), induces an increase in the numbers of splenic plaque forming cells (PFC) and an increase in the titer of specific antibodies in the sera of treated animals. The long-term application of the extract over several months also stimulated the PFC-response without affecting spleen weight, total cell yield per spleen or white blood cell count in mice.

Administration, Oral↗
PubMed1993

[Immunomodulating activity of ethanol-water extracts of the roots of Echinacea gloriosa L., Echinacea angustifolia DC. and Rudbeckia speciosa Wenderoth tested on the immune system in C57BL6 inbred mice].

The ethanolic extract from the roots Echinacea gloriosa L. (Moench), Echinacea angustifolia DC. and Rudbeckia speciosa Wenderoth shows immunomodulating activity. It was seen on the seventh day after five days of in vivo treatment of mice. The most marked immunostimulatory effect was observed on the lysosomal and peroxidal activity of peritoneal macrophages, and splenic cells after in vivo treatment with the ethanolic extract of the roots of R. speciosa Wenderoth.

Adjuvants, Immunologic↗
PubMed2002

Adverse reactions associated with echinacea: the Australian experience.

BACKGROUND: Fifty percent of Australians use complementary and alternative medicines (other than vitamins) in any 12-month period, of which echinacea-containing products are increasingly popular. Recent reports have highlighted the risk of allergic reactions to complementary medicines in atopic patients. OBJECTIVE: To determine the characteristics of adverse reactions linked to use of the popular herbal remedy echinacea. METHODS: Five privately referred patients were evaluated by the authors in their office practice via skin prick testing (SPT) on the volar aspect of the forearm and radioallergosorbent test after adverse reactions to echinacea. As there was little published information on adverse reactions to echinacea, reports to the Australian Adverse Drug Reactions Advisory Committee were reviewed. Those suggestive of possible allergic reactions were evaluated in greater detail by anonymously surveying the healthcare professionals who had reported the cases and from one unreported case. Serum was collected for further analysis where possible. RESULTS: Five cases of adverse reactions to echinacea were personally evaluated by the authors. Two patients suffered anaphylaxis and a third had an acute asthma attack 10 minutes after their first ever dose of echinacea. The fourth patient suffered recurrent episodes of mild asthma each time echinacea was ingested, and the fifth developed a maculopapular rash within 2 days of ingestion which recurred when rechallenged. Three of the patients had positive SPT results. Three reported repeated spontaneous "challenges" and symptoms after further ingestion of echinacea. Fifty-one Australian adverse drug reports implicating echinacea were also reviewed. There were 26 cases suggestive of possible immunoglobulin E-mediated hypersensitivity (4 anaphylaxis, 12 acute asthma, 10 urticaria/angioedema). Of these 26 patients, age ranged from 2 to 58 years, 78% were female and >50% were known to be atopic. Four were hospitalized, 4 reacted after their first known exposure, and 1 patient suffered multiple progressive systemic reactions. Twenty percent of 100 atopic subjects who had never taken echinacea also had positive SPT results to this substance when tested by one of the authors in his office practice. CONCLUSION: Some atopic subjects have positive SPT results to echinacea in the absence of known exposure. Atopic subjects are also overrepresented in those experiencing reactions to echinacea. The possibility that cross-reactivity between echinacea and other environmental allergens may trigger allergic reactions in "echinacea-naïve" subjects is supported by the Australian data. Given its widespread (and largely unsupervised) community use, even rare adverse events become inevitable. Atopic patients should be cautioned appropriately.

Adult↗
PubMed2006

Echinacea for preventing and treating the common cold.

BACKGROUND: Preparations of the plant Echinacea (family Compositae) are widely used in some European countries and in 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 addition of other components. OBJECTIVES: The objective of this review was to assess whether there is evidence that Echinacea preparations are 1) more effective than no treatment; 2) more effective than placebo; 3) similarly effective to other treatments in A) the prevention and B) the treatment of the common cold. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2005); PubMed (1997 to April 2005), EMBASE (1998 to June 2005), AMED (to August 2005), Centre for Complementary Medicine Research (in Munich) (1988 to May 2005), contacted experts, and screened references of reviews. SELECTION CRITERIA: We included randomized controlled trials that compared mono-preparations of Echinacea with a placebo, no treatment, or another treatment for the prevention or treatment of common colds. Trials on combinations of Echinacea and other herbs were excluded. DATA COLLECTION AND ANALYSIS: For all studies, at least two authors independently assessed eligibility and trial quality, and extracted data. Outcomes of interest in prevention trials were: numbers of individuals with one or more colds, and severity and duration of colds; and in treatment trials: total symptom scores, nasal symptoms, and duration of colds. MAIN RESULTS: Sixteen trials including a total of 22 comparisons of an Echinacea preparation and a control group (19 with placebo, 2 with no treatment, 1 with another herbal preparation) met the inclusion criteria. All trials except one were described as double-blind. The majority had reasonable to good methodological quality. Three comparisons investigated prevention of colds and 19 comparisons tested treatment of colds. A variety of different Echinacea preparations were used. None of the three comparisons in the prevention trials showed an effect over placebo. Comparing an Echinacea preparation with placebo as treatment, a significant effect was reported in nine comparisons, a trend in one, and no difference in six. More than one trial was available only for preparations based on the aerial parts from Echinacea purpurea (E. purpurea). AUTHORS' CONCLUSIONS: Echinacea preparations tested in clinical trials differ greatly. There is some evidence that preparations based on the aerial parts of Echinacea purpurea might be effective for the early treatment of colds in adults but results are not fully consistent. Beneficial effects of other Echinacea preparations, and for preventative purposes might exist but have not been shown in independently replicated, rigorous randomized trials.

Common Cold↗
PubMed2003

Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial.

CONTEXT: 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. OBJECTIVES: 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. DESIGN, SETTING, AND PARTICIPANTS: 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. INTERVENTIONS: 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. MAIN OUTCOME MEASURES: 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. RESULTS: 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). CONCLUSIONS: 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.

Child↗
PubMed2003

[History of a plant: the example of Echinacea].

In comparison with other medicinal plants, the history of use of Echinacea is relatively short. The plant originates from North America and was employed by the indigenous Indians. The first archaeological evidence dates from the 18th century. Included in the name Echinacea or purple coneflower are several species of the Asteraceae family: Echinacea purpurea (L.) Moench, Echinacea angustifolia DC. and Echinacea pallida (Nutt.) Nutt. Information about the use of the plant from traditional healers ranges from external application for wounds, burns and insect bites to the chewing of roots for toothache and throat infections, and internal application for pain, coughs, stomach cramps and snake bites. The interest of white settlers was also drawn to this medicinal plant. The first Echinacea preparation, known as Meyers Blood Purifier, arrived on the market around 1880, with rheumatism, neuralgia and rattlesnake bites as indications. At the beginning of the 20th century, Echinacea was the most frequently used plant preparation in the USA. Commercial cultivation was started in Germany around 1939. The introduction and cultivation of Echinacea in Switzerland by A. Vogel was around 1950. Chemists and pharmacologists became interested in Echinacea and many constituents are now known, such as polysaccharides, echinacoside, cichoric acid, ketoalkenes and alkylamides. The extracts exhibit immunostimulant properties and are mainly used in the prophylaxis and therapy of colds, flu and septic complaints. Although there are over 400 publications concerning the plant and dozens of preparations of Echinacea n the market, the true identity of the active principles still remains open.

Adjuvants, Immunologic↗
PubMed2005

The safety of herbal medicinal products derived from Echinacea species: a systematic review.

Echinacea spp. are native to North America and were traditionally used by the Indian tribes for a variety of ailments, including mouth sores, colds and snake-bites. The three most commonly used Echinacea spp. are E. angustifolia, E. pallida and E. purpurea. Systematic literature searches were conducted in six electronic databases and the reference lists of all of the papers located were checked for further relevant publications. Information was also sought from the spontaneous reporting programmes of the WHO and national drug safety bodies. Twenty-three manufacturers of echinacea were contacted and asked for data held on file. Finally our own departmental files were searched. No language restrictions were imposed. Combination products and homeopathic preparations were excluded. Data from clinical studies and spontaneous reporting programmes suggest that adverse events with echinacea are not commonly reported. Gastrointestinal upsets and rashes occur most frequently. However, in rare cases, echinacea can be associated with allergic reactions that may be severe. Although there is a large amount of data that investigates the efficacy of echinacea, safety issues and the monitoring of adverse events have not been focused on. Short-term use of echinacea is associated with a relatively good safety profile, with a slight risk of transient, reversible, adverse events. The association of echinacea with allergic reactions is supported by the present evaluation. While these reactions are likely to be rare, patients with allergy or asthma should carefully consider their use of echinacea. The use of echinacea products during pregnancy and lactation would appear to be ill-advised in light of the paucity of data in this area.

Adult↗