Wild Rose College and Wholistic Clinic

(09/01/1999), Canada - Echinacea is the second largest selling herb in North America and the top selling herb in the Health Food industry.(1,2) Does it deserve all of this attention because of its effect on the common cold? Does it do more than just work in this area? Let`s re-visit this popular herb and see how the information is stacking up on it these days. Before we get to our quest to find out more about Echinacea, I think it is best to look at a common false myth about Echinacea. ``You can only take Echinacea for 10 - 20 days, then you need a 10 - 20 break for it to remain effective.``

As a Clinical Herbalist, using this herb day in and day out on thousands of patients for over 20 years, I find this to be completely false. This concept comes from a mistranslation of some German papers, most notably a graph showing increase in phagocyte (immune cells) activity after the consumption of Echinacea purpurea fresh juice as compared to a placebo. In this study it clearly shows that the phagocyte action increases steadily for five days.(3) It then slowly declines until the action is almost back to normal after tens days. This appears to be good evidence that Echinacea loses effect over time. This mis-information spread throughout the industry at a rate that can only be described as phenomenal. It wasn`t until five years later that it was pointed out the patients in the study only took Echinacea for the first five days then stopped. Whoops, the graph was the only thing that was translated, not the whole paper. The graph, in fact, showed clearly the effects of Echinacea last for at least five days after stopping its consumption. It has since been shown that long term use of Echinacea does not lose effectiveness.(4)

Since the time of the Eclectics, Echinacea has been recognized as one of the best alterative herbs for detoxifying the blood. Its effect is via the lymphatic system and through the strengthening of the immune system. Echinacea is used to increase resistance to a large variety of infections, especially those of the upper respiratory tract such as colds and flu. Other areas of use are for conditions including typhoid fever, cellular abscesses, carbuncles and cancer.

Over 350 extensive scientific research investigations have been done on this plant over the last twenty years. Results indicate that Echinacea demonstrates an antibiotic activity, a cortisone-like activity, assistance in synovial membrane healing, support of collagen through hyaluronic acid protection, promotion of wound healing, interferon-like activity, and stimulation of T-cell lymphocytes.

Early studies confirmed the Amerindian use of Echinacea for wound healing, used both internally and externally as a wash or ointment. This native herb was not used by the Amerindians for the immune system. They had very little problems in this area. They used it for arrow wounds. Today it has been shown that alcohol extract of Echinacea has a cortisone-like action in the body (effects due to the mucopolysaccharide component, echinacin), helping to reduce inflammation and swelling associated with infection. It does this by inhibition of the enzyme, hyaluronidase, an enzyme that breaks down hyaluronic acid. Hyaluronic acid is a mucopolysaccharide found in the ground substance of connective tissue. It functions as the ``glue`` in the connective tissues of the body, helping to maintain the structure and integrity of the tissue. Echinacea increases cell growth of fibroblasts, activates macrophages, regenerates new tissue and helps eliminate infectious organisms. Later studies have shown that Echinacea protects collagen from free radical induced degradation. This means it can function as an excellent sun block, reducing wrinkling, when used either internally or externally as an ointment. It has also been shown to reduce a large number of organisms that affect the skin. These factors can have great significance on other skin problems such as inflammatory skin conditions, eczema, burns, varicose ulcer or the legs and ulcers.(4-10)

Immune Function

There have been many papers reflecting Echinacea`s immuno-modulating and immuno-stimulatory action. Probably the most significant factor here is that it does this in a non-specific manner without a direct immune response. Even though there has been plenty of study on Echinacea`s immune function, with plenty of theories, there still has not been a clear scientific understanding of how it works. Some say it increases the amount of body`s properdin, thus activating part of the immune system called the complementary pathway. This in turns sends white blood cells into infected areas to do battle with viruses, bacteria and fungi. Other researchers suggest that lipophilic amides and polar caffeic acid derivatives inhibit integrase, an enzyme that`s important in viral reproduction. One of Echinacea`s major components, inulin (a branched polysaccharide), activates the alternate complement pathway, thus promoting chemotaxis of neutrophils, monocytes and eosinophils, solubilization of viruses, and bacteriolysis. Other polysaccharides have also shown significant immuno-stimulatory effects including the stimulation of T-lymphocytes, the production of interferon-like activity, and the secretion of lymphokines. This same component has shown significant inhibition of the growth of Walker carcinosarcoma and lymphocytic leukemia.(13-18)

The antiviral effect of Echinacea is thought to be due to an interferon-like activity against viruses such as the influenza, herpes and vesicular stomatitis viruses. Blocking of the receptor site for the virus is the mechanism. Inhibition of hyaluronidase, or possibly an effect related to T-cell excitation or the transcription of viral RNA, are also suspected.(19,20)

Antibacterial properties are relatively mild but have been demonstrated against Staphylococcus aureus, Corynebacterium diphtheria, and Proteus vulgaris.(21) The polysaccharides have shown to be protective to mice against Candida albicans.(17)

With all of these ideas and theories, the most significant aspect of Echinacea`s action is that it is a combination of several of the active compounds working together harmoniously. This is a clear example of the fact that we have to look at a full spectrum of chemical markers to determine the activity of a herb. We can not standardize a herb to a single chemical that has become so popular in the health food industry of late. Nature is just more complicated than that. The real active constituent of Echinacea is - - - Echinacea!

One of the major questions is what is the best form of Echinacea to use? I think this really has to do with the activity you want to achieve. If you want to use Echinacea as an immune prophylactic to prevent colds and flues I think it should be used either as a powder (capsule or tablet) of root and aerial parts of any of the Echinacea spp. or fresh expressed juice of Echinacea purpurea. This is because the polysaccharides are still present in these forms. Polysaccharides are not soluble in alcohol, therefore it`s tincture is not recommended as a immune prophylactic. The alcohol extract or tincture of Echinacea is quite stimulatory to the immune system though and is good to use at the first stage of a cold / flu.(17-22)

Dosage is somewhat of a question also. To prevent colds or flues, I suggest 2 - 3 capsules; two to three times a day depending on exposure levels. At the first stage of a cold / flu, I suggest 60 drops or one tsp. every two hours. We would also suggest the use of beta-carotene (20,000 IU, twice daily), and Ester C (1,000 mg, every two hours). Echinacea has very little effect on a cold if it goes for more than about four days. At this stage we suggest you combine it with Astragalus, cultivated Goldenseal, Reishi or other deep acting herbs.

References

1. New Hope communications, lecture, Baltimore, Expo East - Sept 98
2.Whole Foods Journal; Herb survey (10/98)
3.Bauer R., Wagner H.; Probanden- und kotrollierte Patientenstudien; in Echinacea: Handbuch fur Arzte, Apotheker und andere Naturwissenschaftler; p. 156; 1990.
4. Lersch C.; Zeuner M, et al; Nonspecific Immunostimulation with low doses of Cyclophoshanide (LDCY), Thymostimulin, and Echinacea purpurea in patients with Far Advanced Colorectal Cancer; Cancer Investigation, 10(5), 343-348; 1992
5. Koch, E., and Haaze, H., Arzneimittel Forschung 2, 464; 1952.
6. Koch, E., Uebel, Arzneimittel Forsch. 1, 16; 1953.
7. Busing, K.H., Hyaluronidase-hemmung durch echinacin, Arzneimittel Forsch. 2:467-9; 1952.
8. Kuhn, O., Arzneimittel Forsch. 1, 194, 1953.
9. Tubaro A, et al, Anti-inflamatory activity of a polysaccharideic fraction of echinacea angustifolia; J. Pharm. Pharmacol; 39, 567-569, 1987.
10. Tragni E, et al; Evidence from two classic iritation tests for an anti-inflammatory action of natural extract, echinacin b; Food and Chemical Toxicology 23(2); 317-19, 1985.
11. Zoutewellw G , et al; Effect of Echinacea purpurea extract on fibroblast populated collagen lattice contraction; Phytotherapy Research 4(2); 77-81., 1990
12. Facino R.M., et al; Echinacoside and caffeoly conjugated protect collagen from free-radical induced degradation: a potential use of echinacea extracts in the prevention of skin photodamage; Planta Medica 61; 510-514; 1995.
13. Mose, J., Effect of echinacin on phagocytosis and natural killer cells., Med. Welt 34: 1463-7, 1983.
14. Wagner, V., Proksch, A., et al., Immunostimulating polysaccharides (heteroglycans) of higher plants / preliminary communication, Arzneimittel Forsch. 34:659 -60, 1984.
15. Vomel, V., Influence of a non-specific immune stimulant on phagocytosis of erythrocytes and ink by reticuloendothelial system of isolated perfused rat liver of different ages, Arzneim. Forsch. 34:691-5, 1984.
16. Voaden, D.J., Jacobson, M., Journal of Medicinal Chemistry 15(6), 619-23, 1972.
17. Leung A, Foster S; Encyclopedia of Common Natural Ingredients; John Wiley & Son NY; p. 216 -219;1996
18. Duke J; The Green Pharmacy; Rodale Press; Emmaus Pen; p. 449; 1997
19. Wacker, A., Hilbig, W., Virus-inhition by echinacea purpurea, Planta Medica 33:89-102, 1978.
20. Hopp, E., and Burn, H., Ground substance in the nose in health and infection, Annal. Otto. Rhino. Laryngol. 65:480-9, 1956.
21. Cizmarik, J., Matle, I., Examination of the chemical composition of propolis I: Isolation and identification of the 3,4 dihydroxycinnamic acid (caffeic acid) from propolis, Experentia 26:713, 1970.
22. Bauer r, Wagner H et al; Economic and Medicnal Plant Reasearch, Vol 5, Academic Press, NY, p. 253; 1991