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Echinacea

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This article is about the flowering plant. For Superorder Echinacea (Echinodermata) see Sea urchin

Echinacea
Echinacea purpurea
Scientific classification
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Echinacea
Species

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Echinacea, commonly called Purple coneflower, is a genus of nine species of herbaceous plants in the Family Asteraceae. All are strictly native to eastern and central North America. The plants have large showy heads of composite flowers, blooming from early to late summer. Some species are used in herbal medicines.

E. purpurea flower centre

The genus name is from the Greek echino, meaning "spiny", due to the spiny central disk. They are herbaceous, drought-tolerant perennial plants growing to 1 or 2 m in height. The leaves are lanceolate to elliptic, 10–20 cm long and 1.5–10 cm broad. Like all Asteraceae, the flowers are a composite inflorescence, with purple (rarely yellow or white) florets arranged in a prominent, somewhat cone-shaped head; "cone-shaped" because the petals of the outer ray florets tend to point downward (are reflexed) once the flower head opens, thus forming a cone.

Species

A Bee on an Echinacea paradoxa flower

The species of Echinacea are:

The spiny flower center from which the name derives

Medicinal Effects

In carefully controlled double-blind study documented in the New England Journal of Medicine [1] shows that Echinacea had no effect on rates of infection or on the duration of the cold.

Echinacea is popularly believed to be an immunostimulator, stimulating the body's non-specific portion of their immune system and warding off infections. A common reference source is one Meta-analysis which supports echinacea's benefit [2]; however, this study fails to indicate important factors that could drive the proported conclusion. The studies pooled in the meta-analysis used different types of echinacea from different parts of the plant and also different dosages. This review could not tell anyone who might wish to try it what type of echinacea to buy, how much to take, when to start taking it or for how long. Nor is it known how safe echinacea is to take in the long term.

Its use and concerns such as not to be used by children under 12 years old, nor during pregnancy, is documented by European medicine agency. [3] [4].

History

Echinacea angustifolia rhizome was used by North American Plains Indians, perhaps more than most other plants, for various herbal remedies. Echinacea was one of the basic antimicrobial herbs of Eclectic medicine in the mid 1800s through the early 1900s and its use was documented for snakebite and anthrax. In the 1930s "Echinacea" became popular in both Europe and America as a herbal medicine.

Active substances

The full spectrum of echinacea's chemical components responsible for its health effects are not well understood. Like most crude drugs from plant or animal origin, the constituent base is complex and some parts may be directly antimicrobial while others work at stimulating or modulating different parts of the immune system. All species have chemical compounds called phenols, which are common to many other plants. Both the phenol compounds Cichoric and caftaric are present in E. purpurea, other phenols include echinacoside, which is found in greater levels within E. angustifolia and E. pallida roots than in other species. When making herbal remedies, these phenols can serve as markers to evaluate the quantity of echinacea in the product. Other chemical constituents that may be important in echinacea health effects include alkylamides and polysaccharides.

Root or whole plant

A medical study (Taylor et al. 2003[5].) found that when echinacea products made from the entire plant (not just the root) were taken after the second cold symptom appeared they provided no measurable beneficial effect for children in treating the severity or duration of symptoms caused by the common cold virus. Dosage however was about a third of what clinical herbalists routinely use, and the leaves and stems are not thought to be clinically effective. Studies by the University of Virginia School of Medicine (Turner, 2005 [6]) confirmed these results, and added that Echinacea had no clinically significant effects on the common cold even if taken immediately upon infection, or as a prophylaxis starting a week prior to symptoms of infection. However, a University of Maryland review of available studies concluded that Echinacea, when taken at first sign of a cold, reduced cold symptoms or shortened their duration. This conclusion was based on 13 European studies.[7] The University of Maryland study also found that three of four studies concluded that taking Echinacea to prevent a cold was ineffective, although including studies that use subclinical doses, the wrong part or unassayed material will bias such conclusions. Another scientific review, however, of 14 published studies found that the incidence of colds was reduced by 58% and the duration by a day and half.[8]

Alcohol-based or dry

Leading herbalists claim that many studies do not distinguish between alcohol-based echinacea tinctures, which retain potency for up to seven years after production, and capsules containing the dried herb, which lose their efficacy over time.[citation needed] Capsules not only lose strength, but must be digested in the stomach while alcohol tinctures enter the lymphatic system through the tongue.[citation needed]

Frequency of administration

Proponents of echinacea assert that it is not a "one-dose" treatment, and that in order to work effectively, a dose should be taken at the very first sign of a cold symptom. Subsequent doses must be taken every two to four hours after the first dose, including every two to four hours during the overnight sleeping period, until the cold symptoms have disappeared (generally within 24 hours.)

Species

Not all species of Echinacea are thought, by advocates, to be equally effective. A Cochrane review of the published studies [9] has found that there is some evidence of benefit in the treatment (but not prevention) of the common cold by the aerial parts of Echinacea purpurea; other formulations of the plant did not show the same effect, and no formulation was effective for prevention.

Side effects and contraindications

Reported adverse effects of echinacea include nausea, dizziness, dyspnea, rash, dermatitis, pruritis, and hepatotoxicity. These tend to be infrequent, mild and transient.[10][11] Echinacea should not be taken by persons with progressive systemic and auto-immune disorders, connective tissue disorders, or related diseases. It should not be used with immunosuppressants or hepatotoxic drugs.[11][12]

In one investigation by an independent consumer testing laboratory, 5 of 11 selected retail echinacea products failed quality testing, all but one due to insufficient phenol levels.[13]

Other uses

Miscellaneous Medical

Echinacea may be useful when treating Athlete's foot with Econazole, or in cancer treatment[14].

Others

Some species of Echinacea, notably E. purpurea, E. angustifolia, and E. pallida, are grown as ornamental plants in gardens[15] They tolerate a wide variety of conditions, maintain attractive foliage throughout the season, and multiply rapidly. Appropriate species are used in prairie restorations.

References

  1. ^ New England Journal of Medicine [1]
  2. ^ Shah SA, Sander S, White CM, Rinaldi M, Coleman CI. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis.Lancet Infect Dis. 2007 Jul;7(7):473-80. [2]
  3. ^ EMEA Monograph on Echinacea purpurea[3]
  4. ^ Caruso TJ, Gwaltney JM (2005). "Treatment of the common cold with echinacea: a structured review". Clin. Infect. Dis. 40 (6): 807–10. doi:10.1086/428061. PMID 15736012.
  5. ^ "Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial", Taylor, J. A., et al. 2003., Journal of the American Medical Association 2003 Dec 3;290(21):2824-30
  6. ^ "An evaluation of Echinaceae angustifolia in experimental rhinovirus infections." Turner, R. B. et al. 2005., New England Journal of Medicine 353: 341-348..
  7. ^ Paul Bergner. "Healing Power of Echinacea and Goldenseal and Other Immune System Herbs" (The Healing Power)1997
  8. ^ Shah, Sachin A (2007). "Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis". The Lancet Infectious Diseases. 7 (7): 473–480. doi:10.1016/S1473-3099(07)70160-3. PMID 17597571. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  9. ^ Linde K, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000530
  10. ^ Cheeseman, Mark (2002-12-13). "Echinacea" (PDF). Complementary Medicines Summary (pdf). UK Medicines Information, National Health Service. Retrieved 2007-07-07. {{cite web}}: Check date values in: |date= (help)
  11. ^ a b Mayo Clinic. "Echinacea (E. angustifolia DC, E. pallida, E. purpurea)". Retrieved 2007-12-18.
  12. ^ Miller LG (1998). "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions". Arch. Intern. Med. 158 (20): 2200–11. PMID 9818800.
  13. ^ "Product Review: Echinacea". ConsumerLab.com, LLC. 2004-03-18. Retrieved 2007-08-02. {{cite web}}: Check date values in: |date= (help)
  14. ^ University of Maryland Echinacea Study Review
  15. ^ "A Comprehensive Echinacea Germplasm Collection Located at the North Central Regional Plant Introduction Station", USDA