Dietary Echinacea purpurea during murine pregnancy: effect on maternal hemopoiesis and fetal growth

Herbal Medicines-Are They Effective and Safe during Pregnancy?

Since the teratogenicity of Thalidomide has been proven, herbal products are more commonly used in pregnancy to not only relieve morning sickness but also to fight infections. These products are frequently considered as natural and therefore harmless. However, herbs contain a number of active substances that, when used during pregnancy, can affect the development of the fetus. Often, pregnant women do not consult the usage of herbal medicines with a physician. The access to these products is easy and treatment of certain ailments with the use of herbs is common in many countries. The aim of the present literature review was to discuss available data regarding the efficacy and safety of cranberry, chamomile, Echinacea purpurea, garlic, ginger, Ginkgo biloba, and peppermint, which are used to counteract the most common ailments during pregnancy, i.e., infections and pregnancy-related ailments (e.g., nausea and vomiting, dizziness, and headache). Analysis of available data showed that ginger is one of the most extensively analyzed herbal remedies. The dose of ginger below 1000 mg per day may help to relief hypereremesis gravidarum, and such an amount of ginger did not increase frequency of adverse effects for either woman or developing fetus. Data regarding other herbs are most often heterogeneous and give conflicting results with no clear conclusions. However, all herbal products should be used with a special caution in pregnancy. Further high-quality human studies should be determined to confirm the safe doses of herbal products which could be used by pregnant or breast-feeding women.

Can Echinacea be a potential candidate to target immunity, inflammation, and infection - The trinity of coronavirus disease 2019

Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing public health emergency. The pathogenesis and complications advanced with infection mainly involve immune-inflammatory cascade. Therefore, the therapeutic strategy relies on immune modulation, reducing infectivity and inflammation. Given the interplay of infection and immune-inflammatory axis, the natural products received attention for preventive and therapeutic usage in COVID-19 due to their potent antiviral and anti-immunomodulatory activities. Recently, Echinacea preparations, particularly E. purpurea, have been suggested to be an important antiviral agent to be useful in COVID-19 by modulating virus entry, internalization and replication. In principle, the immune response and the resultant inflammatory process are important for the elimination of the infection, but may have a significant impact on SARS-CoV-2 pathogenesis and may play a role in the clinical spectrum of COVID-19. Considering the pharmacological effects, therapeutic potential, and molecular mechanisms of Echinacea, we hypothesize that it could be a reasonably possible candidate for targeting infection, immunity, and inflammation in COVID-19 with recent recognition of cannabinoid-2 (CB2) receptors and peroxisome proliferator-activated receptor gamma (PPARγ) mediated mechanisms of bioactive components that make them notable immunomodulatory, anti-inflammatory and antiviral agent. The plausible reason for our hypothesis is that the presence of numerous bioactive agents in different parts of plants that may synergistically exert polypharmacological actions in regulating immune-inflammatory axis in COVID-19. Our proposition is to scientifically contemplate the therapeutic perspective and prospect of Echinacea on infection, immunity, and inflammation with a potential in COVID-19 to limit the severity and progression of the disease. Based on the clinical usage for respiratory infections, and relative safety in humans, further studies for the evidence-based approach to COVID-19 are needed. We do hope that Echinacea could be a candidate agent for immunomodulation in the prevention and treatment of COVID-19.

A strategy for test article selection and phytochemical characterization of Echinacea purpurea extract for safety testing

Botanical dietary supplements (BDS) are used around the world for many purported therapeutic properties. The selection of an authentic product and it's phytochemical characterization is critical to generate robust safety data. Because botanicals are complex mixtures with variable quality, identification of a representative product for testing has been challenging. Echinacea is used for its purported immune stimulant properties and was listed as the 2nd top-selling BDS in 2018. However, there are limited safety data for Echinacea. Hence, the National Toxicology Program (NTP) has selected Echinacea for safety testing using rodent models. Here, we describe selection and comprehensive characterization of an Echinacea purpurea root extract to be used in the NTP testing program. Using non-targeted chemical analyses combined with chemometric analysis, a potential unfinished product (i.e., an extract that serves as source material for finished products) of Echinacea purpurea was selected. The product was then authenticated using chemical and DNA techniques and characterized, including the phytochemical composition. Among numerous constituents identified, caftaric acid, chicoric acid, chlorogenic acid and dodeca-2(E),4(E),8(Z),10(E/Z)-tetraenoic acid isobutylamide made up a small fraction of the extract. Based on these analyses, an approach is proposed for test article selection for Echinacea research which can be adapted to other botanicals.

Supplementation of Plants with Immunomodulatory Properties during Pregnancy and Lactation-Maternal and Offspring Health Effects

A pregnant woman’s diet consists of many products, such as fruits, vegetables, cocoa, tea, chocolate, coffee, herbal and fruit teas, and various commercially available dietary supplements, which contain a high number of biological active plant-derived compounds. Generally, these compounds play beneficial roles in women’s health and the development of fetus health. There are, however, some authors who report that consuming excessive amounts of plants that contain high concentrations of polyphenols may negatively affect the development of the fetus and the offspring’s health. Important and problematic issues during pregnancy and lactation are bacterial infections treatment. In the treatment are proposals to use plant immunomodulators, which are generally considered safe for women and their offspring. Additional consumption of biologically active compounds from plants, however, may increase the risk of occurrences to irreversible changes in the offspring’s health. Therefore, it is necessary to carry out safety tests for immunomodulators before introducing them into a maternal diet. Here, we present data from animal experiments for the four most-studied plants immunomodulators genus: Rhodiola, Echinacea, Panax, and Camellia, which were used in maternal nutrition.

Herbal Therapy in Pregnancy-What to Expect when you Expect?

The use of herbal therapy in pregnancy is common for pregnancy related nausea, vomiting, gestational diabetes, anxiety, insomnia, and preparation for labor, as well as for treating infections. Many conventional drugs may interfere with fetal development and herbal products are considered to be safe. However, herbal therapy requires competent healthcare professional advice before prescribing. Knowledge about the possible adverse effects of active compounds of the herbs on pregnancy outcome is limited. Interference of herbal ingredients with conventional medication or the ailment should also not be excluded. For many herbal products, the pharmacological effect is not clinically proven, and the safe usage in pregnancy is not guaranteed. Here, based on published clinical trials, an overview is given of the efficacy and safety for fetal development and pregnancy outcome of the most frequently used herbs: ginger, cranberry, echinacea, mint, chamomile, valerian, flaxseed, tea and raspberry leaf.

Rabbit dietary supplementation with pale purple coneflower. 1. Effects on the reproductive performance and immune parameters of does

Echinacea pallida (EPAL), also known as pale purple coneflower, is a herbaceous flowering plant with immune-enhancement and antioxidative properties. The effect of EPAL on the reproductive performance, serum biochemistry and haematological parameters of rabbit does has been studied here. A total of 100, 21-week-old Grimaud rabbit does, were randomly assigned to two groups. One group was fed a basal diet supplemented with 3 g EPAL/kg diet (Echinacea group, E), while the other was fed the basal diet without the supplementation (control group, C). The reproductive performance of the does was not affected by the treatment (P>0.05). The haematological parameters of pregnant rabbits showed that there was no interaction between gestation day and treatment. The EPAL supplementation induced a reduction (-47.3%) in the basophil cell rate (0.55% and 0.29%, for the control and treatment groups, respectively; P=0.049). The gestation day significantly affected most of the haematological parameters (P<0.05). The white blood cell counts declined progressively after day 14. The mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width, mean platelet volume and eosinophils increased steadily throughout the study, and reached a maximum value on day 28. The red blood cells, haemoglobin, haematocrit, mean corpuscular volume and neutrophils increased slightly up to day 14, and then subsequently decreased progressively until day 28. The lymphocytes and platelet distribution width decreased until day 14, and then increased to a maximum value on day 28. No significant effect of gestation day or treatment was observed on the blood serum chemistry. As far as the immune parameters are concerned, no significant differences were observed between groups, while a significant effect of gestation day was observed for lysozymes (6.02 v. 7.99 v. 1.91; for 0, 14 and 28 days, respectively; P=0.014). In conclusion, a lack of effect of EPAL has been observed. In fact, no impacts of EPAL have been observed on the reproductive or haematological parameters of the does. The effects of dietary supplementation with EPAL on the performances, bacterial community, blood parameters and immunity in growing rabbits are reported in the second part of this study.

The influence of aqueous and hydro-alcoholic extracts of roots and rhizomes of Rhodiola kirilowii on the course of pregnancy in mice

Plants belonging to the Rhodiola genus, originating from Asia, are traditionally used as tonic, adaptogen, antidepressant and anti-inflammatory drugs. These plants have also potent immunomodulatory properties and in some situations possibly could be used instead of standard antibiotic therapy (e.g. during pregnancy or lactation). The aim of our present study was to establish whether aqueous (RKW) or hydro-alcoholic (RKW-A) extracts from roots and rhizomes of Rhodiola kirilowii given to pregnant mice influence the course of pregnancy and the number of progeny. Performed HPLC analysis showed that the RKW-A extract had a generally higher concentration of all identified polyphenols. The highest differences were observed for (+)-catechin, p-coumaric acid and naringenin. Everyday addition of the RKW or RKW-A extract did not change the length of pregnancy. At the same time, both RKW and RKW-A extracts significantly increased the number of mated females without offspring but only in the RKW-A group we noticed a few neonatal deaths in the first 5 days after delivery. The results reported in the present study do not encourage to the use of R. kirilowii hydro-alcoholic extracts supplementation during pregnancy and lactation, however the possibility of limited dietary intake of R. kirilowii water extract should be thoroughly examined.

Echinacea and elderberry-should they be used against upper respiratory tract infections during pregnancy?

This review evaluates the safety of echinacea and elderberry in pregnancy. Both herbs are commonly used to prevent or treat upper respiratory tract infections (URTIs) and surveys have shown that they are also used by pregnant women. The electronic databases PubMed, ISI Web of Science, AMED, EMBASE, Natural Medicines Comprehensive Database, and Cochrane Library were searched from inception to November 2013. Relevant references from the acquired articles were included. No clinical trials concerning safety of either herb in pregnancy were identified. One prospective human study and two small animal studies of safety of echinacea in pregnancy were identified. No animal- or human studies of safety of elderberry in pregnancy were identified. Twenty clinical trials concerning efficacy of various echinacea preparations in various groups of the population were identified between 1995 and 2013. Three clinical trials concerning efficacy of two different elderberry preparations were identified between 1995 and 2013. The results from the human and animal studies of Echinacea sp. are not sufficient to conclude on the safety in pregnancy. The prospective, controlled study in humans found no increase in risk of major malformations. The efficacy of Echinacea sp. is dubious based on the identified studies. Over 2000 persons were given the treatment, but equal amounts of studies of good quality found positive and negative results. All three clinical trials of Elderberry concluded that it is effective against influenza, but only 77 persons were given the treatment. Due to lack of evidence of efficacy and safety, health care personnel should not advice pregnant women to use echinacea or elderberry against upper respiratory tract infection.

Effects of dietary administration of Echinacea purpurea on growth indices and biochemical and hematological indices in rainbow trout (Oncorhynchus mykiss) fingerlings

This study was conducted to evaluate the effects of Echinacea purpurea (EP) on growth and some hematological and blood biochemical indices of rainbow trout fingerlings. A basal diet was supplemented with 0 (control), 0.25, 0.5, 1, and 2 g EP kg⁻¹ to formulate five experimental diets. Each diet was randomly allocated to triplicate groups of fish with an initial average weight of approximately 8 g. After 8 weeks of feeding trial, fish fed diets with 0.25 and 0.5 g EP kg⁻¹ showed highest final weight and SGR and fish fed with the control diet indicated the lowest final weight and SGR. There was a significant (P < 0.05) decrease in FCR between the control group and the groups fed with diets of 0.25 and 0.5 g EP kg⁻¹. Biochemical parameters such as serum total protein content, albumin content, globulin content, and albumin/globulin ratio in the fish were evaluated. There were significant differences between hematological parameters including RBC, WBC, HB, lymphocyte, and neutrophil percentage in fish fed with dietary nucleotide compared with control treatment (P < 0.05). The results suggest that EP administration at 0.25 and 0.5 g EP kg⁻¹ exerted positive effects on growth and biochemical and hematological indices in rainbow trout.

The effectiveness of Echinacea extract or composite glucosamine, chondroitin and methyl sulfonyl methane supplements on acute and chronic rheumatoid arthritis rat model

The study aimed to investigate the effect of the oral administration for 15 days of either Echinacea (E) or genuphil (a composite of chondroitin sulphate, glucosamine and methyl sulfonyl methane [GCM]) nutraceutical supplements on female rat model of acute or chronic arthritis induced by bacterial outer membrane protein (OMP) from faecal flora of healthy and rheumatic humans. Anti-cyclic citrullinated peptide (anti-CCP2), C-reactive protein (CRP) and rheumatoid factor (RF) values increased ( p < 0.05) in both arthritic groups as compared to normal values. The rheumatic markers anti-CCP2, CRP and RF values decreased significantly in E- and GCM-treated groups compared to arthritic none-treated acute or chronic groups. The results of RF values of GCM-treated groups in acute and chronic models decreased exhibiting no statistical difference compared with the normal value. Histological examinations of the hind paw sections revealed moderate inflammation, oedema and mild proliferation of synovial cells in acute arthritic rats and more damage to cartilage and bone with severe inflammation in chronic ones. Echinacea acute treated group showed edema with proliferated synovial membrane and partial damage in cartilage and bone. While in the E -chronic treated group, rough edge with destructed cartilage and bone existed. However, the acute GCM group revealed mild cartilage damage. But the chronic GCM group showed mild synovial cells proliferation and revealed no inflammation with mild cartilage damage edge. Results demonstrated the OMP arthropathic property and through promising light on arthritis treatment using E- or GCM, with the advantage of GMC results over that of E -. The composite GCM is needed for further studies over the dose and duration to assess its preventive effects against the bacterial OMP arthrogenicity.