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Echinacea

SCIENTIFIC NAME(S): - Echinacea angustifolia DC. The related species E.purpurea (L.) Moench and E. pallida (Nutt.) Britton have also been used in traditional medicine.
Family: Compositae

COMMON NAME(S):- American coneflower, black susans, comb flower, echinacea, hedgehog, Indian head, Kansas snakeroot, narrow-leaved purple coneflower, purple coneflower, scurvy root, snakeroot

Echinacea, the purple coneflower, is the best known and researched herb for stimulating the immune system. Thousands of Europeans and Americans use echinacea preparations against colds and flu, minor infections, and a host of other major and minor ailments.

The constituents of echinacea include essential oil, polysaccharides, polyacetylenes, betain, glycoside, sesquiterpenes and caryophylene. It also contains copper, iron, tannins, protein, fatty acids and vitamins A , C , and E .

History

Echinacea is a popular herbal remedy in the central US, an area to which it is indigenous. The plant was used in traditional medicine by the American Indians and quickly adopled by the settlers. During the 1800s, claims for the curative properties of the plant ranged from a blood purifier to a treatment for dizziness and rattlesnake bites. During the early part of the 20th century, extracts of the plant were used as anti-infectives; however, the use of these products fell out of favor after the discovery of modem antibiotics.

The plant and its extracts continue to be used topically for wound-healing action and internally to stimulate the immune system. Most of the research during the past 10 years has focused on the immunostimulant properties of this plant.

Botany :- There are at least 9 species of echinacea. The ones most commonly studied are E. purpurea, E. pallida, and E. angustifolia.

Echinacea is native to Kansas, Nebraska, and Missouri. There has been confusion regarding the identification of echinacea. Because of this confusion, it should be recognized that much of the early research conducted on this plant (in particular with European E. angustifolia) was probably conducted on E. pallida.At least 6 synonyms have been documented for these plants.

E. angustifolia is a perennial herb with narrow leaves and a stout stem that grows to 90 cm in height. The plant terminates in a single, colorful flower head. The plant imparts a pungent, acrid taste when chewed and causes tingling of the lips and tongue.

Echinacea products have been found to be adulterated with another member of the family Compositae, Parthenium integrifolium L. This plant has no pharomacologic activity.

Uses of Echinacea

There is some evidence that echinacea (purpurea and pallida species) is effective in shortening the duration of symptoms of URIs, including the common cold, but it has not been shown to be effective as a preventative. The variation in available products makes specific recommendations difficult to determine.

Side Effects of Echinacea

Side effects are rare. Patients with allergies, specifically allergies to daisy-type plants (Asteraceae/Compositae family) might be more susceptible to reactions. Nausea and other mild GI effects have been reported in clinical trials.

Dosage

Variable doses and preparations were used in the studies that make specific dosing recommendations difficult. The dosing range for E. pallida root is 6 to 9 mL/day and E. purpurea leaf is approximately 900 mg/day. Because echinacea may be an immunostimulant, it should not be taken for more than 8 consecutive weeks. Usually 7 to 14 days is sufficient. However, there is no data to support or refute this theory.

Toxicology

Little is known about the toxicity of echinacea despite its widespread use in many countries. It has been documented in American traditional medicine for more than a century and generally has not been associated with acute or chronic toxicity. Purified echinacea polysaccharide is relatively nontoxic. Acute toxicity studies found that doses of arabinogalactan as high as 4 g/kg injected intraperitoneally or IV were essentially devoid of toxic effects.

Side effects: According to The German Commission E, Echinacea purpurea and pallida, when taken orally, do not cause any side effects. Parnham and colleagues reported results from an unpublished practice study to determine adverse effects and safety of the squeezed sap of E. purpurea. A total of 1231 patients with relapsing respiratory and urinary infections given echinacea for 4 to 6 weeks demonstrated the following side effects: Unpleaseant taste (1.7%); nausea or vomiting (0.48%); abdominal pain, diarrhea, sore throat (0.24%). The authors reported that 90% of patients took the medication as directed. Parenteral administration was associated with immunostimulating-type reactions such as shivering, fever, and muscle weakness. Degenring reported that 1 out of 77 patients who received the 6.78 mg, 95% herb, and 5% root formulation experienced nausea, restlessness, and aggravation of cold symptoms 4 days after starting the medication. The symptoms were severe enough to require discontinuation of therapy. Other side effects reported in clinical trials were primarily GI in nature, such as mild nausea.

At the American Academy of Allergy, Asthma and Immunology 2000 annual meeting, 23 unpublished cases (2 "certain," 10 "probable," and 11 "possible") of allergic reaction to echinacea consistent with IgE-mediated hypersensitivity were reported. Of the 23 cases, 34% were atopic, 13% were nonatopic, and 44% did not provide this information. Of another 100 atopic patients who had never taken echinacea, 20% had positive skin test reactions to echinacea, indicating a hypersensitivity without prior exposure to echinacea. There was also a case of anaphylaxis caused by a combination echinacea product (E. angustifolia and E, purpurea) with other dietary supplements. The amount of echinacea product consumed was approximately double that recommended by the manufacturer, The patient had a high incidence of allergies to other substances. Of an additional 84 patients with asthma or allergic rhinitis, 16 subjects (19%) reacted to an echinacea skin prick. Only 2 patients had prior expo­sure to echinacea.

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